ACRA UPGRADES GK MEDSI TO AA(RU), CHANGES OUTLOOK TO STABLE, AND UPGRADES BOND ISSUES TO AA(RU)

The credit rating of AO GK MEDSI (hereinafter, MEDSI or the Company) has been upgraded due to the improvement of the scores for leverage and interest payment coverage due to growth of FFO against the backdrop of generally unchanged external borrowings. The operational profile remains strong and is based on high scores for the business sub-factors and the leading market position of the Company, which has a broad chain of clinics. The financial profile is characterized by low leverage, high profitability, and strong liquidity. Business size and the free cash flow (FCF) margin are medium.

MEDSI is the leading Russian federal chain of private clinics providing services in all key areas of medicine. The Company is present in Moscow, the Moscow Region and other Russian regions. As of the start of 2026 the MEDSI chain included 138 assets with a total area of more than 330,000 sq. m. The Company has more than 10,000 employees.

KEY ASSESSMENT FACTORS

MEDSI’s strong operational profile stems from its leadership in the fragmented commercial healthcare sector. The Company is strongest in its key market (Moscow), although 74 clinics (approximately half of the chain) are located outside the capital. In the Agency’s opinion, the Company’s business is characterized by very high diversification both in the areas of medical services and in sales channels. The Company has a strong, well-known brand with a long history, while the promotion policy has proven to be highly effective. ACRA notes that the national private medical services market is characterized by low cyclicality, but has a long-term trend of demand growth due to growing life expectancy of the population, as well as higher rates of investment in private healthcare compared to the public health system.

The Agency highly assesses the Company’s strategy, the success of which has been historically proven. The main vector of development is focused on further expansion of the chain. MEDSI has key management bodies, as well as policies and formalized procedures for making managerial decisions. Risk management is assessed by ACRA at a high level. The Group’s structure is somewhat complicated, which is due to the specifics of the Company’s business and is economically justified. The Agency positively evaluates the level of financial transparency of MEDSI. The Company publishes consolidated IFRS financial statements on a semi-annual basis.

Medium size and high profitability. The Company’s total revenues for 2025 increased by 21.8% to RUB 61.4 bln, driven by a 9% year-on-year increase in visits (to approximately 16.6 mln) and a 12% increase in the average spend per visit.

FFO before net interest payments and taxes grew was RUB 8.8 bln in 2025, which corresponds to a medium assessment of the size of business as per ACRA’s methodology.

The Agency continues to highly assess the Company’s operating margins. As of the end of 2025, the FFO margin before net interest payments and taxes was 14.3%. ACRA expects profitability to improve somewhat in 2026–2028.

Low leverage and high interest payment coverage. The Company’s debt for loans and other borrowings remains stable — as of June 30, 2026 it amounted to RUB 10.9 bln. MEDSI’s debt is mainly on bonds. The Company’s repayment schedule is generally comfortable. According to ACRA’s calculations, the weighted average ratio of total debt (excluding lease) to FFO before net interest payments will be 1.0x, while the ratio of lease-adjusted total debt to FFO before fixed payments for the same period is 1.9x.

The weighted average coverage metrics for 2023 to 2028 are high: the ratio of FFO before net interest payments after lease payments to interest payments excluding lease payments is 9.5x, while the ratio of FFO before fixed payments to fixed payments is 3.8x.

High liquidity assessment and medium cash flow. Despite its low leverage, MEDSI has a significant reserve of available credit limits from a large number of major lending banks. ACRA notes the growing balances in deposits and current accounts, the high diversification of debt instruments, and the potential for attracting financing from new shareholders. The medium cash flow score is explained by significant operating income, dividend payments, and significant capital expenditures associated with rapid business expansion.

KEY ASSUMPTIONS

• Annual growth of revenues at 17% in 2026–2028;

• FFO margin before fixed payments and taxes of no less than 23%;

• Dividend payments of no more than 50% of net profit for the previous year;

• The Company’s capital expenditures and expansion in 2026–2028 as planned.

Potential outlook or rating change factors

The Stable outlook assumes that the rating will highly likely stay unchanged within the 12 to 18-month horizon.

A positive rating action may be prompted by:

• Weighted average ratio of lease-adjusted total debt to FFO before fixed payments falling below 1.0x coupled with the ratio of FFO before fixed payments to fixed payments exceeding 5x;

• Weighted average FCF margin exceeding 5% coupled with the weighted average FFO margin before net interest payments and taxes exceeding 25%.

A negative rating action may be prompted by:

• Weighted average ratio of FFO before net interest payments after lease payments to interest payments excluding lease payments falling below 8.0x;

• Weighted average ratio of total debt (excluding lease payments) to FFO before net interest payments exceeding 2.0x;

• Weakening of the Company’s market position amid a more noticeable expansion of competitors, including through M&A transactions;

• Regulatory changes that are capable of having a negative impact on the Company’s metrics.

rating components

Standalone creditworthiness assessment (SCA): aa.

issue ratings

Bonds of AO GK MEDSI, series 001P-02 (RU000A105YB1), maturity date: February 25, 2038, issue volume:
RUB 3 bln — AA(RU).

Bonds of AO GK MEDSI, series 001P-03 (RU000A106K27), maturity date: June 28, 2038, issue volume:
RUB 3 bln — AA(RU).

Bonds of AO GK MEDSI, series 001P-04 (RU000A10EG28), maturity date: February 18, 2029, issue volume:
RUB 5.5 bln — AA(RU).

Rationale. The issues are senior unsecured debt of MEDSI. Due to the absence of either structural or contractual subordination of the issues, ACRA regards them as equal to other existing and future unsecured and unsubordinated debt obligations of the Company in terms of priority. As per ACRA’s methodology, the simplified approach was used, according to which the credit ratings of the issues are on par with the credit rating of the Company — AA(RU).

REGULATORY DISCLOSURE