During the first term of Socialist Prime Minister Edi Rama (2013-2017), the Albanian Government procured four major services for the public health system through private-public partnerships. Opposition parties opposed the procurement of the four services, and the media criticised their efficiency, their cost and irregularities in the public procurement procedures.

The Ministry of Health, led by Ilir Beqaj, organised the procurement. The procured services were for (1) health checks for adults between the ages of 40 and 65 years old, (2) sterilisation of hospital equipment, (3) laboratory services and (4) haemodialysis. The contracts had a minimum total value of approximately €310 million and each contract was valid for ten years. The fourth contract for haemodialysis was signed during the second term of the Socialist government, when Beqaj was no longer minister for health, but the bidding process started under his tenure.

The Ministry of Health declared the winner of the contract to perform health checks on 6 October 2014. The winning operator, 3P Life Logistik, was a joint venture between Marketing & Distribution, which held 80 per cent of its shares, and Trimed sh.p.k. Before the procurement, the main business of Marketing & Distribution was the sale of office goods, while the main activity of Trimed sh.p.k was the sale of pharmaceuticals. In order to take part in the procurement, they had to obtain a licence to build biochemical laboratories, which was issued just two days before the deadline for submission of bids. Also, their bid was the highest. The ministry estimated that the cost of the procurement should be proportional to the number of patients and would amount to 13.8 billion leks (approximately €100 million). Contrary to the official statement, the opposition Democratic Party argued that the real value of the procurement should actually be a million euros less.

The opposition Democratic Party filed criminal charges with the Special Prosecution Office (SPAK) against the Ministry of Health and the owners of the winning operator for the provision of health checks.

The ministry declared the winner of the contract for sterilising hospital equipment on 28 September 2015. The winning bid came from Servizi Italia Spa, which is a merger of three Italian companies: Servizi Italia, Tecnosanimed, U.Jet S.r.l. However, a Kosovo-based company, Investital LLC, owns 40 per cent of the consortium. The declared cost of the contract is 9.6 billion leks (approximately €68.8 million). The opposition Democratic Party has accused that this value is 80 times greater than the previous spending on the sterilisation of hospital equipment.

After investigating the consortium that won the contract for the sterilisation of hospital equipment, a local media outlet called BIRN ran a story revealing the case.