Economic Observer reporter Zhang Ling

On June 10th, Aier Ophthalmology (300015. SZ) announced plans to invest 700 million yuan to acquire control of the Brazilian Ophthalmic Medical Services Group through its wholly-owned overseas subsidiary AIER Brazil.

This is another important milestone in the global layout of Aier Ophthalmology.

After the transaction is completed, Aier Ophthalmology will add 81 ophthalmology centers, bringing its total number of overseas ophthalmology centers and clinics to 260. This number is close to 40% of the scale of its domestic medical network. According to the 2025 annual report of Aier Ophthalmology, it has 391 hospitals and 272 outpatient departments or clinics in China, totaling 663 medical institutions. This is the result of more than 20 years of deep cultivation and continuous high-speed expansion in the country.

By 2025, Aier Ophthalmology's overseas revenue will exceed 3 billion yuan, accounting for 13.7% of the total revenue. However, Aier Ophthalmology is not satisfied with this. At the annual shareholders' meeting held in May 2026, Aier Ophthalmology Chairman Chen Bang listed globalization as one of the core strategic directions and hoped that the proportion of overseas revenue could reach 30% or even 50% in the future.

In other words, Aier Eye's goal is to achieve overseas revenue that is close to or even comparable to domestic business in the future. For this private healthcare giant that has grown through chain expansion, this is almost equivalent to building another Aier Eye Clinic overseas.

Why Brazil

The Brazilian ophthalmic medical services group acquired by Aier Ophthalmology is the largest ophthalmic medical group in Latin America, with 81 ophthalmic centers covering multiple sub specialty fields such as cataracts, refractive error, retina, glaucoma, etc. By 2025, it will have completed over 1.2 million outpatient visits and more than 180000 surgeries.

Aier Ophthalmology believes that Brazil has long-term growth potential. As the largest economy in Latin America, Brazil has a population of over 200 million and is also the fourth largest cataract surgery market in the world. With the worsening of population aging and the continuous growth of demand for eye health, there is still significant room for development in the Brazilian ophthalmic medical market.

Aier Eye Hospital disclosed that the two parties have maintained cooperation and communication since 2017, and this acquisition is not a temporary decision.

For Aier Ophthalmology, going to Brazil is not a completely new attempt. One of its most successful overseas mergers and acquisitions was the acquisition of the Spanish ophthalmic chain Cl í nica Baviera in 2017. After being acquired, the group increased its number of institutions from over 70 to 151 by the end of 2025 through endogenous growth and external expansion, with revenue growing from approximately 100 million euros to 300 million euros and a compound annual growth rate of over 20% in net profit margin.

Zhao Heng, founder of medical strategy consulting firm Latitude Health, analyzed the Economic Observer that the price level of medical services in Brazil is higher than that in China, and the coverage rate of commercial insurance is also significantly higher than that in China. From the perspective of payment system and market maturity, there is no fundamental difference between entering Brazil and entering Europe, "he said.

Aier Ophthalmology previously mentioned in an investor survey that its principle for overseas expansion is "global development, local operation, and two-way empowerment", respecting local culture and management teams, and achieving synergy through technology exchange and management sharing. This time in Brazil, Aier Ophthalmology plans to continue this path.

A senior executive of a private medical group responsible for hospital operations in Southeast Asia told Economic Observer that when private hospitals go abroad, the mature management experience in China may not necessarily be directly replicated overseas. He cited his own experience as an example: Southeast Asian employees naturally have a slower work pace, and some employees would rather change jobs than accept high-intensity work. This cultural difference is a real management challenge. In his opinion, Aier Ophthalmology has accumulated a mature diagnosis and treatment system and specialized capabilities. When going abroad, the risks in medical technology are relatively controllable, but the more difficult aspect is cross regional organizational management.

Under the merger and acquisition expansion model, Aier Eye Hospital's management model in China has become relatively dispersed, and its management radius will further expand overseas, "said the executive.

Aier Eye Hospital has also realized this risk. In the 2025 annual report, Aier Eye Hospital mentioned that chain operation is conducive to leveraging its advantages of full resource sharing, rapid replication of models, and rapid expansion of scale. However, as the chain medical service network continues to expand, it will face significant challenges in management.

Self built or acquired

Aier Ophthalmology has been globally expanding for ten years.

In 2015, Aier Ophthalmology acquired Asia Medical Group in Hong Kong, taking the first step towards overseas expansion. Over the next 10 years, Aier Ophthalmology gradually acquired assets such as Cl í nica Baviera, Southeast Asian ophthalmology group ISEC Healthcare, and MINGWANG Ophthalmology Center in the United States, expanding its business to markets in Europe, Southeast Asia, and North America. Now, through this transaction in Brazil, Aier Ophthalmology has extended its tentacles to South America.

There are two main strategies for private hospitals to go global: one is to build their own hospitals locally, and the other is to directly acquire local hospitals. Ophthalmologist Zheng Yajie, who once served as a senior executive in an ophthalmology chain, told Economic Observer that the latter's advantage lies not only in its fast expansion speed, but also in the fact that the acquired hospitals have generally completed team building and market training locally, gaining a certain level of popularity and reducing the risks borne by the acquirer itself.

Zheng Yajie further analyzed that medical services have strong regional attributes. When a hospital enters a new market, it often needs to rebuild patient trust. Different ophthalmic chain institutions also show distinct regional advantages as a result. For example, Chaoju Ophthalmology (02219. HK) has strong strength in Inner Mongolia, and He's Ophthalmology (301103. SZ) has a high reputation in Northeast China. She observed that some ophthalmic patients would go to Beijing Tongren Hospital for treatment across provinces, but few would make a special trip to remote private ophthalmic hospitals for treatment. Most ophthalmic hospitals, including those under Aier Eye Hospital, can only radiate to surrounding patients.

People are willing to try new restaurants, but trust is important when seeking medical treatment, "said Zheng Yajie. The core competitiveness of the medical service industry is built on long-term accumulated brands and trust. It is difficult to directly replicate the reputation of a hospital that has been operating locally for many years to another market. Therefore, mergers and acquisitions have become a more realistic choice for private medical groups such as Aier Ophthalmology when going global.

The regional attributes of healthcare itself are too strong. "The aforementioned executives also mentioned that in unfamiliar overseas markets, the original resources and brand effects of medical groups may not necessarily be effective. Directly acquiring institutions that have already established trust in the local area is often the most efficient way. This saves time and costs, and can retain the original management team. They have local social and industrial resources, which are the core chips for survival overseas. In his view, Aier Ophthalmology is replicating its expansion logic that has been validated in the Chinese market overseas.

Why Go Overseas

In May 2026, Aier Ophthalmology officially submitted its application for listing on the Hong Kong stock market. According to the prospectus, one of the main purposes of the funds raised is to acquire domestic and foreign ophthalmic institutions. For Aier Ophthalmology, listing on the Hong Kong stock market is not only an expansion of financing channels, but also a reserve of funds for the next round of global mergers and acquisitions.

At the 2025 annual shareholders' meeting, when asked why he had stated a year ago that he was not considering going public in Hong Kong but had launched a Hong Kong IPO a year later, Chen Bang responded that there had been significant changes in the past year, with the proportion of overseas business continuing to increase and the contribution constantly increasing. In the past 10 years, Aier Eye Hospital has accumulated rich experience overseas. Most of the existing hospitals overseas have been operating for more than six or seven years and have now reached a stage where they can further develop. The listing on the Hong Kong stock market is an important and inevitable step towards achieving globalization strategy.

Chen Bang also mentioned that if there had been no double-digit growth in overseas business last year, there would not have been the overall growth of Aier Ophthalmology for the whole year.

Chen Bang revealed that Aier Ophthalmology has formulated a "three-year tough" plan from 2026 to 2028, and one of the core contents of the plan is to "deepen international layout and build a global ophthalmic leader". He said, "Our going global is not following the trend, but a strategic layout that has been honed over ten years. Unlike other companies' products going global, we are going global through service and management

The acceleration of globalization strategy is closely related to changes in the domestic market environment.

Aier Ophthalmology was founded in 2003 and listed on the A-share market in 2009. Over the past 20 years, Aier Ophthalmology has continued to expand through large-scale mergers and acquisitions, growing into a leading private ophthalmic chain in China and gradually becoming the world's largest ophthalmic medical group.

But in recent years, the competition in the domestic ophthalmic medical market has become increasingly fierce. In the Hong Kong stock prospectus, Aier Eye Hospital mentioned that its competitors include public hospitals with ophthalmic departments as well as private ophthalmic hospitals and clinics, and some public hospitals have always enjoyed higher patient trust and stronger brand recognition, which makes it difficult for private ophthalmic service providers to establish market position and attract patients. In addition, the continuous growth of the ophthalmic health market and ophthalmic medical services market may attract new entrants, including international operators with stronger financial, marketing, or operational resources, which may further intensify competition.

The pressure of slowing growth has begun to be reflected in financial data. In 2025, Aier Eye Hospital achieved a total annual revenue of 22.353 billion yuan, a year-on-year increase of 6.53%; The net profit attributable to the parent company was 3.24 billion yuan, a year-on-year decrease of 8.88%, marking the first negative growth since its listing. Meanwhile, the gross profit margins of multiple core business segments have all declined.

In contrast, overseas business is becoming a new source of growth. From 2023 to 2025, Aier Ophthalmology's overseas revenue will reach 2.312 billion yuan, 2.625 billion yuan, and 3.057 billion yuan respectively, increasing its proportion of total revenue from 11.4% to 13.7%. In 2025, its overseas business revenue will increase by 16.47% year-on-year, significantly higher than the domestic business growth rate of 5.11%.

Overall, the overseas competitive environment is relatively relaxed, and the market space is huge. "Aier Eye Hospital previously judged during investor exchange activities that its future overseas revenue share is expected to continue to increase, and the specific pace depends on market opportunities.

The executive in charge of hospital operations in Southeast Asia analyzed the Economic Observer that for private medical groups, going from one city to the whole province, then from the whole province to the whole country, and finally to the world, is already the normal rhythm of strategic development. Nowadays, with the tightening of domestic medical insurance policies and intensified market competition, going global is gradually becoming an important strategic option for leading private medical groups.