Healthcare sector poised to buck trend on falling M&A deals

Adamed Pharma’s acquisition of DaviPharm, Bamboo Capital Group’s takeover of Tipharco, and Clermont Group’s presence in Hoan My Hospital are just a few of the mergers and acquisitions (M&A) that have been conducted in Vietnam's health sector.

Notable deals

In April, Poland’s Adamed Pharma announced that it had bought a 100% stake in Dat Vi Phu Pharmaceuticals JSC (DaviPharm). The deal value was not disclosed, but the Polish group's presence at DaviPharm is expected to help the company become one of the largest drug manufacturers and a provider of high-quality drugs at affordable prices in Vietnam, as stated by Dr. Malgorzata Adamkiewicz, head of the company’s supervisory board.

In addition to Davipharm, the pharmaceutical industry in particular and the healthcare industry in general has witnessed many other M&A deals, notably Bamboo Capital Group’s acquisition of Tipharco Pharmaceutical JSC.

On July 5, 2022, the board of directors of Bamboo Capital Group, listed on the Ho Chi Minh Stock Exchange (HOSE) as BCG, approved a resolution for a capital contribution to Tipharco. At that time, Tipharco had a charter capital of VND63 billion ($2.67 million).

At Tipharco's 2022 annual general shareholder meeting, BCG chairman Nguyen Ho Nam was elected chairman of Tipharco for the 2021-2025 term.

According to a report delivered at the meeting, Nam and a group of BCG-related shareholders were holding nearly 90% of Tipharco shares.

Last year, Tipharco recorded a net revenue of VND297.1 billion ($12.63 million), up 46% year-on-year; and an after-tax profit of VND18.2 billion ($773,600) in 2022, 19 times higher than the previous year and the highest since its establishment in 1976.

One of the most famous and earliest M&A deals in the health industry was Ho Chi Minh City-based Hoan My Hospital, one of the first medical facilities in Vietnam to receive foreign capital.

Hoan My Hospital was founded by medical doctor Nguyen Huu Tung in 1997. After intensive investment in six hospitals, the private hospital group was in danger of bankruptcy. In 2009, Tung sought help from investors, including VinaCapital and Duxton Asset Management of Deutsche Bank, which paid $20 million for a 44% stake in Hoan My Medical Joint JSC, the owner of the hospitals.

After two years, the parties fell out. Hoan My was transferred to India’s Fortis Healthcare at a price of $64 million for a 65% stake. Two years later, Fortis Healthcare decided to transfer 65% to Richard Chandler Corp., an investment group based in Singapore, for $80 million.

In the hands of Richard Chandler Corp., Hoan My continued to expand by acquiring and merging hospitals in other provinces and cities.

The company's newly published financial report showed that after recording a profit of VND285.6 billion ($12.1 million) in 2021, Hoan My Medical JSC reported a loss of nearly VND50 billion ($2.12 million) last year.

This result led to its equity decreasing 3.5% to over VND1.39 trillion ($58.8 million) and the bond debt-to-equity ratio increasing from 1.6 times to 1.66 times. By the end of 2022, its total outstanding debt was VND 2,305 billion ($97.7 million).

Door opens for FDI

According to experts, the healthcare market is a special market that requires investors to be knowledgeable and have clear and methodical orientations and strategies. A lot of hospitals, clinics and pharmaceutical companies operate sustainably and have become well-known brands. However, many private hospitals have been offered for sale due to less-than-expected business results.

A CEO of a private hospital in Ho Chi Minh City, who refused to be named, said that he is planning to sell his stake because of losses. “This is the common situation of many private hospitals currently when most patients are hesitant to visit newly established and unfamous hospitals,” he said.

Many well-developed private hospitals and medical brands have been looking for opportunities to expand scale and markets through the acquisition of low-end medical facilities. For example, world-class Ho Chi Minh City-based FV Hospital acquired ACC specialist clinics, and the Hanoi-based Tam Anh General Hospital is seeking established medical facilities to invest in.

“We acquired the ACC chain because it provides chiropractic services that were not available at FV before. The two sides can support each other,” said French doctor Jean-Marcel Guillon, CEO of FV Hospital.

“Another reason is that FV is based in Ho Chi Minh City while ACC has clinics in Hanoi, Danang, and of course Ho Chi Minh City. Following the acquisition, we now have a nationwide foothold," he added.

According to Vietnam Briefing, a website of FDI consultancy Dezan Shira & Associates, although M&A transactions in Vietnam have slowed, with the 2022 transaction value 35% lower than in 2021, the healthcare sector could buck the trend this year.

Vietnam's healthcare market was worth $16.2 billion in 2020, accounting for 6.0% of GDP, said Vietnam Report, a leading local ranking and research company. Total health spending increased from $16.1 billion in 2017 to over $20 billion in 2021. It is projected to reach $23.3 billion in 2025 and $33.8 billion in 2030. Pharmaceutical spending also rose to over $6.6 billion in 2021.

PwC’s 2023 Global M&A Industry Trends Outlook showed that despite facing difficulties, global M&A activity will likely rise in the second half of 2023 as investors and executives look to balance short-term risks with their long-term business transformation strategies.

The outlook finds that M&As, particularly portfolio optimization, remains a tool to help CEOs reposition their businesses, bolster growth and achieve sustained outcomes over the longer term. And health will be one of the sectors with the most vibrant M&A activity.

The need to innovate and transform businesses to achieve growth goals will drive M&A activity in this industry in 2023, PwC said, forecasting that healthcare will be one of the few sectors attracting FDI into Vietnam this year.

Sharing the same opinion, Andy Ho, managing director of VinaCapital, said that the manufacturing of medical equipment and pharmaceuticals, drug distribution, and medical services are becoming attractive to foreign investors.

With a rapidly growing middle class, an aging population, challenges facing the public hospital system, and a growing awareness of the importance of good quality healthcare, opportunities for foreign businesses to invest in this industry in Vietnam are obvious, he said.