Earnings before Interest, Tax, Depreciation and Amortization (EBITDA)
Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).
The financial performance between 2017 and 2021 is characterized by a general upward trajectory in operational profitability, interrupted by a notable contraction in 2020 followed by a strong recovery in 2021. Earnings before interest, tax, depreciation and amortization (EBITDA) served as a primary indicator of this trend, growing consistently from US$ 2,952 million in 2017 to a peak of US$ 3,627 million in 2019.
- EBITDA Growth and Recovery Patterns
- A positive growth trend is evident from 2017 through 2019, with EBITDA increasing by approximately 22.8% over this period. A significant decline occurred in 2020, where EBITDA fell to US$ 3,081 million, representing a 15% decrease from the previous year. However, a robust recovery was observed in 2021, as the figure rose to US$ 3,608 million, nearly returning to the 2019 peak and indicating a restoration of operational cash flow generation.
- Analysis of Depreciation and Amortization
- The gap between EBITDA and Earnings before interest and tax (EBIT) has expanded consistently every year from 2017 to 2021. In 2017, the difference was US$ 642 million, which grew to US$ 990 million by 2021. This steady increase in depreciation and amortization expenses suggests a continuous investment in fixed assets or intangible acquisitions, indicating an expansion of the company's long-term asset base.
- Earnings Volatility and Net Income Divergence
- While operational metrics like EBITDA and EBIT remained relatively stable, net earnings exhibited significant volatility. A substantial spike is noted in 2018, where net earnings reached US$ 3,553 million, far exceeding the EBIT and EBT for that year, which suggests the impact of non-operating gains or one-time tax benefits. Subsequent years show a normalization of net earnings, which fluctuated between US$ 1,599 million and US$ 2,083 million, trailing the operational EBITDA trend more closely.
- Operating Margin Resilience
- The relationship between EBIT and EBT indicates a gradual increase in interest or non-operating expenses over the five-year period. The difference between these two metrics rose from US$ 247 million in 2017 to US$ 337 million in 2021. Despite these increasing costs, the ability of the organization to rebound its EBITDA in 2021 demonstrates operational resilience in the face of the 2020 downturn.
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Enterprise Value to EBITDA Ratio, Current
| Selected Financial Data (US$ in millions) | |
| Enterprise value (EV) | 100,693) |
| Earnings before interest, tax, depreciation and amortization (EBITDA) | 3,608) |
| Valuation Ratio | |
| EV/EBITDA | 27.91 |
| Benchmarks | |
| EV/EBITDA, Competitors1 | |
| Abbott Laboratories | 14.36 |
| Elevance Health Inc. | 8.27 |
| Intuitive Surgical Inc. | 33.26 |
| Medtronic PLC | 13.24 |
| UnitedHealth Group Inc. | 16.92 |
| EV/EBITDA, Sector | |
| Health Care Equipment & Services | 14.65 |
| EV/EBITDA, Industry | |
| Health Care | 19.75 |
Based on: 10-K (reporting date: 2021-12-31).
1 Click competitor name to see calculations.
If the company EV/EBITDA is lower then the EV/EBITDA of benchmark then company is relatively undervalued.
Otherwise, if the company EV/EBITDA is higher then the EV/EBITDA of benchmark then company is relatively overvalued.
Enterprise Value to EBITDA Ratio, Historical
| Dec 31, 2021 | Dec 31, 2020 | Dec 31, 2019 | Dec 31, 2018 | Dec 31, 2017 | ||
|---|---|---|---|---|---|---|
| Selected Financial Data (US$ in millions) | ||||||
| Enterprise value (EV)1 | 104,469) | 103,264) | 88,412) | 73,519) | 59,894) | |
| Earnings before interest, tax, depreciation and amortization (EBITDA)2 | 3,608) | 3,081) | 3,627) | 3,343) | 2,952) | |
| Valuation Ratio | ||||||
| EV/EBITDA3 | 28.95 | 33.52 | 24.38 | 21.99 | 20.29 | |
| Benchmarks | ||||||
| EV/EBITDA, Competitors4 | ||||||
| Abbott Laboratories | 17.42 | — | — | — | — | |
| Elevance Health Inc. | 10.05 | — | — | — | — | |
| Intuitive Surgical Inc. | 44.10 | — | — | — | — | |
| Medtronic PLC | 24.41 | — | — | — | — | |
| UnitedHealth Group Inc. | 17.39 | — | — | — | — | |
| EV/EBITDA, Sector | ||||||
| Health Care Equipment & Services | 18.05 | — | — | — | — | |
| EV/EBITDA, Industry | ||||||
| Health Care | 14.33 | — | — | — | — | |
Based on: 10-K (reporting date: 2021-12-31), 10-K (reporting date: 2020-12-31), 10-K (reporting date: 2019-12-31), 10-K (reporting date: 2018-12-31), 10-K (reporting date: 2017-12-31).
3 2021 Calculation
EV/EBITDA = EV ÷ EBITDA
= 104,469 ÷ 3,608 = 28.95
4 Click competitor name to see calculations.
The financial trajectory between 2017 and 2021 is characterized by a significant expansion in enterprise valuation alongside fluctuating operational earnings, resulting in an overall increase in the valuation multiple.
- Enterprise Value Trends
- A consistent upward trajectory in enterprise value is observed, rising from US$ 59,894 million in 2017 to US$ 104,469 million by 2021. This represents a substantial increase in the total market valuation over the five-year period.
- EBITDA Performance
- Earnings before interest, tax, depreciation, and amortization grew steadily from 2017 to 2019, reaching US$ 3,627 million. A notable contraction occurred in 2020, where EBITDA decreased to US$ 3,081 million, before recovering to US$ 3,608 million in 2021.
- EV/EBITDA Ratio Analysis
- The EV/EBITDA ratio experienced a sustained increase from 20.29 in 2017 to a peak of 33.52 in 2020. This expansion was driven by the simultaneous rise in enterprise value and the decline in EBITDA during 2020, suggesting a period of higher valuation relative to earnings. In 2021, the ratio contracted to 28.95, reflecting the recovery of operational earnings relative to the growth in enterprise value.
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