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麦格理-中国-互联网服务业-中国互联网医疗:参与创作-826-78页.pdf
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麦格理-中国-互联网服务业-中国互联网医疗:参与创作-826-78页.pdf
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Please refer to page 76 for important disclosures and analyst certification, or on our website
www.macquarie.com/research/disclosures.
26 August 2019 China
EQUITIES
Internet Healthcare Comps
Company
Ticker
Rating
Price
TP
Upside
PAGD
1833 HK
OP
48.35
65.00
34%
AliHealth
241 HK
OP
7.32
9.30
27%
Source: Bloomberg, Macquarie Research, August 2019,
Price as of 22 August 2019.
Company
Rev
CAGR*
Mkt Cap
(US$ bn)
3m ADTV
(US$ m)
52w price
range (HK$)
PAGD
51%
7.8
6.05~10.0
AliHealth
68%
6.2
9.8
27.4~52.3
Source: Company data, Macquarie Research, August 2019,
*PAGD forecast period 2018-21E, AliHealth forecast period
FY19-22E.
Inside
Key charts 2
Investment summary 5
Accessibility and affordability - two pain
points 6
The Internet is disrupting healthcare market
in China 12
New policies should drive even faster growth
going forward 19
Ping An Healthcare and Technology
(1833 HK) 21
Alibaba Health Information Technology
(241 HK) 48
MacVisit: DHC Software 70
Analysts
Macquarie Capital Limited
John Wang +852 3922 3578
john.wang@macquarie.com
Frank Chen +852 3922 1433
frank.chen@macquarie.com
Ellie Jiang +852 3922 4110
ellie.jiang@macquarie.com
China Internet Healthcare
Present at the Creation
Key points
China’s Internet and insurance giants have a decade-long structural
opportunity to address the challenges of the socialist healthcare system.
We think new policies in the next six months should accelerate growth for
the disruptors.
We initiate coverage of Ping An Good Doctor (PAGD) with 34% TSR and
AliHealth with 27% TSR.
Accessibility and affordability – the two pain points
Skeptics on this sector point out that neither PAGD nor Alihealth is likely to make
a profit for at least 3 years. We think this misses the enormous growth
opportunities for this sector from solving two major pain points: 1) accessibility -
limited healthcare resources and overworked and understaffed healthcare
facilities; and 2) affordability - healthcare expenses grew at 13% annually over
2013-18, considerably faster than the 9% CAGR in disposable income. This is
especially worrisome in the context of funding pressure for social healthcare
insurance backed by government and enterprises. In order to spend an average
of 8 minutes with doctors on diagnosis, patients need to spend 3 hours in traffic
and waiting. Further, an ordinary household in China can spend up to 9% of its
annual expenditures on healthcare. There two bottlenecks are only getting tighter
in China’s rapidly-aging society; over a quarter of the population will be 60 years
or older by 2030.
Socialist healthcare system ripe for disruption
The Internet is disrupting various parts of the value chain of China’s healthcare
market by: 1) enhancing the efficiency of healthcare services with advanced
technologies, such as online medical consultation – PAGD is a pioneer in the
market and could achieve a significant monetization potential; and 2) enabling
end-to-end drug & service distribution channels. Meanwhile, AliHealth is
expanding its GMV rapidly, with its extensive experience in e-commerce retailing
and well-educated user base.
New policies should accelerate growth going forward
Two important new policies should be positive for the sector. On 31 July 2019,
National Healthcare Security Administration (NHSA) of China announced that the
pricing guideline for online healthcare will be released before the end of
September 2019. This means online healthcare services will soon be included in
the coverage of social healthcare insurance plan. In addition, new measures
on online drug sales are expected to be released before the end of 2019, where
online prescription drug sales will be conditionally allowed.
Outperform rating on the two market leaders
We initiate coverage on PAGD (1833 HK) and AliHealth (241 HK) with 34% and
27% upside, respectively. We think first-mover advantage is very real in this
industry, given high entry barriers. We like PAGD for its: 1) disruptive business
model, which could potentially reshape the healthcare industry value-chain; and
2) positive impact from new policies. We like AliHealth’s straightforward business
model, which will continue to benefit from improving online penetration and more
online-offline integration. Risks associated with both stocks include regulatory
risks, execution risks, and related-party transaction risks.
10.0
Macquarie Research China Internet Healthcare
26 August 2019 2
Key charts
Fig 1 Per capita medical staff in different countries
Fig 2 Time consumption for hospital visits
Source: OECD Stat, Macquarie Research, August 2019
Source: Frost & Sullivan, Macquarie Research, August 2019
Fig 3 Family doctor as % of all doctors across countries
Fig 4 Uneven distribution of medical resources in China
Source: OECD Stat, NBS of China, Macquarie Research, August 2019
Source: NBS of China, Macquarie Research, August 2019
Fig 5 PAGD traffic and monetization capability forecast
Fig 6 AliHealth Traffic and GMV forecast
Source: Company data, Macquarie Research, August 2019
Source: Company data, Macquarie Research, August 2019
Macquarie Research China Internet Healthcare
26 August 2019 3
Fig 7 Internet Healthcare Industry Landscape in China
Source: Company data, Frost & Sullivan, NBS of China, Macquarie Research, August 2019
Macquarie Research
China Internet Healthcare
26 August 2019
4
Fig 8 Major Internet Healthcare Players and Business Involvement
Business Lines
Comments
Healthcare IT
Online Medical
Consultation
Healthcare E-commerce
Consumer Healthcare
Nature of business
Provide healthcare software
solutions, such as Hospital
Information System, Clinical
Information System,
Electronic Health Record,
etc.
Provide medical
consultations to online
users, especially for
primary care.
Provide e-commerce
platforms for healthcare-
related merchandise including
1P model (self-operated
stores) and 3P model
(commission-based services)
Referral service to
offline consumer
healthcare service such
as health check-up,
dental care, medical
aesthetics, etc.
Company
Name
Ticker
Market Cap
(US$ m)
Last FY Revenue
(RMB bn)
DHC
002065 CH
3,018
8.5 (1.1 in
healthcare)
Leader in Top Hospital IT
solutions (30% market share
in Top100 hospitals)
Tencent-backed
Winning
300253 CH
3,453
1.4
Leader in Hospital IT solutions
Alibaba-backed
Neusoft
600718 CH
1,938
7.2 (1.7 in
healthcare)
Leader in Hospital IT solutions
B-soft
300451 CH
1,622
1.3
Leader in Hospital IT solutions
PAGD
1833 HK
6,212
3.3
Acquired Wanjia Healthcare
to provide clinic/pharmacy
management software
No.1 with 10.6m MAU in
05/2019
Rmb2.9bn Gross Merchandise
Volume (GMV) in 2019
(primarily 1P)
Rmb905m revenue
Ping An Group-
backed
Chunyu Doctor
unlisted
n.a.
n.a.
No.2 with 2.2m MAU in May
2019
DXY
unlisted
n.a.
n.a.
No.3 with 1.1m MAU in May
2019
Started as a medical
community
Good Doctor
Online
unlisted
n.a.
n.a.
No.6 with 0.6m MAU in
05/2019
Tencent-backed
AliHealth
241 HK
10,005
5.1
Invested in Jiahe Meikang
and Jiamei Online to provide
clinic information system
Started to ramp-up online
consultation from third party
doctors
Rmb59.5bn GMV in FY19
(4.2bn revenue in 1P, and 0.7bn
revenue in 3P)
Rmb128m revenue
Alibaba-backed
JD Health
unlisted
n.a.
n.a.
Major player with B2B, 1P, and
3P models
JD-backed
WeDoctor
unlisted
n.a.
n.a.
Provide hospital online
registration and online
consultation from third party
doctors
Started to ramp-up
Tencent-backed
SoYoung
SY US
1,550
0.6
Leader in the medical
aesthetics vertical
Tencent-backed
Source: Company data, Macquarie Research, August 2019, shaded blocks mean no business involvement.
Macquarie Research China Internet Healthcare
26 August 2019 5
Investment summary
Three reasons that Internet healthcare providers can achieve fast growth in China.
1. Internet is the perfect solution for two pain points in China’s healthcare system.
China’s healthcare system is not only characterized by its lack of medical staffs but also by uneven
distribution of medical resources among different regions and different types of medical services.
Fig 9 Uneven distribution of medical resources in China
Fig 10 Healthcare as % of household spending in China
Source: NBS of China, Macquarie Research, August 2019
Source: NBS of China, Macquarie Research, August 2019
The ultimate solution is to improve the overall efficiency of the healthcare system so that everyone
can get access to the most appropriate medical resources at a reasonable price. Internet
technologies have come to help and start to solve these pain points in the healthcare system. We
favour two types of business models—online hospital model, in which patients can consult with
doctors through an online platform, and online pharmacy model, in which patients can purchase
drugs and healthcare-related products online. These two models are led by PingAn Good Doctor
and AliHealth, respectively, in China.
2. First-movers will gain more market share in the fast-growing Internet healthcare industry
due to the Matthew Effect.
The Internet healthcare industry is expected to grow at a 7-year CAGR of 31% to reach
approximately Rmb136bn in market size by 2025 (Fig 42), according to Frost & Sullivan. In this
fast-evolving market, we expect the first movers to gain more market share due to the Matthew
Effect: 1) the healthcare-related industry has a very high entry barrier due to regulatory scrutiny
and compliance costs; 2) a certain threshold of scalability needs to be achieved in order to be
profitable; and 3) accumulation of user data will help improve the user experience, which in return
will attract more user traffic.
3. Policy tailwind could trigger faster growth in the Internet healthcare industry.
A year after the release of a guideline to promote ‘Internet Plus Healthcare’ in China, the National
Healthcare Security Administration commented on 31 July 2019 that social healthcare insurance
will start to cover online healthcare services, and the policy will be released no later than the
end of September. We expect the pro-Internet Chinese government will continue to use Internet
technologies to reform the existing low-efficiency healthcare system and invite private service
providers to become an integral part of the healthcare market.
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