In this quarter, net revenues for the segment grew 35% compared to the same period of the prior year. And for the nine-month period, we saw an increase of 43%, reaching a net revenue of BRL108 million. Moving to Slide number 12, I will discuss the Digital Services operational metrics. On the first graph, you can see our total active payers, which are those ones that generate revenues in B2B. With a continuous growth trend in this quarter, we’ve reached 217,000 paying users, a 12% growth compared to the last year. As you can see in the second graph, our ecosystem reached 285,000 monthly active users, representing around 34% of all medical students and physicians in Brazil, as Virgilio said before. Finally, our last graph shows our digital service net revenues for the quarter, which increased more than 19% year-over-year and regarding the nine-month period increased by almost 22% year-over-year.
The organic growth is the combination of the start of the B2B engagements with pharmaceutical companies and the expansion of active payers in the B2P. In addition, since 2022, we started to break down our Digital Services net revenue within B2P and B2B segments. So from the BRL164 million of Digital Services net revenues during the nine-month period, more than BRL134 million came from the B2P and almost BRL30 million came from B2B. B2B strategy holds a huge potential and [indiscernible]. And now moving to my three last slides, I will discuss our cash and net debt positions, also giving more color on our cost of debt. Cash and cash equivalents at the end of the quarter were BRL822 million, an increase of 15% over the third quarter 2022, and an increase of 11% over the second quarter 2023.
Net debt, excluding IFRS 16, totaled BRL1,788 million compared to the net debt of BRL1,348 million in the same period of 2022. The increases when compared to the third quarter of 2022 is mainly due to the BRL825 million of UNIT Alagoas and FITS Jaboatao acquisitions, closed on January 2, 2023, which was partially offset by the free cash flow generation in the first nine-month period of 2023, as we can look closely on the next page. In this slide, I presented the net debt reconciliations for 2023. The cash flow from operating activities was allocated to income tax and lease payments. CapEx activities for the service of the financial debt and our churn buyback program. We were able to generate BRL418 million as free cash and reduced our net debt in the nine-month period.
On the next slide, you can see a table with the breakdown of our gross debt and our total cost of debt, considering our main debt, the Softbank transaction, other loans and finance, account payables to selling shareholders plus other financial obligations. Our capital structure remains solid with a conservative leverage position and the low cost of debt. This ends our prepared remarks. As we approach the end of the year, even considering the challenging economic and political scenario, we can gladly see Afya delivering strong results. With a quarter marked by significant increases in net revenues in our three segments, positive EBITDA, cash generations and EPS growth and the consistent business expansion. I will now open the conference for the Q&A session.
Thank you.
A – Renata Couto: [Operator Instructions] We are going to start our Q&A with Lucas Nagano from Morgan Stanley. Lucas, you can now talk.
Lucas Nagano: Hello. Good evening. Thanks for taking our questions. We have two questions. First one is related to Mais Medicos 3. Is it possible to provide us some color on your plans for the program in terms of how many proposals you plan to submit, how many seats does it represent, and which regions you’re targeting? And the second question is related to tuition readjustment for the next year. So how much you’re increasing prices for 2024? And if it — there is between schools, so — if you could give us some color on the range of tuition readjustment in all of Afya’s schools? Thank you.
Virgilio Gibbon: Hi, Lucas. Virgilio, thanks for your question. So regarding the Mais Medicos 3, we have 18 institutions that all of them is going to propose for additional two medical schools. So we will be allowed to send the proposal for 36 new additional schools. So the number of medical seats will be 36×60 per school. So this is the number that we are going to participate on this entire process. So regarding the tuition adjustment, I’ll pass to Blanco here to give you more color.
Luis Blanco: Hi, Lucas. It’s Blanco speaking. Regarding the second question about readjustments. We have defined the increase in tuition fees for the next year. Specifically from the medicine courses, we are increasing most part of the courses in 4.95% for freshmen and existing students. Most part of our institutions, we’re going to have this kind of readjustments.
Lucas Nagano: Okay. Thank you. Thank you very much.
Renata Couto: Thank you, Lucas. The next question comes from Marcelo Santos from JPMorgan. Marcelo, you may now go ahead and start.
Marcelo Santos: Thank you. Thank you very much. Good evening, Virgilio, Luis, Renata. Thanks for the opportunity. I have two questions. The first is, considering we are already in the middle of the fourth quarter, would you please provide an update on the outlook of the prep business, probably already had a lot of the intake. So it would be interesting to see how do you see this next cycle? The second question is, if you could comment a bit on Digital business. We saw a slight sequential decline in revenues, so isn’t this a business where we should be hoping for a little bit higher growth? Could you please comment this change from the second to the third quarter, what are the moving parts here? And how do you see this moving forward? Thank you.
