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Health care, a long term
investment opportunity
This document is solely for the use of professionals and is not for general public distribution.
The value of an investment and the income from it can fall as well as rise and you may not get back the amount originally invested.
1
Why Health Care?
Innovation: Accelerating innovation addressing unmet medical needs
Demographics: Aging global populations drive health care
spending growth
Globalisation: Rising standards of living lead to higher health care
spending globally
Diversification and Defensive Characteristics: Historically, the
sector has one of the lowest correlations to the broader equity markets
and has held up better in down markets
2
Why Health Care? Opportunities for Innovation
Cardiovascular Disease
Cardiovascular disease is the leading cause
of death worldwide – an estimated 17.3
million deaths each year. That’s one every
two seconds. The cost of cardiovascular
disease is estimated at $863 billion per year
worldwide.
$863B Annual global spend
Cancer
39.6% of people will be diagnosed with
cancer at some point during their
lifetimes. The number of new cases is
expected to rise by about 70% over the
next 2 decades. Cancers figure among
the leading causes of morbidity and
mortality worldwide, with approximately
14 million new cases and 8.2 million
cancer-related deaths in 2012.
$895B Annual global spend
Diabetes
The number of people with diabetes
globally has risen from 108 million in
1980 to 422 million in 2014. 9.3% of the
United States population has diabetes.
If current trends continue as many as 1 in
3 American adults will have diabetes in
2050. The total annual estimated cost of
diagnosed diabetes globally is $825
billion.
$825B Annual global spend
What are we seeking:
Innovative and differentiated therapies
addressing unmet medical needs Sources: American Cancer Society, 2010. World Health Organisation – Diabetes, June 2016.
Cancer Connect.net – http://news.cancerconnect.com/worldwide-cancer-has-biggest-economic-impact-of-any-cause-of-death.
3
Why Health Care? Innovation
Pace of innovation is accelerating
$1,000
$10,000
$100,000
$1,000,000
$10,000,000
$100,000,000
oore’s a
• The Human Genome Project was
completed in 2000
• It took over 13 years to complete and
cost over $3 billion
• Since that time there have been
dramatic improvements in genetic
analysis
• Leading to a better understanding of
the underlying causes of human
disease
Cost per Genome
Source: National Human Genome Research Institute. As of October 2015.
* Moore's law refers to a prediction by Intel co-founder Gordon Moore that the number of transistors on integrated circuits would double every two years. Moore’s law has
been credited with driving advances in the semiconductor industry that helped make computing widespread and affordable.
4
Why Health Care? Innovation
Pace of innovation is accelerating
Number of drugs receiving FDA approval Biotechnology sales
72
96
108
0
20
40
60
80
100
120
2008-2010 2011-2013 2014-2016$0
$20
$40
$60
$80
$100
$120
$140
$160
$180
Top 40 Biotech Drugs
$161B
$ (
Bill
ions)
50% Increase
• 22 drugs approved in 2016, YTD the FDA has
approved 23 drugs, with 16 pending
• The 108 drugs approved between 2014–2016 is a
50% increase compared to the 3 year period
ending 31 December 2010
• Sales up 30x since 1999
Sources: FDA Sources: ISI Group and Janus Henderson Investors
5
Why Health Care? Innovation in Action
69%
58%
Hepatitis C
10%
25%
40%
70%
>95%
1989 1992 1998 2001 2011 2015
Source: Pharmaceutical Research and Manufacturers of America Source: American Association of Cancer Research
Hep C
identified
Inteferon
Interferon
/RBV
Peg IFN
/RBV
Peg IFN RBV/
Protease
Direct acting
antivirals
Melanoma
Survival rate
27%
Chemotherapy
1975 – 2010
Opdivo
December 2014
Opdivo &
Yervoy
October 2015
Cure rate
6
Why Health Care? Demographics
Health care spending to increase as the U.S. undergoes a demographic shift
U.S. Population Age 65+ (millions)
• 10K people a day in the U.S. turn 65 until 2030
Source: U.S. Census Bureau
7
Why Health Care? Demographics
Health care spending to increase as the U.S. undergoes a demographic shift
Health Care Spending Per Capita Medicare Spending Per Capita
• People over 65 spend 3x more on health care
than adults under 65 • Above 65, health care spending continues to
grow with age
Sources: Kaiser Family Foundation analysis of a 5 percent sample of Medicare claims from the Chronic Conditions Data Warehouse, 2011. Center for Medicare and Medicaid
Services, Office of the Actuary, National Health Statistics Group, 2010.
6.125
18.424
$0
$2.000
$4.000
$6.000
$8.000
$10.000
$12.000
$14.000
$16.000
$18.000
$20.000
Adults <65 years Adult >65 years
3.0x
65
70
75
80
85
90
95
$5.5
62
$7.5
66
$9.7
60
$11.6
81
$13.4
66
$14.7
45
$15.7
32
8
Why Health Care? Globalisation
Higher GDP correlated with higher health care spending
GDP growth drives health care spending*
Source: * OECD Health Data 2011; WHO Global Health Expenditure Database as of 28 October 2011
9
Description Health Care
Energy Materials Industrials Consumer Discretionary
Consumer Staples
Financials Information Technology
Telecom Utilities
MSCI The World Index – Health Care 1.00
MSCI The World Index – Energy 0.52 1.00
MSCI The World Index – Materials 0.66 0.83 1.00
MSCI The World Index – Industrials 0.74 0.77 0.89 1.00
MSCI The World Index – Consumer Discretionary 0.73 0.66 0.81 0.93 1.00
MSCI The World Index – Consumer Staples 0.79 0.60 0.65 0.77 0.75 1.00
MSCI The World Index – Financials 0.72 0.67 0.79 0.91 0.89 0.72 1.00
MSCI The World Index – Information Technology 0.69 0.69 0.80 0.88 0.91 0.73 0.82 1.00
MSCI The World Index – Telecom Services 0.68 0.66 0.69 0.74 0.69 0.80 0.67 0.70 1.00
MSCI The World Index – Utilities 0.68 0.59 0.62 0.69 0.61 0.79 0.63 0.64 0.80 1.00
MSCI The World Index 0.81 0.80 0.89 0.97 0.94 0.83 0.93 0.92 0.80 0.75
Why Health Care? Diversification
The Health Care sector has had one of the lowest correlations to the global
market of all GICS sectors over the past decade
Source: Janus Henderson Investors, FactSet. Past performance is no guarantee of future results.
Correlation Matrix
Period: 7/2007 – 6/2017
Benchmark: MSCI The World Index – Gross Return
10
Why Health Care? Defensive Characteristics
Health Care has typically held up better in down markets with lower volatility
Performance and downside capture
MSCI World Health Care IndexSM averaged 63% downside capture of MSCI World IndexSM returns
Source: FactSet, as at 30 June 2017
Past performance is no guarantee of future results
Graph reflects market declines of 10% or greater in the MSCI World IndexSM since 2000
Cum
ula
tive r
etu
rns (
%)
-46,3
1%
-53,6
5%
-12,5
5%
-19,4
3%
-11,6
4%
-14,1
5
-34,5
4
-7,5
6
-9,5
6
-12,8
2
-60
-50
-40
-30
-20
-10
0
04/2000 -09/2002
11/2007 -02/2009
05/2010 -06/2010
05/2011 -09/2011
06/2015 -02/2016
MSCI World Index MSCI World Health Care Index Downside captureSM SM
31% 64%
60%
49%
110%
Beta
MSCI World Health Care IndexSM vs MSCI
World IndexSM
10 year period (01/07/07 –
31/06/17) 0.66
Standard deviation
10 Year Period (1/7/07 – 30/6/17)
MSCI World Health Care
IndexSM 13.53
MSCI World IndexSM 16.47
11
Why Health Care? Historical Valuations
$0
$100
$200
$300
0.0x
10.0x
20.0x
30.0x
40.0x
50.0x
60.0x
70.0x
Historical Health Care Valuations (1 Year Forward P/E)
1 Y
ea
r F
orw
ard
P/E
S
&P
Bio
tech
nolo
gy S
ele
ct In
du
stry
Ind
ex
1 Y
ea
r Forw
ard
EP
S
$256
18.1x
17.0x
14.7x
S&P Biotechnology
Select Industry Index
S&P 500® Index S&P 500®
Health Care Index S&P Biotechnology
1 Year Forward EPS
Source: Bloomberg, as at 30 June 2017
12
v . o ll ealth are to s vera e o o vera e o otto
-
-
Why Health Care? The Case for Active Management
Active management based on fundamental research is important as:
• Binary nature of drug development often results in extreme outcomes
• Large disparity between winners and losers
10 Year Average Disparity of Returns for the Top
and Bottom 5 of sector (1/1/0731/12/16)
Average Performance of Top 5 and Bottom 5
Health Care Stocks
0
50
100
150
200
250
300
Sources: Janus Henderson Analytics, as at 31 December 2016. Sources: Wilshire 5000 Index. Includes average performance of stocks over $500
M in market cap.
When valuations fall and market and economic conditions change it is possible for
both actively and passively managed investments to lose value.
% D
iffe
rence in
perf
orm
ance
Annual sto
ck p
erf
orm
ance (
%)
13
Why Health Care? The Case for Active Management
90 “ he
Rule” 90
Source: BIO Industry Analysis, 2016.
14
Portfolio construction risk
Source: Janus Henderson Investors, as at 30 June 2017
Position management
Higher Lower Risk
Lower
Con
vic
tion
Higher
2.5% - 5.0% 1.0% - 2.5%
1.0% - 2.5% <1.0%
15
Portfolio construction risk
Value At Risk approach
Value at Risk Framework
• Assess downside risk in worst-case scenario from any foreseeable event
• Limit position size so worst- ase s enario i a t on ort olio won’t ex eed basis oints
• Example: If worst case is 50% drop in stock price, position size is no more than 2%
• Conservative approach: No probability weighting in assessing worst case risk
Any portfolio risk management process discussed includes an effort to monitor and manage risk which should not be confused with and does not imply low risk or the ability to control
certain risk factors.
Maximum position
2%
Maximum position
1.4%
Maximum position
3%
100 bps VAR
33% drawdown 50% drawdown 70% drawdown
Maximum drawdown
16
Nuvelo
Case study Clinical risk
0
10
20
30
40
50
Dec-04 Dec-05 Dec-06 Dec-07
Source: Nuvelo Press Releases, as at 30 June 2017
Note: Nuvelo was not owned in the Janus Global Life Sciences Fund
Positive
Phase 2 data
(De ‘ )
Negative
Phase 3 data
(De ‘ )
-74%
Clinical assessment
• Evaluated Phase 2
clinical results trials and
mechanism of action
• Interviewed key opinion
leaders
• Analyzed trial design
hesis: Positive hysi ian ex e tations or a new treat ent or eri heral vas ular disease didn’t translate into a tual
clinical benefits
Price
($)
17
Medivation
Case study Clinical risk
0
10
20
30
40
50
60
70
80
90
Sep-10 Sep-11 Sep-12 Sep-13 Sep-14 Sep-15 Sep-16
Source: Medivation Press Releases, as at 30 June 2017
Note: Medivation was not owned in the Janus Global Life Sciences Fund
Clinical assessment
• Evaluation of data from a
similar therapy at a later
stage of development
• Analysis of commercial
opportunity
• Proprietary statistical
modeling analyzing
probability of success
Clinical data for late
stage prostate cancer
(Nov ‘ )
FDA approval for late
stage prostate cancer
( u ‘ )
Positive data for early
stage prostate cancer
(O t ‘ ) FDA approval for
early stage prostate
an er ( e ‘ )
Pfizer acquisition for
$ ( e t ‘ )
+30%
Price
($)
Thesis: We believed Medivation’s prostate cancer treatment possessed a higher probability of success for early stage
prostate cancer than the market anticipated
18
0
50
100
150
200
250
300
May-10 May-11 May-12 May-13 May-14 May-15
Pharmacyclics
Case study Commercial risk
Source: Pharamcyclics Press Releases, as at 30 June 2017
Note: Pharmacyclics was not owned in the Janus Global Life Sciences Fund
Commercial assessment
• Evaluation of IMS data to
track and extrapolate
early launch trends
• Interviews with key
opinion leaders to gauge
excitement level
• Evaluation of competitive
landscape
• Surveys of hematologists
to determine pace of
uptake
Thesis: Our proprietary surveys predicted rapid acceptance and sustained uptake of Pharmacyclics’ a e-changing
treatment for leukemia
Price
($) Positive data for CLL
(Jul ‘ )
Imbruvica approval
and launch
(Nov ‘ )
Abbvie buyout for
$20 B
(Mar ‘ )
19
Aegerion
Case Study Commercial risk
Source: Pharamcyclics Press Releases, as at 30 June 2017
Note: Pharmacyclics was not owned in the Janus Global Life Sciences Fund
Commercial assessment
• Evaluation of IMS data to
track and extrapolate
early launch trends
• Feedback from
physicians/market
surveys
• Assessment of the
competitive intensity from
other cholesterol fighting
drugs
• Patient compliance/side
effects
Thesis: Initial enthusias and ra id u ta e o e erion’s dru to hel lower LDL holesterol was not sustained
Price
($)
0
10
20
30
40
50
60
70
80
90
100
Oct-10 Oct-11 Oct-12 Oct-13 Oct-14 Oct-15
FDA approval
of Juxtapid
(De ‘ )
Initial rapid uptake
(Jan ‘ )
Guidance cuts
(May ‘ )
Guidance cuts
(O t ‘ )
PCSK9 competition launched
(Jul ‘ )
Global Life Sciences Fund
21
Global Life Sciences Investment Team
Experienced team of specialists
• Over 100 years of combined investment experience
Andy Acker, CFA Portfolio Manager
Analyst: Biotechnology
21 years of investment experience
Ethan Lovell Portfolio Manager Analyst: Global Pharmaceuticals / Devices
23 years of investment experience
Dan Lyons, Ph.D., CFA 17 years of
investment experience
Biotechnology
Andy Summers, CFA 19 years of
investment experience
Specialty Pharmaceuticals
Aaron Schaechterle 10 years of
investment experience
Health Care IT Medical Technology
Rich Carney, CFA 17 years of
investment experience
Health Care Services
Ryan Smith Associate Analyst
Pharmaceuticals
John Scotti, DPhil 3 years of
investment experience
Biotechnology
Source: Janus Henderson Investors, as at 30 June 2017
22
Portfolio Composition
Diversified across the sub sectors within health care
Portfolio Composition MSCI World Health Care IndexSM
(% of Index)
Source: Janus Henderson Investors, as at 30 June 2017
23
Performance (%) Q3 17 YTD 1 yr 3 yr 5 yr 10 yr Since PM
Inception
* (1/5/07)
Global Life Sciences Fund (Class I$acc Shares) 4.10 23.88 13.19 7.88 18.60 11.77 11.84
MSCI World Health Care IndexSM 2.42 18.77 12.41 6.72 13.85 8.72 8.22
Difference
(Fund vs MSCI World Health Care IndexSM) +1.68 +5.12 +0.78 +1.16 +4.75 +3.05 +3.62
Performance as at 30 September 2017
Strong performance versus health care sector
Source: Janus Henderson Investors, as at 30 September 2017
Returns include reinvestment of dividends and capital gains. Returns greater than one year are annualised.
* From 1/5/2007 to 11/1/2016, Andy Acker was sole Portfolio Manager. From 12/1/2016, Andy Acker and Ethan Lovell are Co-Portfolio Managers.
Past performance is not a guarantee of future results. There is no assurance that the investment process will consistently lead to successful investing.
24
Performance (%) Q3 17 YTD 1 yr 3 yr 5 yr 10 yr Since PM
Inception
* (1/5/07)
Global Life Sciences Fund (Class I$acc Shares) 4.10 23.88 13.19 7.88 18.60 11.77 11.84
MSCI World IndexSM 4.84 16.01 18.17 7.69 10.99 4.22 4.48
Difference
(Fund vs MSCI World IndexSM) -0.74 +7.87 -4.98 +0.19 +7.61 +7.55 +7.36
Performance as at 30 September 2017
Strong performance versus the broad market
Source: Janus Henderson Investors, as at 30 September 2017
Returns include reinvestment of dividends and capital gains. Returns greater than one year are annualised.
* From 1/5/2007 to 11/1/2016, Andy Acker was sole Portfolio Manager. From 12/1/2016, Andy Acker and Ethan Lovell are Co-Portfolio Managers.
Past performance is not a guarantee of future results. There is no assurance that the investment process will consistently lead to successful investing.
25
Performance as at 30 September 2017
020406080
100120140160180200220240260280300320340360380
me
i-20
07
sep-2
007
jan-2
008
me
i-20
08
sep-2
008
jan-2
009
me
i-20
09
sep-2
009
jan-2
010
me
i-20
10
sep-2
010
jan-2
011
me
i-20
11
sep-2
011
jan-2
012
me
i-20
12
sep-2
012
jan-2
013
me
i-20
13
sep-2
013
jan-2
014
me
i-20
14
sep-2
014
jan-2
015
me
i-20
15
sep-2
015
jan-2
016
me
i-20
16
sep-2
016
jan-2
017
me
i-20
17
sep-2
017
Janus Global Life Sciences I $ Acc
MSCI World/Health Care NR USD
MSCI World NR USD
Source: Janus Henderson Investors, as at 30 September 2017
Note: Returns are for Janus Global Life Sciences I $acc, cumulative, net of fees. Rebased to 100 on 1 May 2007
Past performance is not a guide to future performance
+320.67%
+227.72%
%
+157.8%
26
Consistent Outperformance
Annualised Monthly Rolling 3 year Performance*(%)
-20
-10
0
10
20
30
-20 -10 0 10 20 30
84% of the time
Janus Global Life Sciences
Fund Class I$acc Shares
outperformed the MSCI World
Health Care Index 101 of 120
monthly rolling 3-year periods,
or 84% of the time over the last
10 years.
Outperformance
Underperformance
Glo
bal Life S
cie
nces F
und (
Annualis
ed
3 y
ear
retu
rn)
MSCI World Health Care Index (Annualised 3 year return)
* Through 30 September 2017
Past performance is not a guarantee of future results. See page 32 and 33 for complete performance and disclosure. Source: Janus Henderson Investors and Morningstar, Inc
27
Consistent Outperformance
Annualised Monthly Rolling 3 year Performance*(%)
Glo
bal Life S
cie
nces F
und (
Annualis
ed
3 y
ear
retu
rn)
MSCI World Health Care Index (Annualised 3 year return)
-20
-10
0
10
20
30
-20 -10 0 10 20 30
89% of the time
Global Life Sciences Fund
Class I$acc Shares
outperformed the MSCI World
Health Care Index 84 of 94
monthly rolling 3-year periods,
or 89% of the time since
i le entin our “Value at
Ris ” a roa h on / / .
Outperformance
Underperformance
* Data shown is or the “Value at Ris ” a roa h eriod ro / / – 30/9/17.
Past performance is not a guarantee of future results. See page 32 and 33 for complete performance and disclosure. Source: Janus Henderson Investors and Morningstar, Inc.
28
Why Global Life Sciences?
• Experienced and specialised investment team • Over 100 years of combined health care investment experience
• Differentiated fundamental research • Understand the science and the business
• Disciplined investment process • Diversified approach across industries, geographies and market capitalisations
• Value at Risk Framework
• Strong Performance • The Global Life Sciences Fund outperformed the MSCI World Health Care Index in 89% of the
rolling 3-year periods since implementing our “Value at Ris ” a roa h on 1/1/07
• The Fund’s lass I$a hares out er or ed the M I World Index by over b s er year
over the last 10 years*
Source: Janus Henderson Investors, as at 30 June 2017
Past performance is no guarantee of future results. See page 32 and 33 for performance.
* Average annualised outperformance since fund inception (1/4/00)
29
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"Regulations"). Article 4(b)[(1)/(4)] of the Regulations states that, if investment fund units are offered to [no more than 200 offerees in the Kingdom of Saudi Arabia/certain persons specified in the
Regulations]* and the minimum amount payable per offeree is not less than Saudi Riyals 1 million or an equivalent amount in another currency, such offer of investment fund units shall be deemed a private
placement for purposes of the Regulations. Investors are informed that Article 4(g) of the Regulations places restrictions on secondary market activity with respect to such investment fund units.
This presentation is strictly private and confidential and may not be reproduced or used for any purpose other than evaluation of a potential investment in Janus Capital International Li ited’s products or the
procurement of its services by the recipient of this presentation or provided to any person or entity other than the recipient of this presentation.
Janus Capital Management LLC serves as investment adviser. Janus, INTECH and Perkins are registered trademarks of Janus International Holding LLC. © 2017, Janus Henderson Investors. The name
Janus Henderson Investors includes HGI Group Limited, Henderson Global Investors (Brand Management) Sarl and Janus International Holding LLC. For more information or to locate your ountry’s Janus
representative contact information, please visit www.janushenderson.com.
Effective 12th January 2016 Ethan Lovell was promoted to Co-Portfolio Manager of the Janus Global Life Sciences Fund and affiliated accounts, joining Andy Acker, who was previously sole manager of the
Fund.
© 2017, Janus Henderson Investors. The name Janus Henderson Investors includes HGI Group Limited, Henderson Global Investors (Brand Management) Sarl and Janus International Holding LLC.
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