Quarterly Report • Jul 26, 2019
Quarterly Report
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| € millions (€m) | Q2 2019 | Q2 2018 | Growth | 6M 2019 | 6M 2018 | Growth | FY 2018 |
|---|---|---|---|---|---|---|---|
| Revenue | 202.9 | 161.1 | 26% | 402.6 | 323.0 | 25% | 671.6 |
| Operating profit | 10.1 | 7.5 | 35% | 21.4 | 16.5 | 30% | 33.7 |
| Operating profit margin, % | 5.0% | 4.7% | 5.3% | 5.1% | 5.0% | ||
| Net profit | 4.9 | 5.5 | -11% | 11.8 | 14.0 | -16% | 24.2 |
| Net profit margin, % | 2.4% | 3.4% | 2.9% | 4.3% | 3.6% | ||
| Basic/diluted earnings per share, € | 0.031 | 0.039 | -21% | 0.077 | 0.099 | -22% | 0.167 |
| EBITDA | 27.3 | 21.2 | 29% | 54.8 | 43.4 | 26% | 90.7 |
| EBITDA margin, % | 13.5% | 13.2% | 13.6% | 13.4% | 13.5% | ||
| EBITDAaL | 17.5 | 13.2 | 33% | 36.0 | 27.7 | 30% | 58.5 |
| EBITDAaL margin, % | 8.6% | 8.2% | 8.9% | 8.6% | 8.7% | ||
| EBITA | 11.6 | 8.0 | 45% | 24.1 | 17.6 | 37% | 37.0 |
| EBITA margin, % | 5.7% | 5.0% | 6.0% | 5.4% | 5.5% |
For definition and reconciliation of alternative performance measures, refer to note 10.
All comparative figures have been restated for the impact of the adoption of IFRS 16, Leases compared to the published consolidated financial statements as at and for the year ended 2018. Refer to the restatement release of 17 April 2019.
Medicover is a leading international healthcare and diagnostic services company and was founded in 1995. Medicover operates a large number of ambulatory clinics, hospitals, specialty-care facilities and laboratories and the largest markets are Poland and Germany. In 2018, Medicover had revenue around €672 million and 20,970 employees. For more information, go to www.medicover.com


During the quarter we have closed the acquisition of Neomedic, a leading neonatology and obstetrics hospital group based in south of Poland. We look forward to the continued development and integration of Neomedic into Medicover.
The strong start to the new year continued also in the second quarter. Revenue growth increased further to 25.9% reaching €202.9m (€161.1m). Organic revenue grew by 14.2%.
EBITDA for the quarter increased by a strong 28.8% to €27.3m (€21.2m), with 30bps margin-expansion to 13.5%. This includes expensing higher M&A costs of €1.6m this quarter mostly related to the Neomedic closing, equivalent to an additional 79bps margin expansion.
With reference to our stated financial profit growth target of 18-20%, organic adjusted EBITDAaL growth amounted to 26.8%, reflecting the strong
underlying development in the business and flow through of volume increases to profits.
Our strategy to grow private pay Fee-For-Service, both organically and through acquisitions, is being well executed in both divisions. This is illustrated by the Fee-For-Service segment increasing its quarterly revenue share versus last year in both divisions, in Healthcare Services to 40% (35%) and in Diagnostic Services to 66% (65%), representing strong growth of 51% and 20% for each division respectively versus prior year. For the Group, Fee-For-Service represented 52% of total revenue for the quarter and grew a healthy 31% on the prior year period.
Our core business the integrated healthcare model together with good performance for our Fee-For-Service offerings, as well as the enhanced M&A activity continue to be the main growth drivers for Healthcare Services. The division had a strong quarter with revenue growth of 33.7% lifting revenue to €108.6m (€81.2m), with organic growth of 17.0%. The number of members reached 1.3 million at the end of the quarter, with growth of 13.5% compared to the same period last year.
Healthcare Services EBITDA reached €15.3m (€10.7m), a margin of 14.1% (13.2%), which was a strong growth of 43.0% on prior year.
Revenue for Diagnostic Services grew by 18.2% to €97.6m (€82.6m) in the quarter with organic growth of 11.6%. The laboratory operations in Ukraine, Romania and Poland have been the strongest contributors to top-line growth. Number of laboratory tests grew by 7.9% to 25.9 million (24.0 million). A total of 24 new blood drawing points (BDPs) opened during the quarter and we are now operating a total of 614 BDPs across all geographies.
Diagnostic Services EBITDA increased by 23.6% to €17.3m (€14.0m), an EBITDA margin of 17.7% (16.9%).
We will continue to focus on operating efficiency, successful integration of our acquisitions and look forward to continued revenue growth.
Fredrik Rågmark CEO

Consolidated revenue increased by 25.9% to €202.9m (€161.1m) with organic growth of 14.2%. All main revenue lines have been strong. Acquisitions made within the last 12 months contributed €20.2m to acquired revenue in the quarter representing almost half of the total year on year growth of €41.8m. These included Neomedic, a leading neonatology and obstetrics hospital group, Klein, a German genetic laboratory, Pelican, a hospital operator in Romania, as well as other Romanian and Polish businesses.

Healthcare Services revenue grew by a very strong 33.7% to €108.6m (€81.2m) with organic growth of 17.0%. Members grew by 13.5% to 1,278K versus prior year quarter (1,126K).

The employment market in the major countries continues to be tight, supporting employer demand for funded employee health packages. The trend for out of pocket Fee-For-Service being the larger component of organic growth in the first quarter has continued into the second quarter representing just over half of the organic growth. Fee-For-Service volume increased in the quarter reflecting demand and the impact of acquisitions and prior investments. Healthcare Services continued to benefit from a good economic background in the major countries of operation.
In May the Group acquired Neomedic for a total price including debt assumed of €69.0m and
additional direct related costs expensed now and in 2018 of €1.7m. This acquisition was consolidated as from May. Revenue recognised in the quarter amounted to €5.2m. For further information on this acquisition, refer to note 4.
The MaxCure group, which is an associate and not consolidated, had revenue of approximately €16.4m (€14.0m) with local currency growth of 14.9%, with the most recently opened hospital contributing to growth. In June additional existing shares were acquired for €1.0m increasing the interest in MaxCure to 46.7% from 45.1%.
Diagnostic Services revenue grew by 18.2% to €97.6m (€82.6m) with organic growth of 11.6%. The Romanian currency was weaker, the Polish zloty slightly weaker, offset by the Ukrainian currency maintaining its recent strength. The laboratory test volume increased by 7.9% to 25.9 million (24.0 million).

The established businesses grew well in all major markets reflecting economic development and contribution from prior period investments. Underlying growth in the German laboratory business is clear even though year on year growth was held back by earlier school holidays in Medicover areas of operations and given the price reforms were applicable also in the comparative period. This was from a mixture of growth of number of customers and also doctors' referral patterns largely normalised.
The German clinical business showed good underlying growth. For the second quarter, revenue was €14.5m (€13.3m), an increase of 9.0%.
The continuing strong economic development in the fast growing markets has led to increased ability to self-pay for healthcare and the expansion of access through more BDPs supports this growth. During the quarter, 24 new BDPs were opened and 9 closed, bringing the total to 614 locations at quarter end.

Consolidated revenue increased by 24.6% to €402.6m (€323.0m) with organic growth at 14.6%. Growth has been weighted to the Healthcare Services segment being 57.9% of the organic growth.

Revenue recognised in the first half 2019 from acquisitions was €35.3m.
Healthcare Services revenue grew by 31.0% to €211.5m (€161.5m) with organic growth of 16.8%. A favourable employment market combined with continued good economic development are driving member and revenue growth in the employer funded business. The Fee-For-Service business in both Poland and Romania grew at a faster rate but from a smaller base. 26 new medical facilities were added in the first half 2019 reaching 200 at the end of the period.

In May 2019 the Group acquired Neomedic for a total price including debt assumed of €69.0m. For further information on this acquisition, refer to note 4.
The MaxCure group, which is an associate and not consolidated, had revenue for the first 6 months of €32.3m (€27.6m) with local currency growth of 16.4%. The restructuring of the share capital has been completed in 2019 and additional existing shares were acquired for €1.0m, increasing the
interest in MaxCure group to 46.7% from 45.1%. Construction work continues with 2 new cancer treatment centres to be opened towards the end of 2019 and fully commissioned in early 2020.
Diagnostic Services revenue grew by 18.4% to €197.8m (€167.0m) with organic growth of 12.6%. All 3 main markets outside of Germany (Romania, Ukraine and Poland) showed strong growth. Despite the reimbursement revision actions impact, the German laboratory business still maintained its revenue levels and overall for the year grew with private paid revenue and growth in referrers mitigating the impact of the revisions. This is despite timing of school holidays impacting first half 2019 versus the prior year comparative period.

Revenue for the center for genetic diagnostics of Dr. Klein, Dr. Rost, and colleagues ("Klein") which was acquired in January 2019 amounted to €7.8m. This acquisition was consolidated for the full first half of 2019. For further information on this acquisition, refer to note 4.
As of June 2019, 26 clinics were operating for the German clinical business with revenue of €29.6m (€26.3m), a strong growth of 12.5%.
53 new BDPs were opened and 9 were closed during the first half 2019 bringing the total to 614.
The laboratory test volume increased by 8.1% to 53.5 million (49.5 million), with the increase being predominantly driven from private pay markets and weighted to higher value tests.

| % of total |
% of total |
||||||||
|---|---|---|---|---|---|---|---|---|---|
| €m | 6M 2019 |
6M 2019 |
6M 2018 |
6M 2018 |
Growth | Q2 19 |
Q1 19 |
Q2 18 |
Q1 18 |
| Total Healthcare Services revenue |
211.2 | 161.3 | 108.5 | 102.7 | 81.1 | 80.2 | |||
| Of which funded: |
|||||||||
| Privately | 196.2 | 92.9% | 156.2 | 96.8% | 25.6% | 99.1 | 97.1 | 78.5 | 77.7 |
| Publicly | 15.0 | 7.1% | 5.1 | 3.2% | 194.1% | 9.4 | 5.6 | 2.6 | 2.5 |
| Originating from: |
|||||||||
| Poland | 161.9 | 76.7% | 129.6 | 80.4% | 24.9% | 84.4 | 77.5 | 64.8 | 64.8 |
| Romania | 29.4 | 13.9% | 16.0 | 9.9% | 83,8% | 14.0 | 15.4 | 7.9 | 8.1 |
| Other countries |
19.9 | 9.4% | 15.7 | 9.7% | 26,8% | 10.1 | 9.8 | 8.4 | 7.3 |
| Total Diagnostic Services revenue |
191.2 | 161.6 | 94.3 | 96.9 | 79.9 | 81.7 | |||
| Of which funded: |
|||||||||
| Privately | 123.3 | 64.5% | 102.2 | 63.2% | 20.6% | 61.3 | 62.0 | 51.1 | 51.1 |
| Publicly | 67.9 | 35.5% | 59.4 | 36.8% | 14.3% | 33.0 | 34.9 | 28.8 | 30.6 |
| Originating from: |
|||||||||
| Germany | 96.4 | 50.4% | 80.2 | 49.6% | 20.2% | 47.0 | 49.4 | 39.2 | 41.0 |
| Romania | 29.9 | 15.6% | 26.2 | 16.2% | 14.1% | 14.6 | 15.3 | 13.1 | 13.1 |
| Ukraine | 29.5 | 15.4% | 22.2 | 13.8% | 32.9% | 14.9 | 14.6 | 11.3 | 10.9 |
| Poland | 18.1 | 9.5% | 15.8 | 9.8% | 14.6% | 8.9 | 9.2 | 7.8 | 8.0 |
| Other countries |
17.3 | 9.1% | 17.2 | 10.6% | 0.6% | 8.9 | 8.4 | 8.5 | 8.7 |
Revenue generated from external customers

Operating profit (EBIT) increased by 34.7% to €10.1m (€7.5m) with an operating margin of 5.0% (4.7%).
Profit for the period amounted to €4.9m (€5.5m), a margin of 2.4% (3.4%), which was lower than prior year due to lower other income recognised in the quarter of €0.5m (€3.2m) mainly relating to fair value changes. Although net profit reduced, the underlying component excluding other income increased strongly from €2.3m to €4.4m.
Other income/costs of €0.5m (€3.2m) included the movement for non-cash fair value changes in puts written and calls held over share interests in MaxCure, with release of deferred gains from initial recognition in 2017, and other related fair value movements.
Net financial cost amounted to €4.1m (€4.3m). €3.7m (€2.6m) of interest was charged on the Group's debt, commitment fees and other discounted liabilities. Foreign exchange losses were €0.8m (€1.9m) and interest income earned on cash balances amounted to €0.4m (€0.2m). €1.8m (€1.4m) of the interest charged was in relation to lease liabilities.
Basic/diluted earnings per share amounted to €0.031 (€0.039).
Consolidated EBITDA increased by 28.8% to €27.3m (€21.2m), an EBITDA margin of 13.5% (13.2%), despite higher merger and acquisition related costs being charged for the period. Adjusted EBITDA was €29.4m (€21.8m) increasing by 34.9% and with a margin of 14.5% (13.5%). Adjusted EBITDAaL amounted to €19.6m (€13.8m), an increase of 42.0% with a margin of 9.7% (8.6%). Of this increase 26.8% was organic.

The improvement predominantly reflected the increased revenue in both divisions and flow through to profit, driven by growth and increasing volume in existing facilities.
In the second quarter 2018, the fertility business in the UK was disposed of with a non-cash loss of €1.8m recorded in other income/costs. In the same quarter, Medicover completed and sold a real estate development in Poland thereby realising the value of a plot of surplus land, with a profit of €1.5m recognised in other income/costs.
The MaxCure equity stake along with certain rights to call shares and obligations to fulfil put options over MaxCure shares was acquired in the fourth quarter 2017. As these options are recognised as financial instruments they are required to be fair valued using valuation models. As this is not operating income it is recognised in other income with €0.4m (€3.0m) relating to these revaluations.
EBITDA for Healthcare Services increased by 43.0% to €15.3m (€10.7m), an EBITDA margin of 14.1% (13.2%). Organic growth was 18.7% for the quarter. EBITDAaL increased by 57.6% to €10.4m (€6.6m). Contribution from increased volume of activities in major business lines has strongly supported margin development. Cost pressure remains in medical costs in all markets. Pricing is disciplined with likely some dampening of growth rates but supportive of margin development. Acquisitions impacting the quarter include acquisitions made in the second half 2018 in Romania, several Polish dental practises and Neomedic hospital group in Poland. Neomedic has been consolidated for 2 months of the quarter. This acquisition will boost the inpatient activities of the division and adds 236 beds across 3 hospitals in southern Poland.

Operating profit increased by 65.7% to €5.8m (€3.5m), a margin of 5.3% (4.3%). All major business units grew strongly in the quarter across all markets.

The segment results were driven by the increase in employer funded members, good growth of the Fee-For-Service business areas such as dental, hospital admissions as well as acquisitions. The expansion of the Pelican hospital is in construction with commissioning expected early in 2020. This will add 100 beds to the current hospital capacity of 142 beds with new medical modalities, expansion of the intensive care unit (ICU) department and new medical imaging diagnostics.
The two main markets for Healthcare Services, Poland and Romania, continued to see strong demand for privately paid healthcare services, driven by strong economic development and real wage growth.
EBITDA for Diagnostic Services increased by 23.6% to €17.3m (€14.0m), an EBITDA margin of 17.7% (16.9%), of which 22.9% was organic growth. EBITDAaL increased by 22.5% to €12.5m (€10.2m), a margin of 12.8% (12.3%).

Operating profit increased by 28.9% to €9.8m (€7.6m), a margin of 10.0% (9.2%).
In Germany the changes on reimbursement of public paid laboratory tests implemented in April 2018 still continue to have some negative impact on doctor prescribing patterns, however this has largely normalised. Volume increases have offset both referring patterns and regulatory price reductions. Patterns of school holidays had a softening impact on volume at the end of the quarter however this will likely be positive for the third quarter.
The German clinical business continued to develop with an EBITDA of €1.6m (€1.5m) and a margin of 11.0% (11.3%). EBITDAaL amounted to €0.7m (€0.7m) with a margin of 4.8% (5.3%). The additional doctors within the existing infrastructure were starting to feed through to profitability and existing doctors improving productivity as patients get to know the Medicover clinics and services. The total number of clinics operating was 26 (17).
Operating profit (EBIT) grew by 29.7% to €21.4m (€16.5m) with an operating margin of 5.3% (5.1%).
Profit for the period was €11.8m (€14.0m), a margin of 2.9% (4.3%) with lower other income recognised in the first half of €0.6m (€6.9m) mainly relating to fair value changes. Although the net profit reduced, the underlying component excluding other income increased strongly from €7.1m to €11.2m.
Other income/costs, mainly representing fair value movements on financial instruments and other nonoperating income and costs, was net €0.6m (€6.9m).
Net financial cost amounted to €6.1m (€6.3m). €6.4m (€5.3m) of interest was charged on the Group's debt, commitment fees and other discounted liabilities. Foreign exchange losses were €0.4m (€1.6m) and interest income earned on cash balances amounted to €0.7m (€0.6m). Within
the interest charged €3.3m (€2.8m) was related to lease liabilities.
Basic/diluted earnings per share were €0.077 (€0.099).
Consolidated EBITDA increased by 26.3% to €54.8m (€43.4m), an EBITDA margin of 13.6% (13.4%), despite higher merger and acquisition related costs being charged for the first half. Adjusted EBITDA was €57.4m (€44.5m) increasing 29.0% with a margin of 14.3% (13.8%). Adjusted EBITDAaL amounted to € 38.6m (€28.8m) an increase of 34.0% with a margin of 9.6% (8.9%). Of this increase 22.5% was organic.


The increase in EBITDA was slightly weighted to the Healthcare Services driven by the increase in employer funded members. Diagnostic Services was supported by Romania, Ukraine, Poland and overall held back by the German reimbursement revision actions.
Medicover disposed of its UK based fertility operation in the second quarter 2018 with a noncash loss of €1.8m recorded in other income/costs. The EBITDA loss for this business for the first half 2018 was €-0.7m.
Medicover completed and sold a real estate development in Poland thereby realising the value of a plot of surplus land, with a profit of €1.5m recognised in other income/costs in the second quarter 2018.
The MaxCure group equity stake along with certain rights to call shares and obligations to fulfil put options over MaxCure shares was acquired in the fourth quarter 2017. These options are recognised as financial instruments and are required to be fair valued using valuation models. As this is not operating income it is recognised in other income. Over the first half of the year, other income of €0.6m (€7.0m) was recognised relating to these revaluations and release of the initially deferred net profit on these positions.
EBITDA for Healthcare Services increased by 35.4% to €26.4m (€19.5m), an EBITDA margin of 12.5% (12.1%). Organic growth was 17.9%. EBITDAaL increased by 49.1% to €17.0m (€11.4m).
Operating profit amounted to €8.3m (€5.4m), an increase of 53.7% with an operating margin of 3.9% (3.3%).

Given the strong background of increasing membership, facilities and medical staff have been expanded to enable to meet the service requirements. This has been against a backdrop of increasing general inflation and demand for medical staff. As a ratio to revenue, medical costs have decreased slightly for 2019 in the main business in Poland compared to 2018. Indexation of contract prices has offset inflation cost increases.
EBITDA for Diagnostic Services increased by 24.8% to €38.2m (€30.6m), an EBITDA margin of 19.3% (18.3%), of which 22.5% was organic growth. EBITDAaL increased by 25.0% to €29.0m (€23.2m), a margin of 14.7% (13.9%). Except for the German laboratory business unit, the established businesses grew very well and gross profit has been the main driver for the increased profitability.

Operating profit for the segment followed a similar trend with 28.7% growth to €23.3m (€18.1m), a margin of 11.8% (10.8%). Good economic activity in Romania, Ukraine and Poland continued to support out of pocket private pay demand. The Diagnostic Services segment continues to invest in accessibility to services and has increased its number of BDPs and distribution in all geographies, with the addition of 53 BDPs in 2019.
The German clinical business continued to develop contributing €4.1m (€3.0m) to EBITDA with a margin of 13.9% (11.4%). EBITDAaL amounted to €2.3m (€1.4m), a margin of 7.8% (5.3%).

| Medicover, €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Growth | Jan-Jun 2019 |
Jan-Jun 2018 |
Growth | FY 2018 |
|---|---|---|---|---|---|---|---|
| Revenue | 202.9 | 161.1 | 26% | 402.6 | 323.0 | 25% | 671.6 |
| Operating profit | 10.1 | 7.5 | 35% | 21.4 | 16.5 | 30% | 33.7 |
| Operating profit margin, % | 5.0% | 4.7% | 5.3% | 5.1% | 5.0% | ||
| Net profit | 4.9 | 5.5 | -11% | 11.8 | 14.0 | -16% | 24.2 |
| Net profit margin, % | 2.4% | 3.4% | 2.9% | 4.3% | 3.6% | ||
| Basic/diluted earnings per share, € | 0.031 | 0.039 | -21% | 0.077 | 0.099 | -22% | 0.167 |
| EBITDA | 27.3 | 21.2 | 29% | 54.8 | 43.4 | 26% | 90.7 |
| EBITDA margin, % | 13.5% | 13.2% | 13.6% | 13.4% | 13.5% | ||
| EBTIDAaL | 17.5 | 13.2 | 33% | 36.0 | 27.7 | 30% | 58.5 |
| EBITDAaL margin, % | 8.6% | 8.2% | 8.9% | 8.6% | 8.7% | ||
| Adjusted EBITDA | 29.4 | 21.8 | 35% | 57.4 | 44.5 | 29% | 94.1 |
| Adjusted EBITDA margin, % | 14.5% | 13.5% | 14.3% | 13.8% | 14.0% | ||
| Adjusted EBITDAaL | 19.6 | 13.8 | 42% | 38.6 | 28.8 | 34% | 61.9 |
| Adjusted EBITDAaL margin, % | 9.7% | 8.6% | 9.6% | 8.9% | 9.2% | ||
| EBITA | 11.6 | 8.0 | 45% | 24.1 | 17.6 | 37% | 37.0 |
| EBITA margin, % | 5.7% | 5.0% | 6.0% | 5.4% | 5.5% | ||
| Adjusted EBITA | 13.7 | 8.6 | 59% | 26.7 | 18.7 | 43% | 40.4 |
| Adjusted EBITA margin, % | 6.8% | 5.3% | 6.6% | 5.8% | 6.0% | ||
| Healthcare Services, €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Growth | Jan-Jun 2019 |
Jan-Jun 2018 |
Growth | FY 2018 |
| Revenue | 108.6 | 81.2 | 34% | 211.5 | 161.5 | 31% | 346.1 |
| Operating profit | 5.8 | 3.5 | 66% | 8.3 | 5.4 | 54% | 15.6 |
| Operating profit margin, % | 5.3% | 4.3% | 3.9% | 3.3% | 4.5% | ||
| EBITDA | 15.3 | 10.7 | 43% | 26.4 | 19.5 | 35% | 45.8 |
| EBITDA margin, % | 14.1% | 13.2% | 12.5% | 12.1% | 13.2% | ||
| EBITDAaL | 10.4 | 6.6 | 58% | 17.0 | 11.4 | 49% | 29.3 |
| EBITDAaL margin, % | 9.6% | 8.1% | 8.0% | 7.1% | 8.5% | ||
| EBITA | 6.9 | 3.7 | 86% | 10.3 | 5.9 | 75% | 17.8 |
| EBITA margin, % | 6.4% | 4.6% | 4.9% | 3.7% | 5.1% | ||
| Members (period end) (000's) | 1,278 | 1,126 | 13% | 1,278 | 1,126 | 13% | 1,209 |
| Apr-Jun | Apr-Jun | Jan-Jun | Jan-Jun | ||||
| Diagnostic Services, €m | 2019 | 2018 | Growth | 2019 | 2018 | Growth | FY 2018 |
| Revenue | 97.6 | 82.6 | 18% | 197.8 | 167.0 | 18% | 336.7 |
| Operating profit | 9.8 | 7.6 | 29% | 23.3 | 18.1 | 29% | 32.5 |
| Operating profit margin, % | 10.0% | 9.2% | 11.8% | 10.8% | 9.7% | ||
| EBITDA | 17.3 | 14.0 | 24% | 38.2 | 30.6 | 25% | 58.8 |
| EBITDA margin, % | 17.7% | 16.9% | 19.3% | 18.3% | 17.5% | ||
| EBITDAaL | 12.5 | 10.2 | 23% | 29.0 | 23.2 | 25% | 43.3 |
| EBITDAaL margin, % | 12.8% | 12.3% | 14.7% | 13.9% | 12.9% | ||
| EBITA | 10.2 | 7.9 | 29% | 24.0 | 18.7 | 28% | 33.6 |
| EBITA margin, % | 10.5% | 9.6% | 12.1% | 11.2% | 10.0% | ||
| Lab tests (period volume) (m) | 25.9 | 24.0 | 8% | 53.5 | 49.5 | 8% | 98.1 |
For definition and reconciliation of alternative performance measures, refer to note 10.

Cash generated from operations before working capital changes and taxes paid amounted to €26.6m (€23.0m), being 97.4% of EBITDA (108.5%). Net working capital increased by €9.1m (increase of €4.5m). Cash paid tax was €1.8m (€3.8m). Cash generated from operations was €15.7m (€14.7m).
Investments in tangible and intangible assets amounted to €10.8m (€8.9m) with a focus on Poland with continuing growth of members, dental in Poland as well as laboratory and clinical services in Germany. Investments for acquisitions of subsidiaries and associates amounted to €62.5m (€13.6m) with €59.1m paid in cash for the acquisition of Neomedic. Interest received was €0.4m (nil) earned on cash investments in liquid instruments.
Net loans drawn amounted to €80.0m (net loans drawn €21.7m) with €89.2m funded under the short-term commercial paper program at quarter end, used to repay drawings under the revolving credit facility, and to fund acquisitions. Leases repaid were €7.1m (€5.9m) in the quarter. Interest paid amounted to €3.6m (€1.9m), of which €1.8m (€1.4m) related to lease liabilities.
Cash and cash equivalents increased by €6.8m to €53.0m.
Cash generated from operations before working capital changes and taxes paid amounted to €55.4m (€45.7m), being 101.1% of EBITDA (105.3%). Net working capital increased by €8.7m (increase of €8.9m) with an increase in stock, receivables and payables. Cash paid tax was €6.9m (€8.4m). Cash generated from operations was €39.8m (€28.4m).
Investments in tangible and intangible assets amounted to €24.7m (€19.2m) with approximately 57% being growth capital investment and 43% being maintenance investment.
Investments for acquisitions of subsidiaries and associates amounted to €67.4m (€24.5m), with €59.1m paid in cash for the acquisition of Neomedic. Interest received was €0.6m (€0.5m) earned on cash investments in liquid instruments.
Net loans drawn amounted to €90.9m (net loans drawn €21.5m) with €89.2m funded under the short-term commercial program at the end of the first half, used to repay drawings under the revolving credit facility and to fund acquisitions. Leases repaid were €14.2m (€11.6m) in the second half. Interest paid amounted to €6.3m (€3.9m), of which €3.3m (€2.8m) related to lease liabilities.
Cash and cash equivalents increased by €13.1m to €53.0m.
Consolidated equity as at 30 June 2019 amounted to €329.4m (€317.5m). The increase in the levels of equity resulted from profit for the 6 months and positive movements on translation reserves.
Consolidated loans payable amounted to €238.6m (€131.3m) and lease liabilities of €146.4m (€125.4m) for total financial debt of €385.0m (€256.7m). Debt net of cash was €185.6m up from €92.9m at year end 2018 funding acquisitions, of which Neomedic was the largest. The ratio of debt net of cash to adjusted EBITDAaL for the trailing 12 months was 2.6x, up from 1.5x at year end. This has increased temporarily with the largest acquisitions of 2019 yet to be reflected for a full year basis in the earnings measure.
Lease liabilities increased by €21.0m over the first half with just under half coming from the organic businesses with new leases or extensions
recognised and just over half coming from the recognition of leases in acquired businesses.
To achieve lower cost of funding at the end of the quarter the Group launched a SEK 2 billion commercial paper program of short-term drawings with the possibility to issue in both Swedish Krona and Euro. At June 30, €89.2m has been issued with tenors between 2-6 months. The proceeds have financed borrowings under the Group's revolving credit facility. As these drawings are short-term, part of the Group's debt is reclassified as current from non-current, however the Group has a committed long-term €300m revolving credit facility backing the program to assure liquidity and fully mitigating any refinancing risk. In January 2019, the Group's debt facilities were increased by €100m from €200m to €300m on the same terms and the same lenders. The maturity of the facility was extended until June 2022 during the quarter.

The Group's effective tax rate for the year is forecasted to be 27.0% (29.0%) with a tax charge for the first half 2019 of €4.1m (€3.4m). Cash paid
There was no significant revenue. The loss after tax was €2.1m (€-1.7m) in the quarter and €3.4m (€-2.1m) for the first half. The parent company's assets consist of investments in subsidiaries. The business is financed with equity contributed by the owners and a short-term commercial paper program launched in June 2019. €89.2m was
taxes for the 6 months were €6.9m (€8.4m) with settlements for 2018 and provisional payments for 2019.
drawn under this program at quarter end. The proceeds of the program have been lent to the parent's principal subsidiary on the same maturity as the program drawings. Equity of the parent company as at 30 June 2019 was €454.3m (€457.0m at year end).
Operating risks faced by Medicover include risk relating to access to sufficient qualified employees and the related payroll expense to fulfil growth and customer service expectations, risk relating to medical quality or service deficiencies and medical malpractice. External risks include risk relating to the regulatory environment and the general economy, political risk and change in public government funding policies.
Apart from the risks described in the 'Risk and risk management' section of the management report in the annual report 2018 (pages 44-47), no other significant new risks are deemed to have emerged.
This interim report has been prepared in accordance with IAS 34, Interim Financial Reporting. It should be read together with the consolidated financial statements of the Group as at and for the year ended 31 December 2018 as well with the restatement for IFRS 16, Leases and accounting policy update released on 17 April 2019. The comparative amounts presented in this statement have been restated for the impacts of the adoption of IFRS 16.
Medicover is exposed to various financial risks, such as credit risk, interest rate risk, liquidity risk and foreign currency risk. Financial risks are managed by the central finance department.
For further information on risk management and financial instruments, see the consolidated financial statements of the Group as at and for the year ended 31 December 2018: note 24 on pages 78- 80.
The interim information on page 1-12 is an integral part of this interim report. This report has not been reviewed by the Company's auditor.

The Board of Directors and Chief Executive Officer declare that the interim report for the period January-June 2019 gives a fair overview of the parent company´s and Group´s operations, financial position and results of operations and describes significant risks and uncertainties facing the parent company and companies included in the Group.
Stockholm on 26 July 2019
Fredrik Stenmo Chairman of the board
Peder af Jochnick Robert af Jochnick Arno Bohn Board member Board member Board member
Board member Board member Board member
Sonali Chandmal Michael Flemming Margareta Nordenvall
Fredrik Rågmark Board member and CEO
This is information that Medicover AB is obliged to make public pursuant to the EU Market Abuse Regulation and the Securities Markets Act. The information was submitted for publication through the agency of the contact person set out below at 7.45 (CEST) on 26 July 2019. This interim report and other information about Medicover is available at medicover.com.
Financial Calendar
Interim report July-September 2019 6 November 2019
For further information, please contact: Hanna Bjellquist, Head of Investor Relations Phone: +46 70 303 32 72 E-mail: [email protected]
Org nr: 559073-9487 Medicover AB (publ) P.O. Box 5283 S-102 46 Stockholm Visiting address: Riddargatan 12A SE-114 35 Stockholm, Sweden Phone: +46 8-400 17 600

| Note | €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|---|
| 2 | Revenue | 202.9 | 161.1 | 402.6 | 323.0 | 671.6 |
| Operating expenses | ||||||
| Medical provision costs | -154.0 | -121.5 | -302.6 | -243.1 | -507.3 | |
| Gross profit | 48.9 | 39.6 | 100.0 | 79.9 | 164.3 | |
| Distribution, selling and marketing costs | -10.5 | -8.8 | -21.0 | -16.8 | -35.2 | |
| Administrative costs | -28.3 | -23.3 | -57.6 | -46.6 | -95.4 | |
| Operating profit | 10.1 | 7.5 | 21.4 | 16.5 | 33.7 | |
| 3 | Other income/(costs) | 0.5 | 3.2 | 0.6 | 6.9 | 8.6 |
| Interest income | 0.4 | 0.2 | 0.7 | 0.6 | 1.4 | |
| Interest expense | -3.7 | -2.6 | -6.4 | -5.3 | -9.6 | |
| Other financial income/(expense) | -0.8 | -1.9 | -0.4 | -1.6 | -0.6 | |
| Total financial result | -4.1 | -4.3 | -6.1 | -6.3 | -8.8 | |
| Share of profit/(loss) of associates | 0.0 | 0.3 | 0.0 | 0.3 | -1.8 | |
| Profit before income tax | 6.5 | 6.7 | 15.9 | 17.4 | 31.7 | |
| Income tax | -1.6 | -1.2 | -4.1 | -3.4 | -7.5 | |
| Profit for the period | 4.9 | 5.5 | 11.8 | 14.0 | 24.2 | |
| Profit attributable to: | ||||||
| Owners of the parent | 4.1 | 5.1 | 10.3 | 13.2 | 22.3 | |
| Non-controlling interests | 0.8 | 0.4 | 1.5 | 0.8 | 1.9 | |
| Profit for the period | 4.9 | 5.5 | 11.8 | 14.0 | 24.2 | |
| Earnings per share attributable to parent: | ||||||
| Basic/diluted, € | 0.031 | 0.039 | 0.077 | 0.099 | 0.167 |
| Note | €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|---|
| Profit for the period | 4.9 | 5.5 | 11.8 | 14.0 | 24.2 | |
| Other comprehensive income/(loss): Items that may be reclassified subsequently to income statement: |
||||||
| Exchange differences on translating foreign operations |
3.5 | -1.8 | 3.6 | -4.1 | -6.1 | |
| Income tax relating to these items | -0.2 | 0.2 | -0.4 | 0.2 | 0.5 | |
| Other comprehensive income/(loss) for the period, net of tax |
3.3 | -1.6 | 3.2 | -3.9 | -5.6 | |
| Total comprehensive income for the period | 8.2 | 3.9 | 15.0 | 10.1 | 18.6 | |
| Total comprehensive income attributable to: | ||||||
| Owners of the parent | 7.4 | 3.5 | 13.5 | 9.3 | 16.7 | |
| Non-controlling interests | 0.8 | 0.4 | 1.5 | 0.8 | 1.9 | |
| Total comprehensive income for the period | 8.2 | 3.9 | 15.0 | 10.1 | 18.6 |

| 30 Jun | 30 Jun | 31 Dec | ||
|---|---|---|---|---|
| Note | €m | 2019 | 20181 | 2018 |
| ASSETS | ||||
| Non-current assets | ||||
| 4 | Goodwill | 223.3 | 132.3 | 150.1 |
| 4 | Other intangible fixed assets | 58.5 | 35.6 | 50.8 |
| Tangible fixed assets | 194.8 | 149.4 | 164.4 | |
| Right-of-use assets | 137.6 | 113.9 | 117.0 | |
| Total fixed assets | 614.2 | 431.2 | 482.3 | |
| Deferred tax assets | 5.6 | 5.2 | 4.2 | |
| Investment in associates | 44.9 | 46.1 | 43.8 | |
| 5 | Other financial assets | 16.2 | 4.8 | 9.3 |
| Total non-current assets | 680.9 | 487.3 | 539.6 | |
| Current assets | ||||
| Inventories | 32.6 | 27.1 | 30.3 | |
| 5 | Other financial assets | 6.7 | 3.0 | 27.8 |
| 5 | Trade and other receivables | 106.9 | 86.4 | 92.3 |
| 5 | Cash and cash equivalents | 53.0 | 36.6 | 38.4 |
| Total current assets | 199.2 | 153.1 | 188.8 | |
| Total assets | 880.1 | 640.4 | 728.4 | |
| SHAREHOLDERS' EQUITY | ||||
| Issued capital and reserves attributable to owners of | ||||
| the parent | 324.4 | 305.1 | 313.1 | |
| Non-controlling interests | 5.0 | 1.7 | 4.4 | |
| Total shareholders' equity | 329.4 | 306.8 | 317.5 | |
| LIABILITIES | ||||
| Non–current liabilities | ||||
| 5 | Loans payable | 143.6 | 71.6 | 126.4 |
| 5 | Lease liabilities | 116.0 | 96.1 | 96.4 |
| Deferred tax liabilities | 26.2 | 22.9 | 23.7 | |
| Provisions | 0.3 | 0.3 | 0.3 | |
| 5 | Other financial liabilities | 28.7 | 28.7 | 28.6 |
| Other liabilities | 5.8 | 5.5 | 5.6 | |
| Total non-current liabilities | 320.6 | 225.1 | 281.0 | |
| Current liabilities | ||||
| 5 | Loans payable | 95.0 | 3.4 | 4.9 |
| 5 | Lease liabilities | 30.4 | 26.1 | 29.0 |
| Provision for unearned premiums/deferred revenue | 10.3 | 9.2 | 10.3 | |
| Corporate tax payable | 3.4 | 2.9 | 4.2 | |
| 5 | Other financial liabilities | 5.3 | 4.7 | 3.6 |
| 5 | Trade and other payables | 85.7 | 62.2 | 77.9 |
| Total current liabilities | 230.1 | 108.5 | 129.9 | |
| Total liabilities | 550.7 | 333.6 | 410.9 | |
| Total shareholders' equity and liabilities | 880.1 | 640.4 | 728.4 |
1 Comparative figures have been restated to reflect the impact of the final purchase price allocation of an acquisition closed in June 2018.

| Note | €m | Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|
| Opening balance shareholders' equity as reported | 317.5 | 299.8 | 299.8 | |
| 1 | IFRIC 23 impact – first application | -1.9 | - | - |
| Opening balance shareholders' equity - restated | 315.6 | 299.8 | 299.8 | |
| Total comprehensive income for the period | 15.0 | 10.1 | 18.6 | |
| Transactions with owners in their capacity as owners: | ||||
| Share issue for cash | - | - | 0.4 | |
| Acquisition of treasury shares | - | - | -0.4 | |
| Acquisition of interest in a subsidiary | 0.2 | - | - | |
| Disposal of interest in a subsidiary | - | - | -1.5 | |
| Non-controlling interests on deconsolidation of a subsidiary | - | -1.4 | - | |
| Non-controlling interests put-option reserve | -2.1 | -1.9 | -3.3 | |
| Recognition of non-controlling interests on business combinations | - | -0.1 | 2.6 | |
| Employee share-based compensation costs | 0.7 | 0.3 | 1.3 | |
| Total transactions with owners in their capacity as owners | -1.2 | -3.1 | -0.9 | |
| Closing balance shareholders' equity | 329.4 | 306.8 | 317.5 |

| Note | €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|---|
| Profit before income tax | 6.5 | 6.7 | 15.9 | 17.4 | 31.7 | |
| Adjustments for: | ||||||
| Depreciation and amortisation | 17.2 | 13.7 | 33.4 | 26.9 | 57.0 | |
| Gain on disposal of fixed assets | -0.1 | - | -0.2 | - | -0.1 | |
| Gain on termination of leases | -0.6 | -0.1 | -0.6 | -0.1 | -0.1 | |
| 3 | Other costs (non-cash components) | -0.5 | -1.9 | -0.6 | -5.5 | -7.2 |
| Net interest expense | 3.3 | 2.4 | 5.7 | 4.7 | 8.2 | |
| Employee share-based compensation costs | 0.5 | 0.4 | 0.8 | 0.6 | 1.6 | |
| Other non-cash transactions | 0.8 | -0.1 | 2.0 | 0.2 | 3.3 | |
| Unrealised foreign exchange (gain)/loss | -0.5 | 1.9 | -1.0 | 1.5 | 0.0 | |
| Cash generated from operations before working capital changes and tax payments |
26.6 | 23.0 | 55.4 | 45.7 | 94.4 | |
| Changes in operating assets and liabilities: | ||||||
| (Increase)/decrease in receivables & inventories | -2.7 | 0.6 | -11.9 | -4.7 | -13.3 | |
| Increase/(decrease) in payables | -6.4 | -5.1 | 3.2 | -4.2 | 5.2 | |
| Cash generated from operations before tax | ||||||
| payments | 17.5 | 18.5 | 46.7 | 36.8 | 86.3 | |
| Income tax paid | -1.8 | -3.8 | -6.9 | -8.4 | -11.9 | |
| Net cash from operating activities | 15.7 | 14.7 | 39.8 | 28.4 | 74.4 | |
| Investing activities: | ||||||
| Payment for acquisition of fixed assets | -10.8 | -8.9 | -24.7 | -19.2 | -41.0 | |
| Proceeds from disposal of fixed assets | 0.0 | 0.1 | 0.1 | 0.1 | 0.1 | |
| Payment for acquiring interest in associates | -1.0 | -6.4 | -1.0 | -15.3 | -15.3 | |
| Dividends received from associates Payment for acquisition of subsidiaries, net of |
- | - | - | - | 0.1 | |
| 4 | cash acquired | -61.5 | -7.2 | -66.4 | -9.2 | -34.5 |
| Proceeds from disposal of subsidiaries, net of cash sold |
- | - | - | - | 0.5 | |
| Payments into escrow for acquisitions | - | - | - | - | -24.7 | |
| Loans granted | -5.0 | - | -5.0 | - | -2.7 | |
| Interest received | 0.4 | 0.0 | 0.6 | 0.5 | 1.4 | |
| Net cash used in investing activities | -77.9 | -22.4 | -96.4 | -43.1 | -116.1 | |
| Financing activities: | ||||||
| Proceeds from issue of shares | - | - | - | - | 0.4 | |
| Acquisition of treasury shares | - | - | - | - | -0.4 | |
| Loans repaid | -78.3 | -1.8 | -80.0 | -32.5 | -35.6 | |
| Loans received | 158.3 | 23.5 | 170.9 | 54.0 | 106.1 | |
| Leases repaid | -7.1 | -5.9 | -14.2 | -11.6 | -24.5 | |
| Interest paid Distribution to non-controlling interests |
-3.6 -0.3 |
-1.9 - |
-6.3 -0.7 |
-3.9 - |
-9.4 -2.0 |
|
| Net cash from financing activities | 69.0 | 13.9 | 69.7 | 6.0 | 34.6 | |
| Total cash flow | 6.8 | 6.2 | 13.1 | -8.7 | -7.1 | |
| Cash and cash equivalents | ||||||
| Cash balance as at beginning of the period | 45.0 | 30.4 | 38.4 | 45.4 | 45.4 | |
| Net effects of exchange gain/(loss) on cash | ||||||
| balances | 1.2 | 0.0 | 1.5 | -0.1 | 0.1 | |
| Total cash balance as at end of the period | 53.0 | 36.6 | 53.0 | 36.6 | 38.4 | |
| Increase/(decrease) in cash and cash equivalents |
6.8 | 6.2 | 13.1 | -8.7 | -7.1 |

| Note | €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|---|
| Revenue | 0.3 | 0.1 | 0.5 | 0.2 | 0.6 | |
| Operating expenses | -2.2 | -1.8 | -3.8 | -2.4 | -6.3 | |
| Operating loss | -1.9 | -1.7 | -3.3 | -2.2 | -5.7 | |
| Other income/(costs) | - | - | - | - | 30.5 | |
| Interest income from Group companies | -0.2 | - | -0.1 | 0.1 | 0.1 | |
| Profit/(loss) before income tax | -2.1 | -1.7 | -3.4 | -2.1 | 24.9 | |
| Income tax | - | - | - | - | - | |
| Profit/(loss) for the period | -2.1 | -1.7 | -3.4 | -2.1 | 24.9 |
As the loss for the period corresponds with the amount in total comprehensive income, no separate statement is presented.
| Note | €m | 30 Jun 2019 |
30 Jun 2018 |
31 Dec 2018 |
|---|---|---|---|---|
| Tangible fixed assets | 0.0 | 0.1 | 0.0 | |
| Investments in subsidiaries | 434.8 | 434.8 | 434.8 | |
| Other non-current assets | - | 0.0 | 28.0 | |
| Total fixed assets | 434.8 | 434.9 | 462.8 | |
| Current receivables | 114.0 | 0.7 | 0.9 | |
| Cash and cash equivalents | 0.0 | 0.0 | 0.0 | |
| Total current assets | 114.0 | 0.7 | 0.9 | |
| Total assets | 548.8 | 435.6 | 463.7 | |
| Restricted equity | 27.1 | 26.7 | 27.1 | |
| Non-restricted equity | 427.2 | 402.3 | 429.9 | |
| Total equity | 454.3 | 429.0 | 457.0 | |
| Non-current liabilities | 3.3 | 3.3 | 3.3 | |
| Current liabilities | 91.2 | 3.3 | 3.4 | |
| Total equity and liabilities | 548.8 | 435.6 | 463.7 |

Medicover AB (publ) ("the Company") together with its subsidiaries are referred to as "the Group". Medicover AB (publ) is a company domiciled in
This interim report has been prepared in accordance with IAS 34, Interim Financial Reporting and should be read together with the consolidated financial statements of the Group as at and for the year ended 31 December 2018. The interim financial statements do not include all disclosures that would otherwise be required in a complete set of financial statements.
Sweden, with its head office in Stockholm. The reporting and functional currency of the Company is the Euro.
A restatement and updated accounting policies communication was published on 17 April 2019, detailing the impact of and restatement of reported results and amounts for 2018 and prior periods. This interim report should be read in conjunction with that communication and is an integral part.
The condensed interim financial information on pages 1-12 is an integral part of this interim report.
The Group applies the International Financial Reporting Standards (IFRS) as adopted by the European Union. The accounting policies applied by the Group in this condensed consolidated interim financial information are the same as those applied by the Group in its consolidated financial statements as at and for the year ended 31 December 2018, except for the changes described in the restatement release of 17 April 2019. For convenience these changes are summarised as follows:
Consolidated statement of financial position as at 31 December 2018:
Consolidated income statement for year 31 December 2018:
IFRIC 23, Uncertainty over Income Tax Treatments impact – first application as at 1 January 2019:
Other new and amended standards as well as interpretations issued by the IASB that will apply for the first time in the 2019 annual consolidated financial statements are not expected to impact the Group as they are either not relevant to the Group's activities or require accounting which is consistent with the Group's current accounting policies.
The preparation of interim condensed financial statements in compliance with IAS 34 requires the use of certain critical accounting estimates. It also requires the Group's management to exercise judgement in applying the Group's accounting policies. Refer to the Group's consolidated financial statements as at and for the year ended 31 December 2018 and the restatement release of 17 April 2019 for further information on the use of estimates and judgements.
The parent company applies the Swedish Annual Accounts Act and the Swedish Financial Reporting Board's Recommendation RFR 2, Reporting for Legal Entities.

For further details on segment information, see the consolidated financial statements as at and for the year ended 31 December 2018: note 6 on pages 67-69.
No changes in the basis of segmentation from the consolidated financial statements as at and for the year ended 31 December 2018 has occurred. The basis of measurement of segment profit or loss has changed from EBITDA to EBITDAaL, a new alternative performance measure. Due to the adoption of IFRS 16, Leases, the utility of the EBITDA measure has reduced as it now excludes costs of leases. EBITDAaL addresses this to be an approximation of the previously used profit and loss performance measure including the costs of leases. Refer to note 10 for more details on EBITDAaL.

| Apr-Jun 2019 |
Apr-Jun 2018 |
||||||||
|---|---|---|---|---|---|---|---|---|---|
| €m | Healthcare Services |
Diagnostic Services |
Central/ other |
Group total |
Healthcare Services |
Diagnostic Services |
Central/ other |
Group total |
|
| Revenue | |||||||||
| Total revenue |
108.6 | 97.6 | 0.1 | 81.2 | 82.6 | 0.0 | |||
| Inter-segment revenue |
-0.1 | -3.3 | 0.0 | -0.1 | -2.7 | 0.1 | |||
| Total revenue from external customers |
108.5 | 94.3 | 0.1 | 202.9 | 81.1 | 79.9 | 0.1 | 161.1 | |
| Of which funded: |
|||||||||
| Privately | 99.1 | 61.3 | 0.1 | 160.5 | 78.5 | 51.1 | 0.1 | 129.7 | |
| Publicly | 9.4 | 33.0 | - | 42.4 | 2.6 | 28.8 | - | 31.4 | |
| Originating from: |
|||||||||
| Poland | 84.4 | 8.9 | 0.0 | 93.3 | 64.8 | 7.8 | - | 72.6 | |
| Germany | - | 47.0 | - | 47.0 | - | 39.2 | - | 39.2 | |
| Romania | 14.0 | 14.6 | 0.0 | 28.6 | 7.9 | 13.1 | - | 21.0 | |
| Ukraine | 2.6 | 14.9 | - | 17.5 | 1.6 | 11.3 | - | 12.9 | |
| Other countries |
7.5 | 8.9 | 0.1 | 16.5 | 6.8 | 8.5 | 0.1 | 15.4 | |
| Operating profit |
5.8 | 9.8 | -5.5 | 10.1 | 3.5 | 7.6 | -3.6 | 7.5 | |
| Margin, % |
5.3% | 10.0% | 5.0% | 4.3% | 9.2% | 4.7% | |||
| Depreciation and amortisation |
9.5 | 7.5 | 0.2 | 17.2 | 7.2 | 6.4 | 0.1 | 13.7 | |
| EBITDA | 15.3 | 17.3 | -5.3 | 27.3 | 10.7 | 14.0 | -3.5 | 21.2 | |
| Margin, % |
14.1% | 17.7% | 13.5% | 13.2% | 16.9% | 13.2% | |||
| Right-of-use depreciation |
-3.9 | -4.0 | -0.1 | -8.0 | -3.3 | -3.2 | -0.1 | -6.6 | |
| Interests on lease obligations |
-1.0 | -0.8 | 0.0 | -1.8 | -0.8 | -0.6 | - | -1.4 | |
| EBITDAaL1 Segment result: |
10.4 | 12.5 | -5.4 | 17.5 | 6.6 | 10.2 | -3.6 | 13.2 | |
| Margin, % |
9.6% | 12.8% | 8.6% | 8.1% | 12.3% | 8.2% | |||
| Other income |
0.5 | 3.2 | |||||||
| Net interest expense |
-3.3 | -2.4 | |||||||
| Other financial expense |
-0.8 | -1.9 | |||||||
| Share of profit of associates |
0.0 | 0.3 | |||||||
| Tax | -1.6 | -1.2 | |||||||
| Group profit after tax |
4.9 | 5.5 |
1 EBITDA under previous accounting standards was reported as the segment measure of profit or loss. This has been changed to EBITDAaL under the new accounting standard, IFRS 16, Leases, as applicable from 1 January 2019. The difference between EBITDA as previously reported and EBITDAaL for Q2 2018 was €0.3m, split between €0.2m in Healthcare Service and €0.0m in Diagnostic Services, with the balance of €0.1m for central services.

| Jan-Jun 2019 |
Jan-Jun 2018 |
||||||||
|---|---|---|---|---|---|---|---|---|---|
| €m | Healthcare Services |
Diagnostic Services |
Central/ other |
Group total |
Healthcare Services |
Diagnostic Services |
Central/ other |
Group total |
|
| Revenue | |||||||||
| Total revenue |
211.5 | 197.8 | 0.2 | 161.5 | 167.0 | 0.1 | |||
| Inter-segment revenue |
-0.3 | -6.6 | 0.0 | -0.2 | -5.4 | 0.0 | |||
| Total revenue from external customers |
211.2 | 191.2 | 0.2 | 402.6 | 161.3 | 161.6 | 0.1 | 323.0 | |
| Of which funded: |
|||||||||
| Privately | 196.2 | 123.3 | 0.2 | 319.7 | 156.2 | 102.2 | 0.1 | 258.5 | |
| Publicly | 15.0 | 67.9 | - | 82.9 | 5.1 | 59.4 | - | 64.5 | |
| Originating from: |
|||||||||
| Poland | 161.9 | 18.1 | 0.0 | 180.0 | 129.6 | 15.8 | - | 145.4 | |
| Germany | - | 96.4 | - | 96.4 | - | 80.2 | - | 80.2 | |
| Romania | 29.4 | 29.9 | 0.0 | 59.3 | 16.0 | 26.2 | - | 42.2 | |
| Ukraine | 4.6 | 29.5 | - | 34.1 | 2.8 | 22.2 | - | 25.0 | |
| Other countries |
15.3 | 17.3 | 0.2 | 32.8 | 12.9 | 17.2 | 0.1 | 30.2 | |
| Operating profit |
8.3 | 23.3 | -10.2 | 21.4 | 5.4 | 18.1 | -7.0 | 16.5 | |
| Margin, % |
3.9% | 11.8% | 5.3% | 3.3% | 10.8% | 5.1% | |||
| Depreciation and amortisation |
18.1 | 14.9 | 0.4 | 33.4 | 14.1 | 12.5 | 0.3 | 26.9 | |
| EBITDA | 26.4 | 38.2 | -9.8 | 54.8 | 19.5 | 30.6 | -6.7 | 43.4 | |
| Margin, % |
12.5% | 19.3% | 13.6% | 12.1% | 18.3% | 13.4% | |||
| Right-of-use depreciation |
-7.5 | -7.8 | -0.2 | -15.5 | -6.5 | -6.2 | -0.2 | -12.9 | |
| Interests on lease obligations |
-1.9 | -1.4 | 0.0 | -3.3 | -1.6 | -1.2 | - | -2.8 | |
| EBITDAaL1 Segment result: |
17.0 | 29.0 | -10.0 | 36.0 | 11.4 | 23.2 | -6.9 | 27.7 | |
| Margin, % |
8.0% | 14.7% | 8.9% | 7.1% | 13.9% | 8.6% | |||
| Other income |
0.6 | 6.9 | |||||||
| Net interest expense |
-5.7 | -4.7 | |||||||
| Other financial expense |
-0.4 | -1.6 | |||||||
| Share of profit of associates |
0.0 | 0.3 | |||||||
| Tax | -4.1 | -3.4 | |||||||
| Group profit after tax |
11.8 | 14.0 |
1 EBITDA under previous accounting standards was reported as the segment measure of profit or loss. This has been changed to EBITDAaL under the new accounting standard, IFRS 16, Leases, as applicable from 1 January 2019. The difference between EBITDA as previously reported and EBITDAaL for first half 2018 was €0.8m, split between €0.6m in Healthcare Service and €0.2m in Diagnostic Services, with the balance of €0.0m for central services.

As almost all sales in each geography are denominated in the countries' respective currency the above table shows the exposure of the Group to foreign currency risks for revenue. Within the Healthcare Services segment, revenue for
insurance contracts for 2019 was €112.1m (€99.2m). For further information on insurance contracts, see the consolidated financial statements as at and for the year ended 31 December 2018: note 4 on page 67.
| €m equivalent | 30 Jun 2019 |
30 Jun 2018 |
31 Dec 2018 |
|---|---|---|---|
| Non-current assets by location of assets | |||
| Poland (PLN) | 281.2 | 184.1 | 199.2 |
| Germany (EUR) | 205.3 | 165.2 | 165.8 |
| Romania (RON) | 87.8 | 43.2 | 80.6 |
| India (INR) | 30.2 | 24.8 | 25.4 |
| Ukraine (UAH) | 19.1 | 13.5 | 14.9 |
| Other (various) | 51.7 | 51.3 | 49.5 |
| Total non-current assets by location of assets | 675.3 | 482.1 | 535.4 |
Non-current assets by geography include land and buildings, equipment, intangible assets including goodwill, other financial assets, right-of-use assets and investments in associates. Deferred tax assets of €5.6m (€5.2m) are excluded.
| €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|
| Other income/(costs) | |||||
| Change in fair value of MaxCure financial assets and | |||||
| liabilities | 0.4 | 3.0 | 0.6 | 7.0 | 8.6 |
| Change in fair value of other non-current liabilities | - | 0.2 | - | 0.2 | 0.2 |
| Loss on disposal of interest in subsidiaries | - | -1.8 | - | -1.8 | -1.6 |
| Profit on real estate development project | - | 1.5 | - | 1.5 | 1.5 |
| Other | 0.1 | 0.3 | 0.0 | 0.0 | -0.1 |
| Total other income/(costs) | 0.5 | 3.2 | 0.6 | 6.9 | 8.6 |
Preliminary purchase price allocation has been performed, subject to change in the next twelve months from the acquisition date, presented below.
In January 2019, the Group acquired 100% of the voting rights in the center for genetic diagnostics of Dr. Klein, Dr. Rost and colleagues ("Klein") located near Munich in Germany for a total consideration of €25.3m including contingent and deferred liabilities of €3.9m. €21.4m was released from money deposited in an escrow account in 2018. €2.7m has been allocated to other intangibles. €20.0m goodwill was recognised on this acquisition, unallocated to specific intangibles representing expected synergies with existing operations.
Included in the income statement for the first half is revenue of €7.8m and net operating profit of €0.6m.
In May 2019, 100% of the voting rights in Neomedic has been acquired for a total consideration of €69.0m including debt assumed. €4.0m has been allocated to other intangibles. €47.1m goodwill was recognised on this acquisition, unallocated to specific intangibles representing expected synergies with existing operations. Included in the income statement is revenue of €5.2m and net operating profit of €1.4m.
In the first half 2019, the following cash flows (net of cash acquired) were paid in relation of business combinations.

| €m | Klein | Neomedic | Other | Total |
|---|---|---|---|---|
| Cash | - | 2.5 | 0.3 | 2.8 |
| Accounts receivable and inventories | 0.6 | 4.7 | 0.8 | 6.1 |
| Tangible fixed assets | 2.1 | 18.7 | 0.8 | 21.6 |
| Right-of-use assets | 5.8 | 3.6 | 1.9 | 11.3 |
| Goodwill | 20.0 | 47.1 | 5.5 | 72.6 |
| Other intangible fixed assets: | 2.7 | 4.0 | 2.4 | 9.1 |
| Brand | - | 3.7 | 0.9 | 4.6 |
| Customer relations | 2.7 | - | 1.5 | 4.2 |
| Set-up costs | - | - | 0.0 | 0.0 |
| Other | 0.0 | 0.3 | 0.0 | 0.3 |
| Deferred tax asset | - | 0.2 | 0.1 | 0.3 |
| Lease liabilities | -5.8 | -3.6 | -1.9 | -11.3 |
| Deferred tax liability | - | -1.1 | -0.2 | -1.3 |
| Corporate tax payable | - | -0.1 | 0.0 | -0.1 |
| Accounts payable | -0.1 | -4.2 | -1.0 | -5.3 |
| Third party loans | - | -9.9 | -0.2 | -10.1 |
| Acquisition of non-controlling interests | - | - | 0.5 | 0.5 |
| Total purchase price | 25.3 | 61.9 | 9.0 | 96.2 |
| Less: cash acquired | - | -2.5 | -0.3 | -2.8 |
| Deferred and contingent consideration payable (discounted) | -3.9 | -0.3 | -0.9 | -5.1 |
| Release from escrow account | -21.4 | - | -1.6 | -23.0 |
| Prepayment acquisition | - | - | 1.1 | 1.1 |
| Total cash flow for acquisitions net of cash acquired | - | 59.1 | 7.3 | 66.4 |
The following table shows the Group's significant financial assets and liabilities. All financial assets and liabilities are carried at amortised cost with the exception of:
receive cash based on the value of equity instruments of an associate, carried at fair value through profit or loss;
All financial assets and liabilities at amortised cost are considered to have carrying amounts that materially correspond to their fair value; for loan borrowings this is due to floating interest rates.

| 30 Jun 2019 |
30 Jun 2018 |
31 Dec 2018 |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Non | Non | Non | ||||||||
| Note | €m | current | Current | Total | current | Current | Total | current | Current | Total |
| Financial assets at fair value through profit or loss |
||||||||||
| b) | Call options on associate's shares |
2.0 | 3.8 | 5.8 | 2.4 | 3.0 | 5.4 | 1.6 | 3.1 | 4.7 |
| c) | Other financial assets |
2.8 | - | 2.8 | - | - | - | 2.8 | - | 2.8 |
| Financial assets at amortised cost |
||||||||||
| Other financial assets |
11.4 | 2.9 | 14.3 | 2.4 | - | 2.4 | 4.9 | 24.71 | 29.6 | |
| Trade and other receivables, gross |
- | 115.0 | 115.0 | - | 91.5 | 91.5 | - | 98.4 | 98.4 | |
| Provision for expected credit losses |
- | -8.1 | -8.1 | - | -5.1 | -5.1 | - | -6.1 | -6.1 | |
| Subtotal financial assets at amortised cost |
11.4 | 109.8 | 121.2 | 2.4 | 86.4 | 88.8 | 4.9 | 117.0 | 121.9 | |
| Cash and cash equivalents |
- | 53.0 | 53.0 | - | 36.6 | 36.6 | - | 38.4 | 38.4 | |
| Total financial assets |
16.2 | 166.6 | 182.8 | 4.8 | 126.0 | 130.8 | 9.3 | 158.5 | 167.8 | |
| Financial liabilities at fair value through profit or loss |
||||||||||
| b) | Put options on associate's shares |
1.2 | - | 1.2 | 1.0 | -1.0 | - | 1.7 | -1.1 | 0.6 |
| d) | Other financial liabilities |
11.1 | - | 11.1 | 12.4 | - | 12.4 | 11.2 | - | 11.2 |
| e) | Contingent acquisition consideration payable |
10.6 | 0.6 | 11.2 | 3.0 | 1.1 | 4.1 | 5.6 | 0.6 | 6.2 |
| Subtotal financial liabilities at fair value through profit or |
||||||||||
| loss | 22.9 | 0.6 | 23.5 | 16.4 | 0.1 | 16.5 | 18.5 | -0.5 | 18.0 | |
| a) | Put option liquidity obligation with non-controlling shareholder (with movement through equity) |
16.4 | - | 16.4 | 15.3 | - | 15.3 | 15.7 | - | 15.7 |
| Subtotal financial liabilities at fair value |
39.3 | 0.6 | 39.9 | 31.7 | 0.1 | 31.8 | 34.2 | -0.5 | 33.7 | |
| Financial liabilities at amortised cost |
||||||||||
| Borrowings | 128.3 | 92.8 | 221.1 | 65.7 | 1.1 | 66.8 | 117.3 | 1.8 | 119.1 | |
| Lease liabilities |
116.0 | 30.4 | 146.4 | 96.1 | 26.1 | 122.2 | 96.4 | 29.0 | 125.4 | |
| Other liabilities |
- | 5.3 | 5.3 | - | 5.7 | 5.7 | - | 4.7 | 4.7 | |
| Trade and other payables |
- | 85.7 | 85.7 | - | 62.2 | 62.2 | - | 77.9 | 77.9 | |
| Deferred consideration payable |
4.7 | 1.6 | 6.3 | 2.9 | 1.2 | 4.1 | 3.5 | 2.5 | 6.0 | |
| Subtotal financial liabilities at amortised cost |
249.0 | 215.8 | 464.8 | 164.7 | 96.3 | 261.0 | 217.2 | 115.9 | 333.1 | |
| Total financial liabilities |
288.3 | 216.4 | 504.7 | 196.4 | 96.4 | 292.8 | 251.4 | 115.4 | 366.8 |
1 Amount deposited into an escrow account relating to 2019 acquisitions.

The following amounts were recognised in other income/(costs) in respect of changes in fair value:
| €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|
| Change in fair value of financial assets/liabilities | |||||
| Release of deferred profit upon initial call option | |||||
| recognition | 0.5 | 1.3 | 0.9 | 4.3 | 4.9 |
| Release of deferred loss upon initial put option recognition |
-0.3 | -0.3 | -0.6 | -0.6 | -1.1 |
| Change in fair value of call/put option on associate's | |||||
| shares | 0.1 | 2.2 | 0.2 | 3.3 | 3.7 |
| Change in fair value of other financial liabilities | 0.1 | -0.2 | 0.1 | 0.0 | 1.1 |
| Total fair value recognised in other income | 0.4 | 3.0 | 0.6 | 7.0 | 8.6 |
A breakdown of how fair value is determined is indicated in the following three levels:
Level 1: Medicover presently has no financial assets or liabilities where the valuation is based on level 1.
Level 2: The fair value of interest rate swaps is determined by discounting the estimated cash flows. Discounting is based on quoted market rates on comparable instruments at the balance sheet date.
Level 3: The Group has the following financial assets and liabilities recurrently measured using level 3 fair value measurements.
a) The Group is contractually obliged to acquire at a future date a non-controlling interest at a market price determined at that future time. This put option relates to one of the Group's German subsidiaries. The valuation is based on management's estimate of the exercise date and the expected valuation of the put option at that time. Due to contracted terms disadvantaging the holder, it is estimated that the put option will be exercised in 2023 at the earliest. In determining the fair value of the obligation, estimations of key variables are made, of which the most significant are the growth rate of the business to determine its profitability at the future date of exercise (compound rate of 5.5% at the end of Q2 2019 and in 2018) and the discount rate applied to the nominal value (0.9% at the end of Q2 2019 and 1.7% in 2018). This is a level 3 fair value technique with subsequent changes in fair value of the future obligation recognised as a movement within equity.
b) The Group has rights to invest in an associate to inject new capital and to acquire a set number of existing shares at a price per share-based upon a formula linked to a profit measure. In addition, the Group has written put option agreements to certain investors to acquire the shareholding in the future, these can be exercised anytime between March
2020 and March 2023 and between March 2024 and March 2027 or until they cease to be shareholders. The model used for fair valuing these financial instruments is a Monte Carlo simulation model that takes into account the exercise price, the term of the options, the underlying equity value at grant date and expected volatility, the risk free interest rate for the term of the option and the correlations and volatilities of the peer group companies. Each option was valued individually. Market observable input for share price volatility was based on a group of listed Indian hospital stocks, matched to the duration of the options being valued.
c) Other financial assets at fair value through profit and loss include a purchase of 11.2% of shares in an innovative biotechnology company that is specialised in non-invasive diagnostics for a total of €2.8m.
d) The Group has a contractual obligation to an unrelated third party in relation to the investment in the associate for services rendered in sourcing and negotiating the transaction and ongoing assistance in mergers and acquisitions as well as corporate governance of the associate. This is remunerated through a contract that grants the advisor a simulated participation in the Group's investment. The liability has been measured at the purchase date using a model relying upon observable and unobservable inputs related to the associate specifically projected growth of underlying profits and estimates of the likely date of exercise and payment of the obligation. The observable inputs relate to discount rates for the equity risks for the listed Indian hospital sector, represented by some 9 listed entities. The rate used at acquisition date was 12.1% and at the end of Q2 2019 revalued to 12.9% (12.9% at year end 2018). Management felt that this was a more appropriate model than one weighted to market based information. The expectations for growth are higher than market

rates given the infusion of funds that Medicover is likely to make over 2019 and the resulting boost to growth and profitability above the hospital sector averages in India. This gives a more prudent and more reliable estimation of the eventual liability likely to be payable. As the contractual obligation is payable regardless of subsequent assistance in areas identified above, the total liability is recognised at acquisition and subequently remeasured at fair value at each reporting date with differences accounted through profit or loss.
e) The fair value of contingent considerations payable is based on an estimated outcome of the conditional purchase price/contingent payments arising from contractual obligations. This is initially recognised as part of the purchase price and subsequently fair valued with changes recorded in the profit or loss. An additional €5.0m has been recognised as contingent consideration relating to acquisitions based on future performance targets. No additional material changes have occurred to any related assumptions over the quarter until 30 June 2019.
No financial assets or financial liabilities have been reclassified between the valuation categories in 2019.
As described in section b) above, the Group has entered into certain call and put option agreements over shares of an associate. The strike price of these acquisitions/ subscriptions is to be determined based upon formulas linked to profitability with price caps in some cases. The fair value of these options was determined using valuation techniques which rely on some observable inputs, including volatility of share prices of listed entities in the same field and market profit growth rates of similar listed entities, but also
rely on unobservable inputs particularly in respect of inputs specific to the associate. The Group views these fair value calculations as reasonable given comparable observable price metrics that are considerably higher even when adjusted for liquidity and size. The accounting policy of the Group is that upon initial recognition of the financial instruments the Group recognises the fair value and will account for the difference between cost and fair value as an adjustment to bring the carrying amount in line with the transaction price. The net profit will be deferred by reducing the initial carrying amount of the net asset. This reduction will then be reversed in the income statement over the life of the options until exercised or lapsed. Management has judged that this gives assurance of the underlying value of the shares covered by the options as the associate increases its profitability. Subsequent fair value re-measurement of the options at each reporting date is reflected in profit or loss along with the release of the initial deferral.
The exercise price of the call options to increase the investment is based on a surrogate for the fair value of the shares at the date of exercise. A valuation of the four call options and two put options has been performed using a Monte Carlo simulation model at inception with a defined set of variables and volatility. The fair value of the call and put options amounted to 7.7m (€7.6m at year end 2018) and €6.1m (€6.0m at year end 2018) respectively at the end of the quarter. Any subsequent change in fair value will be recognised in profit or loss.
The aggregate difference yet to be recognised in the profit or loss at the beginning and end of the period and a reconciliation of the changes of the balance during the period for derivative assets and liabilities are outlined below:

| €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|
| Call Options | |||||
| Opening balance | 5.4 | 4.9 | 4.7 | 4.2 | 4.2 |
| Increase due to options acquired/recognised | - | 0.0 | - | 0.4 | 0.4 |
| Deferral of profit of options acquired | - | -0.0 | - | -0.4 | -0.4 |
| Decrease due to options exercised and transfer to cost of investment |
- | -1.0 | - | -4.3 | -6.1 |
| Release of profit deferral | 0.5 | 1.3 | 0.9 | 4.3 | 4.9 |
| Revaluation of options | -0.1 | 0.2 | 0.2 | 1.2 | 1.7 |
| Closing balance | 5.8 | 5.4 | 5.8 | 5.4 | 4.7 |
| Put Options | |||||
| Opening balance | -1.1 | -1.7 | -0.6 | -1.5 | -1.5 |
| Increase due to options acquired/recognised | - | -0.0 | - | 0.3 | -0.3 |
| Deferral of loss of options acquired | - | 0.0 | - | -0.3 | 0.3 |
| Release of loss deferral | -0.3 | -0.3 | -0.6 | -0.6 | -1.1 |
| Revaluation of options | 0.2 | 2.0 | -0.0 | 2.1 | 2.0 |
| Closing balance | -1.2 | 0.0 | -1.2 | 0.0 | -0.6 |
The following table summarises the quantitative information about the significant unobservable inputs used in level 3 fair value measurements.
| Fair Value at (€m) | Range of inputs | |||||
|---|---|---|---|---|---|---|
| Description | 30 Jun 2019 |
31 Dec 2018 |
Unobservable inputs |
30 Jun 2019 |
31 Dec 2018 |
|
| Put option (liquidity obligation with non controlling shareholder) |
16.4 | 15.7 | Earnings growth factor Risk adjusted discount rate |
5.5% 0.9% |
5.5% 1.7% |
|
| Call option1 (asset to acquire additional associate's shares) |
7.7 | 7.6 | Risk free rate EBITDA growth rate |
7.2%-7.5% 9.2% |
7.2%-7.5% 9.2% |
|
| Put option2 (liability to acquire associate's shares held by other investors) |
6.1 | 6.0 | Risk free rate EBITDA growth rate |
7.2%-8.1% 9.2% |
7.2%-8.1% 9.2% |
|
| Economic interest option (other non-current liability) |
11.1 | 11.2 | 4 year projected CAGR EBITDA Risk adjusted discount rate |
33.6% 12.9% |
33.6% 12.9% |
|
| Contingent acquisition consideration payable |
11.2 | 6.2 | Risk adjusted discount rate | 5.5%-8.7% | 5.5%-8.5% |
1 Fair value of the call option includes the unamortised deferral of day one profit.
2 Fair value of the put option includes the unamortised deferral of day one loss.

Share capital as at 30 June 2019 was €27.1m represented by 135,735,195 shares divided into 78,820,351 class A shares, 54,514,844 class B shares and 2,400,000 class C shares. The quota value was €0.2 per share. Celox Holding AB owned 47,157,365 shares with 55.8% of the voting rights. The class C shares are all held by the Company in
The Group's financial position as at 30 June 2019 and 30 June 2018 and profit for the 6 months period then ended were not significantly affected by conjunction with the long-term performance-based share programs.
The number of shares used to calculate the basic and diluted earnings per share is 133,335,195 (133,335,195).
the existence of balances and transactions with related parties.
| €m | 30 Jun 2019 |
30 Jun 2018 |
31 Dec 2018 |
|---|---|---|---|
| Financial debt | |||
| Non-current loans payable | 143.6 | 71.6 | 126.4 |
| Current loans payable | 95.0 | 3.4 | 4.9 |
| Non-current lease liabilities | 116.0 | 96.1 | 96.4 |
| Current lease liabilities | 30.4 | 26.1 | 29.0 |
| Total financial debt | 385.0 | 197.2 | 256.7 |
| Less: cash balance | -53.0 | -36.6 | -38.4 |
| Total net financial debt | 332.0 | 160.6 | 218.3 |
| 30 Jun | 30 Jun | 31 Dec | |
| €m | 2019 | 2018 | 2018 |
| Other financial liabilities | |||
| Non-current | 28.7 | 28.7 | 28.6 |
| Current | 5.3 | 4.7 | 3.6 |
| Total other financial liabilities | 34.0 | 33.4 | 32.2 |
€89.2m of the Group's debt is funded under the commercial paper program launched during the
The acquisition of 100% of the voting rights in Dentim, a dental company operating 3 dental clinics in Poland, was completed early July 2019 for a total estimated consideration of €3.6m.
quarter, presented in current loans payable.
After the reporting period, the outstanding noncontrolling interest of 21.5% in OK System, a sports/fitness employee benefit operator in Poland, was acquired for a total consideration of €2.3m.
In its decision making, the Group uses some alternative performance measures (APMs) that are not defined in IFRS. They are used because they provide information useful to assess the Group's development and performance. These measures should not be viewed in isolation or as an alternative to the measures presented in
accordance with IFRS. These APMs may not be comparable to similar measures presented by other companies. The main alternative performance measures used by the Group are explained and reconciled below.

Represents revenue recognised from acquired businesses in the first 12 months from the acquisition. This represents non-organic growth. If there is significant expansion of the acquired business post-acquisition due to investments made post-acquisition and such revenue can be readily identified then this additional revenue is excluded from acquired revenue.
Organic revenue combines real internally generated growth and also comprises price changes. This represents the growth of the business after removing the impact of acquisitions and disposals or other scope changes as well as exchange rate movements. This provides a "like for like" comparison with the previous year or period in constant scope and constant currency enabling a deeper understanding of the business and evolution of revenue.
The revenue of an acquired business is generally excluded for the 12 months following the business combination, but revenue generated by postacquisition expansion of the business due to investments made subsequent to acquisition, if significant, are included. Revenue of disposed businesses is removed from the comparatives for the 12 months prior to the disposal. The effects of changes in foreign exchange rates are calculated as the current year's revenue less the current year's revenue converted at the prior year's rates.
Organic revenue growth is the comparison of organic revenue for the current year to the comparable prior year revenue, expressed as a percentage or absolute figure.
Earnings before interest, other financial income/(expense), tax, amortisation and impairment, other income/(costs) and share of profit/(loss) of associates.
Earnings before interest, other financial income/(expense), tax, amortisation, depreciation and impairment, other income/(costs) and share of profit/(loss) of associates. This is a measure that investors and other users find useful in appraising and understanding the Group's activities.
EBITDA, as defined above, reduced by depreciation and interest charges associated with leases. This APM gives a measure of performance that equates more closely to the cash flow of the
business and is used by management in making decisions and accountability.
EBITA, as defined above, adjusted for non-cash equity settled share-based payments as well as merger and acquisition related expenses.
EBITDA, as defined above, adjusted for non-cash equity settled share-based payments as well as merger and acquisition related expenses.
Adjusted EBITDA, as defined above, reduced by depreciation and interest charges associated with leases.
EBITA as a percentage of revenue.
EBITDA as a percentage of revenue.
EBITDAaL as a percentage of revenue.
Adjusted EBITA as a percentage of revenue.
Adjusted EBITDA margin Adjusted EBITDA as a percentage of revenue.
Adjusted EBITDAaL as a percentage of revenue.
Operating profit as a percentage of revenue.
Gross profit as a percentage of revenue.
Profit for the period as a percentage of revenue.
Net financial debt represents the net level of financial debt contracted by the Group with external parties (banks, bonds) upon which interest is charged, and lease liabilities recognised under IFRS 16 net of cash and cash equivalents. Refer to note 8 for further details.
Number of individuals covered under a pre-paid subscription or insurance plan within the Healthcare Services segment at the end of the relevant period.

Number of laboratory tests performed within the Diagnostic Services segment for the period referenced.
| Reconciliation to EBITDAaL, €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
Jan-Dec 2018 |
|---|---|---|---|---|---|
| Operating profit | 10.1 | 7.5 | 21.4 | 16.5 | 33.7 |
| Amortisation | 1.5 | 0.5 | 2.7 | 1.1 | 3.3 |
| EBITA | 11.6 | 8.0 | 24.1 | 17.6 | 37.0 |
| Depreciation | 15.7 | 13.2 | 30.7 | 25.8 | 53.7 |
| EBITDA | 27.3 | 21.2 | 54.8 | 43.4 | 90.7 |
| Non-cash equity settled share-based payments | 0.5 | 0.4 | 0.8 | 0.6 | 1.6 |
| Merger and acquisition related expenses | 1.6 | 0.2 | 1.8 | 0.5 | 1.8 |
| Adjusted EBITDA | 29.4 | 21.8 | 57.4 | 44.5 | 94.1 |
| Right-of-use depreciation | -8.0 | -6.6 | -15.5 | -12.9 | -26.6 |
| Interest on lease obligations | -1.8 | -1.4 | -3.3 | -2.8 | -5.6 |
| Adjusted EBITDAaL | 19.6 | 13.8 | 38.6 | 28.8 | 61.9 |
| Less: EBITDA adjustments (see above) | -2.1 | -0.6 | -2.6 | -1.1 | -3.4 |
| EBITDAaL | 17.5 | 13.2 | 36.0 | 27.7 | 58.5 |
| Revenue | 202.9 | 161.1 | 402.6 | 323.0 | 671.6 |
| Operating profit margin, % | 5.0% | 4.7% | 5.3% | 5.1% | 5.0% |
| EBITDA margin, % | 13.5% | 13.2% | 13.6% | 13.4% | 13.5% |
| EBITDAaL margin, % | 8.6% | 8.2% | 8.9% | 8.6% | 8.7% |
| Adjusted EBITDA margin, % | 14.5% | 13.5% | 14.3% | 13.8% | 14.0% |
| Adjusted EBITDAaL margin, % | 9.7% | 8.6% | 9.6% | 8.9% | 9.2% |
| Profit margin, % | 2.4% | 3.4% | 2.9% | 4.3% | 3.6% |
| Reconciliation to organic revenue, €m | Apr-Jun 2019 |
Apr-Jun 2018 |
Jan-Jun 2019 |
Jan-Jun 2018 |
|---|---|---|---|---|
| Revenue | 202.9 | 161.1 | 402.6 | 323.0 |
| Less: acquired revenue impact | -20.2 | -35.3 | ||
| Revenue excluding acquisitions | 182.7 | 367.3 | ||
| Currency effect | 1.3 | 2.7 | ||
| Organic revenue | 184.0 | 370.0 | ||
| Organic revenue growth | 14.2% | 14.6% |
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