Procurement and the National Healthcare System
The Italian healthcare system, the Servizio Sanitario Nazionale (SSN), is the primary purchaser of medical equipment, accounting for over 75% of total sales.
Public Tenders and Centralized Purchasing Procurement is largely decentralized, managed at the regional and local levels by public health units and hospitals. However, the system has moved toward more centralized purchasing through designated procurement centers and the National Procurement Agency (CONSIP). Most high-value medical equipment is purchased through public tenders, which are open to both domestic and international bidders. These tenders increasingly prioritize "value-based" healthcare, seeking products that offer better clinical outcomes and long-term cost-effectiveness rather than just the lowest initial price.
Health Technology Assessment (HTA) Italy has a well-established National HTA Program, which evaluates the safety, effectiveness, and economic impact of new medical technologies. Before a high-tech device—such as a robotic surgical system—is widely adopted, it undergoes a rigorous assessment. These HTA reports serve as an essential guide for regional decision-makers, ensuring that public funds are invested in innovations that provide a genuine therapeutic advantage over existing standards of care.