Dr. Agarwal’s Health Care Limited (NSE: AGARWALEYE) Q3 2025 Earnings Call dated Feb. 17, 2025
Corporate Participants:
Aashna Dharia — Head of Investor Relations
Adil Agarwal — Chief Executive Officer
Yashwanth Venkat — Chief Financial Officer
Analysts:
Tushar Manudhane — Analyst
Gautam — Analyst
Ankit Shah — Analyst
Ankur Shah — Analyst
Yash — Analyst
Chintan Sheth — Analyst
Dheeresh Pathak — Analyst
Dishant Jain
Dhawal Khut — Analyst
Ashish — Analyst
Shriram R — Analyst
Presentation:
Operator
Ladies and gentlemen, good day and welcome to the Dr. Agarwal’s Healthcare Limited’s Q3 and 9 months FY25 earnings conference call. As a reminder, all participant lines will be in the listen only mode and there will be an opportunity for you to ask questions after the presentation concludes. Should you need assistance during the conference call, please signal an operator by pressing star then zero on your touch tone phone. I now hand the conference over to Mr. Tushar Manandani from Motila Loosewail Financial Services. Thank you. And over to you sir.
Tushar Manudhane — Analyst
Thank you Rutuja. Good morning and a warm welcome for 3Q FY25 earnings call of Dr. Agarwal’s healthcare. From the management side we have Dr. Adil Agarwal, CEO, Mr. Yashwant Venkat, CFO and Ms. Ashna Dhariya, Head of Investor Relations. Now I hand over call to Ms. Ashna, head of investor relations at Dr. Agarwal. Over to you Ashna.
Aashna Dharia — Head of Investor Relations
Thank you Tushal. Good morning everyone. We appreciate everyone joining us today for up Q3 and 9 month FY25 earnings call. Our financial results, press release and investor presentation have been released and are available on our website as well as on the exchanges. Before we continue we want to remind everyone that this call is being recorded and the transcript will be made available on our website afterwards. Additionally, please be aware that today’s discussion may include certain forward looking statements which should be. Considered in the light of the risk our business faces. Please refer to the detailed statement on page two of our investor presentation. It is now my pleasure to hand over the call to Dr. Adil who will share his insights and remarks. Dr. Adil, over to you.
Adil Agarwal — Chief Executive Officer
Thank you Aashna and good morning to all of you. I would like to welcome you all to Dr. Agarwal Healthcare maiden Earnings call as a public listed entity. I am Dr. Azil Agarwal and the CEO of Dr. Agarwal Healthcare Limited. As you all know the company got listed on 4th February 2025 and I would like to take this opportunity first to thank all our patients, our doctors, our employees, our shareholders, our investors and all stakeholders who have supported us in this journey. Let me begin by providing you an update on quarter three financials and the nine month performance of the year. We are pleased to report a strong financial performance with a 28.6% year on year revenue growth reaching 443 crores for quarter three FY25 our EBITDA also saw a strong growth of 26.3% totaling 128 crores which resulted in an EBITDA margin of 28.8%. For the third quarter our pack stood at 28 crores reflecting a growth of 25% year on year with a fat margin of 6.4%. Now correspondingly, we recorded a year on year revenue growth of 27.2% reaching 1281 crores for nine months. FY25 our EBITDA also grew by 27.5% totaling 356 crores with an EBITDA margin of 27.8% in the nine months our PAT stood at 68 crores reflecting a 26.2% year on year growth with a PAT margin of 5.3% for the nine months now. This revenue growth has largely been driven by increase in surgical volumes, a shift towards high end surgeries and enhanced patient footfalls from our business development and marketing initiatives. Our team at Dr. Agarwal has worked tirelessly to build a network of 221 hospitals across India and Africa serving approximately 17.7 lakh patients and performing over 2.1 lakh surgeries during the nine months ending December 2024 in India. We operate through a network of 205 facilities spread across 14 states and 4 union territories covering 124 cities. Our presence is highly diversified with 33% of our facilities located in tier 1 town, 60% in other cities and 7% internationally. This strategic distribution ensures that we provide accessible and high quality eye care to a broad and diverse patient. We have expanded our network from 209 facilities in H1 FY 2025 to 221 facilities, marking a net addition of 12 facilities for the quarter. In this year alone, we have added 42 new facilities. Now if you look at our business model, we operate through something which we call a hub and spoke business model which is built around three different formats of our hospitals. The largest are what we call the tertiary hospitals. Then you have the daycare surgical centers which are called the secondary centers and the smallest format are called the primary centers or what we define as the eye clinics. We work on an asset light model enabling us to scale effectively with minimum CAPEX. As of December 31, 2024, we have 28 tertiary facilities and 193 spokes which include how 132 secondary and 61 primary centers. If you look at our market expansion strategy, it is designed to strengthen our presence in our core markets while targeting underpenetrated clusters to create new growth opportunities in the fourth quarter. Already we have launched three new facilities to date. Looking ahead in Q4, we are targeting to launch another eight to 10 additional surgical facilities with six to seven located across our core states which are Tamil Nadu, Maharashtra, Karnataka, Andhra Pradesh and Telangana. We will also expand into the north coast states of Gujarat, Jammu and Odisha. Furthermore, we plan to open seven primary facilities in quarter four, FY 2025. These strategic expansions will significantly enhance our operational reach and further strengthen our market presence across key regions. Now I would like to hand over to our CFO Mr. Yashwant Venkar who will give us a deeper dive into our financial performance for the year.
Yashwanth Venkat — Chief Financial Officer
Thank you Dr. Adil. I’ll start by providing a breakdown of our revenue across segments. Surgical revenues form the main pillar of our service offering, contributing over 65% to group revenue. Diagnosis consultations and non surgical treatments account for 14% while the sale of optical products and pharmacy contribute to 21% of the total revenues. During Q3FY25 we performed 72,815 surgeries resulting in a 35.7% year on year growth, whereas in nine months of FY25 we performed above 2.1 lakh surgeries reflecting in a 31.8% year on year growth. Cataract surgeries have been the major contributor for approximately 75% of the volumes followed by retractive surgeries at around 5%. In 9 months. FY25 volume of cataracts and refractive surgeries have grown. By approximately 28% year on year. The payer mix has remained relatively consistent over time with 62% of the payments made through cash self paying in patients, 27% through insurance and TPA and nearly 12% from government schemes. There has been a greater focus on India with its contribution to the overall group revenue increasing from 86.8% in 9 month FY24 to 89.9% in 9 month FY25. Revenue from Operations India for Q3 FY25 stood at 390 crores INR reflecting a growth of 34.5% year on year. Revenue from Operations India for 9 months FY25 totaled to about 1125 crores marking a growth of 31.7% year on year. The number of non source facilities has risen from 17 facilities as of March 2022 to 59 as of December 2024 with the group predominantly expanding in Punjab, Maharashtra and Gujarat. Nature facilities are those facilities which have been owned or operated by the group for more than three years. As of December 2024 we operate about 100 mature facilities. The revenue from Metro facilities has risen by 16.6% totaling nearly 291 crores in the third quarter of FY25. The revenue from mature facilities for India has grown by 21.2%. In Q3 FY25 the revenue from mature facilities has increased by 15% reaching about 875 crores in the nine month period and correspondingly for India it has grown by 18.5%. Now let’s move on to discussing two major heads on the expenses side. Cost of goods sold and Dr. Cost. Cost of goods sold in QT FY25 have been slightly upwards due to greater focus towards higher end procedures. Out of the 1.5 lakh cataract surgeries performed about close to 31,000 were higher end procedures which was about close to 21% of the overall cataract surgeries performed up from 19.2% in FY24. Doctor costs in Q3FY25 were impacted by addition of new facilities and also full year impact of branches set up acquired in the previous year. Other expenses include a one time cost of nearly 4 crores for production expenses relating to our marketing segment. In conclusion, we are pleased to report strong financial results for Q3FY25 driven. By solid year on year growth across key metrics, our revenue increased by 29.5%, EBITDA grew by 26.3% and packed by 25%, reflecting in the strength of our operations and continued strategic execution. Furthermore, our year to date performance demonstrates a consistent upward trajectory with a 27.2% increase in revenue, 27.5% rise in EBITDA and 26.2% growth in PAMP. These results reflect our commitment to delivering sustained growth and operational excellence, positioning us well for continued success in the upcoming quarters. Thank you.
Operator
Thank you. Shall we begin the question and answer session, sir?
Yashwanth Venkat — Chief Financial Officer
Yes, you can start the Q and A.
Questions and Answers:
Operator
Thank you very much. Ladies and gentlemen, we will now begin the question and answer session. Anyone who wishes to ask a question may press star and one on the Touchstone telephone. If you wish to remove yourself from the question queue, you may press star and 2. Participants are requested to use handsets while asking a question. Ladies and gentlemen, we will wait for a moment while the question queue assembles. The first question is from the line of Gautam from LEO Capital. Please go ahead.
Gautam
Hi. Good morning, sir. Thank you for this opportunity. I had a question on our center in Chennai. So when is this flagship center in Chennai expected to be operational? And how much revenue growth do we expect from that over our existing base?
Adil Agarwal
Hi. This facility is expected to become operational in the next nine to 10 months. Construction is underway and we should be looking at sometime early FY2026 to begin operations at this particular center. We would not like to comment on what the revenue guidance for that particular center will be, but it will be standard in line with what our current tertiary centers are expecting to provide.
Gautam
And what would be that? That the standard growth rate is for the other centers.
Adil Agarwal
So if you look at our existing centers, our mature facilities are growing at SSG of about 18%. I think that’s a fair estimate which we can. We can expect from our mature facilities.
Gautam
Yeah. So that is what we can expect from this SL at least.
Adil Agarwal
Yes.
Gautam
Okay. Thank you so much. Father. I’m done. Thank you.
Operator
Thank you. The next question is from the line of Ankit Shah, an individual investor. Please go ahead.
Ankit Shah
Yeah. Thanks for the opportunity. I had one question which was on the growth rate expected. Over the next two, three years because we have a mix of we are aggressively expanding, plus we have old mature centers. So what is the growth both in terms of revenue and ebitda? The second is today our margins are low, I’m assuming, because we are expanding aggressively. So there’ll be some burn on the older centers, which would give a. Which would take some time to get to a stable state. So what would be our steady state EBITDA margin that one should look at? Thanks. That’s my question.
Adil Agarwal
Sure, sure, Ankit. So I will request my CFO to give you some guidance on revenue before he answers that quickly. Our same store sales growth for the last three years, which is defined as how you see our mature facilities, have been growing by around 18%. We expect a combination of that plus what are the new center additions we have? And we will continue to grow similarly to where we have grown in the last nine months. Do you want to give guidance in terms of how the EBITDA margins have progressed?
Yashwanth Venkat
See, just to add to Dr. Adil’s point, in terms of revenue, the revenue from our mature facilities and the newer facility additions for the next two, three year perspective, we should be close to about 20% now in terms of EBITDA margins. We believe that the EBITDA margins would sustain at the current levels, considering the fact that we will be opening about close to 45 to 50 facilities this year as well.
Ankit Shah
Okay. Okay, thanks. And we have this listed subsidiary. So just in terms of. Because there’ll be a dilution whenever you merge that. So is there any ballpark, what’s the dilution one should look at from that perspective?
Adil Agarwal
So we have not yet started exploring conversations with our bankers on this particular matter. But our endeavor is in the next few months we will start to work and then we will have some information for our shareholders in terms of what the swap issue will effectively look like. But our endeavor is to get this done within a time span of three years and ideally sooner than that.
Ankit Shah
Got it. Thank you.
Operator
Thank you. The next question is from the line of Uncle Shah from Kasar Capital. Please go ahead.
Ankur Shah
Yeah. Hi sir. Congrats on the listing, Sir. Three questions. So one is since, you know, our hospital model is quite different from, you know, some of the listed hospitals which are operating large hospitals. It is more like of more sort of a retail clinical setup. So sir, how do you see, like, how should we read the capacity utilization? How should we see the average revenue per patient? What is the pricing price hike which, you know, you all expect over a period of next three years. Can you give some. You know, Link On that.
Adil Agarwal
Sure. So to help you understand this we will explain to you the unit economics of the three different types of hospitals that we have. As I was mentioning on my opening statement, we have the largest format which is called the tertiary hospital. Now these tertiary hospitals average anywhere between 8,000 to 12,000 square feet in size. Then you have the secondary facilities which average between 4,000 to 7,000 square feet. And then you have the clinics with which average about 750 to 1000 square feet in size. I would request Mr. Yashwant Venkar to give you an update on what the average revenue for these facilities look like and what is the kind of capex we look at which will give you a sense in terms of how we think about revenue and capacity utilization from some of these centers.
Yashwanth Venkat
Sure, yeah. In terms of capex for a typical primary facility the capex is between 30 to 35 lakhs. And in terms of square feet area between 150 up to 1,500 square feet. When the primary facility is at a maturity level of about close to three years we should be looking at somewhere between 12 to 15 lakhs revenue on a monthly basis with a margin between about close to 15% at a store level. This is as far as primary facilities are concerned. Secondary facilities, the CAPEX range from about close to four and a half up to seven crores. In terms of square feet area, between 4,000 to 7,000 will be the square feet area. One anomaly to this is Mumbai wherein we have secondary facilities even as low as 2,000 2,500 square feet. In terms of maturity profile for a secondary facility by the end of third year on an average the revenue on an annual basis will be close to about 9 to 9 and a half crores. With the store level operating margin between 22 to 24%. At the end of say the fifth year this revenue should trend between 13 to 15 crores. Store level operating margins between 32 to 33%. Coming to the largest format tertiary facility. Tertiary facility are generally greater than 8,000 square feet. This is the average across India. Again barring Mumbai. In terms of the setup cost per tertiary facility between 10 to 12 crores on an average basis excluding the centers of excellence and in terms of maturity, by the third year typical tertiary facility, the revenue will be close to about 10 to 10 and a half crores with the store level operating margins between 20 to 22%. And by the fifth year around 15 to 16 crores. In terms of revenue and in terms of store level operating margins closed. o about 30 to 32%.
Ankur Shah
Okay. And sir, can you help me with the price hike number? Let’s say at least in the last, last three, three to four years on an average price hike figures.
Adil Agarwal
Yeah. So if you look at our change to sales growth, it’s a component of three factors. It’s a comp, It’s a component of patient footwork, the combination of pricing and the third thing which we do is we do something which we call it higher end surgery. So there is a product mix which is, which is, which is included. In the last two, three years we’ve seen an average price increase of what, 2 to 3%. 2 to 3%.
Ankur Shah
Okay. Okay, sure. And sir, again, because you know, it is more linked to retail format. Can we know the EBITDA margin? Because the India is, you know, it accounts for some of the rental costs. So can we get the actual margins post the rental cost?
Yashwanth Venkat
Sure, sure. See you just have to subtract 7 to 7 and a half percent from the India’s margin to derive the actual I gap margins. Seven to seven and a half percent has been the number over the last three years
Ankur Shah
And that’s across facility or you all have an ownership model as well?
Adil Agarwal
No, no. So if you see out of the 221 facilities, 220 are listed, only one hospital is owned. So effectively leads to the significant component, which is what he’s saying is what? 77 and a half percent which you deduct from your indirect margins to arrive at your IGA EBITDA margin.
Ankur Shah
Okay, sure. And the just last question on the structure front, I think one of the participants did ask, but I’ll just try to go more detailed because let’s say, you know, both the companies are listed, both the companies are having same brand names. Arguably both the companies are, you know, trading at very different valuations. And obviously the old listed company is maybe much more profitable than the just listed in terms of margins in terms of establishment. So sir, how would you think of this merger considering the minority shareholders sitting out there?
Adil Agarwal
So from management perspective, it is our fiduciary responsibility to take care of our monetary shareholders in the industry subsidy. Which is why when we get down to this process, we will do a fair valuation of both entities. And based on the fair evaluation, we will do a share swap of both the entities.
Operator
Sorry to interrupt you, Mr. Shah. May we request you to please rejoin the queue? We have other participants waiting for the turn.
Ankur Shah
Sure, sure. Thank you. Thank you so much. All the best.
Operator
The next question is from the line of Yash from Stallion Asset. Please go ahead.
Yash
Hi. Thank you for the opportunity. Just wanted to understand your target for additional number of eye centers in the next three years. So in the nine months, we have added 42 new facilities. And we are targeting to open about eight to 10 new facilities in this quarter.
Adil Agarwal
I think that’s a fair estimate. Of what we should expect over the next few years to expand at least for the next two to three years. This is what we’re looking towards.
Yash
Okay. Okay, got it. Got it. And you know, any, any sort of plans for acquisition of smaller, smaller eye hospitals or any inorganic expansion that you have in your mind.
Adil Agarwal
So we predominantly are focusing only on organic expansion. That said, we continue to look at strategic opportunities. If we are looking at expanding into newer markets right now, we don’t have anything for you. But as we continue to explore and as our business alone teams continue to look at strong partners to work with, we will continue to expose those. Assuming that they come at the right price and you have the right cultural fit from some of these partners, we would look at exploring those opportunities. But that said, we don’t have anything right now concrete for us to look at.
Yash
Okay, got it. Thank you.
Operator
Thank you. The next question is from the line of Chintan Sheikh from Giric Capital. Please go ahead.
Chintan Sheth
Thank you. Hi. Hi. Hi doctor. Thank you for the opportunity. So if I look at network we currently have emerging will be, you know, Punjab and the northern clusters that we acquired recently and then Maharashtra again couple of years that we acquired and now expanding into Gujarat and Rajasthan. So core growth area or the region will be this market or will continue to, you know, the 50 centers which we spoke about in terms of extension going forward on an annualized basis, where should we look at the extension to be? And then the white spaces like Bihar, Chhattisgarh and the northeastern part and obviously Jammu and other area. So how should one look at your strategy in terms of extension where we will be expecting those going forward?
Adil Agarwal
So good question. If you see our core states are the four southern states of Tamil Nadu, Andhra, Telangana and Karnataka. And we also consider Maharashtra now core state. Given that we have 26 centers located across Maharashtra, 15 are located in Mumbai and the rest are across Pune, Nashik and Sahara. 75 to 80% of our new center rollouts will come in these five core clusters. And if you add Kerala to this as well, the remaining 15 to 20% will come from non core clusters like Delhi, NCR, Punjab, Gujarat, Rajasthan and UP along with Madhya Pradesh
Chintan Sheth
And Inorganic. Sorry, I couldn’t get the last one.
Adil Agarwal
So about 75% of new centers will come in our existing markets. The remaining. 25% will come in non core markets.
Chintan Sheth
And the inorganic opportunities, if any, which you will be targeting will be in the white spaces of like Northeast or Bihar, Chhattisgarh area or it will continue to be in the core like Gujarat or Rajasthan where the presence is still limited, where we want to expand further and try to get more market share within that geography.
Adil Agarwal
Exactly. So Chintan, the acquisition strategy is based around us acquiring hospitals and getting access to strong partners in newer markets where we don’t have a presence. Once we have established ourselves in a market and we have access to strong partners, then we go back to your base expansion strategy which is organic expansion. For example, now that we have a good set of partners for us in Mumbai, we are looking at setting up more greenfield centers. For example, we have three new facilities coming up in in Mumbai and at Sabhar Colon we have a center coming up in Vashi, we have a center coming up in Dumbi, Bali and we have a center coming up in Virat. Similar strategy we use across all our core markets to predominantly expand in core clusters using an organic approach. Our acquisitions are predominantly used for us to expand into new markets like how you have described. So if you are looking at entering into certain markets like Delhi, NCR or up, we will be looking at acquisitions to enter into those markets. And on Africa we are not focusing as aggressively as we are in India. We added one center in nine months.
Chintan Sheth
But how do we, you know, given that most of the facilities will be mature enough to generate a significant cash flows, how are we kind of set up in terms of repatriating that cash flows to India or whether that cash flow stays there, if you can throw some light on it. And medium term outlook in Africa, whether we want to stay in that market given the geopolitical uncertainty has been the history of that region. If you can give some sense of that,
Adil Agarwal
Africa has been an interesting journey for us. We commenced our Africa operations in 2012. In the last 13 years now we have set up 16 facilities in Africa. As you can see the trend over the last three years the contribution from Africa has steadily been declining. And as of the last nine months, Africa contribution is only about 10.1% of the overall group. Relevance. We are not looking at any significant expansion in Africa. But that said, we have some quality facilities which we have set up which are doing great clinical work across countries like Mauritius, Kenya, Tanzania, Mozambique, just to name a few. We will continue to operate these centers. It does not pick up any management bandwidth. But the advantage which we have is we have first mover advantage in many of these countries. And we are doing a good amount of clinical work in these countries. We believe that African operations will continue and we will continue to grow at a moderate rate. But the kind of growth we are seeing in India will not come in Africa. Just to give you a catch, Margin profile and cash flow, how they managed. I will request our CFO to give you a sense in terms of how the African operations are doing more financial performance
Yashwanth Venkat
In terms of margin profile. The Africa operations continue to operate at similar margins as of the domestic operations. One second key point to notice. Africa is a self sustaining business. The last funding which went from India to Africa was about five years back. And in terms of cash flow over the last three years nearly about 9 to 12 crores have been repatriated to India. In addition to whatever the existing amounts have been used to further expand into Africa as well. So in terms of expansion as far as Africa is concerned, we’ve been looking to open say two or three facilities on a yearly basis.
Chintan Sheth
Sure. If I may, last question. If I look at the post minority growth on the profitability, it is the minority set has increased I believe because of the Punjab acquisition where the minority holding is higher. If you can share, how should one look at post minority growth? At least medium term till the time the consolidation doesn’t. Consolidation is still a couple of years away from here because that is failing lower than the core consolidated growth. We are looking, right?
Yashwanth Venkat
Yes. I’ll just take that question. As of March 2024, out of 95 crores of PAT, 83 crores was the number which came from the owners of the company. And 12 crores was not from the owners. That number is currently at about close to 75%. And 25% is the number which we are currently looking at out of 67.72 crores. This number going forward over two or three year period should come down to similar numbers as of March 31, 2024. By 2026 we should be looking at about 84%. 16% and by 2027 we should be looking at 87 or 88. 88%.
Chintan Sheth
Got it. Thanks. Thanks for clarification. I’ll jump back into. Thank you.
Operator
Thank you. The next question is from the line of Girish Pathak from White Oak Capital. Please go ahead.
Dheeresh Pathak
Yeah, thank you. Sir, can you comment on the performance of Agarwal Eye Hospital as well? And I would request you to also have some slides like you have for the other entity which got recently. Listed also have a presentation for the other entity as well highlighting the key KPIs on an ongoing basis.
Adil Agarwal
Sure, Ganesh. So we will share some of those details for both the listed entity and the standard of business. But if you look at the P and L for the listed listed entity, we ended nine months till December 2024 at the top line of 302 crores. Comparatively last year December 2023 we had done 241 crores which was a growth of 25.4%. Our EBITDA margins were at 30.4% for the nine months which stood at 91.9 crores. This signified a growth of 32.9% over the previous nine months. PAT for the nine months was at 58.7 crores signifying a growth of 15.2% over the last nine months which was at 33.6 crores.
Dheeresh Pathak
Okay, and one more request, sir. If you can in your presentation just call out the rental element clearly and give the India if it does on an ongoing basis to be very useful.
Adil Agarwal
Sure, we will do that. We will call up.
Dheeresh Pathak
Thank you sir. Thank you.
Operator
Thank you. The next question is from the line of Dashan Jen from Qatar Capital. Please go ahead.
Dishant Jain
Yeah, am I audible? Sir?
Adil Agarwal
Hi. Hi Vishal.
Dishant Jain
Yeah, thanks for the opportunity. So I just have one question like how does the management bifurcate the growth and the geographical allocation between the listed and the parent company since both are listed and I think both have. So is there any pre agreement that has been signed between both the companies or particular states or particular region? So just wanted to understand that part, sir. Thank you.
Adil Agarwal
Sure. Vishal, that’s a good question. Now if you see the way the companies, the way operations are divided is most of the older centers which were set up in the state of Tamil Nadu and in Chennai particularly are all located in the listed subsidiary. So we see most of the expansion which happens in Tamil Nadu will happen in the listed subsidiary. All of the expansion outside of Tamil Nadu, which includes all our southern states which is Andhra, Telangana, Karnataka, Maharashtra, the north centers, west centers and Africa is all located in the holding company which is Agarwal Healthcare Limited. So there is a clear demarcation in terms of expansion which happens outside of Tamil Nadu in the holding company. And the subsidiary has all Tamil Nadu centers which continues to grow at its current rate. We are seeing robust growth in both the regions given strong performance by our operations across both the entities has grown at about 25% revenue. And our holding company also has grown at about 27.2%.
Dishant Jain
Okay. Thank you, sir. Thanks for the answer. Yeah.
Operator
Thank you. The next question is from the line of dhsawal code from Jeffrey, please. Go ahead.
Dhawal Khut
Hi, thank you for taking my question. Just needed few data points. What is the organic growth for the company for 3Q as well as 9 month? That’s my question number one. Number two also can you inform about how does the pricing look across various payer mix? Let’s say cash is at 100, what will TPA be at and what will the government payers be at? Those are my two questions.
Adil Agarwal
I’ll answer your second question first which is your payer mix and then I will come back to your first question. In terms of how our organic centers or what we call as a mature centers are doing. Yeah. In terms of pair mix over the last three years the payer mix has remained relatively consistent with about close to 88% coming through cash and self paying patients and about close to 26 to 27% through insurance and TPA and the rest 11 to 12% from the government schemes. Now one key point to notice how we break down our business is we break down our business into two categories. Mature facilities and emerging facilities. Those facilities which have been owned or operated by us for more than three years are mature facilities. So the growth in mature facilities for the nine month period has been close to about 15%. On an overall basis the growth in mature facilities from India they have grown by about 18.5%. This growth in mature facilities is akin to your same store sales growth.
Dhawal Khut
Yes. What I was trying to know is like. For like procedure, let’s say you know cash has certain rate, then what is the discount for you know the TPA patient and for the government patient? So. So you know the pricing for like for like procedure across various peer groups.
Adil Agarwal
So you are asking is there any discount for insurance patients? There is no discount for insurance patients. Whatever, whatever the provider charges for particular procedures is what we effectively do. There is no discount on that.
Dhawal Khut
So the net realization for same procedure is comparable for TPA as well as cash. Is that correct? Understanding.
Adil Agarwal
Okay. See as far as TPA is concerned the two major parties are Medifx and MD India Healthcare. TPA in terms of realization for those two two parties it is close to about 35,000 rupees. About 32,500 to 35,000 rupees. Now coming to the overall cataract mix, when you look at both cash as well as. As TPA, the net realization is close to about 38,000 rupees. So in terms of realizations, as far as TPA and the overall contracts are concerned, it will be. The difference will be close to about 8 to 12%.
Dhawal Khut
Okay, got it. And for government channel, what, how, what is the that difference be for government?
Adil Agarwal
Again, it varies from scheme to scheme. In India, the overall contribution from government schemes is close to about only 6%.
Dhawal Khut
Okay, okay. And on the organic growth side, do you have the numbers available?
Adil Agarwal
So the way we categorize our business is we classify them as whether it is an organic center or we have acquired a particular center. If it is lesser than three years old, we classify it as the emerging center. And if it is greater than three years old, we classify it as a mature center. So as Ashwin was alluding to, out of the 221 centers, now we have 100 mature facilities and 121 emerging facilities. These 100 mature facilities are growing at a KEGR of about 15% over the last nine months. And that’s the way we view the business. And what matters is what are your mature centers growing in? Because it is the same yardstick. Now, once you whatever is the route through which that center has been onboarded. The same yardstick is predominantly used to look at growth going forward. And those centers are now growing at about 15% year on year.
Dhawal Khut
Okay, thank you. Thank you for answering.
Operator
Thank you. The next question is from the line of Ashish, an individual investor. Please go ahead.
Adil Agarwal
Hi Ashish.
Ashish
Hi. Good morning, sir. Thank you for the opportunity. My question is with respect to the future growth strategy, with respect to opening the organic centers and versus acquisition of hospitals or IH centers in the rural territories, as you mentioned. And also the second part of this question is actually just.
Adil Agarwal
Pardon me, can you just speak a little louder because I couldn’t hear that question clearly.
Ashish
Okay. Am I audible now? Yes, much better now. Yeah. So my question is with respect to the acquisition strategy going forward, with respect to the newer territories, as you mentioned that mainly the acquisition is in the newer territories. They were to venture out into Delhi or UP or other geographies. So in such a scenario, when you acquire a new hospital, does it include equity dilution as well to the owners of the newer hospital? Or these are like more of a cash trade or how does it happen? And second question is, with respect to the growth strategy, is it fair to say that most of the growth is. In future would be through organic centers vis a vis through acquisition of newer hospitals in the newer geography. Thank you, sir.
Adil Agarwal
Absolutely correct. Our future will predominantly revolve around and which is what we have demonstrated over the last nine months that most of the expansion will come through the organic route. Only when we look at acquisitions to enter new markets will we consider doing acquisitions like for example what we have done in Varanasi early this year. But just to give you a sense in terms of how we think about acquisitions and how that works, it’s in terms of the structure. Almost all of our acquisitions are done through business transfer agreements wherein we acquire 100% of the business on day one. However, the payment is structured as follows. 70% of the total payout is done on day one. The rest 30% is paid out over a three or four year period linked to certain revenue milestones.
Ashish
Understand. And is there any equity issuance as well of say the acquiring company to the owners doctors of the acquisition targets?
Adil Agarwal
So far we have not done any equity dilution for any of the acquisitions that they’ve done. All of this been predominantly cash payouts.
Ashish
Sure, sir. Thank you so much.
Operator
Thank you. The next question is from the line of Dashan Jain from Prasar Capital. Please go ahead.
Dishant Jain
Thanks for the opportunity again. Sir, can you just help me with the growth of Medford Hospital in Tamil Nadu region particularly, is it possible?
Adil Agarwal
Yes, just give us. Give us a second. So if you see right now the contribution from Tamil nadu is approximately 40% of the overall group business comes from Tamil Nadu. Tamil Nadu has about 76 facilities. If you look at the overall network, the second largest contributor is from Maharashtra which is about 15.7%. Karnataka is about 11.5%. Telangana is about 8.4% and Andhra Pradesh is about 6%. So effectively these five states contribute to about 82% of our growth revenue from this. The biggest contributor is obviously Chennai which stands at about 18.7%. Now to give you a sense in terms of what the Tamil Nadu business is effectively growing, you can compare it to what is happening in our listed entity. Our listed entity predominantly has all the Tamil Nadu centers. And that entity is going about 25% which is roughly around the range in terms of what our Tamil Nadu business is doing. Okay. 300 crores of revenue which has come in our listed south is about 25% growth. And most of the centers there are all located in Tamil Nadu which will approximately give you a sense in terms of where our business is. Good.
Dishant Jain
Okay, fair enough. Thank you.
Operator
Thank you. Participants who wishes to ask a question may press star and 1. The next question is from the line of Sushant Manandane from Motilal Oswal. Please go ahead. Please go ahead with your question. Your line is unmuted.
Tushar Manudhane
Yeah. Am I audible now?
Adil Agarwal
Yes, you are.
Tushar Manudhane
Yes. So sorry sir. Just wanted to understand, you know, how the competition is shaping up as far as the organized eye care chains are concerned across India and you know, how are sort of be better than the other just in case if you want to attribute key aspects.
Adil Agarwal
So Pushar, this is obviously, you know, good competitive space. You have players like asg, you have center for site. We have Maxi Vision, we have I Foundation which is great in the south. Other than these, you also have a lot of regional players like Ahmed Eye Hospital which is based out of Tamil Nadu. There is a hospital in Chennaik or Chakra Nativa which has been doing a lot of great work. You have Narayana Naitrala in Karnataka and Elvi Prasad in Hyderabad. These are some of the big names which are doing a lot of good work. We continue to focus on our growth strategies and we believe that we are the largest both in terms of revenue and the number of centers that we have. I would not like to comment on the other hospitals, but I know a lot of these doctors very well and a lot of these promoters and they’re doing great amount of work and they’re also continuing to grow. I think the overall market is growing at 12 to grow the Cagrade of 12 to 14% over the next few years. And we believe the current number of centers which across all our organized players only have about 13 to 15% of the overall market, which signifies that is significant room for all the organized players to continue to grow at a significant rate.
Tushar Manudhane
Got you, sir. And if you could further elaborate on this. Apart from cataract surgeries, which could be sort of a big growth driver in terms of surgeries for say next four to five years.
Adil Agarwal
So obviously cataract continues to be the biggest contributor to our group revenue. 76% of our total surgical volumes come predominantly from cataract surgeries. But that said, other than cataract surgeries, we also have refractive surgeries which have increased significantly. About 5.2% of all the surgeries performed is coming from refractive surgeries. And that is continuing to be a significant contributor to our good revenue. Other than this, we have other surgeries like retinal surgeries. We have retinal injections, we have glaucoma surgeries and a bunch of other surgeries which contribute to what, 20.9% the trend that we have been seeing. Seeing in the last few years is both cataract and contribution from refractive surgery is continue to increase. The growth in refractive surgeries has actually been quite significant. We have added 43 new refractive machines in the last couple of years and both are again contributing to a significant increase in our top line growth coming from refractive procedures.
Tushar Manudhane
Is it more to do with the patient’s inclination to remove, I mean to eliminate the spikes or I mean because there’s been mixed opinion at least as far as the survey goes in terms of, you know, having aspects or not having aspects.
Adil Agarwal
So two, three reasons which contribute to this. One is obviously there has been increase in patient awareness of some of these procedures. We have, you know, been been teaching our patients and have been educating our patients on, on the safety of some of these procedures. Second, as you have an influx of, you know, better machines coming into the country and your surgeons are getting trained, they’re actually able to perform better procedures. Third, there has been from a demographic perspective since COVID because of increase in screen usage time, there has been an increase in the refractive errors as well. Some of these factors also have contributed to increase in refractive procedures. And fourth is obviously with increase in consumption power, patients are finding some of these procedures a little bit more affordable and they’re opting for some of these procedures. Last but not the least, I think patients have started to take their health a lot more seriously. Similarly, iHealth falls into that category which is why you are seeing patients offer some of these procedures.
Tushar Manudhane
Got it sir. Thanks. Thanks for that. Thank you sir.
Operator
Thank you. The next question is from the line of Sriram are an individual investor. Please go ahead.
Shriram R
Thank you for the. Yeah, thank you for the opportunity. I have a question on Dr. Agarwal’s you know, I hospital, the other the existing listed entity. Now if I look at the historical financials of the entity, I mean pre Covid the growth has been in single digit. Now post Covid there’s been a surge in revenue. So I just want to understand what happened post Covid for the overall group as such.
Adil Agarwal
I think this has been a trend not just in Agarwal per se, but across all the other eye care players and all other healthcare players per se. One of the trends which we did see is if you see early on during COVID our chairman, Dr. Amar Garwal gave us instructions to keep all the hospitals open. So we were one of the first hospitals to keep ourselves open. Second, there has been a trend where patients have started to move away from smaller eye clinic and they started to gravitate more towards the larger corporate based hospitals. So you are starting to see better patient footwork coming in. As we continue to expand our footprint using our hub and spoke model, you have started to increase market share in many of these regions that we are present in. So you’re starting to see an increase in the revenue growth and support coming in because of that. Last but not the least, as we move towards higher end procedures, the average realization in many of our. You know, different surgeries have also started to increase which is also leading to higher top line growth. These are some of the factors which we have seen has changed in the last four to five years, which is why you’re seeing that kind of growth across both our entities.
Shriram R
Okay, so that’s helpful. Now if I were to bifurcate this growth into football and realization, how much would that be? Like how much would be the growth due to football and how much ballpark figures.
Adil Agarwal
So will this give you a sense? I would say about 6 to 7% is coming from increase in footfall, 2 to 3% is coming from pricing and about 6 to 7% would say is coming from better realizations. Do you want to add on this?
Yashwanth Venkat
Yeah. As Dr. Rajan was explaining earlier, over a three year period from FY22 to FY24, in terms of the revenue per mature facility, we have grown at a CAGR of about 18%. This is akin to your same store sales growth. If you have to break down this 18%. This 18% can be broken down into about 7 to 8% because of increase in volumes, about close to 3% from increase in prices. And the rest 7% coming from due to the effect of premiumization.
Shriram R
Okay, okay, okay, that’s, that’s super helpful. Thank you so much. All the best.
Operator
Thank you. The next question is from the line of the world from Jeffries. Please go ahead.
Dhawal Khut
Yeah, hi, thanks for taking my question again. Wanted to know what is the, you know, current ticket size for cataract, refractive and the other surgeries that we have maybe for quarter or nine month. And second is what will be the gross margin hierarchy for these three segments versus the corporate average.
Adil Agarwal
Sure. So our, if you look at our cataract surgery, we have three different forms of cataract surgery. You have the lower end procedures, you have mid end procedures, and you have a higher end procedures. But at an overall group level, our average cataract surgery yields are about 38,000. Refractive surgeries, which are again a significant contributor are about 75 to 80,000. 75 to 80,000 are our average realization coming in from refractive procedures. If you look at the margin profile of, you know, the three main revenue items for us, one will be surgeries, second would be optical and third would be pharmacies. I request our CFO to just give you an update on the what the gross market profile are for these three different categories.
Yashwanth Venkat
@ an overall level, the gross Margins are between 77 and 79.7% for surgeries, especially for cataracts. It is between 82 to 83% for. Refractive it is around 75%. For opticals it is close to 65% as far as the gross margins are concerned and the pharmacy between 45 to 50%. So on a blended basis, the gross margins are close to 77.5 to 71.7%.
Dhawal Khut
Just a follow up. So pharmacy, usually, you know, retailers don’t have more than let’s say 20, 25% of a margin. So how come we are, you know, able to get that 45, 50%? Is it a tender driven procurement or something else that I’m missing? Because ideally our margins should be in line with those of retailers, right?
Adil Agarwal
So if you see our pharmacies, we only focus on I products. We don’t, most of the other retailers sell all kinds of products. Given that there are any focus on I product, given our economy of scale, we are also able to negotiate better prices with our vendors, which is why we believe our margins are a little higher compared to other retailers.
Dhawal Khut
Do we directly procure from various manufacturers or is it we go through the regular channels and we procure it from the distributor?
Adil Agarwal
Both. We do both.
Dhawal Khut
Okay, okay. Okay. Thank you. Thanks for answering my questions.
Operator
Thank you. The next question is from the line of Ashish, an individual investor. Please go ahead.
Ashish
Hello sir. Thanks for the opportunity. Again, my question was with respect to extension by many of the hospitals as well into newer geographies, newer facilities and into daycare procedures as well. So how would the eye care change, compete vis a vis with respect to main headline hospitals? Thank you.
Adil Agarwal
So there is a fundamental differentiator between us and the multi specialty hospitals. Ashish. The multi specialty hospitals predominantly are much larger in terms of the size and format and it’s focused across different specialties like cardiac sciences, ortho, oncology, etc. We are predominantly focused only on eye care. We work on a hub and spoke model. Our model operandi is predominantly daycare. Patients come in, they get their procedures done and they leave the same day. It is a specialty business. So it is difficult to compare in terms of what is happening here versus what is happening with the multi specialty hospitals. We have specialists across all different specialties of ophthalmology. And if you see how we have grown over the last few years, it’s a combination of both existing and setting up new centers. We go a lot more deeper into existing markets and then continue to keep rolling out more centers. Multispecialty hospitals typically work on an operating bed model, which is they have a metric called rpop. We don’t have any of those metrics. Available. So our. Our business model is completely different from the multi specialty drugs.
Ashish
Sure. So my question was basically with respect to the premium surgical procedures where the margins are also high and where the 67% of the remaining growth of the balance 18% is coming in. So would there be competition from that perspective into that surgeries model? That was precisely what I was looking at.
Adil Agarwal
Okay, so you’re saying compared to the other eye care players and other players from that perspective. So we believe that we have some of the best clinicians working with us who continue to deliver outstanding clinical performance. We also work with some of the best equipment manufacturers and have high quality equipment available at our centers. For example, in cataract surgeries we work with the likes of companies like Alcon and J and J For the refractive procedures we have the best dice machines, alcohol machines and GNG machines. Again, we see many of our surgeons, they are very well trained in performing these procedures and we continue to deliver best results. As long as we continue to deliver quality clinical outcomes, we believe that patients will come to us and will be happy with our performance.
Ashish
Sure, sir. Thank you so much.
Operator
Thank you. Ladies and gentlemen, due to time constraints, that was the last question for today. I would now like to hand the conference over to Mr. Adil Agarwal for closing comments.
Adil Agarwal
So thank you everyone for taking the time. Very pleased to report strong financial results for Quarter 3 FY 2025 which has been driven by solid year on year growth across all metrics. You know, given our revenue increased by 29.5%, our EBITDA grew by 23% and PAT grew by 25%. This reflects the strength of our operations and and continued strategic execution. We believe that we will continue to show strong performance as we progress over the next years. And thank you all for us for the support. Thanks once again for taking the time and we will see you next time.
Operator
Thank you on behalf of Dr. Agarwal’s Healthcare Limited. That concludes the conference call. Thank you for joining us and you may now disconnect your lines.