Ladies and gentlemen, good day and welcome to the Apollo Hospitals Enterprise Limited Q3 FY26 earnings conference call. As a reminder, all participant lines will be in the listen-only mode, and there will be an opportunity for you to ask questions after the presentation concludes. Should you need assistance during the conference call, please signal an operator by pressing star, then zero on your touch-tone phone. Please note that this call is being recorded. I now hand the conference over to Mr. Mayank Vaswani from CDR India. Thank you, and over to you.
Thank you, Yashashree. Good afternoon, everyone, and thank you for joining us on this call hosted by Apollo Hospitals to discuss the financial results for the third quarter and nine months of FY26, which were announced yesterday. We have with us today the senior management team represented by Mrs. Suneeta Reddy, Managing Director, Mr. A. Krishnan, Group CFO, Dr. Madhu Sasidhar, President and CEO of the Hospitals Division, Mr. Madhivanan Balakrishnan, CEO of Apollo Healthco, Mr. Sriram Iyer, CEO of AHLL, Mr. Sanjeev Gupta, CFO of Apollo Healthco, and Mr. Obul Reddy, CFO of the Pharmacy business. Before we begin, I would like to mention that some of the statements made in today's discussion may be forward-looking in nature and may involve risks and uncertainties. Please note the disclaimer mentioning these risks and uncertainties, which is on slide two of the investor presentation shared with all of you earlier.
Documents relating to our financial performance have been circulated earlier, and these have also been posted on the corporate website. I would now like to turn the call over to Mrs. Sunita Reddy for her opening remarks. Thank you, and over to you, ma'am.
Thank you, Mayank. Good afternoon, everyone, and thank you for joining us on today's earnings call. I trust that you have all received our earnings material that was shared yesterday. We are pleased to report a strong performance within what is typically a seasonally weak quarter. Importantly, we have sustained the positive momentum from the first half of the year into Q3, delivering double-digit top-line growth across all three of our business verticals: healthcare services, Apollo Healthco, and AHLL. On a consolidated basis, revenue grew by 17% year-on-year to INR 6,477 crore. Within this, the healthcare services business recorded revenue of INR 3,183 crores, reflecting a healthy 14% year-on-year growth. This growth was driven by a well-balanced mix: 5% from volume growth, 4% from case mix, and the remaining 5% from pricing.
Surgical volumes grew by 6% during the quarter, supported by our continued focus on congruent specialties: cardiac, oncology, neurosciences, gastroenterology, orthopedics, and transplant. These specialties remain a key growth engine for us and delivered a robust 16% year-over-year revenue growth. Group-wide occupancy stood at 67% in quarter three FY26. Insurance and cash patients together accounted for 83% of inpatient hospital revenues for quarter three FY26, underscoring the strength and resilience of our payer mix. Average revenue per patient was INR 180,917 in quarter three FY26 compared to INR 173,246 in quarter two FY26, reflecting an increase in clinical intensity during the quarter. Apollo Healthco reported revenues of INR 2,827 crore, 20% year-over-year growth. Revenues from Apollo Health and Lifestyle increased by 20% year-over-year to INR 467 crore during the quarter. Consolidated EBITDA for the quarter was at INR 965 crore, registering a robust growth of 27% year-over-year.
Within this, healthcare services was at INR 719 crore, up by 18%, with margins at 24.8%. Within Apollo Healthco, the pharmacy distribution business recorded EBITDA of INR 195 crore compared to INR 159 crore last year, reflecting a 23% year-on-year increase. Losses in the digital business were at INR 67 crore. Cumulatively, Apollo Healthco more than doubled EBITDA to INR 128 crore in quarter three FY26 compared to INR 57 crore in quarter three FY25. Cash losses in the digital business were at INR 29 crore, the lowest in any quarter by far. The private label and generics accounted for 15.53% of total pharmacy sales. Our digital platform, Apollo 24/7, added 2 million new users during the quarter and now serves over 46 million users. Platform GMV stood at INR 525 crore, a 28% growth over last year. AHLL delivered an EBITDA of INR
48 crore, a strong 39% year-on-year growth, with margins improving to 10.2% from 8.8% in quarter three last year. With all three engines of the business performing well, evidenced by double-digit top-line growth alongside a accretive margin and profitability expansion, we reported a consolidated PAT of INR 502 crore in quarter three FY26, a growth of 35% year-on-year. Turning to the nine-month performance, consolidated revenue for nine months FY26 stood at INR 18,623 crore, growing 15% year-on-year, supported by balanced expansion across all three verticals. Healthcare services reported revenues of INR 9,287 crore, up by 12% year-on-year, driven by continued traction in high-acuity specialties and an improving payer mix. Apollo Healthco delivered revenues of INR 7,960 crore, registering a 19% year-on-year increase, while AHLL revenues grew 19% to INR 2,376 crore. Consolidated EBITDA for the nine-month period stood at INR.
2,758 crore, reflecting a 22% year-on-year increase, and PAT grew to 34% year-on-year to INR 2,412 crore. During the quarter, we operationalized 75 beds in our Pune facility. As we enter the next fiscal, we will be commissioning four new hospitals, one each in Hyderabad, Kolkata, Bangalore, and Gurugram, further strengthening our presence in key metropolitan markets with strong fundamentals. These facilities, along with a ramp-up in our recently commissioned Pune Hospital, will approximately add 1,500 additional operating beds to our network, representing a significant step-up in capacity and a clear runway for medium-term growth. We expect to operationalize roughly half of this capacity in the upcoming fiscal year, with the balance coming online early FY 2028. This phased commissioning approach allows us to calibrate ramp-up efficiency, optimize capital deployment, and drive occupancy-led operating leverage as demand scales.
Together, these additions position us well to capture growth opportunities in high-acuity care, deepen our market penetration, and enhance long-term shareholder value. We have also made progress with respect to the regulatory integration process for the Composite Scheme of Keimed merger and demerger of Apollo Healthco, and remain well positioned to capture the full benefits of scale with a combined entity to achieve a run rate of INR 25,000 crore in combined revenues with 7% EBITDA. Let me conclude by stating that Apollo's performance over the recent quarters reflects the depth, resilience, and scalability of our integrated healthcare ecosystem. Consumer interactions across all formats of care have increased, and cross-format journeys are becoming more visible. These results are a reinforcement of our patient-centric strategy.
We have and will continue to invest ahead of the curve on in-hospital technology such as robotics, and the benefits of such investments are reaching the patient, as evidenced by our growth in high-end surgeries. More importantly, we believe these results demonstrate the deep level of trust that our consumers place in Apollo. We value this trust and engagement and will continue to sharpen our clinical differentiation, expand our capabilities across high-acuity specialties, and strengthen our omnichannel healthcare platforms to improve access, efficiency, and high-quality care outcomes. On that note, I would like to hand it over to the moderator and open the line for questions. I have Krishnan, our CFO; Dr. Madhu Sasidhar, the CEO of the hospital division; Sriram Iyer, CEO of AHLL; Madhivanan, CEO of Apollo Healthco; and Obul Reddy and Sanjiv from Apollo Healthco with me to take all of your questions. Thank you.
Thank you very much. We will now begin the question-and-answer session. Anyone who wishes to ask a question may press star and one on the touch-tone telephone. If you wish to remove yourself from the question queue, you may press star and two. Participants are requested to use handsets while asking a question. Ladies and gentlemen, we will wait for a moment while the question queue assembles. We'll take our first question from the line of Binay Singh from Morgan Stanley. Please go ahead.
Hi team. Congratulations on a strong set of numbers across businesses. I'll first start on the hospital side. It's a very busy time for your two hospitals you've ramped up, and we also have Sarjapur and Kolkata around the corner. Last time we discussed about INR 150 crore cost headwind coming out of this ramp-up. Any updated thoughts on that? How much of it is already built into these numbers? How much should we expect in the coming quarters? That's the first one. Thanks.
So we will come back to you by Q4 one more time, but we continue to believe that INR 150 crore is a good number for now. We have started Pune and Asansol just by the last months in the previous quarter, and we are hoping to ramp both of that up over the next two, three quarters well. Currently, in the embedded numbers, we have approximately INR 15 crore of losses in the overall reported numbers for Pune and Asansol, which is part of the number that has been reported now. As we go into next year, we are hoping that by Q1, we should be operationalizing Hyderabad, the Kolkata facility, as well as Bangalore, which is the wellness one.
Gurugram would be more like Q2 because it is still because of all these issues with the environmental-related delays, which we couldn't complete our construction; there is a 2-3-month delay. So it will be mostly in Q2.
Okay. So to an extent, some of the costs of that would start to come up in the March quarter, right? All your hiring costs and all.
Yeah, March or more likely April.
Okay. And secondly, just on the GMV of the digital business, we've seen a sequential drop in GMV. And in fact, our revenue-to-GMV ratio also went up. Could you share your thoughts on that?
Madhi.
Sanjiv, you want to explain the reinstatement of the GMV, please?
I can take that question. Thanks, Madhu. Yeah, it's a good callout. See, there are two things which have happened. One is that on 21st of September, we had a very large reduction in the GST on the pharmacy and the other products, which resulted into GMV impact of roughly INR 30 crore-INR 35 crore a quarter. And secondly, we had one channel of e-commerce, which was Amazon. We were supplying to Amazon, and then we stopped that business or that segment somewhere in early Q2 of this fiscal year. And for us to compare apples to apples, we had to remove these two. Accumulated impact of these two would be roughly INR 75 crore for Q3. These are the only two adjustments that have been done to ensure that we compare apples to apples between the last year figures and current year figures. Thank you.
Thanks, team. I'll come back in the queue.
Thank you. Ladies and gentlemen, in order to ensure that management is able to answer queries from all participants, kindly restrict your questions to two at a time. You may join back the queue for follow-up questions. The next question is from the line of Neha Manpuria from Bank of America. Please go ahead.
Yeah, thanks for taking my question. Just extending the question on the digital business, I see that the revenue growth here has also been low. Sort of, I wouldn't say lower, but there's been a moderation in revenue growth as well quarter-on-quarter. One, can you take us through what should be the revenue base for the digital business? What drove this moderation? And second, from a guidance perspective, do we still keep our guidance for cash EBITDA break-even for the digital business? I think it was supposed to be at the end of fourth quarter. Any update there?
Madhi?
Yes, ma'am.
No, so our revenue projections continue. So the entire focus is on trying to build a sustainable operating model. So if you have to peel the onion a little bit, our pharmacy online business, which is our mainstay of the GMV, has actually grown by 32%. There has been a little bit of pull-down in some of the other areas because of which our revenue at an overall level, GMV level, is at a flatter basis. However, the quality of the business is improving. If I were to give you some highlights, our discount is stabilizing. Our average order value has gone up by almost INR 111 net of the GST, which has a positive impact on our unit economics. Our cost of delivery, which is one of the biggest components of our cost structure on the revenue side, is also coming down.
Our marketing spends, we have been extremely frugal in the way we are building a business, but in spite of this, showing a 32% growth in our GMV and proportionate revenue is holding on. In fact, at a CM1 level, we were positive last quarter. We have made it even better in this quarter, and the trajectory continues. There have been some little changes in the way we recognize the income/revenue for the hospital business, which we are recalibrating in terms of the attribution and the kind of campaigns that we're driving. So there was a little bit of a pause, which we will reactivate it again from the next quarter. But it's a full reoperating model that we're doing.
The third area on the revenue side where we are facing a little bit of a mismatch, I wouldn't say, is the way our insurance business, which we started off, is getting recognized. Since September, any collections, any gross return premium, which is the equivalent of revenue, was coming to our commissions on a full basis. We were almost getting 80%-85% of the total logins that we do. We were able to generate commission. However, post-September, given the GST change, which happened in the health insurance industry, there has been a bit of a mismatch between the business that we book and the collections that we do. That is impacting our revenue a little bit. So it's a mismatch in the sense that my revenue recognition is getting deferred over the next 12 months for the money that I'm collecting.
Some of these changes are normalizing it a little bit, so we are on our course. On our forecast about our ability to close it in Q4, given this insurance story, which has sort of pushed us back by around INR 17-odd crore, given this mismatch of our revenue recognition, we will be able to close this loop in Q1 of FY27.
If I were to understand it correctly, you're saying that the digital sorry, the digital cash EBITDA break-even is now probably pushed out by a quarter.
By one quarter. By one quarter, yeah, because of this insurance mismatch that has happened. Otherwise, we are very much on course. That's why you'll see the -INR 29 crore, which the cash EBITDA that we are speaking about, the biggest negative is coming from the -INR 17 crore from the insurance business, which has got deferred into the next year. So we will recognize that income as we go along. And some of these revenue recognition modules that we follow in the hospital business is undergoing a change. So these are two things. So we hope to catch it up in the next quarter. But rest assured, all the primary indicators are on course. Sorry.
On the revenue front, if I were to understand it correctly, we will see this revenue plus the IP/OP that will get resumed from next quarter. Would that be a fair understanding? This quarter's number is an aberration?
Correct. Correct. Yes, we will reactivate those.
Okay. Only thing that has changed is the insurance bit.
Yeah, that's the one which has a bigger impact. There are some businesses wherein our revenue gets recognized at the end of the year because some of them are back-ended. That will also come into play as we go along.
Understood. Okay, that's helpful.
Just correcting one number. I think Madhu said wanted to say INR 7 crore of insurance impact into Q3, not exactly INR 17 crore out of INR 29 crore. Just as a correction.
My apologies.
Okay, got it. And my second question is, in the cluster numbers that we are giving, other than probably AP Telangana and Chennai cluster, we've seen the IP volumes pretty much moderate in most other clusters year-on-year. So just wanting any color to why we are seeing this trend, whether I see it in north, west, or east cluster, there seems to be a moderation in the IP volume trends.
Yeah, so I think you're seeing different phases of optimization, especially in our west market. We've undertaken a lot of work to improve the quality of revenue. So I think volume by itself may not be the right indicator. You took a more holistic look into it, especially at the quality of revenue and the average revenue per patient. So especially our Navi Mumbai unit has been performing very well on that basis, especially with higher specialty care.
All right. Okay, got it. Thank you so much.
Thank you. Next question is from the line of Karan Vora from Goldman Sachs. Please go ahead.
Thank you for taking my question. My first question is with respect to the bed expansion. So I think we've mentioned, other than Gurugram, all the other greenfields or the larger units will come up by Q1. But just wanted to get a sense on how many beds will be operationalized in Q1 and how will the ramp-up look like. I guess you will not operationalize all the beds, right? So at a hospital level, how the ramp-up could look like over the next six to nine months or even one year, that will be helpful for each hospital.
So we will come back again by Q4 on this. But broadly, if you look at it, Sonarpur around Kolkata is 225 beds. Half of that should get operationalized in Q1. Hyderabad is 300. Again, we think that at least 50% should get operationalized by Q1. Pune also, we have now operationalized 75, but we think by Q1, we will add another 100 beds, which will also get operationalized. And Gurugram would be by Q2, 200-250 beds. Sarjapur, 150 beds. We are hoping that we should be able to operationalize 100 beds out of that.
By Q1.
That's right. So roughly around 50% of these beds, right? 1,500 beds, if you look at it in these, we have Jubilee Hills expansion and Secunderabad, which will come a bit later, which will be during the year. But of these four new hospitals, almost 40%-50% will get operationalized by Q1.
Got it. Got it. When we operationalize the remaining half in Q1 FY28 or somewhere around that time, will there be any more startup losses or fixed costs or elevations which we need to keep in mind?
It will be there. So we will have to look at it in a phased manner. So we will see that Q1 should have so when we are saying at INR 150 crores, there will be quarters which will have some higher losses also, right? There could be a quarter where there is a INR 50-crore loss which is coming in. But otherwise, we should look at overall at INR 150 crores for the next year is how we would look at it. So it's difficult to guide now quarter by quarter. We will definitely, as we operationalize these, give you a broad guidance. But you can we have said that this is something that we are hoping that can be offset by the overall volume and revenue growth in the existing hospitals.
Okay, got it. And my second question is with respect to the ARPOB growth. So I understand that we've moved away from ARPOB, but just if we backcalculate ARPOB growth, it is healthy at around 15 levels. So just wanted to get a sense that what is driving this growth? And in the opening remarks, there was a mention of 5% price growth, but in the PPT, it's mentioned 3% price growth. So what is that mismatch, if you can just tie it down, whether it's three or five?
Sure. 3% was the tariff increase that we have taken during the year, whereas 5% is the effective price realization that we have done in this year because there were some insurance contracts which got reset also during the year. So the tariff, what has been presented in the PPT is more the tariff increase which was done in this year. So that is the difference between the two numbers. Your other point on ARPP, of course, we don't give ARPOB. You can compute the ARPOB, of course, but because we don't do ARPOB because the reason is, again, we have OP, we have radiation therapy, we have other stuff also, and a lot of daycare procedures also now come in. ARPP has gone up, which is a combination of, as we said, higher complexity cases that we have seen across and the IP occupancy growth and surgical growth.
This is what has increased the ARPP at a broad level. Pricing realization in that has been 5%. The balance has been case mix.
Okay, got it. Just one last thing, if I can squeeze in. So Apollo 24/7 or the digital piece, overall break-even, EBITDA break-even, is there any target? Not the cash, but even after including ESOPs.
Sanjiv, you want to give them a color of ESOPs for the next year?
I think better would be that when we meet again somewhere in the Q4 earnings call, we have a better understanding about all this as we get into AOP. But I think one point clearly that the ESOP cost maximum is getting consumed until this year. And after that, we have a very less cost on the ESOP specifically. But overall question about including ESOP, I think I would request just to wait for quarter. We are into the middle of annual operating exercise, planning exercise, and we'll get a better position to tell next time.
Okay, got it. Thanks, sir.
Thank you.
Thank you. Next question is from the line of Bino Pathiparampil from Elara Capital. Please go ahead.
Hi, good afternoon. Congrats on a great quarter. Just following up from the previous question, the price increase and realization increase that you are talking about, did that kick in in Q3, or was it already there in Q2 and Q1?
It was there in Q2 also.
Mostly Q3. Mostly Q3. So if I look at the kind of growth you delivered in Q1 and Q2 versus Q3, there is a big step jump. From your competitors, we haven't heard about a great season or anything in the healthcare side. So can I assume a significant part of that is coming from this realization improvement?
No, see, you have to remember that some of our competitors are in various different geographies. See, please appreciate that we are a Pan-India player. Look at our inpatient volume growth in Q2. We saw 2% volume growth, whereas inpatient volume growth in Q3 is 4.5% versus last year. So there will be various different reasons on the way that our numbers can go versus people who are more north-centric or somewhere else because each of the competitors, not many players are as Pan-India as we are. So you have to keep that in your mind. Of course, we have got the benefit of the price realization from Q2 onwards and which has moved into Q3.
But the more important point that you should also consider is the fact that there has been a higher complexity of cases also that we are focused on and the concomitant specialty, and we should be able to sustain as we move forward.
Got it. Second, in AHLL, we have seen quite a few additions in the number of senders. Are these mostly on the diagnostic side, or is it all across?
Sreeram?
Hi. Yeah, so most of these additions are on the diagnostic side. We also launched two new clinics, one in Chennai and one in Hyderabad. Otherwise, most of these additions are on diagnostics.
Okay. When you say diagnostic, are these full-fledged labs or just collection centers?
No, obviously, we have expanded into new labs, new geographies also, but most of these are the infrastructure that you create in the existing geographies. So we open the collection centers and our company-owned outlets. So that is what you can see as expansion.
Understood. Okay. And finally, an update on what's happening on the Healthco side regarding the corporate action about demerger, etc. How is the progress on the team side in terms of accumulation of the different pieces of business that were separate, etc.? It would be great.
Obul, please.
No. We have obtained the Competition Commission approval and SEBI approval. We have filed with NCLT. NCLT started it as listed and started the hearing. We are waiting for the next step.
Okay. And Keimed was supposed to buy out some of the associates which were holding part of shares in different entities. How is that progressing? Is that all progressing on time?
Keimed is progressing on time, and Keimed has streamlined their entire subsidiary network, and they are 100% subsidiaries of Keimed, which is going to get—I mean, Keimed is going to merge into AHL.
Great. Thank you very much.
Thank you. Ladies and gentlemen, we request you to restrict to two questions at a time, please. You may join back the queue for follow-up questions. Next question is from the line of Damayanti Kerai from HSBC. Please go ahead.
Hi. Thank you for the opportunity. My first question is on your hospital business. So not specific to you, but just want to understand your negotiation with the health insurance companies. How is it going? Because we heard some of your peers had some issues. So from your hospital, either for existing as well for some of the new hospitals, how things are progressing on contracting or onboarding of health insurance?
It does take, so we have a good relationship with all the insurance companies across. We have always been maintaining that, and we have a central relationship with them as well. And as of now, basically, yes, there have been some delays in getting certain insurance approvals in some of the markets, which is why even last quarter, we saw some of that contract getting pushed out for renewal. But with that said, I think we are on course, and we are seeing that we are fine going forward.
Okay. These contracts are generally for two-three years, or you are moving for some annual renewal contract as well?
We would prefer annual, but as of now, it is still two years.
It's generally two-year contract. And when do you start this empanelment process for the new hospitals? Say four hospitals coming next year. So when do you start your negotiations to empanel the companies there?
We start the negotiations much before we operationalize the hospital. To give you an example, some of the hospitals that Krishnan spoke about, some of the agreements have been in place, or there has been an agreement by both parties on the terms. So we started much before operationalization, if that answers your question.
Yes. Thank you. My second question is, again, on 24/7. Actually, I'm not still very clear. So you mentioned the majority of changes happened on the pharmacy post-GST changes. But when we look at other metrics, say doctors' consultation number or doctors' platform, diagnostic sample, all of these numbers change compared to what we saw in the September number. So actually, if you can help us understand what all changes were there when you're booking GMV. And if you can just clarify, you mentioned INR 75 crore kind of number, which would adjust in the two numbers, right? Some clarification will be great. Thank you.
Madhivanan, please. Madhivanan, let me just take this question. I think what we're trying to say is a very simple point that when you compare numbers across previous year, on the overall GMV side, there are two factors which have undergone change. One is the GST, and secondly, one of the channels that we closed. So obviously, when you compare GMV to GMV, this factor has to be taken into consideration while seeing growth things. So this is one change that has happened. Now, as far as you also checked I think you asked this question also that total revenue for Q3 versus Q3 FY25 versus Q3 FY26, you are seeing a little lesser growth or 15% growth. I think the answer there lies with the Amazon channel, which is part of the sales for Q3 FY25, which is not part of the sales in Q3 FY26.
If I minus that out, you would see a growth of 32% on the overall revenue versus 15%, which now mathematically can be calculated. This is just a, I would say, small correction because of the GST came in somewhere in Q2, 21st of September, as I said. We had to change the numbers for Q3 for comparative purposes. Somewhere in April month sorry, somewhere in June end, we closed the Amazon channel. Hence, those numbers from Q2 had to undergo change. This is just a change in the change in the numbers constituting to these two things to arrive at a better growth factors. On the diagnostic and the consultation side, there is no change. The business remains as it is. Whatever commission rates are there between the entities, those related party agreements are still good to go. There is absolutely no change.
I think you also touched upon IP/OP GMV. I think in the last earnings call we did, Madhivanan did mention this that the new arrangement with the hospital is more of a flat fee that we get on a quarterly basis. And it's like a booking or ensuring the tech platform for the entire Apollo ecosystem. And that is where the commercials are between both the organizations. I think this should be helpful in case you still think that you've got some doubt. Maybe separately, we can connect, and then we can discuss about this. Thank you.
Sure. So just in terms of annual GMV, any target we are looking for, say this quarter, we did around INR 425 crore. So will this be the run rate to look ahead, or you think we can see much better numbers going ahead? Thank you. That's my last question.
You can expect a consistent growth of around, say, 30% on the GMV for this financial year. Once we are done with the numbers, we'll come back for the next year plan.
Okay. Thank you. All the best.
Thank you. Next question is from the line of Tushar Manudhane from Motilal Oswal Financial Services. Please go ahead.
Thanks for the opportunity. So on the base hospitals per se, if I exclude the new hospitals, at the metros, we are already at 70% occupancy, non-metros 62%, ROC of 31%. So if you could just elaborate in terms of what is further scope for these hospitals to sort of drive EBITDA going forward, maybe through case mix or payer mix for, let's say, the payer needs. That's my first question.
Yeah. So I think even in Q3 of last year, we had resiliency for a little bit. You're right. The occupancy at our metro units is fairly high. There are several levers that we are depending on. One is I think there is a little bit more opportunity on length of stay, reduction through operational excellence, a lot of investment in digital technologies that is helping us with that. The second is there is still some volatility, I think, day-to-day, weekwise, and seasonal volatility. And we're looking at ways in which we can minimize that volatility. And the third is, of course, a consistent focus on case mix, and especially in flagship hospitals, making sure that there is an intentional shift to high-complexity cases.
Any broad number, if you could share, the seasonality impact for the quarter or, let's say, for the nine months, how much it has been?
Yeah. It's very hard to tell because, as you know, it varies from year to year, right? It especially shows up on the medical cases. Some years, we have a bad dengue year, and that skews the occupancy number. That is the unpredictable part of our business. There is a lot that we can predict, which is usually on the elective and semi-elective cases, the surgical cases, and the high-complexity cases like solid organ transplant where we've made a lot of commitment and a lot of investments. Transplant, as an example, this quarter compared to last quarter is about a 50% increase in revenue at the group level.
Got it. And just second me on the overall combined Keimed plus offline plus online, we are at a quarterly revenue of INR 50 billion. And the target is to reach INR 250 billion annualized by Q4 FY27, which is effectively 60-62. If I go by earlier quarter numbers, we are sort of growing at 4%. Then what could be while we've explained them in detail in terms of the online pharmacy or the Healthco. But any other factors which will drive these numbers to INR 62 billion by Q4 FY27?
Ranjith?
I think all the business lines, whether it is the front-end or Keimed or online as you rightly said, online pharmacy is growing by about 30%. We are seeing decent growth in the other business lines also. I think where we stand today at Q3 annualized number, we are roughly at INR 20,000 crore. And we've got five more quarters to hit the run rate of about INR 25,000 crore, which is roughly about 25% from now to there. Five quarters also, I think if we continue to see the business with a growth trajectory of about 20%-22% annually, we should be able to meet this number easily. At this stage, we do not see any challenge coming our way with respect to hitting the top-line number. Thank you.
Got it, sir. Thank you.
Thank you. Next question is from the line of Lavanya from UBS. Please go ahead. Lavanya, your line is unmuted. Please go ahead with your question.
Hi. Could you hear me now?
Yes. Please go ahead.
Yeah. Thank you for the opportunity. I just wanted to check how sustainable you see the hospital margins given the new hospitals being operational over the next couple of quarters.
So I think we will continue to be able to maintain margins. We are carefully balancing the EBITDA deterioration in our new hospitals with how we are managing our existing hospitals. Also, I think for the new hospitals, we are very, very focused on quickly ramping up to profitability by both making sure that our recruitment and our human capital costs are aligned with the occupancy numbers.
Just a question on this. Actually, here, even in this quarter, we have some new operational beds. But still, if I see consolidated employee cost, it has been down on a sequential basis. Any specific reason there?
Yeah. So in Q2, there were two one-offs which are there also. So if you look at Q2, there was a six-week leave encashment provision that was required under the accounting standard that was an INR 12 crore number. And there was also an additional cost of PLVP or performance-linked variable pay that we have in Q2 because July is when we do the increment. So this was there in Q2, and that's not there in Q3. Otherwise, it's aligned with the numbers.
Okay. Okay. Got that. Just on the physical pharmacy, how do you see growth in terms of on a sustainable basis, like store addition plus same-store growth overall? How do you see it, 18%, 20%, or what's the level that you expect in terms of physical pharmacy growth?
We are currently at about 20%-20.5% on the total network. On the same-store growth, about 16%. Store additions will continue to be in the range of 600 per annum.
Okay. We should maintain this kind of run rate going ahead in near to medium term. Is that the right assumption?
We are confident of it.
18% of the same-store, how should one look at it? What should drive 18%-20%?
16% same-store growth against 20.5% overall growth.
Okay. Key drivers for the 16% is increasing Private Label, or how should one see it?
Private Label, then we are even doing the refresh store, changing the model, changing the inventory, particularly with the dynamically. All those things add to that growth.
Okay. Okay. Got it. Got it. Thank you. Thank you so much. All the best.
Thank you. Next question is from Vivek Agarwal from Citigroup. Please go ahead.
Hi. Thanks for the opportunity. One question on hospital ARPP growth. So 10% growth in nine months looks quite impressive. So just want to understand how sustainable it is. So can you maintain this 10% kind of growth, or is there a possibility that it can come down? Thank you.
So see, we have been always guiding saying that we would like to achieve more volume growth, and we would continue to focus on getting the volume growth to a higher number. And then the combination of volume plus the case mix focus, which Dr. Madhu already said. So that's the mix that you would get to. So maybe this is a very dynamic number in the industry, right, as we focus on certain clinical programs in a quarter. And then depending on how that clinical program's ramp up, you will see the ARPPs come up accordingly. So as of now, we would like to believe that when it is at 12%-13% organic growth that we look at, or 14%, we would like to be half on the volume and the balance, half on combination of case mix and pricing.
Thank you. Just one question again on margin trajectory next year as you are guiding for INR 150 crore kind of loss in the new units. So just want to understand, do you have levers in the existing network that can mitigate the impact of losses in the new units, or are you seeing a significant dip as far as the margins or the hospital business margins cumulatively in the next year? Thank you.
Well, I think the lever that we have is asset utilization. So as we look at our assets and occupancy and even in spite of bringing down the ALOS, we have a headroom for lifting volume and asset utilization by another 8%. We will focus on this as we go forward into the new year. The second, of course, we've not done any significant cost-cutting, which we hope will bring us another 82 basis points. With this, we hope to minimize the losses coming from new hospitals.
Understood. Ma'am, so just one more thing. What kind of a margin expansion that is possible, let's say, in the existing business?
At least 100 basis points is the margin expansion which is possible in the existing business next year.
Thank you. Just last question from my side. It is on talent retention. So as we are seeing that hospitals in India are expanding capacities, it looks like that Apollo can become a hunting ground for big doctors. And very recently, we have seen one of the star oncologists in Delhi has been poached by one of your peers. So just want to understand how you are tackling this issue.
Well, I think the reverse is also happening. So I think we should be aware that Apollo will continue to attract the best talent because, number one, I think we've created a platform that invests not only in technology but in terms of reach, in terms of market, and market share. We will continue to lead with market share. And I think this is what doctors want. Our systems are strongly embedded so that clinical outcomes at Apollo continue to be the best in class. And in terms of innovation, research, and collaborations with other hospitals, this will continue to drive very high-end procedures. I think this is what doctors would like to see. Madhu, you want to add to that?
No, I think that Sanjiv Gupta is absolutely right. I will just share our experience in recruiting into the new markets that we have opened hospitals in, like Pune or existing markets where we have new hospitals, is that we've had a very good brand recognition and brand affinity with the doctors in the community that has made it easy for us to recruit. I think that you will see the sporadic cases of doctors leaving. Sometimes it's for personal reasons that has nothing to do with the hospitals that we operate in. I don't see that in the next year as being a problem, either retention or recruitment.
Thank you. That's from my side.
Thank you. Next question is from the line of Madhu Marda from FIL. Please go ahead.
Hi. Good afternoon. Thank you so much for your time once again. So just on the margins again, if you look at our reported margins, 24.8%, I think you said INR 15 crore of cost is already there for the new units. So base network margin seemed to be 25.3% approximately in quarter three. You're saying that that 25.3 has scoped to go up by 100 basis points. So base network can be above 26% next year. Is that how we should read it?
Yes.
Okay. And then so basically, the impact of the losses from the new unit, the INR 150 crore, should come on this 26%, right? Basically, on that, we should assume the drag.
That's correct.
Okay. Understood. Okay. And so just second question, just on the hospital business growth, given the timeline for the expansions that we have of the new beds coming in, how should we think about hospital business revenue growth next year on the base network, and then how much revenue can we add from the newer beds which are coming in? Thank you.
So we wouldn't want to guide specifically around that, right, because it is forward-looking. So as you know, we continue to look at seeing how we can at least be at the 12%-14% growth on the existing hospitals. But we'll see how the year starts and how we progress. And then the additional beds should clearly add another 3%-4%.
Understood. Thank you so much.
Thank you. Next question is from the line of Avnish Tiwari from Vaikarya Change LLP. Please go ahead.
Yeah. Hi. Good afternoon. Thanks for taking my question. I just have a couple of questions on Keimed. We saw some good margin expansion this quarter on a QOQ and a YOY basis. Can you just articulate what were the key reasons for that?
Sanjiv?
So I think what you saw was the aberration in Q2 and as well as in Q1 where the overall EBITDA percentage was low because of the restructuring and the necessary legal cost associated with them. So now those are removed. And this is what we discussed in the last earnings call also, that in Q3, you would see we will be coming back to a position of 3.1% upwards. And 3.3% is what we have in Q3. But it is more of an aberration that got cleared in Q3 than and plus the business efficiencies.
Okay. Because of the GST change that happened in September, did we see some kind of revenue push-out from the 2Q to 3Q because I'm guessing the retailers would be reducing inventories in 2Q and then building again in Q3? Did that happen, or on a quarter-wise basis, it was just normal Q2 and Q3 operations and revenue?
No, we didn't see any such impact.
Obul Reddy.
We have seen very good improvement in the FMCG. Pharma slightly plus or minus stays at the same level. But FMCG consumption is very good. We have seen good growth on that.
Okay. Understood. Thanks. I'll get back into the call.
Thank you. Next question is from the line of Kunal Damesha from Macquarie. Please go ahead.
Hi. Thank you for the opportunity. Just one on the potential losses from the new units. You suggested that the first month from just the two hospitals is around INR 15 crore. And we are guiding for full-year losses of INR 150 crore. So is it more conservative number because the annualized losses itself could be more like INR 180 crore? I'm sure it would improve in the existing units more. But the INR 150 crore number, is it more conservative on the side given we are also opening a greenfield in Gurugram, which would definitely take some more time, right, versus the brownfield that we are doing?
Kunal, can you mute your line, please? There's some background disturbance.
Sure. Sure.
See, we have two quarters of Pune to ramp up from here on before some of the other hospitals come on stream also. So that's one that should kind of benefit us as we move into the next year. Then you will start to see some of the other hospitals coming in. So it's going to be three quarters of next year when you will be seeing the other new hospitals coming in. So that's what we are looking at. But I think broadly, as of now, we would like to keep it at INR 150 crore. That's what we would like to keep it for now. And this number of INR 15 crore is really for three months of Pune in terms of costs of Athena. The revenues have more been in the last one month or one, one and a half months.
But the cost has been for three months. So you should so that's the way you should look at it. So now we'll go with 150. We'll see during the next year.
Sure. Sure.
As well as the second one on the GMV growth, as we guided, we suggested that we would be ending the year with 30% GMV growth. So that means before would be 30%, or we guided for the year 30%, a full-year FY26?
Madhu?
Yeah. This is on a full-year FY basis. We will obtain our 30%-32% growth on the GMV basis. On this quarter, we move around 4%-5%.
And sir, for nine months, this number looks much lower, right, in terms of so you are adjusting the base for the GST impact and the Amazon impact for this 30%?
Correct. Correct. Correct. Correct. Because the Amazon business, the reason why we walked out was because it was a negative business for us. So while it impacted the GMV, on the revenue side, it's been much more beneficial. So that's the new normal now.
Tell me the Q2 billings number for?
I'm sorry. You're sounding muffled, Kunal.
Can you hear me now?
Yes. Please repeat the question.
Yeah. What was the full-year number for Amazon last year for us to adjust the billings?
Sanjiv, can you give the exact number, please? It was roughly INR 160 crore.
160 crore on a INR 3,000-crore GMV, right? So yeah, roughly, you said 5%.
I think another important point that you need to keep in mind is that what we're talking here about is the entire platform GMV to grow year-on-year, this year growth as well as for the next year. And when we're defining platform GMV, while obviously, we discussed about GST and Amazon impact, in this platform GMV, we are not adding IP/OP GMV. And IP/OP GMV is, and that's the reason we would see in the earnings call presentations also, we have highlighted this separately because in the earlier year, this used to be a variable pay model. From this year onwards, it has converted into more of a fixed fees to us supporting the technology side of expenses that we are incurring for the group as a whole.
I think going forward, our guidance would continue to be excluding IP/OP, what is the growth that we'll be looking at. I think Madhu, in one of the questions, did say that next year, you can expect in the range of about 30%. This year also, if I just look at some numbers, we should be in the range of about 28% growth for the full year versus previous year, adjusted for the reasons that we just discussed. Thank you.
Basically, IP/OP, GST, and Amazon, these are the three impacts we should address, right?
Definitely. Definitely.
Okay. Thank you, Ananda.
Thank you. Next question is from the line of Raunak Agarwal from iThought PMS. Please go ahead.
Hello. Am I audible?
Yes. Please go ahead.
Yeah. Thank you for the question, ma'am. So it's a sort of broad overview for the hospital. So 1,500 beds will be coming in the next year, out of which 50% will be operationalized. So what is the 50, 60? What's the time period which we are looking for, let's say, occupancy of 60, 70%?
On the overall, all the beds or half of the beds?
So we'll open 750 beds next year, sorry, in the coming year, and post that another 750 beds. In two years, we should be breaking the 1,300 beds that we're talking about. So I'm asking, let's say we are opening 750 beds. So what is the occupancy rate we are looking in the first year itself? It'll be around 40%.
Okay. Okay, ma'am. Thank you.
Thank you. Ladies and gentlemen, that was the last question for today. I now hand the conference over to management for closing comments. Over to you.
Thank you all for your presence. I'm sure that in the upcoming quarters, we will continue to remain focused on phased capacity operationalization and the opening up of new beds in healthcare services and a continued ramp-up of revenue and profitability in AHL and AHLL. Disciplined execution leading to volume and value growth, sustained investments in clinical excellence and technology, and market share gains across key markets will help us to sustain momentum over medium term. We are committed to delivering consistent performance while creating enduring value for our patients, consumers, partners, and all of our shareholders. So thank you all for your support.
Thank you, members of the management team. On behalf of Apollo Hospitals Limited, that concludes this conference. Thank you for joining us. You may now disconnect your line.