Investor Presentation January 2018 Disclaimer (1/2) The following - - PowerPoint PPT Presentation

▶

Feb 27, 2024 31 likes •486 views

Investor Presentation January 2018 Disclaimer (1/2) The following applies to this document, the oral presentation of the information in this document and any question-and-answer session that follows the oral presentation (collectively, the

SLIDE 1

Investor Presentation

January 2018

SLIDE 2

Disclaimer (1/2)

The following applies to this document, the oral presentation of the information in this document and any question-and-answer session that follows the oral presentation (collectively, the “presentation”), each of which should be considered together and not taken out of context. This presentation has been prepared by MLP Sağlık Hizmetleri A.Ş. (the “Company”) and is being provided to you solely for discussion purposes in relation to the Company’s proposed listing on Borsa Istanbul and the proposed offering (the "Offering") of ordinary shares of the Company (the “Shares”) by the Company and certain shareholders of the Company (the “Selling Shareholders”). This presentation does not constitute or form part of any offer or invitation to sell or issue, any offer or inducement or invitation or commitment to purchase or subscribe for, or any solicitation of any offer to purchase or subscribe for, the Shares or any other securities of the Company or securities in any other entity nor shall it or any part of it nor the fact of its distribution form the basis of, or be relied on in connection with, any contract or investment decision in relation thereto. Any purchase of the Shares in the Offering should be made solely on the basis of the information contained in the Turkish language prospectus for the Turkish retail and institutional investors to be published in respect to the Offering within the Republic of Turkey (the "Turkish Prospectus") or the final offering circular for institutional investors to be prepared in connection with the Offering outside the Republic of Turkey (the "Offering Circular"), as applicable. This presentation is the sole responsibility of the Company. The information contained in this presentation does not purport to be comprehensive and has not been independently verified. The information contained herein is for discussion purposes only and does not purport to contain all information that may be required to evaluate the Company and/or its business, financial position or future performance. The information and opinions contained in this document are provided

nly as at the date of the presentation and are subject to change without notice. Some of the information is still in draft form and will be finalised or completed only at the time of publication by the Company of the Turkish Prospectus or the final

Offering Circular, as applicable, in connection with the Offering. Goldman Sachs International (“GS”), J.P. Morgan Securities plc (“JPM”), HSBC Bank plc ("HSBC"), and Merrill Lynch International ("BofAML"), which are authorised in the United Kingdom by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority, are acting exclusively for the Company and the Selling Shareholders and for no-one else in connection in respect of the Offering and will not regard any other person (whether or not a recipient of this presentation) as a client in relation to the Offering and will not be responsible to any other person for providing the protections afforded to their respective clients, or for advising any such person on the contents of this presentation or in connection with any transaction referred to in this presentation. The contents of this presentation have not been verified by GS, JPM, HSBC, BofAML or any of their respective affiliates (together, the “Banks”). No reliance may be placed for any purposes whatsoever on the information contained in this presentation or on its completeness. Details included in this presentation are subject to updating, revision, further verification and amendment. Neither the Company nor the Selling Shareholders are under any obligation to update or keep current the information contained in this presentation. No representation or warranty, express or implied, is given by or on behalf of the Company, the Selling Shareholders or the Banks or their respective subsidiary undertakings, affiliates, agents or advisers or any of such persons’ affiliates, directors, officers or employees or any other person as to the fairness, accuracy, completeness

r verification of the information or the opinions contained in this presentation and no liability is accepted for any such information or opinions. Each of the Company, the Selling Shareholders and the Banks or any such persons’ directors,
fficers, employees or affiliates or any other person disclaim all and any responsibility and liability whatsoever, whether arising in tort, contract or otherwise, for any errors, omissions or inaccuracies in such information or opinions or for any

loss, cost or damage suffered or incurred howsoever arising, directly or indirectly, from any use of this presentation or its contents or otherwise in connection with this presentation. Persons reading this presentation must make all trading and investment decisions in reliance on their own judgement and not in reliance on the Banks. No statement in this presentation is intended to be nor may be construed as a profit forecast. The Banks are not providing any advice on the suitability of the matters set out in this presentation or otherwise providing any investment advice or personal recommendations. Any research or other information communicated or otherwise made available in this presentation is incidental to the provision of services by the Banks to the Company and the Selling Shareholders and is not based on individual circumstances. This presentation is not intended to provide, and should not be relied upon for, accounting, legal or tax advice nor does it constitute a recommendation regarding the Offering. Accordingly, by attending any presentation in which this presentation is made available or by receiving this presentation through any other means, you represent that you are able to receive this presentation without contravention of any legal or regulatory restrictions applicable to you and will not use this information in relation to any investment decisions (if any). This presentation and its contents are confidential and may not be reproduced, redistributed, published or passed on, directly or indirectly, to any other person or published, in whole or in part, for any purpose. Failure to comply with these restrictions may constitute a violation of applicable securities laws. Certain information contained in this presentation has been obtained from published and non-published sources prepared by other parties, which in certain cases have not been updated to the date hereof. While such information is believed to be reliable for the purpose used in this presentation, each of the Company, the Selling Shareholders and the Banks do not assume any responsibility for the accuracy or completeness of such information and such information has not been independently verified by the Company, the Selling Shareholders or the Banks. Except where otherwise indicated herein, the information provided in this presentation is based on matters as they exist as of the date of preparation and not as of any future date, and will not be updated or otherwise revised to reflect information that subsequently becomes available, or circumstances existing or changes occurring after the date hereof. This presentation does not constitute an offer of securities for sale and is not for transmission to, publication or distribution or release in the United States of America (including its territories and possessions, any state of the United States of America and the District of Columbia) (“United States”), Canada, Australia, Japan or the Republic of South Africa, or to any other country where such distribution may lead to a breach of any law or regulatory requirement.

SLIDE 3

Disclaimer (2/2)

This presentation is only addressed and directed at (a) persons in member states of the European Economic Area (“Member States”) who are “qualified investors” within the meaning of Article 2(1)(e) of the Prospectus Directive (Directive 2003/71/EC as amended (including amendments by Directive 2010/73/EU to the extent implemented in the relevant Member State) (“Qualified Investors”); (b) within the United Kingdom, this presentation is intended for distribution only to persons who (i) have professional experience in matters relating to investments and who fall within the definition of “investment professionals” in Article 19(5) of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005 (as amended) or are high net worth companies, unincorporated associations or partnerships or trustees of high value trusts as described in Article 49(2) of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005 (as amended) and investment personnel of any of the foregoing (each within the meaning of the Financial Services and Markets Act 2000 (Financial Promotion) Order 2005) and (ii) are “qualified investors” as defined in section 86 of the Financial Services and Markets Act 2000, as amended; (c) outside the United States to non-US Persons (as defined in Regulation S (“Regulation S”) under the US Securities Act of 1933, as amended (the “Securities Act”) in reliance upon Regulation S; (d) in the United States to persons reasonably believed to be “qualified institutional buyers” as defined in Rule 144A under the Securities Act; and (e) other persons to whom it may otherwise lawfully be communicated (all such persons together being referred to as “Relevant Persons”). This presentation must not be made available (i) in the United Kingdom, to persons who are not Relevant Persons, and (ii) in any Member State other than the United Kingdom, to persons who are not Qualified Investors. No person should act or rely on this presentation and persons distributing this presentation must satisfy themselves that it is lawful to do so. By accepting this presentation you represent, warrant and agree that you are a Relevant Person. The Shares or any other securities of the Company have not been and will not be registered under the Securities Act, or under any applicable securities laws of any state or other jurisdiction of the United States. Subject to certain exceptions, none of the securities of the Company may be offered, sold, taken up, resold, transferred or delivered, directly or indirectly, into or within the United States or to or for the account or benefit of US Persons (as defined in Regulation S) unless registered under the Securities Act or pursuant to an exemption from or in a transaction not subject to such registration requirements and in accordance with any applicable securities laws of any state or other jurisdiction of the United States. There will be no public offer of the securities of the Company in the United States. Distribution of this presentation may be prohibited in the United States and it must not be transmitted to, published or distributed or released in the United

States. You are required to inform yourself or, and comply with, all such restrictions or prohibitions and none of the Company, the Selling Shareholders or the Banks or any other person accepts liability to any person in relation thereto.

Certain statements in this presentation constitute forward-looking statements. All statements that address expectations or projections about the future, including statements about operating performance, market position, industry trends, general economic conditions, expected expenditures and financial results, are forward-looking statements. Some of the forward-looking statements may be identified by words like “expects”, “anticipates”, “plans”, “intends”, “projects”, “indicates” and similar expressions. Any statements contained herein that are not statements of historical fact are forward-looking statements. These statements are not guarantees of future performance and involve a number of risks, uncertainties and assumptions. Accordingly, actual results or the performance of the Company or its subsidiaries may differ significantly, positively or negatively, from forward-looking statements made herein. Unanticipated events and circumstances are likely to occur. Factors that might cause such differences include, but are not limited to, risks related to regulatory changes and other external factors that may affect the healthcare industry; global economic and business conditions and their impact on the Company’s business; business strategy and plans not achieving the anticipated results; the Company’s ability to manage its growth; the Company’s use of information technology and ability to protect its data from breaches; the Company’s ability to satisfy the requirements of its licenses and other applicable regulations; the Company’s ability to receive payments from private insurers, government-sponsored insurers, contracted institutions and private payors; the impact of foreign currency fluctuations; and the ability to retain senior management and attract and retain qualified and experienced medical professionals and employees. Due to various risks and uncertainties, actual events or results or actual performance may differ materially from those reflected or contemplated in such forward-looking statements. As a result, you should not rely on such forward-looking statements in making any investment decision. No representation or warranty is made as to the achievement or reasonableness of and no reliance should be placed on such forward-looking statements. THE INFORMATION WITH RESPECT TO ANY PROJECTIONS PRESENTED HEREIN IS BASED ON A NUMBER OF ASSUMPTIONS ABOUT FUTURE EVENTS AND IS SUBJECT TO SIGNIFICANT ECONOMIC AND COMPETITIVE UNCERTAINTY AND OTHER CONTINGENCIES, NONE OF WHICH CAN BE PREDICTED WITH ANY CERTAINTY AND SOME OF WHICH ARE BEYOND THE CONTROL OF THE COMPANY OR THE SELLING SHAREHOLDERS. THERE CAN BE NO ASSURANCES THAT THE PROJECTIONS WILL BE REALISED, AND ACTUAL RESULTS MAY BE HIGHER OR LOWER THAN THOSE INDICATED. NONE OF THE COMPANY, THE SELLING SHAREHOLDERS OR ANY OF THEIR RESPECTIVE SECURITYHOLDERS, DIRECTORS, OFFICERS, EMPLOYEES, ADVISORS OR AFFILIATES, OR ANY REPRESENTATIVES OR AFFILIATES OF THE FOREGOING, ASSUMES RESPONSIBILITY FOR THE ACCURACY OF THE PROJECTIONS PRESENTED HEREIN. By attending this presentation and/or accepting or reading a copy of this presentation, you agree to be bound by the foregoing limitations and conditions and, in particular, will be taken to have represented, warranted and undertaken that: (i) you have read and agree to comply with the contents of this notice including, without limitation, the obligation to keep this presentation and its contents confidential, (ii) you are a Relevant Person (as defined above); and (iii) you will be solely responsible for your own assessment of the Company and its business, financial position and future performance and will make any investment decision solely on the basis of the final Turkish Prospectus or the final Offering Circular, as applicable. Private and Confidential For personal use only and not for distribution

SLIDE 4

Overview of MLP

SLIDE 5

5 14 1 29 1993 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 Today Number of Hospitals

MLP: The #1 Private Hospital Group in Turkey

1 Assumes USD:TL average exchange rate of 3.02. 2 Calculated as Reported EBITDA (please see Appendix for definition) adjusted for TL 44m of one-time operational FX loss, TL 3m of one-time revenues loss and TL 5m of non-cash expense provisions. 3 Denotes 2014A-2016A CAGR. 4 Includes two managed hospitals.

The Largest Private Hospital Group in Turkey

(Hospitals, beds, cities)

Year Track Record

Hospitals; More than the #2 and #3 Competitors Combined

Addresses All Price Segments

in the Turkish Market

TL 312m (~$103m1)

2016 Adjusted EBITDA2

22% Growth3

TL 354m (~$117m) 2016 Reported EBITDA / 34% Growth3

16,000+

Employees

2,000+

Doctors

Cities Covered

TL ~2bn (~$700m1)

2016 Revenue

19% Growth2 3 JCI Accredited Hospitals 3 Centers of Excellence 5,300+

Beds; Over 2x the #2 Largest Competitor

SLIDE 6

MLP is the Leading Private Hospital Group in Turkey

Operates in the Attractive Turkish Healthcare Market 1 Clear Leader in Private Hospital Provision 2 Strong Brand Recognition and Unique Business Model Addressing All Price Points 3 Clinical Excellence and World Class Service Offering 4 Superior Operational and Financial Performance 5 Outstanding Platform for Further Growth 6 Visionary Leadership Supported by Outstanding Management Team 7

SLIDE 7

18 18 19 19 18 19 16 19 7 9 2016 2023 2016-2023 CAGR 1% 4% 2% 0% 0% 0% 79 84 0-14 15-29 30-44 45-64 65+

24% 17% 17% 13% 27% 24% 24% 31% 9% 15%

2016 2023 2016-2023 CAGR 9% 5% 0% (3)% (4)%

Operates in the Attractive Turkish Healthcare Market

Significant Scope For Expansion Compared to OECD2 Peers

Turkish Healthcare Spending to Providers1 (TLbn)

Growth in Aging Turkish Population (millions)

Source: IMS Health, Euromonitor International, OECD, Espicom Business Intelligence, MoH Statistics 2015 (published in Dec-2016), Turkish Statistical Institute, TOBB Report

1 Denotes hospitals only excluding pharmaceutical, medical equipment, dental and other. 2 Denotes the Organization for Economic Cooperation and Development including 35 member countries: USA, Sweden,

Switzerland, France, Germany, Austria, New Zealand, Netherlands, Denmark, Belgium, Canada, Japan, Norway, Finland, Portugal, Australia, Italy, Slovenia, UK, Spain, Iceland, Greece, Slovakia, Israel, Chile, Ireland, Czech Republic, Hungary, Luxembourg, Lithuania, Estonia, Poland, Mexico, Latvia and Turkey. 3 209,648 beds in Turkey.

Healthcare Spending Per Capita ($’000) Healthcare Spending % of GDP Hospital Beds Per Capita (‘000)3

Turkey is an attractive healthcare market with a growing elderly population and level of affluence, with significant scope for expansion compared to OECD players

1

Growing Levels of Affluence in Turkey

Income Bracket Distribution (%)

Low (<$10k) Lower Mid ($10-15k) Mid ($15-25k) Upper Mid ($25-50k) High (>$50k)

0.6 3.9 Turkey OECD Median² 5.4% 9.2% Turkey OECD Median² 2.7 4.6 Turkey OECD Median²

MoH Goal: 3.2

36 76 2009 2015

SLIDE 8

18% 31% 34% 53% 82% 69% 66% 47% Doctors' Consultations Inpatient Stays All Surgeries Complex Surgeries² Private Public¹ 32% 43% 68% 57% 16 32 2009 2015 12% 17% 9% 2009-2015 CAGR 13% 21% 87% 79% 189 210 2009 2015 2009-2015 CAGR 2% 10% 0%

Operates in the Attractive Turkish Healthcare Market

Number of Hospital Beds (’000) Hospital Bed Utilization (Licensed Capacity) Number of Inpatient Visits (m)

Source: Ministry of Health, Health Statistics Yearbook 2013, 2015, TOBB report; 1 Public includes Ministry of Health and University hospitals; 2 A1 type surgeries e.g., organ transplants, 2014 numbers due to data availability

1

Private operators have increased their market share, by increasing capacity and by focusing on procedures with higher complexity. Private players now account for 21% of beds, but provide 53% of complex surgeries.

Provision of Healthcare Services (2015) Number of Intensive Care Beds (‘000)

Private Public¹ Private Public¹ Private Public¹ 25% 31% 75% 69% 10 13 2009 2015 2009-2015 CAGR 5% 9% 4% 50% 60% 65% 72% 81% 76% 2009 2015 Private Public University

SLIDE 9

Operates in the Attractive Turkish Healthcare Market

Healthcare system and key participants

Source: OECD reviews of health systems, Turkey 2008, Turkstat, TOBB report

1 TOBB report; 2 SUT prices = SSI tariffs; 3 200%+ on all services (except a few specified services); 4 Based on number of policies sold

Supportive government policies have underpinned the expansion of private hospital groups

Ministry of Health (MoH) Social Security Institute (SSI)  Monitors quality at all public and private hospitals  Owns and operates public hospitals  Controls the number of licences in the sector  Main provider of financing to the healthcare sector  Monitors usage statistics across private and public hospitals

Universal Healthcare Coverage with Patient Choice

Universal healthcare coverage (UHI)

 Healthcare reforms initiated in 2004  Primary care free of charge for all citizens Regulation Funding Service Patients

MoH
University Hospitals
Private Healthcare

Institutions

Treasury
SSI
Private Insurance
Self-Pay

 98%1 population

coverage by UHI

System favours patient choice

 Services provided by both public and contracted private hospitals with SSI being the key payor

 Private hospitals are able to charge

higher rates than public hospitals, with some payment required from SSI patients

–

SSI reimburses private hospitals using SUT prices2 (stable since 2008)

–

Private hospitals have the right to charge +200%3 over and above SUT prices2

 Patients’ choice  Partial SSI

reimbursements

 Co-pay up to

200% above SUT prices2

Top-up insurance (since 2014)

 Cheaper form of PMI to cover SSI patients’ co- pay costs  Can only be used at hospitals that signed a contract with SSI  Top-up PMI is the fastest growing segment of the health insurance market with 2014-16 CAGR of >150%4

 Attractive funding

structures increasing accessibility

Government
MoH

Regulator Payor 43% 58% 57% 42% 10 19 2009A 2015A

Healthcare expenditure in private providers by payor type (TLbn)

CAGR 2009–2015 13% 7% 19% Private Public (SSI + MoH)

1

SLIDE 10

10 Total Turkish Private Sector Total Turkish Public Sector

Source: TOBB report (Private and Public Sector data), Latest information from company websites, Company Analysis, Turkstat (population estimates 2016)

Clear Leader in Private Hospital Provision

MLP is the leading Turkish player in terms of footprint with ~2x as many hospitals, beds and cities present in as nearest competitor Competitors (with 10 or more hospitals) Number of Hospitals Locations Covered Number of Beds

29 16 10 10 562 ~970 5.330 2.271 1.476 1.380 43.645 17 8 5 5 68 81

Avg. number of beds / hospital

184 142 148 138 42 30 26 24

Population served (mm, 2016)

~75 ~166,000

2

SLIDE 11

Clear Leader in Private Hospital Provision

MLP is the largest multi-specialty hospital group in Turkey and the only private player with a truly nationwide network

 National and local leader with a network covering the greatest number of cities  40% of beds located in the attractive Istanbul market  MLP has the highest number of beds in nearly every city in which they are present

MLP network (# of hospitals and locations)

Batman Elazığ Gaziantep Tarsus Antalya Uşak İzmir Çanakkale Ordu Tokat Samsun Ankara Ereğli Kocaeli Bursa Trabzon 1 1 1 1 1 1 1 2 1 2 2 1 2 1 1 1 9 İstanbul

Bed concentration in İstanbul:

MLP: 40%
Acibadem: 67%
Memorial: 34%
Medicana: 42%

Source: Source: Latest information from company websites, Company Analysis, Turkstat (population estimates 2016)

1 Turkstat, 2016 population; 2 Latest information from company websites

Location (in order

f population)2

İstanbul 9 2,132 9 1,513 3 509 6 577 Ankara 2 348 1 103 1 230 1 146 İzmir 1 244

Bursa

1 214 1 174

Mersin (Tarsus)

1 133

Antalya

1 228

342

Adana
1

105

Konya
1

201 Gaziantep 1 243

Kocaeli

2 300 1 61

Diyarbakır
2

276

Kayseri
1

104 1 119

Samsun

2 347

285 Bodrum (Muğla)

104

Eskişehir
1

107

Trabzon

2 238

Ordu

1 168

Sivas
1

171 Tokat 1 100

Ereğli (Zonguldak)

1 113

Elazığ

1 206

Batman

1 110

Çanakkale

1 75

Uşak

1 131

Total

29 5,330 16 2,271 10 1,476 10 1,380

>5mm 2mm – 5mm 1mm- 2mm <1mm Pop.¹

2

SLIDE 12

Clear Leader in Private Hospital Provision

¹ Ministry of Health, Health statistics yearbook 2015, as of 2015

MoH is investing in the PPP program, but large private players do not expect to see an impact in the near / mid term

Premium

 Private hospital’s target population is significantly different from what the PPP

hospitals are expected to attract

 Emergence of large PPP hospitals can accelerate consolidation in the industry,

resulting in smaller hospitals having just license value

 As such, MLP is expected to be minimally impacted by the MoH’s PPP

initiative Highly illustrative schematic of the Turkish Healthcare Sector

Private Hospital market

Public Hospital market PPP success factors

Operational excellence High service quality Healthcare personnel

 City hospitals are mega health complexes requiring operational excellence to ensure financial sustainability and top quality  Right governance system needs to be in place  MoH needs to staff city hospitals with the right quantity and quality of medical staff  Some public hospitals may need to be closed and staff re-located  Re-location of medical staff may pose some risk due to remote location of city hospitals  MoH needs to ensure patient demand through high quality service  Significant increase in travel time, especially for outpatient or unplanned visits may hinder demand

Top end of the Private Hospital market

Public and Private Hospital market

PPP will likely attract patients from public hospitals and less competitive, smaller private hospital

perators

2

SLIDE 13

13 Concept Overview and Positioning

Strong Brand Recognition and Unique Business Model Addressing Multiple Price Points

Three concepts targeting three different price points with consistently outstanding medical service quality

Premium

Relative Average Price per Payor Type (2016A)

Outpatients Inpatients

Number of hospitals including a particular concept

Note: Three acquired hospitals (Ereğli, Avcılar and Çanakkale) are operated under the name of “Anadolu Hastanesi”, instead of Medical Park

3 13 22

29 Total Hospitals in Portfolio 1.0x 1.9x 5.3x 1.0x 1.8x 3.6x

Premium segment Premium mass segment Upper mass segment

3

SLIDE 14

14 SSI 36% Self-Pay 33% PMI and Contracted Institutions 17% Medical Tourism 7%

Strong Brand Recognition and Unique Business Model Addressing Multiple Price Points

Business model results in a balanced portfolio covering multiple payor types YTD Sep-2017 Revenue Breakup by Payor Type  SSI coverage allows us to reach the majority of the Turkish population  Self-pay increasing via premium service offering and elective procedures  PMI market share has grown through increased focus; increase in market share from 2% in 2012 to 7% in 20161  Medical Tourism growing from a small and sustainable base  Ancillary services serve our hospitals and help support the business

Denotes revenue growth over the period 9M 2016 – 9M 2017

Source: Turkish Reinsurers and Insurers Association. 1 Calculated as MLP revenue from private medical insurance (excluding contracted institutions revenue) divided by the total payment made by insurers to healthcare providers.

8% 17% 32% 54% 49% Other Ancillary Business 7%

3

SLIDE 15

Clinical Excellence and World Class Service Offering 4

MLP benefits from a “Virtuous Circle” of best-in-class service, infrastructure and academic affiliations

1 Denotes Surgical Review Corporation.

Highly diversified full service offering

(No medical department comprises >9% of total sales)

JCI accreditation

The Gold Standard in Healthcare Globally

Bahçelievler Göztepe İzmir Colorectal Surgery Robotic Surgery Metabolic and Bariatric Surgery 1st outside the US World’s 1st 100% success rate

SRC1

The Global standard for quality surgical care

Gamma Knife Da Vinci Robotic Surgery

 518 academicians working as

physicians at MLP hospitals University affiliations

 13,000 scientific activities and

publications in the last two years

 Enable us to maintain flexibility in our doctor

portfolio

 Attract Turkey’s most skilled and

experienced doctors

SLIDE 16

16 153 308 518 1.555 1.525 1.517 1.708 1.833 2.035 2015 2016 Eyl.17 # Share of academicians # Other physicians

11% 2% MLP share in private beds MLP share in total beds

Ability to attract and retain top-tier physicians… …and drive patient in-flows to grow market share in Turkey Top tier talent and patients are attracted to MLP’s unrivalled reputation, resulting in a steadily growing market share Key points of attraction Proven track record of physicians recruitment Top tier physicians choose MLP for:  Strong and reliable brand  Leading market share  State-of-the-art infrastructure  Universities affiliations  Vast exposure to complex cases MLP share in beds1 MLP share in inpatients1 MLP share in complex surgeries1

15% 4% MLP share in inpatients in the private sector MLP share in total inpatients 48% 36% 19% 17% 16% 15% 14% 14% Bone Marrow Transplant Chemotherapy Radiotherapy Stent By-Pass Invasive Procedures Angio A-type surgeries

Complex surgeries in private sector

Source: Turkish Ministry of Health. 1 Data as of 2017. 2 Assumes growth in beds based on 7.2% 2013-2015 private beds CAGR and 1.9% 2013-2015 total beds CAGR applied to 2015 MoH figures.

Clinical Excellence and World Class Service Offering 4

2 2

CAGR 2015–Sep-2017 11% 101%

SLIDE 17

Superior Operational and Financial Performance

Attractive double-digit historical growth

Adjusted EBITDAR¹ (TLm) Total Revenue (TLmm) Adjusted EBITDA¹ (TLm)

Margin % Margin %

299 371 463 333 422 285 368 504 342 412 2014A 2015A 2016A 9M 2016A 9M 2017A 1.518 1.843 2.160 1.569 1.873 2014A 2015A 2016A 9M 2016A 9M 2017A 210 238 312 222 282 196 235 354 232 272 2014A 2015A 2016A 9M 2016A 9M 2017A 21.4% 17.2% 19.7% 20.1% 21.4% 13.8% 12.9% 14.5% 19.4% Adjusted EBITDAR Reconciliation to Reported EBITDAR Adjusted EBITDA Reconciliation to Reported EBITDA

¹ Based on adjusted EBITDA for non-recurring FX gain/losses and non-cash GAAP provision expenses (please see Appendix for details)

14.2% 15.1% 21.2% 22.5%

Growth %

5

SLIDE 18

254 276 319 224 263 2014 2015 2016 9M 2016A 9M 2017A 18.4% 17.5% 18.8% 18.1% 18.2% 3 18 8 15 2014 2015 2016 9M 2016A 9M 2017A 4.8% 0.2% 5.5% 3.2% 5.1%

Superior Operational and Financial Performance

Estate Overview Developing Estate

Note: Revenue and Contribution from Managed Hospitals is not consolidated in Hospital Revenues and included as part of Other Ancillary Business. Mature refers to hospitals opened, or acquired as well as integrated in the MLP IT system, prior to 2015, and Developing refers to hospitals opened / acquired / integrated after 2015. 1 Hospital counts by Estate as part of current MLP portfolio as at Sep-2017. 2 Excludes headquarters costs and contribution from Other Ancillary Business.

Mature Estate

FYE Dec-2016A Breakdown of Beds FYE Dec-2016A Revenue Breakdown Revenue2 (TLm) / Growth (%) Contribution2 (TLm) / Margin (%) Revenue2 (TLm) / Growth (%) Contribution2 (TLm) / Margin (%) Total: TL 2,160m

Robust growth and financial performance seen across Mature and Developing hospitals…

9 Developing Hospitals1 18 Mature Hospitals1 Mature 67% Developing 26% Managed 8% 2 Managed Hospitals1 Developing 15% Mature 78% Other Ancillary Business 6%

5

1,385 1,575 1,695 1,240 1,449 2014 2015 2016 9M 2016A 9M 2017A 13.7% 7.6% 16.9% 68 187 333 241 293 2014 2015 2016 9M 2016A 9M 2017A 176.3% 77.6% 21.5%

SLIDE 19

390 18 79 487 8 92 587 2014 Hospital Revenue Volume Price 2015 Hospital Revenue Volume Price 2016 Hospital Revenue 34 58 5 96 43 39 178 2014 Hospital Revenue Volume Price 2015 Hospital Revenue Volume Price 2016 Hospital Revenue 34 52 2 88 30 29 146 2014 Hospital Revenue Volume Price 2015 Hospital Revenue Volume Price 2016 Hospital Revenue 771 88 24 882 70 50 1,003 2014 Hospital Revenue Volume Price 2015 Hospital Revenue Volume Price 2016 Hospital Revenue

Note: Analysis based on domestic revenues excluding medical tourism

Superior Operational and Financial Performance

…driven by balanced increases in volume and price…

Mature Portfolio (TLm) Outpatient Inpatient Developing Portfolio (TLm)

5

SLIDE 20

20 82 86 115 113 134 115 138 164 161 183 2014 2015 2016 9M-2016 9M-2017 406 1,012 1,274 942 928 3,407 3,534 3,585 2,635 2,742 2014 2015 2016 9M-2016 9M-2017 44 109 143 105 119 381 423 455 335 369 2014 2015 2016 9M-2016 9M-2017 769 888 1,244 1,230 1,328 2,025 2,087 2,206 2,195 2,242 2014 2015 2016 9M-2016 9M-2017 131 157 279 202 211 484 551 551 403 433 2014 2015 2016 9M-2016 9M-2017

50% 52% 55% 55% 56% 66% 64% 63% 63% 62% 50% 48% 45% 45% 44% 34% 36% 37% 37% 38%

Superior Operational and Financial Performance

Outpatient Volume (‘000)1 Revenue Mix and Utilization

Note: Mature refers to hospitals opened, or acquired as well as integrated in the MLP IT system, prior to 2015, and Developing refers to hospitals opened / acquired / integrated after 2015. 1 Analysis based on domestic KPI metrics excluding contribution from Medical Tourism. 2 Calculated as: Total minutes of bed usage / (Total beds* number of operational days in year*24*60). Number of operational days in year = 365 where hospitals have opened / been acquired in a previous year. 3 Includes Medical Tourism.

Outpatient Average Revenue per Visit (TL)1 ... and growth in Key Performance Indicators across the estate…

Developing Mature

Inpatient Volume (‘000)1 Average Revenue per Bed (TL ‘000)3 Inpatient Average Revenue per Protocol (TL)1

Developing Mature Average Utilization2,3

52%

Inpatient Outpatient

74% 52% 75% 57% 74%

2014

Dev. Mat.

2015

Dev. Mat.

2016

Dev. Mat.

9M-16

Dev. Mat.

9M-17

Dev. Mat.

60% 69% 62% 67%

5

SLIDE 21

Superior Operational and Financial Performance

Maintenance Capex (TLm)1

¹ Includes expenditure on assets acquired through finance lease.

Capex of New Hospitals (TLm)1 Cash Flow Conversion (TLm)

5

44 54 56 45 47 2,9% 2,9% 2,6% 2,9% 2,5% 2014A 2015A 2016A 9M 2016A 9M 2017A Maintenance Capex % of sales 13 145 78 65 119 2015A 2016A 9M 2016A 9M 2017A Expansion Capex (New Investment) Acquisition Capex 152 181 298 187 225 2014A 2015A 2016A 9M 2016A 9M 2017A Cash Conversion (Reported EBITDA - Maintenance capex) 77% 83% 84% 81% 77% % Cash Conversion = Cash Conversion / Reported EBITDA

... resulting in strong cash flow generation

SLIDE 22

Superior Operational and Financial Performance

Balanced debt composition with adequate liquidity headroom

Currency Average Interest Rate 30-Sep-17 Pro-forma assuming TL660mm of primary¹ TL 15.96% 647 647 EUR EURIBOR + 5.5% 874 214 USD 6.99% 31 31 Total Debt 1,552 892 Cash (199) (199) Net debt 1,353 693

Debt composition by currency (TLm) Debt composition by type Debt maturity profile2 (TLm)

1 Assuming all repayment of FX debt is EUR, TL660mm repayment based on middle of the price range; 2 Lease payments of TL75m to be

paid within 1 year, TL65m to be paid between 1-2 years, TL69m to be paid between 2-3 years, TL60m to be paid between 3-4 years, TL41m to be paid between 4-5 years, TL13m to be paid between 5-6 years, TL2m to be paid between 6-7 years; 3 Include rolling NWC loans of TL68m and bonds to be paid on December 5, 2017 of TL100m. Bond payable of TL100m will be replaced with long term bank loan

 Balanced mix of TL and hard currency debt driven primarily due to limited availability

f long-term TL denominated loans and unattractive interest rates

Structured finance facility in place:  Tranche A: EUR158m long term loan (8 years of maturity+6 months grace period) used to refinance existing loans  42% was withdrawn as TL and rest 58% was withdrawn in EUR  Tranche B: Capex facility - EUR141m cash and non-cash loan facilities (8 years of maturity+2 years grace period) used to finance hospital openings  As of Sept 30, 2017, EUR61 million still available for new hospital openings  Tranche C: NWC loan - TL150m rolling NWC loan and letter of guarantee, maturing

n an annual basis with annual roll-overs

 As of Sept 30, 2017, TL80m available for use

Commentary

Bank Loans 67% Financial Leases 21% Bonds Issued 11% Interest Accrual 1%

Total: TL1,552m

5

403³ 255 207 205 182 167 112 21

<1 year 1-2 years 2-3 years 3-4 years 4-5 years 5-6 years 6-7 years Interest accruals

26% 16% 13% 13% 12% 11% 7% 1% % of Total

MLP’s currency breakdown of total debt (TLmm)

TL 42% EUR 56% USD 2% TL 73% EUR 24% USD 3%

30-Sep-2017 Pro-forma 30-Sep-2017 adjusted for debt repayment Total FX denominated debt: 58% Total FX denominated debt: 27%

TL660mm primary used to repay FX denominated debt1

Implying a pro-forma net debt / LTM reported EBITDA

f 1.76x as of 30-Sep-17

SLIDE 23

Outstanding Platform for Further Growth Outstanding Platform for Further Growth

Quick and successful ramp up in greenfields as well as acquisitions with typical range of 12-18 months to EBITDA-neutral hospitals

Total Investment TL50m Total Beds at Opening 110 Covered Area (sqm) 22,500

Example of Greenfield

3 Months 15 Months 27 Months

Period open for:

Total Investment Cost TL23m Total Capex TL8m Total Costs TL31m Total Beds 107 Covered Area (sqm) 12,000 (2,057) 2014 (359) 2015 10,780 2016 2014 2015 2016 4 Months 16 Months 28 Months

Hospital Contribution per year in TL’000s Contribution Margin (%) Sales TL’000s

3,252 (63)% 44,408 (1)% 61,863 17% 8,332 (10)% 35,024 5% 42,987 19%

Example of Acquisition Batıkent (Oct-2014) Yıldızlı (Sep-2014)

(807) 8,348 1,910

6

SLIDE 24

Outstanding Platform for Further Growth

Proven track record of greenfield expansions and M&A

2014 2015 2016 2017 2018 2019 2020 Total Beds Added to Portfolio 745 674 568 708 500 500+ 500+ Cumulative Total Beds 3,380 4,054 4,622 5,330 5,830 6,330 6,830 25 Total Hospitals At Year End 27 26 29 31 33 35

Acquisitions Greenfields Expansions

Note: Bed counts based on licensed capacity

1 2014-2017 average.

Pipeline 2014 2015 2018 2016 2017 2019 2020

Acquired 6 hospitals (of which 2 in İstanbul) Opened 2 greenfield hospitals in İstanbul and Kocaeli Opened 2 greenfield hospitals in Ankara Opened one managed university hospital in İstanbul 2 New Hospitals being opened in Mersin and İstanbul Opened one managed university hospital in İstanbul and one greenfield hospital in Samsun Two greenfield hospital developments under construction Two potential hospital

penings /

acquisitions Bed expansion in Goztepe  MLP actively seeks out new opportunities in acquiring existing private hospitals  10 of 29 hospitals acquired  Multiple targets identified and in consideration Top 5 private players 70 Remaining private hospitals 492 Total private hospitals = 562 12% 88% Vast amount of potential targets

M&A

 MLP has added on average c.400 beds p.a.1 through greenfield projects since 2014  Multiple opportunities identified for expanding bed capacity in the near term

Greenfield

6

SLIDE 25

Outstanding Platform for Further Growth

Growth plans anchored by four new hospitals opening in the near‐term

Pendik (2018) Mersin (2018) Topkapı (2019) Çekmeköy (2019) Location

 İstanbul  Mersin  İstanbul  İstanbul

Plan

 To be opened in H1 2018  62,000 sqm  Building construction complete  License already available  To be opened in H1 2018  35,604 sqm  Building construction complete  License already available  To be opened in 2019  Building construction nearly complete  License already available  To be opened in 2019  Building construction nearly complete  License already available

Key Stats

 250 Beds  250 beds  250 beds  250 beds

6

SLIDE 26

2.214 2.281 2.678 2.150 2.147 2.273 64 134 405 2014 2015 2016 Comprehensive insurance Top-up insurance

Outstanding Platform for Further Growth 6

MLP has several avenues to continue its growth trajectory

Source: TOBB Report; Insurance Association of Turkey; Medical tourism association; TURKSTAT, Departing Visitors by Purpose of Visit, 2003 - 2017

1 Calculated as: MLP revenue from private medical insurance (excluding contracted institutions revenue) divided by the total payment made by insurers to healthcare providers

Top line growth via the favourable insurance scheme

 MLP has increased its market share in PMI over the years, growing its revenue from private medical insurance by c.60% p.a. from 2012 to 2016  Top-up insurance is the fastest growing portion of the PMI market  MLP has been a pioneer in Top-up insurance

High Growth in Top-up Insurance Segment Total # of policies sold (‘000s) 10% 152% 5% CAGR 2014A-16A 163 377 2010 2016 85 130 YTD Sep-2016 YTD Sep-2017

Growth through revenue diversification

 Expand premium service offering (e.g. Liv,VM)  Increase elective procedure offering (e.g. Aesthetics)  Self-Pay share of total pay in MLP revenues has risen from c. 25% in 2012 to c. 36% in 2016

Visitors to Turkey with health / medical related purpose (‘000s)

 Outstanding medical quality in line with OECD countries  Comparatively affordable with c. 50-65% in estimated savings compared to US treatment costs

Self-Pay Medical tourism

MLP Medical Tourism Revenue (TLm) High Growth of MLP in the PMI market MLP market share in the PMI market1 2% 3% 4% 5% 7% 2012 2013 2014 2015 2016

SLIDE 27

Visionary Leadership and Outstanding Management Team

Team Structure Field Organization per Hospital

Visionary founder & CEO supported by an outstanding management team, leading the company’s exemplary growth; Significant breadth and depth of experience across the Senior management and executive level teams

1 Independent director reporting to the Board.

Dr. Muharrem Usta

Chairman & CEO Burcu Öztürk Chief Financial Officer

Dr. Adem

Elbaşı Chief Operations Officer Öykü Tükenmez Chief HR Officer Barış Bezel Chief Marketing Officer Barış Turgutoğlu International Patient and Planning Coordinator

Dr. Ruhsan

Gezgin Contracted Institutions Coordinator Deniz Yücel Investment Relations Director

Dr. Şerif

Köksal Medical Services Director

Dr. Taner

Özcan Business Development Coordinator Bora Gökçe IT Director Jale Güney Internal Audit Director1 Mustafa Isık Supply Chain Director Nihal Ünlütürk Quality Group Manager

Dr. Hikmet

Çavuş Chief Strategy and Performance Officer Hospital GM Head Physician Head Nurse EVP Operations EVP Financial Affairs

7

SLIDE 28

MLP is the Leading Private Hospital Group in Turkey

SLIDE 29

Appendix

SLIDE 30

1 98% of the population, TOBB report; 2 On all services (except a few specified services)

Interaction between key participants Illustrative SSI reimbursement schematic

Patient

(covered by SSI1)

Government Private hospitals SSI

Surcharge Treatments Taxes Budgetary allocation Reimbursements

 SSI is a self-funded mechanism with premiums as the main source of funding and depends on government budgetary allocation only to take care of green-card holders  SSI pays regularly (60 days after the receipt of the online invoice). For materials it pays when invoiced

% SUT list price Surcharge Total payment to private hospitals

 Surcharge is determined based on the treatment and services provided  Pricing levels vary across different hospitals

Paid by patient and can be covered by an insurance solution (top-up) Maximum permissible 200%2

Invoice

Overview of SSI Reimbursements

Fixed and reimbursed by SSI: Same for a particular treatment across all hospitals

Premiums

SLIDE 31

Overview of Ancillary Business

Laboratory Services and Imaging Services  Largest laboratory platform in Turkey  Provides services to third parties as well as to 26 MLP

hospitals — Outsources all laboratory services for 14 non-MLP Hospitals in İstanbul — Outsources all laboratory services for 4 hospitals of Iraqi Ministry of Health in Basra and Diyala — Includes laboratory planning, site planning, equipment installation / purchasing and technical maintenance services

 Leading outsourced imaging service supplier in

İstanbul — Provides imaging services including MRI, CT, X-ray, Ultrasound, Bone Densitometry and SPECT — Leases high-end equipment from leading manufacturers such as GE, Siemens and Philip — Equipment is typically under 3 years of age — Integrated digital platform; X-ray film has not been used since October 2009

Hospital Management Services  Two university hospitals (Istinye University, Aydin

University) in MLP’s portfolio

 Owned by the respective universities and operated by

MLP under a management services contract, for which MLP receives a share of the hospitals’ annual revenue and profit

 Include the full range of MLP’s brands and concepts  Strong presence of academicians in both universities Other Services

BTN Insurance

 Authorized agency for Ergo, Axa, Ray and Güneş

Insurance

 Provides agency services for the insurance policies

covering devices, malpractice etc. and for MLP hospitals and doctors Sotte Catering

 Catering supplier for 15 MLP hospitals

Strong ancillary businesses support the hospital business (c. 7% of Revenue)

1 Denotes subsidiaries of MLP. 1 1 1

SLIDE 32

32 Cardiology: 20,422 Bypasses and 240,988 Angiographies¹ Gynecology Oncology: Turkey’s first private cancer hospital

Diversified Revenue Streams Across Departments

Source: SSI. 1 Over 2011-16. 2 Includes departments ranked 31st or lower (below 0.9%) in terms of contribution to 2016 MLP revenue.

General Surgery Neonatal intensive care unit (NICU) Internal diseases Cardiovascular surgery Orthopedics: 99.3% Surgery success rate Brain and Neuro Surgery: State of the art Gamma Knife process Pediatrics Intensive Care Unit (ICU)

2016 Revenues TL2.2bn

Others2 Top 5 departments contributed only 35% of total revenues in 2016  Urology: 3%  ENT: 3%  Emergency: 3%  Gastroenterology: 2%  Neurology: 2%  Physical Rehabilitation: 2%  Pulmonary Diseases: 2%  Pediatric Bone Marrow Transplant: 2%  Ophthalmology: 2%  Radiation Oncology: 2%  Plastic Surgery: 2%  Dermatology: 2%  Bone Marrow Transplant: 1% — 48% market share with c.600 transplants p.a.  Hematology: 1%  IVF: 1%  Organ Transplant: 1% — Leader in Turkey with c.600 transplants p.a. — c. 20% market share in Kidney Transplants  Pediatric Hematology: 1%  Bariatric Surgery: 1%  Check Up: 1%  Other: 7%2 9% 8% 7% 6% 6% 5% 4% 4% 4% 4% 4% Other 40%

SLIDE 33

Business Intelligence Tool

 Benchmarks key KPIs across hospitals, departments and individual doctors, e.g. : — Revenue — Doctor efficiency — Patient Satisfaction  Provides KPI tracking over time  Target Management — Provides management as well as doctors visibility of targets — Provides daily updates to forecasts of target achievement, based on performance to date

SLIDE 34

IFRS Historical P&L Statements

TLm 2014 2015 2016 2016 2017 FY FY FY 9M 9M Revenue 1,518 1,843 2,160 1,569 1,873 Cost of service (-) (1,240) (1,562) (1,854) (1,360) (1,593) Gross Profit 278 281 306 209 281 General administration expenses (-) (157) (175) (127) (89) (136) Other income 210 117 200 115 256 Other expenses from operations (-) (88) (107) (168) (102) (250) Operating Income 243 117 212 133 150 Finance expenses (-) (128) (194) (274) (174) (238) Net profile (loss) before tax 115 (77) (62) (42) (88) Tax income / (expense) from

perations

29 35 14 5 15 Net profit / (loss) 144 (43) (49) (36) (73)

SLIDE 35

IFRS Historical Balance Sheet

TLm 2014 2015 2016 2017 Dec 31 Dec 31 Dec 31 Sep 30 Cash and cash equivalents 213 92 111 199 Trade receivables 471 612 724 699 Inventory 31 42 45 46 Short term other assets 82 155 136 135 Short term assets 798 901 1,016 1,079 Fixed assets 1,039 1,207 1,173 1,218 Deferred tax assets 62 99 146 165 Long term other assets 115 95 101 119 Long term assets 1,216 1,401 1,420 1,501 Total Assets 2,014 2,302 2,435 2,580 Trade payables 358 352 449 500 Short term other liabilities 111 123 175 185 Short term financial liabilities (incl. leases) 350 738 408 438 Short term liabilities 819 1,214 1,031 1,124 Long term other liabilities 76 57 53 55 Deferred tax liabilities 106 96 124 118 Long term financial liabilities (incl. leases) 643 614 962 1,114 Long term liabilities 826 767 1,139 1,287 Shareholders' equity 286 227 175 79 Non-controlling interest 83 94 90 90 Total liabilities & equity 2,014 2,302 2,435 2,580

SLIDE 36

Mature Hospitals - Cost Comparison as % of Sales

Note: Revenue and Contribution from Managed Hospitals is not consolidated in Hospital Revenues and included as part of Other Ancillary Business;¹ Excludes headquarters costs and contribution from Other Ancillary Business; ² Include utilities costs, maintenance expenses (equipments, building, IT), outsourced services (cleaning, laundry, patient meal), marketing spend and other various operational costs

82% 82% 81% 82% 82% 18% 18% 21% 21% 21% 23% 24% 24% 24% 24% 21% 21% 19% 20% 18% 5% 6% 6% 7% 7% 2% 2% 3% 3% 3% 12% 11% 9% 9% 9% 2014A 2015A 2016A 9M 2016A 9M 2017A 17.5% 18.8% 18.2% 18.4%

Margin %

18.1% Others² Outsourcing medical service purchases Rent Personnel Doctor Material

SLIDE 37

Developing Hospitals - Cost Comparison as % of Sales

95% 100% 94% 97% 95% 10% 13% 15% 15% 17% 31% 33% 29% 30% 28% 27% 28% 23% 24% 22% 9% 12% 13% 13% 14% 1% 1% 2% 2% 2% 17% 13% 12% 13% 12% 2014A 2015A 2016A 9M 2016A 9M 2017A

Margin %

0.2% 5.5% 5.1% 4.8% 3.2% Others² Outsourcing medical service purchases Rent Personnel Doctor Material

SLIDE 38

Net Working Capital

Note: Based on 365 days; Receivable days are adjusted by 108% for VAT rate of sales and payable days by 110% for blended VAT rate on purchases; ¹ Exclude Libyan foreign medical tourism receivables balance that relates to Libyan patients treated several years ago which are no longer part of the business. Current medical tourism receivables are mostly paid in cash; 2 Based on LTM revenues as of Sep 30, 2017

Payable days (costs ex. material) Receivable days (on sales)

105 112 113 93 75 76 82 76 2014A 2015A 2016A 9M 2017A Receivable days Receivable days ex. Libyan receivables¹ Improvements due to  Better medical invoicing process  Shift of revenues towards higher Self- Pay collections both in domestic and medical tourism revenues 117 94 112 104 2014A 2015A 2016A 9M 2017A The increase in payable days from 2015 to 9M 2017 was materialized through:  Minimum threshold for payment terms  Finance department approval over supplier contracts  Whole payment process through Oracle system

NWC as % of sales Inventory days (on material costs)

38 43 34 29 2014A 2015A 2016A 9M 2017A  Includes inventory at hospitals and laboratory business  Improvements due to better inventory management through inventory transfers across hospitals  Inventory purchases are directly sent to hospitals by suppliers, there is no central warehouse 10% 20% 15% 10% 1% 10% 6% 5% 2014A 2015A 2016A 9M 2017A² Reported Adjusted to ex. Libyan receivables¹  The decline trend in 2016 and 9M 2017 is related to the bulk collections made with regards to medical tourism revenues

SLIDE 39

Reconciliation from Contribution to Adjusted EBITDA

Note: Revenue and Contribution from Managed Hospitals is not consolidated in Hospital Revenues and included as part of Other Ancillary Business ¹ Other Ancillary business includes Laboratory, Imaging and Management service income from university hospital management operations

TLm 2014A 2015A 2016A 9M 2016A 9M 2017A Hospital Contribution Mature 254 276 319 224 263 Developing 3 18 8 15 Total Hospital Contribution 258 276 337 232 278 Other Ancillary Business Contribution¹ Other Ancillary Business Revenues 65 81 132 88 131 Other Ancillary Business Costs (69) (67) (114) (71) (94) Total Other Ancillary Business Contribution (4) 13 18 17 38 HQ Expenses (44) (52) (43) (27) (34) Adjusted IFRS EBITDA 210 238 312 222 282

A B C A B C

SLIDE 40

Reconciliation from Reported IFRS EBITDA to Adjusted EBITDA

TLm 2014A 2015A 2016A 9M 2016A 9M 2017A Net Profit / (Loss) Before Taxes - IFRS 115 (77) (62) (42) (88) Depreciation and Amortization of Tangible and Intangible Fixed Assets 99 129 153 108 128 Total Interest Expenses, Net of Interest Income and Gain on Financial Derivatives 122 185 263 164 232 Net (Gains) / Losses from the Disposal of Tangible and Intangible Assets and Income from Negative Goodwill (141) (2) 1 1 (0) Reported IFRS EBITDA 196 235 354 232 272 Net One-off (Gains) / Losses (47) (12) 7

/w One-off Net Operational FX (Gains) / Losses

(44)

/w One-off Revenues

(3) (12) 7 Non-cash GAAP Provision Expenses 14 3 5 3 4 Adjusted EBITDA 210 238 312 222 282

SLIDE 41

Foreign Exchange Exposure of EBITDA and Net Income

TLm 9M 2017A Hard Currency Hard Currency as % of total revenues Domestic revenues 1,743 Medical tourism revenues 130 130 Total revenues 1,873 130 7% Material (433) (42) (2%) Doctor (429) 0% Personnel (355) 0% Rent (140) (44) (2%) All other exp. (234) (14) (1%) Total costs (1,591) (100) (5%) EBITDA 282 30 2% Amortisation (128) 0% Extraordinary income / (expense), net (17) 0% Finance expenses, net of interest income (144) (37) (2%) FX gain / (loss), net (81) (81) (4%) Income / (expense), net before tax (88) (88) (5%) Taxation income / (expense), net 15 0% Net profit / (loss), net (73) (88) (5%)

Management Calculations

SLIDE 42

Foreign Exchange Exposure of Cash flows

TLm 9M 2017A Realized FX Losses % Adjusted IFRS EBITDA 282 30 11% Operational cash flow 359 30 Capex (196) (63) 32% Free cash flow 163 (33) Financing activities (74) (101) Principal payments (195) (64) 33% Interest payments (157) (37) 24% Proceeds from bank loans, bonds and other transactions 277 Change in cash and cash equivalents 89 (135) Hard currency denominated debt service / Total debt service 29%

Management Calculations

SLIDE 43

Covenant Ratios

 MLP has rapidly de-levered itself since 2015 as result of increased cash flows, better capital structure management  However, at the same time it has continued to invest and grow Covenants ratios to be complied:  Debt Service Coverage Ratio  >= 1.1x during 2016-24, tested every 6 months  Net debt / reported EBITDA:  <=4.0x for 2016 and H1 2017  <= 3.5x for 2017 and H1 2018  <= 3.0x for 2018 and H1 2019  <2.5x from 2019 - 2024

Commentary Covenant ratios

3,56x 3,43x 1,21x 1,38x 2016A LTM as of 30 Sep 2017A Net Debt/ EBITDA Debt Service Coverage Ratio

TLm 2016A LTM as of 30 Sep 2017A Reported EBITDA 354 394 Net Debt 1,259 1,353 Debt service 309 333 Operational cash flow 375 459 Net debt / reported EBITDA 3.56x 3.43x Debt service coverage ratio (DSCR) 1.21x 1.38x

SLIDE 44

Net Income Analysis

TLm 2014A 2015A 2016A 9M 2017A Net profit / (loss) 5¹ (43) (49) (73) FX gains/(losses), net arising from financial liabilities (6) (41) (85) (88) Net profit / (loss) w/o FX impact 10 (2) 36 15 Financial expenses incurred (122) (153) (190) (150) Net profit / (loss) w/o FX impact and financial expenses 132 151 225 165 Total FX exposure within financial liabilities (TLm) 208 279 651 904

Net Income FX Analysis (TLm)

10 (2) 36 15 2014A 2015A 2016A 9M 2017A Net profit / (loss) w/o FX impact

Management calculations; 1 Excludes one time revenues with regards to negative goodwill at an amount of TL139m from reported net income of TL143m in 2014

SLIDE 45

Overview of Operating Lease Contracts

Maturity Profile Non-cancelable Lease Commitments (TLm) Auto-Renewal Clause < 1 year 175  1 – 5 years 611  > 5 years 548  Total 1,334

Commentary Summary of Hospital Facility and Building Leasing Contracts

 All hospital buildings are leased from third parties − Hospitals typically purpose built / fitted out by owner based on

MLP requirements

 Leases typically structured as 10-year contracts with 5-year

renewal extension option and clauses to allow renewal unless terminated by MLP

− Option to renew the lease is held by MLP − Under Turkish Code of Obligations, lessor typically cannot

terminate agreement unilaterally solely due to term expiration

 Most lease agreements provide for specific fee adjustment

clauses in case of renewal or extension of the agreement

 No Change of Control clause in leases − Lease agreements annotated with relevant title registries,

allowing us to continue the lease on the same terms if the property is sold to a third party

 c.32% of leases by value are Euro / Dollar denominated in 9M

2017

 Local currency leases are linked to inflation MLP hospitals are leased with auto-renewal clauses and non-cancelable lease commitments