Medtech sales compensation in the UK is built from three parts: a base salary, commission or variable pay tied to a sales target, and a bonus or accelerator that rewards beating that target. Base pay for a UK medical device rep runs from roughly £28,000 at entry level to £75,000 or more for a senior account manager, and the variable element can add a substantial amount on top at target, depending on the product and the employer.
Those ranges come from my own market observation placing scientific and commercial staff in life sciences, not from a published survey. Treat them as a guide to where an offer should land, and check any figure against live adverts and more than one source before you rely on it.
Why medtech pay plans need a closer read in 2026
Two things have made the headline salary a poorer guide than it used to be. First, the NHS buying landscape is more fragmented. Procurement is increasingly routed through frameworks and integrated care boards, so a rep's territory can look generous on paper while the actual route to a purchasing decision is slow. A plan that assumes quarterly closes in that environment is optimistic.
Second, employers have grown cautious about fixed costs. Many now hold base pay steady and push more of the package into variable pay, which is fine if the plan is fair and punishing if it isn't. A £50,000 base with a £40,000 variable on target reads very differently from a £65,000 base with a £15,000 variable, even though both are advertised as 'up to £90,000' or 'OTE £90,000'.
OTE means on-target earnings: base plus the variable you'd receive if you hit exactly 100 per cent of quota. It isn't a guarantee and it isn't a ceiling. It's the number the whole plan is designed around, and it's the one to compare.
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How the three parts of a package work
Base salary
Base is what you're paid regardless of performance. In medtech it tends to rise with clinical complexity and the seniority of the buyer you're selling to. A rep selling consumables into a ward works at a different level from a specialist supporting surgeons in theatre, and the pay reflects it. Specialists who scrub in and hold product knowledge to a clinical standard command a premium, because the hiring cost of someone who can stand in an operating theatre without disrupting it is high.
Commission and variable pay
Commission is a percentage of the revenue you generate, or a fixed payment per unit or per quota point. Many medtech firms prefer a quota-based variable instead: a target pot is set, and the amount you receive depends on the percentage of quota achieved. Three structures turn up most often.
| Structure | How it pays | Where it fits | Main risk for the rep |
|---|---|---|---|
| Straight commission on revenue | A set percentage of every sale | Distributors, smaller firms, capital equipment | Low or no base cushion in a slow quarter |
| Quota-based variable (target pot) | A fixed pot paid in proportion to quota attainment | Larger manufacturers, consumables and implants | An unrealistic quota makes the pot theoretical |
| Tiered accelerators | Rate rises above 100% of quota, sometimes drops below a threshold | Territories with strong growth potential | Thresholds that pay nothing until 80% or so |
Accelerators are worth reading slowly. A plan that pays 1.5 times the rate above quota rewards a strong year handsomely. A plan with a cliff, paying nothing below 85 per cent attainment, can leave a competent rep with just their base in a territory that was never going to deliver the number.
Bonuses
A bonus is separate from commission. It might be an annual payment tied to company performance, a team target, or a one-off for launching a product or winning a named account. Treat these as lower in certainty than commission. Discretionary bonuses in particular are only as reliable as the finance director's year.
UK benchmarks by level
The table below is my read of where UK offers tend to land in 2026. It is indicative, it is not survey data, and it varies by product area. Orthopaedics, cardiovascular and robotics-assisted surgery pay towards the top of each band. General consumables and diagnostics sit lower.
| Level | Base salary | Variable at target | Typical OTE |
|---|---|---|---|
| Graduate or associate rep | £28,000 to £38,000 | £5,000 to £15,000 | £35,000 to £50,000 |
| Sales representative | £38,000 to £52,000 | £15,000 to £35,000 | £55,000 to £85,000 |
| Senior or specialist rep | £50,000 to £68,000 | £25,000 to £50,000 | £80,000 to £115,000 |
| Key account or regional manager | £65,000 to £85,000 | £30,000 to £60,000 | £100,000 to £140,000 |
Top performers in surgical specialities can exceed these numbers, particularly where a plan has uncapped commission and a strong territory. That's the exception, though. I'd plan around the band, not the outlier you heard about at a conference.
Location matters less than it does in many professions, because territories are defined by hospitals and trusts, not by where you live. A rep covering the East of England from Cambridge and a rep covering the Midlands are paid on the territory's potential, not on a local cost-of-living index. Pay for the area you live in rarely moves the offer. What moves it is the size and maturity of the patch you inherit.
How to judge whether a plan is competitive
Start with the ratio of base to variable. A split of roughly 60:40 or 70:30 is common for established territories. A 50:50 split or heavier can be sound for a growth product with real upside, but it moves risk onto you and deserves more scrutiny.
Then look at the quota, because it matters more than the rate. Ask what share of the current team hit quota last year. A firm with a healthy plan will tell you that most reps land close to or above target. If the honest answer is that a minority reach target, the OTE on the offer letter is a fiction. I'd treat evasion on this question as an answer in itself.
Check how the territory is credited. If a hospital buys through a national contract, or a tender is won centrally, does the revenue still land in your number? Many UK medtech disputes come from this single point. A rep builds a relationship at a trust, and the sale is booked to someone else because the contract was negotiated at framework level.
A short list of things to ask before accepting:
- Is the quota set per territory or as a company-wide average, and when is it reset?
- Is there a cap on commission, and a clawback if a customer returns product or doesn't pay?
- What is the guarantee or draw during the first six months while you build a pipeline?
- Who owns the account if you leave, and does commission continue on in-flight deals?
- How are shared or tender-won accounts credited?
The guarantee is particularly worth pressing. A new rep inheriting an empty or lapsed territory needs time. A guaranteed variable for two quarters is reasonable and common. Without it you're being paid base only while you do the hardest part of the job.
Who this suits, and who it doesn't
Variable-heavy medtech pay suits people who are comfortable with income that moves. If a bad quarter would force you to sell your car, a plan that ties a large part of the package to attainment is a poor fit regardless of how good the OTE sounds. A higher base with a modest variable will serve you better, and you should be willing to trade some upside for it.
It suits people with a scientific or clinical background who can hold a conversation with a consultant surgeon, a theatre manager and a procurement lead in the same week. Those from nursing, biomedical science, perfusion or physiology routes into sales often move quickly, because they already speak the customer's language. Graduates without that background can still get in, usually through associate or trainee programmes, but expect the first year to be about product and compliance training before the commission starts to matter.
It suits people who handle long cycles. A device that needs clinical evaluation, a value analysis committee and a tender can take well over a year to land. If you need quick feedback and quick payouts, a faster-moving field will frustrate you.
Where to check your numbers
No single source gives a clean UK medtech benchmark, so build the picture from several. The Office for National Statistics publishes earnings data that helps you place a base salary against the wider labour market, though it won't break out medical device sales. Live adverts are more useful for variable pay: compare stated OTE across a dozen roles in your product area and note how often a role discloses the split. Be wary of any advert that gives only OTE with no base.
For the regulatory side, which affects what you can promise customers and how your employer structures incentives, the Medicines and Healthcare products Regulatory Agency sets out the UK framework for medical devices. Incentive plans sit inside a compliance culture, and an employer that is sloppy about one is often sloppy about the other.
If you're searching for roles, browse current medtech and life sciences jobs on OHUB and compare the pay disclosed against the bands above. Reading what employers say about what they look for in commercial hires also tells you how seriously a company treats its sales function, which tends to show up later in how fairly it sets quota.
The last point is the one I'd push hardest. Ask to see the plan document before you sign, not a summary of it. A full written compensation plan, with the quota, the crediting rules and the clawback terms, is a normal request. A firm that won't share it before the offer is accepted is telling you something about the year ahead.
