Healthy Profits Part 2 - identifying opportunities

 In Healthy Profits Part 1, we introduced the theme of health in our investments, and explored how this can be a significant financial factor for investors.  We looked at risks in Part 1, and in Part 2 we turn our attention to the opportunities.

Opportunities can be found in both specific companies which are capitalising on emerging health themes to generate returns for investors, as well as companies which are more broadly contributing to better health for all, which in turn benefits the global economy. 

As a large, diversified investor, we benefit from macroeconomic trends as well as from the specific companies in which we invest.

Investing directly in healthcare

As at 31 Dec 2023, WPF held shares in 135 different healthcare companies, at a total value of £150m!  You can learn more about which companies these are via our transparency tool. The largest such holdings at this time were Novo Nordisk (approx. £14m) and UnitedHealth Group (approx. £14m).

Novo Nordisk (WPF holding approx. £14m)

Novo Nordisk is a Danish pharmaceutical company, with a focus on diabetes care medications and devices.  Novo Nordisk is the manufacturer of Ozempic and Wegovy, traditionally intended as diabetes medications, demand for these drugs has skyrocketed perhaps in part due to celebrities and influencers using them for weight loss. 

This has been significant for Novo Nordisk - recent financial information showed these two drugs as having grown to be over half of the company's revenue, and strong stock performance off the back of this trend has led to the share price increasing by 70% over the last year! 

However, this has lead to shortages of Ozempic which are predicted to persist well into 2024.  This concerned us, as although we are impressed at the financial performance, is this detracting from delivering positive health outcomes for diabetes sufferers, and could that imply that these returns are not sustainable?  We asked our managers for more information.

We were reassured to learn that the although the current shortages are impacting diabetes patients, this is seen as a short-term issue, with the company taking steps to address this with increased production facilities.  We also learned that in spite of the noise in the press, the vast majority of patients for both Ozempic and Wegovy are not from high socio-economic groups, and that the average BMI of patients taking these drugs is considered "obese", therefore the drug is almost entirely being used to deliver better health outcomes and not just aesthetic purposes.

We also enquired about the sustainability of Novo Nordisk's expansion, and whether there was a threat from new entrants to the market.  Our managers felt that although competitors will develop similar products, this is still several years away, and that as Novo Nordisk is only currently treating a small percentage of the potential pool of patients and has also demonstrated an ability to switch capacity between different business areas, this risk is well managed.

We were also interested to learn about an initiative championed by the company: Preventing childhood overweight and obesity (novonordisk.com)

UnitedHealth Group (WPF holding approx. £14m)

UnitedHealth is a US health insurance company.  The company's mission is:

"to help people live healthier lives and help make the health system work better for everyone". 

Their sustainability report discusses their goals to improve health equity, but we wanted to understand how meaningful this can be within the environment in which they are operating, i.e. one with no national health service and significant wealth inequality (the US has the highest income inequality in the developed world). 

We asked our managers for their insights and were pleased to learn that UnitedHealth's customer base includes large national US employers and state programmes which target those without private insurance.  They also have a division that provides insurance to customers aged 65+, a demographic which finds it hard to access affordable insurance.  This demonstrates that the company is making a positive contribution to society.

In addition, we learned that UnitedHealth's Optum division is using AI and vast amounts of healthcare data, including information from patients, professionals, and pharmaceuticals, to enhance healthcare quality and efficiency. With a size five times larger than any competitor in healthcare technology coupled with significant market share in healthcare insurance, this places UnitedHealth in a unique position to potentially drive substantial improvements in the US healthcare sector as a whole.

Conclusion

Identifying opportunities within the health sector reveals a landscape rich with potential for investors who are keen to support and capitalise on advancements in healthcare and well-being. The examples of Novo Nordisk and UnitedHealth Group illustrate the diverse avenues through which investments can contribute to public health outcomes while also earning returns. The challenges and sustainability considerations highlighted above underscore the importance of a balanced approach, ensuring that financial gains can come from the delivery of equitable health access and outcomes.