Healthcare

Mediclinic’s contribution to Remgro’s headline earnings, which includes the contribution of Manta Bidco Limited (Manta Bidco), amounted to R2 386 million (2024: R1 515 million), representing an increase of 57.5%. As a result of the Mediclinic acquisition (being the acquisition, through Remgro’s 50% interest in Manta Bidco, which is jointly owned by Remgro and MSC Mediterranean Shipping Company SA (MSC), of the entire issued ordinary share capital of Mediclinic), Remgro’s indirect interest in Mediclinic increased from 44.6% to 50.0% (or by 5.4%) during June 2023. As Mediclinic has a March year-end, the comparative year included Remgro’s portion of the Mediclinic results for the two months ended 31 May 2023 at 44.6% and for the ten months to 31 March 2024 at 50.0%. Mediclinic’s contribution in the comparative year also included transaction costs of R165 million relating to the Mediclinic acquisition. Excluding these transaction costs, Mediclinic’s contribution to headline earnings increased from R1 680 million to R2 386 million (or 42.0%).

Mediclinic (including Manta Bidco) reports adjusted earnings, which removes volatility associated with certain types of significant income and charges from headline earnings, to assess financial and operational performance and as a method to provide investors and analysts with complementary information to better understand its financial performance. These adjustments include the portion of the above-mentioned transaction costs incurred by Mediclinic and the comparative year also included an increase in a redemption liability of $40 million relating to the acquisition of Hirslanden La Colline Grangettes SA.

Mediclinic delivered good results for the year ended 31 March 2025 against a backdrop of a persistently challenging operating environment, particularly in Switzerland where simultaneous pressure on prices and operating costs is impacting the performance of healthcare service providers. Mediclinic’s board and management team are responding to these challenges through a comprehensive plan aimed at reducing costs, improving efficiencies, and adapting the business to a path of sustainability and growth.

Mediclinic’s performance for the year ended 31 March 2025 was driven by strong volume growth across all divisions. Mediclinic group revenue was up 5% at $4 818 million (2024: $4 592 million) and up 4% in constant currency terms. Inpatient admissions and day cases grew by 1.5% and 3.2%, respectively.

Adjusted EBITDA was up 9% at $737 million (2024: $673 million) and up 9% in constant currency terms. Adjusted EBITDA margin was 15.3% (2024: 14.7%), reflecting good revenue growth and cost efficiency, partially offset by higher consumables and supply costs mainly because of ongoing mix changes. Adjusted operating profit was up 16% at $415 million (2024: $356 million) and up 16% in constant currency terms. Adjusted earnings were up 21% at $239 million (2024: $197 million). Adjusted depreciation and amortisation were up 2% to $323 million (2024: $318 million), reflecting ongoing investment in facilities and equipment across the three divisions, and adjusted net finance cost was up 1% at $107 million (2024: $106 million), which further explains the increases in adjusted operating profit and adjusted earnings.

Mediclinic delivered a cash conversion of 104% (2024: 92%), marginally ahead of the targeted 90–100%, mainly due to improved collections in Switzerland and the Middle East.

Switzerland’s revenue for the year increased by 2% to CHF1 940 million (2024: CHF1 905 million), reflecting good growth in inpatient admissions of 2.2%. The general insurance mix was marginally higher at 52.6% (2024: 52.1%) as growth in generally insured admissions exceeded that of supplementary insurance. Growth in inpatient admissions, partly offset by a decrease in the average length of stay by 3.4%, resulted in an improved occupancy rate of 58.8% (2024: 58.1%). Outpatient and day-case revenue was broadly flat at CHF417 million (2024: CHF408 million), contributing some 21% (2024: 21%) to total revenue during the period. The revenue growth delivered a 4% increase in adjusted EBITDA to CHF266 million (2024: CHF255 million). The adjusted EBITDA margin increased from 13.4% to 13.7%, reflecting disciplined cost management, offset by higher consumables and supply costs driven by increased volumes and mix changes.

Southern Africa’s revenue for the year increased by 8% to R22 369 million (2024: R20 786 million) in a challenging economic environment. In comparison with the prior year, paid patient days (PPDs) increased by 1.2%, with day cases increasing by 3.2%. Occupancy improved to an average of 67.7% (2024: 67.4%) as the admission growth was partially offset by a 0.3% reduction in average length of stay. Average revenue per bed day was up 6.5% compared with the prior year, reflecting year-on-year price increases and speciality mix changes. Adjusted EBITDA increased by 8% to R4 097 million (2024: R3 784 million), resulting in an adjusted EBITDA margin of 18.3% (2024: 18.2%).

The Middle East revenue for the year increased by 5% to AED5 135 million (2024: AED4 892 million), driven by continued growth in client activity and increased pharmacy revenue. Inpatient admissions and day cases were up 4.8% and 3.5%, respectively, and outpatient cases increased by 1.0%. Adjusted EBITDA increased by 10% to AED788 million (2024: AED714 million), driven by revenue growth and strong cost discipline. The adjusted EBITDA margin increased to 15.4% (2024: 14.6%).