In the space of fifteen years, the private medicine sector has been the subject of an unprecedented movement of concentration. In 1980, France had more than 4,000 city medical biology laboratory companies, compared to less than 400 in 2021. In the meantime, large private groups, backed by investment funds, have bought their laboratories from doctors biologists and merged the structures. Six groups held 61% of city medical biology in 2021: Unilabs, Biogroup, Cerba Healthcare, Inovie, Synlab, Eurofins. From now on, they would have “more than two thirds”according to the estimate of the director general of the National Health Insurance Fund, Thomas Fatôme, in July 2023.
How did we get there ? “We broke the independents, we put pressure on them on prices, with at the same time very heavy quality standards to respectaccuses Lionel Barrand, liberal biologist and president of the national union Medical Biologists. Many were afraid and preferred to sell rather than risk bankruptcy, taking advantage of the large checks offered to buy them back. The State has thrown biology into the arms of investors. »
Until the end of the 1980s, medical biology practices were in fact owned by biologists who owned their work tools, who managed small teams. The business was very profitable, driven by strong demand and productivity gains boosted by the increasing automation of analysis techniques.
From the 1990s, the public authorities, seeking to reduce expenses through economies of scale, encouraged the profession to regroup to form larger entities, operating up to five laboratories. To facilitate financing, the law authorizes external investors, non-biologists, to acquire up to 25% of the capital of the companies thus formed: professional companies. The majority must be held by biologists practicing there.
Financial juggernauts
If the groupings remained modest the following decade, the model changed for good in 2001, thanks to a legal breach into which investment funds rushed. The Murcef law of 2001 authorizes larger groupings, allowing biologists who do not work in the private practice society to be in the majority. Financial funds will then use the possibilities offered by European law to take majority stakes in French firms by foreign biology companies. Thus constituting very large chains of laboratories.
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