Elite Diagnostic Valuation Multiples

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.

Natera Inc is a diagnostic and research company with proprietary molecular and bioinformatics technology. The company's key product offerings include its Panorama Non-Invasive Prenatal Test (NIPT) which screens for chromosomal abnormalities of a fetus as well as in twin pregnancies, typically with a blood draw from the mother, Horizon Carrier Screening (HCS) to determine carrier status for a large number of severe genetic diseases that could be passed on to the carrier’s children, Signatera molecular residual disease (MRD) test, which detects circulating tumor DNA in patients previously diagnosed with cancer to assess molecular residual disease and monitor for recurrence; and Prospera, to assess organ transplant rejection.

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%).

Quest Diagnostics is a leading independent provider of diagnostic testing, information, and services in the US. The company generates over 95% of its revenue through clinical testing, anatomic pathology, esoteric testing, and substance abuse testing with specimens collected at its national network of roughly 2,300 patient service centers, as well as multiple doctors offices and hospitals. The firm also runs a much smaller diagnostic solutions segment that provides clinical trials testing, risk-assessment services, and information technology solutions.

Labcorp is one of the nation's two largest independent clinical laboratories, with roughly 20% of the independent lab market. The company operates approximately 2,000 patient-service centers, offering a broad range of 5,000 clinical lab tests, ranging from uncomplicated routine blood and urine screens to complex oncology and genomic testing.

Exact Sciences, headquartered in Madison, Wisconsin, provides cancer screening and diagnostic test products in the United States and internationally. Exact’s Cologuard screening test is a noninvasive stool-based DNA test for colorectal cancer. The company also competes in the precision oncology market with Oncotype DX, a suite of tissue-based genomic tests for estimating recurrence risk and likelihood of benefit from chemotherapy for breast and colon cancer, and OncoExTra, a liquid-based comprehensive genomic profiling test. It also has a pipeline of blood-based tests for molecular residual disease, colorectal cancer screening, and multicancer screening.

Shanghai United Imaging Healthcare Co Ltd provides customers with high-performance medical imaging equipment, radiotherapy products, life science instruments, and medical digitalization and intelligent solutions. The company’s products include MRI systems, CT scanners, X-ray imaging equipment, molecular imaging systems, radiotherapy linear accelerators, and life science instruments.

Guardant Health, based in Redwood City, California, is a leader in liquid-based cancer tests for clinical and research use. The company's main franchises are Guardant360 for genomic profiling of tumors, Reveal for molecular residual disease testing, and Shield for colorectal cancer screening. Additionally, Guardant offers research development services such as regulatory approval consultancy and clinical trial referrals.

Revvity is a global life sciences and diagnostics company formed in 2023 following the rebranding of PerkinElmer. The company operates in two segments: life sciences, which provides reagents and instruments for biopharma and academic research, and signals software, and diagnostics, which offers tools in immunodiagnostics and newborn and reproductive health. Revvity’s products and services are sold worldwide, with major markets in the US, Europe, and China.

BioMérieux designs, develops, and manufactures a broad portfolio of in vitro diagnostics for detecting disease-causing pathogens and contamination. The company operates in four segments: molecular biology (42% of 2024 sales), microbiology (33%), immunoassays (10%), and industrial applications (about 15%). The Americas account for the largest portion of the firm's revenue (40%), followed by Asia-Pacific (27%) and Europe, the Middle East, and Africa (27%). BioMérieux is headquartered in Marcy-l'Étoile, France.

Pro Medicus is a healthcare IT company specializing in radiology imaging software. Its main product, Visage 7, is a clinical desktop application that radiologists use to view, enhance, and manipulate images from any device and make a diagnosis. Its main customers are US private academic hospitals. In fiscal 2025, Pro Medicus earned 90% of revenue in North America, 8% from Australia, and the remaining 2% in Europe.

Sonic Healthcare is a global pathology provider. It is the largest private operator in Australia, Germany, Switzerland and the UK, the second-largest in Belgium and New Zealand, and the third largest in the US. In addition to pathology, which contributes roughly 85% of group revenue, Sonic is the second-largest player in diagnostic imaging in Australia and the largest operator of medical centers in Australia. The company typically earns about 35% of group revenue in Australia and New Zealand, 25% in the US, and 40% in Europe.

Qiagen offers proprietary sample and assay technology to extract, purify, amplify, and interpret DNA, RNA, and proteins. The company's sales are split almost evenly between applications in life sciences and molecular diagnostics. Qiagen generates nearly 90% of its revenue from consumables with the balance coming from instrumentation and related services. The Americas account for the largest portion of the firm's revenue (52% of 2024 sales), followed by EMEA (33%), and the Asia-Pacific (15%).

Lantheus Holdings Inc caters to the United States healthcare sector with the development of diagnostic products. Its products are in three categories: Precision Diagnostics, Radiopharmaceutical Oncology, and Strategic Partnerships and Other Revenue. Precision Diagnostic products assist healthcare professionals Find and Follow diseases, with a focus in cardiology. Radiopharmaceutical Oncology diagnostics and therapeutics help HCPs Find, Fight and Follow cancer. Strategic Partnerships focus on enabling precision medicine through the use of biomarkers, digital solutions and pharma services platforms, and also includes license of RELISTOR to Bausch Health Companies, Inc.

RadNet Inc is a national provider of diagnostic imaging services that operates in two business segments: Imaging Center segment and Digital Health segment. The Imaging Center segment provides physicians with imaging capabilities to facilitate the diagnosis and treatment of diseases and disorders. Services include magnetic resonance imaging (MRI), computed tomography (CT), positron emission tomography (PET), nuclear medicine, mammography, ultrasound, diagnostic radiology (X-ray), and fluoroscopy. The Digital Health segment develops and deploys clinical applications to enhance the interpretation of medical images and improve patient outcomes with an emphasis on brain, breast, prostate, and pulmonary diagnostics.

Diasorin develops and manufactures a broad portfolio of in vitro diagnostics used for detecting pathogens and contamination of samples from the human body, as well as used in industrial settings such as food and water contamination testing. The company operates three segments: immunodiagnostics (66% of sales), molecular diagnostics (17%), and licensed technologies (14%). Diasorin was an important manufacturer of covid tests, which boosted its profits during the pandemic, but this segment’s importance has decreased over the years, and in 2024, it accounted for only 2% of total sales.

Telix develops radiopharmaceuticals to manage cancer. Radiopharmaceuticals are radioisotopes bound to molecules that can target specific cells. At low doses, these drugs can bind to specific cancer cells with radiation, and then positron emission tomography imaging can accurately visualize tumors. At high doses, these drugs can selectively target and treat tumors with radiation, known as radioligand therapy. Radiopharmaceuticals are usually injected into the bloodstream. Telix has a pipeline of potential radiopharmaceuticals but currently earns most of its revenue from US sales of Illuccix, largely used as an imaging agent to visualize the spread of prostate cancer.

Veracyte Inc is a genomic diagnostics company. The group empowers clinicians with the insights necessary to guide and assure patients at pivotal moments in the race to diagnose and treat cancer. It offers tests for prostate cancer (Decipher Prostate), thyroid cancer (Afirma), breast cancer (Prosigna), and bladder cancer (Decipher Bladder). In addition, its Percepta Nasal Swab test is being run in CLIA labs in support of clinical studies.

Dr. Lal PathLabs Ltd is a pathology lab based in India. It is involved in providing diagnostic services and other healthcare tests in the areas of pathology and radiology. The company operates laboratories for carrying out pathological diagnostic services in various branches of biochemistry, hematology, histopathology, microbiology, electrophoresis, immunochemistry, immunology, virology, cytology, and other pathological and radiological investigations. Its diagnostic services assist in preventing, monitoring, and treating diseases and improving health conditions. The company has business operations in India and other countries, of which maximum revenue is generated within India.

GRAIL Inc is a healthcare company focused on developing technologies for early cancer detection. The company has developed a multi-cancer early detection blood test that has the ability to detect all types of cancer, across all stages. It operates in one reportable operating segment which provides multi-cancer early detection testing and service.

HeartFlow Inc is a commercial-stage medical technology company that has pioneered the use of software and AI to deliver a non-invasive solution for diagnosing and managing coronary artery disease CAD. The company operates and manages its business as one reportable and operating segment, which is the business of non-invasive coronary artery disease detection solutions. Geographically, it operates in United States, United Kingdom, Japan, and Rest of Europe, of which it derives maximum revenue from United States.

Fleury SA is engaged in the provision of medical services in the diagnostic, treatment, clinical analysis, health management, medical care, orthopedics and ophthalmology areas and offers its digital healthcare platform. The company carries out its activities through customer service units and hospital-based units. Furthermore, the company has a mobile service operation with coverage in municipalities in addition to a digital platform. It has two reportable business segments: Diagnostic Medicine and Integrated Medicine. The maximum revenue is generated from Diagnostic Medicine Segment.

Vimian Group AB specializes in the areas of animal health, such as specialty pharma, diagnostics, medtech, and veterinary services. It offers proprietary diagnostics, prescription, and non-prescription treatments for preventive care and treatment of chronic conditions for companion animals, with a position within allergy, dermatology, otology, and specialized nutrition. Its geographical segments include Europe, North America, and the Rest of the world.

Sonoscape Medical Corp is a Chinese manufacturer of medical devices for ultrasound diagnostic systems and transducers. The company's product categories include Ultrasound, Endoscope which also includes video equipment, and Electrocardiography consisting of veterinary ECG and resting ECG. Ultrasound category covers color Doppler trolley systems, color Doppler HCU, B/W trolley systems, and probe, among others. The organization has a business presence in China and in other countries.

Daan Gene Co Ltd is a high-tech enterprise-oriented in molecular diagnostic techniques. It is primarily committed to research and development, production, and service of in-vitro diagnostic products, including qPCR, Sequeacing, TRF, ELISA, and Liquid-Based Cytology diagnostic kits and equipment. Geographically, tahe group operates in China.

Diagnostyka SA is engaged in providing laboratory diagnostics services in Poland. The company offers comprehensive laboratory services from collecting biological material, through testing, to providing results online.

Beijing Wandong Medical Technology Co Ltd is engaged in the development, manufacture, and distribution of medical equipment. Its products consist of radiological imaging equipment, including angiographic and cardiac systems, digital direct radiography (DR) imaging equipment, high frequency diagnostic systems, high frequency radiographic systems, conventional x-ray diagnostic equipment and high frequency mobile units, magnetic resonance imaging (MRI) equipment, as well as digital medical image management systems, among others. The company is also engaged in providing maintenance services.

Sinocare Inc operates in the healthcare industry. It is engaged in the development, manufacturing, and marketing of diagnosis testing products for people with chronic diseases and healthcare professionals. Its product range covers household blood glucose meter, medical blood glucose meter, urinary microalbumin test strip and blood lipid uric acid products. In addition, the company also provides diabetes management information systems.

Guangzhou Wondfo Biotech Co Ltd manufactures medical diagnostic tests. Its products include immunodiagnostic rapid test kits, including fertility, which include pregnancy HCG, ovulation LH, and others. The company's products are used in a clinical test, field test, and personal health management, among others.

Ramsay Generale de Sante SA operates in the private healthcare sector in France. The company provides a comprehensive range of patient care services in thirteen business segments: Nouvelle Aquitaine, Bourgogne-Franche Comte, Brittany, Centre-Val de Loire, Hauts de France, Normandy, Provence Alpes Cote d'Azur, Ile de France, Auvergne-Rhone Alpes, Occitanie, Italy, Nordics, and Head Office. It generates maximum revenue from the Ile de France segment. The company also specializes in cardiology, heart surgery, digestive surgery, dermatology, urology, ophthalmology, vascular and endovascular surgery.

NeoGenomics Inc provides oncology diagnostic testing and consultative services which include technical laboratory services and professional interpretation of laboratory test results by licensed physicians or molecular experts in pathology and oncology. The company operates a network of cancer-focused testing laboratories in the United States and the United Kingdom. The company operates in a single segment and derives revenue from clients by providing clinical cancer testing, interpretation, and consultative services, molecular and NGS testing, comprehensive technical and professional services offerings, clinical trials and research, validation laboratory services, and oncology data solutions.

Butterfly Network Inc is a digital health business transforming care with handheld, whole-body ultrasound. Powered by its proprietary Ultrasound-on-Chip technology, its solution enables the acquisition of imaging information from an affordable, powerful device that fits in a healthcare professional’s pocket with a combination of cloud-connected software and hardware technology that is easily accessed through a mobile application. The company enables the practical application of ultrasound information in the clinical workflow. Butterfly iQ+ is an ultrasound device that can perform whole-body imaging in a single handheld probe using semiconductor technology. With its small, handheld size, low cost, and simple user interface.

Clinica Baviera SA operates ophthalmological clinics. It is involved in the diagnosis, treatment, and monitoring of various types of ophthalmological disorders. It offers diagnosis and treatment for various eye problems such as long-sightedness, short-sightedness, astigmatism, cataracts and eye strain.

Innovita Biological Technology Co Ltd is a biotechnology company focusing on the research and development, production, and sales of POCT in vitro diagnostic products.

Lumexa Imaging Holdings Inc is a provider of diagnostic imaging services. The company offers a broad range of imaging modalities including MRIs, CT scans, PET scans, X-rays, ultrasounds, and mammography. Its products and operations are managed and reported in two operating segments: Outpatient Imaging Centers (Outpatient) and Professional Services (Professional). The professional services segment generates revenue from interpreting imaging studies conducted by other parties, mainly hospital imaging departments. The majority of revenue is generated from the Outpatient segment, which generates revenue by performing imaging studies and providing radiologists’ interpretations of those studies.

Lunit Inc is a medical AI software company devoted to providing AI-powered total cancer care. Its products comprise of Lunit INSIGHT CXR, AI solution for Chest x-ray; Lunit INSIGHT MMG, AI solution for Mammography; Lunit SCOPE IO, AI-Powered Biomarker for Immuno-Oncology; and Lunit SCOPE PD-L1, AI Solution for PD-L1 Expression.

Jiangsu Bioperfectus Technologies Co Ltd is engaged in product development, production and sales of disease prevention and control, female genital micro-ecological testing and tumor screening. Its products portfolio includes Fever respiratory pathogen detection series, Fever with a rash pathogen test series, Fever with bleeding pathogen test series, Foodborne diseases and diarrheal pathogen detection and Other types of pathogen detection series.

Diagnosticos da America SA operates as a medical diagnostics company in Brazil. The company offers clinical analysis, diagnostic imaging tests, and patient service centers. It has three operating segments. Outpatient care services and care coordination includes Diagnosis and health management, Hospitals and oncology include Medical and hospital services & Foreign operations include Diagnosis. The majority is from the Hospitals and oncology segment. Geographically, it operates in Brazil and South America (Argentina, Uruguay, Chile and Colombia).

Assure Tech (Hangzhou) Co Ltd is a biotechnology company. The company is engaged in research & development, production, sell of diagnostic reagents, POCT and biological materials.

RaySearch Laboratories AB is a Sweden-based medical technology company. The company develops advanced software solutions for improved cancer treatment. The company develops and markets the RayStation* treatment planning system and RayCare* oncology information system to clinics all over the world and distributes products through licensing agreements with medical technology companies. Its geographic segments consist of Sweden, North America, Asia Pacific, Europe and the rest of the world.

Integral Diagnostics is a major Australian diagnostic imaging provider. In Australia, imaging revenues are almost entirely earned via the public health Medicare system. Integral typically earns approximately 90% of group revenue from diagnostic imaging in Australia and the remainder from diagnostic imaging in Auckland, New Zealand. In Australia, Integral services regional areas in Queensland, Victoria, New South Wales, and Western Australia.

Castle Biosciences Inc is a molecular diagnostics company. The group provides test solutions for the diagnosis and treatment of dermatologic cancers, Barrett's esophagus (BE), and uveal melanoma. The product portfolio of the company includes DecisionDx-Melanoma, a risk stratification gene expression profile (GEP) test; DecisionDx-SCC, a risk stratification test for cutaneous squamous cell carcinoma; MyPath Melanoma, a diagnostic GEP test for use in patients with difficult-to-diagnose melanocytic lesions; and TissueCypher, a test to predict future development of progression of high-grade dysplasia and/or esophageal cancer. It also provides DecisionDx-UM, a risk stratification GEP test. The company also offers its products to the skin cancer and gastroenterology markets.

Lumibird, formerly Quantel SA is an enterprise engaged in the designing, manufacturing, and sale of scientific laser solutions. Scientific and industrial applications lasers used by research laboratories in the study of material, cleaning lasers, marking, measurement, and others. whereas, Medical applications include specialized lasers for ophthalmology, dermatology, and esthetics. The company generates a majority of its revenue from the scientific and industrial applications.

Varex Imaging Corp Designs, manufactures, sells, and services X-ray imaging components, including X-ray tubes, detectors, ionization chambers, high-voltage connectors, software, collimators, generators, exposure control devices, and heat exchangers.. The company operates through two segments: Medical, the key revenue driver, providing X-ray imaging components and accessories for healthcare applications, and Industrial, which provides Linatron X-ray accelerators, X-ray tubes, flat panel detectors, high-voltage connectors, and coolers for non-medical use. Geographically, it generates the majority of its revenue from Europe, the Middle East, and Africa (EMEA), with the rest coming from the Americas and Asia Pacific.

NIOX Group PLC is a medical device company that develops a range of therapies for asthma, chronic obstructive pulmonary disease, and allergy. The company has a single operating segment: NIOX. The NIOX segment relates to the portfolio of products used to improve asthma diagnosis and management by measuring fractional exhaled nitric oxide (FeNO). Geographically, it derives a majority of its revenue from the Asia Pacific and also has a presence in the European Union, the United States, the United Kingdom, and the Rest of the world.

Voxel SA is a network of diagnostic imaging laboratories created for patients and to increase access to high-quality tests. The company operates diagnostic imaging centers and laboratories and provides several services such as magnetic resonance imaging, computed tomography and positron emission tomography. It has 33 specialised laboratories in 21 cities throughout Poland.

Healius is Australia’s second-largest pathology provider. Pathology revenue is almost entirely earned via the public health Medicare system and makes up the majority of Healius' group revenue. A small portion comes from its clinical testing business, Agilex.

Australian Clinical Labs is Australia’s third-largest private pathology provider. ACL earns almost its entire group revenue from pathology services in Australia, which are mostly earned via the publicly funded health Medicare system. ACL is well established in the states of Western Australia, South Australia, Victoria, and the Northern Territory.