The collaboration between AXA Health and Doctor Care Anywhere is a great example of how an innovative healthcare service can be added to an insurer’s well established offering. Historically, medical training was based on the notion that physical examination (eg auscultation, palpation, percussion) was a necessary part of evaluating a patient. Copyright: Copyright 2021 Edison Investment Research Limited (Edison). As a Doctor Care Anywhere patient you have 24/7 access to your DCA patient record. How to access AXA Doctor at Hand. The company’s route to market is through its channel relationships and partnerships, which provides a lower cost of customer acquisition than a direct B2C model. Improving operational efficiency: the company plans to invest and use more automation of workflows across its operations to increase operational efficiency, which will lead to a better patient experience. The telehealth market is forecast to grow robustly. It also meant I did not have to take time off work and all of my information held electronically so no concern over losing my notes. The key sensitivity is customer concentration. DOC is a fast-growing telehealth company focused on delivering high-quality, effective and efficient care to its patients, while reducing the cost of providing healthcare for health insurers and healthcare providers. Global Market Insights, for example, estimates that the global telehealth market will increase by a CAGR of 25.2% between 2019 and 2026, from US$45.5bn to US$175.5bn. Our forecast for activated lives in 2022e year end of 725k implies a 29% CAGR growth versus 2020e year-end levels, as DOC invests in marketing to drive activations, by working on joint promotions with its partners and corporate clients. DOC’s strategy is to move towards ‘total care’ by capturing a greater proportion of the care pathway. Traditional vs Internet Hospital: Analog vs digital. Additionally DOC will also receive its share of any dividends paid by the AXA Health JV. KPI growth assumptions over the next two years. DOC currently services over 1,500 corporate clients and had a base of 2.2 million patients at the end of 2020. Key growth drivers for increased telehealth adoption and growth include increased prevalence of chronic diseases, long waiting times at hospitals, greater need for cost-saving in healthcare delivery, a growing number of smartphone users and advances in consumer information and communications technologies. The prescription can thereon be picked up from the pharmacy or delivered to their address. Committed to creating a superior customer experience, we are able to design and implement swift, simple referral pathways from primary to secondary healthcare services; The breadth of integrated services, such as NHS repeat prescriptions, ePrescriptions, health tracking and the international capability of Doctor Care Anywhere, was a clear differentiator from the rest of the competition. We forecast eligible lives to increase at an 9% CAGR (2020 to 2022e) to 2.64m year end 2022e resulting from DOC onboarding additional customers through its existing relationships, in particular with recently signed up Allianz Partners, as well as winning new partners whose customers it will onboard. AXA Doctor at Hand, powered by Doctor Care Anywhere, is a private online GP service that puts better health in easy reach for everyone. In addition to traditional IPOs, companies like Hims & Hers Health Inc. listed on the NYSE on 21 January by way of being acquired by a SPAC, valuing the business at US$1.6bn. Kate is a graduate from Guy’s, Kings and St Thomas’ School of Medicine and holds a BSc in Radiological Sciences with Basic Medical Sciences from King’s College London. earnings, and multiples related to revenue and profitability. Babylon, last valued at US$1.9bn in 2019 when it raised US$450m in funding, could be valued at over US$4bn according to Bloomberg. He is a graduate from Guy’s, King’s and St Thomas’ Medical School, the medical school of King's College London, and holds a BSc in philosophy from King’s College London. Source: Refinitiv, Edison Investment Research. Edison Investment Research Limited, 280 High Holborn, London, WC1V 7EE UK. From 2005 to 2014, he served as chairman of Korn Ferry in EMEA where he was involved in chair and CEO succession planning at a number of the largest global financial services companies, including one of the leading banks in Australia. The target segment for VGP services includes payors (healthcare insurers like AXA Health and Allianz Partners), healthcare providers (like HCA and Nuffield), health services resellers (such as Perkbox) and corporates. : DOC plans to boost revenue by expanding its marketing to drive customer activation and consultations, by working on joint promotional campaigns with channel partners and corporate clients. The security and confidentiality of your AXA Doctor at Hand consultation is an absolute priority for AXA Health and Doctor Care Anywhere (DCA). Note: *Acuity refers to the severity of a patient’s illness or condition which determines the level of attention or service they will need from professional staff. the company plans to promote its Mental Health services, which launched in November 2020, to its channel partners and corporate clients. Any advice given by Edison AU is general advice only and does not take into account your personal circumstances, needs or objectives. A doctor-founded organisation, clinical excellence lies at the core of Doctor Care Anywhere’s services. at its last assessment in September 2019. The service provides patients with: GP appointments: a 20-minute video or phone appointment available 24/7 and 365 days of the year. It has been helping people access the medical care they need for over 75 years. Although the ranking of the three regions is forecast to remain unchanged come 2024, rapid growth in Asian telehealth sees the region increase its share of the global telehealth market to 19% (from 13% in 2019). This Communication is being supplied to you solely for your information and may not be reproduced by, further distributed to or published in whole or in part by, any other person. The company has strong corporate governance with six non-executive directors, four of whom are independent. FX: DOC reports its financials in pounds sterling as its revenue is currently almost entirely from the UK and most of its cost base is in pounds sterling. The insurer was looking to extend further its services to members and decided that providing easy and convenient access to a private GP service was an excellent way to achieve this. EV/sales forms the basis of our valuation as the peer group companies are fast growing and pre-profitability. Group strategy: Joined up care leads to better outcomes. AXA – Global Healthcare customer: ‘It’s good to talk to someone when local appointments are unavailable’ “The World Health Organization encourages ministries for health around the globe to embrace telemedicine and virtual care for this very reason. Bayju co-founded DOC in 2013 and became CEO in 2020. DOC currently has two established service offerings: Virtual GP (VGP): a video or phone consultation with a GP who can provide advice and guidance, medicine prescriptions, referral letters and sick notes. A breakdown of the use of proceeds from the issue of shares at the IPO is detailed in the table below. International expansion: the company is in talks with several health insurers to roll out its Internet Hospital service across various European markets, including Belgium, Germany, Italy, Spain and Switzerland. We believe DOC will reduce the valuation discount to its telehealth peer over the next 12–18 months, as it increases its activated customer base and consultations, expands into new international markets, signs up partners for its mental healthcare service and meets or beats market expectations on revenue and KPIs. There is an independent Clinical Governance Committee (CGC), which reports to the board on matters such as effectiveness of clinical governance, quality and compliance arrangements and performance. Prescription medication: the patient’s prescription is automatically uploaded to their account for them to take to any participating pharmacy, which currently includes Boots, Tesco, Superdrug, Day Lewis and Rowlands. Additionally, Kooth’s online platform will provide outreach on an anonymous basis to an online peer community, with trained professionals monitoring and engaging with users to ensure safety and the effectiveness of the service. Exhibit 9: Teladoc versus major US, UK and AU indices, Exhibit 10: Teladoc versus the FAANG stocks. Our forecast for DOC implies a net cash burn of £19m in 2021e and £13.1m during 2022e. DOC made its first foray outside the UK in 2020, expanding into the Republic of Ireland using a team of doctors registered by the Irish Medical Council. Via its channel partners, DOC sells its services to over 1,500 corporate clients and has a base of 2.2 million patients. We believe DOC is well placed to continue to grow by executing on management’s expansion strategy of increasing its activated customer base, developing new services and expanding into Europe and Asia. As Reshni is able to travel 15 miles to a diagnostics centre that’s still open and providing support during lockdown, an appointment is arranged for her in a couple of weeks. As we can see from Exhibits 9 and 10 above, TDOC shares have solidly outperformed the major US, UK and Australian indices as well as the fast-growing FAANG (Facebook, Amazon, Apple, Netflix and Google) stocks. Additionally, it plans to invest in further developing its EHR to substantially expand its functionality and expand the range of services that can be conducted online. Microsoft Healthcare and Education Industry Lead. DOC ended 2020 with a net cash position of £38.4m and zero debt, benefiting from £31.2m net proceeds (after IPO expenses and fees) from its December 2020 IPO. Consultations increased to 215k in 2020 from 29k in 2018; a 173% CAGR. An increase or decrease in the pound, would imply higher or lower Australian dollar. DOC trades at 6.9x our 2021e revenue forecast on an EV/sales multiple, which is a sizable 60% discount to its peer group of global telehealth companies. The global telehealth market is forecast to grow at a CAGR of 23.1% from US$5.3bn in 2019 to US$14.9bn (+181%) in 2024, according to Signify research, primarily driven by COVID-19 related changes to consumer habits. Group revenue increased 102% y-o-y to £11.6m in 2020; 6% ahead of the prospectus forecast of £10.9m, benefiting from higher-than-expected utilisation consultations. Additionally, DOC is regulated by the Care Quality Commission (CQC)4 and obtained an overall rating of Good5 at its last assessment in September 2019. A loss in some or all of the business with AXA Health would materially affect our revenue and profitability forecast for DOC. Utilisation revenue increased 359% y-o-y to £9m and accounted for 78% of group revenue (versus 34% in 2019). COVID-19 pandemic has sped up the adoption of telehealth. It looks to integrate a range of digital and in-person treatment options, including digital therapies and access to self-management tools to improve accessibility and effectiveness. Virtual consultations over the platform are encrypted to ensure patient data remains private as well as appropriately stored and used. Company description: Technology enabled healthcare. Patient has a VGP consultation over video/phone. With a network of over 250 hospitals and almost 400 scanning centres, its members receive prompt access to medical care from healthcare professionals. In the case of a non-participating pharmacy, DOC liaises with the pharmacy to make sure the medication is ready for collection. The prescription can thereon be picked up from the pharmacy or delivered to their address. As a result telehealth usage has increased significantly over the last decade. Doctor Care Anywhere’s ability to scale up its service and continue to provide quality care to each and every patient was also been crucial to success. Enabled by DOC’s EHR, referrals could be made directly to specialists in advance of diagnostic tests or immediately afterwards. DOC’s route to market is through channel relationships, which provide a lower cost of customer acquisition than a direct business to consumer (B2C) model. The company is listed on the ASX and its share price is denominated in Australian dollars. He led the development and launch of the internet hospital programme, as well as the commercial negotiations for the JV with AXA Health. Patients benefit from better and quicker access to healthcare, with fewer in-person appointments. Both patients and medical practitioners are able to access records related to their consultations over the DOC platform online 24/7, thereby leading to more complete information for the practitioner to base their decision on. AXA Health sets up a video appointment for Reshni with Mr Neal, an orthopaedic consultant, in three days time. This is not a solicitation or inducement to buy, sell, subscribe, or underwrite any securities mentioned or in the topic of this document. Dan has over a decade’s experience in finance, having started his career in public practice before moving into industry, where he has worked in sectors including software development, customer engagement and healthcare. In addition to headline (total) consultations, utilisation consultations in a given period is an important KPI. 2020 was a transformational year for the company: it signed up major new partners, listed on the ASX, delivered triple-digit revenue and KPI growth and ended 2020 with strong balance sheet (£38.4m in net cash). Additionally, DOC also receives income from revenue generated from the AXA Health JV in the UK from rebates on referred diagnostic tests. Our forecast implies a net cash position of £19.4m at the end of 2021e and £6.3m by the end of 2022e. Valuation: Significant discount to global telehealth peer group. Doctor Care Anywhere Group is a research client of Edison Investment Research Limited. The company has ambitious plans to grow its service offerings as well as expand into new markets in Europe and Asia-Pacific. Enters into a strategic relationship with, Establishes a strategic relationship with major US healthcare facilities provider, Partners embedding DOC into its UK and European international private medical insurance (PMI) policies. DOC’s chief medical officer holds primary accountability for clinical governance, while the chairman of the CGC provides assurance oversight of the application and effectiveness of clinical governance standards and performance. Whether it’s the middle of the night, or you’re away from home, AXA Doctor at Hand is the private online GP service that works around you, not the other way around. Group revenue increased 102% y-o-y to £11.6m in 2020; 6% ahead of the prospectus forecast of £10.9m, benefiting from higher-than-expected utilisation consultations. It has been helping people access the medical care they need for over 75 years. We note that DOC’s 2-year forecast revenue CAGR of 80% is 34% of the peer group average 60% growth rate for the next 2 years. Now you can see a GP whenever you want, wherever you are, without the wait. Asynchronous: the patient or physician collects medical history, images and pathology reports, which are then sent to a specialist for diagnostic and treatment expertise. Jonathan, who has served as chairman since November 2018, has extensive board and governance experience. Exhibit 7: Traditional vs Internet Hospital, Step 1: GP > specialist > diagnostic tests. DOC listed on the ASX in December 2020 and has just a three-month of track record as a listed business. Also, the information provided by us should not be construed by any subscriber or prospective subscriber as Edison’s solicitation to effect, or attempt to effect, any transaction in a security. Dan joined DOC in 2016 as FD and was made CFO in January 2021. We never take payment in stock, options or warrants for any of our services. I was able to sign up within a minute and able to book an appointment that afternoon utilising the online booking tool. In 2022 we forecast revenue to grow 75% yoy to £37.4m, with consultations increasing 75%. I opted for a telephone appointment that lasted 15 minutes. The robust growth in demand for telehealth since the start of the pandemic combined with the stellar returns investors earned by investing in Teladoc, the largest Telehealth company in the world (up 10x since its June 2015 IPO on the NYSE), led to a raft of telehealth company listings in 2020. The Care Quality Commission is part of the Department of Health and Social Care of the UK and is tasked with regulating and inspecting health and social care services in England. a video or phone consultation with a GP who can provide advice and guidance, medicine prescriptions, referral letters and sick notes. Revenue is largely generated from the provision of services in connection with: VGP services, which are charged either based on number of consultations performed or on a subscription basis; and. TDOC shares began trading on the NYSE on 1 July 2015, at an IPO price of $19 per share, giving the company a market capitalisation of US$758m. Doctor appointments, prescriptions and patient records | Doctor Care Anywhere Doctor Care Anywhere is the smart, easy and convenient way to manage your health. It gives me great peace of mind to know that I can book an appointment for my family at the last-minute and out- of-hours. increased to 215k in 2020 from 29k in 2018; a 173% CAGR. Sector: Health Care. The JV, which was set up in 2020, is currently loss making. The distribution of this document is not a “personalised service” and, to the extent that it contains any financial advice, is intended only as a “class service” provided by Edison within the meaning of the FAA (i.e. includes both primary and secondary care services, including video or phone consultations with a GP, diagnostic referrals and specialist diagnostic reviews across seven medical specialties. Additionally we assume customers who have already had a consultation in the past continue to avail of consultations in 2021 and 2022.

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