麦格理互联网服务业医疗参与创作

1、Please refer to page 76 for important disclosures and analyst certification, or on our website.26 August 2019ChinaEQUITIESChina Internet HealthcarePresent at the CreationKey points Chinas Internet and insurance giants have a decade-long structural opportuto address the challenges of the socialist he

2、althcare system. We think new policies in the next six months should accelerate growth for the disruptors. We initiate coverage of Ping An Good Doctor (PAGD) with 34% TSR and AliHealth with 27% TSR.Accessibility and affordability the two pain pointsSkeptics on this sector point out that neither PAGD

3、 nor Alihealth is likely to make a profit for at least 3 years. We think this misses the enormous growth opportunities for this sector from solving two major pain points: 1) accessibility - limited healthcare resources and overworked and understaffed healthcare facilities; and 2) affordability - hea

4、lthcare expenses grew at 13% annually over 2013-18, considerably faster than the 9% CAGR in disposable income. This is especially worrisome in the context of funding pressure for social healthcare insurance backed by government and enterprises. In order to spend an average of 8 minutes with doctors

5、on diagnosis, patients need to spend 3 hours in traffic and waiting. Further, an ordinary householdcan spend up to 9% of its annual expenditures on healthcare. There two bottlenecks are only getting tighters rapidly-aging society; over a quarter of the population will be 60 years or older by 2030.So

6、cialist healthcare system ripe for disruptionThe Internet is disrupting various parts of the value chain of Chinas healthcare market by: 1) enhancing the efficiency of healthcare services with advanced technologies, such as online medical consultation PAGD is a pioneer in the market and could achiev

7、e a significant monetization potential; and 2) enabling end-to-end drug & service distribution channels. Meanwhile, AliHealth is expanding its GMV rapidly, with its extensive experience in e-commerce retailing and well-educated user base.New policies should accelerate growth going forwardTwo importa

8、nt new policies should be positive for the sector. On 31 July 2019, National Healthcare Security Administration (NHSA) of China announced that the pricing guideline for online healthcare will be released before the end of September 2019. This means online healthcare services will soon be included in

9、 the coverage of social healthcare insurance plan. In addition, new measures on online drug sales are expected to be released before the end of 2019, where online prescription drug sales will be conditionally allowed.Outperform rating on the two market leadersWe initiate coverage on PAGD (1833 HK) a

10、nd AliHealth (241 HK) with 34% and 27% upside, respectively. We think first-mover advantage is very real in this industry, given high entry barriers. We like PAGD for its: 1) disruptive business m, which could potentially reshape the healthcare industry value-chain; and2) positive impact from new po

11、licies. We like AliHealths straightforward business m, which will continue to benefit from improving online penetration and more online-offline integration. Risks associated with both stocks include regulatory risks, execution risks, and related-party transaction risks.Internet Healthcare CompsCompa

12、nyTickerRatingPriceTP UpsidePAGD1833 HK OP48.35 65.0034%AliHeal h241 HKOP7.329.3027%Source: Bloomberg, Macquarie Research, August 2019, Price as of 22 August 2019.CompanyRev Mkt Cap 3m ADTV52w price CAGR* (US$ bn)(US$ m) range (HK$)PAGD51%510.0AliHeal h68%10.09.827.452.3Source: Company data

13、, Macquarie Research, August 2019,*PAGD forecast period 2018-21E, AliHealth forecast period FY19-22E.InsideKey charts2Investment summary5Accessibility and affordability - two pain points6The Internet is disrupting healthcare market12New policies should drive even faster growth going forward19Ping An

14、 Healthcare and Technology(1833 HK)21Alibaba Health Information Technology(241 HK)48MacVisit: DHC Software70AnalystsMacquarie Capital LimitedJohn Wangjohn.wangFrank Chenfrank.chenEllie Jiangellie.jiang获取报告1、2、3、每周群内7+报告；当日华尔街日报、4、行研报告均为公开利归原作者所有，起点财经仅分发做内部学习。扫一扫关注 回复：加入“起点财经”群。Macquarie ResearchChin

15、a Internet HealthcareKey chartsFig 1 Per capita medical staff in different countriesFig 2 Time consumption for hospital visitsSource: OECD Stat, Macquarie Research, August 2019Source: Frost & Sullivan, Macquarie Research, August 2019Fig 3 Family doctor as % of all doctors across countriesFig 4 Uneve

16、n distribution of medical resourcesSource: OECD Stat, NBS of China, Macquarie Research, August 2019Source: NBS of China, Macquarie Research, August 2019Fig 5 PAGD traffic and monetization capability forecastFig 6 AliHealth Traffic and GMV forecastSource: Company data, Macquarie Research, August 2019

17、Source: Company data, Macquarie Research, August 201926 August 20192Macquarie ResearchChina Internet HealthcareFig 7Internet Healthcare Industry LandscapeSource: Company data, Frost & Sullivan, NBS of China, Macquarie Research, August 201926 August 20193Fig 8Major Internet Healthcare Players and Bus

18、iness InvolvementSource: Company data, Macquarie Research, August 2019, shaded blocks mean no business involvement.Macquarie ResearchChina Internet Healthcare26 August 20194Business LinesCommentsHealthcare ITOnline Medical ConsultationHealthcare E-commerceConsumer HealthcareNature of businessProvide

19、 healthcare software solutions, such as Hospital Information System, Clinical Information System, Electronic Health Record, etc.Provide medical consultations to online users, especially for primary care.Provide e-commerce platforms for healthcare- related merchandise including 1P m(self-operated sto

20、res) and 3P m (commission-based services)Referral service to offline consumer healthcare service such as health check-up, dental care, medical aesthetics, etc.Company NameTickerMarket Cap(US$ m)Last FY Revenue(RMB bn)DHC002065 CH3,0188.5 (1.1 inhealthcare)Leader in Top Hospital IT solutions (30% mar

21、ket share in Top100 hospitals)Tencent-backedWinning300253 CH3,4531.4Leader in Hospital IT solutionsAlibaba-backedNeusoft600718 CH1,9387.2 (1.7 inhealthcare)Leader in Hospital IT solutionsB-soft300451 CH1,6221.3Leader in Hospital IT solutionsPAGD1833 HK6,2123.3Acquired Wanjia Healthcare to provide cl

22、inic/pharmacy management softwareNo.1 with 10.6m MAU in 05/2019Rmb2.9bn Gross Merchandise Volume (GMV) in 2019 (primarily 1P)Rmb905m revenuePing An Group- backedChunyu Doctorunlistedn.a.n.a.No.2 with 2.2m MAU in May 2019DXYunlistedn.a.n.a.No.3 with 1.1m MAU in May 2019Started as a medical commuGood

23、Doctor Onlineunlistedn.a.n.a.No.6 with 0.6m MAU in 05/2019Tencent-backedAliHealth241 HK10,0055.1Invested in Jiahe Me kang and Jiamei Online to provide clinic information systemStarted to ramp-up online consultation from third party doctorsRmb59.5bn GMV in FY19 (4.2bn revenue in 1P, and 0.7bn revenue

24、 in 3P)Rmb128m revenueAlibaba-backedJD Healthunlistedn.a.n.a.Major player with B2B, 1P, and 3P msJD-backedWeDoctorunlistedn.a.n.a.Provide hospital online registration and online consultation from third party doctorsStarted to ramp-upTencent-backedSoYoungSY US1,5500.6Leader in the medical aesthetics

25、verticalTencent-backedMacquarie ResearchChina Internet HealthcareInvestment summaryThree reasons that Internet healthcare providers can achieve fast growth.1. Internet is the perfect solution for two pain pointss healthcare system.Chinas healthcare system is not only characterized by its lack of med

26、ical staffs but also by uneven distribution of medical resources among different regions and different types of medical services.Fig 9 Uneven distribution of medical resourcesFig 10 Healthcare as % of household spendingSource: NBS of China, Macquarie Research, August 2019Source: NBS of China, Macqua

27、rie Research, August 2019The ultimate solution is to improve the overall efficiency of the healthcare system so that everyone can get access to the most appropriate medical resources at a reasonable price. Internet technologies have come to help and start to solve these pain points in the healthcare

28、 system. Wefavour two types of business msonline hospital m, in which patients can consult with, in which patients can purchase s are led by PingAn Good Doctordoctors through an online platform, and online pharmacy mdrugs and healthcare-related products online. These two mand AliHealth, respectively

29、,.2. First-movers will gain more market share in the fast-growing Internet healthcare industry due to the Matthew Effect.The Internet healthcare industry is expected to grow at a 7-year CAGR of 31% to reach approximately Rmb136bn in market size by 2025 (Fig 42), according to Frost & Sullivan. In thi

30、s fast-evolving market, we expect the first movers to gain more market share due to the Matthew Effect: 1) the healthcare-related industry has a very high entry barrier due to regulatory scrutiny and compliance costs; 2) a certain threshold of scalability needs to be achieved in order to be profitab

31、le; and 3) accumulation of user data will help improve the user experience, which in return will attract more user traffic.3. Policy tailwind could trigger faster growth in the Internet healthcare industry.A year after the release of a guideline to promote Internet Plus Healthcare, the NationalHealt

32、hcare Security Administration commented on 31 July 2019 that social healthcare insurance will start to cover online healthcare services, and the policy will be released no later than theend of September. We expect the pro-Internetgovernment will continue to use Internettechnologies to reform the exi

33、sting low-efficiency healthcare system and invite private service providers to become an integral part of the healthcare market.26 August 20195Macquarie ResearchChina Internet HealthcareFig 11 Comps TableCompany NameBBGCodePrice (lcy)TP(lcy)Upside/ DownsideMacq RatingMkt CapPS(x) PE(x)EV/EBITA(x)(US

34、$m)201920202021201920202021201920202021Initiated stocksAliHealth241 HK7.329.3027%Outperform11,2342.6169.751.8636.9156.651.6PingAn Good1833 HK Doctor48.3565.0034%Outperform6,57-43.4-64.91233-33.9-48.6247Domestic peersE-commerce platformAlibaba JDPinduoduoBABA US JD US PDD US164.5

35、28.829.5NR NR NRNR NR NRNR NR NR428,39241,83134,275.03.72.627.834.3-74.731.120.524.559.122.516.218.021.0-39.620.715.414.4-1218.114.912.010.928.211.4Subsector Average*Internet servicesTencent Meituan Dianping 58.COMAutohome700 HK3690 HK334.2NRNRNR407,1327.56.04

36、.930.525.120.921.718.215.370.052.179.0NR NR 94.00NR NR 19%NR NROutperform51,7027,7399,3304.03.03.0-83.419.219.516.719.033.813.314.516.276414.315.717.235.911.813.114.417.09.811.612.2WUBA US ATHM USSubsector Average*Vertical e-commerceCtrip SoYoung Vipshop BabyTr

37、ee MogujieCTRP US SY US VIPS US 1761 HK MOGU US2.53.6NR NR NR NR NRNR NR NR NR NRNR NR NR NR NR17,7891,5135,2415403811.9-10.121.019.4-8.812.54.8-28.58.922.035.46.01.4-3.95.00.9-6.18.712.36.94

38、.80.9-59.66.2Subsector Average*Healthcare ITDHC Software 002065 CH6.8415.1211.0315.49NR NR NR NRNR NR NR NRNR NR NR NR3,0033,4611,9311,59021.959.231.741.238.517.944.424.730.729.416.332.820.554.135.932.834.613.537.924.724.325.1nmf 28.4nmf 19.9

39、24.1Winning Neusoft B-SOFT300253 CH600718 CH300451 CHSubsector AverageOffline pharmacy chainsLaobaixing Yixintang Yifeng Pharmacy DaShenLin603883 CH002727 CH603939 CH75.125.0NR NRNR NRNR NR3,0322,0040.222.332.918.226.615.324.614.320.012.216.510.378.252.9NR NRNR NRNR NR4,1743,8742.

40、1.71.451.733.730.930.327.825.034.323.924.326.620.019.721.716.916.4603233 CHSubsector AverageGlobal ex. China peers E-commerce platformAmazon eBay Rakuten Cafe24AMZN US EBAY US 4755 JP042000 KS1749.638.71012220042.00NR26%9% NR 45%OutperformNeutralNROutperform865,46032,4

41、6013,7735363.13.01.23.02.22.047.333.039.712.544.733.832.628.011.129.424.623.322.214.617.712.613.610.369200 100000Subsector AverageOnline Healthcare ServicesTeladoc M3 Inc.TDOC US 2413 JP56.12322.0NR NRNR NRNR NR4,03814,9467.412.710

42、.16.011.07.2-36.069.169.1-48.458.158.1-11050.450.4136.641.889.263.235.749.434.831.133.0Subsector Average*Healthcare IT Medidata Change Healthcare Cerner Corp Inovalon CompuGroup MedicalMDSO US CHNG US91.50NRNRNR5,749.043.022.314.4067.9315.64NR NR NRNR NR NRNR NR NR1,7

43、9821,6292,4nmf 25.433.19.321.428.08.919.124.1nmf 11.614.21.610.412.8CERN US INOV US COP GR51.75NRNRNR3,0683.84.03.323.032.620.924.520.421.516.019.314.813.814.612.3Subsector AverageOffline pharmacy chainsCVS Health WalgreensCVS US WBA US60.249.3NR NRNR

44、 NRNR NR78,34244,547.77.88.321.015.88.4nmf8.413.1Subsector Average Total Average*Source: Company data, Macquarie Research, August 2019, Price as of Aug 23 2019, * Negative values are not summed.26 August 20196Macqua

45、rie ResearchChina Internet HealthcareAccessibility and affordability - two pain pointsUnder-invested healthcare system that supports an aging societyTremendous success has been achieved by Chinas healthcare system to increase life expectancy, from 66.8 years in 1980 to 76.4 years in 2017, according

46、to the World Bank. However, China is now facing a challenge in healthcare for the aging population. According to the National Health Commission of China, the percentage of population above 60 years old has increased from 10.3% in 2000 to 13.3% in 2010 between two national censuses, while the number

47、is expected to reach to 17.8% in 2020 and further increase to 34.9% in 2050.Fig 12 Life expectancyFig 13 Percentage of population 60 years oldSource: National Health Commission of China, Macquarie Research, August 2019Source: World Bank, Macquarie Research, August 2019To address the increasing deman

48、d for healthcare services, China has been investing abundantly in the healthcare system. A total of Rmb5.8 trillion has been spent on healthcare nationwide in 2018. Government spending and social spending (primarily employers) are taking the lead to pay for the increasing healthcare services, and re

49、corded a 10-year CAGR of 16% and 17% respectively over2008-2018. As a result,al spending, primarily in the form of out-of-pocket spending andcommercial health insurance, contributed only 29% of total healthcare spending in 2018, 11ppts lower than in 2008.Fig 14 Breakdown of total spending on healthc

50、areSource: National Bureau of Statistics of China, Macquarie Research, August 201926 August 20197Macquarie ResearchChina Internet HealthcareDespite the increasing share of healthcare spending from total government spending, which increased from 5.7% in 2008 to 7.5% in 2017, the relative healthcare s

51、pending as a percentage of GDP is low comparing to other countries. The United States, known for its expensive healthcare system, spent 16.9% of GDP on healthcare in 2017, while the developed nations, such as Japan and Korea spent between 8-11% of their GDP on healthcare in 2017. In contrast, China

52、only spent 5.0% of its GDP on healthcare in 2017.Fig 15 Percentage of govt spending on healthcareFig 16 Healthcare spending as percentage of GDP (2017)Source: National Bureau of Statistics of China, Macquarie Research, August 2019Source: OECD Stat, Macquarie Research, August 2019Accessibility and af

53、fordability are two bottleneckss healthcare systemThe under-investedhealthcare system has two major pain points for its usersaccessibility and affordability.AccessibilityFig 17 Medical staff per 1000 population (as of end-2018)Fig 18 Hospital beds per 1,000 population (as of end-2018)Source: OECD Stat, Macquarie Research, August 2019Source: OECD Stat, Chyxx,