In short: Referenced only — held, no new view. Weight ~8.3% (2nd). Sheet: EPS 15.28 → 20.81, 10.84%/yr expected, no dividend.
In short: BUY (portfolio), and the essay's case study of "Mr. Market overreacting." In April 2025 higher rates, few IPOs, VC flowing to AI and regulatory uncertainty squeezed customers' funding and took the stock from ~$450 to below $300 — "a temporary issue" because drug makers must always test, and FDA rules require it. EPS kept growing; the stock is near $600 and the position is "+140% since we bought it in October 2023." On the sheet it is now barely a Buy: fair value $623.3 vs $592.41 (5.0% under), ER 10.4%, fwd PE 29.7 vs 29.4 (−1.0%), RDCF −1.3pp.
Medpace runs clinical trials for drug and medical-device companies — the lengthy, regulated testing that must happen before anything can be sold. Many of its customers are small biotech firms that live on investor funding.
In spring 2025 that funding dried up at once — higher interest rates, few stock-market listings, venture money chasing AI — and the shares fell from about $450 to under $300. The letter uses it as the model case of a temporary scare: new drugs still have to be tested, the law still requires it, and earnings kept growing. The stock is back near $600, and the position is up about 140% since October 2023.
The flip side is on this month's sheet: after that recovery, Medpace is only about 5% below the letter's estimate of fair value — a Buy on paper, but the cheap part is behind it.
In short: The largest position at ~8.3%, and named as one of the two most expensive. "Games Workshop and Medpace are the two most expensive companies in Our Portfolio" — 30x NTM P/E on a 15% EPS CAGR. The best performer of the book year-to-date at +21% (though −11% over twelve months); 260 shares yielding $6,380.40, and a modelled three-year return of 10.84%. Not named for reduction — the price has never been the reason it is held.
Medpace runs clinical trials for small and mid-sized biotech companies. It is paid for running the trial whether or not the drug works, so it is a services business rather than a bet on any one medicine — the reason it has been the archive's highest-conviction holding since 2024.
At 8.3% it is the largest position, and at 30 times next year's earnings it is named as one of the two most expensive. That does not put it on the reduction list, which tells you something about how this framework works: the price has never been the reason it is held, and the tiers rank the business rather than the entry point.
It is also the best performer of the year within the portfolio, up 21%, though still down 11% over twelve months.
In short: BUY (portfolio) — the thinnest case in the book: fair value $615.6 against $585.0 is only 5.0% under; the forward PE of 29.7 is above its own 29.4 average; and the reverse DCF requires 13.3% against 12.0% expected (−1.3pp). Two of three models say fully priced, and it keeps its Buy on an ER of 10.42% — consistent with April's framing of it as a wonderful company at a fair price.
In short: BUY on the valuation sheet — but the only holding shown as trading above fair value. Bought 23 Oct 2023, the oldest position listed; $526.6 against a $439.4 fair value, i.e. -16.6% (overvalued). The second sheet is milder — fair value 586.7 against a 557.6 price, 5.0% undervalued — and its forward PE of 29.7 sits right on its 29.4 five-year average. Expected return 10.4%. The two tables use different exit multiples, and the disagreement is left unexplained.
Medpace runs clinical trials for small and mid-sized biotech companies. It gets paid for running the trial whether the drug works or not, which is why it is owned instead of the drug developers — the same exposure to biotech activity without the binary outcome.
It is the oldest position in the portfolio, bought in October 2023, and it is the only holding shown as trading above its fair value: $526.6 against $439.4, roughly 17% too expensive on that sheet. The separate valuation sheet reaches a milder conclusion — 5% undervalued — and still rates it BUY. The two tables use different assumptions about the multiple, and the disagreement is not explained.
Its own multiple, 29.7 times forward earnings, is almost exactly its five-year average, so there is no re-rating to collect. Earnings are forecast to grow about 11% a year with no dividend, giving an expected return of 10.4% — right at the threshold. This is what a fully-valued quality holding looks like in the model: not a sale, but not a source of the portfolio's upside either.
In short: Fourth-best performer at +17.3% in June 2026. A portfolio holding elsewhere in this archive, but here it appears only as a performance line with no commentary.
In short: BUY, Very Strong conviction — up 23.7% in the month, YTD from −20.4% to −2.4%. The valuation is now the thinnest in the book: FV $586.7 vs $557.6 = 5.0% under, with the forward PE at 29.7 against a 29.4 average, i.e. 1.0% over. Upgraded to Buy only three weeks earlier.
In short: Held ~1 yr; the healthcare pick. Runs clinical-trial sites for pharma/biotech — the "toll booth on R&D spending": high-FCF, high-margin, low-capital, buys back stock aggressively. Results track VC-funding cycles; AI likely a net positive via more R&D. ~$10B cap.
Medpace runs the clinical trials that drug companies need to test new medicines — it operates the sites and facilities. Teich calls it the "toll booth on R&D spending": it collects fees as pharma and biotech spend on research, without the risks of drug pricing, regulation, or device competition. It's a high-cash-flow, high-margin business that needs very little reinvestment, so it piles up cash and aggressively buys back stock (10% of shares in one stretch). Its results swing with how much venture-capital money is flowing into biotech, and he thinks AI likely means more drug research over time, which helps it.
32:17healthcare that we own, a company that we've owned for now just about a year, but we think is really interesting. It's called Medpace Holdings. Okay.
32:24And what we like about it is they do essentially clinical research trials. They run the sites for
In short: UPGRADED HOLD → BUY; Very Strong conviction. The upgrade is marginal on every measure, which is the point: FV $478 vs $454.3 = 5.0% under, the thinnest on the list; fwd PE 29.7 against a 29.4 average — i.e. 1.0% overvalued on the multiple test; RDCF 9.9% vs 12.0% expected. A quality upgrade at a fair price, exactly as the archive has always described it.
Medpace runs clinical trials for small and mid-sized biotechnology companies. It is paid to conduct the trial, not for the drug to succeed, which is why the archive holds it as a way to be exposed to drug development without betting on any individual drug.
The upgrade from Hold to Buy here is marginal on every measure — a 5% discount to fair value, and a multiple fractionally above its own five-year average. That is the point rather than a flaw: this is the company the archive has always described as a wonderful business at a fair price, so the upgrade reflects the price catching down to fair rather than becoming a bargain.
In short: Third of the "boring quality stocks", +2.2% in the same week. A portfolio holding, excluded from the ranked list.
In short: BUY, Very Strong conviction, and the least undervalued holding in the book: EPS growth 12.0%, FWD PE 29.7 against a fair exit 25, expected return 10.4%, fair value 439.4 against a 417.7 price = 5.0% undervalued. Consistent with the standing description of it as a wonderful company at a fair price rather than a cheap one.
In short: Third-worst performer at -12.8%, and a Very Strong conviction holding — so excluded from the ranking by the issue's own rule. Performance table only.
In short: Listed Very Strong (#1) on the published conviction slide; argued in full in Part I. No new view here.
In short: Very Strong conviction. A contract research organisation that "helps drug and medical device makers test and develop new treatments by managing clinical trials and research." "Medpace is an amazing company. On top of that, August Troendle is one of the best capital allocators in the world. The only thing not to like about Medpace? The current valuation level. Today, the company trades at a Forward PE of 30.3x. It's the perfect example of a wonderful company at a fair price."
Medpace is the outsourced laboratory-and-paperwork arm of drug development. Small and mid-size biotech companies that have a promising molecule but no infrastructure hire Medpace to design and run their clinical trials, recruit patients, collect the data and deal with the regulators. It gets paid for running the trial whether or not the drug ultimately works, which is what makes it a very different proposition from owning the biotech itself.
Slegers keeps it in his highest conviction tier for the business and the person running it — August Troendle, the founder, whom he calls "one of the best capital allocators in the world." The honest caveat is price: at roughly 30 times next year's earnings it is the one name in the tier he does not describe as cheap. His phrase for it is the useful one — "a wonderful company at a fair price" — which is a deliberate echo of Buffett's rule and an admission that you are paying full value for quality here rather than getting a bargain.
In short: HOLD in the portfolio. The reason is visible in the columns: 26.5x forward against a 29.4x five-year average is only 9.9% under, and the reverse-DCF margin is a slim +2.1pp. A holding whose price has caught up with its quality — consistent with it being the book's second-best performer.
In short: Second-best holding: +80.6%. Reported only. Notable against the rest of the archive — the CRO argued four days earlier as the "AI can't do science on real humans" case is also, quietly, one of the two positions carrying the book.
In short: Worked example, "Where Rules and Humans Still Win." A CRO running trials end to end, "from recruiting patients to navigating the Food and Drug Administration." The AI answer is three-part: "You can't digitize a blood draw. You need real nurses, real doctors, and real patients"; regulators "demand proof of how it actually works in a human body"; and "one poorly managed trial can wipe out $100 million and 10 years of work overnight." Conclusion: at those stakes "executives want the most trusted partner with the best human judgment."
When a drug company wants to test a new medicine, it hires a contract research organisation like Medpace to run the trial: recruiting the patients, coordinating the doctors, collecting the data and steering the whole thing past the FDA. Medpace is paid for running the trial, not for whether the drug works — so it is not a bet on any one medicine.
The reason this is the post's answer to AI is that the work is physical and legally exposed. "You can't digitize a blood draw"; regulators want evidence from real bodies, not model predictions; and a badly run trial can destroy "$100 million and 10 years of work overnight." When the downside is that large, buyers do not shop on price or novelty — they pick the most trusted operator, which is exactly the position a reputation-based business wants to be in.
In short: The largest position (~8.2%) and the largest gain (~+$46,000). Named as one of the three names carrying the book — "A few companies will drive the majority of your returns" — but rated Hold on the 5 February sheet as the one holding trading above its own five-year multiple. Not individually rated here.
In short: HOLD on the portfolio sheet — the one holding trading above its own history: 33.3x forward against a 29.4x five-year average (13.3% over), with an 11.6% expected return and a $777.3 fair value against $610.9. A 34.3% five-year and 36.2% ten-year CAGR; the position's success is why it is a Hold rather than a Buy.
In short: HOLD — the largest position in the book, and the most expensive. Weight 11.1%, performance +147.9%; "our largest positions thanks to the very strong stock performance… The stock increased by +69% over the past year." Operating detail: "lower cancellations and a growing backlog, with a book-to-bill ratio of 1.03x," after a hard start to 2025 for biotech during which "Medpace heavily bought back shares… a strong sign of great capital allocation skills." Valuation: 37.8x forward against a 29.7x five-year average ❌, Earnings Growth Model 11.9% ✅, reverse DCF needing 14.1% against a 14% long-term estimate. The clinching evidence is the company's own behaviour: "Management also stopped buying back shares because of this reason." Verdict: "an amazing business. However, you can't call the company cheap today."
Medpace runs clinical trials on behalf of small biotech companies that have a promising drug and no infrastructure. It is paid for running the trial regardless of whether the drug works.
It has been an outstanding investment — up about 148% since it was bought, up 69% in the last year alone, and now the largest holding at 11% of the portfolio. The business is fine: fewer cancellations, a growing order book, and slightly more work being booked than delivered.
The rating is Hold anyway, because the shares now cost 37.8 times next year's earnings against an average of 29.7 over the past five years. And the confirming evidence is unusually good — Medpace itself was buying back its own shares heavily during the biotech downturn and has now stopped. The people with the best information and the strongest incentive have concluded the price is no longer attractive, and Slegers is simply agreeing with them.
In short: HOLD — bought 23 October 2023 and now the largest position at 10.2%, on about +$83,000 of profit, the biggest single contributor in the book. The weight is a consequence of performance, not of conviction: the rating is Hold, which is the sheet's clearest statement that Slegers lets winners run past his own buy price.
Medpace runs clinical trials for small biotech companies that have a promising drug but no infrastructure of their own. It gets paid for running the trial whether the drug works or not, which is what separates it from betting on the biotech itself.
It is the largest thing in the portfolio at 10.2% — but that is because it went up about $83,000, not because it was bought that big. The published rating is Hold. That combination is the useful disclosure: Slegers is happy to own it and will not add at this price, and he is not trimming it either. The position size is an outcome, not a decision.
In short: A CRO that runs small/mid biotech clinical trials — "gets paid no matter what" (not a zero-to-one biotech bet). Founder August Troendle (1992) is still CEO with $1.9B of a $2B net worth in the stock. Reverse DCF implies ~11% FCF growth needed for a 10% return vs ~15% historical — "too conservative… a great investment today." Tariff turmoil = a cheaper entry.
Medpace is a contract research organisation (CRO): biotech companies pay it to run their clinical drug trials. The key point is that Medpace gets paid whether or not the drug ends up working — so you get exposure to biotech activity without the all-or-nothing risk of betting on one drug. The founder, who started it in 1992 and still runs it, keeps almost his entire net worth ($1.9B of $2B) in the stock, so his interests are aligned with shareholders. Running a "reverse DCF" (working backwards from today's price to the growth the market is assuming), Slegers finds the price only requires ~11% cash-flow growth to deliver a 10% return, versus the ~15% it has actually been growing — so he thinks the market is being too pessimistic and the stock is a good buy.
36:46And then I noticed in his body language that he said more than he would have or should have wanted. So that's a great example to me and a company I'm very happy about. Another one, maybe it's Medpace, and that might sound a bit like a weird move given what's going on with Trump and the drug administration in the US right now because Medpace is a company that basically helps small and midsize biotech companies to execute their clinical research. So it's important,
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Verbatim excerpts from the public transcripts (auto-pulled at each mention's timestamp, lightly cleaned). Timestamps link into the video; "source page" opens that commentator's full analysis at this row. Click a mention's header line to expand it (one open at a time). For personal study — not investment advice.