Morningstar Advisor - August/September 2010 - 38

Spotlight

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diagnostic testing before patients can receive certain therapeutic treatments. This is the flip side of personalized medicine. In 2009, UnitedHealth instituted a policy of requiring colon cancer patients to provide diagnostic proof that they have the wild type KRAS gene before UnitedHealth would pay for the drugs Erbitux or Vectibix. Even a pharmacy-benefit manager, Medco MHS, is getting into the act. Medco is launching a more-than-14,000-patient trial over whether anti-platelet medicine Plavix is as effective as another one, Effient, for the 70% of patients whose CYP2C19 gene is normal. Considering that Plavix is set to lose patent protection in 2011, payers are extremely interested in the prospect of switching most patients on Plavix to a generic version. If this study shows that Plavix is equivalent to Effient, pharmacy-benefit managers could require this CYP2C19 diagnostic test before allowing patients to get Effient.
The Risks

More Health-Care Coverage
Morningstar Healthcare Observer, edited by Damien Conover, gives investors in-depth news and analysis of the sector every month, including data on 250 health-care companies and the Health-Care Focus List, our analysts’ top 10 health-care picks. Information about Healthcare Observer is available at http://healthcare.morningstar.com.

costs, we expect more cuts going well into the future. Finally, bad-debt expense could increase substantially if unemployment remains high or if managed care pushes more of the out-of-pocket burden on patients. Overall, however, we see bright prospects ahead for the diagnostic testing market. Health-care reform, the trend toward personalized medicine, continued scientific discovery, and growing pressure from managedcare organizations to contain costs all will benefit the industry. Within the group, narrow-moat companies Quest and LabCorp, with their nationwide presence, cost controls, and partnerships with pharmaceutical companies, are best positioned for stable long-term growth. K
Bill Buhr is a stock analyst covering the healthcare industry. Debbie S. Wang is a senior stock analyst on the health-care team covering the medicaltechnology industry.

It’s clear that diagnostic labs are well positioned for steady growth over the coming years, but investors should keep a few potential pitfalls in mind. For one, there may be a shift toward capitated contracts, in which a managed-care company would offer the diagnostic lab a flat revenue figure per patient per time period. This type of contract accounted for a small slice of LabCorp’s total revenue in 2009 (less than 4%), but if reimbursement pressure ratchets up, more managed-care contracts may switch to this type of compensation system. Also, Quest and LabCorp remain vulnerable to changes in the Medicare and Medicaid fee schedules. Both firms are reliant on Medicare for about 15% to 20% of net revenue— a large enough proportion to sway the balance if cuts are steep. Although there was a 4.5% increase in the Medicare fee schedule in 2009, this was more the exception than the rule. The fee schedule is set to decline by 1.9% in 2010. Furthermore, as Medicare comes under more pressure to contain

38 Morningstar Advisor August/September 2010


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Morningstar Advisor - August/September 2010

Table of Contents for the Digital Edition of Morningstar Advisor - August/September 2010

Morningstar Advisor - August/September 2010
Contents
New on MorningstarAdvisor.com
Contributors
Letter From the Editor
What Aspects of Health-Care Reform Will Most Affect Your Clients?
Bonds, Chicago Style
Investment Briefs
Which Risk Are You Managing?
Eye on the Prize
Advisors Can’t Rely on Fidelity Alone
Health Care Gets Back to Business
An Opportune Time to Bet the Pharm
Reform’s Impact on Other Health-Care Industries
Top Takeover Targets in Biotech
After Reform, Narrow-Moat Firms Have Strong Prospects in Diagnostics
Health-Care Investing Alive and Well
Quest for Knowledge
Four Picks for the Present
How to Make Your Bond Portfolio Inflation-Resistant
Weeding Through the Energy Patch
Uncertainty and Value in Basic Materials
Stock Market Doom-Busters
Hunting Down European Debt-Dodgers
Mutual Fund Analyst Picks
50 Most Popular Equity ETFs
Undervalued Stocks With Wide Moats
VA Sales Slip a Bit in First Quarter
New at Morningstar
Star Wars, the Sequel
Morningstar Advisor - August/September 2010 - Morningstar Advisor - August/September 2010
Morningstar Advisor - August/September 2010 - Cover2
Morningstar Advisor - August/September 2010 - 1
Morningstar Advisor - August/September 2010 - 2
Morningstar Advisor - August/September 2010 - Contents
Morningstar Advisor - August/September 2010 - 4
Morningstar Advisor - August/September 2010 - 5
Morningstar Advisor - August/September 2010 - New on MorningstarAdvisor.com
Morningstar Advisor - August/September 2010 - 7
Morningstar Advisor - August/September 2010 - Contributors
Morningstar Advisor - August/September 2010 - Letter From the Editor
Morningstar Advisor - August/September 2010 - What Aspects of Health-Care Reform Will Most Affect Your Clients?
Morningstar Advisor - August/September 2010 - 11
Morningstar Advisor - August/September 2010 - Bonds, Chicago Style
Morningstar Advisor - August/September 2010 - 13
Morningstar Advisor - August/September 2010 - Investment Briefs
Morningstar Advisor - August/September 2010 - 15
Morningstar Advisor - August/September 2010 - Which Risk Are You Managing?
Morningstar Advisor - August/September 2010 - 17
Morningstar Advisor - August/September 2010 - 18
Morningstar Advisor - August/September 2010 - Eye on the Prize
Morningstar Advisor - August/September 2010 - 20
Morningstar Advisor - August/September 2010 - 21
Morningstar Advisor - August/September 2010 - Advisors Can’t Rely on Fidelity Alone
Morningstar Advisor - August/September 2010 - 23
Morningstar Advisor - August/September 2010 - 24
Morningstar Advisor - August/September 2010 - 25
Morningstar Advisor - August/September 2010 - 26
Morningstar Advisor - August/September 2010 - Health Care Gets Back to Business
Morningstar Advisor - August/September 2010 - An Opportune Time to Bet the Pharm
Morningstar Advisor - August/September 2010 - 29
Morningstar Advisor - August/September 2010 - Reform’s Impact on Other Health-Care Industries
Morningstar Advisor - August/September 2010 - 31
Morningstar Advisor - August/September 2010 - 32
Morningstar Advisor - August/September 2010 - Top Takeover Targets in Biotech
Morningstar Advisor - August/September 2010 - 34
Morningstar Advisor - August/September 2010 - 35
Morningstar Advisor - August/September 2010 - After Reform, Narrow-Moat Firms Have Strong Prospects in Diagnostics
Morningstar Advisor - August/September 2010 - 37
Morningstar Advisor - August/September 2010 - 38
Morningstar Advisor - August/September 2010 - 39
Morningstar Advisor - August/September 2010 - 40
Morningstar Advisor - August/September 2010 - Health-Care Investing Alive and Well
Morningstar Advisor - August/September 2010 - 42
Morningstar Advisor - August/September 2010 - 43
Morningstar Advisor - August/September 2010 - 44
Morningstar Advisor - August/September 2010 - 45
Morningstar Advisor - August/September 2010 - 46
Morningstar Advisor - August/September 2010 - 47
Morningstar Advisor - August/September 2010 - 48
Morningstar Advisor - August/September 2010 - Quest for Knowledge
Morningstar Advisor - August/September 2010 - 50
Morningstar Advisor - August/September 2010 - 51
Morningstar Advisor - August/September 2010 - Four Picks for the Present
Morningstar Advisor - August/September 2010 - 53
Morningstar Advisor - August/September 2010 - How to Make Your Bond Portfolio Inflation-Resistant
Morningstar Advisor - August/September 2010 - 55
Morningstar Advisor - August/September 2010 - 56
Morningstar Advisor - August/September 2010 - 57
Morningstar Advisor - August/September 2010 - Weeding Through the Energy Patch
Morningstar Advisor - August/September 2010 - 59
Morningstar Advisor - August/September 2010 - 60
Morningstar Advisor - August/September 2010 - Uncertainty and Value in Basic Materials
Morningstar Advisor - August/September 2010 - 62
Morningstar Advisor - August/September 2010 - 63
Morningstar Advisor - August/September 2010 - Stock Market Doom-Busters
Morningstar Advisor - August/September 2010 - 65
Morningstar Advisor - August/September 2010 - Hunting Down European Debt-Dodgers
Morningstar Advisor - August/September 2010 - 67
Morningstar Advisor - August/September 2010 - Mutual Fund Analyst Picks
Morningstar Advisor - August/September 2010 - 69
Morningstar Advisor - August/September 2010 - 70
Morningstar Advisor - August/September 2010 - 71
Morningstar Advisor - August/September 2010 - 50 Most Popular Equity ETFs
Morningstar Advisor - August/September 2010 - 73
Morningstar Advisor - August/September 2010 - Undervalued Stocks With Wide Moats
Morningstar Advisor - August/September 2010 - 75
Morningstar Advisor - August/September 2010 - VA Sales Slip a Bit in First Quarter
Morningstar Advisor - August/September 2010 - 77
Morningstar Advisor - August/September 2010 - 78
Morningstar Advisor - August/September 2010 - New at Morningstar
Morningstar Advisor - August/September 2010 - Star Wars, the Sequel
Morningstar Advisor - August/September 2010 - Cover3
Morningstar Advisor - August/September 2010 - Cover4
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