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2
Recent UpdatesRecent Updates
Bangkok Facility
• Renovation of all inpatient beds completed in May 2010
• Opened new Women’s Center in March 2010 and new Digestive Diseases Center in May 2010
• Healthy Living Club continues to attract domestic patients, with over 25,000 members as at May 2010
Bumrungrad International Limited
• Asian Hospital Inc. in the Philippines:
− Renovation completed; construction of a new 14-storey building, with additional outpatient & inpatient capacity, is in progress
− Bumrungrad International Limited’s shareholding in AHI increased to 56.4% from conversion of management fee into equity
• Asia Renal Care:
− Sale to be completed in July 2010
3
AgendasAgendas
• Overview and Corporate Information
• Bumrungrad International Hospital, Bangkok
• Bumrungrad International Limited
• Vitallife Corporation Limited
• Asia Global Research Company Limited
4
BHBH’’ss Core AttributesCore AttributesBangkok Flagship Facility
Medical Tourism
Quality
Financial Strength
Technology
Opportunistic Growth
Corporate Information
• 1st hospital in Asia to receive US JCI Accreditation (since 2002)
• JCI ‘Disease-Specific’ certifications: heart and stroke programs (2006), diabetes and kidney programs (2010)
• 1st private hospital in Thailand with Thai Hospital Accreditation (since 1999)
• 1st private hospital to receive Thailand Quality Class standard (2008) - based on US Baldrige Award
• Comprehensive hospital management system – Amalga
• Digitized PACS (Picture Archiving and Communication System) for imaging
• 1st hospital in Asia to implement:
− robotic pharmacy dispensing system
− automated laboratory system
• Diverse international patient base, with 40% international volume
• Treats over 400,000 international patients from 190 countries
• 31 representative offices
• Established specialized international services to accommodate international patients
• Proven revenue & profit growth, even through the economic crisis
• Stable margins
• Strong balance sheet (as at YE09):
−Net D/E 0.23x
−DSCR 24.8x
−ROA 14.9%
−ROE 24.1%
• Example: Sale of software in Global Care Solutions to Microsoft in 2007
• Other possible opportunities:
− Bumrungrad International Limited (international investments)
− Vitallife & VitechPro (wellness & anti-aging)
− Asia Global Research (clinical research)
• All new hospital, both inpatient and outpatient services, by mid-2010
• Room for additional capacity as needed:
−Current outpatient capacity of 4,500 visits per day vs. maximum capacity of 6,000 visits per day
−Current inpatient capacity of 484 beds vs. maximum capacity of over 600 beds
5
Fact SheetFact Sheet
Shareholding Structure
Others, 51.21%
Bangkok Insurance Pcl. , 13.17%
Sinsuptawee AM, 8.66%
Bangkok Bank Pcl., 1.08%
Istithmar, 5.94%
Temasek, 5.94%
UOB Kay Hian (HK) - Client Account ,
8.00%Littledown Nominees
Limited9, 6.00%
As of Apr 2010
Net Profit Contribution
Bumrungrad International
Hospital, Bangkok96.5%
Bumrungrad International
Limited3.5%
For the year 2009
Total Net Profit = THB 1,246 million
• Established in 1980; listed on SET in 1989• Major operations divided into Bangkok facility and international business
Bangkok FacilityFacilities
One of the largest and most sophisticated private hospitals in South-East Asia538 licensed inpatient beds and 4,500 outpatient capacity per dayThailand’s leading tertiary medical center
Accreditation1st hospital in Asia to receive US JCI Accreditation1st private hospital in Thailand with Thai Hospital Accreditation
Patient Volume & RevenueOver one million patients treated annuallyInternational following with over 400,000 international patients from 190 countries
Services19 specialist departments; 102 sub-specialist departments
International PresenceAsian Hospital Inc. in the Philippines with 217-bed capacityBumrungrad Al Mafraq Hospital, a public hospital in Abu Dhabi with 488 beds (management contract)
With a 30-year track record, BH is now the leading healthcare service provider in South-East Asian region
Corporate Information
6
Group StructureGroup StructureCore business of BH is the renowned Bumrungrad Hospital
Comprehensive wellness center specializing in preventive care
Vitallife Corporation Ltd.(“Vitallife”)
100.0%
Note: As of May 2010
31.5%
Asian Hospital Inc.(“AHI”)
56.4%
* Strategic partners of Bumrungrad International Limited are:- Istithmar 19.5%- Temasek 19.5%- Asia Financial Holding 19.5%- Bangkok Bank 10.0%
Bumrungrad Al Mafraq Hospital
ManagementContract
International business
BumrungradInternational Ltd.*
Asia Global Health Ltd.(“AGH”)
100.0%
Regional healthcare opportunities
Asia Global Research Co., Ltd.
(“AGR”)Clinical research
100.0%
Operates Bumrungrad International Hospital, Bangkok
Bumrungrad Hospital Public Company Limited
(“BH”)
Corporate Information
7
Management TeamManagement TeamBH’s management team comprises individuals with extensive experience in healthcare management
Mr. Dennis BrownCorporate CEO
K. Linda LisahapanyaManaging Director
Mr. Dennis BrownActing CEO
Bumrungrad International Ltd.
Note: Effective as at 1 Aug 2010
Mr. Theo SeilerCEO
Asian Hospital Inc.Philippines
Mr. Mack BannerCEO
Bumrungrad International, Bangkok
Mrs. Lee Chan YowCFO
Bumrungrad International, Bangkok
Ms. Karen CarterCOO
Bumrungrad International, Bangkok
Mr. John NickensCEO
Bumrungrad Al Mafraq Hospital Abu Dhabi, U.A.E.
Mr. Anthony TanCEO
Vitallife Corporation Ltd.
Mr. James MashCEO
Asia Global Research Co., Ltd.
Corporate Information
Dr. Sinn AnurasGroup Medical Director
8
Operating PerformanceOperating Performance 20052005--20092009Total Revenue
Net Income
EBITDA
1,6641,928
2,070 2,1552,258
0
500
1,000
1,500
2,000
2,500
3,000
2005 2006 2007 2008 2009
EBIT
DA
(TH
B m
m)
8% CAGR
829
6,8077,896
8,584
8,925 9,385
0
2,000
4,000
6,000
8,000
10,000
12,000
2005 2006 2007 2008 2009
Sale
s (T
HB
mm
)
8% CAGR
4581,0961,053
1,147
1,191 1,246
0
500
1,000
1,500
2,000
2005 2006 2007 2008 2009
Net
Inco
me
(TH
B m
m) 4% CAGR
DILUTED EPS
1.21 1.26
1.29
1.37 1.440.56
0.0
0.5
1.0
1.5
2.0
2005 2006 2007 2008 2009
Dilu
ted
EPS
(TH
B)
Source: Audited FS
Source: Audited FS Source: Audited FS
4% CAGR
One-time profit of THB 458 million in 2007 was share of profit in investment in GCS Thailand, netted off with impairment of hospital software system
9,413
BH reported a one-time gain on share of profit in investment in CDE Trading (previously GCS Thailand) in 2007 of THB 829 million, mainly from sale of GCS Thailand’s assets
1,605
Source: Audited FS
1.85
Corporate Information
9
Revenue from Hospital Operations
2,2612,554
0
1,000
2,000
3,000
1Q09 1Q10
1Q10 Update1Q10 Update
Source: Audited FS
EBITDA
Source: Audited FS
13% 611679
0
200
400
600
800
1Q09 1Q10
11%
Net Income
Source: Audited FS
• Revenue from hospital operations was up 13% as a result of:
− Inpatient revenue growth of 18%
− Outpatient revenue growth of 7%
• EBITDA increased by 11%, slightly lower than the increase in revenue from hospital operations because of expenses in start-up businesses such as Asia Global Research and Asia Global Health
• Net income increased by 9%
338369
0
100
200
300
400
1Q09 1Q10
9%
THB million THB million
THB million
Corporate Information
10
Margins & TrendMargins & Trend
• Margins are on a rising trend over the past 5 years,
signifying the efficiency of the operations
• BH had tax-loss-carried-forward which can be used in
2005 (therefore low effective tax rate) and paid full tax
rate in 2006 onwards
Gross Margin Trend
40.8%38.8%38.3%38.5%37.6% 37.6%
25%
30%
35%
40%
45%
50%
2005 2006 2007 2008 2009 1Q10
Net Profit Margin Trend vs. Effective Tax Rate
15.5%13.9%
17.1%
13.3% 14.0%13.3%
17.2%
28.6% 28.5% 27.7% 27.1%31.3%
0%
5%
10%
15%
20%
25%
2005 2006 2007* 2008 2009 1Q100%
20%
40%
60%
80%
100%Net Margin (LHS)Effective Tax Rate (RHS)
* Net margin in 2007 includes one-time non-operating items
EBITDA Margin Trend
24.5%24.5% 24.2% 24.3% 24.2%25.8%
15%
20%
25%
30%
2005 2006 2007 2008 2009 1Q10
Corporate Information
11
LeverageLeverageDebt to Equity
Net Debt to Equity
0.16
0.280.23
0.31
0.39
0.27
0.00
0.10
0.20
0.30
0.40
0.50
2005 2006 2007 2008 2009 1Q10
0.41 0.39
0.250.30
0.68
0.54
0.00
0.20
0.40
0.60
0.80
2005 2006 2007 2008 2009 1Q10
x
x
Interest Coverage
18.7
43.2
24.8
18.815.6 17.7
0.0
10.0
20.0
30.0
40.0
50.0
2005 2006 2007 2008 2009 1Q10
x
• Improvement of the balance sheet over the years, both in terms of D/E and interest coverage as the long-term debt was gradually paid-off
• Loan was refinanced on 1 Oct 09, with additional credit line of THB 1.4 billion, extended repayment schedule and lower interest rate
Corporate Information
12
Effect from the Political InstabilityEffect from the Political Instability
Overall Inpatient Volume (ADC) Trend Y10
• Volumes have been effected by the
political protest, especially the outpatient
volume
• The sharp rebound in outpatient volume is
very encouraging
• July will be the start of our high season
Overall Outpatient Visits Trend Y10
2,000
3,000
1 Jan - 11 Mar 10 12 Mar - 2 Apr 10 3 Apr - 31 May 10 1-30 Jun 10
Before start of protest Protest @ Panfah
Protest @ Rajprasong After Protest
-9.1%
-19.1%+ 32.9%
200
400
1 Jan - 11 Mar 10 12 Mar - 2 Apr 10 3 Apr - 31 May 10 1-30 Jun 10
-8.0%
-9.0%+ 1.3%
OPD visit per day
ADCs
13
Effect from the Political InstabilityEffect from the Political Instability (cont(cont’’d)d)
Overall Inpatient Volume (ADC) (% y-o-y increase/decrease)
• There is a lag of the effect on the inpatient
volume. However, the magnitude of the
effect is not as large as outpatient
Overall Outpatient Visits (% y-o-y increase/decrease)
% increase/decrease y-o-y
% increase/decrease y-o-y
3.6%
-4.5%
-18.4%
-3.4%
-20%
-15%
-10%
-5%
0%
5%
1 Jan - 11 Mar 10 12 Mar - 2 Apr 10 3 Apr - 31 May 10 1-30 Jun 10
Y-O-Y Volume Growth
1Q10 2Q10
• IPD (ADC) +13% +5%
• OPD Visits +2% -13%
13.6%
10.1% 9.8%
-1.9%-3%
2%
7%
12%
1 Jan - 11 Mar 10 12 Mar - 2 Apr 10 3 Apr - 31 May 10 1-30 Jun 10
Before start of protest Protest @ Panfah
Protest @ Rajprasong After Protest
14
2010 Strategy2010 Strategy
BH continues to improve and strengthen its core business, Bumrungrad International Hospital, Bangkok
• Improve facilities with focus on patient safety, innovation and efficiencies
• Focus on targeted specialties
• Domestic marketing efforts include Healthy Living Club membership program, advertisements, fairs, and packages
• International marketing through representative offices, internet marketing, international publications and media
Corporate Information
15
2010 Strategy2010 Strategy
• Continue to improve and strengthen core business, Bumrungrad International Hospital, Bangkok
BrandQuality
Diversified customer baseInnovations
Information Technology
Corporate Information
Leverage on core strengths:
16
Bumrungrad International Hospital, BangkokBumrungrad International Hospital, Bangkok
Bumrungrad International Hospital, Bangkok
17
Revenue BreakdownRevenue Breakdown
Inpatient vs. Outpatient (% of revenue) Method of Payment (% of revenue)
• Revenue contribution from outpatient continues as majority share following worldwide trends towards ambulatory care; BI Clinic well positioned for future growth.
• Corporate contracts increasing especially from foreign accounts; self-pay remains the primary method of payment.
47% 49% 49% 51% 51% 50%
50%53% 51% 51% 49% 49%
0%
25%
50%
75%
100%
2005 2006 2007 2008 2009 1Q10
Inpatient Outpatient
As of Mar 2010
Insurance13%
Corporate Contracts -
Intl6%
Corporate contracts - Domestic
9%
Self-pay72%
Bumrungrad International Hospital, Bangkok
18
Volume Contribution by Nationality Revenue Contribution by Nationality
International PatientsInternational PatientsGrowth in International Patients • International patients remain a solid customer base; BH
served over 400,000 international patients in 2009
• Two main sources of international patients: - Domestic expatriate community - Foreign “medical tourists”
• Due to the generally high revenue intensity for international patients, foreign patients revenue expanded at a rate of 8% CAGR (5 years)
• Top growing countries are the Middle East and Myanmar, while the US is picking up after a slow down due to the global economic meltdown & Thailand’s political situation.
1,5571,659
1,862
2,0552,223
0
500
1,000
1,500
2,000
2,500
2005 2006 2007 2008 2009
OP
D R
even
ues
OPD
International Revenues
1,620 1,654
1,915 1,8712,025
0
500
1,000
1,500
2,000
2,500
IPD
Rev
enue
s
IPD 9% CAGR6% CAGRNote: Revenues net of doctors’ fees
THB mn THB mn
38% 41% 41%
59% 59% 59%
45%41% 40%
60% 55%62%
0%
20%
40%
60%
80%
100%
2005 2006 2007 2008 2009 1Q10
% o
f Vol
ume
International Thais
53% 55% 54%
46% 45% 46%
61%55%54%
45% 39%47%
0%
20%
40%
60%
80%
100%
2005 2006 2007 2008 2009 1Q10
% o
f Rev
enue
International Thais
Bumrungrad International Hospital, Bangkok
19
More experience treating international patients More experience treating international patients
Annual International Patient Volumes at Top Medical Travel Destinationsbased on 2009 published sources
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
450,000
Country
Num
ber o
f Int
erna
tiona
l Pat
ient
s
estimated 407,000 370,000 200,000 200,000 150,000 130,000 100,000 50,000
Bumrungrad Malaysia Singapore Turkey India Jordan Costa Rica Korea
Bumrungrad International Hospital, Bangkok
* Data from various sources and may not match
20
Inpatient Capacity - Open Beds
Capacity
Outpatient Visit Capacity per day
Bangkok Facility Expansion PlanBangkok Facility Expansion Plan
• Bumrungrad International Bangkok plans to expand and upgrade its facilities over the next 5 years
• The facilities will give a better overall hospital experience for the patients
Outpatient: 4,500 6,000 visits per dayInpatient: 500 600 beds
Renovation Expansion
• BI Hospital Building• BI Clinic Building
• BH Tower
+
600484
484484484484458
0
100
200
300
400
500
600
700
2009 2010E 2011E 2012E 2013E 2014E M ax
6,0006,0005,700 5,100
4,500 4,800
0
1,000
2,000
3,000
4,000
5,000
6,000
2009 2010E 2011E 2012E 2013E 2014E
Opening of BI Clinic: 17th Fl
Renovation of BI Hospital Building• Women’s Center• Digestive Disease Center
Opening of BI Clinic: 19th & 20th Fl
Opening of BI Clinic: 21st Fl
Opening of BI Clinic: 18th Fl
* BI Clinic Building was opened in mid-2008, resulting in increase in outpatient capacity from 3,500 visits per day to 4,500 visits per day
Bumrungrad International Hospital, Bangkok
21
CAPEX Program CAPEX Program
0
500
1,000
1,500
2009A/E 2010E 2011E 2012E 2013E 2014E
Construction in ProgressEquipment & softwareBuilding and Construction
0
500
1,000
1,500
2009A 2010E 2011E 2012E 2013E 2014E
BH Tow erBI Hospital BuildingBI Clinic BuildingMaintenance
CAPEX allocated by project
765
1,132
937
1,161
896
CAPEX allocated by asset type
1,038
Bt million
Bt million
Total CAPEX for the capacity expansion and renovation over the next 5 years (2010-2014):
(Excluding Maintenance CAPEX)
- New BI Clinic Building Bt 335 million
- Existing BI Hospital Building Bt 606 million
- BH Tower Bt 660 million
Total Bt 1,601 million
1,132
937
1,161
8961,038
Bumrungrad International Hospital, Bangkok
765
22
An All New Concept An All New Concept –– BI ClinicBI Clinic
Ground Floor Lobby
Sky Lobby
Ground Floor Lobby, Parking and 5 floors of clinic space of the new outpatient building are now open
Welcome Center
New Clinics
Bumrungrad International Hospital, Bangkok
23
Renovated Inpatient WardsRenovated Inpatient Wards
The hospital room of the future – today!
Bumrungrad International Hospital, Bangkok
24
New Women Center & Digestive Diseases CenterNew Women Center & Digestive Diseases CenterThe renovation of Digestive Diseases Center is expected to be completed by mid-2010
Women’s Center
Digestive Diseases
Center
Bumrungrad International Hospital, Bangkok
25
Bumrungrad International Limited Bumrungrad International Limited
Bumrungrad International Limited
26
Asian Hospital, the Philippines (AHI) Asian Hospital, the Philippines (AHI)
• 2002: Opened as a private hospital, one of the largest in the southern Luzon corridor of metropolitan Manila, the Philippines
• Feb 2005: Acquired by Bumrungrad International Limited
• 2010:
− A 217-bed private hospital
− Since the acquisition, the hospital has turned around and became profitable in 2007
− With the hospital operating at almost its full capacity, AHI is undergoing an expansion plan over the next two years to increase the number beds to 346 beds
Bumrungrad International Limited
Facts & Figures:
− Ownership (by Bumrungrad International Limited):from conversion of management fees into equity & and new capital injection@ acquisition 43.0%@ present 56.4%
- Amount and year invested: (by Bumrungrad International Limited)2005 USD 10 million2008 USD 9 million
− Other shareholders:Dr. Garcia 8.2%Insular Life 11.8%Filinvest 8.3%Others 15.3%
27
Bumrungrad Al Mafraq Hospital, Abu DhabiBumrungrad Al Mafraq Hospital, Abu Dhabi,, U.A.E. U.A.E.
• Management contract signed with the Health Authority of Abu Dhabi for 4 years, December 2007 - 2011
• Inpatient capacity of 460 acute care beds, 28 intensive care and 14 special care baby unit beds
• Patient volume of ~310,000 patients, including more than 25,000 inpatients annually
• Simultaneously, a new modern hospital building is being constructed on an adjacent site that will replace the current facility
Bumrungrad International Limited
28
Bumrungrad International LimitedBumrungrad International Limited In SummaryIn Summary
Bumrungrad International Limited is profitable, with net profit of USD 2.5 million in 2009, as the three operating projects in the portfolio are profitable
- AHI is profitable and generating good internal cash flow
- Management fees from Bumrungrad Al Mafraq Hospital is accretive
Capacity expansion plans for AHI in progress & on schedule
Bumrungrad International Limited’s management continues to pursue additional investment opportunities in the region
Bumrungrad International Limited
29
2002: Establishment of Vitallife Wellness Center
• Vitallife Wellness Center was opened as Thailand’s first anti-aging and preventive medicine clinic
• Products offered include:− Age Management− Preventive & Regenerative Care− Beauty & Skin− Weight Management− Sports Medicine− Hormone
2009: Establishment of VitechPro Wholesale Business
• Launched VitechPro, comprehensive solution for affiliated wellness clinics
• Products include nutraceuticals, lab services and training services
Vitallife & Asia Global Research
30
Asia Global ResearchAsia Global Research
AGR, established in 2009, offers clinical research services to the global pharmaceutical, biotech and medical device industries
AGR has two functional units, which are complementary to each other:
− Contract research organization (CRO)performs multicenter clinical trials for the international biotech, pharmaceutical and device companies (Sponsors).
− Site management organization (SMO)manages groups of investigational sites for the purpose of providing Sponsors and CROs with numerous sites capable of providing quality research and quality data. SMO’s clients can include Sponsors or CROs.
Vitallife & Asia Global Research