Press Release - April 2026

• The activity of the ground ambulance services sector maintained positive momentum in 2025, with significant turnover growth, although it slowed from the high pace of 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 'Ambulance Services' Special Basic 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—ground 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, confirms the market's continued expansionary trajectory, 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 progressive slowing in growth, amid more stable demand and an adjustment in activity levels following the previous strong boost.

At the beginning of 2026, there were 223 companies authorised to provide ground ambulance services. Eighty-eight per cent of these operated in the public service segment, while a minority operated exclusively in the private segment.

The supply-side restructuring process intensified in recent years, as a result of concession adjustments, as well as numerous acquisitions and mergers between companies. This 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 majority presence of small companies operating locally or regionally, the weight of large groups continues to rise steadily.

Supply-side concentration strengthened markedly, with the five leading operators holding a combined share of close to 38% of the market in 2024; the top ten, 52% of total turnover.

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

Data Synthesis