picture alliance/picture alliance via Getty Images
picture alliance/picture alliance via Getty Images
The following segment was excerpted from this fund letter.
Second only to AI last year was the rhetoric and enthusiasm around GLP-1 weight loss drugs. These drugs, which by some estimates will generate over $100 billion in sales by the end of this decade, were popping up on just about every earnings call last year, with analysts drilling management teams on the risks to their business and investors punishing their stocks. Our work ramped alongside the hysteria. We analyzed the implications of everything from coffee and beer consumption to snacks and candy cravings before landing squarely on obesity and diabetes, where we found the greatest potential threats, the largest dislocations, and the widest gap between perception and reality.
We established a position in Fresenius Medical Care, a German healthcare company specializing in kidney dialysis and related products, at "Peak Obesity" in October of last year.
Before the word "coronavirus" entered the world's vernacular, dialysis volumes predictably grew at 3% - 4% annually, which made for a pretty good business for industry behemoths Davita (DVA. which counts Berkshire Hathaway as its largest shareholder) and Fresenius, who dominate the US market. That trend ground to a halt as mortality rates for patients on dialysis, which typically average 20% - 25% per year, surged during the pandemic, sending "predictable" volume growth sharply negative.
Things went from bad to worse as new "miracle drugs" promised to put an end to obesity, lower the prevalence of diabetes and kidney disease, and "permanently" impair the value of businesses serving these critical markets. We think investors might have gotten a bit out in front of their skis on this one, considering that Fresenius shed nearly three-quarters of its market capitalization from the pandemic's peak.
To start, the sheer number of assumptions across dozens of interrelated variables required to forecast these drugs' long-term implications makes for an incredibly wide range of outcomes. Yet, at current prices, shares appear to discount only the worst possible scenarios.
It's just not that simple. For starters, the timing of any potential impact is up for grabs at this point. Even assuming the drugs are widely available (they are not), are fully covered by Medicare (they are not), and are taken forever (they are not), kidney disease progression takes place over many years, so any impact on dialysis volumes would not appear overnight.
At the same time, any reduction in mortality rates (another benefit of these drugs) would extend the time patients are on dialysis, providing upside to current numbers, something the consensus conveniently ignores in their models. Considering that less than 40% of patients are on dialysis because of diabetes and as many as half of those "crash" into dialysis (meaning they are not diagnosed until they are hospitalized), the potential impact here seems far less worrisome than overwhelmingly bearish investors would lead you to believe.
While only one in four analysts currently rate the shares a buy, 20 analysts rate the stock a hold or sell, yet still fail to forecast any material deterioration in the business. Instead, the biggest driver of the bearish call appears to be valuation.
With the stock trading near a 50% discount to European peers and those peer multiples already considerably depressed, we find that argument challenging at best. As we see it, shares are trading at 12x depressed earnings, sentiment is thoroughly washed out, and new additions to the board and the executive team are correctly focused on increasing margins and returns.
| ABOUT BROYHILL Broyhill Asset Management is a boutique investment firm, initially established as a family office in 1980 and guided by a disciplined value orientation. Founded in the foothills of North Carolina's Blue Ridge Mountains, we operate outside of the fray and invest with a rational, objective, long-term perspective. DISCLOSURES Broyhill Asset Management LLC ("Broyhill") is an investment adviser in North Carolina. Broyhill is registered with the Securities and Exchange Commission (SEC). Registration of an investment adviser does not imply any specific level of skill or training and does not constitute an endorsement of the firm by the Commission. Broyhill only transacts business in states in which it is properly registered or exempted from registration. A copy of Broyhill's current written disclosure brochure filed with the SEC which discusses, among other things, Broyhill's business practices, services, and fees is available through the SEC's website at www.adviserinfo.sec.gov. The information presented herein is unaudited, subject to change, and provided for informational purposes only. Performance is calculated using time-weighted rates of returns, net of fees. Portfolio statistics are presented by exposure. Broyhill exercises judgment in assessing the exposures provided herein, whether concerning a particular strategy, asset class, sector, industry, geography, or in the aggregate. Exposure does not necessarily reflect the risk associated with the underlying positions. The investment return and principal value of an investment will fluctuate. Therefore, an investor's account, when liquidated or redeemed, will almost always have a different value than that shown herein. Current performance may be lower or higher than the return data quoted herein. Past performance is not indicative of future returns. This information should not be used as a general guide to investing or as a source of any specific investment recommendations and makes no implied or expressed recommendations concerning how an account should or would be handled, as appropriate investment strategies depend upon specific investment guidelines and objectives. Information presented herein is subject to change without notice and should not be considered a solicitation to buy or sell any security. This document contains general information that is not suitable for everyone. The information contained herein should not be construed as personalized investment advice. There is no guarantee that the views and opinions expressed in this document will come to pass. Investing in the stock market involves gains and losses and may not be suitable for all investors. No representations, expressed or implied, are made as to the accuracy or completeness of such statements, estimates, or projections, or concerning any other materials herein. Under no circumstances does the information contained within represent a recommendation to buy, hold, or sell any security, and it should not be assumed that the securities transactions or holdings discussed were or will prove to be profitable. There are risks associated with purchasing and selling securities and options thereon, including the risk that you could lose money. Certain information contained herein constitutes "forward-looking statements," which can be identified by the use of forward-looking terminology such as "may," "will," "should," "expect," "anticipate," "project," "estimate," "intend," "continue," or "believe," or the negatives thereof or other variations thereon or comparable terminology. Due to various risks and uncertainties, actual events, results or actual performance may differ materially from those reflected or contemplated in such forward-looking statements. Nothing contained herein may be relied upon as a guarantee, promise, assurance, or representation of the future. Market value information (including, without limitation, prices, exchange rates, accrued income, and bond ratings furnished herein) has been obtained from sources that Broyhill believes to be reliable and is for the exclusive use of the client. Market prices are obtained from standard market pricing services or, in the case of less liquid securities, from brokers and market makers. Broyhill makes no representations, warranty, or guarantee, express or implied, that any quoted value necessarily reflects the proceeds that may be received on the sale of a security. Changes in rates of exchange may have an adverse effect on the value of investments. Indices represent unmanaged, broad-based baskets of assets. They are typically used as proxies for the overall market's performance. Index returns typically assume that dividends are reinvested and do not include the effect of management fees or expenses. You cannot invest directly in an index. Without prior written permission of the index owner, this information and any other index-related intellectual property may only be used for your internal use, may not be reproduced, or redistributed in any form, and may not be used to create any financial instruments or products or any indices. This information is provided on an "as is" basis, and the user of this information assumes the entire risk of any use made of this information. Neither the index owner nor any third party involved in or related to the computing or compiling of the data makes any express or implied warranties, representations, or guarantees concerning the index-related data, and in no event will the index owner or any third party have any liability for any direct, indirect, special, punitive, consequential or any other damages (including lost profits) relating to any use of this information. Investing in some private funds is limited to persons who are "qualified purchasers" (as defined in the United States Investment Company Act of 1940, as amended (the "Investment Company Act")) and "accredited investors" (as defined in Rule 501(a) under the Securities Act). Such securities will not be registered under the Securities Act or qualified under any applicable state securities. For additional information about other indices or strategies mentioned here, you may contact us atir@broyhillasset.com. No part of this material may be copied, photocopied, or duplicated in any form, by any means, or redistributed without Broyhill's prior written consent. |
Editor's Note: The summary bullets for this article were chosen by Seeking Alpha editors.
Editor's Note: This article discusses one or more securities that do not trade on a major U.S. exchange. Please be aware of the risks associated with these stocks.