In this blog post, the Bloom Burton equity research team summarizes the performance of the Canadian healthcare sector during 4Q-2018, and provides commentary on select stock movements and overall market trends.
Our analysis includes all Canadian publicly-listed healthcare companies, defined as companies that are Canadian headquartered and/or listed on Canadian exchanges, with a market capof C$10 MM or greater. Our definition of healthcare includes companies operating in the following areas: therapeutic R&D; commercial therapeutics; healthcare services; healthcare IT; medical devices; medical supplies; diagnostics; consumer health and veterinary. We do not include medical cannabis producers (unless they are developing cannabis-based products under the traditional drug development regulatory process) or companies that operate long term care facilities. Based on these criteria we identified 85 companies.
We classify companies as “Tier 1” and “Tier 2” based on their enterprise value (EV) – Tier 1 companies are those with EV of >C$100 MM and Tier 2 are those with EV of <C$100 MM (for a complete listing of companies included in Tiers 1 and 2 of Bloom Burton’s “blog universe”, please see Appendix 1 at the end of the blog).
- The 85 Canadian healthcare companies included in Bloom Burton’s 4Q-2018 blog were collectively down -21.6% in 4Q-2018, underperforming the S&P/TSX Composite Index (-10.9%) but in line with the S&P/TSX Venture Composite Index (-21.6%). The poor performance of Canadian healthcare stocks during the quarter is largely a reaction to broader market weakness as a result of higher interest rates and heightened global trade tensions, creating an environment that is particularly unfavourable for high risk sectors like biotech, which is a large component of our healthcare blog universe.
- Among Canadian healthcare companies, larger Tier 1 companies performed better than smaller Tier 2 companies (-17.2% vs -23.8% respectively) due to the perceived lower risk of commercial pharma stocks, which make up a greater proportion of the Tier 1 group compared to Tier 2. We see a similar trend in the U.S., where the NYSE Pharmaceutical Index (DRG) performed better than the NASDAQ Biotechnology Index (NBI) in 4Q-2018 (-4.2% vs -20.7% respectively).
- Despite the punishing quarter for both Tier 1 and Tier 2 companies where the number of decliners (23 and 51 respectively) greatly outnumbered the number of advancers (5 and 6 respectively), due to the event driven nature of healthcare stocks, company-specific positive milestone events can lift stocks even in the toughest of market conditions (e.g. HLS Therapeutics increased +7.4% during 4Q-2018 on top of the +53.9% increase in 3Q-2018 after its partner Amarin, on September 24, reported positive clinical data for Vascepa, a pure EPA omega-3 prescription product that HLS has in-licensed for the Canadian market).
- The performance of Canadian healthcare stocks largely follows that of healthcare stocks south of the border and as mentioned above, the NBI was down -20.7% and the DRG was down -4.2% during 4Q-2018, erasing gains earlier in the year. In addition to macroeconomic factors which impacted the broader U.S. markets (S&P 500 Index and NASDAQ composite down -14.0% and -17.5% respectively), large cap biopharmas continue to face headwinds around identifying new sources of growth to replace aging blockbuster drugs, while facing increased scrutiny around drug pricing. Nonetheless, demographic trends and innovation continue to push the healthcare industry forward.
- While all healthcare subsectors in Bloom Burton’s Canadian tracking universe were down in 4Q-2018, the best performing subsectors were diagnostics (2 companies – see Appendix 1: -9.2%), commercial therapeutics (15 companies: -14.2%), healthcare services (7 companies: -14.9%) and consumer health (6 companies: -17.3%), possibly due to the perceived lower risk of these subsectors. The worst performing subsectors were healthcare IT (1 company: -30%), medical supplies (5 companies: -28.0%), therapeutic R&D (33 companies: -25.9% – the therapeutic R&D subsector had been the highest flyer in 3Q-2018, up 7.3% (2Q-2018 up 16.6%), providing additional fuel for underperformance in a risk-off market), veterinary (2 companies: -25.3%) and medical devices (14 companies: -23.0%). However, several of the subsectors contain only a few companies so we are hesitant to draw any definitive conclusions from these trends.
|Company Grouping/Share Price Changes||4Q-2018||3Q-2018||2Q - 2018||Q1 - 2018*||FY 2017*|
|S&P/TSX Composite Index||-10.9%||-1.3%||+5.9%||-5.8%||+5.2%|
|S&P/TSX Venture Composite Index||-21.4%||-4.2%||+7.1%||-8.5%||+9.9%|
|S&P 500 Index||-14.0%||+7.2%||+2.9%||-2.0%||+18.4%|
|NASDAQ Biotechnology Index (NBI)||-20.7%||+11.1%||+3.0%||-2.5%||+18.7%|
|NYSE Pharmaceutical Index (DRG)||-4.2%||+12.5%||-0.3%||-3.8%||+11.7%|
|Canadian Healthcare Overall - Average (93 companies)||-21.6%||+1.0%||+8.8%||+3.9%||+16.2%|
|Tier 1 - Average (32 companies)||-17.2%||+9.3%||+7.0%||+1.8%||+32.0%|
|Tier 2 - Average (61 companies)||-23.8%||-2.9%||+9.8%||+4.8%||+9.8%|
|Tier 1 and 2 - Number of Advancers||11||35||45||34||36|
|Tier 1 and 2 - Number of Decliners||74||46||45||48||43|
|Share price increase 40% or greater - Overall||1||6||18||10||19|
|Share price decrease 40% or greater - Overall||16||3||7||6||11|
4Q-2018 Healthcare Stock Performance (%) By Sector
Tier 1 Company Performance
- Overall, we included 28 companies in our Tier 1 analysis with EV of $100 M or greater, which collectively had a 4Q-2018 return of -17.2%.
- The number of Tier 1 decliners (23) was higher than the number of advancers (5) this quarter.
Notable advancers in the quarter include:
- Aurinia Pharmaceuticals – The stock finished 4Q-2018 up +8.8% after the company announced that it had completed enrolment of its phase 3 trial (AURORA) of voclosporin in lupus nephritis in September, and in anticipation of a phase 2 data readout for voclosporin ophthalmic solution in dry eye disease expected in January 2019.
- HLS Therapeutics – The stock increased +7.4% during 4Q-2018, continuing its run from late 3Q-2018, which saw the stock price increase +53.9% following partner Amarin’s September 24 reporting of strong efficacy results for cardiovascular drug Vascepa, a pure EPA omega-3 prescription product that HLS has in-licensed for the Canadian market.
- Cardiol Therapeutics – The stock finished 4Q-2018 up +7.2% after its IPO on December 20 raised C$15.1 MM to advance the development of pharmaceutical cannabidiol products and targeted therapies for heart failure and cancer.
- Clementia Pharmaceuticals – The stock finished 4Q-2018 up +5.5% after the company announced on October 23 that it was planning to submit an NDA in 2H-2019 for episodic dosing of palovarotone, its drug candidate for the treatment of fibrodysplasia ossificans progressiva, based on existing phase 2 data, prior to ongoing phase 3 trial completion.
Notable decliners in the quarter include:
- Novelion Therapeutics – The stock was down -71.6% in 4Q-2018, as the company faces a short timeline to develop a long term capital strategy to address its looming US$412 MM of debt which matures between February and August 2019.
- Arbutus Biopharma – The stock decreased -59.5% in 4Q-2018 after the company provided a corporate update on October 9, which announced the decision to delay the initiation of a phase 1 trial for AB-452, its novel HBV RNA destabilizer, that was planned in 4Q-2018, following nonclinical safety findings.
- Prometic Life Sciences – The stock finished 4Q-2018 down -46.9%, continuing its slide from 3Q-2018 which saw the stock lose -38.5% due to continued balance sheet risk, uncertainty regarding timelines for NDA resubmission for lead drug candidate, Ryplazim, and leadership changes.
Tier 2 Company Performance
- Overall, we included 57 companies in our Tier 2 analysis (with EV of less than $100 M), which as a group had a 4Q-2018 return of -23.8%.
- The number of decliners (51) outnumbered the number of advancers (6) this quarter.
Notable advancers in the quarter include:
- Aeterna Zentaris – The stock increased +80.4% in 4Q-2018 after the company announced on November 1 that Novo Nordisk was acquiring rights to Macrilen for adult growth hormone deficiency in the U.S. and Canada from Strongbridge Biopharma (Aeterna Zentaris out-licensed U.S. and Canadian rights to Macrilen to Strongbridge).
- biOasis Technologies – The stock increased +31.5% in 4Q-2018 after the company announced positive results on November 20 from a peripheral whole-body PET/CT scan study in non-human primates for xB3-001, its preclinical drug candidate for brain metastases.
- Ceapro – The stock finished 4Q-2018 up +11.6% after the company announced on October 9 that it had received Health Canada approval to commence a human clinical study assessing the natural health product beta glucagon as a cholesterol-lowering agent in hyperlipidemia patients on statins.
Notable decliners in the quarter include:
- Neovasc – The stock was down -76.5% in 4Q-2018, continuing the slide that began on September 11 when the company announced that it was the subject of a lawsuit brought about by Endovalve and Micro Interventional Devices alleging trade secret misappropriation, breach of contract and unfair competition.
- Trillium Therapeutics – The stock decreased -68.2% in 4Q-2018 due to investor concerns that the company has slipped behind and has a weaker balance sheet than its competitor, Forty Seven.
- DiaMedica Therapeutics – The stock was down -62.7% in 4Q-2018, concurrent with the company announcing on November 12 its intention to list on NASDAQ and announcing on December 7 the pricing of its NASDAQ IPO (issuing 4.1 MM common shares at US$4.00 per share).
- Kalytera Therapeutics – The stock finished 4Q-2018 down -60.0%, with the slide occurring alongside the company providing a progress update on September 27 for its cannabinoid-based products for the treatment of pain.
|Company||EV (C$ MM)||Market Cap (C$ MM)||Subsector|
|Bausch Health Companies Inc.||39,685.2||8,823.9||Commercial Therapeutics|
|Advanz Pharma Corp.||1,791.9||1,258.5||Commercial Therapeutics|
|Jamieson Wellness Inc.||1,017.5||810.9||Consumer Health|
|Medical Facilities Corp.||778.7||466.6||Healthcare Services|
|Resverlogix Corp.||744.4||635.1||Therapeutic R&D|
|Theratechnologies Inc.||654.5||639.6||Commercial Therapeutics|
|Aurinia Pharmaceuticals Inc.||612.3||791.8||Therapeutic R&D|
|HLS Therapeutics Inc.||521.6||369.8||Commercial Therapeutics|
|CRH Medical Corp.||470.5||302.1||Healthcare Services|
|Zymeworks Inc.||447.0||641.0||Therapeutic R&D|
|Clementia Pharmaceuticals Inc.||403.4||607.3||Therapeutic R&D|
|Akumin Inc.||395.2||278.6||Healthcare Services|
|Eastwood Bio-Medical Canada Inc.||378.1||114.9||Consumer Health|
|Novelion Therapeutics Inc.||377.1||21.7||Commercial Therapeutics|
|Knight Therapeutics Inc.||357.8||1,098.2||Commercial Therapeutics|
|Prometic Life Sciences Inc.||346.0||183.1||Therapeutic R&D|
|IMV Inc.||297.3||309.1||Therapeutic R&D|
|Helius Medical Technologies Inc.||282.3||319.0||Medical Devices|
|Arbutus Biopharma Corp.||266.0||290.3||Therapeutic R&D|
|Neptune Wellness Solutions Inc.||258.3||276.4||Consumer Health|
|Viemed Healthcare Inc.||202.7||198.3||Healthcare Services|
|Zomedica Pharmaceuticals Corp.||188.3||194.7||Veterinary|
|Correvio Pharma Corp.||145.4||121.2||Commercial Therapeutics|
|Centric Health Corp.||140.6||61.6||Healthcare Services|
|Fennec Pharmaceuticals Inc.||130.5||168.7||Therapeutic R&D|
|VBI Vaccines Inc.||124.8||212.7||Therapeutic R&D|
|Cardiol Therapeutics Inc.||104.0||101.1||Therapeutic R&D|
|BELLUS Health Inc.||103.9||160.2||Therapeutic R&D|
|Hamilton Thorne Ltd.||97.2||107.9||Medical Supplies|
|BioSyent Inc.||94.6||116.8||Commercial Therapeutics|
|Covalon Technologies Ltd.||93.1||91.0||Medical Supplies|
|Greenbrook Tms Inc.||89.6||133.1||Healthcare Services|
|Arch Biopartners Inc.||75.7||76.4||Therapeutic R&D|
|Aptose Biosciences Inc.||69.8||98.2||Therapeutic R&D|
|Antibe Therapeutics Inc.||64.5||68.2||Therapeutic R&D|
|ProMIS Neurosciences Inc.||61.8||66.6||Therapeutic R&D|
|Opsens Inc.||61.3||72.0||Medical Devices|
|Intelgenx Technologies Corp.||60.5||68.9||Therapeutic R&D|
|Spectral Medical Inc||59.7||64.3||Therapeutic R&D|
|Cipher Pharmaceuticals Inc.||58.0||45.6||Commercial Therapeutics|
|Helix BioPharma Corp.||53.5||55.5||Therapeutic R&D|
|Xenon Pharmaceuticals Inc.||45.3||217.5||Therapeutic R&D|
|Aeterna Zentaris Inc.||45.0||66.8||Commercial Therapeutics|
|Theralase Technologies Inc.||40.0||42.5||Medical Devices|
|Acasti Pharma Inc.||37.5||89.0||Therapeutic R&D|
|TSO3 Inc.||37.1||35.5||Medical Devices|
|ImmunoPrecise Antibodies Ltd.||36.8||39.0||Medical Supplies|
|Profound Medical Corp.||36.0||59.4||Medical Devices|
|LexaGene Holdings Inc.||33.8||45.7||Diagnostic|
|Neovasc Inc.||33.8||20.7||Medical Devices|
|InMed Pharmaceuticals Inc.||33.3||58.1||Therapeutic R&D|
|Acerus Pharmaceuticals Corp.||31.9||27.1||Commercial Therapeutics|
|Medexus Pharmaceuticals Inc.||29.8||70.8||Commercial Therapeutics|
|Trillium Therapeutics Inc.||29.3||33.9||Therapeutic R&D|
|Microbix Biosystems Inc.||28.8||22.7||Medical Supplies|
|Sernova Corp.||28.2||33.5||Medical Devices|
|DiaMedica Therapeutics Inc.||27.1||48.9||Therapeutic R&D|
|biOasis Technologies Inc.||26.2||28.1||Therapeutic R&D|
|Ceapro Inc.||26.1||29.7||Consumer Health|
|Oncolytics Biotech Inc.||25.3||42.8||Therapeutic R&D|
|Medicure Inc.||24.8||95.8||Commercial Therapeutics|
|Protech Home Medical Corp.||23.7||50.1||Healthcare Services|
|Novoheart Holdings Inc.||22.9||10.9||Medical Supplies|
|Nuvo Pharmaceuticals Inc.||21.7||23.9||Commercial Therapeutics|
|Hemostemix Inc.||21.3||22.7||Therapeutic R&D|
|LED Medical Diagnostics Inc.||21.2||13.8||Medical Devices|
|Medx Health Corp.||18.9||18.9||Medical Devices|
|Aurora Spine Corp.||18.8||15.0||Medical Devices|
|CVR Medical Corp.||18.6||25.7||Diagnostic|
|Bionik Laboratories Corp.||18.1||17.6||Medical Devices|
|Quest PharmaTech Inc.||16.7||16.7||Therapeutic R&D|
|Sirona Biochem Corp.||16.2||13.8||Therapeutic R&D|
|Medicenna Therapeutics Corp.||15.8||20.0||Medical Devices|
|Kalytera Therapeutics Inc.||15.0||16.7||Therapeutic R&D|
|Eyecarrot Innovations Corp.||12.8||15.4||Healthcare IT|
|BriaCell Therapeutics Corp.||12.8||10.1||Therapeutic R&D|
|Delivra Corp.||12.7||11.6||Consumer Health|
|Waverly Pharma Inc.||11.9||15.1||Commercial Therapeutics|
|SQI Diagnostics Inc.||9.8||11.1||Medical Devices|
|Eastgate Biotech Corp.||7.1||14.6||Consumer Health|
|ESSA Pharma Inc.||1.4||15.7||Therapeutic R&D|
|Titan Medical Inc.||(6.9)||36.6||Medical Devices|
|Sierra Oncology Inc.||(9.8)||134.0||Therapeutic R&D|
|Aquinox Pharmaceuticals Inc.||(42.7)||69.2||Therapeutic R&D|
This Research Report is issued and approved for distribution by Bloom Burton Securities Inc. (“Bloom Burton”), a member of the Investment Industry Regulatory Organization of Canada.
This Research Report is provided for informational purposes only and is not an offer to sell or the solicitation of an offer to buy any of the securities discussed herein in any jurisdiction where such offer or solicitation would be prohibited. The securities mentioned in this Research Report may not be suitable for all types of investors. This Research Report does not take into account the investment objectives, financial situation or specific needs of any particular investor. Recipients of this Research Report should not rely solely on the investment recommendations contained herein and should contact their own professional advisors to determine if an investment is suitable for them.
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Company Specific Disclosures
- Bloom Burton & Co. or its affiliates have provided investment banking services for Cipher Pharmaceuticals, Knight Therapeutics, Nuvo Pharmaceuticals, CRH Medical, BELLUS Health and Titan medical during the 12 months preceding the date of issuance of the research report or recommendation.
- Bloom Burton has managed an offering of securities by Knight Therapeutics and Titan Medical in the past 12 months.
- The research analyst responsible for this report and recommendations may hold securities discussed in the report indirectly through Bloom Burton Canadian Healthcare Fund, LP which is indirectly affiliated with Bloom Burton & Co.
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