The popular tourist destination beckons with a universal healthcare system, satisfied citizens and targeted healthcare funding. Read our latest blog to learn all about Spain’s attractive health market.

Population

With over 47 million inhabitants, Spain is the fourth-most populous country in Europe. The parliamentary monarchy comprises 17 autonomous regions and two exclaves (Melilla and Ceuta) in North Africa and is the second-most visited country in the world, trumped only by France.

The key indicators for the country’s state of health also seem sound: figures issued by the Ministerio De Sanidad, the Spanish Ministry of Health, show that almost eight out of ten Spanish citizens consider their health to be good. At the same time, healthcare expenditure is only 10.7% of the country’s gross domestic product (GDP), compared to 11.3% in the UK, which reports the same level of satisfaction.

Life expectancy in Spain is also among the highest in Europe, but has fallen significantly in 2020 due to the effects of the Covid-19 pandemic. On average, the Spanish live to be 83 years old. Women are clearly in the lead: at 85.1 years (compared to 82.9 years in the UK), they have significantly longer lives than men, with a reported life expectancy at birth of 79.7 years (compared to 79.0 years in the UK).

This development translates to an increasingly aging population: as in the UK, one in five inhabitants was aged older than 65 in 2022. Thus, the numbers of age-related health problems, such as cardiovascular disease and osteoarthritis, are also rising, with almost one in three adults suffering from at least one chronic condition.

In terms of mortality, ischemic heart disease, stroke and cancer are among the leading causes of death in Spain. Here, health-related risk factors play a significant role. Despite targeted health initiatives launched by the government, one in five adults (nearly one in four men) still smoked daily in 2022. Alcohol consumption has increased in recent years and was slightly above the EU average. Overweight and obesity are also a burden on the health of Spanish citizens, with about 18% of 15-year-olds being overweight or obese in 2018.

Health market

Spain has a universal, nationwide healthcare system called the Sistema Nacional de Salud (SNS), which is funded primarily by taxes. Public health services were regionalized in the early 2000s. This gave the autonomous regions financial independence and allowed them to take over operational planning. The Ministry of Health is still responsible for national planning and the medical benefits schedule as well as the marketing approval of medicines.

Despite the high standard of care provided by the public health system, around 20% of the Spanish population opt to take out additional private health insurance. This allows them to avoid the sometimes long queues and waiting lists for some health services. It also gives them access to the expensive Spanish private hospitals and their excellent facilities. In general, the Spanish also invest significantly more in out-of-pocket payments than in the UK (19.6% compared to only 13.6%), i.e. for co-payments for pharmaceuticals, but also medical devices and dental care.

In market terms, the Spanish medical technology sector is expected to grow to a volume of nearly € 7.1 billion (approx. £ 6.1 billion) by 2024, corresponding to a cumulative increase of around 10% compared to 2020. This growth is further fueled by various national and EU-wide subsidies. Investments made in the areas of science, research and public healthcare in the EU funding period from 2021 to 2026 will amount to € 4.24 billion (approx. £ 3.65 billion), including € 1.07 billion (approx. £ 0.92 billion) that will go directly to the SNS.

In the strategic plan for cutting-edge healthcare, the government defined four main funding priorities: innovation and research, personalized high-precision medicine, digitalization of the SNS and digital transformation. The plan envisages health data to be consolidated in a repository called Data Lake Sanitario to enable comprehensive analytics for diagnostics and treatment.

In addition to the training of healthcare professionals, the plan also includes the modernization of technical equipment. The country aims to become a leader in research, particularly for conditions such as diabetes and neurodegenerative disorders. The strategic plan is expected to inject € 1.47 billion (approx. £ 1.27 billion) of investment into the industry between 2021 and 2023.

Trends

The rapidly aging population is driving demand for products and services that support people in staying active and healthy. Here, many trends intertwine: digital health solutions are met with a desire for preventative healthcare and lifestyle optimization. Health apps help you count steps to become more aware of your activity levels and set measurable goals. Digital sleep coaches remind you to maintain good sleep habits and improve their sleep hygiene. Blood glucose sensors for people with diabetes send real-time levels directly to their smart watches. The AI-assisted apps recognize recurring patterns and make meaningful recommendations.

Health and the environment are also closely linked: there is increasing awareness of how our environment impacts our health, leading to heightened interest in pursuing a healthy, sustainable diet and lifestyle. This is boosting demand for organically produced foods and other goods that are free of pesticides and other harmful chemicals, including cosmetics and beauty products.

Not least since the pandemic, mental health has attracted much attention. People are increasingly prioritizing wellness and well-being. Illnesses such as depression and burnout are also major issues in Spain and, fortunately, have lost some of their stigma. This means the need for counseling and therapy as well as for products and services from the fields of naturopathy, mindfulness, yoga and coaching is rising.

Spain is also becoming increasingly popular for health tourists seeking quality medical care, including cosmetic surgery, dentistry and fertility treatments. In some cases, the services will be offered at significantly lower prices compared to other countries.

Legal and regulatory conditions

The healthcare industry in Spain is regulated by the Spanish Ministry of Health. The Agency for Medicines and Medical Devices (Agencia Española de Medicamentos y Productos Sanitarios, AEMPS), which reports to the Ministry of Health, is tasked with the registration and standardization of medical devices.

Software with a medical purpose (e.g. apps) and other pieces of digital health equipment are considered medical devices and are subject to the applicable regulatory requirements. Like other medical devices (syringes, blood pressure monitors, eyeglasses, etc.), they must be tested by a notified body to obtain CE marking.

The AEMPS is also responsible for regulating pharmaceutical products. To obtain marketing authorization, the manufacturer or distributor must submit an application to the regulatory authority, which will review the product’s quality, safety and efficacy data and check its compliance with national and European regulations. Upon successful evaluation, the AEMPS grants approval and the drug product may be placed on the Spanish market. Safety and quality are then further monitored, for example for emerging side effects and quality issues.

EU-wide and international health market

In the European Union (EU), each Member State is responsible for its own health policy. The EU provides a framework consisting of directives and regulations that must be implemented in national legislation. A current example is the Medical Devices Regulation (Regulation (EU) 2017/745), called MDR, which defines the requirements for all medical devices sold in the European single market. Regulatory compliance must be demonstrated by obtaining a declaration of conformity (Conformité Européenne or CE).

For medicinal products, manufacturers have the option to submit the application for marketing authorization either at the national level, i.e. with the AEMPS in Spain, or use the “centralized procedure” provided by the European Medicines Agency (EMA). The latter allows manufacturers to get approval for the entire European Economic Area (EU, Iceland and Norway) by submitting only a single application, thus saving time and money for the complex regulatory processes.

Internationalization

Internationalization allows Spanish clinics and healthcare centers to present their range of services beyond national borders and increase their attractiveness for patients from abroad. The translation of scientific publications and training materials for educating healthcare professionals (HCPs) also offers the opportunity to benefit from the experience and best practices of other countries, thereby raising the overall quality of medical care.

Translations are used throughout the lifecycle of medical devices, pharmaceuticals and dietary supplements as well as health and lifestyle products. Here, it is vital to consider the target audience and the purpose of the text. The requirements differ considerably when addressing authorities, HCP audiences or laypersons, and they also vary according to text type and channel. Mastering this task requires a high degree of linguistic acuity, experience and comprehensive specialist knowledge.

When addressing consumers and patients directly, the translation must be easy to understand and avoid unnecessary technical terms, while also engaging the reader. Examples include information portals, brochures or social media. In some cases, it may be preferable to commission translators with a background in marketing to prepare a creative adaptation of the text at hand.

The most relevant language for the Spanish market is, of course, Castilian Spanish, the country’s official language. Some autonomous regions also have their own official language, in addition to Castilian. These comprise Catalan, Valencian and Aranese in Catalonia, Galician in Galicia, and Basque in the Basque Country and parts of Navarre.

Astur-Leonese and Aragonese are protected languages, which do not have the status of another official language (lengua co-oficial), but can be taught in schools as an elective subject and may also be used for television shows. For targeted marketing and awareness campaigns, in particular, it can make sense to localize the content for the Spanish market in the respective regional language.

The main immigrant languages in Spain are French, German and Arabic.

Summary

The Spanish healthcare market is experiencing substantive growth. Targeted funding projects and EU subsidies are adding further stimulus, making the country very attractive, especially in the biotech and digital health industries. The planned technical modernization of the SNS and ongoing hospital projects also open up promising sales opportunities for state-of-the-art medical technology. As a leading supplier country, the UK stands to benefit from this increased demand.

However, obstacles arise from strong competition in the import sector and the decentralization of the public health system, which consists of a central Ministry of Health and numerous regional structures, which makes it difficult to keep track of the regulatory framework.

In the Spanish healthcare market, translations can be a decisive success factor for success. After all, translation errors would have disastrous consequences: they would put patients, users and professionals at risk and would expose businesses to immense liability.

Highly qualified professional translators are therefore indispensable in order to prevail in the sensitive healthcare market. They offer extensive expertise in the medical field and are familiar with the cultural characteristics of the local market. Accurate and error-free communication also underlines a company’s commitment to quality and reinforces trust in the brand.

References

 

autor_eurotext_100Author: Eurotext Editorial Team

We explain how internationalization works, provide tips for your translation projects and outline some of the technology and processes used. We also report on current e-commerce developments and cover a range of language-related topics.