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Medtech in 2026 to be shaped by innovation and complianceA stronger focus on femtech and innovative AI-powered wearables are just some of what we can expect from medtech moving forward.AI-powered administrationLloyd Price, a Partner at Nelson Advisors predicts a “widespread” adoption of ambient voice technologies and AI scribes in European clinical settings with the aim of reducing administrative burden on healthcare staff.Compliance-driven M&amp;AsThe European health-tech market is poised for “a robust, albeit structurally transformed” resurgence in capital deployment and mergers and acquisitions, says Nelson Advisors, adding that EU regulations will cause harm to firms that lack capital to check all compliance boxes.Source: <a href="https://www.siliconrepublic.com/innovation/medtech-2026-ai-innovation-compliance-tech-trends-silicon-republic">https://www.siliconrepublic.com/innovation/medtech-2026-ai-innovation-compliance-tech-trends-silicon-republic</a>

Nelson Advisors featured in Silicon Republic's "Medtech in 2026 to be shaped by innovation and compliance' article

The enterprise value (EV) to equity value bridge represents the critical calculation that determines what shareholders actually receive in a transaction, the difference between a buyer's headline offer and the cash distributed to founders and investors. In the European HealthTech and MedTech sectors entering 2026, this bridge calculation has become increasingly complex, driven by structural market shifts including the end of the zero interest rate policy (ZIRP) era, heightened regulatory compliance burdens under MDR/IVDR, refinancing pressures from 2019-2021 vintage debt, and the maturation of the sector from "growth at all costs" to "industrial efficiency." &nbsp; This report examines the ten most significant factors affecting the EV to equity value bridge, ranked by their typical financial impact and prevalence in 2026 European HealthTech and MedTech transactions. Each factor is analysed through the lens of current market conditions, including the €2.5 Trillion private equity dry powder deployment cycle, distressed M&amp;A driven by regulatory Darwinism, and the flight to quality favouring profitable, compliant platforms over high-burn ventures. &nbsp; Understanding these bridge factors is essential for founders, investors and acquirers navigating an environment where enterprise values for AI-enabled, MDR-compliant assets command 6x-8x revenue multiples and 12x-15x EBITDA multiples, while non-compliant or sub-scale assets face distressed exits at 3x-4x revenue. &nbsp; 10 Key Factors affecting the Enterprise Value to Equity Value bridge in European HealthTech and MedTech 2026 &nbsp; 1. Net Debt Adjustment 2. Preferred Stock Liquidation Preferences 3. Working Capital Adjustments 4. Transaction Costs and Advisory Fees 5. Earn outs and Deferred Consideration 6. Escrow and Holdback Provisions 7. Minority Interest and Non-Controlling Interest Adjustments 8. Pension Liabilities and Unfunded Obligations 9. Options, Warrants and Dilution 10. Normalised EBITDA Adjustments and Other Balance Sheet Items &nbsp; The ten factors examined, net debt, liquidation preferences, working capital adjustments, transaction costs, earn outs, escrows, minority interests, pension liabilities, dilution, and EBITDA normalisation, collectively determine the translation of headline enterprise values into actual cash distributed to founders and investors. In an environment where AI-enabled, MDR-compliant assets command 12x-15x EBITDA multiples while non-compliant or sub-scale assets face distressed exits at 3x-4x revenue, understanding these bridge mechanics is essential for maximising shareholder value. &nbsp; Source: <a href="https://www.healthcare.digital/single-post/10-key-factors-affecting-the-enterprise-value-to-equity-value-bridge-in-european-healthtech-and-medt">https://www.healthcare.digital/single-post/10-key-factors-affecting-the-enterprise-value-to-equity-value-bridge-in-european-healthtech-and-medt</a>

10 Key Factors affecting the Enterprise Value to Equity Value bridge in European MedTech and HealthTech 2026

The winners in the 2026 HealthTech and MedTech ecosystem are those with the strongest "Compliance Moats," the most "Interoperable Data," and the clearest "Industrial Logic", profitability, unit economics, and infrastructure status. The industry is graduating from the "laboratory" phase to the "factory" phase, and consolidation is the primary mechanism of this maturation.Sustainable competitive advantage is no longer about first-to-market technology or venture capital firepower; it is about constructing institutional-grade moats at the intersection of regulatory approval, proprietary data assets, workflow integration, reimbursement pathways, clinical evidence, and operational scale.&nbsp; &nbsp; For investors and M&amp;A professionals, understanding which moats compound versus which erode under competitive pressure is the difference between acquiring strategic assets and overpaying for features that commoditise within 18 months.The companies that will command premium valuations in this environment are those that demonstrate not just innovation, but defensible innovation, moats that deepen with every regulatory approval, every patient enrolled, every data point captured, and every year of clinical evidence accumulated. These are the businesses that executives, investors, and decision-makers would pay premium consulting fees to access, and they represent the future of healthcare technology M&amp;A. &nbsp; I. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Regulatory and Compliance Moats: The New Infrastructure Advantage II. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Proprietary Data Moats: The Fuel for AI Flywheels III. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Clinical Workflow Integration and Switching Costs IV. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Reimbursement and Payor Pathway Moats V. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Brand, Trust and Clinical Evidence Moats VI. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Scale, Network Effects and Platform Economics VII. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; Intellectual Property and Patent Portfolios VIII. &nbsp; &nbsp; &nbsp; &nbsp; Clinical Trial Infrastructure and Real-World Evidence Capabilities IX. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;X. Vertical Integration and End-to-End Solutions X. &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Customer Lifetime Value and Retention Economics &nbsp; Source: <a href="https://www.healthcare.digital/single-post/the-10-best-moats-in-healthtech-and-medtech">https://www.healthcare.digital/single-post/the-10-best-moats-in-healthtech-and-medtech</a>To discuss how Nelson Advisors can help your HealthTech, MedTech, Health AI or Digital Health company, please email <a data-mce-href="mailto:lloyd@nelsonadvisors.co.uk" href="mailto:lloyd@nelsonadvisors.co.uk" title="lloyd@nelsonadvisors.co.uk" target="_blank" rel="noopener" data-mce-selected="inline-boundary">lloyd@nelsonadvisors.co.uk</a> &nbsp;

The 10 Best MOATs in MedTech and HealthTech

Nelson Advisors has been invited to mentor and judge the MedTech Innovator 2026 programme alongside a panel of esteemed US and European industry executives. &nbsp;&nbsp; Now in its 13th year, MedTech Innovator, the world’s largest medtech accelerator continues to identify the most promising medical device, diagnostic, and digital health startups developing innovative tools to improve patient care. &nbsp;&nbsp; <a href="https://medtechinnovator.org/" data-mce-href="https://medtechinnovator.org/">https://medtechinnovator.org/</a>MedTech Innovator is the world's largest accelerator for medical device, digital health, and diagnostic companies. Our mission is to improve patients' lives by accelerating the growth of companies transforming healthcare worldwide. &nbsp;&nbsp; "According to Silicon Valley Bank’s CipherBio, MedTech Innovator is the largest accelerator of Life Science companies in the world. The dominant part of our portfolio is Medical Devices, in addition to our leadership position as an accelerator of diagnostics, digital health, and life science tools technologies. 93% of our portfolio are still in business or have been acquired, and 86% of our companies have raised equity financing. In Q1 2023, approximately 30% of all funds raised in the medtech sector went to a graduate of MedTech Innovator." &nbsp;&nbsp; Our corporate partners include leading manufacturers like Johnson &amp; Johnson, Dexcom, NIPRO Medical Corp., Olympus Medical Systems Group, W. L. Gore &amp; Associates, Asahi Intecc, Edwards Lifesciences, Fujikura, Jabil Healthcare, Maxim Integrated Ventures. and many others. They participate as thought leaders, application reviewers, event judges, and accelerator mentors. &nbsp;&nbsp; Hundreds of investors like RCT Ventures, Aphelion Capital, Life Science Angels, Healthtech Capital, Sofinnova Partners, Vensana, Treo, Hunniwell Lake Partners, Seroba Life Sciences participate as application reviewers, mentors, and judges. &nbsp;&nbsp; <a href="https://medtechinnovator.org/about-us/" data-mce-href="https://medtechinnovator.org/about-us/">https://medtechinnovator.org/about-us/</a>MedTech Innovator is the world’s largest accelerator of medical technology companies, with a mission to improve the lives of patients by accelerating the growth of transformative health care startups.&nbsp; Along with its sibling programs, BioTools Innovator and MedTech Innovator Asia Pacific, the organization provides founders with mentorship, exposure to industry leaders, and access to funding opportunities.&nbsp; Each year, thousands of startups compete for a place in the programs’ cohorts, gaining global visibility and connections that help bring their innovations to market faster.

MedTech Innovator 2026 Programme: Nelson Advisors invited to Judge and Mentor world's largest accelerator for Medical Device, Digital Health and Diagnostic companies

Nelson Advisors Partner Lloyd Price has been invited to Judge the PitchFest Awards at ReWired 2026. This is the third time Lloyd has judged the prestigious awards, highlighting the pedigree of UK Digital Health and MedTech companies.Unlike standard "demo days," PitchFest is specifically designed to break down the barriers between start-ups and the NHS. The judges are not just venture capitalists but also Chief Information Officers (CIOs) and Chief Clinical Information Officers (CCIOs) who have the actual authority to procure new technology for hospitals. &nbsp;&nbsp; PitchFest Awards at ReWired 2026 The PitchFest Awards at ReWired 2026 is the final stage of the UK's most high-profile digital health start-up competition, organised as part of the annual Digital Health Rewired conference and exhibition. It provides a platform for innovators to pitch their solutions to influential leaders, investors, and NHS digital teams. The competition follows a phased process to select the final winners: &nbsp;&nbsp; Application: Start-ups submit their proposals. The deadline for 2026 applications is 21 November 2025. Virtual Heats: Shortlisted contestants pitch their solutions virtually to a panel of judges from the NHS, venture capitalists, and digital health accelerators. Live Final: The top finalists compete live on stage at the Rewired conference. &nbsp;&nbsp; <a href="https://digitalhealthrewired.com">https://digitalhealthrewired.com</a> Winner's Prize &nbsp; The winners receive significant support and exposure, most notably: &nbsp;&nbsp; Pilot Opportunity: Expert advice and the potential to run a real-world project within the Chelsea and Westminster Hospital NHS Foundation Trust, delivered through the CW Innovation Team and Pitchfest partner CW+. Visibility: Free entry to Rewired 2026 and features on Digital Health News. &nbsp;&nbsp; The competition often includes separate categories for pre-revenue and revenue-generating start-ups. Past winners have achieved significant growth and secured funding within the NHS and international markets. &nbsp;&nbsp; <a href="https://digitalhealthrewired.com/pitchfest">https://digitalhealthrewired.com/pitchfest</a>

Digital Health ReWired 2026: Nelson Advisors invited to Judge the PitchFest Awards

Nelson Advisors referenced by The Ministry of Health, Welfare and Sport of the Netherlands report ‘Financing and making available of digital health applications in Europe’ &nbsp; Source: <a href="https://www.zorgakkoorden.nl/documenten/publicaties/2025/251210-vws-financing-and-making-available-of-digital-health-applications-in-europe.pdf" data-mce-href="https://www.zorgakkoorden.nl/documenten/publicaties/2025/251210-vws-financing-and-making-available-of-digital-health-applications-in-europe.pdf">https://www.zorgakkoorden.nl/documenten/publicaties/2025/251210-vws-financing-and-making-available-of-digital-health-applications-in-europe.pdf</a>The toll increases as in the equation p (price) x q (quantity), q (the number of prescriptions) is in the current stage of the digital transformation low. This means that returns on the significant investments are low, and even fixed costs may be hard to cover, making manufacturers dependent on investors, who in turn will need an appealing financial perspective over a reasonable period of time. Goeldner &amp; Gehder (2024)[21] report that by the end of September 2023, 15 DiGA had surpassed the threshold of 5000 prescriptions over their lifetime, Nelson Advisors (2025)[53] that the top 15 DiGA, which account for 82% of total prescriptions receive between 8 and 77 prescriptions a day. &nbsp; 53. Nelson Advisors. The German Digital Health Act (DiGA): Strategy, Impact, Challenges and Future Direction. 2025; Available from: https://nelsonadvisors.co.uk/blog/the-german-digital-health-act--diga---strategy-- impact--challenges-and-future-directionZorgakkoorden.nl&nbsp;Zorgakkoorden.nl is the Dutch government’s central health policy portal for “zorgakkoorden” (care agreements) and the broader transformation agenda in healthcare.&nbsp;Zorgakkoorden.nl is an official platform linked to the Ministry of Health, Welfare and Sport (VWS), and is the successor to the policy site “De Juiste Zorg op de Juiste Plek”.​ The site functions as a public knowledge and documentation hub rather than a commercial site, hosting policy documents, guidance and examples from government-initiated programmes.Source: <a href="https://www.zorgakkoorden.nl/documenten/publicaties/2025/251210-vws-financing-and-making-available-of-digital-health-applications-in-europe.pdf">https://www.zorgakkoorden.nl/documenten/publicaties/2025/251210-vws-financing-and-making-available-of-digital-health-applications-in-europe.pdf</a>

Nelson Advisors referenced by The Ministry of Health, Welfare and Sport of the Netherlands report ‘Financing and making available of digital health applications in Europe’

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Nelson Advisors featured in Silicon Republic's "Medtech i...

10 Key Factors affecting the Enterprise Value to Equity V...

The 10 Best MOATs in MedTech and HealthTech

MedTech Innovator 2026 Programme: Nelson Advisors invited...

Digital Health ReWired 2026: Nelson Advisors invited to J...

Nelson Advisors referenced by The Ministry of Health, Wel...