Step 1 — Earnings Normalization (cleaning the input)
Reported Q1 2026 net profit was 23.5M SAR, but it contained a non-cash loss of 13.3M from fair-value revaluation of derivative instruments. Stripping that out:
Normalized Q1 2026 profit = 23.5 + 13.3 ≈ 36.8M SAR
This is the single most important step. Garbage in, garbage out — any multiple applied to the polluted 23.5M figure would have produced a fake fair value.
Step 2 — Annualizing with seasonal adjustment
I did not simply multiply 36.8 × 4 = 147M, because Q1 was the seasonal trough (Ramadan + Eid suppressed elective procedures). Q1 2025 normalized was 51.1M while full-year 2025 delivered 200.4M — meaning Q1 historically contributes roughly 25% or slightly less of the year. Applying a similar seasonal pattern, plus partial recovery of the new centers' occupancy through the year:
FY2026E normalized earnings ≈ 170–200M SAR
EPS range = 170/44.3 to 200/44.3 = 3.84 – 4.51 SAR
Step 3 — Multiple selection (the judgment call)
Saudi healthcare peers trade roughly between ~20x (mature operators) and ~35x+ (premium growth like Al Habib). Almoosa sits below the premium tier: mid-cap, single-region, currently in margin compression. I assigned a fair P/E band of 24–28x — a discount to the sector leaders, a premium to no-growth operators.
Method 1 (Comps): 3.84 × 24 = 92 → 4.51 × 28 = 126 SAR
Step 4 — Forward exit value (capturing the expansion)
Method 1 punishes the company for facilities that consume costs today but produce revenue tomorrow. So Method 2 values the completed platform:
Assumption: third Al-Ahsa center + new Khobar specialist hospital lift bed capacity by roughly half, gross margin reverts to ~31%.
Projected FY2028 normalized profit: 280–320M SAR → EPS 6.3–7.2.
Exit multiple: 26x (midpoint of the fair band, since by 2028 it's a proven grower).
Exit value (2028) = 6.3×26 to 7.2×26 ≈ 164 – 188 SAR
Step 5 — Discounting to present value
Discount rate: 9.5% — a cost-of-equity proxy built roughly as: Saudi risk-free ~5% + equity risk premium ~5.5% × beta ~0.8 for a defensive healthcare operator. Discount period: 2 years (mid-2026 → mid-2028).
PV = Exit value / (1.095)² = 164/1.199 to 188/1.199 ≈ 137 – 157 SAR
Step 6 — Triangulation (weighting the methods)
MethodRangeWeightRationaleNormalized comps92–126~30%Real but punishes transition yearDiscounted exit multiple137–157~50%Best fits an expansion-phase assetStreet target169–192~20%Single-analyst coverage, low reliability
Weighted blend → fair value ≈ 140–155 SAR, midpoint ~148.
Step 7 — Sensitivity (the honesty layer)
The output's fragility, quantified:
±1 point on the P/E multiple → ±~4.5 SAR on fair value
±10M SAR on the earnings estimate → ±~6 SAR
±1% on the discount rate → ±~3 SAR on the Method-2 leg
So the defensible claim is never "the stock is worth 148.00" — it's "fair value clusters in the 140s under reasonable assumptions, and the dominant swing variable is gross margin recovery, not the discount rate."
One final point of intellectual honesty: Steps 2, 3, and 4 each contain a judgment of mine (seasonality pattern, multiple band, 2028 earnings power). A different analyst with equally defensible inputs could land at 120 or at 170. That's not a flaw of this model specifically — it's the nature of valuation. The method's value isn't the point estimate; it's that it forces every disagreement into a specific, testable assumption you can monitor quarter by quarter.
Almoosa Health Company operates as a private healthcare provider in the Kingdom of Saudi Arabia. It stores medical items and sells medicine, cosmetics, and disposable medical items. The company also operates specialist and rehabilitation hospitals, medical and emergency centers, pharmacies, mental health clinics, and oncology centers, as well as a college of health sciences. Its medical specialties include pain management, lymphatic massage, hyperbaric oxygen therapy, occupational therapy, speech and language disorders, personality and behavioral disorders, supportive devices and prosthetics, urology, ophthalmic surgery, general surgery, otolaryngology (ear, nose, and throat), wound care, emergency medicine, audiology, rheumatology, allergy and immunology, health education, angiography and interventional radiology, infectious diseases, chest diseases, dermatology, internal medicine, pediatrics, dentistry, nephrology, endocrinology, gastroenterology, pediatric neurology, physiotherapy, psychiatry, bone and joint surgery, psychiatric rehabilitation, therapeutic nutrition, and vascular medicine. The company was formerly known as Al Moosa Specialist Hospital and changed its name to Almoosa Health Company in February 2024. The company was incorporated in 1996 and is based in Al Mubarraz, the Kingdom of Saudi Arabia. Almoosa Health Company operates as a subsidiary of Abdulaziz bin Abdullah Almoosa Investment Company.