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Market access for medical technologies in Spain

A brief overview of key market access pathways and challenges for medical devices, in-vitro diagnostic tests in Spain

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Key topics

There are two key themes describing market access for medical technologies in Spain:

  • Funding: explicit inclusion of service or implant into the package of benefits provided within the NHS
  • Health technology assessment: HTAs by national and regional organizations

There is no reimbursement, but only funding framework in Spain. Hospitals receive funding through a global budget, although the responsibility for the allocation of hospital budgets is assigned to the health authority of the Autonomous Communities. 

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Funding

One of the key aspects of market access in Spain is the explicit inclusion of service or implant into the package of benefits provided within the NHS. The package of benefits is defined by the Interterritorial Council of the NHS (CISNS), composed of the Health Regional Ministers and the Health Minister of Spain.

The Common Package of Benefits of the National Health System is the set of techniques, technologies or procedures, understood as each of the methods, activities and resources based on scientific knowledge and experimentation, through which health benefits are made effective («BOE» num. 222, 16/09/2006). The Common Package of Benefits is common for all regions of Spain, and each Autonomous Community has its complementary package.

The decision to include new technologies in the package of benefits is made by the Interterritorial Council of the NHS upon the proposals submitted by the Commission of Benefits, Insurance and Financing and the (mandatory) technical advice of the Spanish Network of HTA Agencies (RedETS).

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Health technology assessment

HTAs are performed at the regional level by seven HTA bodies (in Andalusia, Aragon, Basque Country, Canary Islands, Catalonia, Galicia, and Madrid) and at the national level by the Health Institute Carlos III (ISCIII).

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Specifics for IVD tests

There is no specific reimbursement framework for in-vitro diagnostic tests. Most IVD tests are funded using a global budget principle as part of the funding of the labs. 

Genomic and genetic tests that are guaranteed nationwide are included in the Common Catalog of Genetic and Genomic Tests of the NHS.

MTRC has experience with more than 126 projects in Spain

News and insights

Spain Publishes New and Emerging Health Technology Fact Sheets Across Multiple Clinical Areas in October 2026

In October 2026, the Canary Islands Healthcare Evaluation Service (SESCS), operating within the Spanish Network of Health Technology Assessment Agencies (RedETS), published several New and Emerging Health Technology Fact Sheets. The publications cover technologies across gastrointestinal, gynecological, pulmonary, neurovascular, diagnostic imaging, and in vitro diagnostic fields. The purpose of the Fact Sheets is to inform the prioritization of new and emerging technologies for evaluation by RedETS.

Spain consults on Draft Order updating the Health Cohesion Fund regulations

On September 24, 2026, the Spanish Ministry of Health launched a hearing and public information procedure on a Draft Order updating the rules governing the Health Cohesion Fund (FCS). The update aims to align the Fund’s compensation system with current NHS healthcare needs, with changes expected across endocrine, gastrointestinal, endoscopy, extracorporeal treatments, neurology and neurosurgery, neurovascular, in-vitro diagnostics, and some other areas. Comments may be submitted until October 16, 2026.

Annual List of New and Emerging Technologies published in August 2026 in Spain

In August 2026, the Spanish Network of HTA Agencies published the annual List of New and Emerging Technologies for 2025. The evaluations of a total of 66 technologies, covering multiple areas such as cardiovascular, diagnostic imaging, e-Health, endoscopy, gastrointestinal, in-vitro diagnostics, interventional radiology, men’s health, urology, neurology and neurosurgery, neuromodulation, neurovascular, obstetrics and gynecology, ophthalmology, orthopedics, pulmonary, radiotherapy, spine, and surgical procedures, have been assigned for evaluation to the relevant HTA bodies.

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