Press Release - April 2026

• The activity of the road ambulance services sector maintained positive momentum in 2025, with significant turnover growth, albeit moderating from the strong pace seen in the previous two fiscal years.

• The sector's revenue dynamism continues to be underpinned by higher service utilisation, in both the public and private spheres, as well as tariff updates. In parallel, the supply-side concentration process continues to advance, strengthening the position of the leading operators.

• INFORMA's DBK Sectoral Observatory recently published these insights in the basic Sectors 'Ambulance Services' report.

Madrid, 14 April 2026.- According to INFORMA's (Cesce's subsidiary) DBK Sectoral Observatory—a leading provider of business, financial, sectoral, and marketing information in Spain and Portugal—the provision of road ambulance services generated turnover of €2.15 billion in 2025, up 8.6% year-over-year.

This growth, although below that seen in the previous two-year period, confirmed the market's continued expansion, supported by increased ambulance utilisation by both the National Health System and the private sector, as well as higher tariffs.

After the double-digit growth rates recorded in previous fiscal years, the sector entered a phase of continued slowing in growth, amid more stable demand and an adjustment in activity levels following the earlier surge.

In early 2026, there were 223 companies authorised to provide road ambulance services, 88% of which operated in the public service segment, while a minority operated exclusively in the private segment.

The supply-side reorganisation process intensified in recent years, as a result of the adjustment of concession contracts, as well as numerous acquisitions and mergers between companies, which led to a significant reduction in the number of active operators over the last decade.

Thus, although the sector continues to be characterised by the predominance of small companies with a local or regional scope, the weight of the large groups continued to rise steadily.

Supply concentration strengthened notably, with the five leading operators reaching a combined market share of nearly 38% in 2024; the top ten, 52% of total turnover.

The authorised ambulance fleet comprised 12,662 vehicles, also significantly below the figure reached in 2021.

Data Synthesis