This research study focuses on the drive to operationalize capital and service costs favoring non-conventional business models (MES and MVS) in Italy over traditional capital-intensive purchasing and service models. The study also features a detailed elaboration on the legacy of public-private partnerships (PPP), framework agreement case studies, market opportunity, market size and penetration analysis coupled with merger and acquisitions and the competitive landscape, in addition to growth opportunities.

Frost & Sullivan's Definition on MES and MVS for Italy market Managed Equipment Services (MES): This is a bundled solution that includes the purchase of new equipment in addition to basic maintenance and support, technology management, planning and potentially a number of more advanced value-adding services. The bundle is usually financed by the customer through operational expenditure and typically extends, at a minimum, throughout the lifecycle of the equipment (7+ years).

Multi-Vendor Services (MVS): This is a vendor-neutral offering combining basic and more advanced services, such as repair and maintenance services in addition to replacement planning (small components in imaging systems) for multimodality imaging fleet. The MVS does not include purchase of new equipment like in MES. The MVS provider can be the OEM of part of the equipment, or a third-party company, and act as a single source for service, working in line with in-house resources at the imaging provider site.

Key Market Dynamics:
The high cost sensitivity among Italian public healthcare providers and their limited access to capital funding form the key motivation for their consideration to adopt new purchasing and service models for capital imaging equipment. To address the ageing equipment fleet and worsening technology obsolescence situation in the installed bases, different regional communities in Italy are looking closely at the opportunity for framework agreements with industry consortia to provide a viable long-term equipment renewal strategy. Framework agreements involving a multi-vendor consortium represent the majority of market activity in Italy as of 2016.

Frost & Sullivan's research on Italy indicates that National and Regional GPOs continue to engage in customer-vendor partnerships amidst growing windows of opportunities by the PPP models. Moving forward, the number of existing and planned public-private partnerships (PPP) for green-field hospital build may offer a strong basis for new capital purchasing models in imaging technology.