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CNX Nifty: 21,545 ICICI Securities Limited is the author and distributor of this report

10 January 2024 India | Equity Research | Q3FY24 Preview

Healthcare

Poised for a steady Q3 show!

Hospitals under our coverage are likely to report Q3FY24E revenue/EBITDA/PAT growth at 13%/15%/37% YoY, but the
performance may not be comparable on a sequential basis due to the offset of festive season in Q3FY24. Better inflow
of patient volumes, M&A and bed expansion plans chalk out a steady growth path for most listed hospitals. Backed by
volume growth of 9-10%, we expect diagnostic companies to report steady growth of 12%/22%37% YoY in
revenue/EBITDA/PAT in Q3FY24E. Growth in diagnostic business is likely to improve as discounts offered by online
competitors on preventive care test are reducing, non-covid volumes are recovering and organised players are taking
price increases (2-4%) in selective specialised tests. Our top picks in healthcare space are KIMS, Dr. Lal and
Thyrocare.
Hospitals - preview synopsis Abdulkader Puranwala
Revenue for our coverage universe is likely to grow 13% YoY (-0.5% QoQ) to abdulkader.puranwala@icicisecurities.com
+91 22 6807 7339
INR 59.6bn in Q3FY24E due to better in-patient volumes. EBITDA margin may
Kashish Thakur
dip 50bps YoY (-77bps QoQ) to 14.2% due to pressure from ancillary business kashish.thakur@icicisecurities.com
and new bed additions. PAT is likely to grow 37% YoY (-2% QoQ) to INR 3.3bn.

Apollo may grow the fastest among the pack


Apollo is likely to register EBITDA growth of 17% YoY driven by its hospital
business and a turnaround in its online pharmacy business. KIMS may witness
a 50bps YoY dip in EBITDA margin to ~26.4% (EBITDA growth of 14% YoY)
due to the addition of medical staff and restarting of operations at a hospital
under Sunshine. HCG is likely to report a nominal 4% YoY jump in EBITDA.

Diagnostics – preview synopsis


Revenue for our coverage universe is likely to surge ~12% YoY (-5% QoQ) as the
impact of covid base is largely behind and traction in non-covid test continues to
be healthy. Most online competitors have reduced discounts offered on their
platforms, and established chains have started taking price increases in their
specialised test portfolio. EBITDA margin is likely to jump 225bps YoY (-190 bps
QoQ) due to operating leverage and price increases. Q3FY24E EBITDA and PAT
for coverage universe is likely to rise 22%/37% YoY, respectively.

Sturdy volumes to improve performance of diagnostic chains


i) Dr. Lal is likely to report 14% YoY surge in revenue to INR 5.6bn in Q3FY24E.
It is now expanding across tier-3 towns in North, South and Western regions.
On a low base, EBITDA margin may expand 340bps YoY to 26.5%, while
absolute EBITDA may grow 31% YoY. PAT is likely to grow 49% YoY (-28%
QoQ). ii) Metropolis may report a mere 3% YoY rise in revenue due to
discontinuation of tender business. The company plans to add 600-800
collection centres and 50 hi-tech centres in FY24. Its EBITDA margin may
shrink ~60bps to ~24.1% while PAT may decline 8% YoY. iii) Vijaya is likely to
grow its revenue at a faster pace of 18% YoY driven by its strong foothold in
AP and Telangana regions and consolidation of PH. EBITDA margin may
expand 115bps YoY (-100bps QoQ) to ~40.3% while PAT may grow 72% YoY
to INR 282mn owing to its lower base. iv) Thyrocare’s revenue growth is likely
to inch up to 17% YoY as the impact of discontinued business is behind.
EBITDA and PAT are likely to grow 40% and 61%, respectively, in Q3FY24E.

Please refer to important disclosures at the end of this report


Healthcare | Sector Update | 10 January 2024

Key financials – hospitals


Revenue (INR mn) EBITDA (INR mn) PAT (INR mn)
Company
Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%) Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%) Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%)
Apollo 48,166 48,469 42,636 (0.6) 13.0 5,924 6,275 5,054 (5.6) 17.2 2,231 2,310 1,535 (3.4) 45.4
KIMS 6,521 6,525 5,622 (0.1) 16.0 1,721 1,773 1,512 (2.9) 13.9 911 920 760 (1.0) 19.9
HCG 4,877 4,869 4,247 0.2 14.9 829 846 794 (2.0) 4.4 165 136 114 21.7 44.3
Coverage
59,564 59,863 52,504 (0.5) 13.4 8,475 8,894 7,359 (4.7) 15.2 3,308 3,366 2,409 (1.7) 37.3
Universe
Source: Company data, I-Sec research

Key financials – diagnostics


Revenue (INR mn) EBITDA (INR mn) PAT (INR mn)
Company
Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%) Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%) Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%)
Dr Lal 5,580 6,013 4,894 (7.2) 14.0 1,479 1,778 1,130 (16.8) 30.9 788 1,093 528 (27.9) 49.3
Metropolis 2,946 3,085 2,855 (4.5) 3.2 710 782 705 (9.2) 0.7 328 379 358 (13.5) (8.3)
Vijaya 1,332 1,389 1,131 (4.1) 17.7 537 574 443 (6.5) 21.2 282 336 164 (16.0) 72.4
Thyrocare 1,504 1,480 1,280 1.6 17.4 389 375 279 3.8 39.8 237 201 147 18.1 61.1
Coverage
11,361 11,967 10,160 (5.1) 11.8 3,115 3,508 2,556 (11.2) 21.8 1,636 2,009 1,197 (18.6) 36.7
Universe
Source: Company data, I-Sec research

Key financials – medical devices


Revenue (INR mn) EBITDA (INR mn) PAT (INR mn)
Company
Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%) Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%) Q3FY24E Q2FY24 Q3FY23 QoQ (%) YoY (%)
Polymedicure 3,508 3,373 2,848 4.0 23.2 895 842 710 6.2 25.9 646 622 500 3.9 29.2
Tarsons 706 663 613 6.5 15.2 268 254 267 5.7 0.6 136 128 161 5.9 (15.8)
Source: Company data, I-Sec research

Valuation summary
Target
Rating EPS (INR) CAGR ROCE (%) P/E (x) EV/ EBITDA (x)
Company Price
(INR) FY23 FY24E FY25E FY23-25E FY23 FY24E FY25E FY23 FY24E FY25E FY23 FY24E FY25E
Apollo 5,350 HOLD 56.4 77.9 105.8 36.9 9.5 11.6 13.8 102.8 74.5 54.8 43.1 33.3 26.7
KIMS 1,985 ADD 40.6 44.6 53.9 15.1 15.8 13.7 14.2 49.7 45.3 37.5 27.4 24.0 20.0
HCG 410 ADD 2.1 5.1 8.6 101.6 3.9 8.4 10.3 170.2 69.7 41.9 19.1 17.0 14.3
Dr Lal 2,690 ADD 28.6 41.9 52.7 35.6 11.6 16.9 18.5 86.9 59.4 47.2 41.2 31.9 26.4
Metropolis 1,550 HOLD 27.9 31.9 40.3 20.2 12.0 13.1 15.5 59.5 52.0 41.2 30.0 27.1 22.8
Vijaya 590 REDUCE 8.3 12.6 16.3 40.0 13.7 16.9 18.3 81.8 53.7 41.7 38.0 29.7 22.8
Thyrocare 740 BUY 12.1 15.3 18.6 23.7 12.7 14.9 17.4 54.6 43.4 35.7 28.2 23.4 19.6
Poly Medicure 1,470 ADD 18.7 25.8 33.6 34.0 14.0 17.1 19.7 80.5 58.4 44.8 53.8 39.8 30.9
Tarsons 670 BUY 15.2 11.2 16.8 5.2 13.8 8.7 11.0 34.6 47.0 31.3 21.9 23.4 15.8

Source: Company data, I-Sec research

India | Equity Research 2


Healthcare | Sector Update | 10 January 2024

Key developments in Q3FY24


Company Key developments
Mr. Adwik Bollineni has been appointed as the Additional Director effective Nov 28, ’23. Also Mr. Shantanu Rastogi has resigned
from the position of Non-Executive & Non-Independent Director effective Nov 07, ’23.
KIMS
KIMS increased its holding in KIMS Kingsway(Nagpur) from 51% to 69.30%. The shares were acquired at INR 221.99 per equity and
the total cost of acquisition was INR 710.1mn. Also, its subsidiary KIMS Hospital Enterprises Private acquired an additional stake
of 12.09% in Kondapur Healthcare for INR 241.1mn. Post the transaction, its stake in Kondapur Healthcare has increased to 37.18%.
HCG has terminated its business transfer agreement with Radiant Hospital Services Private for the acquisition of Radiant's
HCG
radiation therapy centre, along with its assets located in Sambalpur, Odisha for a consideration of INR 160mn signed on Jun’22.
Vijaya Diagnostics acquired 100% stake in Pune-based PH Diagnostic Centre Private for a cash consideration of INR 1,475mn
Vijaya Diagnostics
(including INR 128mn for debt repayment) on Dec 19, ’23.
Tarsons Products acquired in Germany-based Nerbe R&D GmbH and Nerbe plus GmbH & Co. KG for a total consideration of Euro
Tarsons Products
10-15mn on Dec 20, ’23.
Apollo Hospitals diluted its stake in its subsidiary (Apollo Home Healthcare Limited) from 89.69% to 74% for a consideration of INR
155.6mn. Nearly 1.4mn equity shares were allotted to Apollo Hospitals upon conversion of loan extended by the company to AHHL
Apollo Hospitals
and ~5.6mn equity shares to Dr. Prathap C Reddy, Promoter of the company, both by way of conversion of optionally convertible
preference shares issued to him and also by way of subscription of equity shares on private placement/preferential basis.
Source: Company data, I-Sec research

Better in-patient volume to drive Q3 revenue Margins to dip due to pressure from ancillary
business and new bed additions
Revenue % Growth (RHS) EBITDA Margin (%) (RHS)
70000 90

18
10000 19
77.6

18
60000 80
9000 18
70 8000 17
16
16
50000
15

60 7000

15
15
15

15
16
40000 6000

14
50

14
15
31.1

14

14
29.3

13
5000
24.2

40
(INR mn)
(INR mn)

30000 14
21.5

19.6

4000

(%)
(%)
16.8

16.7
14.3

30
13.4

13
10.4

20000 3000
9.6

20 12
6.4

2000
3.1

10000 10 1000 11
0 0 0 10
Q3FY23
Q2FY21
Q3FY21
Q4FY21
Q1FY22
Q2FY22
Q3FY22
Q4FY22
Q1FY23
Q2FY23

Q4FY23
Q1FY24
Q2FY24
Q3FY24E
Q2FY21
Q3FY21
Q4FY21
Q1FY22
Q2FY22
Q3FY22
Q4FY22
Q1FY23
Q2FY23
Q3FY23
Q4FY23
Q1FY24
Q2FY24
Q3FY24E

Source: Company data, I-Sec research Source: Company data, I-Sec research

Net profit for our hospital coverage universe Healthy traction in non-covid volumes to boost
to surge 37% YoY Q3FY24 revenue
PAT % Growth (RHS) Revenues % Growth (RHS)
14000 160
289.3

136.1
128.7

4500 400 140


97.3

(11.3)
(23.0)
43.1

39.2

12000
37.3
34.5

(35.4)
13.3
(3.4)

4000 200 120


(216.0)

3500 10000 100


60.9

0
47.0

3000 80
39.9

8000
2500 -200 60
(INR mn)

(INR mn)

11.8

2000 -400 6000 40


(%)

9.8

(%)
(0.0)
(0.2)
(0.7)
10.5

5.8
5.8
5.5

(16.9)
(914.7)

1500 4000 20
-600
1000 0
500 -800 2000
-20
0 -1,000 0 -40
Q2FY21
Q3FY21
Q4FY21
Q1FY22
Q2FY22
Q3FY22
Q4FY22
Q1FY23
Q2FY23
Q3FY23
Q4FY23
Q1FY24
Q2FY24
Q3FY24E

Q3FY24E
Q2FY21
Q3FY21
Q4FY21
Q1FY22
Q2FY22
Q3FY22
Q4FY22
Q1FY23
Q2FY23
Q3FY23
Q4FY23
Q1FY24
Q2FY24

Source: Company data, I-Sec research Source: Company data, I-Sec research

India | Equity Research 3


(INR mn)
(INR) (INR) (INR)

0
500

200
400
600
1000
1200
1400
1800
2500
3000
3500
4000

0
800
1600
1000
1500
2000
0
500
1000
1500
2000
2500
3500
4000
4500

3000

2000
3000
4000
5000
6000
7000

0
1000
margins
Jan-21 Jan-21

Metropolis
Jan-21
Q2FY21 33.6

Price charts

Polymedicure
Jul-21 Jul-21
Jul-21

Source: Bloomberg
Q3FY21 33.3

Apollo Hospitals
Jan-22 Jan-22 Jan-22
Q4FY21 33.0

India | Equity Research


Jul-22 Jul-22 Jul-22
Q1FY22 34.4
Jan-23 Jan-23 Jan-23
Q2FY22 34.1
EBITDA

Jul-23 Jul-23 Jul-23

Source: Company data, I-Sec research


Q3FY22 26.4
Jan-24 Jan-24 Jan-24
Q4FY22 27.1

(INR) (INR)
Q1FY23 25.8
Q2FY23 27.8
Healthcare | Sector Update | 10 January 2024

Vijaya

500
600
700
800

0
100
200
300
400
500
1000
1500
2500
3000
3500
4500

0
2000
4000
Oct-21 Q3FY23 25.2
Jan-21
Jan-22 Q4FY23 25.2
Apr-22 Jul-21

Dr. Lal PathLabs


Q1FY24 27.2
Jul-22
Jan-22
Oct-22 Q2FY24 29.3
Margin (%) (RHS)

Jan-23 Jul-22
Q3FY24E 27.4
Apr-23 Jan-23
Jul-23
20
22
24
26
28
30
32
34
36

Jul-23
Operating leverage and price hikes to boost

Oct-23 (%)
Jan-24 Jan-24

(INR mn)
(INR) (INR)
YoY

HCG

250
300
350
400

0
200
400
600
800
1000
1200
1400
1600
0
50
100
150
200
0
500
1500
2500
3000

1000
2000

Jan-21 Jan-21

Thyrocare
Q1FY21 (71.7)
Jul-21 Jul-21
Q2FY21 35.6
Jan-22 Jan-22
Q3FY21 70.0
Jul-22 Jul-22 Q4FY21 230.7 741.1
Jan-23 Jan-23 Q1FY22
PAT

Jul-23 Jul-23 Q2FY22 20.3


Source: Company data, I-Sec research

Q3FY22 (31.0)
Jan-24 Jan-24
Q4FY22 (31.6)
(INR) (INR) Q1FY23 (53.6)
KIMS

Q2FY23 (41.7)

100
200
400
500
600
700
800
900
1000

0
300
1000
1500
2000
2500

0
500

Dec-21
Tarsons Q3FY23 (17.5)
Jul-21
Oct-21 Q4FY23 (11.1)
Mar-22
Jan-22 Q1FY24 18.9
Jul-22 Apr-22
% Growth (RHS)

Jul-22 Q2FY24 33.2


Oct-22
Oct-22 Q3FY24E 36.7
Feb-23 Jan-23
0

May-23 Apr-23
100
200
300
400
500
800

600
700

Jul-23
-200
-100

Sep-23
Oct-23 (%)
Net profit of diagnostic universe to surge 37%

Jan-24 Jan-24

4
Healthcare | Sector Update | 10 January 2024

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India | Equity Research 5


Healthcare | Sector Update | 10 January 2024

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