WWH.L

Worldwide Healthcare Trust Plc
Worldwide Healthcare Trust PLC - Half-year Report
15th November 2024, 07:00
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LONDON STOCK EXCHANGE ANNOUNCEMENT

Worldwide Healthcare Trust PLC

Unaudited Half Year Results for the six months ended

30 September 2024

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 2024. 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
2024 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 0203 008
4913.

Performance

                                             Six months to  One year to
                                             30 September   31 March
                                             2024           2024
Net asset value per share (total return)* #  0.6%           12.0%
Share price (total return)* #                3.6%           8.6%
Benchmark (total return)^ #                  0.0%           10.9%

                                      30 September  31 March  Six months
                                      2024          2024      change
Net asset value per share             381.5p        381.1p    0.1%
Share price                           345.0p        335.0p    3.0%
Discount of share price to the net    9.6%          12.1%
asset value per share
Leverage1                             13.3%         10.8%
Ongoing charges*                      0.9%          0.9%
Ongoing charges (including            0.9%          0.9%
performance fees crystallised during
theperiod)*

# Source - Morningstar.

^ Benchmark - MSCI World Health Care Index on a net total return, sterling
adjusted basis (see Glossary).

* Alternative Performance Measure (See Glossary).

1 Leverage calculated under the Commitment Method (see Glossary).

Statement from the Chair

"During the period, the Company's net asset value per share total return of
+0.6% and share price total return of +3.6% outperformed the Benchmark, which
was flat."

PERFORMANCE

Macroeconomic and geopolitical factors again buffeted global markets during the
period under review. Positive factors for markets included the initiation of
interest rate reductions in the U.S. as well as new stimulus measures in China.
These were somewhat offset by concerns about a global economic slowdown and the
knock-on impacts of interest rate increases in Japan. There were also unexpected
events in the U.S. Presidential race, including the assassination attempt on
former President Trump and the withdrawal from the race of the incumbent,
President Biden.

Against this backdrop, during the period under review, the MSCI World and the
FTSE All-Share Indices produced sterling based total returns of +2.8% and +6.1%,
respectively. The Company's Benchmark, the MSCI World Healthcare Index, measured
on a net total return, sterling adjusted basis was flat during the period.

In comparison, the Company's net asset value (NAV) per share total return was
+0.6%, outperforming the Benchmark during the period and building on our
outperformance in the previous financial year. The NAV performance was achieved
despite the headwind of sterling strengthening against the U.S. dollar by +6.2%,
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 was +3.6%, greater than its NAV total
return, reflecting a narrowing of the discount of the Company's share price to
its NAV per share from 12.1% at the beginning of the half year to 9.6% at the
end.

Looking at specific names in the portfolio, the largest contributions during the
reporting period came from healthcare services company Tenet Healthcare and
medical technology company Boston Scientific.

The principal detractors from performance were the large capitalisation
biotechnology company Biogen, and healthcare equipment manufacturer Dexcom.

Further information regarding the Company's investments and performance can be
found in the Portfolio Manager's Review.

The Company had, on average, leverage of 12.4% during the period, which added
0.5% to performance. As at the half year-end, leverage stood at 13.3%, compared
to 10.8% at the beginning. Our Portfolio Manager continues to adopt both
apragmatic and a tactical approach to the use of leverage, which adds to
performance in periods of rising portfolio share prices and has benefitted the
Company over time.

Our Portfolio Manager, through its extensive private equity research
capabilities, continues to review unquoted opportunities although, in the period
under review, no new unquoted investments were made. The Company is able to
invest up to 10% of the portfolio, at the time of acquisition, in unquoted
securities. Exposure to unquoted equities accounted for 5.3% of the total
portfolio at the half year-end, and these holdings made a negative contribution
of 0.7% to the Company's performance during the period under review.

PERFORMANCE FEE

No performance fee was accrued as at 30 September 2024 and no performance fee
can become payable within the next year. The performance fee arrangements are
described in detail in the Company's Annual Report.

CAPITAL

Share price discounts continue to persist across the U.K. investment company
sector. As at the period end, the average level of share price discount to NAV
stood at 13.7%. (source: Winterflood Investment Trusts)

It is the Board's policy to buy back our shares if the Company's share price
discount to the NAV per share exceeds 6% on an ongoing basis. Despite the
Company's share buybacks, the discount can remain greater than 6% for extended
periods of time, depending on overall sentiment towards the Company, the sector
and investment trusts generally. Nonetheless, buybacks enhance the NAV per share
for remaining shareholders. In addition, the Board believes that regular
buybacks help to narrow the discount and go some way to dampening discount
volatility.

During the period under review, the Company repurchased a total of 28,230,376
shares for treasury at a cost of £99.8m and at an average discount of 9.6%. At
the period end, there were 517,711,956 shares in issue (excluding the
83,953,244shares held in treasury). Since the period end to 13 November 2024, a
further 4,860,440 shares have been bought back for treasury, at a cost of £16.8m
and at the time of writing, the share price discount stands at 10.5%.

DIVIDENDS

The Board has declared an unchanged interim dividend of 0.7p per share, for the
year to 31 March 2025, which will be payable on 9 January 2025 to shareholders
on the register of members on 29 November 2024. The associated ex-dividend date
is 28 November 2024.

I remind shareholders that it remains the Company's policy to pay out dividends
at least to the extent required to maintaininvestment trust status. These
dividend payments are paid out of the Company's net revenue for the year and,
inaccordance with investment trust rules, a maximum of 15% of income can be
retained by the Company in any financial year.

It is the Board's continuing belief that it is in shareholders' best interests
to see the Company's capital deployed in its investment portfolio rather than
paid out as dividends to achieve a particular target yield.

COMPOSITION OF THE BOARD

I am delighted to confirm that, at the beginning of October, Sian Hansen and
William Hemmings joined the Board. Sian is a non-executive Director of Pacific
Assets Trust plc, and formerly the Chief Operating Officer at global strategic
consultancy group CT Group as well as a non-executive Director of JP Morgan
Multi-Asset Global Growth & Income plc. William was the former Head of Closed
End Funds and Head of Investment Companies at abrdn PLC (formerly Aberdeen Asset
Management PLC) and a Director and Deputy Chair of the Association of Investment
Trust Companies. With their significant experience in the investment trust
sector as well as portfolio management, financial, governance and geopolitical
matters, Sian and William will be valuable additions to the Board and our future
deliberations.

OUTLOOK

While macroeconomic and geopolitical conditions continue to be challenging, your
Board believes that the fundamentals of the healthcare sector remain strong.

Our Portfolio Manager is positive about the outlook for the sector, a view
driven in part by strong innovation cycles, elevated patient volumes and an
ageing global demographic. They also believe that the current high level of
merger and acquisition activity in the sector will continue, supported by
attractive valuations, healthy balance sheets and an increasing need for larger
pharmaceutical and biotechnology companies to address future patent expirations.

Finally, they also believe that the Republican victory in the U.S. election,
having won both the Presidency and also control of Congress, will provide a
positive backdrop for the healthcare sector, as it is not expected that
legislation detrimental to the industry will be enacted.

Doug McCutcheon

Chair

14 November 2024

Portfolio

AS AT 30 SEPTEMBER 2024

                                                         Market     % of
                                                         value
Investments             Sector            Country/regi   £'000      investments
                                          on
Eli Lilly               Pharmaceuticals   United         194,711    9.4
                                          States
Boston Scientific       Health Care       United         161,020    7.8
                        Equipment &       States
                        Supplies
Intuitive Surgical      Health Care       United         124,748    6.0
                        Equipment &       States
                        Supplies
AstraZeneca             Pharmaceuticals   United         122,151    5.9
                                          Kingdom
Novo Nordisk            Pharmaceuticals   Denmark        120,276    5.8
Merck                   Pharmaceuticals   United         95,328     4.6
                                          States
Tenet Healthcare        Health Care       United         79,290     3.8
                        Providers &       States
                        Services
Biogen                  Biotechnology     United         78,681     3.8
                                          States
UnitedHealth            Health Care       United         78,003     3.8
                        Providers &       States
                        Services
Stryker                 Health Care       United         76,271     3.7
                        Equipment &       States
                        Supplies
Top 10 investments                                       1,130,480  54.6
Daiichi Sankyo          Pharmaceuticals   Japan          67,535     3.3
Sarepta Therapeutics    Biotechnology     United         46,781     2.3
                                          States
Natera                  Life Sciences     United         46,186     2.2
                        Tools & Services  States
Argenx                  Biotechnology     Netherlands    45,960     2.2
Eisai                   Pharmaceuticals   Japan          44,425     2.1
Integer Holdings        Health Care       United         44,413     2.1
                        Equipment &       States
                        Supplies
Ionis                   Biotechnology     United         40,985     2.0
Pharmaceuticals                           States
Vertex                  Biotechnology     United         37,953     1.8
Pharmaceuticals                           States
Thermo Fisher           Life Sciences     United         32,628     1.6
Scientific              Tools & Services  States
Elevance Health         Health Care       United         30,545     1.5
                        Providers &       States
                        Services
Top 20 investments                                       1,567,892  75.8
Caris Life Sciences     Life Sciences     United         29,554     1.4
*                       Tools & Services  States
Alnylam                 Biotechnology     United         28,290     1.4
Pharmaceuticals                           States
Evolent Health          Health Care       United         25,385     1.2
                        Providers &       States
                        Services
SI-BONE                 Health Care       United         23,954     1.2
                        Equipment &       States
                        Supplies
Crossover Health *      Health Care       United         23,883     1.2
                        Providers &       States
                        Services
Cytokinetics            Biotechnology     United         21,992     1.1
                                          States
ICON                    Life Sciences     Ireland        21,664     1.0
                        Tools & Services
Universal Health        Health Care       United         21,162     1.0
Services                Providers &       States
                        Services
Amgen                   Biotechnology     United         20,265     1.0
                                          States
Shanghai INT Medical    Health Care       China          20,241     1.0
Instruments             Equipment &
                        Supplies
Top 30 investments                                       1,804,284  87.2
Regeneron               Biotechnology     United         20,066     1.0
Pharmaceuticals                           States
Jiangxi Rimag           Health Care       China          19,926     1.0
                        Providers &
                        Services
Apellis                 Biotechnology     United         19,574     0.9
Pharmaceuticals                           States
Exact Sciences          Life Sciences     United         18,926     0.9
                        Tools & Services  States
Neurocrine              Biotechnology     United         17,443     0.8
Biosciences                               States
Vaxcyte                 Biotechnology     United         17,097     0.8
                                          States
Sino                    Pharmaceuticals   Hong Kong      14,872     0.7
Biopharmaceutical
VISEN                   Biotechnology     China          13,143     0.6
Pharmaceuticals *
Innovent Biologics      Biotechnology     China          13,103     0.6
Beijing Yuanxin         Health Care       China          12,031     0.6
Technology *            Providers &
                        Services
Top 40 investments                                       1,970,464  95.2
EDDA Healthcare &     Health Care         China        10,677       0.5
Technology *          Equipment &
                      Supplies
Ruipeng Pet Group *   Health Care         China        9,834        0.5
                      Providers &
                      Services
Medpace               Life Sciences       United       8,896        0.4
                      Tools &             States
                      Services
New Horizon Health ^  Life Sciences       China        8,672        0.4
                      Tools &
                      Services
Galderma              Pharmaceuticals     Switzerland  6,944        0.3
Gushengtang           Health Care         China        5,980        0.3
                      Providers &
                      Services
MabPlex *             Health Care         China        5,081        0.2
                      Providers &
                      Services
API Holdings *        Health Care         India        4,270        0.2
                      Providers &
                      Services
Oscar Health          Health Care         United       3,835        0.2
                      Providers &         States
                      Services
Sinopharm             Health Care         China        3,784        0.2
                      Providers &
                      Services
Top 50 investments                                     2,038,437    98.4
Shandong Weigao       Health Care         China        3,231        0.2
Group Medical         Equipment &
Polymer               Supplies
Ikena Oncology        Biotechnology       United       2,049        0.1
                                          States
Shanghai Bio-heart    Health Care         China        1,704        0.1
Biological            Equipment &
Technology            Supplies
Passage Bio           Biotechnology       United       1,050        0.1
                                          States
Peloton Therapeutics  Biotechnology       United       503          0.0
- Milestone *                             States
Total equities                                         2,046,974    98.9
Biotech M&A Target    Swap Baskets        United       175,109      8.5
Swap                                      States
Apollo Hospitals      Health Care         India        16,989       0.8
Enterprise            Providers &
                      Services
Less: Gross exposure                                   (170,072)    (8.2)
on financed swaps
Total OTC Swaps                                        22,026       1.1
Total investments                                      2,069,000    100.0
including OTC Swaps

* Unquoted holding

* Private holding

^ Shares suspended - subject to fair valuation process

SUMMARY

                   Market value  % of
Investments        £'000         investments
Quoted Equities    1,937,998     93.6
Equity Swaps       22,026        1.1
Private Equities   108,976       5.3
Total investments  2,069,000     100.0

Portfolio Manager's Review

MARKETS

Global equity markets moved higher in the reported six-month period, continuing
a trend that first commenced in November 2023. Overall enthusiasm for global
economic conditions, avoidance of a recession, and anticipation of interest rate
cuts all contributed to steady market gains. The MSCI World Index, the S&P 500
Index, and the FTSE All-Share Index all closed at or near all-time highs as of
30 September 2024.

Global healthcare stocks also advanced and reached an all-time high (see MSCI
World Health Care Index; in U.S. terms), but modestly lagged the broader markets
during the period. The defensive nature of the sector, coupled with uncertainty
around the frequency and magnitude of interest rate cuts, conspired to create a
headwind. This was particularly true in U.S. markets, where the S&P 500 rose
3.3% (in sterling terms) versus the S&P 500 Health Care Index which declined
1.8% (in sterling terms).

ALLOCATION

The Company's long standing allocation strategy remained unchanged in the first
half of the financial year. Overall, our allocation strategy represents a
diverse distribution of investments across all of the major sub-sectors and
across the global healthcare industry. This allows investors to view the Company
as a "one-stop-shop" for all of their healthcare investment needs given the
broad exposure of the portfolio to the entirety of the healthcare ecosystem -
from therapeutics, to services, to medical technologies, to growth of emerging
markets - given the embedded diversification of the portfolio of companies
represented in the portfolio.

Other key traits of our allocation strategy remained deployed in the reported
period. Specifically, allocation to Large Cap Pharma remained underweight, owing
to (1) disparate fundamentals across the group and (2) the relatively large
weight that is represented within the Benchmark. As of 30 September 2024, total
investments across Large Cap Pharma was 13.8% below the Benchmark (27.0% vs.
40.8%) and total Pharmaceutical holdings (ex-Japan) was 27.8%, or 17.4% below
the Benchmark weight (45.2%).

Additionally, allocation to Biotechnology remained above the collective
Benchmark weighting, owing to (1) the enormous therapeutic innovation and new
drug production that stems from Emerging Biotech companies and (2) the
relatively small weight that is represented in the Benchmark. As of 30 September
2024, total investments across Emerging Biotech were 18.2% above the Benchmark
(20.4% vs. 2.2%) and total Biotechnology holdings were 28.5%, or 19.7% above the
Benchmark weight (8.8%).

WWH vs. MSCI World Health Care Index

                                 As of 30 September 2024
Subsector                        WWH       MSCI HC  +/-
                                 % of NAV  %        %
Biotechnology                    28.5      8.8      19.7
 Large Cap Biotech*              8.1       6.6      1.5
 Emerging Biotech*               20.4      2.2      18.2
Pharmaceuticals                  27.8      45.2     (17.4)
 Large Cap Pharma*               27.0      40.8     (13.8)
 Spec Pharma*                    0.8       4.4      (3.6)
Healthcare Equipment & Supplies  21.9      16.4     5.5
Healthcare Providers & Services  12.0      15.1     (3.1)
Life Science Tools & Services    6.5       10.6     (4.1)
Japan                            5.7       3.9      1.8
Emerging Markets                 5.5       -        5.5
Privates                         5.5       -        5.5
Total                            113.4     100.0    13.4

^ Figures expressed as a % of total Net Asset Value. This includes all
derivatives as an economically equivalent position in the underlying holding and
allocated to the underlying holding's respective Sector and Region.

See Glossary for definition of Pharmaceutical and Biotechnology subsectors.

PERFORMANCE

We are pleased to report a positive return, in excess of the Benchmark, for the
reported period. Specifically, for the six-month period ended 30 September 2024,
the Company returned a net asset value per share total return of +0.6%
ascompared to the MSCI World Health Care Index which was flat on a net total
return, sterling adjusted basis. Thiscontinued the trend from the previous
financial year, namely positive returns, both absolute and relative to
theBenchmark.

Overall, positive performance came primarily from stock picking across non
-therapeutic stocks, including Life Science Tools & Services (`Tools'),
Healthcare Providers & Services (`Services'), and Healthcare Equipment &
Supplies (`Medtech') and Emerging Markets, offset by stock picking in
therapeutic stocks (Pharmaceuticals and Biotechnology). Asset allocation effects
were more muted outside of Biotechnology.

Of note, three periods of volatility contributed to the shape of performance
across the six-month period. First, equity markets dipped for the first time in
five months at the start of the financial year (April) as inflation data was
"hotter" than expected and investor optimism for an interest rate cut
temporarily waned. Whilst equity markets declined in response, asdid the
Company's performance, stock picking generated relative outperformance which
helped offset losses in April. Subsequent gains (both absolute and relative)
were extended into May and June restoring nearly 6.0% of relative performance,
despite Biotechnology's relative underperformance.

Second, after equity markets reached all-time highs in June (led by market
favourite, Nvidia), Technology stocks wobbled on earnings in July and triggered
a broad macro trade in which "retail favourites" were sold and year-to-date
laggards were bought. This phenomenon adversely impacted the Company's
performance materially, given our positioning within these same segments from a
healthcare perspective, resulting in losses of almost 5.0% of both absolute and
relative performance in only eight trading days at the end of July and the
beginning of August.

That said, those losses were more than reversed in the remaining days of August
due to (1) extreme market volatility that originated from economic news in U.S.
and Japan which turned healthcare defensive and (2) solid earnings reports by a
host of portfolio companies to close the second quarter reporting period which
also aided performance.

Finally, in September 2024, an interest rate cut by the U.S. Federal Reserve was
the first rate reduction in over four years. Whilst this action boosted broad
markets, healthcare stocks lost their defensive positioning, resulting in stark
declines in the month. The Company's negative performance was exacerbated by
idiosyncratic negative newsflow from portfolio companies including Novo Nordisk,
Daiichi Sankyo, AstraZeneca, and Ionis Pharmaceuticals during this same period,
reducing absolute and relative total return performance to +0.6% in the six
-month period.

Despite these volatile periods, we do note that a record high net asset value
was achieved during the reported period. Aclosing net asset value per share of
408.7p was achieved on 8 August 2024 eclipsing the previous high set in
January2021.

Performance since inception to 30 September 2024 remains strong, with a
+4,769.8% return since April 1995. This represents an average annualised return
of 14.1% over the 29-plus year period. This ranks the Company in third place of
all closed end trusts across this period, regardless of industry (source:
Winterflood).

SUBSECTOR PERFORMANCE

As mentioned, positive performance came primarily from stock picking across non
-therapeutic stocks (including Tools, Services, Medtech and Emerging Markets),
offset by stock picking in Pharmaceuticals and allocation/stock selection in
Biotechnology.

The largest contribution on a sub-sector level was from Services, predominantly
through stock selection in the U.S. hospitals area and U.S. managed care,
supported by prevailing U.S. Presidential election sentiment that favoured a
Democrat win ahead of the November election. Medtech was the second largest
contributor, primarily from stock selection in multiple large cap companies with
above average growth and operational execution from a pipeline and innovation
perspective. Finally, we note the contribution from Emerging Markets,
specifically China, where healthcare stocks rallied more than 20.0% (sterling;
as per the Hang Seng Healthcare Index) on the heels of a number of new economic
stimulus packages announced in late September, including interest rate cuts.

On the detractor side, Biotechnology was the largest negative contributor due to
allocation and was exacerbated by stock picking (notably Apellis Pharmaceuticals
and Biogen. See the Major Detractors section for more information).
Pharmaceuticals was also a material detractor, again due to stock selection
(including Merck and Novo Nordisk).

The largest area of relative outperformance on sub-sector level came from
Medtech through both stock picking and allocation. On the latter point, our
emphasis on large cap over small cap with an overlay of operational excellence,
created nearly 1.5% of return over the Benchmark. Other sub-sector performance
was similar in both relative and absolute terms. One exception of note was in
Pharmaceuticals, where the absence of holdings in Roche and Novartis hurt
relative returns in that sub-sector.

PRIVATE HOLDINGS

During the first half of the current financial year, the Company strategically
refrained from making new investments inprivate companies, as we continued to
cautiously navigate the challenging public offering market for small and
mid-capitalisation healthcare firms. While the capital market funding landscape
continues to improve, most of our private companies are well capitalised and are
being selective with regards to pursuing listings. We remain optimistic about
the ability of our unquoted investments to achieve listings within the next year
as we anticipate further improvement of the capital market funding environment.

As of the end of the period, private investments made up 5.5% of total net
assets, a decrease from 6.4% on 31 March 2024. This decrease was the result of
one unquoted investment, Jiangxi Rimag Group, which completed its Initial Public
Offering (IPO) in Hong Kong and closed the half year with a post offering return
of roughly 74%.

For the first six months of the current financial year, the Company's private
investments generated a loss of £14.2 million, from an opening market value of
£133.8 million across 10 companies. The private strategy as a whole had an
implied return of -11.6% which detracted -0.7% from performance.

The existing private portfolio constitutes a diverse set of companies.
Geographically, exposure is evenly distributed among Emerging Markets and North
American companies. On a sub-sector basis, the exposure is concentrated in
Services and Tools, with small exposures to Biotechnology and Medtech.

MAJOR CONTRIBUTORS TO PERFORMANCE

Historically, key performance drivers for the Company, whilst diverse from a sub
-sector perspective, usually share some common characteristics. These typically
include growth, innovation, new product flow, astute business development
acumen, operational excellence, among other positive characteristics. The
current interim period was no different.

The largest contributor in the reported six-month period was Tenet Healthcare, a
Dallas-based, diversified healthcare services company and a leading U.S.
hospital operator. The company's share price appreciated nearly 50% (sterling)
due to a multitude of factors. First, the company posted very strong operating
results with substantial outperformance versus expectations. Second, the company
executed on some value-creative divestitures of hospitals at highly favourable
multiples and acquisitions of ambulatory surgery centres. Finally, the company
was able to procure improvements in reimbursement from their Medicaid programs.
We expect Tenet will continue to operate well as the utilisation environment
remains favourable for providers.

Another significant contributor in the interim period, Boston Scientific, has
been a long-term portfolio holding. Themedical technology company has a history
of innovation, operational excellence, and above average industry growth. The
management team is considered top of their field and investors were again
rewarded over the past six months after the company experienced a material
acceleration in organic sales growth driven by the company's next generation
pulsed field ablation device for the treatment of atrial fibrillation. Whilst
the company has several other new products launching, investors are particularly
focused on the pulsed field ablation device as the multi-billion dollar atrial
fibrillation market has begun rapidly shifting toward this new technology.
Looking ahead, investors are optimistic that this market transition can move
more rapidly than consensus expectations. Moreover, Boston Scientific has
several important trials evaluating pulse field ablation in combination with the
company's Watchman left atrial appendage closure device. Positive results should
lead to material market increases for both technologies. We believe the ongoing
company algorithm of best-in-class organic sales growth, differentiated margin
expansion potential and ongoing mergers & acquisitions (M&A) should result in
continued strong and durable profit growth for the foreseeable future.

The undisputed leader in surgical robotic technology is Intuitive Surgical. The
California-based company extended its lead with the debut of their next
generation surgical suite, the da Vinci 5 (Dv5). With a seasoned management
team, a multi-decade head start, and superior robotic technology, we view
Intuitive Surgical as the best positioned company in the fast-growing and vastly
underpenetrated surgical robotics space. The company operates as a monopoly with
its da Vinci suite of robotic systems, and we see upcoming competitor system
launches as being market expansive as opposed to driving material share gains
against Intuitive. During the past six months, investor expectations for the
company's new Dv5 robotic surgery platform have rapidly improved. Dv5 system
placements have been stronger than investor expectations during the past two
quarters and, importantly, sales of prior generation systems have outpaced
expectations as well. Procedure volumes have continued to grow at elevated
levels, and new instruments have allowed the company to generate a higher amount
of sales per procedure. Lastly, the company's margin profile has improved in
recent quarters, which has historically been a point of contention amongst
investors. With the Dv5 system launch still in the early stages, we see
continued strong trends for the company for the next several years.

The treatment of cancer continues to evolve and perhaps the leader to emerge
over the past decade has been U.K.-based AstraZeneca. With dominant positions in
both solid and liquid tumours, the company has been a key innovator in oncology.
The company can also claim leadership in respiratory, cardiovascular,
immunologic, metabolic, and rare diseases. This diversity has led to outsized
growth in the near and long term, the latter was highlighted during a May 2024
Investor Day in which the company articulated a plan to more than triple
revenues during the current decade. The share price rose in response, although
some gains were pruned in the September period after the company disclosed
efficacy data for a late-stage oncology asset that were below expectations.
Despite the late sell-off, the stock remained a top contributor in the period.
The calendar year 2025 is poised to be catalyst rich for AstraZeneca, and
continued commercial and development execution could push the share price back
to all-time highs.

The rise of "diabesity" continues to be a major theme in therapeutics. The most
recent entrant, Zepbound (tirzepatide for obesity), from Eli Lilly, was approved
in December 2023 and set launch records in 2024, reaching blockbuster status
(more than U.S.$1 billion in sales) in the second quarter alone. Sales of
Mounjaro (tirzepatide for diabetes) reached over U.S.$3 billion at the same
time. The tremendous growth at the company is unprecedented for a global large
cap pharmaceutical company and the share price was rewarded, reaching an all
-time high in August 2024. Some volatility has crept into the share price, as
generalists and retail investors alike crowded into the name, becoming a "market
favourite," which elicited some unwanted, non-fundamental trading action.
Despite a modest sell-off into the half-year end, the stock remained a major
contributor to performance. Moreover, we expect this to continue as
manufacturing efforts to increase supply will boost sales, global rollouts
inflect, outcomes studies will read out, and data for next generation products
(both orals and injectables) will be presented in earnest in 2025.

MAJOR DETRACTORS FROM PERFORMANCE

Merck is a global large cap pharmaceutical company that is well regarded as a
pioneer in immuno-oncology and vaccine development. It has seen its top line
rise by more than 50% over the past five years and is expected to eclipse the
U.S.$60 billion sales threshold in 2024. Sales in China comprise a portion of
the company's growth strategy. However, an unexpected slowdown in Gardasil (a
cancer-preventing vaccine) sales in the second quarter spooked investors who
then quickly dumped the stock on the fears that a key long-term growth driver
was in question. The stock fell in late-July 2024 as a result and never
recovered into the financial half-year end. The investment was the largest
detractor in the reported period. Subsequently, the company argued (thus far
unsuccessfully) that this was a near-term issue only and so we continue to
assess the risk/benefit of the company's impressive pipeline and growth
potential versus near-term sales uncertainty.

The Emerging Biotech company, Apellis Pharmaceuticals has displayed all of the
hallmarks of investing in a speculative Biotechnology company, with high rewards
and high risks. The company developed Syfovre (pegcetacoplan injection), afirst
-in-class treatment for geographic atrophy, a specific form of progressive
blindness. Its approval in early 2023 heralded a new treatment for a devastating
disease for which there was no treatment - a breakthrough innovation - and the
company's valuation soared to over U.S.$10 billion by mid-2023. However, rare,
unexpected, but serious side effect (ocular vasculitis) leading to irreversible
blindness emerged in real world use. Company efforts to identify and contain the
side effect ultimately proved futile in 2024. European approval was subsequently
denied. Questions later arose around true visual acuity benefit and a follow-on
competitor with likely better efficacy and absent the vasculitis continued to
take share. The company's valuation at the end of September was less than
U.S.$3.5 billion.

Pharmaceutical brand names rarely become part of popular culture, but Novo
Nordisk has recently succeeded with two, Ozempic and Wegovy, joining the ranks
such as Viagra and Lipitor. With the immense popularity and insatiable demand
for these drugs, the share price has enjoyed similar popularity, rising over 30%
since the beginning of the calendar year and peaking above 1,000 Danish Kroner
in late June 2024. However, with such admiration comes great expectations.
First, a solid but less-than-perfect second quarter report in August 2024
exacerbated a macro sell-off that had commenced in late July 2024. Second,
additional selling pressure was triggered in late September 2024 when the
company announced Phase II data for monlunabant, a novel CB1 inverse agonist,
the company's lead oral asset in the obesity space. The positive trial was
sufficient for Novo Nordisk to advance the agent into the next stage of clinical
trials, but the reported efficacy and safety data disappointed investors. The
share price ultimately finished the six-month period more than 20% below its
peak and more than 10% below its 29 March 2024 share price. We remain confident
that the long-term opportunity in the "diabesity" category (and associated
indications) can evolve into the largest market in the pharmaceutical industry,
and that Novo Nordisk can retain a leadership position that may allow it to more
than double its revenues before the decade's end.

In the Medtech space, Dexcom stands out as the leader in the development and
production of continuous glucose monitors for diabetes management.
Unfortunately, the company experienced unexpected and unprecedented issues
during the second quarter, where growth slowed considerably due to: (1) a
disruptive U.S. sales force realignment, (2)aslowdown in growth in certain
customer channels, and (3) underperformance in international markets. As a
result of these stunning announcements, the share price fell by more than 40%
(local currency) in late July 2024. Whilst we view the category as very
promising and maintain our belief in Dexcom as a strong company and innovator,
we exited our position as we viewed the current situation as too uncertain and
without asymmetric positive risk.

One of the most innovative new drugs over the past 20 years was Leqembi
(lecanemab), an antibody developed and commercialised by Eisai and partnered
with Biogen for the treatment of mild to moderate Alzheimer's disease. The
positive pivotal trial (CLARITY-AD) in September 2022 was a landmark study that
surprised both the clinical and investment communities. The subsequent filing
with the U.S. Food and Drug Administration (FDA), a positive Advisory Committee
meeting, an accelerated approval (January 2023) and a full approval (July 2023)
set the stage for a much-anticipated launch. However, some 12 months later, the
uptake for Leqembi remained modest and was even denied approval in Europe over
safety concerns, which was overly conservative in our opinion. Despite positive
expert opinion on the clinical importance of Leqembi for Alzheimer's patients
and their families and caregivers, obstacles for uptake remain, including lack
of a blood-based diagnostics, infusion centre availability, burden of dose
frequency, and a launch primarily presided over by an inexperienced Tokyo-based
pharmaceutical company. All of which pressured the share price of Biogen in the
reported period.

DERIVATIVE STRATEGY

The Company has the ability to utilise equity swaps and options as part of its
financial strategy. Equity swaps are a financial tool (a derivative contract),
that allow for synthetic exposure to a basket of single stocks in an efficient
manner and within a well-defined theme. For example, having 15 to 50+ additional
positions at smaller weights in the portfolio (i.e.,non-core) is suboptimal. An
equity swap basket facilitates management of the investment theme and tracking
of performance. The swaps contain multiple single stock long positions and the
basket swap counterparty is Goldman Sachs, allowing for confidence in forward
trading and rebalancing strategies.

The Company strategically invested in two customised tactical basket swaps,
targeting growth opportunities in undervalued small and mid-capitalisation
Biotechnology, Pharmaceutical and Medtech companies.

These baskets were constructed to capitalise on three prevailing themes: 1)
investment opportunities possessing considerable potential as attractive
acquisition targets for larger corporations (M&A swap basket) and 2) substantial
valuation dislocations in small and mid-capitalisation medical device companies
brought about by the GLP-1 weight losscraze.

During the period under review, the basket swaps gained £8.0 million, which
added 0.4% to performance. The gains were primarily due to the returns generated
by the propriety Biotechnology M&A Target Swap.

Throughout the year, the Company also used single stock equity swaps to access
Chinese and Indian investments, which would otherwise be inaccessible through
more traditional investment methods. During the period under review, single
stock equity swaps contributed £1.7 million to performance, and we remain
confident in the long-term prospects of emerging market securities, particularly
those trading locally in mainland China.

LEVERAGE STRATEGY

Historically, the typical leverage level employed by the Company has been in the
mid-to-high teens range. Considering the market volatility during the past three
plus financial years, we have, more recently, used leverage in a more tactical
fashion.

In 2024, we have flexed leverage modestly in response to the economic climate,
including in consideration of a putative recession earlier in the period and
interest rate fluctuations and speculation. Most recently, leverage has
converged to the low-double digit range, a reflection of our overall bullishness
on the portfolio and a turn in biotechnology stocks. Some factors that keep us
from extending leverage even further are the continued uncertainty with the
macro backdrop, further geopolitical risk, the looming U.S. Presidential
election, and relatively high borrowing costs at present.

SECTOR DEVELOPMENTS

As innovation continues to be the hallmark of our investment strategy, we
persist in monitoring and measuring developments at the FDA, perhaps the most
objective measure of industry productivity. Whilst 2023 was a record yearfornew
drug approvals with 67, the current calendar year looks nearly as robust with 43
approvals to date (as of 30September 2024) and is on pace for over 50 approvals
in the full year. This is commensurate with the seven-year average of 55 per
annum and most important, moves the total number of new drugs approved over the
past eight years at over 450.

This era of productivity is simply incredible, especially considering evolving
standards for new product approvals - both efficacy and safety - is ever
increasing. This year has seen approvals for another antibody for the treatment
of Alzheimer's disease (Kisunla from Eli Lilly), a first-in-class "activin"
inhibitor for pulmonary arterial hypertension (Winrevair from Merck), a best-in
-class pneumococcal vaccine (Capvaxive from Merck), and the first ever cell
therapy for melanoma (Amtagvi from Iovance).

Another important value driver in the therapeutics space has been the
acceleration of biotechnology M&A over the past three years. A number of factors
have fuelled this M&A frenzy, including a quarter trillion U.S. dollars of
branded drug sales losing patent protection by the end of the decade, pricing
pressure in the U.S. from the Inflation Reduction Act, the plethora of
innovation coming from small-cap Biotechnology companies, and the still
attractive valuations of those companies. The total dollar volume has decreased
in 2024 from 2023 as acquiring companies have pivoted from larger scale, already
commercialised assets to mid-to-late clinical stage assets that come with
smaller price tags. However, thenumber of deals to date - 33 - is expected to
eclipse last year's record number of 40. That said, we do note that after a
typical summer holiday hiatus of deal making, we expect M&A to remain quiet
until after the U.S. Presidential election in November, as risk-averse large cap
executives will hedge further efforts until after the polls are in.

On the legislative front, nothing has been more scrutinised in healthcare than
the emergence of the Inflation Reduction Act (IRA), passed into law by the Biden
Administration in 2022. For the pharmaceutical industry, the IRA is more
commonly referred to as "drug price reform" and this year saw important
developments in Medicare drug price negotiations between the Federal Centres for
Medicare & Medicaid Services (CMS) and companies on the first "List of 10" (ten
prescription drugs chosen by CMS given length of time on market, lack of generic
competition, and total Federal expenditures). The list included Eliquis,
Jardiance, Xarelto, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara,
andFiasp.

Whilst investors were appropriately concerned over this potentially industry
-altering pricing mechanism, most breathed a sigh of relief when actual
negotiated prices were released ahead of the 1 September 2024 deadline. Current
estimates assumed that Medicare-reimbursed drugs included a rebate of
approximately 50% from list price. Investors believed that this discount could
be extended to 65% or even as much as 80% through the IRA. However, the average
negotiated rebate came to 63% (source: CMS), clearly better than expected. We
believe this may alleviate near term fears about the potential financial impact
of the IRA across the industry.

We continue to monitor the roll out of the IRA. The new drug prices for the
first list of 10 do not take effect until 1 January 2026. However, the next list
will increase to 15 drugs and continue to be published on a rolling basis.
Actual prices may also continue to surprise (in either direction). In addition,
2025 will see the first implementation of the so called "Part D Redesign", which
includes, among other things, patient annual out-of-pocket costs that will be
capped at U.S.$2,000 for people with Medicare Part D. Funding for this benefit
comes from a number of sources, including increased government subsidies,
increased patient premiums, increased contribution from the manufacturers, and
also private payers. Impact will vary company-to-company but also may be offset
by increased volumes in certain therapeutic categories given the improved access
to medicine.

Finally, the much-anticipated U.S. Presidential election of 2024 ended with much
of the same drama that led up to it. Whilst polls toggled back and forth between
the candidates, ultimately it was Republican nominee Donald Trump beating out
incumbent candidate Kamala Harris, marking a second (albeit interrupted) term
for President Trump. The final result was without doubt, as president-elect
Trump swept three key battle ground states and easily eclipsed - with more than
310 - the necessary 270 electoral votes required to become President. Trump also
won on the popular vote at 51% to Harris who polled less than 48%. The Senate
majority control also moved in the Republican's favour with more than 51seats
whilst the Republican party also held the majority of House of Representatives
seats. The final result was an unexpected "Republican Sweep".

The implications for healthcare are unequivocally positive. Healthcare stocks
were weak ahead of the election on concerns of a Harris win that obviously did
not come to fruition. Moreover, the "Red Sweep" was probably the best-case
scenario for healthcare. Whilst the implications may vary by sub-sector, overall
the Republican party history (and previous Trump administration) has been
industry friendly. With Republicans in total control, we can expect no
controversial legislation to be posited and some possibility now exists that
Drug Price Reform may be repealed/amended in the industry's favour. But perhaps
the biggest positive is now the lack of any negative legislation by the
Democrats now that they are completely out of power.

OUTLOOK

The malaise that hung over the Biotechnology industry post-COVID has now
evaporated, and investors are re-focused on the fundamentals. The healthcare
industry continues to benefit from significant technological advancements and
accelerating innovation in drug discovery and development. Across therapeutics,
continuous advancements in genetic engineering, personalised medicine, and
synthetic biology are fostering a robust pipeline of new therapies and
treatments. Increased investment in early-stage science feeds long-term
opportunities. Artificial intelligence and machine learning are already
impacting all facets of the industry despite still being in its infancy. New
product approvals are delivering a quantity and quality of medicines never seen
before. The growing elderly demographic worldwide is driving demand for new
healthcare solutions, particularly in areas such as cancer treatment, chronic
disease management, and age-related health issues. Overall, the future of
healthcare will remain robust and dynamic, driven by data, shaped by innovation,
improving access and quality for patients on a global basis.

Sven H. Borho and Trevor M. Polischuk

OrbiMed Capital LLC

Portfolio Manager

14 November 2024

CONTRIBUTION BY INVESTMENT

PRINCIPAL STOCK CONTRIBUTORS TO AND DETRACTORS FROM ABSOLUTE NET ASSET VALUE
PERFORMANCE

FOR THE SIX MONTHS ENDED 30 SEPTEMBER 2024

Top five contributors     Sector                            Country
Contribution  Contribution

                                                                            £'000
per share*


p
Tenet Healthcare          Health Care Providers & Services  United States
35,414        6.7
Boston Scientific         Health Care Equipment & Supplies  United States
21,269        4.0
Intuitive Surgical        Health Care Equipment & Supplies  United States
19,549        3.7
AstraZeneca               Pharmaceuticals                   United Kingdom
13,808        2.6
Eli Lilly                 Pharmaceuticals                   United States
12,777        2.4

Top five detractors       Sector                            Country
Contribution  Contribution

                                                                            £'000
per share


p
Biogen                  Biotechnology                         United States
(14,308)    (2.7)
Dexcom**                Health Care Equipment & Supplies      United States
(15,958)    (3.0)
Novo Nordisk            Pharmaceuticals                       Denmark
(18,414)    (3.5)
Apellis Pharmaceutical  Biotechnology                         United States
(20,982)    (3.9)
Merck                   Pharmaceuticals                       United States
(21,119)    (4.0)

*          531,337,518 Weighted average number of shares

**        Not held at 30 September 2024.

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.

A review of the half year and the outlook for the Company can be found in the
Chair of the Board's Statement and the Portfolio Manager's Review. 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.

The Company uses leverage (both through derivatives and gearing) the effect of
which is to amplify the gains or losses the Company experiences.

Macro events (including geopolitical and regulatory) 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, and the risk of a global recession,
are likely to adversely affect the performance of the Company's investments.

Further information on these risks is given in the Annual Report for the year
ended 31 March 2024. The Board has noted that global markets are continuing to
experience unusually high levels of uncertainty and heightened geopolitical
risks. The Board continues to monitor this closely.

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, the 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 12 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.

The Directors noted the result of the continuation vote held in 2024 (where
93.7% of the votes cast were in favour of continuation). As part of their going
concern assessments, stress testing was carried out in May 2024, which modelled
the effects of substantial falls in markets and significant reductions in market
liquidity, on the Company's net asset value, itscash 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

(b)         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 goodfaith 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

Doug McCutcheon

Chair

14 November 2024

INCOME STATEMENT

For the six months ended 30 September 2024

               (Unaudited)                (Unaudited)

               30                         30
               September                  September
               2024                       2023
               Revenue  Capital  Total    Revenue  Capital   Total

               Return   Return   £'000    Return   Return    £'000

               £'000    £'000             £'000    £'000
Gains/(losses  -        2,585    2,585    -        (11,111)  (11,111)
) on
investments
Foreign        -        6,906    6,906    -        (6,791)   (6,791)
exchange
gains/(losses
)
Income from    8,830    -        8,830    12,481   -         12,481
investments
(note 2)
AIFM,
portfolio
management,
and
performance    (408)    (7,751)  (8,159)  (411)    (7,803)   (8,214)
fees (note
3)
Other          (654)    -        (654)    (686)    -         (686)
expenses
Net            7,768    1,740    9,508    11,384   (25,705)  (14,321)
return/(loss)
before
finance
charges and
taxation
Finance        (176)    (3,342)  (3,518)  (246)    (4,673)   (4,919)
charges
Net            7,592    (1,602)  5,990    11,138   (30,378)  (19,240)
return/(loss)
before
finance
Taxation       (357)    -        (357)    (1,486)  -         (1,486)
Net            7,235    (1,602)  5,633    9,652    (30,378)  (20,726)
return/(loss)
after
taxation
Return/(loss)  1.4p     (0.3)p   1.1p     1.6p     (5.0)p    (3.4)p
per share
(note 4)

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 2024

                               (Unaudited)   (Unaudited)

                               30 September  30 September

                               2024          2023

                               £'000         £'000
Opening shareholders' funds    2,080,417     2,150,721
Shares purchased for treasury  (99,759)      (133,365)
Return/(loss) for the period   5,633         (20,726)
Dividends paid - revenue       (11,198)      (14,709)
Closing shareholders' funds    1,975,093     1,981,921

STATEMENT OF FINANCIAL POSITION

As at 30 September 2024

                                                (Unaudited)   (Audited)

                                                30 September  31 March

                                                2024          2024

                                                £'000         £'000
Fixed assets
Investments                                     2,046,974     2,108,235
Derivatives - OTC swaps                         22,026        944
                                                2,069,000     2,109,179
Current assets
Debtors                                         8,635         10,232
Cash and cash equivalents                       41,496        73,797
                                                50,131        84,029
Current liabilities
Creditors: amounts falling due within one year  (144,038)     (100,373)
Derivative - OTC Swaps                          -             (12,418)
                                                (144,038)     (112,791)
Net current liabilities                         (93,907)      (28,762)
Total net assets                                1,975,093     2,080,417
Capital and reserves
Ordinary share capital - (note 5)               15,042        15,042
Capital redemption reserve                      9,564         9,564
Share premium account                           841,599       841,599
Capital reserve                                 1,092,035     1,193,396
Revenue reserve                                 16,853        20,816
Total shareholders' funds                       1,975,093     2,080,417
Net asset value per share - (note 6)            381.5p        381.1p

CASH FLOW STATEMENT

For the Six months ended 30 September 2024

                           Note  (Unaudited)       (Unaudited)

                                 Six months ended  Six months ended

                                 30 September      30 September

                                 2024              2023

                                 £'000             £'000
Net cash (outflow)/inflow  8     (4,336)           5,174
from operating activities
Purchases of investments         (411,658)         (554,711)
and derivatives
Sales of investments and         420,462           560,892
derivatives
Realised gains/(losses)          4,803             (2,218)
on foreign exchange
Net cash inflow from             13,607            3,963
investing activities
Shares repurchased               (98,072)          (133,365)
Equity dividends paid            (11,198)          (14,709)
Interest paid                    (3,518)           (4,919)
Net cash outflow from            (112,788)         (152,993)
financing activities
Increase in net debt             (103,517)         (143,856)

Cash flows from operating activities includes interest received of £1,684,000
(2023: £1,885,000) and dividends received of £7,448,000 (2023: £10,135,000).

RECONCILIATION OF NET CASH FLOW MOVEMENT TO MOVEMENT IN NET DEBT

                                (Unaudited)       (Unaudited)

                                Six months ended  Six months ended

                                30 September      30 September

                                2024              2023

                                £'000             £'000
Increase in net debt resulting  (103,517)         (143,856)
from cash flows
Gains/(losses) on foreign       2,103             (4,574)
currency cash and cash
equivalents
Movement in net debt in the     (101,414)         (148,430)
period
Net debt at 1 April             4,855             2,997
Net debt at 30 September*       (96,559)          (145,433)

*          The net debt figure as at 30 September 2024 includes cash and cash
equivalents less the overdraft drawn of £138,055,000 (30 September 2023:
£219,230,000).

NOTES TO THE FINANCIAL STATEMENTS

1. ACCOUNTING POLICIES

The condensed Financial Statements for the six months to 30 September 2024
comprise the 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 published in July 2022 (`SORP') and using the
same accounting policies as set out in the Company's Annual Report and Financial
Statements at 31 March 2024.

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 AT 30 SEPTEMBER 2024   Level 1    Level 2  Level 3  Total

                          £'000      £'000    £'000    £'000
Investments held at fair  1,929,327  -        117,647  2,046,974
value through profit or
loss
Derivatives: OTC swaps    -          22,026   -        22,026
(assets)
Derivatives: OTC swaps    -          -        -        -
(liabilities)
Financial instruments     1,929,327  22,026   117,647  2,069,000
measured at fair value

As at 31 March 2024       Level 1    Level 2   Level 3   Total

                          £'000      £'000     £'000     £'000
Investments held at fair  1,975,108  -         133, 127  2,108,235
value through profit or
loss
Derivatives: OTC swaps    -          944       -         944
(assets)
Derivatives: OTC swaps    -          (12,418)  -         (12,418)
(liabilities)
Financial instruments     1,975,108  (11,474)  133,127   2,096,761
measured at fair value

2. INCOME

                   (Unaudited)       (Unaudited)

                   Six months ended  Six months ended

                   30 September      30 September

                   2024              2023

                   £'000             £'000
Investment income  7,146             10,596
Interest Income    1,684             1,885
Total              8,830             12,481

3. AIFM, PORTFOLIO MANAGEMENT AND PERFORMANCE FEES

                 (Unaudited)              (Unaudited)

                 Six months ended         Six months ended

                 30 September 2024        30 September 2023
                 Revenue  Capital  Total  Revenue  Capital  Total

                 £'000    £'000    £'000  £'000    £'000    £'000
AIFM fee         72       1,365    1,437  72       1,369    1,441
Portfolio        336      6,386    6,722  339      6,434    6,773
management fee
Performance fee  -        -        -      -        -        -
charge for the
period
                 408      7,751    8,159  411      7,803    8,214

As at 30 September 2024 no performance fees were accrued or payable (31 March
2024: nil accrued).

No performance fee could become payable by 30 September 2025.

See Glossary for further information on the performance fee.

4. RETURN/(LOSS) PER SHARE

                            (Unaudited)       (Unaudited)

                            Six months ended  Six months ended

                            30 September      30 September

                            2024              2023

                            £'000             £'000
The return per share is
based on the following
figures:
Revenue return              7,235             9,652
Capital (loss)/return       (1,602)           (30,378)
Total return                5,633             (20,726)
Weighted average number of  531,229,280       606,004,086
shares in issue for the
period
Revenue return per share    1.4p              1.6p
Capital (loss)/return per   (0.3)p            (5.0)p
share
Total (loss)/return per     1.1p              (3.4)p
share

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. SHARE CAPITAL

                                  Shares        Treasury    Total

                                  number        shares      shares

                                                number      in issue

                                                            number
As at 1 April 2024                545,942,332   55,722,868  601,665,200
Purchase of shares into treasury  (28,230,376)  28,230,376  -
As at 30 September 2024           517,711,956   83,953,244  601,665,200

                                          (Unaudited)   (Audited)

                                          30 September  31 March

                                          2024          2024

                                          £'000         £'000
Issued and fully paid:
Nominal value of ordinary shares of 2.5p  15,042        15,042

During the period ended 30 September 2024 the Company bought back ordinary
shares into treasury at a cost of
£99.8m (Year ended 31 March 2024: £252.8m).

At the AGM of the Company held in July 2023, shareholders approved a resolution
for a ten for one share split such that each shareholder would receive ten
shares with a nominal value of 2.5 pence each for every one share held.
541,498,680 additional shares (541,019,916 to shareholders and 478,764 in
relation to shares held in treasury) were created on
27 July 2023 following this approval.

6. NET ASSET VALUE PER SHARE

The net asset value per share is based on the assets attributable to equity
shareholders of £1,975,093,000 (31 March 2024: £2,080,417,000) and on the number
of shares in issue at the period end of 517,711,956 (31 March 2024:
545,942,332).

*          restated to reflect the ten for one share split.

7. TRANSACTION COSTS

Purchase transaction costs for the six months ended 30 September 2024 were
£204,000 (six months ended 30September 2023: £499,000).

Sales transaction costs for the six months ended 30 September 2024 were £340,000
(six months ended 30 September 2023: £528,000).

8.              RECONCILIATION OF OPERATING RETURN TO NET CASH INFLOW/(OUTFLOW)
FROM OPERATING ACTIVITIES

                                       (Unaudited)       (Unaudited)

                                       Six months ended  Six months ended

                                       30 September      30 September

                                       2024              2023

                                       £'000             £'000
Gains/losses before finance costs and  9,508             (14,321)
taxation
(Less: capital gains)/add: capital     (1,740)           25,705
losses before finance charges and
taxation
Revenue return before finance charges  7,768             11,384
and taxation
Expenses charged to capital            (7,751)           (7,803)
Decrease/(increase) in other debtors   226               (474)
Increase in other creditors and        3,754             2,678
accruals
Net taxation suffered on investment    (825)             (611)
income
Amortisation                           -                 -
Net cash (outflow)/inflow from         (4,336)           5,174
operating activities

9. 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 2024.

10. 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 2024 and
30September 2023 has not been audited or reviewed by the Company's auditor.

The information for the year ended 31 March 2024 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
transposed 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.

LARGE CAP BIOTECH

Biotechnology company with fully integrated discovery, development and
commercial capabilities and considered sustainably profitable.

LARGE CAP PHARMA

Global, multinational pharmaceutical companies with fully integrated discovery,
development and commercial capabilities.

DISCOUNT OR PREMIUM

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 then dividing by the net
asset value per share. It 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 BIOTECH

Biotechnology company that does not fit the criteria of Large Cap Biotech,
ranging from early-stage development to newly profitable.

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.

GENERICS

Any therapeutics company, domestic or global, that focuses a majority of its
efforts (not necessarily 100%) on developing and selling generic and/or
biosimilar prescription and/or OTC products.

LEVERAGE

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 percentage 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 Equity Swaps for more details on how exposure through
derivatives is calculated.

                     As at                  As at
                     30 September 2024      31 March 2024
                     Fair Value  Exposure*  Fair Value  Exposure*

                     £'000       £'000      £'000       £'000
Investments          2,046,974   2,046,974  2,108,235   2,108,235
OTC equity swaps     22,026      191,150    (11,474)    198,082
                     2,069,000   2,238,124  2,096,761   2,306,317
Shareholders' funds              1,975,093              2,080,417
Leverage %                       13.3%                  10.8%

*          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)

NET ASSET VALUE (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 to  Year to

                                30 September   31 March

                                2024           2024

                                (p)            (p)
Opening NAV per share           381.1          343.5
Increase in NAV per share       0.4            37.6
Closing NAV per share           381.5          381.1
% Change in NAV per share       0.1%           10.9%
Impact of reinvested dividends  0.5%           1.1%
NAV per share Total Return      0.6%           12.0%

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 to  One year to

                                              30 September   31 March

                                              2024           2024

                                              £'000          £'000
AIFM & Portfolio Management fees              8,159          16,267
Other Expenses                                654            1,294
Total Ongoing Charges                         8,813          17,561
Performance fees paid/crystallised            -              -
Total                                         8,813          17,561
Average net assets                            2,067,356      2,036,653
Ongoing Charges (annualised)                  0.9%           0.9%
Ongoing Charges (annualised, including        0.9%           0.9%
performance fees paid or crystallised during
the period)

PERFORMANCE FEE

Dependent on the level of long-term outperformance of the Company, a performance
fee can 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 Company's Annual Report & Accounts for the year ended 31 March
2024 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 12 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 to  One year to

                                30 September   31 March

                                2024           2024

                                (p)            (p)
Opening share price             335.0          311.5
Increase in share price         10.0           23.5
Closing share price             345.0          335.0
% Change in share price         3.0%           7.5%
Impact of reinvested dividends  0.6%           1.1%
Share price Total Return        3.6%           8.6%

SPEC PHARMA

Any other therapeutics company that does not fit the criteria of Large Cap
Pharma that develops and sell pharmaceutical products, often focused on a
limited number of therapeutic areas (or technologies), with a domestic and
sometimes global footprint.

For and on behalf of

Frostrow Capital LLP, Secretary

14 November 2024

- ENDS -

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