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巴克莱-美股-医疗保健行业-美国生命科学与诊断行业展望-13-397页.pdf
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《美国生命科学与诊断行业展望:工具与诊断的避风港》
在医疗保健行业中,美国的生命科学工具与诊断行业被视为一个相对稳定的领域。2018年虽然以动荡收尾,但该行业仍然跑赢市场,实现了10%的增长,而同期S&P 500指数下跌了6%,这表明其具有一定的抵御风险能力。2019年的展望中,我们预计生命科学工具与诊断将继续保持强劲的增长势头。
生物制药行业将继续作为增长引擎。随着对研发投资的增加,生物制药公司对创新技术和差异化服务的需求不断增长,特别是在生物制品生产、伴随诊断(CDx)以及合同研究组织(CRO)的服务方面。近期的融资和投资数据显示出积极的态势,这为工具类公司的增长提供了有力支持。
全球范围内对学术研究的资金支持将推动生命科学工具行业的发展。学术研究的进步是创新技术的重要来源,持续的投入将有助于推动行业的长期增长。
然而,尽管医疗保健行业拥有可持续的长期增长动力,但我们对诊断领域的选择仍然谨慎。近年来国家实验室面临的挑战,如临床实验室公正性法案(PAMA)带来的价格削减和整合趋势,是我们关注的主要风险因素。这将对我们的实验室和诊断覆盖范围内的公司产生显著影响。
在我们2019年的展望报告中,我们特别关注了两个关键部分:
1. 冷冻电子显微镜(Cryo-EM)调查——分辨率革命:通过对17家客户的访谈和调查,我们发现Thermo Fisher Scientific收购FEI后的Cryo-EM技术在结构生物学研究中开辟了新的机会,客户反馈非常积极。结合Thermo Fisher的客户服务理念和战略,我们将其选为我们的首选股票。
2. Jack的工作板——推出生命科学工具与诊断职业追踪器:我们利用网络爬虫技术监控覆盖范围内公司的招聘活动。初期发布时,我们注意到MYGN(未上市)在基因检测领域的招聘活动增加,这可能预示着公司在这一领域的扩张和技术创新。
美国生命科学工具与诊断行业在2019年将面临机遇与挑战并存的局面。投资者应关注行业内的技术创新、市场需求以及政策影响,以做出明智的投资决策。同时,对于那些能够提供独特价值和应对市场变化的公司,如Thermo Fisher Scientific,可能蕴藏着更大的投资潜力。
Equity Research
3 January 2019
FOCUS
U.S. Life Science Tools & Diagnostics
2019 Outlook: Tools & Dx a Relative
Safe Haven, TMO Our New Top Pick
Looking into 2019, our view is that Life Science Tools & Diagnostics should continue
to be a relative safe haven in healthcare. While 2018 ended on a rocky note, the group
again outperformed the market – up 10%, vs the S&P 500 down 6%. Looking across
end markets, we believe biopharma will remain a growth engine supported by R&D
investment. The push toward personalized medicine drives demand for bioproduction,
CDx, and differentiated offerings from the CROs. Recent data on funding and
investment has been strong. Additionally, industrial macro datapoints provide 2-3
quarters of visibility into end market momentum, an important growth driver for our
Tools coverage. Next, global support for academic funding should continue to drive
LSD growth. Finally, while healthcare has sustainable long-term drivers of growth, we
remain selective in Dx given recent challenges at the national labs. PAMA remains a key
risk, where cuts and consolidation are major themes for our labs & Dx coverage.
We highlight several proprietary sections of our 2019 Outlook:
- Cryo-EM Survey – the Resolution Revolution, TMO Our Top Pick: Customer
feedback on Cryo-EM is very positive – further strengthening the strategic rationale of
Thermo Fisher’s FEI acquisition, and our conviction that the company can sustain peer-
leading growth into 2019. In 4Q18, we performed a series of interviews and survey of
17 customers. Feedback was very positive on how Cryo-EM at FEI is pioneering new
research opportunities in structural biology. Coupled with Thermo Fisher’s customer
value proposition and compelling strategy, we designate TMO as our Top Pick.
- Jack’s Job Board - Launching our Life Science Tools & Dx Careers Tracker: We are
using web-scraping to monitor hiring activity for our coverage universe. For our initial
publication, we highlight A) MYGN (UW): increased GeneSight sales rep openings,
almost 30% annualized since April. B) HOLX (EW): adding “Customer Success
Managers” at CynoSure, while GYN Surgical openings have increased. C) CROs: a
significant increase in the number of employees being hired, which could suggest an
approaching inflection in revenue growth. IQV’s (OW) hiring stands out among peers.
- Lab Survey Says: Network Access Drives Share Changes to Start 2019: We surveyed
primary care docs (n=50) on lab ordering patterns with upcoming network access
expansion. 1) Quest (OW) is expected to gain share (+570bp to 36.1%), predominantly
at the detriment of hospital based labs (-360bp to 19.8%). LabCorp (OW) is expected to
lose modest share (-80bp to 28.6%). 2) Quest and LabCorp were expected to gain
share with 16 and 22 physicians, respectively; a wide margin over hospital labs (3) and
other independent labs (1). 3) Regionally, Quest’s strength was broad-based.
Actions: We designate Thermo Fisher (TMO) as our Top Pick, and raise our PT to $280.
We also upgrade Bio-Rad (BIO) to OW. Finally, we lower our PTs on Myriad Genetics
(MYGN) to $21 and Syneos Health (SYNH) to $45.
In this report, we provide a comprehensive update on the Life Science Tools,
Diagnostics, Labs & CRO industries – including our proprietary end market trackers
and industry overviews. Please join us for a 2019 Outlook conference call today,
January 3, at 11:00am ET: Dial-in: 1-800-706-8249, Passcode: 7757098.
INDUSTRY UPDATE
U.S. Life Science Tools & Diagnostics
NEUTRAL
Unchanged
For a full list of our ratings, price target and
earnings changes in this report, please see
table on page 2.
U.S. Life Sc
ience Tools & Diagnostics
Jack Meehan, CFA
+1 212 526 3909
jack.meehan@barclays.com
BCI, US
Mitchell Petersen
+1 212 526 3367
mitchell.petersen@barclays.com
BCI, US
Andrew Wald
+1 212 526 9436
andrew.wald@barclays.com
BCI, US
Barclays Capital Inc. and/or one of its affiliates 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.
PLEASE SEE ANALYST CERTIFICATION(S) AND IMPORTANT DISCLOSURES BEGINNING ON PAGE
391.
Barclays | U.S. Life Science Tools & Diagnostics
3 January 2019 2
Summary of our Ratings, Price Targets and Earnings Changes in this Report (all changes are shown in bold)
Company
Rating
Price
Price Target
EPS FY1 (E)
EPS FY2 (E)
Old
New
31-Dec-18
Old
New
%Chg
Old
New
%Chg
Old
New
%Chg
U.S. Life Science Tools & Diagnostics
Neu
Neu
Bio-Rad Laboratories (BIO)
EW
OW
232.22
315.00
315.00
-
5.45
5.45
-
6.50
6.55
1
Myriad Genetics Inc. (MYGN)
UW
UW
29.07
23.00
21.00
-9
1.73
1.73
-
1.90
1.75
-8
Syneos Health, Inc. (SYNH)
EW
EW
39.35
51.00
45.00
-12
2.73
2.73
-
3.15
3.10
-2
Thermo Fisher Scientific, Inc. (TMO)
OW
OW
223.79
275.00
280.00
2
11.06
11.06
-
12.30
12.30
-
Waters Corp. (WAT)
EW
EW
188.65
190.00
190.00
-
8.05
8.05
-
9.05
9.30
3
Source: Barclays Research. Share prices and target prices are shown in the primary listing currency and EPS estimates are shown in the reporting currency.
FY1(E): Current fiscal year estimates by Barclays Research. FY2(E): Next fiscal year estimates by Barclays Research.
Stock Rating: OW: Overweight; EW: Equal Weight; UW: Underweight; RS: Rating Suspended
Industry View: Pos: Positive; Neu: Neutral; Neg: Negative
Barclays | U.S. Life Science Tools & Diagnostics
3 January 2019 3
TABLE OF CONTENTS
EXECUTIVE SUMMARY – NEUTRAL INDUSTRY VIEW ............................. 5
INVESTMENT POSITIVES ................................................................................. 9
INVESTMENT RISKS ........................................................................................ 22
CRYO-EM SURVEY: THE RESOLUTION REVOLUTION, TMO IS OUR
TOP PICK ............................................................................................................ 38
Background on FEI and the Opportunity in Cryo-EM ........................................................................ 38
The Resolution Revolution as a Driver of Market Demand .............................................................. 42
Biopharma Adoption Provides an Avenue for Future Demand ...................................................... 46
Thermo Fisher is the Dominant Player in Cryo-EM ............................................................................ 48
Mass Spec + Cryo-EM Opportunity Exists, but Remains Niche ...................................................... 52
NMR Viewed as Complementary, X-Ray Crystallography Viewed as a Competitor ................. 55
Funding Trends Remain Strong ............................................................................................................... 58
Gatan Takeaways: The Clear Leader in Direct Detection ................................................................. 62
JACK’S JOB BOARD: THE LIFE SCIENCE TOOLS AND DX CAREERS
TRACKER ........................................................................................................... 64
Myriad Genetics: Increased Turnover Among GeneSight Reps...................................................... 64
Hologic: CynoSure “Customer Success,” GYN Openings ................................................................. 66
CROs: Ready to Rip? Higher Hiring and Start-Up Employees .......................................................... 67
LAB SURVEY SAYS: NETWORK ACCESS DRIVES SHARE CHANGES TO
START 2019 ...................................................................................................... 70
COMPANY OUTLOOKS .................................................................................. 73
1) Agilent (A), Overweight/Neutral, $80 PT ........................................................................................ 73
2) Bio-Rad Labs (BIO), Overweight/Neutral, $315 PT ...................................................................... 85
3) Bruker (BRKR), Equal Weight/Neutral, $34 PT ............................................................................... 95
4) Charles River (CRL), Equal Weight/Neutral, $128 PT ................................................................ 102
5) Genomic Health (GHDX), Underweight/Neutral, $38 PT ......................................................... 108
6) Hologic (HOLX), Equal Weight/Neutral, $43 PT ......................................................................... 115
7) ICON (ICLR), Equal Weight/Neutral, $130 PT .............................................................................. 130
8) Illumina (ILMN), Overweight/Neutral, $370 PT .......................................................................... 136
9) IQVIA (IQV), Overweight/Neutral, $140 PT .................................................................................. 149
10) LabCorp (LH), Overweight/Neutral, $165 PT ............................................................................ 159
11) Mettler Toledo (MTD), Equal Weight/Neutral, $625 PT ......................................................... 173
12) Myriad Genetics (MYGN), Underweight/Neutral, $21 PT ...................................................... 180
13) PerkinElmer (PKI), Equal Weight/Neutral, $90 PT .................................................................... 208
14) PRA Health (PRAH), Overweight/Neutral, $115 PT ................................................................. 217
15) QIAGEN (QGEN), Overweight/Neutral, $43 PT ......................................................................... 223
16) Quest Dx (DGX), Overweight/Neutral, $117 PT ....................................................................... 233
17) Quidel (QDEL), Overweight/Neutral, $77 PT ............................................................................. 245
18) Syneos Health (SYNH), Equal Weight/Neutral, $45 PT ........................................................... 255
Barclays | U.S. Life Science Tools & Diagnostics
3 January 2019 4
19) Thermo Fisher (TMO), Top Pick, OW/Neutral, $280 PT ........................................................ 263
20) Waters (WAT), Equal Weight/Neutral, $190 PT ....................................................................... 280
LIFE SCIENCE TOOLS INDUSTRY OVERVIEW ........................................ 288
Life Science Tools Porter’s Five Forces ................................................................................................ 288
Company End Market and Mix Exposure............................................................................................ 289
Life Science Tools and Dx Market Share Analysis ............................................................................ 291
Chromatography Overview ($9 Billion Market) ................................................................................ 292
Mass Spectrometry Overview ($4 Billion Market)............................................................................ 293
Next Generation Sequencing Overview ($3 Billion Market) .......................................................... 297
Bioproduction Overview ($10 Billion Market) ................................................................................... 302
DIAGNOSTICS AND CLINICAL LABS INDUSTRY OVERVIEW ............ 308
Diagnostics Porter’s Five Forces ............................................................................................................ 308
Diagnostic Kits vs. Lab Developed Tests (LDTs) ............................................................................... 310
Test Quality Metrics .................................................................................................................................. 311
Clinical Laboratory Overview and Landscape .................................................................................... 311
Routine Testing Overview ....................................................................................................................... 313
Esoteric Testing: Molecular Dx, Companion Dx and Genomics ................................................... 314
Point of Care Testing ................................................................................................................................ 322
Core Lab Testing ........................................................................................................................................ 325
HCPCS Coding System & Top Test Trends ......................................................................................... 328
The HMO Framework for Diagnostics Reimbursement ................................................................. 334
CONTRACT RESEARCH ORGANIZATION (CRO) INDUSTRY
OVERVIEW ...................................................................................................... 336
Biopharma Services Industry Landscape ............................................................................................ 336
Porter’s Five Forces ................................................................................................................................... 336
The Trend Is Outsourcing ....................................................................................................................... 341
The Emergence of Strategic Resourcing ............................................................................................. 343
The Demand for Data and the “Next Generation CRO”.................................................................. 346
Performance Metrics: New Business, Cancellations, Net Book-to-Bill, and Revenue Burn ... 352
Barclays Biopharma R&D Tracker ......................................................................................................... 357
Barclays Biopharma Cash & Funding Trackers.................................................................................. 360
Barclays FDA Clinical Trials Tracker ..................................................................................................... 364
Drug Development Overview ................................................................................................................. 369
Central Laboratory Overview ................................................................................................................. 378
Outsourced Commercial Services ......................................................................................................... 380
Private Equity Interest .............................................................................................................................. 383
STOCK PRICE PERFORMANCE AND VALUATION ................................ 385
Stock Price Performance ......................................................................................................................... 385
Barclays | U.S. Life Science Tools & Diagnostics
3 January 2019 5
EXECUTIVE SUMMARY – NEUTRAL INDUSTRY VIEW
Looking into 2019, our view is that Life Science Tools & Diagnostics should continue to
be a relative safe haven in healthcare. While 2018 ended on a rocky note, the group again
outperformed the market – up 10%, vs the S&P 500 down -6%. Looking across end
markets, we believe the biopharma will remain a growth engine, supported by R&D
investment. The push toward personalized medicine drives demand for bioproduction, CDx,
and differentiated offerings from the CROs. Recent data on funding and investment has
been strong. Additionally, industrial macro datapoints provide 2-3 quarters of visibility into
end market momentum, an important growth driver for our Tools coverage. Next, global
support for academic funding should continue to drive LSD growth. Finally, while healthcare
has sustainable long-term drivers of growth, we remain selective in Dx given recent
challenges at the national labs. PAMA remains a key risk, where cuts and consolidation are
major themes for our labs & Dx coverage.
FIGURE 1
Organic Growth by End Market
Source: Company Documents, Barclays Research
Actions - We Make a Few Changes to our Recommendations and PTs:
Please see the following table for a summary thesis, as well as the company update
sections for full details:
Thermo Fisher (TMO): We designate as our Top Pick, and raise our PT to $280 (from
$275).
Bio-Rad (BIO): We upgrade to OW (from Equal Weight), and maintain out $315 PT
Myriad Genetics (MYGN): We lower our PT to $21 (from $23)
Syneos Health (SYNH): We lower our PT to $45 (from $51).
-6%
-4%
-2%
0%
2%
4%
6%
8%
10%
12%
Biopharma
Academic
Healthcare
Industrial
Applied
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