The Business of Medicine
Private equity in reproductive medicine, increasing healthcare costs in corporate hospital-owned private practice, & lobbying against maternity leave
Private equity in reproductive medicine—a physician practicing in Spain offers his perspective
It doesn’t happen too often that a physician in fertility medicine writes an article about Private Equity’s increasing involvement in the international infertility field. But this is what recently happened when Dr. Andreas Abraham Zadeh, who is the director of EuginMed International in Spain, published a really interesting and quite encompassing article on the subject in Reproductive Biology and Endocrinology, which is making it an increasingly common practice to publish interesting and relevant papers in the fertility field.
What further adds to the interest in this publication is the fact that Eugin Clinics is part of the global Eugin Group, which, in turn, was not too long ago, in 2023, acquired from German hospital chain Fresenius Helios by a consortium led by KKR’s portfolio company IVI RMA and GED Capital and integrated into IVI RMA, which, of course, has a considerable presence in the U.S. market as well. In Spain, the enterprise is, however, absolutely dominant, as IVI and Eugin Group were the number one and two providers in the country before all of these merger activities even took place.
The author’s professional existence right in the center of the largest Private Equity provider of infertility services in the world, therefore, of course, makes one wonder about his objectivity. We, however, must acknowledge that we ended up impressed and, therefore, recommend his article as likely the best recent overall review article on this subject we have read. Nothing is, of course, perfect, but Zadeh is clearly to be congratulated for providing the interested reader with a comprehensive and objective overview of what is “good” and “bad” about the progressively quickening takeover of especially IVF practice by Private Equity.
Private Equity has, of course, by now been a steadily growing subject in these pages. An additional reason for suggesting this article to our readers was, however, the concluding sentence of the article, when Zadeh noted that, and we are quoting, “The trend of concentration with ever larger fertility groups, with its inherent drop in personalized medicine and quality counseling, might eventually lead to a shift back to smaller enterprises with the operational principle of ‘quality over quantity.”
We couldn’t agree more and want to reemphasize that this comes from a colleague at the largest Private Equity-owned chain in the world, with a market value in the billions of U.S. dollars!
Reference
Zadeh AA. Reprod Biol Endocrinol 2025;23:113
Further evidence that incorporating private practices into hospital corporations increases health care costs
It is bad enough that hospitals that purchase private physician practices and only legally incorporate them into their corporate hospital structure without any additional major changes (same physician, etc.) instantly can raise prices because “in hospital practices” can charge facility fees, which physician owners of the same facilities are not allowed to do. Now, a study was reported demonstrating that patients treated by hospital “owned physicians” are far less likely to receive specialty procedures in lower-cost settings, while Private Equity-affiliated doctors are the most likely to steer patients toward these options.1
What the paper moreover, demonstrated was that cost differences between sites of care are mostly again determined by facility fees: As noted, while physician offices cannot bill for facility costs at all, ambulatory surgery centers do charge those, though to much lower degree than outpatient facilities at hospitals, where charges to Medicare were between 24% and 861% higher than at lowest cost sites.
Hospitals are really milking our medical system!
Reference
1. Ambulatory Surgery Center News. August 12, 2025. https://ascnews.com/2025/08/hospital-affiliated-doctors-least-likely-to-use-lower-cost-settings/
UNBELIEVABLE—formula makers are now lobbying against maternity leave!
This subject just came to our attention because of an article in The New York Sun, where a pediatrician was pointing out that “many moms decide to formula feed because returning to work makes breastfeeding difficult. Millions of mothers (therefore) return to work just weeks after giving birth, relying on formula not out of preference but necessity.” 1
Especially in its opinion pages, one cannot always believe what The Lancet publishes, but in regard to this subject, The Lancet already in a three-part series on the subject published in 2023 reported that large infant formula companies use lobbying and other corporate political shenanigans to oppose prolonged maternity leave policies. 2 More specifically, quoting one of this three-part series co-authors and a professor at the Yale School of Public Health, “globally many women who wish to breast feed face barriers, including parental leave.” 3
These companies usually claim that—“as recommended by the medical field”—they promote healthy breastfeeding. Yet, companies like Nestlé, Danone, and Abbott have, against federal marketing regulations, engaged in this subject, and have not hesitated through a network of trade associations and front groups to lobby against breastfeeding protection laws.
Unsurprisingly, the Internet has not reacted very well to this news. Here are a few verbatim postings not demonstrating much love for the industry:
“It’s stuff like this that shows we can’t let Corporate Lobbyists control our government. It took until 2023 for the PUMP Act to be enacted, requiring pumping breast stations, and for employers to provide a private space to do so. I have not-so-fond memories of pumping my BABY’S FOOD in a bathroom stall for some semblance of privacy.”
“I gave birth before the PUMP act and was specifically told by my employer that I should use formula because there would be no way I could breastfeed and work for them. I was a single mom, so really locked into having to go back to work at 4 weeks PP no less. It still grinds my gears over a decade later.”
“I would love to know how they found out that my wife was pregnant. We got mailed a bunch of samples from both Similac and Enfamil before our daughter was born.”
“They also conducted extensive studies to see how much sugar to put in the formula to make it more addictive and preferable to breast milk.”
References
1. The New York Sun. August 30, 2025. https://www.nysun.com/article/big-formula-makers-lobbying-big-against-maternity-leave-marketing-for-products-that-mimic-breast-milk
2. Lancet, 2023;401(10375):409; editorial
3. Yale School of Public Health. February 7, 2023. https://ysph.yale.edu/news-article/experts-call-for-an-end-to-the-exploitative-marketing-used-by-the-baby-formula-milk-industry/