Medical Devices & Equipment

4543 Terumo

Revenue is Cardiac and Vascular Company (60%), Blood and Cell Technologies Company (20%) and Medical Care Solutions Company (19%).

Owner earnings 2018–2026 ¥82.7B¥54.2B¥55.2B¥59.2B¥88.0B¥64.8B¥85.6B¥142.2B¥145.6B

Retained capital Retained ¥542.0B of earnings over 2018–2026; annual owner earnings grew ¥60.4B, ¥0.11 per ¥1 retained.

Balance sheet Modest net debt, ¥99.3B · dividend paid 9 of 9 yrs, never cut

7733 Olympus

Revenue is Gastrointestinal Solutions (69%) and Surgical and Interventional Solutions (31%).

Owner earnings 2018–2026 ¥46.3B¥19.8B¥95.8B¥85.5B¥128.0B¥50.9B(¥4.1B)¥144.5B¥45.0B

Retained capital Retained ¥171.4B of earnings over 2018–2026; annual owner earnings grew ¥7.8B, ¥0.05 per ¥1 retained.

Balance sheet Modest net debt, ¥51.5B · dividend paid 9 of 9 yrs, never cut

7741 Hoya

A diversified business; where the profit really comes from, and whether it is earned or bought, is what the segment detail settles.

Owner earnings 2018–2026 ¥117.5B¥119.9B¥129.0B¥120.6B¥161.2B¥168.4B¥181.7B¥187.2B¥221.9B

Retained capital Retained ¥168.1B of earnings over 2018–2026; annual owner earnings grew ¥74.8B, ¥0.44 per ¥1 retained.

Balance sheet net position not read (debt under-captured) · dividend paid 9 of 9 yrs, never cut

ALC Alcon Inc.

This report outlines Alcon's overall 2025 compensation framework and philosophy for the members of the Board as well as for the members of the Executive Committee of Alcon and provides a general outlook for our 2026 compensation structure.

Owner earnings 2010–2025 $2.2B$1.1B$994M$767M$684M$1.2B$1.0B$1.2B$1.9B$2.1B

Retained capital Retained $2.4B of earnings over 2010–2025; annual owner earnings grew $298M, $0.12 per $1 retained.

Balance sheet Modest net debt, $2.7B · dividend paid 6 of 10 yrs, cut at least once

ALGN Align Technology

Align TM Digital Platform is an end-to-end digital platform that combines software, systems and services designed to provide a seamless experience and end-to-end workflow that integrates and connects those critical to successful treatment outcomes doctors, labs, patients and consumers.

Owner earnings 2016–2025 $224M$401M$500M$668M$569M$1.1B$443M$608M$623M$491M

Retained capital Retained $2.3B of earnings over 2016–2025; annual owner earnings grew $199M, $0.09 per $1 retained.

Balance sheet Net cash, debt-free, +$1.4B

ANGO AngioDynamics Inc.

AngioDynamics was founded in Queensbury, N.Y., U.S., in 1988 and began manufacturing and shipping product in the early 1990s.

Owner earnings 2017–2026 $53M$39M$34M($22M)$19M($11M)($4M)($31M)($15M)$508K

Retained capital Paid out $465M more than it earned over 2017–2026; annual owner earnings fell $57M.

Balance sheet Net cash, debt-free, +$68M

AORT Artivion Inc.

Artivion Inc. markets, Products, Services, and Competition Our medical devices and preservation services are primarily used by cardiac and vascular surgeons to treat patients with aortic disease, including heart valve disease, aortic aneurysms and dissections, and, to a lesser extent, other conditions in cardiac and vascular surgery.

Owner earnings 2016–2025 $14M$4M$4M$8M$5M($16M)($16M)$9M$11M$17M

Retained capital Paid out $72M more than it earned over 2016–2025; annual owner earnings grew $5M.

Balance sheet Heavy net debt, $150M

APT Alpha Pro Tech Ltd.

Alpha Pro Tech Ltd. is the parent company of Alpha Pro Tech, Inc. and Alpha ProTech Engineered Products, Inc.

Owner earnings 2017–2025 $3M$1M$2M$18M($1M)$4M$8M$5M$2M

Retained capital Retained $25M of earnings over 2017–2025; annual owner earnings grew $2M, $0.09 per $1 retained.

Balance sheet Net cash, debt-free, +$17M · buybacks at an average near $4.76

ATEC Alphatec Holdings

We are a medical technology company, headquartered in Carlsbad, California, focused on the design, development, and advancement of technology for better surgical treatment of spine disorders.

Owner earnings 2016–2025 ($19M)($16M)($32M)($41M)($57M)($100M)($125M)($135M)($128M)$3M

Retained capital not read

Balance sheet Net debt against an operating loss, $405M

ATRC AtriCure

AtriCure market Overview Afib is the most commonly diagnosed sustained cardiac arrhythmia, with over one million diagnoses annually in the United States alone.

Owner earnings 2016–2025 ($23M)($15M)($10M)($23M)($25M)($21M)($30M)($5M)$745K$48M

Retained capital not read

Balance sheet Net cash, +$99M

AVNS Avanos Medical Inc.

Avanos Medical, Inc. is a medical technology company focused on delivering clinically superior medical device solutions that help patients get back to the things that matter.

Owner earnings 2016–2025 $160M$101M($179M)($111M)($23M)$66M$72M$15M$83M$43M

Retained capital Paid out $469M more than it earned over 2016–2025; annual owner earnings grew $20M.

Balance sheet Net debt against an operating loss, $158M · no dividend paid

AVR Anteris Technologies Global Corp.

Anteris is a structural heart company dedicated to revolutionizing cardiac care by pioneering science-driven and measurable advancements to restore heart valve patients to healthy function.

Owner earnings 2024–2025 ($63M)($80M)

Retained capital not read

Balance sheet Net cash, +$13M

AXGN Axogen Inc.

We are the leading company focused specifically on the science, development, and commercialization of technologies for peripheral nerve regeneration and repair.

Owner earnings 2016–2025 ($12M)($10M)($19M)($21M)($11M)($16M)($19M)($10M)$1M($3M)

Retained capital not read

Balance sheet Net debt against an operating loss, $9M

BAX Baxter International Inc.

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2016–2025 $935M$1.1B$1.4B$1.4B$1.2B$1.5B$834M$1.3B$573M$332M

Retained capital Paid out $1.1B more than it earned over 2016–2025; annual owner earnings fell $397M.

Balance sheet Net debt against an operating loss, $2.4B · buybacks at an average near $69.72 · dividend paid 10 of 10 yrs, cut at least once

BBNX Beta Bionics Inc.

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2023–2025 ($33M)($49M)($52M)

Retained capital not read

Balance sheet Net cash, debt-free, +$219M

BDMD Baird Medical Investment Holdings Ltd

We have identified the relevant risk characteristics of its customers and the related receivables and other receivables which include size, type of the products we provide, or a combination of these characteristics.

Owner earnings 2022–2025 ($5M)($4M)($9M)($1M)

Retained capital not read

Balance sheet Net debt against an operating loss, $9M

BDX Becton Dickinson and Company

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2016–2025 $1.9B$1.8B$2.0B$2.4B$2.8B$3.5B$1.5B$2.1B$3.1B$2.7B

Retained capital Paid out $454M more than it earned over 2016–2025; annual owner earnings grew $749M.

Balance sheet Heavy net debt, $18.5B · dividend paid 10 of 10 yrs, never cut

BFLY Butterfly Network Inc.

Butterfly is the pioneer of the Ultrasound-on-Chip semiconductor platform and a leader in semiconductor-based point-of-care ultrasound technology.

Owner earnings 2019–2025 ($121M)($83M)($191M)($175M)($105M)($44M)($16M)

Retained capital not read

Balance sheet Net cash, debt-free, +$226M

BLCO Bausch + Lomb Corporation

Revenue is Vision Care (57%), Pharmaceuticals (25%) and Surgical (18%).

Owner earnings 2020–2025 $269M$680M$170M($198M)($59M)($66M)

Retained capital Paid out $767M more than it earned over 2020–2025; annual owner earnings fell $481M.

Balance sheet Heavy net debt, $4.7B

BLFS BioLife Solutions Inc.

We are a life sciences company that develops, manufactures, and markets bioproduction products and services which are designed to improve quality and de-risk biologic manufacturing, distribution, and transportation in the cell and gene therapy industry.

Owner earnings 2017–2025 $461K$2M$538K$5M($9M)($15M)($19M)$5M$18M

Retained capital Paid out $269M more than it earned over 2017–2025; annual owner earnings grew $393K.

Balance sheet Net cash, +$28M

BSX Boston Scientific Corporation

Boston Scientific makes the tools and implants that physicians use inside the body during minimally-invasive procedures — devices that open and treat blood vessels, that pace and manage the heart's rhythm, and instruments used in endoscopy, urology, and the stimulation of nerves. The buyers are hospitals and the physicians who perform the procedures, not patients directly. Many of the products are single-use or are left in the body, so each procedure consumes the device and the next one requires a fresh purchase.

Owner earnings 2016–2025 $806M$1.1B($6M)$1.4B$1.1B$1.3B$938M$1.8B$2.6B$3.7B

Retained capital Retained $14.0B of earnings over 2016–2025; annual owner earnings grew $2.1B, $0.15 per $1 retained.

Balance sheet Meaningful net debt, $9.2B · dividend paid 4 of 10 yrs, cut at least once

BVS Bioventus Inc.

We are a global medical device company focused on helping patients recover and live life to the fullest by relieving pain and addressing musculoskeletal challenges through a diverse portfolio of high-quality, innovative, and clinically-proven solutions.

Owner earnings 2019–2025 $38M$55M$9M($15M)$8M$38M$72M

Retained capital Paid out $286M more than it earned over 2019–2025; annual owner earnings grew $5M.

Balance sheet Heavy net debt, $243M

BWAY BrainsWay Ltd.

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2017–2021 ($4M)($4M)($8M)($2M)$324K

Retained capital not read

Balance sheet Net cash, +$66M

CBLL CeriBell Inc.

We are a medical technology company focused on transforming the diagnosis and management of patients with serious neurological conditions.

Owner earnings 2023–2025 ($30M)($36M)($42M)

Retained capital not read

Balance sheet Net cash, +$139M

CDRE Cadre Holdings Inc.

We are a global leader in the manufacturing and distribution of safety equipment and other related products for the law enforcement, first responder, military and nuclear markets.

Owner earnings 2020–2025 $41M$37M$42M$66M$26M$57M

Retained capital Retained $110M of earnings over 2020–2025; annual owner earnings grew $10M, $0.09 per $1 retained.

Balance sheet Meaningful net debt, $184M · dividend paid 5 of 6 yrs, cut at least once

CERS Cerus Corporation

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2016–2025 ($54M)($53M)($32M)($68M)($43M)($35M)($28M)($46M)$10M$3M

Retained capital not read

Balance sheet Net debt against an operating loss, $35M

CLPT ClearPoint Neuro Inc.

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2016–2025 ($6M)($6M)($5M)($3M)($8M)($13M)($16M)($14M)($9M)($24M)

Retained capital not read

Balance sheet Net debt against an operating loss, $3M

CNMD CONMED

CONMED is a medical technology company that provides devices and equipment for surgical procedures.

Owner earnings 2016–2025 $25M$53M$58M$75M$52M$97M$17M$106M$154M$151M

Retained capital Retained $142M of earnings over 2016–2025; annual owner earnings grew $92M, $0.65 per $1 retained.

Balance sheet Heavy net debt, $794M · dividend paid 10 of 10 yrs, never cut

COO The Cooper Companies Inc.

Cooper sells products in over 130 countries and positively impacts over fifty million lives each year.

Owner earnings 2016–2025 $357M$466M$475M$421M$337M$524M$450M$215M$288M$434M

Retained capital Retained $5.2B of earnings over 2016–2025; annual owner earnings fell $121M, $-0.02 per $1 retained.

Balance sheet Meaningful net debt, $2.4B · buybacks at an average near $72.76 · dividend paid 8 of 10 yrs, cut at least once

CV CapsoVision Inc.

We are a global commercial-stage medical technology company focused on creating diagnostic and screening products to identify abnormalities of the GI tract.

Owner earnings 2024–2025 ($20M)($23M)

Retained capital not read

Balance sheet net position not read

DCTH Delcath Systems Inc.

We are an interventional oncology company focused on the treatment of cancers primary or metastatic to the liver.

Owner earnings 2021–2025 ($23M)($25M)($31M)($19M)$22M

Retained capital not read

Balance sheet Net cash, +$38M

DRIO DarioHealth Corp.

We are a vertically integrated health intelligence platform with a mission to power the behavior changes that drive better health.

Owner earnings 2016–2025 ($9M)($11M)($12M)($16M)($18M)($51M)($48M)($31M)($39M)($26M)

Retained capital not read

Balance sheet Net debt against an operating loss, $14M

DXCM DexCom Inc.

We are a medical device company primarily focused on the design, development and commercialization of continuous glucose monitoring, or CGM, systems for the management of diabetes and metabolic health by patients, caregivers, and clinicians around the world.

Owner earnings 2016–2025 $41M$76M$94M$266M$409M$341M$514M$563M$772M$1.2B

Retained capital Retained $324M of earnings over 2016–2025; annual owner earnings grew $771M, $2.38 per $1 retained.

Balance sheet Modest net debt, $231M · buybacks at an average near $85.97

ELMD Electromed Inc.

Electromed Inc. develops, manufactures, markets and sells innovative products that provide airway clearance therapy, including the SmartVest Airway Clearance System to patients with compromised pulmonary function with a commitment to excellence and compassionate service.

Owner earnings 2016–2025 $2M$572K$2M$2M$4M$3M($1M)$765K$9M$11M

Retained capital Retained $20M of earnings over 2016–2025; annual owner earnings grew $6M, $0.28 per $1 retained.

Balance sheet Net cash, +$14M

ENOV Enovis Corporation

Enovis associates in every business develop strategic and operating plans that are based on the principle of the Voice of the Customer .

Owner earnings 2017–2025 $150M$157M$6M$187M$252M($161M)$13M($67M)$20M

Retained capital Paid out $2.4B more than it earned over 2017–2025; annual owner earnings fell $116M.

Balance sheet Net debt against an operating loss, $1.3B

ESTA Establishment Labs Holdings Inc.

We are a global medical technology company focused on improving patient safety and aesthetic outcomes, initially in the breast aesthetics and reconstruction market.

Owner earnings 2017–2025 ($33M)($35M)($32M)($14M)($30M)($55M)($91M)($63M)($57M)

Retained capital not read

Balance sheet Net debt against an operating loss, $172M

EW Edwards Lifesciences Corporation

Edwards Lifesciences Corporation is the leading global structural heart innovation company, driven by a passion to improve patient lives.

Owner earnings 2016–2025 $633M$919M$849M$1.1B$947M$1.6B$1.1B$751M$387M$1.4B

Retained capital Retained $5.1B of earnings over 2016–2025; annual owner earnings grew $58M, $0.01 per $1 retained.

Balance sheet Net cash, +$3.6B

FOCL EDAP TMS S.A.

EDAP TMS S.A. is a medical technology company focused on the development, manufacturing, marketing, and sale of non-invasive therapeutic ultrasound and energy-based medical devices.

Owner earnings 2024–2025 ($16M)($18M)

Retained capital not read

Balance sheet Net cash, +$2M

GEHC GE Healthcare Technologies Inc.

GE Healthcare Technologies Inc. is a leading global healthcare solutions provider of advanced medical technology, pharmaceutical diagnostics, and AI, cloud and software solutions that help clinicians tackle the world's most complex diseases.

Owner earnings 2021–2025 $1.4B$1.8B$1.7B$1.6B$1.5B

Retained capital Retained $9.4B of earnings over 2021–2025; annual owner earnings fell $41M, $-0.00 per $1 retained.

Balance sheet Modest net debt, $5.5B · buybacks at an average near $71.43 · dividend paid 3 of 5 yrs, never cut

GKOS Glaukos Corporation

Revenue is Glaucoma (83%) and Corneal Health (17%).

Owner earnings 2016–2025 $8M$20M$13M($5M)($30M)($5M)($63M)($78M)($68M)($22M)

Retained capital not read

Balance sheet Net debt against an operating loss, $192M

GMED Globus Medical

Medical device company that develops and commercializes healthcare solutions whose mission is to improve the quality of life of patients with musculoskeletal disorders.

Owner earnings 2016–2025 $107M$108M$140M$119M$135M$219M$104M$165M$405M$589M

Retained capital Retained $868M of earnings over 2016–2025; annual owner earnings grew $268M, $0.31 per $1 retained.

Balance sheet Net cash, +$140M · buybacks at an average near $44.38

HAE Haemonetics

Haemonetics is a global medical technology company dedicated to improving the quality, effectiveness and efficiency of health care.

Owner earnings 2017–2026 $84M$146M$40M$109M$72M$76M$180M$144M$142M$260M

Retained capital Paid out $138M more than it earned over 2017–2026; annual owner earnings grew $92M.

Balance sheet Heavy net debt, $979M · buybacks at an average near $74.48

HOLX Hologic

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2016–2025 $751M($50M)$675M$593M$798M$2.2B$2.1B$959M$1.2B$998M

Retained capital Retained $2.3B of earnings over 2016–2025; annual owner earnings grew $598M, $0.26 per $1 retained.

Balance sheet Modest net debt, $316M · buybacks at an average near $110

HTFL Heartflow Inc.

We provide software and artificial intelligence designed to deliver a more accurate and clinically effective non-invasive solution for diagnosing and managing coronary artery disease, a leading cause of death worldwide.

Owner earnings 2023–2025 ($81M)($73M)($59M)

Retained capital not read

Balance sheet Net cash, debt-free, +$177M

IART Integra Lifesciences Holdings Corp

Integra LifeSciences Holdings Corporation is a global medical technology company dedicated to restoring lives.

Owner earnings 2016–2025 $69M$71M$122M$162M$165M$264M$222M$99M$87M$6M

Retained capital Paid out $275M more than it earned over 2016–2025; annual owner earnings fell $23M.

Balance sheet Net debt against an operating loss, $1.5B · buybacks at an average near $47.62

ICUI ICU Medical

ICU develops, manufactures and sells innovative medical products used in infusion therapy, vascular access, and vital care applications.

Owner earnings 2016–2025 $67M$80M$67M$25M$131M$199M($152M)$82M$125M$92M

Retained capital Retained $122M of earnings over 2016–2025; annual owner earnings grew $28M, $0.23 per $1 retained.

Balance sheet Heavy net debt, $962M

INMD InMode Ltd.

Revenue is Capital Equipment (78%) and Consumables and Service Revenues (22%).

Owner earnings 2017–2025 $14M$37M$62M$79M$174M$181M$176M$132M$85M

Retained capital Retained $459M of earnings over 2017–2025; annual owner earnings grew $93M, $0.20 per $1 retained.

Balance sheet Net cash, debt-free, +$386M

INSP Inspire Medical Systems

We are a medical technology company focused on the development and commercialization of innovative, minimally invasive solutions for patients with obstructive sleep apnea.

Owner earnings 2016–2025 ($18M)($16M)($19M)($33M)($54M)($21M)$10M$22M$124M$103M

Retained capital Paid out $232M more than it earned over 2016–2025; annual owner earnings grew $101M.

Balance sheet Net cash, +$284M

IRMD iRadimed Corporation

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2016–2025 $9M$3M$7M$10M$5M$11M$9M$13M$25M$24M

Retained capital Retained $40M of earnings over 2016–2025; annual owner earnings grew $14M, $0.36 per $1 retained.

Balance sheet Net cash, debt-free, +$59M · dividend paid 4 of 10 yrs, never cut

IRTC iRhythm Technologies

IRhythm is a leading digital healthcare company that creates trusted solutions that detect, predict, and prevent disease.

Owner earnings 2016–2025 ($17M)($17M)($31M)($25M)($21M)($48M)($36M)($66M)($17M)$60M

Retained capital not read

Balance sheet Net debt against an operating loss, $66M

ISRG Intuitive Surgical Inc.

Intuitive Surgical makes robotic-assisted systems that let a surgeon operate through small incisions while seated at a console, sold mainly to hospitals under the da Vinci and Ion names. It places the system once, then sells the instruments and accessories that each procedure consumes, plus service contracts and surgeon training. Most of its revenue comes not from the systems themselves but from those per-procedure instruments and accessories — the placed system is the razor, and every operation sells the blades.

Owner earnings 2016–2025 $1.0B$1.1B$1.1B$1.4B$1.3B$1.7B$1.2B$1.4B$2.0B$2.5B

Retained capital Retained $6.9B of earnings over 2016–2025; annual owner earnings grew $913M, $0.13 per $1 retained.

Balance sheet Net cash, debt-free, +$5.9B · buybacks at an average near $117

ITGR Integer Holdings

Integer Holdings Corporation, headquartered in Plano, Texas, is one of the world's largest medical device contract development and manufacturing organizations, serving the Cardio and Vascular, Neuromodulation, and Cardiac Rhythm Management markets.

Owner earnings 2016–2025 $47M$102M$122M$117M$135M$103M$42M$60M$100M$105M

Retained capital Retained $841M of earnings over 2016–2025; annual owner earnings fell $2M, $-0.00 per $1 retained.

Balance sheet Heavy net debt, $1.2B

KIDS OrthoPediatrics Corp.

OrthoPediatrics Corp. is a Delaware corporation, headquartered in Warsaw, Indiana, and organized in November 2007.

Owner earnings 2016–2025 ($3M)($10M)($18M)($22M)($27M)($21M)($32M)($44M)($41M)($16M)

Retained capital not read

Balance sheet Net debt against an operating loss, $41M

KMTS Kestra Medical Technologies Ltd.

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2024–2026 ($84M)($86M)($90M)

Retained capital not read

Balance sheet Net cash, +$154M

LIVN LivaNova PLC

LivaNova PLC is a market-leading global medical technology company.

Owner earnings 2016–2025 $52M$58M$83M($116M)($114M)$77M$43M$50M$158M$226M

Retained capital Paid out $1.3B more than it earned over 2016–2025; annual owner earnings grew $80M.

Balance sheet Net cash, +$259M · buybacks at an average near $69.95

LMAT LeMaitre Vascular Inc.

We are a global provider of medical devices and human tissue cryopreservation services largely used in the treatment of peripheral vascular disease, end-stage renal disease, and cardiovascular disease.

Owner earnings 2016–2025 $14M$19M$16M$10M$32M$30M$22M$29M$37M$74M

Retained capital Retained $168M of earnings over 2016–2025; annual owner earnings grew $31M, $0.18 per $1 retained.

Balance sheet Meaningful net debt, $140M · buybacks at an average near $42.77 · dividend paid 10 of 10 yrs, never cut

MASI Masimo

The Masimo Hospital Automation Platform facilitates data integration, connectivity and interoperability through solutions like Patient SafetyNet , Iris , iSirona , Replica and UniView to facilitate more efficient clinical workflows and to help clinicians provide the best possible care, both in-person and remotely.

Owner earnings 2015–2026 $83M$399M$36M$222M$198M$182M($23M)$56M$175M$198M

Retained capital Paid out $262M more than it earned over 2015–2026; annual owner earnings fell $30M.

Balance sheet Modest net debt, $372M · buybacks at an average near $88.35 · no dividend paid

MBOT Microbot Medical Inc.

A medical-device business, placing equipment that pulls consumables and service behind it.

Owner earnings 2009–2015 ($25M)($25M)($22M)($20M)($28M)($28M)($767K)

Retained capital not read

Balance sheet Net cash, +$78M

MDLN Medline Inc.

Medline Inc. is the largest provider of medical-surgical products and supply chain solutions serving all points of care, based on total net sales of med-surg products.

Owner earnings 2023–2025 $1.4B$1.4B$1.3B

Retained capital not read

Balance sheet Heavy net debt, $10.6B

MDT Medtronic plc.

Medtronic makes medical devices and therapies — the equipment surgeons and physicians implant in patients or use to treat them. It sells mainly to hospitals and clinics, and gets paid when a device is bought and used in a procedure. The patient needs the treatment, but the customer writing the check is the health system, often buying through a purchasing group.

Owner earnings 2017–2026 $5.6B$3.6B$5.9B$6.0B$4.9B$6.0B$4.6B$5.2B$5.2B$5.4B

Retained capital Paid out $9.5B more than it earned over 2017–2026; annual owner earnings grew $232M.

Balance sheet Meaningful net debt, $17.0B · buybacks at an average near $97.65 · dividend paid 10 of 10 yrs, never cut

MDXG MiMedx Group Inc

MIMEDX provides a leading portfolio of products for applications in the wound care, burn, and surgical sectors of healthcare.

Owner earnings 2016–2025 $21M$59M$30M($41M)($34M)($5M)($19M)$25M$65M$73M

Retained capital Paid out $28M more than it earned over 2016–2025; annual owner earnings grew $18M.

Balance sheet Net cash, +$148M · buybacks at an average near $11.43

MMED MiniMed Group Inc.

We are a scaled global medical technology company that develops, manufactures, and markets a comprehensive suite of solutions for the management of diabetes.

Owner earnings 2024–2026 ($107M)($3M)($353M)

Retained capital not read

Balance sheet Net cash, debt-free, +$298M

MMM 3M Company

3M is a diversified manufacturer that turns coatings, adhesives, abrasives and related materials science into tens of thousands of small products — tapes, films, abrasives, filters, respirators, medical supplies, and consumer staples like Post-it notes and Scotch tape. It sells through industrial distributors, retailers and healthcare channels to customers across factories, hospitals, offices and homes, mostly in modest repeat purchases rather than big-ticket sales. The money comes from making a specialty input that a buyer specifies into a product or process and then keeps reordering.

Owner earnings 2016–2025 $5.2B$4.9B$4.9B$5.4B$6.6B$5.9B$3.8B$5.1B$638M$1.4B

Retained capital Paid out $12.9B more than it earned over 2016–2025; annual owner earnings fell $2.6B.

Balance sheet Modest net debt, $7.0B · buybacks at an average near $168 · dividend paid 10 of 10 yrs, cut at least once

MMSI Merit Medical Systems

Merit Medical Systems, Inc. is a leading manufacturer and marketer of proprietary medical devices used in interventional, diagnostic and therapeutic procedures, particularly in cardiology, radiology, oncology, critical care and endoscopy.

Owner earnings 2016–2025 $21M$24M$23M($360K)$119M$119M$69M$111M$186M$216M

Retained capital Retained $551M of earnings over 2016–2025; annual owner earnings grew $148M, $0.27 per $1 retained.

Balance sheet Modest net debt, $299M

MSA MSA Safety Incorporated

MSA Safety Incorporated is the global leader in advanced safety products, technology and solutions.

Owner earnings 2016–2025 $109M$207M$230M$128M$158M$155M$115M$50M$242M$295M

Retained capital Retained $664M of earnings over 2016–2025; annual owner earnings grew $14M, $0.02 per $1 retained.

Balance sheet Modest net debt, $416M · dividend paid 10 of 10 yrs, never cut

NNOX NANO-X IMAGING LTD

Revenue is Radiology Services (89%), AI Solutions (7%) and Nanox ARC (4%).

Owner earnings 2018–2025 ($4M)($6M)($22M)($39M)($44M)($46M)($38M)($42M)

Retained capital not read

Balance sheet Net cash, +$61M

NPCE Neuropace Inc.

We are a medical device company focused on transforming the lives of people living with epilepsy by reducing or eliminating the occurrence of debilitating seizures.

Owner earnings 2020–2025 ($22M)($25M)($37M)($20M)($18M)($11M)

Retained capital not read

Balance sheet Net cash, +$2M

NSPR InspireMD Inc.

We are a medical device company specializing in the development and commercialization of products for the treatment of carotid artery disease and other vascular conditions.

Owner earnings 2015–2025 ($12M)($8M)($8M)($10M)($9M)($13M)($16M)($17M)($23M)($37M)

Retained capital not read

Balance sheet Net cash, +$49M

NVCR NovoCure

We are a global oncology company with a proprietary platform technology called Tumor Treating Fields, which are electric fields that exert physical forces to kill cancer cells.

Owner earnings 2016–2025 ($113M)($41M)($9M)$16M$90M$73M$20M($84M)($38M)($64M)

Retained capital not read

Balance sheet Net debt against an operating loss, $101M

NVST Envista Holdings

Envista is a global family of more than 30 trusted dental brands, including Nobel Biocare, Ormco, DEXIS, and Kerr, united by a shared purpose: to partner with professionals to improve lives.

Owner earnings 2017–2025 $310M$328M$320M$236M$307M$107M$218M$303M$230M

Retained capital Retained $195M of earnings over 2017–2025; annual owner earnings fell $69M, $-0.36 per $1 retained.

Balance sheet Modest net debt, $237M

OFIX Orthofix Medical Inc. Common Stock (DE)

Orthofix is a global medical technology company headquartered in Lewisville, Texas.

Owner earnings 2016–2025 $43M$24M$36M$13M$59M$690K($33M)($106M)($9M)($1M)

Retained capital Paid out $494M more than it earned over 2016–2025; annual owner earnings fell $73M.

Balance sheet Net debt against an operating loss, $75M · buybacks at an average near $41.06

OMCL Omnicell

Omnicell is focused on helping its customers define and deliver a cost-effective medication management strategy designed to equip and empower pharmacists and nurses to focus on patient care rather than administrative tasks, and to drive improved clinical, operational, and financial outcomes across all care settings.

Owner earnings 2016–2025 $36M$9M$80M$129M$163M$203M$30M$140M$151M$87M

Retained capital Retained $66M of earnings over 2016–2025; annual owner earnings grew $84M, $1.26 per $1 retained.

Balance sheet Net cash, +$29M

PEN Penumbra

Penumbra, the world's leading thrombectomy company, is focused on developing the most innovative technologies for challenging medical conditions such as ischemic stroke, venous thromboembolism such as pulmonary embolism, and acute limb ischemia.

Owner earnings 2016–2025 ($15M)$9M$23M$19M($46M)($7M)($75M)$82M$147M$221M

Retained capital Retained $244M of earnings over 2016–2025; annual owner earnings grew $145M, $0.59 per $1 retained.

Balance sheet Net cash, debt-free, +$382M · buybacks at an average near $194

PHG KONINKLIJKE PHILIPS NV

Revenue is led by Diagnosis & Treatment (48%) and Connected Care (28%), with 2 more segments behind.

Owner earnings 2016–2025 €810M€1.4B€1.4B€1.3B€2.0B€1.2B(€617M)€1.8B€1.3B€903M

Retained capital Paid out €1.7B more than it earned over 2016–2025; annual owner earnings grew €109M.

Balance sheet Meaningful net debt, €4.2B · dividend paid 10 of 10 yrs, cut at least once

PLSE Pulse Biosciences Inc Common Stock (DE)

We expect to pursue more clinical evidenced-based milestones in connection with the limited market release of our percutaneous electrodes.

Owner earnings 2020–2025 ($36M)($55M)($47M)($33M)($36M)($54M)

Retained capital not read

Balance sheet Net cash, debt-free, +$89M

PODD Insulet Corporation

Insulet Corporation is primarily engaged in the development, manufacture, and sale of its proprietary continuous insulin delivery systems for people with insulin-dependent diabetes.

Owner earnings 2016–2025 $2M$27M$20M$71M$29M($126M)$56M$70M$349M$479M

Retained capital Retained $800M of earnings over 2016–2025; annual owner earnings grew $283M, $0.35 per $1 retained.

Balance sheet Modest net debt, $502M

PRCT PROCEPT BioRobotics Corporation

We are a surgical robotics company focused on advancing patient care by developing transformative solutions in urology.

Owner earnings 2020–2025 ($49M)($58M)($83M)($112M)($104M)($55M)

Retained capital not read

Balance sheet Net cash, +$235M

PROF Profound Medical Corp.

We are a commercial-stage medical device company focused on the development and marketing of AI-powered, MRI-guided, incision-free therapies for the ablation of diseased tissue utilizing our platform technologies.

Owner earnings FY2025 ($38M)

Retained capital not read

Balance sheet Net cash, +$53M

QTEX QTREX Quantum Ltd.

We are a specialty medical device company the research, development, manufacturing, and commercialization of proprietary life support technologies.

Owner earnings 2019–2025 ($1M)($2M)($8M)($8M)($10M)($10M)($10M)

Retained capital not read

Balance sheet Net cash, debt-free, +$3M

RMD ResMed Inc.

We are a global leader in digital health and cloud-connected medical devices.

Owner earnings 2016–2025 $489M$352M$442M$390M$707M$634M$216M$574M$1.3B$1.7B

Retained capital Retained $3.7B of earnings over 2016–2025; annual owner earnings grew $751M, $0.20 per $1 retained.

Balance sheet Net cash, +$541M · buybacks at an average near $215 · dividend paid 10 of 10 yrs, never cut

SI Shoulder Innovations Inc.

We are a commercial-stage medical technology company exclusively focused on transforming the shoulder surgical care market.

Owner earnings 2024–2025 ($16M)($32M)

Retained capital not read

Balance sheet Net cash, +$12M

SIBN SI-BONE Inc.

We are a leader in developing innovative procedural solutions for compromised bone, grounded in expertise in biomechanical design and anatomy-specific innovation.

Owner earnings 2017–2025 ($18M)($15M)($32M)($32M)($42M)($45M)($24M)($17M)($6M)

Retained capital not read

Balance sheet Net cash, +$7M

SNN Smith & Nephew SNATS Inc.

By the late 1990s, Smith+Nephew had expanded into being a diverse healthcare company with operations across the globe, producing various medical devices, personal care products and traditional and advanced wound care treatments.

Owner earnings 2016–2025 $457M$714M$584M$1.0B$764M$705M$263M$401M$759M$1.0B

Retained capital Retained $947M of earnings over 2016–2025; annual owner earnings grew $149M, $0.16 per $1 retained.

Balance sheet Modest net debt, $827M · dividend paid 10 of 10 yrs, never cut

SOLV Solventum Corporation

Solventum Corporation, is a leading global healthcare company developing, manufacturing, and commercializing a broad portfolio of solutions that leverages deep material science, data science, and digital capabilities to address critical customer and patient needs.

Owner earnings 2022–2025 $1.4B$1.6B$805M($10M)

Retained capital Retained $4.7B of earnings over 2022–2025; annual owner earnings fell $479M, $-0.10 per $1 retained.

Balance sheet Modest net debt, $4.2B

SSII SS Innovations International Inc.

We are a commercial-stage surgical robotics company focused on transforming patient lives by democratizing access to advanced surgical robotics technologies.

Owner earnings 2022–2025 ($6M)($16M)($10M)($20M)

Retained capital not read

Balance sheet Net cash, +$2M

STAA STAAR Surgical Company

STAAR Surgical Company designs, develops, manufactures, and sells implantable lenses for the eye and accessory delivery systems used to deliver the lenses into the eye.

Owner earnings 2016–2026 ($2M)$2M$11M$22M$40M$31M$9M$9M($40M)

Retained capital Paid out $14M more than it earned over 2016–2026; annual owner earnings fell $11M.

Balance sheet Net cash, +$183M · buybacks at an average near $17.20

STE Steris

STERIS is a leading global provider of products and services that support patient care with an emphasis on infection prevention.

Owner earnings 2017–2026 $251M$292M$350M$376M$450M$397M$395M$613M$778M$972M

Retained capital Retained $928M of earnings over 2017–2026; annual owner earnings grew $490M, $0.53 per $1 retained.

Balance sheet Modest net debt, $1.5B · buybacks at an average near $188 · dividend paid 10 of 10 yrs, never cut

STVN Stevanato Group S.p.A.

Revenue is Biopharmaceutical and Diagnostic Solutions (88%) and Engineering (12%).

Owner earnings 2019–2025 (€4M)€102M€77M€38M€27M€75M€198M

Retained capital Retained €715M of earnings over 2019–2025; annual owner earnings grew €42M, €0.06 per €1 retained.

Balance sheet Net cash, debt-free, +€141M · dividend paid 7 of 7 yrs, never cut

SYK Stryker Corporation

Stryker sells the hardware of surgery and the hospital floor: orthopaedic implants such as artificial hips and knees, surgical instruments and powered tools, and the beds, stretchers and other equipment that fill an operating room and a ward. Its customers are hospitals, surgeons and surgery centers around the world. It makes its money selling these devices, the disposables that go with them, and the service to keep them running.

Owner earnings 2016–2025 $1.4B$961M$2.0B$1.5B$2.8B$2.7B$2.0B$3.1B$3.5B$4.3B

Retained capital Retained $13.6B of earnings over 2016–2025; annual owner earnings grew $2.2B, $0.16 per $1 retained.

Balance sheet Meaningful net debt, $11.8B · buybacks at an average near $147 · dividend paid 10 of 10 yrs, never cut

TCMD Tactile Systems Technology Inc.

Technology company that develops and provides innovative medical devices for the treatment of underserved chronic diseases.

Owner earnings 2016–2025 $6M$2M$5M($1M)$735K$528K$3M$34M$38M$40M

Retained capital Retained $30M of earnings over 2016–2025; annual owner earnings grew $33M, $1.10 per $1 retained.

Balance sheet Net cash, +$60M · buybacks at an average near $12.86

TFX Teleflex

Teleflex is a global provider of medical technology products that enhance clinical benefits, improve patient and provider safety and reduce total procedural costs.

Owner earnings 2016–2025 $357M$355M$354M$334M$346M$581M$264M$160M$211M$1M

Retained capital Retained $633M of earnings over 2016–2025; annual owner earnings fell $232M, $-0.37 per $1 retained.

Balance sheet Heavy net debt, $2.3B · dividend paid 10 of 10 yrs, never cut

TMDX TransMedics Group

We are a medical technology company transforming organ transplant therapy for end-stage organ failure patients across multiple disease states.

Owner earnings 2018–2025 ($26M)($32M)($31M)($31M)($49M)($21M)$29M$166M

Retained capital Retained $34M of earnings over 2018–2025; annual owner earnings grew $88M, $2.56 per $1 retained.

Balance sheet Net cash, +$103M

TNDM Tandem Diabetes Care

Tandem Diabetes Care is a global leader in insulin delivery and diabetes technology, specializing in the design, development, and commercialization of advanced solutions that reduce the burden of diabetes management.

Owner earnings 2016–2025 ($67M)($72M)($11M)$36M$14M$97M$36M($48M)$5M($30M)

Retained capital Paid out $971M more than it earned over 2016–2025; annual owner earnings grew $26M.

Balance sheet Net debt against an operating loss, $58M

UFPT UFP Technologies Inc.

UFP Technologies Inc. is a contract development and manufacturing organization that specializes in single-use and single-patient medical devices.

Owner earnings 2016–2024 $4M$12M$16M$25M$21M$9M$4M$31M$57M

Retained capital Retained $226M of earnings over 2016–2024; annual owner earnings grew $20M, $0.09 per $1 retained.

Balance sheet Modest net debt, $115M

WRBY Warby Parker Inc.

Warby Parker is a mission-driven, lifestyle brand that operates at the intersection of design, technology, healthcare, and social enterprise.

Owner earnings 2019–2025 $7M$13M($54M)($21M)$22M$53M$61M

Retained capital Paid out $480M more than it earned over 2019–2025; annual owner earnings grew $57M.

Balance sheet Net cash, debt-free, +$286M

WST West Pharmaceutical

We are a leading global manufacturer in the design and production of technologically advanced, high-quality, integrated containment and delivery systems for injectable drugs and healthcare products.

Owner earnings 2016–2025 $129M$167M$184M$241M$363M$462M$603M$639M$498M$583M

Retained capital Retained $1.6B of earnings over 2016–2025; annual owner earnings grew $414M, $0.27 per $1 retained.

Balance sheet Net cash, +$596M · buybacks at an average near $225 · dividend paid 10 of 10 yrs, never cut

XRAY DENTSPLY SIRONA Inc.

DENTSPLY SIRONA Inc. is the world's largest diversified manufacturer of professional dental products and technologies, with a 139-year history of innovation and service to the dental industry and a vision of improving oral health and continence care globally.

Owner earnings 2016–2025 $438M$458M$317M$516M$562M$515M$368M$228M$281M$104M

Retained capital Paid out $7.8B more than it earned over 2016–2025; annual owner earnings fell $200M.

Balance sheet Net debt against an operating loss, $1.9B · buybacks at an average near $47.43 · dividend paid 10 of 10 yrs, never cut

ZBH Zimmer Biomet Holdings Inc.

Zimmer Biomet is a global medical technology leader with a comprehensive portfolio designed to maximize mobility and improve health.

Owner earnings 2016–2025 $1.4B$1.4B$1.6B$1.4B$1.1B$1.4B$1.2B$1.3B$1.3B$1.5B

Retained capital Retained $1.4B of earnings over 2016–2025; annual owner earnings fell $133M, $-0.09 per $1 retained.

Balance sheet Heavy net debt, $6.9B · buybacks at an average near $98.93 · dividend paid 10 of 10 yrs, never cut