FidelityConnects: Pulse Check: What’s next for Canadian Tech, Health and U.S. MedTech?

[00:05:05] Patrick Farkas: Hello, and welcome to Fidelity Connects. I'm Patrick Farkas, Vice President of Regional Sales. As we move through 2026 the medtech industry finds itself at a pivotal point. Companies are contending with regulatory hurdles, geopolitical tensions, and supply chain pressures that continue to influence the sector, yet long term tailwinds remain strong, particularly ageing populations, and increasingly, AI is beginning to reshape how healthcare technologies are developed and deployed. Where are the biggest opportunities in healthcare and medtech emerging and what developments could define the next phase of growth of the sector? Joining me now to outline the technologies gaining traction and to highlight cross-border dynamics that matter for client portfolios are equity research associate Vishal Chopra and equity research analyst Kosta Kringas. Welcome, thanks for joining us.

[00:05:59] Vishal Chopra: Thanks for having us.

[00:06:00] Kosta Kringas: Thanks, Patrick.

[00:06:02] Patrick Farkas: Excellent. Let's dive right into it. Just to start, if you don't mind please quickly going over the definition of what's the difference of medtech versus healthcare.

[00:06:13] Kosta Kringas: I think when you think about healthcare it's a really broad sector. It encompasses things like hospitals, biotech, pharmaceuticals, device companies. When you dive into what's medical devices or medtech it's actually the intersection of medical and technology. Some of the things that people might be familiar with are things like pacemakers, stents, or MRI machines, that's some of the devices that have really driven a lot of innovation over time in medical devices.

[00:06:49] Patrick Farkas: Thanks for clarifying. I think to move into things, a very common question we're getting is around AI. If you don't mind just speaking on the resiliency of your sectors and sub-sectors to AI and just how disruptive could this be to the areas you're covering.

[00:07:07] Vishal Chopra: I cover broadly technology and healthcare companies. The way that I would distinguish it is the cost of code creation is coming down. That has impacted some of the software companies in my coverage. I think beyond software, if you think about the areas that are less impacted, hardware is still very difficult to design, it's still very difficult to build, it requires a physical manufacturing footprint. I think beyond that, within healthcare itself, it's still really difficult to ... whether or not it's design new drugs or design new medical devices because at the end of the day there's very significant safety risk. I'm sure Kosta can talk a lot more about healthcare and how resilient it is.

[00:07:50] Kosta Kringas: Definitely. I see healthcare as a beneficiary of AI, actually. On the other side of Vishal's point about the cost of coding coming down, that's actually a potential benefit for the development of tech stacks and technology for these healthcare companies as that gets cheaper over time. At the same time, on the pharmaceutical side it's possible, and there's early discussions of can we discover drugs quicker with the help of AI. Does that also lead to cheaper drugs as well? That's some of the potential benefits. I think it could be a margin tailwind for some of these healthcare companies as they realize efficiencies from using AI.

[00:08:33] Patrick Farkas: Thank you. Just to kind of stay on tech a bit, it seems like there's recent momentum and money flowing to Mag7 with the recent geopolitical risks just maybe as a move to what seems safe. Where are you seeing money moved to for safety at the moment?

[00:08:49] Vishal Chopra: Within technology I think there's just so many debates. There's debates about the sustainability of AI CapEx and how much people are spending there. There's debates around software moats. What people are really looking for is where am I really confident that these businesses have pricing power? Within the TMT sector that has been in places hardware focused where there's shortages. Whether or not that's in optical or storage that are in relative shortages those are definitely areas of interest today because of strong near term certainty around earnings.

[00:09:27] Patrick Farkas: Excellent. Another very popular question is around software. There seems to be a rotation out of software at the start of the year, would you expect that to further unwind? Are fundamentals still good in software? Is it through an anticipation that they'll deteriorate in the future? So, essentially, hyper real.

[00:09:52] Vishal Chopra: It's a great question and I think it's a constant source of internal debate. I think there's always software companies that have created little widgets that were always challenged in the past. With the cost of code creation coming down they'll be challenged in the future. I think no doubt there are losers in that basket. I think the flip side is, if you think about how much of software is not related to code, whether or not It's the service or the fact that it's still really difficult to provide significant uptime when you're hosting something on the cloud, or the fact that it might deal with people or healthcare systems, there are moats that are not just code-based within software. While you have seen, I think, the sector be indiscriminately sold over the last nine months to a year you are starting to see people start to pick out winners versus losers in terms of, hey, maybe these companies that are a little bit more defensive, maybe they sell into the healthcare system, or maybe they're cybersecurity companies where there's other services that they provide beyond just the written words and code, be recognized more so as winners versus losers in this landscape.

[00:11:13] Patrick Farkas: To kind of stay on that topic a bit, on tech, investors don't like seeing markets get squeezed. Some software companies are getting less and less efficient for each new dollar that they're getting. If you can speak a bit more on that, just how concerned are you on that?

[00:11:30] Vishal Chopra: It is definitely a concern. I think the big issue with software and technology companies today has been the use of non-GAAP. While the cash comp or the cash compensation of employees has been relatively steady they've paid a lot of their employees in stock. When you deduct stock as a cash expense rather than a stock-based expense some of these businesses are still unprofitable or their breakeven don't necessarily make a lot of money. I would say the flip side of that is that AI can really benefit there. If you think about the major cost centres, whether or not it's R&D where AI definitely provides a productivity lift, but also talking to companies, you're seeing a lot more talk about sales and marketing efficiencies, improvements. We're not necessarily hiring more sales reps but we're using these AI tools to better screen our existing customer prospect list and make our sales more efficient. It's true, over the last three, four years since the pandemic sales efficiency has come down. A sales rep is not landing the same amount of deals as they did in 2021. I think there are reasons to be optimistic for innovative tech companies that are able to build solutions that make their salespeople more efficient.

[00:12:46] Patrick Farkas: Just for the both of you, could you please speak on any other areas in your sectors and sub-sectors that you're seeing momentum and just speak on what's driving that?

[00:12:59] Kosta Kringas: I'll kick off, Patrick. In healthcare where you're seeing a lot of momentum is in the pharmaceutical and the biotech space recently. Over the last year or so the biotech sector is up about 20%. What's driving some of that is these weight loss drugs, and I'm sure we'll talk in more detail about those later on, these weight loss drugs have been a big beneficiary for companies like Eli Lilly, Novo Nordisk. What's happening is their top line is accelerating or has accelerated quite significantly as these drugs have gone from injectables to oral delivery methods. We're sort of going up a very steep S-curve on adoption with those drugs. That's been an area of momentum within healthcare.

[00:13:42] What you've also seen on the medical device side, which is what I look at, there's been big cycles of momentum driven by product cycles. For example, in mid to late 2023 we saw Intuitive Surgical launch their DB5 robot which is a new surgical robot for doctors and surgeons to use. What that robot offered was things like force feedback and that dramatically improved the usability for those doctors. We saw an acceleration in revenue for Intuitive Surgical and the stock price also followed that. You've seen these product cycles in medtech drive momentum as well over the past.

[00:14:27] Patrick Farkas: Vishal, would you add anything in that we haven't covered from momentum, or do you feel like we covered the basics there?

[00:14:32] Vishal Chopra: I think to Kosta's point we're really looking for the next product cycle within technology. You had lots of exciting product cycles over the last couple of years, whether or not that was Nvidia with Blackwell, Google with their TPUs and the beneficiaries there. Within software you just have not seen, I think, a similar level of product innovation. I think that also explains sort of where interest lies. You always want to be excited about a new product that's being launched, and there are certainly a lot of exciting hardware product launches but not necessarily exciting software product launches yet.

[00:15:08] Patrick Farkas: Thank you. Let's stick to the weight loss drugs, very hot topic. You talked a little bit about the evolution that you've seen but would like to further dive into how are you seeing this change consumer behaviour. Maybe we've heard that maybe hit some of the alcohol companies so just maybe broad areas that are being negatively and positively impacted.

[00:15:36] Kosta Kringas: Where I'd start with is if you take a step back what drove this adoption was celebrities endorsing it in 2023 as well as some really pivotal trials from Eli Lilly on Wegovy and some of these weight loss drugs. You can refer to them as GLP-1s but essentially they've led to weight loss reduction of about 10 to 15% over a year of usage which has massive ramifications. You do have to stay on these drugs for a consistent period of time to maintain that weight loss but at the same time the form factor is improving. As we talked about we've gone from injectables to now orals. It's becoming more accessible. Reimbursement is opening up. More indications are getting coverage in the US so you're seeing the usage really pick up. What does that mean in terms of trends? You've seen basket sizes change in consumer. People eating less at the margin that are using these drugs. Then there's other things like apparel is a potential for people to change clothes sizes more regularly, for example, so things like that you have to think about.

[00:16:42] On the healthcare side what's really interesting is you've had winners and losers and, obviously, the weight loss companies like Eli Lilly have been a big winner, but on the negative side bariatric surgery, which is basically a surgery for people that are really overweight to lose a significant amount of weight if it's a health problem, that procedure has been impacted quite negatively and volumes have gone from growing to declining. There's been winners and losers. Another winner I'd call out is on the sleep apnea side. You've seen companies like ResMed who have talked about growing awareness of sleep apnea because Eli Lilly is marketing these drugs to that cohort. You're seeing awareness increase for health in general, that's a big tailwind for some of these healthcare companies as well.

[00:17:35] Patrick Farkas: Just very curious, this might be a silly question, but from all your company meetings and what you're seeing and everything you're reading what do you think maybe 20 to 30 years from now, what do you think the evolution of these weight loss drugs will look like?

[00:17:50] Kosta Kringas: It's really interesting. I think one of the things we have to monitor, from a safety point of view, is there some long term potential negative side effects from these, from using them for prolonged periods of time. That's something we don't know and will be discovered over a long period of time. On the positive, I mean, could it lead to a much healthier population? I think it could, definitely. It makes it easier to maintain and lose weight. That could be a potential negative for some of these medical device companies if there's less demand for procedures but on the other hand, it does increase awareness about health. Some of the things that are a bit more optional with healthcare could actually get boosted over time. I think there is positives and negatives over the long term and I think there's a lot to be seen and an exciting future ahead.

[00:18:36] Patrick Farkas: Excellent, thank you. Question for the two of you, would love to hear a bit more about what's the day in the life of an analyst at Fidelity. I've heard some interesting stories. I've had a portfolio manager tell me that almost as soon as ... when they were an analyst that they started conducting company meetings pretty quickly. I had another portfolio manager telling me that when they were an analyst they had quite a lot of freedom in being able to travel around the world and go to certain conferences, meet companies, get insights if you think it's worth it. We'd just kind of love to hear about what does a day-to-day look like, the freedom, flexibility you've got. Is it mostly talking with the portfolio managers, is it talking to companies or doing notes? Hopefully, that makes sense.

[00:19:23] Vishal Chopra: I think everything that you've heard is true. There's lots of responsibility that you get right off the bat, whether or not it's meeting companies, talking to people internally, talking to experts externally to try to figure out particular issues or try to get an expert opinion on something. For example, I was in San Francisco last week to meet with technology companies, both public and private. I thought that was a valuable use of my time to go to the city where so much innovation is happening, try to figure out what are people working on today and what companies sound interesting, which company executives are really pushing the ball forward when it comes to innovation. I think that's a great example of a trip that we have the opportunity to do at Fidelity. They, in fact, encourage us to go to these conferences and these trips to go meet people in the industry to try to figure out what's going on.

[00:20:24] Kosta Kringas: I'd add a few things to that as well, I guess. When I start my day first thing I check is what's going on on the macro headlines, is there any company-specific news that I have to adapt to and include in my new models and forecasts? That's some of the things I do every day, I get up, I look at what's happening in the world, try and change my forecast assumptions around that, communicate that to portfolio managers. What should we be doing with the stock, should we be buying, should we selling? That's also part of our day-to-day job.

[00:20:57] Patrick Farkas: I've heard portfolio manager Joe Overdevest say that we hunt as a pack, that Fiddly does have a unique culture on that analyst, portfolio manager team. Can you speak a bit more of that? Is there anything that really stands out that gives you an edge?

[00:21:12] Vishal Chopra: I think it's the collaboration. Great example is Kosta and I sit right beside one another and we talk about stocks pretty much all day. It can be quite long sometimes. I think beyond that, constant communication with portfolio managers that may have covered your sector before. The fact that there's just such a wide depth of expertise at Fidelity, whether or not it's covering a technology name that another portfolio manager may have covered or talking through a situation that's similar to a situation, call it 10, 15 years ago, that a portfolio manager went through on a different sector. I think not only is there the obsession at Fidelity to look at stocks, look at businesses, and get the stock calls right but there's also a very unique collaboration culture. I'm sure Kosta can talk more about what makes Fidelity unique.

[00:22:07] Kosta Kringas: Definitely. To double down on Vishal's point, I think when it came to the weight loss drugs the team collaboratively worked really well together. We utilized people from across the globe to try and get access to the most recent clinical data, get people's understanding of that data and make an informed decision. You saw at the time there was very little dispersion. Everything was selling off broadly within healthcare in late 2023 when those drugs first came into the spotlight. I think what you've seen with software recently is not too different in some regards. I mean, it's a different thematic and different topic but there's also been little dispersion there. That always creates opportunities. I think we as a team do a really good job of identifying the winners and losers when people are panicked a bit about a certain topic. I think that's been a really great area of using the team's collaborative minds together to get the right answer.

[00:23:05] Patrick Farkas: Thank you. Vishal, I just want to dive a bit more into AI. You and I were discussing this a bit earlier this week, there's this big change over the past year where now companies are having a much greater focus on measuring the impact of AI and tools, trying to figure out how exactly things are being used. Does this change, make you believe companies are becoming more effective at using it, any examples you can provide would be great.

[00:23:39] Vishal Chopra: If I look a year ago talking to companies, and I think this is part of the Fidelity advantage is being able to compare messaging across years, you would ask a company about AI and you would get a very simple answer. We've rolled out Copilot to our employees, or we've rolled out ChatGPT Enterprise to our employee, there was no real measurement of are employees actually using Copilot. You may have given the product but maybe nobody wants to use it. Now today when I ask my companies  it's all about token usage. You can think about token usage as effectively the amount of words that one of these chatbots is writing , input or the output from those chatbots, it's a better method of usage, or a better metric to measure usage. That's really been more uniform across the board when I talk to companies, we are using more tokens than we have in the past. Sometimes they provide a quantification, whether or not the tokens are up 15x versus last year.

[00:24:39] Also beyond that they're doing it at a per employee level in terms of tracking to be able to share wins. You go to a company and they'll be like, well, we noticed an engineer was using 10x the amount of tokens that their team was using. We asked them to sort of present to the team and figure out how was he using an AI coding chatbot to make himself more efficient than his peers. That's going across the entire organization. I think one thing that you see in AI is there's so much focus on coding but talking to the company is that's expanded beyond just the R&D organization, beyond software engineers. In fact, number two or number three, depending on the company that you talk to, is actually the finance organization. Think about the amount of reporting that you need to do, whether or not that's cost-based or revenue-based. It's such tedious work. It's not necessarily the bulk of your job but it is a really annoying part of your job. Companies are figuring out ways to whether or not to use coding tools, or AI coding tools, or build their own solutions that use AI to make their finance teams more productive. I think that's a really interesting new use considering you don't hear about that as often as you hear about the coding use case.

[00:25:55] Patrick Farkas: I think this might be one of my last questions in AI but I would love to hear your thoughts on if long term AI is friend or foe, and if you have any very interesting debates that you hear with either company management or your colleagues I'd love to hear any hot takes that have been not shared.

[00:26:13] Vishal Chopra: I think there's lots of hot takes from software is dead to AI is basically a fraud and it doesn't actually improve productivity and everything should go back to normal. I think the most interesting debate over the last couple of weeks has really been around white collar work in general rather than something that's software specific. It started out with a blog post, or an article, a couple of week ago calling for sort of the death of white collar and how there's going to be mass unemployment in the future. I think my pushback, or at least my hot take on it, if you think about the work that you do, the work you do has a certain amount of value. I don't think the value is particularly attributable to how much you cost, whether or not that's as an analyst how much money you can make on a stock call or whether or that's an accountant helping somebody with their taxes. There is value with that work and reducing the cost of that work doesn't necessarily lead to a mass reduction in demand. In certain cases it leads to more demand. I think while we're seeing sort of a lot of focus on the fact that it's going to reduce demand and cause companies to cut costs I think there's value in what white collar workers do. I'm a little bit maybe biassed in that statement. I think my hot take would be as the costs come down for white collar work and white collar workers are made more productive you will see more job growth in white collar work over the next 1- years than you have over the last 10 years.

[00:27:49] Kosta Kringas: I think on the healthcare side, we talked about AI previously but there's some interesting potential big tailwinds for innovation longer term when you think about AI. For example, there's a company that IPO'd last year called Hinge Health, they look at using a digital platform to connect people with physiotherapists and they send out wearable sensors and use that along with AI to make sure that you are doing the exercise correctly with the right technique, with the right form. People are seeing really improved clinical outcomes from that. Another maybe long shot or a hot take would be what's the potential for robotic procedures and robotic surgery to be enhanced with AI. At the moment when it comes to using robotics in surgery it is assisted. The surgeon is using the robotic instrument to help them with the procedure. It's possible that over time that becomes more automated. AI takes over to some extent with the right regulation and that becomes perhaps a more effective surgery with better outcomes, better safety, being assisted with AI. That's something that's really interesting that could happen in the long term.

[00:29:09] Patrick Farkas: Very interesting, thanks for sharing that. Something I think we're getting a question on is just around have recent geopolitical matters or tariffs had any impacts on your areas, maybe around manufacturing?

[00:29:24] Kosta Kringas: Definitely. When you look at manufacturing, we take a step back, before COVID I think companies, at least in the healthcare space, were moving manufacturing offshore to some extent incrementally. That's to lower the cost of goods sold but also to diversify the supply chains a little bit. With COVID you saw freight prices come up a lot. That inflation led to the cost shipping going up but then also you've had President Trump put on these broad sweeping tariffs starting last year. That's made supply chains come back to the US to some extent. That's been really interesting. You've also now had the geopolitical pressures with the war going on in Iran. I think at the increment supply chains, at least in healthcare, are moving back to the US a little bit.

[00:30:23] Patrick Farkas: I'll let you hit that question too, if you have any comments, sorry.

[00:30:27] Vishal Chopra: I think covering primarily digital companies I would say tariffs isn't necessarily a direct cos but if you think about the companies that they generally serve, it can be a manufacturing company, it's just a reason to either adopt a new technology, whether or not it's something that helps them manage tariffs, manage their supply chain, which you're seeing a lot more interest in, or it's a reason to say, do we really need this new software solution if our costs are going up by 15%. It's not something that is a direct impact that I'm seeing on technology companies in particular but it is definitely something where it's a little bit more of a second derivative impact and nuance that you have to pay attention to.

[00:31:11] Patrick Farkas: Thank you. Just given that we're coming pretty close to the end of the show, just to wrap up, are there any areas you're very excited about that we haven't hit or maybe areas that people might not have on the radar that you think is important to discuss?

[00:31:28] Kosta Kringas: I think with healthcare as a whole, and maybe it's a bit of a different way to answer that question, you've seen it not really act defensively over the last few months with growing geopolitical pressures that we talked about, growing macroeconomic fears. I think healthcare as whole as a sector could be really interesting here when you think about the underperformance it's had relative to the market but also the defensive nature. We talked about ageing population, really sticky cash flows that are really consistent, reliable, predictable and tied to the ageing population. I think healthcare as a sector could act a bit more defensively than it has recently.

[00:32:11] Vishal Chopra: I think on my end, while there's so much focus on generative AI there's a lot less focus on traditional AI. I think when you're talking to companies what you realize is generative AI agents, while it is really exciting there are so many new breakthroughs that are happening in traditional AI, whether or not that's figuring out how to target ads more accurately or figuring out how to just make a model a little bit more efficient. I think that's a really exciting area that I'm spending some time on that I think is a little underappreciated.

[00:32:47] Patrick Farkas: Well, that brings us to a close. A huge thank you for joining us, Kosta and Vishal, very interesting conversation. Thank you everyone who joined us online this week. Next up, I'm just going to go into what's coming up on the webcast next week. On Monday we have Investment Director Tom Stevenson joins Pamela Ritchie for a discussion on global markets and where he's seeing opportunity in the months ahead.

[00:33:11] Next Tuesday please don't miss our conversation with Ellen Bessner, leading defence lawyer for advisors and dealers. Ellen will identify tangible tools and strategies advisors can implement to build trust and better business relationships with the newer generation of investors. This webcast will feature live French audio interpretation.

[00:33:33] My last comment, on next Wednesday we have Étienne Joncas-Bouchard, Fidelity Director of ETFs and Alternative Strategy, will join us for his analysis of the current ETF landscape including an update on Fidelity's All-in-One ETFs and ETF product lineup. Étienne will first join us in French at 10:30 a.m. Eastern Time and then 11:30 a.m. in English. Thanks for watching. Have a great weekend. I'm Patrick Farkas. Thanks, everyone.