Public-Private Partnerships in Healthcare Logistics: A Private Perspective on Advantages, Disadvantages, and Critical Success Factors in Italy

Public-private partnerships (PPPs) are increasingly applied to healthcare to increase coverage and improve service delivery, yet their application to logistics remains underexplored. This paper investigates the advantages, disadvantages, and critical success factors of PPP implementation in healthcare logistics from the perspective of private logistics providers, by comparing them with literature evidence. To this end, the study adopts a qualitative multi-method design combining a literature review with semi-structured interviews. The empirical phase relied on purposeful sampling of experts from the main companies currently active in PPP initiatives in healthcare logistics in Italy. The findings show that PPPs in healthcare logistics should be understood not merely as financing mechanisms, but as long-term governance arrangements whose effectiveness depends on contractual design, public-sector readiness, stakeholder collaboration, and the integration of network-level and hospital-level logistics. Expected benefits such as cost savings, knowledge transfer, and risk sharing are not inherent to the PPP model, but emerge only when supported by logistics process reengineering, performance-based incentives, and adequate managerial capabilities. Key challenges include contract rigidity, lock-in effects, public-sector capability gaps, and difficulties in assessing long-term impacts. The work contributes to the literature by providing a more operational understanding of PPP implementation in healthcare logistics and offers practical implications for the governance and sustainable design of these initiatives.