Market View

The U.S. market is in an Uptrend Under Pressure. The S&P 500 and Nasdaq broke below their respective 50-

DMA, staging multiple downside reversals to eventually close near the lows of the week. The S&P 500 is nar-
rowly holding above 100-DMA (4,491) support before price support at ~4,430. The Nasdaq is now 7% off

highs and sitting on its 100-DMA (15,082). The next level of price support is ~14,755 before the rising 200-
DMA (14,411). The distribution day count stands at three each with no expiration next week.

Market View

The U.S. market remains in a Confirmed Uptrend. The S&P 500 and Nasdaq pulled back sharply this week, with both closing below their respective 21-DMA. The next level of support is September highs at 4,545 and 15,403, respectively, which may also coincide with the rising 50-DMA. The distribution day count remains low at three and one, respectively, with one day expiring on the S&P 500 next week.

Market View

The U.S. market remains in a Confirmed Uptrend. The S&P 500 and Nasdaq are trading at or near all-time

highs and above 10- and 21-DMA support. The distribution day count remains low at three and one, respec-
tively, with one day expiring on the Nasdaq next week.

IQVIA Holdings

Key points from this report:

 

  • Buy IQVIA: The stock is breaking out from a 10-week flat base in heavy volume into all-time highs.
  • Upbeat medium-term outlook: On November 16, the company hosted its investor day and announced a new medium-term outlook through 2025. Revenue, EBITDA, and EPS are expected to grow 11%, 12%, and at a double-digit CAGR through 2025, respectively. Consensus expects 8–10% revenue growth and double-digit earnings growth. 2022 guidance assumes revenue and earnings growth of 8% and 13%, respectively, which is likely conservative given that this is their initial guide.
  • Strong backlog: TAM of $67B: New clinical trials are up 23% versus 2020 and 13% above 2019 levels, with 85% of sites now accessible. The global CRO target opportunity is expected to have a 6% CAGR through 2025 to reach $67B. IQVIA has a backlog of $24.4B (+13% y/y), of which $6.9B is expected to convert to revenue in the next 12 months.
  • Dominant position in the $130B addressable healthcare information market: IQVIA estimates the total addressable market for healthcare information and technology enabled commercial operations is worth $130B. IQVIA has one of the world’s largest and most comprehensive collections of healthcare information. This database sharpens IQVIA’s competitive edge to win large contracts at premium pricing.
  • Next catalyst: Q4 results are expected in February 2022.

IPO Rewind

Winners (annualized gain of 30% or greater)
• Median market cap at IPO was 38% higher than the median market cap of losers.
• Median revenue growth was similar to losers a year before IPO. However, the revenue growth decline is less than losers.
• Two-thirds of winners were losing money a year before IPO, but nearly two-thirds are improving toward profitability after the IPO.

U.S. Elective Surgery

Key points from this report:

 

  • Recovery expected in surgeries: Overall admissions and surgeries are running at 90% and 91% of pre-pandemic levels, respectively. Though the Delta variant did cause a sequential slowdown, surgeries are expected to recover in Q4 and into 2022.
  • New COVID-19 antiviral pills: Pfizer and Merck have presented data that can reduce the risk of hospitalization by 89% and 50%, respectively. Both studies saw all high-risk patients recover with no deaths. The U.S. FDA advisory committee will give their views on emergency use authorization of Merck’s pill by the end of November.
  • Reopening beneficiaries: Though elective surgery ideas were negatively impacted in Q3 by the Delta variant, results were better than feared. Management commentaries are positive heading into Q4 with sequential growth expected.
  • High COVID-19 exposure: The majority of leading ideas through Q3 came from Tools and Bioprocessing as they were benefiting from vaccine production. We believe Avantor (AVTR), Bio-Rad (BIO), Catalent (CTLT), Danaher (DHR), and Repligen (RGEN) need time to digest major moves higher earlier this year. Look for all to remain above their rising 200-DMA to remain constructive long term.
  • Elective surgery/reopening ideas: We believe the following ideas can beat Q4 consensus: ABMD, ALGN, CNMD, DXCM, EW, GMED, INMD, INSP, ISRG, NVST, PCRX, PEN, PGNY, PODD, SYK, TNDM.

Market View

The U.S. market remains in a Confirmed Uptrend. The S&P 500 and Nasdaq found support near their respective
10-DMA, eventually closing ~1% off all-time highs for the week. Support below this level remains the rising 21-
DMA (S&P 500: 4,603; Nasdaq: 15,515). The distribution day count remains low at three and one, respectively.