Albia IMAP took part in Hospitaltec’s Issue No. 5 with an interview featuring Fernando Cabos, Partner at Albia IMAP, where he shares the key Healthcare M&A insights in Spain: market trends, investor appetite, consolidation dynamics, and the growing weight of cross-border transactions.
In this conversation, Fernando highlights which subsectors are seeing the most activity—hospitals and clinics, MedTech, pharma, biotech and HealthTech—and what is increasingly decisive in healthcare mergers and acquisitions, from regulation and compliance to intellectual property, scalability, and how well a company is prepared to attract the right buyer or investor.
Below, the interview.
“In healthcare, the market is global—and international investors are no longer an ‘extra’, they are a necessary condition”
ALBIA IMAP is a firm specialised in M&A advisory, supporting clients in sell-side processes, acquisitions and investor entry at key strategic moments. As part of an organisation with a presence in more than 50 countries and consistently ranked among the top ten global middle market advisors, the firm combines sector specialisation—with a strong focus on healthcare—and a high level of cross-border activity, which in Spain has ranged between 40% and 60% over the past five years. Its distinctive value proposition, they explain, is built on international reach and a positioning grounded in closeness and trust as core elements to structure solid, sustainable transactions.
The healthcare and biotech sector has remained dynamic even during periods of economic uncertainty. How do you assess the current evolution of healthcare M&A in Spain and worldwide?
M&A activity peaked in 2021 and, since then, the number of transactions has been adjusting. First came the impact of energy and raw-material costs; later, macroeconomic uncertainty and geopolitical tensions led to a contraction in overall M&A volumes.
Neither the healthcare sector nor Spain has been immune to this cycle. However, in this demanding context, the correction in healthcare M&A activity in Spain has been more moderate than across Europe as a whole, positioning Spain as one of the most dynamic geographies even under today’s uncertain conditions.
Looking ahead to 2026, we anticipate an acceleration—and even an intensification—of the M&A rebound that began in Spain in the last quarter of the previous financial year.
The momentum will be driven by financial investors and mid-sized companies, increasingly inclined and accustomed to this type of transaction, in a selective environment that is not particularly favourable for mega-deals.
Selective acquisitions of innovative assets and new products, together with sector consolidation and geographic expansion, will be the main drivers of healthcare M&A.
Which healthcare subsectors are attracting the most interest from buyers and investors?
In terms of activity segments, transactions in Spain have been led by hospitals and clinics, where different groups and financial investors are acquiring hospitals, clinics, specialised centres and care services with the aim of creating large groups that generate economies of scale and expand geographically; and, in highly fragmented subsectors such as ophthalmology clinics, radiology or aesthetics centres—to name a few—carrying out sector consolidation processes.
The next segment by transaction volume is medical devices (MedTech), following strategies focused on acquiring technology, entering new markets or consolidating.
The third is the pharmaceutical sector, which in many cases pursues portfolio diversification (products and/or markets), consolidation of production capacity and the acquisition of high-potential innovative assets.
In this area, we are also seeing strong interest in CDMOs and CROs, following a trend observed for years in other geographies, although the number of deals is still not very high.
“The fourth major focus is consumer health. Dermatology and supplements are undergoing a real transformation.”
Demand is growing strongly in both segments, driven by an ageing population increasingly oriented toward prevention and wellbeing. These sectors are undergoing a genuine transformation: the entry of investors from other industries, strong appetite from financial sponsors and, in addition, a clear convergence between dermatology and supplements, with companies crossing sector boundaries in search of synergies and to differentiate their value propositions. All of this is significantly energising M&A activity.
“From pharma’s perspective, the strategic rationale for entering these two segments is impeccable.”
It means adding profitable products to their channel, with lower regulatory risk and without the long R&D timelines typical of pharmaceuticals, while also bringing a distinctive seal of quality and trust derived from a pharma origin. At the same time, food-sector companies are strengthening their presence in supplements, seeking to capture the preventive wellbeing trend. And financial investors are entering with intensity, building platforms and driving consolidation processes.
Who are the most active buyers in the sector?
Of the 141 transactions recorded in the sector in Spain in 2025, 72 were led by industrial operators and 69 by financial investors. The fact that financial sponsors accounted for nearly 50% of activity highlights the strong interest the sector attracts.
“In parallel, 51% of transactions involving Spanish companies were cross-border.”
This is a true reflection of the global nature of healthcare, where innovation, commercialisation and strategic decision-making transcend borders. In terms of geography, Spanish sector players directed their investments mainly toward Portugal, Germany, the United States and Italy. Meanwhile, the most active investors in Spanish companies came from the United Kingdom, the United States, Sweden and Germany.
What specific challenges do cross-border transactions present in healthcare compared to other sectors?
Beyond the challenges seen in other industries, regulation and compliance are not a detail—they are a structural part of the transaction. And not only due to the target’s local regulations, but also because of the real capacity to adapt products to other regulatory frameworks.
This is compounded by another critical element: intellectual property. In many transactions, one of the greatest attractions is precisely the IP—patents, formulations, brands, know-how… For investors, it is therefore essential to define precisely ownership, scope and the degree of protection.
That said, these are not insurmountable barriers: as noted, in 2025, 51% of M&A activity was cross-border; which implies additional layers of sophistication that increase both the complexity and the demands of such transactions.
In a context of digital transformation, what role does M&A play in innovation and scalability for HealthTech companies and clinical services?
It plays an extremely important role. In 2025, 372 transactions were completed globally in the digital health (Healthcare Technology) sector, which—putting it into context—meant that the value of deals in this segment grew by 15% versus 2024. That said, the figure should be viewed in perspective: 2024 saw a significant adjustment in M&A activity compared to 2023.
Rather than a step back, the 2024 correction represented a market maturation process—identifying where value truly resides in an asset—as has been demonstrated in 2025. Integrated assets with recurring, scalable revenues are the most valued, while highly customised, project-based and hard-to-scale solutions have lost appeal.
“This has moved the market beyond the speculative phase (…) and into a more strategic phase.”
In this phase, software, data and AI platforms have become critical infrastructure for both healthcare systems and sector companies.
The shift in HealthTech M&A is reflected in the fact that 70% of transactions have been led by companies within the sector itself, underscoring the strategic importance of incorporating integrated AI, virtual care and remote monitoring tools and platforms into clinical processes.
Financial investors are also highly active in consolidation processes within highly fragmented verticals such as digital therapeutics or technology applied to mental health.
Spain is seeing the same dynamics: a public healthcare system under strain due to quality challenges and budget pressure, a top-tier clinical and scientific base, and an ecosystem in full expansion in AI applied to diagnostics, clinical trials and hospital management. In this context, the question is no longer what role M&A plays in HealthTech, but whether a company is able to prepare itself to be acquired—or to lead a consolidation project.
What are the keys for a company in the sector to be attractive in an M&A process?
From our experience, the first key to any M&A transaction is a clear strategic reflection: what you want to achieve and why. A company becomes truly attractive when it has defined the project it wants to drive, the purpose behind that project and the resources needed to execute it. Bringing in a partner is not simply about adding capital—it is about accelerating the project: well-defined objectives, clear leadership and identified growth levers.
“And when a sale is considered, the most common mistake is to stay in the past narrative.”
Track record matters, but for a buyer it is only the starting point. What truly determines interest and value is the company’s future potential.
The second key is preparation and the ability to highlight the company’s differentiators. It is not enough to have a good business; you must be able to demonstrate the value drivers and why they are sustainable. This may lie in proprietary technology, a strong clinical position, the product portfolio, customer recurrence, scalability, etc. And, of course, in a sector like healthcare, there can be no weaknesses in compliance, regulation and intellectual property protection.
Having everything in order does not add value, but any grey area in these dimensions can seriously jeopardise a transaction.
The third key is the management team. Their role is crucial to executing any project. Experience, cohesion, motivation and credibility are elements investors assess with particular care. Given the significant regulatory and technological risk, the decision to invest is based to a large extent on the people who must turn the project into results.
The fourth key is process execution. In an M&A transaction, creating competition is essential to maximise value. For that, the company must have access to the best potential buyers regardless of geography. A competitive process designed with international reach not only expands the universe of investors, but also optimises conditions and enables the company to select the most appropriate investor.
Can you share a recent success case where you supported a company in the sector?
We are currently advising on a transaction that reflects very well the kind of work we do. It involves a biotech company operating exclusively in Spain, with truly differentiated and scalable products.
The company’s objective was to bring in an investor to help capture its full potential. During the preparation phase, it became clear that the real value was not only in raising capital, but in activating its main strategic lever beforehand: internationalisation. For that reason, we are structuring licensing agreements in Europe, Asia and the Americas that expand the market before launching the transaction. Entering the process with internationalisation already underway strengthens the project’s attractiveness for investors.
In parallel, we are in conversations with investors—mainly international—who no longer analyse the company as a Spain-focused asset, but as a platform with global runway. The value lies not only in its products, but in the interest of multinationals in licensing them across different geographies, which completely changes the conversation.
“When growth stops being local and becomes international, investor appetite multiplies.”
How has internationalisation impacted healthcare investment?
As mentioned, currently more than 50% of healthcare transactions involving Spanish participation are cross-border. This is a figure that reflects a reality: in healthcare, technology, products and capital operate in a global market. Therefore, approaching a transaction with an exclusively domestic focus would mean giving up part of its potential.
“We’re not only talking about capital; we’re talking about international strategic partners with the ability to scale a company, open markets and accelerate growth.”
That is why our practice is structured with that logic: from day one, we activate foreign corporates and funds because access to this type of investor is not an “extra”—it is a necessary condition to optimise any transaction.
What message would you share with sector executives who are considering starting an M&A process?
There is no perfect moment; what matters is being prepared. Before focusing on the transaction itself, the company should clearly define its strategy, the project it wants to pursue and the right partner. The best deals are planned in advance and, in a global sector like healthcare, access to international investors is key to maximising value and choosing the ideal partner.
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