COMPETITIVE ANALYSIS DEMO REPORT MAIN PRIVATE MEDICAL SERVICES OPERATORS IN ROMANIA MEDLIFE MEDICOVER REGINA MARIA 1. MedLife 1. General data Company name: Med Life SA Address (headquarters): Calea Victoriei 222, Bucharest Phone: +4021 4402787 Fax: +4021 4402761 Web: www.medlife.ro E-mail: office@medlife.ro Year of establishment: 1996 Ownership: Marcu family (51%), IFC (12.75%), Value4Capital - formerly known as SGAM Eastern Europe (36.25%) 2. Financial data Year/Category Net turnover (mil. EUR) Average no of employees 2010 32.9 1,170 2.8 2009 25.8 990 2.5 2008 21.2 949-0.2 Net profit (mil. EUR)
3. Key persons Name Position Contact details Mr. Mihail Marcu President Email: office@medlife.ro Mr. Nicolae Marcu Executive Director Email: office@medlife.ro Ms. Mirela Mistrianu Sales Manager Corporate Email: mmistrianu@medlife.ro Accounts Ms. Ina Badarau PR Coordinator Email: ibadarau@medlife.ro 4. Brief profile MedLife is controlled by the Marcu family, and it is co-owned by the IFC - the International Finance Corporation and SGAM Eastern Europe. The first MedLife clinic was opened in 1996, the unit having four medical specialties: Pediatrics, Obstetrics - Gynecology, Ophthalmology and Internal Medicine. MedLife launched its first analysis and paraclinical investigations laboratory in 1999. In 2002, MedLife added in its offer the services of dentistry orthodontics and opened a physio-kinetotherapy and rehabilitation therapy unit. In 2006, the owners have attracted the first important investor: IFC, the World Bank investment division, with whom the Marcu family have further invested in the creation of the first network of private hospitals in Romania. In 2007, MedLife opened the Life Memorial Hospital in Bucharest. The hospital covers 1,400 sqm and has five surgery rooms. The hospital has its own laboratory of medical analysis. In 2009, the Marcu family and IFC have achieved the largest transaction in the medical services sector in Romania, worth an estimated 20 million EUR, attracting in the ownership of MedLife the private investment fund SGAM Eastern Europe, of Societe Generale Asset Management, currently renamed Value4Capital. In September 2011, MedLife opened a multidisciplinary hospital in Brasov that has the surface of 5,500 sqm and some 140 employees. The investment in the medical equipment totalled two million EUR. In December 2011, MedLife opened an Orthopaedic Hospital in Bucharest with the total capacity of 45 beds, following investments of 8.5 million EUR. The unit has 80 employees,
the surface of 2,000 sqm and the hospital s representatives estimate that the monthly number of the treated patients will be of 1,000 persons and the turnover will reach two million EUR in the first year of activity. In 2011, MedLife entered the national program of the in-vitro fertilisation sustained by the Ministry of Health in Romania. At present, MedLife operates a network of nine hyper-clinics in Bucharest, Timisoara, Brasov and Arad, eight laboratories of medical analysis, six hospitals in Bucharest, Brasov and Arad, three maternity units in Bucharest, Brasov and Arad, eight centres of excellence and six pharmacies in the PharmaLife network. The six hospitals have a total of 540 beds and 22 surgery rooms. Also, MedLife collaborates with 135 partner medical clinics all over the country. Some 4,000 paying patients are treated daily in MedLife s ambulatories and hyperclinics, not adding the subscriptions, the labour medicine and the patients treated off-premises. Some 70% of the Medlife s revenues are generated by the cash-paying patients in ambulatory, some 5% of the revenue comes from the Health Insurance House and some 25% from corporate subscriptions. In the first six months of 2011, 500 new companies (and respectively 20,000 subscribers) chose the MedLife services. Source of Medlife s revenues 25% 5% 70% Ambulatory Health Insurance House Corporate subscriptions Source: business publications
MedLife registered in the first semester of 2011 a turnover of 23.8 million EUR, up by 37% compared to the same period of 2010. This growth was a result of the sustained investments on the retail segment (fee-for-service) and the recent acquisitions. For the entire year 2011, the majority shareholders estimate a turnover of some 50 million EUR, which represents approx. 10% of the private medical services market. In the first semester of 2011, MedLife recorded over 475,000 patients. MedLife has a partnership with the software producer TotalSoft, owned by the Global Finance Investment Fund, for the implementation of a complete software platform, based on the Charisma applications (Charisma Medical Software, Charisma ERP, Charisma HCM). MedLife announced an investment programme of 52.1 million EUR for the period 2011-2015, that will be sustained through credits and own funds. MedLife contracted a syndicated credit of 40 million EUR from the International Finance Corporation and Erste Group. For 2012, the opening of the MedLife Hospital Floreasca in Bucharest is the MedLife s main project. The investment in this hospital is estimated at over ten million EUR. For the period 2011-2015, MedLife has announced an investment program totalling 52.1 mil. EUR raised from loans and own funds. 5. Recent acquisitions In 2006, the Marcu family sold for 5 million EUR 20% of the shares to International Finance Corporation (IFC), the World Bank investment division, the shareholder structure after the transaction being: Mihai Marcu (31.9%), Mihaela Gabriela Cristescu (24%), Nicolae Marcu (24%), IFC (20%). At present, the IFC exposure in MedLife is of 57 mil. USD, which represents minority participation and long term loans. In 2009, the owners have sold 36.25% shares to SGAM Eastern Europe, since renamed Value4Capital, for a record transaction in the medical services sector in Romania at the time, estimated at 20 million EUR. In 2010, MedLife acquired 80% of the Policlinica de Diagnostic Rapid (PDR) in Brasov. The transaction exceeded three million EUR.
In 2011, MedLife acquired 55% of the Genesys Medical Clinic Group in Arad, one of the biggest private medical operators in the Western region of the country. The value of the transaction was of some three million EUR. The Group in Arad included a hospital with four surgery rooms and an ambulatory, on a total surface of some 4,000 sqm. In 2011, MedLife finalised the 100% acquisition of the Eva Maternity Unit in Brasov. Set up in 2007, the Eva unit has two surgery rooms, three birth rooms and a total capacity of 26 beds. Since its launching, 4,700 babies have been born in this maternity, out of which 23% have been from areas outside Brasov. For the next period, MedLife does not exclude the possibility to make new acquisitions on the domestic market. 6. Examples of prices in MedLife units: Service Price (RON) Echocardiography in clinic 160 Gynecological and senology consultation in clinic 130 Osteoporosis consultation in clinic 100 Auricular aspiration in clinic 25 Simple respiratory functional tests in clinic 70 Laparoscopic appendectomy in hospital 3,000 Rectum amputation in hospital 4,500 Surgical cure of varicose veins (unilateral) in hospital 2,000 Pilonidal abscess drainage in hospital 1,000 Glycosylated hemoglobin (HbA1c) in laboratory 35 Mycological examination in laboratory 50
2. Medicover 1. General data Company name: Medicover SRL Address (headquarters): Str. Monetariei 8, Bucharest Phone: +4021 3101699 Fax: +4021 3101699 Web: www.medicover.ro E-mail: office@medicover.ro Year of establishment: 1997 Ownership: Medicover Group 2. Financial data Year/Category Net turnover (mil. EUR) Average no of employees 2010 10.9 447-0.1 2009 11.6 445 0.6 2008 12.8 428 1.2 Net profit (mil. EUR) 3. Key persons Name Position Contact details Ms. Catalina Balan CEO Email: catalina.balan@medicover.ro Mr. Bogdan Pana Executive Director - Hospital Email: bogdan.pana@medicover.ro and Clinics Ms. Claudia Oanea Development Director Email: claudia.oanea@medicover.ro 4. Brief profile Medicover Romania is part of the Swedish group Medicover. The Medicover Group also owns the company Synevo Romania SRL that includes a network of laboratories. Medicover entered the Romanian market through the acquisition of the Rombel company in 1997. Medicover has 11 clinics in Bucharest, Cluj Napoca, Constanta, Iasi, Ploiesti, Timisoara and Brasov. Also, Medicover collaborates with some 140 partner clinics all over the country.
At the beginning of 2012, Medicover has opened its first hospital in Romania, following investments of some 20 million EUR. The hospital is located in Bucharest, has 75 beds and three surgery rooms. In September 2011, Medicover opened a diagnostic centre in Bucharest with investments of some 0.5 million EUR. Medicover has over 70,000 subscribers from 1,500 companies in Romania, which is considered to be the largest subscription base in the private medical services market. Since 2005, Medicover uses the Charisma Medical Software solutions produced by TotalSoft, one of the main software companies in Romania. Medicover Romania intends to expand its activity on the segment of the medical clinics both in Bucharest and other cities in the next future, including through acquisitions. For 2013, they have announced the opening of a private hospital worth 50 million EUR, the largest investment of its kind in Romania so far. By 2013, Medicover aims to grow its cash-paying patient base and insured clients to 60% of its revenues. 5. Examples of prices in Medicover units: Service Price (RON) Allergy consultation in clinic 110 Cryogenic cauterization in clinic 75 Lower gastrointestinal endoscopy in clinic 300 Sigmoidoscopy in clinic 220 Bilateral breast ultrasound in clinic 120 HPV vaccine Cervarix in clinic 400 Hematology consultation in clinic 110 Exercise electrocardiogram in clinic 245 Doppler fetoplacentar ultrasound in clinic 130 Pediatric general clinical examination in clinic 85
3. Regina Maria 1. General data Company name: Centrul Medical Unirea SRL Address (headquarters): Str. Garlei 39A, Bucharest Phone: +4021 9268 Fax: +4021 2330241 Web: www.reginamaria.ro E-mail: office@reginamaria.ro Year of establishment: 1991 Ownership: Advent International (80%), Mr. Wargha Enayati (20%) 2. Financial data Year/Category Net turnover (mil. EUR) Average no of employees 2010 16.9 318-0.1 2009 13.6 235 3.0 2008 n/a n/a n/a Net profit (mil. EUR) 3. Key persons Name Position Contact details Mr. Ionut Patrahau CEO Email: office@reginamaria.ro Mr. Fady Chreih Executive Director Email: office@reginamaria.ro Mr. Alexandru Popescu General Manager, Euroclinic Email: alexandru.popescu@reginamaria.ro Medical Centers Ms. Cristiana Vago Marketing & PR Manager Email: cristiana.vago@reginamaria.ro Ms. Cristina Rusu PR Executive Email: cristina.rusu@reginamaria.ro Ms. Mariana Chetrari Marketing Coordinator Email: mariana.chetrari@reginamaria.ro 4. Brief profile Regina Maria, controlled by the Advent International investment fund and Mr. Wargha Enayati, is one of the most dynamic operators of private medical services in Romania. After the fusion with Euroclinic in 2010, in 2011, Centrul Medical Unirea (CMU) went through a rebranding process becoming Regina Maria.
CMU opened its first unit - a cardiology practice - in 1995, in an apartment in Bucharest. The first CMU unit with multiple medical specialties, CMU Unirea, was opened in 1999. At present, Regina Maria has some 18 policlinics in Bucharest, Cluj Napoca, Brasov, Constanta and Bacau, six hospitals (Hospital of Obstetrics and Gynecology in Bucharest, Surgery Hospital Arcul de Triumf in Bucharest, Euroclinic Hospital in Bucharest, Children s Hospital Dorobanti in Bucharest, Hospital in Brasov and also offers multidisciplinary day hospitalisation services in its medical campus in Bacau), three maternity units in Bucharest and Brasov, three medical campuses in Bucharest, Bacau and Brasov, five imaging centres in Bucharest, Brasov and Bacau, a division of clinical laboratories in Bucharest, Brasov, Constanta, Bacau and the Central Bank of Stem Cells. The Hospital of Obstetrics and Gynecology in Bucharest was launched in December 2008 following a total investment of 5.5 million EUR. In 2011, Regina Maria opened the Policlinic Floreasca, located near the Euroclinic Hospital in Bucharest, following investments of two million EUR. This is the largest policlinic of the Regina Maria network. The unit has the surface of 2,000 sqm, 43 medical practices and 115 doctors. The unit includes also a pharmacy, under the Farmacia Centrala brand, and this represents the first step of the Regina Maria as an operator in the drugs retail segment. In May 2009, the medical operator performed its first harvesting, processing and storage procedure of stem cells (CD34 +) from the umbilical cord blood. In 2010, the operator received the accreditation for the storage of the cord tissue in Romania. Regina Maria has over 130,000 subscribers. Its national network of laboratories performs over 7,500 medical analyses per day and has over 1,300 patients per day. For IT systems, Regina Maria collaborates with the company Relevance, the first supplier of business intelligence services on the QlikView platform in Romania. The collaboration started in 2010. Also, Regina Maria acquired the Charisma Medical Software produced by the software development company TotalSoft. For 2012, Regina Maria plans to open an Obstetrics and Gynecology Hospital, to develop the infertility treatment services and to develop its hospital services outside Bucharest.
For 2012, the representatives of Regina Maria have a reserved growth scenario of 10-15% but do not discard an optimistic scenario of over 20% growth. 5. Recent acquisitions In 2010, the owner of CMU sold 80% shares to the investment fund, Advent International, for more than 40 million EUR the larges transaction of this kind in the private medical services sector in Romania. In 2011, Regina Maria acquired the Promed Clinic in Bucharest and therefore developed its activity on the segment of the in vitro fertilisation and maternal - foetal medicine. The Promed Clinic in Bucharest generates revenues of some two million EUR per year and the business is estimated to increase after the acquisition process. The acquisition of the Promed Clinic and the investments in the necessary equipment are estimated at some two million EUR. In 2008, CMU acquired the Medical Center Motilor (owner of two medical clinics in Cluj Napoca) and Avamedica (owner of three medical clinics in Constanta). In 2010, CMU acquired the Euroclinic Hospital in Bucharest, in a transaction estimated at some 30 million EUR. 6. Examples of prices in Regina Maria units: Service Price (RON) Transthoracic echocardiogram in clinic 150 Thyroid ultrasound in clinic 100 Consultation - spine special medical rehabilitation 200 in clinic PENTAXIM vaccination in clinic 209 Subtotal longitudinal gastrectomy (gastric sleeve) 25,800 in hospital Carotid endarterectomy in hospital 21,400 Pigmentary nevus excision - in hospital 400 Exploratory laparotomy - in hospital 4,720 Folic acid in laboratory 40 Resistance to activated protein C in laboratory 100
4. Competitive analysis Net turnover dynamics* 40 30 million EUR 20 10 0 2008 2009 2010 MedLife Medicover Centrul Medical Unirea * Net turnover of Centrul Medical Unirea in 2008 is not available. Source: Ministry of Public Finances Net profit / loss dynamics* 4.0 3.0 million EUR 2.0 1.0 0.0 2008 2009 2010-1.0 MedLife Medicover Centrul Medical Unirea * Net profit/ loss of Centrul Medical Unirea in 2008 is not available. Source: Ministry of Public Finances
Average no of employees - dynamics* 1,400 1,200 1,000 800 600 400 200 0 2008 2009 2010 MedLife Medicover Centrul Medical Unirea Source: Ministry of Public Finances * Average no of employees of Centrul Medical Unirea in 2008 is not available. No of hospitals - dynamics 8 6 6 6 6 4 2 2 1 1 0 2009 2010 2011 MedLife Regina Maria / CMU Source: FRD Center
Price example comparison - medical procedures 500 400 300 RON 200 100 0 MedLife Medicover Regina Maria Holter electrocardiogram Colonoscopy Colposcopy Source: FRD Center Price example comparison - medical consultations 160 140 RON 120 100 80 MedLife Medicover Regina Maria Infertility consultation Ophthalmological consultation Endocrinology consultation Source: FRD Center
Price example comparison - laboratory tests 40 30 RON 20 10 0 MedLife Medicover Regina Maria Total bilirubin Ionic calcium Apolipoprotein A1 Source: FRD Center Disclaimer: Whilst every care is taken in compiling this report, no responsibility is taken for errors or omissions. FRD Center guarantees that this information, collected and generated, has been operated in a professional manner and best efforts were applied with a view to offering accurate and complete results. However, FRD Center will not be held liable for any damage or loss resulting from the use of the information contained herein. For tailor-made market research and market entry support to the markets in CE, SE and Eastern Europe, please do not hesitate to contact our team directly. FRD Center Market Entry Services Bucharest ROMANIA www.market-entry.ro Contact: Jackie Bojor, Director europa@frdcenter.ro