Vietnam’s healthcare market experienced a slight slowdown in 2024 following a strong year in 2023. While no major M&A transactions occurred, foreign investors continued to show strong interest and confidence in the sector’s growth potential.
ASKA Pharmaceutical Co., Ltd. steadily grew its ownership in Hatay Pharmaceutical Joint Stock Company, approaching 40%. KWE Beteiligungen AG also increased its stake in Bidiphar to more than 10%. Both companies are continuing their efforts to acquire additional shares and expand their ownership.
Despite a quieter year for large-scale acquisitions, Vietnam’s healthcare sector remains an attractive investment destination. The demand for high-quality medical services continues to grow, driven by an expanding middle class and increasing healthcare expenditure. According to the 2024 performance report of the Department of Medical Services Administration, there were 1,645 hospitals nationwide, including 384 private hospitals. The healthcare system handled over 170 million outpatient visits and provided inpatient treatment for more than 17 million patients.
The digital healthcare sector in Vietnam has experienced significant growth, driven by a surge in organisations ranging from ICT services to medical equipment distributors and start-ups, all aimed at improving healthcare services through technological innovations. The Vietnamese market has seen many health-tech start-ups catering to various market segments, including telehealth (such as JioHealth, Med247, and eDoctor), medical insurance compensation support services (such as Insmart and South Asia Services), and online pharmacies (such as Buymed and POC Pharma).
There has also been significant interest in hospital investments in Vietnam from global investment funds. These funds have a longer-term investment horizon where they are working to build a platform of hospital and healthcare facilities. Warburg Pincus, KKR and CVC Capital Partners are recent examples of these strategies.
Recent Regulatory Developments
On 21 November 2024, the National Assembly of Vietnam passed the Law on Amendments and Supplements to the Law on Pharmacy. The amended law will take full effect on 1 July 2025, although certain provisions will come into force at the start of 2025. This legislation introduces several significant changes aimed at enhancing the efficiency and transparency of the pharmaceutical market.
Among the key updates, the amended law officially recognises new business models for the trade of pharmaceuticals, including pharmacy chains and e-commerce platforms. While pharmacy chains already exist in the market, the revised law formally establishes their rights and obligations, notably the ability to transfer drugs and pharmacists between pharmacies within the same chain.
In addition, the amended law explicitly sets out the rights and obligations of foreign-invested pharmaceutical companies, creating a clearer regulatory framework for their operations in Vietnam. In line with the ongoing trend of reducing and simplifying administrative procedures, the amended law eliminates certain document requirements for Drug Registration Certificate applications and permits the continued use of certificates pending renewal. Furthermore, it incorporates international standards by recognising Good Manufacturing Practice (GMP) compliance assessments from trusted regulatory authorities.
New foreign invested start-ups in the healthcare sector typically use a Singapore holding company to establish the Vietnam subsidiary to operate the healthcare business in Vietnam. Singapore has promoted itself as the hub for the Southeast Asia operations. That said, holding companies in Hong Kong, Cyprus, Delaware and Luxembourg also work as the direct parent company of the Vietnam subsidiary.
The incorporation process for a wholly Vietnamese owned company is an easy process with little regulatory hurdles and requires five to ten days. However, incorporating a foreign invested enterprise will require the foreign investor obtaining an investment registration certificate (IRC) which approves the investment project of the foreign investor in Vietnam. The foreign investor must file a range of documents to the local department of planning and investment (DPI) showing corporate authority and financial capability to implement the project which will include a project business plan. Once the IRC is issued, an application is then made by the foreign investor to the DPI to obtain an enterprise registration certificate (ERC) which incorporates the foreign invested entity in Vietnam. Generally obtaining the IRC and ERC should take 6–8 weeks. However, given business in the healthcare sector for a foreign investor has regulatory hurdles, the DPI may consult with the Ministry of Health when assessing the application for IRC which may push the timing to 3–6 months.
100% foreign ownership is permitted in the healthcare sector. However, there are minimum investment capital requirements. A foreign invested hospital requires a minimum investment capital of USD20 million. A foreign invested polyclinic requires a minimum investment capital of USD2 million. A foreign invested speciality health facility requires a minimum investment capital of USD200,000.
A foreign-invested enterprise may use the following corporate forms:
A SMLLC and MMLLC do not issue shares and ownership in the entity is represented by the actual amount of capital contributed. A JSC can issue ordinary and other classes of shares and can potentially list on a Vietnam stock exchange. Entrepreneurs that want to provide an ESOP programme for its employees and consultants would normally incorporate a JSC.
A start-up often raises seed investment through a variety of sources.
In early-stage financing the documentation is often less rigorous given the stage and size of the investment. The authors typically see the financing structured as a convertible loan agreement, share subscription agreement or a SAFE. The shareholder and governance arrangements are set out in the shareholders agreement and this will cover matters such as liquidation preference, next round financing and reserve matters.
There is limited access to capital from local venture capital and government-sponsored funds. This is because establishing a local fund structure requires regulatory approval. The authors see venture capital from local investors being provided through an offshore fund structure rather than onshore.
Foreign venture capital firms are active in the Vietnam market and global venture capital firms have made investments in Vietnam such as Sequoia Capital, Jungle Ventures, IDG Ventures, Y Combinator and SoftBank Vision Fund.
There are no standard venture capital documentation and standards in Vietnam. However, the Singapore Venture Capital and Private Capital Association together with the Singapore Academy of Law have developed Venture Capital Investment Model Agreements that include model term sheets, subscription agreement, convertible notes and shareholders agreement. These have been adopted in some transactions as a starting point for use in Vietnam.
Most start-ups in Vietnam will be established in the form of a joint-stock company and, therefore, there is no need to migrate their corporate forms. However, the authors do see that in VC financing, the VC investor may request that the Vietnam entity and shareholders undertake a re-domiciliation to move the shareholding structure to a Singapore holding company with the Vietnam entity being a subsidiary of the Singapore holding company.
Investors would tend to run a sale process rather than undertake an IPO. This is because there has only been a small number of successful IPOs of start-up businesses with the key one being MobileWorld Group’s listing on the Ho Chi Minh City Stock Exchange in July 2014.
Although a listing on the local stock exchange is not normally a rigorous exercise and lawyers are not typically involved in the listing process, the local stock exchange is less liquid and Vietnam’s stock exchange is still classified as a frontier market. Vietnam’s stock market is expected to be upgraded to a Secondary Emerging Market under FTSE Russell Benchmark, potentially opening access to greater global capital. While the exact timeline for the upgrade is monitored, several key initiatives have been implemented.
An IPO and listing of a Vietnamese company in an offshore securities exchange is challenging. There are Vietnam FDI and foreign ownership regulatory issues. Further, the strict corporate governance, accounting and reporting rules may mean that many Vietnamese companies may automatically not qualify. In addition, for a Vietnamese company to list offshore, that requires approval from the State Securities Commission of Vietnam and there is also a requirement for the Vietnam stock exchange and the offshore stock exchange to have entered into a co-operation agreement.
On that basis a trade sale is a more likely liquidity event for investors in a start-up. The start-up can engage an adviser for the sale process that can involve a competitive bidding process.
Vietnamese companies may find it more straightforward to list on the home country’s stock exchanges like HOSE or HNX due to familiarity with local regulations and reporting standards, and this is a more common practice for Vietnamese companies. In comparison, listing on a foreign exchange or dual listing can provide access to the greater capital market, as discussed, but can be more challenging.
For a Vietnamese company that is already listed on a Vietnam stock exchange to list its shares overseas, it must seek an approval from the State Securities Commission of Vietnam (SSC). Vietnamese companies typically require two to three years to prepare for an overseas listing. This is primarily due to differences between international and Vietnamese accounting standards, as well as the high standards demanded for corporate governance.
In the case of dual listing, Vietnamese companies are required to meet certain obligations pertaining to both Vietnam and the country where their shares are listed. These obligations include, among others, complying with Vietnamese foreign exchange controls and disclosure requirements stipulated by both Vietnamese stock exchange and foreign stock exchange, as well as Vietnamese laws on foreign ownership room for listed companies.
There has been no Vietnamese company that has achieved any dual listing or a listing of a Vietnamese company’s shares on an offshore stock exchange. VinFast is the first Vietnamese operated entity to have its offshore parent listed on a foreign stock exchange. However, while VinFast originated from Vietnam, it used a Singaporean entity to list on NASDAQ.
The authors have discussed the difficulty in listing a Vietnamese company in an offshore jurisdiction. If the company does succeed with an offshore listing, then there will be issues with any squeeze-out from a Vietnamese law perspective. This is because Vietnam’s securities law does not provide for any squeeze-out provisions for minority shareholders. Any acquisition of minority shares will need to be done by consent of the minority shareholder.
A competitive auction or bidding process is typically chosen.
The typical transaction structure is for a sale of a controlling interest with the founder or sponsor retaining 20% of the shareholding which would be subject to an earn-out in three to five years following completion.
The consideration is typically on a cash basis.
Founders are expected to stand behind customary representations and warranties though there are typical limitations of liability on the founders that relate to caps on liabilities (eg, 20–100% of purchase price depending on whether the warranty is fundamental or relates to tax or a general warranty), warranty claim period, double counting or double recovery, consequential loss and other customary limitations.
VC investors, unless they have a reasonable degree of management oversight, do not typically stand behind company warranties other than warranties relating to their ownership of the shares and warranties relating to power and authority and solvency of the VC investors.
A deposit or escrow arrangement are normally negotiated and agreed in healthcare transactions where the regulatory approval process and timeframe to satisfy the conditions precedent would be a lengthy one. The authors would typically see a deposit of 10–15% being paid after the signing of the transaction documents. A retention sum would normally be negotiated if there is a high likelihood that the completion and closing balance sheets would result in an adjustment to the purchase price in favour of the purchaser or if there is a concern about the future tax liability of the company following completion. The retention sum is typically around 5–10% of the purchase price.
Representation and Warranty Insurance are not commonly used in transactions, though the authors have seen an increasing number of PE firms using this insurance product for Vietnam M&A transactions.
Spin-offs or “company separation”, the better Vietnamese terminology, are not customary in Vietnam. This is because new healthcare licences and land title will need to be issued to the new entity following the spin-off which will be a lengthy process in Vietnam of 1–2 years. However, as a majority foreign owned company is not able to distribute pharmaceuticals on a retail/wholesale basis, the drug dispensing arm of a hospital or healthcare facility is normally carved out and restructured.
A company separation is a form of company reorganisation and generally does not give rise to any capital gains tax.
A spin-off immediately followed by a business combination is possible in Vietnam.
The business combination would require a range of regulatory approvals. The local DPI will need to approve the business combination. The Ministry of Health will generally need to provide an opinion on the business combination. Further, the licence of any additional healthcare facilities will need to be obtained from the local department of health. Depending on the size of the transaction an economic concentration notification may need to be filed with the Vietnam Competition Commission (VCC).
The timing for a spin-off is typically around two to three months. No tax ruling is required to be obtained.
There are no restrictions on acquiring shares before making a public tender offer in Vietnam. Investors may buy minority stakes as a “testing the waters” step.
Acquiring 5% or more of a company’s voting shares triggers disclosure obligations. The investor must report to the target company, SSC, and stock exchange within five business days. Similar reporting applies when selling shares that reduces ownership below 5% or by more than 1% (combined with affiliates).
While Vietnamese regulations do not explicitly require stating the acquisition’s purpose or future plans, the tender offer application to the SSC must include details such as funding source, acquisition rationale, and post-acquisition business plans. This indirectly addresses the purpose and plans.
Vietnam has no “put up or shut up” rule. The buyer does not need to make a formal offer or declare future intentions within a specific timeframe.
Vietnam has a mandatory offer threshold for public company acquisitions. An investor and their affiliated entities must make a public tender offer if their combined ownership reaches certain thresholds of the target company’s voting shares:
of the total voting shares.
The mandatory tender offer may be exempted if the acquisition is approved by the General Meeting of Shareholders of the target company.
In Vietnam, acquisitions of public companies are typically in form of share acquisition.
Asset acquisition is not common due to limitations. Certain assets, like land-use rights, might not be freely transferable or require specific approvals. Foreign investors may need to establish a new Vietnamese company to acquire the target’s assets.
Mergers are not as frequently used for public company acquisitions in Vietnam compared to share acquisitions, due to the following.
So, while mergers are technically possible, the relative ease and efficiency of share acquisitions generally make them the preferred option for public company takeovers in Vietnam.
Public company acquisitions in Vietnam’s healthcare industry can be financed with either cash or shares. Cash remains the preferred method due to its simplicity and clarity for sellers. Stock-for-stock deals are less frequent, especially considering potential stock price volatility.
Vietnam implements a minimum price requirement specifically for cash tender offers. The offer price must not be lower than:
The investor cannot decrease the offer price during the tender offer period. However, increasing the offer price is allowed. Any price increase must be:
Contingent value rights (CVRs) are not yet a common tool in Vietnamese M&A. However, alternative mechanisms like earn-outs may be considered to bridge valuation gaps, especially in deals with high growth potential or significant regulatory uncertainties.
While takeover offers in Vietnam tend to be less conditional compared to some other jurisdictions, there are specific requirements that a tender offer must satisfy the following.
Beyond the specific conditions, the overall emphasis in Vietnam’s takeover offer process is on the following.
The Vietnamese takeover process emphasises transparency and shareholder decision-making, with less focus on pre-offer agreements and extensive representations and warranties from the target company.
Transaction Agreements in Vietnamese Takeovers
Unlike some other jurisdictions, Vietnam’s takeover framework does not typically involve formal transaction agreements between the bidder and target company before a public tender offer.
The primary legal document governing the acquisition is the tender offer document itself. This document outlines the offer terms, conditions, and procedures for shareholder participation.
Target Company Involvement
While a formal agreement is not customary, the target company might be of assistance in the following aspects during the tender process.
Board Recommendation
The target company’s board typically issues a recommendation to shareholders regarding the offer. However, this recommendation is not a formal agreement binding the company.
Representations and Warranties
Public companies in Vietnam are less likely to provide extensive representations and warranties compared to some other legal systems.
The board of directors of the target company must act in the best interests of the company and its shareholders. Providing extensive warranties could potentially conflict with this fiduciary duty.
The tender offer can include a minimum threshold of shares the investor seeks to acquire. This threshold is determined by the investor’s specific objectives, such as:
Vietnam’s Law on Securities does not include a “squeeze-out” provision forcing remaining shareholders to sell after a tender offer. However, there is a mandatory buyback requirement if the investor successfully acquires more than 80% of the target company’s shares through the tender offer. In this scenario, the investor must offer to purchase any remaining shares from willing sellers at the same price terms as the original tender offer. This allows remaining shareholders a chance to exit but does not compel them to sell.
To launch a public tender offer in Vietnam, investors must prove they have sufficient funds. This is achieved by securing one of the following.
The investor must submit this financial evidence (payment guarantee or escrow certificate) to the SSC before the SSC confirms receipt of a complete tender offer dossier.
In Vietnam, the legal framework for public tender offers is still developing, and deal protection measures commonly used in other jurisdictions are not as prevalent.
While failing to acquire 100% ownership of a target company limits control, Vietnamese law still offers some rights to significant minority shareholders (holding 10% or more of voting shares, or a lower threshold specified in the company’s charter).
Negotiating irrevocable commitments is uncommon in Vietnam, but not entirely absent. The enforceability of such agreements might be uncertain. In particular, the following should be considered.
Launching a public tender offer in Vietnam involves a multi-step process with specific deadlines for both the investor and the target company.
Each sector of healthcare in Vietnam has distinct regulations. Understanding these is crucial for successful entry into the market. Among those sectors, attractive ones for foreign investors include: (i) healthcare services (hospitals, clinics and diagnostics); (ii) medical equipment; and (iii) pharmaceuticals.
Regulatory Landscape
The Ministry of Health (MOH) sets national healthcare policies and oversees technical guidelines. Local authorities manage health activities within their provinces. Key regulatory bodies include:
Regulations by Sector
1. Healthcare Services:
2. Medical equipment:
3. Pharmaceuticals:
The SSC is the primary regulator for mergers and acquisitions (M&A) involving listed companies in Vietnam. Operating under the Ministry of Finance (MOF), the SSC plays a crucial role in the following.
Vietnam’s healthcare industry welcomes foreign investment, governed by national investment laws and international treaties like WTO agreements and Free Trade Agreements (FTAs) with various partners. The specific conditions for foreign investors depend on the treaty they rely on.
Open Sectors
Healthcare and medical equipment – foreign investors generally face no limitations in establishing wholly foreign-owned companies, joint ventures, or business co-operation contracts for hospitals, medical and dental services, and medical equipment businesses.
Restricted Sector
Pharmaceuticals – foreign investors are currently prohibited from distributing pharmaceuticals in Vietnam. However, they can invest in pharmaceutical manufacturing and other aspects of the industry.
Navigating Investment Treaties
A country can belong to multiple international agreements with similar coverage. Therefore, foreign investors should choose the FTA that offers the most favourable conditions for their specific investment in Vietnam.
Capital Requirements and Treaty Benefits
Vietnam’s WTO commitments set minimum investment capital requirements for foreign hospitals, clinics, and specialty establishments. See 2.1 Establishing a New Company.
However, some FTAs, like the EU–Vietnam Free Trade Agreement (EVFTA), eliminate these capital requirements for member states, providing them with a competitive advantage.
Licences and Procedures
See 2.1 Establishing a New Company.
National Security Reviews
Investor Restrictions Based on Nationality
Vietnam promotes foreign investment and generally does not have blanket restrictions based solely on investor nationality.
Foreign investors can leverage Free Trade Agreements (FTAs) with Vietnam for potentially more favourable conditions compared to WTO terms.
Export Control Regulations
Vietnam has export control regulations, which aim to control the export of goods, technologies, and services that could have potential military or security applications.
The Ministry of Industry and Trade (MOIT) is the primary authority responsible for export controls. Exporters are responsible for classifying their goods and obtaining any necessary licences before export.
The specific list of controlled goods is subject to change but can include items like weapons, ammunition, encryption software, and certain chemicals.
Vietnam’s Merger Control Process
Vietnam’s MOIT oversees merger control through VCC. A filing with the VCC is mandatory if a transaction involves a significant concentration of economic power in Vietnam, regardless of whether it is domestic or cross-border.
Economic concentration may be in form of (i) mergers; (ii) consolidations; (iii) acquisitions of shares or assets; or (iv) joint ventures.
When Is a Filing Required?
Filing is triggered if the transaction meets one of the following thresholds, with different thresholds applying to banking, insurance, and securities sectors.
Filing Process
The VCC conducts a two-step assessment.
Silent approval – if the VCC does not issue a preliminary conclusion within 30 days of the initial filing, the transaction can proceed.
Employee Rights and Liabilities
Acquirers in Vietnamese M&A transactions should be aware of key labour law regulations concerning the following.
Work Councils and Consultation
Vietnam does not mandate works councils. However, existing trade unions in the target company can play a role in employee representation and consultation during M&A, though their influence is limited.
Consulting with employee representatives or the trade union during the M&A process, especially if it involves workforce changes, is recommended for transparency and mitigating potential disputes.
Trade union opinions are not legally binding on the board of directors, who have ultimate decision-making authority.
Employee Transfer
The approach to employee transfers depends on the M&A transaction structure.
Asset transfer transactions
Employee transfers do not automatically occur with the asset transfer. Specific procedures will apply in the following instances.
Vietnam does have currency control regulations, but they generally do not require central bank approval for the entire M&A transaction itself.
Currency Control Regulations
Vietnam maintains some restrictions on foreign exchange transactions. These are overseen by the State Bank of Vietnam (SBV).
Foreign investors involved in M&A deals need to ensure they comply with these regulations when dealing with foreign currency. This will include using authorised channels for foreign currency exchange (including using the right specialised bank account for the payment of purchase price).
Central Bank Approval (Limited Cases)
In most M&A transactions, central bank approval for the overall deal is not required. However, there might be specific situations where SBV approval is necessary, such as acquisition of a bank or financial institution: The SBV regulates the banking and financial sector, and acquiring such an entity might require their approval.
There have not been any major court decisions reported publicly in the past three years that specifically deal with healthcare M&A transactions in Vietnam. Legal developments in this area tend to be through legislative changes or policy pronouncements, rather than court rulings.
Vietnam Streamlines Foreign Investment in Healthcare M&A
The revised Law on Investment, effective January 2021, simplifies foreign investment in Vietnamese M&A transactions, particularly within the healthcare sector. Here is how.
Shift from conditional access
Previously, foreign investors faced specific conditions for entering conditionally open business lines in healthcare. These conditions were defined in a complex web of laws, decrees, and treaties.
Clearer path forward
The revised law introduces a streamlined approach. It establishes a definitive list of restricted sectors, while all others allow foreign investors on equal footing with domestic players. This transparency and consistency make the investment process more efficient and predictable.
Healthcare sector benefits
Emerging fields like digital healthcare and telehealth, previously not explicitly open to foreign investment, can now potentially attract international capital. This is also a trend reiterated in the new Law on Medical Examination and Treatment 2023. This paves the way for the following.
Overall, the revised Law on Investment offers a more welcoming environment for foreign investors in the Vietnamese healthcare M&A landscape, potentially accelerating innovation and growth in the sector.
Board’s Authority and Insider Trading
The board of directors of the target public company ultimately decides the following.
Balancing Transparency and Confidentiality
The board must balance transparency for bidders with the need to protect confidential information. This might involve:
Board Fiduciary Duty and Insider Trading Rules
Board members have a fiduciary duty to act in the best interests of the company and its shareholders. This includes the following.
Fairness and Transparency for Bidders
Public companies have a legal obligation to treat all bidders fairly and transparently throughout the M&A process. This includes the following.
Level of Healthcare Due Diligence
The board’s decision on the acceptable level of healthcare due diligence should consider the following.
The scope of due diligence might encompass the following aspects.
Public Offer Requirements and Information Disclosure
When making a public offer to acquire a public company, Vietnamese regulations require the following.
Therefore, the board will generally provide the same information to all qualified bidders to comply with these regulations and ensure a fair bidding process.
Data Protection Regulations
Vietnam’s regulations on personal data protection (in Decree 13/2023 and the Law on Medication Examination and Treatment 2023) govern data privacy and applies to the due diligence process in healthcare M&A transactions. Those regulations protect personal data, including sensitive information like patient health data.
Challenges for Due Diligence
The data privacy regulations generally require consent from the data subject (patient) before disclosing their personal data. Obtaining individual patient consent for all data involved in due diligence can be impractical.
Alternative approaches for data sharing
Cross-Border Data Transfer Considerations
If the acquirer is a foreign entity, transferring Vietnamese citizen data requires additional steps.
Current Gap for Non-Vietnamese Citizens’ Data
There are currently no specific requirements for cross-border transfers of personal data for non-Vietnamese citizens residing in Vietnam. However, this is an evolving area, and regulations might change in the future.
See 6.2 Mandatory Offer and 6.13 Securities Regulator’s or Stock Exchange Process.
With respect to a stock-for-stock public tender offer, the offering party must submit a prospectus to the SSC, which needs to detail two key aspects.
Listing requirement for foreign acquirers – for foreign offering parties involved in a stock-for-stock public tender offer with a Vietnamese target company, an additional step is required. Upon completion of the offer, the foreign acquirer’s shares must be listed or registered for trading on a Vietnamese securities trading system.
The requirement for including financial statements in a public tender offer application depends on the type of offer.
Cash-Based Public Tender Offer
While not always mandatory, the SSC might request the foreign offering party’s financial statements during their review of the tender offer application. This helps them assess the financial capacity of the acquirer to complete the cash purchase.
Stock-for-Stock Public Tender Offer
Since stock-for-stock tender offer are considered public offers in Vietnam, the foreign offering party must register the offer and provide financial statements.
Financial statement requirements
While the SSC does not require submitting the entire transaction agreement for a public tender offer, the application itself needs to disclose specific key terms and conditions, including the following.
By disclosing these essential details in the tender offer application, the SSC and target company shareholders have a clear understanding of the offer’s terms.
The Law on Enterprises outlines the core fiduciary duties of directors in Vietnam. These duties emphasise acting in the best interests of the company and its shareholders. In a business combination, this may translate to directors making decisions that maximise shareholder value, ensure the long-term sustainability of the company, and comply with all applicable laws and regulations.
Directors have a duty to provide full and fair disclosure of all material information concerning the business combination to the company’s shareholders. This information should allow shareholders to make informed decisions regarding the proposed transaction.
Directors must avoid conflicts of interest. They should not engage in any personal activities that could potentially harm the company or its shareholders. This is particularly important during business combinations where directors might have personal incentives that could influence their decisions.
It is not as common in Vietnam for boards of directors to establish special or ad hoc committees for business combinations. However, their use may be useful in larger or complex transactions. Here is a breakdown of the reasons for and against using special committees, as well as the role of conflicts of interest.
Reasons for Using Special Committees
Reasons Why Special Committees Might Not Be Used As Often
Once the board receives a tender offer application from the bidder(s), Vietnamese regulations require them to disclose this information to the company’s shareholders within ten days. This disclosure should be accompanied by a written assessment and recommendation from the board itself.
The board’s assessment and recommendation typically focus on two key aspects.
In situations where the tender offer is considered “friendly” (meaning it is supported by the board), the offering entity or individual will typically engage in direct negotiations with the board. This allows for a more collaborative process and can help ensure the terms of the offer are mutually beneficial.
In Vietnamese business combinations and takeovers, directors typically rely on several forms of independent outside advice to make informed decisions. Here is a breakdown of the most common types.
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minh@asia-counsel.com www.asia-counsel.comThe Healthcare Market in Vietnam
Demand
Vietnam has a population of more than 100 million people and is currently classified by the World Bank as a lower-middle-income country. Vietnam’s population growth rate has steadily fallen during the last 60 years, from 3.9% in 1960 to 1.14% in 2019 and 1.03% in 2023. This population growth rate is expected to continue to decline during the foreseeable future. The natural consequence of this decline in population growth rate is an ageing population.
Vietnam aims to be elevated to upper-middle-income country status by 2030 and to high-income country status by 2045. According to the former Ministry of Labour, Invalids, and Social Affairs of Vietnam (now the Ministry of Home Affairs), a middle class (defined on the basis of per-capita spending from USD11 to USD110 per day) is forming rapidly in the large cities of Vietnam and accounts for approximately 13% of the total population (with this percentage expected to increase to 26% by 2026). By 2030, Vietnam is projected to have an increase of 23.3 million people entering the middle class, making it the third-ranked country in ASEAN for the highest growth in middle-class population.
The number of foreign citizens living and working in Vietnam is also steadily increasing. As of March 2024, the approximate number of foreign citizens living and working in Vietnam was 139,824 – a significant increase as compared with the estimated number of 101,550 at the end of 2021.
Ageing population, rapidly expanding middle class, and increasing numbers of foreign workers are all factors which exert strong and positive influence on the growth of demand for quality healthcare services in Vietnam.
In addition, many Vietnamese people’s overall levels of health awareness have increased significantly as a result of the COVID-19 pandemic and its aftermath. This factor, combined with overcrowding within the public hospital system in Vietnam, have resulted in higher demand for general medical and long-term care services in Vietnam.
Healthcare market and state expenditure
Vietnam’s healthcare system consists of both public and private healthcare providers, overseen from a regulatory perspective by the Ministry of Health (the MOH).
Previously, public hospitals in Vietnam were categorised into four levels: central, provincial, district, and community. This classification was based on their association with different levels of the governmental hierarchy. However, starting from 1 July 2024, public hospitals have been classified into four new levels: Special Level, Level I, Level II, and Level III. This new classification is determined by evaluating criteria related to the scale and scope of activities, human resources, and professional capacity, as well as infrastructure and equipment.
Public hospitals currently play fundamentally important roles in the provision of healthcare services to people in Vietnam. For example, many Vietnamese people will present themselves at a public hospital in order to procure first-instance care – as opposed to the situation in many more developed countries, where people will in most cases consult with a private general practitioner at the local clinic before considering attendance at a hospital.
As of October 2024, there were 1,773 registered hospitals in Vietnam, of which the number of private hospitals was 384, accounting for 23.3%. The majority of these hospitals are located in major urban areas such as Ho Chi Minh City, Hanoi and Danang.
In relation to healthcare expenditure in Vietnam, total expenditure appears to be divided between public and private expenditure in almost equal proportions. As of December 2023, private sector expenditure accounted for approximately 49.5% of total healthcare expenditure in Vietnam, although only approximately 6% of the total number of hospital beds in Vietnam were provided by private operators. The Vietnamese government has stated in its key national healthcare network plans an intention to increase the proportion of private hospital beds (as compared with public hospital beds) up to 15% by 2030 and up to 25% by 2050.
Increasing demand for healthcare services has also driven significant increases in Vietnam’s national healthcare spending. According to the British Chamber of Commerce in Vietnam, Vietnam’s public healthcare spending has increased steadily and significantly during recent years. For example, per-capita public expenditure on healthcare services increased from USD149 per capita per year in 2017 to USD164.90 per capita per year in 2022 – representing approximately a 2.5% increase per year. Projections through to 2032 anticipate that public healthcare spending will likely continue to increase at approximately 2.3% per year.
Regulation
Investment in the healthcare sector in Vietnam is regulated by two main bodies of legislation, namely:
Investment laws
The laws which primarily regulate investment activities and the operation of enterprises in Vietnam are the Law on Investment (2020) and the Law on Enterprises (2020) – together with their various respective implementing legislation – among others.
Under these key investment and related laws, there is no foreign ownership cap or other market access barriers which apply to foreign investors, in relation to the development, ownership, or operation of hospitals, except for certain requirements for minimum investment capital in relation to investment projects in the hospital sector. Nor are there any foreign ownership restrictions or market access barriers which apply in relation to the development, ownership, or operation of healthcare clinics.
On the other hand, whilst there are no foreign ownership restrictions or other market access barriers in relation to the manufacture of pharmaceutical products in Vietnam, foreign ownership in the pharmaceutical distribution sector is completely prohibited. Thus, although wholly or partly foreign owned companies may manufacture pharmaceutical products in Vietnam and/or import finished pharmaceutical products and/or manufacturing ingredients into Vietnam, only companies which are wholly owned by domestic investors may engage in wholesale or retail distribution of pharmaceutical products in Vietnam.
The private healthcare sector is eligible for investment incentives under the Law on Investment (2020). Eligible investors have the potential to enjoy a range of investment incentives, including the application of a lower corporate income tax rate, exemption from or reduction of import duties on certain types of imported goods, and/or exemption from or reduction of land use fees.
Healthcare laws
The provision of healthcare services in Vietnam is primarily governed by the Law on Medical Examination and Treatment (2023) (the “Medical Law”) and its implementing legislation. The current Medical Law was adopted by the National Assembly of Vietnam in 2023. Decree No 96/2023/NĐ-CP dated 30 December 2023 has been issued under the Medical Law and provides general guidance as to its implementation.
All private healthcare facilities in Vietnam are required to obtain an operational licence from the MOH or the relevant provincial or municipal Department of Health (the DOH), depending on the scale and scope of their operations. Medical practitioners must also obtain specific licences in order to be able lawfully to practise medicine in Vietnam.
In terms of pharmaceutical products, the Law on Pharmacy (2016), as amended, is the key regulating law, together with its implementing legislation.
Recent Regulatory Developments
Amendments to the Law on Pharmacy
On 21 November 2024, the National Assembly of Vietnam adopted a law amending and supplementing the Law on Pharmacy (2016) (the “Law on Pharmacy Amendment”). The Law on Pharmacy Amendment aims to address practical requirements within the pharmaceutical sector, attract foreign investment into the pharmaceutical sector, and enhance domestic pharmaceutical production and distribution. The Law on Pharmacy Amendment will take effect from 1 July 2025.
Significant changes arising from the Law on Pharmacy Amendment will include the following.
Healthcare Investment Trends
Attracting private investment in healthcare infrastructure
The Vietnamese government actively encourages private sector participation in the healthcare sector. The Medical Law contemplates private investment being encouraged in the following areas:
Further specific legislation in relation to PPP investment in the healthcare sector is being formulated.
Establishment of pharmaceutical industrial parks
In Vietnam, industrial parks are generally concerned with the manufacture or production of industrial products and attract various types of investment and business incentives, including favourable tax treatment. As outlined in Decision No 376/QD-TTg dated 17 March 2021 of the Prime Minister, which approves a programme for development of the pharmaceutical industry and domestically produced pharmaceutical materials in Vietnam through to 2030 with a vision to 2045, plans have been formulated to allocate land for the establishment of pharmaceutical industrial parks. The aim of these special-purpose industrial parks would be to attract both domestic and foreign investors to manufacture patented pharmaceutical products, specialised medications, generic pharmaceutical products with advanced dosage forms, vaccines, and medical-biological products, to meet both domestic and export demands.
In alignment with this vision, the Ministry of Health (MOH) has recently collaborated with the municipal and provincial authorities of Ho Chi Minh City and Thai Binh province to establish pharmaceutical industrial parks in these regions. Ho Chi Minh City has designated Le Minh Xuan 2 Industrial Park (located in Binh Chanh district) for the development of a specialised medical and pharmaceutical industrial park spanning 338 hectares. Once operational, this industrial park aims to attract investment in high-tech pharmaceutical and medical fields, including biotechnology, specialty drugs, cancer treatments, plasma-derived products, and the application of nanotechnology in drug formulation. It will also serve as a hub for the production and trade of specialised medical and pharmaceutical products, particularly in the high-tech segment. This industrial park is projected to become fully operational by 2031. Simultaneously, the procedures for implementing the pharmaceutical-biotechnology industrial park project in Thai Binh province are being expedited by relevant state authorities. This planned industrial park covers an area of over 292 hectares, with an estimated infrastructure investment of approximately VND3,800 billion (approximately USD152 million). This industrial park is expected to attract around USD2 billion in investment, including USD800 million during the 2024–2027 phase and USD1.2 billion during the 2028–2030 phase.
M&A in relation to hospitals and medical facilities
The M&A market for hospitals and medical facilities in Vietnam saw lower volumes of activity during 2024, as compared with previous years. Notable deals during 2024 included the strategic partnership between FPT Long Chau and IHH Healthcare Singapore, and Warburg Pincus’s announcement of its investment in the Xuyen A hospital system. M&A activity in the healthcare sector is expected to increase in 2025 – although it remains to be seen as to what impact the recent US tariffs imposed upon Vietnam will have in relation to the Vietnam M&A market generally, including with respect to key industry sectors such as healthcare. This anticipated growth is driven by the increasing demand for high-quality healthcare services and the expanding middle class. Private hospitals and specialised medical facilities, particularly in ophthalmology and oncology, are expected to be the focal points of M&A activities.
From a legal perspective, Vietnam’s healthcare sector continues to welcome foreign investment, aligning with the country’s commitments under its accession commitments to the WTO. Foreign investors have various options available to them for participation in the healthcare sector in Vietnam, including establishment of wholly foreign-owned hospitals or clinics, formation of joint ventures with Vietnamese partners, or entry into business co-operation contracts with local partners. The minimum investment capital required varies, depending upon the nature of an investment project in the healthcare sector, for example, USD20 million for hospitals, USD2 million for general clinics (polyclinics), and USD200,000 for specialised treatment facilities. These investment opportunities reflect Vietnam’s commitment to fostering collaboration and innovation in healthcare delivery while facilitating international partnerships to enhance the sector’s development and accessibility.
Medtech start-ups
Resolution 20-NQ/TW dated 25 October 2017 of the Communist Party of Vietnam on innovation, development, and enhancing collective economic efficiency, provides that medtech development is a key priority in Vietnam. This resolution underscores the importance of leveraging technology across various healthcare domains, spanning hospital management, health insurance assessment, electronic medical records, and remote diagnosis, testing, examination, and treatment. The market is proving this viewpoint to be accurate.
According to Statista data, Vietnam’s digital health market is poised for substantial revenue growth, with projections indicating a rise to reach USD1.07 billion by the end of 2025. Furthermore, a steady annual growth rate of 8.39% (CAGR 2025–2029) is anticipated, leading to a projected market volume of USD1.48 billion by 2029. Key technology areas targeted for development in Vietnam include electronic health records, telemedicine, artificial intelligence for disease diagnosis, and smart wearable devices for health monitoring.
Some noteworthy investment deals in the medtech start-up space include Mekong Capital’s USD21 million investment in Gene Solutions as part of its Series B round and BuyMed’s receipt of USD33.5 million from UOB Venture Management and other investors. NVIDIA, a world-leading technology corporation, has also completed its acquisition of VinBrain Joint Stock Company, a medtech start-up renowned for its innovative AI-driven healthcare solutions. These investments underscore the growing confidence in Vietnam’s medtech sector and its potential for innovation and growth.
While Vietnam lacks a clear legal framework specifically tailored to regulate medtech business, start-ups in this sector can navigate lawful business models within existing regulatory frameworks related to health, information technology, and personal data protection. Importantly, the Vietnamese government offers numerous incentives to support start-ups in science and technology, including tax breaks, financial assistance, and credit support. Medtech start-ups are well-positioned to capitalise on these incentives.
Outlook
Jurisdiction-specific factors such as changing demographics, deterioration of existing resources, increasing sophistication of patients, increases in chronic diseases and conditions, and the rapid development and adoption of technology, are expected to continue to drive strong market demand and M&A activity in the healthcare sector in Vietnam for the foreseeable future, despite the geopolitical headwinds which are being faced by Vietnam as well as by many other countries worldwide as a result of recent tariff imposition actions by the US government.
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