AALR3

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 between radiologists recognized within the medical community, partners of imaging diagnostics companies, and the fund Pátria Investimentos, which contributed capital to make the expansion plan feasible. The group’s operational origins lie in the merger of four imaging diagnostic clinics: Axial, in Belo Horizonte and other cities in Minas Gerais, Cedimagem, in Juiz de Fora, Plani, in the Vale do Paraíba (SP) region, and Diimagem, in Campo Grande (MS). The merger of the last three into Axial gave rise to the national brand “Alliar Medicina Diagnóstica,” which ended 2010 operating 23 care units and 21 MRI machines.

From this initial consolidation, Alliar adopted a growth strategy based on partnerships and acquisitions, combining payment in cash and shares, which led controlling physicians from regional clinics to join the shareholder base. Between 2011 and 2013, the company significantly expanded its geographic footprint, 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 became the largest nuclear medicine player in Brazil, with a fleet of fifteen gamma cameras and five PET-CT scanners. In 2014, it advanced its public-private partnership (PPP) model by setting up, 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 imaging diagnostic services in hospitals belonging to the state-owned network of the Government of Bahia.

Alliar’s business model is centered on the provision of Ancillary Diagnostic Services (SAD), which represent 100% of consolidated net revenue, as disclosed for fiscal years 2022, 2023, and 2024. Within this umbrella, the company structures its activities mainly into two service lines: imaging diagnostics and clinical analysis, in addition to operating in nuclear medicine, cytology, pathology, vaccination, restricted medical consultations, services for the public sector, remote diagnostic solutions, and a health marketplace. Imaging diagnostic 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, exercise stress tests, and cardiopulmonary tests. In clinical analysis, the company performs sample collection and brokers laboratory tests — such as blood counts, urine and stool tests, cholesterol and triglyceride measurement, pathology, and tests to identify infectious diseases — with processing carried out by contracted laboratories.

Alliar’s activities combine outpatient care, hospital support services, and contracts with health insurers and the public sector. In the public segment, the PPP with the Government of the State of Bahia stands out, for the management and operation of imaging diagnostic services in 11 hospital units, under a long-term contract with monthly consideration paid by the state health department. The company also provides services to hospitals within the Brazilian Unified Health System (SUS) and maintains significant contracts with large payors, including one client that accounted for 11% of 2024 gross revenue, with greater impact on the imaging diagnostic line. In 2019, Alliar launched the iDr – Inteligência Diagnóstica Remota platform, which monetizes its operational expertise through teleoperation solutions, centralized reporting, protocol optimization, and remote management of diagnostic centers, serving everything from independent clinics to hospitals and vertically integrated health insurers.

Beyond its core diagnostic medicine operations, 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, allowing 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 and telemedicine medical consultations, laboratory and imaging tests, 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 professionals trained to administer vaccines to adults and children.

Alliar’s geographic footprint is nationwide and concentrated within Brazil, with no revenue from abroad. The company is present in 45 cities across 11 Brazilian states, with 105 care units distributed in different regions, supported by local brands such as CDB, Axial, RBD, Delfin, Multiscan, among others. The main operating 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 entered into a ten-year service agreement with Unimed FAMA, covering the states of Amazonas, Amapá, Pará, Acre, Rondônia, and Roraima, which expanded its reach in the North region. In February 2025, it announced the acquisition of 100% of the imaging diagnostics and clinical analysis operations of the Cura brand in the city of São Paulo, strengthening its presence in the country’s main healthcare market.

From a regulatory standpoint, Alliar’s activities are subject to intensive oversight by federal, state, and municipal authorities. The company is subject to the rules of the Brazilian Health Regulatory Agency (ANVISA), which regulates healthcare facilities, clinical laboratories, diagnostic radiology services, nuclear medicine, and healthcare waste management through various Collegiate Board Resolutions (RDCs). Nuclear medicine operations require licensing and supervision by the National Nuclear Energy Commission (CNEN), which oversees facilities and radioactive sources and sets radiological protection standards. There are also requirements for registration with the Regional Councils of Medicine (with designated technical officers), enrollment with 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 the National Land Transport Agency (ANTT).

In terms of operations and clinical governance, Alliar relies on 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 assessing medical performance and reviewing reports, in which top-performing physicians can be invited to become shareholders. Several units hold accreditation from the National Accreditation Organization (ONA) at levels 2 and 3 and quality certifications specific to imaging diagnostics, such as PADI from the Brazilian College of Radiology, reinforcing patient safety and care quality standards. Despite these practices, the company does not yet report structured information on environmental, social, and governance (ESG) criteria in a dedicated report.

Alliar’s ownership structure has undergone significant changes since its formation. Pátria Investimentos’ investment cycle 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 cornerstone investors.