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Buy Amazon.Com 10 September 2018 Internet Amazon.com Provided for the exclusive use of Research Research at Provisional Access on 2018-09-12T02:14+00:00. DO NOT REDISTRIBUTE Deutsche Bank Research Rating Company Date Buy Amazon.com 10 September 2018 Company Update North America United States Reuters Bloomberg Exchange Ticker Price at 4 Sep 2018 (USD) 2,039.51 TMT AMZN.OQ AMZN US NSM AMZN Price target 2,300.00 Internet 52-week range 2,039.51 - 938.60 Pharma the latest Rx for Amazon's Healthcare Ambitions Valuation & Risks Lloyd Walmsley Prime + Whole Foods + PillPack sets stage for more holistic healthcare offering We believe Amazon's ~$1B acquisition of PillPack ( link ), which has pharmacy Research Analyst licenses in 49 states, could accelerate Amazon's move into healthcare more +1-212-250-7063 broadly, increasing the value of the Prime service and overall consumer wallet Kunal Madhukar, CFA share in a large part of the economy. PillPack currently delivers medications in Research Analyst pre-sorted dose packaging, coordinates refills and renewals, and makes sure +1-212-250-0237 shipments are sent on time. We see Amazon likely to expand this effort to helping customers more holistically manage health, using prescription information to Chris Kuntarich help educate customers on their conditions and merchandise over-the-counter Research Associate medicine, healthcare supplies and healthy food to customers and to sell +1-904-520-4899 advertising. Amazon is further looking at healthcare through its JV with Berkshire Hathaway and JP Morgan, which just hired a COO. Amazon has a history of Seth Gilbert starting small, testing the market and fine-tuning the service, before launching a Research Associate full fledged commercial operations. As such, we believe it is a question of when +1-212-250-1268 and where – and not if – Amazon enters the healthcare space more forcefully. In this report, we dive into the healthcare ecosystem to better understand the Greg Vlahakis potential opportunities for Amazon, recognizing fully well that it is a complex Research Associate space where it may take years before Amazon (and its JV partners) are able to +1-212-250-7149 make any meaningful change to status quo. We inform this with a fresh cut of data gleaned from our survey conducted earlier this year which highlights (1) a Price/price relative strong willingness for consumers to try Amazon for pharmaceutical purchases, (2) 3000 a particularly strong inclination among Prime members, and (3) a willingness to 2000 allow Amazon to merchandize other products and services based on a consumer's 1000 medications. We see Amazon addressing a near-term TAM of ~$22B from 0 mail order pharma, ~$55B of front-end OTC/supplies, and ~$2.6B of US online 2016 2017 2018 healthcare advertising, which gives us a total TAM of ~$80B ( Figure 5 ). We look Amazon.com S&P 500 INDEX (Rebased) at TAM in more detail and bottoms-up potential from this pace in this note. Performance (%) 1m 3m 12m DB Survey Suggests Consumers Want Amazon too Absolute 11.9 22.5 108.5 We conducted a proprietary survey in conjunction with our Health Care S&P 500 INDEX 2.0 5.5 17.0 Technology & Distribution team led by Glen Santangelo to better understand Source: Deutsche Bank consumer preferences with respect to pharmacy options. The survey included Stock option liquidity data a diverse set of consumers ranging from 18 years old to 65+ in order to better Market Cap (USDm) 993,094.0 understand their current purchasing habits and preferences, and how they differ Shares outstanding (m) 486.9 by age category and insurance-type. The key takeaways from the survey include Volume (4 Sep 2018) 1,518,451 the following. Source: Deutsche Bank Deutsche Bank Securities Inc. Distributed on: 11/09/2018 00:33:09 GMT Deutsche Bank does and seeks to do business with companies covered in its research reports. Thus, 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. DISCLOSURES AND ANALYST CERTIFICATIONS ARE LOCATED IN APPENDIX 1. MCI (P) 091/04/2018. 7T2se3r0Ot6kwoPa Provided for the exclusive use of Research Research at Provisional Access on 2018-09-12T02:14+00:00. DO NOT REDISTRIBUTE 10 September 2018 Internet Amazon.com Key takeaway #1 – Consumers willing to try AMZN: A surprising 71% suggested they would be willing to purchase prescription drugs through Amazon. While interest declined by age, we were still surprised to see that approximately 52% of the respondents in the 65+ age category would be willing to purchase drugs through Amazon. Key takeaway #2 – Prime Drives Interest: 85% of Prime Members who have insurance indicated a willingness to purchase, which we think is broadly indicative of the trust consumers have in Amazon. What is surprising is that 55% of the respondents who were not Prime members also said they will purchase pharma drugs from Amazon if they were available. – See Figures 2 and 3 Key takeaway #3 – Willingness to purchase other products/services: For Prime members, 73% said they were open to upsell offers based on their prescriptions and while privacy may be the key issue here, only 12% said they were not open to suggestions. Non-Prime consumers were less open to the idea of receiving suggestions from Amazon based on their prescriptions at only 43%, likely because of privacy concerns, but likely also because as non-Prime members, they may be charged for shipping on the additional items. – See 20 and 21 What is the Addressable Opportunity for Amazon? The health/personal care vertical represents more than $450B in retail spend annually, of which we see the $22B market for mail order chronic pharmaceuticals excluding speciality drugs ( Figure 3 ) as the near-term directly addressable market enabled by PillPack (PillPack is not well positioned to address specialty medications, which are expected to represent over 50% of the overall spend by 2021). We also see the front end store sales that the top 3 pharma retailers generate ($55B annually) as another opportunity for the company to take share. Finally, we think Amazon is able to take some share of the US online healthcare advertising market of $2.6B, which gives us a $80B combined total TAM Figure (4 ). If Amazon can get to 30% of mail order pharmacy market, attaching ~$55B of front office sales and achieve 4% of the US online healthcare advertising, it could add an estimated ~$3B in gross profit or ~ 4% using 2019 Amazon retail gross profit. Amazon Remains Our Top Pick Amazon remains our top pick. Our $2,300 TP is based on a SOTP of retail and AWS on a blend of 2019 and 2020 estimates; the multiples include an average of 22.5x EBITDA and 3% FCF yield for retail and 11x revenue multiple for AWS. Key risks include higher competition, margin compression from higher fulfillment/ shipping costs, acquisition integration, and potential slowdown in retail and AWS. Forecasts and ratios Year End Dec 31 2017A 2018E 2019E FY EPS (USD) 11.69 21.76 28.32 Revenue (USDm) 177,866.0 234,748.4 282,132.9 Source: Deutsche Bank estimates, company data Page 2 Deutsche Bank Securities Inc. Provided for the exclusive use of Research Research at Provisional Access on 2018-09-12T02:14+00:00. DO NOT REDISTRIBUTE 10 September 2018 Internet Amazon.com Consumers Open to Adding Pharma to their Cart In our original report with the Health Care Technology & Distribution team ( link ) post the announcement of the PillPack acquisition, we had outlined four high-level takeaways from our survey: (1) a strong willingness for consumers to try Amazon for pharmaceutical purchases, (2) a particularly strong inclination among Prime members, and (3) a willingness to allow Amazon to merchandize other products and services based on a consumer's medications. In this report, we delve deeper into the survey to better understand how receptive Prime members may be to Amazon selling prescription medications. PillPack Acquisition Gives Amazon an Entry into the Space PillPack is a full-service pharmacy that primarily provides mail order services to people who manage multiple medications. Founded in 2013, PillPack distributes pills in easy-to-use packages designed for consumers with chronic conditions and multiple prescriptions. PillPack sorts prescriptions by the dose and includes a label with a picture of each pill and directions on how it should be taken making it easier for patients to take the appropriate dose (which can be complicated by half-pills) at the right time. PillPack also works with the doctors' offices to process refills, regularly reviews medication schedule, and manages consumers' bills and claims directly with the insurance companies. Essentially, we think PillPack is more than just a pharmacy – it is a service where consumers don't have to ever 1) sort their medication 2) worry about taking it correctly 3) wait in line for their medicines and 4) worry about tracking refills. PillPack is contracted as an in-network pharmacy with all the major PBMs, including CVS Caremark, Express Scripts, Optum Rx, Prime Therapeutics, Humana Pharmacy Solutions, Cigna, Aetna, MedImpact, EnvisionRx, and CastiaRX. The company has operations nationwide and is available in 49 states (does not currently ship to Hawaii). PillPack’s primary pharmacy is located in Manchester, NH, though it also has a number of pharmacies across the country, including locations in Miami, FL, Brooklyn, NY, and Austin, TX. The details of the acquisition haven't been disclosed, but it is expected to close in 2H18, and media sources ( link ) peg the transaction value at around $1B or at around 10x the estimated ~ $100M in annual revenue.
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