With the deployment of the fifth generation (5G) mobile network systems and the envisioned heterogeneous ultra-dense networks (UDNs), both small cell (SmC) and distributed antenna system (DAS) technologies are required by mobile network operators (MNOs) and venue owners to support multiple spectrum bands, multiple radio access technologies (RATs), multiple optical central offices (COs), and multiple MNOs. As a result, the neutral host business model representing a third party responsible for managing the network enterprise on behalf of multiple MNOs has emerged as a potential solution, mainly influenced by the desire to provide a high user experience without significantly increasing the total cost of ownership (TCO). However, designing a sustainable business model for a neutral host is a nontrivial task, especially when considered in the context of 5G and beyond (5GB) UDNs. In this paper, under an integrated optical wireless network infrastructure, we review how SmC and DAS technologies are evolving towards the adoption of the neutral host business model and identify key challenges and requirements for 5GB support. Thus, we explore recent candidate advancements in heterogeneous network integration technologies for the realization of an efficient 5GB neutral host business model design capable of accommodating both SmC and DAS. Furthermore, we propose a novel design architecture that relies on virtual radio access network (vRAN) to enable real-time dynamic resource allocation and radio over Ethernet (RoE) for flexible and reconfigurable fronthaul. The results from our simulations using MATLAB over two real-life deployment scenarios validate the feasibility of utilizing switched RoE considering end-to-end delay requirements of 5GB under different switching schemes, as long as the queuing delay is kept to a minimum. Finally, the results show that incorporating RoE and vRAN technologies into the neutral host design results in substantial TCO reduction by about 81% in an indoor scenario and 73% in an outdoor scenario.