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SYNLAB AG — Interim / Quarterly Report 2021
Nov 12, 2021
723_10-q_2021-11-12_530cbc6c-5918-4773-852c-a875069a6276.pdf
Interim / Quarterly Report
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QUARTERLY REPORT 30 September 2021

| Contents | Page |
|---|---|
| Business performance of SYNLAB Group | 3 |
| Condensed consolidated statement of income | 11 |
| Condensed consolidated statement of comprehensive income | 12 |
| Condensed consolidated statement of financial position | 13 |
| Condensed consolidated statement of changes in equity | 15 |
| Condensed consolidated statement of cash flows | 16 |

Business Performance of SYNLAB Group
Key financials
| Simplified P&L | ||||||
|---|---|---|---|---|---|---|
| In EUR million | 9M 2021 | 9M 2020 | Growth | |||
| Revenue | 2,772.3 | 1,690.9 | 64% | |||
| Gross profit | 2,082.9 | 1,253.9 | 66% | |||
| AEBITDA | 908.0 | 384.5 | x2.4 | |||
| As % of revenue | 32.8% | 22.7% | +10.1pts | |||
| Adjusted operating profit (AOP) | 761.4 | 257.2 | x3.0 | |||
| As % of revenue | 27.5% | 15.2% | +12.3pts | |||
| Operating profit | 689.1 | 79.7 | x8.6 | |||
| Financial result | (86.6) | (142.4) | (39%) | |||
| Income tax expenses | (145.1) | (36.1) | n.a. | |||
| Adjusted net profit | 514.9 | 67.6 | +447 | |||
| Net profit (Group share) | 471.3 | (93.7) | +565 | |||
| Basic EPS (€) | 2.22 | (0.47) | n.a. | |||
| Simplified Cash flow | ||||||
| In EUR million | 9M 2021 | 9M 2020 | Growth | |||
| Operating cash flow | 786 | 192 | +595 | |||
| Unlevered Free Cash Flow | 630 | 60 | +570 | |||
| Net debt and leverage | ||||||
| In EUR million | Sep. 2021 | Dec. 2020 | Improvement | |||
| Net debt | 1,503 | 2,235 | (732) | |||
| Adjusted net debt | 1,513 | 2,254 | (740) | |||
| Leverage ratio | x1.3 | x3.3 | (x2.0) |
Financial highlights
Strong revenue growth delivered since the beginning of the year
9M 2021 revenue was up 64% to EUR 2,772 million (9M 2020: EUR 1,691 million), showing SYNLAB's ability to combine both leadership in the COVID-19 response and good execution of its underlying growth strategy:
- the net revenue contribution from COVID-19 was EUR 1.137 million1 during the nine months to September 2021, with SYNLAB performing 20.8 million PCR and 3.5 million non-PCR tests during the period;
- underlying growth was 9.1%: SYNLAB was able to deliver underlying organic growth over 3% each quarter since the beginning of the year, notably thanks to the "For You" growth initiatives. In the last two quarters, growth was further supported by the contribution of the South-East London hospital outsourcing contract (SEL).
Volume growth strongly improved profitability
For 9M 2021 adjusted EBITDA was EUR 908 million and the margin 32.8%, an increase of 10.1 percentage points compared to 9M 2020 reflecting the record growth experienced during the first 9 months of the year.
Margins have further benefited from productivity and procurement savings related to the SALIX program (EUR 15 million in 9M 2021), as well as procurement efficiencies for PCR test reagents and strict management of personnel and other OPEX costs.
Net profit at all-time high
Adjusted operating profit reached EUR 761 million at the end of September 2021 (EUR 257 million in 9M 2020). Post adjustments, which were mainly comprised of customer relationship amortization, IPO-related costs and acquisitionsrelated costs, operating profit was EUR 689 million (EUR 80 million in 9M 2020).
The key bridge items from operating profit to net profit were:
- a EUR 87 million net financial expense, improving by EUR 56 million compared to 9M 2020. This major decrease came from a combination of lower borrowings and lower borrowing costs. The SYNLAB average cost of borrowing reduced from 4.7% in 9M 2020 to 2,5% in 9M 2021;
- a EUR 145 million tax expense (EUR 36 million in 9M 2020). The effective tax rate was ~24% for the period, lower than the 28% normalized rate due to the use of tax attributes carried forward;
- a EUR 17.9 million positive impact from a residual sale of the A&S business in Q1 2021, classified as discontinued operations.
Net profit (Group share) reached EUR 471 million (EUR (94) million in 9M 2020), and basic earnings per share were up at EUR 2.222 .
Record cash flow generation
Operating cash flow from continuing operations expanded materially, to EUR 786 million at the end of 9M 2021, driven by profit growth. The negative impact of COVID-19 testing activity on working capital has materially reduced over the
1 consisting of EUR 1,166 million testing revenue (~EUR 373 million in 9M 2020) netted against an estimated EUR (29) million attrition impact (EUR (171) million in 9M 2020)
2 Based on 212,745,098 weighted average shares outstanding

past quarters, with inventory going down and DSOs normalizing to 57 days at the end of 9M 2021, compared with 80 days at the end of 9M 2020.
Total CAPEX (including leases and related interest payments) was EUR 156 million in 9M 2021 (EUR 132 million in 9M 2020) representing 5.6% of 9M 2021 revenue (7.8% in 9M 2020). It included EUR 9 million of COVID-19 related CAPEX.
Despite the CAPEX increase in absolute terms, strong operating cash flow led to record unlevered free cash flow of EUR 630 million in 9M 2021. The cash conversion ratio (unlevered free cash flow / adjusted EBITDA) was 69%.
Strong balance sheet
At the end of September 2021, the adjusted net debt stood at EUR 1,513 million compared with EUR 2,254 million at the end of December 2020. The leverage ratio3 was at 1.3x compared with 3.3x at the end of 2020, the lowest level since the creation of the SYNLAB Group, attributable to the EUR 394 million of net proceeds from its successful IPO and the strong cash generation since the beginning of the year.
Exceeding EUR 200 million of M&A spend in 2021
Since the beginning of the year, SYNLAB has completed 18 acquisitions for a total enterprise value of about EUR 250 million. These acquisitions represent additional annualized revenue of around EUR 113 million or 5,5% growth of the base business4 . In addition to the 10 acquisitions completed in H1 2021, SYNLAB closed 3 acquisitions in Q3 2021 and 5 more since the beginning of Q4 2021, four of which are located in the South region and one in France.
Most of them were bolt-on acquisitions, with SYNLAB also completing two mid-sized deals in Italy and Mexico:
- Gruppo Tronchet (EUR 22 million revenue in 2020), a strong regional player to strengthen SYNLAB's number one position in Italy with 17 patient-centric healthcare centers in and around Bologna.
- Laboratorio Médico Polanco -LMP- and Laboratorio Clinicos de Puebla -LCR- (EUR 55 million revenue in 2020), a top 4 player in Mexico (100 diagnostic service points and 1,700 skilled employees) as a platform to further consolidate the Mexico and Latam markets.
The pipeline for future acquisitions is strong and diversified, and SYNLAB keeps a very disciplined acquisition approach.
3 Net debt to LTM pro-forma adjusted EBITDA
Based on 2020 revenue

Segment review
| In EUR million | Revenue | AOP | ||||||
|---|---|---|---|---|---|---|---|---|
| 9M 2021 | 9M 2020 | Organic Growth |
Underlying Growth |
9M 2021 | 9M 2020 | Margin 9M 2021 |
Margin 9M 2020 |
|
| France | 628.6 | 412.7 | 49.8% | 1.4% | 166.8 | 88.4 | 26.5% | 21.4% |
| Germany | 512.1 | 384.2 | 33.0% | 2.8% | 110.2 | 41.2 | 21.5% | 10.7% |
| South | 785.3 | 538.2 | 44.9% | 4.4% | 189.7 | 76.2 | 24.2% | 14.2% |
| North & East | 846.4 | 355.8 | 137.2% | 30.0% | 294.7 | 51.4 | 34.8% | 14.4% |
| SYNLAB Group | 2,772.3 | 1,690.9 | 62.8% | 9.1% | 761.4 | 257.2 | 27.5% | 15.2% |
France (23% of 9M Group revenue)
9M 2021 total growth was 52%, lifted by high COVID-19 testing volumes since the beginning of the year. Underlying organic growth was 1.4%, with solid volume growth offsetting the regulatory price decrease.
9M 2021 AOP was broadly in line with the first half of the year at 26.5% (+5.1 percentage points compared with 9M 2020), reflecting the sustained margin-accretive impact of high COVID-19 testing volumes.
SYNLAB closed three bolt-on acquisitions in France in the first quarter of 2021 for a total annualized revenue of ~EUR 14 million. After a strong start to the year, M&A activity reduced over the period due to SYNLAB's selective approach, with a primary focus on small bolt-on acquisitions.
Germany (18%)
9M 2021 total growth was 33%, including high COVID-19 testing volumes, in particular in the first two quarters of the year, and underlying organic growth of 2.8%.
9M 2021 AOP margin remained elevated at 21.5% (+10.8 percentage points compared with 9M 2020), reflecting the margin-accretive impact of COVID-19 testing volumes. The reduction in AOP margin in Q3 2021, to 9.9%, reflects the drop of COVID-19 volume and prices as well as one-off personnel expenses incurred in the quarter.
SYNLAB closed one bolt-on acquisition in the nine months of 2021 representing ~EUR 2 million in annualized revenues.
South (29%)
9M 2021 total growth was 46%, lifted by high COVID-19 testing volumes since the beginning of the year, peaking in Q2 2021. Underlying organic growth was 4.4%: the softer Q3 2021 growth came after two quarters above 5%:
- Switzerland (14% of South revenue) was still negative but improved quarter on quarter as the 2020 customer loss impact is phasing out;
- Iberia (31% of South revenue) recorded low single digit growth;
- Latam (16%) and Italy (39% of South revenue) achieved robust growth.
9M 2021 AOP margin remained elevated at 24.2% (+10.0 percentage points compared with 9M 2020), reflecting the margin-accretive impact of high COVID-19 testing and robust underlying activity volumes since the beginning of the year.
SYNLAB closed nine acquisitions in the South segment in the first nine months of 2021, located in Italy, Spain and Mexico, representing total annualized revenue of ~EUR 35 million. This includes a mid-sized deal in Italy. SYNLAB also reached an agreement for the purchase of another mid-sized lab business in Mexico (see M&A paragraph p.5).
North & East (30%)
9M 2021 total growth was a record 138% reflecting both the high COVID-19 contribution and a 30% underlying organic growth at the end September. The UK (24% of revenue) recorded a triple digit percentage growth thanks to the contribution of the SEL contract.
Excluding SEL, underlying organic growth was a robust 5.3% in 9M 2021.
- growth was particularly strong in emerging market in H1 2021;
- more mature North markets (50% of North & East revenue) also grew nicely, highlighting the benefits of "For You" growth initiatives such as retail initiatives in the Nordics or connecting to doctors in Austria.
9M 2021 AOP margin was a very strong 34.8% (+20.4 percentage points compared with 9M 2020), reflecting the margin-accretive impact of high COVID-19 testing, including government testing contracts in North Europe, and robust underlying activity volumes since the beginning of the year.
Subsequent events
On 2 November, SYNLAB completed the acquisition of Laboratorio Médico Polanco -LMP- and Laboratorio Clinicos de Puebla -LCR. In addition to LMP, SYNLAB has closed 4 bolt-on acquisitions since the start of Q4 2021.
On 28 October, SYNLAB prepaid EUR 75 million of loans due in 2026.
Outlook
Over-delivering on 2021 IPO targets
At IPO, SYNLAB presented a growth strategy of customer centric medical excellence. The focus was notably on: 1) consistently outperforming market growth through the implementation of growth initiatives ("For You" initiatives), 2) successfully delivering in 2021 on the biggest hospital outsourcing contract in the UK ("SEL" contract) and 3) deploying around EUR 200 million to continue to consolidate the highly fragmented medical diagnostic services market.
At the same time, SYNLAB aimed at maintaining its leadership in the SARS-CoV-2 pandemic response.
Six months after its IPO, SYNLAB is showing excellent progress on all areas of focus:

| At IPO | Current guidance |
Status | Key enablers | |
|---|---|---|---|---|
| Organic growth (ex COVID-19) | ~10% | ~10% | Delivering | -ForYou -SEL |
| M&A (EV, in €m) | ~200 | >200 | Acceleration | -Strong & diversified pipeline -Mid-sized M&A -Price discipline |
| COVID-19 revenue (€m) | ~800 (2021) ~500 (2022) |
>1,300 (2021) | 2 years in 1 | -Best medical, commercial, operational execution |
Consequently, the current 2021 financial guidance shows very material upside compared to the IPO guidance. This guidance is adjusted slightly upward today to reflect rising COVID-19 incidence rates in a number of SYNLAB countries since October:
| At IPO | Current guidance | Outperformance | |
|---|---|---|---|
| Revenue (€bn) | >3.0 | >3.5 | >+0.5 |
| Total growth | ~17% | >34% | >x2 |
| AEBITDA (€m) | ~8005 | >1,000 | >200 |
| AEBITDA margin | ~26% | >30% | >4ppts |
| Unlevered FCF (€m) | 300-350 | >700 | >350 |
Thanks to the strong cash flow generation, SYNLAB can further accelerate its development plan, notably through M&A.
Consensus of analysts as of 7 June 2021
FY 2022 outlook
In 2022, SYNLAB will continue with the implementation of its growth strategy: outperforming market growth through initiatives and continuing to grow through M&A. The Group also expects COVID-19 testing revenue to decline but to remain significant due to SYNLAB's large-scale, geographically diversified and medically relevant service offering.
Therefore, SYNLAB expects 2022 revenue and EBITDA margin to remain significantly higher than the pre-COVID period (2019):
| 2022 outlook | Vs. 2019 | |
|---|---|---|
| Revenue (€bn) | ~2.9 | +1.0 |
| AEBITDA margin | 23-25% | >2.2ppts |
| M&A spend (€m) | >200 | >100 |
Mid-term financial outlook (set at IPO)
| Mid-term outlook | |
|---|---|
| Organic growth6 | 3%+ |
| Total growth6 | ~10% |
| AEBITDA margin | 23% |
| AEBITDA to unlevered FCF conversion | 45-50% |
| M&A spend (€m) | 200 |
Per year, using 2019 as base year

Supplementary materials
Q3 financial highlights
| Simplified P&L | |||||
|---|---|---|---|---|---|
| In EUR million | Q3 2021 | Q3 2020 | Growth | ||
| Revenue | 849.3 | 708.1 | 20% | ||
| Gross profit | 636.1 | 517.9 | 23% | ||
| AEBITDA | 245.3 | 191.6 | x1.3 | ||
| As % of revenue | 28.9% | 27.1% | +1.8pts | ||
| Adjusted operating profit (AOP) | 192.1 | 146.8 | x1.3 | ||
| As % of revenue | 22.6% | 20.7% | +1.9pts | ||
| Operating profit | 173.8 | 8.1 | x21.5 | ||
| Financial result | (11) | (42) | +31 | ||
| Income tax expenses | (33) | (31) | (3) | ||
| Adjusted net profit | 143.3 | 60.1 | +83 | ||
| Net profit (Group share) | 128.0 | (72.2) | +200 | ||
| Simplified Cash flow | |||||
| In EUR million | Q3 2021 | Q3 2020 | Growth | ||
| Operating cash flow | 263 | 99 | +164 | ||
| Unlevered Free Cash Flow | 202 | 51 | +151 |
Q3 segment reporting
| In EUR million | Revenue | AOP | ||||||
|---|---|---|---|---|---|---|---|---|
| Q3 2021 | Q3 2020 | Organic Growth |
Underlying Growth |
Q3 2021 | Q3 2020 | Margin Q3 2021 |
Margin, Q3 2020 |
|
| France | 187.0 | 176.8 | 3.3% | 3.4% | 50.1 | 47.7 | 26.8% | 27.0% |
| Germany | 144.9 | 149.9 | (3.3)% | 2.6% | 14.3 | 20.4 | 9.9% | 13.6% |
| South | 239.8 | 232.0 | 1.2% | 2.6% | 50.5 | 45.6 | 21.1% | 19.7% |
| North & East | 277.6 | 149.5 | 83.6% | 44.1% | 77.2 | 33.2 | 27.8% | 22.2% |
| SYNLAB Group | 849.3 | 708.1 | 18.1% | 12.2% | 192.1 | 146.8 | 22.6% | 20.7% |
Conde nse d c onsoli da te d Sta tement of I nc ome
Condensed Consolidated Statement of Income For the nine months ended 30 September 2021
| For the nine months ended 30 September 2021 2020 * |
|||
|---|---|---|---|
| Continuing operations | € 000 | € 000 | |
| Revenue | 2,772,338 | 1,690,863 | |
| Material and related expenses | (689,427) | (437,000) | |
| Payroll and related expenses | (826,068) | (633,524) | |
| Other operating income | 24,104 | 13,301 | |
| Other operating expenses | (373,671) | (251,875) | |
| Depreciation and amortisation | (184,858) | (166,219) | |
| Operating profit before acquisition, restructuring and impairment of non-current assets |
722,418 | 215,546 | |
| Restructuring and other significant expenses | (27,147) | (15,602) | |
| Acquisitions related income / (expenses) | (6,159) | (5,254) | |
| Impairment of non-current assets | - | (115,003) | |
| Operating profit | 689,112 | 79,687 | |
| Share of loss of associates and other non-controlling interest | (1,817) | (983) | |
| Profit on disposal of investment | (50) | (241) | |
| Finance income | 24,524 | 14,343 | |
| Finance costs | (111,146) | (156,699) | |
| Profit / (loss) before taxes | 600,623 | (63,893) | |
| Income tax expenses | (145,105) | (36,089) | |
| Profit / (loss) for the period from continuing operations | 455,518 | (99,982) | |
| Profit / (loss) for the period from discontinued operations | 17,868 | 7,555 | |
| Profit / (loss) for the period | 473,386 | (92,427) | |
| Profit / (loss) attributable to non-controlling interests | 2,092 | 1,262 | |
| Profit / (loss) attributable to equity holders of the parent company | 471,294 | (93,689) | |
| Profit / (loss) for the period | 473,386 | (92,427) | |
| Basic earnings per share (in EUR) | 2.22 | (0.47) | |
| Diluted earnings per share (in EUR) | 2.22 | (0.47) |
* Restated to reflect the Group's discontinued operations in accordance with IFRS 5
Condensed Consolidated Statement of Comprehensive Income

Condensed consolidated Statement of Comprehensive Income For the nine months ended 30 September 2021
| For the nine months ended 30 September |
||
|---|---|---|
| 2021 | 2020 | |
| € 000 | € 000 | |
| Net profit / (loss) for the period | 473,386 | (92,427) |
| Actuarial gains or losses on pension obligations | 5,631 | (2,828) |
| Taxes on actuarial gains or losses on pensions obligations | (1,135) | 490 |
| Items that will not be reclassified to profit or loss (a) | 4,496 | (2,338) |
| Foreign exchange gains/losses | 6,234 | (6,812) |
| Reclassification from translation reserve to income statement arising on divestment |
- | (3,080) |
| Items that may be reclassified subsequently to profit or loss (b) | 6,234 | (9,892) |
| Other comprehensive income for the year (a) + (b) | 10,730 | (12,230) |
| Total consolidated comprehensive profit / (loss) attributable to | 484,116 | (104,657) |
| Equity holders of the parent company | 481,928 | (105,749) |
| Non-controlling interests | 2,188 | 1,092 |
| Total consolidated comprehensive profit / (loss) | 484,116 | (104,657) |

Condensed Consolidated Statement of Financial Position
Condensed Consolidated Statement of Financial Position 30 September 2021
| As at 30 September | As at 31 December | ||
|---|---|---|---|
| 2021 | 2020 | ||
| € 000 | € 000 | ||
| ASSETS | |||
| Goodwill | 2,326,233 | 2,212,128 | |
| Intangible assets | 705,689 | 715,380 | |
| Property, plant and equipment | 231,874 | 217,069 | |
| Right of use assets | 496,374 | 401,109 | |
| Investments in associates | 4,768 | 4,574 | |
| Other non-current assets | 47,274 | 38,611 | |
| Deferred tax assets | 32,082 | 29,017 | |
| Total non-current assets | 3,844,293 | 3,617,888 | |
| Inventories | 103,620 | 149,055 | |
| Trade accounts receivables | 544,565 | 534,910 | |
| Other current assets | 104,413 | 72,194 | |
| Cash and cash equivalents | 619,851 | 904,900 | |
| Assets classified as held for sale | - | 4,242 | |
| Total current assets | 1,372,448 | 1,665,301 | |
| Total assets | 5,216,741 | 5,283,189 |

Conde nse d Cons oli dat ed S tat ement of Changes in E qui ty
Condensed Consolidated Statement of Financial Position 30 September 2021
| As at 30 September | As at 31 December | |
|---|---|---|
| 2021 | 2020 | |
| € 000 | € 000 | |
| EQUITY AND LIABILITIES | ||
| EQUITY | ||
| Contributed capital | 222,222 | 134,388 |
| Additional paid-in capital | 3,788,812 | 1,523,590 |
| Cumulative translation adjustment | -2,228 | -8,365 |
| Accumulated deficit | -1,926,412 | -443,973 |
| Total parent company interests | 2,082,394 | 1,205,640 |
| Non-controlling interests | -1,269 | -2,088 |
| Total equity | 2,081,125 | 1,203,552 |
| Loans and borrowings (non-current) | 1,579,936 | 2,680,895 |
| Non-current lease liabilities | 428,973 | 338,166 |
| Employee benefits liabilities | 47,422 | 47,806 |
| Non-current provisions | 2,474 | 2,458 |
| Contract liabilities | 7,496 | - |
| Other non-current liabilities | 54,636 | 27,191 |
| Deferred tax liabilities | 175,196 | 171,638 |
| Total non-current liabilities | 2,296,133 | 3,268,154 |
| Current loans and borrowings | 13,197 | 36,750 |
| Current lease liabilities | 100,559 | 83,745 |
| Trade accounts payable | 314,904 | 386,523 |
| Contract liabilities | 4,946 | 22,935 |
| Current provisions | 10,921 | 6,440 |
| Income tax liabilities | 120,088 | 48,326 |
| Other current liabilities | 274,868 | 224,449 |
| Liabilities directly associated with assets classified as held for sale |
- | 2,315 |
| Total current liabilities | 839,483 | 811,483 |
| Total liabilities | 3,135,616 | 4,079,637 |
| Total equity and liabilities | 5,216,741 | 5,283,189 |
Conde nse d Cons oli dat ed S tat ement of Cas h Flow
Condensed Consolidated Statement of Changes in Equity For the nine months ended 30 September 2021
| Contributed capital |
Additional paid-in capital |
Cumulative translation adjustment |
Accumulat ed deficit |
Total | Non controlling interests |
Equity | |
|---|---|---|---|---|---|---|---|
| € 000 | € 000 | € 000 | € 000 | € 000 | € 000 | € 000 | |
| Balance as at 1 January 2021 | 134,388 | 1,523,590 | (8,365) | (443,973) | 1,205,640 | (2,088) | 1,203,552 |
| Net profit for the period | - | - | - | 471,294 | 471,294 | 2,092 | 473,386 |
| Other comprehensive income | - | - | 6,137 | 4,497 | 10,634 | 96 | 10,730 |
| Total comprehensive income for the period |
- | - | 6,137 | 475,791 | 481,928 | 2,188 | 484,116 |
| Issue of share capital | 222,222 | 3,776,928 | - | - | 3,999,150 | - | 3,999,150 |
| Reorganisation of equity | (134,388) | (1,506,455) | - (1,958,255) (3,599,098) | - (3,599,098) | |||
| Expenses for equity contribution | - | (6,000) | - | - | (6,000) | - | (6,000) |
| Acquisition of non-controlling interests | - | - | - | 25 | 25 | (1,365) | (1,340) |
| Credit to equity for equity settled share based payments |
- | 749 | - | - | 749 | - | 749 |
| Dividends | - | - | - | - | - | (4) | (4) |
| Balance as at 30 September 2021 | 222,222 | 3,788,812 | (2,228) (1,926,412) | 2,082,394 | (1,269) | 2,081,125 |
| Contributed capital |
Additional paid-in capital |
Cumulative translation adjustment |
Accumulat ed deficit |
Total | Non controlling interests |
Equity | |
|---|---|---|---|---|---|---|---|
| € 000 | € 000 | € 000 | € 000 | € 000 | € 000 | € 000 | |
| Balance as at 1 January 2020 | 134,388 | 1,519,640 | (6,219) | (698,611) | 949,198 | (1,737) | 947,461 |
| Net profit for the period | - | - | - | (93,689) | (93,689) | 1,262 | (92,427) |
| Other comprehensive income | - | - | (9,722) | (2,338) | (12,060) | (170) | (12,230) |
| Total comprehensive income for the period | - | - | (9,722) | (96,027) | (105,749) | 1,092 (104,657) | |
| Acquisition of non-controlling interests | - | - | - | 247 | 247 | 46 | 293 |
| Credit to equity for equity settled share based payments |
|||||||
| - | 2,775 | - | - | 2,775 | - | 2,775 | |
| Dividends | - | - | - | - | - | (1,686) | (1,686) |
| Balance as at 30 September 2020 | 134,388 | 1,522,415 | (15,941) | (794,391) | 846,471 | (2,285) | 844,186 |

Condensed Consolidated Statement of Cash Flows For the nine months ended 30 September 2021
| For the nine months ended 30 September |
|||
|---|---|---|---|
| 2021 | 2020 * | ||
| € 000 | € 000 | ||
| Operating profit | 689,112 | 79,687 | |
| Depreciation, amortisation, impairment | 184,856 | 281,228 | |
| Change in provisions | 2,326 | 1,629 | |
| Loss (income ) from the disposal of non-current assets | (67) | (75) | |
| Other non-cash revenues and expenses | 28,082 | 8,340 | |
| Operating cash flow before changes in net working capital | 904,309 | 370,809 | |
| Change in inventories | 53,811 | (53,264) | |
| Change in trade accounts receivable | (6,676) | (183,613) | |
| Change in trade accounts payable | (93,356) | 57,429 | |
| Change in other net working capital | 22,132 | 27,349 | |
| Income tax paid | (94,109) | (27,186) | |
| Cash flow from operating activities continuing operations | 786,111 | 191,524 | |
| Cash flow from operating activities discontinued operations | 1,021 | 30,622 | |
| Cash flow from operating activities (A) | 787,132 | 222,146 | |
| Acquisition of subsidiaries, net of cash acquired and changes | |||
| in debt related to acquisitions | (118,035) | (24,999) | |
| Purchase of intangibles and property, plant and equipment | (75,364) | (50,035) | |
| Sale of subsidiaries, net of cash disposed and changes in debt | 4,544 | - | |
| Proceeds from sale of intangibles and property, plant and equipment | 978 | 1,239 | |
| Cash paid for other non-current assets | (49) | (113) | |
| Cash received from other non-current assets | 24 | 255 | |
| Interest received | 568 | 639 | |
| Net cash from disposal of investments | 348 | 12,882 | |
| Dividends received | 290 | 281 | |
| Cash flow used in investing activities continuing operations | (186,696) | (59,851) | |
| Cash flow used in investing activities discontinued operations | (1) | (4,099) | |
| Cash flow (used in)/from investing activities (B) | (186,697) | (63,950) |
* Restated to reflect the Group's discontinued operations in accordance with IFRS 5

Condensed Consolidated Statement of Cash Flows For the nine months ended 30 September 2021
| For the nine months ended 30 September |
|||
|---|---|---|---|
| 2021 | 2020 * | ||
| € 000 | € 000 | ||
| Proceeds from share capital increase | 394,050 | - | |
| Interest paid | (92,016) | (112,867) | |
| New loans, borrowings and other financial liabilities | 727,627 | 1,050,833 | |
| Repayment of loans, borrowings and other financial liabilities | (1,844,717) | (966,838) | |
| Repayment of lease liabilities | (71,078) | (75,162) | |
| Dividends paid and other payments to non-controlling interests | (2,257) | (3,233) | |
| Cash flow used in financing activities continuing operations | (888,391) | (107,267) | |
| Cash flow used in financing activities discontinued operations | (22) | (6,880) | |
| Cash flow used in financing activities (C) | (888,413) | (114,147) | |
| TOTAL CASH FLOWS (A+B+C) | (287,978) | 44,049 | |
| Cash and cash equivalent at the beginning of the period | 904,707 | 238,580 | |
| Net foreign exchange differences | 2,903 | (5,765) | |
| Change cash and cash equivalent assets held for sale | - | - | |
| Cash and cash equivalents at the end of the period | 619,632 | 276,864 | |
| NET INCREASE/(DECREASE) IN CASH AND CASH EQUIVALENTS | (285,075) | 38,284 |
* Restated to reflect the Group's discontinued operations in accordance with IFRS 5
Munich, 10 November 2021
SYNLAB AG The Management Board Mathieu Floreani Sami Badarani