Afya Limited Announces Third-Quarter and Nine Months 2022 Financial Results

Guidance On Track

Robust EPS Expansion

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 and nine-month period ended September 30, 2022 (third quarter 2022). Financial results are expressed in Brazilian Reais and are presented in accordance with International Financial Reporting Standards (IFRS).

Third Quarter 2022 Highlights

  • 3Q22 Adjusted Net Revenue increased 25.2% YoY to R$580.2 million. Adjusted Net Revenue excluding acquisitions grew 17.1%, reaching R$542.4 million.
  • 3Q22 Adjusted EBITDA increased 19.5% YoY, reaching R$228.7 million, with an Adjusted EBITDA Margin of 39.4%. Adjusted EBITDA excluding acquisitions grew 10.2%, reaching R$211.0 million, with an Adjusted EBITDA Margin of 38.9%.
  • 3Q22 Adjusted Net Income increased 2.7% YoY, reaching R$120.1 million, with an EPS growth of 47.4% in the same period.

Nine Months 2022 Highlights

  • 9M22 Adjusted Net Revenue increased 38.2% YoY to R$1,724.0 million. Adjusted Net Revenue excluding acquisitions grew 15.6%, reaching R$1,441.5 million.
  • 9M22 Adjusted EBITDA increased 28.6% YoY reaching R$719.7 million, with an Adjusted EBITDA Margin of 41.7%. Adjusted EBITDA excluding acquisitions grew 5.3%, reaching R$589.2 million, with an Adjusted EBITDA Margin of 40.9%.
  • 9M22 Adjusted Net Income increased 18.8% YoY, reaching R$406.4 million, with an EPS growth of 77.5% in the same period.
  • Cash conversion of 104.6%, with a solid cash position of R$715.6 million.
  • ~286 thousand monthly active physicians and medical students using Afya’s Digital Services, an increase of 15.7% over the same period of last year.
Table 1: Financial Highlights
 
For the three months period ended September 30, For the nine months period ended September 30,
(in thousand of R$)

2022

2022 Ex

Acquisitions*

2021

% Chg

% Chg Ex

Acquisitions

 

2022

2022 Ex

Acquisitions*

2021

% Chg

% Chg Ex

Acquisitions

(a) Net Revenue

580,575

542,810

454,387

27.8%

19.5%

1,745,055

1,462,585

1,221,112

42.9%

19.8%

(b) Adjusted Net Revenue (1)

580,198

542,433

463,278

25.2%

17.1%

1,723,993

1,441,523

1,247,321

38.2%

15.6%

(c) Adjusted EBITDA (2)

228,730

210,968

191,400

19.5%

10.2%

719,717

589,167

559,709

28.6%

5.3%

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

39.4%

38.9%

41.3%

-190 bps -240 bps

41.7%

40.9%

44.9%

-320 bps -400 bps
*For the three months period ended September 30, 2022, “2022 Ex Acquisitions” excludes: UNIGRANRIO (only July, 2022; Closing of UNIGRANRIO was in August, 2021), RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic (all from July to September, 2022; Closing of RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic were after October, 2021).
*For the nine months period ended September 30, 2022, “2022 Ex Acquisitions” excludes: iClinic (only January, 2022; Closing of iClinic was in January, 2021), Medicinae (from January to March, 2022; Closing of Medicinae was in March, 2021), Cliquefarma (from January to April, 2022; Closing of Cliquefarma was in April, 2021), Medical Harbour (from January to April, 2022; Closing of Medical Harbour was in April, 2021), Shosp (from January to May, 2022; Closing of Shosp was in May, 2021), UNIFIPMoc and FIP Guanambi (from January to May, 2022; Closing of UNIFIPMoc and FIP Guanambi was in June, 2021), UNIGRANRIO (from January to July, 2022; Closing of UNIGRANRIO was in August, 2021), RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic (all from January to September, 2022; Closing of RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic were after October, 2021).
(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 08).

1. Message from Management

As we approach the end of the year, we can gladly see Afya delivering strong results again. This quarter was marked by significant increases in net revenue in our three segments, positive EBITDA, cash generation and EPS growth, and a consistent business expansion. All these factors combined enable us to reassure our 2022 guidance, reinforcing our business strategy execution.

Back in the third quarter of 2021, we were hoping to see the pandemic lose its strength. Now, in 2022, we can finally see our students, employees, and partners extracting the best from our ecosystem again. After the opening of six new Continuing Education campuses – a segment that was impacted during COVID-19 times -, we can see, for the third time this year, an incredible recovery compared to last year, with strong intake processes, new campuses and courses maturation, and our practical classes boosting again.

On the Undergrad side of the education segment, we can also see important movements. First, the successful opening of four Mais Médicos campuses – Abaetetuba, Bragança, Itacoatiara, and Manacapuru -, along with UniSL Ji-Parana campus, all of them combined totaling 228 new medical seats to our portfolio this quarter, allowing us to reach an impressive number of 2,709 medical operating seats, strengthening our consolidation as the medical undergrad leader in Brazil. Second, to further boost this leadership, on October 13rd, we announced the entering into a share purchase agreement for our largest acquisition so far, UNIT Alagoas and FITS Jaboatão dos Guararapes, adding 340 more medical seats to our base. With the conclusion of this acquisition, will increase our 2,759 approved seats to 3,099. And third, the completeness of Unigranrio’s integration process also in October, one year after its acquisition, proving our commitment to extracting synergies within the operation. All this effort means one thing: our medical education business remains, and will continue to be, the cornerstone of our business in the short and middle terms, delivering highly predicted growth combined with strong profitability and cash generation.

On our Digital Services segment, we are proud to see another quarter of strong inorganic and organic growth. Afya’s Digital Health Services is being able to help physicians’ during their medical journey and now, with our 6 pillars complete after the acquisition of Glic, we will further explore the development of our ecosystem, which is being built with multiple offerings, unlocking new interactions and revenue streams that go beyond the physicians, achieving pharma players, hospitals, labs and drugstores chains, scratching the surface of a total addressable market of R$28.4 billion. Since the beginning of the year, we have been disclosing our B2P and B2B figures, breaking down our Digital Service’s net revenue within these two for a better perspective.

As a reflection of our great results and actions that are being shown to the market, we are also glad to announce that, for the third time in a row, we’ve won the “Anuário Época Negócios 360º” award as the best Company in the Education segment. We are very proud of this achievement, as it is the recognition of the work and passion of our more than nine thousand employees around a unique vision: to transform health together with those who have medicine as a vocation.

With another round of high and sustainable growth, our mission remains solid as ever: to provide an ecosystem that integrates education and digital solutions for the entire medical journey, enhancing the development, updating, assertiveness, and productivity of health professionals. We are very proud of our business and of what we have achieved so far, as well as excited about what we are planning for the future.

2. Subsequent Events in the Quarter:

  • Afya announced on October 13th, 2022, that it has entered into a share purchase agreement for the acquisition of 100% of the total share capital of Sociedade Educacional e Cultural Sergipe DelRey Ltda., that encompasses the operations of Centro Universitário Tiradentes Alagoas (“UNIT Alagoas”) and Faculdade Tiradentes Jaboatão dos Guararapes (“FITS Jaboatão dos Guararapes”). The acquisition will contribute 340 medical school seats to Afya, increasing Afya’s total medical school seats from 2,759 to 3,099. The aggregate purchase price (enterprise value) is R$825.0 million before the deduction of Net Debt that will be calculated at the closing date, and it will be paid as follows: R$575 million in cash on the transaction closing date and R$250 million in three annual installments, respectively, of R$150 million, R$50 million, and R$50 million, adjusted by the Brazilian interest rate (SELIC). We expected an EV/EBITDA of 5.8x at maturity and post synergies (2024). With the acquisition, Afya further consolidates its presence in the Brazilian Northeast, entering a new state in the region.

3. Full Year 2022 Guidance Reaffirmed

The Company is reaffirming its previously issued guidance for FY22 including the successfully concluded acceptances of new medical students for the second semester, ensuring 100% occupancy in all of its medical schools.

The guidance for FY2022 is defined in the following table:

Guidance for 2022

Important considerations

2022 Adjusted Net Revenue is expected to be between R$2,280.0 million – R$2,360.0 million

Includes four Mais Médicos units start operating in 2H22;
Includes Ji-Parana acquisition start operating in the 2H22;
Includes Além da Medicina acquisition;
Excludes any acquisition that may be concluded after the issuance of the guidance, such as Cardiopapers and Glic.
 

2022 Adjusted EBITDA is expected to be between R$935.0 million – R$1,015 million

 

4. 9M22 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 Nine months period ended September 30,

2022

2021

% Chg

Undergrad Programs
MEDICAL SCHOOL
Approved Seats

2,759

2,611

5.7

%

Operating Seats

2,709

2,361

14.7

%

Total Students (end of period)

17,997

15,977

12.6

%

Average Total Students

17,692

13,983

26.5

%

Average Total Students (ex-Acquisitions)*

15,237

13,983

9.0

%

Tuition Fees (Total – R$MM)

1,522,393

1,081,135

40.8

%

Tuition Fees (ex- Acquisitions* – R$MM)

1,282,263

1,081,135

18.6

%

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

9,351

8,591

8.8

%

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

7,765

7,109

9.2

%

UNDERGRADUATE HEALTH SCIENCE
Total Students (end of period)

18,114

19,297

-6.1

%

Average Total Students

19,932

14,587

36.6

%

Average Total Students (ex-Acquisitions)*

14,401

14,587

-1.3

%

Tuition Fees (Total – R$MM)

254,613

163,270

55.9

%

Tuition Fees (ex- Acquisitions* – R$MM)

167,925

163,270

2.9

%

OTHER UNDERGRADUATE
Total Students (end of period)

23,085

26,953

-14.4

%

Average Total Students

23,746

18,533

28.1

%

Average Total Students (ex-Acquisitions)*

14,190

18,533

-23.4

%

Tuition Fees (Total – R$MM)

201,116

161,063

24.9

%

Tuition Fees (ex- Acquisitions* – R$MM)

135,500

161,063

-15.9

%

TOTAL TUITION FEES
Tuition Fees (Total – R$MM)

1,978,122

1,405,468

40.7

%

Tuition Fees (ex- Acquisitions* – R$MM)

1,585,688

1,405,468

12.8

%

*For the nine months period ended September 30, 2022, “2022 Ex Acquisitions” excludes: UNIFIPMoc and FIP Guanambi (from January to May, 2022; Closing of UNIFIPMoc and FIP Guanambi was in June, 2021), UNIGRANRIO (from January to July, 2022; Closing of UNIGRANRIO was in August, 2021), and Garanhuns (from January to September, 2022; Closing of Garanhuns was in November, 2021).

Key Revenue Drivers – Continuing Education and Digital Services

Table 3: Key Revenue Drivers Nine months period ended September 30,

2022

2021

% Chg

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

4,036

2,835

42.4

%

Average Total Students

3,686

3,273

12.6

%

Average Total Students (ex-Acquisitions)

3,686

3,273

12.6

%

Net Revenue from courses (Total – R$MM)

75,568

51,481

46.8

%

Net Revenue from courses (ex- Acquisitions¹)

75,568

51,481

46.8

%

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

12,886

16,878

-23.7

%

Prep Courses & CME – B2B

5,704

4,097

39.2

%

Além da Medicina Active Payers

5,696

n.a.

 

Cardio Papers Active Payers

5,090

n.a.

 

Medical Harbour Active Payers

5,080

306

1560.1

%

Clinical Decision Software
Whitebook Active Payers

133,926

117,826

13.7

%

Clinical Management Tools²
iClinic Active Payers

22,596

15,984

41.4

%

Shosp Active Payers

2,348

2,093

12.2

%

 
Digital Services Total Active Payers (end of period)

193,326

157,184

23.0

%

Net Revenue from Services (Total – R$MM)

134,243

109,613

22.5

%

Net Revenue – B2P

117,256

103,596

13.2

%

Net Revenue – B2B

16,987

6,017

182.3

%

Net Revenue From Services (ex-Acquisitions¹)

111,050

109,613

1.3

%

(1) For the nine months period ended September 30, 2022, “2022 Ex Acquisitions” excludes: iClinic (only January, 2022; Closing of iClinic was in January, 2021), Medicinae (from January to March, 2022; Closing of Medicinae was in March, 2021), Cliquefarma (from January to April, 2022; Closing of Cliquefarma was in April, 2021), Medical Harbour (from January to April, 2022; Closing of Medical Harbour was in April, 2021), Shosp (from January to May, 2022; Closing of Shosp was in May, 2021), RX PRO, Além da Medicina, Cardiopapers, and Glic (all from January to September, 2022; Closing of RX PRO, Além da Medicina, Cardiopapers, and Glic were after October, 2021).
(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 286 thousand, 15.7% higher over the same period in the 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. Since this concept is being implemented this year, the historical metrics of MuaU could not be disclosed.

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

3Q22

3Q21

% Chg YoY

2Q22

% Chg QoQ

Content & Technology for Medical Education

21,811

20,015

9.0

%

20,739

5.2

%

Clinical Decision Software

239,640

194,082

23.5

%

221,862

8.0

%

Clinical Management Tools¹

23,036

32,909

-30.0

%

21,151

8.9

%

Physician-Patient Relationship

1,397

n.a.

1,101

26.9

%

Total Monthly Active Users (MaU) – Digital Services

285,884

247,006

15.7

%

264,853

7.9

%

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

3Q22

Total Monthly Unique Active Users (MuaU) – Digital Services

263,587

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

Seasonality

Undergrad’s and Continuing Education tuition revenues are related to the intake process and monthly tuition fees charged to students over the period thus the Company does not have significant fluctuations during the semester. Digital Services is comprised mostly by 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, as a result of the enrollments of Medcel’s clients period. 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 compared to the second and third quarters of the year.

Revenue

As disclosed in our 2Q22 earnings release, the Company has been recovering amounts related to mandatory discounts in tuition fees previously granted by individual and collective legal proceedings and public civil proceedings related to COVID-19. For the nine months period ended September 30, 2022, this amount represents R$21.1 million, and, as Afya has excluded these mandatory discounts from Adjusted Net Revenue in 2020 and 2021, this recovery is not counted for Adjusted Net Revenue in 2022.

Adjusted Net Revenue for the third quarter of 2022 was R$580.2 million, an increase of 25.2% over the same period of the prior year. Excluding acquisitions, Adjusted Net Revenue in the third quarter increased 17.1% YoY to R$542.4 million, a strong increase, mainly due to the maturation of medical seats and the beginning of the 4 Mais Médicos operations during the third quarter, higher tickets in Medicine courses, and the Continuing Education recovery, which ended the third quarter with a 72.2% year over year increase in net revenue, mainly due to the strong student base expansion during 2022.

Once again, the Digital Services segment has also contributed to the Adjusted Net Revenues growth this quarter, increasing 59.4% year over year, and 30.4%, excluding acquisitions. This organic growth is a combination of (a) a great start of the B2B engagements, reaching 61 contracts – including pharma solutions and RX PRO contracts -, with 40 different pharmaceutical industry companies, and (b) the expansion of the active payers in the B2P, mainly in Whitebook and iClinic.

For the nine-month period ended September 30, 2022, Adjusted Net Revenue was R$1,724.0 million, an increase of 38.2% over the same period of last year. Excluding acquisitions, Adjusted Net Revenue in the nine-month period increased 15.6% YoY to R$1,441.5 million.

Table 6: Revenue & Revenue Mix
(in thousands of R$) For the three months period ended September 30, For the nine months period ended September 30,

2022

2022 Ex

Acquisitions*

2021

% Chg

% Chg Ex

Acquisitions

 

2022

2022 Ex

Acquisitions*

2021

% Chg

% Chg Ex

Acquisitions

Net Revenue Mix
Undergrad

509,097

479,424

410,059

24.2%

16.9%

1,538,037

1,278,760

1,060,345

45.1%

20.6%

Adjusted Undergrad¹

508,720

479,047

418,950

21.4%

14.3%

1,516,975

1,257,698

1,086,554

39.6%

15.8%

Continuing Education

27,906

27,906

16,209

72.2%

72.2%

75,568

75,568

51,481

46.8%

46.8%

Digital Services

44,548

36,456

27,948

59.4%

30.4%

134,243

111,050

109,613

22.5%

1.3%

Inter-segment transactions

-976

-976

171

n.a.

-670.8%

-2,793

-2,793

– 327

754.1%

754.1%

Total Reported Net Revenue

580,575

542,810

454,387

27.8%

19.5%

1,745,055

1,462,585

1,221,112

42.9%

19.8%

Total Adjusted Net Revenue ¹

580,198

542,433

463,278

25.2%

17.1%

1,723,993

1,441,523

1,247,321

38.2%

15.6%

*For the three months period ended September 30, 2022, “2022 Ex Acquisitions” excludes: UNIGRANRIO (only July, 2022; Closing of UNIGRANRIO was in August, 2021), RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic (all from July to September, 2022; Closing of RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic were after October, 2021).
*For the nine months period ended September 30, 2022, “2022 Ex Acquisitions” excludes: iClinic (only January, 2022; Closing of iClinic was in January, 2021), Medicinae (from January to March, 2022; Closing of Medicinae was in March, 2021), Cliquefarma (from January to April, 2022; Closing of Cliquefarma was in April, 2021), Medical Harbour (from January to April, 2022; Closing of Medical Harbour was in April, 2021), Shosp (from January to May, 2022; Closing of Shosp was in May, 2021), UNIFIPMoc and FIP Guanambi (from January to May, 2022; Closing of UNIFIPMoc and FIP Guanambi was in June, 2021), UNIGRANRIO (from January to July, 2022; Closing of UNIGRANRIO was in August, 2021), RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic (all from January to September, 2022; Closing of RX PRO, Garanhuns, Além da Medicina, Cardiopapers, and Glic were after October, 2021).
(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 08).

Adjusted EBITDA

Adjusted EBITDA for the three-month period ended September 30, 2022 increased 19.5% to R$228.7 million, up from R$191.4 million in the same period of the prior year, while the Adjusted EBITDA Margin decreased 190 basis points to 39.4%. For the nine-month period ended September 30, 2022, Adjusted EBITDA was R$719.7 million, an increase of 28.6% over the same period of the prior year, with an Adjusted EBITDA Margin decrease of 320 basis points in the same period. The Adjusted EBITDA Margin reduction is due to (a) the Digital segment, mostly in the performance of Medcel in the residency preparatory market, (b) the expansion of the Continuing Education segment, which is still maturing the new campuses, and (c) the increase in corporate expenses in the period.

Excluding acquisitions, Adjusted EBITDA for the three-month period increased 10.2% YoY to R$211.0 million, while the Adjusted EBITDA Margin decreased 240 basis points to 38.9%. For the nine-month period, excluding acquisitions, Adjusted EBITDA increased 5.3% YoY to R$589.2 million, while the Adjusted EBITDA Margin decreased 400 basis points to 40.9%, mainly due to the same reasons previously explained.

Table 7: Adjusted EBITDA
(in thousands of R$) For the three months period ended September 30, For the nine months period ended September 30,

2022

 

2022 Ex

Acquisitions*

 

2021

 

% Chg

 

% Chg Ex

Acquisitions

 

 

2022

 

2022 Ex

Acquisitions*

 

2021

 

% Chg

 

% Chg Ex

Acquisitions

Adjusted EBITDA

228,730

210,968

191,400

19.5%

10.2%

719,717

589,167

559,709

28.6%

5.3%

% Margin

39.4%

38.9%

41.3%

-190 bps -240 bps

41.7%

40.9%

44.9%

-320 bps -400 bps

Contacts

Investor Relations Contact:

Afya Limited

ir@afya.com.br

Media Contact:

Cíntia Moraes Marin

cintia.marin@afya.com.br

Read full story here