GPs are only likely to win APMS contracts when large private firms are not bidding, according to research.
A review of APMS contracts in the British Journal of General Practice found just two cases where an independent GP beat commercial companies to secure an APMS contract.
'GPs or social enterprises are more likely to win a contract in the absence of any competition or when they are competing with each other,' it found.
'This raises serious concerns about the existence of a "level playing field",' write its authors, from the University of Edinburgh's Centre for International Public Health Policy.
The researchers asked all PCTs in England for details of any APMS contracts that had been awarded or were out to tender. A total of 49 PCTs had awarded one or more of the contracts and 30 also gave details of unsuccessful bidders.
Half of all APMS contract tenders were awarded to large commercial companies (36 out of 71) compared with 28 awarded to GPs. At least 14 commercial providers hold APMS contracts in England, and at least eight other firms have bid unsuccessfully.
The researchers said the lack of data the DoH has on APMS deals makes comparing cost, value and services difficult.
GPC deputy chairman Dr Richard Vautrey said the research showed private companies were 'cherry picking' financially attractive deals.
He also said the difficulty obtaining information about APMS contracts from PCTs was 'a real concern'. 'There isn't the openness and support we see with standard contracts. That's worrying when the government is pronouncing value for money.'