GuideAI Health Valuation Multiples

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.

Palantir is an artificial intelligence, analytics, and automated decision-making company that leverages data to drive efficiency across its clients' organizations. The firm serves commercial and government clients via its Foundry and Gotham platforms, respectively. Palantir works only with entities in Western-allied nations and reserves the right not to work with anyone that is antithetical to Western values. The company was founded in 2003 and went public in 2020.

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.

CrowdStrike is a cloud-native cybersecurity company specializing in security verticals such as endpoint, cloud workload, identity, and security operations. CrowdStrike's primary offering is its Falcon platform, which provides enterprises with a unified view to detect and respond to security threats across their IT infrastructure. The Austin, Texas-based firm was founded in 2011 and went public in 2019.

Founded in Germany in 1972 by former IBM employees, SAP is the world’s largest provider of enterprise application software. Known as the leader in enterprise resource planning software, SAP’s portfolio also includes software for supply chain management, procurement, travel and expense management, and customer relationship management, among others. The company operates in more than 180 countries and has more than 400,000 customers, approximately 80% of which are small to medium-size enterprises.

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).

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.

Salesforce provides enterprise cloud computing solutions. The company offers customer relationship management technology that brings companies and customers together. Its Customer 360 platform helps the group deliver a single source of truth, connecting customer data across systems, apps, and devices to help companies sell, service, market, and conduct commerce. It also offers Service Cloud for customer support, Marketing Cloud for digital marketing campaigns, Commerce Cloud as an e-commerce engine, the Salesforce Platform, which allows enterprises to build applications, and other solutions, such as MuleSoft for data integration.

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.

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.

ServiceNow Inc provides software solutions to structure and automate various business processes via a SaaS delivery model. The company primarily focuses on the IT function for enterprise customers. ServiceNow began with IT service management, expanded within the IT function, and more recently directed its workflow automation logic to functional areas beyond IT, notably customer service, HR service delivery, and security operations. ServiceNow also offers an application development platform as a service.

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.

S&P Global provides data and benchmarks to capital and commodity market participants. Its ratings business is the largest credit rating agency in the world and S&P's largest segment by profitability. S&P's largest segment by revenue is market intelligence, which provides desktop, data and advisory solutions, enterprise solutions, and credit/risk solutions mostly in the financial-services industry. S&P's other segments include energy (formerly commodity insights, this segment includes Platts and other data), mobility (Carfax), and indexes. S&P plans to spin off mobility in 2026.

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.

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.

Adobe provides content creation, document management, and digital marketing and advertising software and services to creative professionals and marketers for creating, managing, delivering, measuring, optimizing, and engaging with compelling content multiple operating systems, devices, and media. The company operates with three segments: digital media content creation, digital experience for marketing solutions, and publishing for legacy products (less than 5% of revenue).

Datadog is a cloud-native company that focuses on analyzing machine data. The firm's product portfolio, delivered via software as a service, enables clients to monitor and analyze their entire information technology infrastructure, from servers to applications and Python scripts. Datadog's platform can ingest and analyze large amounts of machine-generated data in real time, allowing clients to utilize it for a variety of applications throughout their businesses to ensure uptime and latency objectives.

Moody’s, along with S&P Ratings, is a leading provider of credit ratings on fixed-income securities. The ratings segment, Moody’s Investors Service, includes corporates, structured finance, financial institutions, and public finance ratings. MIS represents a majority of the firm’s profit and often (depending on bond issuance levels) a majority of the firm's revenue. The other segment, Moody’s Analytics, consists of decision solutions, research and insights, and data and information.

Cadence Design Systems is a provider of electronic design automation software, intellectual property, and system design and analysis products. EDA software automates and aids in the chip design process, enhancing design accuracy, productivity, and complexity in a full-flow end-to-end solution. Cadence offers a portfolio of design IP, as well as system design and analysis products, which enables system-level analysis and verification solutions.

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.

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.

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.

Workday is a software company that offers human capital management, financial management, and business planning solutions for enterprises. Known for being a cloud-only software provider, Workday was founded in 2005 and is headquartered in Pleasanton, California.

Founded in 1982, Autodesk is a multinational software company best known for pioneering computer-aided design, or CAD, with its AutoCAD product. Nowadays, Autodesk provides design software for a variety of verticals, including architecture & construction, manufacturing, and media & entertainment. Autodesk products have been used in some of the world's most iconic landmarks, like Burj Khalifa, and well-known movie titles like Avatar.

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.

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.

Constellation Software is an acquirer, manager, and developer of vertical market software, or VMS, businesses globally. VMS differentiates from horizontal software in that it provides mission critical solutions within a specific industry for customers in a particular market. Constellation operates through a decentralized model in which each business operates as its own independent entity. Managers of individual businesses are incentivized to optimize their business for returns on invested capital and revenue growth. Excess cash generated by the individual businesses is repatriated to portfolio managers who focus on allocating as much capital as possible on new acquisitions. As of 2025, Constellation consisted of over 1,000 individual businesses and 64,000 employees.

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.

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.

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.

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.

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.

Founded in 2007, MongoDB is a vendor of a document-oriented database that accelerates development processes of new applications. Enterprise customers can choose between the fully managed offering, MongoDB Atlas, or the self-managed version, MongoDB Enterprise Advanced. MongoDB is a popular tool among developers, and its free Community Server has recorded over 500 million downloads since 2009.

Dassault Systèmes is a leading provider of computer-assisted design and product lifecycle management software, serving customers like Boeing and Volkswagen throughout the production process. The company’s flagship product, Catia, primarily serves the transportation, industrial equipment, and aerospace and defense industries. In life sciences, Dassault’s Medidata cloud platform optimizes clinical trial efficiency and is the leader in electronic data capture.

Kuehne+Nagel is a global transportation and logistics company founded in Switzerland in 1890. Following DSV's acquisition of DB Schenker, Kuehne+Nagel will be the second-largest seafreight forwarder globally and hold a minimum of the top three spots in airfreight. Seafreight has traditionally accounted for the largest part of the business, contributing 40% of the group's revenue in 2024. The company aims to become a more balanced, fully integrated freight forwarder, continually improving its end-to-end offering to clients.

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%).

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.

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%.

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.

Founded in 1987 by four major European airline carriers (Air France, Lufthansa, Iberia, and SAS), Amadeus became the world’s second global distribution system operator, or GDS, after Sabre’s development in the 1960s and 1970s. Today, among the top three GDS operators that control nearly 100% of industry sales, Amadeus' 40%-plus market share ranks as the largest. Overall, Amadeus’ GDS segment represented 48% of total in 2024. Moreover, the company has an expanding IT solutions division (52% of 2024 revenue) that addresses the airline, airport, rail, hotel, and travel agency markets. Transaction fees, which are tied to volume and not price, account for the bulk of consolidated sales and profits.

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.

Aristocrat Leisure is an electronic gaming machine manufacturer that sells machines to pubs, clubs, and casinos. The firm is licensed in all Australian states and territories, North American jurisdictions, and essentially every major country. Aristocrat is one of the top three largest players in the space along with International Game Technology and Light & Wonder. The company also develops and distributes mobile games, principally in the social casino niche. The more nascent iGaming business sits between these two businesses, providing digital content and capabilities to real-money gaming providers.

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.

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.

Liberty Media Corp along with its subsidiaries is engaged in the media and entertainment industries in North America and the United Kingdom. The company owns interests in a high-quality portfolio of assets across the media, entertainment and sports industries. The company derives its maximum revenue from United Kingdom.

Hithink RoyalFlush Information Network Co Ltd is engaged in providing Internet financial information services and online financial software. The company's business includes an online market trading system, mobile financial information service, fund sales, financial big data processing, and cloud services. It serves individuals, brokers, funds, private placements, banks, insurance, government, and research Institutional clients.