AALR3 Alliar

Alliar, currently named Alliança Saúde e Participações S.A., is a Brazilian diagnostic medicine services company, with common shares traded on B3 under the ticker AALR3. The company began operating as a corporation in December 2010, following the association of radiologists recognized in the medical community, partners of diagnostic imaging companies, and the private equity fund Pátria Investimentos, which contributed capital to enable the expansion plan. The group’s operational origin lies in the merger of four diagnostic imaging clinics: Axial, in Belo Horizonte and other cities in Minas Gerais, Cedimagem in Juiz de Fora, Plani in the Vale do Paraíba region (SP), and Diimagem in Campo Grande (MS). The incorporation of the last three by Axial gave rise to the national brand “Alliar Medicina Diagnóstica,” which started operating with 23 service units and 21 MRI machines at the end of 2010.

Following the initial consolidation, Alliar adopted a growth strategy based on partnerships and acquisitions, combining cash and share payments, which led physician-owners of regional clinics to join the shareholder base. Between 2011 and 2013, the company significantly expanded its geographic presence, entering cities such as Dourados, Belém, Ponta Grossa, Ipatinga, Rio Claro, João Pessoa, Mogi das Cruzes, Taubaté, Pindamonhangaba and Vitória, in addition to strengthening operations in Belo Horizonte, Juiz de Fora and Campo Grande. In 2013, it reached the position of largest nuclear medicine player in Brazil, with a portfolio of fifteen gamma cameras and five PET-CT scanners. In 2014, it advanced in the public-private partnership (PPP) model by creating, together with Philips Medical Systems and Fundação Instituto de Pesquisa e Estudo de Diagnóstico por Imagem, Rede Brasileira de Diagnósticos SPE S.A., focused on managing diagnostic imaging services in hospitals belonging to the Bahia state government network.

Alliar’s business model is centered on the provision of Auxiliary Diagnostic Services (SAD), which account for 100% of consolidated net revenue, as disclosed for fiscal years 2022, 2023 and 2024. Under this umbrella, the company structures its activities mainly into two service lines: diagnostic imaging and clinical analysis, in addition to operating nuclear medicine, cytology, anatomic pathology, vaccination, restricted medical consultations, services for the public sector, remote diagnostic solutions and a health marketplace. Diagnostic imaging services include exams such as magnetic resonance imaging, computed tomography, ultrasound, x-ray, bone densitometry, mammography, scintigraphy and PET-CT, as well as graphic methods such as electrocardiogram, Holter monitoring, stress tests and cardiopulmonary tests. In clinical analysis, the company collects samples and intermediates lab tests — such as complete blood counts, urine and stool tests, cholesterol and triglyceride measurement, anatomic pathology and tests for identifying infectious diseases — with processing carried out by contracted laboratories.

Alliar’s activities combine outpatient care, hospital support services and contracts with health plan operators and the public sector. In the public segment, the highlight is the PPP with the State Government of Bahia for managing and operating diagnostic imaging services in 11 hospital units, under a long-term contract and a monthly remuneration paid by the state Health Department. The company also provides services to hospitals within the Brazilian public healthcare system (SUS) and maintains relevant contracts with major payors, including one client that accounted for 11% of gross revenue in 2024, with the greatest impact in the diagnostic imaging line. In 2019, Alliar launched the iDr – Inteligência Diagnóstica Remota (Remote Diagnostic Intelligence) platform, which monetizes its operational expertise through teleoperation solutions, centralized report issuance, protocol optimization and remote management of diagnostic centers, serving independent clinics as well as hospitals and vertically integrated health insurers.

In addition to its traditional diagnostic medicine core, Alliar has diversified its portfolio with technology and healthcare access initiatives. In 2015, in partnership with Siemens, it developed a remote command center for MRI equipment, enabling centralized operation of multiple machines, with gains in standardization, productivity and exam availability across different locations. In 2020, the company launched the Cartão Aliança health marketplace, aimed at people without private health insurance, which offers in a single channel discounted access to in-person or telemedicine medical consultations, lab and imaging exams, Covid-19 tests, as well as a pharmacy network and other providers. The company is also active in vaccination and human immunization, using a cold chain with strict temperature control and trained professionals to administer vaccines to adults and children.

Alliar’s geographic presence is nationwide and concentrated in Brazil, with no revenue from abroad. The company operates in 45 cities across 11 Brazilian states, with 105 service units distributed throughout different regions, supported by local brands such as CDB, Axial, RBD, Delfin, Multiscan, among others. The main production hubs are concentrated in São Paulo, Minas Gerais and Bahia, but the company also operates in states such as Mato Grosso do Sul, Espírito Santo, Pará, Rio Grande do Norte, Paraíba and Rio de Janeiro. In 2023, it signed a ten-year service contract with Unimed FAMA, covering the states of Amazonas, Amapá, Pará, Acre, Rondônia and Roraima, which increased its reach in the North region. In February 2025, it announced the acquisition of 100% of the diagnostic imaging and clinical analysis operations of the Cura brand in the city of São Paulo, reinforcing its presence in the country’s main healthcare market.

From a regulatory standpoint, Alliar’s activities are heavily supervised by federal, state and municipal authorities. The company is subject to rules issued by the National Health Surveillance Agency (ANVISA), which regulates healthcare facilities, clinical laboratories, diagnostic radiology services, nuclear medicine and healthcare waste management, through various Resolutions of the Collegiate Board (RDC). Operating in nuclear medicine requires licensing and oversight by the National Nuclear Energy Commission (CNEN), which controls facilities and radioactive sources and establishes radiation protection rules. There are also requirements for registration with Regional Medical Councils (with designation of technical officers), registration with the National Registry of Health Establishments (CNES) for units that perform certain specialized services, local health surveillance licenses and additional controls related to the use, transport and storage of controlled chemical substances, under the supervision of the Army, Federal Police, Civil Police and National Land Transport Agency (ANTT).

On the operational and clinical governance front, Alliar seeks support from integrated information systems and standardized processes. Corporate management, based in São Paulo, monitors the operations of different units in real time using business intelligence (BI) platforms to track performance, productivity and financial efficiency indicators. The company reports the adoption of methodologies such as zero-based budgeting and lean thinking in its administrative and production routines, as well as formal programs for medical performance evaluation and report review, where top-performing physicians may be invited to become shareholders. Several units hold accreditation from the Organização Nacional de Acreditação (ONA) at levels 2 and 3 and quality certifications specific to diagnostic imaging, such as PADI from the Colégio Brasileiro de Radiologia, reinforcing patient safety and care quality standards. Despite these practices, the company does not currently report structured environmental, social and governance (ESG) information in a dedicated report.

Alliar’s ownership structure has undergone significant changes since its formation. The investment cycle of Pátria Investimentos ended in 2021, when the fund sold its stake to Fonte de Saúde, managed by MAM Asset Management. In 2022, there was a change of control with the acquisition of the former controlling shareholders’ stake by Fonte de Saúde, led by Nelson Tanure, followed by a process of operational and financial optimization and the adoption of the new corporate name Alliança Saúde e Participações S.A. In 2023, Lormont Participações S.A. completed a tender offer and, together with Fonte de Saúde Fundo de Investimento em Participações Multiestratégia, came to hold most of the voting capital, totaling around 93.3% of the common shares. AALR3 shares remain listed on B3, allowing trading on the secondary market, albeit with a shareholder base concentrated in reference investors.