Afya Limited Announces Fourth Quarter and Full-Year 2023 Financial Results

Another Year of Strong Performance

Robust EPS Expansion

Guidance Achievement

NOVA LIMA, Brazil–(BUSINESS WIRE)–Afya Limited (Nasdaq: AFYA; B3: A2FY34) (“Afya” or the “Company”), the leading medical education group and digital health services provider in Brazil, reported today financial and operating results for the fourth quarter and full-year period ended December 31, 2023. Financial results are expressed in Brazilian Reais and are presented in accordance with International Financial Reporting Standards (IFRS).


Fourth Quarter 2023 Highlights

  • 4Q23 Adjusted Net Revenue increased 22.6% YoY to R$729.5 million. Adjusted Net Revenue excluding acquisitions grew 12.5% to R$669.7 million.
  • 4Q23 Adjusted EBITDA increased 19.3% YoY, reaching R$288.9 million, with an Adjusted EBITDA Margin of 39.6%. Adjusted EBITDA excluding acquisitions grew 6.4% to R$257.7 million with an Adjusted EBITDA Margin of 38.5%.
  • 4Q23 Adjusted Net Income increased 27.7% YoY, reaching R$164.4 million, with an adjusted EPS growth of 29.6% in the same period.

Full-Year 2023 Highlights

  • FY23 Adjusted Net Revenue increased 23.9% YoY to R$2,874.1 million. Adjusted Net Revenue excluding acquisitions grew 13.3% to R$2.626.9 million.
  • FY23 Adjusted EBITDA increased 21.2% YoY reaching R$1,165.7 million, with an Adjusted EBITDA Margin of 40.6%. Adjusted EBITDA excluding acquisitions grew 9.5% to R$1,052.8 million with an Adjusted EBITDA Margin of 40.1%.
  • FY23 Adjusted Net Income increased 10.5% YoY, reaching R$591.1 million, with an adjusted EPS growth of 11.5% in the same period.
  • Cash conversion of 97.1% generating R$1,088.8 million of cash flow from operating activities that resulted in a cash position of R$553.0 million.
  • Around 268 thousand monthly active physicians and medical students using Afya’s Digital Service, an increase of 2.8% over the same period last year.
Table 1: Financial Highlights

For the three months period ended December 31,

 

For the twelve months period ended December 31,

(in thousand of R$)

2023

2023 Ex Acquisitions*

2022

% Chg 

% Chg Ex Acquisitions

 

2023

2023 Ex Acquisitions*

2022

% Chg 

% Chg Ex Acquisitions

(a) Net Revenue

729,866

670,071

584,002

25.0%

14.7%

2,875,913

2,628,723

2,329,057

23.5%

12.9%

(b) Adjusted Net Revenue (1)

729,479

669,684

595,138

22.6%

12.5%

2,874,085

2,626,895

2,319,131

23.9%

13.3%

(c) Adjusted EBITDA (2)

288,912

257,744

242,207

19.3%

6.4%

1,165,678

1,052,844

961,924

21.2%

9.5%

(d) = (c)/(b)  Adjusted EBITDA Margin

39.6%

38.5%

40.7%

-110 bps -220 bps

40.6%

40.1%

41.5%

-90 bps -140 bps
*For the three months period ended December 31, 2023, «2023 Ex Acquisitions» excludes: UNIMA and FCM Jaboatão (October to December, 2023; Closing of UNIMA and FCM Jaboatão was in January 2023).
*For the fiscal year ended December 31, 2023, «2023 Ex Acquisitions» excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Cardiopapers (January to March 2023; Closing of Cardiopapers was in April, 2022), Glic (January to May, 2023; Closing of Glic was in May, 2022), and UNIMA and FCM Jaboatão (January to December, 2023; Closing of UNIMA and FCM Jaboatão was in January 2023).
(1) Includes mandatory settlements 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 07).

 

Message from Management

We are delighted to showcase another year of remarkable operational and financial achievements for Afya. Once more, we have demonstrated the robustness of our business, the effective implementation of our strategy, the dedication of our team members, and the reliability of our business model.

This year we disclosure notable rises in net revenue across our three segments, strong cash generation, and substantial growth in EPS, underscoring our ongoing business expansion. The convergence of these elements has empowered us to meet our 2023 targets, and we are now looking ahead to the objectives set for 2024.

For another year we are pleased to disclose that the most significant growth of the year, in terms of revenue, stemmed from our Continuing Education segment. Through a robust intake process, the establishment of three new campuses, and course maturation, we can see once more, our students, employees, and partners benefit from our constantly developing ecosystem.

Our second most noteworthy growth originated from our undergrad business — our core business remains as robust as ever, with Medicine courses increasing tickets higher than inflation, maturation of medical seats and the completion of UNIMA and Faculdade de Ciências Médicas Jaboatão integration process in November, less than one year after its acquisition, proving our commitment to extract synergies within the operation.

In our Digital Services Segment we are proud to see another year of organic growth, reaffirming the immense potential of the business. This surge can be attributed to the success of our B2B engagements, where we have secured new contracts with pharmaceutical industry leaders. Furthermore, the continuous growth in B2P subscribers reflects our unwavering dedication to expanding our reach.

Afya´s 2023 Net Revenues was almost four times higher than in 2019, the year of our IPO. Furthermore, there has been a notable increase in cash generation. We have witnessed the cash conversion rate consistently above 90%, demonstrating our ability to achieve substantial growth while enhancing profitability and cash generation. Lastly, our earnings per share (EPS) have more than doubled since 2019 and is still growing, underscoring our capability to blend organic and inorganic growth with disciplined capital allocation, resulting in significant returns to propel our growth.

Besides its results achievements, Afya also has been investing in building its sustainability strategy and ESG (Environmental, Social, and Governance) vision to enhance value generation and impact for its stakeholders, as well as to contribute to the longevity of the business with socio-environmental responsibility. Aware of the role we play, ESG-related aspects permeate our strategies and routines. We aim to contribute to the social and economic development of the communities in which we operate and enable physicians to experience the best aspects of their profession.

As an indication of our outstanding results and impactful initiatives that are being shown to the market, the announcement of our sponsored BDRs this year, marked the entrance of Afya in B3 and we proudly celebrate several awards recognitions this year, such as «Executivo de Valor” recognizing Virgilio Gibbon as the top CEO in the Education Sector, “Valor Econômico’s Best Education Company in Innovation», and another prestigious recognition for being the best Company in the Education Sector in the «Valor 1000» award and “Great Place to Work”.

Strong performance, consistent growth, success in all segments, social responsibility and public recognition: this is how we are evolving and empowering our mission to provide an ecosystem that integrates education and digital solutions for the entire medical journey. We are very proud of our business and what we have achieved so far, and excited the future.

1. Key Event in the Quarter:

  • On October 31st, Afya announced, through its wholly owned subsidiary Afya Participações S.A. (“Afya Brazil”), the acquisition of an additional 15% in Centro de Ciências em Saúde de Itajubá S.A. («CCSI”;” FMIT”), consolidating our position of ownership to 75% of the total share capital. The aggregate purchase price for the additional 15% was R$21.0 million paid 100% in cash on the closing date.

2. Subsequent Event

  • On January 24, 2024, the Ministry of Education (MEC) authorized the increase of 40 medical seats of Faculdades Integradas Padrão (FIP Guanambi), located in the city of Guanambi, State of Bahia, which will result in an additional payment of R$49.6 million. With the authorization, Afya reaches 100 medical seats on this campus, and 3,203 total approved seats.

3. Full Year 2023 Guidance Achievement

The Company’s financial results reaffirmed the resiliency and predictability of Afya’s business model.

Guidance for 2023 Actual 2023
Adjusted Net Revenue* R$ 2,750 mn ≤ ∆ ≤ R$ 2,850 mn 2,874 mn
Adjusted EBITDA R$ 1,100 mn ≤ ∆ ≤ R$ 1,200 mn 1,166 mn
 
*Includes UNIMA and Faculdade de Ciências Médicas Jaboatão’ acquisitions;
Includes the increase of 64 medical seats of Faculdade Santo Agostinho, in the city of Itabuna;
Excludes any acquisition that may be concluded after the issuance of the guidance.

4. 2024 Guidance

The guidance for FY2024 is defined in the following table:

Guidance for 2024
Net Revenue1 R$ 3,150 mn ≤ ∆ ≤ R$ 3,250 mn
Adjusted EBITDA R$ 1,300 mn ≤ ∆ ≤ R$ 1,400 mn
CAPEX2 R$ 220 mn ≤ ∆ ≤ R$ 260 mn
(1) Excludes any acquisition that may be concluded after the issuance of the guidance.
(2) The 2024 Capex guidance does not encompass the earn-out payment in the amount of R$49.6 million related to the 40-seat increase at Faculdades Integradas Padrão (FIPGuanambi).

5. 4Q23 and 2023 Overview

Operational Review

Afya is the only company offering educational and technological solutions to support physicians across every stage of the 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 operating segments. 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 operating segment 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, which 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

Twelve months period ended December 31,

2023

2022

% Chg

Undergrad Programs
MEDICAL SCHOOL
Approved Seats

3,163

2,823

12.0%

Operating Seats (1)

3,113

2,773

12.3%

Total Students (end of period)

21,446

17,968

19.4%

Average Total Students

21,154

17,761

19.1%

Average Total Students (ex-Acquisitions)*

19,040

17,761

7.2%

Tuition Fees (Total – R$ ‘000)

2,573,704

2,032,888

26.6%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

2,332,745

2,032,888

14.8%

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

10,210

9,538

7.0%

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

8,548

7,898

8.2%

UNDERGRADUATE HEALTH SCIENCE
Total Students (end of period)

21,117

17,967

17.5%

Average Total Students

21,365

19,441

9.9%

Average Total Students (ex-Acquisitions)*

19,690

19,441

1.3%

Tuition Fees (Total – R$ ‘000)

388,799

336,238

15.6%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

359,647

336,238

7.0%

OTHER UNDERGRADUATE
Total Students (end of period)

23,471

22,265

5.4%

Average Total Students

24,336

23,376

4.1%

Average Total Students (ex-Acquisitions)*

21,170

23,376

-9.4%

Tuition Fees (Total – R$ ‘000)

304,276

266,306

14.3%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

263,275

266,306

-1.1%

TOTAL TUITION FEES
Tuition Fees (Total – R$ ‘000)

3,266,778

2,635,432

24.0%

Tuition Fees (ex- Acquisitions* – R$ ‘000)

2,955,667

2,635,432

12.2%

*For the fiscal year ended December 31, 2023, «2023 Ex Acquisitions» excludes: UNIMA and FCM Jaboatão (January to December, 2023; Closing of UNIMA and FCM Jaboatão was in January 2023).
(1) The difference between approved and operating seats is ‘Cametá’. A campus for which we already have the license but haven’t started operations.

Key Revenue Drivers – Continuing Education and Digital Services

Table 3: Key Revenue Drivers

Twelve months period ended December 31,

2023

2022

% Chg

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

4,976

4,280

16.3%

Average Total Students

4,838

3,835

26.1%

Average Total Students (ex-Acquisitions)

4,838

3,835

26.1%

Net Revenue from courses (Total – R$ ‘000)

146,827

108,806

34.9%

Net Revenue from courses (ex- Acquisitions¹)

146,827

108,806

34.9%

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

7,563

14,569

-48.1%

Prep Courses & CME – B2B

5,649

5,887

-4.0%

Além da Medicina Active Payers

7,557

6,081

24.3%

Cardiopapers Active Payers

9,202

5,034

82.8%

Medical Harbour Active Payers

12,133

7,668

58.2%

Clinical Decision Software
Whitebook Active Payers

153,541

137,767

11.4%

Clinical Management Tools²
iClinic Active Payers

26,293

22,764

15.5%

Shosp Active Payers

3,768

2,915

29.3%

 
Digital Services Total Active Payers (end of period)

225,706

202,685

11.4%

Net Revenue from Services (Total – R$ ‘000)

229,285

189,984

20.7%

Net Revenue – B2P

190,838

166,515

14.6%

Net Revenue – B2B

38,448

23,469

63.8%

Net Revenue From Services (ex-Acquisitions¹)

222,196

189,984

17.0%

(1) Clinical management tools includes Telemedicine and Digital Prescription features.
(2) For the fiscal year ended December 31, 2023, «2023 Ex Acquisitions» excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Cardiopapers (January to March 2023; Closing of Cardiopapers was in April, 2022), Glic (January to May, 2023; Closing of Glic was in May, 2022).

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 around 268 thousand.

Monthly Active Unique Users (MUAU) represents the number of unique individuals, without overlap of users among products, in the last 30 days of a specific period.

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

4Q23

4Q22

% Chg YoY

3Q23

2Q23

Content & Technology for Medical Education

20,215

16,539

22.2%

26,012

24,973

Clinical Decision Software

219,420

221,762

-1.1%

230,732

230,338

Clinical Management Tools¹

26,703

20,936

27.5%

26,944

24,880

Physician-Patient Relationship

1,579

1,473

7.2%

1,583

1,782

Total Monthly Active Users (MaU) – Digital Services

267,917

260,710

2.8%

285,271

281,973

1) Clinical management tools includes Telemedicine and Digital Prescription features

Includes Shosp, Medicinae and Além da Medicina starting in 1Q22 and Cardiopapers and Glic starting in 2Q22
Table 5: Key Operational Drivers for Digital Services – Monthly Unique Active Users (MuaU)

4Q23

4Q22

% Chg QoQ

3Q23

2Q23

 
Total Monthly Unique Active Users (MuaU) – Digital Services

241,753

241,949

-0.1%

254,894

251,487

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

Seasonality

Undergrad’s tuition revenues are related to the enrollment and re-enrollment process and monthly tuition fees charged to students over the period; thus, does not have significant fluctuations during the year. Continuing Education revenues are related to monthly intakes and tuition fees and do not have a considerable concentration in any period. Digital Services is comprised mainly of 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 due to the enrollments. In addition, 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 than in the second and third quarters.

Revenue

Adjusted Net Revenue for the fourth quarter of 2023 was R$729.5 million, an increase of 22.6% over the same period of the prior year, mainly due to UNIMA and FCM Jaboatão acquisition, higher net tickets in Medicine courses, maturation of medical seats and the growth of Continuing Education and Digital Services segments.

Net Revenue of Continuing Education for the fourth quarter of 2023 was R$38.6 million, an increase of 16.0% YoY, boosted by the growth in the number of students.

Digital services increased 17.1% YoY, totaling R$65.2 million for this quarter. The organic growth is a combination of (a) an increase in the B2B engagements, increasing B2B Net Revenue by 63.8%, and (b) the expansion of the active payers in the B2P, mainly in Whitebook, Medical Harbour, Shosp, IClinic, Cardiopapers and Além da Medicina.

For the full year ended December 31, 2023, Adjusted Net Revenue was R$2,874.1 million, an increase of 23.9% over the same period of last year. Excluding acquisitions, Adjusted Net Revenue grew 13.3% over the same period.

Table 6: Revenue & Revenue Mix
(in thousands of R$) For the three months period ended December 31, For the twelve months period ended December 31,

2023

2023 Ex Acquisitions*

2022

% Chg

% Chg Ex Acquisitions

 

2023

2023 Ex Acquisitions*

2022

% Chg

% Chg Ex Acquisitions

Net Revenue Mix
Undergrad

627,929

568,135

499,852

25.6%

13.7%

2,511,018

2,270,917

2,037,889

23.2%

11.4%

Adjusted Undergrad¹

627,542

567,748

510,988

22.8%

11.1%

2,509,190

2,269,089

2,027,963

23.7%

11.9%

Continuing Education

38,564

38,564

33,238

16.0%

16.0%

146,827

146,827

108,806

34.9%

34.9%

Digital Services

65,249

65,249

55,741

17.1%

17.1%

229,285

222,196

189,984

20.7%

17.0%

Inter-segment transactions

-1,876

-1,876

-4,829

-61.2%

-61.2%

-11,217

-11,217

-7,622

47.2%

47.2%

Total Reported Net Revenue

729,866

670,071

584,002

25.0%

14.7%

2,875,913

2,628,723

2,329,057

23.5%

12.9%

Total Adjusted Net Revenue ¹

729,479

669,684

595,138

22.6%

12.5%

2,874,085

2,626,895

2,319,131

23.9%

13.3%

*For the three months period ended December 31, 2023, «2023 Ex Acquisitions» excludes: UNIMA and FCM Jaboatão (July to December, 2023; Closing of UNIMA and FCM Jaboatão was in January 2023).
*For the fiscal year ended December 31, 2023, «2023 Ex Acquisitions» excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Cardiopapers (January to March 2023; Closing of Cardiopapers was in April, 2022), Glic (January to May, 2023; Closing of Glic was in May, 2022), and UNIMA and FCM Jaboatão (January to December, 2023; Closing of UNIMA and FCM Jaboatão was in January 2023).
 (1) Includes mandatory settlements 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 07).

Adjusted EBITDA

Adjusted EBITDA for the three-month period ended December 31, 2023, increased 19.3% to R$288.9 million, up from R$242.2 million in the same period of the prior year, while the Adjusted EBITDA Margin decreased 110 basis points to 39.6%. For the full year ended December 31, 2023, Adjusted EBITDA was R$1.165.7 million, an increase of 21.2% over the same period of the prior year, with an Adjusted EBITDA Margin decrease of 90 basis points in the same period. The Adjusted EBITDA Margin reduction this year is due to: (a) Mix of Net Revenue, with higher participation of Continuing Education segment, and (b) the consolidation of 4 new Mais Médicos campuses (operation started on 3Q22).

Table 7: Adjusted EBITDA
(in thousands of R$)

For the three months period ended December 31,

 

For the twelve months period ended December 31,

2023

2023 Ex Acquisitions*

2022

% Chg

% Chg Ex Acquisitions

 

2023

2023 Ex Acquisitions*

2022

% Chg

% Chg Ex Acquisitions

Adjusted EBITDA

288,912

257,744

242,207

19.3

6.4%

1,165,678

1,052,844

961,924

21.2%

9.5%

% Margin

39.6%

38.5%

40.7%

-110 bps -220 bps

40.6%

40.1%

41.5%

-90 bps -140 bps
*For the three months period ended December 31, 2023, «2023 Ex Acquisitions» excludes: UNIMA and FCM Jaboatão (October to December, 2023; Closing of UNIMA and FCM Jaboatão was in January 2023).
*For the fiscal year ended December 31, 2023, «2023 Ex Acquisitions» excludes: Alem da Medicina (January & February 2023; Closing of Alem da Medicina was in March, 2022), Cardiopapers (January to March 2023; Closing of Cardiopapers was in April, 2022), Glic (January to May, 2023; Closing of Glic was in May, 2022), and UNIMA and FCM Jaboatão (January to December, 2023; Closing of UNIMA and FCM Jaboatão was in January 2023).

Adjusted Net Income

Net Income for the fourth quarter of 2023 was R$101.9 million, an increase of 42.8% over the same period of the prior year, mainly due to the increase in operational results and the recognition of income tax credit. Adjusted Net Income for the fourth quarter of 2023 was R$164.4 million, an increase of 27.7% over the same period of the prior year, mainly due to the reasons previously mentioned and lower non-recurring expenses in the quarter when compared to the same period of the prior year.

For the twelve-month period ended December 31, 2023, Net Income increased 3.2%, from R$392.8 million to R$405.4 million. Adjusted Net Income for the twelve-month period of 2023 was R$591.1 million, an increase of 10.5% year over year. Adjusted EPS reached R$6.37 per share for the full year of 2023 ended December 31, an increase of 11.5% year over year, reflecting the increase in our Net Income and capital allocation discipline executing our business combination.

Table 8: Adjusted Net Income

(in thousands of R$)

For the three months period ended December 31,

 

For the twelve months period ended December 31,

2023

2022

% Chg

 

2023

2022

% Chg

Net income

101,886

71,331

42.8%

405,416

392,756

3.2%

Amortization of customer relationships and trademark (1)

29,273

22,015

33.0%

110,052

77,974

41.1%

Share-based compensation

11,453

10,860

5.5%

31,535

31,274

0.8%

Non-recurring (income) expenses:

21,837

24,547

-11.0%

44,121

33,133

33.2%

– Integration of new companies (2)

8,169

7,748

5.4%

28,120

24,763

13.6%

– M&A advisory and due diligence (3)

239

(697)

n.a.

12,616

2,497

405.3%

– Gain on tax amnesty (4)

n.a.

(16,812)

n.a.
– Expansion projects (5)

1,873

1,053

77.9%

4,409

3,411

29.3%

– Restructuring expenses (6)

6,291

5,307

18.5%

11,964

12,388

-3.4%

– Mandatory Discounts in Tuition Fees (7)

5,265

11,136

-52.7%

3,824

(9,926)

n.a.
Adjusted Net Income

164,449

128,753

27.7%

591,124

535,137

10.5%

Basic earnings per share – in R$ (8)

1.09

0.74

47.2%

4.30

4.14

4.0%

Adjusted earnings per share – in R$ (9)

1.79

1.38

29.6%

6.37

5.71

11.5%

Contacts

Investor Contact: ir@afya.com.br
IR Website: ir.afya.com.br

Media Contact:
Cíntia Moraes Marin

cintia.marin@afya.com.br

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