Healthcare M&A Report Q2 2018
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- Harriet Cole
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1 Integrity Expertise Results John Hill Senior Managing Director (813) John McDonald Senior Managing Director (813) Healthcare M&A Report Q Keith Hodgdon Managing Director (813) Charlie Hendrick Vice President (813) Jeff Hendricks Vice President (678) Hyde Park Capital Advisors, LLC 701 N. Franklin Street Tampa, FL Tel: Member FINRA/SIPC
2 Capital Markets Overview Healthcare Commentary Major market indices including the Nasdaq, S&P 500 and S&P Health Care Sector Index posted positive results over the 12-month period ended June 30, 2018, increasing 22.3%,, and 7.5%, respectively. The table to the right highlights select public offerings completed in the Healthcare industry during Q Tricida, Inc. (NASDAQ:TCDA), a late-stage pharmaceutical company, completed the largest IPO during the quarter, raising $222 million. The Healthcare Equipment & Supplies and Biotechnology segments remain the industry s leaders with respect to valuation during Q2 2018, trading at revenue multiples of 5.0x and 4.9x, respectively. Select Public Offerings Healthcare (Q2 2018) Offer Date Issuer Industry Sector Offering Type Offering Size ($mm) 06/19/18 Community Health Systems, Inc. Healthcare Facilities Fixed-Income $3,125 05/01/18 Centene Corp. Managed Healthcare Follow-on Equity $2,600 05/17/18 Becton, Dickinson and Co. Healthcare Equipment Fixed-Income $354 06/27/18 Tricida, Inc. Pharmaceuticals IPO $222 06/27/18 Translate Bio, Inc. Biotechnology IPO $122 06/27/18 Forty Seven, Inc. Biotechnology IPO $113 05/02/18 Inspire Medical Systems, Inc. Health Care Technology IPO $108 04/18/18 Surface Oncology, Inc. Biotechnology IPO $108 06/19/18 Eidos Therapeutics, Inc. Biotechnology IPO $106 06/20/18 Aptinyx, Inc. Biotechnology IPO $102 Public Market Performance (LTM) Public Company Market Performance by Sector 22.3% 7.5% Median Change in Stock Price LTM Industry Sector 3 Months 12 months Revenue EBITDA Healthcare Equipment & Supplies 8.6% 6.6% 5.0x 18.0x Healthcare Distribution (4.2%) (23.6%) 0.2x 9.2x Healthcare Services 7.9% 4.3% 2.1x 11.6x Healthcare Facilities 7.7% 1.2x 8.6x Managed Healthcare 10.6% 26.7% 0.6x 9.9x Healthcare Technology 10.4% (3.5%) 2.5x 26.4x Pharmaceuticals 1.2% 3.8% 3.8x 13.2x S&P 500 Nasdaq S&P Health Care Sector Index Source: S&P Capital IQ. Biotechnology 3.8% (5.9%) 4.9x 15.5x Life Sciences Tools & Services 1.6% 11.5% 4.2x 18.7x 2
3 Total Transaction Volume Total Transaction Value ($ in billions) Annual Middle-Market M&A Activity Healthcare Commentary Middle-Market M&A Transactions by Deal Size Healthcare As detailed below, middle-market Healthcare completed transaction volume and value fell during the first half of 2018 compared to Deal volume dropped 24% to 97 closed transactions, down from 127 during the prior half year period, and deal value decreased 9% to $17.8 billion compared to $19.6 billion the prior year. Deal volume for all transactions, including those without disclosed deal values, fell 21% to 554 closed transactions, down from 702 during the prior half year period. Deal volume continues to be impacted by uncertainty surrounding Healthcare policy. ($ in billions) Deal Size Volume Value Volume Value Volume Value Less than $100M 85 $ $1.7 (41%) (44%) $100 - $499M 31 $ $8.0 16% (1%) $500 - $999M 11 $ $8.1 0% (5%) Total Middle Market 127 $ $17.8 (24%) (9%) % of Middle Market 1H H 2018 % Change Less than $100M 67% 15% 52% 9% $100 - $499M 24% 41% 37% 45% $500 - $999M 9% 44% 11% 46% Total Middle Market 400 U.S. Middle-Market M&A Activity Annual Trends: VOLUME $60 U.S. Middle-Market M&A Activity Annual Trends: VALUE $50 $40 $30 $29.4 $33.4 $29.6 $25.9 $32.5 $49.8 $ $20 $12.0 $21.7 $19.6 $17.8 $ H H 2018 $ H H 2018 Less than $100M $100 - $499M $500 - $1,000M Less than $100M $100 - $499M $500 - $1,000M Source: S&P Capital IQ (middle market includes all closed deals with disclosed deal value between $10 million and $1 billion). 3
4 Total Transaction Volume Total Transaction Value ($ in billions) Quarterly Middle-Market M&A Activity Healthcare Commentary Middle-Market M&A Transactions by Deal Size Healthcare Middle-market M&A activity in the Healthcare industry slowed during Q to 46 closed transactions, a 27% decrease from the 63 transactions closed in Q The total value of deals closed in the industry fell just 5% to $8.4 billion in Q2 2018, down from $8.8 billion in the prior year period, with the only decline being in transactions valued less than $100 million (down 43%). Although Healthcare M&A activity has steadily declined since 2016 robust demand from both corporate and financial buyers has driven up pricing and deal multiples. ($ in billions) Deal Size Volume Value Volume Value Volume Value Less than $100M 40 $ $0.8 (45%) (43%) $100 - $499M 19 $ $4.7 5% 2% $500 - $999M 4 $2.9 4 $2.9 0% 1% Total Middle Market 63 $ $8.4 (27%) (5%) % of Middle Market Q Q % Change Less than $100M 64% 15% 48% 9% $100 - $499M 30% 52% 43% 56% $500 - $999M 6% 33% 9% 35% Total Middle Market U.S. Middle-Market M&A Activity Quarterly Trends: VOLUME U.S. Middle-Market M&A Activity Quarterly Trends: VALUE $20 $ $15 $10 $12.7 $15.2 $12.4 $11.8 $10.4 $10.7 $8.8 $10.0 $9.0 $9.4 $ $5 0 Q3'15 Q4'15 Q1 '16 Q2'16 Q3'16 Q4'16 Q1'17 Q2'17 Q3'17 Q4'17 Q1'18 Q2'18 $0 Q3'15 Q4'15 Q1 '16 Q2'16 Q3'16 Q4'16 Q1'17 Q2'17 Q3'17 Q4'17 Q1'18 Q2'18 Less than $100M $100 - $499M $500 - $1,000M Less than $100M $100 - $499M $500 - $1,000M Source: S&P Capital IQ (middle market includes all closed deals with disclosed deal value between $10 million and $1 billion) 4
5 Recent M&A Activity Healthcare Select Announced M&A Transactions (Q2 2018) Announced Date Target Buyer Industry Enterprise Value ($mm) EV / Revenue EV / EBITDA 06/28/18 PillPack, Inc. Amazon.com, Inc. Drug Retail NA NA NA 06/19/18 Cotiviti Holdings, Inc. Verscend Technologies, Inc. Health Care Technology $4, x 17.1x 06/19/18 Foundation Medicine, Inc. Roche Holdings, Inc. Biotechnology $5, x NA 06/11/18 Envision Healthcare Corp. KKR & Co. Healthcare Services $10, x 9.7x 06/06/18 ASPS, Inc. Fortive Corp. Healthcare Equipment $2, x NA 05/29/18 Caidan Enterprises, Inc. The WellCare Management Group, Inc. Managed Healthcare $2,500 NA NA 05/16/18 Abaxis, Inc. Zoetis, Inc. Healthcare Equipment $1, x 39.4x 05/10/18 ARMO BioSciences, Inc. Eli Lilly and Co. Biotechnology $1,463 NA NA 05/07/18 athenahealth, Inc. Elliott Management Health Care Technology $6, x 32.2x 05/02/18 Benevir Biopharm, Inc. Janssen Biotech, Inc. Biotechnology $1,040 NA NA 04/23/18 Curo Health Services, LLC TPG Capital / WCAS Healthcare Facilities NA NA NA 04/21/18 Sound Inpatient Physicians, Inc. Summit Partners Managed Healthcare NA NA NA 04/10/18 Analogic Corp. Altaris Capital Partners Healthcare Equipment $ x 20.4x 04/09/18 AveXis, Inc. Novartis AG Biotechnology $8,110 NA NA 04/02/18 GE Health (Value Based Care) Veritas Capital Health Care Technology $1,050 NA NA Source: S&P Capital IQ. 5
6 M&A Activity by Healthcare Sector U.S. Middle Market M&A Activity by Healthcare Sector: VOLUME % Change Pharmaceuticals, Biotechnology, and Life Sciences % Healthcare Equipment & Supplies % *Healthcare Services % Healthcare Facilities % Healthcare Technology % Q Q U.S. Middle Market M&A Activity by Healthcare Sector: VALUE % Change Pharmaceuticals, Biotechnology, and Life Sciences $1.6 $3.6 55% Healthcare Equipment & Supplies $0.6 $ % *Healthcare Services $1.4 $1.8 20% Healthcare Facilities $1.3 $2.1 40% Healthcare Technology $0.8 $1.2 54% $0.0 $0.5 $1.0 $1.5 $2.0 $2.5 $3.0 $3.5 $4.0 Q Q Source: S&P Capital IQ (includes all closed deals with disclosed deal value between $10 million and $1 billion). *Managed Healthcare and Healthcare Distribution transactions are included in the Healthcare Services sector. 6
7 Transaction Volume Private Equity Activity Healthcare Commentary Select Announced Private Equity M&A Transactions (Q2 2018) Financial sponsors were active across the board in the Healthcare industry during Q2 2018, with 44 deals announced, up from the 37 deals in Q1. Several notable private equity deals were announced during the quarter, including: KKR & Co. s proposed purchase of Envision Healthcare Corp. for $10.4 billion, and Elliott Management s announced acquisition of athenahealth, Inc. The Healthcare Services sector remained the most active in the industry with 20 announced deals in Q2 after 14 announced deals in the previous quarter. Announced Date Target Buyer Industry 06/15/18 Infu System Holdings, Inc. Argonne Capital / Meson Capital Enterprise Value ($mm) EV / Revenue EV / EBITDA Healthcare Services $ x 11.5x 06/11/18 Envision Healthcare Corp. KKR & Co. Healthcare Services $10, x 9.7x 06/06/18 PT Solutions Holdings, LLC Lindsay Goldberg Healthcare Services NA NA NA 06/06/18 Paladina Health, LLC New Enterprise Associates Managed Healthcare $100 NA NA 05/07/18 athenahealth, Inc. Elliott Management Health Care Technology $6, x 32.2x 05/01/18 Abode Healthcare, Inc. Tailwind Capital Group Healthcare Services NA NA NA 04/30/18 Redbrick Health Corp. Marlin Equity Partners Health Care Technology NA NA NA 25 Financial Sponsors Activity by Sector 04/23/18 Curo Health Services, LLC TPG Capital / WCAS Healthcare Facilities $1,400 NA NA 04/21/18 Sound Inpatient Physicians, Inc. Summit Partners Managed Healthcare $2,150 NA NA 04/18/18 Cadence, Inc. Kohlberg & Co. Healthcare Supplies NA NA NA /13/18 Center For Autism And Related Disorders, Inc. Blackstone Group Healthcare Services NA NA NA 04/10/18 Analogic Corp. Altaris Capital Partners Healthcare Equipment $1, x 20.4x 15 04/10/18 Jordan Health Services, Inc. Kelso & Co. / Blue Wolf Capital Partners Healthcare Services NA NA NA 10 04/02/18 GE Healthcare (Value-Based Care Division) Veritas Capital Fund Management Health Care Technology $1,050 NA NA Healthcare Equipment & Supplies *Healthcare Services Healthcare Facilities Healthcare Technology Pharmaceuticals, Biotechnology, and Life Sciences Source: S&P Capital IQ. Graphic includes transactions with undisclosed transaction values. Financial sponsors include private and public investment firms, and corporate and financial service investment arms. 7
8 Industry Sector Overview Recent Stock Price Performance Commentary Healthcare Services The charts included on the following pages detail the recent stock price performance by sector for the leading public companies within the Healthcare industry for the 12-month period ended June 30, The shaded section is the most recent 3-month period (Q2 2018) for each sector relative to the S&P 500. For the 12-month period ending June 30, 2018, the majority of the Healthcare industry had positive performances, led by the Managed Healthcare sector (up 26.7%) and the Healthcare Facilities (up ). 4.3% During the recently completed second quarter, all sectors in the Healthcare industry except Healthcare Distribution had positive returns. 80% S&P 500 Healthcare Equipment & Services Healthcare Facilities Managed Healthcare 140% 26.7% 80% S&P 500 Healthcare Facilities S&P 500 Managed Healthcare Source: S&P Capital IQ. 8
9 Industry Sector Overview Recent Stock Price Performance Healthcare Technology Healthcare Equipment & Supplies 6.6% 3.5% 80% 80% S&P 500 Healthcare Technology S&P 500 Healthcare Equipment & Supplies Healthcare Distribution Pharmaceuticals 3.8% 80% 23.6% 70% Source: S&P Capital IQ. S&P 500 Healthcare Distribution S&P 500 Pharmaceuticals 9
10 Industry Sector Overview Recent Stock Price Performance Biotechnology Life Sciences Tools & Services 11.5% 5.9% 80% S&P 500 Biotechnology S&P 500 Life Sciences Tools & Services Source: S&P Capital IQ. 10
11 Industry Sector Overview Public Company Analysis ($ in millions, except per share) Healthcare Facilities LTM LTM Margins LTM HCA Holdings, Inc. HCA $ % $37,671 $71,642 $44,414 $16,533 $8, % 18.7% 1.6x 8.6x Tenet Healthcare Corp. THC $ % $3,389 $19,927 $19,065 $6,850 $2, % 12.7% 1.0x 8.2x Universal Health Services, Inc. UHS $ % $10,660 $14,576 $10,485 $4,321 $1, % 16.3% 1.4x 8.5x Community Health Systems, Inc. CYH $ % $372 $14,441 $14,556 $5,054 $ % 5.7% 1.0x 17.5x* Encompass Health Corp. EHC $ % $6,731 $9,664 $4,008 $1,661 $ % 21.0% 2.4x 11.5x Select Medical Holdings Corp. SEM $ % $2,349 $6,472 $4,526 $893 $ % 12.0% 1.4x 11.9x Lifepoint Hospitals, Inc. LPNT $ % $1,964 $4,914 $6,264 $2,001 $ % 10.7% 0.8x 7.4x Hanger Orthopedic Group, Inc. HNGR $ % $617 $1,034 $1,041 $351 $ % 8.0% 1.0x 12.4x Average 81.0% $7,969 $17,834 $13,045 $4,708 $1, % 13.1% 1.3x 9.8x Median 87.0% $2,869 $12,053 $8,374 $3,161 $ % 12.3% 1.2x 8.6x Healthcare Services LTM LTM Margins LTM Laboratory Corp. of America Holdings LH $ % $18,613 $25,034 $10,641 $3,555 $2, % 19.2% 2.4x 12.3x DaVita, Inc. DVA $ % $13,054 $23,234 $11,110 $3,286 $2, % 21.5% 2.1x 9.7x Quest Diagnostics, Inc. DGX $ % $15,337 $19,271 $7,776 $3,048 $1, % 20.2% 2.5x 12.3x MEDNAX, Inc. MD $ % $4,027 $5,828 $3,525 $1,047 $ % 16.5% 1.7x 10.0x RadNet, Inc. RDNT $ % $708 $1,290 $925 $192 $ % 12.0% 1.4x 11.7x Average 88.2% $10,348 $14,931 $6,795 $2,226 $1, % 17.9% 2.0x 11.2x Median 94.3% $13,054 $19,271 $7,776 $3,048 $1, % 19.2% 2.1x 11.7x Source: S&P Capital IQ. *Excluded from the average and median calculations. 11
12 Industry Sector Overview Public Company Analysis ($ in millions, except per share) Managed Healthcare Unitedhealth Group, Inc. UNH $ % $242,396 $260,313 $207,624 $49,184 $17, % 8.5% 1.3x 14.8x Aetna, Inc. AET $ % $60,894 $60,051 $60,705 $16,591 $6, % 10.3% 1.0x 9.6x Anthem, Inc. ANTM $ % $63,292 $59,702 $90,063 $18,324 $5, % 6.4% 0.7x 10.4x Cigna Corp. CI $ % $42,755 $45,089 $42,522 $14,224 $4, % 11.7% 1.1x 9.0x Humana, Inc. HUM $ % $42,583 $29,280 $54,284 $10,444 $3, % 6.7% 0.5x 8.0x Centene Corp. CNC $ % $21,829 $21,035 $47,198 $8,630 $2, % 4.5% 0.4x 9.9x WellCare Health Plans, Inc. WCG $ % $11,095 $6,746 $17,699 $2,471 $ % 4.0% 0.4x 9.5x Magellan Health Services, Inc. MGLN $ % $2,383 $2,893 $6,338 $276 $ % 3.6% 0.5x 12.8x LTM LTM Margins LTM Average 91.5% $60,903 $60,639 $65,804 $15,018 $5, % 7.0% 0.7x 10.5x Median 95.0% $42,669 $37,185 $50,741 $12,334 $4, % 6.6% 0.6x 9.8x Healthcare Technology LTM LTM Margins LTM Cerner Corp. CERN $ % $20,214 $19,738 $5,073 $4,288 $1, % 26.2% 3.9x 14.9x Athenahealth, Inc. ATHN $ % $6,533 $6,660 $1,264 $684 $ % 16.8% 5.3x 31.4x Medidata Solutions, Inc. MDSO $ % $4,855 $4,712 $567 $435 $ % 15.5% 8.3x* 53.7x* Allscripts Healthcare Solutions, Inc. MDRX $ % $2,167 $4,244 $1,907 $946 $ % 7.6% 2.2x 29.3x Quality Systems, Inc. QSII $ % $1,237 $1,245 $531 $289 $ % 8.4% 2.3x 28.0x Healthstream, Inc. HSTM $ % $879 $684 $251 $143 $ % 11.0% 2.7x 24.9x Computer Programs & Systems, Inc. CPSI $ % $442 $583 $284 $158 $ % 13.1% 2.1x 15.6x Average 90.1% $5,190 $5,409 $1,411 $992 $ % 14.1% 3.1x 24.0x Median 93.8% $2,167 $4,244 $567 $435 $ % 13.1% 2.5x 26.4x Source: S&P Capital IQ. *Excluded from the average and median calculations. 12
13 Industry Sector Overview Public Company Analysis ($ in millions, except per share) Healthcare Equipment & Supplies LTM LTM Margins LTM Medtronic, Inc. MDT $ % $117,132 $131,784 $29,953 $20,983 $9, % 31.7% 4.4x 13.9x Becton, Dickinson and Co. BDX $ % $56,662 $78,188 $13,503 $6,633 $3, % 28.6% 5.8x 20.2x Stryker Corp. SYK $ % $64,243 $69,701 $12,730 $8,432 $3, % 27.3% 5.5x 20.1x Teleflex, Inc. TFX $ % $12,521 $14,374 $2,246 $1,294 $ % 27.8% 6.4x 23.0x The Cooper Companies, Inc. COO $ % $11,619 $13,938 $2,339 $1,551 $ % 32.1% 6.0x 18.6x DENTSPLY International, Inc. XRAY $ % $10,009 $11,373 $4,049 $2,211 $ % 20.5% 2.8x 13.7x Steris Corp. STE $ % $9,001 $10,127 $2,620 $1,094 $ % 22.8% 3.9x 16.9x Varian Medical Systems, Inc. VAR $ % $10,468 $9,981 $2,812 $1,234 $ % 20.4% 3.5x 17.4x Average 89.7% $36,457 $42,433 $8,781 $5,429 $2, % 26.4% 4.8x 18.0x Median 93.4% $12,070 $14,156 $3,430 $1,881 $ % 27.6% 4.9x 18.0x Healthcare Distribution LTM Margins LTM McKesson Corp. MCK $ % $27,881 $35,030 $208,357 $11,184 $3, % 1.9% 0.2x 9.0x Cardinal Health, Inc. CAH $ % $15,479 $22,895 $134,426 $7,069 $3, % 2.4% 0.2x 7.1x AmerisourceBergen Corp. ABC $ % $18,894 $21,872 $159,327 $4,619 $2, % 1.5% 0.1x 9.2x Henry Schein, Inc. HSIC $ % $11,390 $13,940 $12,759 $3,472 $1, % 8.5% 1.1x 12.9x Patterson Companies, Inc. PDCO $ % $2,110 $3,064 $5,466 $1,199 $ % 5.6% 0.6x 10.1x Owens & Minor, Inc. OMI $ % $1,002 $1,812 $9,362 $1,215 $ % 2.1% 0.2x 9.1x LTM Average 65.5% $12,793 $16,435 $88,283 $4,793 $1, % 3.6% 0.4x 9.6x Median 68.2% $13,435 $17,906 $73,593 $4,045 $1, % 2.3% 0.2x 9.2x Source: S&P Capital IQ. 13
14 Industry Sector Overview Public Company Analysis ($ in millions, except per share) Pharmaceuticals LTM LTM Margins LTM Pfizer Inc. PFE $ % $219,467 $249,640 $52,673 $41,985 $21, % 40.4% 4.7x 11.7x Eli Lilly and Company LLY $ % $89,630 $96,715 $23,343 $17,049 $6, % 29.7% 4.1x 14.0x Bristol-Myers Squibb Company BMY $ % $90,993 $92,036 $21,040 $14,817 $5, % 27.0% 4.4x 16.2x Mylan N.V. MYL $ % $19,215 $33,861 $11,873 $4,864 $3, % 30.2% 2.9x 9.4x Catalent, Inc. CTLT $ % $5,500 $7,875 $2,395 $734 $ % 20.2% 3.3x 16.3x Prestige Brands Holdings, Inc. PBH $ % $2,054 $4,015 $1,041 $585 $ % 34.2% 3.9x 11.3x Amneal Pharmaceuticals, Inc. AMRX $ % $2,113 $3,532 $1,041 $546 $ % 26.9% 3.4x 12.6x Akorn, Inc. AKRX $ % $2,074 $2,581 $772 $367 $ % 14.8% 3.3x 22.7x ANI Pharmaceuticals, Inc. ANIP $ % $772 $923 $187 $114 $ % 38.0% 4.9x 13.0x Average 80.1% $47,980 $54,575 $12,707 $9,007 $4, % 29.0% 3.9x 14.1x Median 81.3% $5,500 $7,875 $2,395 $734 $ % 29.7% 3.9x 13.0x Biotechnology LTM LTM Margins LTM Amgen, Inc. AMGN $ % $134,289 $137,658 $22,939 $19,068 $12, % 54.3% 6.0x 11.1x Gilead Sciences, Inc. GILD $ % $93,438 $97,873 $24,690 $20,275 $14, % 57.3% 4.0x 6.9x Celgene Corporation CELG $ % $63,375 $78,899 $13,579 $12,037 $5, % 37.2% 5.8x 15.6x Biogen, Inc. BIIB $ % $61,516 $61,517 $12,594 $10,903 $6, % 55.0% 4.9x 8.9x Alexion Pharmaceuticals, Inc. ALXN $ % $27,906 $29,496 $3,612 $3,293 $1, % 43.4% 8.2x 18.8x Myriad Genetics, Inc. MYGN $ % $2,661 $2,573 $778 $604 $ % 15.1% 3.3x 21.9x Emergent Biosolutions, Inc. EBS $ % $2,539 $2,389 $562 $249 $ % 26.3% 4.3x 16.2x Eagle Pharmaceuticals, Inc. EGRX $ % $1,191 $1,143 $207 $156 $ % 23.7% 5.5x 23.3x XOMA Corporation XOMA $ % $174 $147 $53 $49 $ % 46.1% 2.8x 6.0x Average 79.2% $43,010 $45,744 $8,779 $7,404 $4, % 39.8% 5.0x 14.3x Median 83.1% $27,906 $29,496 $3,612 $3,293 $1, % 43.4% 4.9x 15.6x Source: S&P Capital IQ. 14
15 Industry Sector Overview Public Company Analysis ($ in millions, except per share) Life Sciences Tools & Services LTM LTM Margins LTM Thermo Fisher Scientific Inc. TMO $ % $83,063 $103,211 $22,006 $9,892 $5, % 25.0% 4.7x 18.7x Agilent Technologies, Inc. A $ % $20,098 $19,206 $4,720 $2,560 $1, % 24.2% 4.1x 16.8x Mettler-Toledo International Inc. MTD $ % $15,201 $16,096 $2,791 $1,605 $ % 24.1% 5.8x 23.9x Waters Corporation WAT $ % $15,553 $14,249 $2,342 $1,384 $ % 34.7% 6.1x 17.5x PerkinElmer, Inc. PKI $ % $8,139 $10,035 $2,387 $1,139 $ % 19.3% 4.2x 21.7x Syneos Health, Inc. SYNH $ % $4,105 $6,889 $2,658 $1,049 $ % 13.9% 2.6x 18.6x Medpace Holdings, Inc. MEDP $ % $1,659 $1,860 $456 $235 $ % 24.9% 4.1x 16.4x Luminex Corporation LMNX $ % $1,283 $1,155 $311 $200 $ % 19.7% 3.7x 18.8x Average 87.3% $18,638 $21,588 $4,709 $2,258 $1, % 23.2% 4.4x 19.1x Median 87.3% $11,670 $12,142 $2,522 $1,262 $ % 24.1% 4.1x 18.7x Source: S&P Capital IQ. 15
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