Contract manufacturing of medicines: how Italia remains the European leader with a turnover of 4.3 billion

It is one of the jewels in the crown of Italian pharmaceutical production, to the extent that it has secured us a virtually unassailable European leadership for many years now: it is the CDMO (Contract Development and Manufacturing Organisation) sector – in practice, contract manufacturers – a sector that is growing at a relentless pace and which, in the last 10 years alone, has quadrupled its export turnover. According to the initial findings of the Farmindustria-Prometeia 2026 study, which has been monitoring the sector for over 10 years, by 2024 Italia will be the European leader with a turnover of 4.3 billion euros, accounting for 24 per cent of the EU total (17.8 billion), ahead of Germany (3.5 billion) and France (2.9 billion). The initial figures for 2025 confirm this excellent performance. This leading position will be on display from today until 8 October at the ‘Cphi Europe’ trade fair in Milan, where the global pharmaceutical supply chain will gather.

However, the records set so far by this Italian-made medicine could be under threat from increasingly fierce competition from China and the strong headwinds blowing from across the Atlantic, with the Most Favoured Nation (MFN) clause pushed for by US President Donald Trump. This is the view of Marcello Cattani, president of Farmindustria, who does not take the figures achieved – 74 billion in production and 69 billion in exports by 2025 – “for granted”, “because the geopolitical balance is shifting”. On the one hand, the US, with the MFN clause and measures to attract investment; on the other, China, which is racing ahead in the development of new medicines and vaccines. And in the middle, Europe, facing a crossroads: improve the framework or lose out permanently in international competition?”. According to Cattani, in the face of the research boom – 23,000 medicines in development globally and 2,000 billion dollars in investment – “the ecosystems capable of adapting to change and attracting innovation, resources and expertise will prevail. That is why it is essential in Europe to have pro-innovation and pro-investment policies in Italia, both directly and through CDMOs.” Furthermore, according to the president of Farmindustria, it is necessary to “implement reforms, move beyond the payback period immediately and rely on a Budget Law in Italia that effectively recognises the value of our industry, which is strategic”.

But let’s turn to the CDMO figures: according to the study, turnover in Europe has more than doubled over 12 years (+9.3 billion), with Italia accounting for around a third of that growth (+2.6 billion euros). Over the past year, our lead over Germany, France and the United Kingdom has actually widened, driven by a 7.4 per cent increase in turnover, which outpaced that of our competitors. Among the ‘big five’, only Spain’s CDMOs recorded double-digit growth in 2024 (+13 per cent), whilst the others posted more modest figures, all showing slower growth (+5.7 per cent in France, +4.3 per cent in Germany, +3.9 per cent in the UK). Among the other countries, the outstanding results from Romania (+53%), the Netherlands (+41%), Portugal (+18%) and Greece (+13%) stand out.

Preliminary figures for 2025 show that the share of turnover generated by overseas markets stood at 85 per cent in the two-year period 2024–25, a sharp increase from 65 per cent in 2015, with export turnover more than quadrupling between 2015 and 2025 (+352 per cent). Following the strong expansion of 2023, overseas sales maintained double-digit growth rates in 2024–25 (+29% over the two-year period as a whole, at current values), particularly to advanced economies (Europe, the United States and Japan), which account for almost 95 per cent of the total. During the same two-year period, the number of employees in the CDMO sector in Italia continued to grow at a sustained rate: there are now 16,800 (+10 per cent). The CDMO sector is also characterised by a strong propensity to invest: over the 2023–2025 period, companies reinvested, on average, 17 per cent of their turnover, a figure more than double the manufacturing sector average (7.4 per cent). With regard to the type of investment, expenditure on production lines accounts for 80 per cent of the total and, in particular, investment in new production lines accounts for around 60 per cent. For Anna Maria Braca, Chair of the Cdmo Farmindustria Group, these figures are the ‘result built up over the years thanks to our companies’ ability to invest, innovate and offer pharmaceutical partners scientific expertise, industrial quality, flexibility and supply chain reliability’. However, Braca also notes that, in light of geopolitical tensions, supply chain security, energy and regulatory costs, and increasingly fierce competition, ‘Italia’s leading position cannot be taken for granted. To maintain this position, Europe must translate the recognised strategic importance of the pharmaceutical sector into an effective and concrete industrial policy’, whilst also supporting ‘appropriate skills and incentive schemes, including in relation to energy and costs linked to the ETS’.