Press Release 06/2025

July 17, 2025

 

The transaction

The Portuguese Competition Authority (AdC) has opened an in-depth investigation into the acquisition by CUF – Sociedade Gestora de Participações, S.A. of sole control over Hospital Particular do Algarve, S.A.

The AdC has decided to proceed with an in-depth investigation on the basis that, in light of the information gathered to date, it cannot be ruled out that the notified concentration may result in significant impediments to effective competition in the national market or a substantial part of it, to the detriment of consumers.

The acquiring company, CUF, is part of the CUF, S.A. group, which comprises several undertakings primarily active in the provision of healthcare services, operating 12 hospitals and 17 clinics.

The target, HPA, is the holding company of the HPA Group, a private hospital group with hospital and clinic facilities located in the Algarve, the Alentejo region and the Autonomous Region of Madeira.

Entities within the HPA Group operate a network-based healthcare model, providing services across a range of medical specialities, as well as ancillary services such as diagnostic testing and pathology. The target also provides dental services under the “Dental HPA” brand, which are integrated within the broader HPA Group network.

 

Competition concerns

Following the investigatory steps undertaken to date, the AdC has reached the preliminary view that the concentration under review may give rise to significant impediments to effective competition in the private hospital healthcare services market.

According to the evidence gathered, the private hospital healthcare sector has experienced a significant increase in demand in recent years, driven in part by the expansion of coverage offered by health insurance and complementary health subsystems.

Concurrently, the sector has undergone a process of consolidation which, according to most market participants consulted, has been accompanied by a deterioration in commercial conditions. The sector is also characterised by high barriers to entry.

The concentration in question involves the acquisition, by the largest private healthcare provider operating in Portugal, of one of the leading regional providers, whose activities are concentrated in geographic areas where CUF currently has no presence.

Given the national significance of CUF and the regional importance of the HPA Group, the AdC considers that it cannot be excluded, at this stage of the proceedings, that the concentration may result in a significant strengthening of the Parties’ bargaining power vis-à-vis health insurers and complementary health subsystems.

Such an increase in bargaining power may lead to less favourable commercial terms for these entities, with potential negative spillover effects throughout the value chain, including increased costs for end-users.

Furthermore, the AdC has identified competition law concerns relating to a potential elimination of future (potential) competition.

 

The decision

By its nature, this decision does not constitute a final decision on the case.

The AdC opens an in-depth investigation into a concentration when it deems further investigatory steps to be necessary in order to fully assess the potential impact of the transaction on competition.

Under the Portuguese Competition Law, following the in-depth investigation, the AdC may decide to:

Clear the transaction (unconditionally or subject to remedies), if it concludes that the notified concentration, as originally submitted or following commitments proposed by CUF, is not likely to give rise to significant impediments to effective competition in the relevant market; or

Prohibit the transaction, if it finds that the concentration is likely to result in significant impediments to effective competition in the relevant market, to the detriment of intermediate and/or final users, who represent the demand side of that market.