Operator
Ladies and gentlemen, thank you for standing by. The conference will begin shortly.
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, and during the management's presentation, all participants will be in a 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 * and 0 on your telephone or by dialling the telephone numbers under the "Ask a Question" section on the webcast page.
At this time, I would like to turn the conference over to Mr. Mihai Marcu, Chairman of the Board and CEO of MedLife Group.
Mr. Marcu, you may now proceed.
Mihai Marcu
Thank you. Good day, good day, and thank you for participating today to our conference related with the results of MedLife in the first quarter 2026.
With me today are with all the team, the usual team: Dorin Preda, the Deputy CEO; Alina Irinoiu, CFO; and Ioana [Bârsu?] , IR Manager.
Alina will hold the presentation as usual, and after that, we shall be here for your Q&A session. Today, the final statement will be made by Dorin Preda, the Deputy CEO.
Alina, the table is yours.
Alina Irinoiu
Good afternoon, everyone. Thank you very much for joining the presentation today, and thank you, Mihai, 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 856 million RON, 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 showing basically that the underlying demand for healthcare services remains solid. Across our core business lines, clinics remained the primary growth driver, which reflects, of course, both the resilience of the healthcare platform, but also the sustained demand for medical services during a 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 healthcare 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 124 million RON, namely a 10% increase compared to the same period last year, while pro forma net result amounted to 12.6 million RON.
Margin-wise, we have observed a slight decrease in the average ticket per patient, particularly in non-urgent and discretionary medical services, but this effect was more than upset 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 at 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 Genesys network in Arad. We have opened there the fourth clinic.
This offers over 17 medical specialties, together with laboratory services and dedicated preventive care programs. In terms of acquisitions, we have finalized Med-Star 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 €2 million investment in one of the most advanced robotic neurosurgery systems in Romania, which is in our hospital in Sibiu. We also announced the first results of Longevity 100+ 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 adjustments in Romania and a broader period of economic normalization. Nevertheless, as I mentioned, we delivered revenue growth of 10%, demonstrating that the healthcare system remains and the healthcare 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 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, which is supported, 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 confirmed our view that prevention, predictive medicine, and personalized healthcare will become increasingly important over the coming years.
This is why we will continue to expand access to genetic testing and advanced 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 healthcare more accessible, more integrated, more easier to navigate for patients, while also improving efficiency across the group.
We see the healthcare 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 sizeable 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 said, moving on to the next section, the financial results, 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 856 million RON. Pro forma operating profit increased by 7% to 47 million RON.
Pro forma EBITDA increased by 10%, reaching 124 million RON, 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 12.6 million RON, 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.
It's 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 reportings.
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 market environment is characterized by decreased consumer spending and a slight decrease in the average ticket per patient, even though patients became somewhat more selective in certain categories of spendings, it's obvious that demand for healthcare services remained 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 higher complexity medical services and procedures, thus resulting in a more favorable service mix. Hospitals remain, nevertheless, one of the group's primary growth engines, 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, continued to perform very well. Subscription volumes increased by 7%, while revenue growed 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 needs 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.
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 as DENTESTET 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 an improved product mix. 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 a bit the cost structure.
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 revaluation 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, non-current 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, we have 3.8 as 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 123 million, pretty much in line with EBITDA, reflecting strong underlying cash generation capacity. Net cash from operating activities was RON 70 million, down by 22% due to timing.
Investment cash outflows decreased compared to the first quarter of 2025, having 63 million RON being invested in acquisitions of subsidiaries and the purchase of equipments and development of units basically. In terms of guidance for 2026 capex budget, this stands at €20 million, of course not including acquisition.
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
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 dialling one of the numbers provided and pressing * followed by 1 on your telephone.
If you wish to remove yourself from the question queue, then you may press * and 2. Please use your headset when asking your question for better quality.
Anyone who has a question may press * and 1 at this time. One moment for the first question, please.
The first question is from the line of Elias New with ODDO BHF. Please go ahead.
Elias New
Yes, good afternoon. I hope you can hear me, and thank you for the time.
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 IFRS is at 14%, and the full-year budget is for 14.5%?
Should we expect a progressive margin improvement over the course of the year? I guess the second part of that question is you mentioned a softer consumer spending in the quarter, I was just wondering, did you see any deterioration here compared to the prior-year quarters in Q1?
Alina Irinoiu
Thank you for your questions. 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 at different services level is affected. Nevertheless, we see that the demand of our services remained 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. To answer, has slowed down, let's say, compared to last year, but still strong and in line with the budget.
Elias New
Okay. Just to clarify on that, sequentially, has consumer spending slowed down as well?
Looking at Q4 compared to Q1, just wondering if anything surrounding the environment, any color you could provide would be helpful. 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 the Q1 EBITDA margin.
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.
Alina Irinoiu
That's correct. If we keep the budget, then we will see slow progressions as we go along the year.
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.
Elias New
That's helpful. I guess my second question would relate to D&A.
D&A came in somewhat higher in Q1, at 77 million RON. I know there's a lot of volatility within the D&A line for you from one quarter to the next.
I was just wondering, in terms of that 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 sort of trying to wrap my head around that, given the quarterly volatility that you sort of report here and whether there's anything to call out.
Alina Irinoiu
That's true. There is an increase in absolute amounts.
It's coming on one hand due to the investments 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, we plan to further invest, we assumed that for this year, the share as compared to sales will keep the same, roughly 9%, as you see it now, shall be consistent for this year.
Elias New
That's very helpful. A final question on my side would be on your financial result guidance as part of the budget, which I believe is for 138 million RON.
Could you just perhaps elaborate a little bit on the moving parts here? What assumptions does this include in terms of any potential adverse FX movements of the RON compared to the euro that we've also seen in recent weeks and months?
Also, given the increase in the EURIBOR interest rates in recent months, is this also already reflected in that financial result guidance?
Alina Irinoiu
Thank you for your question. We have modeled or included in our budget a 2% depreciation of the RON against euro.
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 a governor, a new governor appointed.
Elias New
In terms of the just EURIBOR interest rates moving quite adversely in recent months since the Iran crisis, is that sort of also already captured by the budget, or is there sort of risk that also leads to essentially higher financial results for you than what you're guiding?
Alina Irinoiu
I don't think I followed the question, but I will just say what I understood. I clarified that we have modeled and included a 2% depreciation that was in line also with consensus coming from financial institutions.
Elias New
No, just to clarify, my question is actually relating to the actual interest rate that you are paying, given your debt is euro-denominated. Given the sort of swings we've seen in terms of interest rates, short-term interest rates in recent weeks and months, compared to when you released 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 still is accurate in terms of the number that you're guiding for.
Alina Irinoiu
I will touch also the interest. I understood after that.
From interest expense, we have also modeled well in line with the evolution today. We have a biannual reset of the EURIBOR.
It happened already in May, and it's in line with our budget. We are covered for the interest expense that we have on our euro loans.
Elias New
That's great. That answers my question.
Many thanks.
Operator
Thank you. As a reminder, if you would like to ask a question, please press * and 1 on your telephone.
There are no further audio questions. I will now pass the floor to management to accommodate any written questions from the webcast participants.
Dorin Preda
Yes, thank you very much. Actually, we see some number of questions on the app.
I will try to summarize the answers, because some of them have already been answered by Alina already, but other are somehow repeating, and I will try to get them together by subjects. One of the first subject was related to the profitability and the expectation that we can send to the market regarding the profitability.
As Alina was mentioning a bit earlier, we see 2026 as a year of improving profitability. As some of our greenfield projects that we have done in 2025 and also 2024, which is Timișoara Hospital, which has already break-even in the last quarter of 2025, but also Nord Hospital, that has break-even 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 two hospital are not yet in contract with the National Health House. Of course, their performance, as we speak, is influenced by that.
From our point of view, it's not a problem of if, it's a problem of when they're going to be part of the contract with the National Health House. 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 question. I think that what I can add here is also that we continue to focus on efficiencies improvements and looking on other synergies inside the group already.
Somehow, we continue to do things that we said also in the other conference call up to day that we are trying to add different layers of either legal or operational integration among the subsidiaries, so that out of this, that 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 we are 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 deleverage 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 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 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 than what we see today in terms of FX rate exchange. Alina was of course mentioning that we already have a kind of depreciation of the currency that we have already in our balance sheet.
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.
Alina Irinoiu
There are also several questions in the area of price increases planned in the coming quarters. Our response is no.
There are no further price increases that we plan at this stage at least. 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 5%; 5% and 10% was related to hospitals, and in laboratories with 3%. In terms of 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.
This is why the fluctuation, but it's something manageable and recoverable as well. It's only timing.
Dorin Preda
I think this would be the question. I think there is one on longevity.
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 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 lines, maybe corporate in corporate division as a first step. Of course, the idea is that coming with this type of products will differentiate us from the other players on the market and will bring us advantages on the long
Alina Irinoiu
term. The last one, and then I will leave Dorin to make the closing remarks, is regarding Med-Star.
The question around Med-Star is regarding the contribution to the group. It was consolidated from February.
It is a business with around 3, 3.5 million RON revenues per month. 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 at the closing.
Dorin Preda
Yes, thank you very much, all of you, for participating today. 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 touched all this aspect already, but I think it's worth it to have it more clear. 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. 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 this reconfirmed that the ongoing interest of the patient 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 ideas, because we really think that both technology and genetics are fields that will play a very important role in the medicine of the future. We are focused on development modern solutions that will improve patient experience, and also facilitate quick access to medical services and relevant medical information, with major emphasis that it will be placed on increasing interaction and accessibility through the new mobile application that we are working on.
The third and last, 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. We continue to monitor our costs and also optimize internal processes, so that we will be able to support a 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's being said, thank you once again for your participation today, and have a very pleasant weekend.
Thank you very much.
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