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  • CMP : 7,051.5 Chg : -35.0 (-0.49%)
  • Target : 5,480.0 (13.11%)
  • Target Period : 12-18 Month

21 Mar 2022

In-line Quarter; numbers trend pre-Covid level…

About The Stock

Apollo is one of the leading integrated healthcare service provider with avenues like hospitals, pharmacies, primary care & diagnostic clinics.

  • Group capacity of 10,033 beds across 71 hospitals in India. Total 8660 beds owned in 44 hospitals; 278 beds in 11 cradles; 244 beds in 11 day-care/short surgical stay centres; 851 beds in five hospitals under O&M contracts
  • It has got a digital presence with “ASK Apollo” & digital health platform “Apollo 24/7”. Apollo Hospitals is the exclusive supplier for APL, which operates India’s largest standalone pharmacy chain with 4,390 outlets
  • Apollo Health & Lifestyle Ltd runs the largest chain of standardised primary healthcare models, multi-specialty clinics under the brand: Apollo Clinics in India and Middle East, diabetes management clinics: Apollo Sugar, diagnostic centres: Apollo Diagnostics, specialty formats: Apollo Cradle for women & children, Apollo Spectra for planned surgery
Q3FY22

Apollo reported in-line results but skewed with Hospitals lagging our expectations but pharmacies a beat on our estimates.

  • Revenues increased 31.9% YoY to ₹ 3638.9 crore
  • EBITDA was at ₹ 587 crore, up 50.4% YoY with margins at 16.1%
  • Adjusted PAT was at ₹ 228.4 crore (up 75.1% YoY)
What should Investors do?

Apollo’s share price has grown by ~3.9x over the past five years (from ~₹ 1235 in Feb 2017 to ~₹ 4845 levels in March 2022).

  • We maintain BUY due to 1) resurgence in elective surgeries and sustained margins at hospitals, 2) impending value unlocking through Apollo HealthCo and 3) unique theme of AHLL along with visible growth for diagnostics
Target Price Valuation

We value Apollo at ₹ 5480 based on SOTP valuation.

Key Triggers for future price performance
  • Apollo is undergoing optical transformational journey towards creating an omni-channel healthcare platform that could set the platform for tapping new-age investors enabling rapid scale up of the digital healthcare platform
  • Business normalisation in healthcare is expected to continue with further momentum due to lifting of travel restrictions, international patients. Also with strong healthcare pedigree & asset base, the company is on course to integrate all entities digitally to leverage its brand and physical presence
  • The new hospitals, ventures are turning profitable on the back of a judicious case mix besides better occupancy & ramp up at new hospitals and AHLL
New Stock Ideas

Apart from Apollo, in our hospital coverage we like Narayana

  • Narayana operates a duel model, which perfectly blends established ‘’Asset-right’’ India business with a hospital in Cayman Islands
  • BUY with a target price of ₹ 765

Key Financial Summary

Particulars FY19 FY20 FY21 5 Year CAGR(FY16-FY21) FY22E FY23E FY24E 3 Year CAGR (FY21-FY24E)
Net Sales 9,617.4 11,246.8 10,560.0 11.2 14,644.7 16,054.3 18,182.0 19.9
EBITDA 1,064.6 1,583.4 1,137.4 10.6 2,274.2 2,609.5 3,092.8 39.6
EBITDA margins (%) 11.1 14.1 10.8 - 15.5 16.3 17.0 -
PAT 236.0 454.9 113.0 -5.0 957.3 1,160.0 1,500.8 136.8
EPS (|) 16.4 22.6 7.9 - 66.6 80.7 104.4 -
PE (x) 295.1 153.1 463.2 - 59.4 60.1 46.4 -
P/BV (x) 20.9 20.9 15.1 - 12.6 10.8 9.2 -
RoE (%) 7.1 9.7 2.5 - 17.3 18.0 19.7 -
RoCE (%) 8.8 10.2 6.3 - 16.3 18.1 20.6 -
Source: Company, ICICI Direct Research

Key takeaways of recent quarter & conference call highlights

Q3FY22 Results: Robust performance continues

  • Consolidated revenues grew 31.9% YoY to | 3638.9 crore (I-direct estimate of | 3616.8 crore) driven by growth of 40.9% YoY in Hospitals segment to | 2023.9 crore vs I-direct estimate of | 2118.2 crore. Pharmacies grew 16.1% YoY to | 1307.4 crore (I-direct estimate: | 1113.8 crore) and while AHLL revenues grew 58.7% YoY to | 313.2 crore (I-direct estimate: | 384.7 crore). EBITDA margins improved 199 bps YoY to 16.1% (I-direct estimate: 17%) mainly due to change in case mix. EBITDA in absolute terms grew 50.4% YoY to | 587 crore (I-direct estimate: | 613.3 crore). Adjusted profit for the quarter was at | 228.4 crore v/s profit of | 130.5 crore in Q3FY21 (I-direct estimate: | 261.8 crore). Delta vis-à-vis EBITDA was mainly due to higher other income and lower interest and tax expense
  • Apollo Hospitals’ result was almost in line with I-direct estimates but skewed with Hospitals lagging our expectations but pharmacies a beat. Healthcare business is more or less back to normalcy due to rebound in patient visit and elective procedures. Structurally, cost reduction drives, expanding of complex procedures and profitability of new hospitals and AHLL remain key management focus areas. The Pharmacy business remains a steady growth engine albeit in a changed structure.

Q3FY22 Earnings Conference Call highlights

  • Hospitals: ARPOB (excluding vaccination) was at | 46,062 Vs |40,092 registering a growth of 15% in Q3FY22 due to increased focus on centre of excellence and change in case mix. ARPOB expected to improve with inflow of international patients. Q3 was mainly driven by domestic medical travel.
  • Inpatient Volumes across the group increased 28% YoY from 99,197 to 127,441 in Q3FY22 despite seasonal festivities and lower international patient mix.
  • Blended occupancy at group level was 65% this quarter vs 63% in Q3FY21. Management guided for headroom for improvement in occupancy levels, especially at newer hospitals, guidance for blended 75% occupancy in 2 years’ time.
  • Margins are sustainable for newer hospitals due to case mix, payee mix (over 75% from self-pay and insurance category) and cost cutting measures. Guidance for 25% margins.
  • Apollo kept 203 beds allocated for Covid against 348 beds in Q2FY22. Vaccination revenue for the quarter at ~ | 50 crore.
  • Outpatient volumes are lower sequentially due to lower vaccination sequentially and Q3 also has ~ 70,000 vaccinations, so a normalised base is likely going ahead.
  • Guidance to add 2000 additional beds in 3-year time, Bangalore (Brownfield:400-500 beds; Greenfield: 300 beds) for an outlay of | 600-700 crore in Karnataka. Additional 400 beds in Bombay for an investment of ~ 600 crore in 3 years’ time. Apollo plans to expand in Gurgaon, North Delhi (Brownfield) and Noida for an estimated investment of ~ | 1500 crore.
  • Pharmacy: One-time incentives of ~ | 10 crore and annual increments lead to higher expense attributed to pharmacy. COGS for Apollo 24*7 was at ~ | 55 crore this quarter.
  • Apollo’s contract with amazon is for 10 years, company targets ~ 1 billion in revenues cumulatively over 3 to 4 years.
  • Cost of customer acquisition for 24*7 to remain | 150-200 for next nine months.
  • Combined pharmacy revenue at | 1661.3 crore in Q3FY22, Private label sales at 11.3%. Stores added in Q3FY22 stands at 98.
  • AHLL: Diagnostics has very low Covid revenue in Q3 and management expects to grow on this base. Management guiding for upwards of 50% growth in diagnostics.
  • Diagnostic – B2B:B2C: 45:55, company targeting both segments, industry average is 40:60 for B2B:B2C
  • Primary and secondary care has seen better footfalls and electives.

Investor Meet: Apollo pharmacy to list its products on Amazon India

  • Apollo 24*7: Omni-channel platform to mesh digital and physical capabilities. Leveraged pharmacies, doctors, partner doctors, pan India diagnostics. Medicine delivered in under 2 hours in 150 cities and tele-consults, allows patients to stay in Apollo ecosystem, helps in customer retention.
  • Investing in technological excellence: E-commerce platform, Patient history database, working on AI/ML/NLU technology implementation, Technology backed by Google in UI/UX, Customer Journey etc.
  • Partnership with amazon is a non-exclusive arrangement to list Apollo pharmacy products on Amazon India.
  • 21,000 home-delivery from online channel, 25,000 from home delivery through offline channel puts Apollo at number 2 ranking in India but with Amazon, management expects Apollo to be ranked number 1. Apollo Services 2 million prescriptions in a year, capability to increase by 50% by next year which requires technological engine.
  • Too preliminary to finalize margins, there would be subscription cost for amazon marketplace but will optimize Apollo’s existing investment by scaling up sales. Company expects to start with pilot in February 2022 and then scale up in geographies.
  • Management sees this deal as an opportunity to do US$1 billion in revenue cumulatively over next 3 years, while expecting some cannibalization.
  • Guidance for Apollo 24*7 to break-even in 3 years, growth and profitability being focus area. Current cost of acquisition ~ | 150 per customer
Variance Analysis:
 
  Q3FY22 Q3FY22E Q3FY21 Q2FY22 YoY (%) QoQ (%)   Comments
Revenue 3,638.9 3,616.8 2,759.8 3,717.1 31.9 -2.1   YoY growth amid rebound in patient visit and elective procedures 
Raw Material Expenses 1,823.5 1,821.8 1,486.5 1,872.3 22.7 -2.6    
Employee Expenses 439.6 444.5 352.4 456.8 24.8 -3.8    
Other expenditure 788.8 737.2 530.7 772.9 48.6 2.1    
EBITDA 587.0 613.3 390.3 615.0 50.4 -4.5    
EBITDA (%) 16.1 17.0 14.1 16.5 199 bps -41 bps   YoY growth amid change in mix towards high margins elective surgeries
Interest  93.7 95.4 101.0 95.4 -7.2 -1.8    
Depreciation 149.0 144.8 125.0 144.8 19.2 2.9    
Other Income 17.2 5.5 5.5 5.6 211.8 204.6    
PBT before EO & Forex 361.5 378.6 169.8 380.5 112.9 -5.0    
EO 0.0 0.0 0.0 0.0 0.0 0.0    
PBT after Exceptional Items 361.5 378.6 169.8 380.5 112.9 -5.0    
Tax  124.2 115.0 51.2 115.6 142.7 7.5    
Tax rate (%) 34.4 30.4 30.1 30.4 14.0 13.1    
 Net Profit  228.4 261.8 130.5 247.8 75.1 -7.8    
 Adj. Net Profit  228.4 261.8 130.5 247.8 75.1 -7.8   Delta vis-à-vis EBITDA was mainly due to higher other income and lower interest and tax expense
EPS (|) 15.9 18.2 9.1 17.2 75.1 -7.8    
Key Metrics                
Hospitals 2018.3 2118.2 1436.1 2168.6 40.5 -6.9   Occupancy in mature hospitals at 66%, new hospitals at 63%
Pharmacy  1307.4 1113.8 1126.3 1167.1 16.1 12.0   Combined pharmacy platform sales at | 1661.3 crore
AHLL 313.2 384.7 197.3 381.4 58.7 -17.9   Diagnostics: |92.2 crore, Primary care: |105.2 crore and Specialty care: |138.1 crore
 
 
SOTP Valuation:
 
Particulers FY24E (|cr) Valuation Matrix Multiple (x) EV (| cr)
Healthcare (Existing Hospitals) 1645.0 EV/EBITDA 18.0 29,611
Healthcare (New Hospitals) 2931.7 EV/Sales 3.0 8,795
Pharmacy  7496.2 EV/Sales 4.0 29,985
AHLL 1963.8 EV/Sales 5.0 9,819
Net Debt FY24E (| cr)       -654.0
Targeted MCap (| cr)       78,864
No of shares (cr)       14.4
Per Share Value (|)       5,480

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