Medical writing in Italy
Medical writing in Italy encompasses employed and freelance work across medical communications, promotion and regulatory documents, with varied professional and tax classifications.
The 2024 national survey
The first Italian survey of medical writers and scientific communicators ran from 1 to 29 February 2024, inviting medical writers living in Italy and Italian medical writers abroad at any professional level. Its 68 respondents comprised 32 employees (47%), 34 freelances (50%) and two agency owners (3%); the agency owners were included in totals but not analysed separately. The employee group included hybrid professionals combining partial contractual work and occasional services with their own VAT registration; freelances had VAT registration or single-person companies, while agencies had more than one employee or working partner.
Earlier EMWA surveys had drawn no more than eight Italian respondents.
Respondents’ backgrounds
Gender, age and academic-title distributions were similar for employees and freelances. Demographic and educational characteristics are shown below; percentages are within each occupational-status column, and the two agency owners are included only in the total.
| Characteristic | All respondents, n=68 | Employees, n=32 | Freelances, n=34 |
|---|---|---|---|
| Gender | |||
| Female | 57 (84%) | 25 (78%) | 30 (88%) |
| Male | 11 (16%) | 7 (22%) | 4 (12%) |
| Age, years | |||
| <29 | 3 (4%) | 2 (6%) | 1 (3%) |
| 30–39 | 24 (35%) | 9 (28%) | 14 (41%) |
| 40–49 | 26 (38%) | 11 (34%) | 14 (41%) |
| 50–59 | 9 (13%) | 3 (9%) | 6 (18%) |
| ≥60 | 6 (9%) | 2 (6%) | 4 (12%) |
| First language | |||
| Italian | 64 (94%) | 31 (97%) | 31 (91%) |
| Other | 4 (6%) | 1 (3%) | 3 (9%) |
| Residence | |||
| Northern Italy | 36 (53%) | 20 (63%) | 15 (44%) |
| Central Italy | 15 (22%) | 4 (13%) | 11 (32%) |
| Southern Italy and islands | 13 (19%) | 6 (19%) | 6 (18%) |
| Outside Italy | 4 (6%) | 2 (6%) | 2 (6%) |
| Prevalent working languages | |||
| English | 53 (78%) | 23 (72%) | 28 (82%) |
| Italian | 53 (78%) | 22 (69%) | 29 (85%) |
| EMWA affiliation | |||
| Yes | 25 (37%) | 13 (41%) | 10 (29%) |
| No | 43 (63%) | 19 (59%) | 24 (71%) |
| Medical-writing certification | |||
| Yes | 11 (16%) | 4 (13%) | 7 (21%) |
| No | 57 (84%) | 28 (88%) | 27 (79%) |
| Academic title | |||
| Advanced: MD, PhD, MBA or equivalent | 41 (60%) | 17 (53%) | 22 (65%) |
| Master’s degree | 20 (29%) | 10 (31%) | 10 (29%) |
| Bachelor’s degree | 3 (4%) | 3 (9%) | 0 (0%) |
| Other: master’s or equivalent | 4 (6%) | 2 (6%) | 2 (6%) |
The four other first languages were English for two respondents, Spanish for one and French for one.
Activities, hours and workplace
More than half of respondents had less than ten years’ medical-writing experience (40, 59%). Professional characteristics were reported below; percentages are within occupational-status columns, with the agency owners included only in totals.
| Characteristic | All respondents, n=68 | Employees, n=32 | Freelances, n=34 |
|---|---|---|---|
| Medical-writing experience, years | |||
| ≤2 | 7 (10%) | 2 (6%) | 5 (15%) |
| 2–5 | 19 (28%) | 11 (34%) | 8 (24%) |
| 5–10 | 14 (21%) | 6 (19%) | 8 (24%) |
| 10–15 | 15 (22%) | 6 (19%) | 7 (21%) |
| >15 | 13 (19%) | 7 (22%) | 6 (18%) |
| Main activity | |||
| Medical communications: journal papers, abstracts, congress materials and similar work | 20 (29%) | 10 (31%) | 10 (29%) |
| Promotional materials: leaflets, visuals, carriers, newsletters and similar work | 18 (26%) | 9 (28%) | 7 (21%) |
| Regulatory documents: study protocols, clinical study reports, dossiers and similar work | 9 (13%) | 8 (25%) | 1 (3%) |
| Advisory-board moderation | 5 (7%) | 1 (3%) | 4 (12%) |
| Web communication | 4 (6%) | 1 (3%) | 3 (9%) |
| Translation | 4 (6%) | 0 (0%) | 4 (12%) |
| Lay communication | 3 (4%) | 1 (3%) | 2 (6%) |
| Editing, copywriting or proofreading | 2 (3%) | 1 (3%) | 1 (3%) |
| Medical education | 2 (3%) | 1 (3%) | 1 (3%) |
| Bioethics communication | 1 (1%) | 0 (0%) | 1 (3%) |
| Hours worked per week | |||
| 1–10 | 1 (1%) | 0 (0%) | 1 (3%) |
| 11–20 | 8 (12%) | 2 (6%) | 6 (18%) |
| 21–30 | 13 (19%) | 1 (3%) | 12 (35%) |
| 31–40 | 30 (44%) | 16 (50%) | 13 (38%) |
| 41–50 | 12 (18%) | 11 (34%) | 0 (0%) |
| >50 | 4 (6%) | 2 (6%) | 2 (6%) |
Employees more often worked mainly on regulatory or promotional documents, while freelances more often translated or moderated advisory boards. Fifty-six per cent of freelances worked 30 hours or fewer a week. Exclusive remote working was reported by 43 respondents (63%), including 33 freelances (97%) and nine employees (28%); 14 employees (44%) worked mainly on site and remotely on occasion. The discussion reported 83% working remotely or remotely with some office days.
The flexibility of medical writing, particularly part-time freelancing, was considered attractive to professional women with family responsibilities.
Employee pay and responsibilities
Among 32 employees, 15 (47%) worked for communication or promotional agencies, nine (28%) for pharmaceutical, nutraceutical or veterinary companies, three (9%) for contract research organisations, three (9%) for universities or other research organisations, and two (6%) elsewhere, including consultancy agencies and private research funds. Their median full-time gross annual salary for 2023 was €40,000, with a mean of €45,860 and a range of €14,000–€110,000 among 31 answers.
Employees reporting responsibilities sometimes or always had these salaries:
| Responsibility | Employees reporting it | Median annual salary | Mean annual salary | Range |
|---|---|---|---|---|
| Mentoring | 27 (84%) | €45,000 | €50,210 | €16,000–€110,000 |
| Team management | 26 (81%) | €41,000 | €48,530 | €16,000–€110,000 |
| Project management | 31 (97%) | €40,000 | €45,730 | €14,000–€110,000 |
These responsibilities appeared unrelated to higher pay in Italy, unlike the European findings.
The Italian mean of €45,860 exceeded the median Italian annual wage of €30,284 in 2022 but was below the European employed-medical-writer mean of €54,924 in 2006 and €67,205 in 2021. Italy’s general mean annual salaries were close to the European mean in 2021.
Freelance income, rates and experience
Freelance median annual income was €32,000 and median hourly rate €50; the running-text means were €41,900 annually and €62 hourly. Figure 7 instead gave mean annual income as €42,900, with a range of €8,000–€150,000, and hourly rates of €10–€110, each on 31 answers.
Annual income and hourly rates increased with freelance experience, particularly beyond 15 years; freelances earned less than employees at comparable experience up to ten years and more beyond ten years. The compensation table covered 66 employees and freelances, excluding agency owners; annual figures below are thousands of euros.
| Experience | Employee annual salary: median (mean; range; n) | Freelance annual income: median (mean; range; n) | Freelance hourly rate: median (mean; range) |
|---|---|---|---|
| <2 years, n=7 | 40 (n=1; one missing value) | 22 (25.0; 15–40; n=5) | €40 (€41.0; €30–€55) |
| 2–5 years, n=19 | 37 (37.5; 14–70; n=11) | 23 (22.1; 8–37; n=8) | €50 (€43.1; €10–€75) |
| 5–10 years, n=14 | 39 (42.2; 30–62; n=6) | 30 (33.9; 12–87; n=7; one missing value) | €50 (€53.6; €30–€85) |
| 10–15 years, n=13 | 38 (40.1; 30–55; n=6) | 48 (54.0; 20–100; n=5; two missing values) | €50 (€56.0; €35–€90) |
| >15 years, n=13 | 70 (68.0; 47–110; n=7) | 82 (81.7; 36–150; n=6) | €90 (€121.7; €60–€300) |
The two agency owners had 10–15 years’ experience but were not included in the salary results.
The Italian mean hourly rate of €62 was below the European means cited for comparison: €82.20 in 2023, €78 in 2021 and €81 in 2017, despite general hourly labour costs in Italy being practically identical to the European mean. The discussion also described rates above 15 years’ experience as similar between Italian and European professionals (€82 versus €80), whereas the Italian experience table gave a median hourly rate of €90 for that group. The mean annual income of €41,900 was compared with €39,500 for European employed writers working up to 20 hours weekly, in view of the high proportion of Italian freelances working under 30 hours; freelance annual income was nevertheless considered far below European levels.
Freelance clients, payment and services
Communication or promotional agencies were the main clients for 22 freelances (65%); 23 (67%) mainly found new clients through professional or social networks and clients or colleagues. Other customer-finding options included consolidated clients, direct email, freelance directories and a personal website. Fourteen freelances (41%) outsourced work to colleagues.
Mean time from invoice to payment was reported by 34 freelances as follows:
| Time | Number of respondents |
|---|---|
| 60 days | 19 |
| 30 days | 9 |
| 90 days | 3 |
| More than 90 days | 2 |
| Immediate | 1 |
Accountancy was the most-needed service (27 freelances, 79%), followed by education (18, 53%) and IT support (14, 41%). Statistical support and insurance were each named by eight respondents. This specialised-service ecosystem was considered an economic spin-off of Italian medical writing.
Satisfaction and difficulties
Forty-nine respondents (72%) were satisfied or very satisfied with their work, with no difference between employees and freelances. Salary satisfaction was reported for 36 respondents (53%); the results gave 21 satisfied employees as 59% and 16 satisfied freelances as 47%. Dissatisfaction or strong dissatisfaction with compensation was reported for nine freelances (27%) and four employees (13%), while the discussion separately compared Italian and European freelance dissatisfaction as 19% versus 6%. Compensation dissatisfaction was considered consistent with the lack of relationship between pay, experience and responsibility, alongside high reported workloads.
Deadlines were the commonest difficulty (37 respondents, 54%), followed by professional education and courses (23, 34%); finding new clients and delayed payments were reported by 20 and 16 respondents respectively. Strict deadlines troubled 23 employees (72%), while freelances most often reported finding new clients and delayed payment (17, 50%, for each). Education was a concern for five EMWA members (20%) versus 18 non-members (42%), and finding clients for five members (20%) versus 15 non-members (35%). EMWA members also showed less need for networking opportunities and easier access to potential clients. Time pressure was attributed to clients’ limited awareness of content-production time or difficulty scheduling production phases; training needs were considered easier to address through private providers and EMWA’s expanding programme.
Professional recognition and taxation
ATECO economic-activity codes identify activities in Italy for tax and statistical purposes; the survey reported freelances using at least ten different codes. The reported distribution was:
| ATECO code | Number | Percentage |
|---|---|---|
| 74.90.99 | 10 | 29% |
| 74.30.00 | 4 | 12% |
| 72.11.00 | 3 | 9% |
| 90.03.09 | 3 | 9% |
| 70.22.09 | 2 | 6% |
| 56.45.45 | 1 | 3% |
| 58.11.00 | 1 | 3% |
| 70.21.00 | 1 | 3% |
| 72.19 | 1 | 3% |
| Unspecified | 8 | 24% |
In 2024 there was no uniform identification of the profession in Italy, and a specific ATECO code for medical writing and scientific communication was proposed as a starting point for recognition. Lack of standardisation at sector and taxation levels and low compensation compared with European colleagues were identified as features of the Italian landscape, alongside a need for greater awareness of EMWA training and networking and targeted local development.
A national network
In June 2023, a developing Italian national network sought aspiring and established medical writers, scientific communicators, university researchers, clinicians and scientific journalists living and working in Italy or elsewhere. It planned open discussion in Italian of national and international aspects of the profession, using a local-language initiative to promote medical writing and recognition of its contribution to science. EMWA was helping establish the network.
The first meeting at the Mario Negri Institute on 6 March 2023 attracted more than 50 participants, mostly native Italian speakers; more than 75% had a scientific degree, over a third were self-employed and a third were employed in business, with smaller groups of owners, translators and newcomers. Morning presentations covered medical writing, EMWA membership, professional social media and future challenges; afternoon discussions addressed national and international issues. Participants considered consensus about the profession essential to a national framework and created the private LinkedIn group Professionisti della Comunicazione Scientifica e Medical Writers Italiani. They planned a second meeting alongside the November 2023 virtual conference opening and intended to develop an Italian Local EMWA Group.
By 2024, the LinkedIn group and Italian Local EMWA Group had been established, and members had written a document defining Italian medical writers’ activities. The network addressed a profession in which most Italian practitioners worked in isolation; its first meeting discussed EMWA salary-survey findings highlighting Italian peculiarities. At the November 2023 virtual congress, the local group decided to evaluate the Italian environment and compensation trends.