Dr Paul DavisDHAFER ABDULLAH MOHAMMED ALAHMARI2022-05-192022-05-19https://drepo.sdl.edu.sa/handle/20.500.14154/15059A qualitative comparative case study approach was adopted which was augmented by in-depth semi-structured interviews with key healthcare procurement experts and secondary analysis. The research identified significant differences and similarities between both countries’ procurement outcomes. Despite efforts made by both policymakers, the institutional logic in practice focuses mainly on efficiency. While, Saudi uses the lowest-cost approach, the Irish system uses MEAT which is supposed to give significant weight to quality and socio-environmental factors. In fact, both countries eventually focused on cost, with little emphasises on other elements. The theoretical contribution comes from mapping procurement practices in two different contexts. This study expands the scope of existing procurement management knowledge. It also provides an original analysis of the institutional logic in tackling the challenges that pervade the procurement processes. The main implication of this research is that the two systems, although set in different political contexts, have relatively similar outcomes, and both systems require creative solutions to enable socio-environmental factors, quality, and innovation to be reflected and persist. In other words, political pressures, in these two cases seem to be ineffective in mobilising institutionalised practice to achieve the desired outcomes for medical deviceen