Doctor Care Anywhere Group — Making progress towards profitability

Doctor Care Anywhere Group (ASX: DOC)

Currency in AUD

Last close As at 30/01/2023

AUD0.06

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Market capitalisation

AUD22m

Research: TMT

Doctor Care Anywhere Group — Making progress towards profitability

Doctor Care Anywhere Group’s (DOC) Q122 results showed continuing revenue momentum from FY21, as well as a significant expansion in its gross margin as the costs of delivering consultations reverted to more normalised levels. Over the quarter, DOC significantly reduced its overheads and believes the platform’s operating leverage will allow it to scale and reach its goal of EBITDA run-rate profitability by H123.

Max Hayes

Written by

Max Hayes

Associate Analyst

TMT

Doctor Care Anywhere Group

Making progress towards profitability

Q122 results

Software & comp services

25 April 2022

Price

A$0.27

Market cap

A$89m

A$1.75/£

Net cash (£m) at 31 March 2021

17.0

Shares in issue

329.8m

Free float

53.3%

Code

DOC

Primary exchange

ASX

Secondary exchange

N/A

Share price performance

%

1m

3m

12m

Abs

(6.9)

(44.9)

(74.4)

Rel (local)

(8.7)

(46.9)

(75.9)

52-week high/low

A$1.04

A$0.26

Business description

Doctor Care Anywhere Group is a fast-growing telehealth company focused on delivering high-quality care to its patients, while reducing the cost of providing healthcare for health insurers and healthcare providers.

Next events

Q222 trading update

July 2022

H122 results

August 2022

Analysts

Max Hayes

+44 (0)20 3077 5700

Katherine Thompson

+44 (0)20 3077 5730

Doctor Care Anywhere is a research client of Edison Investment Research Limited

Doctor Care Anywhere Group’s (DOC) Q122 results showed continuing revenue momentum from FY21, as well as a significant expansion in its gross margin as the costs of delivering consultations reverted to more normalised levels. Over the quarter, DOC significantly reduced its overheads and believes the platform’s operating leverage will allow it to scale and reach its goal of EBITDA run-rate profitability by H123.

Year end

Revenue (£m)

PBT*
(£m)

EPS*
(p)

DPS
(p)

EV/Sales
(x)

P/E
(x)

12/20

11.6

(13.5)

(7.8)

0.0

5.8

N/A

12/21

25.0

(19.3)

(5.9)

0.0

2.7

N/A

12/22e

36.2

(14.7)

(4.1)

0.0

1.9

N/A

12/23e

50.4

(1.9)

(0.5)

0.0

1.3

N/A

Note: *PBT and EPS are normalised, excluding amortisation of acquired intangibles, exceptional items and share-based payments.

Sustained positive momentum

In Q122, DOC achieved underlying revenue growth of 95% y-o-y (+9% q-o-q) to £8.6m. The annualised revenue run rate was £34.4m, providing visibility for management’s reaffirmed guidance of FY22 revenue of at least £35–38m (>40% year-on-year). Consultation volumes, its primary revenue driver, were up 68% y-o-y and 6% q-o-q to 151.9k, with the group delivering a record 54.7k primary care consultations in March. More patients used its Internet Hospital for secondary care diagnostics, up 227% y-o-y to 7.2k (+20% q-o-q). Continued growth should result in a positive step change in revenues, as well as the timing of cash flows, from Q222, following the change in the way it collects rebates (analysis in our latest outlook). However, management believes the concentration of public holidays in Q222 may affect both patient demand and clinician supply, creating short-term headwinds.

Margin pressure easing as expected

Costs per consultation reduced from £38.54 to £32.46, returning to more normalised levels following the temporary impact on the UK’s clinical workforce of COVID-19. This resulted in a 9.8pp q-o-q increase in gross margin to 45.5%, in line with management’s expectations and progressing towards our forecast margin of 47.% for FY22. We believe that consultation costs should continue to decline as the group rolls-out its new operating model from Q222 onwards, expanding its more costly GP service to also include advanced nurse practitioners or a ‘QuickConsult’ questionnaire. Operating leverage could further strengthen after the launch of its ‘health navigator’ automated triage system in Q222 and from a £3.3m reduction in annual headcount costs. Our forecasts for FY22 and FY23 remain materially unchanged, which are in line with management’s guidance, and include gross margins of 47.4% and 53.5% respectively (guidance – FY23: 50–60%) and run-rate EBITDA profitability by H123.

Valuation: Discount to peers

On EV/Sales across FY22e and FY23e, DOC trades at an average 77% and 79% discount to peers, which is at a similar level to the discounts seen across FY21.

Building towards profitable growth

Underlying group revenue increased by 95% y-o-y and by 9% q-o-q to £8.6m, driven by 68% y-o-y growth (+6% q-o-q) in consultations to 151.9k. Consultation volumes expanded month-on-month in the first quarter, reaching a record 54,700 in March. We believe that record-high waiting lists and potentially higher costs for payors due to medical cost inflation using traditional consultation routes should support ongoing growth.

Annualised revenue on a run-rate basis was £34.4m, notable given management’s reiterated guidance for FY22 revenue of at least £35–38m. This provides an early indication that its guidance, as well as our £36.2m forecast for the year, looks achievable given that the company expects to deliver another three quarters of growth. Performance during the year will be supported by the roll-out of its new operating model, and updated partnerships with AXA and Nuffield Health. These provide new revenue opportunities, as well as allowing DOC to scale more rapidly and efficiently by providing patients with broader access to the UK’s clinical workforce. More detail can be found in our latest outlook note.

However, DOC sounded a note of caution, as the concentration of UK public holidays in Q222 may lead to a short-term reduction in patient demand and clinician supply.

Exhibit 1: DOC Q122 summary

£m

Q122

Q421

q-o-q change

Q121

y-o-y change

Revenue

8.6

7.9

8.9%

6.4

34.4%

Underlying revenue*

8.6

7.9

8.9%

4.4

95.5%

Gross profit

3.9

2.8

39.3%

3.9

0.0%

Gross margin

45.5%

35.7%

9.8pp

61.0%

(15.5pp)

Underlying gross profit*

3.9

2.8

39.3%

1.9

105.3%

Underlying gross profit margin*

45.5%

35.7%

9.8pp

43.2%

2.3pp

Contribution

2.4

1.4

71.4%

2.9

(17.2%)

Contribution margin

27.8%

17.4%

10.4pp

45.0%

(17.2pp)

Underlying contribution*

2.4

1.4

71.4%

0.9

1.7pp

Underlying contribution margin*

45.5%

35.7%

9.8pp

20.0%

25.5pp

Source: Doctor Care Anywhere. Note: *Excludes one-off revenue such as underwritten volume top-up payments, tech platform licensing fees and digital design service fees.

The company saw a 9.8pp q-o-q and 2.3pp y-o-y increase in underlying gross margin in Q122, driven by a £6.08 reduction in the cost of sales per consultation to £32.46. Throughout 2021, management had to invest significantly in onboarding GPs due to supply constraints relating to COVID-19, but remained confident that margins would revert to normal levels once restrictions were lifted. An expected further reduction in consultation costs and the roll-out of its new operating model should further expand its gross margin towards our forecast of 47.4% for FY22 and 53.5% for FY23 (management’s FY23 guidance is 50–60%). Investment in automating technologies, such as its ‘health navigator’ triage tool, could help strengthen its operating leverage as it continues to scale.

Operating cash burn remained high during the period at £5.5m (+£0.1m q-o-q), but included £0.4m in one-off payments relating to headcount reduction. We believe cash burn will reduce as the group continues to scale and benefits from its expected gross margin expansion. Its balance sheet was strengthened by its February fund-raise of A$11.2m (£6.1m), which will help fund the group’s ambition of reaching EBITDA run-rate profitability by the end of H123. Our estimates are unchanged and we forecast an adjusted EBITDA loss of £0.8m for FY23.

Operational highlights

Eligible lives, the number of people that can use DOC’s platform across all its channel partners at the end of a given period, saw notable q-o-q growth for the first time since Q121, increasing by 5% to 2.6m. Activated lives, the number of eligible lives that are signed up to DOC’s platform in a given period, grew by 9% q-o-q to 735,000, with its share of eligible lives remaining flat q-o-q at 21%. This also indicates the scope for growth in its existing UK market, with management providing the example that it would only need activated lives to reach one million and for those patients to receive two consultations per year for annual revenues to exceed £100m.

Consultations, the number of virtual GP (VGP) appointments that are delivered over DOC’s platform during the period, increased to 151.9k, up 6% q-o-q and 68% y-o-y, with more than 68% from returning patients showing robust patient satisfaction. Demand continued to grow linearly in the quarter, with DOC delivering a record 54,700 consultations in March.

Exhibit 2: Consultation q-o-q growth, split between repeat and new customers

Source: Doctor Care Anywhere


Exhibit 2: Financial summary

£m

2019

2020

2021

2022e

2023e

31-December

IFRS

IFRS

IFRS

IFRS

IFRS

INCOME STATEMENT

Total Revenue

 

 

5.7

11.6

25.0

36.2

50.4

Underlying Revenue

 

 

5.7

11.6

23.0

36.2

50.4

Cost of Sales

(1.4)

(5.9)

(14.6)

(19.0)

(23.4)

Gross Profit

4.4

5.7

10.4

17.2

27.0

Normalised EBITDA

 

 

(3.7)

(11.6)

(18.0)

(13.7)

(0.8)

Normalised operating profit

 

 

(4.4)

(12.6)

(19.1)

(14.7)

(1.9)

Amortisation of acquired intangibles

0.0

0.0

0.0

0.0

0.0

Exceptionals

0.0

6.0

0.6

0.6

0.6

Share-based payments

(0.1)

(2.2)

(1.0)

(1.0)

(1.0)

Reported EBITDA

(3.8)

(13.8)

(19.0)

(14.7)

(1.2)

Reported operating profit

(4.5)

(14.7)

(20.1)

(15.7)

(2.3)

Net Interest

(0.0)

(0.1)

(0.1)

0.0

0.0

Joint ventures & associates (post tax)

0.0

(0.8)

(0.0)

0.0

0.0

Exceptionals

(1.3)

(21.7)

0.0

0.0

0.0

Profit Before Tax (norm)

 

 

(4.4)

(13.5)

(19.3)

(14.7)

(1.9)

Profit Before Tax (reported)

 

 

(5.8)

(31.4)

(20.3)

(15.7)

(2.9)

Reported tax

0.1

0.0

0.3

0.0

0.0

Profit After Tax (norm)

(4.3)

(13.3)

(19.0)

(14.7)

(1.9)

Profit After Tax (reported)

(5.7)

(31.3)

(20.0)

(15.7)

(2.9)

Basic average number of shares outstanding (m)

117.0

171.9

321.5

359.7

366

EPS - basic normalised (p)

 

 

(3.69)

(7.76)

(5.90)

(4.08)

(0.53)

EPS - diluted normalised (p)

 

 

(3.69)

(7.76)

(5.90)

(4.08)

(0.53)

EPS - basic reported (p)

 

 

(4.85)

(18.23)

(6.21)

(4.36)

(0.80)

Revenue growth (%)

184.2

102.1

115.7

45.0

39.3

Gross Margin (%)

76.1

49.2

41.6

47.4

53.5

EBITDA Margin (%)

(66.0)

(119.5)

(76.0)

(40.6)

(1.6)

Normalised Operating Margin

(76.9)

(108.5)

(76.7)

(40.6)

(3.8)

BALANCE SHEET

Fixed Assets

 

 

3.8

7.5

15.0

16.3

17.5

Intangible Assets

3.6

3.6

5.8

6.9

8.0

Tangible Assets

0.3

1.7

1.9

2.0

2.2

Investments & other

0.0

2.2

7.3

7.3

7.3

Current Assets

 

 

0.9

42.0

21.8

13.8

12.5

Stocks

0.0

0.0

0.0

0.0

0.0

Debtors

0.6

3.6

4.1

6.0

8.3

Cash & cash equivalents

0.3

38.4

17.2

7.4

3.7

Other

0.0

0.0

0.5

0.5

0.5

Current Liabilities

 

 

(2.1)

(3.8)

(5.9)

(7.8)

9.6

Creditors

(2.1)

(3.8)

(5.9)

(7.8)

9.6

Tax and social security

0.0

0.0

0.0

0.0

0.0

Short term borrowings

0.0

0.0

0.0

0.0

0.0

Other

0.0

0.0

0.0

0.0

0.0

Long Term Liabilities

 

 

(8.2)

(1.2)

(1.3)

(1.2)

1.3

Long term borrowings

0.0

0.0

0.0

0.0

0.0

Other long-term liabilities

(8.2)

(1.2)

(1.3)

(1.2)

1.3

Net Assets

 

 

(5.6)

44.5

29.6

21.0

40.9

Minority interests

0.0

0.0

0.0

0.0

0.0

Shareholders' equity

 

 

(5.6)

44.5

29.6

21.0

40.9

CASH FLOW

EBITDA

(3.8)

(7.8)

(19.0)

(14.7)

(1.8)

Working capital

0.3

(1.2)

1.6

0.1

(0.5)

Exceptional & other

0.3

(1.6)

1.1

1.0

1.0

Tax

(0.1)

(0.0)

0.3

0.0

0.0

Net operating cash flow

 

 

(3.3)

(10.7)

(15.9)

(13.5)

(1.3)

Capex

(1.7)

(1.8)

(2.7)

(2.3)

(2.3)

Acquisitions/disposals

0.0

3.0

(1.8)

0.0

0.0

Net interest

(0.3)

(0.3)

0.0

0.0

0.0

Equity financing

0.2

31.2

(0.1)

6.0

0.0

Dividends

0.0

0.0

0.0

0.0

0.0

Other

4.0

16.4

(0.5)

0.0

0.0

Net Cash Flow

(1.1)

37.8

(21.1)

(9.8)

(3.6)

Opening net debt/(cash)

 

 

(1.7)

(0.3)

(38.4)

(17.2)

(7.4)

FX

0.0

0.0

(0.1)

0.0

0.0

Closing net debt/(cash)

 

 

(0.3)

(38.4)

(17.2)

(7.4)

(3.7)

Source: Doctor Care Anywhere Group, Edison Investment Research


General disclaimer and copyright

This report has been commissioned by Doctor Care Anywhere Group and prepared and issued by Edison, in consideration of a fee payable by Doctor Care Anywhere Group. Edison Investment Research standard fees are £60,000 pa for the production and broad dissemination of a detailed note (Outlook) following by regular (typically quarterly) update notes. Fees are paid upfront in cash without recourse. Edison may seek additional fees for the provision of roadshows and related IR services for the client but does not get remunerated for any investment banking services. We never take payment in stock, options or warrants for any of our services.

Accuracy of content: All information used in the publication of this report has been compiled from publicly available sources that are believed to be reliable, however we do not guarantee the accuracy or completeness of this report and have not sought for this information to be independently verified. Opinions contained in this report represent those of the research department of Edison at the time of publication. Forward-looking information or statements in this report contain information that is based on assumptions, forecasts of future results, estimates of amounts not yet determinable, and therefore involve known and unknown risks, uncertainties and other factors which may cause the actual results, performance or achievements of their subject matter to be materially different from current expectations.

Exclusion of Liability: To the fullest extent allowed by law, Edison shall not be liable for any direct, indirect or consequential losses, loss of profits, damages, costs or expenses incurred or suffered by you arising out or in connection with the access to, use of or reliance on any information contained on this note.

No personalised advice: The information that we provide should not be construed in any manner whatsoever as, personalised advice. Also, the information provided by us should not be construed by any subscriber or prospective subscriber as Edison’s solicitation to effect, or attempt to effect, any transaction in a security. The securities described in the report may not be eligible for sale in all jurisdictions or to certain categories of investors.

Investment in securities mentioned: Edison has a restrictive policy relating to personal dealing and conflicts of interest. Edison Group does not conduct any investment business and, accordingly, does not itself hold any positions in the securities mentioned in this report. However, the respective directors, officers, employees and contractors of Edison may have a position in any or related securities mentioned in this report, subject to Edison's policies on personal dealing and conflicts of interest.

Copyright: Copyright 2022 Edison Investment Research Limited (Edison).

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New Zealand

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General disclaimer and copyright

This report has been commissioned by Doctor Care Anywhere Group and prepared and issued by Edison, in consideration of a fee payable by Doctor Care Anywhere Group. Edison Investment Research standard fees are £60,000 pa for the production and broad dissemination of a detailed note (Outlook) following by regular (typically quarterly) update notes. Fees are paid upfront in cash without recourse. Edison may seek additional fees for the provision of roadshows and related IR services for the client but does not get remunerated for any investment banking services. We never take payment in stock, options or warrants for any of our services.

Accuracy of content: All information used in the publication of this report has been compiled from publicly available sources that are believed to be reliable, however we do not guarantee the accuracy or completeness of this report and have not sought for this information to be independently verified. Opinions contained in this report represent those of the research department of Edison at the time of publication. Forward-looking information or statements in this report contain information that is based on assumptions, forecasts of future results, estimates of amounts not yet determinable, and therefore involve known and unknown risks, uncertainties and other factors which may cause the actual results, performance or achievements of their subject matter to be materially different from current expectations.

Exclusion of Liability: To the fullest extent allowed by law, Edison shall not be liable for any direct, indirect or consequential losses, loss of profits, damages, costs or expenses incurred or suffered by you arising out or in connection with the access to, use of or reliance on any information contained on this note.

No personalised advice: The information that we provide should not be construed in any manner whatsoever as, personalised advice. Also, the information provided by us should not be construed by any subscriber or prospective subscriber as Edison’s solicitation to effect, or attempt to effect, any transaction in a security. The securities described in the report may not be eligible for sale in all jurisdictions or to certain categories of investors.

Investment in securities mentioned: Edison has a restrictive policy relating to personal dealing and conflicts of interest. Edison Group does not conduct any investment business and, accordingly, does not itself hold any positions in the securities mentioned in this report. However, the respective directors, officers, employees and contractors of Edison may have a position in any or related securities mentioned in this report, subject to Edison's policies on personal dealing and conflicts of interest.

Copyright: Copyright 2022 Edison Investment Research Limited (Edison).

Australia

Edison Investment Research Pty Ltd (Edison AU) is the Australian subsidiary of Edison. Edison AU is a Corporate Authorised Representative (1252501) of Crown Wealth Group Pty Ltd who holds an Australian Financial Services Licence (Number: 494274). This research is issued in Australia by Edison AU and any access to it, is intended only for "wholesale clients" within the meaning of the Corporations Act 2001 of Australia. Any advice given by Edison AU is general advice only and does not take into account your personal circumstances, needs or objectives. You should, before acting on this advice, consider the appropriateness of the advice, having regard to your objectives, financial situation and needs. If our advice relates to the acquisition, or possible acquisition, of a particular financial product you should read any relevant Product Disclosure Statement or like instrument.

New Zealand

The research in this document is intended for New Zealand resident professional financial advisers or brokers (for use in their roles as financial advisers or brokers) and habitual investors who are “wholesale clients” for the purpose of the Financial Advisers Act 2008 (FAA) (as described in sections 5(c) (1)(a), (b) and (c) of the FAA). This is not a solicitation or inducement to buy, sell, subscribe, or underwrite any securities mentioned or in the topic of this document. For the purpose of the FAA, the content of this report is of a general nature, is intended as a source of general information only and is not intended to constitute a recommendation or opinion in relation to acquiring or disposing (including refraining from acquiring or disposing) of securities. The distribution of this document is not a “personalised service” and, to the extent that it contains any financial advice, is intended only as a “class service” provided by Edison within the meaning of the FAA (i.e. without taking into account the particular financial situation or goals of any person). As such, it should not be relied upon in making an investment decision.

United Kingdom

This document is prepared and provided by Edison for information purposes only and should not be construed as an offer or solicitation for investment in any securities mentioned or in the topic of this document. A marketing communication under FCA Rules, this document has not been prepared in accordance with the legal requirements designed to promote the independence of investment research and is not subject to any prohibition on dealing ahead of the dissemination of investment research.

This Communication is being distributed in the United Kingdom and is directed only at (i) persons having professional experience in matters relating to investments, i.e. investment professionals within the meaning of Article 19(5) of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005, as amended (the "FPO") (ii) high net-worth companies, unincorporated associations or other bodies within the meaning of Article 49 of the FPO and (iii) persons to whom it is otherwise lawful to distribute it. The investment or investment activity to which this document relates is available only to such persons. It is not intended that this document be distributed or passed on, directly or indirectly, to any other class of persons and in any event and under no circumstances should persons of any other description rely on or act upon the contents of this document.

This Communication is being supplied to you solely for your information and may not be reproduced by, further distributed to or published in whole or in part by, any other person.

United States

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Frankfurt +49 (0)69 78 8076 960

Schumannstrasse 34b

60325 Frankfurt

Germany

London +44 (0)20 3077 5700

280 High Holborn

London, WC1V 7EE

United Kingdom

New York +1 646 653 7026

1185 Avenue of the Americas

3rd Floor, New York, NY 10036

United States of America

Sydney +61 (0)2 8249 8342

Level 4, Office 1205

95 Pitt Street, Sydney

NSW 2000, Australia

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Research: Healthcare

Context Therapeutics — R&D webinar highlights pipeline potential

Context Therapeutics’ R&D webinar covered key takeaways from its five posters presented at the AACR Annual Meeting in April 2022. While the results reiterated the potential benefits of ONA-XR with standard-of-care treatment, the notable highlight was the possible combination with checkpoint inhibitors (turning ‘immunologically cold tumors hot’) and the Aurora A/STAT3 oncogenic signaling pathway (implicated in resistance to endocrine treatment) for treatment of hormone-driven cancers. Beyond ONA-XR, preclinical data presented on the CLDN6xCD3 library reasserted the higher selectivity of Context’s pipeline for CLDN6 (versus competitors), with the final clinical candidate expected to be selected by H222.

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