COVID-19 and the international lockdown crashed the world economy in 2020. Many people have already been vaccinated and are looking forward to normalization. But COVID is mutating, and the new delta variant might toss a wrench into the world's reopening. How might investors protect themselves?
A panel of Motley Fool contributors offers three ideas for healthcare stocks that will zoom higher in 2021, even if COVID takes a turn for the worse. Read more to see why you might want to buy shares of Pfizer (PFE -0.33%), Inari Medical (NARI -4.17%), and Novavax (NVAX -1.96%).
Pfizer: More room to run
George Budwell (Pfizer): American pharma titan Pfizer might not sound like a sexy pick among the present cohort of COVID vaccine players. Wall Street's current consensus has Comirnaty, the drugmaker's vaccine -- produced in partnership with BioNTech (BNTX 0.16%) -- losing steam from a sales perspective starting in 2022.
Because of the delta variant, however, Comirnaty's commercial life could turn out to be much longer than originally expected. And while the emergence of the highly transmissible variant is obviously terrible news for society at large, Pfizer and its shareholders are probably going to benefit from this unfortunate development.
There are two clear reasons to think that Pfizer's stock could move higher on the delta issue. First and foremost, the company announced that an Emergency Use Authorization submission for a booster third shot might happen as soon as this month. Second, Pfizer plans to start clinical trials for a delta-specific version of the vaccine this month.
Although the Food and Drug Administration and the Centers for Disease Control and Prevention have both recently downplayed the need for booster shots, Pfizer has already put forth a compelling case for a third jab in response to the rampant spread of the delta variant and the waning efficacy of Comirnaty 6 to 12 months following full vaccination.
The big picture for investors is that Pfizer's 2022 revenue might jump by as much as 9.7% compared to 2021 -- that is, if a booster shot is indeed approved and the company also successfully develops a delta-specific vaccine. By contrast, Wall Street currently has the drugmaker's top line falling by 14.8% next year relative to 2021.
Where is Pfizer's stock possibly headed? If all the pieces fall into place on the vaccine front, shares ought to command a $50 handle, from a conservative standpoint. That's roughly a 17% upswing from where the drugmaker's shares presently stand, and that's not even accounting for the company's attractive 3.64% dividend yield at current levels. Put simply, Pfizer's stock would only be trading at approximately 3.5 times 2022 sales if this scenario pans out, which is a rather modest valuation for a dividend-paying big pharma stock.
Inari Medical: Skyrocketing Sales
Patrick Bafuma (Inari Medical): If you are looking for a stock with staying power after tailwinds from the pandemic subside, look to Inari Medical. There were 108,000 new COVID cases on July 27, 2021 -- the most since February 5, 2021, according to The New York Times -- and that number was up over eight times the seven-day average at the start of July. To make things even worse, COVID not only causes difficulty breathing but also more than triples a patient's risk of disabling and potentially life-threatening blood clots. And we're still not sure if being vaccinated fully mitigates the risk of blood clots when a patient has an asymptomatic or a mild COVID infection.
This seems like a good setup for a commercial-stage med-tech company that has developed minimally invasive products designed to remove large blood clots without the need for powerful clot-busting drugs. Through the use of its ClotTriever and FlowTriever devices, Inari has treated over 25,000 patients so far. Clinicians performed approximately 5,500 procedures with the company's devices in the first quarter of 2021, up 130% from the same quarter last year and about 20% higher than the fourth quarter of 2020. With about 12% of admitted COVID patients developing blood clots, and about 35,000 COVID hospitalizations in the U.S. (and rising) as of July 27, according to The Times, Inari is likely to see an uptick in eligible cases.
Not to mention the company's results thus far for blood clots in the lung are spectacular:
- With the historic 30-day mortality rate of intermediate and high-risk blood clots in the lungs at 9.7%, Inari's 0.4% 30-day mortality rate is impressive.
- There's a decreased 30-day readmission rate of 6.7% versus 24.4% with the usual care.
- Major adverse events within 48 hours occur at only a 1.3% rate.
- No ICU stays are required after the procedure.
Add it all up, and Inari's retrieval device seems like an obvious choice.
The company grew first-quarter revenue at 113% year over year, and 18% sequentially, and had gross margins of 91.9% for the first quarter of 2021. So Inari's price-to-sales ratio of 18 makes it a growth stock on sale.
Inari has less than 5% penetration in the $3.8 billion U.S. market, and there's also lots of room to grow in Europe, where it launched earlier this year. That means there are plenty of opportunities for this $4.5-billion market cap company. While COVID has affected many elective and semi-elective procedures, it has clearly not slowed Inari, and it could even accelerate its uptake.
Novavax: How high can it go?
Taylor Carmichael (Novavax): The vaccine biotech Novavax had an amazing 2020, with its share price running up 2,700% on optimism for its COVID vaccine. While the company has yet to file for an Emergency Use Authorization, it expects to do so in this quarter. So far in 2021, the stock is up 60%.
Positive phase 3 data for the COVID-19 vaccine sent the stock soaring early in the year, but the share price has come back down to earth as the company has suffered delays getting its vaccine to market. First there was a shortage of raw materials necessary to make the vaccine. Now the company has to prove that its various contract manufacturing facilities will keep the vaccine quality consistent across all the sites.
Despite these delays, long-term investors have reasons to be bullish. Manufacturing is scaling up, with production rates expected to hit 100 million doses a month by the end of the third quarter, and 150 million doses a month by December. While many people in the U.S. have already been vaccinated, the opportunity in the rest of the world is sizable. Novavax has pre-sold 1.1 billion doses to COVAX (an international vaccine consortium), and has contracted to supply hundreds of millions of doses around the world.
In the U.S., the Novavax vaccine might primarily be used as a booster shot for people who have already been vaccinated. "They may be really the right ones for boosters," Dr. Luciana Borio, the acting chief scientist at the F.D.A. from 2015 to 2017, told The New York Times.
Down the road, Novavax plans on combining its COVID vaccine with its flu vaccine, making a one-shot regimen. While COVID does not mutate as quickly as the flu, we've seen several mutating strains over the last year. It's likely that we will need to vaccinate more than once in the years ahead.