Operator
Ladies and gentlemen, thank you for standing by. I'm Constantinos, your chorus call operator.
Welcome and thank you for joining the MedLife conference call to present and discuss the third quarter 2025 financial results. Please note that the conference call is being recorded and during the management's presentation all participants will be in listen-only mode.
The presentation will be followed by a question-and-answer session, and you can submit questions via the webcast platform or via telephone. Should anyone need assistance during the conference call, you may signal an operator by pressing star and zero on your telephone or by dialing the phone numbers under the Ask Question section on the webcast page.
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.
Mihail Marcu
Good evening, everybody. Thank you very much for participating today to our conference related with the results of the third quarter of 2025.
Today I'm here with Mr. Dorin Preda, the Deputy CEO, with Alina Irinoiu Titu, the CFO of the company, and Alina Bîrsu, that is the Investor Relations Manager.
I will give the mic to Alina, that she will make the main presentation, and after that, of course, we'll be here for the Q&A session. Alina, please take over.
Alina Irinoiu
Thank you, Mihail. Good afternoon everybody, and thank you for joining our presentation today.
As always, I will start the presentation with the highlights for this period. In the 9 months of this year, we have recorded a consolidated pro forma turnover of 2.36 billion RON, namely an increase of 19.5% compared to the same period last year.
Looking to pro forma EBITDA, we see an advancement of 20.4%, reaching 349 million RON. Out of this increase presented in revenues, the organic growth was of 15.5% and has the following pillars: on one hand, robust demand for medical services and also the gradual ramp-up of the newly added capacities, while the rest of 4% is coming from the acquisitions that were mainly completed in the fourth quarter of 2024, but also limited transactions this year.
Across all business lines, the hospitals led the strongest performance. They were followed by the clinics network and the laboratories division.
The positive impact of recent investments in modern equipment, in the new facilities, but also the medical teams are now being reflected both in financial and operational results, but more important, we see them to set the foundation for sustained profitability growth over the medium and long term. In the third quarter of this year, we have continued to expand the group's medical infrastructure, and we have completed a series of organic projects that were announced for this year and were already underway, some of them started since last year.
The first one is the new operating theater in MedLife Craiova Hospital that consolidates our position of one of the most modern medical centers in the Oltenia region. The equipment used in the new operating rooms meet the highest technological standards, while the medical team consists of over 20 specialists, including general surgeons, orthopedics, neurosurgeons, and vascular surgeons.
Starting next year, the hospital attention will increasingly focus on highly complex oncological surgeries, given that a large part of MedLife Craiova patients are treated for oncological conditions, they having basically this specialty very well represented nowadays. The second organic project that was finalized in the third quarter is the new multidisciplinary hyperclinic that was opened in Pitești following a €3 million investment.
The new facility was designed as a medical hub with 21 consultation rooms. They also have sampling points, have day hospitalization with 13 beds, and its own laboratory.
Moving next to the outlook for short and medium term, we expect the group to maintain a stable trend. We have adopted a prudent approach while capitalizing on the available resources in order to sustain strategic investments and adapt to the evolving macroeconomic environment.
We continue to closely monitor the impact of the current macro environment on the purchasing power, and we are ready to address potential challenges while supporting the growth and stability of the group. The laboratories, as I mentioned, and the hospitals networks have maintained consistent performances, while the chronic disease and acute care business lines have also increasingly driven the sales growth in recent years.
The capital expenditures for the fourth quarter in relation to new projects remain very low. We don't have planned new capex initiatives.
We will continue to prioritize operational efficiency and the strategic allocation of resources. All future investments also will be assessed carefully, taking into account the market conditions and the strategic business priorities.
In the fourth quarter, Neolife Oncology and Radiotherapy Center in Bacău will be opened. It was finalized, while the new hyperclinic in Arad that we have also announced is scheduled for completion in the first quarter of 2026.
On the list of strategic priorities, we want to accelerate research projects and actively contribute to improving both medical outcomes as well as patient experience. A defining initiative in this direction is the recently launched pilot research project in medical imaging, where our radiologists work aside with the AI algorithm trained in order to identify patterns and to support the creation of standardized, comprehensive, and highly accurate imaging reports, of course, with the ultimate target of enhancing the diagnostic precision and the time to give the results.
With a database of nearly 1 million MRIs investigations that we currently have, we expect this project to position us at the forefront of private medical research, most probably also in the region, demonstrating how technology can amplify and be together with the human experience and to work together with the doctors. On a different project, we have made important progress in developing our strategic genetic testing program.
We launched early October Longevity 100+. This is the first and largest genetic testing program in the region.
This initiative aims to democratize the access to genetic testing and shift basically the focus from treating advanced diseases to their early risk identification and prevention. After this research that is conducted on approximately 4,000 patients across Romania, starting next year, the genetic testing will become available to the general public, making a significant step toward the transformation of preventive medicine in Romania.
The idea behind is basically to move beyond the traditional screening, to move towards personalized health plans supported by genetic data, supported also by cutting-edge technology and the expertise of our medical teams. The investments made in this direction are estimated to reach €10 million, which is basically a balanced level relative to the size of the group.
In terms of this project, we anticipate to see the first results of these investments most probably in the second half of next year. Now it's still very early to advance some estimates regarding expected volume or the potential contribution to volume growth.
Moving on to the next section: good, the financial results. We are looking now at the consolidated statement of profit and loss, 9 months 2025 pro forma as compared to 9 months 2024.
Gross sales, the one with the National Health Program for chemotherapy drugs included, have increased by 19.5%, reaching 2.36 billion RON, while net sales, the one without National Health Program drugs, increased by 9.4%, reaching RON 2.16 billion. Operating expenses increased by 9.1%, reaching 2 billion RON.
Consequently, the operating profit increased by 18.1%, reaching 133 million RON. Pro forma EBITDA increased by 20.4%, reaching 349 million RON, resulting in a margin of 16.1%, similar to the pro forma margin, last year.
You will see in terms of IFRS basis, we have 14.3% EBITDA margin as compared with 14.7% in the first 9 months of 2024. The last one, the bottom line pro forma net result, was 2.5 million RON, representing 88% decrease versus the same period of last year.
This is mostly determined by the FX depreciation that you already know took place in the second quarter, where we had the largest hit basically coming from the revaluation. Regarding pro forma figures, on the next slide, the bridge in revenues and the bridge in EBITDA: so for revenues from IFRS figures to pro forma figures, we have included only 2.3 million normalization adjustments coming from acquisitions.
This is because we weren't that dynamic on acquisitions and on the development through acquisitions during this period. We have completed Rutinmed, and this entered into consolidation in February, and Allclinic, that entered into consolidation in April.
Here we normalized only January for Rutinmed and the first quarter of Allclinic, the transactions not being significant in terms of sales either. The second adjustment is the extraction of roughly 200 million reclass of the National Health Program for chemotherapy drugs, which you can see that have increased by 44% as compared to the same period last year when we had 138 million.
This is also linked with what I mentioned before about the good evolution in the oncology sector. In terms of the bridge in EBITDA from IFRS figures to pro forma figures, 200,000 correspond to the normalization adjustments from acquisition, while 10 million RON are presented as one-off expenses.
Moving next to the quarter-on-quarter EBITDA evolution, we have registered over the past 2 years a constant improvement in EBITDA levels, looking at absolute amounts, even though we had integrated throughout this period new units. That most of our development in the past 2 years was coming from organic development projects, they were coming with a negative contribution to EBITDA in the reporting period.
The revenues have steadily increased in recent years, reflecting the platform's capacity for growth through both acquisitions and organic projects. I already mentioned the increase of 19%, with 15.5% being organic, mostly linked to the hospital in Bucharest, the hospital in Timișoara, most significant amounts, let's say Pareto, from the increase, and 4% coming from acquisitions.
Moving to KPI and business line evolution, clinics continue to be the group's primary sales driver, it's accounting for 37.4% of total sales. 19.2% growth in the first 9 months of the year is driven by roughly 14% increase in the number of visits and a 5% increase in the average fee.
The higher volumes are largely attributable to the latest acquisitions, including Euromedica in Baia Mare, VP Med in Hungary, and Rutinmed in Tulcea and Antares, as well as to growth in the oncology units, in the imaging divisions, and also the increasing contribution of the newly developed units. Stomatology division accounts for 4% of total sales.
Sales declined here by 2.8% over the 9 months period. However, you will see in the third quarter of 2025 that the trend softened, recording a 3.4% year-on-year increase.
Here we have discussed also in our prior presentations, the premium stomatology segment is showing signs of saturation, and here we are evaluating and we will pilot alternative service models. Hospitals represent 27.6% of total sales.
The growth for this period as compared to last year is of almost 40%, and is driven by 32% increase in the number of patients compared to the same period last year, with 5.5% increase in average fee. Looking at the increase in the number of patients, the reasons are the acquisitions, namely Euromedica Hospital in Baia Mare that it's consolidated starting with October 2024.
Then I'll add the investments in technology and equipment across all our mature hospitals, the ones in Bucharest, Cluj, Sibiu, Brașov, and Arad, along with the onboarding of new medical teams. The increased number of interventions and expanded medical teams at Nord Hospital in Bucharest that was opened at the beginning of last year, and the opening of the Timișoara Hospital at the end of 2024, which had a very strong start and it's now experiencing accelerated growth.
Laboratories account for 11% of total sales, and posted 16% increase year-on-year. The drivers are 21% increase in the number of lab tests performed, offset by a small 4% decline in the average fee, which is basically reflecting a different service mix.
Here volume was supported across all our laboratories, both in MedLife and Sfânta Maria brands, with a particular strong increase in the molecular biology and genetics division. Corporate accounts for 10% of total sales, with revenue posting a small increase of 1% compared to the same period last year.
The number of preventive packages increased year-on-year by 2%, which offset the small average fee decrease of 1%. As previously mentioned here, the corporate portfolio has undergone a broad repositioning process.
We were taken efforts and in order to increase the profitability, efforts that have already been captured in pricing and profitability levels. Going forward, what we see and plan here is to introduce new products and enlarge the clients base.
Pharmacies represent 2.4% of total sales. Here the revenue has grown with 11%, mostly due to 18% increase in the average spend per client.
The last business line is others, which accounts for 8% of total sales, and posted a 9.3% increase in revenues. This is driven primarily by the pharma distribution, the increase in the pharma distribution, but also increase in stem cell banks and the wellness services, as they are all together presented in others division.
Moving forward at operating expenses, as a percentage of sales, we can see an increase of 0.6 percentage points, reaching 95.2%, which is coming from: increase in consumable materials and repair materials as percentage of sales, from 18.1% to 19.7%. This is in line with the higher contribution of oncology, laboratory, and hospital services to the revenue mix, and this is offset by the decrease in commodities and pharma contribution to total sales; then it's an increase in third-party expenses and salaries with 0.7 percentage points, which is expected to normalize as the newly created capacities continue to ramp up; and the last one is increase in depreciation with 0.2 percentage points, which is in line with the newly investments commissioned, and here we also expect to normalize going forward.
Looking at the financial position: non-current assets increased by 3.4%, which is mostly explained by the increase in goodwill through those two acquisitions and property, plant, and equipment. Financial debt has increased by 12%, driving an 8.5% rise in net debt.
The increased debt level reflects basically the utilization to partially fund the M&A and the ongoing investments, but also reflects the foreign exchange impact from the depreciation of RON against euro. Looking at the net debt to pro forma EBITDA ratio, it held steady at 3.71 times EBITDA, compared with 3.78 times at the end of 2024.
This is primarily driven by the completion of the ongoing investments, and some of which are still in very early stages and not yet generating revenues, such as the investment in the Neolife Oncology and Radiotherapy Center that is going to be opened in the fourth quarter, as well as those in the genetics division. Moving to consolidated cash flow: net cash from operating activities amounted to RON 168 million, a 22% decrease compared to the same period last year, which is mainly driven by changes in working capital.
During the first 9 months of this year, 175 million RON were allocated to investing activities, including here the acquisition of subsidiaries and the capex for ongoing projects. The most significant was Timișoara Hospital, the Oncology and Radiotherapy Center in Bacău, the hyperclinic in Pitești, and genetics laboratory.
On the outlook, as mentioned earlier, capex plan for the last quarter of the year is very low, while the capex needs and the projects for next year will be further discussed at the budget meeting. This is my presentation for today.
Thank you very much for being with us, and we can now move to the Q&A session.
Operator
Ladies and gentlemen, at this time we will begin the question-and-answer session. You can submit questions through the platform in the Ask a Question section or via telephone by dialing one of the numbers provided and pressing star followed by one on your telephone.
If you wish to remove yourself from the question queue, then you may press star and two. Please use your handset when asking your question for better quality.
Anyone who has a question may press star and one at this time. One moment for the first question, please.
Ladies and gentlemen, there are no audio questions at this time, and I will now pass the floor over to management for any written questions. Thank you.
Dorin Preda
Thank you very much. I'd like to take the first question, which has been raised by Mr.
Daniel Munteanu regarding the Banu Manta building that we have bought from Telekom in 2017. Actually, we have thought about this building as being our new offices because we are still occupying medical spaces in the Medical Park.
Because we have prioritized other projects and we considered that is better to invest in hospitals and businesses that are going to produce, we have allocated lower priority for this building. However, starting with next year, we are going to allocate more capex investments for this building, in order to have it ready, hopefully, in 2027.
What is important to mention here is that, despite the offices, we also have here a clinic, an ambulatory, that is going to be open, hopefully, in the same time with us moving in the building. This was the first question.
The second question is coming from Mr. Cristian Petre and is actually asking if we have seen any slowdown during this period.
He is comparing the first quarter with the third quarter and actually he's seeing figures rather flat. Actually, it's a very small growth.
I would say here that we are seeing solid volumes as well these days. September was a very good month.
October is a good month as well. We had maybe a bit not that happy summer.
August was not such a very good month for us, but as we see it today, we are seeing volumes being solid. We are pretty optimistic about the months to come.
Alina Irinoiu
The third question is coming also from Cristian Petre: "But I would kindly ask if you can explain a bit, how do you approach different growth rates across segments?" What do you mean, maybe in terms of price adjustments?
I will comment on that, and if you want to add more, please. This year, we have increased prices at the beginning of the year, even though in August there were adjustments in VAT that came with an impact of €200,000 per month in terms of cost for us, because VAT is a cost for the healthcare network.
We didn't increase prices across the board, with only one exception. We did some increases in the hospitals division, and that was it, with no intention to adjust prices by the end of this year.
There will be a discussion for next year. We still have this option, of course, to adjust prices, but we didn't decided yet if this will be pursued starting with next year.
Operator
Ladies and gentlemen, there are no further questions at this time. I will now turn the conference over to management for any closing comments.
Thank you.
Mihail Marcu
Thank you again for participating to our conference today. As a general note, you should notice that MedLife still growing organically quite strong, despite the economic downturn, at least the decrease of the sales in the retail and online in Romania that have been published recently.
We have seen some decreasing demand, especially during August and September and the beginning of September, actually, but in October, this came back to us. I can tell you that it's right, to the clinics, there were addressed less clients than we expected at the beginning of the year.
Here they are mostly clients that they address not only for medical conditions, but also for health assessment. Of course, maybe this have been a bit adjusted, not less than last year, but we expected to grow a bit faster.
In exchange, we succeed to grow on hospitals business where most of the clients cannot postpone their medical needs to the next economic cycle, and actually also driven by the new units. Actually, the units that didn't perform as well and were part of our in-success in making margin this year, but actually mostly Medici's and Nord as well, the new hospital in Craiova also started to deliver.
We considered them growing slower than we expected 1.5 year ago, but now they are paying back. Still, they have also some room to grow, but we are satisfied with their performance.
We have launched also some new business lines. I think you've seen in the press, innovative and using very high technology.
I can tell you that we are going to launch some new products in imaging and AI soon at the beginning of next year. The same, very, very innovative and at the frontier of research.
We are very proud of that. You should keep in mind that these new business lines are not tested yet to the clients.
We think these products even can change the medical sector and in the future, not only our products launched by MedLife, but these new products in genomics, these products in AI in imaging will change the sector in the years to come. Personally, I believe this sector will look differently in 5 years, and the patients also are going to look different, and they'll have different needs.
I think we should be there. If any medical company will not be there, I think will not deliver in 5 years from now on.
This is one thing that we are trying to keep up with the new technology and with the new innovations around the world in medical sector. Also, we know that the Romanian economy is not doing well, and we'll carefully balance the investments, given our present level of debts that we know it's a bit high, we still want to adjust it.
With this, I thank you again, and I wish you a very nice weekend. Thank you very much.
Good evening.
Operator
Ladies and gentlemen, the conference is now concluded and you may disconnect your telephone. Thank you for calling and have a good afternoon.
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