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Apollo Hospitals Enterprise Ltd>
  • CMP : 6,258.6 Chg : -125.50 (-1.97%)
  • Target : 4,500.0 (22.28%)
  • Target Period : 12-18 Month

27 May 2022

Q4 impacted by Omicron; FY23 guidance upbeat…

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 9911 beds across 71 hospitals in India. Total 8538 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 4529 outlets
  • Apollo Health & Lifestyle 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
Q4FY22

Apollo’s result was below I-direct estimates. In terms of revenues, hospitals lagged our expectations but pharmacies performed better than estimated.

  • Revenues increased 24% YoY to ₹ 3546 crore
  • EBITDA was at ₹ 463 crore, up 12%% YoY with margins at 13.1%
  • Adjusted PAT was at ₹ 90 crore (down 40% YoY)
What should Investors do?

Apollo’s share price grew 3x over past three years.

  • We maintain BUY due to 1) pick-up in elective surgeries and margins at hospitals to improve, 2) impending value unlocking through Apollo HealthCo albeit with some delay and 3) Upbeat guidance across segments, on the margins front and past history of guidance execution
Target Price Valuation

We value Apollo at ₹ 4500 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 ₹ 750

Key Financial Summary

Particulars FY19 FY20 FY21 FY22 5 Year CAGR(FY17-FY22) FY23E FY24E 2 Year CAGR (FY22-FY24E)
Net Sales 9,617.4 11,246.8 10,560.0 14,662.6 15.1 16,544.9 18,884.0 13.5
EBITDA 1,064.6 1,583.4 1,137.4 2,185.1 24.6 2,555.1 3,056.1 18.3
EBITDA margins (%) 11.1 14.1 10.8 14.9 - 15.4 16.2 -
PAT 236.0 454.9 113.0 850.4 36.7 1,163.2 1,544.3 34.8
EPS (|) 16.4 22.6 7.9 59.1 - 80.9 107.4 -
PE (x) 295.1 153.1 463.2 50.1 - 45.5 34.3 -
P/BV (x) 20.9 20.9 15.1 9.4 - 8.1 6.8 -
RoE (%) 7.1 9.7 2.5 15.1 - 17.7 19.9 -
RoCE (%) 8.8 10.2 6.3 15.1 - 16.7 19.3 -
Source: Company, ICICI Direct Research

Key takeaways of recent quarter & conference call highlights

Q4FY22 Results: Omicron Affected Quarter

  • Consolidated revenues grew 24% YoY to | 3546 crore. Hospitals segments grew 21% YoY to | 1863 crore vs I-direct estimate of | 1946 crore. HealthCo and pharmacy grew 23% YoY to | 1374 crore. AHLL reported growth of 47% YoY to | 309 crore. EBITDA margins declined 130 bps YoY to 13.1% mainly on back of increase in other expenditure. EBITDA in absolute terms grew 12.5% YoY to | 463 crore. Adjusted profit for the quarter was at | 90 crore vs. profit of | 150 crore in Q4FY21. Delta vis-à-vis EBITDA was mainly due to higher tax and depreciation being partially offset by higher other income. The board also recommended a dividend of | 11.75 per equity share
  • Apollo Hospitals’ result was below I-direct estimates. In terms of revenues, hospitals lagged our expectations but pharmacies were better than estimated. Q4FY22 margins was a miss against our estimates. Healthcare business was impacted in Q4FY22 due to omicron wave and is largely reflected in this quarters numbers for Apollo. Pharmacy distribution business re-organised into a 100% subsidiary Apollo HealthCo Ltd along with Apollo 24/7, the group’s Digital healthcare services platform. Apollo Diagnostics has set an aspirational target to achieve | 1000 crore revenues mark over the next three years. Structurally, cost reduction drives, expanding of complex procedures and profitability of new hospitals remain key management focus areas. The pharmacy business remains a steady growth engine albeit in a changed structure

Q4FY22 Earnings Conference Call highlights

  • Hospitals ARPOB (excluding vaccination) was at 48,510 vs. 43,239, registering growth of 12% in Q4FY22 compared to the same period in the previous year. Mature hospitals ARPOB improved from | 44024 in Q4FY21 to | 49231 in Q4FY22. New hospitals ARPOB improved from | 41154 in Q4FY21 to | 46715 in Q4FY22. ARPOB levels are set to increase due to cost reduction and case mix. Inpatient volumes across the group increased by 7% from 108,169 to 115,902. Q4FY22 occupancy across the group was at 4,604 beds (58% occupancy) compared to 4,631 beds (63% occupancy) in Q4FY21. The Q4FY22 occupancy in mature hospitals was at 3,284 beds (60% occupancy). New hospitals had an occupancy of 1,320 beds (55%) occupancy) in Q4FY22. Cardiac sciences grew 33%, oncology 36%, neuroscience 11%, orthopaedics at 27%, gastro at 19% and transplant at 29%. Healthcare overall is expected to show mid teen growth with margins set to go up to ~25%
  • Capital allocation for FY23: Currently Apollo has cash surplus of | 600 crore and | 800 crore in mutual funds. Out of this cash, following would be the deployment: | 350 crore for normalised capex and remaining in brownfield hospital acquisition in OMR, a part of Chennai. It would consume another | 500 crore over two years and remaining would go towards expansion of 300 beds in Bangalore, a brownfield project
  • Pharmacy: Number of pharmacies 4529. Net addition of 139 stores in Q4FY22 and 411 in FY22 whole. Private label sales at 11.21% of revenues in Q4FY22. GMV at | 70 crore, 30,000 orders (pharmacy + consultancy + diagnostic) per day of which pharma orders are 26000 and 4000 are non-pharma orders. It is targeting 500 pharmacy stores addition in FY23. In ticket size 900 to 1000, the average order value has gone up by 6% vs. Q4FY21. Topline of pharmacy is expected to show 20% growth in FY23
  • AHLL: Footfalls were impacted in January and February. Vaccination revenue was minimum in Q4FY22
    • Others: In Q4, on account of Omicron, margins were impacted and the occupancy levels were also low. Headline price increase to be in the range of 4-5% in FY23.
Variance Analysis

  Q4FY22 Q4FY22E Q4FY21 Q3FY22 YoY (%) QoQ (%)   Comments
Revenue 3,546.4 3,613.0 2,868.0 3,638.9 23.7 -2.5   QoQ decline due to Omicron wave in January and February affecting healthcare services
Raw Material Expenses 1,815.7 1,806.5 1,475.0 1,823.5 23.1 -0.4    
Employee Expenses 446.6 436.5 388.4 439.6 15.0 1.6    
Other expenditure 820.9 803.6 592.7 788.8 38.5 4.1    
EBITDA 463.2 566.5 411.8 587.0 12.5 -21.1    
EBITDA (%) 13.1 15.7 14.4 16.1 -130 bps -307 bps   QoQ decline due to lower occupancy and ~ | 84 crore expense for 24/7 
Interest  94.9 93.7 98.6 93.7 -3.7 1.3    
Depreciation 166.4 149.0 138.5 149.0 20.2 11.7    
Other Income 30.7 17.0 20.5 17.2 50.2 79.1    
PBT before EO & Forex 232.7 340.8 195.2 361.5 19.2 -35.6    
EO 0.0 0.0 -25.2 0.0 0.0 0.0    
PBT after Exceptional Items 232.7 340.8 220.4 361.5 5.5 -35.6    
Tax  138.7 117.1 67.7 124.2 104.9 11.6    
Tax rate (%) 59.6 34.4 30.7 34.4 94.2 73.5    
 Net Profit  90.1 215.7 167.9 228.4 -46.3 -60.5    
 Adj. Net Profit  90.1 215.7 150.4 228.4 -40.1 -60.5   Delta vis-à-vis EBITDA mainly due to higher tax and depreciation being partially offset by higher other income
EPS (|) 6.3 15.0 11.7 15.9 -46.3 -60.5    
Key Metrics                
Hospitals 1863.1 1945.6 1538.8 2018.3 21.1 -7.7   Occupancy in mature hospitals at 60%, new hospitals at 55%
Pharmacy  1374.5 1330.6 1118.7 1307.4 22.9 5.1   Combined pharmacy platform sales at | 1747.7 crore
AHLL 308.9 336.8 210.5 313.2 46.7 -1.4   Diagnostics: | 108.7 crore, Primary care: | 79.3 crore and specialty care: | 136 crore

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