What is driving M&A in healthcare
Reading time
9 minutes
Date
Jul 30, 2026
Author
Murilo Oliveira — Partner, igc Partners
M&A in healthcare is driven by consolidation and the pursuit of scale, efficiency and technical capacity — and happens along two axes that connect to each other. The first is the chain of medical devices and equipment: national manufacturers, importers, distributors, sales representatives, technical support and diagnostic lines. The second is the chain of care services: clinics, laboratories, hospitals and healthtechs.
The two axes start from the same economic logic — diluting fixed costs, expanding coverage, integrating the chain around the patient journey — but what the buyer examines in each is quite different. In a network of clinics, the central question is whether the revenue belongs to the brand or to the doctors. In a medical device manufacturer or distributor, the central question is what happens to registrations, representation agreements and inventory the day after the sale.
It is in the medical device axis that a significant part of the sector's middle-market activity is concentrated, and it is there that igc focuses its sector reading.
Because the segment brings together, at the same time, high fragmentation and a real barrier to entry — the classic combination that sustains long consolidation cycles.
The Brazilian industrial base is made up of a large number of small and mid-sized manufacturers, alongside importers and a broad web of regional and multinational distributors with local production. In this design, scale translates into purchasing power, logistics, commercial coverage and the ability to maintain technical support on the front line. Consolidating channel, portfolio and territory is the thesis that repeats.
Regulation works as a filter. An active registration with Anvisa (Brazil's health surveillance agency), an operating license, risk classification, good manufacturing practices and a post-market surveillance (tecnovigilância) history take time and discipline to build. This makes organic growth more expensive for those who want to grow and values those who already have the house in order: for the strategic buyer, buying a compliant company is buying time.
There is also the market access component. Global manufacturers use acquisitions in Brazil as a gateway to Latin America, taking advantage of the industrial base, registrations already granted and an installed distribution channel — three things that cannot be replicated quickly.
The most active niches tend to be those in which the equipment or the supply has recurring use and a fragmented market: ventilation and intensive care, orthopedics and implants, dentistry, rehabilitation, diagnostics and hospital consumables lines.
On the global stage, the movement appears in the numbers of private capital. According to Bain & Company's annual report on private equity in healthcare, 2025 was a record year in transaction value in the sector, with the medical technology segment gaining relative weight since 2020.
The movement is visible along both axes.
In medical devices, the Brazilian market grew by about 7% in 2025 on the apparent consumption measure — national production plus imports, minus exports —, according to an economic bulletin from ABIIS. Imports totaled US$10.2 billion, up 10.9% over 2024, and the segment's trade balance deficit was US$9.2 billion. On the other side, exports of the Brazilian medical device industry grew 6.8% in the year, according to a survey by ABIMO. The picture is of a sector that grows above the industrial average and depends heavily on imports — which gives economic weight to the distribution channel and explains why distributors and representatives appear so often in transactions.
In services, operations involving hospitals and laboratories totaled 22 transactions between January and September 2025, up about 37% over the same period of 2024, according to a quarterly survey by KPMG echoed by the sector's press, driven by the pursuit of scale, efficiency and digitalization. Analyses of the supplementary (private) health sector point in the same direction, with the segment consolidating and platforms with good governance being increasingly valued.
As always, this is a volume figure — the number of operations —, which reveals recurring appetite for the sector, not price.
The segment's due diligence has an agenda of its own, different from that of a care asset. Seven points appear in practically every transaction:
Regulatory portfolio. Active registrations with Anvisa, operating license, risk classes and post-market surveillance history. A registration in order is a transferable asset; a pending or expired registration is a discount at the table.
Quality and traceability. Quality management system, good manufacturing practices, batch traceability and recall history. Existing documentation is worth more than a well-executed informal process.
Representation and distribution agreements. Exclusivity, term, territory and, above all, the change-of-control clause. A contract that can be terminated precisely because of the sale changes the price conversation.
Concentration of clients and payers. Dependence on a few hospitals, networks, health-plan operators, distributors or on public procurement, and the quality of those contracts.
Working capital, inventory and FX. Import cycle, inventory turnover, currency exposure and collection terms. It is here that much apparent margin comes undone.
Recurring revenue from consumables and services. Installed base, maintenance and supplies tied to the equipment. Real recurrence is what sustains the multiple.
Technical team and regulatory capability. Engineering, regulatory and development — capacity that the buyer does not build quickly and therefore pays to acquire.
At the same time as they pursue scale, buyers have come to assess regulatory compliance, quality and outcome indicators rigorously. Risks on these points weigh directly on value and can, in fact, make a transaction unfeasible.
It applies to both axes, in different forms. In a care service, the examination falls on licenses, accreditations, protocols and clinical indicators. In medical devices, it falls on registrations, traceability, manufacturing compliance and history with the regulator. In both, an asset with good financial performance and regulatory fragility tends to be penalized, while those who keep the house in order come to the table at an advantage.
Some situations repeat in the sector's transactions.
In a medical device manufacturer or distributor, the buyer starts with the regulatory portfolio and the representation agreements: they want to know which registrations are in the company's name, which lines depend on third parties and what a change of control triggers in each contract. Then they go to inventory, FX and client concentration.
In a network of clinics, they examine the dependence on specific doctors: if the revenue follows the professionals and not the brand, the risk of post-sale loss rises. In services that depend on health-plan operators, they assess the concentration of payers and the quality of the contracts.
In a healthtech, they break down the recurrence and the real integration with the clients' workflow, as well as retention and usage metrics.
The company that anticipates these answers leads the conversation instead of reacting to it.
The universe combines three profiles. Global strategics, which buy registrations, an industrial base and a channel in Brazil to access the region. National consolidators, which seek coverage, distribution density, a complementary portfolio and chain integration. And financial buyers, with consolidation theses in fragmented niches and growth through successive acquisitions.
Putting different profiles to compete for the same asset, with a precise sector reading of who is active and what each one is looking for, tends to improve the outcome for the seller, both in price and in terms.
igc works in healthcare with the seller's exclusive mandate, with a sector reading that covers the chain of medical devices and equipment — industry, importation, distribution, representation and technical support — as well as care services, diagnostics and healthtechs. Knowledge of the sector's dynamics, including its regulatory requirements, guides the positioning of each company.
In medical devices, this positioning involves translating what the asset represents for each buyer profile: for the global strategic, access to registrations, an industrial base and a channel; for the national consolidator, coverage and portfolio; for the financial buyer, a platform in a fragmented market.
The combination of sector specialization with access to more than 6,000 buyers in Brazil and abroad is what makes it possible to build real competition for healthcare assets, with the partners conducting each process owner to owner.
Fragmentation of the industry and of distribution, a regulatory requirement that works as a barrier to entry, and the interest of global manufacturers in using Brazil as a regional gateway. Scale in purchasing, logistics, commercial coverage and technical support is the thesis that repeats.
Yes, especially when it adds registrations, territory, a complementary portfolio or technical capability to a larger platform. Compliance in order and stable representation agreements increase interest and perceived value.
Yes. Operations involving hospitals and laboratories totaled 22 transactions between January and September 2025, up about 37% over 2024, according to a market survey. In the medical device axis, the Brazilian market grew by about 7% in the year, according to a bulletin from ABIIS.
It adds layers of analysis, but it rewards those who are compliant. Active registrations, traceability and quality documentation reduce the risk perceived by the buyer and tend to protect value in the negotiation.
Beyond scale and coverage, revenue recurrence, real integration with the healthcare ecosystem and the technical capability of the team all count. Retention and usage metrics are usually examined closely.
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