Margarita Alfonsel, general secretary of Fenin, Spain’s medtech association, outlines the sector’s success stories from the past four years and her ongoing priorities.

What is the role of Fenin as Spain’s medical technologies association within the country’s healthcare system and what have been your most exciting collaborations and success stories in the past four years?

Since our foundation, 40 years ago, Fenin has been working with the aim of building a strong relationship with the National Authorities, in order to develop and sustain a stable framework to facilitate incorporating innovation into the Spanish healthcare system in an agile and equitable manner for the patients. This contributes to improve the national health system, the diagnosis and treatment of diseases and the quality of life of the citizens.

At present, the Federation represents a key manufacturing sector in the Spanish economy, since we generate wealth thanks to the investment in innovation and the creation of thousands of highly qualified jobs. For all these reasons, the health technology industry plays a fundamental role as a strategic partner of the Spanish economy and the health system and is fundamental for its advancement and transformation.

We have carried out different initiatives, activities and projects along these 40 years. If I have to mention some of them, these are probably the recognition of the strategic role of the medical technology sector by all the stakeholders, the drive for innovation, which has been key to develop the sector in Spain, the plan to eliminate late payments in public administrations, the work developed to keep the reduced VAT for some products and the plan to reduce the high rate of obsolescence in the technology park installed in our country.

For many years, our companies had to deal with late payments from the public administration, that in many cases went above the year, accounting for a debt above 6 billion euros. For us it has been a big institutional effort, while from a government perspective, a big community attempt to provide a solution. Fenin created a working group with the Ministry of Finance to study possible solutions to sort out this problem. This made possible the extraordinary and structural measures launched by the Government like the Supplier payment plan (FFPP) to Autonomous Regions and Local Entities, the regional monetary liquidity fund (FLA) to Autonomous Regions, extraordinary measures for Local Entities with financial problems, the law for electronic invoicing, the creation of an invoice accounting register in the public sector and the law to control commercial debt in the public sector.

These measures reduced significantly the debt. Fenin keeps collaborating with the public administration to eliminate definitively the late payments in the public health system.

Regarding the work done by Fenin in relation to the VAT for medical devices, an European resolution condemned Spain for the incorrect application of VAT to medical devices and we worked intensively in collaboration with the treasury department to demonstrate that in other EU countries, the VAT applied to the medical devices which are directly used by the patients or are going to be implanted in the patients, is within the reduced VAT rate. We conducted a specific study to understand the positive models in other EU countries on this issue.

One of the most important priorities for Fenin is to work towards correcting the obsolescence of hospital technology equipment. Fenin has developed a study along relevant Scientific Societies to identify the age profile of the existing technology equipment base in the National Healthcare System, that shows that the percentage of technologies older than 5 years is higher than the rate recommended by the COCIR golden rules. When technology is too old, it can mean less precision in the diagnostic exams or less quality in the health assistance. This would impact at the end in the patient’s health and sustainability of the system. For this reason, we have collaborated with the Spanish Ministry of Health on a Renewal Plan to solve this problem. Our first estimates would involve mobilizing an investment of around 1.4 billion euros in a period of four years.

With a new Spanish minister of health in place, what are the healthcare challenges that you will continue to prioritize?

We are in an interesting and important moment. The irruption of powerful ICT based technologies are leading the digitalization and transformation of the system. An internal working group has been established to offer guidelines and support to the administration.

We are also supporting the companies to be adapted to the two new regulations about medical devices and IVD. They will come into force in 2020/2022.

And of course, we work in collaboration with other agents and experts to implement the value-based healthcare delivery and procurement, in the framework of the new public procurement law.

FENIN recently hosted ‘MedTech Week’. What is the main idea behind this initiative and what did you hope to achieve as the main outcome?

This has been the fourth time for us participating in the MedTech Week organized by Medtech Europe, the European trade association representing the medical technology industries operating in Europe, in order to communicate to the society during a week the value and benefits of the medical technology for the patients, the healthcare professionals and the health system.

This year, among other activities, we prepared infographics on the role, value and performance of in-vitro diagnostics that were shared on Twitter and Linkedin and participated in the Conference on Management and Evaluation in Health, hosted by the Signo Foundation in Barcelona. In the conference a representative of Fenin presented the new models of innovative public procurement of services.

What are FENIN’s strategic priorities for the next four years?

We are working to facilitate the adaptation of the members companies to the new regulation on Medical Devices and In Vitro Diagnostics with the great support of MedTech Europe.

In addition, the new Code of Ethics of the Medical Technology Sector in Spain is another of our most immediate challenges. Since its approval by Medtech Europe in 2015, Fenin immediately began to work on its implementation, becoming the first national member association in its transposition.

We also feel that there should be a major collaboration between the public and private sectors to allow funds to be more accessible. We believe the collaboration between the public and private system is the future and is already happening.

Fenin aim’s is to work with the public administration on health technology investment in innovation to establish new management and procurement models to introduce value-based innovations for healthcare professionals and patients.

Within the new government we are part of a group of experts, for example, to review and define the health strategy within professionals from hospitals and administration for the National Strategic Health Action.

We’ll keep supporting and developing innovation activities through our Spanish Innovation Platform on Medical Technologies, which has the approval and support of the Ministry of Economy and Enterprise. It is the first one created in Europe on Medical Technologies. The Platform allows us to identify and join together research on different ideas and proposals from the scientific community. Through this Platform both large and small enterprises can gain financing for their projects and we can support entrepreneurship too. We’ll keep supporting the small enterprises grow up until the final commercialization.

Finally, Fenin will keep focusing being the main reference interlocutors with the Administration. We want to be the reference partner for the MedTech industry in Spain, sharing our vision with the public administration about how much the technology has advanced and helping our citizens to improve their living conditions.