MEDTECH PAYBACK

What happens when a hospital supplier fulfils its contract-and years later is ordered to pay back part of its revenue?

In Italy, this is the reality of medical-device payback: a mechanism requiring suppliers to cover a share of public healthcare spending above government-set limits, even though they neither set those limits nor control overall purchasing.

In MedTech Payback: The Law That Turns Creditors into Debtors, entrepreneur Gennaro Broya de Lucia examines the decisions, payment demands and institutional battles behind this system-and the consequences for businesses, healthcare professionals and patients.

Combining first-hand experience with legislative analysis, research findings and institutional correspondence, he traces how demands relating to past financial years can undermine cash flow, consume profits and threaten the companies hospitals depend on. He explains why a levy calculated on revenue can affect a small distributor very differently from a multinational manufacturer, and how pressure on suppliers can affect competition, innovation and continuity of care.

For European and American MedTech entrepreneurs and executives, this Italian case raises urgent questions about public procurement, financial exposure and the reliability of contracts. For procurement leaders, public administrators, policymakers and physicians, it reveals the connections between healthcare funding decisions and the resilience of the medical supply chain.

The author makes an explicit case for abolishing medical-device payback and restoring responsibility for healthcare expenditure to the public institutions that decide it.

A warning from Italy with implications beyond its borders-for everyone who builds, buys, funds or relies on medical technology.

By Gennaro Broya de Lucia.
English translation and foreword to the English edition by Elvio Gramignano, CommunID CEO.