Good morning, and thank you for waiting. Welcome to Viveo's conference call to discuss the results of quarter three 2021. Today we have here with us Mr. Leonardo Byrro, CEO and IR Director. Mr. Guilherme Fonseca Goulart, CFO. Thiago Liska, Diagnostics Director, and André Pacheco, Strategy and Marketing Director. We inform that this conference call is being recorded, and all participants will be in a listen-only mode during Viveo's presentation. After the presentation, we will open for questions, and at that time, further instructions will be given. Should any of you need assistance during the conference call, please press star zero to reach the operator. This conference call is also being simultaneously broadcast over the internet via webcast and may be accessed at url.ri.viveo.com.br, where the slide presentation is also available. Feel free to flip through the slides during the company's presentation.
The replay will be available right after the conference call. Participants may also send their questions through the website. These questions will be answered during or after the conference call by the IR team. Before proceeding, we must inform that any forward-looking statements that may be made during this conference call relative to the company's business prospects, projections, operating and financial targets are based on beliefs and premises of the company's management, as well as on information currently available to Viveo. These forward-looking statements are not a guarantee of future performance. They involve risks, uncertainties and premises, since they refer to future events and may therefore depend on circumstances that may or may not occur.
Investors and analysts should understand that general conditions, industry conditions, and other operating factors may affect the future results of Viveo and may lead to results that materially differ from those expressed in such forward-looking statements. Now, I would like to hand the conference over to Mr. Leonardo Byrro, CEO and IRO, to start his presentation. Mr. Byrro, you may proceed.
Good morning, everyone. Thank you for participating today. Welcome to the first earnings conference call of Viveo after our IPO. If you don't know us yet, we are the newbies between the publicly traded companies. Viveo is a company with an ecosystem of products and services for the healthcare system. We manufacture hospital products, personal care and hygiene items, and we work with distribution of drugs and vaccines, and we provide logistics services to the healthcare chain.
We have the mission of simplifying the healthcare industry and democratizing access to health through support and maintenance of each link of this chain. We had our IPO a little more than three months ago on August 9, and Viveo's shares started being traded on B3. The total funds raised were BRL 1.9 billion and BRL 670 million stayed in the cash of the company. Right after, we started using these resources to expand our business, and we already bought seven companies since then. On slide number three. On August 16, one week after our shares started being traded, we announced the acquisition of Profarma Specialty, which works with distribution, special pharmacy, and support services to patients. And also Cirúrgica Mafra , which sells hospital materials, special drugs, orthopedic products, and others. Profarma Specialty is one of the largest players in the distribution of drugs to hospitals and clinics in Brazil.
This acquisition will improve Viveo's leadership and market share in distribution and will add other products and services to the company's portfolio. The acquisition of Cirúrgica Mafra, in turn, reinforces together with Far.me our direct relationship with our customer in a specialized and personalized way. This will be an important addition to the patient support programs with patient care and patient follow-up for high complexity patient, post-hospitalization, chronic diseases, and the other fronts that are already ongoing in the company. These operations added up to a total of BRL 900 million, and together, the two companies have an annual revenue of BRL 1.8 billion. On October 18, which was after the closing of quarter three, we had the acquisition of two other companies, Tecno4 and Pointmed, which work in imports and distribution of instruments and materials for medical use, hospitals, surgeries, and laboratories.
With these acquisitions, Viveo is expanding its work in distribution of single-use items for hospitals, generating value to the entire chain. Together, the two companies have an annual revenue of BRL 559 million and an EBITDA of BRL 11 million. The total value of the transition was BRL 43 million. Last Friday on November 12, we announced three more companies acquired, Apijã, Laborsys, and Macromed. They are distributors of Roche in the regions of Goiás, Tocantins, Paraná, Santa Catarina, São Paulo, and Mato Grosso do Sul. Viveo is the only company with a combined offer of single-use products for pre-analysis and supplies for analysis, and the three companies have a combined annual revenue of BRL 80 million and an EBITDA of BRL 15 million. The total value of these acquisitions was about BRL 82 million. On slide number four, we show all the business in the ecosystem of Viveo.
The acquisitions with the most recent closing after the closing of quarter three are highlighted in yellow. These acquisitions have a combined net revenue of BRL 201 million and a combined EBITDA of BRL 34 million. Profarma Specialty, Cirúrgica Mafra, and the three acquisitions of reagent distributor companies are not shown here because we haven't had the closing of the operation. Cirúrgica Mafra was already approved by the Brazilian Competition Authority in the recent days, and we are expecting a closing still in 2021. For Profarma Specialty, we expect to have the transition completed until the end of the first quarter 2022. On slide five, we show the synergies captured from the M&As performed in 2020. The continuity of the execution of synergies between the companies in the ecosystem and the search for strategies focused on simplification, innovation, and integration of the operations.
This all helps us generate value through operational leverage and corporate structure. By September 2021, the synergies captured in Expressa added up to 97% of the total expected and Flexicotton 21%. Additionally, Flexicotton had an increase in its net revenue, an increase of 106% comparing quarter-over-quarter and 86% year-to-date. The laboratory companies had an increase in their net revenues of 14.2% quarter-over-quarter and 37.5% year-to-date. Despite the strong top-line growth, we never considered this a premise for the decision about acquisitions in Viveo. On slide number six, we have some operational highlights of the quarter. In addition to our acquisitions, we continue to advance with our internal work, growing our products and services initiatives. We have an agenda of 14 future growth initiatives in our planning, and all of them are already ongoing.
In the end of September, for example, we had 79 hospitals already using our storage and transportation services and 122 companies using our transportation service. We closed the quarter with 38 consigned customers, and during the quarter, we also started new VMI and stock management contracts. We also developed an innovative customer care system in healthcare comprising practically all of Viveo's companies. The portal has a customized area for each customer, very agile virtual service, and the support of a virtual assistant called. We invested in this project about BRL 2 million to offer more easiness of use and agility to our customers, and we are already seeing the results of that. One of our KPIs, the NPS, went from 65- 75 points. This quarter, we also highlight some advances in our product growth initiatives.
In hospitals and clinics, we had an increase in our medical materials portfolio with the addition of parenteral nutrition products from B. Braun and infection control and skin health products from GOJO and PURELL. In the public market, we are growing, always maintaining our discipline and our rigorous credit analysis. We had an increase of 180% in our future contracts in the past nine months with a very high ROIC of about 8% per month. In retail, we had a strong growth in private label. Year- to- date, we had an increase of 84% in sales for Flexicotton, boosted by the commercial synergies and the new products with Cremer. This is an important brand in our ecosystem with important products, and their positioning is taking care of living, and we are also increasing their presence and offer in major channels in Brazil, such as grocery stores, retail, and e-commerce.
On slide number eight, we see the net revenue of quarter three 2021, and here excluding the portion referring to DIFAL because DIFAL was ruled as unconstitutional by the Supreme Federal Court of Brazil and is now part of the revenue. We prefer to maintain a more conservative position and disclose our results without this parcel of the revenue, and we think this tax may return in the future. We also present the evolution of our performance, considering that the acquired companies were already consolidated in Viveo since January 2020, so that you can have a better idea of the effective growth of the business. That's why we call this slide accounting, and we also showed the organic growth. Even if we include these values in the quarter three 2020 growth, in the quarter three 2020 results, the percentages were still double digit.
The net revenue, adjusted net revenue, excluding the BRL 15.2 million referring to the DIFAL was BRL 1,443 million, at 19% increase or 13.9% increase if we consider that the acquired company were already present in Viveo's results during the entire quarter three. The adjusted gross income reached BRL 214 million, a 33% increase. The EBITDA was also adjusted, and the growth year-over-year was 33.5% total or 15.3% organic. In the last line of our results, we record the adjusted net income of BRL 80.5 million, more than double the results of quarter three 2020. Our cash cycle was 48 days, a six-day reduction year-over-year. Another important indicator for the company is the ROIC. We use the ROIC to monitor the performance of our business and ensure the correct capital allocation. It is used in our everyday routine. It's a management tool that ensures healthy returns.
Year- to- date, our ROIC was 19.6%. On slide number nine, we show the very strong accounting results that we had from January to September, as well as the adjusted results. Year- to- date in 2021, the accounting net revenue was BRL 4.6 billion, a 54% increase compared with the first nine months of 2020. Gross income reached BRL 841 million, a 97% increase year- over- year. The EBITDA this quarter was BRL 469 million year to date. An increase of 126.6% compared with the first nine months of 2020. This accounting EBITDA is negatively impacted by the phantom shares that I am going to explain, and it is an BRL 86 million effect. If we exclude this effect, the accounting EBITDA of the first nine months of the year would have been approximately BRL 550 million. Here we have our net income of BRL 314 million, a nearly 400% increase year- over- year.
On the right side, we show our adjusted numbers. We maintain the same adjustments that I already talked about, excluding from the revenue, from the net income and the EBITDA, the amount referring to the default, and excluding M&As and M&A expenses and phantom shares from our EBITDA. Our adjusted net revenue was BRL 4.4 billion, a 47.4% increase year-over-year. Our adjusted gross income was up by 49%, and adjusted EBITDA was BRL 342 million, a 49% increase year-over-year. Finally, an adjusted net income of BRL 214 million. On slide 10, I would like to give you more information about the phantom share event, which was the only one this quarter. We had an integral impact of the compensation plan payment in the form of phantom shares of the company.
We paid 20% in cash, and the remaining 80% of the plan was delivered in shares to the executives with a lock-up of up to four years. So we had this non-recurring expense in quarter three with a cash impact of BRL 113 million and an accounting impact of BRL 86 million due to the payment of labor contributions, INSS, IR, and FGTS, because this incentive plan to executives is treated as compensation. The entire effect of the phantom share, including the 80% delivered in shares, was already accounted for in quarter three 2021, so we will not have any future impacts referring to this compensation plan in the company. On slide 11, here we have the evolution of the adjusted net revenue, which was BRL 1,444 million. An 18% increase year-over-year. This is due to the double-digit growth of all our four channels.
On slide number 12, we have the annual evolution of our revenue. The adjusted net revenue was BRL 4,595 million year to date, a total growth of 47.4% year-over-year or 17.9% in the pro forma view. On slide 13, we see that the gross profit of Viveo is growing, following the increase in its margin and the increased profitability of its business. We are reaching this result despite the cost pressures, with an expressive increase in the costs with raw materials, costs with freight, and the foreign exchange rate. The adjusted gross profit of BRL 214 million, we accumulated BRL 637 million year to date, and the gross margin was 14.8% in the quarter and 14.5% year to date. The diversification of our business mix and the accelerated growth in more profitable businesses is what allows us for this gain of margin in the consolidated numbers.
On slide 14, we have the quarterly evolution and the accumulated results of our EBITDA. In addition to the compensation program in the form of phantom shares, the EBITDA was also adjusted including other non-recurring expenses such as M&A expenses. We also had in the quarter growth as well as in the first nine months of 2021, both in absolute terms and also in our margin over adjusted revenue. The EBITDA in quarter three was BRL 119 million, a margin of 8.2%, and year to date BRL 342 million with a margin of 7.8%.
If we also consider the EBITDA of FW, which will be consolidated starting November 1st, 2021, and we also add the EBITDA of Daviso from January to June 2021, the adjusted EBITDA would have been BRL 127.5 million in quarter three, considering FW, and BRL 374.2 million in the first nine months of the year, considering Daviso in the first half of the year. With that, our EBITDA margin would have been 8.6% in quarter 3 2021, and 8.3% year to date. On slide 15, we talk about our adjusted net income. The strong operational performance led to results of BRL 61 million, or BRL 80 million if we consider the additional revenue of BRL 19 million due to the adjustments made on the EBITDA. The adjusted net income was BRL 80 million in the quarter, a 153.1% increase year-over-year.
In addition to the previously mentioned factors, we have two other important effects that had an impact on our net income this quarter. The recognition of the subvention for investment or the fiscal incentive adding up to BRL 28 million relative to January to June 2021. Starting in quarter four, this will be a recurring impact, approximately BRL 12 million per quarter. Also the positive tax balance of BRL 29 million that we excluded from the adjusted net income of BRL 80 million. This factor is not accounted for in the BRL 80 million of adjusted net income. The social contribution over net income to recover is BRL 85.9 million in financial revenue coming from monetary actualizations. Due to the decision of the Supreme Federal Court that ruled unconstitutional the incidence of the IRPJ and CSLL over the standard interest rate, the Selic rate.
As I said, this latter effect of BRL 29 million, we are excluding from the BRL 80 million of our adjusted net income. In the accumulated numbers year to date, the accounting net income was BRL 114 million, and if we make the same adjustments in the first nine months of the year, our accounting result was BRL 100 million and our adjusted net income was BRL 214 million, a 150% increase year-over-year. Now on slide 16, on the left side, we have a summary of our cash flow with the final balance in the quarter of BRL 1.7 billion, compared with an initial balance of BRL 1.3 billion. A BRL 400 million increase in the period. We had a reduction of BRL 67 million in our operating activities, and this was driven by the increase in our stocks and the impact of the phantom share charges of BRL 86 million.
A reduction of BRL 63 million in our investment activities due to our disbursements with M&A and acquisition of equipment and CapEx in the period. The increase in our social capital and loans were responsible for this BRL 519 million increase to our cash. Here we are already discounting the payment of the loans and the impact of BRL 25 million from the phantom share due to the parcel that was effectively paid to executives. BRL 86 million were charges and BRL 25 million were actually delivered. On slide 17, we have some charts showing the company's indebtedness. With a cash of BRL 1.7 billion by the end of September, we closed the quarter with a net cash position of BRL 137 million. This is due to the entry of the IPO funds and the M&As that part of the disbursements for M&As that had not taken place until the end of September 2021.
This means we are well prepared to continue with our planning and the growth of our business. Our gross debt was BRL 1.6 billion on September 30, with 83% of long-term maturation, whereas BRL 774 million, or practically half of the total gross debt, will mature after 2025. A portion of the contracted debt in foreign currency is integrally hedged by financial instruments. On slide 19, we will talk about Far.me, which comes to add to the services agenda that we already mentioned on slide number six. The work that we are doing in Far.me will help us boost this services agenda and will offer an incredible experience to the patient. Let us start with our main results. In December, we started with 312 patients. In September, we have more than 1,100 patients. An average growth of 16% per month in the period with very high retention and customer enchantment.
We have an NPS of 94%, and in the period, our box had a retention of 17 months and a churn under 2%. Our spot agenda, non-recurring agenda, we increased seven times the number of leads for Far.me between quarter three 2021 and quarter two 2021, and we expect very robust growth for the coming quarters. The patient support program, or PSP, has been operating for less than five months, but we already serviced more than 1,200 lives in different states in Brazil. This generated savings of about 5.2% of the total expenses of the operators, and we avoided 11% of errors in patient care errors. As for these initiatives, we will continue to accelerate the expansion of the current channels, increasing our investment in technology to drive Far.me's operation and to further improve patient experience. I will stop here and we can now open for questions. Thank you.
Ladies and gentlemen, we will now open for questions. To ask a question, please press star one. To remove yourself from the queue, please press star two. The first question is from Vinicius Figueiredo, Itaú.
Good morning. The first point I would like to explore is the cash conversion. We saw an increase in that number, and that was mainly due to the increase in your stocks, as you mentioned. But what was the reason for that? What is the normal level that you expect looking forward? My second question is, we are seeing lower occupancy rates in hospitals, lower volumes due to the decrease in COVID-related hospitalizations, but we did not really see an impact on your results due to that. So what is the reason behind your resilience?
Thank you for your question.
Yes, this increase in our cash cycle is driven by stocks, and this is a transition period, a period of adjustment of consumption and demand for products more related with COVID, for which we saw a decrease in demand in the past few months, and the comeback of elective procedures. We couldn't really anticipate the speed of this comeback, so that's why we had to accumulate stocks. We chose to be better prepared not to lose any business opportunities in this initial period, but the comeback is a little slower than we expected. As you said, the occupancy rates were about 75%, a little higher for a few hospitals, but this was the average. Our expectation is during the course of quarter four to already see an adjustment in our stocks and to go back to the normal levels.
André, I don't know if you have anything to add.
Well, the difference that we have about the stocks is due to the change in product mix. In quarter three, we saw a very fast change in the product mix over a few months. Considering that this type of chain has a high lead time, it takes a while to adjust. But we're expecting to do this in quarter four and go back to ideal stock levels. We should go back to that level of 56 days of stocks that we had if you look at the two last quarters. Now, regarding your second question about hospitals and clinics, we did see a lower demand than expected. I think that our resiliency is because we can grow in line with the market if you compare with the previous year.
For example, if you look at the IQVIA data, if we look at the growth rate versus the previous year, 15%. But what we didn't see was the quarter-over-quarter growth, because what happened was that the level increased a little bit in January of this year, and then in the second and third quarter, particularly for drugs where we have more reliable data, you see that it moved horizontally. But if you look at the accumulated for the year, for the first quarter this year versus last year, that is a 15% growth in the market. This means that we are maintaining our market share despite the lower demand. That's why we think we have opportunity to continue to grow as the demand comes back.
Excellent. Thank you.
The next question is from Gustavo Tiseo, Bank of America.
Good morning. I have two questions.
The first one is, can you give us an update about your M&A pipeline? We had some expectations, and we saw your numbers. We know that some of these acquisitions are already completed, but do you have new entrants in your pipeline, just to have an idea of your future M&As? Can you give us more color about Far.me? Is Far.me already performing at about BRL 40 million- BRL 50 million in revenue per quarter? Just to give us more information about the operational values, just to give us some tracking. You showed the numbers of patients, but if you could show more of the revenue or the average ticket per patient so that we can have a better idea of how Far.me is performing. Thank you.
Thank you for your questions. Regarding our M&A pipeline, we're still very active. We have at least 10 possibilities in our pipeline.
Some in more initial stages, some in more advanced stages. We have more than BRL 1 billion in net revenue in this current pipeline that is in our radar today, and at least BRL 150 million in EBITDA in the current pipeline. Many other things will come and go, but today we have 10 potential transactions that are closer in sight. The level is BRL 1 billion in revenue and BRL 150 million in EBITDA that could potentially turn into something. I cannot really give you any precise information in the short term, but this is our expectation. We worked on the raising of the fund so that we can have a strong balance and so that we could continue with our M&A movement regardless of the scenario or any macroeconomic difficulties.
Regarding Far.me, I think that we are now entering a phase in which we will see a huge boost starting 2022, particularly due to the acquisition of Cirúrgica Mafra and the patient support program of Profarma Specialty. We are designing the combination of all these businesses here with the support of Integration, a company that supports us with M&A integrations. We expect to have, by the end of the year or the start of next year, a very robust and detailed strategic plan to share with you in the beginning of next year. Everything is within expected and on track so that we can deliver the numbers that we want to deliver for this business platform. Far.me today, regarding the average ticket, there are two models.
When we look at the box model that I mentioned, that we have more than 1,100 patients, we expect to close the year with 1,500 recurring patients. This ticket has BRL 440 of the monthly average ticket of the box patients. When you look at the spot revenue or spot sales, which are sales in which we convert the leads from electronic prescriptions in our connection with Memed or other electronic prescription platforms with which we connect, this is a spot sale and not recurring. That average ticket is about BRL 180 when we convert. That is something that we talked a little bit about. In the patient support program, which is also a recurring program with more relevant sales, the average ticket is much higher. The average ticket ranges between BRL 1,700 to potentially BRL 8,000- BRL 9,000 in a month.
These are chronic patients, polypharmacy patients that use this recurrently, not just the products, but also the services. This is a business that we started in quarter two this year. We already serviced more than 1,200 patients, which are not those 1,100 of the box patients. These are a different 1,200 patients. So we are recurrently servicing nearly 1,300 patients every month in this modality. There is a lot of integration with Profarma Specialty so that we can start in 2022, gain more acceleration and traction for this agenda. We are closing 2021 in line with the expected and the desirable. What really excites us is the quality of the experience that we are providing. We have an NPS that increases at every survey that we conduct. It is at about 94% now. We have a churn of 1.9%, so these are very positive results.
Now we need to take care of these results so that we can maintain this incredible experience, and so that we can scale up the business with quality. We don't want to scale up too fast and lose this richness of the experience that we are providing to our patients today.
Thank you for the answer, and congratulations on your results.
Thank you.
The next question is from Ian Seskin, BTG Pactual.
Good morning. This is Ian. I have two questions. One is a follow-up to Vinicius' question. I want to better understand the evolution of the mix that you're seeing now that we are resuming or nearly resuming pre-pandemic levels. What do you see in that respect looking forward, FW and B2C?
I want to better understand this breakdown and what we can expect for quarter four in 2022 if you're going back to more normal levels. The second question further explores what Gustavo asked about M&As. I want to better understand where your pipeline stands. The 10 MOUs that you mentioned, are these opportunities more concentrated in hospital distribution? Or maybe these potential opportunities are more related with B2C or manufacturing. Can you give us more details? Thank you.
Thank you, Ian, for your question and for attending this call. In the mix evolution, I'll try to highlight where we stand in quarter three and our prospects for the coming months.
I think the most important transition that we see in hospital and clinics is a reduction in items more linked with outpatient clinic, PPE, and anesthetics, which were a big pain for the industry in quarter two with the second wave of the pandemic. We saw a strong reduction in these items and a comeback of products more related with elective surgeries or even oncology products, because even oncology had reduced activities during the COVID pandemic because people were not frequenting the clinic. Oncology products are coming back really strong right now. We will go back to more normal levels, the normal levels of 2019, and we have to know that we had a bottleneck, and we will have to meet this repressed demand looking forward.
One thing is what we need to do, and a different thing is being able to do it and at what speed, right? This is the main change that we're going to see. Regarding Viveo as a whole, we will have greater growth in reagents due to the acquisitions that we just made last week. We can expect that as of next year. Daviso and FW, we will start working on an integration plan between the two companies. For example, we showed you the growth of Flexicotton, for example, now that we integrated with Cremer. We will also work on a robust plan of accelerating the growth of these two companies and platforms for next year.
This will certainly help us with our consolidated margin of our business here, not just because of the retail division and the greater margin, but also because we have always bet on a larger margin for these companies. These are the main bets for next year. The other one is the organic agenda of adding single-use materials that I mentioned during the call. I gave you some examples, B. Braun and GOJO and other companies. We are working really strongly with our internal growth team to bring this organic growth in single-use materials, which have very interesting margin levels and very interesting technical differentiators. We have other global companies that either are not present in Brazil or have limited presence in Brazil, and they will have a strong potential to see Viveo as a platform so that they can reach healthcare channels in Brazil.
This is an agenda that we are working strongly on, the organic growth, to have a robust pipeline of products to offer and to add to that list of materials that offer a huge opportunity for future growth. This is what I have to say about the mix. Regarding the M&A pipeline, looking at distribution, the main opportunities that we have today are also related with single-use materials and not so much with drugs. We had two large movements related with drugs in the past few years, Expressa, and we are now expecting approval by the Brazilian Competition Authority for Profarma Specialty. But in terms of single-use supplies, we also have a lot of opportunities in our pipeline to advance. Services and technologies, both in B2B for hospitals and also complementation to the PSP business, to Far.me business, and direct customer service, direct patient care.
We have many opportunities that we are working on today. Also in manufacturing, we have very nice opportunities. Some of them are more advanced, others are more incipient. They are also related with products that come to complement our portfolio and that have industrial characteristics that are very similar to what we have today. They are not very different from what we do today. They are within the range of our expertise so that we can have a lot of synergies and higher margin levels. This is how we see the M&A pipeline.
Perfect, Leo. Thank you.
The next question is from Vinicius Ribeiro, UBS.
Good morning. Thank you for taking my question. I have two questions. The first question, thinking of your gross margin gain, can you give us a breakdown of the efficiency gains per synergy?
Also, along the lines of the previous question about mix, we are already at an abnormal scenario in terms of price and volume and the composition of purchases by healthcare providers. But what is the gross margin level that we can expect for the company? My second question is about 2022 and prices. Should we expect any type of structural change associated with higher inflation rates or more expensive dollar compared to what you expected a few months ago, considering the very different macroeconomic variables that we had back then?
Hello, Vinicius. Thank you for your presence and for your question. Regarding the gross margin, the effect that we had this year is much more related with the mix than other effects. It is actually the opposite. The other effects were actually moving against this tide.
Considering our manufacturing platform, we have some increases between 40% and 100% in terms of costs of our production supplies in the first nine months this year versus the first nine months last year. This has been a daily struggle for us to mitigate these increases and to be able to somehow pass on some of this cost. We cannot pass on 100%, but at least partially, and gain internal efficiencies to try to mitigate this. We have not really seen any huge gain of scale or industrial scale that will reflect on our results. The largest gain was in the mix.
If you look at the gain that we had in our laboratory-related businesses with higher margins, or Flexicotton with higher margins, or the services business, or the retail business, this mix, both the channel mix or the business units mix or the product type mix, this is what has been helping us compensate the cost impact and have a better weighted average. I can tell you that when we actually have a more normal inflation rate and when the local scenario and the global scenario of supplies is going back to normal, then perhaps we will be able to see some gain in scale, volume, and more efficiency in the industrial platforms. We also intend to capture synergies. Flexicotton has industrial synergies from investments that we made.
We are now completing the installation of these machines and these investments, and we expect to have gains in scale and synergies starting next year. This is much more an effect of the integrations and our M&As here. The foreign exchange rate certainly affects us, particularly manufacturing products. In drugs, the impact is slightly lower considering that the foreign exchange rate is the main component. If you look at CMED and the drug survey that is done every year, foreign exchange rate does affect drugs, but this transfer is a little more natural in the chain. For raw materials, particularly for adhesives, which are bandages and tapes, there we see a very high weight of the foreign exchange rate, and we have to try to mitigate this internally.
You see in our release that all the cost factors, cardboard and cotton, the prices are still increasing. They have not reached their peak. They will continue to increase. We have not seen any sign of a drop in price for any of them, so we will have to work with these higher scenarios and see whether this is going to improve in 2022. Whenever possible, we have been readjusting our prices, but it is not always possible to do that. When we can, we transfer some of the cost on to the buyers and always ensuring the same level of market share, both for hospitals and clinics and also retail, so that we can at least maintain or gain some market share in some of our categories. Regarding the future margin, it is very hard to give you accurate numbers.
What we can tell you is that we will continue to have an improve in our mix through the factors that we can control. For example, the growth in materials with higher margins. Also higher growth in segments such as laboratories and retails with higher margins. Growth in our services agenda that also has higher margins. Whatever we can do organically and inorganically to grow in these business areas will improve our weighted average, but I cannot really give you any future guidance.
Thank you, Leo. Thank you for the answer.
To ask a question, please press star one. The next question comes from the webcast platform, Carlos Herrera, Condor Insider.
You have made acquisitions for more than BRL 1 billion. I have a question. What is the additional EBITDA level that these acquisitions should be bringing starting 2022?
Hello, Carlos. Thank you for your question.
When we add all the acquisitions that we made, including FW, that was approved now in the start of November, we had a closing, and also the three acquisitions that we announced last week. The pre-synergies, the combined net revenue would be about BRL 2 billion in these companies, and the EBITDA of the pre-synergies reported is BRL 124 million. This has to be projected in our synergies, but this is what we expect for the most recent acquisitions.
If you have a question, please press star one. Since we have no further questions, we are now closing the question and answer session. Now I hand the conference back to Mr. Leonardo for his final remarks. Mr. Leonardo, you may proceed.
I would like to thank you all for participating today.
Thank you for sending your questions, and we will be available for any future clarifications you may need, and we will continue to firmly execute our growth strategy and our 14 growth levers with our very clear mission of simplifying the healthcare market and becoming more and more a solution provider to all our customers in the different channels that we have. Thank you very much. Have a good day.
Viveo's conference call is now closed. Thank you all for participating and have a great day. Thank you for using Chorus Call.