大中華區(qū)醫(yī)療設(shè)備：人口老齡化的隱性受益者

1、14 January 2020Greater ChinaEQUITIESAging population % in China and TaiwanGreater China Medical DevicesHidden beneficiaries of aging population25%20%15%10%5%1990200 0201 02018203 0EChinaTaiwanKey points We see buying opportunities in orthopaedic and ophthalmic segments given the aging population of

2、Greater China Initiate coverage on AK Medical (40% upside) and Universal VisionBiotechnology (91% upside) with Outperform ratings Reiterate Outperform on Weigao and lift our TP to HK$11.2 from HK$8.1Beneficiaries of aging population trendsSource: NBS, MOI, GIND, Macquarie Research, Jan 2020Greater C

3、hina Medical Device CoverageMkt *30d-UpCap ADTV Rec Price TP side NameCodeUS$m US$mLCY LCY%Lepu300003 CH 9,000 104.0 O 34.96 50.00 43%Weigao1066 HK5,2647.6 O9.04 11.20 24%Yuyue002223 CH 3,004 25.8 N 20.74 20.50 -1%MicroPort 853 HK1,9163.1 O9.17 10.80 18%AK Med 1789 HK1,4104.0 O 10.40 14.60 40%St Shi

4、ne 1565 TT7244.6 U 430.5 284.0 -34%Ginko8406 TT6341.7 U 205.5 153.0 -26%UVB3218 TT1591.9 O 62.70 120.0 91%We highlight two segments in the greater China medical device space geared to benefit from the aging population trend: 1) orthopaedic segment, especially for joint implant devices, and 2) ophtha

5、lmic segment. We initiate coverage on AK Medical (AK), the largest domestic joint implant brand in China, and Universal Vision Biotechnology (UVB), the largest eye clinical chain in Taiwan. We also reiterate our OP on Shandong Weigao, a maker of consumables and Ortho.Strong Ortho demand growth in Ch

6、inaChinas aged population (65 years old) will grow to 17% of total population by 2030, from 12% in 2018, according to a United Nations estimate. Joint implantEPSDivPERCAGR PEG P/S P/B ROE Yielddevice demand in China has been growing at 15-20% in the past 5-10 years,Name20E 21E 19-21E 20E 20E 20E 20E

7、 20ELepu25.0 19.438%0.7 7.46.228% 1.0%Weigao15.7 13.818%0.9 3.02.014% 1.8%Yuyue22.2 19.022%1.0 3.63.014% 0.9%MicroPort*31.0 24.643%0.7 2.23.412% 0.7%AK Med30.0 22.041%0.7 7.79.331% 1.0%St Shine18.2 17.4-8%NA 3.53.720% 4.4%Ginko14.9 13.611%1.3 2.21.611% 3.7%UVB15.7 12.536%0.4 2.92.718% 3.8%*30-day av

8、erage daily trading value*MicroPort EPS CAGR based on reported numbers Source: Macquarie Research, Jan 2020; as of 10 Jan 2020InsideHidden beneficiaries of aging population3 Strong Ortho demand growth in China 4Presbyopia hit at earlier ages in Taiwan 6AK Medical Holdings 8Universal Vision Biotechno

9、logy 25Shandong Weigao 42Appendix 49AnalystsMacquarie Capital Limited, Taiwan Securities BranchCorinne Jian, CFA +886 2 2734 7522given rising demand from elders, outpacing the overall health care spending CAGR of 13%. Domestic brand revenue growth is even stronger at 20-40% thanks to import substitu

10、tion. We expect AK and Weigao to be key beneficiaries, given their leading positions in the Ortho market in China.Presbyopia hit at earlier agesIn Taiwan, in addition to rising presbyopia medical demand along with the aging population, heavier usage of electronic devices such as smartphones has led

11、to earlier onset of presbyopia. Regulations to enhance childrens myopia control should also fuel professional optometry demand growth. We expect UVB to be a key beneficiary given its leading position in eye surgery services in Taiwan.AK Medical (1789 HK, initiate with OP, TP HK$14.6, 41% TSR)The lar

12、gest domestic joint brand in China and a 3D-printing Ortho pioneer, with highest earnings growth among Ortho peers; under-researched. Our 2019-21E EPS are 15%, 21% and 26% higher than Bloomberg consensus.Universal Vision Biotech (3218 TT, initiate with OP, TP NT$120, 95% TSR)Taiwans largest eye clin

13、ical chain, benefit from rising demands for myopia & presbyopia Lasik and OK lens, and share gains; gem with little to no following.Shandon Weigao (1066 HK, OP, lift TP to HK$11.2, 26% TSR)The largest consumables and domestic Ortho brand in China, benefit from strong ortho growth and consumables mar

14、ket consolidations; cheap valuation.Valuation summary HYPERLINK mailto:corinne.jian corinne.jianMkt30-d19-21DivCapADV PriceTP Up-PEREPS PEG PBR ROE yieldShannen Lin +886 2 2734 7518 HYPERLINK mailto:shannen.lin shannen.linNameCode US$m US$m Lcy Rec Lcy side20E 21E CAGR20E 20E 20E 20EUVB3218 TT 1591.

15、9 62.70 O 120.0 91%15.7 12.536%0.42.7 18% 3.8%Colin Fu +886 2 2734 7532AK Med 1789 HK 1,4104.0 10.40 O 14.60 40%30.0 22.041%0.79.3 31% 1.0% HYPERLINK mailto:colin.fu colin.fuWeigao 1066 HK 5,2647.6 9.04 O 11.20 24%15.7 13.818%0.92.0 14% 1.8%Source: Bloomberg, Macquarie Research, January 2020. Pricin

16、g date: 10 January 2020.Please refer to page 50 for important disclosures and analyst certification, or on our website HYPERLINK /research/disclosures /research/disclosures.Fig 12020E PERs vs 2019-21E earnings CAGRsFig 22020E PBRs vs ROEs60%55%50%45%40%35%30%25%20%15%10%2019-21E CAGR2020E ROEAKLepuC

17、hunli St ShineDoubleMindrayWeigaoGinko WandongUVBYuyueEuroEyesMicroPort35%30%25%20%15%10%5%0%C-merMicroPortChunliAKUVBLepu St ShineAierWandongYuyueDoubleWeigaoLifetechMindrayGinko0.020.040.060.080.02020E PER0.02.04.06.08.010.012.014.02020E P/BVSource: Bloomberg, Macquarie Research, January 2020Sourc

18、e: Bloomberg, Macquarie Research, January 2020Fig 3 Greater China Med Device sector valuation comparisonMarket 30-day19-21Price/DivNetCap trading PriceTPUp-PEREPS PEGSalesPBR ROEyieldGearingNameCodeUS$mUS$mLcyCrncyRecLcyside20E21ECAGR20E20E21E20E20E20E20EHK/China85,387451.542.033.426%1.95.44.49.222%

19、0.8%-34%Lepu Medical300003 CH9,000104.034.96CNYO50.0043%25.019.438%0.77.46.06.228%1.0%3%Shandong Weigao1066 HK5,2647.69.04HKDO11.2024%15.713.818%0.93.02.72.014%1.8%-5%Yuyue Medical002223 CH3,00425.820.74CNYN20.50-1%22.219.022%1.03.63.13.014%0.9%-28%MicroPort*853 HK1,9163.19.17HKDO10.8018%31.024.643%

20、0.72.22.03.412%0.7%-18%AK Medical1789 HK1,4104.010.40HKDO14.6040%30.022.041%0.77.75.79.331%1.0%-50%Mindray300760 CH32,93499.3187.50CNYNRNRNA39.932.720%2.06.45.39.724%0.6%-58%Aier Eye300015 CH18,691123.141.76CNYNRNRNA71.454.533%2.21.81.414.821%0.7%-16%Double Medical002901 CH3,50414.860.29CNYNRNRNA41.

21、633.025%1.68.76.811.728%0.7%NABluesail Medical002382 CH1,72710.612.40CNYNRNRNA16.114.323%0.72.42.11.48%3.1%NAKinetic300326 CH1,58125.715.15CNYNRNRNA27.922.02%12.3NANA3.513%0.4%NAEndoVastec688016 CH1,54112.8148.22CNYNRNRNA61.946.2nmfNA25.819.79.716%0.0%NAChunli Medical1858 HK9731.554.60HKDNRNRNA23.72

22、4.138%0.66.05.55.925%0.8%-54%Shinva Medical600587 CH8589.314.61CNYNRNRNANANAnmfNANANANANANANALifeTech1302 HK8461.11.52HKDNRNRNA28.727.021%1.36.75.5NANANANAWandong Medical600055 CH8277.710.58CNYNRNRNA23.519.225%1.04.53.92.410%NANAC-mer Eye Care3309 HK6630.44.90HKDNRNRNA40.830.655%0.76.65.3NANANANAEur

23、oEyes1846 HK3540.68.36HKDNRNRNA22.518.6nmfNA5.34.53.214%NANAPW Medtech1358 HK2930.11.45HKDNRNRNANANAnmfNANANANANANANATaiwan2,47712.018.015.65%2.73.02.72.717%3.6%-2%St Shine1565 TT7244.6430.50TWDU284.0-34%18.217.4-8%NA3.53.53.720%4.4%-35%Ginko8406 TT6341.7205.50TWDU153.0-26%14.913.611%1.32.22.11.611%

24、3.7%46%UVB3218 TT1591.962.70TWDO120.091%15.712.536%0.42.92.52.718%3.8%-40%Pegavision6491 TT4071.2174.50TWDNRNRNA22.017.53%6.33.42.9NANA1.0%NABioteque4107 TT2782.1121.00TWDNRNRNA14.4NAnmfNA3.8NA3.424%4.0%NAPahsco4126 TT1610.473.00TWDNRNRNA14.513.319%0.82.22.11.813%5.5%NAUOC4129 TT1140.142.50TWDNRNRNA

25、36.0NAnmfNA1.2NANANANANA*MicroPort 2019-21E EPS CAGR based on reported numbersPricing date: 10 January 2020. Data for not-rated stocks is Bloomberg consensus. Source: Bloomberg, Macquarie Research, January 2020We see 40% and 24% share price upside for AK and Weigao, thanks to rising orthopaedic dema

26、nd from agingpopulation.For ophthalmic, we seeUVB be a key beneficiary of rising presbyopia and cataract, with 91%upside to TPHidden beneficiaries of aging populationAlong with aging population trends, we see investment opportunities in two segments in the Greater China Med Device space: 1) Orthopae

27、dic segment, especially for joint implant devices, and 2) Ophthalmic segment, on rising presbyopia and cataract demand. We look for industry leaders in the respective segments that can benefit from the rising demand.For the orthopaedic segment, we initiate coverage on AK Medical (AK), the largest do

28、mestic joint brand in China, with an Outperform rating and 40% upside. We also reiterate our Outperform on Shandon Weigao, the largest ortho domestic brand in China, and lift our TP of to HK$11.20, implying 24% upside.For the ophthalmic segment, we initiate coverage on Universal Vision Biotech (UVB)

29、, the largest eye clinical chain in Taiwan, with an Outperform rating and 91% upside.AK Medical (1789 HK, initiate with OP, TP HK$14.6) The largest domestic joint brand in China and a pioneer in 3D printing in the ortho market, with highest earnings growth among ortho peers Benefit from aging popula

30、tion trend, import substitution, and share gain from smaller players amid tighter regulations Attractive valuation, trading at 30.0/22.0 x 2020/2021E PER, or 0.7x PEG, compared with 42.0/33.4x PER and 1.9x PEG of China Med Device peers Under-researched; there are only one foreign broker and three do

31、mestic brokers covering AK Medical, according to Bloomberg. Our 2019-2021E EPS are 15%, 21% and 26% higher than Bloomberg consensus.Universal Vision Biotech (1789 HK, initiate with OP, TP NT$120) The largest eye clinical chain in Taiwan, and the only brand offering a total solution across optometry

32、and clinical services with scale Benefit from rising demand of presbyopia and myopia LASIK and OK lens, on an aging population and heavier smartphone usage A market consolidator in a fragmented market, supported by superior service and brand value Cheap valuation, trading at 15.7/12.5x 2020/2021E PE

33、R, or 0.4x PEG, compared with 64.9/49.7x PER and 2.2x PEG of Greater China Ophthalmic peers Under-researched; Macquarie is the only broker covering UVB after our initiation, according to BloombergShandon Weigao (1066 HK, OP, lift TP HK$11.2) The largest consumables and the largest domestic orthopaed

34、ic medical brand in China Strong orthopaedic sales growth thanks to rising market demand and import replacement Consumable growth better than expected, thanks to market consolidations on tighter regulations Cheap valuation trading at 15.7/13.8x 2020/2021E PER, with 19% earning CAGR over 2019-2021E,

35、compared with 42.0/33.4x 2020/2021E PER of China Med Device peersWe see AK Medical and Weigao to be the key beneficiaries of the strong orthopaedic demand amid aging population trend.Strong Ortho demand growth in ChinaAccording to a United Nations 2019 report, the aging population (65 years old) in

36、China is estimated to grow to 17% of the total population by 2030E, up from 12% in 2018A. Joint implant device demand in China has been growing at 15-20% in the past 5-10 years, outpacing the overall China healthcare spending CAGR of 13%, given rising demand from elders. Domestic brand revenue growt

37、h is even stronger at 20-40% pa in the past 2-3 years thanks to import substitution.We expect the Ortho demand to continue to grow 15% in the next 5-10 years, especially in the joint segment. It is interesting to note that joint accounts for 54% of total Ortho demand globally, while its only 32% in

38、China in 2018, implying more segment growth upside. Joints import replacement potential is also the highest, as 70-80% of the market is still occupied by foreign brands, compared with 60% of Spine and 30% of Trauma.Among the five key listed domestic orthopaedic implant device suppliers, AK Medical,

39、the largest joint brand, has highest projected earnings growth and ROIC, thanks to its high exposure to the joint segment, where entry barriers are higher, and its leading technology in 3D-printed Ortho products. Weigao is the largest domestic Orthopaedic brand in China in terms of sales and has the

40、 broadest product portfolio across joint, spine and trauma. We expect both AK and Weigao to be key beneficiaries of the strong orthopaedic demand growth given the aging population trend in China.Fig 4 China orthopaedic implant peers overview comparisonTotal sales,OrthoOrtho sales,Domestic Domestic o

41、rtho2018 domestic salesDomestic ortho2018%2018%sales, 2018JointSpine TraumaOther2sales YoY4Company TickerRMBm2018RMBm2018RMBmRMBmRMBmRMBmRMBm20181H19Weigao11066 HK8,80913%1,18195%1,1221685723146736%30%MicroPort3 853 HK4,44135%1,5658%11911900031%53%AK Medical 1789 HK60198%58985%5014731001843%56%Doubl

42、e1,5002901 CH77290%69592%638171414542629%24%Chunli11858 HK498100%49896%480467130070%76%1. For Weigao, Double, and Chunli, the whole companys regional breakdown was used to calculate domestic % of orthopaedic sales. 2. For Double the Other segment is neurosurgery. 3. Besides joint, MicroPort also has

43、 spine and trauma products with very small contribution and breakdown is not available. 4. All top line growth excludes impact of acquisition. 5. Doubles sales YoY is 24% in 1H19 and 28.5% in 9M19 excluding two invoice effect; report sales grew 54% YoY in 1H19 and 69% YoY in 3Q19;.Source: Company da

44、ta, January 2020Fig 5 China orthopaedic implant peers profitability comparisonCompany TickerMkt Cap US$mRecOrtho EBIT margin, % 2018A2019E2018AROIC, % 2019E2018AROE, % Recurring profit CAGR, % 2019E2015-18A2019-21EWeigao11066 HK5,264O30%33%11%11%13%13%12%19%MicroPort1, 2853 HK1,916O-3%-9%5%5%-5%2%nm

45、f43%AK1789 HK1,410O28%31%51%50%26%25%32%42%Double002901 CH3,504NR56%42%53%41%25%27%25%31%Chunli1858 HK973NR24%19%56%63%18%22%27%17%Total/ avg13,06731%28%29%26%15%17%17%21%1. Used ortho segment EBIT of Weigao and MicroPort. 2. MicroPort reported a net loss in 2014-15 and 2018; 2019-21E based on repor

46、ted EPS CAGR.Source: Company data, Bloomberg, Macquarie Research, January 2020, Market cap pricing date: 10 January 2020. Estimation for non-rated names based on Bloomberg consensus.Fig 6Aging population % (65 years old) in ChinaFig 7 Orthopaedic market by segment, 2018 m ppl 25020015010050199 0199

47、1199 2199 3199 4199 5199 6199 7199 8199 9200 0200 1200 2200 3200 4200 5200 6200 7200 8200 9201 0201 1201 2201 3201 4201 5201 6201 7201 82030E018%16%14%12%10%8%6%4%100 %90%80%70%60%50%40%30%20%10%0%32%53%33%26%35%20%ChinaGlo balTota l a ging popu latio nAgin g p opula tion %Source: National Bureau of

48、 Statistics of China, United Nations, Macquarie Research, January 2020Trauma Spin e JointSource: Sanyou, Double, Orthoworld, Macquarie Research, January 2020Fig 8China orthopaedic implant market size and YoYFig 9 Market share of local vs. foreign brands by segments in China, 2018 RMBm 35,00030,00025

49、,00020,00015,00010,0005,0000TraumaSpineJointYoY25%20%15%10%5%0%100%90%80%70%60%50%40%30%20%10%0%JointSpineTrauma DomesticForeignSource: Sanyou, Double, Macquarie Research, January 2020Source: Blue Book of medical device industry in China (2019), MacquarieResearch, January 2020Fig 10 China orthopaedi

50、c market share (value), 2018EFig 11Domestic ortho revenue CAGR in China, 2015-18 WeigaoDoubleAK medicalChunliMicroOthersForeign brandPort40%35%30%25%20%15%10%5%0%Source: Company data, Blue Book of medical device industry in China (2019), Macquarie Research, January 2020*Exclude JRI acquisition impac

51、t of AK.Source: Company data, Macquarie Research, January 2020We see UVB to benefit from rising presbyopia and cataract surgery amid the aging population trend inTaiwan.Presbyopia hit at earlier ages in TaiwanTaiwans aged population (65 years old) reached 14.3% in 2018 from 10.4% in 2008 and will ri

52、se to 23.9% by 2030, according to estimates from the Graduate Institute of National Development. In addition to rising presbyopia medical demand in light of the aging population, the heavier usage of electronic devices, such as smart phones, has also led to earlier onset of presbyopia (as early as 3

53、5 years old).Along with an aging population, the number of ophthalmic patients in Taiwan grew from 6.5m in 2012 to 7.1m 2018, 30% of the total population, and eyecare medical spending paid by national insurance in Taiwan has grown at a 5% CAGR in the past six years, accounting for 4% of total medica

54、l spending in 2018.Its also interesting to see the average eyecare medical spending per person grew 2.8% CAGR to NT$5,169 in 2018 in the bracket above 65 years old and 2.7% CAGR to NT$2,956 in the bracket of 55-64 years old, higher than that of NT$2,229 of the average eyecare medical spending in Tai

55、wan. The data shows older patients tend to spend more on eyecare medical services, and their spending per person is also on the rise, implying elder patients are also willing to pay higher price for better services year by year.We expect UVB to be a key beneficiary given its leading position in eye

56、surgery services. We expect UVBs recurring earnings to grow 36% CAGR over 2019-2021E, on rising demand for high- end services and share gains in a fragmented segment.Fig 12 Taiwan eye clinic chain peer comparisonChainUVBDr EyeIQLASIKEyePlus*NobelSunmingB&BDr. TungNumber of stores, 20194410655432Clin

57、ic2210655432Optometry441010NAFS Cataract-Surgery60-1007070-8065NA60-70IOL (Aspherical myopia)30-4020-40304015-20NANA29-33IOL (Myopia + astigmatism)40-5045-50454521-25NANA43IOL (Myopia + presbyopia)60-10090608530-42.5NANA60-89IOL (Myopia + astigmatism80-100110NA12045-62.5NANA120+ presbyopia)*EyePlus

58、borrows IQLASIKs equipment to perform FS LASIK surgeries for patients with myopia and presbyopia problem, charging NT$30k per eye. Source: Company data, Macquarie Research, January 2020Fig 13Aging population and % of total populationFig 14Taiwan eyecare medical spending, aged 55 vs total; Aged 55 %

59、of total eyecare patient, 2012-2018 ople2019-2030E:Aging growth: 4.2%2001-2018:Aging growth: 3.3%000 pe6,0005,0004,0003,0002,0001,000025%23%21%19%17%15%13%11%9%7%5%TW aging people (000 people)TW aging population % (RHS)NT$m* 16,00014,00012,00010,0008,0006,0004,0002,00002012201320142015201620172018Ag

60、ed 55, eyecare spending Total eyecare, spendingAged 55 % of total eye care patient37%36%35%34%33%32%31%30%29%28%Source: National Development Council, Macquarie Research, Jan 2020*Assume 1 relative value unit = NT$1.Source: Ministry of Health and Welfare, Macquarie Research, January 2020Fig 15 Taiwan