A 49.9% stake in Flight Ambulance International (FAI), the largest for-profit fixed wing medical evacuation group in Europe, has been sold for €15m by the Axtmann family to Marfin Investment Group, with the right to buy control available for an additional €2.5m. The deal values Air Ambulance at 6.5 times forecast pre-tax 2008 profits.
Greek financial group Marfin raised €5.2 billion in July 2007 to invest in South East Europe, and has invested a total of €74.5 million in Hygiea, one of the top 3 Greek hospital chains, where it has a 31% stake.
Marfin has played a major role at Hygiea in consolidating the sector, with the acquisition of 2 highly profitable maternity hospitals - Mitera and Leto. Marfin Investment Director George Koulouris said there should be synergies between FAI and Hygeia.
FAI Chairman Siegfried Axtmann told Healthcare Europa: "The three other big contenders in medical evacuation in Europe are all not-for-profit groups - Swiss group Rega and the German and Lumxembourg Air Rescue services."
Thanks to the high debt levels common to airline financing, the EBITDA multiple comes to just 4.9 times, but Axtmann says the pre-tax multiple, at 6.5 times, is at the industry norm. Flight Ambulance sales came to €26 million.
Some 75% of revenue comes from medical evacuation for insurers and corporates, with 25% mainly from working for the United Nations and other NGOs. Axtmann indicated that the NGO market was where the growth was likely to be.
Axtmann says that the US market is completely separate from the European market: "We don't get involved in the Americas, but focus on Europe-Asia and Europa-Africa, and the Americans don't get involved over here."
Interestingly, he says the US market is more fragmented than Europe, and doubted whether there were any fixed-wing medical evacuation companies of his size in the USA.
Marfin is likely to make large acquisitions in healthcare services in south east Europe, says Koulouris: "We are interested in Romania, although we will wait until the market settles, but we are mainly interested in Turkey, because of its size and the weakness of the public sector." Marfin has also recently raised €5bn to invest in financial services in the region.
