Healthcare

• Novartis published its offer document for MorphoSys AG (MOR GR) (US: MorphoSys AG (MOR US)) following approval by BaFin. The acceptance period has commenced on 11 April, and will expire on 13 May.
• I remain confident NVS’ acquisition of MOR closes on track. I maintain my TP at €68/share, $18.25/ADR offer price, as deal will highly likely close in H1, in my view.
• As of 11 April, gross spread is 0.82% and the estimated annual return is 7.78%. Long and tender.

• Amvis Holdings Inc (7071 JP) opened 57 facilities during FY20–23, which raised total borrowings 37% YoY to ¥17B in FY23 and further to ¥19B at the end of Q1FY24.
• The impact of the monetary policy is expected to be immaterial based on the current interest incidence of just 0.44%. Interest expenses account for less than 1% of revenue.
• Amvis started FY24 on a solid note, with all key parameters reporting more than 30% YoY growth in Q1FY24. The company has reiterated full-year FY24 guidance.

• The ChiNext Index represents the performance of the 100 largest and most liquid A-share stocks listed on the ChiNext Market of the Shenzhen Stock Exchange.
• The ChiNext 50 index is a subset of the ChiNext Index and it consists of the top 50 names in the ChiNext index with the highest daily average turnover.
• In this insight, we take a look at the names leading the race to become ADDs and DELs in the June 2024 index rebal event.

• Shineway’s performance in 23H2 was disappointing, mainly due to the VBP of formula granules and anti-corruption campaign. Accordingly, TCM injection and TCM formula granule businesses had negative growth in 23Q4.
• As the NHSA has further lifted the reimbursement restrictions on Chinese medicine injections, Shineway’s injection business is expected to help “hedge against” the headwinds in TCM formula granule business.
• 24H1 growth is under pressure due to 23H1 high base. Growth in 24H2 would pick up.As long as TCM favorable policies remain, profit is expected to increase by 20%-30% annually.

In the lead up to its capital markets day, Basilea Pharmaceutica announced it has received initial funding of up to US$0.9m through a grant from Combating Antibiotic-Resistant Bacteria Biopharmaceutical Accelerator (CARB-X), a global non-profit partnership backed by governments and foundations, for its preclinical antibiotics program. CARB-X is focused on supporting early-stage antibacterial research and development, and this grant is expected to support development work up until clinical candidate nomination in H224, with potential additional funding subject to achieving certain milestones. 2024 is shaping up to be an active year for Basilea, following the recent FDA approval and anticipated subsequent commercial launch of Zevtera in the US, as well as the initiation of Phase III studies for newly acquired antifungal asset Fosmanogepix (mid-2024).

• TRX is focused on the development and commercialisation of two proprietary processing technologies for the repair of soft tissue (dCELL®) and bone (BioRinse®).
• It has a broad portfolio of products used in biosurgery, orthopaedics and dental markets.
• Investment in tissue processing, manufacturing capacity and strong commercial partners, together with its “4S” strategy, has generated six consecutive reporting periods of strong growth, with TRX turning EBITDA-positive in 2023.

• Since “no dividend was proposed for the year ended 31 December 2023”, the privatization is highly likely to succeed. It may not be wise for investors to bet against privatization.
• The recent high-level personnel changes in Taiji is “thought-provoking”, which seems to be preparing for the next step of integrating with China TCM. Spin-offs and integrations are expected within Taiji.
• We analyzed possible playbook. In this way, CNPGC is able to solve the problem of horizontal competition. China TCM could also relist in A-share to gain higher valuations/better liquidity.

• Masimo Corporation had a mixed Q4 and fiscal year 2023 earnings call, reporting both positive results and some challenges.
• The company generated over $2 billion in consolidated revenues, with healthcare revenues reaching $1.28 billion.
• In addition, Masimo saw strong growth in its hearables business and reported a record number of contract wins.

• The Ensign Group offers a variety of services, including skilled nursing, rehabilitative care services, home health care, hospice care, and physical, occupational and speech therapies, among others.
• In their most recent earnings presentation, the company reported impressive clinical and financial results backed by the commitment and efforts of its employees.
• Ensign reported a same-store occupancy of 79.9%, a 240 basis point increase over the last year, and also noticed improvements in their occupancy on a sequential basis of 40 basis points over the third quarter.

• Throughout 2023, Exelixis Inc, showed a strong overall performance with increased demand and revenue growth in its cabozantinib franchise, globally.
• As per their recent conference call, they revealed that the franchise’s net product revenues rose by 14% YoY in Q4 2023.
• The 2023 full-year revenue also grew by 16% YoY. Moreover, the global cabozantinib franchise net product revenues produced by Exelixis, and its partners reached approximately $2.3 billion in 2023.

• Inspire Medical Systems, a manufacturer of devices for treating obstructive sleep apnea, recently reported their fourth quarter and full year 2023 financial results.
• The company delivered strong results, noting this was their first quarter with operating income and that they had completed the year on a high note.
• The company reported revenue of $192.5 million for the fourth quarter, a 40% increase from Q4 2020, and net income of $14.8 million, compared to $3.2 million in the prior year.

• Intra-Cellular Therapies, during their fourth quarter and full-year 2023 earnings, expressed a positive outlook based on strong and consistent growth throughout the past year.
• Key achievements included establishing CAPLYTA as a significant treatment option for a broad patient population with bipolar depression and schizophrenia, and advancing several of their pipeline programs.
• Baptista Research looks to evaluate the different factors that could influence the company’s price in the near future and attempts to carry out an independent valuation of the company using a Discounted Cash Flow (DCF) methodology.

• This is our first report on Option Care Health.
• The company reported a decent set of Fourth Quarter 2023 Earnings.
• They attribute a significant part of their growth to their commitment to offering innovative services aiming to improve patient outcomes and reduce costs.

With the FDA investigational new drug (IND) application clearance, Oryzon can commence its Phase I/II cooperative research and development agreement (CRADA) trial sponsored by the National Cancer Institute (NCI; part of the National Institutes of Health) with Dr Noura Choudhury from the Memorial Sloan Kettering Cancer Center (MSKCC) as the principal investigator. This trial will evaluate iadademstat in combination with immune checkpoint inhibitors (ICIs) for the treatment of first-line extensive-stage small-cell lung cancer (SCLC). This is a key development for Oryzon as interim results from this study will influence the design of the company-sponsored Phase Ib/II STELLAR trial. The IND application for this is likely to be filed by end-2024 (trial commencing in 2025). ICIs atezolizumab and durvalumab are currently approved as first-line treatments in SCLC and Oryzon expects a combination with iadademstat to enhance immune activity in patients, increasing therapeutic efficacy. The CRADA-MSKCC trial will enrol 40–50 patients, with updates expected through 2024.

• Encompass Health’s earnings for the fourth quarter of 2023 revealed yet another strong showing for the company, capping off a robust year of performance.
• On the positive side, a significant growth in both volume and revenue was reported for the year.
• The company recorded a 10.4% increase in revenue, driven by an 8.7% spike in total discharges, indicating its value proposition indeed resonates with referral sources, payers, and the patients it serves.

• Aster DM Healthcare Ltd (ASTERDM IN) completes a significant restructuring, separating its India and GCC operations, with a consortium led by Fajr Capital acquiring a 65% stake in Aster GCC. 
• The substantial cash consideration received provides financial flexibility for further investments, debt reduction, or strategic opportunities.
• Explore the implications of Aster’s restructuring on shareholder value, with a special dividend of INR 110 to INR 120 per share planned.

• Ansell Ltd (ANN AU) is looking to raise US$262m in its primary follow-on to partially fund its acquisition of KCPPE.
• Despite the firm having been on an acquisition spree, it remains uncertain to us if the market has been factoring in such a large one. 
• The deal would be a large one to digest, representing 52.5 days of the stock’s three month ADV.

• On 8 April, the Korea Exchange announced special changes to KOSDAQ 150. NKMAX will be excluded from KOSDAQ 150 and it will be replaced by GI Innovation.
• NKMAX was designated as “administrative issue” and “investment attention issue” on 8 April 2024, which resulted in the Korea Exchange deciding to remove this stock from KOSDAQ 150. 
• We believe that this inclusion of GI Innovation in KOSDAQ 150 is likely to further positively impact its share price.

• Gland Pharma Ltd (GLAND IN) reported mid-single-digit revenue and EPS growth in its base business (ex-Cenexi) during 9M FY24. The company is confident to end FY24 on a high note.
• Gland Pharma starts FY25 on a strong note with gaining U.S. approval for eribulin mesylate injection, used for breast cancer that has spread to other parts of the body.
• Over the next 12–15 months, Gland Pharma is poised for enhanced geographical foot-print in Europe through Cenexi. The addressable CDMO business opportunity is estimated at €4B.

• Natera, Inc.’s latest quarterly earnings reveal positive growth prospects and the firm’s commitment to maintaining momentum in their healthcare ventures.
• The company saw a rise in revenue, reaching $311 million for Q4, a substantial growth of 43% over the same period in 2022.
• Furthermore, its full-year revenues were reported at $1.08 billion, up by more than 30% compared to the previous year.

• This is our first report on Roivant.
• The company’s Q3 2023 earnings were decent and the neutral positives can be highlighted from the continuous growth of VTAMA, ROIV’s best-selling branded topical in psoriasis, recording over 300,000 prescriptions and revenues of $20.7 million.
• Additionally, the pipeline for Roivant has compelling developments, with brepocitinib showing promising potential in orphan rheumatology.

• BenQ BM Holding Cayman Corp (2228515D KY) is looking to raise at least US$100m in its upcoming Hong Kong IPO. The bookrunners on the deal are CICC and Citigroup.
• BenQ BM Holding Cayman Corp (BenQ BM) is a general hospital operator.
• As of Dec 2023, BenQ BM owned and operated two hospitals, with a total combined GFA of approximately 380,000 sqm and 1,850 registered beds.

• The biggest changes in 2023 medical insurance catalog are the lifting of payment restrictions on TCM injections, which would drive rapid sales growth in the hospital market this year.
• GLP-1s are not flawless, and patients will lose not only fat but also muscle during weight-loss process. Then, another noteworthy opportunity has emerged – reduce fat and increase muscle.
• In 2024, Sino Biopharm is expected to achieve single-digit revenue growth. Deficiencies in corporate governance are one reason why the market is reluctant to offer Sino Biopharm high valuation.

• The review period for the June rebalance ends 30 April. We expect the changes to be announced 31 May with the implementation taking place after the close on 14 June.
• We expect the index committee to continue using a 6-month minimum listing history resulting in three changes to the index.
• With a big jump in tracking AUM over the last few months, passives will need to trade a lot of stock on implementation date.

• Acadia Healthcare delivered a robust financial performance for 2023, marked by a 12.2% annual revenue growth, 13.1% adjusted EBITDA growth, and 14.3% adjusted EPS growth compared to 2022.
• In the fourth quarter, its same-facility revenue rose by 10.3% on the back of rate improvements and patient day growth.
• Acadia also saw consistent improvement in its labor trends throughout 2023.

• Tenet Healthcare’s Q4 2023 earnings indicated a strong performance, with net operating revenues of $20.5 billion, and consolidated adjusted EBITDA of $3.54 billion, which translates into an attractive 17.2% adjusted EBITDA margin.
• The company has demonstrated its ability to maintain profitability while focusing on quality and innovation.
• Yet, some challenges were also mentioned during the earnings call.

• Chemed Corporation reported their fourth quarter 2023 earnings with continued improvement in their VITAS operational metrics, including a 7% increase in admissions over the prior year period and an average daily census of 1,918.
• This is an 11% increase in comparison to the prior year and suggests that a hiring and retention program initiated in 2022 to remedy any potential worker turnover and expand clinical workforce capacity has been successful in maintaining VITAS’ operational performance.
• Baptista Research looks to evaluate the different factors that could influence the company’s price in the near future and attempts to carry out an independent valuation of the company using a Discounted Cash Flow (DCF) methodology.

• Examining the fourth quarter 2023 earnings for Dentsply Sirona reveals an investment thesis that emphasizes the company’s successful strategies, robust performance and rigorous financial discipline, alongside ambitious future business growth targets and consistent value creation for its stakeholders.
• Starting with the positives, Dentsply Sirona achieved over 2% organic sales growth for 2023, outperforming projections via growth in three of its four business segments.
• Notably, its orthodontic business experienced double-digit growth with both Byte and SureSmile.

• In Q4 2023, Elanco Animal Health reported a 5% constant currency revenue growth, driven by innovations, the strength of the farm animal business, improved conditions in the European Pet Health retail market, and increased pricing.
• The strong performance in 2023 indicates that the company’s innovation, portfolio, and productivity strategy are working, leading to confidence in the potential success of future investments.
• Going into 2024, the company aims to focus on three priorities: sustained revenue growth, innovation, and improved cash conversion.

• Fresenius Medical Care’s Q4 2023 earnings highlighted the progress made against their strategic plan that was set out a year prior.
• The plan focused on significant structural, operational and cultural changes, with the operating model being transformed at the start of 2023.
• This allowed the company to introduce a new financial report with increased transparency, which reflected a commitment to their operational turnaround initiatives that aided organic growth in both segments and improved operational performance.

• Globus Medical, a leading musculoskeletal solutions provider, has reported record revenues of $1.569 billion for the full year 2023, marking a growth of 53% compared to the previous year.
• The strong performance includes four months of sales after its merger with NuVasive.
• This remarkable growth maintained the company’s industry-leading profitability, generating a record non-GAAP EPS of $2.32 and an adjusted EBITDA of 30%.

• Ionis Pharmaceuticals Inc. had a remarkable year in 2023, with significant advancements in their RNA targeting platform and a steady stream of upcoming independent medicines delivering directly to patients.
• The company’s forward-looking stratagem involves expanding their technology and broadening its applicability to cater to patients’ needs.
• Baptista Research looks to evaluate the different factors that could influence the company’s price in the near future and attempts to carry out an independent valuation of the company using a Discounted Cash Flow (DCF) methodology.

• Medpace Holdings, a leading full-service clinical contract research organization (CRO), reported robust results for the fourth quarter and full year of 2023.
• The company’s revenue increased 26.5% year-over-year in Q4, reaching $498.4 million.
• For the full year, revenue stood at $1.89 billion, a rise of 29.2% from 2022.

• Neurocrine Biosciences Inc, a biopharmaceutical company specializing in neurologic, psychiatric, and endocrine related disorders, showed significant growth during its remarkable year of 2023.
• According to Neurocrine’s executives, the firm’s performance reflected the ongoing progress and the successful execution of business strategies with nearly 30% year-over-year sales growth for its flagship product, INGREZZA, which is a drug indicated for the treatment of tardive dyskinesia in adults.
• Baptista Research looks to evaluate the different factors that could influence the company’s price in the near future and attempts to carry out an independent valuation of the company using a Discounted Cash Flow (DCF) methodology.

• The victorious brothers plan to join forces with KKR to secure over 51% ownership of Hanmi Science. They aim to persuade the mother and daughter to part with their shares.
• Should this negotiation fail, KKR is prepared to initiate a tender offer in the open market, intending to acquire an additional 10-15% of Hanmi Science’s shares.
• KKR can target a maximum of 16%. With 10-15% aimed for, this tender offer will cause significant price impact.

• The 2024 AGM of Hanmi Science is over and the two Lim brothers have control of the company. Nonetheless, the fight for the control of Hanmi Science is not over.
• There is an increasingly probable scenario where the KKR private equity firm gets involved, joining hands with the Lim brothers.
• If mum and sister do not sell their shares (which seems to be the higher likely scenario), then KKR may issue a tender offer to the remaining minority shareholders.

• Johnson & Johnson (JNJ US) entered into a definitive agreement to acquire Shockwave Medical Inc (SWAV US) for $335/share in cash or an enterprise value of $13.1B.
• Offer price represents 4.7% premium over yesterday’s closing price or around 19% premium over the undisturbed price. The deal is expected to close by mid-2024.
• With no product overlap and competition concern, the deal is expected to get regulatory approval. With reasonable deal valuation, shareholders approval is also expected.

• Cochlear Ltd (COH AU) shares rallied 30%+ over the last six months. Shares are trading at NTM P/E of 51.3x, versus other Australia-listed medical devices companies’ P/E of 23–32x.
• The underlying business strength depicted by strong financial performance and guidance raise, and superior product offerings justify the pricey valuation.
• Cochlear lifted FY24 net profit guidance to A$385–400M (+26–31% YoY) from A$355–375M. The company expects FY24 cochlear implant volume growth of 10–15% YoY.

• Jinxin Fertility Group Ltd., China’s largest private provider of in vitro fertility (IVF) services, is buying a stake in an Indonesian peer, venturing into Southeast Asia as demand in China declines with more couples opting not to have babies.
• Hong Kong-listed Jinxin Fertility has signed an equity investment deal to become a “significant shareholder” of PT Morula Indonesia, an IVF specialist affiliated with PT Bundamedik Tbk, a major women- and children-focused health care services group in Indonesia, according to a joint statement Monday.
• It did not specify how much capital Jinxin will invest.

For the third consecutive time, Oryzon Genomics has received the INNOVATIVE SME Seal from the Spanish Ministry of Science and Innovation. This external recognition highlights Oryzon’s key R&D activities, including its lead central nervous system (CNS) asset, vafidemstat, and lead oncology asset, iadademstat, and overall contributions to the field of epigenetics. Along with the acknowledgement, the INNOVATIVE SME Seal may allow Oryzon to benefit from certain tax deductions and incentives, as well as potential access to certain financing facilities.

Basilea has announced the FDA approval of its second lead asset, Zevtera (ceftobiprole), for the treatment of severe bacterial infections (three indications), marking a major commercial win. The US is the most commercially lucrative market for Zevtera, accounting for 85–90% of its total market potential. Zevtera is already approved in several countries (including in Europe) and the FDA nod is based on three Phase III studies (including the ERADICATE and TARGET studies with R&D partly funded by the BARDA). Note that the drug holds the Qualified Infectious Disease Product (QIDP) designation, which will provide up to 10-years of market exclusivity following approval. As we await more details on the US commercial partner (expected by mid-2024), we upgrade our US probability of success (PoS) to 100%, bumping our valuation to CHF1,008.6m or CHF84.0/share (from CHF80.7/share).

• Major milestones with high expectations coming in the next 2-3 years: 1) Phase IIb US trials for H-1337 as “first choice as a second-line Glaucoma drug” for patients who do not respond to PGs
• 2) 2024 application/approval and 2025 launch of DW- 1002 in Japan, 2023 application and 2024 approval/launch in China, as well as orphan drug designation for combination formula MembraneBlue-DualⓇ (DW-1002 + trypan blue) in the US,
• 3) in Japan, start P2 clinical trials in 2024, P3 trials in late 2025 though 2026, and normal schedule application for approval for regenerative cell-therapy DWR-2206 in 2027

SIGA Technologies announced a strategic step in fortifying its distribution partner, Meridian, allowing greater control over planning and executing its international development efforts, a key growth pillar. The amended terms allow the company to actively manage future promotion activities outside the US (effective 1 June 2024). While Meridian will continue to administer existing international contracts, we expect the renegotiated terms to benefit the bottom line in the medium term as SIGA gains traction internationally. In a separate development, and one that could have a positive read-across for SIGA’s TPOXX, Bavarian Nordic, a key vaccine peer, has commenced the commercial launch of its mpox vaccine Jynneos in the US, which has only been available through the strategic national stockpile to date. We view this as a positive milestone for this therapeutic group and SIGA as TPOXX is the only approved anti-viral treatment for a range of orthopox viruses (including mpox) in Europe and is currently undergoing clinical trials in the US for expansion into mpox (presently approved for smallpox).

• Hansoh Pharmaceutical Group (3692 HK) reported a whopping 55% YoY net profit growth to RMB3 billion on just 13% YoY revenue growth to RMB6 billion in 2H23.
• Revenue from innovative drugs zoomed 52% YoY to RMB4 billion and its proportion to total revenue increased to 73% in 2H23 from 54% in 2H22 and 62% in 1H23.
• Although Hansoh is not expected to receive marketing approval for any in-house innovative product in 2024, existing portfolio of innovative drugs will continue to drive the growth of the company.

• Besides the core product Utidelone Injection, the rest pipelines are mostly related to the indications expansion/new formulations R&D for Utidelone Injection. Excessive dependence on single product is hard to improve. 
• We’re not optimistic about the future sales growth of Utidelone Injection due to fierce competition/inconvenient administration methods/expired patent protection. Biostar is facing survival risks if new financing cannot be obtained.
• Biostar’s post-investment valuation is already RMB4.49 billion. Given the gloomy sentiment and the concerns about the pipeline/prospects, we think it could fall below this valuation level after IPO in HKEX.

Immix Biopharma is continuing its strategic pivot towards exploring non-traditional indications for its CAR-T asset, NXC-201, leading with relapsed/refractory (r/r) amyloid light chain amyloidosis (ALA). This tactical approach targets opportunities with a potential first mover advantage and the strategy is expected to be consolidated in 2024 with the initiation of the Phase Ib NEXICART-2 study in the US and the selection of the first autoimmune indication for NXC-201. Readouts in ALA are expected in Q424, with a potential Biologics License Application (BLA) in 2025, both key catalysts for Immix. Pro forma cash of $33.5m includes the February 2024 $15.5m (net) raise and is expected to support operations to Q225, past several key readouts. We adjust our assumptions for the latest updates, which results in resetting our valuation to $142.2m or $5.4 per share (from $86.6m or $4.0/share previously).

• Soon-To-Be ex-healthcare technology platform play IntelliCentrics Global Holding (6819 HK) is a pseudo risk arb. 
• IntelliCentrics is selling its key ops, declaring a special dividend from the sale proceeds, subsequently being wound up, then delisted. 
• Shareholders have the option of voting on a raft of resolutions on the 18th April. Irrevocables total 72.1%. This is done. Just the final dividend amount needs to be confirmed.

• Aster DM Healthcare Ltd (ASTERDM IN) shares took a beating as Olympus Capital offloaded ~49M shares at a price range of INR405.00–406.72 (~7% discount to the last close price).
• GCC business separation is expected to complete in Q4FY24. Aster DM plans to consider distributing 70–80% of the upfront consideration of $903M as dividend to its shareholders.
• Stake sale by Olympus Capital is not a warning sign for the company. Despite CGHS rate overhang, we think recent pullback in Aster DM share provides an attractive entry point.

• Zadaxin is the biggest performance driver of SciClone. However, due to the challenge of generic drugs/VBP, sales of Zadaxin wouldn’t maintain strong growth momentum.  SciClone’s revenue/profit would face a significant decline.
• The capital participating the IPO had reduced their holdings or exit entirely. Considering the low valuation/poor liquidity in HKEX, we think this privatization provides investors with a great exit opportunity.
• For arbitrage investors, the annualized return depends on the time it takes to complete the privatization (e.g. about 5%-10%). If the privatization fails, share price could fall back to HK$14.

• The sBLA of Carvykti is under review by FDA with a target PDUFA date of April 5. If approved for 2L therapy, Carvykti would become “a game changer” in MM treatment.
• The peak sales of US$5 billion is becoming possible. From this perspective, as Carvykti advances towards earlier line treatment, the subsequent valuation leap of legend Bio is becoming more certain.
• However, considering lower gross margin and Legend Bio/J&J’s 50/50 split ratio, Legend Bio’s market value performance could be inferior to BeiGene. Investors should also closely monitor the changes in macro.

OSE Immunotherapeutics’ (OSE’s) FY23 update summarised an active period for its clinical pipeline that was capped by the post-period $713m deal with AbbVie for preclinical asset OSE-230. The company is anticipated to hit meaningful milestones in 2024 with its lead immuno-oncology asset, Tedopi, gearing up for the confirmatory pivotal Phase III trial in Q224 and lead immuno-inflammation programme, Lusvertikimab, set to report Phase II top-line results in mid-2024. OSE-230 (being developed as a treatment for chronic inflammation) is also anticipated to enter the clinic this year, potentially tiggering another milestone payment for OSE. Gross cash of €18.7m at end-FY23 was fortified by the AbbVie $48m upfront payment and expected €5.8m in research tax credit, extending the cash runway into 2026, past several key milestones. We update our estimates for the FY23 results and adjust the launch timelines for the partnered programmes (from 2028 to 2029). Our valuation adjusts to €317.1m or €14.6 per share (from €311.3m or €14.4/share previously).