Healthcare

• Vancocin/Ceclor/FPN are currently the “cash cow” for Edding, but they’re facing the challenges of generics, VBP and increasing competition. Their current market leading position may be lost in the future.
• Edding seeks business transformation as its CSO model doesn’t work under domestic negative policies. But peak sales of three innovative drugs Vascepa/Mulpleta/EDP 125 may not reach the level of Vancocin/Ceclor.
• Edding’s core advantage still lies in sales capabilities. Its R&D capabilities have always been questioned. It’s unsure whether the market would give high valuation to a company without core competitiveness.

• NDRC issued “Guiding Catalogue for Industrial Structure Adjustment“. The newly proposed adjustments deserve investors’ attention, because they are the areas where investors could receive excess returns in China healthcare.
• Obtaining assets from external sources remains paramount for MNCs. License-in mode isn’t outdated. As long as companies can make money, the ways to acquire assets can be diversified.
• Intco’s performance/stock price has bottomed out, and would gradually resume growth/rebound afterwards. Its market value would return to RMB20-30 billion. Intco would achieve a distress reversal, with attractive investment value.

• In 2Q23, Intuitive Surgical (ISRG US) recorded 15% YoY revenue growth to $1.76B, driven by growth in da Vinci procedure volume and an increase in the installed base of systems.
• 2Q23 procedure growth was 22%, compared to 14% for 2Q22 and 26% last quarter. Areas of strength included general surgery and gynecology for benign conditions, particularly in the U.S.
• The company now expects 2023 procedure volume growth of 20–23%, up from previous estimates of 18–21% growth. Significant material supply chain disruptions or hospital capacity constraints are not expected.

• Pharmaessentia Corp (6446 TT) has reported record-high revenue of NT$509 million for June 2023, representing growth of 84% YoY and 22% MoM, mainly driven by its sole marketed product Besremi.
• Besremi got marketing approval in Japan this year. Besremi’s marketing application is also under review process in China, Hong Kong, Singapore, and Malaysia.
• In April, Pharmaessentia has raised $462.74M through the issuance of 34M GDS to accelerate commercialization of Besremi and global clinical trials. The company has also announced NT$9.6B equity buyback program.

OpGen has announced that Curetis (its German subsidiary) has met its objectives agreed under its extended R&D collaboration with FIND (a global non-profit alliance for diagnostics), triggering a $0.2m milestone payment to OpGen. Under the expanded scope of the feasibility study for the Unyvero A30 RQ platform, OpGen was required to provide three more deliverables: an antimicrobial stewardship module, a ‘data everywhere’ concept and next-generation sequencing (NGS) strain analysis. While successful completion of the feasibility stage supports Unyvero A30’s applicability in low-to-middle income countries (LMICs), it also paves the way for a subsequent R&D agreement with FIND in developing LMIC-specific Unyvero A30 antimicrobial resistance (AMR) solutions. We await further details from management on the next potential steps of the collaboration.

• In 1Q23, SK Biopharmaceuticals Co Ltd (326030 KS) recorded Xcopri U.S. revenue of KRW53.9B, up 70% YoY and 8% QoQ. Xcopri growth is expected to accelerate in US in H2.
• The company’s operating loss narrowed to KRW23B in 1Q23, recording the lowest level excluding the one-off sales, compared with operating loss of KRW45B in 4Q22 and KRW37B in 1Q22.
• The company is looking for Xcopri revenue of KRW300B in 2023. With stable cash generation and expansion into three new modalities, SKBP aims to become a $15B company by 2026.

• Imugene Ltd (IMU AU) got US patent for its oncolytic virotherapy CF33 products, including VAXINIA and CHECKVacc. The patent protects the method of composition and use of CF33 until 2037.
• Imugene has appointed two-decade experienced Dr Ron Weitzman as Interim Chief Medical Officer. Dr Weitzman’s expertise in solid-tumor and hematologic malignancies is of particular interest for Imugene.
• Imugene is actively recruiting patients for its five ongoing clinical trials. The company has a strong balance sheet holding more than A$150 million in cash, providing a runway through 2025.

Immix has shared interim data from the Phase Ib/IIa trial evaluating IMX-110 in combination with tislelizumab for solid tumors. As of the data cut-off (7 July 2023), it was found that three of four participants with metastatic colorectal cancer (mCRC) showed tumor shrinkage and one of four experienced tumor control; all patients had stage IV relapsed/refractory (r/r) mCRC and had received a median eight lines of prior therapy. Dose escalation is proceeding, and dosing of the second cohort of patients in the Phase Ib portion of this study is complete. The higher dose cohort (Cohort 3) of patients with solid tumors is currently being enrolled, aiming to establish the recommended Phase II dose. With no severe adverse events reported to date, and with the early signs of efficacy, we believe these results are encouraging for the clinical development of IMX-110. We anticipate a steady flow of data readouts throughout H223 and FY24.

• Lucror Analytics’ ESG Scores are based on a 3-tiered scale and are adjusted for Controversies (if applicable).
• We assess Teva’s ESG as “Adequate”, in line with its “Adequate” Environmental and Social scores. The company has “Strong” Governance. Controversies are “Material”, but Disclosure is “Strong”.
• Teva Pharmaceutical Industries Limited is a global company that develops, produces and markets generic medicines and a focused portfolio of speciality medicines.

• In this insight, we take a look at the names leading the race to become ADDs/DELs for the SE600 and EURSTX Indices for the September 2023 Rebalance.
• SimCorp A/S (SIM DC) could trigger an intra-review ADD prior to the September 2023 Rebalance.
• Apart from that, I expect four other changes during the regular rebalance in September 2023. These expected ADDs and DELs are different from those in my last insight.

• Max Healthcare Institute (MAXHEALT IN) reported robust Q4 performance, with revenue and EBITA increasing 26% and 44%, YoY, respectively. Growth was driven by increase in ARPOB and occupied bed days.
• Max commissioned new 92 beds oncology block at one of its network hospitals in March. New oncology block contributed positively to revenue and EBITDA in the first month of launch.
• Max is on track to double its bed capacity in next 5–6 years. Apart from ongoing brownfield expansions, the company has land parcels with potential to add 1,000 beds.

• Porton’s performance declined significantly in 23H1 compared with high base last year, because most of Pfizer’s COVID-19 big orders have been completed. Porton’s performance in 2023 would be under pressure.
• Porton isn’t a first-tier CXO and lags behind industry leaders in terms of new businesses (CGT/ADC CXO). Valuation of entire CXO sector and Porton hasn’t yet reached an inflection point.
• Market’s expectation for CXO would decrease and then bottom out in 2023H2. Whether CXO’s performance would rebound in 2024 still needs to wait for the turnaround in macro environment.

• Lucror Analytics’ ESG Scores are based on a 3-tiered scale and are adjusted for Controversies (if applicable).
• We assess Stada’s ESG as “Adequate”, in line with its Environmental, Social and Governance scores. Controversies are “Material” and Disclosure is “Adequate”.
• Stada is a leading pharmaceuticals company headquartered in Bad Vilbel, Germany. It manufactures and sells a diverse range of generic and branded products across 125 countries globally.

• China has started taking measures to optimize fertility policies. The inclusion of assisted reproduction technologies in medical insurance is a general trend, which would generate increasing demand in the future.
• From the current domestic assisted reproductive industry chain, there is significant import substitution space and growth potential in the fields of related drugs, prenatal/newborn genetic testing, and downstream medical services.
• Companies such as Livzon/BGI/Jinxin would be the direct beneficiaries of related policy. We analyzed the industry characteristics, investment rationale, key risks and comparison with peers of these companies. 

• Hisamitsu Pharmaceutical Co (4530 JP) announced strong Q1FY24 result, with double-digit top-line and triple-digit bottom-line growth, driven by its largest selling OTC product, Salonpas. The company has reiterated FY24 guidance.
• In Q1FY24, Hisamitsu has launched Apohide Lotion in Japan for the treatment of primary palmar hyperhidrosis and Xelstrym transdermal system in the U.S. for the treatment of Attention-Deficit/Hyperactivity Disorder (ADHD).
• Hisamitsu has announced buyback of up to 2M of its shares (representing 2.57% of issued shares) from July 2023 to February 2024 for ¥10B.

• In this insight, we take a look at the names leading the race to become ADDs/DELs for the DAX, MDAX, and SDAX Indices in the September 2023 Rebalance.
• As things stand, I do not see any changes for the DAX index as-is, but there are couple of names requiring only small price gains to trigger Fast Entry changes.
• I see one change between MDAX and SDAX and one separate ADD/DEL for the SDAX index in the September 2023 rebalance.

• As the core candidate in Everest Medicines’s current pipeline, the peak sales of Nefecon could be significantly lower-than-expected, mainly due to low diagnostic rate, limited applicable patient population, high price, competition from latecomers.
• For the rest late-stage candidates, such as Etrasimod, Eravacycline, Taniborbactam, their peak sales would all be lower than that of Nefecon. So, they are unable to bring enough imagination space.
• Based on license-in mode, cost of Everest Medicines is higher than independent-R&D companies. Whether products would be returned to licensors again because of weak sales prospects is also uncertain factor.

• WuXi XDC Cayman Inc (1877628D HK) is looking to raise >US$100m in its upcoming Hong Kong IPO. The bookrunners on the deal are Morgan Stanley, Goldman Sachs, and JP Morgan.
• WuXi XDC Cayman (WXDC) is a contract research, development, and manufacturing organization (CRDMO) focused on the global antibody drug conjugates (ADC) and broader bioconjugate market providing integrated and end-to-end services.
• As per Frost & Sullivan (F&S), the firm was the second largest CRDMO for ADCs and other bioconjugates globally in terms of FY22 sales.

Respiri has announced a three-year distribution and marketing agreement (non-exclusive) with Fi-Med Management, a US-based company providing healthcare support and management solutions to large healthcare organisations. Under this revenue-share arrangement, Respiri will receive $30 per patient per month for active patients enrolled as wheezo RPM users. Although the initial Fi-Med customer review suggests an immediate opportunity to address 5,000 patients, the collaboration is anticipated to enable Respiri to access a wider patient base. The development closely aligns with management’s strategic focus to expand into other indications and generate incremental top-line growth.

• According to local media (Seoul Economic Daily), Hahn & Company plans to make a second round of tender offer for Lutronic Corp, in order to meet the delisting requirements.  
• The tender offer price is 36,700 won, the same as the first tender offer price.
• We believe that Hahn & Co is likely to successfully complete this second round of tender offer of Lutronic and it is likely to be delisted in the coming months.

• In this insight, we take a look at the potential index changes for ASX 300, 200, 100, 50, and 20 in the run up to the September 2023 Rebalance.
• Blackmores Ltd (BKL AU) could get deleted from the index family, triggering intra-review changes in the next few days.
• Including the intra-review changes, ASX 300 could see 12 ADDs and 10 DELs, ASX 200 could see 4 changes, and ASX 100 could see one change between now and September.

• Although WuXi XDC has financing needs, we’re more inclined to view this spin-off listing as another capital operation of WuXi AppTec/WuXi Bio, who may not want to take risks alone.
• Global ADC/broader bioconjugate market is at a nascent stage of development, with high R&D risks/commercialization uncertainties. We cannot guarantee whether WuXi XDC will maintain its industry-leading position in the future.
• Although high growth can bring good stories, we’re not sure how much actual market space WuXi XDC will have in the future,which is the key to determining the valuation ceiling.

• Guangdong Archealth Health Industry Group (GAHI HK) is looking to raise around US$100m in its upcoming Hong Kong IPO. The bookrunners on the deal are CICC and ABCI.
• Guangdong Archealth Health Industry Group (GAHI) is a digital health management provider.
• According to F&S, the firm ranked first in the weight management industry and first in the digital weight management industry in China as per 2022 sales.

• New Horizon Health reported a solid set of preliminary results for 1H2023
• We speak to the company’s management post result announcement to figure out the key drivers and summarize the key points in this note.
• The company upgraded its full year guidance and is on track to meet its long term target.

• Busy week in India with the adhoc changes to the NIFTY, NSE Nifty Next 50, S&P BSE SENSEX and Nifty Bank due to the HDFC Limited and HDFC Bank merger.
• The IDX could announce the changes to the IDX30, LQ45 and IDX80 indices in the coming week, though there is no firm schedule for announcements.
• Yet another week of inflows to the Tracker Fund of Hong Kong Ltd (2800 HK) ETF and outflows from the Hang Seng H Share Index ETF (2828 HK). 

• According to Invest Chosun, Celltrion Inc (068270 KS) plans to submit a merger registration statement to the KRX in July, with Mirae Asset Securities acting as the lead underwriter.
• Fast Retailing (9983 JP) investors are in a conundrum. The stock is doing well. With one quarter to go, the company just raised its full-year EPS target by 8.3%.
• Canon (7751 JP)‘s most recent buyback should be done now-ish. They have been ~15-20% of volume over the past month. The Trade would be short Canon vs Ricoh (7752 JP).

• Neuren Pharmaceuticals (NEU AU) announced the expansion of partnership with Acadia Pharmaceuticals for trofinetide. Acadia’s exclusive license for trofinetide in North America has been expanded to a worldwide exclusive license. 
• Neuren is now entitled for additional payments and will receive $100M up-front, plus additional potential milestone payments of upto $427M and royalties on net sales of trofinetide outside North America.
• Neuren has also granted Acadia an exclusive worldwide license to develop and commercialize NNZ-2591 for Rett and Fragile X syndromes and retains worldwide rights to NNZ-2591 in all other indications.

• The recent announcement that Indonesia will allow foreign doctors to operate in Indonesia should benefit listed healthcare players with Siloam International Hospitals being a key beneficiary of the move.
• The company has come out of the pandemic stronger and more profitable with an ongoing focus on increasing the complexity of treatments and the efficiency of operations. 
• Siloam International Hospitals will continue to open 1-2 new hospitals each year but it only utilises 3,000 out of 7,000 bed capacity leaving room for organic growth. Valuations are attractive.

• In 1Q23, Bangkok Chain Hospital (BCH TB) recorded 62% YoY decline in revenue from hospital operation, dragged by 39% YoY decline in revenue from general patients (66% of total revenue).
• COVID-19 revenue contributed 48% of revenue in 1Q22, thereby creating a high base for 1Q23. Even if we exclude COVID-19 revenue received in 1Q22, 1Q23 revenue was down 28% YoY.
• BCH will need time to recover and record growth. Consensus expects BCH to report revenue and EPS decline of 34% and 47%, YoY, respectively in 2023.