Farmacosmo Valuation Multiples

Amazon is the leading online retailer and marketplace for third party sellers. Retail related revenue represents approximately 74% of total, followed by Amazon Web Services (17%), and advertising services (9%). International segments constitute 22% of Amazon's total revenue, led by Germany, the United Kingdom, and Japan.

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.

Tencent is the world's largest game publisher, with top-grossing mobile hits like Honor of Kings and Peacekeeper Elite and a steady pipeline of new titles. It also operates WeChat-China's super-app with roughly 1.3 billion users-embedded in daily life for messaging, short video, mini programs, payments, and shopping. Beyond its own platforms, Tencent is a prolific strategic investor, holding stakes in leading internet companies such as PDD, Kuaishou, and Xiaohongshu.

UnitedHealth Group is one of the largest private health insurers and provides medical benefits to about 51 million members globally, including 1 million outside the US as of December 2024. As a leader in employer-sponsored, self-directed, and government-backed insurance plans, UnitedHealth has obtained massive scale in medical insurance. Along with its insurance assets, UnitedHealth's Optum franchises help create a healthcare services colossus that spans everything from pharmaceutical benefits to providing outpatient care and analytics to both affiliated and third-party customers.

Alibaba is the world's largest online and mobile commerce company as measured by gross merchandise volume. It operates China's online marketplaces, including Taobao (consumer-to-consumer) and Tmall (business-to-consumer). The China retail e-commerce platform is the most valuable cash flow-generating business at Alibaba. Additional revenue sources include China wholesale e-commerce, international retail and wholesale e-commerce, local consumer services, travel services, cloud computing, digital media and entertainment, Cainiao logistics services, and other businesses.

Siemens is a multi-industry company focused on the areas of automation, electrification, mobility, and healthcare. Its top three geographic regions—the United States, Germany, and China—contribute over half of group revenue. Siemens has a 71% investment in separately listed Siemens Healthineers. Recent portfolio activity included the listing of Siemens Energy, spinning out its power and gas and Siemens Gamesa business divisions in 2020.

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).

Intuitive develops, produces, and markets a robotic system for assisting minimally invasive surgery. It also provides the instrumentation, disposable accessories, and warranty services for the system. The company has placed more than 10,000 da Vinci systems in hospitals worldwide, with more than 6,000 installations in the US and a growing number in emerging markets.

Abbott manufactures and markets cardiovascular and diabetes devices, adult and pediatric nutritional products, diagnostic equipment and testing kits, and branded generic drugs. Products include pacemakers, implantable cardioverter defibrillators, neuromodulation devices, coronary stents, catheters, infant formula, nutritional liquids for adults, continuous glucose monitors, and immunoassays and point-of-care diagnostic equipment. Abbott derives roughly 60% of sales outside the United States.

PDD Holdings operates commerce businesses in over 80 countries globally. Its main operations are Pinduoduo, a social commerce platform in China, and Temu, a global e-commerce marketplace. PDD also has a community group purchase business in China. PDD has built a network of sourcing, logistics, and fulfillment capabilities that support its underlying businesses.

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.

Stryker designs, manufactures, and markets an array of medical equipment, instruments, consumable supplies, and implantable devices. The product portfolio includes hip and knee replacements, extremities, endoscopy systems, operating room equipment, embolic coils, hospital beds and gurneys, and orthopedic robotics. Stryker remains one of the three largest competitors in reconstructive orthopedic implants and holds the leadership position in operating room equipment. Roughly one-fourth of Stryker's total revenue currently comes from outside the United States.

CVS Health offers a diverse set of healthcare services. Its roots are in its retail pharmacy operations, where it operates over 9,000 stores primarily in the US. CVS is also a large pharmacy benefit manager (acquired through Caremark), processing about 2 billion adjusted claims annually. It operates a top-tier health insurer (acquired through Aetna) through which it serves about 27 million medical members. The acquisition of Oak Street Health added primary care services to the mix, which could have significant synergies with all existing business lines.

One of the largest medical-device companies, Medtronic develops and manufactures therapeutic medical devices for chronic diseases. Its portfolio includes pacemakers, defibrillators, transcatheter heart valves, stents, insulin pumps, spinal fixation devices, neurovascular products, advanced energy, ablation laser therapy, and surgical tools. The company primarily markets its products to healthcare institutions and physicians in the United States, Western Europe, and Japan. Foreign sales account for roughly 50% of the company's total sales.

MercadoLibre runs the largest e-commerce marketplace in Latin America, with about 150 million active users and more than 600 million active listings across 18 countries stitching into its commerce network or fintech solutions when last reported. The company operates a host of complementary businesses to its core online shop, with shipping solutions (Mercado Envios), a payment and financing operation (Mercado Pago and Mercado Credito), advertisements (Mercado Clics), classifieds, and a turnkey e-commerce solution (Mercado Shops) rounding out its arsenal. MercadoLibre generates revenue from final value fees, advertising royalties, payment processing, insertion fees, subscription fees, and interest income from consumer and small-business lending.

Boston Scientific produces less invasive medical devices that are inserted into the human body through small openings or cuts. It manufactures products for use in angioplasty, blood clot filtration, kidney stone management, cardiac rhythm management, catheter-directed ultrasound imaging, upper gastrointestinal tract diagnostics, interventional oncology, neuromodulation for chronic pain, and treatment of incontinence. The firm markets its devices to healthcare professionals and institutions globally. Foreign sales account for roughly 36% of the firm's total sales.

Carvana Co is an e-commerce platform for buying and selling used cars. The company derives revenue from used vehicle sales, wholesale vehicle sales and other sales and revenues. The other sales and revenues include sales of loans originated and sold in securitization transactions or to financing partners, commissions received on VSCs and sales of GAP waiver coverage. The foundation of the business is retail vehicle unit sales. This drives the majority of the revenue and allows the company to capture additional revenue streams associated with financing, VSCs, auto insurance and GAP waiver coverage, as well as trade-in vehicles.

Sea started as a gaming business, Garena, but in 2015 expanded into e-commerce. Sea operates Southeast Asia's largest e-commerce company, Shopee, in terms of gross merchandise value. Shopee is a hybrid C2C and B2C marketplace platform operating in Indonesia, Taiwan, Vietnam, Thailand, Malaysia, the Philippines, and Brazil. For Garena, Free Fire is the key revenue generating game. Sea’s third business, SeaMoney, provides lending, payment, digital banking, and insurance services.As of March 31, 2025, Forrest Xiaodong Li, the founder, chairman and CEO, owned 59.1% of voting power. Tencent owned 18.5% of issued shares with no voting power.

Spun off from Baxter International in 2000, Edwards Lifesciences designs, manufactures, and markets a range of medical devices and equipment for advanced stages of structural heart disease. It has established itself as a leader across key products, including surgical tissue heart valves, transcatheter aortic valves, and transcatheter mitral and tricuspid valve technologies. The firm derives about 60% of its total sales from outside the US.

Siemens Healthineers is engaged in therapeutic imaging, radiotherapy, laboratory, and point-of-care diagnostics. The imaging segment (56% of sales in fiscal 2025) includes magnetic resonance imaging, computed tomography, X-ray systems, molecular imaging, and ultrasound. The Varian segment (18% of sales) offers radiotherapy and other oncology solutions. The diagnostics segment (19%) includes in vitro diagnostics and point-of-care diagnostics. The advanced therapies (now part of precision therapy) segment (9%) products are designed to support image-guided minimally invasive treatments in cardiology, interventional radiology, and surgery. The Americas represents 44% of total sales, Europe, Middle East, and Africa 32%, and Asia-Pacific, including China (11%), the remainder.

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.

JD.com is the third-largest Chinese e-commerce platform by gross merchandise volume in 2024. it offers a wide selection of authentic products with speedy and reliable delivery. The company has built its own nationwide fulfilment infrastructure and last-mile delivery network, staffed by its own employees, which supports both its online direct sales, its online marketplace and omnichannel businesses.

Coupang is South Korea’s largest e-commerce platform that sells both owned and third-party inventory. Headquartered in the US, Coupang operates e-commerce businesses mainly in South Korea and Taiwan. The company has built an integrated logistics network that covers the entirety of South Korea, with extensive fulfillment centers that ensure timely delivery, even for orders placed seconds before midnight. Outside of its bread-and-butter e-commerce business, Coupang has expanded into Rocket delivery services to third-party merchants (fulfillment and logistics by Coupang), online grocery delivery Rocket Fresh, online meal delivery (Eats), e-commerce in Taiwan, luxury e-commerce (Farfetch), and travel.

Roper Technologies is a holding company focused on acquiring, managing, and developing niche market-leading technology businesses. The company operates a decentralized business model whereby each portfolio company operates independently from the others. Roper positions itself as a free cash flow compounder, whereby excess free cash flow generated by its portfolio businesses is repatriated to the parent company, which is then utilized to acquire additional businesses. Presently, the company operates 30 distinct businesses with over three-fourths of the revenue coming from software products and over two-thirds of the revenue coming from recurring and recurring sources.

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.

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.

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.

Shenzhen Mindray Bio-Medical Electronics Co Ltd is a developer, manufacturer, and supplier of medical devices. The company is focused on the medical industry in the fields of Patient Monitoring & Life Support, InVitro Diagnostics, and Medical Imaging.

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.

Veeva is the global leading supplier of cloud-based software solutions for the life sciences industry. The company's best-of-breed offerings address operating and regulatory requirements for customers ranging from small, emerging biotechnology companies to departments of global pharmaceutical manufacturers. The company leverages its domain expertise to improve the efficiency and compliance of the underserved life sciences industry, displacing large, highly customized and dated enterprise resource planning systems that have limited flexibility. Its two main products are Veeva CRM, a customer relationship management platform for companies with a salesforce, and Veeva Vault, a content management platform that tackles various functions within any life sciences company.

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%).

Iqvia is the result of the 2016 merger of Quintiles, a leading global contract research organization, and IMS Health, a leading healthcare data and analytics provider. The research and development segment focuses primarily on providing outsourced late-stage clinical trials for pharmaceutical, device, and diagnostic firms. The technology and analytics segment provides aggregated information and technology services to clients in the healthcare industry, including pharmaceutical companies, providers, payers, and policymakers, as well as data and analytics capabilities for clinical trials, including virtual trials. The company also has a small contract sales business.

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%.

Koninklijke Philips is a diversified global healthcare company operating in three segments: diagnosis and treatment, connected care, and personal health. Nearly 50% of the company's revenue comes from the diagnosis and treatment segment, which features imaging systems, ultrasound equipment, and image-guided therapy solutions. The connected care segment (under 30% of revenue) encompasses monitoring and analytics systems for hospitals, informatics business, and also houses the sleep and respiratory care segment. Personal health business (remainder of revenue) is mainly oral health and personal care product lines, which include electric toothbrushes and men's grooming and personal-care products.

DexCom designs and commercializes continuous glucose monitoring systems for diabetic patients. CGM systems serve as an alternative to the traditional blood glucose meter process, and the company is evolving its CGM systems to provide integration with insulin pumps from Insulet and Tandem for automatic insulin delivery. DexCom's CGMs are available through medical equipment distributors as well as retail pharmacies.

Sigma Healthcare is Australia’s largest retail pharmacy franchisor, most notably owning the Chemist Warehouse brand, which it merged with in 2025. Sigma is also Australia’s largest full-line wholesaler to franchised and independent pharmacies and distributes a broad range of pharmacy products, including prescription medicines, over-the-counter products, and front of store, or FOS, products, at low prices. The group also operates in New Zealand, Ireland, China, and Dubai, has a growing private label range, and offers third-party logistics services.

Dr Sulaiman Al Habib Medical Services Group provides private health and ancillary services in the Kingdom and the region through the establishment, management, and operation of hospitals, medical complexes, day surgery centers, pharmaceutical facilities, and other ancillary areas, including home health care, specialized laboratories, technology and information systems, facility maintenance, tele-medicine, revenue cycle management, medical equipment maintenance, and real estate activity. The company reports in three segments: Hospitals and Healthcare Facilities, Pharmacies, and HMG Solutions and Others. The majority of revenue comes from the Hospitals and Healthcare Facilities segment.

Naver has been the leading search portal in South Korea for many years. The company has also been evolving into an internet platform providing a variety of internet services, such as news, a dictionary, maps, digital comic content, social networking, e-commerce, videos, fintech services based on online payments, and Cloud services. Naver was also the incubator of Line Yahoo, the leading mobile messaging app in Japan, Taiwan, Thailand, and Indonesia, which merged with Z Holdings (Yahoo Japan), with Naver now owning 32.5% of the merged entity renamed LY.

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.

Steris is an Ireland-domiciled medical technology company focused on sterilization services and infection prevention. The company is the global leader in contract sterilization services, ensuring the safe delivery of single-use and implantable medical equipment to hospitals around the world. Steris also sells sterilizers, washer-disinfectors, and other decontamination equipment and supplies for use by care provider facilities and in biopharma manufacturing sites. Domiciled in the United States before its inversion to Ireland, the firm derives approximately 70% of its revenue from Healthcare Services, 19% from Applied Sterilization Technologies, or AST, and 11% from life sciences services after the divestment of its dental products business.

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.

JD Health is the largest healthcare e-commerce platform in China in terms of revenue. The company offers pharmaceutical drugs and healthcare products on its platform, both as a marketplace that connects merchants to consumers and as a first-party, or 1P, direct retailer. It also offers online consultation from real life doctors and separately partners with offline pharmacies that can provide location-based 24/7 delivery as part of an omnichannel initiative to complement its core e-commerce business. Its closest competitors are Alibaba Health and Meituan for its e-commerce business. As of Dec. 31, 2024, the platform has over 200 million active annual users and over 70,000 merchants. JD Health is 67.49% owned by its parent company, JD.com.

LY is a leading Japanese internet services conglomerate. Its main services are Yahoo Japan, the oldest portal site in Japan that offers a wide variety of services, such as news, e-commerce, financial information, and Line, a national messenger application. In 2019, the company acquired Zozo, a leading online apparel retailer, to grow its e-commerce business. In 2022, LY consolidated with its wholly owned subsidiary PayPay, the most popular QR code payment service in Japan.

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.

Shionogi & Co Ltd is a specialty and generic drug manufacturing company. The company focuses on the manufacturing and distribution of pharmaceuticals, diagnostic reagents, and medical devices. The company engages in manufacturing, formulation, packaging, and analysis as part of its commercialization research that spans late-stage drug discovery through commercial production. It provides products and services in Japan, Europe, North America, and other regions.

Tenet Healthcare is a Dallas-based healthcare services organization. It operates acute and specialty hospitals (50 as of December 2025) and hundreds of ambulatory surgery centers and other outpatient facilities across the US, primarily in the South. Through its Conifer segment, Tenet also provides revenue cycle management solutions.

Zimmer Biomet designs, manufactures, and markets orthopedic reconstructive implants as well as supplies and surgical equipment for orthopedic surgery. With the acquisitions of Centerpulse in 2003 and Biomet in 2015, Zimmer holds the leading share of the reconstructive market in the United States, Europe, and Japan. Roughly two-thirds of total revenue is derived from sales of large joints; another fourth comes from extremities, trauma, sports medicine, and related surgical products. The firm spun out its dental and spine businesses in 2022.