Investing in health does not just mean supporting welfare, but strengthening the country’s human capital, productivity and competitiveness. The logic is ironclad and is the basis of a vision that links Healthcare and Life Sciences together as components of a single strategic ecosystem, capable of responding to new health needs and, at the same time, generating growth, research, innovation, skills and investments. The Meridiano Sanità Forum remembers this “Healthcare and Life Sciences: Governing transitions, building the future”, sponsored by the Conference of Regions and Autonomous Provinces, the Ministry of Health and FIASO.
“Health is today a strategic asset for growth and competitiveness. In Italy its ecosystem is worth 12.4% of GDP and 14.5% of national employment and contributes to human capital, productivity and the country’s ability to compete. The challenge is to keep two objectives together: an NHS ready to respond to new health needs and a more competitive Italy in the new global geography of Life Sciences”
is the comment of Valerio De Molli, Managing Partner & CEO of The European House – Ambrosetti and TEHA Group.
Healthcare to be preserved
The economic relevance of health is expressed first and foremost at a global level: the health economy generates over 6,300 billion dollars in added value, equal to 7.6% of global GDP, and approximately 194 million jobs. Numbers that reinforce the need to consider health not only as an expense item, but as a component of development and competitiveness policies. The perspective has also been recognized by the European Commission, which includes health, together with education, research and development and infrastructure, among the components of public spending with the greatest potential to support growth.
For Italy, a reallocation of spending towards these growth-friendly investments could result in a GDP level of up to 9.6% higher in the long term, with around 3 points associated with healthcare. A particularly significant potential for a country where, over the last twenty years, real GDP has grown by 5.3%, compared to 29.4% in the EU-27. Italian public health spending continues to grow and is expected to reach 148.8 billion euros in 2026, equal to 6.4% of GDP. Despite the increase in resources allocated to healthcare, a gap of around 6 billion euros persists between healthcare spending and the level of financing of the NHS. In the face of growing health needs, the direct contribution of families to health spending is also increasing. In 2025, directly incurred expenditure reached 42.4 billion euros, while approximately 7 billion are intermediated through health funds, insurance and other voluntary schemes.
How to decline the future
The great challenge now is to anticipate the evolution of needs. The forecast model developed by Meridiano Sanità, in light of the country’s demographic, epidemiological and healthcare changes, estimates that in 2050 public health spending should reach 218.8 billion euros in nominal values, almost 9% of GDP, with around three-quarters of spending associated with the over 60 population. Human capital represents another decisive issue for the sustainability of the NHS.
Compared to the main European countries (average of France, Germany and Spain), Italy records a gap of around 75,000 healthcare professionals – including GPs, specialists and nurses – in relation to the population, while average salaries are 35% lower. Staff shortages, increased workloads and pay gaps risk feeding each other, making it more difficult to retain professionals in the NHS and attract new ones.
Planning the healthcare of tomorrow therefore means planning resources, professionals and skills together, also strengthening the attractiveness of the public service. The strength of the NHS is also measured in its ability to guarantee the same health opportunities in the different territories. The Meridiano Sanità Regional Index highlights significant North-South variations in all three dimensions analysed: health status of the population, health determinants (including socio-economic and environmental context and risk factors) and capacity of regional health systems to maintain and improve health outcomes. No region in the South exceeds the national average in any of the three indices and the gaps between the territories are significant. Reducing these distances is one of the main tests for the fairness and sustainability of the system.
Medicines and expenses
Finally, in terms of planning, it is necessary to think in terms of public pharmaceutical spending. In 2025, public pharmaceutical spending reached the figure of 24.9 billion euros, 18.4% of the National Health Fund, compared to planned resources equal to 15.3%. Against a surplus of around 500 million euros in affiliated pharmaceuticals, direct purchases exceed their ceiling by around 4.9 billion, with a payback paid by companies rising to 2.4 billion. A misalignment destined to persist in 2026, when the overall gap between planned resources and pharmaceutical spending should exceed 5 billion euros, focusing once again on direct purchases. At the same time, the Fund for Innovative Medicines is only used at 53%. The framework therefore highlights the need for programming that is more in line with the actual composition of spending and the evolution of needs, capable of guaranteeing sustainability for the NHS and greater predictability for the sector.
