Ladies and gentlemen, welcome to the Q4 and FY 2025 earnings conference call of HealthCare Global Enterprises Limited. This conference call may contain forward-looking statements about the company, which are based on the beliefs, opinions, and expectations of the company as on the date of this call. These statements do not guarantee the future performance of the company, and it may involve risks and uncertainties that are difficult to predict. 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 conference is being recorded. Now, I hand over the conference to Dr. B. S. Ajaikumar, Executive Chairman of HealthCare Global Enterprises Limited. Thank you, and over to you, sir.
Thank you very much, and good morning, and warm welcome to all present on the Q4 and FY 2025 earnings conference for HealthCare Global Enterprises. Today, I'm joined by our CEO, Mr. Raj Gore, Ruby Ritolia, our CFO, and senior management team, along with our SGA, our investor relations advisor. We have concluded another good year, good performance, and very meaningful progress. Also, as you know, it's an exciting year for us with new investors coming. As we have already announced, we have CDC is diluting place. KKR is coming in. Formalities are being completed. We look with the new investors for a long-term vision for HCG, which is very, very important to us. HCG continues to be the leader in cancer care, quality of care outcome, standing as the only major healthcare institution with truly pan-India presence.
Over the past year, we have strengthened this position by upgrading our infrastructure significantly across and also that's an M&A, details of which you will hear later on. Over the past two decades, we have championed a distinctive integrated model that combines multidisciplinary clinical expertise with over nearly 350-400 doctors, advanced molecular and genetic diagnosis supported by robust hub-and-spoke model network. This comprehensive approach enables superior clinical outcomes powered by skilled clinicians, cutting-edge technology, and most important, data-driven decision-making in real time. In the past, we used to say, "Bedside to bench," and then a patient would get the necessary next patient would get. Today, I'm very happy to report we are pioneered in bedside to bench and bed to bedside so the patients get the right treatment at the right time very first time.
Looking ahead, we are making focused investments in next-generation capabilities, especially in early cancer detection and precision medicine. The most important part in any cancer treatment is proper staging diagnosis and the right treatment for the patient at the right time so that the failures will become less. In line with our commitment to cutting-edge diagnosis and research, we are pleased to share that we are acquiring the Orbitrap Astral Mass Spectrometer from Thermo Fisher Scientific, one of the most advanced platforms globally for high-resolution mass spectrometry. In this regard, I'm also happy to say this advanced equipment is now first time being released, and we are one of the first acquirers of this in the world. We are very proud.
We have put together a solid team to see how we can go into the depth of cancer management and also acquire the necessary data for future research and development. It will enhance our molecular and proteogenomic profiling capabilities. We are going from genetics to proteogenomics, enabling our precise disease characterization and paving the way for next-generation biomarker discovery, targeted therapies, and repository in terms of all drugs in new bottles. Our long-term commitment is to our patients, building a strong academic and research foundation. Through our fellowship programs, which are expanding rapidly, and clinical research initiatives, we are nurturing the next generation of oncology leaders.
Together, we are shifting the narrative around cancer from fear to confidence, from complexity to clarity, from inequality to including access for all so we can make cancer a lifestyle disease and people with cancer can have a good quality of life for long term. I would like now to hand over the call to Mr. Raj Gore, our CEO, who will provide insights into our strategies moving forward and share the operational performance of the quarter and the year. Raj, handing over to you.
Thank you, Dr. Ajai. Good morning. A very warm welcome to all the participants on the call. We are proud to report a strong operational and financial performance this year. Excluding our Milann centers, the company's revenues grew by 20% in the quarter and 17% for the full year, reaching INR 571.1 crore for Q4 and INR 2,165.1 crore for FY 2025. Our adjusted EBITDA for the quarter was INR 106.9 crore, up 14% with a margin of 18.3%, while for the full year, it stood at INR 396.3 crore, a 17% increase with a margin of 17.8%. This strong performance reflects the strength of our business model, brand, and the expertise of our clinical teams and the efficiency of our advanced technology centers.
Before we dive into our operational highlights, I would like to take a moment to reflect on how cancer care in India is evolving and how HCG is playing a pivotal role in driving that transformation. Cancer care in our country continues to face deep-rooted challenges, particularly when it comes to early detection, awareness, and equitable access to quality treatment. Even today, far too many cases go unnoticed until they reach an advanced stage, especially in Tier II and Tier III cities, where awareness levels and diagnostic infrastructure are still evolving. At HCG, we have taken this challenge head-on. Through focused awareness campaigns, screening initiatives, and active community outreach, we are educating people about the importance of early diagnosis and preventive care. Awareness alone is not enough. We are backing it with action and infrastructure.
We have made strategic investments in some of the most advanced technologies in the world: linear accelerator machines, PET-CT scanners, robotic surgery platforms, bringing precision personalization and world-class cancer treatment even to smaller cities across India. Patients do not have to travel long distances or face delays in getting the care they need. This integrated approach, combining education, access, and innovation, is already making a real difference. We are seeing more patients coming earlier. We are delivering better outcomes, and we are improving quality of life across communities. Let me now walk you through some of the key operational highlights of FY 2025 that are shaping HCG's performance and positioning us for continued leadership in the cancer care space. First, our expansion in Vizag through the addition of MG Hospital marks a significant milestone.
With this acquisition, we have further consolidated our presence in the region and strengthened our position as the number one oncology care provider in the region. Second, during the year, we added five state-of-the-art linear accelerator machines across multiple centers. LINAC machines are capital-intensive but essential for delivering precision radiation therapy. Our innovative paper-use model has allowed us to remain asset-light while still offering world-class treatment. I'm happy to share that these machines are seeing rising utilization rates, indicating both growing demand and increased trust in our clinical capabilities. Our emerging centers have also shown strong performance, and we are beginning to see the results of the groundwork laid over the past few years. Our South Mumbai center, which was previously impacted by a drop in international patient flow, has made a remarkable comeback. We recorded year-on-year growth of 37% for the quarter ending 31st March 2025.
Meanwhile, our Kolkata center delivered a robust 22% growth, fueled by increasing local awareness, improved clinical offering, and better operational alignment. Both centers are now well-positioned to continue to contribute meaningfully to our overall performance. We remain confident in the long-term potential of these emerging hospitals. As they continue to mature, we expect them to enhance our margin profile, especially as operating leverage begins to settle. On the digital front, we are seeing encouraging results. Digital revenue for FY 2025 has doubled over the past year, and we are committed to scaling this further. We launched our official HCG mobile app, a platform that enables us to book appointments, consult doctors virtually, access reports, and manage their care journey end-to-end. The response has been very positive.
As we continue to digitize our patient experience, we expect digital revenue to become a major growing contributor to our top line in the coming years. Looking ahead at FY 2026, we have started the year on a strong note with the formal inauguration of our flagship HCG cancer center in Ahmedabad, a 189-bedded, state-of-the-art facility that marks a significant milestone in our expansion journey. This new center is designed to deliver comprehensive oncologic care at scale, featuring nine OTs, 34 ICU beds, 22 daycare beds, and six dedicated bone marrow transplant units. This strategic capacity enhancement positions us to handle a projected 30%-40% increase in patient footfall at this center. Additionally, as a part of our continued efforts to deepen our leadership in key markets, we will commence operations of two new hospitals in Bangalore.
The first unit is North Bangalore, a fast-growing urban cluster with rising demand for quality cancer care, which will come in the second half of FY 2026. This facility will help us tap into new catchment areas while expanding access for patients in the northern corridor of the city. The second facility will be in Whitefield. It is a strategic extension of our existing center of excellence in Bangalore. This expansion will act as an arm to our flagship unit, enhance patient experience, and deliver specialized services with greater operational efficiency. As informed earlier, we aim to expand in our existing markets by operationalizing over 900 beds across networks within the next three years, including this year's addition and 350 beds that are fully invented but not yet operational.
Backed by a strong clinical backbone, a patient-first approach, and a future-ready mindset, we are not just building hospitals. We are shaping a more hopeful, accessible, and technologically advanced future for cancer care. With this, I hand over to Ms. Ruby, our CFO, for financial highlights.
Thank you, Raj, and good morning to everyone. As Raj mentioned, we've carried the momentum from previous quarter into the flows of financial year 2025, and I'm pleased to report another strong performance that underscores both the resilience and scalability of our business model. For the quarter ending 31st March 2025, we recorded a robust 18% year-on-year growth in revenue, reaching INR 585 crore, and on a full-year basis, revenue grew 16% through INR 2,223 crore, reflecting consistent execution and growing trust in our network. Our core HCG centers, excluding Milann, were the primary driver of this growth, delivering a 20% increase in revenue, accompanied by a 17% growth in EBITDA, resulting in a healthy EBITDA margin of 18.5%. Revenue for HCG oncology specialty centers, excluding newly acquired MGM , grew by a strong 16%, and EBITDA at 17% year-on-year.
EBITDA margin was at par with the quarter four of FY 2024 at 19.7%. We believe these achievements place us firmly ahead of industry averages, and we are optimistic about delivering even stronger growth in FY 2026, both in terms of revenue and profitability. A few key operational metrics further reinforce this momentum. Outpatient footfall rose by 13.8%, indicating higher patient engagement. In medical oncology, we saw a 24% growth in chemotherapy sessions, a clear indicator of growing patient demand. Our LINAC machine utilization remained steady at 60% in quarter four of FY 2025, despite the addition of three new LINAC machines and the acquisition of two LINACs with MGM Hospital over the last 12 months. Bed occupancy stood at 54% in quarter four, slightly down from 56% in the previous year, driven by the capacity increase of 235 new beds.
This short-term dip is well within expectations and aligns with our long-term growth strategy. Turning to the performance of our centers, for the quarter ending March 31st, 2025, our established centers continued their steady upward trajectory with a 22% increase in revenue and a 15% growth in EBITDA. Our emerging centers outperformed expectations with a 32% revenue growth and a remarkable 44% increase in EBITDA, clearly reflecting the operating leverage at play as these centers scale. Strong growth in our emerging centers is a testament that these locations are not just growth drivers but key strategic hubs in tier-one cities and access to large domestic and international patient bases. Their sustained recovery and performance will be instrumental in strengthening our margin profile going forward. On the pricing and efficiency front, for the quarter ending March 31st, 2025, our ARPOB across our network increased by 4%, reaching INR 44,236.
Established centers recorded an ARPOB of INR 42,595, growing by 2.5%, while emerging centers delivered an impressive ARPOB of INR 66,755, growing by 12.5%. Looking ahead, we plan a CapEx of INR 286 crore in FY 2026 in line with our network expansion and technology upgrade plans. Our effective tax rate for the quarter stood at 50.3%, and for the year, at 14.3%. We main focus on improving efficiency while maintaining compliance and governance standards. Our PAT for the quarter was INR 7 crore, and for the year, it was INR 44 crore. As we communicated during the year, we added two new centers. The HCG new facility was operationalized, and we acquired the new MG center in Vizag. Our expansion efforts led to ROU creation of INR 275 crore, fixed assets addition of INR 400 crore, and an increase in net debt of about INR 250 crore.
This together led to an increase in depreciation and interest, together of about INR 25 crore. With the scale-up of our expansion efforts, both in HCG and completion of our integration in Vizag center, we expect a higher return on these investments going forward. Before I take questions, I request Dr. B. S. Ajai to add anything further.
Thank you, Ruby. I just want to say, Ruby has explained the rationale for our numbers, including the PAT. In this regard, as we know, in the last four years, we have been in a consolidation mode. We have taken a call to expand with merger acquisition and including what Raj Gore mentioned about the greenfield centers. All of this, I believe, particularly with the new partner coming, KKR, will be a solid foundation for future long-term growth of HCG. The measures we have taken now are all very much in line with the long-term growth of HCG, and we really want to be in a dominant position to provide quality cancer care across India. With this, I would like to conclude, and I will hand over to the people. Thank you very much.
One other addition I want to add before you take is regarding the debt issue. We have communicated to the investors in the past that once the new investors' shareholders come, we will be looking at the possibility of equity, primary equity coming into the system, and this will be decided in the coming few months. Thank you very much.
We can now take questions from the participants.
Sure, ma'am. 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 touchstone phone. 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. First question is from the line of Gautam Rajesh from EverFlow Partners. Please go ahead.
Hi, good morning. Am I audible? Hello, am I audible?
Yeah, good morning.
Yeah, good morning. Yes, sir. I have two major questions on the margins. Our margins are much lower than the other hospital chains. Is there going to be a steady margin profile for our type of single specialty-based healthcare? My second question was, what kind of margin profile do you then expect at a company level for the coming year and maybe the next three years?
Hi, this is Ashutosh . The margins, if I can draw your attention to the slide number where we have showcased our established and slide number 29, which showcased our established and emerging centers, you would notice that we have over 20% margin in our established centers, showcasing the strength of the platform. However, our emerging centers are a little over 10%. Together, we are delivering close to about 18% margin. As our emerging centers continue to grow, which is again reflected in last year's performance, you will see that our revenue grew by 32%, and our EBITDA has grown by 44% in the same quarter for emerging centers, reflecting an increase in EBITDA margin as well. As they inch closer towards EBITDA margin of the established centers, we expect our EBITDA margin to improve going forward.
Now, with respect to the current quarter's margin, we have seen a slight decrease of almost about 40 basis points-50 basis points in the EBITDA margin corresponding to the same quarter last year. That is primarily because we have experienced higher medical oncology business, which is reflected in our chemotherapy share. You would see in slide number 30 that our chemotherapy volumes have grown by 34%, which is far superior than other modalities. I would like to just inform the participants here that while we look at comprehensive cancer care and all the modalities are equally important for us, however, from a financial outcome perspective, medical oncology, although it is least profitable, is highly return accretive.
The way we say it is, as the medical oncology also grows, it may have some pressure on our gross margin, but as we go along, we will have a higher operating leverage returning and eventually leading to better returns.
Okay, sir. Over the next three years, do we see it improve? Is there a particular number or you can quantify it by any form of how much improvement can be seen as the emerging centers also catch up in margins?
All put together, from our current portfolio, excluding the expansion path we have taken in terms of we are opening up new centers, from the current portfolio, we should be expecting more than 20% in the near future. I mean, I can give a picture, as you mentioned, about two years' time.
And I.
Okay, okay.
I just want to add there that please, they have to keep in mind some of the new centers in Bangalore which will come that can also have a stance on the margin. I think it is good to say, as the emerging centers also rack up, our margin, as we always indicated, will be in the low 20%. That is our initial goal.
Understood, sir. The low 20% would be the initial goal. Understood. Thank you, sir. That will be fine.
Thank you. Ladies and gentlemen, to ask a question, please press star and one. I repeat, participants who wish to ask questions may please press star and one at this time. We take the next question from the line of Yash Sinha from MIPL Family Office. Please go ahead.
Hi, am I audible? Hello?
Yeah.
Yeah, hi. I just wanted to understand what our strategy was in terms of calculating a lot of the revenue growth and EBITDA growth that we've had over the past two or three years into tangible PAT growth going forward. What are the specific strategies that we are incorporating in order to do that in terms of maybe using the primary issues to pay down some debt so that we can see some PAT generation going forward?
As Ruby and Dr. Ajai also indicated in their speech, right now we have taken up a lot of investment initiatives, including organic and inorganic growth. We may see a little bit of pressure on PAT. Our goal is to optimize EBITDA, focus on the growth of EBITDA, grow revenues.
I think if we all have to look at our PATs from the existing portfolio, we expect a healthy growth, which may see some dilution happening from our new investments in the near future. As this EBITDA of the new investments continues to grow, maybe in a year's time or maybe after one year, we should see a healthy growth in PAT as well.
Got it. The primary issue to be focused on.
Ashutosh, you want to comment on the interest-related PAT effect, how will it get improved with the possibility of primary coming in?
Yeah, yeah. Sorry, doctor , thanks for adding this up. Now, as we have, including the CapEx we have done in the last year, a lot of it has got funded through debt, which has resulted in higher interest costs and corresponding depreciation because of the asset addition. However, as Dr. Ajai indicated, depending on the quantum of primary we infuse, it will substantially reduce our interest costs, which would help our PAT. While we are right now evaluating how much primary is sufficient for near and long term for the company at this point of time, once we announce, probably we would see the primary helping reduce our debt and would have corresponding effect on our interest.
Got it. Understood.
I think it will be better. I think that's it from my end. Congratulations on another good set of numbers and all the best.
Thank you. Participants who wish to ask questions may please press star and one at this time. To ask a question, please press star and one now. We take the next question from the line of Devang Patel from Sameeksha Capital. Please go ahead.
Hi, sir. The first question was on receivables which are higher on a year-on-year basis. Could you throw some light on that?
Yeah. Hi, Devang. So the receivables, we had a little higher during the year. Last year, we saw a lot of getting into [audio distortion], and there were code of conduct getting applied. Because of this, some of the collections actually spilled over to April. In fact, April usually is the slowest in collection, but this year there was difference. March, we did a higher-table collection that we could do in March, and that continued in the month of April itself also. Now we will see a mostly 9/1 with a normal increase in our credit sales which is happening.
If you can quantify this, Ruby, for you, it's like if you look at our cash flow statement, I think last year we had almost about INR 40 crore-INR 45 crore of working capital increase against that about INR 80 crore-INR 85 crore current year. The increment, the deficit of INR 40 crore probably we have married up in the month of April.
In the month of April.
There is not large gap from the timing issue which got spilled over to current quarter.
Will this be the new normal in terms of receivable days?
As I said, the receivable days at the end of March were temporarily high. This already got corrected in April. I would not say that the March number is the new normal. In fact, in terms of number of days, if I have to say, 105-107 should be the new normal which we will maintain. However, at the end of March, we were at somewhere around 115. We have covered up around seven to eight days in the month of April.
Just one more point, maybe. Ruby, is that we also acquired MGM Hospital in Vizag. That incremental receivable has also come in our book.
Correct.
Okay. You explained at different points on the margins for the mature centers. Now, Vizag had 35% margin in the earlier year. Did that not pull up our margins for the mature centers? What was the impact of Vizag in revenues and profits in the second half of the full year?
Vizag, when I'll give you the exact numbers, Vizag, as Dr. Ajai indicated, we are transitioning right now. We are putting up some, we are integrating the facility at that place. During our evaluation, we had evaluated some of the costs not being sustainable in terms of process costs and other schemes of costs. That has been corrected, and we have brought them at the standards of HCG. That's point number one. Second is we have also experienced, for example, Andhra government pulling out its government scheme from non-research states. And Vizag in Andhra Pradesh had been the largest beneficiary of taking patients from Orissa under this scheme. That scheme has been now only consolidated for the state of Orissa and has been removed from other states. That had a little bit of impact on our Vizag centers.
That has resulted in a decrease of revenue per month, which is about INR 1 crore-INR 1.5 crore, almost INR 4 crore -INR 4.5 crore. That has suppressed our revenue and has had its impact on EBITDA. However, we have taken enough initiatives within the states. We have got a good leader at that place. Right now, we are looking at augmenting the business within the state and compensate for the losses which we had in Vizag centers. Now, as far as revenue and EBITDA is concerned, I think I can you can just hold on. I'll just give you the number right away. Just a minute. So MGM had a revenue of INR 50 crore in H2 with an EBITDA of INR 9.5 crore.
Sorry, can you repeat the revenue number?
INR 50 crore.
This is the new.
EBITDA of INR 9.5 crore.
Sorry? What would be the normalized EBITDA margin for this center going forward?
Right now, we are in a rebuilding phase of the lost revenue from Orissa. However, as we make up that revenue, which we are hopeful to do in the next two quarters, I think we should be operating somewhere close to about 25%-30% margin.
Okay. My other question was on.
In the current quarter, we also had, sorry, I'll just add to this. In the current quarter, we also had one-time impact of some costs which was identified during diligence. Those costs we have taken up to regularize some of the things which were not there, which have been done. That had an impact of almost about INR 1.5 crore. Including that, our EBITDA should be in the range of about INR 11 crore.
Thank you. Another question was on CapEx. There are two centers on which CapEx is mentioned in the slide. Is there any other CapEx over and above these two centers for the next two years? Also, given we are looking at the primary issue to be infusion, is that only to reduce debt, or could we look at further CapEx in the next two years after that?
Ruby did indicate our current year's CapEx plan. I think it is in the range of about INR 20 crore-INR 80 crore. We already invested a little over INR 200 crore in the last financial year. That includes close to about INR 100 crore of maintenance CapEx. Large growth CapEx within our existing centers and markets are in Bangalore and Cuttack. Outside of it, right now, we have not much plans in terms of further growth CapEx. This INR 286 crore in the current year should reduce going forward with maintenance CapEx of about INR 100 crore and some growth CapEx would come. We will keep the market appraised of our growth plans once we again sit together, draw a strategy for three to five years, offer incremental CapEx if at all it comes.
However, we have given visibility in terms of how much CapEx we would do in the current year, which is close to about INR 280 crore.
Okay. So then lastly, on the regulation of the earlier PE investor giving bonuses directly to some of the employees, how many employees are covered, and what was the rationale for doing that? Was there an earlier agreement on that?
I think all the relevant information has been disclosed at [Delhi]. There was no direct agreement between the company and the investor. I think for the company to comment on this would be a little difficult. We would like to.
What is the question, Ashutosh? What is the question?
The question, Doctor, is that there was transaction bonus which was paid to the employees directly by the shareholders. What was the thought process behind it, and is there any other arrangement right now?
It is purely a thought process of CVC. They felt because of their exit, they should reward the bonus for some employees. For this, there was an approval by the majority of the minority shareholders. Any questions they have on this regard, I would direct them to talk to CVC because we are not in a position to comment.
Sure, sir. That's all from my side. Thank you so much.
Thank you. Participants who wish to ask questions may please press star and one at this time. Next question is from the line of Aditya Khemka from InCred Asset Management. Please go ahead.
Good morning. You mentioned that if I got it right in the initial comments, there were 900 beds additional over the next three years, and 650 are invested but not yet operational. Can you explain that better? There is a slide 32 which says 85% of capacity beds are operational. If you can explain more on that, it would be helpful to know your plans going forward.
Aditya, of the current capacity, I think we have almost about 150 beds-200 beds which are still not operational. In addition to that, we'll be investing in the remaining 700 beds-800 beds. Almost about 200 beds have been invested already, and the further investment on 700 beds has to happen for the guidance of about 900 beds-1,000 beds in the next few years.
Got it. My next question was in terms of cluster growth with the new Ahmedabad facility and facilities in Bangalore, Karnataka, and Gujarat. Would these be the ones which are expected to drive growth in the near term? Is it a right inference that these are higher ARPOB clusters versus the company average for us as of now?
That's absolutely right. If you look at it, wherever we have presence in metros and tier one cities, there we have ARPOB which is almost close to about two times of what we generally have in Tier II cities. These centers are where, I mean, obviously, Ahmedabad and Bangalore, they would contribute. In addition to that, we also expect the higher ARPOB to come from Kolkata and Mumbai centers. If you look at our slide, emerging centers, which is primarily two centers in Mumbai and one center in Kolkata, is delivering over INR 60,000 per bed compared to overall of INR 44,000-INR 45,000.
Got it. This should circulate into a high single-digit ARPOB growth for us directionally?
Yeah, that's right.
Got it, sir. Thank you. That's it from me.
Thank you. Ladies and gentlemen, to ask a question, please press star and one at this time. I repeat, participants who wish to ask questions, may please press star and one at this time. We take the next question from the line of Kashish Thakur from Elara Capital. Please go ahead.
Hi, thank you for the opportunity. Two or three questions from my end. First question will be on the revenue which we generate from the digital channels. Can you just shed some light that what is, how it is, and how we are planning to grow it? Yeah, of course, will be around that part.
Yeah. Thank you for that question. Just to give a little bit of background, there are about 2 million new cancer patients every year in India in a population base of 140 crores. This is a widely spread, thinly, dense, and fragmented customer base. One way of looking at it is a traditional way to reach out to them through traditional approaches of advertising, reaching out, cancer, etc. Because it is such a widely spread segment, there are limitations on physical outreach. We know that consumers in every sector, patients want more information, want more power over their patient journeys, want to have more say in the decision-making, and they are using digital mediums to get informed, find information, and to reach the right care provider.
Basically, what digital platform gives us is the ability to make patients easier to find us rather than we trying to find these 2 million patients among 140 crore population. Now, we try to reach out to them through different digital channels: website, patient app, social media handles. There are some third-party channels. Our majority of revenue comes from our website and our social media handles. The way to drive it is search engine optimization, market after market, local. I think in last year, we have doubled our revenue. We are still working on making our search engine optimization better at each geographic location. As that journey moves forward, we will be ranked higher in potential patient searches, and therefore, it gets us into their consideration set right away. That we have seen from our experience.
As long as we are in their consideration set, we are able to convert them into a purchase decision or make them walk into our doctor's consultation room. That conversion ratio historically has been very high for us because of our brand and clinical capabilities, etc. As you know, among healthcare, if there is any specialty where patients do not mind traveling long distance to any corner of India or the world, it is cancer because it is a life and death. We feel that as we invest our efforts, energy, resources in digital, we will be able to reach out to more and more diagnosed cancer patients across the country and even outside the country in our international market. This is a channel that will continue to grow for us going forward, contributing more and more revenue to our top line.
Thank you. Thank you for such a beautiful explanation. The next question will be on the tax rate. What kind of tax rate should we expect for FY 2026?
Sir, come again?
Can you repeat the question, please?
I was asking about the tax rate, Aditya. What kind of effective tax rate should we expect for FY 2026?
I think we can expect about 30% to remain in that level during the next one year.
Understood. Just wanted a clarity. What kind of competition are you seeing in the oncology space? As many of your multi-specialty competitors have been aggressively taking steps in this direction. How do you see the competition, especially in the markets outside Bangalore?
Yeah.
Go ahead, Dr. Ajai.
See, as we know, we are a focused specialty. We believe we continue to garner a higher share of the market in Bangalore City, like Bangalore, Greater Bangalore. We are known as a destination. In our view, our growth, as you can see in our Bangalore sector, which is doing extraordinarily well. If you look at our main center of excellence in Bangalore, the growth, the margins, everything extraordinary, generating a margin close to 28%-30% with ARPOB over INR 75,000-INR 80,000. This kind of high-quality growth will continue to happen in spite of whatever the number of centers there may be. The reason I say that is oncology has to be a destination. It is not a disease of convenience. In my view, a multi-specialty, this is my view, and that is how we started HCG as a single specialty.
My view, a single specialty hospital always will deliver better quality and outcome overall because of the way we have structured the ICU, the outcome, what we measure, the multiple support system we give for the patient specific, for example, infection. If you look at our mortality rate, let me give you one example. Across India, which I do audit our mortality recurrence rates, when you look at our mortality in 2017 for 5,500 discharges, we had a mortality of 2.5% per month across India. Today, when you look at after we got into this auditing, today, our mortality for 13,000 discharges, 13,000 per month is less than 0.9%, below 1%. Our target should be 1%. Now we are trying to even lower that. I do not think anybody in the world has this kind of low mortality. I can tell as an oncologist.
Understood, sir. Thank you.
People who.
Sir, please go ahead. I think so.
I just want to say we measure it, we put out our data and do all that. We also do data collection for research academics. When you talk about the competitive landscape, we feel honestly they should be worried about us, not worried about them because the way we are expanding, putting together the quality of excellence, the quality we have today is unmatched. I trained in Houston, MD Anderson. I can say we are equal to that very clearly. This is where we are with genomics, proteogenomics coming. I hope I answered your question.
Yes, sir. Yes.
I just want to add two data points. One is let me give an example of Bangalore. There is no other place where there are so many multi-specialty players who are doing oncology, and they have multiple hospitals doing oncology in Bangalore. Yet, we have grown our market share over the last four years. Number two, we entered in the Kolkata and Mumbai market pretty late, and there were existing hospitals who were dominant players. In both markets, we have gained the largest market share over four years and climbed the market share ranking. Both are an example of why our single specialty focus we feel is a better approach to specialize and focus and build confidence and trust of patients because this is the only thing that we do.
We live, eat, breathe, drink oncology, and that gives us our best chance to give the most advanced and comprehensive treatment to our patients. That is what is working for us still. Just one more point if I may add in this regard. It is like all the centers or the states where we have been market leaders. We have not lost our market leadership in the last three or four years in spite of competition coming in. The way we approach this and think about it is that India is an underserved market in terms of supply. As the supply keeps growing, it is going to help the best players who provide the best quality in that space. Oncology is something which is a matter of life and death. This is the only specialty among all other specialties in healthcare where second opinions are the highest.
Once the patients are diagnosed that they have any indications of cancer, they try to figure out who are the best providers in that market to give them the best solution. We have seen this helping us all across the market.
Ashutosh, one other thing is it is not only like if a patient goes to a multi-specialty with abdominal pain and they found that they have a cancer, they may end up taking treatment there. Remember that with significant number of recurrence, when they get recurrence, that is when they come to HCG. That is why I call it a destination. That is how MD Anderson is, and that is how we have positioned ourselves as a destination. That is why we will continue to grow.
Understood, sir. Thank you so much for this. Just one last question. Why do we see our ARPOB still on the lower side? I still believe that oncology treatments are a bit on the expensive front. Why are ARPOBs so low?
If I can take that question, Dr. Ajai. I f you look at we have significant presence in Tier II cities where we see low state of the population. However, we have also showcased, and you may refer to our investor presentation, we have come out with a business model where we look at similar profitability and return in those Tier II markets in spite of ARPOB being lower. While the ARPOBs in metro cities are higher, we have a larger scale in terms of throughput and number of patients we treat in Tier II cities to help us generate similar profitability and return even in Tier II cities.
You may also want to make an observation, Ashutosh, on how our ARPOB is in our centers in the urban areas and why the tier two are maybe way slower, and it is expected to be lower. Maybe you can make a comment on what is our ARPOB in us.
Sure. In a center where we have full offering in terms of high-end therapies as well as being in metro, like for example, Bangalore and Ahmedabad, they clock close to INR 1 lakh ARPOB per patient. Then comes Mumbai and Kolkata, which ranges in the range of about INR 70,000-INR 80,000 in Mumbai and Kolkata. These are the markets we have very high ARPOB. The other markets where we are in the tier two cities, which is Orissa, Andhra, these are the places we have less than INR 30,000-INR 35,000 of ARPOB overall resulting into INR 45,000 ARPOB for the company.
Again, we've been increasing.
It has been steadily increasing. That's it.
Understood, sir. Just one last question. I might have missed. What kind of ARPOB growth might we expect in FY 2026?
In the last three, four years, I mean, coupled with the change in modality, reduction of pay loss, less and less number of beds being required, and the price increase we take, I think we have been seeing 7%-8% increase in ARPOB, which we expect to continue.
Understood, sir. Thank you so much. Thank you, sir.
Thank you. Before we take the next question, we would like to remind participants that you may press star and one to ask a question. To ask a question, please press star and one now. Next question is from the line of Sakshi Pratap from Pratap Securities. Please go ahead.
Hi. Thanks for the opportunity. Just a couple of questions. How was the performance overall for international patients? How do you think we've fared this year compared to last year given this year had a lot of geopolitical issues?
Yeah. Sakshi, the biggest contributor to India, not just for HCG, but for all hospital players in terms of international business is Bangladesh. As you know, because of geopolitical issues between our two countries, India has reduced drastically the number of medical visas that India grants to Bangladeshi patients. That is a major reason for the impact on international business across India, across players. That to some level has improved, but I think that will continue to be suppressed for the next few months till our relationship between the two countries gets completely normalized. That is the outlook in general for India. However, even though our international business got impacted last year, we have more than made up for it through domestic channels. International for us is a small part of our total business. Our core is domestic, and we will continue to monitor the international business situation.
However, we will continue to work on making up for any reduced growth on international through domestic channel like last year, even this year. We do not expect it to impact our revenue growth this year.
I just want to add one more word to what Raj said. When we look at international, as we know, CCK Cancer Center, which is into radiation and medical oncology, I'm very happy to say that this center has been doing very good. We have installed a new radiation equipment, PET scan, and we are now in the process of possibly looking at a second LINAC in Nairobi. We have also discussed at our board concept note to see how we can really further improve there because the international opportunity in countries like Africa is significant. What we have shown is a significant growth, high profitability there with the margin reaching almost 24%-25%.
This is one other angle which we will be addressing in the next few quarters with our new investors, and we will keep you definitely updated on that.
Understood. Would you be able to provide the percentage contribution by international patients to our revenue?
Around 4% of revenue is from international.
Okay. All right. Yeah. Thank you so much.
Thank you. Next question is from the line of Umang Gada from Avener Capital. Please go ahead.
Hi. Thank you for the opportunity. My question was more on the Milann side of the business. That business has evidently continued to struggle to grow. I just wanted an update from the management side that what are the strategies over there or even maybe are we looking to spin off in the future or any strategies over there?
Yeah. I can answer that. You are absolutely right. Milann went through quite a tough time. Particularly with our former partner, a self-starting unit near our center, we have addressed this issue internally. We were just waiting for the new investor also to come. We have also discussed with them. We are definitely putting a proposal to divest Milann. Hopefully, this will happen definitely this fiscal year, and we'll keep you updated.
Management team, I'm so sorry to interrupt.
Sorry. Were you able to hear my answer? There was some background noise. Can they hear the noise? If I could answer?
Yeah. Yeah. The answer was audible. Thank you.
Any further questions?
No. No. That would be all. Thank you for the opportunity.
Thank you. Ladies and gentlemen, that was the last question. I would now like to hand the conference over to the management for closing comments.
Thank you so much for your continued interest in HCG. As informed by many of us during the call, it is a very exciting time for the organization. We have just come out of a very good operational and financial performance in FY 2025. We have been sharing our plans for the next three to four years continuously over the last few calls. As with the incoming new investors, the organization is really excited about moving on from consolidation phase largely in the last four years to a high-growth, high-performance phase in the coming future. We will continue to keep you informed as and when those things materialize and we have more information. Thank you so much. Have a good day.
On behalf of HealthCare Global Enterprises Limited, that concludes this conference. Thank you for joining us, and you may now disconnect your lines.