Maximising shareholder value: 10 Tips for European HealthTech and MedTech founders heading into 2026
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Founders can maximise shareholder value heading into 2026 by building capital efficient, evidence led businesses that are strategically positioned for a consolidation heavy exit market rather than an IPO.
1. Design for M&A
Assume your most likely liquidity event is a strategic or sponsor-led acquisition rather than a listing; most digital health and MedTech exits in 2025 are via M&A, with IPOs still subdued.
Map 5–10 “natural acquirers” and align roadmap, data assets, and geography with their portfolio gaps and roll‑up theses, as PE and VC backed platforms increasingly pursue consolidation plays.
2. Prove hard outcomes and ROI
Investors heading into 2026 are explicitly favouring solutions that show measurable improvements in outcomes, cost, or operational efficiency, not just novel tech.
Build a small number of high‑quality outcome studies (e.g. reduced length of stay, NNT, avoided admissions) and bake a health‑economic case into every board pack and fundraising narrative.
3. Be ruthlessly capital efficient
The funding model has shifted to “selective scale”: fewer but larger cheques go to companies that demonstrate capital efficiency and clear paths to profitability.
Track and manage burn multiple, CAC payback, and time-to-profitability at board level; investors now explicitly reward disciplined cost control and opex leverage in valuations.
4. Navigate EU regulation as an edge
New frameworks such as MDR/IVDR, the EU HTA Regulation and the European Health Data Space are creating both barriers and defensible moats, reinforcing a flight to quality.
Invest early in regulatory, data protection, and quality infrastructure so you are “acquisition ready” and can sell regulatory readiness and EHDS compliance as part of the asset.
5. Focus on consolidating hot sub‑sectors
Consolidation pressure is highest in fragmented segments like diagnostics, imaging, virtual care, women’s health, mental health, home care, and specialty outpatient services, which are priority areas for PE.
Position as a “must‑own” platform in a narrowly defined niche rather than a generalist; depth in one consolidation theme typically commands better multiples.
6. Build a data and AI moat, not just features
Investors and acquirers are favouring AI‑enabled solutions with proprietary data sets and workflow‑embedded models, especially in diagnostics, imaging, and personalised medicine.
Treat data architecture, interoperability, and model performance as core IP, ensuring ownership and rights to use and commercialise datasets are clean for diligence.
7. Professionalise governance and reporting
Strong governance, clean cap tables, and high‑quality financial and clinical reporting are now non‑negotiable for value-maximising exits.
Move early to institutional‑grade board packs: monthly KPI dashboards, cohort economics, regulatory risk registers, and ESG metrics that match healthcare PE and corporate buyer expectations.
8. Optimise equity and dilution
In a market of larger, less frequent rounds, poor dilution management can erase founder and early shareholder upside even if the exit headline looks strong.
Model multiple financing and secondary scenarios, use structured rounds sparingly, and align option pools and vesting so key talent is still meaningfully incentivised at exit.
9. Play offense on portfolio and geography
Large strategics and sponsors are actively pruning portfolios and seeking carve‑outs and cross‑border platform plays across Europe.
Consider disciplined tuck‑in acquisitions or partnerships to secure missing capabilities or key geographies, making your platform more attractive to roll‑up buyers.
10. Tell a 2026 ready equity story
Shareholder value in 2026 will accrue disproportionately to companies that combine credible growth, clear profitability path, regulatory readiness, and a role in major thematic trends (AI, outpatient shift, home care, women’s health, electric medicine).
Refresh your narrative around these themes, anchor it in data, and ensure every investor and strategic conversation connects your company directly to where healthcare capital is actually flowing in 2026.
To discuss how Nelson Advisors can help your HealthTech, MedTech, Health AI or Digital Health company, please email [email protected]