Healthcare & Life Sciences Industry Update...08/22/12 08/22/12 Wright Medical Group Inc WMGI...
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www.harriswilliams.com Member FINRA/SIPC Healthcare & Life Sciences Industry Update September 2012
Transcript of Healthcare & Life Sciences Industry Update...08/22/12 08/22/12 Wright Medical Group Inc WMGI...
www.harriswilliams.com
Member FINRA/SIPC
Healthcare & Life Sciences Industry Update
September 2012
What We’ve Been
Reading
September 2012
1
• In an article published in The New Yorker titled “Big Med,” Dr. Atul Gawande compares
the need for standardization while reducing costs in medicine to the accomplishments of
casual dining restaurant chains like the Cheesecake Factory. He contrasts the generally
reliable levels of food quality delivered at these restaurants for well-defined prices to the
U.S. hospital system’s tendency to deliver highly variable quality while charging a wide
range of (often high) prices for the same services. The article is tongue-in-cheek, but the
discussion around the need to gain scale, standardize processes, and measure quality are
very real and relevant to the current challenges facing U.S. hospitals.
• In early September, the Institute of Medicine (IOM) released its report, “Best Care at
Lower Cost.” The report suggests that the U.S. healthcare system is performing far short of
its potential and continues unsustainable cost increases. For example, the report estimates
that $750 billion of U.S. healthcare expenditures are wasted and that one-third of the 40
million Americans hospitalized each year are harmed in the process. The solution, as
proposed by the report, is for the healthcare system to adopt practices already in use by
other industries. For example, the non-transferability of medical records between
practitioners can be remedied by mimicking online banking. The report goes on to discuss
practices that can be borrowed from other industries such as manufacturing or airlines.
• The Wall Street Journal published an article highlighting the tendency for physician groups
to raise their rates for the same services following acquisition by a larger hospital system.
As private physician practices are integrated into larger hospitals, they are able to bill their
services based on the reimbursement schedule the hospital has in place with insurers which
tends to be more generous than the arrangements they operated under previously. Insurers
and employers have cited the increased volume of practice acquisitions by hospitals as a
major driver in rising provider healthcare costs.
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Key Trading
Statistics
(detail begins
on page 6)
Equity Trading
Overview
September 2012
Public Company
Sector
Performance
(12-month %
change in stock
price)
Change in Stock Price
3 mos. 12 mos. Revenue EBITDA Revenue EBITDA
Clinical Laboratories 3 $8,147 6.3% 20.8% 1.7x 8.1x 1.7x 7.8x
Contract Pharma Manufacturing 5 870 53.9% 72.1% 1.5x 16.0x 1.5x 10.6x
Contract Research Organizations 5 1,596 7.6% 7.6% 1.2x 9.6x 1.1x 8.7x
Disease Management 2 3,014 31.1% (20.7%) 1.5x 7.5x 1.4x 8.0x
Emergency Services 1 2,027 27.9% 75.1% 2.6x 8.7x 2.4x 8.3x
Health Care Staffing 4 1,102 12.3% 52.6% 0.9x 11.9x 0.8x 11.2x
HMO - Medical 11 13,072 (2.6%) 14.3% 0.4x 6.1x 0.4x 6.8x
Information Services 12 2,241 5.6% 11.3% 2.6x 11.7x 2.8x 9.8x
Specialty Managed Care 2 1,648 2.1% (1.9%) 0.7x 5.5x 0.7x NA
Specialty Pharmacy Management 4 18,475 22.9% 21.2% 0.6x 8.8x 0.8x 10.0x
Dental Products 4 19,028 8.5% 12.7% 2.6x 11.1x 2.5x 10.4x
Durable Medical Equipment 4 2,265 4.5% (1.0%) 1.2x 6.2x 1.2x 7.3x
Life Sciences Tools 3 13,608 3.9% 0.8% 2.1x 8.4x 2.2x 8.1x
Medical Devices and Products 14 35,653 7.7% 6.7% 2.4x 9.1x 2.4x 8.7x
Medical / Surgical / Dental Supplies 7 8,686 2.2% (2.7%) 0.2x 7.6x 0.2x 7.1x
Acute-Care Hospitals 6 12,762 10.0% 4.2% 0.9x 6.3x 0.9x 6.2x
Assisted Living 7 1,648 31.6% 34.9% 2.0x 13.4x 1.6x 8.9x
Diagnostic Imaging 3 2,454 16.7% (6.7%) 1.4x 5.7x 1.6x 7.5x
Dialysis Services 2 22,426 14.1% 18.8% 2.1x 10.0x 2.0x 9.5x
Home Care / Hospice 6 601 20.5% 4.4% 0.5x 5.2x 0.5x 5.4x
Long-Term Care 4 969 25.4% 28.0% 0.6x 5.7x 0.6x 4.9x
Physician Practice Management 4 1,320 19.9% 8.1% 1.5x 8.4x 1.4x 7.9x
Psychiatric Hospitals / Management 3 2,248 3.1% (0.5%) 0.3x 6.1x 0.3x 6.3x
Surgicenters / Rehabilitation 4 2,149 9.8% 30.4% 1.6x 7.3x 1.5x 7.3x
Payer, Provider, & Pharmacy Support Services 49 $5,219 16.7% 25.2% 1.4x 9.4x 1.4x 9.0x
Products & Devices 32 $15,848 5.4% 3.3% 1.7x 8.5x 1.7x 8.3x
Provider-Based Services 39 $5,175 16.8% 13.5% 1.2x 7.6x 1.2x 7.1x
HW&Co. HCLS Composite Index 120 $7,417 14.4% 16.3% 1.4x 8.5x 1.4x 8.1x
S&P 500 7.3% 15.4%
Payer
, P
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& P
harm
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Su
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Ser
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Pro
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Median TEV/
Forward MulitplesSectorNumber of
Companies
Average
Enterprise
Value ($ mm)
Median TEV/
LTM Multiples
Emergency Services
Contract Pharma Manufacturing
Health Care Staffing
Assisted Living
Surgicenters / Rehabilitation
Long-Term Care
Specialty Pharmacy Management
Clinical Laboratories
Dialysis Services
HW&Co. HCLS Composite Index
S&P 500
HMO - Medical
Dental Products
Information Services
Physician Practice Management
Contract Research Organizations
Medical Devices and Products
Home Care / Hospice
Acute-Care Hospitals
Life Sciences Tools
Psychiatric Hospitals / Management
Durable Medical Equipment
Specialty Managed Care
Medical / Surgical / Dental Supplies
Diagnostic Imaging
Disease Management
(40.0%) (30.0%) (20.0%) (10.0%) (0.0%) 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0%
3
Healthcare &
Life Sciences
Industry Stock
Performance
Top 25 Equity
Offerings
(by proceeds)
Equity Markets
Overview
September 2012
37.1%
39.4%
30.2%
40
60
80
100
120
140
160
Aug-09 Nov-09 Feb-10 May-10 Aug-10 Nov-10 Feb-11 May-11 Aug-11 Nov-11 Feb-12 May-12 Aug-12
S&P 500 Dow Jones U.S Health Care Index HW&Co. HCLS Index
Closing Date Filing Date Issuer Ticker Transaction Type
Gross Proceeds
($mm)
08/22/12 08/22/12 Wright Medical Group Inc WMGI Convertible $300.0
08/09/12 08/06/12 Exelixis Inc EXEL Convertible 287.5
08/07/12 08/07/12 Isis Pharmaceuticals Inc ISIS Convertible 201.3
08/02/12 07/31/12 Idenix Pharmaceuticals Inc IDIX Follow-On 176.0
08/09/12 06/08/12 Exelixis Inc EXEL Follow-On 146.6
08/02/12 03/28/12 Globus Medical Inc GMED IPO 115.0
08/09/12 04/15/11 Infinity Pharmaceuticals Inc INFI Follow-On 88.4
08/14/12 08/14/12 Horizon Pharma Inc HZNP Follow-On 75.0
08/24/12 08/24/12 AP Pharma Inc APPA Follow-On 74.5
08/16/12 04/04/12 Fluidigm Corp FLDM Follow-On 60.0
08/01/12 02/12/10 MAP Pharmaceuticals Inc MAPP Follow-On 59.8
08/28/12 08/28/12 OvaScience Inc NA IPO 42.0
08/30/12 03/03/11 Achillion Pharmaceuticals Inc ACHN Follow-On 41.8
08/13/12 08/13/12 MRI Interventions Inc MRIC Follow-On 30.6
08/31/12 08/31/12 Cerus Corp CERS Follow-On 30.0
08/31/12 08/31/12 Oragenics Inc ORNI Follow-On 21.4
08/09/12 07/17/12 Sunshine Heart Inc SHC Follow-On 20.8
08/31/12 08/31/12 Cytomedix Inc CMXI Follow-On 20.4
08/02/12 05/01/12 Solta Medical Inc SLTM Follow-On 17.4
08/01/12 06/20/12 Zalicus Inc ZLCS Follow-On 14.6
08/24/12 08/24/12 NeoStem Inc NBS Follow-On 13.8
08/24/12 08/24/12 OncoSec Medical Inc ONCSD Follow-On 10.0
08/23/12 06/26/12 Alexza Pharmaceuticals Inc ALXA Follow-On 8.1
08/24/12 08/24/12 NeoStem Inc NBS Follow-On 7.7
08/31/12 08/31/12 AcelRx Pharmaceuticals Inc ACRX Follow-On 7.5
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Announced
Healthcare &
Life Sciences
M&A
Announced Healthcare & Life Sciences Transactions Median Healthcare & Life Sciences Transaction Multiples
PEG Investments and Exits PEG Investments by Segment (Last 3 Years)
Healthcare &
Life Sciences
M&A Trends
Announced
Private Equity
M&A Activity
Middle Market Healthcare Transaction Highlights Quarterly M&A Activity
LTM Deal Statistics
Note: Transactions based on publicly available information
223
278 279
255
225242
256267
245 236219
229
146
11
17 18
19
17
13
1816
1318
11
20
10
0
50
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3Q09 4Q09 1Q10 2Q10 3Q10 4Q10 1Q11 2Q11 3Q11 4Q11 1Q12 2Q12 3Q12
Nu
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PEG Acquirer Strategic Acquirer
$389.4
$194.1 $174.6
$110.6
$141.4
$86.1
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$0
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2007 2008 2009 2010 2011 2012 YTD
Nu
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$ i
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Aggregate Deal Value # of deals
15.5x 15.2x
7.7x
12.8x 11.1x
11.1x
0.0x
0.5x
1.0x
1.5x
2.0x
2.5x
3.0x
3.5x
4.0x
0x
3x
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21x
2007 2008 2009 2010 2011 2012 YTD
EV
/ LT
M R
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ultip
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/ L
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EB
ITD
A M
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TEV / LTM EBITDA TEV / LTM Sales
31
40
58
69
94
113
79
42
71
65
41
2327
40
60 62
95
49 50
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120
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140
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 YTD
Tra
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Number of Investments Number of Exits
HC&LS Industry Number of
Segment Companies
Biotechnology 3
Healthcare Technology 20
Healthcare Distributors 9
Healthcare Equipment 21
Healthcare Facilities 37
Healthcare Services 60
Healthcare Supplies 9
Life Sciences Tools & Services 12
Managed Healthcare 6
Pharmaceuticals 21
Aggregate Number Median Transaction Multiples
Value ($bn) of Deals TEV/Rev TEV/EBITDA
$124.2 963 2.09x 11.0x
Announced Target Buyer
8/31/2012 ConnectYourCare, LLC ABS Capital Partners
8/31/2012 180 Medical, Inc. ConvaTec Inc.
8/29/2012 Accugenix, Inc. Charles River Laboratories International
8/21/2012 Sunrise Senior Living Inc. Health Care REIT, Inc.
8/20/2012 IntegraCare Holdings, Inc. Kindred Healthcare Inc.
8/19/2012 Coventry Health Care Inc. Aetna Inc.
8/17/2012 Avid Health, Inc. Church & Dwight Co. Inc.
8/7/2012 InterDent, Inc. H.I.G. Capital, LLC
8/5/2012 Brighton Bay The Carlyle Group LP
8/2/2012 Octagon Research Solutions, Inc. Accenture plc
M&A Overview
September 2012
5
Key Credit
Statistics
Top Recent
Healthcare &
Life Sciences
Debt Offerings
(by deal amount)
Average Secondary Spread
Average Spread on Healthcare Loans
Credit Statistics
Quarterly Healthcare Loan Volume
Debt Markets
Overview
September 2012
L + 0
L + 200
L + 400
L + 600
L + 800
L + 1000
Av
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LIB
OR
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0.0x
2.0x
4.0x
6.0x
Debt/EBITDA Senior Debt/EBITDA EBITDA/Cash Interest EBITDA - Capex/Cash Interest
EB
ITD
A M
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__
2006 2007 2008 2009 2010 2011 2012 YTD
L + 0
L + 100
L + 200
L + 300
L + 400
L + 500
2006 2007 2008 2009 2010 2011 2012 YTD
Aver
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Sp
read
Over
LIB
OR
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Revolving Credit / Term Loan A Weighted-Average Institutional
$0
$3
$6
$9
$12
$15
$18
$21
$24
2Q06 4Q06 2Q07 4Q07 2Q08 4Q08 2Q09 4Q09 2Q10 4Q10 2Q11 4Q11 2Q12
Lo
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Pro Rata Institutional
Date Effective Borrower Name Description Tranche Amount ($mn) Type Rating Spread
08/21/12 DaVita Inc Kidney dialysis centers $1,350 Term Loan A B / B2 L+ 250
08/21/12 DaVita Inc Kidney dialysis centers 1,650 Term Loan B B / B2 L+ 300
08/22/12 Stryker Corp Surgical appliances and supplies 1,000 Revolver/Line >= 1 Yr. A+ / A3 L+ 88
08/13/12 Capsugel, Capsugel Financeco SCA Pharmaceutical preparations 875 Term Loan B BB- / B1 N/A
08/20/12 Immucor Inc Diagnostic substances 615 Term Loan B B- / Caa1 L+ 450
08/10/12 HealthSouth Corp Offices & clinics of medical doctors 600 Revolver/Line >= 1 Yr. BB- / B1 L+ 175
08/17/12 Warner Chilcott Corp Pharmaceutical preparations 300 Term Loan B NR / WR L+ 325
08/17/12 Warner Chilcott Corp Pharmaceutical preparations 300 Term Loan B NR / WR L+ 300
08/01/12 Haemonetics Corp Surgical and medical instruments 50 Revolver/Line >= 1 Yr. NR / NR L+ 138
08/01/12 Haemonetics Corp Surgical and medical instruments 475 Term Loan A NR / NR L+ 138
08/17/12 One Call Medical Offices & clinics of medical doctors 35 Revolver/Line >= 1 Yr. B+ / Ba3 L+ 575
08/17/12 One Call Medical Offices & clinics of medical doctors 415 Term Loan B B+ / Ba3 L+ 575
08/23/12 Trinity Health Corp Offices & clinics of medical doctors 200 Revolver/Line >= 1 Yr. NR / Aa2 L+ 56
08/29/12 Correct Care Solutions LLC Offices & clinics of medical doctors 25 Revolver/Line >= 1 Yr. NR / NR L+ 450
08/29/12 Correct Care Solutions LLC Offices & clinics of medical doctors 145 Term Loan A NR / NR L+ 650
08/10/12 Quidel Corp Surgical and medical instruments 140 Revolver/Line >= 1 Yr. NR / NR L+ 150
08/10/12 Fayette Regional Health System General medical & surgical hospitals 46 Standby Letter of Credit NR / NR N/A
Healthcare & Life Sciences Trading Statistics
September 2012
As of August 31, 2012 6
Payer, Provider, & Pharmacy Support Services Stock Price
% Change 52 Week8/31/2012 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Clinical LaboratoriesBio-Reference Laboratories Inc. $26.12 35.8% 29.1% $30.15 $11.41 $723 $24 $20 $727 $637 $88 $72 Jul-12 Oct-11 $662 $93 $76 1.1x 8.2x 1.1x 7.8xLaboratory Corp. of America Holdings 87.95 5.6% 5.3% 95.30 74.57 8,434 2,110 124 10,440 5,617 1,279 1,085 Jun-12 Dec-11 5,687 1,330 1,100 1.9x 8.1x 1.8x 7.8xQuest Diagnostics Inc. 60.47 6.3% 20.8% 63.98 45.13 9,600 3,823 174 13,275 7,629 1,647 1,358 Jun-12 Dec-11 7,636 1,640 1,350 1.7x 7.9x 1.7x 8.1xNumber of Companies 3 Median: 6.3% 20.8% Total $18,757 $8,147 $13,883 $13,985 1.7x 8.1x 1.7x 7.8x
Mean: 15.9% 18.4% $8,147 1.6x 8.1x 1.6x 7.9x
Contract Pharma ManufacturingAkorn, Inc. $13.84 1.4% 72.1% $16.87 $7.10 $1,316 $103 $24 $1,394 $194 $64 $56 Jun-12 Dec-11 $261 $95 $84 7.2x 21.8x 5.3x 14.6xCambrex Corporation. 12.18 69.4% 145.1% 12.96 4.40 361 81 22 420 274 57 35 Jun-12 Dec-11 275 59 37 1.5x 7.5x 1.5x 7.1xIntegrated Biopharma Inc. 0.20 248.2% 143.8% 0.33 0.02 4 13 1 16 23 1 1 Mar-12 Jun-11 NA NA NA 0.7x 16.0x NA NA Patheon Inc. 2.78 53.9% 69.8% 3.02 1.10 359 317 35 655 721 52 9 Jul-12 Oct-11 727 53 20 0.9x 27.8x 0.9x 12.4xWest Pharmaceutical Services, Inc. 47.35 (0.9%) 18.0% 51.82 35.50 1,612 386 107 1,865 1,230 214 139 Jun-12 Dec-11 1,243 212 132 1.5x 8.5x 1.5x 8.8xNumber of Companies 5 Median: 53.9% 72.1% Total $3,652 $870 $2,442 $2,506 1.5x 16.0x 1.5x 10.6x
Mean: 74.4% 89.8% $870 2.4x 16.3x 2.3x 10.7x
Contract Research OrganizationsAlbany Molecular Research Inc. $3.33 28.6% (4.6%) $3.65 $2.08 $103 $8 $13 $97 $201 $10 ($8) Jun-12 Dec-11 $209 $26 $8 0.5x 9.6x 0.5x 3.8xCharles River Laboratories International, Inc. 36.32 8.8% 9.7% 37.56 25.52 1,770 686 76 2,375 1,139 265 183 Jun-12 Dec-11 1,142 267 197 2.1x 8.9x 2.1x 8.9xCovance Inc. 47.79 3.0% (3.6%) 53.02 42.02 2,633 330 398 2,565 2,149 303 195 Jun-12 Dec-11 2,168 303 189 1.2x 8.4x 1.2x 8.5xICON Public Limited Company 22.92 6.8% 7.6% 25.03 15.03 1,370 0 95 1,202 1,013 78 36 Jun-12 Dec-11 1,094 115 72 1.2x 15.3x 1.1x 10.5xPAREXEL International Corporation 28.79 7.6% 41.3% 29.42 17.56 1,733 220 214 1,740 1,397 161 95 Jun-12 Jun-12 1,647 200 134 1.2x 10.8x 1.1x 8.7xNumber of Companies 5 Median: 7.6% 7.6% Total $7,608 $1,596 $5,898 $6,260 1.2x 9.6x 1.1x 8.7x
Mean: 10.9% 10.1% $1,596 1.2x 10.6x 1.2x 8.1x
Disease ManagementAlere Inc. $18.78 2.2% (24.8%) $27.22 $17.13 $1,516 $3,559 $304 $5,380 $2,609 $607 $187 Jun-12 Dec-11 $2,774 $596 $488 2.1x 8.6x 1.9x 9.0xHealthways Inc. 10.48 60.0% (16.6%) 12.31 5.59 351 299 1 649 692 101 51 Jun-12 Dec-11 687 93 41 0.9x 6.4x 0.9x 7.0xNumber of Companies 2 Median: 31.1% (20.7%) Total $1,867 $3,014 $3,300 $3,461 1.5x 7.5x 1.4x 8.0x
Mean: 31.1% (20.7%) $3,014 1.5x 7.5x 1.4x 8.0x
Emergency ServicesAir Methods Corp. $116.54 27.9% 75.1% $119.33 $56.17 $1,502 $553 $28 $2,027 $792 $232 $151 Jun-12 Dec-11 $839 $245 $160 2.6x 8.7x 2.4x 8.3xNumber of Companies 1 Median: 27.9% 75.1% Total $1,502 $2,027 $792 $839 2.6x 8.7x 2.4x 8.3x
Mean: 27.9% 75.1% $2,027 2.6x 8.7x 2.4x 8.3x
Health Care StaffingAMN Healthcare Services Inc. $8.40 40.0% 52.5% $8.41 $3.60 $343 $194 $15 $546 $913 $61 $46 Jun-12 Dec-11 $935 $65 $51 0.6x 9.0x 0.6x 8.4xCross Country Healthcare, Inc. 4.05 (10.8%) (17.8%) 6.73 3.76 125 36 6 154 509 15 5 Jun-12 Dec-11 511 14 3 0.3x 10.3x 0.3x 11.3xOn Assignment Inc. 16.51 (0.9%) 117.2% 19.37 6.27 858 467 18 1,307 774 76 66 Jun-12 Dec-11 1,217 118 102 1.7x 17.1x 1.1x 11.0xTeam Health Holdings, Inc. 28.55 25.5% 52.8% 28.85 15.08 1,899 518 14 2,404 1,891 178 142 Jun-12 Dec-11 2,035 206 148 1.3x 13.5x 1.2x 11.7xNumber of Companies 4 Median: 12.3% 52.6% Total $3,225 $1,102 $4,087 $4,698 0.9x 11.9x 0.8x 11.2x
Mean: 13.5% 51.1% $1,102 1.0x 12.5x 0.8x 10.6x
TEV/ LTM MultiplesEquity Mkt. Value
Total Debt Cash and Equiv.
Total Ent.
Value (TEV)
Lastest Twelve Months (LTM)
TEV/ Fwd MultiplesForward EstimateCompany Name LTM
PeriodLastest
FYE Date
Healthcare & Life Sciences Trading Statistics
September 2012
As of August 31, 2012 7
Payer, Provider, & Pharmacy Support Services Stock Price
% Change 52 Week8/31/2012 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
HMO - Medical
Commercial:Aetna Inc. $38.41 (6.1%) (4.0%) $51.14 $33.43 $12,839 $4,706 $922 $16,624 $34,799 $3,677 $3,218 Jun-12 Dec-11 $35,571 $3,297 $2,782 0.5x 4.5x 0.5x 5.0xCigna Corp. 45.77 4.2% (2.1%) 49.89 38.79 13,198 5,222 3,045 15,375 25,325 2,483 2,221 Jun-12 Dec-11 28,835 2,946 2,457 0.6x 6.2x 0.5x 5.2xCoventry Health Care Inc. 41.63 36.9% 26.6% 42.29 25.78 5,572 1,585 1,516 5,641 13,341 923 797 Jun-12 Dec-11 14,174 811 677 0.4x 6.1x 0.4x 7.0xHealth Net, Inc. 23.25 (9.3%) (5.8%) 41.22 16.65 1,895 489 633 1,750 11,557 235 205 Jun-12 Dec-11 11,256 152 155 0.2x 7.4x 0.2x 11.5xHumana Inc. 70.08 (8.3%) (9.7%) 96.46 59.92 11,333 1,878 3,869 9,342 38,275 2,384 2,072 Jun-12 Dec-11 39,583 2,238 1,991 0.2x 3.9x 0.2x 4.2xUnitedhealth Group, Inc. 54.30 (2.6%) 14.3% 60.75 41.32 56,076 12,617 11,578 57,115 105,743 9,516 8,687 Jun-12 Dec-11 109,904 9,779 8,715 0.5x 6.0x 0.5x 5.8xWellPoint Inc. 59.87 (11.2%) (5.4%) 74.73 52.52 19,469 11,916 1,953 29,432 61,538 5,072 4,380 Jun-12 Dec-11 61,066 4,327 3,906 0.5x 5.8x 0.5x 6.8xNumber of Companies 7 Median: (6.1%) (4.0%) Total $120,382 $19,326 $290,578 $300,389 0.5x 6.0x 0.5x 5.8x
Mean: 0.5% 2.0% $19,326 0.4x 5.7x 0.4x 6.5x
Government:AMERIGROUP Corporation $90.92 45.7% 83.8% $91.15 $37.57 $4,475 $478 $624 $4,328 $7,246 $286 $267 Jun-12 Dec-11 $8,806 $390 $334 0.6x 15.1x 0.5x 11.1xCentene Corp. 40.61 12.4% 27.3% 50.98 24.26 2,094 409 422 2,077 6,648 180 127 Jun-12 Dec-11 8,314 195 121 0.3x 11.5x 0.2x 10.6xMolina Healthcare, Inc. 24.24 (5.0%) 26.1% 36.83 13.93 1,128 270 727 672 5,393 104 57 Jun-12 Dec-11 5,983 51 (16) 0.1x 6.5x 0.1x 13.2xWellCare Health Plans, Inc. 56.69 0.4% 23.7% 74.41 33.29 2,443 143 1,150 1,435 6,747 440 424 Jun-12 Dec-11 7,241 407 382 0.2x 3.3x 0.2x 3.5xNumber of Companies 4 Median: 6.4% 26.7% Total $10,140 $2,128 $26,035 $30,344 0.3x 9.0x 0.2x 10.9x
Mean: 13.4% 40.2% $2,128 0.3x 9.1x 0.3x 9.6x
Information Services
Data/Analytics:Accelrys Inc. $7.69 (1.4%) 18.3% $8.48 $5.68 $427 $0 $81 $283 $154 $15 ($8) Jun-12 Dec-11 $164 $33 $23 1.8x 18.5x 1.7x 8.5xNational Research Corp. 49.76 15.8% 47.3% 53.00 28.00 339 14 11 341 81 26 21 Jun-12 Dec-11 87 28 23 4.2x 13.2x 3.9x 12.4xNumber of Companies 2 Median: 7.2% 32.8% Total $766 $312 $235 $251 3.0x 15.9x 2.8x 10.4x
Mean: 7.2% 32.8% $312 3.0x 15.9x 2.8x 10.4x
eHealth:WebMD Health Corp. 14.94 (35.1%) (57.7%) 40.24 13.52 733 800 964 569 505 65 49 Jun-12 Dec-11 $462 $65 ($11) 1.1x 8.7x NA NA Number of Companies 1 Median: (35.1%) (57.7%) Total $733 $569 $505 $462 1.1x 8.7x NA NA
Mean: (35.1%) (57.7%) $569 1.1x 8.7x NA NA
Hospital/Physician:Allscripts Healthcare Solutions, Inc. $10.50 (3.0%) (41.5%) $21.66 $8.84 $1,799 $491 $120 $2,169 $1,487 $237 $147 Jun-12 Dec-11 $1,499 $343 $236 1.5x 9.1x 1.4x 6.3xathenahealth, Inc. 88.37 21.6% 52.4% 97.37 40.79 3,181 0 92 3,026 376 49 30 Jun-12 Dec-11 430 87 64 8.0x 61.4x 7.0x 34.9xCerner Corporation 73.14 (6.2%) 10.9% 88.32 55.69 12,520 176 303 11,716 2,416 658 522 Jun-12 Dec-11 2,614 822 584 4.9x 17.8x 4.5x 14.3xComputer Programs & Systems Inc. 50.55 (7.1%) (28.6%) 74.62 41.80 559 0 5 537 174 42 39 Jun-12 Dec-11 191 50 46 3.1x 12.8x 2.8x 10.8xHMS Holdings Corp. 34.46 28.6% 31.4% 37.19 22.45 2,975 341 105 3,211 419 131 91 Jun-12 Dec-11 506 174 108 7.7x 24.5x 6.3x 18.5xMedAssets, Inc. 17.07 50.8% 49.3% 17.38 8.52 998 948 5 1,941 613 182 79 Jun-12 Dec-11 628 198 82 3.2x 10.7x 3.1x 9.8xMerge Healthcare Incorporated 3.16 34.5% (46.6%) 7.23 2.20 291 250 33 506 248 49 30 Jun-12 Dec-11 253 53 25 2.0x 10.4x 2.0x 9.6xQuality Systems Inc. 17.67 (38.2%) (61.6%) 50.70 15.04 1,049 0 130 914 448 122 111 Jun-12 Mar-12 492 131 113 2.0x 7.5x 1.9x 7.0xSunCoke Energy Inc. 15.82 12.7% 11.7% 17.53 9.20 1,109 725 190 1,679 1,758 184 115 Jun-12 Dec-11 1,927 263 179 1.0x 9.1x 0.9x 6.4xNumber of Companies 9 Median: 12.7% 10.9% Total $24,481 $2,855 $7,940 $8,538 3.1x 10.7x 2.8x 9.8x
Mean: 10.4% (2.5%) $2,855 3.7x 18.2x 3.3x 13.1x
Company Name Equity Mkt. Value
Total Debt Cash and Equiv.
Total Ent.
Value (TEV)
Lastest Twelve Months (LTM) LTM
PeriodLastest
FYE DateForward Estimate TEV/ LTM Multiples TEV/ Fwd Multiples
Healthcare & Life Sciences Trading Statistics
September 2012
As of August 31, 2012 8
Payer, Provider, & Pharmacy Support Services Stock Price
% Change 52 Week8/31/2012 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Specialty Managed CareAssurant Inc. 35.25 5.6% 0.2% 44.54 32.31 2,858 1,067 1,107 2,818 8,375 1,075 945 Jun-12 Dec-11 8,419 NA 947 0.3x 2.6x 0.3x NA CorVel Corporation 43.80 (1.4%) (4.0%) 54.64 39.46 493 0 15 478 415 57 41 Jun-12 Mar-12 430 NA NA 1.2x 8.4x 1.1x NA Number of Companies 2 Median: 2.1% (1.9%) Total $3,351 $1,648 $8,790 $8,849 0.7x 5.5x 0.7x NA
Mean: 2.1% (1.9%) $1,648 0.7x 5.5x 0.7x NA
Specialty Pharmacy ManagementBioScrip Inc. $8.50 25.7% 34.3% $8.53 $5.05 $481 $257 $138 $600 $1,867 $59 $45 Jun-12 Dec-11 $636 $42 $23 0.3x 10.1x 0.9x 14.3xExpress Scripts Holding Company 62.62 20.0% 33.4% 62.80 34.47 50,769 18,242 1,420 67,591 63,498 3,493 2,722 Jun-12 Dec-11 94,915 5,391 5,040 1.1x 19.3x 0.7x 12.5xOmnicare Inc. 32.38 2.7% 9.0% 36.48 20.36 3,612 2,051 564 5,099 6,231 686 550 Jun-12 Dec-11 6,209 678 560 0.8x 7.4x 0.8x 7.5xPharMerica Corporation 12.60 26.9% (14.5%) 16.45 9.03 372 250 12 610 1,972 104 73 Jun-12 Dec-11 1,838 100 70 0.3x 5.9x 0.3x 6.1xNumber of Companies 4 Median: 22.9% 21.2% Total $55,234 $18,475 $73,567 $103,598 0.6x 8.8x 0.8x 10.0x
Mean: 18.8% 15.6% $18,475 0.6x 10.7x 0.7x 10.1x
TEV/ LTM Multiples TEV/ Fwd MultiplesTotal Ent.
Value ( )
Lastest Twelve Months (LTM) LTM
PeriodLastest
FYE DateForward Estimate
Company Name Equity Mkt. Value
Total Debt Cash and Equiv.
Healthcare & Life Sciences Trading Statistics
September 2012
As of August 31, 2012 9
Products & Devices Stock Price
% Change 52 Week8/31/2012 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Dental Products3M Co. $92.60 9.7% 11.6% $94.30 $68.63 $64,016 $6,307 $3,308 $65,887 $29,640 $7,569 $6,307 Jun-12 Dec-11 $30,151 $7,877 $6,596 2.2x 8.7x 2.2x 8.4xDENTSPLY International Inc. 36.27 (2.0%) 3.0% 41.38 28.35 5,143 1,913 53 7,037 2,837 467 351 Jun-12 Dec-11 2,931 595 470 2.5x 15.1x 2.4x 11.8xSirona Dental Systems Inc. 53.14 24.2% 13.9% 55.42 39.15 2,927 79 105 2,905 951 236 162 Jun-12 Sep-11 956 259 230 3.1x 12.3x 3.0x 11.2xYoung Innovations Inc. 37.27 7.4% 36.0% 38.25 25.06 294 0 9 285 108 29 25 Jun-12 Dec-11 109 30 26 2.6x 9.8x 2.6x 9.5xNumber of Companies 4 Median: 8.5% 12.7% Total $72,380 $19,028 $33,536 $34,147 2.6x 11.1x 2.5x 10.4x
Mean: 9.8% 16.1% $19,028 2.6x 11.5x 2.6x 10.2x
Durable Medical EquipmentHill-Rom Holdings, Inc. $27.73 (5.7%) (8.5%) $36.13 $24.69 $1,724 $95 $220 $1,599 $1,633 $300 $213 Jun-12 Sep-11 $1,620 $317 $203 1.0x 5.3x 1.0x 5.0xInvacare Corporation 13.74 (7.7%) (45.3%) 25.63 13.21 437 260 25 671 1,795 123 83 Jun-12 Dec-11 1,703 NA 48 0.4x 5.4x 0.4x NA ResMed Inc. 37.57 21.3% 21.3% 37.85 23.37 5,336 251 810 4,778 1,369 381 295 Jun-12 Jun-12 1,499 425 338 3.5x 12.5x 3.2x 11.2xSteris Corp. 34.24 14.7% 6.4% 34.61 27.08 1,989 210 187 2,014 1,425 287 224 Jun-12 Mar-12 1,433 277 210 1.4x 7.0x 1.4x 7.3xNumber of Companies 4 Median: 4.5% (1.0%) Total $9,487 $2,265 $6,222 $6,255 1.2x 6.2x 1.2x 7.3x
Mean: 5.6% (6.5%) $2,265 1.6x 7.6x 1.5x 7.8x
Life Sciences ToolsAgilent Technologies Inc. $37.16 (8.6%) 0.8% $46.28 $28.67 $12,913 $2,214 $1,923 $13,207 $6,819 $1,439 $1,169 Jul-12 Oct-11 $6,857 $1,569 $1,362 1.9x 9.3x 1.9x 8.4xBecton, Dickinson and Company 75.98 3.9% (6.6%) 80.56 69.59 15,162 4,171 1,659 17,142 7,974 2,211 1,688 Jun-12 Sep-11 7,700 2,126 1,574 2.1x 7.7x 2.2x 8.1xLife Technologies Corporation 47.71 16.6% 13.6% 50.84 36.07 8,363 2,400 260 10,476 3,827 1,251 842 Jun-12 Dec-11 3,786 1,348 1,107 2.7x 8.4x 2.8x 7.8xNumber of Companies 3 Median: 3.9% 0.8% Total $36,439 $13,608 $18,620 $18,342 2.1x 8.4x 2.2x 8.1x
Mean: 4.0% 2.6% $13,608 2.3x 8.5x 2.3x 8.1x
Medical Devices and Products
Abbott Laboratories $65.54 6.1% 24.8% $67.45 $48.96 $102,854 $18,087 $7,053 $110,025 $39,458 $11,578 $8,595 Jun-12 Dec-11 $39,702 $12,512 $9,759 2.8x 9.5x 2.8x 8.8xArthroCare Corporation 29.58 13.0% (8.6%) 32.63 23.54 820 0 181 718 360 20 (3) Jun-12 Dec-11 363 93 68 2.0x 35.5x 2.0x 7.7xBaxter International Inc. 58.68 15.9% 4.8% 60.54 47.55 32,112 5,334 2,353 35,154 14,033 3,809 3,111 Jun-12 Dec-11 14,181 3,961 3,258 2.5x 9.2x 2.5x 8.9xBoston Scientific Corporation 5.40 (5.9%) (20.4%) 6.67 4.79 7,663 4,257 371 11,549 7,416 1,626 947 Jun-12 Dec-11 7,292 1,642 986 1.6x 7.1x 1.6x 7.0xCR Bard Inc. 98.11 0.9% 3.0% 108.31 80.80 8,224 1,214 714 8,724 2,944 945 828 Jun-12 Dec-11 2,989 950 820 3.0x 9.2x 2.9x 9.2xDanaher Corp. 53.57 3.1% 16.9% 56.45 39.34 37,250 4,903 1,118 41,101 18,032 4,016 3,195 Jun-12 Dec-11 18,281 3,947 3,163 2.3x 10.1x 2.2x 10.4xHanger, Inc. 28.61 32.6% 52.3% 29.01 14.57 972 504 42 1,435 953 168 135 Jun-12 Dec-11 984 166 130 1.5x 8.6x 1.5x 8.6xHologic Inc. 19.63 17.1% 18.0% 22.16 13.90 5,196 1,542 905 5,833 1,881 647 338 Jun-12 Sep-11 1,946 674 604 3.1x 9.0x 3.0x 8.7xHospira Inc. 33.58 7.4% (27.3%) 46.29 26.92 5,544 1,790 720 6,614 3,990 468 226 Jun-12 Dec-11 4,041 636 454 1.7x 13.1x 1.6x 10.4xJohnson & Johnson 67.43 8.0% 2.5% 69.75 60.83 185,907 17,565 14,042 171,509 64,874 19,627 16,376 Jul-12 Jan-12 67,292 20,736 17,504 2.6x 8.7x 2.5x 8.3xMedtronic, Inc. 40.66 10.4% 15.9% 41.79 31.06 41,678 10,871 861 49,964 16,246 5,446 4,627 Jul-12 Apr-12 16,435 6,055 5,285 3.1x 9.0x 3.0x 8.3xStryker Corporation 53.26 3.5% 9.0% 57.15 44.55 20,262 1,766 1,393 18,568 8,513 2,501 2,011 Jun-12 Dec-11 8,626 2,558 2,108 2.2x 7.4x 2.2x 7.3xThermo Fisher Scientific, Inc. 57.35 13.6% 4.4% 58.37 43.06 20,964 6,532 732 26,760 12,354 2,541 1,579 Jun-12 Dec-11 12,234 2,680 2,337 2.2x 10.5x 2.2x 10.0xZimmer Holdings, Inc. 61.78 1.9% 8.6% 66.41 47.00 10,793 1,730 651 11,193 4,465 1,497 1,121 Jun-12 Dec-11 4,480 1,683 1,322 2.5x 7.5x 2.5x 6.7xNumber of Companies 14 Median: 7.7% 6.7% Total $480,241 $35,653 $195,519 $198,844 2.4x 9.1x 2.4x 8.7x
Mean: 9.1% 7.4% $35,653 2.4x 11.0x 2.3x 8.6x
Medical / Surgical / Dental SuppliesAmerisourceBergen Corporation $38.52 4.1% (2.7%) $42.32 $34.74 $9,693 $1,876 $1,656 $9,913 $80,609 $1,401 $1,256 Jun-12 Sep-11 $80,341 $1,423 $1,282 0.1x 7.1x 0.1x 7.0xCardinal Health, Inc. 39.55 (4.4%) (6.9%) 46.23 38.56 13,490 2,894 2,274 13,989 107,552 2,191 1,866 Jun-12 Jun-12 100,091 2,288 1,984 0.1x 6.4x 0.1x 6.1xHenry Schein, Inc. 76.81 3.4% 16.5% 80.38 58.56 6,800 535 88 7,608 8,752 730 610 Jun-12 Dec-11 8,958 743 624 0.9x 10.2x 0.8x 10.2xMcKesson Corporation 87.11 (0.2%) 9.0% 97.23 66.61 20,559 3,580 2,013 22,126 123,552 2,919 2,363 Jun-12 Mar-12 124,933 3,117 2,618 0.2x 7.6x 0.2x 7.1xOwens & Minor Inc. 27.99 (1.7%) (4.9%) 32.00 25.87 1,777 212 225 1,766 8,776 251 217 Jun-12 Dec-11 8,897 253 219 0.2x 7.0x 0.2x 7.0xPatterson Companies, Inc. 33.97 2.2% 16.3% 36.42 26.68 3,696 850 581 3,965 3,577 403 359 Jul-12 Apr-12 3,689 421 377 1.1x 9.8x 1.1x 9.4xPSS World Medical Inc. 21.59 6.7% (8.4%) 25.99 18.51 1,086 457 107 1,439 2,131 171 135 Jun-12 Mar-12 1,717 147 116 0.7x 8.4x 0.8x 9.8xNumber of Companies 7 Median: 2.2% (2.7%) Total $57,100 $8,686 $334,950 $328,626 0.2x 7.6x 0.2x 7.1x
Mean: 1.4% 2.7% $8,686 0.5x 8.1x 0.5x 8.1x
Forward EstimateCompany Name
Equity Mkt. Value Total Debt
TEV/ LTM Multiples TEV/ Fwd MultiplesCash and Equiv.
Total Ent.
Value
Lastest Twelve Months (LTM) LTM
PeriodLastest
FYE Date
Healthcare & Life Sciences Trading Statistics
September 2012
As of August 31, 2012 10
Provider-Based Services Stock Price
% Change 52 Week8/31/2012 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Acute-Care HospitalsCommunity Health Systems, Inc. $27.04 22.9% 32.8% $28.79 $14.61 $2,411 $9,547 $115 $12,276 $14,368 $1,880 $1,204 Jun-12 Dec-11 $12,962 $1,937 $1,207 0.9x 6.4x 0.9x 6.3xHealth Management Associates Inc. 7.66 19.5% (6.8%) 9.26 4.81 1,964 3,708 36 5,547 6,355 896 584 Jun-12 Dec-11 6,705 972 638 0.9x 6.2x 0.8x 5.7xHCA Holdings, Inc. 28.55 9.8% 42.5% 31.39 17.20 12,581 27,481 518 40,718 34,779 6,378 4,792 Jun-12 Dec-11 36,099 6,460 4,753 1.2x 6.3x 1.1x 6.3xLifepoint Hospitals Inc. 40.42 9.8% 10.1% 42.19 32.61 1,976 1,612 172 3,464 3,761 556 358 Jun-12 Dec-11 3,911 564 377 0.9x 6.2x 0.9x 6.1xTenet Healthcare Corp. 5.19 10.2% (1.7%) 6.05 3.46 2,163 4,748 82 6,943 9,801 1,100 681 Jun-12 Dec-11 9,846 1,236 811 0.7x 6.3x 0.7x 5.6xUniversal Health Services Inc. 39.95 3.1% (4.0%) 45.31 31.35 3,871 3,506 33 7,623 7,616 1,203 904 Jun-12 Dec-11 7,654 1,210 923 1.0x 6.3x 1.0x 6.3xNumber of Companies 6 Median: 10.0% 4.2% Total $24,965 $12,762 $76,680 $77,177 0.9x 6.3x 0.9x 6.2x
Mean: 12.5% 12.2% $12,762 0.9x 6.3x 0.9x 6.1x
Assisted LivingAssisted Living Concepts Inc. $7.79 (43.7%) (42.0%) $20.33 $6.93 $181 $183 $3 $358 $233 $64 $42 Jun-12 Dec-11 $230 $50 ($22) 1.5x 5.6x 1.6x 7.1xBrookdale Senior Living Inc. 21.73 31.8% 34.9% 22.45 10.98 2,661 2,587 39 5,209 2,385 368 115 Jun-12 Dec-11 2,761 454 131 2.2x 14.1x 1.9x 11.5xCapital Senior Living Corp. 12.03 21.8% 67.5% 12.50 5.44 329 336 37 628 284 44 17 Jun-12 Dec-11 306 51 15 2.2x 14.6x 2.1x 12.4xEmeritus Corp. 20.02 31.6% 14.5% 21.00 13.36 902 2,228 75 3,055 1,294 216 79 Jun-12 Dec-11 1,316 227 94 2.4x 14.3x 2.3x 13.5xFive Star Quality Care Inc. 4.73 52.6% 45.5% 5.02 2.15 227 102 24 296 1,288 41 16 Jun-12 Dec-11 1,392 49 21 0.2x 7.1x 0.2x 6.0xSkilled Healthcare Group, Inc. 5.72 3.8% 5.3% 8.41 3.30 220 463 6 678 869 113 87 Jun-12 Dec-11 879 110 82 0.8x 5.9x 0.8x 6.2xSunrise Senior Living Inc. 14.38 138.9% 93.8% 14.44 3.68 819 541 55 1,311 651 70 26 Jun-12 Dec-11 1,289 147 NA 2.0x 13.4x 1.0x 8.9xNumber of Companies 7 Median: 31.6% 34.9% Total $5,340 $1,648 $7,004 $8,173 2.0x 13.4x 1.6x 8.9x
Mean: 33.8% 31.4% $1,648 1.6x 10.7x 1.4x 9.4x
Diagnostic ImagingAlliance Healthcare Services, Inc. $1.36 30.8% (14.5%) $2.19 $0.72 $70 $637 $62 $696 $489 $148 $41 Jun-12 Dec-11 NA NA NA 1.4x 4.6x NA NA RadNet, Inc. 2.80 16.7% (6.7%) 3.64 1.87 107 556 0 664 663 111 52 Jun-12 Dec-11 664 119 56 1.0x 5.7x 1.0x 5.6xVarian Medical Systems Inc. 58.79 0.2% 3.2% 71.95 48.72 6,509 175 633 6,003 2,770 645 589 Jun-12 Sep-11 2,806 645 588 2.2x 9.3x 2.1x 9.3xNumber of Companies 3 Median: 16.7% (6.7%) Total $6,686 $2,454 $3,921 $3,470 1.4x 5.7x 1.6x 7.5x
Mean: 15.9% (6.0%) $2,454 1.5x 6.5x 1.6x 7.5x
Dialysis ServicesDaVita Inc. $97.27 19.7% 32.2% $100.52 $59.14 $9,202 $4,521 $273 $14,093 $7,574 $1,602 $1,307 Jun-12 Dec-11 $7,876 $1,643 $1,338 1.9x 8.7x 1.8x 8.6xFresenius Medical Care AG & Co. KGAA 71.86 8.5% 5.4% 75.86 58.16 21,925 8,784 677 30,759 13,379 2,734 2,154 Jun-12 Dec-11 13,976 2,974 2,368 2.3x 11.2x 2.2x 10.3xNumber of Companies 2 Median: 14.1% 18.8% Total $31,126 $22,426 $20,952 $21,853 2.1x 10.0x 2.0x 9.5x
Mean: 14.1% 18.8% $22,426 2.1x 10.0x 2.0x 9.5x
Home Care / HospiceAddus HomeCare Corporation $4.87 22.1% (2.8%) $5.35 $3.00 $53 $26 $1 $77 $276 $13 $10 Jun-12 Dec-11 $280 $14 $11 0.3x 5.8x 0.3x 5.5xAlmost Family Inc. 22.08 (0.7%) 11.7% 26.87 12.50 208 1 38 172 352 35 32 Jun-12 Dec-11 351 35 30 0.5x 4.9x 0.5x 5.0xAmedisys Inc. 14.08 28.4% (17.0%) 18.20 9.12 431 128 37 524 1,492 109 69 Jun-12 Dec-11 1,508 100 59 0.4x 4.7x 0.3x 5.3xGentiva Health Services Inc. 10.98 95.7% 44.3% 11.95 2.81 336 938 155 1,120 1,762 179 149 Jun-12 Dec-11 1,728 181 151 0.6x 4.5x 0.6x 6.2xLHC Group, Inc. 17.40 3.9% (12.9%) 20.26 12.34 318 8 0 340 628 61 54 Jun-12 Dec-11 639 63 56 0.5x 5.5x 0.5x 5.4xChemed Corp. 66.03 18.9% 13.7% 67.20 47.66 1,261 171 60 1,372 1,399 186 162 Jun-12 Dec-11 1,439 205 167 1.0x 7.4x 1.0x 6.7xNumber of Companies 6 Median: 20.5% 4.4% Total $327 $601 $1,013 $1,039 0.5x 5.2x 0.5x 5.4x
Mean: 28.0% 6.2% $601 0.5x 5.5x 0.5x 5.7x
Long-Term CareThe Ensign Group, Inc. $29.44 15.9% 26.2% $29.93 $19.70 $632 $204 $33 $810 $795 $116 $89 Jun-12 Dec-11 $835 $130 $102 1.0x 7.0x 1.0x 6.2xKindred Healthcare Inc. 11.16 34.9% (13.8%) 13.62 7.60 591 1,650 38 2,166 6,153 403 209 Jun-12 Dec-11 6,237 439 242 0.4x 5.4x 0.3x 4.9xNational Healthcare Corp. 44.69 4.4% 29.8% 49.06 29.97 624 10 69 638 749 96 66 Jun-12 Dec-11 744 NA NA 0.9x 6.0x 0.9x NA Sun Healthcare Group, Inc. 8.45 74.2% 98.4% 8.50 2.06 216 92 44 264 1,909 68 36 Jun-12 Dec-11 1,857 75 40 0.1x 3.9x 0.1x 3.5xNumber of Companies 4 Median: 25.4% 28.0% Total $2,063 $969 $9,606 $9,673 0.6x 5.7x 0.6x 4.9x
Mean: 32.4% 35.2% $969 0.6x 5.6x 0.6x 4.9x
TEV/ Fwd MultiplesCompany Name
Equity Mkt. Value Total Debt
Cash and Equiv.
Total Ent.
Value
Lastest Twelve Months (LTM) LTM
PeriodLastest
FYE DateForward Estimate TEV/ LTM Multiples
Healthcare & Life Sciences Trading Statistics
September 2012
As of August 31, 2012
Stock Price% Change 52 Week
8/31/2012 3 mos. 12 mos. High Low Revenue EBITDA EBIT Revenue EBITDA EBIT Revenue EBITDA Revenue EBITDA
Physician Practice Management
Multispecialty / Primary Care:IPC The Hospitalist Company, Inc. $44.19 26.3% 10.2% $48.29 $29.70 $735 $0 $9 $727 $491 $53 $49 Jun-12 Dec-11 $523 $58 $55 1.5x 13.8x 1.4x 12.4xNumber of Companies 1 Median: 26.3% 10.2% Total $735 $727 $491 $523 1.5x 13.8x 1.4x 12.4x
Mean: 26.3% 10.2% $727 1.5x 13.8x 1.4x 12.4x
Specialty:Integramed America Inc. $14.02 26.2% 64.4% $14.04 $6.70 $168 $9 $57 $120 $287 $18 $9 Jun-12 Dec-11 $301 $21 $11 0.4x 6.8x 0.4x 5.6xMEDNAX, Inc. 69.28 13.6% 6.1% 75.86 59.24 3,322 0 12 3,307 1,685 394 366 Jun-12 Dec-11 1,811 417 386 2.0x 8.4x 1.8x 7.9xNumber of Companies 2 Median: 19.9% 35.2% Total $3,490 $1,714 $1,972 $2,112 1.2x 7.6x 1.1x 6.8x
Mean: 19.9% 35.2% $1,714 1.2x 7.6x 1.1x 6.8x
Dental:Birner Dental Management Services Inc. $16.36 3.6% (2.3%) $19.49 $14.75 $32 $5 $1 $37 $62 $4 $1 Jun-12 Dec-11 NA NA NA 0.6x 8.7x NA NA Number of Companies 1 Median: 3.6% (2.3%) Total $32 $37 $62 $0 0.6x 8.7x NA NA
Mean: 3.6% (2.3%) $37 0.6x 8.7x NA NA
Psychiatric Hospitals / ManagementMagellan Health Services Inc. $49.61 17.6% (0.5%) $56.58 $40.24 $1,357 $0 $168 $1,118 $2,987 $192 $161 Jun-12 Dec-11 $3,282 $239 $174 0.4x 5.8x 0.3x 4.7xProvidence Service Corp. 11.41 (14.2%) 7.2% 15.94 8.35 149 145 50 252 1,019 39 25 Jun-12 Dec-11 1,094 37 23 0.2x 6.4x 0.2x 6.8xUniversal Health Services Inc. 39.95 3.1% (4.0%) 45.31 31.35 3,871 3,506 33 7,623 7,616 1,203 904 Jun-12 Dec-11 7,654 1,210 923 1.0x 6.3x 1.0x 6.3xNumber of Companies 3 Median: 3.1% (0.5%) Total $5,378 $2,248 $11,622 $12,030 0.3x 6.1x 0.3x 6.3x
Mean: 2.2% 0.9% $2,248 0.4x 4.6x 0.5x 5.9x
Surgicenters / Rehabilitation
Surgery Centers:AmSurg Corp. $29.41 7.7% 30.0% $32.17 $19.86 $929 $420 $38 $1,618 $883 $299 $270 Jun-12 Dec-11 $926 $312 $285 1.8x 5.4x 1.7x 5.2xNumber of Companies 1 Median: 7.7% 30.0% Total $929 $1,618 $883 $926 1.8x 5.4x 1.7x 5.2x
Mean: 7.7% 30.0% $1,618 1.8x 5.4x 1.7x 5.2x
Rehabilitation / Long Term Acute Care:HEALTHSOUTH Corp. $22.90 19.6% 7.1% $24.62 $13.65 $2,191 $1,219 $41 $3,809 $2,088 $484 $405 Jun-12 Dec-11 $2,135 $498 $416 1.8x 7.7x 1.8x 7.6xSelect Medical Holdings Corporation 10.35 12.0% 42.8% 14.89 5.81 1,448 1,374 22 2,834 2,907 395 327 Jun-12 Dec-11 2,960 403 335 1.0x 7.0x 1.0x 7.0xUS Physical Therapy Inc. 25.97 6.9% 30.8% 27.39 16.58 306 21 9 336 247 42 37 Jun-12 Dec-11 253 39 40 1.4x 7.9x 1.3x 8.6xNumber of Companies 3 Median: 12.0% 30.8% Total $3,945 $2,326 $5,241 $5,349 1.4x 7.7x 1.3x 7.6x
Mean: 12.8% 26.9% $2,326 1.4x 7.5x 1.4x 7.8x
Company NameEquity
Mkt. Value Total DebtCash and
Equiv.
Total Ent.
Value
Lastest Twelve Months (LTM) LTM
PeriodLastest
FYE DateForward Estimate TEV/ LTM Multiples TEV/ Fwd Multiples
11
Provider-Based Services
12
M&A Detail
September 2012
Announced U.S.
Healthcare &
Life Sciences
M&A
Enterprise Enterprise Value / LTM Private Equity
Announced Target Seller Buyer Value ($mm) Sales EBITDA EBIT Involvement
8/31/2012 Promise Hospital of San Antonio, Inc. Promise Healthcare, Inc. Post Acute Medical LLC - - - - No
8/31/2012 ConnectYourCare, LLC Express Scripts Holding Company
(NasdaqGS:ESRX)
ABS Capital Partners - - - - Yes
8/31/2012 180 Medical, Inc. Cortec Group ConvaTec Inc. - - - - Yes
8/31/2012 Kryptiq Corporation Voyager Capital; Shelter Capital
Partners
SureScripts-RxHub, LLC - - - - No
8/30/2012 Honesdale Volunteer Ambulance Corps Inc. - Wayne Ambulance, Inc. - - - - No
8/30/2012 Park Nicollet Health Services - HealthPartners, Inc. - - - - No
8/30/2012 Elevation Pharmaceuticals, Inc. Canaan Partners; Care Capital, LLC;
TPG Growth
Sunovion Pharmaceuticals Inc. $430.0 - - - Yes
8/29/2012 Accugenix, Inc. - Charles River Laboratories
International, Inc. (NYSE:CRL)
$17.0 - - - No
8/28/2012 Timberline Knolls, LLC - TK Behavioral, LLC $67.8 2.1x - - No
8/28/2012 Lower Bucks Hospital - Prime Healthcare Services, Inc. - - - - No
8/28/2012 Drug Safety Alliance, Inc. - United Drug plc (ISE:UN6A) $28.0 - - - No
8/28/2012 SynopiaRX LLC - United Drug plc (ISE:UN6A) $12.0 - - - No
8/28/2012 SBSI NUTRACEUTICALS, INC. - EnerBrite Technologies Group, Inc.
(OTCPK:ETGG)
- - - - No
8/27/2012 Alliance Urgent Care, LLC - Capital Group Holdings, Inc.
(OTCPK:CGHC)
$0.4 - - - No
8/27/2012 Axial Biotech, Inc., ScoliScore Adolescent
Idiopathic Scoliosis Prognostic Test
Axial Biotech, Inc. Transgenomic Inc. (OTCPK:TBIO) $4.4 - - - No
8/27/2012 Ascender Software, LLC National Healthcare Services, Inc. Community Care Health Network, Inc. - - - - No
8/27/2012 Recovery Works Drug And Alcohol
Rehabilitation Center LLC
- Pinnacle Treatment Centers, Inc. - - - - No
8/27/2012 Robert Horry Center for Sports and Physical
Rehabilitation
- University General Health System, Inc.
(OTCPK:UGHS)
- - - - No
8/24/2012 Computer Vision Systems Laboratories Corp.
(OTCPK:CVSL)
- Happenings Communications Group,
Inc.
- - - - No
8/24/2012 Putnam Acres Care Center Putnam County Ohio Trilogy Health Services, LLC - - - - No
8/23/2012 OrthoHelix Surgical Designs, Inc. River Cities Capital Funds; Mutual
Capital Partners LLC
Tornier, Inc. $155.0 - - - Yes
8/23/2012 Eaton Scientific Systems Ltd. - Pristine Solutions Inc. $3.8 - - - No
8/23/2012 Xanodyne Pharmaceuticals, Inc., All Rights to
Roxicodone New Drug Application
Xanodyne Pharmaceuticals, Inc. Mallinckrodt, LLC - - - - No
8/22/2012 Elko Diagnostic Imaging LLC - PHC-Elko, Inc. - - - - No
8/22/2012 CareCounsel, LLC - Stanford Hospital & Clinics - - - - No
8/21/2012 Sunrise Senior Living Inc. (NYSE:SRZ) BlackRock, Inc. Health Care REIT, Inc. (NYSE:HCN) $1,413.9 2.2x 14.5x 25.9x Yes
8/21/2012 DiagnosisONE, Inc. Edison Venture Fund Alere Inc. (NYSE:ALR) - - - - Yes
8/21/2012 Kanner, Shteiman LLC - Metcare of Florida, Inc. - - - - No
8/21/2012 Penrith Corporation - Siemens Healthcare - - - - No
8/21/2012 Aperio Technologies, Inc. Galen Partners; Advanced
Technology Ventures
Leica Microsystems GmbH - - - - Yes
8/21/2012 Sunrise Atrium at Boca Raton RSC Atrium, LLC Health Care REIT, Inc. (NYSE:HCN) $31.5 - - - No
8/20/2012 IntegraCare Holdings, Inc. Flexpoint Ford, LLC Kindred Healthcare Inc. (NYSE:KND) $75.0 1.1x 8.3x - Yes
8/20/2012 SCD Enterprises, LLC - Creative Edge Nutrition, Inc. - - - - No
8/20/2012 Advocat Inc., Nursing Center in Arkansas Advocat Inc. (NasdaqCM:AVCA) - - - - - No
8/20/2012 Mercy Hospital, Portland, Maine Catholic Health East Steward Health Care System, LLC - - - - No
8/20/2012 RSC Ashford Court LLC, Ashford Court
Assisted Living at 1700 The Greens Way
RSC Ashford Court LLC Health Care REIT, Inc. (NYSE:HCN) $21.5 - - - No
8/20/2012 Med-Trans Corporation TJ Holding Company, Inc. - - - - - No
8/20/2012 L&S Associates, Inc. - Human Arc Corporation - - - - No
8/19/2012 Coventry Health Care Inc. (NYSE:CVH) - Aetna Inc. (NYSE:AET) $5,795.5 0.4x 6.3x 7.3x No
8/17/2012 Bristol-Myers Squibb Company, Assets and
Certain Liabilities Related to FV-100
Bristol-Myers Squibb Company
(NYSE:BMY)
Synergy Pharmaceuticals, Inc.
(NasdaqCM:SGYP)
$1.0 - - - No
8/17/2012 Avid Health, Inc. - Church & Dwight Co. Inc.
(NYSE:CHD)
$650.0 2.8x 11.2x - No
8/17/2012 XAM | MAX - The Outsource Group, Inc. - - - - No
8/17/2012 Workers’ Implantable Network, Surgical Implant
Business
Workers' Implantable Network Orchid Medical, Inc. - - - - No
8/17/2012 Orthodontic Design & Production, Inc. - G&H Wire Company, Inc. - - - - No
8/16/2012 St. Jude Medical, Inc., Venture Wire Control
Catheter
St. Jude Medical Inc. (NYSE:STJ) Vascular Solutions Inc.
(NasdaqGS:VASC)
$3.0 - - - No
8/16/2012 TRS Behavioral Care, Inc. - Elements Behavioral Health, Inc. - - - - No
8/16/2012 Meta Health Technology, Inc. - Streamline Health, Inc. $16.0 - - - No
8/15/2012 ExcellaDerm Corporation - DermaMed Solutions, LLC - - - - No
8/15/2012 Kinetic Concepts, Inc., Therapeutic Support
Systems Business
Kinetic Concepts Inc. ArjoHuntleigh AB - - 5.7x - No
8/15/2012 TTC LLC - IMS Health Incorporated - - - - No
8/14/2012 Senior Living Campus in Silverdale, Washington - National Health Investors Inc.
(NYSE:NHI)
$25.2 - - - No
8/14/2012 Delphi Healthcare Partners, Inc. - Team Health Holdings, Inc.
(NYSE:TMH)
- - - - No
8/14/2012 Four Independent Pharmacies in Central New
York and Vermont
- Kinney Drugs, Inc. - - - - No
13
M&A Detail
September 2012
Announced U.S.
Healthcare &
Life Sciences
M&A
(Continued)
Turner Bredrup Managing Director
+1 (804) 915-0110
Cheairs Porter Managing Director
+1 (804) 915-0130
James Clark Managing Director
+1 (804) 915-0119
Todd Morris Managing Director
+1 (415) 217-3412
Geoff Smith Director
+1 (804) 915-0195
Andy Dixon Vice President
+1 (415) 217-3419
Contacts
Whit Knier Vice President
+1 (804) 932-1321
Enterprise Enterprise Value / LTM Private Equity
Announced Target Seller Buyer Value ($mm) Sales EBITDA EBIT Involvement
Paul Hepper Vice President
+1 (804) 932-1326
Andy Hewlett Vice President
+1 (415) 217-3427
8/13/2012 Expression Analysis, Inc. - Quintiles Global Laboratories - - - - No
8/13/2012 First Dental Health - Principal Financial Group Inc.
(NYSE:PFG)
- - - - No
8/13/2012 FTMI Operator, LLC - Shefaor Development LLC $13.0 - - - No
8/10/2012 Pier Pharmaceuticals, Inc. Origin Ventures; IllinoisVENTURES,
LLC
Cortex Pharmaceuticals Inc.
(OTCPK:CORX)
$4.1 - - - No
8/10/2012 United Rehab Specialists, Inc., Complex
Rehabilitation Technology Segment
United Rehab Specialists, Inc. ATG Rehab Inc. - - - - No
8/9/2012 Georgetown Healthcare & Rehab, Inc. Winyah Nursing Home, Inc. AdCare Property Holdings, LLC $4.2 - - - No
8/9/2012 Athol Memorial Hospital - Heywood Hospital - - - - No
8/9/2012 Eagle Healthcare, Inc., Ten Rehabilitation Eagle Healthcare, Inc. Prestige Care, Inc. - - - - No
8/8/2012 AllianceCare, Inc. Capital Resource Partners; Cardinal
Partners; GE Equity; Three Arch
Partners; SV Life Sciences Advisers
LLP;
Caresouth Homecare Professionals,
Inc.
- - - - Yes
8/8/2012 Health & Safety Institute The Riverside Company - - - - - Yes
8/8/2012 Classic Pharmaceuticals LLC - Aphena Pharma Solutions, Inc. - - - - No
8/7/2012 InterDent, Inc. Levine Leichtman Capital Partners;
Saratoga Investment Corp.
H.I.G. Capital, LLC - - - - Yes
8/6/2012 Strategic Healthcare Group LLC - Mediware Information Systems Inc.
(NasdaqCM:MEDW)
$8.0 - - - No
8/5/2012 Cardiocore Lab, Inc. Maryland Department of Business
and Economic Development,
Investment Arm
CardioNet, Inc. (NasdaqGM:BEAT) $23.5 - - - No
8/5/2012 Brighton Bay Wells Fargo & Company
(NYSE:WFC)
The Carlyle Group LP
(NasdaqGS:CG)
$19.0 - - - Yes
8/3/2012 Maroland, LLC and 800 HomeCare LLC - Heritage Home Healthcare Services, - - - - No
8/3/2012 Two Skilled Nursing Facilities located in the
Portland, Oregon Metropolitan
Sheridan Care Center LLC; Fernhill
LLC
Cornerstone Healthcare Partners, LLC $8.6 - - - No
8/3/2012 OAD Orthopaedics, Ltd. and DuPage
Orthopaedic Surgery Center, LLC
- CDH-Delnor Health System, Inc. - - - - No
8/3/2012 IOS Technologies, Inc. - Glidewell Laboratories, Inc. - - - - No
8/2/2012 Octagon Research Solutions, Inc. Edison Venture Fund; Ticonderoga
Capital Inc.; Milestone Venture
Partners
Accenture plc (NYSE:ACN) - - - - No
8/2/2012 Wholesale Alliance TPS, LLC Wholesale Alliance, LLC MedTrak Services, LLC - - - - No
8/2/2012 Leprechaun, LLC - Examination Management Services, - - - - No
8/1/2012 Nutrition Consultants LLC - Granite Harbor Business Development
LLC
- - - - No
8/1/2012 MFR Healthcare Solutions, Inc. - MFR Solutions, Inc. - - - - No
8/1/2012 Lipomics Technologies, Inc. - Metabolon, Inc. - - - - No
8/1/2012 Allcare Medical Inc., Complex Rehab
Technology Business
Allcare Medical Inc. ATG Rehab Inc. - - - - No
8/1/2012 Vista Healthcare Center and Discovery Care
Centre and Owyhee Health & Rehabilitation
Center
- The Ensign Group, Inc.
(NasdaqGS:ENSG)
- - - - No
8/1/2012 Children's Dental Center - Children's Hospital Of Wisconsin, Inc. - - - - No
8/1/2012 Reglera, LLC - Dohmen Investment Group, LLC - - - - Yes
8/1/2012 Heritage Arms, LLC - HRC Investors Corp. $5.0 - - - Yes
8/1/2012 Washington Adult Day Services Association - LeadingAge Washington - - - - No
8/1/2012 The Surgical Group of Lancaster General Health - Lancaster General Medical Group Inc. - - - - No
8/1/2012 Milford VNA Milford Regional Medical Center, SALMON Hospice Care LLC - - - - No
8/1/2012 NanoBioMagnetics, Inc. - SWR&D, Inc. - - - - No
8/1/2012 West Escondido Healthcare LLC - The Flagstone Group, Inc. - - - - No
14
Sources:
Capital IQ.
Thomson Financial.
S&P.
Reuters.
Bloomberg.
Irving Levin Associates.
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