Voxel S.a. · GPW:VOX
Voxel — Investor Presentation (May 2023)
59 slides from Voxel's investor presentation, May 2023
Slide 1: Voxel Group 2022
Voxel Group 2022 May 2023
Slide 2: Glossary
Glossary # Number B Budget bn Billion CAGR Compound Annual Growth Rate CAPEX Capital Expenditures CEE Central and Eastern Europe CT Computed Tomography DI Diagnostic Imaging (incl. CT, MRI, PET, SPECT, X-ray, USG, Teleradiology) Est. Estimate EBITDA Earnings Before Interest, Taxes, Depreciation And
Slide 3: Glossary
Glossary MRI Magnetic Resonance Imaging NHF National Health Fund OECD Organisation For Economic Co-operation and Development OEM Original Equipment Manufacturer PACS Picture archiving and communication system P&L Profit and Loss Account p.p. percentage point PET Positron Emission Tomography – Comput
Slide 4: Table of Contents
Table of Contents 1 Introduction 2 Market Overview 3 Company Overview 4 Business Model 5 Development Strategy 6 Financial Information 7 Appendix 4
Slide 5: Introduction
1 Introduction
Slide 6: Management team combines medical, financial and managerial expertise
1 Introduction The management team combines medical, financial and managerial expertise. Founders have on average 20 years of healthcare industry experience Management Founders xxx CEO Vice CEO CFO Supervisory Board Jarosław Furdal Founder Founder Grzegorz Rutkowski Alina Krupa Member Jacek Liszka D
Slide 7: Voxel Group is the leading Polish provider of diagnostic imaging services
1 Introduction Voxel Group is the leading Polish provider of diagnostic imaging services, medical IT systems as well as advanced solutions for radiopharmacy and treatment Voxel Group – investment highlights Voxel Group – key KPIs 2022 1 Top 3 network of diagnostic imaging centers in Poland # of cent
Slide 8: Three business segments are synergetic, diversified and non-cyclical (1/2)
1 Introduction The three business segments are synergetic, diversified and non-cyclical – Voxel Group has reached critical scale of ~0.5m examinations annually(1) (1/2) Recurring cash flows & growth High growth potential • Top #3 business in Poland • Dynamically growing focused on diagnostic imaging
Slide 9: Three business segments are synergetic, diversified and non-cyclical (2/2)
1 Introduction The three business segments are synergetic, diversified and non-cyclical – Voxel Group has reached critical scale of ~0.5m examinations annually(1) (2/2) Diagnostic Imaging IT Systems & Infrastructure • 35 diagnostic imaging centers • RIS and PACS systems • 30 MRIs, 16 CTs • Medical i
Slide 10: Market Overview
2 Market Overview
Slide 11: Key value drivers of the healthcare and diagnostic imaging markets
2 Market Overview Key value drivers of the healthcare and diagnostic imaging markets Healthcare Sector A Ongoing convergence to OECD markets B Fast GDP growth and growing private spending C Structural changes driving demand for healthcare services Diagnostic Imaging A Dynamically growing diagnostic
Slide 12: Significant barriers-to-entry to Diagnostic Imaging market
2 Market Overview – Diagnostic Imaging market There are significant barriers-to-entry to Diagnostic Imaging market, hindering potential market opportunities for new market players Barriers-to-entry Barrier Characteristics Voxel’s competitive advantage CAPEX • Expenditure of ca. EUR 0.5-2m required t
Slide 13: Diagnostic imaging market is fragmented with 3 nationwide players
2 Market Overview – Competitive Landscape Diagnostic imaging market is fragmented with 3 players offering nationwide network coverage TOP 3 players: number of laboratories 2022 Top companies’ KPI – 2021(3) [m PLN] Net 2 Name Revenue EBITDA profit 9 11 2 7 1 Luxmed (1) 2,563.1 416.3 91.5 4 1 2 2 2 2
Slide 14: Company Overview
3 Company Overview
Slide 15: Within ~15 years Voxel has grown into a leading provider
2 Company Overview Within ~15 years of operations, Voxel has grown into one of the leading providers of the imaging diagnostic services and advanced radiology solutions in Poland Establishment First MRI and CT EU grant IPO IPO on GPW Gaining access of Alteris labs received for on Newconnect to 2nd c
Slide 16: Voxel International holds a controlling stake in Voxel S.A.
2 Company Overview Voxel International (~61% of votes) holds a controlling stake in Voxel S.A. Overview of shareholders structure of Voxel S.A. Overview of corporate structure of Voxel S.A. Capital Group Voxel Breakdown by shares 100% Inwestycje Inwestycje Sp. z o.o. Sp. z o.o. 100% Alteris S.A. Oth
Slide 17: Voxel Group pursues organic and inorganic growth
2 Company Overview Voxel Group pursues both organic and inorganic growth, resulting in several acquisitions in 2018-2020 Voxel S.A. A medical entity carrying out services such as imaging diagnostics, nuclear medicine and isotopic therapy as well as a radiopharmaceutical production, a provider of tel
Slide 18: Business Model
4 Business Model
Slide 19: Business Model – Radiology
4a Business Model – Radiology Medical IT Systems & Equipment Radiology Group Treatment
Slide 20: Wide network of diagnostic centers with excellent geographical coverage
# Voivodeship City MRI CT PET SPECT 3a Business Model – Radiology Dolnośląskie Bolesławiec 1 ✓ 2 Dolnośląskie Jelenia Góra ✓ ✓ Voxel has a wide network of diagnostic 3 Kujawsko-Pomorskie Bydgoszcz ✓ ✓ 4 Lubelskie Zamość ✓ centers with excellent geographical 5 6 Łódzkie Małopolskie Łódź Kraków ✓ ✓✓ ✓
Slide 21: Strong growth track record in number of labs and patients
3a Business Model – Radiology Overall, Voxel has demonstrated a strong growth track record in terms of number of labs and patients treated which will be further reinforced by unlimited NHF funding since Q2 2019 Number of examinations(1)(2), 2015-2022 Comments Total number of examinations performed i
Slide 22: Largest teleradiology operator in Poland
4a Business Model – Radiology The Company is the largest teleradiology operator in Poland with a network of over 100 radiologists Number of tele-examinations performed, 2012-2021[k] Teleradiology workflow The number of tele-examinations in the Group grows dynamically in last years. Recently Voxel fo
Slide 23: Business Model – Diagnostic Imaging
4b Business Model – Diagnostic Imaging Diagnostic Medical IT Imaging Systems & (MRI & CT ) Equipment Group Hospital Nuclear care Medicine Gamma Knife
Slide 24: MRI scan overview
4b Business Model – Radiology – Diagnostic Imaging (MRI & CT) The magnetic resonance imaging (MRI) scan is a medical imaging procedure that uses strong magnetic fields and radio waves to generate high quality images of the organs MRI overview MRI equipment 1 Description • An MRI scan uses a large ma
Slide 25: CT scan overview
4b Business Model – Radiology – Diagnostic Imaging (MRI & CT) The computed tomography (CT) scan is a medical imaging procedure that uses x-rays and digital image processing to acquire detailed images of the body CT overview CT equipment 1 Description • The computed tomography (CT) scan is a medical
Slide 26: Business Model – Nuclear Medicine
4c Business Model – Nuclear Medicine Diagnostic Medical IT Imaging Systems & (MRI & CT ) Equipment Group Hospital Nuclear care Medicine Gamma Knife
Slide 27: PET scans detect small or multiple cancer metastases
4c Business Model – Radiology – Nuclear Medicine PET scans are one of the most effective methods to detect small or multiple cancer metastases PET overview PET equipment 1 Description • PET uses small amounts of radioactive materials called radiotracers, a special camera and a CT scanner simultaneou
Slide 28: SPECT method overview
4c Business Model – Radiology – Nuclear Medicine The SPECT method is widely used in the endocrine and oncological diagnosis, in some diseases of the nervous and urinary or osteoarticular system SPECT overview SPECT equipment 1 Description • A SPECT scan is a type of nuclear imaging test, which means
Slide 29: Most innovative PET radiopharmaceuticals production center in CEE
4c Business Model – Radiology – Nuclear Medicine The Group operates the most innovative PET radiopharmaceuticals production center in CEE located in Kraków. Since 2018, Voxel Group leases a cyclotron from Warsaw University, further expanding its scale and potential in this segment Radiopharmaceutica
Slide 30: Internally developed PET radiopharmaceuticals production process
4c Business Model – Radiology – Nuclear Medicine The Company has internally developed state-of-art PET radiopharmaceuticals production and sales process 1 2 3 4 The entire process is carried out in radiopha- Fluorine is the main component of Disposable cartridges are used during the The cartridge an
Slide 31: New examinations and treatments (1/2)
4c Business Model – Radiology – Nuclear Medicine Minimally invasive procedures and treatments as well as new radiopharmaceuticals will contribute to future development of Voxel Group (1/2) New examinations and treatments NUCLEAR MEDICINE SCINTIGRAPHY ISOTOPIC TERAPHY FUSION BIOPSY THERMAL ABLATION T
Slide 32: New radiopharmaceuticals (2/2)
4c Business Model – Radiology – Nuclear Medicine Minimally invasive procedures and treatments as well as new radiopharmaceuticals will contribute to future development of Voxel Group (2/2) New radiopharmaceuticals CURRENT ON-GOING UNDER DEVELOPMENT FDG – Fludeoxyglucose Ga68 chloride ALCEO2 V- NaF 1
Slide 33: Business Model – Gamma Knife & Hospital care
Business Model – Gamma Knife 4d & Hospital care Diagnostic Medical IT Imaging Systems & (MRI & CT ) Equipment Group Hospital Nuclear care Medicine Gamma Knife
Slide 34: Gamma Knife is a new technological initiative by Voxel
4d Business Model – Gamma Knife Gamma Knife is one of the examples of new technological initiatives introduced by Voxel Overview Description • Gamma Knife technology is a type of radiation therapy used to treat tumors and other abnormalities of the brain. Gamma Knife is treatment of choice for some
Slide 35: Infrastructure and high demand for brain cancer treatment
4d Business Model – Gamma Knife State-of-the-art medical infrastructure and high demand for brain cancer treatment will allow Voxel to achieve substantial benefits from innovative gamma-knife technology Overview Applications Clinical benefits Benign and malignant brain High precision allows to spare
Slide 36: Vito-Med – Hospital in Gliwice specialized in strokes treatments
4d Business Model – Hospital care Vito-Med – Hospital in Gliwice specialized in the strokes treatments Overview Description • Vito-Med is hospital equipped with 146 beds, specialized in strokes treatment based on unlimited contracts with NHF. The hospital offers refunded hospitalization in the area
Slide 37: Business Model – Medical IT Systems and Equipment
Business Model – Medical IT Systems 4d and Equipment Diagnostic Medical IT Imaging Systems & (MRI & CT ) Equipment Group Hospital Nuclear care Medicine Gamma Knife
Slide 38: Alteris provides proprietary IT systems for hospitals and diagnostic centres
4d Business Model – Medical IT Systems & Equipment Alteris provides proprietary IT systems for hospitals and diagnostic centres (i.a. RIS, PACS) as well as supplies and integrates advanced medical radiology equipment Product and services portfolio Implementation of information systems such as Radiol
Slide 39: Alteris recurring revenues intended to cover cost base
4d Business Model – Medical IT Systems & Equipment Alteris recurring revenues (approx. 5-10% of total revenues) are intended to cover the cost base of the business. The biggest part of revenue and margin (up to 50%) recognized in 4Q (apart from 2020-2021) Type of revenue Characteristics Alteris Up-f
Slide 40: Alteris IT systems implemented in over 250 hospitals (1/2)
4d Business Model – Medical IT Systems & Equipment Alteris IT systems have been implemented in over 250 hospitals and diagnostic centres all over the country (~40% coverage of accessible market) (1/2) Overview of IT activities Applications Alteris II, RIS, PACS Teleradiology (over 400 implementation
Slide 41: Alteris IT systems implemented in over 250 hospitals (2/2)
4d Business Model – Medical IT Systems & Equipment Alteris IT systems have been implemented in over 250 hospitals and diagnostic centres all over the country (~40% coverage of accessible market) (2/2) Alteris RIS implementations in hospitals Alteris Teleradiology implementations RIS/PACS Installatio
Slide 42: Alteris supplies and integrates advanced medical equipment
4d Business Model – Medical IT Systems & Equipment Alteris supplies and integrates advanced medical equipment in diagnostic laboratories and has been closely cooperating with top OEMs such as GE Medical equipment – advantages Implementations overview „Turn-key” Project financing Design, construction
Slide 43: Unit Dose system implementation
4d Business Model – Medical IT Systems & Equipment The Company offers implementation of Unit Dose system – advanced solutions for comprehensive pharmaceuticals management in hospitals Unit Dose system – advantages Unit Dose system – case study Central pharmacy Patient Increase in patients’ safety Im
Slide 44: OMNIVIDI remote histopathology diagnostic system
4d Business Model – Medical IT Systems & Equipment The Company offers implementation of OMNIVIDI – remote histopathology diagnostic system Omnividi system – advantages Omnividi system – how does it work? Solution to insufficient number Improved cost effectiveness of pathologists in hospitals • Due t
Slide 45: Business Model – Summary
4e Business Model – Summary Diagnostic Medical IT Imaging Systems & (MRI & CT ) Equipment Group Hospital Nuclear care Medicine Gamma Knife
Slide 46: Voxel has 3 complementary and synergetic business units
3b Business Model – Summary 4e Voxel has 3 complementary and synergetic business units Radiology • Recurring orders • Demand for medical for radiotracers IT and infrastructure • Unique Diagnostic • IT systems testing Radio- know-how in nuclear Medical IT Systems Imaging (MRI, CT, pharmaceuticals med
Slide 47: New entrants might enter the market via acquisition only
4e Business Model – Summary New entrants might enter the market via acquisition only Network of DI centers Relationships • 41 uniquely located • ~15 years of market and well-performing presence in the market diagnostic imaging centers • Vast experience causing with long-term rental Network of well-
Slide 48: Development Strategy
5 Development Strategy
Slide 49: Development strategy corresponds to 3 main segments
5 Development Strategy – Summary Company’s development strategy corresponds to 3 main segments, ensuring top- line growth and bottom-line development in all business lines Development strategy – Organic Growth Radiology Medical IT & Equipment Treatment Core Increasing number of initiatives Increasin
Slide 50: Radiology focus: lab utilization, FFS share, new labs
5 Development Strategy – Organic Growth The key strategic focus in the Radiology segment is on increasing utilization of labs, increasing share of FSS and patients & clinical tests as well as opening new laboratories Development strategy – Organic Growth (Radiology) Existing Operations New Operation
Slide 51: Nuclear Medicine focus: cyclotrons and new radiotracers
5 Development Strategy – Organic Growth With regard to development of Nuclear Medicine segment of Radiology, the focus is on increasing utilization of cyclotrons, developing consultancy projects and introducing new radiotracers Development strategy – Organic Growth (Radiology – Nuclear Medicine) Exi
Slide 52: Medical IT & Equipment priorities
5 Development Strategy – Organic Growth Priorities in the Medical IT & Equipment segment include securing recurring revenues, increasing scale of operations & cross selling as well as entering cloud radiology IT software market Development strategy – Organic Growth (Medical IT and Equipment) Existin
Slide 53: Treatment pillar: Exira and Vito-Med
5 Development Strategy – Organic Growth Treatment pillar of the strategy is based on the continuing Exira’s dynamic growth, developing hospital segment via Vito-Med as well as focusing on minimally invasive procedures segment Development strategy – Organic Growth (Treatment) Existing Operations Cont
Slide 54: Financial Information
5 Financial Information
Slide 55: Group revenues generated by Radiology, IT & Infrastructure and Treatment
6 Financial Information The Group’s revenues are generated by Radiology, IT & Infrastructure and Treatment segments Revenue breakdown by business units (PLN m) Consolidated EBITDA by segments 470.0 442.7 175.0 460.0 134.4 450.0 165.0 125.00 440.0 414.8 430.0 420.0 155.0 410.0 106.3 400.0 145.0 390.0
Slide 56: Approx. 60% of examinations benefit from unlimited NHF refunds
6 Financial Information Patients of approx. 60% of examinations in Voxel Group benefit from unlimited NHF refunded treatments Radiology – revenue 2022 (%) Group – revenue 2022 (%) Other Teleradiology Other sales sales Pharmaceutical Refunded Refunded examinations treatments treatments Private patien
Slide 57: Healthy balance sheet with high liquidity and limited indebtedness
6 Financial Information The Group has a healthy balance sheet with high liquidity and limited indebtedness (Net Debt/EBITDA for 2022 equal to 1.0x) and the asset base is strong and well invested Net Debt Net debt / EBITDA(1)(3) PLN m 150.0 130.3 106.4 112.7 105.3 1.9 100.0 55.9 37.2 30.9 27.9 50.0 0
Slide 58: The Group's P&L snapshot (2015-2022)
6 Financial Information The Group’s P&L snapshot (2015-2022) (m PLN) 2015 2016 2017 2018 2019 2020 2021 2022 Sales revenue 132.0 120.7 152.2 170.4 211.7 327.6 442.7 414.8 Cost of sales (96.1) (85.6) (110.5) (122.1) (156.0) (260.0) (315.0) (316.5) Gross profit on sales 36.0 35.1 41.7 48.3 55.7 67.6 1
Slide 59: Thank you for your attention
Thank you for your attention www.voxel.pl hello@voxel.pl