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Launched on 01/26/2011, the SPDR S&P Health Care Equipment ETF (XHE) is a smart beta exchange traded fund offering broad exposure to the Health Care ETFs category of the market.
What Are Smart Beta ETFs?
The ETF industry has traditionally been dominated by products based on market capitalization weighted indexes that are designed to represent the market or a particular segment of the market.
Market cap weighted indexes offer a low-cost, convenient, and transparent way of replicating market returns, and are a good option for investors who believe in market efficiency.
There are some investors, though, who think it's possible to beat the market with great stock selection; this group likely invests in another class of funds known as smart beta, which track non-cap weighted strategies.
By attempting to pick stocks that have a better chance of risk-return performance, non-cap weighted indexes are based on certain fundamental characteristics, or a combination of such.
Even though this space provides many choices to investors--think one of the simplest methodologies like equal-weighting and more complicated ones like fundamental and volatility/momentum based weighting--not all have been able to deliver first-rate results.
Fund Sponsor & Index
Managed by State Street Global Advisors, XHE has amassed assets over $226.25 million, making it one of the average sized ETFs in the Health Care ETFs. Before fees and expenses, XHE seeks to match the performance of the S&P Health Care Equipment Select Industry Index.
The S&P Health Care Equipment Select Industry Index represents the health care equipment segment of the S&P Total Market Index.
Cost & Other Expenses
Investors should also pay attention to an ETF's expense ratio. Lower cost products will produce better results than those with a higher cost, assuming all other metrics remain the same.
With one of the least expensive products in the space, this ETF has annual operating expenses of 0.35%.
The fund has a 12-month trailing dividend yield of 0.03%.
Sector Exposure and Top Holdings
ETFs offer diversified exposure and thus minimize single stock risk, but it is still important to delve into a fund's holdings before investing. Most ETFs are very transparent products and many disclose their holdings on a daily basis.
XHE's heaviest allocation is in the Healthcare sector, which is about 100% of the portfolio.
Looking at individual holdings, Omnicell Inc (OMCL) accounts for about 2.53% of total assets, followed by Icu Medical Inc (ICUI) and Ufp Technologies Inc (UFPT).
Its top 10 holdings account for approximately 21.06% of XHE's total assets under management.
Performance and Risk
Year-to-date, the SPDR S&P Health Care Equipment ETF return is roughly 6.54% so far, and was up about 10.36% over the last 12 months (as of 09/19/2024). XHE has traded between $66.75 and $90.21 in this past 52-week period.
The ETF has a beta of 0.97 and standard deviation of 26.13% for the trailing three-year period, making it a medium risk choice in the space. With about 68 holdings, it effectively diversifies company-specific risk.
Alternatives
SPDR S&P Health Care Equipment ETF is a reasonable option for investors seeking to outperform the Health Care ETFs segment of the market. However, there are other ETFs in the space which investors could consider.
First Trust Indxx Medical Devices ETF (MDEV) tracks INDXX GLOBAL MEDICAL EQUIPMENT INDEX and the iShares U.S. Medical Devices ETF (IHI) tracks Dow Jones U.S. Select Medical Equipment Index. First Trust Indxx Medical Devices ETF has $3.26 million in assets, iShares U.S. Medical Devices ETF has $5 billion. MDEV has an expense ratio of 0.70% and IHI charges 0.40%.
Investors looking for cheaper and lower-risk options should consider traditional market cap weighted ETFs that aim to match the returns of the Health Care ETFs.
Bottom Line
To learn more about this product and other ETFs, screen for products that match your investment objectives and read articles on latest developments in the ETF investing universe, please visit Zacks ETF Center.
Zacks Investment Research
Have you been paying attention to shares of ICU Medical (ICUI)? Shares have been on the move with the stock up 15.2% over the past month. The stock hit a new 52-week high of $181.34 in the previous session. ICU Medical has gained 80% since the start of the year compared to the 12.1% move for the Zacks Medical sector and the 15.9% return for the Zacks Medical - Products industry.
What's Driving the Outperformance?
The stock has an impressive record of positive earnings surprises, as it hasn't missed our earnings consensus estimate in any of the last four quarters. In its last earnings report on August 7, 2024, ICU Medical reported EPS of $1.56 versus consensus estimate of $0.98 while it beat the consensus revenue estimate by 7%.
For the current fiscal year, ICU Medical is expected to post earnings of $5.16 per share on $2.29 billion in revenues. This represents a -23.67% change in EPS on a 1.45% change in revenues. For the next fiscal year, the company is expected to earn $6.58 per share on $2.36 billion in revenues. This represents a year-over-year change of 27.52% and 2.79%, respectively.
Valuation Metrics
ICU Medical may be at a 52-week high right now, but what might the future hold for the stock? A key aspect of this question is taking a look at valuation metrics in order to determine if the company has run ahead of itself.
On this front, we can look at the Zacks Style Scores, as these give investors a variety of ways to comb through stocks (beyond looking at the Zacks Rank of a security). These styles are represented by grades running from A to F in the categories of Value, Growth, and Momentum, while there is a combined VGM Score as well. The idea behind the style scores is to help investors pick the most appropriate Zacks Rank stocks based on their individual investment style.
ICU Medical has a Value Score of B. The stock's Growth and Momentum Scores are C and F, respectively, giving the company a VGM Score of B.
In terms of its value breakdown, the stock currently trades at 34.8X current fiscal year EPS estimates, which is a premium to the peer industry average of 25.3X. On a trailing cash flow basis, the stock currently trades at 11.7X versus its peer group's average of 11.9X. This isn't enough to put the company in the top echelon of all stocks we cover from a value perspective.
Zacks Rank
We also need to consider the stock's Zacks Rank, as this supersedes any trend on the style score front. Fortunately, ICU Medical currently has a Zacks Rank of #2 (Buy) thanks to favorable earnings estimate revisions from covering analysts.
Since we recommend that investors select stocks carrying Zacks Rank of 1 (Strong Buy) or 2 (Buy) and Style Scores of A or B, it looks as if ICU Medical fits the bill. Thus, it seems as though ICU Medical shares could have potential in the weeks and months to come.
How Does ICUI Stack Up to the Competition?
Shares of ICUI have been soaring, and the company still appears to be a decent choice, but what about the rest of the industry? One industry peer that looks good is Koninklijke Philips N.V. (PHG). PHG has a Zacks Rank of # 2 (Buy) and a Value Score of A, a Growth Score of B, and a Momentum Score of C.
Earnings were strong last quarter. Koninklijke Philips N.V. beat our consensus estimate by 7.32%, and for the current fiscal year, PHG is expected to post earnings of $1.51 per share on revenue of $19.99 billion.
Shares of Koninklijke Philips N.V. have gained 5.6% over the past month, and currently trade at a forward P/E of 20.52X and a P/CF of 10.73X.
The Medical - Products industry is in the top 26% of all the industries we have in our universe, so it looks like there are some nice tailwinds for ICUI and PHG, even beyond their own solid fundamental situation.
Zacks Investment Research
Omnicell OMCL is moving closer to achieving the industry-defined vision of Autonomous Pharmacy through automation and advanced services across its cloud-based platform. The company is on track to meet its 2025 financial goals, supported by increasing tech services and long-term customer partnerships. Its strategic expansion into new regions is also encouraging. However, headwinds from competitive pressures and macroeconomic challenges could adversely affect the company’s performance.
In the past year, this Zacks Rank #3 (Hold) stock has declined 20.8% compared to the 6.1% fall of the industry and the 21.1% growth of the S&P 500 composite.
The renowned healthcare technology company has a market capitalization of $2.05 billion. Omnicell surpassed estimates in all the trailing four quarters, delivering an average earnings surprise of 122.04%.
Tailwinds for OMCL Stock
Autonomous Pharmacy Model Holds Potential: Omnicell is aiming to achieve the industry vision of Autonomous Pharmacy with its medication management infrastructure. By delivering automation, intelligence and advanced services through a single, cloud-based platform, the company is empowering healthcare and pharmacy providers to increase healthcare value and improve patient outcomes. Among its key Point-of-Care product market, the company expects further expansion as customers increase the use of dispensing systems within their hospitals and ambulatory care settings.
The Central Pharmacy and IV Compounding market offers significant automation opportunities for high volumes of manual, repetitive and error-prone processes. Meanwhile, in the Retail, Institutional and Payer markets, the shift toward outpatient care from convenient settings also presents a big opportunity.New technologies and increasing pharmacist roles are spurring innovation and clinical services in retail pharmacies. This, along with value-based care, is expected to drive the adoption of Omnicell’s patient engagement solutions.
2025 Roadmap Looks Impressive: Omnicell is aiming to reach $1.9 billion-$2 billion of revenues by 2025, representing a CAGR of 14%-15% in the 2021-2025 period. Additional targets include a non-GAAP gross margin of 52%-53% and a non-GAAP EBITDA margin of approximately 23%. The company delivered a non-GAAP EBITDA of $40 million in the second quarter of 2024, outpacing the previous guidance. Non-GAAP earnings per share benefitted from robust revenue execution, and strong cost and operating expense management. Driven by factors like growing tech services revenues, benefits from long-term sole source customer partnerships and more, the company looks poised to deliver on the 2025 total revenue growth targets.
Planned Geographic Expansion Another Upside: Healthcare providers outside the United States are becoming increasingly aware of the benefits of automation, with substantial demand for adherence packaging equipment. Many government and private entities are heavily investing in information technology and automation, inspired by the recent advancements in the United States. Omnicell intends to strategically expand into new markets, given that the international market is less than 1% penetrated with very few hospitals adopting medication control systems. Presently, the company’s efforts are centered in Canada, Europe, the Middle East and the Asia-Pacific regions and supply chain efforts in Asia.
Concerns for OMCL Stock
Competitive Landscape: Omnicell faces intense competition in the medication management and supply chain solutions market from major players such as Becton Dickinson, ARxIUM. Direct competitors like AutoMed Technologies, Inc. (a subsidiary of ARxIUM) and RX Systems, Inc. also pose threats as they spearhead several expansion programs. This increased competition could result in pricing pressure and reduced margins for the company.
Macroeconomic Issues: Heightened inflationary pressures, supply chain disruptions, labor shortages and geopolitical instability are affecting the broader U.S. and global economies. These can potentially lead to higher costs for the company’s raw materials and other components, which it may not be able to offset from customers through higher prices. Simultaneously, Omnicell is navigating the ongoing healthcare capital budget and labor constraints, which have continued to impact its Point-of-Care product line. However, health system budget improvements are not likely to favor Omnicell’s revenues immediately.
OMCL Estimate Trend
The Zacks Consensus Estimate for OMCL’s 2024 earnings per share has increased 12.9% to $1.40 in the past 30 days.
The Zacks Consensus Estimate for the company’s 2024 revenues is pegged at $1.08 billion. This suggests a 5.8% fall from the year-ago reported number.
Top MedTech Stocks
Some other top-ranked stocks in the broader medical space are TransMedix Group TMDX, AxoGen AXGN and Boston Scientific BSX. While TransMedix Group currently sports a Zacks Rank #1 (Strong Buy), AxoGen and Boston Scientific carry a Zacks Rank #2 (Buy) each. You can see the complete list of today’s Zacks #1 Rank stocks here.
TransMedix Group’s earnings are expected to surge 257.1% in 2024. Its shares have soared 127.9% compared with the industry’s 13.9% rise in the past year.
TMDX’s earnings surpassed the Zacks Consensus Estimate in each of the trailing four quarters, the average surprise being 287.5%.
AxoGen has an estimated 2024 earnings growth rate of 94.1% compared with the industry’s 12.9%. Shares of the company have soared 126.3% compared with the industry’s 13.9% rise over the past year.
AXGN’s earnings surpassed estimates in each of the trailing four quarters, the average surprise being 96.5%.
Boston Scientific has an estimated earnings growth rate of 17.1% compared with the industry’s 14.8%. Shares of the company have rallied 52.2% compared with the industry’s 16.9% rise over the past year.
BSX’s earnings surpassed estimates in each of the trailing four quarters, the average surprise being 7.2%.
Zacks Investment Research
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