Medical Devices

Since the beginning of the global economic crisis, medical device stocks have fared slightly worse than the overall market, losing roughly 400 bps more than the S&P500 (-31%) since September 1, 2008, on a market weighted basis. We continue to recommend that investors focus on companies providing life-sustaining products.

We believe these products will remain insulated from the longer-term effects of the current economic crisis because target patients will be unable to forego procedures. The initial slide in the market left many strong companies looking very attractive.

In the coming year, investors should allocate funds to companies with high earnings quality profiles. We recommend companies with the following characteristics:

Size – (1) Larger companies will find it easier to survive any future liquidity issues and acquire new technologies at cents on the dollar.  
(2) Size also refers to the average ticket price per product the company sells. As hospitals cut their capital spending budgets, allocations for large ticket items will be deferred.  Focus on companies producing smaller ticket items.
Scope – (1) Companies providing life-sustaining products should remain insulated from the current economic crisis, as target patients are unable to forego procedures. (2) Companies that provide a broad assortment of products related to their primary market served will be better positioned to compete when large purchasing organizations consolidate suppliers. 
Strategy – Focus on companies that have historically grown organically. Avoid companies that have a long track record of ‘growth by acquisition’. These companies may find it difficult to fund growth (acquisitions), diminishing underlying growth.  Additionally, the financial statements for these companies are often clouded by one-time charges, lowering their quality of earnings.

For comparison purposes, companies possessing the above characteristics have fared better since the crisis started.  Of the stocks in our coverage that we recommended at the time of our last Industry Overview, most of them have outperformed the market and industry.

At the beginning of June, we upgraded MDT to a BUY.  Since that time, the stock has tracked the S&P 500, losing 6%.

Valuation

Historically, the medical products industry has traded at a trailing and one-year forward P/E multiple of 30 and 25, respectively. Current P/E multiples hover between 17 and 19 for these measures, a discount of 24-40%. The landscape has changed dramatically.

Companies will experience slowing sales growth and pricing pressure as unemployment rises and the governments focus on cost cutting initiatives (competitive bidding in U.S.). Curtailed hospital capital spending will hurt device makers offering larger capital equipment. A stronger dollar will weigh heavily on companies with significant international exposure. And, companies producing products used in elective procedures will feel the effect of delayed procedures.

Opportunities

The items above that changed the landscape over the past few years vary greatly in their effect on individual companies.  The medical products industry is very diverse and some boats sit much higher in low tide than others.  Even during recent economic turbulence, many of these names will continue performing well on a financial basis.  Areas within our coverage that should perform well include cardiovascular devices and surgical equipment, blood related products, and associated consumables.

The names currently on our BUY list that we believe provide safe vehicles over the coming 12 months include St. Jude Medical (STJ - Analyst Report), Baxter (BAX - Analyst Report), Becton Dickinson (BDX - Analyst Report), Boston Scientific (BSX - Analyst Report), CR Bard (BCR - Analyst Report), Haemonetics (HAE - Analyst Report) and Medtronic (MDT - Analyst Report).

Weaknesses

As noted in our prior overview, companies we believed would not fare well at the beginning of this crisis focused on the orthopedic markets and included ArthroCare, Conmed (CNMD - Analyst Report), Symmetry Medical (SMA - Analyst Report), Stryker (SYK - Analyst Report) and Zimmer (ZMH - Analyst Report). This provides evidence of the great diversity within the medical products industry and potential returns an investor can expect. 

Improved Outlook

Lastly, we changed our opinion on medication dispensing, delivery, and software to something more positive in our last Industry Outlook summary. Since the Obama Administration passed a health care stimulus package to incent hospitals and practices to modernize their health record keeping, we believe there are many smaller names that will benefit.

Names in this area include Omnicell (OMCL - Analyst Report), AllScripts (MDRX - Analyst Report) and MRGE Healthcare (MRGE - Analyst Report). Returns shown in parenthesis reflect price changes since our last Industry Overview on May 27, 2009.

We note that MRGE had a 100% move over the last two weeks of May shortly after it announced a partnership with China’s largest health IT provider. And, in the past forty days, the stock has had another tremendous upward movement of 123%. We believe the stock will continue gaining support as the fundamentals show progress.

However, please note that none of these companies match the criteria laid out above for companies we favor during this crisis.

[Industry Outlook as of July 9, 2009]

Read the full analyst report on OMCL

Read the full analyst report on MDRX

Read the full analyst report on MRGE

Read the full analyst report on MDRX

Read the full analyst report on SYK

Read the full analyst report on ZMH

Read the full analyst report on CNMD

Read the full analyst report on SMA

Read the full analyst report on STJ

Read the full analyst report on BDX

Read the full analyst report on BSX

Read the full analyst report on BAX