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Top company profile: Express Scripts grows its clout
Annual report

Top company profile: Express Scripts grows its clout

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When Express Scripts Inc. got blindsided this week by the nation's largest drugstore chain, Walgreen Co. — which publicly threatened to end their multibillion-dollar relationship — the episode marked an epic clash in the pharmaceutical industry.

Walgreen officials, in announcing they had canceled contract negotiations with the St. Louis-based pharmacy benefit manager, pronounced themselves "surprised" that Express Scripts had the temerity to drive such a hard bargain with "the largest retail provider in their pharmacy network."

The reaction from Express Scripts? Whatever — customers can just take their Express Scripts benefit cards to competitors literally down the block. "On average, another pharmacy within the Express Scripts network is within one-half mile of a Walgreens pharmacy," taunted a company release, while careful to also emphasize an interest in continuing talks.

Wall Street responded Tuesday by driving down Walgreen stock — while Express Scripts' shares inched up, apparently unaffected. While such brinksmanship often characterizes such high-stakes negotiations, and some analysts believe a deal will be forthcoming, the dust-up nonetheless underscored the extent to which Express Scripts has penetrated the market after years of explosive growth. And yet investors believe the company has capacity to grow further still, even as the company matures into an established player.

"If there's one thing that's constant, our company is focused on growth," said Larry Zarin, a senior vice president and chief marketing officer at Express Scripts.

For the second year in a row, Express Scripts is the Post-Dispatch's top-performing publicly traded company in the St. Louis region, based on the newspaper's analysis of revenue size and growth, return on capital and profit growth. It is the fourth time since 1992 that the company has claimed the distinction.

Express Scripts, which manages about 656 million prescriptions annually, posted $45 billion in revenue in 2010 and a profit of $1.2 billion — compared with $24.7 billion in revenue and $828 million in profit in 2009.

HURDLES AHEAD

Maintaining that upward trajectory remains a challenge. A new report by bond rating agency Moody's Investors Service concluded that one of the biggest challenges facing the nation's three largest pharmacy benefit managers — New Jersey-based Medco Health Solutions, Express Scripts, and Rhode Island-based CVS Caremark Corp. — is 'stagnant to declining commercial insurance membership trends."

According to Moody's, other challenges faced by the industry include customer resistance on pricing and health care legislation.

Pharmacy benefit managers administer prescription drug benefits for employers, government agencies and health plans. They also help manage the amount of money their clients spend on drugs by encouraging employees to choose generic drugs, rather than brand-name medicines, and obtain these drugs via mail order (effectively skipping retail outlets such as Walgreens).

Moody's praised Express Scripts' financial flexibility but noted that the overall market for pharmacy benefit managers remains uncertain. United Healthcare indicated recently that it is exploring the efficiencies it might gain from "in-house" management of the pharmacy benefits of its $11 billion contract with Medco. Other health insurers, which are under mounting pressure to keep costs down, also may be considering the in-house option.

In the face of such challenges, Express Scripts seems determined to run lean. In a year of reorganization, the company laid off several hundred workers last year and shut down a prescription processing plant near Philadelphia. It opened a high-tech, heavily automated mail-order facility in northern St. Louis County. And like many other large companies, it has outsourced and sent offshore some of its operations.

Wall Street analysts remain upbeat about Express Scripts' growth potential.

"For the next five years, the growth looks good — and near term, it's pretty significant," said Art Henderson, an analyst at Jeffries & Co. in Nashville.

Henderson and other financial analysts said that, although 2011 has provided a bit of a market lull, Express Scripts is well-positioned to exploit the pipeline of drugs whose patents will expire in the next few years — by providing lower-cost generic drugs instead of branded ones.

The company makes higher profits on generic drugs because it can negotiate lower rates from the multiple drugmakers that offer generic substitutes for branded medications.

The patent on Lipitor, a blockbuster anti-cholesterol drug, is due to expire in December; and patents for other top-selling drugs, such as Plavix, antidepressant Lexapro, and Singulair (an asthma drug) are due to expire next year.

Express Scripts' profits on generics, however, could face incursions from government regulation. Some federal and state lawmakers have voiced the need for greater transparency from pharmacy benefit managers about their pricing schemes and acceptance of manufacturer rebates and discounts.

Express Scripts has received kudos from an industry trade association for its degree of transparency, but some lawmakers remain puzzled as to how exactly the company buys and sells prescription medications, how it chooses the drugs on its formularies, and from which kinds of transactions it reaps the largest profits.

Express Scripts spent about $1.9 million last year on federal lobbying activities about such issues as legislation, pricing, antitrust, Medicare payment rates, and generic versions of biotech drugs, according to records filed with the clerk's office of the U.S. House of Representatives.

'FLUSH WITH CASH'

Jeff Jonas, an analyst at Gabelli & Co. in Rye, N.Y., agreed that Express Scripts' has "a bright future" via the generic drug pipeline. But he said the firm also may continue to grow through acquisitions.

"There are still deals out there, either traditional PBMs or something along the lines of specialty companies that manage biotech drugs," Jonas said, "and their track record (for acquisitions) is pretty good."

In the past, Express Scripts has been able to grow its business by expanding its existing operations and acquiring competitors including National Prescriptions Administrators Inc. (2002), Curascript (2004) and Priority Healthcare (2005).

In December 2009, Express Scripts purchased Indianapolis-based Wellpoint's Next RX subsidiary for $4.68 billion.

"Express Scripts is a very strong cash generator. … They're flush with cash, and they have good balance sheets," said Helene Wolk, an analyst at Sanford C. Bernstein & Co. Inc. in New York. "They still have enough flexibility to do acquisitions if one presents itself."

As one of the largest pharmacy benefit managers, it's unclear whether the Justice Department would permit Express Scripts to acquire one of its chief rivals (or, for that matter, to be acquired by one of them). The nation's top three PBMs control about 60 percent of the market. But the company could target a variety of other potential acquisitions.

With or without more acquisitions, Wolk said, it is likely that Express Scripts will experience a "robust growth swing of about 20 percent" in the next three to five years. "Express Scripts' earnings have been stellar in the last few years," Wolk said.

The company appears to want to build its business by becoming more competitive among larger employers. A substantial portion of the company's revenue depends on its contract to manage pharmacy benefits for the military's TriCare Program.

But analysts said Express Scripts has done well locking up long-term contracts with the Defense Department and Wellpoint.

The company is focused heavily these days on cost-cutting, reorganization and sending a portion of its information technology and customer support work to places like India and the Philippines.

"I can assure that we're always trying to get more efficient," Zarin said. "Our clients hire us to reduce costs, with no compromise to clinical outcomes. We are counted on to run lean and mean."

Still, pharmacy benefit managers including Express Scripts are expected to gain more business as an additional 32 million Americans are insured under the health reform law.

Jeff Hall, the firm's chief financial officer, said in a written statement that Express Scripts' research and innovation into consumer behavior "translate into strong returns for shareholders and superior outcomes for our plan sponsors and patients."

Later this year, the company plans to open its fourth headquarters building in northern St. Louis. "We are excited about further expanding our workforce in St. Louis," Hall said.


Editor's note: This story has been updated to correct an outdated number of prescriptions managed by Express Scripts Inc.

Post-Dispatch ranking Return on equity (percentage) Revenue (millions) Profit (millions) Profit margin
This year Last year Company 2010 5-yr avg 2010 Chg 2010 Chg 2010
NR38

Allied Healthcare Products Inc.

-2.2-8.0$46-11.6%-$0.6NM-1.3%
1618

Amdocs Ltd.

10.713.5$2,9844.2%$343.95.4%11.5%
2014

Ameren Corp.

1.87.3$7,6387.0%$139.0-77.3%1.8%
3430

American Railcar Industries Inc.

-8.49.1$274-35.4%-$27.0-274.7%-9.9%
0627

Arch Coal Inc.

7.312.7$3,18623.7%$158.9276.7%5.0%
NRNR

Belden

18.2-1.5$1,61718.7%$108.5NM6.7%
07NR

Brown Shoe Co. *

9.11.7$2,50411.7%$37.2291.9%1.5%
3535

Build-A-Bear Workshop Inc.

0.15.4$4011.4%$0.1NM0.0%
1423

Cass Information Systems Inc.

15.017.1$10510.7%$20.325.9%19.3%
0905

Centene Corp.

13.610.8$4,4488.4%$94.813.3%2.1%
NRNR

Charter Communications Inc.

N/AN/A$7,059---$237.0---3.4%
1920

Commerce Bancshares Inc.

11.412.6$1,138-3.7%$221.731.1%19.5%
18NR

CPI Corp. **

97.473.9$407-3.6%$11.9-13.7%2.9%
0513

Emerson

23.623.8$21,0394.7%$2,164.025.5%10.3%
0418

Energizer Holdings Inc.

20.946.4$4,2486.2%$403.035.3%9.5%
NR36

Enterprise Financial Services Corp.

5.20.0$1401.5%$9.1NM6.5%
2815

Esco Technologies Inc.

8.49.3$607-1.9%$44.8-9.2%7.4%
0101

Express Scripts Inc.

33.051.0$44,97381.9%$1,181.242.7%2.6%
NR31

First Clover Leaf Financial Corp.

4.90.6$28-5.9%$3.8NM13.7%
NRNR

Furniture Brands International Inc.

-14.9-22.5$1,160-5.3%-$39.0NM-3.4%
15NEW

FutureFuel Corp.

10.4N/A$21911.4%$23.135.9%10.5%
0911

Insituform Technologies Inc.

10.66.2$91525.9%$60.5131.0%6.6%
32NR

Isle of Capri Casinos Inc.

-1.4-3.3$1,000-9.8%-$3.3-107.5%-0.3%
NR39

KV Pharmaceutical Co.

N/AN/A$9-92.0%-$283.6NM-3116.5%
1224

LaBarge Inc.

13.614.9$2895.8%$14.944.0%5.1%
2522

Laclede Group Inc.

10.313.0$1,735-8.5%$54.0-15.9%3.1%
2726

LMI Aerospace Inc.

9.112.1$223-7.4%$12.927.3%5.8%
NR33

MEMC Electronic Materials Inc.

1.621.6$2,23992.4%$34.4NM1.5%
2103

Monsanto Co.

11.016.4$10,502-10.4%$1,109.0-47.4%10.6%
2616

Olin Corp.

7.815.6$1,5863.6%$64.8-52.2%4.1%
0706

Panera Bread Co.

18.815.8$1,54214.0%$111.930.0%7.3%
3108

Patriot Coal Corp.

-5.4N/A$2,035-0.5%-$48.0-137.7%-2.4%
0217

Peabody Energy Corp.

18.420.5$6,86014.1%$774.072.7%11.3%
1334

Perficient Inc.

3.86.7$21514.2%$6.5342.9%3.0%
3321

Pulaski Financial Corp.

1.97.5$80-8.5%$3.3-35.1%4.1%
2104

Ralcorp Holdings Inc.

7.510.2$4,0494.0%$208.8-28.1%5.2%
0302

Reinsurance Group of America Inc.

12.910.4$8,26216.9%$574.441.1%7.0%
2925

Reliv International Inc.

12.820.8$79-7.8%$1.7-33.1%2.1%
NRNR

Savvis Inc.

-27.3N/A$9336.7%-$54.0NM-5.8%
1107

Sigma-Aldrich Corp.

21.021.6$2,2715.7%$384.010.8%16.9%
NRNR

Solutia Inc.

11.8N/A$1,95020.5%$78.0NM4.0%
29NR

Spartech Corp.

-23.4-12.2$1,02310.4%-$50.4-703.2%-4.9%
NRNR

Stereotaxis Inc.

-219.9-250.2$545.7%-$19.9NM-36.9%
2309

Stifel Financial Corp.

0.27.9$1,39526.5%$1.9-97.5%0.1%
1728

Synergetics USA Inc.

13.98.6$52-1.7%$5.7259.4%11.0%
NRNR

Viasystems Group Inc.

N/AN/A$92987.2%$15.6NM1.7%
2419

Young Innovations Inc.

12.012.1$1035.2%$14.910.8%14.5%
NR37

Zoltek Cos.

-2.1-17.7$128-7.4%-$6.3NM-4.9%


* Results for fiscal year 2011 ended Jan. 29
** Results for fiscal year 2011 ended Feb. 5
NR Not ranked
N/A Not available

SOURCE: Bloomberg News, company reports

Employees Liquidity/leverage ratios
Company 2010 Chg Total assets Total liabilities Sharehldrs equity Current ratio Debt/equity

Allied Healthcare Products Inc.

307-12.3%$33$6$274.30.0

Amdocs Ltd.

19,45512.8%$4,821$1,591$3,2292.26.2

Ameren Corp.

9,474-3.1%$23,515$15,631$7,8841.5100.1

American Railcar Industries Inc.

1,59819.7%$654$347$3087.989.4

Arch Coal Inc.

4,7002.2%$4,881$2,633$2,2481.471.9

Belden

6,6006.5%$1,696$1,058$6392.486.3

Brown Shoe Co. *

12,100-2.4%$1,148$732$4161.683.8

Build-A-Bear Workshop Inc.

1,2009.1%$276$118$1581.60.0

Cass Information Systems Inc.

6713.9%$1,188$1,046$142N/A0.0

Centene Corp.

4,2007.7%$1,944$1,147$7970.941.6

Charter Communications Inc.

16,600-0.6%$15,707$14,229$1,4780.3832.6

Commerce Bancshares Inc.

4,389-3.9%$18,502$16,479$2,023N/A54.2

CPI Corp. **

5,000-10.7%$144$130$140.6343.1

Emerson

127,700-1.0%$22,843$12,891$9,9521.451.7

Energizer Holdings Inc.

21,10136.1%$6,388$4,288$2,1001.9110.2

Enterprise Financial Services Corp.

3317.5%$2,806$2,622$183N/A206.7

Esco Technologies Inc.

2,2907.0%$974$418$5561.627.7

Express Scripts Inc.

13,170-7.7%$10,558$6,951$3,6070.869.1

First Clover Leaf Financial Corp.

710.0%$575$498$77N/A61.2

Furniture Brands International Inc.

6,200-4.6%$676$417$2603.029.7

FutureFuel Corp.

4905.6%$343$91$2524.47.6

Insituform Technologies Inc.

3,2006.7%$922$307$6152.717.3

Isle of Capri Casinos Inc.

7,500-10.7%$1,675$1,435$2401.0499.9

KV Pharmaceutical Co.

392-42.4%$565$939-$3740.8N/A

KV Pharmaceutical Co.

392-42.4%$565$939-$3740.8N/A

LaBarge Inc.

N/AN/A$205$89$1162.032.3

Laclede Group Inc.

1,697-3.7%$1,840$1,305$5361.296.9

LMI Aerospace Inc.

1,330N/A$180$30$1504.50.1

MEMC Electronic Materials Inc.

5,60022.6%$4,612$2,316$2,2961.430.3

Monsanto Co.

21,400-6.6%$17,867$7,724$10,1432.020.8

Olin Corp.

3,7000.0%$2,049$1,218$8302.359.7

Panera Bread Co.

15,90031.4%$925$329$5961.60.0

Patriot Coal Corp.

3,7005.7%$3,810$2,967$8431.154.0

Peabody Energy Corp.

7,200-1.4%$11,363$6,674$4,6892.059.0

Perficient Inc.

1,0887.2%$208$31$1772.70.0

Pulaski Financial Corp.

457-1.7%$1,453$1,336$116N/A235.3

Ralcorp Holdings Inc.

10,80015.5%$6,805$3,976$2,8291.493.2

Reinsurance Group of America Inc.

1,53512.3%$29,082$24,041$5,041N/A44.2

Reliv International Inc.

2462.9%$25$11$142.133.9

Savvis Inc.

2,44012.6%$1,184$998$1861.2411.0

Sigma-Aldrich Corp.

7,8901.9%$3,014$1,038$1,9763.027.3

Solutia Inc.

3,300-2.9%$3,537$2,798$7391.9199.9

Spartech Corp.

2,4002.1%$577$384$1931.689.4

Stereotaxis Inc.

2049.7%$66$55$101.3275.8

Stifel Financial Corp.

N/AN/A$4,213$2,959$1,254N/A55.0

Synergetics USA Inc.

342-10.0%$73$29$446.59.2

Viasystems Group Inc.

14,8427.7%$781$523$2571.589.1

Young Innovations Inc.

4000.0%$162$35$1273.24.8

Zoltek Cos.

1,095-3.6%$322$29$2934.90.3


* Results for fiscal year 2011 ended Jan. 29
** Results for fiscal year 2011 ended Feb. 5
NR Not ranked
N/A Not available

SOURCE: Bloomberg News, company reports

Post-Dispatch ranking Return on equity (percentage) Revenue (millions) Profit (millions) Profit margin
This year Last year Company 2011 5-yr avg 2011 Chg 2011 Chg 2011
126

Olin Corp.

26.614.7$1,96124%$242273%12.3
22

Peabody Energy Corp.

18.919.0$7,97418%$95824%12.0
35

Emerson

24.624.0$24,22215%$2,48015%10.2
421

Monsanto Co.

14.917.1$11,82213%$1,60747%13.6
5NR

Solutia Inc.

31.7N/A$2,0977.5%$262236%12.5
69

Centene Corp.

12.915.9$5,34120%$11117%2.1
77

Panera Bread Co.

21.716.8$1,82218%$13622%7.5
811

Sigma-Aldrich Corp.

21.921.8$2,50510%$45719%18.2
9NR

Enterprise Financial

13.0-0.9$16120%$25356%19.4
1015

FutureFuel Corp.

12.810.1$31041%$3549%11.1
11NR

Belden Inc.

17.20.2$1,98223%$1145.4%5.8
121

Express Scripts Holding Co.

42.052.1$46,1282.6%$1,2768.0%2.8
13NR

Viasystems Group Inc.

10.5N/A$1,05714%$2883%2.7
1420

Ameren Corp.

6.67.0$7,531-1.4%$519273%6.9
1513

Perficient Inc.

5.75.6$26222%$1166%4.1
166

Arch Coal Inc.

4.99.6$4,28635%$142-11%3.3
173

Reinsurance Group of America Inc.

10.710.4$8,8306.9%$6004.4%6.8
184

Energizer Holdings Inc.

12.433.8$4,6469.4%$261-35%5.6
1923

Stifel Financial Corp.

6.67.6$1,4423.3%$844312%5.8
2027

LMI Aerospace Inc.

10.310.8$25414%$1627%6.5
2128

Esco Technologies Inc.

9.19.3$69414%$5317%7.6
2216

Amdocs Ltd.

11.112.4$3,1786.5%$3470.8%10.9
2314

Cass Information Systems Inc.

15.216.3$1137.5%$2313%21.2
2419

Commerce Bancshares Inc.

12.211.9$1,104-3.0%$25616%24.4
2522

Ralcorp Holdings Inc.

-6.96.1$4,74117%-$187-190%-3.9
2625

Laclede Group Inc.

11.512.7$1,603-7.6%$6418%4.0
27NR

MEMC Electronic Materials Inc.

-102.8-6.8$2,71621%-$1,536NM-56.6
2824

Young Innovations Inc.

12.812.0$1063.3%$1610%15.5
298

Brown Shoe Co.

5.90.1$2,5833.1%$25-34%1.0
3017

Synergetics USA Inc.

11.98.1$567.2%$6-1.7%10.1
3133

Pulaski Financial Corp.

6.95.6$73-8.4%$8145%13.4
3210

Aegion Corp.

4.25.4$9392.6%$27-56%2.8
3329

Reliv International Inc.

7.414.4$74-6.2%$1-38%1.4
34NR

Build-A-Bear Workshop Inc.

-11.9-1.1$394-1.8%-$17-16506%-4.3
35NR

First Clover Leaf Financial Corp.

2.40.5$26-6.8%$2-50%9.8
NRNR

Charter Communications Inc.

-39.1N/A$7,2042.1%-$369NM-5.1
NR---

Post Holdings Inc.

-20.3N/A$968-2.9%-$361-493%-37.3
NRNR

KV Pharmaceutical Co.

N/AN/A$27200%-$174NM-637.4
NR31

Patriot Coal Corp.

-15.3N/A$2,40318%-$115NM-4.8
NRNR

Furniture Brands International Inc.

-22.3-28.1$1,108-4.5%-$44NM-3.9
NRNR

Stereotaxis Inc.

N/AN/A$42-22%-$32NM-76.3
NR30

Spartech Corp.

-11.5-16.3$1,1027.8%-$21NM-1.9
NRNR

Zoltek Cos.

-1.2-0.7$15218%-$4NM-2.4
NRNR

Allied Healthcare Products Inc.

0.8-8.7$471.6%$0NM0.4
NR34

American Railcar Industries Inc.

1.44.4$51990%$4NM0.8
NR32

Isle of Capri Casinos Inc.

1.7-14.5$1,0050.5%$5NM0.5

Key

N/A - Not available
NM - Not meaningful
NR - Not ranked

Notes

Brown Shoe results are for fiscal 2012.
Post Holdings wasn't public last year.
Eastman Chemical is expected to soon close on its proposed acquisition of Solutia.

SOURCES: Bloomberg, company reports

Employees Liquidity/leverage ratios
Company 2010 Chg Total assets Total liabilities Sharehldrs equity Current ratio Debt/equity

Aegion Corp.

3,000-6%$1,125$476$6492.738.9

Allied Healthcare Products Inc.

3132%$32$5$275.10.0

Amdocs Ltd.

19,8262%$4,637$1,613$3,0232.08.3

Ameren Corp.

9,323-2%$23,645$15,577$8,0681.388.4

American Railcar Industries Inc.

2,41351%$704$394$3105.088.7

Arch Coal Inc.

7,44258%$10,214$6,624$3,5901.2113.0

Belden Inc.

6,8003%$1,788$1,094$6952.479.3

Brown Shoe Co.

15,30014%$1,227$814$4141.696.8

Build-A-Bear Workshop Inc.

1,000-17%$242$112$1291.40.0

Cass Information Systems Inc.

75012%$1,319$1,159$161N/A0.0

Centene Corp.

5,30026%$2,190$1,254$9361.137.6

Charter Communications Inc.

16,8001%$15,605$15,196$4090.33143.3

Commerce Bancshares Inc.

4,237-3%$20,649$18,479$2,170N/A63.2

Emerson

133,2004%$23,861$13,310$10,5511.450.0

Energizer Holdings Inc.

22,2055%$6,663$4,562$2,1012.1112.7

Enterprise Financial

45036%$3,378$3,138$240N/A165.6

Esco Technologies Inc.

2,4808%$1,012$411$6011.620.8

Express Scripts Holding Co.

13,120-0.4%$15,607$13,133$2,4741.5326.5

First Clover Leaf Financial Corp.

8013%$563$485$78N/A87.3

Furniture Brands International Inc.

5,600-10%$614$482$1322.758.2

FutureFuel Corp.

5002%$385$97$2886.80.0

Isle of Capri Casinos Inc.

8,60015%$1,575$1,391$1841.3628.7

KV Pharmaceutical Co.

300-23%$565$939-$3740.8N/A

Laclede Group Inc.

1,624-4%$1,783$1,210$5731.671.6

LMI Aerospace Inc.

1,48011%$205$37$1684.40.0

MEMC Electronic Materials Inc.

6,35013%$4,882$4,097$7851.3261.1

Monsanto Co.

20,600-4%$19,844$8,128$11,7161.919.2

Olin Corp.

3,8003%$2,450$1,464$9862.054.4

Panera Bread Co.

18,00013%$1,027$372$6551.50.0

Patriot Coal Corp.

4,30016%$3,777$3,110$6661.066.4

Peabody Energy Corp.

8,30015%$16,733$11,217$5,5161.6121.4

Perficient Inc.

1,48436%$224$25$1993.20.0

Post Holdings Inc.

N/AN/A$2,793$1,289$1,5051.052.1

Pulaski Financial Corp.

410-10%$1,309$1,189$120N/A54.8

Ralcorp Holdings Inc.

11,0002%$6,333$3,714$2,6191.584.1

Reinsurance Group of America Inc.

1,6558%$32,104$25,967$6,137N/A33.7

Reliv International Inc.

205-17%$24$10$142.224.6

Sigma-Aldrich Corp.

8,3005%$3,281$1,082$2,1993.323.7

Solutia Inc.

3,4003%$3,526$2,599$9271.9145.5

Spartech Corp.

2,5004%$550$377$1731.490.9

Stereotaxis Inc.

171-16%$40$59-$190.8N/A

Stifel Financial Corp.

5,0974%$4,952$3,650$1,302N/A64.9

Synergetics USA Inc.

3410%$81$31$513.52.1

Viasystems Group Inc.

14,099-5%$839$546$2931.578.4

Young Innovations Inc.

371-7%$160$30$1303.80.5

Zoltek Cos.

1,28217%$322$41$2823.53.0

Key

N/A - Not available

SOURCES: Bloomberg, company reports

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