Report
Martin Hall

Hardman & Co Healthcare Index: 2023 – Capital demands dent performance

The Hardman & Co Healthcare Index (HHI) has been running since 2009. Its main function is to highlight the attractions of life sciences investments over the long term. For the second year running, apart from global economic influences affecting world markets, performance in 2023 was dented by the capital-intensive nature of the sector. The HHI fell 3.7%, to 483.8, underperforming the main London markets – FTSE 100 (+3.8%) and FTSE All-Share (3.8%) but outperforming the FTSE AIM All-Share Index (-8.2%). Only 15 companies in our index saw share prices rise in 2023, four of these benefiting from trade sales. Despite challenges in raising new capital from the market, 15 companies (29%) did achieve successful outcomes. A number of companies are short of cash and will need more capital in order to get auditors to sign off their accounts – so 2024 looks as though it will be busy again.
Underlyings
10x Genomics Inc Class A

123FAHRSCHULE SE

1895 BANCORP OF WISCONSIN INC

Advanced Medical Solutions Group PLC

Advanced Medical Solutions is engaged in the design, development and manufacture of polymers (both natural and synthetic) for use in woundcare dressings, and distribution of medical adhesives, for closing and sealing tissue, and sutures and haemostats for sale into the global medical device market. Co.'s business units include: Branded Direct, which sells ActivHeal®, LiquiBand® and RESORBA® brands to end users in the U.K., Germany and Czech Republic; Branded Distributed, which provides LiquiBand® and RESORBA® branded products to all markets; and Original Equipment Manufacturer, which supports Co.'s business-to-business partners with a multi-product portfolio.

Advanced Oncotherapy

Advanced Oncotherapy is focused on providing radiotherapy systems for cancer treatment through the use of a proton therapy technology. Co. operates in two business segments: proton therapy and healthcare related properties. The healthcare related property U.K. segment relates to Co.'s property in Folkestone, which is being marketed for sale.

Allergy Therapeutics PLC

Allergy Therapeutics is a pharmaceutical group focused on allergy vaccination. Co. mainly sell its products in European countries and its pipeline of products in clinical development includes vaccines for grass, tree and house dust mite, as well as a peanut allergy vaccine in preclinical development. Co. sells a range of aluminium-free allergy vaccines and diagnostics. Co. sells both injectable and sublingual (oral) formats. The commonly prescribed are those for the treatment of pollen related allergies, particularly for allergies to grasses, weeds and trees. Co.'s vaccines trade under various brand names depending on the market, e.g. Pollinex Quattro, Polligoid and TA Graser Top.

Alliance Pharma PLC

Alliance Pharma is a holding company. Co. is engaged in the acquisition, marketing and distribution of pharmaceutical and other medical products.

ANGLE PLC

ANGLE is a holding company. Through its subsidiares, Co. operates as a medical diagnostic company focusing on the development of products in the fields of cancer diagnostics and foetal health. Co. develops products for use in rare cell diagnostics that enable early identification of an individual's condition for the prevention, treatment, and monitoring of disease. Co.'s principal trading activity is undertaken in relation to the development and commercialization of the Parsortix cell separation system, with deployment in liquid biopsy (non-invasive cancer diagnostics).

Assura PLC

Assura is a healthcare real estate investment trust. Co. owns and procures primary care properties, as well as develops, invests and manages a portfolio of primary care medical centres across the U.K.

Avacta Group

Avacta Group is a biotechnology company that is developing biotherapeutics and reagents based on its proprietary Affimer technology, an engineered alternative to antibodies. Affimer® reagents and therapeutics are a class of non-antibody binding proteins that have been engineered for a range of applications where antibodies and aptamers have limitations. Co. has two operating segments: Life Sciences, which provides custom Affimers for reagents and diagnostics, drug and biomarker discovery in biotech research and development; and Animal Health, which provides tools and contract services to assist diagnosis of conditions in animals to enable treatment for veterinarians.

BENEVOLENTAI

ConvaTec Group Plc

ConvaTec Group is a holding company. Through its subsidiaries, Co. is a global medical products and technologies group. Co. has four franchises: Advanced Wound Care, which provides wound dressings, devices and skin care products used for the management of acute and chronic wounds; Ostomy Care, which focuses on devices, accessories and services for individuals who have a stoma; Continence and Critical Care, which provides products for people with urinary continence issues; and Infusion Devices, which develops and manufactures disposable infusion sets for the suppliers of insulin pumps for diabetes treatment and similar pumps used in continuous infusion treatments for other conditions.

Deltex Medical Group PLC

Deltex Medical Group is engaged in the manufacture and marketing of oesophageal Doppler haemodynamic monitoring systems used in surgery and intensive care. Through its subsidiaries, Co. is engaged in the manufacture and marketing of medical devices in the United States, Spain and Germany; and the provision of employee services. Co.'s product, CardioQ-ODM enables doctors to fine-tune a patient's cardiac performance during surgery using a technique known as Doppler-guided fluid management. The CardioQ-ODM directly measures central blood flows, the indicator of potentially harmful changes in haemodynamic status that are common to all patients having surgery.

Destiny Pharma

Destiny Pharma is engaged in the discovery, development and commercialization of antimicrobials that have properties to improve outcomes for patients and the delivery of medical care into the future.

E-therapeutics

E-Therapeutics is a drug discovery company with a proprietary in silico discovery platform based on the application of network science to the modelling and analysis of cellular processes and utilizing public and proprietary chemical biology and multi-omics data. The therapeutic focus of Co.'s discovery activity is in areas of disease with unmet medical need, including immuno-oncology.

Eco Animal Health Group

Eco Animal Health Group is engaged in the manufacture and supply of animal health products. Co.'s activities were conducted through a network including both regional offices, (notably in Shanghai and Princeton) and overseas subsidiaries. Co.'s patented molecule, Aivlosin® is used for the treatment of pigs and poultry diseases and is prescribed under veterinary control for the short duration treatment of diagnosed diseases. Co.'s products also include Ecomectin, an endectocide that controls worms, ticks, lice and mange in grazing stock and pigs.

EKF Diagnostics Holdings

EKF Diagnostics Holdings is an integrated medical diagnostics business. Co. is engaged in the development, manufacture and supply of products into the in-vitro diagnostic (IVD) market place. Co. has three core divisions: the design and manufacture of point-of-care diagnostic equipment including analyzers and rapid tests; the manufacture of enzymes and liquid reagents used in central laboratories; and molecular diagnostic test kits which are focused on applications within oncological research.

Ergomed

Ergomed is engaged in the provision of specialized services to the pharmaceutical industry and the development of new drugs. Co. focuses on oncology, neurology and immunology and the development of orphan drugs. Co. is building a portfolio of co-development partnerships with pharmaceutical and biotech companies. Co. has two business segments: clinical research services, which provides clinical development services to clients ranging from pharmaceutical companies to small and mid-sized drug development companies; and drug safety and medical information services, which includes Co.'s subsidiary, PrimeVigilance Limited, a pharmacovigilance and medical information services company.

Genedrive

Genedrive is a holding company. Through its subsidiaries, Co. is a molecular diagnostics business developing and commercializing a point of care diagnostics platform for the diagnosis of infectious diseases and for use in patient stratification (genotyping), pathogen detection and other indications. Co.'s Genedrive® is a patented small polymerase chain reaction platform which enables rapid nucleic acid amplification and detection from various sample types, including plasma, sputum and buccal swabs. Co. also provides contract research services to drug development companies under the Epistem brand name.

Genus plc

Genus is engaged as an animal genetics company. Co.'s business is serving pork, beef and dairy farmers with superior genetics. Co.'s porcine genetics business, PIC sells genetically superior sows, boars and semen, to breed pigs with desirable characteristics for pork production. Co.'s bovine genetics business, ABS primarily sells bull semen and embryos, which are delivered through artificial insemination to breed dairy and beef cattle with desirable characteristics for milk and beef production. ABS's subsidiary, In Vitro Brasil S.A., provides in vitro fertilization services.

Hvivo

hVIVO is a holding company. Co. is a specialty biopharma company focusing on a human-based analytical platform to accelerate drug discovery and development in respiratory and infectious diseases. Utilizing human disease models in flu, respiratory syncytial virus and asthma exacerbation, Co.'s platform captures disease in motion, illuminating the entire disease life cycle from healthy to sick and back to health. Co.'s operational activities are carried out through its subsidiary, hVIVO Services Limited. Co. carries out its main activities from the U.K. Co. also conducts sales activity in the U.S. and in Europe through its subsidiaries, hVIVO Inc and hVIVO Services Limited respectively.

Immunocore Holdings ADS

Immupharma

Immupharma is a drug discovery and development company. Co. is engaged in the development of novel drugs, largely based on peptide therapeutics, to treat serious medical conditions such as autoimmune diseases. Co. is developing drug candidates within three technology platforms. Lupuzor™, a treatment for the autoimmune chronic inflammatory disease lupus, is Co.'s key product candidate. The other two platforms include Nucant platform (IPP-204106) for the treatment of cancer and ophthalmology, and a peptide technology platform for the treatment of diabetes.

INDIVIOR PLC

Indivior PLC

Indivior is engaged in the development, manufacture and sale of prescription drugs that are based on buprenorphine for treatment of opioid dependence. Co.'s primary products are: SUBLOCADE™ (buprenorphine extended-release) injection for subcutaneous use (CIII), SUBOXONE® (buprenorphine and naloxone) Sublingual Film, SUBOXONE® (buprenorphine and naloxone) Sublingual Tablet, and SUBUTEX® (buprenorphine) Sublingual Tablet. Co. also has two key pipeline products, RBP-6000 buprenorphine monthly depot developed for the treatment of opioid use disorder; and RBP-7000 risperidone monthly depot developed for the treatment of schizophrenia.

IP Group

IP Group is focused on identifying intellectual property (IP), nurturing and building businesses around such IP and then providing capital and support along the journey from cradle to maturity. As of Dec 31 2016, Co.'s portfolio comprised holdings in 90 companies across the four sectors in which Co. operated: IP Healthcare; IP Tech; IP Cleantech; and IP Biotech. Co. is organized into three operating segments: the commercialization of IP via the formation of long-term partner relationships with universities; the management of venture funds focusing on early-stage U.K. technology companies; and the in-licensing of druggable intellectual property from research institutions.

IXICO

IXICO is a provider of technology enabled services to the global biopharmaceutical industry. Co.'s services are used to select patients for clinical trials, assess the safety and efficacy of new drugs in development and in post marketing surveillance.

Novacyt SAS

Novacyt is an international diagnostics group. Co. sales clinical products used in oncology, microbiology, haematology and serology testing, focusing on the development, manufacture and commercialisation of molecular, protein and whole-cell diagnostic products. Co. also develops new products for the infectious disease and oncology testing markets. Co. operates it business through three divisions that are principally based in the United Kingdom with additional operations in France, China, Australia and the United States: Primerdesign, NOVAprep® and Lab21.

Oxford BioMedica PLC

Oxford BioMedica is a producer of gene and cell therapy in lentiviral vector and cell therapy research, development and production. Gene and cell therapy is the treatment of disease by the delivery of therapeutic deoxyribonucleic acid into a patient's cells. This can be achieved either in vivo (referred to as gene therapy) or ex vivo (referred to as cell therapy), the latter being where patients' cells are genetically modified cells outside the body before being re-infused. Co.'s products include: OXB-102, which targets Parkinson's disease; OXB-202, which targets corneal graft rejection; and OXB-302 (CAR-T 5T4), which targets targets a range of cancers.

Oxford BioMedica PLC

Oxford BioMedica is a producer of gene and cell therapy in lentiviral vector and cell therapy research, development and production. Gene and cell therapy is the treatment of disease by the delivery of therapeutic deoxyribonucleic acid into a patient's cells. This can be achieved either in vivo (referred to as gene therapy) or ex vivo (referred to as cell therapy), the latter being where patients' cells are genetically modified cells outside the body before being re-infused. Co.'s products include: OXB-102, which targets Parkinson's disease; OXB-202, which targets corneal graft rejection; and OXB-302 (CAR-T 5T4), which targets targets a range of cancers.

OXFORD METRICS

Oxford Metrics is a holding Company. Through its subsidiaries, Co. comprises the following business segments: Vicon Group, which is the development, production and sale of computer software and equipment for the engineering, entertainment and life science markets; and Yotta Group, which is the provision of software and services for the management of infrastructure assets and highways surveying services (which are pending disposal) for the Government Agencies, Local Government and major infrastructure contractors.

OXFORD NANOPORE TECHNOLOGIES PLC

Primary Health Properties PLC

Primary Health Properties is a holding company and a real estate investment trust. The principal activity of Co. is investment in primary healthcare property in the U.K. and Ireland. Co.'s properties are leased principally to general practitioners, government healthcare organizations and other associated healthcare users.

Proteome Sciences PLC

Proteome Sciences is a provider of contract research services for identification, validation and application of protein biomarkers. Co.'s clients are mainly pharmaceutical companies but it also performs services for other sectors including academic research. SysQuant® and TMTcalibrator™ are Co.'s two main service products. As a provider of applied proteomics and workflows, Co. uses techniques to detect and characterize differentially expressed proteins in diseases for diagnostic, prognostic and therapeutic applications. PS Biomarker Services® provides integrated proteomic services for biomarker discovery, validation and assay development for use in clinical trials and in vitro diagnostics.

Redx Pharma

Redx Pharma is engaged in drug discovery, pre-clinical development and licensing. The principal activities of the business are the discovery and development of proprietary, small molecule drugs to address areas of high, unmet medical need. Co. is developing a porcupine inhibitor drug candidate, RXC004, as a cancer treatment using in vivo models of pancreatic and gastric cancer. ROCK1/2 inhibitors (known as systemic pan-Rock inhibitors) are known to induce hypotension. Co.'s ROCK inhibitor is designed to only work at the site of action in the gastrointestinal tract and degrades quickly, once absorbed, through enzyme-mediated metabolism in the blood, deeming it a soft inhibitor.

ReNeuron Group

Reneuron Group researches and develops therapies using stem cells. Co.'s products include: CTX cells for stroke disability, which is its therapeutic candidate for the treatment of patients left disabled by the effects of a stroke; human retinal progenitor cells (hRPCs) for retinitis pigmentosa (RP), which is its therapeutic hRPC candidate for the treatment of RP, a blindness-causing disease of the retina; hRPCs for cone-rod dystrophy, which is a hRPC therapeutic candidate across a range of genetic diseases of the eye; and CTX-derived exosomes, which is its exosomes nanomedicine platform that generates early pre-clinical data in cancer.

SAREUM HOLDINGS PLC

Sareum Holdings PLC

Sareum Holdings is a holding company. Through its subsidiary, Co. is engaged as a specialist drug discovery and development company delivering targeted small molecule therapeutics, focusing on cancer and autoimmune disease, and licensing them to international pharmaceutical and biotechnology companies at the preclinical or early clinical trials stage. Co.'s drug development pipeline includes: Chk1 (SRA737), which targets genetically defined solid cancers; TYK2, which targets autoimmune diseases and cancer; and Aurora+FLT3, which targets Acute Myeloid Leukemia and other blood cancers.

Scancell Holdings

Scancell Holdings is engaged in the discovery and development of novel vaccines for the treatment of cancer based on its proprietary immuno-oncology platforms, ImmunoBody®, and Moditope®. Co.'s ImmunoBody® consist of SCIB1 melanoma vaccine, and SCIB2 lung cancer vaccine. Co. has a collaboration partnership to evaluate the use of its SCIB2 to treat non-small cell lung cancer. Co.'s Moditope® technology is a vaccine platform that targets neo-epitopes to overcome immune suppression induced by tumour cells. Co.'s Moditope® product, Modi-1 consists of two citrullinated vimentin peptides and one citrullinated enolase peptide for the treatment of breast cancer, ovarian cancer and sarcoma.

SDI Group

Scientific Digital Imaging is a holding company. Through its subsidiaries, Co. designs and manufactures scientific products for use in applications including life sciences, healthcare, astronomy and art conservation, through its Synoptics Divisions (Syngene, Synbiosis and Synoptics Health), and its Atik Cameras brands (Atik, Artemis CCD and Osiris). Co. also develops and manufactures electrochemical sensors through Sentek, as well as chemical dosing and control equipment via Astles.

Shield Therapeutics

Shield Therapeutics is a specialty pharmaceutical company focused on the development and commercialization of late stage, hospital-focused pharmaceuticals which address areas of high unmet medical need. Co.'s key products are Feraccru®, commercially available for the treatment of Iron Deficiency Anaemia, and PT20, for the treatment of systemic phosphate accumulation (otherwise known as hyperphosphatemia). Co. has an additional pipeline of three prescription pharmaceutical assets (PT20, PT30 and PT40) with commercial synergies.

SILENCE THERAPEUTICS PLC

SMITH & NEPHEW PLC

Smith & Nephew is a global medical devices business operating in the markets for advanced surgical devices comprising orthopaedic reconstruction and trauma, sports medicine and advanced wound management. Co.'s advanced medical products and services include: Orthopaedic Reconstruction and Trauma (joint replacement systems for knees and hips and products to help repair broken bones); Advanced Wound Management (treatment and prevention products for hard-to-heal wounds); and Sports Medicine (implants and enabling technologies for minimally invasive repair of the joint).

SMITH & NEPHEW PLC

Spire Healthcare Group PLC

Spire Healthcare Group is an independent hospital group. Co. owns and operates private hospitals and clinics in the U.K. and provides a range of private healthcare services. As of Dec 31 2016, Co. provided diagnostics, in-patient, daycase and out-patient care from 38 hospitals, 10 clinics and two Specialist Cancer Care Centres throughout the UK. Co. also owns and operate sports medicine, physiotherapy and rehabilitation brand, Perform.

Surgical Innovations Group PLC

Surgical Innovations Group is a holding company. Through its subsidiaries, Co. operates in three segments: SI Brand, which is engaged in the research, development, manufacture and distribution of SI branded minimally invasive devices; Original Equipment Manufacturer, which is engaged in the research, development, manufacture and distribution of minimally invasive devices for third party medical device companies through either own label or co-branding; and Precision Engineering, which is engaged in the research, development, manufacture and sale of minimally invasive technology products for precision engineering applications.

Synairgen PLC

Synairgen is the holding company for Synairgen Research Limited, a respiratory drug discovery and development company. Co. discovers and develops therapies in the areas of unmet respiratory medical need, including severe asthma, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis. Using its BioBank platform and its clinical trial capabilities, Co. indentifies drug targets, progress them through early stage clinical trials and out-license them to partners for progression to market. Co.'s BioBank is a collection of samples from clinically-characterized volunteers, comprising blood, induced sputum, bronchial biopsies and epithelial cells.

Syncona

Syncona is a closed-ended investment company. Co. operates in two segments: Life science portfolio, which invests in those whose activities focus on actively developing products to deliver transformational treatments for patients; and Funds portfolio, which invests in a diversified portfolio of hedge, equity and long-term alternative investment funds across multiple asset classes (Equity hedge funds, Equity funds, Fixed income and credit funds, Global macro funds, Other strategies, and Commodity funds). As of Mar 31 2017, Co.'s investment portfolio consisted of seven life science investments and a range of fund investments.

Tissue Regenix Group

Tissue Regenix Group is a medical technology company. Co. is engaged in the development of regenerative products to create replacement native tissue using biological (human and animal) materials. With its platform technology dCELL®, Co. is focusing on the treatment of patients with wound care, orthopaedic and cardiac applications. The dCELL® technology allows Co. to process both human and animal tissues, removing DNA and cellular material but leaving intact an acellular matrix within which the patient's own cells can repopulate and regenerate, creating like for like tissue.

TISSUE REGENIX GROUP PLC

Tristel PLC

Tristel is a manufacturer of infection prevention and contamination control products. Its key technology is a proprietary chlorine dioxide formulation. Co. has three segments: human healthcare, which includes the manufacture, development and sale of infection control and hygine products including products that incorporate Co.'s chlorine dioxide chemistry, and are used primarily for infection controls in hospitals; animal healthcare, which involves the manufacture and sale of disinfection and cleaning products into veterinary and animal welfare sectors; and contamination control, which addresses the pharmaceutical and personal care manufacturing industries.

ValiRx

Valirx is a biopharmaceutical company engaged in developing technologies and products in oncology therapeutics and diagnostics. Co. operates in two divisions which consist of ValiPharma, the therapeutics division with two embedded technologies primarily directed at the treatment of cancers; and ValiSeek, a joint venture between Co. and Tangent Reprofiling Ltd to develop VAL401 in lung cancer and potentially other indications.

Venture Life Group

Venture Life Group is a holding company, engaged in the development and commercialisation of healthcare products. Co.'s products address healthcare issues from oral healthcare, women's intimate health, neurology, cardiovascular and dermatology. Co.'s products include UltraDEX, a product range for the treatment of halitosis. Co.'s other brands are: NeuroAge™, a food supplement indicated for short-term memory loss and cognitive function; Myco Clear™ , indicated for the management of onychomycosis; Rosa calma™, a range of three topical products that treats this inflammatory skin condition; and Procto-eze™ Plus, a range of medical devices and cosmetics for the treatment of haemorrhoids.

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Analysts
Martin Hall

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