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Global Equity Strategy January 7, 2019

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Global Equity Strategy January 7, 2019 Global Equity Strategy January 7, 2019 Boost your portfolio’s immune system with health care Wietse Nijenhuis Are you worried about the sustainability of earnings growth? Or have trade tensions gotten you down? What about Head - Equity Strategy when the Fed eventually starts cutting rates in response to slowing growth? Does positioning your portfolio through +1-212-559-0341 [email protected] today’s uncertain times give you sleepless nights? If so, health care investments may be right you. While the above reads like a typical health care commercial one might see in the US, a likely continuation of last Joe Fiorica, CFA year’s challenging investment backdrop means lower beta health care stocks may be well placed to help boost Investment Strategy your portfolio’s immune system, without sacrificing growth potential. +1-212-559-3473 [email protected] Health care stocks have continued growing their earnings through each of the last three recessions, with the sector typically outperforming when uncertainty rises. The sector has also outperformed the broader market during each Steven Wieting of the past six Federal Reserve rate cutting cycles. Chief Investment Strategist +1-212-559-0499 And while the near-term case focuses on earnings resilience, we believe the long-term case is equally compelling, [email protected] underpinned by unstoppable trends rooted in demographics – both in the developed as well as the emerging world. Diana Wehner The world’s population is aging at an unprecedented rate – older populations mean significantly higher demand Portfolio Manager for healthcare treatment, as elderly households spend more on health care. Not only that, but the emerging world Citi Investment Management is witnessing a huge shift into the middle class. The number of people in the middle class globally is expected to +1-203-388-3741 [email protected] reach 5 billion by 2027 from 3.3 billion in 2017. This demographic has escaped fears of extreme poverty, and is now able to consume more freely, include spending on health care. Rob Jasminski Near-term risks center around potential changes to US legislation which could put further downward pressure on Head of Global Equities Citi Investment Management drug pricing. To try and mitigate these risks, we believe it makes sense to ‘go global’ in your health care selection. +1-203-890-7929 Not only is the global health care sector’s beta to the S&P 500 lower than that of the US health care sector, but [email protected] dividend yields among European health care names are significantly higher than elsewhere. Long-term risks come from potential disruption from outside of the sector. Amazon’s recent acquisition of digital Charles Reinhard Head - North America pharmacy PillPack serving as the most recent of only a handful of examples. While some disruption is almost Investment Strategy inevitable, incumbents are not standing still, recognizing the need to replicate the same levels of customer +1-212-559-6251 satisfaction that other industries have started achieving. [email protected] We believe that health care investments can play a prominent role in diversified equity portfolios, and see the sector’s potential delivering portfolio benefits that go beyond defensiveness. Depending on an investor’s objectives, a selection of global health care investments can be made that seek growth or yield. Our preference is to invest with a view toward global companies with attractive valuations and strong underlying fundamentals. So as the commercial goes; Consult your investment counselor to find out if allocating to health care stocks is right for you. INVESTMENT PRODUCTS: NOT FDIC INSURED • NOT CDIC INSURED • NOT GOVERNMENT INSURED • NO BANK GUARANTEE • MAY LOSE VALUE Boost your portfolio’s immune system with health care 2018 was a challenging year for equity investors who had to contend with uncertainties ranging from trade wars to Fed tightening. US equities made fresh all-time highs in September, only to correct sharply in the months that followed. Many international markets suffered double digit declines as volatility returned, having been AWOL during 2017. While many investors focused on growth vs. value, cyclicals vs. defensives or technology and financials, one defensive sector (but also a growth sector) quietly went about its business, finishing as the year’s best performing sector globally, alongside utilities. The sector was also the top performer in the US for the first time since 1995, taking the mantle from much loved technology related sectors. The sector in question is health care, and we expect it to continue performing well in this phase of the cycle, boosted by resilient earnings, strong balance sheets and free cash flow generation well above that of the market. Health care provides both growth as well as defensive exposure. The sector has a beta to the S&P 500 of 0.69, while all of the sub-sectors all have a beta below 1 (chart in appendix). At the same time, at around 14%, the sector commands the third largest weight in US growth indices. Sector characteristics S&P 500 sector betas to market Cyclical 1.6 1.44 1.5 Growth Cyclical 1.4 1.4 Value 1.22 Financials Info Tech 1.14 1.3 1.2 1.08 1.08 1.08 Industrials 1.2 Consumer 1.0 Materials Disc. 0.82 1.1 0.79 0.8 0.69 1.0 Beta 0.6 0.51 0.9 Telecom S&P 500 0.42 Beta 0.4 0.8 Health care Energy 0.7 Consumer 0.2 0.6 Stap. 0.0 0.5 Defensive Defensive Value 0.4 Utilities Growth 0.3 15 20 25 30 35 40 Cyclically-Adjusted Price-to-Earnings Source: FactSet as of December 31, 2018. Indices are unmanaged. An investor Source: FactSet as of December 31, 2018. Indices are unmanaged. An investor cannot invest directly in an index. They are shown for illustrative purposes only. cannot invest directly in an index. They are shown for illustrative purposes only. Past performance is no guarantee of future returns. Real results may vary. Past performance is no guarantee of future returns. Real results may vary. Administer a dose of earnings resilience to your portfolio The Citi Private Bank Global Investment Committee remains constructive on equities as we head into 2019, but also recognizes growing late cycle signals. The committee reduced risk exposure on a number of occasions in 2018, thereby raising portfolio quality. As uncertainty remains elevated, we believe it makes sense to continue along this path. Increasing exposure to health care stocks is consistent with this trajectory. The sector tends to perform well late-cycle, having grown its earnings through each of the last three recessions. In fact, looking back at the last instances when overall US earnings growth contracted (for example in 2015), each health care sub-sector managed to grow its earnings during those years, with the single exception of health care providers in 2008. Health care has growth earnings through All sub-sectors tend to grow EPS in years that overal market EPS contracts 40 recessions 40 MSCI AC World MSCI USA Health Care ACWI Health Care 30 30 Pharma Biotech Providers Equipment 20 20 10 10 0 0 Annual EPS Growth (%) Growth EPS Annual YoY YoY EPS Growth (%) -10 -10 -20 -20 '98 '00 '02 '04 '06 '08 '10 '12 '14 '16 2001 2007 2008 2009 2015 Source: FactSet as of December 31, 2018. Indices are unmanaged. An investor Source: FactSet as of December 31, 2018. Indices are unmanaged. An investor cannot invest directly in an index. They are shown for illustrative purposes only. cannot invest directly in an index. They are shown for illustrative purposes only. Past performance is no guarantee of future returns. Real results may vary. Past performance is no guarantee of future returns. Real results may vary. Global Equity Strategy January 7, 2019 2 Another way to view health care’s outperformance during uncertain times is to assess its relative performance during periods of falling interest rates. The US Federal Reserve was the first major central bank to raise rates in 2016 and has continued gradually tightening monetary conditions. We expect this to continue into 2019, but also acknowledge that ultimately the Fed is likely to become the first major central bank to cut interest rates. Such a period often corresponds with softening economic activity, but also with health care outperformance. Each of the past six Fed rate cutting cycles going back to the 1970s has seen health care outperform the broader market between 9%-57%. Health care has outperformed during rate cuts Health care spending tracks broader inflation Fed cutting cycles Health Care/S&P 500 US PCE Proprietary Hospitals (3mma) US Core PCE (3mma, right) Fed Funds Rate (right) 18% 5.0% 3.0 20 16% 18 4.5% +19% 2.5 14% 16 4.0% +15% 14 12% 2.0 +57% 3.5% 10% 12 3.0% 1.5 10 8% 2.5% 8 6% 2.0% Core PCE inflation Health Health care spending 1.0 Fed Funds Rate (%) 6 4% Health Health care rel S&Pto 500 1.5% +56% 4 2% 0.5 +9% +24% 2 0% 1.0% 0.0 0 -2% 0.5% 73 76 79 82 85 88 91 94 97 00 03 06 09 12 15 18 84 86 88 90 92 94 96 98 00 02 04 06 08 10 12 14 16 18 Source: Refinitiv as of December 31, 2018. Indices are unmanaged. An investor Source: Refinitiv as of December 31, 2018. Indices are unmanaged. An investor cannot invest directly in an index. They are shown for illustrative purposes only.
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