下面是小编为大家整理的美国医疗业：如何看待波动中空间,供大家参考。
North America Equity Research March 13, 2020
US Healthcare How We Are Thinking About The Space In The Midst Of Volatility
Pharmaceuticals Chris Schott, CFA AC (1-212) 622-5676 US Biotechnology Cory Kasimov AC 212-622-5266 HC Technology & Distribution Lisa Gill AC
212-622-6466 HC Facilities & Managed Care Gary Taylor AC
+1 212-622-6600 christopher.t.schott@jpmorgan.com
cory.w.kasimov@jpmorgan.com lisa.c.gill@jpmorgan.com| gary.taylor@jpmorgan.com
US SMID Biotechnology Jessica Fye AC
212-622-4165 jessica.m.fye@jpmorgan.com Eric Joseph, PhD AC
212-622-0659 eric.w.joseph@jpmorgan.com
Anupam Rama AC
212-622-0900 anupam.rama@jpmorgan.com Medical Supplies & Devices Robbie Marcus, CFA AC
(1-212) 622-6657 Robert.j.marcus@jpmorgan.com Life Science Tools & Diagnostics Tycho Peterson AC
+1 212 622 6568 Tycho.peterson@jpmorgan.com
See the end pages of this presentation for analyst certification and important disclosures, including non-US analyst disclosures. J.P. Morgan does and seeks to do business with companies covered in its research reports. As a result, investors should be aware that the firm may have a conflict of interest that could affect the objectivity of this report. Investors should consider this report as only a single factor in making their investment decision.
COVID-19
Impact
on
Fundamental
Visibility
(1) Pharma pg. 10 (2) Large Biotech pg. 13 (1) Healthcare Facilities & Managed Care pg. 26 (2) MedTech pg. 32 JP Morgan Cross-Sector Healthcare Summary
The
global
COVID-19
pandemic
represents
a
fluid
situation
characterized
by
incomplete
but
rapidly evolving
data
from
disparate
sources.
The
JP
Morgan
U.S.
healthcare
team
generally
acknowledges
the high
level
of
uncertainty
and
the
strong
likelihood
of
accelerating
U.S.
incidence
growth
over
the
next several
months.
This
deck
represents
the
team’s
current
thinking.
FUNDAMENTAL
VISIBILITY
(by
Sector)
HIGHEST
INTERMEDIATE
(1) Life Science Tools & Diagnostics pg. 20 (2) Healthcare Technology & Distribution pg. 23 (3) SMID Biotech pg. 16/17/18
LOWEST
2
With
the
COVID-19
pandemic
spreading
globally
and
triggering
extended
market
volatility
the
past few
weeks,
we
wanted
to
provide
an
overview
of
the
development
of
the
outbreak
and
share
some thoughts
on
how
we
are
thinking
about
the
sector’s
exposure
in
general
as
well
as
how
to
position in
the
space.
Overall,
we
see
the
healthcare
sector
as
relatively
better-positioned
compared
to
the
broader
market in
the
midst
of
this
pandemic
(a
view
reinforced
by
the
past
two
weeks
with
healthcare
down
~19%
in the
last
month
vs
~26%
for
the
market)
with
demand
for
care
and
drugs
remaining
fairly
inelastic overall.
On
specific
subsector
exposure
and
positioning,
we
expect
biopharma
to
have
least exposure
to
COVID-19
while….
Pharma:
We
expect
COVID-19
to
have
little
impact
to
results
and
see
demand
for
prescription medication
as
fairly
inelastic.
That
said,
certain
therapeutic
areas
(e.g.
Oncology)
will
be
more
resilient than
others
(e.g.
Primary
care)
if
the
pandemic
prolongs.
Like
pharma,
we
expect
a
modest
impact
on
Biotech
commercial
products
given
the
inelasticity
of demand
(though
somewhat
dependent
on
disease
severity
/
patient
pop)
and
anticipate
little
in
the
way of
drug
shortages
from
COVID-19
disruptions.
The
bigger
unknowns,
in
our
view,
revolve
around
impact on
clinical
and
regulatory
timelines,
access
to
capital
markets,
and
BD
activities.
For
Life
Science
Tools
&
Diagnostics ,
not
surprisingly,
tools
and
med
tech
are
seeing
the
greatest COVID-19
impact,
while
CROs
have
benefitted
from
relative
insulation.
Despite
a
YTD
correction, valuations
remain
rich
(~16x
NTM
EBITDA
for
core
tools)
with
expected
financial
resets
still
to
come from
both
the
direct
COVID-19
impact
and
derivatives
(oil
price
volatility,
potential
U.S.
academic slowdown,
etc.)
and
as
such,
we
recommend
select
exposure,
including
diversified
names
(DHR, AVTR),
CRO/CDMOs
(PPD,
IQV,
CTLT)
and
U.S.-focused
growth
stories
(ADPT,
GH,
NSTG,
TXG).
The
impact
of
COVID-19
will
likely
be
mixed
across
the
Healthcare
Technology
&
Distribution
space, with
the
biggest
beneficiaries
in
our
view
telehealth
providers
TDOC
and
ONEM
given
the
ability
to
treat patients
in
a
virtual
setting.
By
sub-sector,
availability
of
supply
will
dictate
the
impact
to
the pharmaceutical
and
medical
distributors,
retail
pharmacies
could
see
curtailed
visits
but
an
uptick
in
mail order/home
delivery
scripts,
and
the
labs
could
see
a
small
benefit
from
COVID-19
testing,
offset
by reduced
routine/wellness
testing
in
the
near
term.
Longer
term,
we
continue
to
favor
names
that
are
at the
intersection
of
cost,
quality
and
convenience,
with
CVS
our
top
pick.
Healthcare
Facilities
&
Managed
Care
are
the
epicenter
of
the
U.S.
healthcare
system
response
to Covid-19
(i.e.
who
is
going
to
treat
the
patients
and
who
is
going
to
pay).
In
the
near-term
(possibly through
2Q20),
we
expect
deferred
procedures
to
exceed
actual
virus
treatment
costs
(hospitals
are
hurt while
managed
care
benefits).
In
the
worst-case
scenario;
hospital
losses
would
build
and
payor
loss ratios
would
increase
–
thus
the
near-term
trade
is
data-dependent
and
likely
lower.
However
with
a
6- 12month
view,
we
see
a
very
attractive
investment
opportunity
across
nearly
the
entire
sector
as
this overhang
ultimately
lifts.
COVID-19
is
likely
to
have
a
measurable
effect
on
the
MedTech
space
as
elective
and postponable/elective
procedures
are
likely
to
take
a
sizeable
hit.
Elective
procedures
in
China
had almost
completely
stopped
in
February
(down
80-90%),
and
we
expect
to
see
significant
procedure delays
and/or
cancellations
in
other
markets
as
the
virus
proliferates.
However,
it’s
important
to
note
that exposure
to
elective
procedures
varies
significantly
within
our
coverage,
with
some
names
fully
exposed and
others
almost
entirely
insulated.
At
the
same
time,
we
note
that
the
majority
of
product manufactured
in
China
is
then
sold
in
the
region,
limiting
the
potential
supply
disruption
to
the
rest
of
the business.
Insulet
is
the
exception,
though
for
now
supply
isn’t
negatively
impacted.
BASIC
STATS
COVID-19:
The
U.S.
currently
has
~1,663+
confirmed
reported
cases.
Based
on
experience
from
other
countries
(China, Italy,
South
Korea,
Iran),
we
could
expect
the
following
scenario
in
the
U.S.
and/or
other
countries
who
have
not yet
experienced
a
surge: o
Potential
Scenario:
(1)
A
country/region
reaches
several
hundred
reported
cases,
(2)
COVID-19
testing becomes
widely
available
to
the
public,
(3)
Strong
growth
(potentially
exponential)
of
reported
cases
to
occur over
the
coming
weeks
with
a
doubling
of
cases
every
few
days.
Early
research
from
experts
suggest
COVID-19
is
not
only
more
contagious
(each
contracted
person
is
likely
to infect
2-4
people)
than
the
Flu
(1.5-3
people)
but
also
more
deadly
(estimated
fatality
rates
currently
ranging from
below
1%
in
some
countries
to
~3-4%
in
others
vs
~0.1%
seasonal
Flu).
POSITIVE
DEVELOPMENTS:
Virus
Containment:
The
number
of
new
cases
in
Asia
(China,
S.
Korea,
SGP,
HK)
are
currently
dropping
with the
cumulative
total
cases
beginning
to
see
a
potential
plateau
(China
and
S.
Korea).
Vaccine/Drug
Development:
Seeing
strong
collaborative
efforts
worldwide
around
vaccine/drug
development and
accelerated
testing
driving
significant
innovation
with
the
growing
possibility
of
achieving
a
working
vaccine or
therapeutic
sometime
in
the
near
future.
The
U.S.
has
implemented
a
rigorous
public
health
response
(limits
on
travel
and
large
group
events)
NOTABLE
“UNKNOWNS”
LIMITING
CAPABILITY
TO
QUANTIFY
FINANCIAL
IMPACT:
Penetration
rates
within
populations,
with
public
demographics
(age),
behavior
(smoking)
and
public
health actions
(testing,
hygiene,
social
distancing
and
quarantine)
seemingly
having
a
material
impact
on
incidence and
prevalence
of
the
virus
Impact
of
non-urgent
procedure
deferrals
from
compromised
individuals
and/or
fear
of
infection
Potential
disruption
of
healthcare
supply
chain
(i.e.
supply
shortages,
ICU
capacity,
labor
availability,
etc…)
KEY
FACTORS:
1) Transmissibility
-
Emerging
data,
modestly
more
transmissible
than
seasonal
influenza
2) Severity
–
Higher
severity/fatality
rate
for
10-20%,
generally
less
severe/symptomatic
than
flu
for
80%
3) Penetration
–
Reliable
data
only
from
China
and
South
Korea
who
have
conducted
widespread
testing, but
emerging
data
suggests
elderly/smokers/immune-compromised
individuals
are
more
susceptible. Public
health
measures/restrictions
are
likely
to
have
the
greatest
impact
on
population
penetration
in the
near-term.
Longer-term
penetration
will
likely
be
dictated
by
the
likely
development
of
treatment regimens
and
vaccines.
CONTEXT/PERSPECTIVE/EXTRAPOLATION:
Epidemiological
experts
(Lawler
&
Osterholm
for
example)
have
predicted
~5-50m
U.S.
hospitalizations. The
range
of
estimates
is
hyperbolic,
obviously
contributing
to
the
current
uncertainty.
On
the
other
hand,
our
population
based
extrapolation
from
China,
South
Korea
&
Italy
would
suggest 50-400k
U.S.
cases,
5-80k
U.S.
hospitalizations
and
0.4-26k
U.S.
deaths.
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