Burjeel Holdings PLC (BURJEEL) Q3 FY2025 Earnings Call Transcript & Summary

November 4, 2025

ADX AE Health Care Health Care Providers and Services Earnings Calls 50 min

Earnings Call Speaker Segments

Sergei Levitskii

Executives
#1

Hello, ladies and gentlemen, and welcome to Burjeel Holdings Earnings Call for the 3 and 9-month periods ending 30, September 2025. Today's call will be hosted by CEO, John Sunil; and CFO, Muhammed Shihabuddin, who will provide an overview on Burjeel Holdings' financial and operational performance, followed by a Q&A session. I'm Sergei Levitskii, Director of Investor Relations, and I will be moderating today's session. First, please review the disclaimer on Slide #2, which includes important information regarding the interpretation and limitations of historical data and forward-looking statements. I will now hand over the floor to our CEO, John Sunil, to present our financial highlights, recent business developments and progress in executing our growth strategy.

John Sunil

Executives
#2

Thank you, Sergei. Good afternoon, everyone. This quarter marks a historic milestone for Burjeel Holdings, a record in financial performance that highlights the strength of the multi-brand network, leadership in complex care and proven ability to deliver on strategic priorities. As shown on the left, both our top and bottom line results in Q3 2025 grew substantially compared to the third quarter of 2024 and even surpassed the strong performance delivered in Q2 2025. Most importantly, this growth was accompanied by a significant expansion in margins. On the right, we want to emphasize that this is more than just another strong quarter. It represents a turning point. The investments and strategic actions made over the past year are now translating into sustainable long-term financial momentum. We have optimized utilization, accelerated the ramp-up of new assets, enhanced our case mix and improved efficiency across the network. Patient volumes continue to rise. Community reach is deepening and our growth is outpacing regional population trends. At the same time, investments in expansion of our hub and spoke network and subspecialties are beginning to yield positive returns, supported by a well-invested workforce and scalable bed capacity. We remain focused on disciplined execution and high ROI growth opportunities in the UAE and Saudi Arabia, which we will discuss in the next slides. Above all, these achievements reflect the dedication of our exceptional teams whose commitment ensures world-class care for every patient. Beyond financial strength, Burjeel’s progress is also reflected in its medical innovation and expanding clinical capabilities. At Burjeel Medical City, we performed the GCC's first hepatic artery infusion pump surgery for liver tumors, reinforcing our leadership in precision oncology. We also completed the Gulf's first uniportal robotic lobotomy, a milestone in minimally invasive thoracic surgery. In parallel, we advanced our precision medicine platform, introducing pharmacogenomic testing and biosimilars to personalize oncology and chronic disease treatments. We also opened the interventional pain management center at Burjeel Hospital for Advanced Surgery in Dubai, broadening access to multidisciplinary outcome-driven care. Our robotic and transplant programs continue to grow strongly as we have now completed over 800 robotic surgeries and 63 organ transplant surgeries across the network. We are also seeing a strong momentum in oncology and orthopedic surgery with oncology volumes doubling to more than 600 cases and complex orthopedic procedures as the Dr. Paley Clinic rising nearly 40% in the first 9 months of this year. Now let's dive into our strategy, where the core driver of our growth remains disciplined geographical expansion, which is supported by an integrated network built to deliver advanced high [effective] care to patients across the region. Today, our network spans more than 100 healthcare assets with close to 1,800 beds and 1,800 physicians across the UAE, Oman and Saudi Arabia, providing a strong foundation for further growth. This approach strengthens our leadership in the GCC's specialized care market while extending our reach through scalable capital-light platforms. At the center of this ecosystem is Burjeel Medical City in Abu Dhabi, our complex care hub, supported by a strong network of secondary and tertiary hospitals across UAE. Around it, we are expanding primary care, day surgery, and specialty centers across the UAE, Oman and Saudi Arabia, creating a seamless referral pathway across all levels of care. We are also extending our O&M and referral partnership across the wider GCC and Africa, exporting Burjeel’s medical expertise with limited investment exposure and expanding our footprint into new growth markets. Together, this model combines scale with specialization, deepening our leadership in complex care and positioning the group for sustainable growth across high-value geographies. On the next slide, we'll look at how this strategy translates into tangible project line, a disciplined multiyear program that will add capacity, talent and new centers across the region. Our 2025-'27 expansion plan includes 19 new healthcare facilities across the UAE and Saudi Arabia currently in active development. Over this period, our UAE network will expand with 2 hospitals in Dubai, 4 day surgery centers and 9 medical centers across all Emirates, along with 2 new branches of Trust Fertility clinic in Al Ain and Dubai. In Saudi Arabia, development is underway for 2 day surgery centers in Riyadh and Al Khobar, both scheduled to open next year. We are progressing in line with this plan, having already delivered the Advanced Oncology Care Center in Dubai, Burjeel Medical Center Saadiyat and newly opened Burjeel Medical Center, Al Fouah. Execution remains on track and CapEx is in line with the guidance with around 30% of the total spending already deployed and several assets nearing completion. Upon full maturity, typically within 3 to 5 years, these projects are expected to add at least 270 beds and 420 doctors across the network, generating over KWD 1.5 billion in annual revenue and delivering EBITDA margins of around 25%, supported by scale, efficiencies and operating synergies. This pipeline marks the next phase of Burjeel’s disciplined growth, which will be driven by strategic expansion, operational excellence and clinical specialization. With that, I'll now hand over to our CFO, Shihab, to walk you through the performance in more detail.

Muhammed Shihabuddin

Executives
#3

Thank you, John. Let me walk you through our quarterly operational performance, which is a clear case study that truly demonstrates the strength of our integrated multi-brand network and our solid market position. Since 1st of May, we temporarily restricted the access for one of the major insurance provider to our Burjeel bonded facilities as a part of negotiation for better terms. As a result, the entire third quarter was recorded without any contribution from this insurer. Despite of that, our patient volume continued to grow faster than the regional population growth rate, which is a clear reflection of our strong network penetrated across the communities and the growing demand for our specialized care services. I'm pleased to share that on October 29, we successfully concluded the negotiation and access was fully reinstated effective from November 1. The total patient footfall increased by 4.6% in Q3 and 7.3 percentage over the 9 months, reaching more than 5 million visits year-to-date. This overall performance was contributed by a strong case mix, increase in high-value specialties and an increase in corporate contracts. Inpatient volume grew 8.4% in Q3 and 12.4 percentage over the 9 months, supported by the ramp-up in surgical oncologies and other advanced minimal invasive procedures. Bed occupancy reached 67 percentage for the first 9 months, highlighting the further room for the utilization gains. Outpatient utilization remained steady at 66 percentage, creating a clear runway for continued patient growth. Moving to our financial performance. In Q3, the group revenue increased by 7.9 percentage, which is all-time high in the quarterly performance of the group since the IPO, amounting to AED 1.42 billion. The group achieved this growth irrespective of the temporary access of the restriction, which was mitigated through the strong inflow from other premium insurance network and self-paying patients, along with a high share of complex and high-value procedures. Revenue growth was also supported by robust demand and a higher surgical conversion rate across the key specialties, including cardiology, urology, gastrology and IVF and oncology. Our profitability was even strong in Q3. EBITDA grew by 17 percentage to an amount of AED 320 million, driven by a stronger complex care mix, cost discipline and operational efficiency, resulting in a margin expansion to 22.5 percentage compared to 20.7 percentage in last year. For the first 9 months, EBITDA increased by 15.3 percentage to an amount of AED 807 million, reflecting the continued operational strength optimization of assets. Both hospitals and Medical Center segments contributed meaningfully with the hospital EBITDA margin at 25.8 percentage in Q3 and medical centers posting a double-digit growth. Overall, these results demonstrated profitable and sustainable growth across our network, translating operational excellence into margin expansion and value creation. When it comes to BMC, which is our flagship hospital, Burjeel Medical City, which is our flagship hospital, the financial momentum remained very strong. BMC continued to scale this quarter with the patient volume up by 14 percentage and revenue increased over 7 percentage. This revenue trend reflects a high share of outpatient and day care procedures, while medical oncology continued to gain the traction. Bed occupancy was at 58 percentage in Q3, reflecting the addition of new capacity and providing an ample headroom as utilization ramp up. EBITDA surged 47 percentage year-on-year to reach a record high margin of 22 percentage. For the first 9 months of the year, EBITDA rose nearly 30 percentage with the margin improving to 19 percentage. This strong improvement was driven by a ramp-up of high-value cases, improvement in efficiency and disciplined cost management. As John mentioned earlier, our ongoing investment in complex care are delivering the tangible results and we expect further upside in both realization and margin progression as these programs mature over the coming months. On next page, I would like to highlight the performance of Trust Fertility Center. It has continued to exceed expectations and deliver the strong result. After being launched less than a year ago, the Trust IVF established itself the presence as the largest and the most advanced fertility center in UAE and becoming a key pillar to our women's health offerings. During the first 9 months of 2025, the center generated AED 40 million in revenue, serving more than 2,500 patients and initiating over 1,600 fertility cycles. Importantly, this performance was achieved at only around 30% utilization, already delivering the high single-digit EBITDA margin, which is demonstrating the efficiency of our model and strong underlying demand for advanced IVF and AI-enabled reproductive services. Clinical outcome also remained exceptional with a pregnancy success rate of more than 50 percentage, which is well above the global benchmark, reinforcing the Trust IVF as the destination of choice for the complex fertility care in the region. Yes, let us take a quick look into our cost blocks, where we continue to see a strong discipline and efficiency across the group. In Q3, the group OpEx fell to 77 percentage of the revenue, showing a consistent improvement through the year as our cost initiatives continue to deliver the results. Staff costs as a share of revenue were down nearly 1 percentage year-on-year, supported by the better workforce optimization -- workforce optimization and tighter administrative controls. Notably, we onboard only 30 new doctors this year compared to 188 additions in 2024, which indicates that the group is now well invested in medical capacity, supporting the margin improvement and operating efficiency. Inventory costs also improved, optimizing by around 2.5 percentage, reflecting a stronger supplier terms and a shift towards a minimal invasive surgical procedure resulted in reduction in consumable intensity. However, it continued to decline quarter-on-quarter, now standing at 13 percentage below the historic peak in Q4 2024, confirming a sustainable cost normalization trend. In addition, the marketing expenses, one of the key cost drivers in the last year are down by 46 percentage from the same Q4 peak in 2024. ECL provision remained stable at 3.5% of the revenue, in line with the global healthcare peers and significantly below the local average. We view this as a normalized level that should remain steady going forward. Together, these efficiencies support -- so together, these efficiencies supported a 17 percentage year-on-year growth in EBITDA, the margin expanding to 22.5 percentage, keeping us firmly on track to meet our full-year margin guidance. As we move on, we can see that our cost optimization efforts are now clearly translating into strong bottom line and cash flow performance. Net profit increased by 27.5 percentage to an amount of AED 175 million in Q3 '25, with the net profit margin improving to 12.3 percentage from 10.4 percentage driven by strong operating leverage and continued optimization of non-operating expenses. Operating cash flow amounting to AED 244 million in the first 9 months of 2025, down by AED 63 million year-on-year, mainly due to normalization of payment cycle to secure better procurement terms and supplier benefits. The days sales outstanding ratio increased slightly to 136 days in Q3 from 128 days in last year. We have initiated several measures to improve the collection efficiency and expect the receivable days to be normalized towards 120 days range over the course of next year. Growth CapEx reached AED 474 million, reflecting ongoing investment in super specialty capabilities, network expansions and strategic M&A initiatives. The maintenance CapEx remained in line with our guidance at around 2.5 percentage of revenue. As a result, free cash flow amounting to AED 295 million, highlighting continued discipline in cash management and disciplined investment execution. Return on capital employed improved to 13 percentage from 12 percentage of the last quarter and remain on track to return of its historical range of 15 to 17 percentage, supported by a strong asset utilization and operating leverage. Regarding our financial position, we continue to follow a conservative and flexible financial policy, ensuring we have the capacity to capture the growth opportunities as they arise. As of 30, September 2025, our net debt and EBITDA stood at 1.9x, reflecting the impact of the growth CapEx linked to strategic acquisition and network expansion. During this quarter, we completed the acquisition of the Medeor Hospital Dubai worth of AED 186 million. Importantly, even with our ongoing expansion program, we reiterate our commitment to maintain the net leverage below 2.5x during the period, reinforcing our balance sheet strength and financial flexibility. Before we go to Q&A, we want to see a few -- I want to say a few words about our guidance, which should be on your screen now. In Q3, we clearly demonstrated our operational strength, reinforcing that we are on a right strategic path and that our midterm guidance remains both reasonable and achievable. For the full-year 2025, we expect our group revenue to grow at least 10 percentage year-on-year with an EBITDA margin improved to a minimum of 19 percentage despite the temporary access restriction to one of the major insurance provider in the country, which is resolved, as I mentioned earlier, effective from 1st of November. This insurance resolution should provide a solid uplift to both our top line as well as the bottom line in next year. The revenue growth and margin expansions will continue to be driven by the ramp-up of our newly launched [assets], ongoing cost optimization and our strategic expansion projects across UAE and KSA. Our fundamentals remain strong, and we expect our midterm guidance across all key metrics to remain stable with the full confidence in our ability to execute and deliver a sustainable and profitable growth. With that, I will hand over to Mr. Sergei for a Q&A.

Sergei Levitskii

Executives
#4

Thank you. Before we begin the Q&A, a short anonymous feedback survey will appear on your screens. We would really appreciate it if you could take a moment to share your thoughts. It help us keep improving. We are now ready to take questions. I will turn it back to the operator.

Operator

Operator
#5

[Operator Instructions] Our first voice question comes from Faisal Irfan from International Securities.

Faisal Irfan

Analysts
#6

This is Faisal from International Securities. My first question is with regards to the company has reported a loss of around AED 3.9 million from share of profit from associates. Could you please explain the nature of these losses and clarify whether they are recurring in nature or not?

Muhammed Shihabuddin

Executives
#7

Yes, sure, Faisal. With regards to our sister concern as JV partners, basically, the Alkalma is a new venture which we started to focus more on to the well-being and mental health basically. That incorporation has happened like a few months back. In the initial period, as all of us knows, basically, it will be contributing negative. That is where it happened this quarter that Alkalma JV contributed negatively to the group level. That is where it reflected the negative trend. Going forward, all of us knows the product what Alkalma is bringing is a well-being, mental health, there is a great demand across the GCC. Recently, Alkalma acquired one of the existing mental health platform and infrastructure, which is called [Apis] Medical Health. They start operating on that basically, and they are expanding in Al Ain, Dubai, Saudi. As an initial period of expansion, obviously, we can expect the initial loss. That is where we are, but it is a calculated decision because the product in demand. That is why like it contributed as of now, but we are expecting a great positive in the coming quarters.

Faisal Irfan

Analysts
#8

My second question is with regards to the revenue from KSA during the 9 months. The group recorded around AED 13.7 million in revenue from KSA during 9 months. Please, if you could guide the EBITDA level impact of this contribution?

Muhammed Shihabuddin

Executives
#9

Yes. For sure, like as of now, the KSA, what we have is the PhysioTherabia network. We have around 32 PhysioTherabia centers across Saudi, including Jiddah, Riyadh, Dammam, across the Saudi as well. As you may be following us, basically, we were opening these centers month-by-month. Obviously, like in our initial facilities, what we brought are getting matured in terms of revenues basically, and it is getting breaking even basically. In that sense, like PhysioTherabia is getting turning positively, and as we speak at the PhysioTherabia segment for the month of September, the whole segment has got broken even. It is a great product, great demand. It is getting ramped up. We are seeing a positive turn in 2026 basically.

Faisal Irfan

Analysts
#10

My third question is with regards to provision for expected credit losses that amounted to around AED 50 million in the third quarter, around 3.5 percentage of the quarterly revenue. Is this level expected to normalize going forward? Any light that you can shed would be great.

Muhammed Shihabuddin

Executives
#11

See, as I explained even in the last call also basically, the auditor, this is ECL calculations, which is clearly driven by an auditor basically on a various method. Previously, the method what they followed is different. Currently, they suggested to follow the historic method on ECL role engine. That is where that the provision is uplift to 3.5 percentage, so we are quite confident that like 3.5 percentage is adequate enough to maintain the or expected loss in the future. We are not seeing any major change in the provision percentage basically, but as I clearly demonstrated, basically, this is a true reflection of a third-party evaluating our receivables and which is EY. Obviously, like it is reasonable, and if we compare the global benchmark, regional benchmark, it is comparable. This is not abnormal. We are quite sure that like this average will be maintained as we go forward.

Faisal Irfan

Analysts
#12

Lastly, I mean, if the previously restricted insurance plan resumes coverage at Burjeel brand facility, how is this expected to impact the group's margin considering the potential shift in patient mix and pricing dynamics? Any color on that?

Muhammed Shihabuddin

Executives
#13

Obviously, the restriction was as a part of negotiation with a particular insurance company in the region. As I demonstrated, basically, it is successfully concluded. From 1st of November, we reopened this particular network in our Burjeel facilities. As clearly we explained before also, Burjeel brand is a premium brand. For that, there is a basic criteria which we are following to accepting any network. It is a premium network. Obviously, the price base criteria is that it has to match with that price terms. Daman -- sorry, initially, it was mismatched. The later part of it, basically, they agreed and now they are in. Obviously, the recent term is very, very good, and we successfully concluded. Obviously, it will add my top line as well as the bottom line basically, because whatever I was achieving before, it was obviously generating. Now whatever incremental will help me to increase my bottom line. That is what we are.

Operator

Operator
#14

We are now moving to the next voice question that comes from Neetika Gupta from Franklin Templeton.

Neetika Gupta

Analysts
#15

Thanks for the presentation, team. I have a couple of questions. First is on the buyback update. Has it started? I mean, what is the execution levels thus far? Could you just update me on the progress of that?

Muhammed Shihabuddin

Executives
#16

Yes. Sure. Regarding the buyback, basically, as I demonstrated, we are in the process of incurring with the SCA. We got an initial response, which is a technical evaluating basically, it is not positive enough. Further, we are exploring to provide more details to SCA to justify our decisions basically, but there are some technical issues. That is why it's not helping us to take it forward. If anything gets resolved, obviously, we'll come back and we'll inform all of you on execution plan. As all of you know, basically, the Board has given us the go ahead to explore with SCA, what is the possibility of executing things, which we enquired, we got the feedback. We communicated back to the Board as well. Any further update, we'll come back to you and take it forward. As of now, the execution is not there basically because we are enquiring SCA, they ask for more questions, we reply, so we are in the clarification stage basically. If we materialize anything coming execution, we'll come back to you.

Neetika Gupta

Analysts
#17

On the working capital, it has been -- it sort of continues to increase, especially receivables. Any particular drivers there that you're seeing?

Muhammed Shihabuddin

Executives
#18

See, as all of us knows basically, the UAE, the market which we operate is a 100% insured market, right? We cannot expect any drastic change unless otherwise like our revenue mix has drastically got changed into the cash or the corporate level, which is not happening that as all of us knows. All of us are carrying the insurance cards and which is covered most of the critical necessary services. Obviously, the receivable will not be drastically changed. Still, there is a room for improvement, but as all of us knows, we all will be facing the same issues. The insurance companies will try their best to push the claim as much they can. This is the part of the process because they can delay their cash flows. That is where the [claim] is getting pushback basically. Ultimately, insurance companies also knows and we also know they can't reject my claim unless it is properly justified. They have to pay today tomorrow for sure, basically, but they will try with additional queries. The problem is that insurance, the process, how it works basically, once we send the claim, there is a time line for the processing. Then they will send a response for additional queries or whatever it is. Then when I start replying, it will take the same time line for the -- my first resubmissions, so they are buying time. It is a process basically. Obviously, ultimately, we are expecting our final rejection rate at what we given the permissions. Rest of all amount, I have to collect. We are in the process improvising that, we are putting a lot of RCM tools to minimize the initial query as much we can. These are the part of improvement, which is in place. We are expecting, as I indicated in the presentation also. In 2026, we are expecting an improvement, but it's not a drastic change. Currently, we are at around 136 days. We are expecting it may be around 120 days in 2026.

Neetika Gupta

Analysts
#19

Just one last one on the -- going back to the provisions for credit losses. I understand that you mentioned it's driven by the auditor. In the 9-month '24 period, it was around 2%, and then it has gone up to 3.5%. Is it a change in auditor assessment? Or basically, these are on the same IFRS standard, right? Still there is a jump. Just trying to get my head around this, if you could help me?

Muhammed Shihabuddin

Executives
#20

Yes, for sure, basically. This is from the IFRS methodology itself, but ECL, they follow 2 principle to run the engine. One is that external data, secondly, internal data. That is truly like the decision of an auditor basically. Historically, they were following different methodology. Then the last quarter, I feel in 2025, beginning, they come up with them saying that this is a new updated methodology all of us has to follow, then -- but we didn't contest it basically. When they run the engine, when they calculate it, they said that, no, you should have a minimum of 3.5 percentage provision. We didn't contest it, we followed. It is, every quarter, they are reviewing the same our data. Any improvement is there, obviously, we will come back to all of you. As of now, this 3.5%, that is what we are reasonably predicting in the near future will continue.

Operator

Operator
#21

We will now move to the text question that we have received from Yassin Mohammed from EFG. There are 3 questions. I'm going to read them all how much did O&M revenue account for third quarter of 2025's revenue and profitability? Second question, why did pharmacies revenue decline year-on-year in third quarter 2025? Are the efficiencies in inventory costs sustainable going forward? Or was third quarter of 2025 level supported by the temporary restriction of patients by an insurance provider?

Muhammed Shihabuddin

Executives
#22

Yes. With regards to the first question regarding the revenue contributions, as we indicated in our presentations, O&M contributes around 13 percentage of our net profit. As we were guided that like we were expecting around 6 percentage to 7 percentage of our bottom line, but O&M segment, we are significantly growing. We are getting a lot of leads either from the corporate or from the government within the country, beyond the country to manage the facilities. Which is -- that is where like we were building the structure. Last 18 years of experience, we are in cashing for the coming years. We have a bigger plan with O&M. There's a lot of assets which we are getting CORI to manage. This segment is absolutely will grow in the near future for sure, very aggressively. There is no capital requirement. It is easy to grow as much we can. We have deployed dedicated team CEO, CMO, finance head, full team to focus on this particular segment. That's why we are growing, and we'll keep growing further as well. With regards to the inventory, obviously, we suspended one of the largest network in the country. That also contributed negative on the pharma as well. Secondly, with regards to the retail, obviously, when we are analyzing the data, the retail pharmacy also will have the prescription element of it basically. That also contributed partially. All these things, we are expecting that will be coming back as and when we reinstate our network, which has happened in 1, November. Then the last question. Yes, it is clearly mentioned that like in November 1, onwards, that particular network is reinstated in our facilities. Obviously, even we are seeing flow to our hospitals, it is growing, and it will be keep improving.

Operator

Operator
#23

Saikat has shared his question via text. Is there any scope for collecting the current receivables after Daman reinstatement?

Muhammed Shihabuddin

Executives
#24

Obviously, if Daman reinstated it or not, our receivables are receivable. For sure, we have to collect it. Obviously, you know that when the negotiation happened -- when the tough deal negotiations happened, there are multiple ways that people drag it, right, to put us under pressure and all. It is all about like how we manage the situation. We successfully manage that particular situation. We face some delays. Obviously, we will -- even both parties are very much happy about the deal. We expect Daman and other insurance company also will be going forward supporting on this particular element. With regards to the receivable from Daman, obviously, we are seeing a very positive response from Daman to fasten the process basically, that will improve. That is why it is guided in 2026, we will be seeing a change. Overall 2026, I'm expecting my receivable days will come down to 120 days.

Operator

Operator
#25

We have a follow-up question from Saikat. The revised guidance implies 4% quarter-on-quarter lower sales and 23% quarter-on-quarter lower EBITDA in Q4. The EBITDA margin implied for Q4 in the guidance is 17%. What is the reason for this lower guidance? Salaries are lower in Q3 versus Q2. I'm wondering if there is any human resource cut. Also, what is the reason for increase in legal and professional fees this year?

Muhammed Shihabuddin

Executives
#26

Yes. With regards to our revenue growth, if we compare year-on-year basis, Q4-to-Q4, we are growing. But Q3, as I demonstrated in the presentation, Q3 is the all-time high for the group since IPO. The growth which you mentioned negative growth is from the Q3 to Q4. Obviously, we cannot -- we are not even forecasted that Q4 will be better than the Q3. Q3 was all-time high for us since IPO. When it comes to the Q4, if we compare the Q4-to-Q4, we are growing and we are going good basically. The second point, basically, what you say? Yes. With regards to the manpower cost, basically, this even if you were a part of our last calls, right? I mentioned very clearly, the group was going aggressively on to the hiring of the required staff in 2024. That's the reason we were struggled and penalized in 2024 result. It was an investment for us because if we need to achieve a growth, the expected level of an aggressive growth in the coming months, we have to be ready in advance. This is healthcare professionals, soft skilled people. It is not that easy like if I need to grow in next month, I can hire the staff. I need to hire the staff in advance. I need to give adequate training. I need to give kind of onboarding, all kind of a process, regulatory requirement, all these things take time. I should be planning in advance, onboard them in advance. I know that a few months, it will be a burning for me, but it is going forward over the long term, it will be giving a return. In 2024, if you may recall, we hired around 188 doctors. It doesn't mean that they were giving me any return in 2024, but now obviously, they start ramping up. When it comes to the ramp-up, as I indicated earlier also, when there is an increase in revenue, I will have only the marginal cost impact because the major cost I already incurred in my system. That is what is getting reflecting now. It is a clear message what I was indicating previously is getting realized and reflecting in our result. Going forward as well, you will see a further improvement. Doesn't mean that I'm removing people. It is improving my top line. When it comes to my percentage, basically, it is improving basically. That is what is happening.

Operator

Operator
#27

We have a follow-up question from Neetika from Franklin.

Neetika Gupta

Analysts
#28

Just one follow-up from me. As per this new presentation for the 9-month period, the expansion plan for '25 and the midterm is quite different, while the CapEx is the same. Could you help us understand that what is driving this change, especially within '25 and '26? I see new LLH hospital, which was not there in the previous presentation. 4 day surgery centers have been upgraded to 4 on the midterm when earlier it was just about 1 in Ras Al-Khaimah. Can you help us understand on the expansion plan, please?

Muhammed Shihabuddin

Executives
#29

Yes, for sure, basically. If we compare our previous list, basically, we were targeting some of the day surgery centers from the greenfield perspective. The investment was high in that day surgery center. Now we have decided that, no, we will not go for the greenfield Instead, we'll go for the brownfield, so the investment is completely changed. What I did basically, I make use of that investment into the expanding some other brands, some other products in different regions. That is where the LLH hospital, Jebel Ali came, which we got the assets for a minimal value. By investing a few amount, I can convert them as a day surgery center, and I can target my -- the lower segment, which is very much required in that region, so like that, we have reshuffled our assets basically. Whatever that extra is coming out of that reshuffling be reasonably used for the further growth. This is what happened, Neetika.

Operator

Operator
#30

As we are seeing no further questions, I'm going to pass the line back to Sergei for his concluding remarks.

Sergei Levitskii

Executives
#31

Thank you all for joining today's call. For any follow-up questions, please find Investor Relations contact at the end of this presentation and on burjeelholdings.com. Thank you.

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