
Polar Capital Global Healthcare Trust plc • Annual Report and Financial Statements 202112
Strategic Report
Investment Manager’s Report continued
Over the financial year to the end of September 2021, the
Company achieved a strong result, with a NAV per share total
return of 19.46%, which was 6.06% ahead of its benchmark
healthcare index (MSCI All Country World Index/Healthcare (total
return in sterling)). The absolute performance of the healthcare
sector was also strong, up 13.40% over the reporting period,
although the sector did lag the broader market (as tracked by
the MSCI All Country World Net Total Return in pounds sterling)
which was up 22.2%. Unprecedented monetary stimulus and
successful COVID-19 vaccination programmes were amongst
the key drivers behind the buoyant market conditions. October
2020 aside, the global equity markets enjoyed pretty consistent,
upwards momentum throughout the reporting period, with
energy and financials leading the way.
Healthcare facilities, healthcare supplies and life sciences tools
and services all performed strongly over the period. The facilities
and supplies companies benefitted from returning patient
volumes, especially in regions with successful vaccination
programmes. The life sciences tools and services sub-sector has
been instrumental in not only delivering COVID-19 testing kits
but also contributing to the vaccine manufacturing processes.
At the other end of the scale, the last 12 months has been
a difficult period for the biotechnology and pharmaceuticals
sub-sectors. For biotechnology, it has been a challenging period
driven by a number of factors including excessive valuations
in certain thematic pockets, disappointing clinical data and
regulatory setbacks. We remain optimistic, however, given that
the innovation cycle is extremely strong, the sector is well-
funded and consolidation remains a distinct possibility. The
pharmaceutical sub-sector continues to innovate and invest
substantially in research designed to address unmet medical
needs, but short-term growth prospects face the challenges of
mature margins and patent expiries between now and the end
of the decade.
Reflecting on last year’s annual report, the focus was
very much on six key investment themes, some of which
accelerated through the COVID-19 crisis. Disrupting the
delivery of healthcare, outsourcing and prevention are key
investment themes for the Company, with all three showing
signs of gathering momentum. Healthcare systems globally
are looking to shift more and more patient volumes to lower-
cost settings such as ambulatory surgery centres and the
home. Outsourcing is also enjoying a period of strong growth
and consolidation, with the clinical research organisations
especially well-positioned. Prevention, not just vaccination
programmes, but early and accurate diagnosis, is also an area
that has flourished and should continue to do so in a post-
pandemic world given the increased investment in diagnostics
infrastructure. The other key themes discussed in last year’s
annual report, namely emerging markets, innovation and
consolidation are no less important, but are perhaps less
influenced by the COVID-19 pandemic. Crucially the six
themes discussed above will, we believe, continue to be
growth drivers for the healthcare industry and should be able
to yield some exciting investment opportunities.
US politics, always an important consideration, has been less
prominent this year than it was in 2020. Top congressional
Democrats are acknowledging for the first time that they will
have to scale back their drug pricing ambitions to gain much-
needed centrist votes for President Joe Biden’s social spending
bill. As such, direct drug price negotiation by the Federal
government feels less likely now, something that would be a big
relief for the bio-pharmaceuticals industry. There remains political
will to address high out-of-pocket costs for US seniors and to
control drug price inflation, but far-reaching legislation remains
some way off. With regards to access to healthcare, President
Joe Biden continues to be a staunch supporter of the Affordable
Care Act, signed in to law by President Barack Obama in early
2010. Indeed, the Administration introduced a special enrolment
period during the pandemic to ensure that US citizens that
needed access to care got it. Priorities from here could involve
making the expansion of the subsidies and eligibility permanent,
expanding Medicaid further and adding dental, vision and
hearing coverage to the Medicare fee-for-service program.
The key investment themes that the Company focused on in
2020 are very much relevant today and will continue to be so
over the medium-term. The COVID-19 pandemic has been
hugely challenging for everyone but has also shone a light on a
couple of things: firstly, the terrific levels of innovation that the
healthcare industry can deliver and, secondly, the acute need
for structural change. It is imperative, given the general ageing
of populations and the rising costs of healthcare, that patient
volumes are directed into lower cost settings, early and accurate
diagnoses become routine and that the industry focuses on
sustainability, whether that be through improving clinical
outcomes, improving affordability and access or improving
efficiency. If the healthcare industry can deliver on these
objectives, the commercial and financial rewards should be there
for investors.
Performance Review
Over the financial year to the end of September 2021, the
Company achieved a strong result, with a NAV per share total
return of 19.46%, which was 6.06% ahead of its benchmark
healthcare index. The absolute performance of the overall
healthcare sector was also strong, with the index returning
13.40%, although it did underperform the broader market.
The Company was marginally ahead of its benchmark in the
first five months of the financial year and started a strong
period of relative performance in mid-March 2021, when
global markets began a steep rally which lasted until the end of
September 2021.