Fortis Healthcare Limited Corporate Presentation Saving and Enriching
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Fortis Healthcare Limited Corporate Presentation “ Saving and Enriching Lives” March 2014
Disclaimer These presentation materials have been prepared by Fortis Healthcare Limited (the “Company” or “Fortis Healthcare”) solely for the use at this presentation and have not been independently verified. You agree to keep the contents of this presentation strictly confidential. This presentation material is highly confidential, is being presented solely for your information and may not be copied, reproduced or redistributed to any other person in any manner. This presentation may not be taken, transmitted or distributed, directly or indirectly, into the United States or to any U. S. persons (as defined in Regulation S of the Securities Act) outside the United States. No representations or warranties, express or implied, are made as to, and no reliance should be placed on, the accuracy, fairness or completeness of the information presented or contained in this presentation. Neither the Company nor any of its affiliates, advisers or representatives accepts any responsibility whatsoever for any loss or damage arising from any information presented or contained in this presentation. The information presented or contained in this presentation is current as of the date hereof and is subject to change without notice and its accuracy is not guaranteed. Neither the Company nor any of its affiliates, advisers or representatives make any undertaking to update any such information subsequent to the date hereof. This presentation should not be construed as legal, tax, investment or other advice. In addition, certain information and statements made in this presentation contain “forward-looking statements. ” Such forward-looking statements can be identified by the use of forward-looking terminology such as “anticipate, ” “believe, ” “considering, ” “depends, ” “estimate, ” “expect, ” “intend, ” “planning, ” “planned, ” “project, ” “trend, ” and similar expressions. All forward-looking statements are the Company’s current expectation of future events and are subject to a number of factors that could cause actual results to differ materially from those described in the forward-looking statements. Caution should be taken with respect to such statements and you should not place undue reliance on any such forward-looking statements. Certain data in this presentation was obtained from various external data sources, and the Company has not verified such data with independent sources. Accordingly, the Company does not make representations as to, and assumes no responsibility or liability for, the accuracy or completeness of that data, and such data involves risks and uncertainties and is subject to change based on various factors This presentation does not constitute an offer or invitation to purchase or subscribe for any securities of the Company and neither any part of this presentation nor any information or statement contained therein shall form the basis of or be relied upon in connection with any contract or commitment whatsoever. By participating in this presentation, you agree to be bound by the foregoing limitations. 1
Indian Healthcare Sector: Strong Growth Prospects Market Size (USD Billion) Ø Over USD 150 Billion in revenues by 2017, a 2 x rise 120 104 15% CAGR 91 Ø Healthcare delivery. i. e. 79 68 Hospitals the largest segment, 60 but highly fragmented Ø Macro growth drivers • • Favorable Demographics Rising Non-communicable diseases Low Insurance Penetration Relatively low healthcare spend 2010 2 2011 Source : Frost & Sullivan 2012 E 2013 E 2014 E 2015 E
Healthcare Delivery Market Channel Mix** Market break-up by revenues (2012 E)* Diagnostics, Insurance, Medical 4% 3% Equip, 9% Others, 30% Pharma 13% Hospitals, 71% Out of Pocket, 70% Ø ~USD 55 billion^ market; ~ 80% contribution from the private sector Ø Significant Out of Pocket expenditure Ø Limited reach of high quality healthcare delivery in tier II and III cities Ø Varying delivery models i. e. Primary Care, Secondary Care, Tertiary Care – Emerging Single Specialty Facilities and Day Care centers. Source : *IBEF, August 2013 **Frost & Sullivan. 3
Robust growth in Private Healthcare Delivery Market size of Private Hospitals ^ (USD Billion) 45 27% CAGR 35 30 22 2009 2010 2011 Source : IBEF, August 2013; Figures mentioned have been rounded off as applicable 4 2012
Favorable Industry Dynamics Healthcare Spend Increase Potential Lifestyle diseases Medical Tourism Opportunity Demographics Indian Healthcare Delivery Market Growing Health Insurance 5 Healthcare Infrastructure Requirements
Demographics Health Expenditure Ø Developed nations ~ 10% of GDP By 2030, India is expected Ø Developing nations ~ 6% of GDP to have the world’s largest population. Ø India ~ 4% of GDP 17. 6% 11. 5% 9. 6% 9. 2% 4. 5% 4. 8% 5. 0% 5. 2% 59. 8% 61. 5% 63. 6% 65. 2% 35. 7% 33. 7% 31. 4% 29. 6% 2000 2005 Age 65+ years 9. 0% 7. 1% Source: WHO, World Health Statistics 2013 3. 7% India Malaysia Korea Brazil Global UK Germany USA 4. 4% 6 15 -64 years 2010 2015 E Under 15 years Source : Frost & Sullivan - Independent Report on the Healthcare Industry in the Asia Pacific Region, September 2012
Healthcare Infrastructure Additional 1. 5 million doctors and 2. 4 million nurses required Additional 1. 8 million beds required by 2025 Health infrastructure per 1, 000 population Beds per 1, 000 population 13. 7 3. 00 2. 90 6. 6 Source: WHO, World Health Statistics 2013 7 Source: WHO, World Health Statistics 2013 2. 1 0. 9 India 2. 3 Thailand 2. 7 Brazil 3. 0 Singapore Physicians Nurses India Global Average US 3. 0 0. 65 France Beds 1. 00 Japan 0. 90 Global 1. 39
Health Insurance Medical Tourism Cost of surgeries USD Market Size (Insurance Premium) 350, 000 6, 081 300, 000 250, 000 200, 000 4, 865 150, 000 27% CAGR 100, 000 3, 867 50, 000 - 3, 021 2, 360 Heart surgery US Bone marrow transplant UK Liver transplant Knee replacement Thailand Singapore India 1, 844 Market size ~ USD 3. 9 billion (2014) • WORLD CLASS QUALITY • CLINICAL EXCELLENCE USD Mn 2010 2011 E 2012 E 2013 E 2014 E 2015 E Source: IRDA, and Frost & Sullivan Report - Independent Report on the Healthcare Industry in the Asia Pacific Region, September 2012 • LOWER COSTS AND LESS WAITING TIME 8 Source: IBEF, August 2013
Indian Diagnostic Market Size Ø USD 5 billion in market size, +20% CAGR through USD Bn 31. 0 20% CAGR 2022 7. 2 8. 6 5. 0 6. 0 2012 2013 2014 2015 Ø Highly fragmented ~ 10% in organized segment ( hub and Diagnostics Split spoke model) Ø Lack of an appropriate Imaging; 30% regulatory framework Pathology; 70% Ø No insurance coverage 9 Source: Health Bridge 2022
Fortis - An Overview § Amongst the largest healthcare service providers in India with ~4, 100(1) operational beds across 63 healthcare facilities and total potential bed capacity of over 9, 500(2) beds § Leader in the organized diagnostics segment with 12 Reference Labs, approx. 260 network laboratories and a footprint spanning over 5000 Collection points across 450 cities in India. INTERNATIONAL BUSINESSES § Amongst the largest private diagnostic and imaging companies in Singapore § A state of the art Greenfield multi-specialty medical and surgical hospital in Singapore (1)Includes owned, managed , leased and operated beds (2)Includes existing capacity, potential expansion in existing facilities and new projects. 10
Fortis Values Talent Clinical Excellence Brand Fortis Values Patient Care $ Community 11
Strategic Focus Asset Light Growth India Focus - Leadership Position - Enhance Penetration Patient Care and Clinical Excellence Financial Health - Business Trust - Brownfield - Opportunistic Greenfield Talent - Margins - Leverage - Clinicians - Paramedics 12
Leading Healthcare Service Provider Ø A young organisation starting in 2001, gone on to become one of the largest healthcare delivery Presence across ~ 18 States ~ 35 Cities providers in the country Ø 63 healthcare delivery facilities – 36 operating facilities, 20 satellite and heart command centers and 7 hospitals under development Ø International and Nationally accredited facilities by JCI, NABH*, NABL*. Ø Presence across key specialties in tertiary care like Cardiac Sciences, Neuro Sciences, Ortho, Renal Sciences, Gastroenterology, Oncology and Operated Facilities O&M Facilities HCCs Projects Pulmonology *JCI – Joint Commissions International, NABH – National Association Board for Hospitals and healthcare providers, NABL – National Association Board for Testing and Calibration Laboratories, 13
SRL Ltd – Largest Laboratory Network In India Ø The largest private player in the organized 12 Reference Labs diagnostic sector in India with over 40% ~260 Network Labs market share >4, 000 Direct Clients Ø Presence across > 450 towns and cities across >1, 300 Collection Centers the country Ø Offering a comprehensive range of Revenue breakup – Q 3 FY 14 Others 7% investigations in Pathology and Imaging with over 3, 500 types of diagnostic tests Imaging 16% Ø Managing a large number of hospital Lab medicine 77% Implants – the largest by any diagnostics network in India 14
Accreditations ü SRL has the highest number of accredited Logistic Capabilities ü Over 500 Cities connected nationally & labs in the country ü Accreditation by CAP, NABL and NGSP internationally with on-line tracking ü 24 -48 hours transit for International shipments (per specimen stability norms) ü Compliance with Clinical Pathology Accreditation (CPA), U. K standards and US ü All shipments under temperature controlled Clinical Laboratory Standards Institute conditions CAP: College of American Pathologists, NABL: National Accreditation Board for Testing & Calibration Laboratories, NGSP : National Glycohemoglobin Standardization Program Level 1 Certification for Hb. A 1 c 15
Key Medical Specialties and Focus on Quality Cardiac Sciences Neuro Sciences Tumors Neurology Neuro Endoscopic Surgery Paediatric Neuro Surgery Paediatric cardiac sciences PTCA, CABG Heart Transplant Key Hole Minimal Invasive Surgery Joint Replacement Spine Surgeries Minimal Invasive Spine Surgery Standardized quality accredited to national and international standards* Renal Sciences Dialysis Lithotripsy Minimal Invasive Surgery Renal Transplants Orthopaedics Emerging Specialties Diagnostics Hematology, Micro and Molecular Biology, Clinical Chemistry, Histopathology and Immunology, Cytogenetics, High end Imaging, etc *Our select facilities have been accredited by organisations which include JCI, CAP, NABH, NABL and ISO CAP – College of American Pathologists, ISO – International Organization for Standardization 16 Gastroenterology Oncology Mother and Child / IVF Stem Cell Treatment
Key Operating Metrics – India Hospital Business Occupancy 72% FY 11 74% 73% FY 12 FY 13 75% 9 MFY 14 Average Revenue per Occupied Bed (Rs Mn) 8. 1 FY 11 9. 3 FY 12 17 10. 4 11. 0 FY 13 9 MFY 14
Specialty Revenue Split & Procedure Volumes – FY 13 Specialty Revenue Split OPD & Others 16% Cardiac 35% Other Multi Specialty 17% Gynaecology 4% Pulmonology 2%Oncology 4% Gastro 4% Key Specialties Neuro 6% Renal 4% Ortho 8% 18 Procedure Volumes Cardiac Sciences 64, 339 Orthopedics 15, 313 Renal Sciences 14, 013 Neuro Sciences 5, 467 Gastroenterology 10, 688 Oncology 17, 652 Gynaecology 16, 822
FMRI – Cutting Edge Medical Technology Ø One of its kind CT based Brain Suite, equipped with intra operative CT for brain and Spine. Ø An installation with Time of Flight (TOF) reconstruction for exceptional image quality. Can detect lesions as small as 0. 1 inches. Ø A 256 Slice Brilliance i. CT scanner with the ability to capture an image of the entire heart in just 2 heart beats 19
New and Upcoming Projects
Upcoming Hospitals Fortis Hospital, Ludhiana, Punjab Ø Commissioned a new 250+ bed state of the art oncology led, multi -specialty facility in Ludhiana in January 2014. Ø Focus on Cardiac, Neuro, Ortho, Renal & Oncology Fortis La Femme, Ludhiana Fortis Hospital, Ludhiana, Punjab Ø Foundation stone laid for Fortis La Femme brand in Ludhiana Ø A 100 bed greenfield facility to come up by 2016 focusing on Mother & Child Health Fortis Hospital, Arcot Road, Chennai Ø A 200+ bed tertiary care multi specialty hospital Ø Expected to be commissioned shortly Fortis Hospital, Arcot Road, Chennai 21
Upcoming Projects Fortis Hospital, Bannerghatta Road, Ø Tower 2, Bengaluru + Additional Floor in existing hospital Ø 210 beds Ø Focus - Oncology Ø Groundbreaking March 25, 2014. Will be Commissioned by Mid 2016 Fortis La Femme Richmond Road , Bengaluru Ø Focus- Mother and Child Health Ø 70 Bed Facility Ø Ground-breaking March 24, 2014. Will be commissioned by Mid 2015 22
Substantial headroom for capacity expansion Greenfield; 20% Current Operational Beds ~ 4, 100 Brownfield / Bolt on, 80% Potential Beds ~ 9, 800 Ø Potential to add ~5, 700 beds, 4, 600 beds through brownfield / bolt on expansion and 1100 through Greenfield expansion. Ø Optimally leveraging the asset light model through the Religare Health Trust (RHT) Ø Additional Greenfield opportunities beyond RHT will continue to be evaluated 23
In Summary Indian Healthcare Sector Ø Large unmet demand Ø Growth drivers – Demographics, Lifestyle related diseases, Insurance, healthcare infrastructure and medical tourism Ø Only supply side constraints – Medical Talent and Capital Ø Relatively young organization; one of the largest private healthcare delivery players with a pan India footprint (95% revenues from India) Fortis Healthcare Ø Strong Brand Equity, focus on Clinical Excellence and Patient Centricity Ø Wide spectrum of medical programs “From womb to Old Age” Ø The only healthcare player in India with a vehicle for pursuing Asset Light growth (Business Trust) Ø Inherent potential to double bed capacity on an asset light basis 24
THANK YOU… Fortis Healthcare Limited March 2014 25
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