Companies face payback, global competition and geopolitical instability, but continue to develop critical technologies for care

With this first article, we inaugurate a series of events dedicated to theinnovation in Italian biomedical, which will be edited by me. Innovando News has in fact decided to entrust me with this role because I have been covering the sector for a long time (I am proudly a boomer), and in recent years, I have had the opportunity to reach an international audience thanks to my collaboration with this newspaper.

That said, to explain the “despite it all" of the title, I will refer to the terrible conditions in which biomedical companies producing in Italy are forced to operate, and then present some examples of innovative solutions capable of improving the quality of healthcare and, therefore, the lives of all of us.

The first of these negative conditions is the absence of a industrial policy that enhances innovationThe ability to develop innovative medical solutions and devices, designed to improve patient care in hospitals, has always represented the only real competitive advantage that, for a long time, biomedical companies have managed to gain and defend from international competition.

Competitors, however, have not remained idle and are gaining market share thanks also to the generous incentives granted by their governments on products sold in our markets. This is a form of "dumping" We lack effective tools to defend ourselves against this threat. Sooner or later, therefore, some Western production will be discontinued, further aggravating our dependence on the Far East.

A strategic sector held back by rules and global competition

The second “bad condition” is the monstrosity represented by a measure called “Payback”We've written about it several times in this newspaper, but, despite the months and years that have passed, it's still there, looming over companies in the sector and their balance sheets.

In short, it is a law that allows the Italian State to charge biomedical companies that supply medical devices a part of the overshooting of regional health spending.

The first request, relating to the period 2015-2018, was closed with a “transaction” in September 2025. For the following years, I fear it is only a matter of time.

It is important to underline that those supplies were made on the basis of tenders, with downward offers applied to the prices set as the basis for the tender by the Regions themselves which, after years, can ask for a part of them back: hence the term "Payback”.

A ""normative monster", which is creating conditions of uncertainty that are calling into question the very investments destined for innovation.

To complete the picture of the geopolitical scenario in which all Western industry is forced to move, we cannot fail to mention the politics of United States in the matter of duties, wars that cause sudden increases in production costs, the growth ofItaly to the "zero point", despite the PNRR, and our productivity index, among the worst in the world.

Despite everything, we are still pleased to share some of the results obtained by Italian small and medium enterprises who continue to innovate.

Modular spacers: new treatments for periprosthetic infections

In recent years, the prosthetic surgery has seen significant progress, allowing thousands of patients to regain mobility and quality of life.

However, alongside the benefits of these procedures, there are complications that still represent a significant challenge for medicine today. Among these, one of the most complex and feared is constituted by periprosthetic infections.

These are relatively rare events, but they have potentially serious consequences for both patients and healthcare systems. Beyond the clinical impact, periprosthetic infections also pose a growing economic burden: in the United States, for example, it is estimated that the costs associated with their treatment could exceed $750 million by 2030.

For this reason, the management of such infections today requires a increasingly multidisciplinary approach and the introduction of innovative technological solutions capable of improving the effectiveness of treatments.

In this scenario, the work of companies committed to the development of fits in biomaterials and innovative technologies, such as G21, which stands out for the design of solutions dedicated to spinal consolidation and the restoration of joint function.

The goal is to improve the therapeutic pathway of orthopedic patients and anticipate the future needs of healthcare professionals.

Precisely in the field of periprosthetic infections, the company has developed an innovative method based on modular spacers that can be made directly in the operating room, allowing surgeons to tailor its size and antibiotic load to the patient's specific needs.

Biomedical silicone for increasingly advanced devices today

Il silicone It is widely used in the design of biomedical devices, particularly when chemical stability, biocompatibility and constant mechanical performance over time are required.

Its stable and flexible structure guarantees predictable behavior even after repeated sterilization cycles, without the release of migratory substances typical of many organic polymers.

These properties make silicone suitable for a wide variety of biomedical applications. However, as devices become increasingly sophisticated and regulatory requirements become more stringent, there is a growing need for partners capable of uniting materials expertise, certified production capabilities and knowledge of the medical sector.

It is in this context that the activity of fits in Silicone & Specialties, an Italian company founded and directed by Emanuele Samuele Berna, directly involved in the activities of the Exsto Group, specializing in the transformation of silicone for biomedical applications.

The company's strategy is to develop increasingly intelligent, integrated and miniaturizable medical materials.

Among the solutions under development are new silicone compounds with advanced properties, such as greater resistance to mechanical stress, certified biocompatibility, and versatility that allows for the creation of increasingly smaller geometries.

The next generation of biomedical devices will in fact require materials capable of guaranteeing safety, high performance and integration with sensors and microelectronic components.

Hospital oxygen: greater autonomy, safety, and continuity

In hospitals, theoxygen It is not a simple supply, but a vital medicine for thousands of patients every day.

The COVID-19 experience has taught us how delicate the balance of health systems is and how devastating emergencies can be: lack of oxygen is not an acceptable eventuality.

Traditionally, oxygen is stored in large cylinders or high-pressure tanks: effective but complex systems that require constant logistics, dedicated space, and rigorous safety measures.

Precisely for this reason, in recent years, the way of conceiving the production and management ofmedical oxygen It's changing. Technology is paving the way for solutions that aim to make healthcare facilities as autonomous and safe as possible.

These are technologies capable of guaranteeing the continuity of supply and to transform oxygen from a potentially critical resource to a constant and reliable presence in daily hospital life.

The innovation developed by fits into this scenario Delta P, an Italian company that has rethought the very concept of hospital “oxygen plant”.

Extended versions of these insights are available at Biomednews.it, the Italian newspaper that I direct.

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