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Johnson & Johnson is the world's largest and most diverse healthcare firm. It has two divisions: innovative medicine and medtech. These now represent all of the company's sales following the divestment of the consumer business, Kenvue, in 2023. After restructurings in 2023-24, the drug division focuses on three main therapeutic areas: immunology, oncology, and neurology. Geographically, just over half of total revenue is generated in the United States.

Roche is a Swiss biopharmaceutical and diagnostic company. The firm's bestselling pharmaceutical products include a variety of oncology therapies from acquired partner Genentech, and its diagnostics group was bolstered by the acquisition of Ventana in 2008. Oncology products account for 50% of pharmaceutical sales, and centralized and point-of-care diagnostics for more than half of diagnostic-related sales.

Thermo Fisher Scientific sells scientific instruments and laboratory equipment, diagnostics consumables, and life science reagents. The firm operates through four segments as of year-end 2024 (revenue figures include some cross-segment revenue): analytical technologies (17% of sales); specialty diagnostic products (11%); life science solutions (23%); and lab products and services, which includes CRO services (the remainder).

In 1984, Danaher's founders transformed a real estate organization into an industrial-focused manufacturing company. Then, through a series of mergers, acquisitions, and divestitures, Danaher now focuses primarily on manufacturing scientific instruments and consumables in the life sciences and diagnostic industries after the late 2023 divestiture of its environmental and applied solutions group, Veralto.

Originally spun out of Hewlett-Packard in 1999, Agilent has evolved into a leading life science and diagnostic firm. Today, Agilent's measurement technologies serve a broad base of customers with its three operating segments: life science and diagnostics, cross lab operations consisting of consumables and services, and applied end markets. Over half of its sales are generated from the biopharmaceutical, chemical, and advanced materials end markets, which we view as the stickiest end markets, but it also supports clinical lab, environmental, forensics, food, academic, and government-related organizations. The company is geographically diverse, with operations in the US and China representing the largest country concentrations.

Water sells liquid chromatography, mass spectrometry, and thermal analysis tools. These analytical instruments provide essential information on various products, such as their molecular structures and physical properties, to help clients enhance the health and well-being of end users. As a percentage of sales in 2024, Waters generated 58% from biopharmaceutical customers, 31% from industrial clients, and 11% from academic/government institutions. In early 2026, Waters plans to merge with BD's life science and diagnostics business, which will substantially change those concentrations. Waters will wind up with more concentration in diagnostics (versus none now) and discovery-related life science tools.

Idexx Laboratories primarily develops, manufactures, and distributes diagnostic products, equipment, and services for pets and livestock. Its key product lines include single-use canine and feline test kits that veterinarians can employ in the office, benchtop chemistry and hematology analyzers for test-panel analysis on-site, reference lab services, and tests to detect and manage disease in livestock. The firm also offers vet practice management software and consulting services to animal hospitals. Idexx derives roughly 35% of its revenue from outside the United States.

Illumina provides tools and services to analyze genetic material with life science and clinical lab applications. The company generates over 90% of its revenue from sequencing instruments, consumables, and services. Illumina’s high-throughput technology enables whole genome sequencing in humans and other large organisms. Its lower throughput tools enable applications that require smaller data outputs, such as viral and cancer tumor screening. Illumina also sells microarrays (9% of 2024 sales) that enable lower-cost, focused genetic screening with primarily consumer and agricultural applications.

ResMed is one of the largest respiratory care device companies globally, primarily developing and supplying flow generators, masks and accessories for the treatment of sleep apnea. Increasing diagnosis of sleep apnea combined with ageing populations and increasing prevalence of obesity is resulting in a structurally growing market. The company earns roughly two thirds of its revenue in the Americas and the balance across other regions dominated by Europe, Japan and Australia. Recent developments and acquisitions have focused on digital health as ResMed is aiming to differentiate itself through the provision of clinical data for use by the patient, medical care advisor and payer in the out-of-hospital setting.

Alcon is one of the leading visioncare companies in the world. Following nine years as a Novartis subsidiary, it was spun off as a public company in April 2019. Alcon operates in two segments: visioncare and surgical. Visioncare comprises contact lenses, lenscare solutions, and a suite of ocular health products. With brands like Dailies, Total1, and Air Optix, Alcon controls about one fourth of the US contact lens market. Surgical comprises intraocular lenses, ophthalmic surgical equipment, and consumables used during surgeries. Its main products include Centurion, a phacoemulsification device used during cataract surgeries, and a portfolio of IOLs including PanOptix and Vivity. Alcon has one of the largest installed bases of eye surgical equipment in the world.

GE HealthCare Technologies is a leading medical technology firm with leading market share in imaging and ultrasound equipment. The company reports four major segments: imaging (45% of revenue), advanced visualization solutions (26%), patient care solutions (15%), and pharmaceutical diagnostics (14%). The company’s sales are geographically diverse, with the United States, EMEA, China, and the rest of the world accounting for 46%, 26%, 11%, and 17% respectively. We estimate approximately half of its revenue is recurring, which consists of servicing (about one third of revenue), pharmaceutical diagnostics (about 10%-15%), and digital solutions (just over 5%).

Mettler-Toledo supplies weighing and precision instruments to customers in the life sciences (around 55% of sales), industrial (around 40%), and food retail (around 5%) industries. Its products include laboratory and retail scales, pipettes, pH meters, thermal analysis equipment, titrators, metal detectors, and X-ray analyzers. Mettler leads the market for weighing instrumentation and controls more than 50% of the market for lab balances. The business is geographically diversified, with the Americas accounting for about 37% of sales, Europe about 27%, China about 16% and the rest of the world about 20%.

Sartorius Stedim Biotech is a leading provider of bioprocessing solutions. Its sells equipment and consumables for fermentation, filtration, fluid management, purification, and cell culture media for manufacturing biologic drugs and has a focus on single-use technology. It is a subsidiary of Sartorius AG, which has 71.5% ownership and 83% voting control. The business is geographically diverse, with 35% of sales from the Americas, 42% from Europe, the Middle East, and Africa, 15% from Asia excluding China, and 8% from China.

Medpace is a late-stage contract research organization that provides full-service drug-development and clinical trial services to small and midsize biotechnology, pharmaceutical, and medical device firms. It also offers ancillary services, including bioanalytical laboratory services and imaging capabilities. The company was founded over 30 years ago and has more than 5,400 employees across 40 countries. Medpace is headquartered in Cincinnati, Ohio, and its operations are primarily based in the US, with additional presence in Europe, Asia, South America, Africa, and Australia. Cinven, a global private equity firm, acquired Medpace for $915 million in 2014 and exited its investment in 2018.

Biosplice Therapeutics is a clinical-stage biotechnology firm headquartered in San Diego, California. The company develops small-molecule modulators of splicing factors to treat degenerative diseases, fibrosis, and cancers, with lead candidates in phase II trials for osteoarthritis and dry age-related macular degeneration.

Neuralink is a neurotechnology company founded in 2016 by Elon Musk and a group of scientists and engineers, focused on developing implantable brain–computer interface (BCI) devices. Its primary product, the N1 chip, is surgically implanted into the skull by a precision robotic system called R1, enabling direct communication between the human brain and external computers or devices. The company's stated mission is to address neurological conditions such as paralysis, blindness, and severe motor impairments, allowing patients to control digital devices using thought alone. In January 2024, Neuralink implanted its first BCI device in a human patient, with the individual subsequently demonstrating the ability to control a computer cursor through neural signals. Headquartered in Fremont, California, the company operates at the intersection of neuroscience, robotics, and semiconductor engineering, and has attracted significant attention for its long-term ambitions around human-AI symbiosis.

MiRus is a medical device company developing bioabsorbable implants for spine and orthopedics. Its Freedom LYRA system, launched in 2023, uses magnesium alloy screws that dissolve over 12-18 months, implanted in 500 cervical fusion surgeries across US centers.

Pulse is a French provider of cardiovascular imaging software for coronary artery assessment. Headquartered in Lyon, the company develops tools that compute fractional flow reserve, pressure drops, and plaque vulnerability from CT angiography scans. Pulse software integrates with scanners from Siemens Healthineers and Philips, enabling non-invasive FFRct analysis in clinics. Used in over 50 countries, the platform supports plaque characterization and endothelial shear stress mapping. Founded in 2016, Pulse partners with hospitals like Cleveland Clinic for clinical validation.