healthtech heartbeat - 2015 market review
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Q3 2015 STRICTLY PRIVATE AND CONFIDENTIAL
HealthTech Heartbeat2015 Market Review
2015 STRICTLY PRIVATE AND CONFIDENTIAL
2QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
About Results International
A MARKET-LEADING CORPORATE FINANCE ADVISORY FIRM… …WITH GLOBAL REACH
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• Broad global network
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• Entrepreneurial and owner-managed
DEEP DOMAIN EXPERTISE IN THREE INTER-RELATED SECTORS… …AND BROAD INDUSTRY NETWORKS
Marketing
HealthcareTechnology
3
80
90
100
110
120
130
140
Healthcare IT - Europe Healthcare IT - US Biopharma IT Generalists NASDAQ Comp FTSE 100
QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
Results International Global HealthTech Indices
Dec-15Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15
(1) Excludes GeneralistsNotes: Based on share prices as at 31st December 2015; indices weighted by market capitalisation; Healthcare IT – US excludes McKesson because the majority of its revenue is generated from pharmaceutical distributionSources: Capital IQ and Results analysis
LAST
12
MON
TH S
HARE
PRI
CE P
ERFO
RMAN
CE
Q4 2015 PERFORMANCEHealthcare IT - Europe 5.8%
Healthcare IT - US 1.1%Biopharma IT 20.6%Generalists 6.8%HealthTech(1) 3.3%
(6.1%)
31.5%
5.7%
(7.6%)
6.9%
(4.9%)
4
(80.0%)
(60.0%)
(40.0%)
(20.0%)
0.0%
20.0%
40.0%
60.0%
80.0% 70.3%
9.7%
30.8%
12.2%
46.8%
67.5%
(5.0%) (6.9%)(0.7%)
20.4%10.5%
56.6%
3.4%
(37.0%)(25.4%)
(18.1%)
(35.8%) (37.0%)
(63.5%)
9.2% 3.2%
69.8%
(30.0%)
(20.0%)
(10.0%)
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
14.9%
(11.1%)
8.4%3.8%
9.3%17.5%
6.6%0.4%
(12.5%)
24.0% 20.7%
54.2%
29.2%
(18.4%)
0.9%
18.1%
(24.1%)(19.4%)
1.7%
23.2%17.1% 17.5%
QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Share Price Performance
(1) Last 12 months reference dates adjusted to first trading day post IPO for Teladoc (01-Jul-15), Evolent Health (05-Jun-15) and Inovalon Holdings (12-Feb-15) Note: Share price performance as at 31st December 2015Sources: Capital IQ and Results analysis
LAST
12
MON
THS
Q4 2
015
HEALTHCARE IT - EUROPE HEALTHCARE IT - US BIOPHARMA IT
(1)(1)(1)
5QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Selected Stocks – Performance Since IPO
COMPANY IPO DATE DESCRIPTION RAISE
D ($M)INDICATIVE PRICE
RANGE ($)IPO LISTING
PRICE ($)INCREASE VS. RANGE
DAY 1 INCREASE
CURRENT INCREASE(1)
CURRENT EV ($M)
EV / REVENUE
2015EEV / EBITDA
2015E
NYSEJun-15 Video telemedicine platform
for medical consultations 156.8 15.00-17.00 19.00 18.8% 50% (5.5%) 566 7.4x n.m.(2)
NYSEJun-15 Healthcare delivery and
payments software 195.5 14.00-16.00 17.00 13.3% 10.9% (28.8%) 794 4.9x n.m.(3)
NasdaqGSFeb-15 Cloud-based healthcare data
analytics software 600.0 24.00-26.00 27.00 8.0% 0.0% (37.0%) 2,136 4.8x 13.9x
NYSEApr-14 Healthcare information
technology and services 1,300.0 18.00-21.00 20.00 2.5% 15.0% 27.4% 12,263 4.2x 13.9x
NYSEMar-14 Healthcare enterprise
management software 177.6 13.00-15.00 16.00 14.3% 148.8% (73.3%) 257 3.4x n.m.(4)
LSEDec-13
Software, hardware and services for the healthcare and energy sectors
199.7 n.a. 2.93 n.a. 20.1% 67.7% 333 3.4x 14.0x
NYSEOct-13 Cloud-based CRM software
for the biopharma industry 260.9 16.00-18.00 20.00 17.6% 85.8% 44.3% 3,497 8.8x 31.2x
(1) Current increase from IPO price; Market data as of 31st December 2015(2) Teladoc projecting negative EBITDA for CY2015(3) Evolent Health projecting negative EBITDA for CY2015(4) Castlight projecting negative EBITDA for CY2015 Note: Calendarised to December year end; $ millions, except share price dataSource: Capital IQ
6
Generalists Healthcare IT - Europe
Healthcare IT - US Biopharma IT0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0% 27.9%
22.5%
17.7%
22.9%
Generalists Healthcare IT - Europe
Healthcare IT - US Biopharma IT0.0 x
5.0 x
10.0 x
15.0 x
20.0 x
25.0 x
30.0 x
35.0 x
11.0 x14.1 x 13.9 x
29.5 x
Generalists Healthcare IT - Europe
Healthcare IT - US Biopharma IT0.0 x
1.0 x
2.0 x
3.0 x
4.0 x
5.0 x
6.0 x
7.0 x
8.0 x
3.8 x 3.6 x 3.8 x
6.8 x
Generalists Healthcare IT - Europe
Healthcare IT - US Biopharma IT0.0%2.0%4.0%6.0%8.0%
10.0%12.0%14.0%16.0%18.0%20.0%
3.5%
7.4%
16.1%
18.9%
QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Valuation Benchmarks
Notes: EV = Enterprise Value; financials calendarised to December year end; median values reported; excludes negative multiples; McKesson excluded from above analysis because majority of revenue is generated from pharmaceutical distribution See Selected Publicly Traded Companies (Slide 11) for details of companies included in each categorySource: Capital IQ
REVENUE GROWTH (2015-16E) EV / REVENUE 2015E
EBITDA MARGIN 2015E EV / EBITDA 2015E
7
Q1 2012
Q2 2012
Q3 2012
Q4 2012
Q1 2013
Q2 2013
Q3 2013
Q4 2013
Q1 2014
Q2 2014
Q3 2014
Q4 2014
Q1 2015
Q2 2015
Q3 2015
Q4 2015
0
10
20
30
40
50
60
70
80
0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
2117
20
3229
18
28 27 2832
44
61
5449
70
56
43
5
11
7
27 5
6
2
812
5
5
2
Healthcare IT Biopharma ITHealthcare IT Total Disclosed Deal Value Biopharma IT Total Disclosed Deal Value
NUM
BER
OF D
EALS
TOTA
L DIS
CLOS
ED D
EAL
VALU
E ($
M)
QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Global M&A Activity Q1 2012 – Q4 2015
Sources: Press releases, Capital IQ, Mergermarket, 451 Research and Results analysis
8QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Selected Deals in 2015
DATE BUYER TARGET EV ($M) EV/REVENUE EV/EBITDA COMPANY DESCRIPTION TARGETLOCATION
Dec-15 71.5 - - Hospital information system and medical imaging software
Dec-15 13.1 - - Hospital insurance claims management software
Dec-15 - - - Clinical databases and data management services
Nov-15 250.0 - - Electronic health records and clinical information management solutions
Nov-15 2,779.2 3.6x 13.0x Revenue and clinical resource management software and services
Oct-15 190.0 - - Mobile Electronic Health Record software
Oct-15 275.0 1.5x 13.8x Pharmacy automation software and hardware
Oct-15 48.0 - - Clinical process and connectivity solutions
Oct-15 261.1 4.6x 16.3x Laboratory information management systems
Sep-15 120.0 - - SaaS-based biopharma marketing compliance software
Sep-15 - - - Mobile clinical assessment and patient flow management systems
Sep-15 - - - Mobile workflow management software for the healthcare, government and industrial sectors
Sep-15 - - - Cloud-based financial performance analytics for healthcare
Aug-15 11.7 2.0x - Clinical patient flow and compliance education software
Aug-15 140.0 3.0x - Data-driven advisory services and BI systems for the life sciences industry
Aug-15 150.0 3.8x - Mobile medical education platform for physicians
Aug-15 65.0 - - Financial management software for hospitals
Aug-15 903.9 4.0x 20.7x Medical image management systems
Note: In certain cases EV/Revenue are publicly reported estimates; TTM financials have been used where possible; EV = transaction value scaled to 100% shareholding plus net debt (incl. minority interest)Sources: Press releases, Capital IQ, Mergermarket, 451 Research and Results analysis
9QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Selected Deals in 2015
DATE BUYER TARGET EV ($M) EV/REVENUE EV/EBITDA COMPANY DESCRIPTION TARGETLOCATION
Jul-15 - - - Laboratory information system middleware
Jul-15 4.7 - - Primary and secondary care administration and compliance software
Jul-15 910.0 - - Cloud-based healthcare data analytics platform and engagement solutions
Jul-15 - - - Clinical decision support software
Jun-15 - - - Nurse and doctor scheduling automation software
May-15 1.9 - - Customer-driven healthcare and reimbursement accounts software and services
May-15 - - - Patient flow and bed management software
Apr-15 24.1 - - Venous biometric patient identification systems
Apr-15 - - - Cloud-based healthcare intelligence software
Apr-15 - - - Cloud-based population health data management software
Mar-15 - - - Healthcare analytics and performance benchmarking software
Mar-15 81.4 1.8x 15.0x(1) Practice management, communication and electronic patient record software
Mar-15 Key Opinion Leader Solutions Assets
- - - Key Opinion Leader campaign optimisation software and services for the biopharma industry
Jan-15 140.0 - - Cloud-based analytics, decision support and financial planning software for the healthcare industry
Jan-15 40.0 - - Cloud-based electronic health record and financial software for rural and community hospitals
Jan-15 65.0 - - Genomic analysis and bioinformatics software
Jan-15 - - - Electronic Clinical Outcome Assessments solutions for clinical trials
Jan-15 37.0 - - Medical imaging software
(1) Multiple quoted directly in seller press releaseNote: In certain cases EV/Revenue are publicly reported estimates; TTM financials have been used where possible; EV = transaction value scaled to 100% shareholding plus net debt (incl. minority interest)Sources: Press releases, Capital IQ, Mergermarket, 451 Research and Results analysis
10QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Selected European Fundraisings in 2015
Sources: Press releases, Capital IQ and Results analysis
DATE COMPANY TYPE OF ROUND
FUNDS RAISED
($M)INVESTOR PARTICIPATION COMPANY DESCRIPTION COMPANY
LOCATION
Dec-15 - - Holosfind Patient recruitment application for clinical trials
Dec-15 Venture 5.0 - Online medical appointment booking platform
Dec-15 DESKTOP GENETICS Series A - Illumina Inc. Genome engineering and editing
softwareDec-15 - - Up to Eleven Digital Solutions Online platform for mental health
consultationDec-15 Series A 1.6 Capricorn Venture Partners Cardiac health tele-monitoring
dashboardDec-15 Venture 5.1 Balderton Capital; Maxfield Capital Patient-controlled online medical
record systemDec-15 Series C 15.0 - Data-driven diagnostic testing
platformNov-15 - - Change Partners Physical rehabilitation programme
design and administration platform Nov-15 Venture 26.8 Dievini Hopp BioTech holding Big data-driven healthcare decision-
making support softwareNov-15 Venture 5.0 Oxford University Hospitals NHS Trust; University Of
Oxford, Endowment ArmMRI-based liver image analysis software
Nov-15 - 0.6 Turenne Capital Partenaires; IT Translation Investissement; CREAZUR France
Touchless medical image viewing platform
Nov-15 Seed 1.1 -Consumer health tracking application and patient insight tool for professionals
Oct-15 Seed - - Dental diagnostic software
Oct-15 - - Visiomed Group SA Healthcare decision-making support platform
Oct-15 Seed 1.1 Inveready Asset Management, S.G.E.I.C., S.A. Medical imaging software
Oct-15 Seed 1.7 Tekes Microscopy visualisation software
Oct-15 Seed 0.6 Enterprise Ireland, Investment Arm; Kernel CapitalAppointment and patient communication management platform
Sep-15 DESKTOP GENETICS Venture 2.1 IQ Capital Partners LLP; London Business Angels; Funding
London; Capital Enterprise, Investment ArmGenome engineering and editing software
11QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Selected European Fundraisings in 2015
Sources: Press releases, Capital IQ and Results analysis
DATE COMPANY TYPE OF ROUND
FUNDS RAISED
($M)INVESTOR PARTICIPATION COMPANY DESCRIPTION COMPANY
LOCATION
Aug-15 Series A - Wild Blue Cohort Online consumer care platform
Aug-15 Series A 3.4 LEO Pharma A/S; Personal Health Solutions Capital Skin health tracking and inspection mobile application
Jul-15 Seed 1.5 - Online GP consultation platform for desktop and smartphone
Jul-15 Seed 5.0 Smedvig Capital Limited Personalised healthcare information assistant applications
Jun-15 Series B 9.2 Amadeus Capital Partners; Gilde Healthcare Partners; Archimedia
Primary care practice and case management software
Jun-15 - - WuXi PharmaTechData management and analysis software for the life sciences industry
May-15 Series A 5.0 Industrifonden; Briban Invest Mobile patient recruitment and trial management software and services
May-15 - 10.0 - Online platform for medical and dental appointment scheduling
May-15 Series A 7.2QUALCOMM Ventures; Mangrove Capital Partners; Innovation Capital; ABRT Venture Fund; TA Ventures; Maya Capital LLP
Online platform for private and public healthcare appointment booking
May-15 Venture 3.9 XLHealth Mobile telemedicine application for video healthcare consultations
May-15 - - Parkwalk Advisors Late phase clinical trial design, data capture and management software
Apr-15 Venture 5.3 Prime VenturesHealthcare information exchange software for clinical information sharing
Mar-15 Seed 0.3 - Genomic data sharing platform
Mar-15 - 8.5 - Neuro-therapy software and hardware
Feb-15 - 9.9 - Diversified healthcare software vendor
Feb-15 Seed 2.5 Creathor Venture; Partech; Stephan Schamback; Heilemann Ventures; Atlantic Labs
Telemedicine application for dermatology
Feb-15 Series B 13.5 Amadeus Capital Partners Limited; Smedvig Capital Limited; Octopus Investments Limited
Patient eMarketplace for clinical trials
Jan-15 Series A 1.5 Capricorn Venture Partners; Participatiemaatschappij Vlaanderen NV
Simulation software for cardiovascular procedures
12
OPERATING METRICS VALUATION METRICSPRICE % OF 52 MARKET TOTAL NET ENTERPRISE REVENUE REV. GROWTH GROSS MARGIN REVENUE EBITDA
COMPANY (31-DEC-15) WEEK HIGH CAP CASH DEBT VALUE CY2015 CY15-16 HISTORICAL CY2015 CY2016 CY2015 CY2016 CY2015 CY2016
GENERALISTS WITH SIGNIFICANT HEALTHTECH EXPOSURE
Oracle 36.53 81% 153,471 52,335 (9,987) 143,484 37,666 0.6% 60.7% 43.9% 45.1% 3.8 x 3.8 x 8.7 x 8.4 xEMC 25.68 85% 49,789 7,642 1,313 51,102 24,900 3.5% 62.4% 25.0% 26.2% 2.1 x 2.0 x 8.2 x 7.6 xSAP 80.25 98% 95,929 5,175 6,179 102,107 22,293 5.3% 72.2% 35.2% 35.0% 4.6 x 4.3 x 13.0 x 12.4 xThermo Fisher Scientific 141.85 99% 56,612 503 12,818 69,430 16,868 4.3% 46.2% 24.8% 25.7% 4.1 x 3.9 x 16.6 x 15.4 xComputer Sciences Corporation 32.68 45% 4,535 1,818 821 5,356 9,003 (16.6%) 24.1% 13.5% 17.7% 0.6 x 0.7 x 4.4 x 4.0 xThomson Reuters 37.77 94% 29,008 869 8,464 37,472 8,836 2.1% 28.0% 27.9% 29.1% 3.1 x 3.0 x 11.0 x 10.3 xAspen Technology 37.76 81% 3,145 181 (181) 2,963 455 7.3% 87.7% 44.8% 47.4% 6.5 x 6.1 x 14.5 x 12.8 x 25th percentile 1.4% 37.1% 24.9% 25.9% 2.6 x 2.5 x 8.4 x 8.0 xMedian 3.5% 60.7% 27.9% 29.1% 3.8 x 3.8 x 11.0 x 10.3 x75th percentile 4.8% 67.3% 39.6% 40.1% 4.3 x 4.1 x 13.8 x 12.6 x
HEALTHCARE IT - EUROPE
CompuGroup Medical 36.80 92% 1,830 32 376 2,206 595 7.7% 33.9% 20.6% 22.8% 3.7 x 3.4 x 18.0 x 15.1 xCegedim 34.75 74% 485 237 197 682 552 2.9% 46.2% 17.9% 18.4% 1.2 x 1.2 x 6.9 x 6.5 xEMIS Group 16.78 98% 1,052 13 6 1,058 237 7.1% 48.2% 31.5% 31.8% 4.5 x 4.2 x 14.2 x 13.1 xServelec Group 4.91 97% 341 8 (8) 333 98 6.2% 45.3% 24.3% 25.4% 3.4 x 3.2 x 14.0 x 12.6 xNoemaLife 7.30 88% 55 4 40 96 82 12.8% 22.4% 19.2% 19.6% 1.2 x 1.0 x 6.1 x 5.3 xCraneware 11.76 95% 316 42 (42) 274 48 10.9% 95.0% 30.6% 31.0% 5.8 x 5.2 x 18.8 x 16.7 x 25th percentile 6.4% 36.7% 19.6% 20.4% 1.8 x 1.7 x 8.7 x 8.0 xMedian 7.4% 45.7% 22.5% 24.1% 3.6 x 3.3 x 14.1 x 12.8 x75th percentile 10.1% 47.7% 29.1% 29.6% 4.3 x 4.0 x 17.0 x 14.6 x
HEALTHCARE IT - US
McKesson 197.23 81% 45,384 5,359 5,524 50,908 189,256 6.2% 6.3% 2.6% 2.7% 0.3 x 0.3 x 10.4 x 9.2 xCerner 60.17 79% 20,584 465 166 20,751 4,591 20.3% 84.5% 33.6% 33.8% 4.5 x 3.8 x 13.5 x 11.1 xIMS Health 25.47 76% 8,369 394 3,894 12,263 2,899 9.0% 53.4% 30.5% 31.0% 4.2 x 3.9 x 13.9 x 12.5 xAllscripts Healthcare Solutions 15.38 97% 2,907 91 575 3,482 1,399 5.5% 45.5% 17.6% 19.5% 2.5 x 2.4 x 14.2 x 12.1 xathenahealth 160.97 94% 6,250 118 182 6,432 925 19.9% 59.8% 19.4% 20.7% 7.0 x 5.8 x 35.9 x 28.0 xMedAssets 30.94 99% 1,837 - 798 2,634 765 0.9% 76.1% 31.0% 31.7% 3.4 x 3.4 x 11.1 x 10.7 xQuality Systems 16.12 86% 981 111 (111) 870 500 6.2% 54.6% 14.7% 16.9% 1.7 x 1.6 x 11.8 x 9.7 xInovalon Holdings 17.00 50% 2,565 714 (429) 2,136 441 21.4% 68.8% 34.8% 35.7% 4.8 x 4.0 x 13.9 x 11.2 xHealthstream 22.00 68% 696 145 (145) 551 207 12.4% 56.6% 16.1% 16.5% 2.7 x 2.4 x 16.5 x 14.3 xComputer Programs & Systems 49.75 79% 562 38 (38) 524 184 5.6% 45.9% 17.9% 22.6% 2.8 x 2.7 x 15.9 x 11.9 xEvolent Health 12.11 52% 714 210 79 794 160 32.4% 27.5% (22.3%) (13.2%) 4.9 x 3.7 x n.m. n.m.Teladoc 17.96 51% 691 152 (125) 566 76 56.0% 77.2% (66.6%) (26.2%) 7.4 x 4.8 x n.m. n.m.Castlight Health 4.27 36% 404 147 (147) 257 75 34.5% 39.1% (83.9%) (46.3%) 3.4 x 2.5 x n.m. n.m. 25th percentile 6.0% 45.8% 5.5% 9.1% 2.8 x 2.5 x 13.5 x 11.1 xMedian 16.1% 55.6% 17.7% 20.1% 3.8 x 3.6 x 13.9 x 11.9 x75th percentile 24.1% 70.6% 30.6% 31.2% 4.9 x 3.9 x 15.9 x 12.5 x
BIOPHARMA IT
Medidata Solutions 49.29 80% 2,729 287 (38) 2,692 399 18.9% 74.7% 22.9% 24.6% 6.8 x 5.7 x 29.5 x 23.1 xVeeva Systems 28.85 86% 3,837 339 (339) 3,497 398 25.7% 62.9% 28.2% 29.4% 8.8 x 7.0 x 31.2 x 23.8 xInstem 3.32 97% 43 2 - 28 22 5.9% 14.8% 15.4% 17.3% 1.9 x 1.8 x 12.5 x 10.5 x 25th percentile 12.4% 38.9% 19.1% 20.9% 4.3 x 3.8 x 21.0 x 16.8 xMedian 18.9% 62.9% 22.9% 24.6% 6.8 x 5.7 x 29.5 x 23.1 x75th percentile 22.3% 68.8% 25.5% 27.0% 7.8 x 6.3 x 30.3 x 23.4 x
EBITDA MARGIN
QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
HealthTech: Selected Publicly Traded Companies
(1) McKesson excluded from ‘Healthcare IT – US’ summary analysis above because majority of revenue is generated from pharmaceutical distributionNote: Calendarised to December year end; $ millions, except share price data; multiples capped at 20x EV / Revenue and 50x EV / EBITDA; net debt includes minority interest Source: Capital IQ
(1)
13QUARTERLY TECH REPORT – 2015 ANNUAL REVIEW: HEALTHTECH
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