Healthcare and Europe’s mid-market PE, VC: doing good while doing well

This sustained flow of capital is essential as Europe faces ageing populations, rising demand for preventive medicine, and increasing pressure on public budgets, with private investment already accounting for 4.4% of total healthcare expenditure across European countries in 2020.

Evidence shows that private equity ownership can enhance efficiency and quality in certain segments, particularly outpatient care, helping Europe meet growing healthcare needs while improving the patient experience.

Similarly, research on 45 hospital leveraged buyouts in the United States shows that when a private equity firm acquires a hospital, financial performance improves without any deterioration in clinical outcomes. In fact, the study found that patients admitted for heart attacks received better-quality care, evidenced by lower all-cause mortality within 30 days of admission.

Two recent examples from Invest Europe members Forbion and Enterprise Investors reveal that mid-market private equity (MM) and venture capital (VC) form a powerful continuum: VC drives breakthrough science while MM scales essential services where patients need them most. 

Venture capital: rare diseases and biomedical progress

Invest Europe’s report VC at the Heart of Life Sciences shows how dramatically venture capital has scaled Europe’s biotech and healthcare innovation.

VC investment in the sector has more than tripled over the past decade, with €13.5 billion deployed between 2017 and 2021 across 2,634 biotech and healthcare venture-stage companies, representing 23% of all European VC activity.

This surge in financing has helped build a robust industry that is both scientifically dynamic and economically significant: VC-backed European biotech and healthcare companies employed 56,867 people in 2020, marking a 20% increase in just one year.

This growing capacity is also reshaping some of the most challenging areas of medicine, including rare diseases.

Rare diseases affect 300 million people worldwide, with 8,000+ genetic conditions and no approved therapy for over 90%. Once seen as commercially unviable, they are now central to precision medicine thanks to sustained specialist investment.

Forbion has made rare diseases a core strategy. Around 30% of its historical investments target rare or orphan indications, supported by €5 billion AUM and 8+ dedicated rare-disease companies. Former portfolio companies have achieved four FDA-approved gene therapies — HEMGENIX, Zynteglo, Lyfgenia and Skysona.

Forbion’s model blends capital with ecosystem building:

• €2 million– €5 million per company for natural-history and real-world-evidence studies.

• Early patient-community involvement to strengthen trial execution.

• Company creation and spinouts translating academic breakthroughs into viable platforms.

Companies from its portfolio illustrates this breadth: Azafaros (lysosomal disorders), VectorY (CNS gene therapy), Dyne Therapeutics (neuromuscular disorders), Beacon Therapeutics (retinal gene therapy), AIRNA (RNA editing), RyCarma (RyR1-myopathies) and Prilenia (Huntington’s disease and ALS).

The common thread: platform technologies, rigorous clinical strategy, and capital stewardship geared toward high-impact science and long-term value creation. Rare-disease innovation is no longer peripheral. It is becoming a core engine for advances that later scale across broader therapeutic areas.

Mid-market private equity: expanding access to life-saving care

While VC operates at the molecular frontier, Europe’s MM transforms care delivery on the ground.