What the private healthcare market is worth
The best measure of demand here is not the state budget but the patient’s wallet. In 2025 a household spent an average of 227.7 lei per person a month on health — around 11 euro, 4.5% of all consumption, and 327 lei in towns. For comparison, education services came to 52.6 lei. Health is the category people reach into their own pockets for four times more readily than for schooling.
Supply followed demand. At the end of 2025 there were 645 private medical institutions providing primary and specialist care, against 589 a year earlier and 568 in 2022. Public institutions of the same kind fell over the same period from 436 to 428. Of the 89 hospitals in the country, 21 are private.
The pharmacy network grew more visibly still: 1,799 pharmacies and branches in 2025, against 1,524 in 2022. What is interesting is where it grew. Chișinău had 524 in 2022 and 528 in 2025 — essentially unmoved. The entire increase of 275 units happened outside the capital.
And the people followed. Health and social care units in forms of ownership other than public employed 12,511 people at 31 December 2025, against 10,598 in 2023.
Why now is a good time to open a clinic or a pharmacy
Because since 30 December 2025 the rules have been written by CAEM code. You know before you sign a lease that 86.21, 86.22, 86.23 and 86.90 are on the sanitary authorisation list and that 47.73 is not. Until then the same list was framed by category of institution and left room for interpretation at every inspection.
Because the most important act costs nothing. The sanitary operating authorisation is issued free of charge — the law has said so outright since 21 March 2026 — and only the sanitary expertise is paid for. The radiological authorisation is likewise free and runs for seven years.
Because you have two revenue channels rather than one. A contract with the National Health Insurance Company is open to private providers on the same terms as to public ones, and the public health budget came to 19,393.1 million lei in 2025 — close to 970 million euro — against 15,944.1 million in 2023. Anyone entering the system enters a sum that is growing.
And because the company that holds all of it together — an SRL — is registered with no minimum share capital, in a few working days. If a pharmacy is the plan, the order matters in cash: the licence fee is halved for companies registered no more than a year before the application is filed.
What it costs to open
On the medical side the permissive acts are cheap and the evaluation is expensive. The sanitary operating authorisation costs nothing; you pay only 875 lei — around 44 euro — for the assessment of sanitary condition. Entry in the register of providers is done by notification to the Ministry of Health. Accreditation, by contrast, is priced by the type of care and the number of doctors, starting from a minimum fee of 12,635 lei multiplied by a complexity coefficient: 1,263.50 lei for family medicine with a single doctor, 6,317.50 lei for dentistry or specialist outpatient care with a single doctor, 12,635 lei — around 630 euro — for a hospital of up to 25 beds. To these is added the annual current evaluation, which a private provider bears from its own funds.
On the pharmaceutical side there is one figure and it is fixed. The licence for pharmaceutical activity costs 3,250 lei, and 1,625 lei for applicants registered no more than a year before the application — around 160 and 80 euro. The trade notification at the town hall costs 100 lei, around 5 euro. No sanitary authorisation is paid for, because none is required.
Registering the SRL has no minimum share capital and takes a few working days at the Public Services Agency — we file the papers, pick the CAEM codes and hand you a company ready for the authorisation file. The rest of the budget — premises with a health-sector designated use, equipment, sterilisation and, above all, salaries — is where your choices matter.
What to know before you open
The sanitary authorisation comes first, accreditation second
The order is not a convention, it is written into the file: the sanitary operating authorisation is attached to the accreditation application. You cannot apply for accreditation until you hold the authorisation, and the authorisation is granted per address, so it depends on the lease.
The health insurance law puts all three conditions in a single sentence: medical care is delivered by providers who are sanitarily authorised, accredited, and entered in the register of providers. Three acts, three authorities — the National Agency for Public Health, the National Council of Evaluation and Accreditation in Health and the Ministry of Health — and one order in which they are obtained.
A pharmacy has no sanitary authorisation; it has a licence and a notification
This is the part that surprises people most often, because it looks backwards. A pharmacy files no application for a sanitary operating authorisation: the premises are checked by the Medicines Agency, inside the licensing procedure, through a control visit that ends in a report within ten working days at most.
What it files instead are two notifications. A trade one, with the town hall, because retail sale of pharmaceutical products is a trade activity like any other. And a public-health one, because that same class 47.73 is on the list of services subject to notification — the light form of the very regime the authorisation belongs to.
The clinic is VAT-exempt; the pharmacy charges 8% — and deducts
Medical services are exempt from VAT, with one exception named in the law: cosmetic ones. The exemption comes without the right to deduct, though, so the VAT a clinic pays on rent, equipment and consumables stays a cost.
At a pharmacy it works precisely the other way. Medicines registered in the State Nomenclature of Medicines are sold with VAT at 8%, which makes a pharmacy a VAT payer — and therefore the only branch in this field that recovers the VAT it pays on rent, fittings and equipment. The same difference in regime explains why the two budgets are built differently from the first line.
The premises must carry a health-sector designated use
The health law requires private providers to work in premises they own or lease that carry a designated use in the field of healthcare. This is not a paperwork formality: it changes the list of buildings you can consider and sometimes the calendar, if the designated use has to be changed first.
Which is why the lease is negotiated before the file, not after — all the more so because the sanitary authorisation runs for five years if you own the building or the lease is longer than five years, and if the lease is shorter, the authorisation ends with it.
In care, medical care decides the regime
The classifier draws the line very precisely. A nursing home with medical care is 87.10; a home with minimal medical assistance or none is 87.30. The first class is on the list of activities subject to sanitary operating authorisation, the second is not. The same building, the same residents, two regimes — the medical component makes the difference.
On top of that sits social accreditation, which is required in both cases: social service providers are accredited every five years as a matter of obligation, by the State Social Inspectorate. And one of the conditions is prepared long before the file: the company’s founding act must provide for activities in the field of social services. It is written at registration, not at accreditation.
An SRL — Moldova’s limited liability company — is the form a health business opens in, and the first reason is given by the very law that says who may found a private provider. The text is short and heavy: natural and legal persons have the right to found private providers of medical services and bear responsibility for their financial and material provision, for the organisation of medical care and for its quality. Responsibility for the quality of the medical act is placed by statute on the founder. In a field where the risk is not commercial but human, the line between the company’s assets and your own is exactly what the legal form buys.
The second reason is that an SRL makes possible everything that follows. You can hire doctors, nurses and pharmacists on individual employment contracts. You can sign the contract with the National Health Insurance Company. You can open a second pharmacy branch and file an authorisation application for each address. You can provide in the founding act for social-service activities, if a care home is also in the plan. And there is no entry threshold: an SRL has no minimum share capital and is registered at the Public Services Agency within a few working days.
The individual family doctor’s practice is the one real alternative, and we will tell you plainly where it applies. The law defines it as a form of organising the professional activity of family doctors who hold a practice, founded by a single family doctor, acting and appearing in legal relations as a natural person. Two or more family doctors may form a family doctors’ centre, which is a legal person. A family doctor may found only one of the two.
The limits, though, are exactly where you might be looking. The form exists only for family medicine. There is no individual practice for dentistry, for a specialist clinic or for a pharmacy — and the individual practice acts as a natural person, so without the separation of assets a company gives you.
The entrepreneur’s patent has a single entry in this field — massage, care of the sick and other medical services provided by junior medical staff — at 140 lei a month in Chișinău, Bălți, Bender and Tiraspol, 70 lei in other municipalities and towns and 35 lei in rural localities. The entry is written for auxiliary staff, not for doctors, and the patent carries its two usual limits besides: at most 300,000 lei — around 15,000 euro — in sales revenue over 12 consecutive months, and no employees. On a patent you cannot hold a pharmaceutical licence, cannot be accredited as a medical service provider and cannot enter the register of providers.
The sole trader — the întreprindere individuală — looks like a shortcut, but it is not: the law states outright that an ÎI is not a legal person and that its owner is liable without limit, with their entire personal estate. You pay the same taxes as a company and keep the same records, but you retain the personal risk — the combination with no advantage at all in a field where responsibility for quality falls on the founder in any case.
We register the SRL, pick the CAEM codes for every activity you will have — including the social ones, if care is part of the plan — and prepare in parallel the file for the sanitary authorisation or, for a pharmacy, the licensing file, so that you do not lose the half-year between the lease and the first patient.
