Comprehensive Stock Comparison
Compare Select Medical Holdings Corporation (SEM) vs Agios Pharmaceuticals, Inc. (AGIO) Stock
Analyze side-by-side fundamentals, valuation, growth, and profitability to decide which stock is the better buy.
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Quick Verdict
| Category | Winner | Why |
|---|---|---|
| Growth | AGIO | 48.0% revenue growth vs SEM's 5.1% |
| Quality / Margins | SEM | 2.8% net margin vs AGIO's -9.0% |
| Stability / Safety | SEM | Beta 0.72 vs AGIO's 0.91 |
| Dividends | SEM | 1.7% yield; AGIO pays no meaningful dividend |
| Momentum (1Y) | AGIO | -14.9% vs SEM's -16.3% |
| Efficiency (ROA) | SEM | 1.9% ROA vs AGIO's -29.0%, ROIC 0.0% vs -26.6% |
Who Each Stock Is For
Income & stability
Growth exposure
Long-term compounding (10Y)
Sleep-well-at-night portfolio
Defensive / Recession hedge
Business Model
What each company does and how it makes money
Select Medical operates a network of specialized healthcare facilities including critical illness recovery hospitals, rehabilitation hospitals, outpatient clinics, and occupational health centers across the United States. It generates revenue primarily from patient care services—roughly 60% from its critical illness and rehabilitation hospital segments and 40% from outpatient and occupational health services—with most payments coming from government programs like Medicare and private insurers. The company's competitive advantage lies in its specialized, post-acute care focus and geographic network density that creates referral relationships with acute-care hospitals.
Agios Pharmaceuticals is a biopharmaceutical company focused on developing treatments for rare genetic diseases related to cellular metabolism. It generates revenue primarily from sales of its lead drug PYRUKYND for pyruvate kinase deficiency — with additional income from research collaborations and milestone payments — while advancing a pipeline of other metabolic therapies. The company's competitive advantage lies in its deep expertise in cellular metabolism science and proprietary platform for targeting metabolic pathways in rare diseases.
Revenue Breakdown by Segment
How each company's revenue is distributed across its business units
Financial Metrics Comparison
Side-by-side fundamentals across 2 stocks. BestLagging
Financial Scorecard
SEM leads in 4 of 6 categories (Financial Metrics, Valuation Metrics). AGIO leads in 1 (Total Returns).
Financial Metrics (TTM)
SEM is the larger business by revenue, generating $3.9B annually — 87.8x AGIO's $45M. SEM is the more profitable business, keeping 2.8% of every revenue dollar as net income compared to AGIO's -9.0%. On growth, AGIO holds the edge at +43.7% YoY revenue growth, suggesting stronger near-term business momentum.
| Metric | SEMSelect Medical Ho… | AGIOAgios Pharmaceuti… |
|---|---|---|
| RevenueTrailing 12 months | $3.9B | $45M |
| EBITDAEarnings before interest/tax | $197M | -$470M |
| Net IncomeAfter-tax profit | $110M | -$401M |
| Free Cash FlowCash after capex | $174M | -$414M |
| Gross MarginGross profit ÷ Revenue | +8.2% | +84.4% |
| Operating MarginEBIT ÷ Revenue | +1.2% | -10.6% |
| Net MarginNet income ÷ Revenue | +2.8% | -9.0% |
| FCF MarginFCF ÷ Revenue | +4.4% | -9.2% |
| Rev. Growth (YoY)Latest quarter vs prior year | -22.6% | +43.7% |
| EPS Growth (YoY)Latest quarter vs prior year | -46.5% | -111.0% |
Valuation Metrics
| Metric | SEMSelect Medical Ho… | AGIOAgios Pharmaceuti… |
|---|---|---|
| Market CapShares × price | $1.9B | $2.25T |
| Enterprise ValueMkt cap + debt − cash | $2.9B | $2.25T |
| Trailing P/EPrice ÷ TTM EPS | 12.91x | -4.25x |
| Forward P/EPrice ÷ next-FY EPS est. | 12.04x | — |
| PEG RatioP/E ÷ EPS growth rate | — | — |
| EV / EBITDAEnterprise value multiple | 20.26x | — |
| Price / SalesMarket cap ÷ Revenue | 0.34x | 9999.00x |
| Price / BookPrice ÷ Book value/share | 0.91x | 1.47x |
| Price / FCFMarket cap ÷ FCF | 4.84x | — |
Profitability & Efficiency
SEM delivers a 5.5% return on equity — every $100 of shareholder capital generates $5 in annual profit, vs $-31 for AGIO. AGIO carries lower financial leverage with a 0.03x debt-to-equity ratio, signaling a more conservative balance sheet compared to SEM's 0.51x. On the Piotroski fundamental quality scale (0–9), SEM scores 6/9 vs AGIO's 3/9, reflecting solid financial health.
| Metric | SEMSelect Medical Ho… | AGIOAgios Pharmaceuti… |
|---|---|---|
| ROE (TTM)Return on equity | +5.5% | -31.2% |
| ROA (TTM)Return on assets | +1.9% | -29.0% |
| ROICReturn on invested capital | +0.0% | -26.6% |
| ROCEReturn on capital employed | +0.0% | -33.8% |
| Piotroski ScoreFundamental quality 0–9 | 6 | 3 |
| Debt / EquityFinancial leverage | 0.51x | 0.03x |
| Net DebtTotal debt minus cash | $1.0B | -$49M |
| Cash & Equiv.Liquid assets | $27M | $89M |
| Total DebtShort + long-term debt | $1.0B | $40M |
| Interest CoverageEBIT ÷ Interest expense | 1.12x | — |
Total Returns (with DRIP)
A $10,000 investment in SEM five years ago would be worth $9,138 today (with dividends reinvested), compared to $6,363 for AGIO. Over the past 12 months, AGIO leads with a -14.9% total return vs SEM's -16.3%. The 3-year compound annual growth rate (CAGR) favors AGIO at 6.1% vs SEM's 2.5% — a key indicator of consistent wealth creation.
| Metric | SEMSelect Medical Ho… | AGIOAgios Pharmaceuti… |
|---|---|---|
| YTD ReturnYear-to-date | +1.0% | +11.2% |
| 1-Year ReturnPast 12 months | -16.3% | -14.9% |
| 3-Year ReturnCumulative with dividends | +7.6% | +19.4% |
| 5-Year ReturnCumulative with dividends | -8.6% | -36.4% |
| 10-Year ReturnCumulative with dividends | +208.0% | -21.2% |
| CAGR (3Y)Annualised 3-year return | +2.5% | +6.1% |
Risk & Volatility
SEM is the less volatile stock with a 0.72 beta — it tends to amplify market swings less than AGIO's 0.91 beta. A beta below 1.0 means the stock typically moves less than the S&P 500. SEM currently trades 80.4% from its 52-week high vs AGIO's 65.7% drawdown — a narrower gap to the peak suggests stronger recent price momentum.
| Metric | SEMSelect Medical Ho… | AGIOAgios Pharmaceuti… |
|---|---|---|
| Beta (5Y)Sensitivity to S&P 500 | 0.72x | 0.91x |
| 52-Week HighHighest price in past year | $18.61 | $46.00 |
| 52-Week LowLowest price in past year | $11.65 | $22.24 |
| % of 52W HighCurrent price vs 52-week peak | +80.4% | +65.7% |
| RSI (14)Momentum oscillator 0–100 | 40.0 | 62.3 |
| Avg Volume (50D)Average daily shares traded | 608K | 948K |
Analyst Outlook
Wall Street rates SEM as "Buy" and AGIO as "Buy". Consensus price targets imply 37.3% upside for AGIO (target: $42) vs 20.2% for SEM (target: $18). SEM is the only dividend payer here at 1.69% yield — a key consideration for income-focused portfolios.
| Metric | SEMSelect Medical Ho… | AGIOAgios Pharmaceuti… |
|---|---|---|
| Analyst RatingConsensus buy/hold/sell | Buy | Buy |
| Price TargetConsensus 12-month target | $18.00 | $41.50 |
| # AnalystsCovering analysts | 13 | 29 |
| Dividend YieldAnnual dividend ÷ price | +1.7% | — |
| Dividend StreakConsecutive years of raises | 0 | — |
| Dividend / ShareAnnual DPS | $0.25 | — |
| Buyback YieldShare repurchases ÷ mkt cap | +5.4% | 0.0% |
Historical Charts
Charts are rendered on first load. Hover for details.
Chart 1Total Return — 5 Years (Rebased to 100)
| Stock | Mar 20 | Feb 26 | Change |
|---|---|---|---|
| Select Medical Hold… (SEM) | 100 | 118.93 | +18.9% |
| Agios Pharmaceutica… (AGIO) | 100 | 81.74 | -18.3% |
Select Medical Hold… (SEM) returned -9% over 5 years vs Agios Pharmaceutica… (AGIO)'s -36%.
Chart 2Revenue Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Select Medical Hold… (SEM) | $4.3B | $5.5B | +27.2% |
| Agios Pharmaceutica… (AGIO) | $70M | $54M | -22.7% |
Select Medical Holdings Corporation's revenue grew from $4.3B (2016) to $5.5B (2025) — a 2.7% CAGR. Agios Pharmaceuticals, Inc.'s revenue grew from $70M (2016) to $54M (2025) — a -2.8% CAGR.
Chart 3Net Margin Trend — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Select Medical Hold… (SEM) | 2.7% | 2.7% | -0.4% |
| Agios Pharmaceutica… (AGIO) | -2.8% | -7.6% | -169.0% |
Select Medical Holdings Corporation's net margin went from 3% (2016) to 3% (2025). Agios Pharmaceuticals, Inc.'s net margin went from -3% (2016) to -8% (2025).
Chart 4P/E Ratio History — 9 Years
| Stock | 2017 | 2025 | Change |
|---|---|---|---|
| Select Medical Hold… (SEM) | 10.9 | 12.8 | +17.4% |
Select Medical Holdings Corporation has traded in a 5x–13x P/E range over 9 years; current trailing P/E is ~13x.
Chart 5EPS Growth — 10 Years
| Stock | 2016 | 2025 | Change |
|---|---|---|---|
| Select Medical Hold… (SEM) | 0.87 | 1.16 | +33.3% |
| Agios Pharmaceutica… (AGIO) | -5.07 | -7.12 | -40.4% |
Select Medical Holdings Corporation's EPS grew from $0.87 (2016) to $1.16 (2025) — a 3% CAGR. Agios Pharmaceuticals, Inc.'s EPS grew from $-5.07 (2016) to $-7.12 (2025).
Chart 6Free Cash Flow — 5 Years
Select Medical Holdings Corporation generated $383M FCF in 2025 (+73% vs 2021). Agios Pharmaceuticals, Inc. generated $-377M FCF in 2025 (+9% vs 2021).
SEM vs AGIO: Frequently Asked Questions
8 questions · data-driven answers · updated daily
01Is SEM or AGIO a better buy right now?
Select Medical Holdings Corporation (SEM) offers the better valuation at 12.9x trailing P/E (12.0x forward), making it the more compelling value choice. Analysts rate Select Medical Holdings Corporation (SEM) a "Buy" — based on 13 analyst ratings — the highest consensus in this comparison. The "better buy" depends entirely on your goals: growth investors should weight revenue trajectory, value investors should weight P/E and PEG, and income investors should weight dividend yield and streak.
02Which is the better long-term investment — SEM or AGIO?
Over the past 5 years, Select Medical Holdings Corporation (SEM) delivered a total return of -8.6%, compared to -36.4% for Agios Pharmaceuticals, Inc. (AGIO). A $10,000 investment in SEM five years ago would be worth approximately $9K today (assuming dividends reinvested). Over 10 years, the gap is even starker: SEM returned +208.0% versus AGIO's -21.2%. Past returns do not guarantee future results, and the stock with the higher historical return may already have its best growth priced in.
03Which is safer — SEM or AGIO?
By beta (market sensitivity over 5 years), Select Medical Holdings Corporation (SEM) is the lower-risk stock at 0.72β versus Agios Pharmaceuticals, Inc.'s 0.91β — meaning AGIO is approximately 25% more volatile than SEM relative to the S&P 500. On balance sheet safety, Agios Pharmaceuticals, Inc. (AGIO) carries a lower debt/equity ratio of 3% versus 51% for Select Medical Holdings Corporation — giving it more financial flexibility in a downturn.
04Which has better profit margins — SEM or AGIO?
Select Medical Holdings Corporation (SEM) is the more profitable company, earning 2.7% net margin versus -764.0% for Agios Pharmaceuticals, Inc. — meaning it keeps 2.7% of every revenue dollar as bottom-line profit. Operating margin tells a similar story: SEM leads at 0.0% versus -873.9% for AGIO. At the gross margin level — before operating expenses — AGIO leads at 88.3%, reflecting greater pricing power or product mix advantage. Stronger margins indicate durable pricing power, lower cost of revenue, or higher mix of software/services. They are one of the clearest signs of business quality.
05Is SEM or AGIO more undervalued right now?
Analyst consensus price targets imply the most upside for AGIO: 37.3% to $41.50.
06Which pays a better dividend — SEM or AGIO?
In this comparison, SEM (1.7% yield) pays a dividend. AGIO does not pay a meaningful dividend and should not be held primarily for income.
07Is SEM or AGIO better for a retirement portfolio?
For long-horizon retirement investors, Select Medical Holdings Corporation (SEM) is the stronger choice — it scores higher on the combination of lower volatility, dividend reliability, and long-term compounding (low volatility (β 0.72), 1.7% yield, +208.0% 10Y return). Both have compounded well over 10 years (SEM: +208.0%, AGIO: -21.2%), confirming both are viable long-term holds — but the lower-volatility option typically results in less emotional selling during corrections. Retirement portfolios generally favour predictability over maximum returns. Consult a financial advisor before making allocation decisions.
08What are the main differences between SEM and AGIO?
Both stocks operate in the Healthcare sector, making this a peer-level intra-sector comparison — the same macro tailwinds and headwinds will affect both. In terms of investment character: SEM is a small-cap deep-value stock; AGIO is a mega-cap quality compounder stock. SEM pays a dividend while AGIO does not, making them suitable for different income and tax situations. These fundamental differences mean investors should not choose between them on a single metric — the "better stock" depends entirely on which of these characteristics aligns with your investment strategy.
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