Afya Limited Announces First-Quarter 2023 Financial Results

High and Predictable Growth

Full Year 2023 Guidance Reaffirmed

NOVA LIMA, Brazil–(BUSINESS WIRE)–Afya Limited (Nasdaq: AFYA) (“Afya” or the “Company”), the leading medical education group and digital health services provider in Brazil, reported today financial and operating results for the three-month period ended March 31, 2023 (first quarter 2023). Financial results are expressed in Brazilian Reais and are presented in accordance with International Financial Reporting Standards (IFRS).

First Quarter 2023 Highlights

  • 1Q23 Adjusted Net Revenue increased 25.0% YoY to R$709.4 million. Adjusted Net Revenue excluding acquisitions grew 13.5%, reaching R$644.3 million.
  • 1Q23 Adjusted EBITDA increased 21.9% YoY reaching R$330.2 million, with an Adjusted EBITDA Margin of 46.5%. Adjusted EBITDA excluding acquisitions grew 12.3%, reaching R$304.2 million, with an Adjusted EBITDA Margin of 47.2%.
  • Cash conversion of 111.9%, with a solid cash position of R$ 722.7 million.
  • ~295 thousand monthly active physicians and medical students using Afya’s Digital Services.
Table 1: Financial Highlights
For the three months period ended March 31,
(in thousand of R$)

2023

2023 Ex Acquisitions*

2022

% Chg

% Chg Ex Acquisitions

(a) Net Revenue

709,961

644,849

566,324

25.4%

13.9%

(b) Adjusted Net Revenue (1)

709,383

644,271

567,716

25.0%

13.5%

(c) Adjusted EBITDA (2)

330,211

304,231

270,801

21.9%

12.3%

(d) = (c)/(b) Adjusted EBITDA Margin

46.5%

47.2%

47.7%

-120 bps -50 bps
 
*For the three months period ended March 31, 2023, “2023 Ex Acquisitions” excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Glic, Cardiopapers and UNIT Alagoas and FITS Jaboatão dos Guararapes (all from January to March, 2023).
(1) Includes mandatory discounts in tuition fees granted by state decrees and individual/collective legal proceedings and public civil proceedings due to COVID 19 on site classes restriction and excludes any recovery of these discounts that were invoiced based on the Supreme Court decision.
(2) See more information on “Non-GAAP Financial Measures” (Item 07).

Message from Management

For us in Afya, these results indicate another great start for the year ahead. We are proud to present, once again, strong results, reaffirming the success and resilience of Afya, along with high and predictable growth, and a solid cash generation.

This quarter was marked by significant increases in net revenue within our three segments and we are delighted to see that the most significant growth came from our Continue Education segment with a robust intake process, six new campuses, and course maturation.

Our second most significant growth came from our core business, as we saw higher tickets in Medicine courses, maturation of medical seats, the beginning of 4 Mais Médicos campuses, consolidation of UNIT Alagoas and FITS Jaboatão dos Guararapes acquisition, and the consolidation of 92 new medical seats, 28 in the UniSL Ji-Paraná campus, located in Rondônia, and 64 in Faculdade Santo Agostinho, in the city of Itabuna, situated in the state of Bahia.

And, once again, Afya reported great results on the Digital Health Services revenue, which ended the quarter with an increase of 20% when compared to last year. This result reinforces the opportunity ahead in Digital Services, and it is explained by the ramp-up in B2B engagements, with new contracts with the pharmaceutical industry companies, and the continuous ramp-up in B2P contracts, as we will discuss further on.

High and predictable growth, strong guidance for the year, and segments ramp-up: this proves how we are evolving and empowering our vision to transform health together with those who have medicine as a vocation. We are proud of our business and also excited for what comes next during this year.

1. Key Events in the Quarter:

  • Afya announced on January 2nd, 2023, the closing of its acquisition of 100% of the total share capital of Sociedade Educacional e Cultural Sergipe DelRey Ltda. (“DelRey”), that encompasses the operations of Centro Universitário Tiradentes Alagoas (“UNIT Alagoas”) and Faculdade Tiradentes Jaboatão dos Guararapes (“FITS Jaboatão dos Guararapes”), on the terms previously disclosed.
  • Afya announced on January 31st, 2023, that it is one of 484 companies across 45 countries and regions to join the 2023 Bloomberg Gender-Equality Index (GEI), a modified market capitalization-weighted index that aims to track the performance of public companies committed to transparency in gender-data reporting. This reference index measures gender equality across five pillars: leadership & talent pipeline, equal pay & gender pay parity, inclusive culture, anti-sexual harassment policies, and external brand. For the second time in a row, Afya was included on the index for scoring above a global threshold established by Bloomberg to reflect disclosure and the achievement or adoption of best-in-class statistics and policies, being 1 of 16 Brazilian companies included in the index this year.
  • Fourth share repurchase program, on March 2023 – the Board of Directors approved a new share repurchase program. Under this share repurchase program, Afya may repurchase up to 2,000,000 of its outstanding Class A common shares which represents approximately 5.8% of its free float in accordance with the conditions established by the Board of Directors on March 24, 2023. Accordingly, in connection with repurchases under the new program, Afya also announced that entered into a written trading plan with BofA Securities, Inc., as the independent broker-dealer, which is intended to comply with the requirements of Rule 10b5-1 and Rule 10b-18 each under the Securities and Exchange Act of 1934, as amended.

2. 2023 Guidance

The Company is reaffirming its previously issued guidance for 2023 which considers the successfully concluded acceptances of new students, ensuring 100% occupancy in all of its medical schools.

Considering the above factors, the guidance for 2023 is defined in the following table:

Guidance for 2023
Adjusted Net Revenue* R$ 2,750 mn ≤ ∆ ≤ R$ 2,850 mn
Adjusted EBITDA R$ 1,100 mn ≤ ∆ ≤ R$ 1,200 mn
 
Includes UNIT Alagoas and FITS Jaboatão dos Guararapes’ acquisitions;
Includes the increase of 64 medical seats of Faculdade Santo Agostinho, in the city of Itabuna;
Excludes any acquisition that may be concluded after the issuance of the guidance.

3. 1Q23 Overview

Operational Review

Afya is the only Company offering educational and technological solutions to support physicians across every stage of their medical career, from undergraduate students in their medical school years through medical residency preparatory courses, medical specialization programs, and continuing medical education. The Company also offers solutions to empower physicians in their daily routine, including supporting clinic decisions through mobile app subscription, delivering practice management tools through a Software as a Service (SaaS) model, and assisting physicians in their relationship with their patients.

The Company reports results for three distinct business units – the first, Undergrad – medical schools, other healthcare programs, and ex-health degrees. Revenue is generated from the monthly tuition fees the Company charges students enrolled in the undergraduate programs – the second, Continuing Education – specialization programs and graduate courses for physicians. Revenue is also generated from the monthly tuition fees the Company charges students enrolled in the specialization and graduate courses. The third is Digital Services – digital services offered by the Company at every stage of the medical career. This business unit is divided into Business to Physician (which encompasses Content & Technology for Medical Education, Clinical Decision Software, Practice Management Tools & Electronic Medical Records, Physician-Patient Relationship, Telemedicine, and Digital Prescription) and Business to Business (which provides access and demand for the healthcare players). Revenue is generated from printed books and e-books and is recognized at the point in time when control is transferred to the customer, and subscription fees, which are recognized as the services, are transferred over time.

Key Revenue Drivers – Undergraduate Courses

Table 2: Key Revenue Drivers Three months period ended March 31,

2023

2022

% Chg
Undergrad Programs
MEDICAL SCHOOL
Approved Seats

3,163

2,759

14.6%

Operating Seats

3,113

2,481

25.5%

Total Students (end of period)

20,822

17,523

18.8%

Average Total Students

20,822

17,523

18.8%

Average Total Students (ex-Acquisitions)*

18,819

17,523

7.4%

Tuition Fees (Total – R$ ‘000)

630,960

501,523

25.8%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

573,747

501,523

14.4%

Medical School Gross Avg. Ticket (ex- Acquisitions* – R$/month)

10,163

9,540

6.5%

Medical School Net Avg. Ticket (ex- Acquisitions* – R$/month)

8,517

7,861

8.3%

UNDERGRADUATE HEALTH SCIENCE
Total Students (end of period)

21,660

20,902

3.6%

Average Total Students

21,660

20,902

3.6%

Average Total Students (ex-Acquisitions)*

19,788

20,902

-5.3%

Tuition Fees (Total – R$ ‘000)

97,968

78,310

25.1%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

90,296

78,310

15.3%

OTHER UNDERGRADUATE
Total Students (end of period)

25,043

24,209

3.4%

Average Total Students

25,043

24,209

3.4%

Average Total Students (ex-Acquisitions)*

21,882

24,209

-9.6%

Tuition Fees (Total – R$ ‘000)

77,174

69,182

11.6%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

66,889

69,182

-3.3%

TOTAL TUITION FEES
Tuition Fees (Total – R$ ‘000)

806,101

649,015

24.2%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

730,932

649,015

12.6%

*For the three months period ended March 31, 2023, “2023 Ex Acquisitions” excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Glic, Cardiopapers and UNIT Alagoas and FITS Jaboatão dos Guararapes (all from January to March, 2023).

Key Revenue Drivers – Continuing Education and Digital Services

Table 3: Key Revenue Drivers Three months period ended March 31,

2023

2022

% Chg

Continuing Education
Medical Specialization & Others
Total Students (end of period)

4,774

3,479

37.2%

Average Total Students

4,774

3,479

37.2%

Average Total Students (ex-Acquisitions)

4,774

3,479

37.2%

Net Revenue from courses (Total – R$ ‘000)

34,960

23,851

46.6%

Net Revenue from courses (ex- Acquisitions¹)

34,960

23,851

46.6%

Digital Services
Content & Technology for Medical Education
Medcel Active Payers
Prep Courses & CME – B2P

6,147

11,673

-47.3%

Prep Courses & CME – B2B

5,988

4,574

30.9%

Além da Medicina Active Payers

6,222

6,345

-1.9%

Cardiopapers Active Payers

7,083

Medical Harbour Active Payers

21,686

Clinical Decision Software
Whitebook Active Payers

143,832

131,193

9.6%

Clinical Management Tools²
iClinic Active Payers

23,740

19,622

21.0%

Shosp Active Payers

2,881

2,278

26.5%

 
Digital Services Total Active Payers (end of period)

217,579

175,685

23.8%

Net Revenue from Services (Total – R$ ‘000)

56,792

47,477

19.6%

Net Revenue – B2P

46,603

41,197

13.1%

Net Revenue – B2B

10,187

6,280

62.2%

Net Revenue From Services (ex-Acquisitions¹)

49,834

47,477

5.0%

*For the three months period ended March 31, 2023, “2023 Ex Acquisitions” excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Glic, Cardiopapers and UNIT Alagoas and FITS Jaboatão dos Guararapes (all from January to March, 2023).
(2) Clinical management tools includes Telemedicine and Digital Prescription features.

Key Operational Drivers – Digital Services

Monthly Active Users (MaU) represents the number of unique individuals that consumed Digital Services content in each one of our products in the last 30 days of a specific period. Total monthly active users reached almost 295 thousand, 13.6% higher than the same period of last year.

Monthly Unique Active Users (MuaU) represents the number of unique individuals, without overlap of users among products, in the last 30 days of a specific period.

Table 4: Key Operational Drivers for Digital Services – Monthly Active Users (MaU)

1Q23

1Q22

% Chg YoY

4Q22

Content & Technology for Medical Education

31,549

21,464

47.0%

16,539

Clinical Decision Software

237,003

218,313

8.6%

221,762

Clinical Management Tools¹

24,568

19,762

24.3%

20,936

Physician-Patiet Relationship

1,773

1,473

Total Monthly Active Users (MaU) – Digital Services

294,893

259,539

13.6%

260,710

1) Clinical management tools includes Telemedicine and Digital Prescription features
Includes Shosp, Medicinae and Além da Medicina starting in 1Q22 and Cardiopapers and Glic starting in 2Q22
 
Table 5: Key Operational Drivers for Digital Services – Monthly Unique Active Users (MuaU)

1Q23

1Q22

% Chg QoQ

4Q22

 
Total Monthly Unique Active Users (MuaU) – Digital Services

262,137

242,374

8.2%

241,949

 
1) Total Monthly Unique Active Users excludes non-integrated companies: Medical Harbour, Medicinae, Shosp, Além da Medicina, Cardiopapers and Glic

Seasonality

Undergrad’s tuition revenues are related to the intake process and monthly tuition fees charged to students over the period; thus does not have significant fluctuations during the semester. Continuing Education revenues are related to monthly intakes and tuition fees and do not have a considerable concentration in any period. Digital Services is comprised mainly of Medcel, Pebmed, and iClinic revenues. While Pebmed and iClinic do not have significant fluctuation regarding seasonality, Medcel’s revenue is concentrated in the first and last quarter of the year due to the enrollments of Medcel’s clients period. In addition, the majority of Medcel’s revenues are derived from printed books and e-books, which are recognized at the point in time when control is transferred to the customer. Consequently, the Digital Services segment generally has higher revenues and results of operations in the first and last quarters of the year than in the second and third quarters.

Revenue

Adjusted Net Revenue for the first quarter of 2023 was R$709.4 million, an increase of 25.0% over the same period of the prior year, mainly due to higher tickets in Medicine courses in 8.3%, maturation of medical seats, the beginning of 4 Mais Médicos campuses, consolidation of UNIT Alagoas and FITS Jaboatão dos Guararapes acquisition, the Continuing Education high performance and Digital Services execution.

The Digital Services segment increased 19.6% year over year, a combination of (a) B2B engagements, and (b) expansion of the active payers in the B2P, mainly in Whitebook, iClinic, and Shosp, partially offset by the lower performance of Medcel, due to a higher competition scenario in the Residency Preparatory market; and (c) consolidation of Alem da Medicina, Glic, and Cardiopapers.

Table 6: Revenue & Revenue Mix
(in thousands of R$) For the three months period ended March 31,

2023

2023 Ex Acquisitions*

2022

% Chg

% Chg Ex Acquisitions

Net Revenue Mix
Undergrad

620,976

562,822

495,395

25.3%

13.6%

Adjusted Undergrad¹

620,398

562,244

496,787

24.9%

13.2%

Continuing Education

34,960

34,960

23,851

46.6%

46.6%

Digital Services

56,792

49,834

47,477

19.6%

5.0%

Inter-segment transactions

– 2,767

– 2,767

– 399

n.a

593.5%

Total Reported Net Revenue

709,961

644,849

566,324

25.4%

13.9%

Total Adjusted Net Revenue ¹

709,383

644,271

567,716

25.0%

13.5%

*For the three months period ended March 31, 2023, “2023 Ex Acquisitions” excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Glic, Cardiopapers and UNIT Alagoas and FITS Jaboatão dos Guararapes (all from January to March, 2023).
(1) Includes mandatory discounts in tuition fees granted by state decrees and individual/collective legal proceedings and public civil proceedings due to COVID 19 on site classes restriction and excludes any recovery of these discounts that were invoiced based on the Supreme Court decision.
(2) See more information on “Non-GAAP Financial Measures” (Item 07).

Adjusted EBITDA

Adjusted EBITDA for the three-month period ended March 31, 2023, increased 21.9% to R$330.2 million, up from R$270.8 million in the same period of the prior year, and the Adjusted EBITDA Margin decreased 120 basis points to 46.5%. The Adjusted EBITDA Margin reduction is mainly due to the following: (a) Digital segment, primarily due to Medcel’s performance; and (b) consolidation of 4 new Mais Médicos campuses (operation started on 3Q22) and UNIT Alagoas and FITS Jaboatão dos Guararapes which are performing better than expected but still present lower margins when compared to the integrated companies.

Table 7: Adjusted EBITDA
(in thousands of R$) For the three months period ended March 31,

2023

2023 Ex Acquisitions*

2022

% Chg

% Chg Ex Acquisitions

Adjusted EBITDA

330,211

304,231

270,801

21.9%

12.3%

% Margin

46.5%

47.2%

47.7%

-120 bps -50 bps
*For the three months period ended March 31, 2023, “2023 Ex Acquisitions” excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Glic, Cardiopapers and UNIT Alagoas and FITS Jaboatão dos Guararapes (all from January to March, 2023).

Adjusted Net Income

Net Income for the first quarter of 2023 was R$117.8 million, a decrease of 12.7% over the same period of the prior year. Adjusted Net Income for the first quarter of 2023 was R$166.4 million, in line with the same period from the previous year, mainly due to better operational performance, which was offset by higher financial expenses, mainly related to the increase in leverage due to UNIT Alagoas and FITS Jaboatao business combination and higher interest rates, when compared to the same period of the prior year.

Table 8: Adjusted Net Income
(in thousands of R$) For the three months period ended March 31,

2023

2022

% Chg

Net income

117,772

134,942

-12.7%

Amortization of customer relationships and trademark (1)

24,203

18,283

32.4%

Share-based compensation

6,495

2,929

121.7%

Non-recurring expenses:

17,907

11,027

62.4%

– Integration of new companies (2)

5,900

4,171

41.5%

– M&A advisory and due diligence (3)

11,039

1,212

810.8%

– Expansion projects (4)

151

602

-74.9%

– Restructuring expenses (5)

1,395

3,650

-61.8%

– Mandatory Discounts in Tuition Fees (6)

– 578

1,392

n.a.
Adjusted Net Income

166,377

167,181

-0.5%

Basic earnings per share – in R$ (7)

1.25

1.42

-12.0%

Adjusted earnings per share – in R$ (8)

1.77

1.77

0.0%

(1) Consists of amortization of customer relationships and trademark recorded under business combinations.
(2) Consists of expenses related to the integration of newly acquired companies.
(3) Consists of expenses related to professional and consultant fees in connection with due diligence services for our M&A transactions.
(4) Consists of expenses related to professional and consultant fees in connection with the opening of new campuses.
(5) Consists of expenses related to the employee redundancies in connection with the organizational restructuring of our acquired companies.
(6) Consists of mandatory discounts in tuition fees granted by state decrees, individual/collective legal proceedings and public civil proceedings due to COVID 19 on site classes restriction and excludes any recovery of these discounts that were invoiced based on the Supreme Court decision.
(7) Basic earnings per share: Net Income/Weighted average number of outstanding shares.
(8) Adjusted earnings per share: Adjusted Net Income attributable to equity holders of the Parent/Weighted average number of outstanding shares.

Cash and Debt Position

On March 31, 2023, Cash and Cash Equivalents were R$722.7 million, a decrease of 33.9% over December 31, 2022, due to UNIT Alagoas and FITS Jaboatão dos Guararapes business combination.

For the three-month period ended March 31, 2023, Afya reported Adjusted Cash Flow from Operations of R$349.4 million, up from R$293.6 million in the same period of the previous year, an increase of 19.0% YoY, boosted by the solid operational results. Operating Cash Conversion Ratio was 111.9% for the three-month period that ended on March 31, 2023.

On March 31, 2023, Net Debt, excluding the effect of IFRS 16, totaled R$2,029 million. When compared to December 31, 2022 Net Debt added to R$825 million related to UNIT Alagoas and FITS Jaboatão dos Guararapes business combination closed on January 2, 2023, the Net Debt reduced R$ 177 million due to the strong cash flow generation in the quarter.

The following table shows more information regarding the cost of debt of 1Q23, considering loans and financing, capital market, and accounts payable to selling shareholders. Afya’s capital structure remains solid with a conservative leveraging position and a low cost of debt.

Table 9: Operating Cash Conversion Ratio Reconciliation For the three months period ended March 31,
(in thousands of R$) Considering the adoption of IFRS 16

2023

2022

% Chg

(a) Cash flow from operations

331,554

278,715

19.0%

(b) Income taxes paid

17,819

14,850

20.0%

(c) = (a) + (b) Adjusted cash flow from operations

349,373

293,565

19.0%

 
(d) Adjusted EBITDA

330,211

270,801

21.9%

(e) Non-recurring expenses:

17,907

11,027

62.4%

– Integration of new companies (1)

5,900

4,171

41.5%

– M&A advisory and due diligence (2)

11,039

1,212

810.8%

– Expansion projects (3)

151

602

-74.9%

– Restructuring Expenses (4)

1,395

3,650

-61.8%

– Mandatory Discounts in Tuition Fees (5)

-578

1,392

n.a.

(f) = (d) – (e) Adjusted EBITDA ex- non-recurring expenses

312,304

259,774

20.2%

(g) = (c) / (f) Operating cash conversion ratio

111.9%

113.0%

-110 bps

(1) Consists of expenses related to the integration of newly acquired companies.
(2) Consists of expenses related to professional and consultant fees in connection with due diligence services for M&A transactions.
(3) Consists of expenses related to professional and consultant fees in connection with the opening of new campuses.
(4) Consists of expenses related to the employee redundancies in connection with the organizational restructuring of acquired companies.
(5) Consists of mandatory discounts in tuition fees granted by state decrees, individual/collective legal proceedings and public civil proceedings due to COVID 19 on site classes restriction and excludes any recovery of these discounts that were invoiced based on the Supreme Court decision.
Table 10: Gross Debt and Average Cost of Debt
(in millions of R$) For the three months period ended March 31,
Cost of Debt
Gross Debt Duration (Years) per year %CDI*
Loans and financing: Softbank

825

3.1

6.5%

48%

Capital Market

519

4.4

15.7%

114%

Loans and financing: Others

580

1.9

15.7%

114%

Accounts payable to selling shareholders

828

1.2

13.3%

97%

Average

2,751

2.6

12.1%

89%

**Based on the annualized Interbank Certificates of Deposit (“CDI”) rate for the period as a reference:
1Q23: ~13.65% p.y.
Table 11: Cash and Debt Position
(in thousands of R$)

1Q23

FY2022

% Chg

1Q22

% Chg

(+) Cash and Cash Equivalents

722,691

1,093,082

-33.9%

789,435

-8.5%

Cash and Bank Deposits

28,375

57,509

-50.7%

42,648

-33.5%

Cash Equivalents

694,316

1,035,573

-33.0%

746,787

-7.0%

(-) Loans and Financing

1,923,737

1,882,901

2.2%

1,388,841

38.5%

Current

193,214

145,202

33.1%

142,654

35.4%

Non-Current

1,730,523

1,737,699

-0.4%

1,246,187

38.9%

(-) Accounts Payable to Selling Shareholders

769,274

528,678

45.5%

698,413

10.1%

Current

417,398

261,711

59.5%

264,520

57.8%

Non-Current

351,876

266,967

31.8%

433,893

-18.9%

(-) Other Short and Long Term Obligations

58,702

62,176

-5.6%

70,880

-17.2%

(=) Net Debt (Cash) excluding IFRS 16

2,029,022

1,380,673

47.0%

1,368,699

48.2%

(-) Lease Liabilities

864,983

769,525

12.4%

733,420

17.9%

Current

38,026

32,459

17.2%

27,750

37.0%

Non-Current

826,957

737,066

12.2%

705,670

17.2%

Net Debt (Cash) with IFRS 16

2,894,005

2,150,198

34.6%

2,102,119

37.7%

Contacts

Investor Relations Contact:

Afya Limited

ir@afya.com.br

Media Contact:

Cíntia Moraes Marin

cintia.marin@afya.com.br

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