Med Life S.A. ($M)

Ladies and gentlemen, thank you for standing by. I'm Polina, your Chorus Call operator. Welcome, and thank you for joining the MedLife Conference Call to present and discuss the first quarter 2026 financial results. Please note that the conference call is being recorded. [Operator Instructions] At this time, I would like to turn the conference over to Mr. Mihail Marcu, Chairman of the Board and CEO of MedLife Group. Mr. Marcu, you may now proceed.

Thank you. Good day, and thank you for participating today into our conference related with the results of MedLife in the first quarter 2026. With me today are with all the teams, the usual team for Dorin Preda, the Deputy CEO, Alina Irinoiu, CFO; and Ioana Birsu, IR Manager. Alina will call the presentation as usual. And after that, we shall be here for a Q&A session. Today, the final statement will be made by Dorin Preda, the Deputy CEO. So Alina, the table is yours.

Good afternoon, everyone. Thank you very much for joining the presentation today, and thank you, Mihail, for the introduction. As always, I will start this presentation with the highlights for the first quarter of this year. You will see that in the first 3 months, the group has recorded a consolidated pro forma turnover of RON 856 million. which represents an increase of 10% compared to the similar period of last year, out of which 9% was organic development, organic growth. Demand in our network remained strong, and we continued to grow the number of patients and clients. This is showing basically that the underlying demand for health care services remains solid. Across our core business lines, clinics remained the primary growth driver which reflects, of course, both the resilience of the health care platform, but also the sustained demand for medical services, during the period with a still challenging economic environment. Moving to hospitals. They also delivered strong performance, closely followed by the laboratories division. Here, we have witnessed a continued demand for complex and rather integrated health care services, as well as an increasing patient attention to prevention, combined with diagnostics and continuity of the Medical act. As you already know, over the past years, we have significantly increased the complexity of the medical services, both in the Hospital division. We made investments in advanced medical equipment and surgical robotics. We had expanded the infrastructure with also bringing highly specialized medical teams. But also if we look to the laboratory segment, we did that through the expansion from routine testing towards advanced diagnostics, including here, genetics and pathology services. In terms of profitability, pro forma EBITDA reached RON 124 million, namely a 10% increase compared to the same period last year, while pro forma net result amounted to RON 12 million. Margin-wise, we have observed a slight decrease in the average ticket per patient, particularly in nonurgent and discretionary medical services. But this effect was more than offset by continued growth in the number of patients and strong volume increase across the network. With constant and stable 10% across most of our business lines, and we will touch this -- the key operational indicators evolution. In terms of expansion and projects. During this period, we had several organic development and strategic investments performed. We have expanded the MedLife Genesis network in [indiscernible]. We have opened there the fourth clinic. This offers over 7 medical specialties together with laboratory services and dedicated preventive care programs. In terms of acquisitions, we have finalized [ MedStar ] transaction. We have obtained the approval from the competition council in January, and consolidated the company in our results beginning with February. We have continued, of course, investments in technologies and new operational capabilities. An example here is the EUR 2 million investment in one of the most advanced robotic neurosurgery systems in Romania, which is in our hospital [indiscernible]. We also announced the first results of [indiscernible] 100-plus program, that highlighted basically the potential that genomics and personalized medicine will have in prevention and early diagnostics, while supporting basically the development of higher value-added medical services. Moving to digitalization. We have continued to invest in digitalization and the expansion of our technological ecosystem. We are particularly focused on enhancing MedLife application, but also to strengthen our capabilities in genomics, personalized medicine and diagnostics. And here, we also talk about imaging because these are areas that we consider as strategic priorities for the medium and long term. Not the least, we have continued to strengthen our corporate division. We have launched new products and services here designed to the evolving needs of our corporate clients. We have seen that the market response has been very positive, supporting both client acquisition and the expansion of our existing partnerships. As a result, and we will go in much more detail later. We have continued to gain market share in the corporate segment. And this is a trend that we expect to continue in the coming periods. Looking at the overall market dynamics, the services market in general is not growing with consumer spending remaining rather slow in the first 4 months of 2024, reflecting basically the continued impact that is coming from fiscal adjustment in Romania and a broader period of economic normalization. Nevertheless, as I mentioned, we delivered revenue growth of 10%, demonstrating that the health care system remains -- under health care services basically remain a priority for Romanian consumers, and that demand for quality and complex medical services continue to be resilient. In terms of outlook, we believe that the stabilization measures implemented at the economic level are gradually beginning to improve the market sentiment here, and that should support a more balanced environment by the end of this year. For MedLife, specifically, our expectations remain positive. We continue to see solid demand across most of our business lines, and we expect to maintain a healthy growth direction. We did support it, of course, both by organic development and also the contribution of recently opened and integrated facilities. In terms of strategic priorities, we remain focused on the areas where we see the strongest long-term opportunities for growth and differentiation. As I mentioned, one of our key priorities is genetics, combined with personalized medicine and precision diagnostics. Following the launch of longevity program, the first results have been encouraging and further confirm that our view that prevention, predictive medicine and personalized health care will become increasingly important over the coming years. This is why we will continue to expand access to genetic testing and diagnostic services. Building on the investments we have already made in these areas. At the same time, we continue to invest in technology and innovation. We are preparing the launch of new interesting products in areas such as genetics and imaging. While also significantly upgrading the medical app and our broader digital ecosystem, Our goal basically is simple in this direction to make the health care more accessible, more integrated, more easier to navigate for patients while also improving efficiency across the group. We see the health care increasingly moving towards more personalized technology-driven solutions. And of course, we want to be and we are at the forefront of this transformation. Moving to the M&A side a bit, just before going to figures, we remain active in the market. we are evaluating opportunities as they arise. We currently don't see any sizable transaction materializing in the near term. But we are very much present in the market, and we are maintaining an active dialogue with potential targets. As I said, moving on to the next section, the financial result and looking at the consolidated statement of profit and loss. The 3 months pro forma versus 3 months IFRS gross sales increased by 10%, reaching RON 856 million. Pro forma operating profit increased by 7% to RON 47 million. Pro forma EBITDA increased by 10%, reaching RON 124 million, resulting in a margin of 16% on a pro forma basis with 14% on IFRS and 14.5% in the first quarter last year. Pro forma net result was RON 12.6 million, with 90% increase versus the same period last year. Moving to pro forma figures. There is the usual bridge that I always present. I don't think necessary to go in detail here. Is a bridge from IFRS figures to pro forma figures, both in terms of revenues and in terms of EBITDA. Here, the methodology didn't change from all our reporting. On the next slide, looking at the quarter-on-quarter evolution, EBITDA margins in the first quarter remained broadly in line with historical levels. Even though I mentioned that the marketing environment is characterized by a decreased consumer spending and a slight decrease in the average ticket per patient. Even though patients became somewhat more selective in certain categories of spending, it's obvious that the demand for health care services remains strong, allowing us to continue growing patient volumes across the group. At the same time, the increasing contribution of higher complexity medical services and the ongoing focus that we have on operational efficiencies help to support the profitability levels. On the revenue side, the first quarter marked another record quarter for the group. Growth continued to be primarily volume-driven, supported by higher patient flows across hospitals, clinics and laboratories, but also the contribution coming from the facilities that were opened or integrated over the past year. Moving to the business lines evolution. Clinics continue to be the main revenue driver, accounting for 39% of total sales. Here, you can see that growth was largely volume driven, with 10% increase in the number of visits. Then we have hospitals that also delivered strong growth, revenue increasing by 11%, driven both by a 6% year-on-year increase in patient volumes and a 5% increase in the average fee. The evolution of the average fee primary reflects the ongoing shift towards the higher complexity medical services and procedures, that's resulting in a more favorable service mix. Hospitals remain, nevertheless, one of the group's primary growth engine. And hospitals are supported by the additional capacities that have been created over recent years. Laboratories, moving to laboratories, we can see 11% increase in revenues, supported by a 12% increase in the number of tests performed. Here, the average fee remained broadly stable. The corporate division as mentioned, continues to perform very well. Subscription volumes increased by 7%, while revenue grew by almost 12%, with also a 4% increase in average fees. We are particularly here encouraged by the market response to the new products and services that we have introduced which are better aligned with their needs, the need of the companies, but also the needs of their employees. We continue to see strong commercial momentum both from new client wins and the expansion of existing contracts. So we will see further market share gains and it's confirming that we are moving in the right direction. Dentistry division registered a 2.7% decline, mainly reflecting softer demand in a market segment that is more closely linked to purchasing power and discretionary spending. However, in response, we are currently reviewing and refining our strategy in this segment with a stronger focus on medium to high-end services rather than premium, high end also [indiscernible] is currently now. Pharmacies represented 3% of total sales, with revenues growing by 30%, this is mainly driven by the increase in spend per client and then improved product mix. And the last one, others which accounts for roughly 7% of total sales and registered a 16% year-on-year decrease, determined mainly by a lower wholesale distribution activity. I have just a few more slides. I will touch with the cost structure. So looking at the cost structure, the increase in consumables and repair materials as a percentage of sales was primarily driven by the growing contribution of hospitals, oncology and laboratory services to the revenue mix. This is, of course, in line with prior quarters, starting with the second quarter of 2025. We also saw a moderate increase in utilities and depreciation expenses, of course, following the investments that we made in recent years in expanding the network, and the gradual ramp-up of the newly opened facilities, but also the impact of the property valuation performed at the end of 2025, which resulted in higher fair value of the group's real estate assets. At the same time, I would like to mention that despite the increase in VAT, and the impact of euro appreciation on part of our procurement costs. We have managed to maintain a stable margin profile. And this was, of course, supported by supplier negotiations, ongoing operational efficiencies initiatives and the benefits generated by the scale of our operations. Looking at the financial position. Noncurrent assets increased by 1.4%. This is mostly explained by increase in goodwill. Financial debt increased by 2.1%, which led to approximately 3% increase in overall net debt. Net debt to pro forma EBITDA ratio remained essentially flat compared with the end of 2025. So we have [ 3.8 ] at 31st of March 2026. And we target as we go along this year to a gradual reduction of leverage towards [ 3.5 ] by the end of this year. Last but not least, moving to the consolidated cash flow. Operating cash flow before working capital increased by 8%, reaching RON 123 million, pretty much in line with EBITDA, reflecting strong underlying cash generation capacity. Net cash from operating activities was around RON 70 million, down by 22% due to timing. Investment cash outflows decreased compared to the first quarter of 2025 having RON 63 million being invested in acquisitions of subsidiaries and the purchase of equipments and development of units basically. And in terms of guidance for 2026 CapEx budget, this stands at EUR 20 million of course, not including acquisitions. This would be my presentation for today. I think we can now move to the Q&A session. Thank you very much. Operator, you can take over.

[Operator Instructions] The first question is from the line of Elias New with ODDO BHF.

I have 3 questions, and I'd like to take them one at a time. If we can just start with the margin. So how can we think about the evolution of margins over the remainder of the year given that the Q1 EBITDA margin is at 14%. The full year budget is for 14.5%. So should we expect a progressive margin improvement over the course of the year? And the second part of the question is you mentioned a softer consumer spending in the quarter. So I was just wondering, did you see any deterioration here compared to the prior year quarters in Q1.

I'll start with the first one. We will keep our projections in the budget. We are in line with the budget, and we don't see deviations coming from this. In terms of your second question, indeed, consumer consumption in Romania, what different services level is affected. Nevertheless, we see that the demand of our services remain strong. Of course, not that strong or we didn't grow as much as we did last year. But still, it is a very good demand compared with the overall market sentiment. So to answer has slowed down, let's say, compared to last year, but still strong and in line with the budget.

And just to clarify on that. So sequentially, has consumer spending down as well sort of looking at Q4 compared to Q1. Just wondering anything surrounding the environment. Any color you would be helpful. And I guess, just to also clarify perhaps my question on the margin side. So in order to reach the 14.5% guided by your budget, I guess, we would need to see some improvement from th Q1 EBITDA margin. So should that improvement come progressively as the year progresses? Or how should we think about that kind of margin uplift spread throughout the remaining quarters of the year? I hope that's clear.

Yes, that's correct. So if you keep the -- if we keep the budget, then we will see slow progression as we go along the year. and getting back consumer demand, I understood that you said the consumer or consumption continued the trend from last quarter. And this is true here in Romania consumption started to decrease with October last year and continued up to now. However, during this period, we have witnessed a good demand.

That's helpful. And I guess my second question would relate to D&A. So D&A came in somewhat higher in the Q1, that's RON 77 million, Ron. So I know there's a lot of volatility within the D&A line for you. from 1 quarter to next. But I was just wondering in terms of a Q1 number, is there anything in particular to call out here? And how should we kind of think about that D&A moving across the year? I'm just trying to wrap my head around that given the quarterly volatility that you sort of report here and whether anything to call out?

That's true. There is an increase in absolute amount. And that is coming on one hand, due to the investment we had made progressively basically last year that now are ramped up, let's say, in full effect. Then it's also a revaluation of the assets that we have performed the fair value of the properties that we own has increased as compared to last year, we do the revaluation every 3 years. Then looking at how we see this depreciation considering that we also have a CapEx activity this year, so we plan to further invest. We assumed that for this year, the share as compared to sales will keep the same. So roughly 9%, as you see it now, shall be consistent for this year.

Okay. That's very helpful. And final question on my side will be on your financial result guidance as part of the budget, which I believe is for RON 138 million, could you just perhaps elaborate a little bit on the moving parts here? So what assumption does this include in terms of any potential adverse FX movements of the RONcompared to the euro that we've also seen in the recent weeks and months? And also given the increase in the [indiscernible] interest rates in recent months, is this also already reflected in that financial result guidance?

Thank you for your question. We have a model that included in our budget a 2% depreciation of the RON against euro. So this is reflected in the budget. At this moment, today, we are at roughly 3% on the market. However, let's see what happens. We expect the FX rate to normalize once we will have over a new government appointed.

And in terms of the [indiscernible] interest rate moving quite adversely in recent months since the Iran crisis, is there is that sort of also already captured by the budget? Or is there some risk that that also leads to essentially a higher financial results for you than what you're guiding?

I don't think I followed the question, but I will just say what I understood. I clarify that we have modeled and included a 2% depreciation, that was in line also with consensus coming from financial institutions.

Just to clarify, my question was actually relating to the actual interest that your interest rate that you are paying given your debt is euro-denominated. And given the sort of things we've seen in terms of interest rates, short-term interest rates in recent weeks and months? And when you compare to an you release the budget. I'm just wondering if this delta perhaps compared to your planning assumptions needs to be reflected in the budget or whether it's still is accurate in terms of the number that you're guiding for?

Okay. I will touch also the interest. I understood after that. So from interest expense, we have also modeled well in line with the evolution today. We have, by annual reset of the Euribor. It happened already in May, and it's in line with our budget. So we are covered for the interest expense that we have on our euro loans.

[Operator Instructions] There are no further audio questions. I will now pass the floor to management to accommodate any written questions from the webcast participants.

Yes. Thank you very much. Actually, we see some number of questions on the app. So I will try to summarize the answers because some of them have already been answered Irinoiu already. But Other are somehow repeating and they will try to get them together by subject. So one of the first subject was related to the profitability and the expectation that we can sent to the market regarding the profitability. And as Alina was mentioning a bit earlier, we see 2026 as a year of improving profitability. As you know, some of our greenfield projects that we have done in 2025 and so 2024, which is [indiscernible] Hospital which has already breakeven in the last quarter of 2005, but also North Hospital that has breakeven early 2026, are also units that are ramping up volumes and probably should contribute increasingly to the earnings throughout the year. More than that, I think there is a thing that we need to say here because none of these 2 hospitals are not yet in contract with the national held house. So of course, the performance as we speak, is influenced by that. But from our point of view, it's not a problem of -- if it's a problem when they are going to be part of the contract with a national health house. And of course, once they will be in that contract their contribution to the actual performance of this year will be even more important. This would be one of the questions. I think that what I cannot hear is also that we continue to focus on efficiencies, improvements and looking on other synergies inside the group already. And somehow, we continue to do things that we said also in the other conference call up today that we are trying to add different layers of either legal or operational integration among the subsidiaries. So that out of this, there should be some synergies or economies that at the end of the day, will help the overall profitability on this year. There is another question that I have seen already, which is related to the leverage and how much you have exposed and what is the direction? Of course, that you can see the results in terms of net debt-to-EBITDA. But strategically, our plan is to leverage also this year with the scope that by the end of 2026 to go around 3.5 net debt to EBITDA. There is another question which I see here, which is related to the FX impact. I think Alina already answered partially this question a bit earlier -- to the question that has been taken already. What we see is that we have studied and we have looked intensively at this hedging opportunities that of course, are available in the market. Unfortunately, at least up to now, the consideration that we should have paid in order to have such protection for us, it didn't make sense because of the fact that the price that we would have paid for this type of hedging options are even more expensive what we see today in terms of FX rate exchange. Alina is, of course, mentioning that we already have a kind of depreciation of the currency that we have already in our balance sheet. And anyway, looking forward in case that we either expand our facilities or looking on other type of structures, of course, we will try to add some other RON denominated currency facility in order to diversify a bit the structure that we have in the -- on the lending side.

There are also several questions in the area of price increases planned in the coming quarters. And our response is no. There are no further price increases that we plan at this stage at least, but we don't think that the market can absorb other price increases than the ones we have already did in the first quarter. Just a reminder, we increased prices in clinics, between 5% and 10% and -- sorry, only [indiscernible] was related to hospitals and in laboratories with 3%. In terms of a large cash flow into receivables and temporary working capital variations, is not related to the quality of the receivables. It's related to timing. The receivables are from the National Health Insurance house that have different payment mechanisms during the year as compared to year-end. So this is why the fluctuation, but it's something manageable and recoverable as well. So it's only timing.

I think this would be the question. I think there is one on Longevity. And of course, Longevity, as we said a bit earlier, it's a combination between technology and genomics, and we are trying to come with a new way of looking at the personalized medicine. I think Alina touched already this subject during the presentation. Of course, as we speak, it's a model that will help us develop all the other business like maybe corporate in a corporate division as a first step. But of course, the idea is that coming with these type of products will differentiate us from the other players on the market and will bring us advantages on the long-term.

And the last one, and then I will leave Dorin to make the closing remarks. It's regarding [indiscernible]. The question around MedStar is regarding the contribution to the group. So it was consolidated from February. It is a business with around RON 3 million, RON 3.5 million revenues per month. And in terms of EBITDA, it's a business similar with our model with between 12% and 15% EBITDA margin. That being said, thank you very much for your questions. And I will let Dorin to say some -- few words on the closing.

Yes. Thank you very much all of you for participating I think that once we are coming close to the end of this call, there would be a few takeaways that I think are important for you in order to understand both the current market context, but also our priorities for the upcoming period. Somehow we touch all these aspects already, but I think it's worth to have it more clear. So the first idea is that, of course, the demand for private medical services remains strong, even if the growth rate is no longer as accelerated as it used to be last year. On the other side, also, we have noticed some pressure on the average ticket size, particularly for services that are not necessarily considered as of immediate medical necessity. So however, despite all these trends, what we have seen in the first quarter is that we managed to increase the number of patients across almost all business lines which, of course, is reconfirmed that the ongoing interest of the patients and needs are, of course, for high-quality accessible and integrated medical services. The second idea that we have here is that, of course, we are prepared to launch new products and services in the coming period, especially in the area of technology and genetics as we already used you to the idea. Because we really think that both technology and genetics are fields that will play a very important role in the medicine of the future. So we are focused on development model solutions that will improve patient experience and also facilitate quick access to medical services and relevant medical information with major emphasis is that it will be placed on increasing interaction and accessibility through the new mobile application that we are working on. [indiscernible] but not the least element that I think that we need to have here is that we will continue focused on operational efficiency and on improving the performance of the most recent open hospital in the network. I will continue to monitor our costs and also optimize internal processes so that, we will be able to support sustainable development of the company. In the same time, we remain in the status of continuing investment for strengthening our medical team for digitalization of internal processes and also for improving the quality of the services that we provide which, of course, needs to be in the same line with the patient increasing needs. That being said, thank you once again for your participation today, and have a very pleasant weekend. Thank you very much.

Ladies and gentlemen, the conference has now concluded, and you may disconnect your telephone. Thank you for calling, and have a good afternoon.