In one the reports issued by centrum on hospitals in which they hosted a sector expert over a call, he mentioned that southern india has a better healthcare infra compared to northern region of india
Hospital_expert_call_northindia.pdf (507.2 KB)
What could be the possible reasons behind this disparity?
Income
Education
Welfare schemes and govt schemes. Aarogya sri was brought 15 years ago in AP and telangana. Likewise similar policies driven this infrastructure.
@JainilK,
My domain is in healthcare tech and services, I think am somewhat capable to answer.
@UrsRafeek rightly pointed the reasons. However one major reason is one person Dr Pratap ready, founder of apollo. He made chennai popular for tertiary medical services. 3-4 decades back patient from whole india was travelling to chennai for challanging surgery like cardiac, neuro etc.
Besides that for Bangladesh & NE patient chennai and Vellore is very famous, they become that due to mouth marketing mainly.
Sometime non clinical factors plays important role, like “Afghan house” in Delhi provides convenient and low cost accommodation for Afghani patient, hence they perfer Delhi vs anyother city for treatment.
Disc: No connection with any city or hospital mentioned in my content.
Mankind Pharma -
Q4 and FY 25 concall and results highlights -
Q4 outcomes -
Revenues - 3079 vs 2422 cr, up 27 pc ( includes sales of acquired BSV portfolio )
Gross margins @ 71.5 vs 69.6 pc
EBITDA - 686 vs 589 cr, up 16 pc ( margins @ 22.3 vs 24.3 pc ). Extra 25 cr were spent towards BSV’s integration otherwise EBITDA and margins would have been slightly higher
PAT - 429 vs 477 cr ( due steep increase in amortisation and finance costs )
Breakup of Q4 sales -
Domestic formulations - 2366 vs 1999, up 14 pc
Consumer healthcare - 178 vs 156 cr, up 14 pc
Exports - 535 vs 267 cr, up 100 pc
FY 25 outcomes -
Revenues - 12207 vs 10260 cr, up 19 pc
EBITDA - 3030 vs 2529 cr, up 19.8 pc Adjusted for non-recurring BSV’s integration related costs, EBITDA margins would have been @ 25.9 pc PAT - 2007 vs 1941 cr, up 3.4 pc ( due steep increase in finance and amortisation costs post BSV acquisition )
Breakup of FY 25 sales -
Domestic formulations - 9866 vs 8741 cr, up 13 pc
Consumer Healthcare - 809 vs 706 cr, up 14.5 pc
Exports business - 1532 vs 813 cr, up 88 pc
Future business growth is going to be driven by 4 pillars -
Steady Base business
Fast growing speciality chronic business
High potential consumer healthcare business
Super speciality, high entry barrier BSV portfolio
Net Debt on 31 Mar @ 5784 cr
Mankind’s mkt share in IPM now stands @ 4.8 pc. Company ranks no 1 in Gynae segment
In Q4, domestic sales growth was impacted by corrective measures adopted to enhance growth and field force productivity + issues related to BSV’s integration
Company’s chronic portfolio grew strongly in Q4 led by Cardiac and Anti-Diabetes portfolios
Mankind’s share of chronic portfolio @ 39.2
BSV’s share of chronic portfolio @ 14.7 pc
Company’s inhaler brands - Combihale + Symbicort grew by 30 pc ( combined ) in Q4
Their Insulin Glargine brand - Nobeglar grew by 59 pc in Q4
Launched Empagliflozin ( used to treat diabetes type 2 in patients with chronic disease ) wef Mar 25. Rapidly gaining mkt share
Company’s therapy wise rank in IPM -
Gynae - 1
Cardio - 3
Anti Diabetic - 5
Anti Infectives - 5
Respiratory - 4
Gastro - 7
Size of their formulation brands in India -
500 cr - 3 brands
200 cr - 11 brands
100 cr - 23 brands
50 cr - 49 brands
Their consumer healthcare ( OTC ) business growth was led by - GasOFast ( up 29 pc ), Manforce ( up 17 pc ) and HealthOK ( up 23 pc )
Prega News continues to be No1 pregnancy detection brand in India
Company’s portfolio of Speciality products in India -
Neptaz - Sacubirtil + Valsartan ( used to prevent heart failures ) - in licensed from Novartis
Crenzlo - Inclisiaran Injectable ( used to treat high LDL cholesterol ) - in licensed from Novartis
Nobeglar - Insulin Glargine ( anti Diabetic ) - in licensed from Biocon
Combihale ( used to treat Chronic Obstructive pulmonary disease ) - acquired from DRL
Symbicort ( used to treat Chronic Obstructive pulmonary disease ) - exclusive distribution arrangement with Astra Zeneca
Daffy ( for paediatric skin and heart care ) - acquired from DRL
Vonatime and Vonalong ( to treat Gastroesophaegeal reflux disease ) - in licensed from Takeda
Company had acquired Bharat Serum and Vaccines ( BSV Ltd ) in Q2. BSV reported annual revenues of 1750 cr in FY 24 with EBITDA margins of 28 pc, growing at 20 pc CAGR for last 3 yrs. Their high entry barrier, difficult to make, speciality products in Women’s healthcare and Critical care are expected to drive a lot of growth for Mankind Pharma in India and EMs. BSV’s brands mainly consist of difficult to make and niche - Recombinants, Biologics, Novel Delivery drugs and Immunoglobulins. Company is confident of growing BSV’s business @ > 15 CAGR rates in medium term with scope of upside from their exports business
The one time actions initiated by the company in Q3 wrt its field force include steps to boost - sales force optimisation, productivity improvement, efficiency improvement. These steps have resulted in one time slowdown in the business on the acute side. Should reverse in Q1 next yr
BSV’s portfolio clocked sales of 415 cr for Q4. On an organic basis, Mankind grew its topline by 10 pc in Q4
Mankind ( Ex - BSV ) has grown by 9 pc in FY 25
Company continues to grow faster than IPM in Cardiac and anti-Diabetic therapies
Bulk of growth in international business is driven by BSV’s acquisition and sales thereof. Organic growth in International business was @ 37 pc
R&D spends to be @ 2.5-3 pc of sales in FY 26 vs 2.1 pc of sales in FY 25
**Guiding for EBITDA margins to be in 25-26 pc band for FY 26 **
Expecting domestic business to grow @ 1.2 times the IPM growth in FY 26
In Q3 + Q4, company has taken a hit of 194 cr on account of amortisation charges due acquisition of BSV
Expecting BSV’s portfolio to grow @ 18-20 pc in FY 26. Company believes - there is a lot of scope for improvement in BSV’s portfolio wrt Doctor connect, operational efficiencies, MR productivity. Seeing good traction in Apr, May in the domestic mkts
Very bullish about their OTC business. Ova News and Nimulid ( pain killer ) are two additional brands that have started to show very good traction. This OTC business should keep growing @ double digit CAGR over the medium term. Company has greatly strengthened their presence in EComm and Modern trade
Company’s MR count remains @ 16500
**Guiding for Debt / EBITDA @ 1.0-1.1 times by end of FY 26. Should be able to retire all the acquisition related Debt by sometime in FY 28 **
Expecting Mankind’s organic export business to grow in single digits + BSV’s export business to grow @ > 20 pc for next FY
OTC business is operating @ high teens EBITDA margins. As their scale improves, OTC business’s margins should keep inching upwards towards company avg
Disc: holding, biased, not SEBI registered, not a buy/sell recommendation
Akums Drugs and Pharmaceuticals -
Q4 and FY 25 results and concall highlights -
Company’s manufacturing facilities -
Haridwar -1 - General - Oral Solids
Haridwar - 2 - General - Oral Liquids
Haridwar - 3 - General - Injectables
Haridwar - 4 - Hormonal - Oral Solids, Injectables, Topical
Haridwar - 5 - Cosmetics - Topical
Haridwar - 6 - Ayurvedic / Nutraceuticals - Oral Solids + Liquids
Haridwar - 7 - General - all 4 dosage forms
Haridwar - 8 - B-Lactams and Steroids - all 4 dosage forms
Haridwar - 9 - General - Injectables
Kotdwar - Penems, Anti Infectives - Oral Solids, Oral Liquids, Injectables
Baddi - General - Oral Solids and Liquids
Derabassi - APIs - B Lactams ( mainly Cephalosporins )
Lalru - APIs - General APIs
Barwala - R&D center
Dosage form wise breakup of FY 25 revenues -
Oral solids - 73 pc
Injectables - 11 pc
Oral liquids - 8 pc
Topicals - 8 pc
Differentiated dosage forms that company offers include - tablet in Tablet, Bi Layered tablets, Tri - Layered tablets, Gummies, multiple tablets in capsule, pre filled syringes, lyophilised vials, mouth melting powder sachets
Q4 outcomes -
Revenues - 1073 vs 954 cr, up 12 pc
EBITDA - 111 vs 98 cr, up 13 pc ( margins @ 10.4 vs 10.3 pc )
PAT - 44 vs 46 cr, down 5 pc
Segmental revenues, margins -
CMO - 840 vs 732 cr. Margins @ 10.6 pc
Domestic branded - 104 vs 94 cr. Margins @ 21.6 pc
International branded - 40 vs 21 cr. Margins @ 22.1 pc
Trade generics - 22 vs 33 cr. Margins @ (-) 50 pc
APIs - 50 vs 64 cr. Margins @ (-) 12 pc
FY 25 outcomes -
Revenues - 4170 vs 4212 cr, down 1 pc
EBITDA - 513 vs 515 cr ( margins @ 12.3 vs 12.2 pc )
PAT - 234 vs 220 cr, up 6 pc
Segmental revenues, margins -
CMO - 3208 cr, down 1.8 pc. Margins @ 14.1 pc
Domestic branded - 434 cr, up 9 pc. Margins @ 17.7 pc
International branded - 143 cr, up 14 pc. Margins @ 19.3 pc
Trade generics - 115 cr, down 35 pc. Margins @ (-) 24 pc
APIs - 219 cr, up 3 pc. Margins @ (-) 20 pc
Capex in API segment is largely behind. Should be able to double their API sales from current levels. Cost optimisation initiatives to improve profitability are progressing well. At present, company makes 22 APIs with top 5 molecules contributing to 80 pc of sales
Company’s top therapeutic areas wrt their domestic branded formulations include - paediatrics, gynaecology, cardiology. Company is currently ranked no 58 in domestic mkt
Company’s top destinations for their exports business include - Uganda, Nigeria, Philippines, Myanmar, Cambodia
Capex lined up for FY 26 @ 300 cr to set up new lines for Onco drugs, Steroids , LBPs ( live bio-therapeutic products )
Have signed a 200 million euros CMO contract with a global Pharma company. have received 100 million Euros advance against the same ( in Apr 25 ). Supplies to start in 2027
ANVISA Brazil inspected their Injectables facilities in Q4. Hopeful to get an approval in H1
Cash on books now @ 1520 cr ( including the 950 cr received against the European CMO contract )
Volume growth for FY 26 should be in high single digits. Absolute topline growth would depend on weather the API prices rise / fall as the company follows a Cost + model
Have been incurring losses in the trade generics business for last 2-3 yrs. Looking to consolidate the business ( operate only in those areas where they are likely to make money ) going forward so as to minimise losses
Looking @ inorganic opportunities ( in CMO or branded generic export segment ) in order to best use the cash on books
In FY 26, company expect to maintain similar margin profile as FY 25 for CMO, Branded generics business. Should be able to reduce EBITDA losses in both the trade generics and API businesses. Hence, overall margins at the company level should move up
Confident of reducing the API business losses to at least half of FY 25 levels in FY 26
Capex required in order to serve the European contract shall be around 200 cr ( to be incurred @ their Baddi plant )
API business will only pickup once the Cephalosporin prices pick up
The API business that the company operates was acquired via IBC proceedings ( where in they acquired Parabolic drugs ). Company got credits against 870 cr of previous losses which they plan to utilise over next 3-4 yrs ( hence their tax rates shall continue to remain on the lower side )
The European contract should be a 320 - 340 cr / yr kind of business for the company, lasting 6 yrs ( starting Mar 2027 ). EBITDA margins should be around 14-15 pc wrt this contract
International branded business should keep growing at rates > mid teens for next 2-3 yrs ( not accounting for any possible inorganic opportunities that the company is on the lookout for )
Capex breakdown for FY 26 - 100 cr of maintenance capex + 200 cr of growth capex ( mostly @ Jammu )
Once the base of API business grows to around 400 cr/ yr, company expects to start making profits in this segment
Disc: not holding, studying, not SEBI registered, not a buy / sell recommendation
Mankind Pharma -
Q1 FY 26 results and concall highlights -
Revenues - 3570 vs 2868 cr, up 24 pc
Gross margins @ 70.5 vs 71.8 pc
EBITDA - 850 vs 675 cr, up 26 pc ( margins @ 23.8 vs 23.6 pc )
PAT - 445 vs 538 cr ( down 17 pc - due steep hike in interest and amortisation charges - on account of BSV acquisition )
Debt on books @ 5239 on 30 Jun vs 5784 cr on 31 Mar 25
Segmental revenues -
Domestic business - 3101 vs 2609 cr, up 19 pc ( led by steady growth in base business and addition of revenues from BSV’s business ). Base business’s volumes grew by 2.5 pc vs 1.6 pc volume growth for IPM. Respiratory and Anti Infective categories grew the fastest @ 18 pc and 9 pc respectively. Chronic therapies now contribute to 38.8 pc of company’s sales vs 36.9 pc @ the end of Q1 LY. 23 of company’s brands clock sales > 100 cr in the domestic mkt. Company’s domestic field force stands @ 16,500 MRs
Domestic consumer healthcare ( OTC ) business - 237 vs 206 cr, up 15 pc YoY. Growth was led by brands like GasOFast, PregaNews, Manforce, HealthOK. Ovanews and Nimulid are gaining good traction in the market. Manforce now commands 29 pc mkt share in Condoms mkt
Exports business - 469 vs 259 cr, up 81 pc. Export growth was primarily led by BSV’s consolidation into Mankind’s results
Some of the speciality brands launched by the company in last 2 yrs -
Neptaz ( heart failure ) - in-licensed from Novartis
Crenzlo ( high LDL ) - in-licensed from Novartis
Nobeglar ( type 1 and 2 Diabetes ) - in - licensed from Biocon
Combinable ( Obstructive pulmonary disease ) - acquired from DRL
Symbicort ( Obstructive pulmonary disease ) - exclusive distribution arrangement with AstraZeneca
Daffy ( Pediatric skin and hair care ) - acquired from DRL
Vonatime + Vonalong ( Gastroesophageal reflux disease ) - in - licensed from Takeda
These r all high growth brands in high growth categories with healthy margins. They intend to keep adding to this list
R&D expenses in Q1 stood @ 80 cr
Going to set up another biosimilars facility near Vadodara to de-risk the BSV’s business. Should be ready by end of CY 27. Expected to cost them aprox 200 cr
Have repaid aprox 500 cr of Debt in Q1. Should be able to repay another 1500 within FY 26
Holding onto their EBITDA margin guidance of 25-26 pc for full FY 26
Company’s dydrogesterone facility is operating @ 60 pc capacity. As they receive more international approvals this yr, the capacity utilisation should move up. They ll even start making the KSMs in house before end of FY 26
Overall growth in Q1 for company’s base domestic business ( including OTC business ) was 10 pc, for international base business was in single digits
Aiming to grow BSV’s business by 18-20 pc for FY 26 with 26-28 EBITDA margins
Tax rate for full FY should be around 20-21 pc for full FY. Finance cost for full FY should be around 450 cr ( due to the planned debt retirement throughout FY 26 )
Company shall be launching both oral and injectable Semaglutide as soon as their India patent expires
Most of the biologic manufacturers across the world are into making MABs ( monoclonal anti bodies ). Whereas BSV’s biologics are mostly recombinants ( a lot of them focussed on infertility treatments ) . That’s why they r investing behind their biologics facilities so as to get complete control over the recombinant manufacturing value chains
Company intends to be debt free by FY 28
Disc: holding, biased, not a buy/sell recommendation, not SEBI registered, posted for educational purposes
Entero Healthcare -
Q1 FY 26 results and Concall highlights -
Revenues - 1404 vs 1097 cr, up 28 pc ( vs IPM growth of 9 pc )
Gross Profits - 140 vs 100 cr, up 40 pc ( gross margins @ 9.9 vs 9.1 pc )
EBITDA - 50 vs 30 cr, up 66 pc ( margins @ 3.6 vs 2.8 pc )
PAT - 30 vs 21 cr, up 47 pc
Company is diversifying into new medical categories like - medical devices, diagnostics, trade generics etc to become one stop solution of its customers
Operating leverage impact was not felt in Q1 due annual salary and wage hikes implemented in Q1. Should happen Q2 onwards
Company’s strategic playbook rests on pillars like -
Disciplined inorganic growth ( have already made 50 + acquisitions )
Organic scale up in underserved markets
Deepening partnerships with Healthcare brands
Company now serves 71 k retailers vs 60.3 k served in Q1 FY 25
Districts covered @ 469 vs 448 YoY ( across 19 states )
No of Warehouses @ 102 vs 85
No of Hospitals procuring from Entero has already crossed 2500
Last 4 yr revenue CAGR @ 30 pc, EBITDA CAGR @ 67 pc
Out of a 28 pc growth in topline, 15 pc is organic growth and 13 pc growth has come from M&A executed in last FY
Company announced aprox 400 cr of acquisitions in Q1. Have closed some of them in Q1 and will close the rest in Q2
As the additional revenues kick in wef Q2, positive operating leverage effects shall be felt as the annual pay hikes are behind. For full year FY 26, company aims to reach EBITDA margins of 4 pc
Aim to reduce working capital days by another 10 days by end of FY 26 - through better use of technology systems
Organised distributors account of < 10 pc of IPM as of today - naturally, the headroom for growth is huge
Maintain their guidance of 30 pc topline growth for FY 26 ( Assumption - @ 3.8 pc EBITDA margins, full year EBITDA should be around 250 cr vs 172 cr LY - a growth of 45 pc )
Q1 is generally a weak Qtr for the company. Q2,Q3 are generally the strongest
For full year FY 26, guiding to be cash flow positive
Have made a lot of investments in the tech platforms over last 2-3 yrs ( for the ease of their customers ie retailers and better inventory management for them ). Going forward is the time to utilise these investments and drive better efficiencies through them
Tax rate for full FY should be around 17-18 pc
Targeting another 100 cr of acquisitions for current FY
Medical devices contributed to 4-5 pc of company’s revenues in Q1 - they have higher margin structure vs the std pharmaceuticals business
Cash on books @ 365 cr
Disc: initiated a new tracking position, business looks interesting to me, not a buy/sell recommendation, not SEBI registered
