Doximity on the New York Inventory Trade for his or her IPO, June 24, 2021.
Supply: NYSE
If the Covid period marked a growth time for digital well being firms, 2024 was the reckoning.
In a yr that noticed the Nasdaq soar 32%, surpassing 20,000 for the primary time this month, well being tech suppliers largely suffered. Of 39 public digital well being firms analyzed by CNBC, roughly two-thirds are down for the yr. Others are actually out of enterprise.
There have been some breakout stars, like Hims & Hers Health, which was buoyed by the success of its fashionable new weight reduction providing and its place within the GLP-1 craze. However that was an exception.
Whereas there have been some company-specific challenges within the business, general it was a “yr of inflection,” in line with Scott Schoenhaus, an analyst at KeyBanc Capital Markets protecting health-care IT firms. Enterprise fashions that appeared poised to interrupt out through the pandemic have not all labored as deliberate, and corporations have needed to refocus on profitability and a extra muted progress setting.
“The pandemic was an enormous pull ahead in demand, and we’re dealing with these robust, difficult comps,” Schoenhaus informed CNBC in an interview. “Development clearly slowed for many of my names, and I feel employers, payers, suppliers and even pharma are extra selective and extra discerning on digital well being firms that they partnered with.”
In 2021, digital well being startups raised $29.1 billion, blowing previous all earlier funding data, in line with a report from Rock Health. Virtually two dozen digital well being firms went public by means of an preliminary public providing or particular objective acquisition firm, or SPAC, that yr, up from the earlier report of eight in 2020. Cash was pouring into themes that performed into distant work and distant well being as buyers regarded for progress with rates of interest caught close to zero.
However because the worst waves of the pandemic subsided, so did the insatiable demand for brand new digital well being instruments. It has been a impolite awakening for the sector.
“What we’re nonetheless going by means of is an understanding of the perfect methods to handle digital well being wants and capabilities, and the push and pull of the present enterprise fashions and the way profitable they might be,” Michael Cherny, an analyst at Leerink Companions, informed CNBC. “We’re in a settling out interval put up Covid.”
GoodRx signage on the surface of the Nasdaq on the day of its IPO, September 23, 2020.
Supply: GoodRx
Progyny, which gives advantages options for fertility and household planning, is down greater than 60% yr so far. Teladoc Health, which as soon as dominated the virtual-care house, has dropped 58% and is 96% off its 2021 excessive.
When Teladoc acquired Livongo in 2020, the businesses had a combined enterprise value of $37 billion. Teladoc’s market cap now sits at underneath $1.6 billion.
GoodRx, which gives value transparency instruments for medicines, is down 33% yr so far.
Schoenhaus says many firms’ estimates have been too excessive this yr.
Progyny minimize its full-year income steerage in each earnings report in 2024. In February, Progyny was predicting $1.29 billion to $1.32 billion in annual income. By November, the range was right down to $1.14 billion to $1.15 billion.
GoodRx additionally repeatedly slashed its full-year steerage for 2024. What was $800 million to $810 million in Might shrank to $794 million by the November.
In Teladoc’s first-quarter report, the corporate mentioned it anticipated full-year income of $2.64 billion to $2.74 billion. The corporate withdrew its outlook in its second quarter, and reported consecutive year-over yr declines.
“This has been a yr of coming to phrases with the expansion outlook for a lot of of my firms, and so I feel we are able to lastly take a look at 2025 as perhaps a greater yr by way of the setups,” Schoenhaus mentioned.
Whereas overzealous forecasting tells a part of the digital well being story this yr, there have been some notable stumbles at specific firms.
Dexcom, which makes units for diabetes and glucose administration, is down greater than 35% yr so far. The inventory tumbled more than 40% in July – its steepest decline ever – after the corporate reported disappointing second-quarter outcomes and issued weak full-year steerage.
CEO Kevin Sayer attributed the challenges to a restructuring of the gross sales group, fewer new prospects than anticipated and decrease income per consumer. Following the report, JPMorgan Chase analysts marveled at “the magnitude of the draw back” and the truth that it “seems to principally be self-inflicted.”
Genetic testing firm 23andMe had a very tough yr. The corporate went public through a SPAC in 2021, valuing the enterprise at $3.5 billion, after its at-home DNA testing kits skyrocketed in reputation. The corporate is now price lower than $100 million and CEO Anne Wojcicki is making an attempt to maintain it afloat.
In September, all seven impartial administrators resigned from 23andMe’s board, citing disagreements with Wojcicki concerning the “strategic course for the corporate.” Two months later, 23andMe mentioned it deliberate to chop 40% of its workforce and shutter its therapeutics enterprise as a part of a restructuring plan.
Wojcicki has repeatedly mentioned she intends to take 23andMe personal. The inventory is down greater than 80% yr so far.
Digital well being’s brilliant spots
Merchandise of Hims & Hers displayed.
Hims & Hers
Buyers in Hims & Hers had a significantly better yr.
Shares of the direct-to-consumer market are up greater than 200% yr so far, pushing the corporate’s market cap to $6 billion, due to hovering demand for GLP-1s.
Hims & Hers started prescribing compounded semaglutide by means of its platform in Might after launching a brand new weight reduction program late final yr. Semaglutide is the lively ingredient in Novo Nordisk‘s blockbuster medicines Ozempic and Wegovy, which might price round $1,000 a month with out insurance coverage. Compounded semaglutide is a less expensive, custom-made various to the model medicine and might be produced when the brand-name therapies are in shortage.
Hims & Hers will doubtless must deal with dynamic provide and regulatory environments subsequent yr, however even earlier than including compounded GLP-1s to its portfolio, the corporate mentioned in its February earnings name that it expects its weight reduction program to usher in greater than $100 million in income by the top of 2025.
Doximity, a digital platform for medical professionals, additionally had a powerful 2024, with its inventory value greater than doubling. The corporate’s platform, which for years has been likened to a LinkedIn for doctors, permits clinicians to remain present on medical information, handle paperwork, discover referrals and perform telehealth appointments with sufferers.
Doximity primarily generates income by means of its hiring options, telehealth instruments and advertising choices for shoppers like pharmaceutical firms.
Leerink’s Cherny mentioned Doximity’s success might be attributed to its lean working mannequin, in addition to the “differentiated mousetrap” it is created due to its attain into the doctor community.
“DOCS is a uncommon firm in healthcare IT as it’s already worthwhile, generates sturdy incremental margins, and is a gradual grower,” Leerink analysts, together with Cherny, wrote in a November be aware. The agency raised its value goal on the inventory to $60 from $35.
One other standout this yr was Oscar Health, the tech-enabled insurance coverage firm co-founded by Thrive Capital Administration’s Joshua Kushner. Its shares are up almost 50% yr so far. The corporate helps roughly 1.65 million members and plans to broaden to round 4 million by 2027.
Oscar confirmed sturdy income progress in its third-quarter report in November. Gross sales climbed 68% from a yr earlier to $2.4 billion.
Moreover, two digital well being firms, Waystar and Tempus AI, took the leap and went public in 2024.
The IPO market has been largely dormant since late 2021, when hovering inflation and rising rates of interest pushed buyers out of danger. Few expertise firms have gone public since then, and no digital well being firms held IPOs in 2023, in line with a report from Rock Well being.
Waystar, a health-care fee software program vendor, has seen its inventory soar to $36.93 from its IPO price of $21.50 in June. Tempus, a precision drugs firm, hasn’t fared as properly. It is inventory has slipped to $34.91 from its IPO price of $37, additionally in June.
“Hopefully, the valuations are extra supportive of alternatives for different firms which were lingering within the background as personal firms for the final a number of years.” Schoenhaus mentioned.
Out with the previous
The Nasdaq MarketSite is seen on December 12, 2024 in New York Metropolis.
Michael M. Santiago | Getty Pictures
A number of digital well being firms exited the general public markets fully this yr.
Cue Health, which made Covid exams and counted Google as an early customer, and Higher Therapeutics, which used digital therapeutics to deal with cardiometabolic situations, each shuttered operations and delisted from the Nasdaq.
Income cycle administration firm R1 RCM was acquired by TowerBrook Capital Companions and Clayton, Dubilier & Rice in an $8.9 billion deal. Equally, Altaris bought Sharecare, which runs a digital well being platform, for roughly $540 million.
Commure, a non-public firm that gives instruments for simplifying clinicians’ workflows, acquired medical AI scribing firm Augmedix for about $139 million.
“There was numerous competitors that entered {the marketplace} through the pandemic years, and we have seen a few of that being flushed out of the markets, which is an effective factor,” Schoenhaus mentioned.
Cherny mentioned the sector is adjusting to a post-pandemic interval, and digital well being firms are determining their function.
“We’re nonetheless biking by means of what might be nearly termed digital well being 1.1 enterprise fashions,” he mentioned. “It is nice to say we do issues digitally, nevertheless it solely issues if it has some strategy towards impacting the ‘triple intention’ of well being care: higher care, extra handy, decrease price.”
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