The Spanish Federation of Health Technology Companies (Fenin) wants health technology to occupy a central place in the programs of political parties and in the priorities of the next Government. Its Secretary General, Pablo Crespo, presented this morning at a press conference four proposals to improve the quality and sustainability of the healthcare system, strengthen the competitiveness of the industry, and prevent taxation from becoming a barrier for patients.
The initiative, as he recalled, “comes at a time of political uncertainty, with pending regulatory projects and growing care challenges, such as the aging population, chronicity, waiting lists, and difficulties in accessing healthcare.” In this scenario, Crespo argued that the incorporation of technological innovation, greater exploitation of health data, and digital transformation are necessary elements to improve health outcomes.
“Healthcare is a priority. One of the keys to the welfare state is health,” emphasized the representative of Fenin, who acknowledged the work done by both the Government and the autonomous communities to modernize the technological park and facilitate access to innovation. However, he believes that there is still a long way to go and that it is necessary to advance more quickly.
The four proposals from Fenin
The first measure involves promoting a public procurement based on value, where price is not the determining factor. Thus, it is proposed to modify the Public Sector Contracts Law so that at least 50% of the award criteria are linked to quality and the incorporation of innovation. Crespo pointed out that the draft law on medicines and health products, which was under processing, proposed to limit the weight of economic criteria to 20%, a direction that, in his opinion, would allow for progress towards a contracting process that takes more into account the clinical and care value of technology.
The second proposal seeks to guarantee the competitiveness and viability of the health technology industry. To this end, the federation demands the recovery of indexing mechanisms for public contracts, currently unindexed since 2015, so that companies can face the increase in production costs without compromising their investments, employment, or the ability to supply technology to the health system. It also proposes to develop a specific plan for the sector, called Plan Protec, that recognizes the business effort in research and development, the installation of manufacturing plants, and environmental transition.
The third initiative focuses on strategic autonomy and industrialization: Fenin insists that Spain maintains a negative trade balance in health technology and depends on international markets to supply essential products. Therefore, it proposes a government plan that attracts investments, favors the establishment of production, distribution, and research centers, and expands national industrial and logistical capacities.
Finally, the fourth measure proposes to reduce the taxation of health products. According to Crespo, 85% is taxed at the general VAT rate of 21%, despite being products that he considers essential. The employers' association calls for a reduction of this tax to facilitate the incorporation of technology into the public system and reduce the costs faced by patients in the private sector. Crespo has estimated that the public health system pays more than 1.3 billion euros annually in VAT, resources that, in his opinion, could be allocated to investment and innovation if the tax burden were reduced.
A sector with health and economic impact
Fenin justifies these proposals by the role that health technology plays both in patient care and in the economy. According to the data presented by Crespo, the sector generates 12.6 billion euros of direct gross added value. Another relevant fact is that every euro invested in it produces another 1.27 euros in the Spanish economy. Furthermore, companies allocate around 7% of their turnover to innovation, leading compared to other industrial sectors.
The industry supplies technologies for the diagnosis, monitoring, and treatment of patients, present in hospitals and other assistive devices. For Fenin, its capacity for innovation can contribute to responding to the challenges of a system that must cater to an increasingly large and aging population. Crespo has recalled that Spain is approaching 50 million inhabitants and that one in five people is already over 65 years old, an age group that requires a higher consumption of health resources.
The federation also highlights the social dimension of the sector: 46% of the employment it generates is female and 3% corresponds to people with disabilities. From its point of view, these indicators reinforce the argument that health technology should not be approached solely as an expense, but also as a source of economic activity, employment, and capacity for care response.
Competitiveness, however, is conditioned by the international context. Crespo has pointed out the difficulties in supply chains, restrictions on access to raw materials, and the rising costs of energy and production. In that scenario, he considers that maintaining public contracts without updating mechanisms may hinder investment and the ability of Spanish companies to compete in other markets.
In relation to indexing, the Secretary General of Fenin has pointed out that countries like Italy, France, and Germany have mechanisms that allow for the updating of public contracts. The federation believes that these formulas favor competition and contribute to attracting technology. It does not propose, therefore, to copy a single European model, but to identify the practices that best fit the characteristics of the Spanish system.
The organization also demands that the health technology industry receive specific treatment in industrial policy. Crespo has argued that the sector has different needs from those of the pharmaceutical industry, both due to its manufacturing processes and its value chain and the characteristics of its products. Therefore, he considers it essential that this differentiation is maintained in future regulation.
The pending questions: political balance, legislation, and relationship with patients
On the balance of the last legislature, Crespo has valued the work of the Ministry of Health and the autonomous communities to modernize the technological park and improve access to innovation. He has also acknowledged the Ministry's willingness to listen to the sector's proposals. However, he has lamented that some positive regulatory projects have not been approved and has requested that they be resumed in the next political stage.
Among the pending priorities, he has cited the necessary legislative changes to favor investment and take advantage of the potential of technologies such as digital health, artificial intelligence, and robotics. In particular, he has argued that the industry bill should recognize health technology as a strategic sector. He has also demanded that the draft royal decree on the advertising of health products move forward, which, as he explained, would improve the way companies promote their technologies.
When asked about the possibility that government changes might slow these advances, Crespo has pointed out that reforms are necessary regardless of who assumes political responsibilities. In his view, those who direct health policy must know the sector, listen to its representatives, and understand the contribution of all actors involved in the system.
Regarding the relationship between the industry, healthcare professionals, and patients, he has advocated for collaboration among the organizations that represent each group. Fenin, he explained, seeks to listen to their needs and develop solutions that help solve clinical problems and improve care. Nevertheless, he has emphasized that each group must represent its own interests independently and with institutional respect, even though they all share the goal of providing higher quality healthcare.
Crespo has also argued that the regulation of health products should continue to be differentiated from that of medicines. Although both sectors contribute to improving health, he has pointed out that their manufacturing processes, value chains, and characteristics are different. As an example, he noted that health technologies do not have generic equivalents in the same terms as certain medicines. Therefore, he believes that applying differentiated regulatory approaches allows for better leveraging the potential of both industries.