TIDMWWH 
 
17 November 2021 
 
                      LONDON STOCK EXCHANGE ANNOUNCEMENT 
 
                        Worldwide Healthcare Trust PLC 
 
             Unaudited Half Year Results for the six months ended 
 
                               30 September 2021 
 
This Announcement is not the Company's Half Year Report & Accounts. It is an 
abridged version of the Company's full Half Year Report & Accounts for the six 
months ended 30 September 2021. The full Half Year Report & Accounts, together 
with a copy of this announcement, will also shortly be available on the 
Company's website: www.worldwidewh.com where up to date information on the 
Company, including daily NAV, share prices and fact sheets, can also be found. 
 
The Company's Half Year Report & Accounts for the six months ended 30 September 
2021 has been submitted to the UK Listing Authority, and will shortly be 
available for inspection on the National Storage Mechanism (NSM): https:// 
data.fca.org.uk/#/nsm/nationalstoragemechanism 
 
For further information please contact: Mark Pope, Frostrow Capital LLP 020 
3008 4913. 
 
Company Summary / Performance 
 
                                                               Six months to   One year to 
                                                                30 September      31 March 
                                                                        2021          2021 
 
Net asset value per share (total return)* #                             0.4%         30.0% 
 
Share price (total return)* #                                         (1.5%)         27.4% 
 
Benchmark (total return)^ #                                            13.0%         16.0% 
 
                                                  30 September      31 March    Six months 
                                                          2021          2021        change 
 
Net asset value per share                             3,700.7p      3,703.0p        (0.1%) 
 
Share price                                           3,625.0p      3,695.0p        (1.9%) 
 
Discount of share price to the net asset value            2.0%          0.2% 
per share* 
 
Leverage*                                                14.7%          7.6% 
 
Ongoing charges*                                          0.8%          0.9% 
 
Ongoing charges (including performance fees               1.3%          0.9% 
crystallised during the period)* 
 
#      Source - Morningstar. 
 
^      Benchmark - MSCI World Health Care Index on a net total return, sterling 
adjusted basis (see glossary) 
 
*      Alternative Performance Measure. Leverage calculated under the 
Commitment Method (see glossary) 
 
Chairman's Statement 
 
Sir Martin Smith 
 
Performance 
 
Following a period of strong relative and absolute performance, the first six 
months of the current financial year have proved to be challenging for the 
Company. While the Company's net asset value per share total return ended the 
period in positive territory (+0.4%), it significantly underperformed the 
Company's Benchmark, the MSCI World Healthcare Index, measured on a net total 
return, sterling adjusted basis, which rose by 13.0%. Sterling depreciated by 
2.3% against the U.S. dollar over the period; the U.S. dollar being the 
currency in which the majority of the Company's investments are denominated. 
The Company's share price total return of -1.5% fared less well and, as a 
result, the discount of the Company's share price to the net asset value per 
share widened to 2.0% as at 30 September 2021 from 0.2% at the beginning of the 
period. 
 
The principal reasons for this underperformance were the significant overweight 
positions in poorly performing Emerging Biotechnology* and China, a strategy 
that had previously served the Company well. These sectors were subject to 
significant volatility as investors rotated to larger stocks in more developed 
markets, which is why they were the largest contributors to the reported 
relative underperformance. In addition, absolute performance was affected by 
the political uncertainty arising from the incoming new Presidential 
administration in the U.S. 
 
Looking at specific names in the portfolio, the largest contributions during 
the reporting period came from UK pharmaceutical and biotechnology company 
AstraZeneca, Indian multinational hospital chain company Apollo Hospitals 
Enterprise and U.S. medical supplies company DexCom. The largest detractors 
from performance were Chinese pharmaceutical company Jiangsu Hengrui Medicine 
and U.S. biopharmaceutical companies Vor Biopharma and Haemonetics. Further 
information regarding the Company's investments and performance can be found in 
the Review of Investments. 
 
The Company had, on average, leverage of 10.9% during the period which 
contributed 0.04% to performance. As at the half year-end leverage stood at 
14.7% compared to 7.6% at the beginning of the period. Our Portfolio Manager 
continues to adopt both a pragmatic and a tactical approach to the use of 
leverage. 
 
The underperformance of the Benchmark in the period has resulted in a reversal 
of the performance fee provision of £18.9m, which now stands at zero. In 
accordance with the terms of the performance fee arrangements*, following an 
exceptional period of outperformance in the period to 30 June 2020, which was 
maintained to June 2021, a performance fee of £12.9m became payable as at 30 
June 2021. Further details are provided in note 3. 
 
*      See Glossary. 
 
As I have mentioned previously, the Company is able to invest up to 10% of the 
portfolio, at the time of acquisition, in unquoted securities. Our Portfolio 
Manager, through its extensive private equity research capability, has 
continued to identify opportunities which have been added to the portfolio. 
Exposure to unquoted equities accounted for 7.5% of the total portfolio at the 
half year-end, and these holdings made a positive contribution of 1.9% to the 
Company's performance during the period under review. 
 
Capital 
 
The Board continues to monitor closely the relationship between the Company's 
share price and the net asset value per share. As a result of continued 
investor demand, a total of 1,122,500 new shares were issued at a premium to 
the cum income net asset value per share during the half year, raising £41.7 
million of new funds. Following the half year end to 16 November 2021, a 
further 75,000 new shares were issued at a premium to the cum income net asset 
value per share, raising £2.8 million of new funds. No shares were repurchased 
by the Company during the period under review and to 16 November 2021. 
 
As mentioned at the Company's year-end, the ongoing share issuance programme 
triggered the requirement for the Company to produce a prospectus which was 
published on 13 July 2021. The prospectus provides authority for the issuance 
of 20 million new shares. A copy of the prospectus can be found on the 
Company's website at www.worldwidewh.com 
 
Revenue and Dividends 
 
The revenue return for the period was £9.0 million, compared to £5.6 million in 
the same period last year. This increase was due primarily due to a rise in 
portfolio income. The Board has declared an increased interim dividend of 7.0p 
per share, for the year to 31 March 2022 (2021: 6.5p), which will be payable on 
11 January 2022 to shareholders on the register of members on 19 November 2021. 
The associated ex-dividend date is 18 November 2021. 
 
I remind shareholders that it remains the Company's policy to pay out dividends 
at least to the extent required to maintain investment trust status. These 
dividend payments are paid out of the Company's net revenue for the year and, 
in accordance with investment trust rules, only a maximum of 15% of income can 
be retained by the Company in any financial year. 
 
It is the Board's continuing belief that the Company's capital should be 
deployed rather than paid out as dividends to achieve a particular target 
yield. 
 
Outlook 
 
Our Portfolio Manager continues to believe that despite this disappointing 
half-year, the positive investment themes which underpin the healthcare sector 
remain intact and they will continue to focus on the selection of investments 
with strong prospects for capital growth. They further believe that innovation 
will continue to be the primary value driver for the healthcare sector. In 
addition, an expected increase in mergers and acquisitions activity, a 
relatively benign political environment in the U.S. and a return to favour of 
both emerging markets healthcare stocks and Emerging Biotechnology companies 
will lead to an improvement in the Company's performance. 
 
Sir Martin Smith 
Chairman 
 
17 November 2021 
 
Review of Investments 
 
Markets 
 
The hallmark of equity markets so far in 2021 has been that share price returns 
are being primarily driven by global factors and events. Whether it be the 
pandemic "recovery" trade, growth-to-value rotation, large capitalisation 
companies over small, inflation concerns, interest rate gyrations, or other 
"factor" influences, the effect of these factors often swamped company specific 
fundamental factors in moving share prices. As a specialist investor in a 
highly complex and idiosyncratic industry like healthcare, it was, at best, a 
frustrating six?month period. 
 
Of course, the global pandemic wrought by the SARS-Cov-2 virus has not ended 
with the administration of billions of COVID-19 vaccine doses worldwide. 
Despite the explosion of the highly contagious Delta-variant in mid-2021 across 
continents, global equity markets continued to move higher, with multiple 
indices reaching record highs in the period. 
 
At a high level, one critical driver of global equities over the past 
six-months has been investor sentiment about the global economic outlook. 
Concerns about U.S. tax reform, global inflation, supply chain disruption and 
unemployment were ignored as stocks moved higher. Recurring waves of COVID-19 
infections across the globe were also ignored by investors as stocks once again 
moved higher. Globally, investor sentiment was buoyed by an economy that was 
expected to expand at a pace not seen in 80 years. 
 
Overall, we saw an MSCI World Index total return of 10.7% in the half-year 
period (sterling adjusted). In the U.S., the S&P 500 finished up 9.2% (dollar) 
on a total return basis. In the U.K., the FTSE All Share total return was 7.9% 
(sterling). For healthcare, the Benchmark return was 13.0%. Similarly, the S&P 
500 Healthcare Sub-Index (sterling adjusted) rose 12.7% on a total return 
basis. 
 
Performance 
 
For the six-month period ended 30 September 2021, the Company posted a net 
asset value total return of +0.4%. and a share price total return of -1.5%. 
This performance lagged the Benchmark return of +13.0%. The Company's 
underperformance was due to multiple factors but was focussed on three primary 
factors. 
 
  * First, two subsectors in which we have long held a strategic overweight 
    position - Emerging Biotechnology and China - significantly underperformed. 
  * Second, a backdrop of a rotation by investors from growth-to-value and from 
    small capitalisation to large capitalisation stocks, hurt the Company's 
    relative performance. 
  * Third, the persistent threat of U.S. drug price reform created an overhang 
    for some parts of healthcare. 
 
Our investment strategy, centred around innovation, resulted in 
underperformance during the six-month period. Our preferences for biotechnology 
over pharmaceuticals, growth over value, and small capitalisation over large 
capitalisation companies all conspired against relative performance. Despite 
this recent challenging performance, we plan to maintain this strategy going 
forward. Whilst this strategy is susceptible to short-term volatility, it has 
proven successful over the longer term. 
 
Since its inception as of 28 April 1995, the Company's NAV has posted a 
+4,505.8% total return, or an average of +15.6% per annum through to 30 
September 2021. The Company's share price return over the same period has been 
+4,282.2%, or +15.4% per annum. This compares to a Benchmark return of 
+1,990.8%, or +12.2% per annum over the same investment horizon and is a 
testament to the long-term success of our investment approach. 
 
Sector Review 
 
Two sectors that are long term, key strategic overweight positions for the 
Company, Emerging Biotechnology and China, were subject to some extreme 
volatility in the six-month period and were the largest factors in the reported 
underperformance versus the benchmark. Partially offsetting this poor 
performance, however, were contributions from other sectors and regions, most 
notably Medical Devices Pharmaceuticals, and India, as well as from the 
Company's portfolio of "unquoteds" (a mix of private companies and fixed 
income). 
 
Biotechnology 
 
Following record performance in 2020, the biotechnology sector, and in 
particular small and mid-capitalisation stocks, has dramatically underperformed 
the overall market thus far in 2021. With the post-election political overhang, 
some negative fundamental news flow, and the abundance of "macro" and sentiment 
factors driving investor behaviour, the sector has materially underperformed to 
a record extent. 
 
Additionally, investor concerns about news flow from the U.S. Food and Drug 
Administration (FDA) increased during the period which applied further pressure 
to biotechnology valuation levels. In 2021, there were several unexpected 
regulatory trends from the FDA, notably: surprise Complete Response Letters 
(effectively "non?approvals" of new drugs), clinical holds (halting a clinical 
trial due to safety concerns), and deferrals on target action dates (when more 
time is required to review a new drug application). Also, of note, was the 
stretched workload of the FDA due to COVID-19 related responsibilities, 
delaying a plethora of clinical trials, advisory committees, manufacturing site 
visits, new drug reviews, and vaccine reviews. 
 
The controversial approval of Biogen's Aduhelm (aducanumab) by the FDA, despite 
mixed clinical trial data and a negative recommendation by an external advisory 
committee, also hurt investor confidence in the agency, leading investors to 
become increasingly wary of potential regulatory risks and uncertainties in 
biotechnology. 
 
Further, the Emerging Biotechnology sector has been plagued by several 
high-profile negative news events in 2021, including multiple late-stage 
clinical trial failures as well as unexpected safety problems across clinical 
trials. This includes some safety concerns among high profile new technologies, 
like gene editing. 
 
Other issues also created headwinds for biotechnology stocks, including modest 
levels of mergers and acquisitions (M&A) in the period, a paucity of positive 
clinical catalysts, and a significant "growth-to-value" rotation that resulted 
in dramatic underperformance of biotechnology stocks (as measured by the S&P 
Biotech ETF or XBI) when compared to the S&P 500 Index. 
 
Nevertheless, we remain positive on the outlook for the sector, and believe the 
broad valuation reset within biotechnology could catalyse strategic action from 
acquirors, which could help reignite investor interest. These companies remain 
the cradle of innovation within the sector and will remain a strategic 
overweight for the Company. 
 
Emerging Markets 
 
Another strategic overweight for the Company that experienced volatility was 
Emerging Market stocks, specifically in China, in the latter part of the 
reported six-month period. Like biotechnology stocks described above, emerging 
market healthcare names experienced robust returns in 2020, in part due to 
COVID-19 related tailwinds. Many Chinese healthcare stocks, especially vaccine 
players, digital healthcare and hospital operators were favoured by investors 
during the pandemic and valuations rose accordingly. 
 
However, with richer valuations, we witnessed some profit taking in 2021. This 
selling pressure was exacerbated by investor concerns over potential tightening 
of government regulations in the Chinese healthcare sector, which first 
occurred in other industries such as the internet and education. Harsher 
government intervention in these sectors caused investors to worry about 
additional regulations that may come in healthcare, creating a "wait and see" 
sentiment which allowed share prices to fall further still. 
 
Despite the recent volatility, we believe the correction in valuations in China 
is largely done and investor sentiment may be swinging positive. Further, the 
China biopharmaceutical industry remains innovation-driven and there has been 
an increasing number of molecules being licensed to overseas players, a 
critical point of validation for the burgeoning research and development (R&D) 
activity coming out of China. 
 
Of course, macro tailwinds remain strong. With a declining number of new-borns, 
an aging population remains one of the largest issues in China. As a result, 
government investment in the healthcare system, including private hospitals, 
internet/ digital healthcare and medical insurance remains the primary focus of 
government in the next five-year plan. 
 
Healthcare 
 
The current calendar year has been challenging for healthcare stocks. The 
outcome of the 2020 U.S. Presidential election created a "Blue Wave" with the 
Democrats in full control of the White House, the House of Representatives, and 
the Senate. 
 
This final election outcome increased the possibility that the incoming 
administration would be both motivated and capable of passing industry-changing 
legislation - specifically on drug pricing - that would be harmful to 
healthcare stocks. Whilst this has yet to happen (and we believe that it will 
not), the compression in valuation compared to the broader market became 
evident as many generalist investors chose to avoid what is seen as a complex 
area of the market. 
 
This is not without precedent. Previously healthcare stocks have traded at a 
steep relative discount due to generalist investor fears over federal 
legislative changes related to prescription drug pricing, notably the 
Democratic controlled Presidencies of Bill Clinton in 1993 ("Hillarycare") and 
Barack Obama in 2009 ("Obamacare"). In both cases, the discount eventually 
reversed after legislation went nowhere or proved benign or even positive for 
the healthcare industry. Ultimately, we expect a similar reversal in valuations 
under Joe Biden. 
 
Life Sciences 
 
The Life Science Tools and Services sector is another which benefited 
significantly from COVID-19 tailwinds in 2020 and this has continued into 2021. 
Whilst the Company did enjoy some modest positive contribution from the sector 
in the reporting period, it was below the Benchmark return. The 
underperformance was principally due to our positioning in the sector, where we 
favour companies we view as long-term secular winners based on novel and 
exciting new innovations, as opposed to the more mature large-capitalisation, 
diversified companies that make up much of this sector. 
 
This reflects our longer-term thesis around compelling investment opportunities 
across key themes such as liquid biopsy and spatial genomics. However, in the 
period, there was significant volatility across the stocks tied to these newer 
trends, unlike the general strength in the larger, more diversified names who 
were able to weather COVID-19 related disruptions to their end markets. 
 
Looking ahead, we continue to see the most attractive opportunity set in our 
preferred high growth areas of innovation, where relative valuations have been 
recently depressed and which investors may appreciate attractive upside moving 
into the end of the calendar year and into 2022. 
 
Major Contributors to Absolute Net Asset Value Performance 
 
As has been an important hallmark of the Company's performance over the years, 
major contributors to performance are represented by a very diverse and 
distinct set of companies. Key contributors in the six-month period ended 
30 September 2021 included a large capitalisation pharmaceutical company from 
the UK, a major hospital operator in India, and three U.S. based companies: a 
specialty drug developer, the maker of an artificial pancreas, and a 
cardiovascular medical device maker. 
 
The COVID-19 pandemic brought industry, governments, and academia together in 
unison to attempt to thwart one of the most deadly pandemics in modern history. 
But it was not without controversy. One company that attempted to do the right 
thing, AstraZeneca, was perhaps the pre-eminent example. Imperfect execution 
across trial design, trial logistics, manufacturing, and communication led to 
over promising and under delivery of a vaccine and (so far) a therapeutic for 
COVID-19. 
 
With it, came share price volatility that obfuscated the company's 
best-in-class growth profile generated by some of the best innovation and 
business development in the industry across a wide range of therapeutic 
categories, including oncology, diabetes, respiratory, and cardiometabolic 
medicine. 
 
We invested in the company during the tumult and now that the pandemic related 
headlines have subsided, the company has maintained a top tier growth 
trajectory despite a difficult operating environment with the share price 
responding accordingly. 
 
Apollo Hospitals Enterprise is the largest hospital chain in India with 71 
hospitals and over 10,000 beds as of June 2021. Alongside this, Apollo has the 
largest retail pharmacy in India with over 4,000 pharmacies. The company has 
recently entered digital healthcare in a significant way under the umbrella 
brand, "Apollo 24*7". Impressive share price performance, including record 
highs, came from several factors. First, occupancy rates have shown a strong 
recovery through 2021, to near pre-pandemic highs, though it had COVID-19 
related occupancy as well. The company's strong execution in terms of cost 
control and managing case-mix led to healthy average revenues per operating 
bed. Second, multiple new business initiatives have fuelled investor 
enthusiasm; another reason for the share price re-rating. These include "Apollo 
Healthco" (a recent carve out from the existing business), "PharmEasy" (a 
potential IPO with a prospective U.S.$9 billion valuation), and other new 
initiatives showing results and margin accretion such as proton therapy, 
clinics, and diagnostics. 
 
Dexcom is a California-based medical device company that is the market leader 
in continuous glucose monitoring (CGM). The company is ushering in a new 
paradigm in diabetes care - an artificial pancreas. Historically, monitoring 
blood glucose was done via needle-based finger pricks and external devices 
which gave only individual data points that were of modest value. Today, using 
the company's innovative technology, patients can now receive real-time 
indications of their blood glucose on their mobile phone, which can detect 
whether the user's blood sugar is improving or worsening, and even communicate 
with an insulin pump to mimic a pancreas by automatically and algorithmically 
administering insulin. 
 
With up to eight million diabetics requiring daily insulin in their core 
markets and hundreds of millions of diabetics globally, Dexcom has been working 
tirelessly to drive adoption of this innovative technology. The past six months 
were strong operationally for the company, in particular it posted a very 
strong second quarter result, suggesting the current business is accelerating 
at the same time as the company moves closer to the expected launch of its next 
generation product; G7. As a result, the share price reached record highs in 
the period. 
 
Horizon Pharmaceuticals is a US-based specialty pharmaceutical company that 
presided over one of the most successful drug launches ever in 2020, Tepezza 
(teprotumumab) which was developed by the company to treat "TED" or thyroid eye 
disease, a painful, disfiguring, and debilitating disorder of the musculature 
of the eye. Launched in January 2020, the drug was well on its way to 
blockbuster status despite the commercial headwinds of the COVID-19 pandemic. 
 
Despite a temporary government-mandated shutdown in the manufacturing of 
Tepezza due to the prioritisation of COVID?19 vaccine production, the re-launch 
of the product in April 2021 exceeded expectations. Management has continued to 
raise near-term estimates for Tepezza sales, pushing the stock to all-time 
highs during the reported period. 
 
Another distinct and unique example of innovation is Edwards Lifesciences, a 
developer of tissue replacement heart valves, and more specifically 
transcatheter heart valves (THV). The company's current valve portfolio is 
largely comprised of aortic heart valves, a market which continues to grow 
solidly in the double-digit range and has remained relatively well insulated 
from COVID-19 disruptions, given the severity of the disease that this 
technology is designed to treat: aortic stenosis. 
 
A strong competitive position and growing demand have allowed the company to 
continue to outperform its peer group with respect to organic sales and 
earnings growth rates, resulting in solid share price performance during the 
six-month period. Importantly, there have been several positive updates on the 
company's product pipeline, specifically around mitral heart valve 
technologies, which has led to increased investor confidence in sustained high 
sales growth for the next several years. 
 
Major Detractors from Absolute Net Asset Value Performance 
 
Theravance Biopharma is a biopharmaceutical company specialising in the 
discovery and development of organ-selective medicines. The company offers the 
marketed drug, Yupelri (revefenacin), a once-daily, nebulised long-acting 
muscarinic antagonist for use in the treatment of chronic obstructive pulmonary 
disease (COPD). The company's pipeline is also innovative and includes a novel 
mechanism - pan-janus kinase (JAK) inhibition - for the treatment of both 
ulcerative colitis and asthma. 
 
Unfortunately, the share price dropped in the reported period after two 
separate but high-profile pipeline failures: (1) TD?1473 - a gut-selective JAK 
inhibitor for the treatment of ulcerative colitis and (2) ampreloxetine - a 
norepinephrine reuptake inhibitor in neurogenic orthostatic hypotension. Both 
TD-1473 and ampreloxetine were discontinued due to a lack of efficacy shown in 
their respective clinical trials. The stock fell as a result, however, the 
company immediately implemented a significant cost reduction programme to focus 
on reaching profitability, which helped buoy the valuation after these 
disappointing catalysts. 
 
Another notable detractor which fell victim to the broader biotechnology 
sell-off was Boston-based Ikena Oncology, which develops targeted cancer 
therapies and modulators of the tumour microenvironment. The company's lead 
programme, IK-930, targets solid tumours with defined genetic mutations. The 
company expects this asset to enter clinical development by the end of 2021 and 
has a promising pipeline of earlier stage programmes that should also generate 
company value. However, in the absence of clinical data, the shares have been 
weak following its March 2021 IPO amidst a broader sell off of early-stage 
biotechnology companies. 
 
Haemonetics is the largest provider of equipment and consumables used for 
plasma collection in the world. The company has worked to provide value for its 
customers by pioneering an innovative new machine and collection process that 
can significantly enhance collection plasma yields per donor, at a time when 
collections have been significantly challenged due to the COVID-19 pandemic. 
Notable players, like Takeda, were readily adopting this new technology. 
Unfortunately, however, one of the company's largest customers, CSL of 
Australia, announced in April 2021 that they would not be renewing their 
contract with Haemonetics and would instead be moving to a new entrant into the 
market. The share price fell as a result, and on the basis of this new 
information we exited the stock. 
 
Vor Biopharma is a Massachusetts-based biotechnology company developing 
cellular therapies for the treatment of acute myeloid leukemia. The company's 
lead programme utilises CRISPR/Cas9-based gene editing technology to disrupt 
the expression of a very specific protein coding gene (called CD33) in stem 
cells that produce blood cells in bone marrow. This is in effort to reduce the 
toxicity of CD33-targeted agents including Mylotarg, an antibody-drug 
conjugate, and of chimeric antigen receptor T cell therapy. The share price for 
the company has waned since its February 2021 IPO, again reflecting a lack of 
current investor interest in the small cap biotechnology space. 
 
Jiangsu Hengrui Medicine is the largest pharmaceutical company listed in China 
and is an example of a "blue-chip" healthcare stock which we target as a 
strategic investment in emerging markets. Their innovative oncology franchise 
consists of many "hot targets" including novel therapies in immuno-oncology 
(PD-1 inhibitors) and targeted therapies (tyrosine kinase inhibitors and PARP 
inhibitors). The company's large and robust generic franchise spans many 
therapeutic categories including oncology, cardiovascular, pain, and 
antibiotics. 
 
Declines in the share price in the reporting period reflected two factors. 
First, the company suffered some reimbursement and pricing setbacks in the 
Chinese Group Purchasing Organisation (GPO) programme that concluded during the 
period, adversely impacting the company's revenue in 2021. Second, changes to 
regulatory guidelines in China for new cancer drug approvals (i.e., the 
requirement of a comparator arm) was a negative development for the company's 
innovative oncology franchise. Intensified debate over pricing for new cancer 
drugs in China also hurt the share price after the company's PD-1 inhibitor, 
AiRuiKa (camrelizumab), faced a government mandated price revision of over 50%. 
 
Contribution from Unquoted Holdings 
 
During the six months ended 30 September 2021, the Company continued to take 
advantage of a favourable market in crossover investments (i.e. investment in 
the last financing round before a company goes public) and we continue to 
believe they offer an attractive combination of near-term liquidity and 
financial return. 
 
As of 30 September 2021, investments in unquoted companies (excluding debt 
securities) accounted for 7.5% of the Company's net assets versus 5.3% as of 31 
March 2021, and 1.0% as of 31 March 2020. The Company initiated positions in 
three China-based unquoted investments during the period; one investment, 
Erasca , completed its initial public offering in July 2021 despite a difficult 
market environment for biotechnology new issues in the United States. For the 
period under review, unquoted equities contributed 1.9% to the Company's 
performance. 
 
Leverage Strategy 
 
Historically, the typical leverage level employed by the Company has been in 
the mid-to-high teens level. Considering the market volatility during the past 
financial year, we have, more recently, used leverage in a more tactical 
fashion. For example, after the dramatic "V"-shape market recovery of April 
2020, leverage was significantly reduced by over 10% month-over-month, to 3% 
and ultimately to 1% in May 2020. This low level of leverage was maintained for 
a period of months but was increased ahead of and into the U.S. Presidential 
election in November 2020 and decreased in the post-election period heading 
into 2021. 
 
However, given the sell-offs in Emerging Biotechnology and China healthcare 
stocks during the six-month period under review, leverage was again increased, 
effectively increasing month-over-month thereafter in 2021. The significant 
potential for a positive resolution to the U.S. drug pricing reforms has also 
pushed gearing up as of the end of October 2021. We expect to continue with a 
tactical approach to leverage in 2022. 
 
Derivative Strategy 
 
The Company has the ability to use equity swaps and options. During the current 
review period the Company employed single stock equity swaps to gain exposure 
to emerging market Chinese and Indian stocks. The exposure via swaps averaged 
6.7% on a gross basis during the period and detracted 0.6% from the Company's 
performance. Analysis of the Company's investments in emerging markets is set 
out earlier in this report. Further explanation regarding swaps can be found in 
the Glossary. 
 
Looking Ahead 
 
We have long espoused the "Golden Era" of innovation that has been the primary 
creator of value for biopharmaceuticals for nearly ten years now. We have no 
reason to believe that this is going to change. In fact, the industry's 
response to the COVID-19 pandemic is just the latest example of the 
unprecedented innovation and societal benefit that the industry can offer. 
 
Despite not attracting as much headline attention as vaccines, the novel 
therapeutics developed to treat and potentially prevent the COVID-19 illness 
are just as impressive as the vaccine initiatives. The development of multiple 
antibodies, antibody cocktails and anti-virals to reduce the severity of 
symptoms, prevent hospitalisations, and lower mortality have been critical in 
the public fight against COVID-19. The re-purposing of many already approved 
medicines to combat the disease burden has been under reported. Also, the 
development of oral therapies to reduce illness and prevent death will be 
another critical arrow in the quiver against the pandemic. 
 
The FDA has certainly been in the spotlight in 2021. From its efforts to combat 
to COVID-19, to much scrutinised delays for some new drug approvals, to the 
controversial approval of new Alzheimer's drug, and the on-going lack of an 
appointed Commissioner; there has certainly been reason for investor concern. 
But what are the facts? 
 
First and foremost, we expect another near record number of new drug approvals 
in 2021. With 41 novel approvals in the first three quarters of the calendar 
year, the Agency has approved one more drug compared to the same time period a 
year ago and has the potential for 58 approvals in 2021 (source: Washington 
Analysis). This would be the second highest level of annual approvals of all 
time and would represent the most productive five-year period in FDA history. 
 
On 7 June 2021, the FDA approved Aduhelm (aducanumab) for the treatment of 
Alzheimer's disease. However, this unexpected approval set off a maelstrom of 
controversy given the debatable clinical efficacy of the drug and the fact that 
an external advisory committee voted against recommending approval of the drug. 
The ultimate approval debunks the myth that the FDA cannot operate properly or 
is too conservative in the absence of a full-time commissioner. We believe this 
view underappreciates the importance of the permanent staff and career 
employees who do almost all of the primary due diligence on behalf of the FDA. 
 
What else can we expect from the Biden Administration in Washington? Both 
Medicare expansion and drug pricing reform have featured prominently in debates 
regarding the social spending bill. The most realistic Medicare proposals being 
discussed are incremental; including the expansion of benefits and lowering the 
cost of premiums. In the effort to lower the cost of prescription drugs to 
patients, there is a notable lack of consensus regarding the preferred size and 
scope of such reforms. We feel that these disagreements may derail drug pricing 
legislative efforts completely or produce a significantly watered-down update, 
either of which would be welcomed by investors. 
 
M&A has been a common industry staple in healthcare for decades, especially in 
the therapeutics space, and a core part of the Company's investment strategy. 
The fragmented and heterogeneous nature of the industry, coupled with clinical 
and technological complexity, will continue to generate many 
business-development deals. That said, there is an ebb and flow to M&A, a 
variable cyclicality driven by influences from capital markets, IPOs, and 
crossovers, plus considerations like valuation, large capitalisation company 
appetites, and of course, the impact of the pandemic. 
 
The summer of 2021 certainly saw an "ebb" in M&A activity with a total 
transaction value of only U.S.$6 billion across eight deals. This inflected in 
earnest in October when Merck announced its intention to acquire Acceleron 
Pharma for U.S.$11.5 billion. We do expect an uptick in M&A given the limited 
cash flow disruption for likely acquirors arising from the pandemic, continued 
solid balance sheets and the positive tone from large capitalisation companies 
about potential M&A. 
 
In our current and fast-changing society, new and novel technologies abound and 
have impacted many industries. Healthcare is no exception and technological 
advances are the primary pillar for our positive outlook on the industry. We 
see an unprecedented level of innovation across the spectrum, from therapeutics 
to services, from devices to diagnostics. Moreover, advances in genomics and 
biotechnology have pushed the therapeutics space to such frontiers that the 
number of known disease states and druggable targets are at an all-time high. 
Novel platform technologies have enabled more therapies to target diseases that 
were previously thought to be untreatable. 
 
Sven H. Borho and Trevor M. Polischuk 
OrbiMed Capital LLC 
Portfolio Manager 
 
17 November 2021 
 
Principal Stock Contributors to and Detractors from Absolute Net Asset Value 
Performance 
 
For the Six Months Ended 30 September 2021 
 
Top Five Contributors                                          Contribution    Contribution 
                                                                      £'000       per share 
                                                                                          £ 
 
AstraZeneca                                                          25,830             0.4 
 
Apollo Hospitals Enterprise                                          24,314             0.4 
 
Dexcom                                                               24,034             0.4 
 
Horizon Therapeutics                                                 20,342             0.3 
 
Edwards Lifesciences                                                 18,870             0.3 
 
Top Five Detractors 
 
Jiangsu Hengrui Medicine                                           (15,075)           (0.2) 
 
Vor Biopharma                                                      (16,320)           (0.2) 
 
Haemonetics*                                                       (17,511)           (0.3) 
 
Ikena Oncology                                                     (18,044)           (0.3) 
 
Theravance Biopharma                                               (23,738)           (0.4) 
 
Based on 65,108,269 shares being the weighted average number in issue during 
the period. 
 
*      Not held at 30 September 2021 
 
Source: Frostrow Capital LLP 
 
Portfolio 
 
At 30 September 2021 
 
                                                     Country/     Market value         % of 
 
Investments                                          Region              £'000  investments 
 
Merck                                                USA               142,736          5.5 
 
Bristol-Myers Squibb                                 USA               137,650          5.3 
 
AstraZeneca                                          United            130,247          5.1 
                                                     Kingdom 
 
Boston Scientific                                    USA               116,803          4.5 
 
Horizon Therapeutics                                 USA               107,162          4.1 
 
Mirati Therapeutics                                  USA                97,106          3.8 
 
AbbVie                                               USA                87,273          3.4 
 
SPDR S&P Biotech Fund                                USA                83,707          3.3 
 
UnitedHealth Group                                   USA                77,142          3.0 
 
Natera                                               USA                73,070          2.8 
 
Top 10 investments                                                   1,052,896         40.8 
 
Vertex Pharmaceuticals                               USA                70,291          2.7 
 
Edwards Lifesciences                                 USA                67,420          2.6 
 
Intuitive Surgical                                   USA                65,578          2.5 
 
DexCom                                               USA                61,592          2.4 
 
Guardant Health                                      USA                60,004          2.3 
 
Humana                                               USA                56,437          2.2 
 
Stryker                                              USA                55,561          2.2 
 
Zimmer Biomet Holdings                               USA                48,380          1.9 
 
Novartis                                             Switzerland        46,563          1.8 
 
Caris Science (unquoted)                             USA                42,556          1.7 
 
Top 20 investments                                                   1,627,278         62.9 
 
Neurocrine Biosciences                               USA                38,982          1.5 
 
Anthem                                               USA                38,724          1.5 
 
Erasca                                               USA                34,077          1.3 
 
Progyny                                              USA                33,060          1.3 
 
Deciphera Pharmaceuticals                            USA                32,336          1.2 
 
ImmunoGen                                            USA                28,454          1.1 
 
CRISPR Therapeutics                                  Switzerland        27,417          1.1 
 
Thermo Fisher Scientific                             USA                25,705          1.0 
 
Oak Street Health                                    USA                25,231          1.0 
 
Biogen                                               USA                23,556          0.9 
 
Top 30 investments                                                   1,934,820         75.0 
 
Alphamab Oncology                                    China              23,475          0.9 
 
HCA Healthcare                                       USA                23,405          0.9 
 
Joinn Laboratories China                             China              22,332          0.9 
 
Select Medical Holdings                              USA                22,154          0.8 
 
Arrail (unquoted)                                    USA                19,772          0.8 
 
Turning Point Therapeutics                           USA                17,859          0.7 
 
Jinxin Fertility Group                               China              17,721          0.7 
 
Shanghai Bioheart Pharmaceutical (unquoted)          China              17,660          0.7 
 
Crossover Health (unquoted)                          USA                17,358          0.7 
 
Galapagos                                            Belgium            16,759          0.6 
 
Top 40 investments                                                   2,133,315         82.7 
 
 
 
                                                     Country/     Market value         % of 
 
Investments                                          Region              £'000  investments 
 
EDDA (unquoted)                                      China              16,759          0.6 
 
Yidu Tech                                            China              16,298          0.6 
 
Iovance Biotherapeutics                              USA                16,136          0.6 
 
Arcutis Biotherapeutics                              USA                16,017          0.6 
 
Ikena Oncology                                       USA                15,088          0.6 
 
SI-BONE                                              USA                14,941          0.6 
 
Beijing Yuanxin Technology (unquoted)                China              14,870          0.6 
 
Shanghai Kindly Medical Instruments                  China              14,831          0.6 
 
MeiraGTx                                             USA                14,531          0.6 
 
Theravance Biopharma                                 USA                14,298          0.6 
 
Top 50 investments                                                   2,287,084         88.4 
 
Celldex Therapeutics                                 USA                14,275          0.5 
 
Visen (unquoted)                                     China              14,164          0.5 
 
Ruipeng Pet Group (unquoted)                         China              13,922          0.5 
 
Tenet Healthcare                                     USA                13,173          0.5 
 
Dingdang Health Technology Group (unquoted)          China              13,083          0.5 
 
New Horizon Health                                   China              13,038          0.5 
 
Seagen                                               USA                12,461          0.5 
 
Burning Rock Biotech                                 China              12,385          0.5 
 
Rimag (unquoted)                                     China              11,704          0.5 
 
uniQure                                              Netherlands        11,664          0.5 
 
Top 60 investments                                                   2,416,953         93.3 
 
CSPC Pharmaceutical Group                            China              11,142          0.4 
 
NanoString Technologies                              USA                11,106          0.4 
 
Hangzhou Tigermed Consulting                         China              11,079          0.4 
 
RxSight                                              USA                 9,889          0.4 
 
Vor BioPharma                                        USA                 9,654          0.4 
 
Danaher                                              USA                 9,652          0.4 
 
Daiichi Sankyo                                       Japan               9,564          0.4 
 
Shenzhen Hepalink Pharmaceutical Group               China               9,299          0.4 
 
Medlive Technology                                   China               9,278          0.3 
 
Harpoon Therapeutics                                 USA                 8,580          0.3 
 
Top 70 investments                                                   2,516,196         97.0 
 
Apollo Hospitals Enterprise                          India               8,447          0.3 
 
Achilles Therapeutics                                USA                 7,988          0.3 
 
CVRx                                                 USA                 7,949          0.3 
 
Shandong Weigao Group Medical Polymer                China               7,809          0.3 
 
Passage                                              USA                 7,502          0.3 
 
United Laboratories International Holdings           China (HK)          6,528          0.3 
 
China Medical System                                 China               6,391          0.3 
 
MabPlex International (unquoted)                     China               5,736          0.2 
 
Abbisko (unquoted)                                   China               5,714          0.2 
 
NanoString Technologies 2.63% 01/03/2025 (unquoted)  USA                 5,681          0.2 
 
Top 80 investments                                                   2,585,941         99.8 
 
 
 
                                                     Country/     Market value         % of 
 
Investments                                          Region              £'000  investments 
 
Shanghai Junshi Biosciences                          China (HK)          5,623          0.2 
 
Simcere Pharmaceutical Group                         China               4,778          0.2 
 
Convey Holding Parent                                USA                 4,050          0.2 
 
Hansoh Pharmaceutical                                China (HK)          1,196          0.0 
 
AiQ Warrant 13/10/2027 (unquoted)                    USA                 1,187          0.0 
 
Peloton (DCC**- unquoted)                            USA                   501          0.0 
 
Total equities and fixed interest investments                        2,603,276        100.8 
 
OTC Equity Swaps - Financed 
 
JPMorgan iDex US SMID Biotech Index*                 United             47,284          1.8 
                                                     States 
 
Apollo Hospitals Enterprise                          India              36,693          1.4 
 
Jiangsu Hengrui Medicine                             China              32,354          1.3 
 
Shandong Pharmaceutical                              China              23,138          0.9 
 
BGI Genomics                                         China              21,304          0.8 
 
Takeout*                                             China              12,984          0.5 
 
Less: Gross exposure added through financed swaps                    (195,211)        (7.5) 
 
Total OTC Swaps                                                       (21,454)        (0.8) 
 
Total investments including OTC Swaps                                2,581,822        100.0 
 
*      Basket Swap. See Glossary. 
 
Summary 
 
                                                                 Market value         % of 
 
Investments                                                             £'000  investments 
 
Quoted equities                                                     2,402,609         93.1 
 
Unquoted equities                                                     194,986          7.5 
 
Unquoted debt securities                                                5,681          0.2 
 
Equity swaps                                                         (21,454)        (0.8) 
 
Total of all investments                                            2,581,822        100.0 
 
**     DCC = deferred contingent consideration. 
 
See note 1 for further details in relation to the OTC Swaps. 
 
Interim Management Report 
 
Principal Risks and Uncertainties 
 
The Directors continue to review the Company's key risk register which 
identifies the risks and uncertainties that the Company is exposed to and the 
controls in place and the actions being taken to mitigate them. This is set 
against the backdrop of increased levels of risk and uncertainty in evidence 
since early 2020, as a result of the impact of the COVID?19 pandemic. The 
Directors have considered the impact of this continued uncertainty on the 
Company's financial position and, based on the information available to them at 
the date of this report, have concluded that no adjustments are required to the 
accounts as at 30 September 2021. 
 
A review of the half-year and the outlook for the Company can be found in the 
Chairman's Statement and the Review of Investments. The principal risks and 
uncertainties faced by the Company include the following: 
 
  * Exposure to market risks and those additional risks specific to the sectors 
    in which the Company invests, such as political interference in drug 
    pricing. 
  * Macro events may have an adverse impact on the Company's performance by 
    causing exchange rate volatility, changes in tax or regulatory 
    environments, and/or a fall in market prices. Emerging markets, which a 
    portion of the portfolio is exposed to, can be subject to greater political 
    uncertainty and price volatility than developed markets. 
  * Unquoted investments are more difficult to buy, sell or value and so 
    changes in their valuations may be greater than for listed assets. 
  * The risk that the individuals responsible for managing the Company's 
    portfolio may leave their employment or may be prevented from undertaking 
    their duties. 
  * The risk that following the failure of a counterparty, the Company could be 
    adversely affected through either delay in settlement or loss of assets. 
  * The Board is reliant on the systems of the Company's service providers and 
    as such disruption to, or a failure of, those systems could lead to a 
    failure to comply with law and regulations leading to reputational damage 
    and/or financial loss to the Company. 
  * The risk that investing in companies that disregard Environmental, Social 
    and Governance (ESG) factors will have a negative impact on investment 
    returns and also that the Company itself may become unattractive to 
    investors if ESG is not appropriately considered in the Portfolio Manager's 
    decision making process. 
  * The risk, particularly if the investment strategy and approach are 
    unsuccessful, that the Company may underperform resulting in the Company 
    becoming unattractive to investors and a widening of the share price 
    discount to NAV per share. Also, falls in stock markets, such as those 
    experienced as a consequence of the COVID?19 pandemic, and the risk of a 
    global recession, are likely to adversely affect the performance of the 
    Company's investments. 
 
Information on these risks is given in the Annual Report for the year ended 31 
March 2021.The Board believes that the Company's principal risks and 
uncertainties have not changed materially since the date of that report and are 
not expected to change materially for the remaining six months of the Company's 
financial year. 
 
Related Party Transactions 
 
During the first six months of the current financial year no material 
transactions with related parties have taken place which have affected the 
financial position or the performance of the Company during the period. 
 
Going Concern 
 
The Directors believe, having considered the Company's investment objectives, 
risk management policies, capital management policies and procedures, nature of 
the portfolio and expenditure projections, that the Company has adequate 
resources, an appropriate financial structure and suitable management 
arrangements in place to continue in operational existence for the foreseeable 
future and, more specifically, that there are no material uncertainties 
relating to the Company that would prevent its ability to continue in such 
operational existence for at least twelve months from the date of the approval 
of this half yearly financial report. For these reasons, they consider there is 
reasonable evidence to continue to adopt the going concern basis in preparing 
the accounts. In reviewing the position as at the date of this report, the 
Board has considered the guidance issued by the Financial Reporting Council. 
 
As part of their assessment, the Directors have given careful consideration to 
the next continuation vote to be held in 2024 and also consequences for the 
Company resulting from the continuing uncertainty arising from the COVID-19 
pandemic. As previously reported, stress testing was also carried out in May 
2021, which modelled the effects of substantial falls in markets and 
significant reductions in market liquidity, on the Company's net asset value, 
its cash flows and its expenses. 
 
Directors' Responsibilities 
 
The Board of Directors confirms that, to the best of its knowledge: 
 
 i. the condensed set of financial statements contained within the Half Year 
    Report have been prepared in accordance with Financial Reporting Standard 
    104 (Interim Financial Reporting); and 
ii. the interim management report includes a true and fair review of the 
    information required by: 
 
 a. DTR 4.2.7R of the Disclosure Guidance and Transparency Rules, being an 
    indication of important events that have occurred during the first six 
    months of the financial year and their impact on the condensed set of 
    financial statements; and a description of the principal risks and 
    uncertainties for the remaining six months of the year; and 
 
 a. DTR 4.2.8R of the Disclosure Guidance and Transparency Rules, being related 
    party transactions that have taken place in the first six months of the 
    current financial year and that have materially affected the financial 
    position or performance of the entity during that period; and any changes 
    in the related party transactions described in the last annual report that 
    could do so. 
 
The Half Year Report has not been reviewed or audited by the Company's 
auditors. 
 
This Half Year Report contains certain forward?looking statements. These 
statements are made by the Directors in good faith based on the information 
available to them up to the date of this report and such statements should be 
treated with caution due to the inherent uncertainties, including both economic 
and business risk factors, underlying any such forward-looking information. 
 
For and on behalf of the Board 
 
Sir Martin Smith 
Chairman 
 
17 November 2021 
 
Income Statement 
 
For the Six Months Ended 30 September 2021 
 
                                                       (Unaudited)                  (Unaudited) 
 
                                                  Six months ended             Six months ended 
 
                                                 30 September 2021            30 September 2020 
 
                                      Revenue  Capital             Revenue  Capital 
 
                                       Return   Return       Total  Return   Return       Total 
 
                                        £'000    £'000       £'000   £'000    £'000       £'000 
 
(Losses)/gains on investments               -  (5,449)     (5,449)       -  382,487     382,487 
 
Foreign exchange losses                     -  (4,482)     (4,482)       -  (5,501)     (5,501) 
 
Income from investments (note 2)       11,246        -      11,246   7,785        -       7,785 
 
AIFM, portfolio management, and         (483)    9,706       9,223   (403) (22,106)    (22,509) 
performance fees (note 3) 
 
Other expenses                          (467)        -       (467)   (750)        -       (750) 
 
Net return/(loss) before finance       10,296    (225)      10,071   6,632  354,880     361,512 
charges and taxation 
 
Finance charges                          (16)    (308)       (324)    (14)    (259)       (273) 
 
Net return/(loss) before finance       10,280    (533)       9,747   6,618  354,621     361,239 
 
Taxation                              (1,287)        -     (1,287)   (992)        -       (992) 
 
Net return/(loss) after taxation        8,993    (533)       8,460   5,626  354,621     360,247 
 
Return/(loss) per share (note 4)        13.8p   (0.8)p       13.0p    9.9p   623.0p      632.9p 
 
The "Total" column of this statement is the Income Statement of the Company. 
The "Revenue" and "Capital" columns are supplementary to this and are prepared 
under guidance published by The Association of Investment Companies. 
 
All revenue and capital items in the above statement derive from continuing 
operations. 
 
The Company has no recognised gains and losses other than those shown above and 
therefore no separate Statement of Total Comprehensive Income has been 
presented. 
 
The accompanying notes are an integral part of these statements. 
 
Statement of Changes in Equity 
 
For the Six Months Ended 30 September 2021 
 
                                                             (Unaudited)    (Unaudited) 
 
                                                              Six months     Six months 
                                                                   ended          ended 
 
                                                            30 September   30 September 
 
                                                                    2021           2020 
 
                                                                   £'000          £'000 
 
Opening shareholders' funds                                    2,381,425      1,538,298 
 
Issue of new shares                                               41,676        192,754 
 
Return for the period                                              8,460        360,247 
 
Dividends paid - revenue                                        (10,085)       (10,512) 
 
Closing shareholders' funds                                    2,421,476      2,080,787 
 
Statement of Financial Position 
 
As at 30 September 2021 
 
                                                             (Unaudited)      (Audited) 
 
                                                            30 September       31 March 
 
                                                                    2021           2021 
 
                                                                   £'000          £'000 
 
Fixed assets 
 
Investments                                                    2,603,276      2,416,038 
 
Derivatives - OTC swaps                                           21,226         18,864 
 
                                                               2,624,502      2,434,902 
 
Current assets 
 
Debtors                                                           19,486         18,172 
 
Cash and cash equivalents                                         60,277         29,595 
 
                                                                  79,763         47,767 
 
Current liabilities 
 
Creditors: amounts falling due within one year                 (240,109)       (92,932) 
 
Derivative - OTC Swaps                                          (42,680)        (8,312) 
 
                                                               (282,789)      (101,244) 
 
Net current assets/(liabilities)                               (203,026)       (53,477) 
 
Total net assets                                               2,421,476      2,381,425 
 
Capital and reserves 
 
Ordinary share capital                                            16,359         16,078 
 
Share premium account                                            837,752        796,357 
 
Capital reserve                                                1,542,095      1,542,628 
 
Capital redemption reserve                                         8,221          8,221 
 
Revenue reserve                                                   17,049         18,141 
 
Total shareholders' funds                                      2,421,476      2,381,425 
 
Net asset value per share - (note 5)                            3,700.7p       3,703.0p 
 
Cash Flow Statement 
 
For the Six Months Ended 30 September 2021 
 
                                                                (Unaudited)   (Unaudited) 
 
                                                                 Six months    Six months 
                                                                      ended         ended 
 
                                                               30 September  30 September 
 
                                                                       2021          2020 
 
                                                         Note         £'000         £'000 
 
Net cash (outflow)/inflow from operating                    7      (13,453)           485 
activities 
 
Purchases of investments and derivatives                          (540,411)     (505,070) 
 
Sales of investments and derivatives                                384,014       546,830 
 
Realised gain/(loss) on foreign exchange                            (1,770)       (5,282) 
transactions 
 
Net cash (outflow)/inflow from investing                          (158,167)        36,478 
activities 
 
Issue of shares                                                      44,253       191,353 
 
Equity dividends paid                                              (10,085)      (10,512) 
 
Interest paid                                                         (324)         (273) 
 
Net cash inflow from financing activities                            33,844       180,568 
 
(Increase)/decrease in net debt                                   (137,776)       217,531 
 
Cash flows from operating activities includes interest received of £780,000 
(2020: £1,290,000) and dividends received of £10,650,000 (2020: £7,629,000). 
 
Reconciliation of Net Cash Flow Movement to Movement in Net Debt 
 
                                                               (Unaudited)  (Unaudited) 
 
                                                                Six months   Six months 
                                                                     ended        ended 
 
                                                              30 September 30 September 
 
                                                                      2021         2020 
 
                                                                     £'000        £'000 
 
(Increase)/decrease in net debt resulting from cashflows         (137,776)      217,531 
 
Losses on foreign currency cash and cash equivalents               (2,712)        (219) 
 
Movement in net debt in the period/year                          (140,488)      217,312 
 
Net debt at 1 April                                               (20,301)    (150,516) 
 
Net debt at period/year                                          (160,789)       66,796 
 
Notes to the Financial Statements 
 
1. Accounting Policies 
 
The condensed Financial Statements for the six months to 30 September 2021 
comprise the Company's primary financial statements together with the related 
notes below. They have been prepared in accordance with FRS 104 'Interim 
Financial Reporting', the AIC's Statement of Recommended Practice issued in 
October 2019 ('SORP') and using the same accounting policies as set out in the 
Company's Annual Report and Financial Statements at 31 March 2021. 
 
Going Concern 
 
After making enquiries, and having reviewed the Investments, Statement of 
Financial Position and projected income and expenditure for the next 12 months, 
the Directors have a reasonable expectation that the Company has adequate 
resources to continue in operation for the foreseeable future. The Directors 
have therefore adopted the going concern basis in preparing these condensed 
financial statements. 
 
Fair Value 
 
Under FRS 102 and FRS 104 investments have been classified using the following 
fair value hierarchy: 
 
Level 1 - Quoted market prices in active markets 
 
Level 2 - Prices of a recent transaction for identical instruments 
 
Level 3 - Valuation techniques that use: 
 
 i. observable market data; or 
ii. non-observable data 
 
AS OF 30 SEPTEMBER 2021                          Level 1   Level 2   Level 3     Total 
 
                                                   £'000     £'000     £'000     £'000 
 
Investments held at fair value through profit  2,402,609       ...   200,667 2,603,276 
or loss 
 
Derivatives: OTC swaps (assets)                        -    21,226         -    21,226 
 
Derivatives: OTC swaps (liabilities)                   -  (42,680)         -  (42,680) 
 
Financial instruments measured at fair value   2,402,609  (21,454)   200,667 2,581,822 
 
 
 
AS OF 31 MARCH 2021                           Level 1   Level 2   Level 3      Total 
 
                                                £'000     £'000     £'000      £'000 
 
Investments held at fair value through      2,275,409         -   140,629  2,416,038 
profit or loss 
 
Derivatives: OTC swaps (assets)                     -    18,864         -     18,864 
 
Derivatives: OTC swaps (liabilities)                -   (8,312)         -    (8,312) 
 
Financial instruments measured at fair      2,275,409    10,552   140,629  2,426,590 
value 
 
2. Income 
 
                                                              (Unaudited)    (Unaudited) 
 
                                                               Six months     Six months 
                                                                    ended          ended 
 
                                                             30 September   30 September 
 
                                                                     2021           2020 
 
                                                                    £'000          £'000 
 
Investment income                                                  11,246          7,785 
 
Total                                                              11,246          7,785 
 
3. AIFM, Portfolio Management and Performance Fees 
 
                                                   (Unaudited)                  (Unaudited) 
 
                                              Six months ended             Six months ended 
 
                                             30 September 2021            30 September 2020 
 
                                  Revenue  Capital       Total  Revenue Capital       Total 
 
                                    £'000    £'000       £'000    £'000   £'000       £'000 
 
AIFM fee                               82    1,565       1,647       74   1,398       1,472 
 
Portfolio management fee              401    7,617       8,018      329   6,261       6,590 
 
Performance fee charge for the          - (18,888)    (18,888)        -  14,447      14,447 
period* 
 
                                      483  (9,706)     (9,223)      403  22,106      22,509 
 
  * During the six months ended 30 September 2021, due to underperformance 
    against the Benchmark in the period, a reversal of prior period provisions 
    totalling £18,888,000 occurred (six months ended 30 September 2020: charge 
    of £14,447,000). 
 
As at 30 September 2021 no performance fees were accrued or payable (31 March 
2021: £31,748,000 accrued). Of the 31 March 2021 accrual £12,860,000 
crystallised and became payable as at 30 June 2021 and £18,888,000 reversed due 
to underperformance, as noted above. The performance fee paid related to 
outperformance generated as at 30 June 2020 that was maintained to 30 June 
2021. 
 
The maximum amount that could become payable by 30 September 2022 is £ 
18,888,000. This would only be payable in full if the current period's 
underperformance is reversed and the outperformance achieved as at 31 March 
2021 is re-attained. 
 
See glossary for further information on the performance fee. 
 
4. Return/(Loss) Per Share 
 
                                                               (Unaudited)  (Unaudited) 
 
                                                                Six months   Six months 
                                                                     ended        ended 
 
                                                              30 September 30 September 
 
                                                                      2021         2020 
 
                                                                     £'000        £'000 
 
The return per share is based on the following figures: 
 
Revenue return                                                       8,993        5,626 
 
Capital (loss)/return                                                (533)      354,621 
 
Total return                                                         8,460      360,247 
 
Weighted average number of shares in issue for the period       65,108,269   56,922,562 
 
Revenue return per share                                             13.8p         9.9p 
 
Capital (loss)/return per share                                     (0.8)p       623.0p 
 
Total return per share                                               13.0p       632.9p 
 
The calculation of the total, revenue and capital returns per ordinary share is 
carried out in accordance with IAS 33, "Earnings per Share (as adopted in the 
EU)". 
 
5. Net Asset Value Per Share 
 
The net asset value per share is based on the assets attributable to equity 
shareholders of £2,421,476,000 (31 March 2021: £2,381,425,000) and on the 
number of shares in issue at the period end of 65,432,755 (31 March 2021: 
64,310,255). 
 
6. Transaction Costs 
 
Purchase transaction costs for the six months ended 30 September 2021 were £ 
461,000 (six months ended 30 September 2020: £831,000). 
 
Sales transaction costs for the six months ended 30 September 2021 were £ 
403,000 (six months ended 30 September 2020: £473,000). 
 
These costs comprise mainly commission. 
 
7. Reconciliation of Operating Return to Net Cash Inflow from Operating 
Activities 
 
                                                                (Unaudited) (Unaudited) 
 
                                                                 Six months  Six months 
                                                                      ended       ended 
 
                                                                         30          30 
                                                                  September   September 
 
                                                                       2021        2020 
 
                                                                      £'000       £'000 
 
Gains before finance costs and taxation                              10,071     361,512 
 
Add: capital loss/(less: capital gain) before finance charges           225   (354,880) 
and taxation 
 
Revenue return before finance charges and taxation                   10,296       6,632 
 
Expenses charged to capital                                           9,706    (22,106) 
 
(Increase)/decrease in other debtors                                  (133)       1,198 
 
(Decrease)/increase in provisions, and other creditors and         (31,781)      15,294 
accruals 
 
Net taxation suffered on investment income                          (1,293)       (428) 
 
Amortisation                                                          (248)       (105) 
 
Net cash (outflow)/inflow from operating activities                (13,453)         474 
 
8. Principal Risks and Uncertainties 
 
The principal risks facing the Company are listed in the Interim Management 
Report. An explanation of these risks and how they are managed is contained in 
the Strategic Report and note 16 of the Company's Annual Report & Accounts for 
the year ended 31 March 2021. 
 
9. Comparative Information 
 
The condensed financial statements contained in this half year report do not 
constitute statutory accounts as defined in section 434 of the Companies Act 
2006. The financial information for the half years ended 30 September 2021 and 
30 September 2020 has not been audited or reviewed by the Company's auditor. 
 
The information for the year ended 31 March 2021 has been extracted from the 
latest published audited financial statements of the Company. Those financial 
statements have been filed with the Registrar of Companies. The report of the 
auditor on those financial statements was unqualified, did not include a 
reference to any matters to which the auditors drew attention by way of 
emphasis without qualifying the report, and did not contain statements under 
either section 498 (2) or 498 (3) of the Companies Act 2006. 
 
Earnings for the first six months should not be taken as a guide to the results 
for the full year. 
 
Glossary of Terms and Alternative Performance Measures (APMs) 
 
Alternative Investment Fund Managers Directive (AIFMD) 
 
Agreed by the European Parliament and the Council of the European Union and 
transported into UK legislation, the AIFMD classifies certain investment 
vehicles, including investment companies, as Alternative Investment Funds 
('AIFs') and requires them to appoint an Alternative Investment Fund Manager 
('AIFM') and depositary to manage and oversee the operations of the investment 
vehicle. The Board of the Company retains responsibility for strategy, 
operations and compliance and the Directors retain a fiduciary duty to 
shareholders. 
 
Benchmark 
 
The performance of the Company is measured against the MSCI World Health Care 
Index on a net total return, sterling adjusted basis. 
 
The net total return is calculated by reinvesting dividends after the deduction 
of withholding taxes. 
 
Discount or Premium (APM) 
 
A description of the difference between the share price and the net asset value 
per share. The size of the discount or premium is calculated by subtracting the 
share price from the net asset value per share and is usually expressed as a 
percentage (%) of the net asset value per share. If the share price is higher 
than the net asset value per share the result is a premium. If the share price 
is lower than the net asset value per share, the shares are trading at a 
discount. 
 
Emerging Biotechnology 
 
Biotechnology companies with a market capitalisation less than U.S.$10bn. 
 
Equity Swaps 
 
An equity swap is an agreement in which one party (counterparty) transfers the 
total return of an underlying equity position to the other party (swap holder) 
in exchange for a one-off payment at a set date. Total return includes dividend 
income and gains or losses from market movements. The exposure of the holder is 
the market value of the underlying equity position. 
 
Your Company uses two types of equity swap: 
 
  * funded, where payment is made on acquisition. They are equivalent to 
    holding the underlying equity position with the exception of additional 
    counterparty risk and not possessing voting rights in the underlying; and, 
  * financed, where payment is made on maturity. As there is no initial outlay, 
    financed swaps increase economic exposure by the value of the underlying 
    equity position with no initial increase in the investments value - there 
    is therefore embedded leverage within a financed swap due to the deferral 
    of payment to maturity. 
 
The Company employs swaps for two purposes: 
 
  * To gain access to individual stocks in the Indian, Chinese and other 
    emerging markets, where the Company is not locally registered to trade or 
    is able to gain in a more cost efficient manner than holding the stocks 
    directly; and, 
  * To gain exposure to thematic baskets of stocks (a Basket Swap). Basket 
    Swaps are used to build exposure to themes, or ideas, that the Portfolio 
    Manager believes the Company will benefit from and where holding a Basket 
    Swap is more cost effective and operationally efficient than holding the 
    underlying stocks or individual swaps. 
 
Leverage (APM) 
 
Leverage is defined in the AIFMD as any method by which the AIFM increases the 
exposure of an AIF. In addition to the gearing limit the Company also has to 
comply with the AIFMD leverage requirements. For these purposes the Board has 
set a maximum leverage limit of 140% for both methods. This limit is expressed 
as a % with 100% representing no leverage or gearing in the Company. There are 
two methods of calculating leverage as follows: 
 
The Gross Method is calculated as total exposure divided by Shareholders' 
Funds. Total exposure is calculated as net assets, less cash and cash 
equivalents, adding back cash borrowing plus derivatives converted into the 
equivalent position in their underlying assets. 
 
The Commitment Method is calculated as total exposure divided by Shareholders 
Funds. In this instance total exposure is calculated as net assets, less cash 
and cash equivalents, adding back cash borrowing plus derivatives converted 
into the equivalent position in their underlying assets, adjusted for netting 
and hedging arrangements. 
 
See the definition of Options and Equity Swaps for more details on how exposure 
through derivatives is calculated. 
 
                                                   As at                   As at 
 
                                       30 September 2021                31 March 
                                                                            2021 
 
                                          Fair Exposure*  Fair Value   Exposure* 
                                         Value 
 
                                         £'000     £'000       £'000       £'000 
 
Investments                          2,603,276 2,603,276   2,416,038   2,416,038 
 
OTC equity swaps                      (21,454)   173,757      10,552     145,636 
 
                                     2,581,822 2,777,033   2,426,590   2,561,674 
 
Shareholders' funds                            2,421,476               2,381,425 
 
Leverage %                                         14.7%                    7.6% 
 
*      Calculated in accordance with AIFMD requirements using the Commitment 
Method 
 
MSCI World Health Care Index (The Company's Benchmark) 
 
The MSCI information (relating to the Benchmark) may only be used for your 
internal use, may not be reproduced or redisseminated in any form and may not 
be used as a basis for or a component of any financial instruments or products 
or indices. None of the MSCI information is intended to constitute investment 
advice or a recommendation to make (or refrain from making) any kind of 
investment decision and may not be relied on as such. Historical data and 
analysis should not be taken as an indication or guarantee of any future 
performance analysis, forecast or prediction. The MSCI information is provided 
on an "as is" basis and the user of this information assumes the entire risk of 
any use made of this information. MSCI, each of its affiliates and each other 
person involved in or related to compiling, computing or creating any 
MSCI information (collectively, the "MSCI Parties") expressly disclaims all 
warranties (including, without limitation, any warranties of originality, 
accuracy, completeness, timeliness, non-infringement, merchantability and 
fitness for a particular purpose) with respect to this information. Without 
limiting any of the foregoing, in no event shall any MSCI Party have any 
liability for any direct, indirect, special, incidental, punitive, 
consequential (including, without limitation lost profits) or any other 
damages. (www.msci.com) 
 
Nav Total Return ('APM') 
 
The theoretical total return on shareholders' funds per share, reflecting the 
change in NAV assuming that dividends paid to shareholders were reinvested at 
NAV at the time the shares were quoted ex?dividend. A way of measuring 
investment management performance of investment trusts which is not affected by 
movements in discounts/premiums. 
 
                                                          Six months   One year 
                                                                  to         to 
 
                                                                  30   31 March 
                                                           September 
 
                                                                2021       2021 
 
                                                                 (p)        (p) 
 
Opening NAV per share                                        3,703.0    2,868.9 
 
(Decrease)/increase in NAV per share                           (2.3)      834.1 
 
Closing NAV per share                                        3,700.7    3,703.0 
 
% Change in NAV per share                                     (0.1)%      29.1% 
 
Impact of reinvested dividends                                  0.5%       0.9% 
 
NAV per share Total Return                                      0.4%      30.0% 
 
Ongoing Charges ('APM') 
 
Ongoing charges are calculated by taking the Company's annualised ongoing 
charges, excluding finance costs, taxation, performance fees and exceptional 
items, and expressing them as a percentage of the average daily net asset value 
of the Company over the year. 
 
                                                              Six months   One year 
                                                                      to         to 
 
                                                                      30   31 March 
                                                               September 
 
                                                                    2021       2021 
 
                                                                   £'000      £'000 
 
AIFM & Portfolio Management fees                                   9,665     17,068 
 
Other Expenses                                                       467      1,338 
 
Total Ongoing Charges                                             10,132     18,406 
 
Performance fees paid/crystallised                                12,860          - 
 
Total                                                             22,992     18,406 
 
Average net assets                                             2,384,758  2,112,164 
 
Ongoing Charges (annualised)                                        0.8%       0.9% 
 
Ongoing Charges (annualised, including performance fees paid        1.3%       0.9% 
or crystallised during the period) 
 
Performance Fee 
 
Dependent on the level of long-term outperformance of the Company, a 
performance fee can be become payable. The performance fee is calculated by 
reference to the amount by which the Company's net asset value ('NAV') 
performance has outperformed the Benchmark. 
 
The fee is calculated quarterly by comparing the cumulative performance of the 
Company's NAV with the cumulative performance of the Benchmark since the launch 
of the Company in 1995. Provision is also made within the daily NAV per share 
calculation as required and in accordance with generally accepted accounting 
standards. The performance fee amounts to 15.0% of any outperformance over the 
Benchmark (see page 44 of the Company's Annual Report & Accounts for the year 
ended 31 March 2021 for further information). 
 
In order to ensure that only sustained outperformance is rewarded, at each 
quarterly calculation date any performance fee payable is based on the lower 
of: 
 
 i. The cumulative outperformance of the investment portfolio over the 
    Benchmark as at the quarter end date; and 
ii. The cumulative outperformance of the investment portfolio over the 
    Benchmark as at the corresponding quarter end date in the previous year. 
 
The effect of this is that outperformance has to be maintained for a 
twelve-month period before the related fee is paid. 
 
In addition, a performance fee only becomes payable to the extent that the 
cumulative outperformance gives rise to a total fee greater than the total of 
all performance fees paid to date. 
 
Share Price Total Return (APM) 
 
Return to the investor on mid-market prices assuming that all dividends paid 
were reinvested. 
 
                                                                Six months  One year to 
                                                                        to 
 
                                                              30 September     31 March 
 
                                                                      2021         2021 
 
Opening share price                                                3,695.0      2,920.0 
 
Increase in share price                                             (70.0)        775.0 
 
Closing share price                                                3,625.0      3,695.0 
 
% Change in share price                                             (1.9)%        26.5% 
 
Impact of reinvested dividends                                        0.4%         0.9% 
 
Share price Total Return                                            (1.5)%        27.4% 
 
For and on behalf of 
 
Frostrow Capital LLP, Secretary 
 
17 November 2021 
 
- ENDS - 
 
 
 
END 
 
 

(END) Dow Jones Newswires

November 17, 2021 02:00 ET (07:00 GMT)

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