Quest Diagnostics Valuation Multiples

Eli Lilly is a drug firm with a focus on neuroscience, cardiometabolic, cancer, and immunology. Lilly's key products include Verzenio and Jaypirca for cancer; Mounjaro, Zepbound, Foundayo, Jardiance, Trulicity, Humalog, and Humulin for cardiometabolic; and Taltz and Olumiant for immunology.

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.

AbbVie is a pharmaceutical firm with a strong exposure to immunology (with Humira, Skyrizi, and Rinvoq) and oncology (with Imbruvica and Venclexta). The company was spun off from Abbott in early 2013. The 2020 acquisition of Allergan added several new products and drugs in aesthetics, including Botox. The 2024 acquisitions of Cerevel (neuroscience) and ImmunoGen (oncology) help supplement AbbVie's portfolio.

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.

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.

Merck makes pharmaceutical products to treat several conditions in a number of therapeutic areas, including cardiometabolic disease, cancer, and infections. Within cancer, the firm's immuno-oncology platform, led by Keytruda, is a major contributor to overall sales. The company also has a substantial vaccine business aimed at preventing pediatric diseases, as well as Gardasil for human papillomavirus. Additionally, Merck sells animal health-related drugs. From a geographical perspective, 47% of the company's sales are generated from US human health (pharmaceuticals and vaccines).

Novartis develops and manufactures innovative drugs. Key areas of drug development are oncology, immunology, neuroscience, and cardiovascular, renal, and metabolic. It also has an established medicines business, which includes off-patent franchises. The company sells its products globally, with the United States constituting close to one-third of total revenue.

AstraZeneca is a British-Swedish multinational pharmaceutical and biotechnology company headquartered on the Cambridge Biomedical Campus in Cambridge, England. It discovers, develops and sells prescription medicines and vaccines in oncology, cardiovascular, renal and metabolic disease, respiratory and immunology, and rare diseases, with medicines such as Tagrisso, Farxiga, Imfinzi, Calquence and Enhertu. The company earns revenue from branded drug sales to health systems worldwide, and in 2025 reported revenue of $58.7 billion, operating income of $13.7 billion and about 89,900 employees. It was formed on 6 April 1999 through the merger of Sweden's Astra AB and the UK's Zeneca Group, itself demerged from Imperial Chemical Industries in 1993. AstraZeneca is listed in London, Stockholm and New York and is led by chief executive Pascal Soriot. It has expanded through acquisitions including MedImmune, a majority stake in Acerta Pharma in 2016 and Alexion Pharmaceuticals in 2021.

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 2025 (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).

Amgen is a leader in biotechnology-based human therapeutics. Flagship drugs include red blood cell boosters Epogen and Aranesp, immune system boosters Neupogen and Neulasta, and Enbrel and Otezla for inflammatory diseases. Amgen introduced its first cancer therapeutic, Vectibix, in 2006 and markets bone-strengthening drugs Prolia/Xgeva (approved 2010) and Evenity (2019). The acquisition of Onyx Pharmaceuticals bolstered the firm's therapeutic oncology portfolio with Kyprolis. Recent launches include Repatha (cholesterol-lowering), Aimovig (migraine), Lumakras (lung cancer), and Tezspire (asthma). The 2023 Horizon acquisition brought several rare-disease drugs, including thyroid eye disease drug Tepezza. Amgen also has a growing biosimilar portfolio.

Siemens is a German industrial technology group headquartered in Munich that supplies automation, electrification, rail and healthcare equipment, software and services. It was founded in Berlin on October 1, 1847 by Werner von Siemens and Johann Georg Halske as Telegraphen-Bauanstalt von Siemens & Halske. The group reports through Digital Industries (factory automation and industrial software), Smart Infrastructure (buildings and electrical distribution), Siemens Mobility (rolling stock, signalling and rail systems) and Siemens Financial Services, and holds about 75% of separately listed Siemens Healthineers. It sells mainly to manufacturers, utilities, infrastructure owners, transit operators and hospitals, and in fiscal 2025 generated revenue of €78.9 billion and net income of €10.4 billion with about 327,000 employees. In 2020 it spun off Siemens Energy, keeping a 17.1% stake, and bought Varian Medical Systems for US$16.4 billion; in 2025 it added Altair Engineering for about US$10 billion, its largest acquisition, and Dotmatics for US$5.1 billion. Roland Busch has been chief executive since February 2021, and the shares trade on the Frankfurt Stock Exchange as a DAX member.

Gilead Sciences develops and markets therapies to treat and prevent life-threatening infectious diseases, with the core of its portfolio focused on HIV and hepatitis B and C. Gilead's acquisition of Pharmasset brought rights to hepatitis C drug Sovaldi, which is also part of newer combination regimens that remain standards of care. Gilead is also growing its presence in the oncology market via acquisitions, led by CAR-T cell therapy Yescarta/Tecartus (from Kite) and breast and bladder cancer therapy Trodelvy (from Immunomedics).

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.

With roughly one-third of the global branded diabetes treatment market, Novo Nordisk is the world's leading provider of diabetes care products. Based in Denmark, the company manufactures and markets a variety of human and modern insulins for patients with diabetes, as well as injectable and oral GLP-1 therapies, across its obesity and diabetes care segment. Novo also has a rare disease segment (contributing less than 10% of revenue) that specializes in protein therapies for hemophilia and other disorders.

Pfizer is one of the world's largest pharmaceutical firms, with annual sales of roughly $60 billion. While it historically sold many types of healthcare products and chemicals, now prescription drugs and vaccines account for the majority of sales. Top sellers include pneumococcal vaccine Prevnar 13 and cardiology drugs Vyndaqel and Eliquis. Pfizer sells these products globally, with international sales representing 40% of total sales. Within international sales, emerging markets are a major contributor.

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.

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.

Vertex Pharmaceuticals is a global biotechnology company that discovers and develops small-molecule drugs for the treatment of serious diseases. Its key drugs are Kalydeco, Orkambi, Symdeko, and Trikafta/Kaftrio, and Alyftrek for cystic fibrosis, where Vertex therapies remain the standard of care globally. Vertex has diversified its portfolio through Casgevy, a gene-editing therapy for beta thalassemia and sickle-cell disease, and Journavx, a non-opioid pain medication approved for the treatment of moderate-to-severe acute pain in adults. Additionally, Vertex is evaluating small-molecule inhibitors of APOL1-mediated kidney diseases. Vertex is also investigating cell therapies to deliver a potential functional cure for type 1 diabetes.

Bristol Myers Squibb discovers, develops, and markets drugs for various therapeutic areas, such as cardiovascular, cancer, and immune disorders. A key focus for Bristol is immuno-oncology, where the firm is a leader in drug development. Bristol derives close to 70% of total sales from the US, showing a higher dependence on the US market than most of its peer group.

Medtronic is a global medical-technology company founded in 1949 and legally headquartered in Ireland, with major operating leadership in Minnesota. It develops and manufactures therapeutic and diagnostic devices for cardiovascular disease, diabetes, neurological conditions, spinal disorders, surgical care and other chronic health problems. Products include pacemakers, defibrillators, transcatheter heart valves, stents, insulin pumps, ablation systems, patient-monitoring equipment and surgical tools. Hospitals, clinicians and healthcare systems buy the company's devices, disposable supplies, software and related services. Medtronic earns most of its revenue from product sales and serves customers across the Americas, Europe, Asia and other international markets. The company is publicly listed and maintains a large global research, manufacturing and commercial organization. Its cardiovascular strategy includes minority investments, partnerships and acquisitions of specialist medical-device developers. Medtronic invested in CathWorks, co-promoted its FFRangio system and completed the acquisition of the remaining shares for $585 million in April 2026.

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.

In the pharmaceutical industry, GSK ranks as one of the largest firms by total sales. The company wields its might across several therapeutic classes, including respiratory, antiviral, and vaccines, and has been growing its presence in oncology and immunology, as well. GSK uses joint ventures to gain additional scale in certain markets like HIV.

Sanofi develops and markets drugs with a concentration in immunology, vaccines, and rare diseases. Although the company offers a diverse array of drugs, its highest-revenue product, Dupixent, accounts for over 30% of total sales. Profits for this immunology blockbuster drug are shared with Regeneron. About 45% of total revenue comes from the United States, 20% from Europe, and 6% from China.

Moderna is a commercial-stage biotech that was founded in 2010 and had its initial public offering in December 2018. The firm's mRNA technology was rapidly validated with its covid vaccine, which was authorized in the United States in December 2020. Moderna had 35 mRNA development candidates in clinical studies as of August 2025. Programs span a wide range of therapeutic areas, including infectious disease, oncology, cardiovascular disease, and rare genetic diseases.

Japan Tobacco primarily sells cigarettes and reduced-risk products, organized in three clusters consisting of Asia (which includes its home market and countries in the Asia-Pacific), Western Europe, and EMA (which includes Eastern Europe, the Middle East, North Africa, Turkey, the Americas, and duty-free). Its leading cigarette brands include Winston (non-US), Camel (non-US), Mevius, and LD. Its reduced-risk brands include Logic in vaping, Ploom in heated tobacco, and Nordic Spirit in nicotine pouches, though these generate less than 5% of tobacco sales.

Regeneron Pharmaceuticals is a biotechnology company based in Tarrytown, New York, that discovers, develops and commercializes medicines for serious diseases. It was founded in 1988 by the physician-scientists Leonard Schleifer and George Yancopoulos, and its shares trade on the Nasdaq under the symbol REGN. Marketed products include Eylea and Eylea HD for eye disease, Libtayo for cancer, Praluent for cholesterol and Kevzara for rheumatoid arthritis, alongside Dupixent, which it develops with Sanofi. Total revenue in 2025 was $14.3 billion, made up of $6.3 billion of net product sales, $5.9 billion of Sanofi collaboration revenue and $1.4 billion of Bayer collaboration revenue, with net income of $4.5 billion. It employs more than 15,000 people. Its research rests on the VelociSuite antibody technologies and the Regeneron Genetics Center, which has sequenced more than 3 million exomes. In January 2025 it committed $119.5 million upfront to Truveta, whose Genome Project the Genetics Center will sequence exomes for.

Merck KGaA operates in three main segments: life science, electronics, and healthcare. The life science segment provides laboratory consumables and instruments to researchers in academia and applied fields, including the biopharmaceutical industry. The electronics segment offers specialty materials to manufacture a variety of products, such as semiconductors and flat-screen televisions. In the healthcare segment, Merck develops, manufactures, and sells branded pharmaceuticals with significant therapeutic concentrations in oncology, multiple sclerosis, and fertility. In 1995, the E. Merck family publicly sold part of the company, resulting in the current 30% public ownership of the firm.

Wuxi AppTec Co Ltd provides a portfolio of research and manufacturing services throughout the discovery, development, and manufacturing spectrum for small molecule drugs, development of computer software and databases as well as consulting services for combinatorial chemistry and pharmaceuticals. The services offered by the company include drug research and development testing, clinical research services, an end-to-end CRDMO platform for peptide, oligonucleotide, and small molecules, and integrated biology services and solutions for drug discovery. The company's reportable segments are WuXi Chemistry, which derives maximum revenue, WuXi Testing, WuXi Biology, and Others. Geographically, it derives key revenue from the United States of America, followed by China, Europe, and other regions.

Chugai Pharmaceutical is a Japanese drug developer and subsidiary of Roche Holding, which owns roughly 60% of the company. Founded in 1925, Chugai deals primarily in the Japanese market, where it generates roughly half of its revenue. It has been the leader in Japan’s oncology market for the past decade, largely due to drugs licensed from its parent’s portfolio. The company also develops its own innovative medicines. It is an industry leader in antibody technology with several flagship therapies, including Hemlibra for hemophilia A patients and Actemra for treating rheumatoid arthritis and covid patients.

Boston Scientific focuses on 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.

CSL is one of the largest global biotech companies and has three main segments. CSL Behring either uses plasma-derived proteins or recombinants to treat conditions including immunodeficiencies, bleeding disorders, and neurological indications. CSL Seqirus is the world’s second-largest influenza vaccination business and was acquired in fiscal 2016. CSL Vifor is an iron deficiency and nephrology business and was acquired in fiscal 2023. CSL has a strong R&D track record, and the product portfolio and pipeline include nonplasma products as the firm continues to broaden its scope. Originally formed in Australia as a government-owned entity, CSL now earns roughly half its revenue in North America and a quarter in Europe.

Takeda Pharmaceutical is Japan’s largest pharmaceutical company, with revenue of JPY 4.6 trillion in fiscal 2024. The company’s five core therapeutic areas are oncology, gastroenterology, neuroscience, rare diseases, and plasma-derived therapies, which account for more than 80% of revenue. Its geographic footprint is well diversified, with over 50% derived from the US, 20% from Japan, 20% from Europe and Canada. Takeda traces its operating history to a medicine wholesaler established in Osaka in 1781 and now maintains major research, manufacturing and commercial operations worldwide. It sells prescription medicines to health systems and patients, with product revenue funding internal research and external business development. The company completed its acquisition of TiGenix in July 2018 to add the approved cell therapy Alofisel and related development capabilities.

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.

Argenx is a Dutch biopharmaceutical company focused on developing antibody-based therapies for rare autoimmune diseases. The company’s lead product, Vyvgart (efgartigimod), was approved by the FDA in December 2021 for the treatment of generalized myasthenia gravis (gMG). In 2022, Argenx also received FDA approval for Vyvgart Hytrulo, a subcutaneous formulation of Vyvgart, offering a more convenient option compared with Vyvgart’s intravenous administration. In 2024, the FDA approved Vyvgart Hytrulo for Chronic Inflammatory Demyelinating Polyneuropathy, a rare immune-mediated neuromuscular disorder of the peripheral nervous system. Argenx is focused on innovation and developing its pipeline for treatments such as primary immune thrombocytopenia, thyroid eye disease, and Sjogren's Disease.

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.

Lonza Group is a contract development and manufacturing organization. It operates under four segments: small molecules, biologics, cell and gene, and capsules and health ingredients. Lonza derives its revenue primarily from long-term supply agreements with pharmaceutical customers. The company provides development and manufacturing services throughout the entire lifecycle of a product, from drug research to commercial supply. The majority of Lonza's customers are pharmaceutical and biotechnology companies, academic institutions, and government research organizations.

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.

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.

Galderma was formed in 1981 as a joint venture between Nestle and L’Oreal. It subsequently became a subsidiary of Nestle, called Nestle Skin Health, before being carved out and launched as a stand-alone company in 2019, acquired by a consortium led by Sweden-based EQT fund. The company went public in March 2024 and is listed on the SIX Swiss exchange. Galderma’s science-based portfolio spans multiple dermatology categories, including injectable aesthetics, dermatological skincare, and therapeutic dermatology. It derives around 40% of net sales from the US and employs around 7,00 people.

Bayer AG is a German life-sciences group founded in 1863 and headquartered in Leverkusen. It is publicly listed and operates pharmaceuticals, consumer-health and crop-science businesses. Its healthcare operations develop, manufacture and commercialise prescription medicines and consumer products globally. Bayer announced an agreement in December 2024 to acquire HiDoc Technologies and its Cara Care digital application for irritable bowel syndrome. The transaction supported Bayer Consumer Health’s precision-health strategy and expanded its digital care offering. Cara Care was expected to remain available through Germany’s reimbursed digital-health system following completion. Bayer earns revenue principally from product sales and related healthcare businesses.

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.

Teva Pharmaceutical, based in Israel, is the world's leading generic drug manufacturer. Teva derives half of its sales from North America and makes up a high-single-digit percentage of the total number of generic prescriptions in the US. It also has a significant presence in Europe, Japan, Russia, and Israel. Besides generics, Teva has a portfolio of innovative medicines and biosimilars in two main therapeutic areas: neurology and immunology. Teva also sells active pharmaceutical ingredients, offers contract manufacturing services, and owns Anda, a US-based generic and specialty drug distributor.

Jiangsu Hengrui Pharmaceuticals Co Ltd is a biopharmaceutical company that engages in the research, development, manufacture, and sale of drugs. It is engaged in the field of cancer treatment drugs, surgical medicines, endocrine therapy drugs, cardiovascular drugs, and anti-infection medications. The company specializes in the research and development of new medicines in areas of antineoplastics, endocrine system, cardiovascular, and the immune system. Geographically, the company is segmented as Chinese mainland and Other countries generating majority revenue from the Chinese region.

Samsung BioLogics Co Ltd is a biopharmaceutical company engaged in drug development and manufacturing services. The company operates two segments: Biopharmaceutical Development and Commercialization, and Contract Development and Manufacturing Organization (CDMO). The Biopharmaceutical Development and Commercialization segment focuses on developing and commercializing biosimilars across therapeutic areas, including autoimmune, oncology, ophthalmology, and hematology. The Contract Development and Manufacturing Organization (CDMO) segment provides biopharmaceutical contract manufacturing along with cell line and process development services. It generates the majority of its revenue from the CDMO segment.

Sun Pharmaceuticals Industries Ltd is India's generic pharmaceutical manufacturing company. The company’s substantial markets are the U.S. and India to make up the majority of revenue. The remaining is spread across both emerging and developed markets. In addition to generics, the company also produces and distributes name-brand formulas to specific geographies. It maintains manufacturing and research and development facilities globally to serve its markets but is majorly based in India.

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.

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.

Haleon is one of the largest consumer health companies in the world. Formed by a combination of consumer health divisions of GSK, Pfizer, and Novartis, Haleon separated from GSK and went public in July 2022. The firm generates 60% of sales from global power brands including Sensodyne, Advil, Centrum, and Poligrip, that play in many geographies and are often leaders in their respective categories. It also has a number of local brands, including Emergen-C, Eno, Tums, and Caltrate, that are more tailored to regional needs and have strong local brand equity. Overall, Haleon’s brands tackle a variety of silos within consumer health including oral care, digestive health, pain relief, and nutrition.