Europe's €173 billion medtech market: what the reports say and who wins public contracts

The European medical technology market was worth roughly €173 billion in 2025, according to MedTech Europe, and a large part of it is paid for by public buyers. Three kinds of source describe it: industry associations count manufacturers' sales, Eurostat counts health spending, and award notices on TED show who wins the public contracts above the EU thresholds. Read together, and never added up across definitions, they give a manufacturer a fairly complete picture.

Putting it simply: medical devices and diagnostics are a market of about €173 billion at manufacturer prices (MedTech Europe, 2025, EU27 + Norway + Switzerland + UK), and medicines about €302 billion at ex-factory prices (EFPIA, 2024, a wider set of 34 countries). The European Commission, quoting industry data, says public procurement is 50 to 70% of the EU medical device market. On TED, public buyers made 142,007 awards for medical equipment and 223,615 for pharmaceutical products in 2025; since November 2023, about 99% of the awards in both groups went to companies registered in the buyer's own country. A Commission study of 2016–2019 awards found that most of the value in medical and pharmaceutical goods went to local companies controlled by foreign groups.

How big the market is, by three measures

Medical technology. MedTech Europe estimates the European market at roughly €173 billion in 2025. The figure is manufacturers' sales, so it leaves out wholesale and retail margins, transport and certain taxes, and it covers the EU27 plus Norway, Switzerland and the UK. It combines medical devices (from the Fitch Solutions factbook) with in vitro diagnostics (from MedTech Europe's own statistics, whose latest market data are marked preliminary). Europe is about a quarter of the world medical device market, second after the US.

The country split that MedTech Europe publishes in the chart table of its market page is for medical devices without diagnostics. Its text lists the five largest markets as Germany, France, the United Kingdom, Italy and Spain, while the table puts Italy slightly ahead of the UK, so read those two as roughly level:

These shares exclude diagnostics while the €173 billion includes them, so multiplying one by the other would not give a correct value per country. MedTech Europe also estimates that medical technology takes about 7.3% of total health spending in Europe, from about 5% to 12% depending on the country.

Medicines. EFPIA's Key Data 2026 puts the European pharmaceutical market at €302 billion in 2024, mostly at ex-factory prices (a few countries report pharmacy purchasing prices, and some large markets are estimates), with an estimate of €330 billion for 2025. Its scope is wider than the EU: the 27 member states, Norway, Iceland, Switzerland and the UK, plus Serbia, Turkey and Ukraine. The figure covers all channels, from pharmacies to hospitals. The largest markets in 2024 were Germany (about €58.0 billion), France (€39.3 billion), the UK (€38.3 billion), Italy (€27.6 billion), Spain (€22.7 billion) and Poland (€13.1 billion). EFPIA does not split the total between hospital and pharmacy sales, so the hospital share, the part most often bought by tender, cannot be read from it.

Health spending. Eurostat reports current healthcare expenditure in the EU-27 of €1,720 billion in 2023, equal to 10.0% of GDP, ranging from 11.7% of GDP in Germany to 5.7% in Luxembourg and Romania. Medical goods took 17.8% of that, which is about €306 billion. That function covers goods patients obtain on prescription or by self-medication; goods used or handed out during a care contact sit in the cost of that care, so 17.8% understates what is spent on products. Hospitals as providers accounted for 36.8% of EU health spending in 2023, from 27.2% in Germany to 50.5% in Croatia.

These three numbers should not be added or set against each other. MedTech Europe counts device makers' revenue, EFPIA counts medicine sales at factory prices in 34 countries, and Eurostat counts spending by every payer, including households, on all health care.

How much of it is bought publicly

The most direct statement comes from the European Commission itself. In Implementing Regulation (EU) 2025/1197, which excludes tenders by economic operators originating in China from procedures for medical devices (CPV 331) with an estimated value of €5 million or more, the Commission writes that "publicly available data from the Union industry show that public procurement accounts for only 50 % to 70 % of the total Union market for medical devices". The range is the industry's, quoted by the Commission; it has no single reference year.

The same regulation describes how that public money is spread. Of all EU procurement procedures for medical devices registered on TED from 2017 to 2022, around 96% had values below €5 million and represented around 41% of the aggregated value. The procedures of €5 million or more, about 4% of the total, carried about 59% of the value. These are estimated values published by the buyers, and they show how much depends on a small number of large procedures.

Eurostat's government accounts give a second angle. General government purchasing for the health function, meaning intermediate consumption, investment and care bought from market producers on behalf of patients, came to about €948.5 billion in the EU-27 in 2024. The seven largest:

This measure depends on how each country organises health care. Where health insurers sit inside government, as in Germany or the Netherlands, the care they pay for counts as public purchasing. Staff wages are not purchases, so a system that runs its own hospitals with salaried staff shows less purchasing than one that pays private providers. It is also a different concept and year from the €1,720 billion above, so the two cannot be compared directly. Every country is in our public purchasing table.

Who wins the public contracts on TED

Award notices published on TED show the winners of contracts above the EU thresholds. Cresques counts them under the same evidence rules as the app: live notices only, a repeated award counted once, and values totalled only where the notice states an awarded amount, never a framework ceiling. Since November 2023, across the 30 countries we cover:

An award is one winner on one lot, not an amount of money. Some countries split tenders into many more lots than others; Romanian buyers, for example, often publish one lot per medicine. Romania accounts for 404,763 of the pharmaceutical awards, about 59% of the total, and 133,067 of the medical equipment awards, about 31%. Poland follows with 126,397 and 131,684. Counts of awards therefore say more about how buyers write tenders than about where the money is; Germany, the largest market in both industry reports, has 14,159 pharmaceutical awards.

The two markets are built differently. Medicines are concentrated: the five most frequent winners hold a quarter of the awards, and 7,097 companies share them. Medical equipment is spread across 15,105 companies, the top five hold 6.4%, and 44.2% of the awards whose notice states the number of tenders had a single bid.

Foreign wins are rare when counted by registration. About 1% of awards go to a company registered outside the buyer's country. That does not mean foreign manufacturers are absent. A Commission study published in 2021, covering TED awards below €200 million in 2016–2019, found that for medical equipment, pharmaceuticals and personal care products, 61.3% of the value went "indirectly cross-border", to local companies controlled by a foreign group. The study measured ownership, so independent local distributors of foreign brands counted as domestic. The two figures use different years, scopes and definitions, and together they describe one pattern: foreign groups sell through local entities.

Checking and testing apparatus (CPV 385), a group that is not purely medical, is a contrast: of its 8,374 awards since November 2023, 12.5% went to companies registered abroad.

Health buyers also buy together across borders. Under the EU Joint Procurement Agreement for medical countermeasures, run by the Commission's HERA, 37 countries had signed as of April 2020, according to HERA's page, including all EU and EEA countries and the UK. A framework contract for a Covid-19 treatment signed in December 2024 involved 13 EU/EEA countries and up to 2.25 million vials. We found no published total value of these joint purchases. All health buyers on TED are listed by sector on the hospitals and health services page.

How we counted and what the sources measure

• MedTech Europe (Data Hub, updated 6 October 2026): manufacturer prices, EU27 + Norway + Switzerland + UK, 2025. Country shares are for devices without in vitro diagnostics and come from the chart table; the page's text ranks the UK before Italy.
• EFPIA (Key Data 2026): ex-factory prices, all channels, 34 European countries including Serbia, Turkey and Ukraine, 2024; the 2025 figure is an estimate.
• Eurostat health accounts: current healthcare expenditure by all payers, EU-27, 2023, excluding capital investment.
• Eurostat government accounts (gov_10a_exp): general government intermediate consumption, gross fixed capital formation and social transfers in kind bought from market producers, the OECD's measure of public procurement, health function (COFOG GF07), 2024, current prices.
• Regulation (EU) 2025/1197: the 50–70% range is industry data quoted by the Commission; the 4% and 59% come from TED estimated values for medical devices, 2017–2022.
• Cresques TED data: contract award notices for supplies from 30 countries, published from 1 November 2023, computed on 9 November 2026, by every CPV group among the lot's main and additional codes (one award can count in both groups); a joint procurement counts on every buyer's market. Values are awarded amounts only, converted at ECB yearly rates. EU imports are Eurostat Comext imports of the EU 27 countries from all partners, including from each other, for the customs headings we match to the category; some headings are broader than the category. They are not a measure of the medical market. Details are in our methodology.

The arithmetic in this post: medical goods €1,720 billion × 17.8% ≈ €306 billion; Romania's share of pharmaceutical awards 404,763 ÷ 685,543 ≈ 59%, of medical equipment awards 133,067 ÷ 432,273 ≈ 31%.

What this means for a manufacturer

Germany, France, Italy, the UK and Spain hold most of the device market, and industry data quoted by the Commission put public procurement at half to seven tenths of EU device sales. On TED, most of the value of device tenders sits in a few large procedures. On TED, nearly every award goes to a company registered in the buyer's country, so the practical question in each market is which local subsidiaries and distributors already win the lots in your category. The European market pages show that by category and country. In the Cresques app, a market view lists the companies that win, and an unlocked company profile shows their awards and whether a winner is an independent distributor, a manufacturer or a manufacturer's subsidiary, where its own pages confirm it.