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Boston Scientific Corp Krause Fund Research Spring 2020 April 15, 2020 Boston Scientific Corporation (NYSE: BSX) NO ACTION Health care – Medical Devices Stock Rating: Analysts Andrew Chelmowski BenJamin Gardner [email protected] [email protected] Current Price: $35.92 Target Price Range: $40 -$53 Investment Thesis DCF & EP IntrinsicStock Values Value: $48 We recommend a neutral, no action rating for Boston Scientific Corporation. BSX features promising long-term growth goals and is a leading player in the advancements of Interventional Cardiology. However, with a highly Key Statistics competitive landscape and global supply chain disruption due to COVID-19, Market Cap $49.2 B we recommend no action at this time. Drivers of Thesis Shares Outstanding 1.39 B 52 Week High-Low $46.6 - $24.10 § Long-Term Growth Goals: In 2019, BSX gave guidance on their long- term growth plans, centered around category leadership and product Beta inancial Ratios 1.08 diversification into faster12-growth-Month Performance markets. R & D spending was P/E Ratio 20E 23.5 approximately $1 Billion dollars, showing their dedication to their long- term growth strategy. Industry Metrics R&D (% of Sales) 11.51% § Foundation of Successful products: Successful products have positioned BSX well to continue expanding. The WATCHMAN, an ROE 20E 13.96% appendage closure device, continues to serve the Cardiovascular ROA 20E 11.88% segment extremely well, while the ACURATERelative Financial Performance Valve, LOTUS Edge, and Millipede all continue to serve the Rhythm Neuro and MedSurg Financial Ratios segments with positive growth rates. Current Ratio 1.89 Risks to Thesis Debt-to-Equity 1.12 § Competitive Landscape: BSX operates in several markets including Company Description Cardiovascular, CRM, Endoscopy and Neuromodulation where its Boston Scientific Corporation (NYSE: BSX), face-to-face with larger, well-capitalized companies like Johnson & headquartered in Natick, Massachusetts Johnson, Abbot, and Medtronic. Staying competitive and unique is manufacturers and develops minimally intrusive the only way BSX combats these colossal companies. medical devices across the globe. BSX generates revenue through three segments: § Supply Chain Disruption: BSX operates in over 70 different countries Cardiovascular, Rhythm Management, and and relies on fluid transportation and manufacturing to operate at MedSurg. These segments transpire into 7 maximum capacity. With COVID-19 shutting down centers, revenue businesses. Endoscopy, Urology and Pelvic will be impacted greatly. Health, Cardiac Rhythm Management, Electrophysiology, Neuromodulation, Earnings Estimates Interventional Cardiology, and Peripheral Interventions. Relative Financial Performance 12-Month Performance BSX: S&P:500: Executive Summary COVID-19 effect on Capital Markets We are issuing a neutral, no action rating for Boston Scientific Corporation (NYSE:BSX) for the Krause COVID-19 sent the stock Market into a spiraling Fund Portfolio. With projected revenue growth of downturn as the S&P500 was down 33% over a 4.25% in 2020 and 7.10% in 2021, we believe BSX is 1-month period during the Midst of the panic. Boston positioned to Match competitors within the Medical Scientific saw an even More drastic downfall of alMost devices Market. With BSX being a leading player in 40% over that same tiMe period. Market consensus is Interventional Cardiology, we believe their that Q1 and Q2 earnings will be negative following the Cardiovascular segMent of their business will continue pandemic however analysts, including ourselves, are to outperforM not only all other segMents at BSX, but weary if current stock prices accurately represent these the greater market as well. We are weary of assumptions. With government-funded bailouts in the coMpetitors like Medtronic in the CRM business, as talks and stiMulus checks to the AMerican people being they create alMost double the revenue off paceMakers delivered, short-terM aid by the government will provide as BSX does.1 In other business segMents like teMporary relief, but is clearly not a long-terM fix. Urology and Pelvic health, Johnson and Johnson (JNJ) has a clear advantage in terMs of capital expenditure and Market capture.2 Statement on COVID-19 Unprecedented tiMes cause uncertainty and worry in the Markets. While it is extremely difficult to encapsulate the total effect of COVID-19 on BSX, the health care sector, and even the Markets as a whole- we reMain confident that the integrity of our analysis reMains intact and the guidance we provide in this report fully represents our beliefs at this tiMe. Note: As of April 2, 2020, Boston Scientific has withdrawn its Q1 and 2020 guidance. Source: Tradingview COVID-19 effect on GDP BSX Response: COVID-19 Recent Models froM McKinsey and Oxford suggest global GDP to decline at 2.0% - 2.5%, with the US GDP In light of the pandemic and uncertainty, we are declining at 3.3%. The healthcare sector Makes for impressed with Boston Scientific’s response to the about 18% of GDP in the United States, Making the matter. As of April 15, 2020, the FDA has authorized healthcare sector and specifically MedTech one of the emergency use of a new low-cost ventilator developed hardest hit sectors by the pandemic. by the University of Minnesota and produced by BSX.3 The “Coventor”, which is the size of a sMall desktop, will provide lifesaving coMpressed oxygen to patients that COVID-19 effect on Unemployment otherwise would not have survived. The Coventor, which was developed in just days, will be sold at cost of As of April 3, unemployMent rose to 4.4% as $1,000. BSX has also begun development on PPE and employMent fell sharply by 701,000 jobs, though we personal respirators for eMergency personal amidst a predict that number is well into the Millions at this point. shortage in hospitals and eMergency response centers. The health care sector felt these iMpacts, as a reported BSX has also donated over $800,000 in supplies to 43,000 jobs were lost across all sectors. MedTech hospitals in the Wuhan region, according to their press coMpanies that rely on worldwide Manufacturing, release.4 While selling products at cost is clearly not a siMilar to BSX, felt the uneMployMent burden the Most sustainable business plan, we coMMend BSX for their as all the puzzle pieces Must align to create their ethics in the Matter and putting people over profits products. If certain parts cannot be fulfilled to complete during these griM tiMes. an instrument, it renders the tool useless. Important disclosures appear on the last page of this report. 2 Macroeconomic Outlook chance that the Fed hikes rates from 0-.25% in the next year. This is an astonishing statistic that we have not seen U.S. Real GDP before. This is a very strong indication that the interest rate environment will remain low and healthcare GDP represents the total value of the country’s production companies can continue to stabilize or expand their consisting of the purchases of domestically produced business operations. goods/services by individuals, businesses, foreigners, and government entities. “The federal government spent nearly $1.1 trillion on health care in fiscal year 2018. Of that, U.S. 10 Year Treasury 5Y Historical Medicare claimed roughly $583 billion, Medicaid and the Children’s Health Insurance Program (CHIP) about $399 billion, and veterans’ medical care about $70 billion.”5 18% of GDP spending is attributed to healthcare. To compare, the current global health expenditure is 9.9% of GDP. While 18% is a large percentage of GDP, we believe this number to be of a “steady state” factor. With the risk of Source: CNBC 9 a universal healthcare system dwindling away, the healthcare industry will continue to a large component of the US GDP.6 Demographics Demographics are one of the most prevalent drivers of GDP growth has been steady since the end of the growth in the healthcare sector with three major recession in 2011, ranging from 1.6-2.9% growth annually. components shaping its outlook: “Baby boomers”, life expectancy, and U.S. fertility rates. The “baby boomer” age group will enter their elderly years (65+) starting in the year 2030 and currently represent the largest generation in the country at roughly 21%. Elderly people are more susceptible to adverse health conditions such as chronic diseases and injuries which will fuel demand for additional healthcare products and services.10 The increasing number and lifespan of elderly Americans will drive up the demand for healthcare services and products including healthcare insurance (managed healthcare industry), hospitals (healthcare provider industry), radiation services for cancer treatment (healthcare provider industry), and prescription drugs (pharmaceutical industry). Interest Rates With life expectancy trending upwards, the older aged U.S. population will be alive for longer and bear continued When interest rates are lower, firms will be able to gain necessity for medical services. The average U.S. life cheaper debt financing to fund their capital expenditures. expectancy has returned to 78.93 years in 2020 for the first Medical Device and biotechnology companies, especially, time since declining from a peak of 78.9 years in 2014. The focus on pursuing inorganic growth through M&A. Low leading contributors to the increase in life expectancy are interest rate environments make it easier to fund declining mortality from cancer, then declining fatalities from 11 acquisitions (cost of capital is lower).7 drug overdoses. The U.S. 10-year Treasury rate has been in a relative The U.S. fertility rate has been on a steady decline in the downturn since hitting its five-year high in late 2018. As of last decade, reinforcing the age distribution skew to older April 15, the 10-year Treasury rate is at 0.60%. According aged citizens and putting more pressure on social security. to CME Group8 and their “FedWatch Tool”, there is a 0.0% Important disclosures appear on the last page of this report.
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