Investor Presentation September, 2013 Presenting team
Binay Shetty, COO
Prasanth Manghat, CFO
Roy Cherry, Head of Strategy & IR
2 Contents
1. Investment highlights
2. Financial performance & analysis
3. Projects under development
4. Outlook
5. Appendix
3 NMC Health Snapshot (NMC LN)
1. NMC is the leading UAE private healthcare company Overview Revenue EBITDA . NMC is the largest UAE private healthcare network, received 1.9mn patients in 2012, heading towards 2mn in 2013 . Market cap is around USD 950mn 26% . Revenue of USD 490.1mn in 2012, up 10.5% YoY. USD 273mn in H1 13, up 15% 51% 49% . EBITDA of USD 79.6mn in 2012, 12.9% higher YoY. 16% growth in H1 13 74% . EBITDA margin H1 13: Health 28.2%, Dist.9.9%, Consolidated 16.9%. . Net profit USD 59.8mn 2012, up 37% YoY. H1 13: USD 32.3mn, 17.3% YoY . UAE is tax free Source: NMC Health H1 13 Healthcare Distribution 2. Business details Hospitals & Medical Centers Pharmacies Distribution Management Dr. BR Shetty . Total: 7 assets, 261 beds. Abu Dhabi, . Total: 8 . Exclusive agency Mr. Khalifa bin Butti, Executive Vice - Chairman CEO & Founder Al Ain, Dubai and Sharjah. . 3 in hospital . 8 warehouses Mr. Binay Shetty Mr. Prasanth Manghat . Umm Al Quwain : 1 Hospital (under . 5 stand alone . 197 delivery vehicles Chief Financial Officer Chief Operating Officer O&M, 200 beds) . Exclusive agent for NIVEA Mr. Roy Cherry Head of Strategy & IR Note: *Operational Beds. Al Ain & Dubai Spl Hospitals has licensed bed capacity of 100 beds each. 3. Use of IPO proceeds & project progress Use of proceeds: Adding 6 assets: 3 hospitals, 2 medical centres and 1 medical suites. Total of up to 410 new beds BR Medical Suites (Dubai) USD 9mn Status: Achieved MBZC Medical Centre (AD) USD 10.4mn Status: Achieved Brightpoint Maternity Hospital (AD, Open Early H1 14) USD 70mn Status: In progress DIP Hospital (Dubai, Open Early H1 14) USD 30mn Status: In progress Al Ain Medical Center (Open H2 14) USD 7mn Status: In progress Khalifa Hospital (AD, Open H1 15) USD 200mn Status: In progress
4 NMC is well positioned in a fast growing market
1. Strong Macro Indicators High population growth in GCC Amongst top-10 highest GDP/Capita UAE est. population by Emirate 89 NMC presence targets 85% National 2.4% 2,731 2,572 17% 2.1% 49 47 1,532 1.2% 1.2% 38 1.1% 1.0% World 36 Expatriate 24 25 27 Avg. 83% 418 401 251 0.0% 97
Africa GCC World Asia OceaniaAmericas Europe KSA UAE Kuwait Oman Qatar Bahrain USA Germany Abu Dubai Sharjah RAK Ajman Fujairah UAQ Source: World Bank, UAE Stats, Banks Dhabi 2. Favourable UAE Healthcare Market UAE healthcare expenditure UAE healthcare manpower KPI’s 13.0 Beds/GDP per capita ('000) Public 9 2.3 11.3 NE 0.9 8 Germany Private 10.0 7 France 2.9 8.6 AD 1.4 8.1 8.1 6 European Nurses 7.1 5 3.6 Physicians 6.5 Lebanon Dubai 4 1.9
5.7 Beds 5.4 UK USA World Avg. 3 KSA UAE 3.0 2 1.5 4.9 Egypt UAE 3.5 4.2 1 Oman Kuwait 2.7 2.9 India Bahrain OECD 8.6 - USD GDP per capita (PPP) 3.1 2011 2012E 2013E 2014E 2015E - 10 20 30 40 50 60 Source: EIU, Booz & Co, IMF, HAAD, DHA, MOH, UAE Stats, Banks - 2 4 6 8 10 3. Adoption of Mandatory Healthcare Insurance, Abu Dhabi first to go Abu Dhabi Est. % of population covered AD insurance categories Most of UAE population resides in
95% 6 Dubai & Northern Emirates 5.3 5 16% Basic 4 50% Millions 2.7 47% 3 Enhanced 2 37% Thiqa 1 - 2006 - Pre 2012 - Post Abu Dhabi Dubai & Northern Emirates Source: EIU, Booz & Co, IMF, HAAD, DHA, MOH, UAE Stats, Banks 5 Strategy to capitalize on potential offered by the UAE healthcare market
Strategy
1. Existing Facilities: Continued investments in new technologies, quality manpower and enhanced patient care at our existing facilities has delivered consistent growth.
- Centers of excellence implementation led to increased uptake of higher value added services - Increased licensed capacity in Dubai Specialty Hospital from original 75 to 100, now 91 beds operational - Phasing licensed capacity at Al Ain Hospital, our most recent addition
2. New Expansions: Grow healthcare division organically and inorganically in what remains a highly fragmented market. Acquired BR Suites in June, 2012 and now focused on developing new hospitals and medical centers. Enhance market position in Dubai ahead of likely roll-out of mandatory healthcare insurance.
- Short to medium term expansion strategy deploying IPO proceeds into four new assets (Ex BRS & MBZC) - 410 new beds (350 in AD, 60 in Dubai) - All assets due for completion in less than 24 months (beds phased)
3. O&M Contracts: Offering operations & management services to the Government for its existing or new healthcare facilities.
- Awarded O&M contract for the 200 bed Sheikh Khalifa Hospital in Umm Al Quwain Emirate recently by UAE Government - Seeking new opportunities
4. NMC brand centric: As oppose to Doctor brand centric – the team and sustainable overall quality supersedes the individual. Fixed salary and no revenue sharing. Lower staff turnover and compensation inflation. 5. Value focused: Appealing to patients across wider segments and income groups – approach consistent with UAE demographics 6. Distribution business: Maintain organic growth through product optimization, improved sales & merchandising efforts and increased efficiencies
6 Contents
1. Investment highlights
2. Financial performance & analysis
3. Projects under development
4. Outlook
5. Appendix
7 NMC posts strong H1 13 growth across both divisions
H1 13 highlights
. We continued to strive towards performance improvements in 2013 through:
our centres of excellence strategy
increased uptake in our high value added services
growing distribution network
improved operational efficiencies
. Our patient centric approach continued to yield results:
patient numbers heading towards 2mn in 2013 – a record for the company
both revenue per patient and occupancy expanded during the period
. Improved product mix coupled with enhanced brand positioning and a sales force increase drove the distribution division’s strong growth in H1 13.
. We delivered a strong 16% YoY growth in Group EBITDA (USD 46.1mn, H1 13)
8 Another strong half for NMC Health
NMC Consolidated overview Performance
. Strong 15% YoY top line growth (USD 273mn in H1 13) NMC Revenue . Healthcare revenue accounted for 49% of group top-line 490 15% YoY growth . EBITDA increased by 16% to USD 46.1mn 444 . EBITDA margin reached 16.9%, improvement of 20bps 273 . Healthcare accounted for 74% of EBITDA 238 . Net profit reached USD 32.3mn, implying 17% YoY growth and a NPM of 11.8%. 2011 2012 H1 12 H1 13 . Adjusted net profit* amounted to USD 35.7mn
EBITDA Net profit EBITDA margin NPM 90 20% 79.6 80 70.5 15.9% 16.2% 16.9% 70 59.8 16.7% 15% 60
9.9% 12.2% 46.1 11.8% 50 43.8 11.6% 39.7 10%
USD USD mn 40 32.3 27.5 Margin 30
20 5%
10 *Note: Excludes the USD 3.4mn booked as one-off expense on fees related to 0 0% replacement of old loans with new JPM loan 2011 2012 H1 12 H1 13
9 Summary financial statements
1. Income statement (USD mn) Group Healthcare Distribution Detail H1 13 H1 12 % Change H1 13 H1 12 % Change H1 13 H1 12 % Change Revenues 273.1 238.0 14.7% 143.2 122.1 17.3% 147.1 131.5 11.9% Gross Profits 90.3 75.8 19.1% 55.6 46.1 20.6% 35.7 30.8 15.9% % Margins 33.1% 31.8% +120bps 38.8% 37.8% +100bps 24.3% 23.4% +90bps
Adjusted EBITDA 46.1 39.7 16.1% 40.4 33.60 20.2% 14.5 13.0 11.5% % Margins 16.9% 16.7% +20bps 28.2% 27.5% +70bps 9.9% 9.9% Nil
Adjusted Net Income 35.7 30.9 15.5% Adjusted NPM 13.1% 13.0% +10bps
Adjusted EPS (USD) 0.192 0.166 15.5%
2. Balance sheet (USD mn)
Detail H1 13 H1 12 Change FY 12 Change Total CWIP Spending 33.6 37.1 -9.4% 94.9 New Projects 28.9 27.1 6.6% 82.3 Maintenance Capex 4.7 10.0 -53.0% 12.6
Working Capital to Sales Working Capital 180.6 161.2 12.0% 185.3 Sales 273.1 238.0 14.7% 490.1 Working Capital to Sales 33.1% 33.9% -2.4% 37.8% -12.5%
Gross Debt 302.6 251.8 20.2% 303.6 -0.3% Bank Balance & Cash 248.6 276.6 -10.1% 257.5 -3.5% Net Debt / (Net Cash) 54.0 -24.8 217.7% 46.1 17.1%
10 Summary financial statements (continued)
3. Cash flow (USD mn)
Details H1 13 H1 12 Change FY 12 Change Adjusted EBITDA 46.1 39.7 16% 79.6 Capex-Non Projects (4.7) (10.0) -53% (12.6) Change in NWC (8.4) (15.2) -45% (40.1) Adjustment for EOSB provision 1.2 0.8 56% 2.1 EOSB paid (0.3) (0.3) 11% (0.6) Adjusted operating cash flow 33.9 15.0 126% 28.5 Adjusted cash flow conversion 74% 38% 95% 36% 106%
Definitions
Adjusted EBITDA: Non-IFRS item, adjusted for exceptional items like pre-operative expenses Adjusted operating cash flow: Adjusted EBITDA less: changes in working capital, cash payments for PPE Adjusted Net income: Adjusted for non-operating one-off expenses Adjusted EPS: Calculated on a like for like basis for both periods using the number of shares in issue as at 30 June 2013, based on adjusted net income.
11 Contents
Financial performance & Analysis
Healthcare Division H1 13
12 NMC’s Healthcare Division strategy paid off
Performance Key figures
. Healthcare had a strong start to 2013, revenues reached USD Healthcare Revenue 252 143.2mn – up a solid 17.3% YoY. 219 17% YoY growth . Division EBITDA hit a new record of USD 40.4mn, gaining 20.2% YoY 122 143 . Both out and inpatient services delivered strong numbers across all of the Group’s three specialty hospitals . Doctors increased by 12% YoY (440 in H1 13) 2011 2012 H1 12 H1 13 . Third party referrals higher Healthcare EBITDA 68.2 56.9 20% YoY growth
33.6 40.4
2011 2012 H1 12 H1 13
13 NMC’s Healthcare Division strategy paid off (Continued)
Key performance indicators 9.2% YoY
9.2% YoY 6.7% YoY Revenue/patient Outpatients Inpatients (‘000) 8.6% YoY
112 1,854 35 1,681 31 106 103 995 100 932 17 19
2011 2012 H1 12 H1 13 2011 2012 H1 12 H1 13 2011 2012 H1 12 H1 13
Operational beds 13.5% YoY Out/inpatient conversion 6 bps Overall occupancy 330 bps 63.6% 261 3.0% 3.0% 60.5% 60.3% 2.9% 230 230 230 2.8% 53.0%
2011 2012 H1 12 H1 13 2011 2012 H1 12 H1 13 2011 2012 H1 12 H1 13
14 Contents
Financial performance & Analysis
Distribution Division H1 13
15 Distribution Division records 12% YoY top-line growth
Distribution Performance
. Distribution achieved 12% YoY revenue growth, reaching Distribution Revenue USD 147mn – It accounted for 51% of the top-line 253 271 12% YoY growth . Division EBITDA hit a new record of USD 14.5mn, gaining 147 11.5% YoY 132 . Healthy EBITDA margin of 9.9% achieved . Our performance improvement was mainly driven by: 2011 2012 H1 12 H1 13 Strong growth in the UAE economy
Increased sales effort backed by a 16% rise in sales Distribution EBITDA and merchandising staff 24.9 26.2 11.5% YoY growth Successfully signing up new brands, including 14.5 AVICO, Zynex, Wallach and Purple Surgical 13.0
2011 2012 H1 12 H1 13
16 Distribution snapshot
Key performance indicators
10% YoY 11% YoY 16% YoY Trading staff (‘000) Sales staff Vehicles 1.68 922 197 188 1.53 821 1.51 796 179
2012 H1 12 H1 13 2012 H1 12 H1 13 2012 H1 12 H1 13
Segment contribution H1 13 Segment contribution H1 12 SKUs ('000) 17% YoY
Others, 3.8% Others, 3.2% 68 Scientific, Scientific, Food, 9.1% 66 Food, 11.0% 14.9% 14.7% Pharma, 29.3% Pharma, FMCG, 43.1% 58 FMCG, 41.3% 29.6%
2012 H1 12 H1 13
17 Contents
1. Investment highlights
2. Financial performance & analysis
3. Projects under development
4. Outlook
5. Appendix
18 Projects under development
. Following a review of the various capital project timelines, and recent experiences in relation to both construction and approval processes in the UAE, management are confident that the opening dates for each of our new facilities will be met. . We highlight that the communicated dates relate to the expected commencement of patient flow. All construction dates remain on track and inline with previous communication, with the exception of Brightpoint which has seen some delay.
BR Medical Suites (Dubai) USD 9mn Status: Achieved
MBZC Medical Centre (AD) USD 10.4mn Status: Achieved
Brightpoint Maternity Hospital (AD, Open Early H1 14) USD 70mn Status: In progress
DIP Hospital (Dubai, Open Early H1 14) USD 30mn Status: In progress
Al Ain Medical Center (Open H2 14) USD 7mn Status: In progress
Khalifa Hospital (AD Open H1 15) USD 200mn Status: In progress
19 NMC launches new project in Al Ain
. Growth in the Al Ain region coupled with the ramp-up at NMC Al Ain Specialty Hospital, which opened in 2009, has been robust – this encouraged us to initiate preparations for the second phase of NMC’s growth there.
. To expand our reach within the region, increase referrals to our hospital and boost medium to long- term growth prospects, we have initiated work on a new medical centre in a prime location in Al Ain’s Sannayia Industrial area.
. The new facility is expected to provide a wide range of healthcare services in an outpatient setting covering General Clinic, Dental, Dermatology, General Surgery, Internal Medicine, Ophthalmology, Orthopedics and Urology.
. Al Ain Medical Centre is expected to have basic diagnostics facility and a pharmacy.
. Expected completion: H2 2014
. Estimated Capex: USD 7mn
20 Contents
1. Investment highlights
2. Financial performance & analysis
3. Projects under development
4. Outlook
5. Appendix
21 Positive outlook
. Positive outlook for the rest of the year, as the UAE economy continues to post high growth
. NMC continues its strong performance
. Encouraging start to H2 13 through the commencement of operations in our new MBZC/Mussafah Day Centre in July 2013
. The impact of our loan consolidation and resulting replacement with JP Morgan, is expected to deliver net savings of USD 2mn annually – starting from H2 13
. Recent news and statements, make us hopeful that the Emirate of Dubai is getting closer to the roll- out of mandatory healthcare insurance.
NMC has two hospitals and one Medical Suites in the emirate and we are approaching completion of the DIP hospital.
We believe NMC is well positioned to benefit from such a development.
. Opening two hospitals and a medical center in 2014
. Opening our largest hospital in 2015
22 Contents
Q&A
23 Contents
1. Investment highlights
2. Financial performance & analysis
3. Projects under development
4. Outlook
5. Appendix
24 Contents
Appendix
Hospitals & Medical Centers
Existing
25 Overview of NMC Hospitals and Medical Centers
Specialty Specialty Specialty General Sharjah MBZC BR Medical Hospital, Hospital, Hospital, Hospital, Medical Medical Suites Abu Dhabi Dubai Al-Ain Dubai Centre Center
July, Established 1975 2004 2008 1999 1996 2011 2013
No. of Beds (1) (2) NA 100 100 100 10 – -
– Accreditation JCI JCI JCI – – –
45 Staff 1100 632 536 260 160 20
No. of Inpatients (FY 2012) 20,025 7,689 6,108 1,387 - n/a n/a No. of Outpatients (FY 2012) 891,147 305,776 367,811 201,308 121,171 1,527 n/a
Bed Occupancy (FY 2012) 68.4% 56.0% 55.6% 37.9% n/a n/a n/a
(1) Hospital has licensed capacity of 100 beds with, as of H1 13, 91 operational beds, (2) Al Ain Hospital has 100 licensed beds with 60 beds operational, as of H1 13.
26
Abu Dhabi Emirate assets deliver strong first half
Abu Dhabi Specialty Hospital Al Ain Specialty Hospital
Patients ('000) Patients ('000) Outpatient Radiology Pathology Inpatient Other Outpatient Radiology Pathology Inpatient Other
817 891 294 306 442 461 158 166
2011 2012 H1 12 H1 13 2011 2012 H1 12 H1 13
Beds & Occupancy Beds & Occupancy 76.5% 60.4% 68.4% 65.7%
100 100 100 100 60 45 45 45 45 54.6% 55.6% 53.3% 34.1% 44.9%
12
40.3% 2011 2012 H1 12 H1 13 2009 2010 2011 2012 H1 12 H1 13 Beds Occupancy Number of Beds Bed Occupancy
27
Dubai Specialty & General Hospitals
Dubai Specialty Hospital Dubai General Hospital
Patients ('000) Patients ('000) Outpatient Radiology Pathology Inpatient Other
Outpatient Radiology Pathology Inpatient Other 294 306
201 158 166 178 103 102
2011 2012 H1 12 H1 13 2011 2012 H1 12 H1 13
Beds & Occupancy Beds & Occupancy
Number of Beds Bed Occupancy Beds Occupancy 60.4% 51.1% 55.0% 91 57.7% 75 75 75 37.9% 37.8% 41.7% 30.4%
10 10 10 10
2011 2012 H1 12 H1 13 2011 2012 H1 12 H1 13
28
BR Medical Suites & Sharjah Medical Centre
BR Medical Suites Sharjah Medical Centre
Patients ('000) Patients ('000)
Outpatient Radiology Pathology Others 2012 H1 13
121 99 73 62 3.80 3.1 1.5 0.1 0.7 1.65
Outpatients Others Total 2011 2012 H1 12 H1 13
29 Contents
Appendix
NMC Distribution Brands
30 Distribution’s robust global brands portfolio, sees new additions
1. Regional Distributor of Leading Brands
2. Sample of new brands introduced in 2012
3. Sample of new brands introduced in H1 13
31 Contents
Appendix
Management team presenting
32 Management team presenting
Mr. Binay Shetty COO BSBA (Bachelor of Science in Business Administration from Boston University, USA (2004) with specialisations in Finance and Entrepreneurship.
Prior to being elevated to the post of COO of NMC Health, he has held the position of COO of the Healthcare Division, Executive Director, planning and governance, Corporate performance review and new projects management.
9 years at NMC
Mr. Prasanth Manghat CFO Fellow member of the Institute of Chartered Accountants of India (FCA), Bachelor of Science (1995), MG University, Kerala, India, CIA, ACCA from UK (2004), pursuing CA (Institute of Chartered Accountants of England and Wales) 12 years of experience in management of treasury and banking functions, corporate finance, accounting and financial reporting activities. Prior to joining NMCH, he has worked as Credit & Operations Head with Kotak Mahindra Finance, one of the leading non-banking financial institutions in India 10 years at NMC
33 Management team presenting (continued)
Mr. Roy Cherry Head of Strategy & Investor Relations
Roy Cherry recently joined NMC Health Plc and works closely with the CEO and the Executive Vice Chairman on NMC’s strategy. He also leads the investor relations efforts.
Roy’s career includes a Senior Consultant role at PwC where he advised on feasibilities and M&As with a combined transaction value exceeding USD10bn across a variety of sectors including healthcare. Roy also headed the Equity Research Department at SHUAA Capital in Dubai, one of the region’s first and most acclaimed. He played an important role on several regional IPOs including, Saudi Catering, NMC Health, Deyaar, DP World & Royal Jordanian Airlines.
Prior to joining NMC Health Plc, Roy was with Saudi Fransi Capital, where he was the Head of Research & Advisory Department. He holds a BSc in Management from the University of London. In addition to English, he is a fluent speaker of both Arabic and Swedish.
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