Healthcare in Lombardy, centralised purchasing but rising costs

There is one figure that is beginning to weigh on the health sector: around 28 million euro of higher costs on non-health services, generated - as an internal regional document shows - by a centralisation of purchases that, instead of squeezing prices, ended up increasing them. This is the flip side of the coin of a manoeuvre that is supposed to keep Lombardy's healthcare accounts in order in 2026.

The picture comes from the progress update presented to the general managers of the Regional Health Service companies and dated 30 April 2026. A working document, a projection for the current year, not a balance sheet: it serves to measure how far we are from the objectives. Here the results are highlighted, but also the critical issues that are still open.

There is an increase for personnel, the most important, with an increase worth 390 million compared to 2025, which the Region, however, defines as sustainable and necessary. However, it remains central then to review purchases, services, and relations with private individuals. It is precisely on the purchasing chapter that the document shows its most ambivalent face.

On the one hand, the results exhibited are concrete, especially on surgical robotics: the direct negotiation of the General Directorate for Welfare with the supplier produced a 44% reduction on consumables compared to the old conditions of the Aria 2022 tender, for an estimated saving in 2026 of 10.5 million euro; the renegotiation of equipment (-10%) adds another 2 million. Still on robotics, the comparison between the old Aria 2022 prices and those of the Consip 2025 tender shows a reduction of 35.9%, with blunt conditions below the same Consip parameters. On medical devices, work is ongoing through the analysis of the regional database. In addition, savings of approximately EUR 31.4 million are expected from company negotiations and aggregated tenders, with a reduction of up to 2% on stand-alone purchases.

On the other hand, on non-medical services, the same logic of centralisation produces the opposite effect. The document lists, without mincing words, the increases: handwashing (washing for hire) +35%, cleaning +22%, medical gases +42%. Increases totalling some 28 million. The single regional centre, designed to achieve critical mass and better prices, is also described here as a factor of rigidity: fewer suppliers, less competition, prices that do not fall.