VGZ: Investing in innovation for future-proof healthcare

June 6, 2025

^{This article was originally written in Dutch. This is an English translation.}

With the Voorop in Zorg fund, Coöperatie VGZ encourages innovative solutions that contribute to accessible and affordable healthcare. Financial Investigator spoke with one of the initiators, Erik Jan van Bergen, Managing Director at Coöperatie VGZ.

By Daan Nijssen

What is the purpose of the Voorop in Zorg fund and why did VGZ introduce it?

We believe that living a healthier life is more important than ever, but being healthy is not a given for everyone. Fortunately, we have good, accessible and affordable healthcare in the Netherlands. We want to keep it that way. That is why VGZ, as a non-profit cooperative, is committed to a healthier Netherlands and innovation in healthcare. Process and product innovation help us achieve this. With the Voorop in Zorg fund, VGZ wants to drive innovation to keep healthcare future-proof. The fund provides financial capital to innovative companies. And we help our portfolio companies with things like market introduction and scaling up in the Netherlands by offering access to our expertise on topics such as reimbursements, market reception, current care pathways, contracting and revenue models.'

How do you combine social and financial returns?

'As an impact investor, we want to use our capital to bring about positive change in Dutch healthcare. Keeping healthcare affordable and accessible is an important social responsibility for us and goes hand in hand with the pursuit of a healthy financial return. Both are equally important. To make impact in healthcare measurable, we are working with a number of like-minded investors to develop a uniform framework for consistently assessing the impact of our investments. VGZ also wants to achieve a market-based financial return on all its investments in order to keep monthly premiums for its members as low as possible. This also applies to the investments of the Voorop in Zorgfonds. We always assess whether both objectives can be achieved.'

What is the composition of the team?

'Our management team consists of six people with expertise in healthcare, commerce, IT, finance and impact. For each investment, the team works closely with the relevant experts in our Healthcare, Members and IT divisions. In practice, this involves healthcare purchasers, innovation specialists, medical advisors, business developers, marketers and data scientists. Our colleagues have in-depth specialist knowledge in their own fields and have good networks in the Dutch healthcare ecosystem, including regulators, central/local authorities, healthcare organisations and interest groups for patients and healthcare professionals.'

How are the companies you invest in selected?

'Our management team uses five key focus areas in its investment process to select potential investments. The following two are specific to VGZ:

• Social impact: How will an innovation contribute to the affordability and accessibility of healthcare for our members in the long term?
• Additionality: What value can VGZ add to the company by investing?

In addition, there are focus areas that are also used by many other investors:

• Value proposition: This concerns the current status of the product or service. What still needs to be done and what makes it unique? What healthcare budgets and/or payment titles are already in place? What is the market potential and positioning of the product, and what does the business model look like?
• Stakeholder analysis: This concerns the quality of the management team, the competition, market relations, key opinion leaders and which buyers/financiers/users stand to gain or lose as a result of the innovation.
• Financial analysis: This involves a detailed examination of, among other things, market potential, revenue potential, valuation, and financial and legal documentation.'

What themes does the Voorop in Zorg fund focus on?

The Voorop in Zorg fund invests in Medtech, Healthtech, Digital Health Services & data exchange. We focus on companies that offer solutions for increasing the labour potential, reducing healthcare consumption and reducing the influx of patients into the healthcare system. In this way, we save time for healthcare professionals, use resources more intelligently and contribute to patient self-management.'

How do you determine whether a company contributes to accessible and/or affordable healthcare?

'We expect to receive more than 100 investment proposals each year. The management team conducts an initial screening to assess the potential contribution to the accessibility and affordability of healthcare. We discuss the most promising proposals with the relevant experts from the Healthcare, Members and IT divisions. Thanks to their daily work, they generally have detailed knowledge of the specific sub-areas and help us to identify the intended impact.'

How do you choose between seed, early stage and growth companies? And between direct and indirect investments? Are there any geographical preferences?

'Our focus is mainly on seed and early stage companies. By getting involved at this early stage, we can use our knowledge, expertise and access to our network to help these companies develop more quickly. When investing in growth companies, we mainly look at companies that accelerate VGZ's strategic objectives.

Geographically, we aim to make as many of our investments as possible in the Dutch market. In the European market, we join consortia of similar investors. We are only open to a limited extent to investments in the US and the rest of the world, because our greatest added value lies in the Dutch healthcare ecosystem.

The emphasis is on direct investments in companies, with room for indirect investments through partnerships with a limited number of fund managers and partners who are also active outside the Netherlands with early-stage investments in healthcare. They offer us the scale, experience, knowledge and/or network in specific segments that are not easy to achieve as a Dutch health insurer.'

What are the biggest challenges in healthcare investments?

'Innovation in healthcare is challenging by definition, because the costs and benefits of many innovations often fall to different parties in the chain. This can hinder adoption. It is therefore particularly important to carefully identify the obstacles on the purchaser side: is there a budget, does the solution fit into the reimbursement system, or does a new reimbursement code need to be created? But even when the business case is clear, the path to market remains very challenging. Product innovations in healthcare involve lengthy and costly regulatory processes in which effectiveness and safety are thoroughly tested before a product can be sold commercially.

This requires investors to take a long-term view, whereby helping to speed up the lead time adds considerable value. However, not every investor is willing or sufficiently equipped to do so. In the current market, we are therefore seeing a retreat by investors from providing early-stage capital in this high-risk sector. We hope that the Voorop in Zorg fund will help to meet this challenge.'