To read our full disclaimer, click here.

I wrote up Strata Critical Medical (NASDAQ: SRTA) at $4.34 in October.

Wednesday’s close was $6.01.

Up 38%.

Almost all of it came after the Q3 results on 3 November. The stock closed at $4.28 the day before and jumped 18% the day after.

In five lines:

• Revenue of $74.1 million, up 50% year-on-year, with Clinical up 20% on Q2

• Adjusted EBITDA of $9.6 million at a 13.0% margin, against 8.5% a year ago

• A record $8.6 million of free cash flow, three times Q2

• Logistics gross margin back to 20.8%, a 2027 target reached a year early

• A new $20 million buyback, with up to $27.5 million more Joby money due by Q1 2027

In October I said one line was the whole debate on this stock. Stock-based pay, running at roughly half of adjusted EBITDA.

This quarter it got worse.

Then management put a number on how much better it gets.

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Below the paywall:

• The stock comp line, and the cut management just guided to

• Why trip distances went backwards, and why management doesn’t seem to mind

• Clinical taking over as the growth engine

• A new 80% NRP estimate, and the footnote under it

• Third Point, four weeks on

• The valuation after the move, with and without the equity cost

• What I’m watching next

Here is everything you need to know…

Read more

To read our full disclaimer, click here.

I first wrote up Eton Pharmaceuticals (NASDAQ: ETON) here at $16.92, on 11 November last year.

Monday’s close was $64.35.

Up 280%.

I put out my Q3 update on Eton on Multibagger Ideas yesterday. This is that update, here for Healthcare Stock Ideas readers who haven’t seen it.

The stock is up another 14% since it went out.

Eton put out its Q3 numbers after the bell on Thursday. In five lines:

• Revenue of $57.9 million, up 158% year-on-year and 54% on Q2

• Adjusted EBITDA margin of 49%, against 13% a year ago

• A $200 million annual revenue run-rate, a goal set for the end of 2027, hit five quarters early

• Full-year revenue guidance raised for the second quarter in a row, to more than $175 million

• $35 million of operating cash flow in one quarter

The share price is the weird part.

It closed at $58.86 the day after Q2 came out in August. By Thursday’s close, the evening of the Q3 release, it had slid 20% to $47.15. Friday took it back to $56.46, and Monday added another 14% to $64.35.

So over three months the stock is up 9%, and quarterly revenue is up 54%.

When I first wrote about Eton it was a $453 million company with eight products.

It now has twelve, another six in late-stage development, and it’s worth about $1.9 billion.

This is what I do across my pages.

I find companies nobody’s following, write them up early, and come back every quarter, bad results included.

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Below the paywall:

• How the biggest product did in its first full quarter

• The pipeline result that didn’t go to plan

• A new move into a $450 million market

• The red flag from August, answered

• What it’s worth once you count stock-based pay

• What I’m watching next

It’s the most important quarter since I first wrote it up.

Here is everything you need to know…

Read more

To read our full disclaimer, click here.

Healthcare microcaps hardly ever make the headlines.

Usually there is 1 or no analyst following them and the news comes out through press releases that few people read.

That’s what this is for.

The results, readouts, deals and dates for the 19 healthcare microcaps I follow, all in one spot.

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The Companies in This Update

Every company I cover has a dedicated page on my Healthcare Research Portal.

At the top of each page is my thesis and below are all of their results and updates with dates. So everything related to one company is on that one page. It’s available on the Perks tab to paid members along with all previous updates and any future ones I write.

Upgrade Now to Access!

Let’s dive in...

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To read our full disclaimer, click here.

This is a business with:

• Fifteen consecutive quarters of year-over-year revenue and profit growth

• Record revenue, record operating income and record EPS in the quarter it just reported

• 78.5% gross margins and an operating margin that has gone from 15.1% to 18.8% in a year

• No debt, cash up $5.2 million in the year, and buybacks running

• A market in which only around one diagnosed patient in six gets the therapy

• A billion-dollar drug launch in the same disease doing the awareness work for free

However, the day after the most recent results (which also came with the CEO’s retirement announcement) the stock fell 19%.

It has not recovered since.

It closed at $27.68 on 29 October, about 30% below the pre-results close and 42% below its 52-week high.

The engine underneath, the part that makes up 90% of sales, grew 15% in the same quarter.

Quality compounder. Operating leverage. Sentiment reset.

Here’s everything you need to know...

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To read our full disclaimer, click here.

Verrica is down 28% since I wrote it up in July, and a reader asked in the comments what is going on.

Fair question.

• Record demand. Units hit an all-time high last quarter, up 28% in three months.

• Non-dilutive funding. The largest shareholder has made $27.5 million available. The full amount unlocked this week on revenue and growth milestones.

• A catalyst pulled forward. The first Phase III readout moved into Q1 2027.

• A tougher competitor. The newer at-home rival is now booking three times the revenue.

Same turnaround, same partner-funded optionality. The funding picture and the competitive picture have both moved, in opposite directions.

Here’s everything you need to know...

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To read our full disclaimer, click here.

Hi, I’m Nico.

If you only read the emails, you’re seeing about half of Healthcare Stock Ideas.

The rest lives outside your inbox. A research portal with every company I’ve covered. A watchlist that updates as names clear the bar. A tracker showing every idea I’ve published, winners and losers.

In just over a year, the page has grown to over 4,000 subscribers and 20 published ideas.

This post puts all of it in one place.

Lock In Today’s Price →

How I Invest

Two posts explain the approach behind everything on this page:

What a Write-Up Covers

Every new idea gets the same treatment:

• The Company and what it actually sells

• The Business Model and where the money comes from

• The Inflection that made it worth writing about now

• The Balance Sheet, because cash decides who survives in healthcare

• The Optionality beyond the core business

• The Risks, set out in full

Free subscribers get the preview of each one. Paid subscribers get the full write-up, every update when a company reports or my view changes, and the portal.

The Healthcare Research Portal

Every company I’ve covered lives here, in one searchable database.

Open any name and you get a single up-to-date thesis that combines everything I’ve written on it, a live price chart, links to every underlying post, and a time-stamped timeline of earnings, filings and anything that changes the picture.

You can filter the whole archive by sector, geography and conviction.

The portal is included with a paid subscription. Logging in takes the same email you subscribed with, through the Perks tab.

Subscribe now

The Watchlist

The watchlist is the pipeline of companies I’m researching but haven’t written up in full yet.

It used to go out as occasional posts. It now lives inside the portal, so it’s always current. Names get added as they clear the bar and removed when they don’t.

→ Why the watchlist moved into the portal

Each entry has a short thesis, the key facts, and a running log of developments.

The Performance Tracker

Every idea I’ve published is tracked from the price on the day it went out.

Winners and losers both stay in. Nothing gets removed when it goes the wrong way.

→ Performance Tracker

That’s Everything.

Healthcare Stock Ideas exists to do the digging on small healthcare companies that very few people cover.

A paid subscription gets you:

• 1-2 new ideas a month, written up in full

• Updates on every company I cover

• The Healthcare Research Portal, including the watchlist

• The full archive

Your price stays locked for as long as you stay subscribed.

Lock In Today’s Price →

As always, this is not investment advice. Do your own research, consider your own risk tolerance, and make your own decisions.

I hope you enjoyed reading,

Nico

Disclaimer: This is not a recommendation to buy or sell any securities. The Content does not constitute investment advice, financial advice, trading advice, or any other sort of advice. Nothing in this newsletter should be construed as a personal recommendation or advice to buy, sell, or hold any investment or security. All Content is provided for general informational purposes only and should not be relied upon for making investment decisions. You should not make any investment decision based solely on the Content without first consulting with qualified financial advisors, conducting your own research, and considering your individual financial circumstances, investment objectives, and risk tolerance. To read our full disclaimer, click here.

To read our full disclaimer, click here.

This is a business with:

• Revenue up 60.7% year-over-year in the most recent quarter, with full-year guidance raised from $260-275 million to $285-295 million

• Adjusted EBITDA guidance lifted to $33-35 million, against $14.1 million for the whole of last year

• Three bolt-on acquisitions closed in a single quarter at mid-single-digit EBITDA multiples, while the company itself is valued at roughly 10x guided EBITDA

• Under 10% share of its largest service market and around 5% of another, in an industry growing mid to high single digits before any share gains

• The only end-to-end operator in its niche, by its own count against nine competitors

• A structural volume driver that has gone from 4.4% adoption in 2022 to 58.7% today, with management modelling the low 60s by 2028

• Two consecutive quarters of positive free cash flow before aircraft purchases after years of burn, and a $17.5 million earn-out expected before year-end

• Roughly $200 million of capital management says it can deploy through 2029, into a market of local operators who cannot compete nationally

• A 5.8% activist stake disclosed this week, with a call for a review of strategic alternatives

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The setup is almost boringly predictable: buy small regional operators at mid-single-digit multiples, plug them into a national platform, watch fixed costs get spread over a bigger base.

Except there is a catch, and it is a real one. The adjusted EBITDA figure everyone quotes adds back stock-based compensation that runs at roughly half of adjusted EBITDA. Strip that out and the multiple doubles.

In my view that single line is the whole debate on this stock.

As of this week, an activist thinks so too.

Here’s everything you need to know...

Read more

To read our full disclaimer, click here.

A week ago I launched the Healthcare Research Portal.

The response completely blew me away with many new paid subscribers joining.

I don’t take that lightly for a second.

This page wouldn’t succeed without the people who decided this work was worth paying for, and I’m grateful for every single one of you.

If you’ve been on the fence, this is the moment to join the people getting full access to everything - the portal, the full archive, and now the watchlist too.

Join Today!

When the portal went live, I promised one thing: the watchlist would move into it, and updates would start happening there instead of in long posts like the old ones.

That’s now underway and I’ve just added my highest-conviction names to it.

Why the Watchlist Moved

If you’ve been around for a while, you’ll remember the old watchlist updates.

They worked, but they had a ceiling. A post is a snapshot - frozen the day I hit publish. By the time you came back to it a month later, half of it was already out of date, and there was no easy way to see what had changed.

The watchlist was never meant to be a static list. It’s a living pipeline. Names move up, names get cut, theses get revised as new numbers come in. That belongs somewhere live, not buried in an old email.

So now it lives in the portal, alongside everything else I track. One place, always current.

I’ve Started With My Highest-Conviction Names

Rather than dumping the whole list in at once, I’ve started with the names I have the most conviction in - the ones at the front of the queue that I’ve done the most work on.

The rest of the watchlist is being added over the coming weeks, so the list inside the portal will keep growing.

This is exactly the point of moving the watchlist into the portal - I can add names the moment they clear the bar, and you get them instantly, without waiting for the next big post.

What a Watchlist Idea Looks Like in the Portal

Open any name on the watchlist and you’ll find a proper research entry rather than a one-line mention.

Every entry follows the same structure:

• Company properties - sector, geography, conviction level, ticker, stage in the funnel. The same fields you can filter and sort the whole list by.

• The mini thesis - a tightened, scannable breakdown of why the company is on the list: the business, the model, the numbers so far, and the genuine risk worth flagging. Not a wall of text, just the reasoning that earned it a spot.

• A comments and updates timeline at the bottom - a running log of every major development since I initiated coverage.

Here’s an example of what each one looks like:

How to Get Access

It’s pretty easy.

First, make sure you’re a paid subscriber (annual subs work out 33% cheaper on normal pricing).

Anyone who subscribes today will lock in their price for as long as they stay subscribed.

Join Healthcare Stock Ideas

Then click the button below and enter the SAME EMAIL you used for your paid subscription.

Access the Portal

These are early days of the portal, so there may be some teething issues. If you run into any, just send me a DM and I’ll get it sorted for you personally.

Last Week’s Giveaway Winners

When I launched the portal, I ran a giveaway - like and restack to enter - and promised I’d announce the winners today, alongside the news on how the watchlist is being integrated.

The response was amazing, so thank you to everyone who shared it. It genuinely helps more than you’d think.

Share

Here are the winners:

One Last Launch Discount

That’s the last free giveaway I’ll run for the launch - but I’ve got one final offer, and it’s a bit different.

I’m putting out a single discounted subscription. Just one.

It’s a 25% discount, and it goes to whoever claims it first through the link below.

Claim Discount!

Thanks as always for your support - it’s the reason any of this exists.

Nico

Disclaimer: This is not a recommendation to buy or sell any securities. The Content does not constitute investment advice, financial advice, trading advice, or any other sort of advice. Nothing in this newsletter should be construed as a personal recommendation or advice to buy, sell, or hold any investment or security. All Content is provided for general informational purposes only and should not be relied upon for making investment decisions. You should not make any investment decision based solely on the Content without first consulting with qualified financial advisors, conducting your own research, and considering your individual financial circumstances, investment objectives, and risk tolerance. To read our full disclaimer, click here.

To read our full disclaimer, click here.

It’s finally here…

Welcome to the Healthcare Research Portal!

There has been an immense amount of interest in this new development.

I honestly think this is at least a 3x to the value of a Healthcare Stock Ideas subscription. Not only do you get everything on Substack, but you now have a completely dedicated research portal included in the price.

A huge amount of work has gone into building this, and it genuinely wouldn’t have been possible without your support.

This post serves two purposes.

• First, I’m going to explain how the portal works and why I think it’s so groundbreaking for sharing finance content on Substack.

• Second, it’s the first time I’m sharing the link to the portal itself.

I’ve integrated it seamlessly with Substack, so as long as you have a paid subscription to Healthcare Stock Ideas, you can use that email to log in to the portal.

It’s as simple as that.

The Problem with Substack

Substack has been an amazing platform for sharing ideas and growing the community, but it was never really built for equity research.

As the archive has grown, it’s become harder to find old write-ups, track which companies are in the portfolio, or get a sense of how the body of work hangs together.

The ideas have performed very well so it was a shame people were struggling to find them.

• 65% average peak return since publication. Not the best one. The average.

• 7 of the 19, 37%, up 75% or more at some point.

• Average idea is 226 days old. Seven and a half months.

That’s exactly what this portal solves - a single, clean place to keep the research organised, searchable, and easy to navigate.

So here’s what I’ve built…

The Portal

Start Here

Before you dive into the research, I’d recommend reading through the Foundation pages below. These cover my investment philosophy, the live performance of every idea, and the disclaimers you should know about.

How the Portal Is Organised

On the main page you’ll find two databases that do most of the heavy lifting:

• Recent Updates shows the latest activity across the research library - new write-ups, thesis revisions, anything I’ve added or edited recently. This is the page to check when you come back to the portal.

• Full Research Archive holds every company I’ve covered - 19 of them at launch. The tabs at the top give you curated views - Covered, Watchlist, US Stocks - but the real power is in the filters.

You can slice by sector, geography, conviction level, ticker, and more. For example: filter to US companies, sort by highest conviction, then group by industry. Or pull up everything I’ve ever written on a single sector. This becomes more valuable as the archive grows.

You can also use the site’s main search bar (or the search button at the top of the database) to look up specific tickers or even keywords.

Inside Each Research Entry

Open any company page in the archive and you’ll find:

• Company properties - the same fields you can use to search and filter.

• A Files & Media section linking every Substack post I’ve written on that company, in chronological order.

• A live price chart at the top of every page, so you can see where the stock is trading against the thesis without leaving the portal.

• The thesis itself - a concise breakdown of why the company is interesting, the setup, and what could go wrong. These aren’t carbon copies of the Substack write-ups. They’re tightened, more scannable versions, so you’re getting extra value rather than just rereading the same thing.

• A comments and updates section at the bottom of the page with time-stamped notes for new earnings prints, regulatory filings, and material changes to the thesis.

How to Get Access

It’s pretty easy.

First, make sure you’re a paid subscriber.

To celebrate the launch we are offering 50% off the annual plan for anyone who joins in the next 24 hours:

Claim Your Discount!

Then click the button below and enter the SAME EMAIL you used for your paid subscription.

Access the Portal

This is day one of the portal, so there may be some teething issues. If you run into any, just send me a DM and I’ll get it sorted for you personally.

How to Get a Free Subscription

As promised at the top, we have some paid subscriptions to give away so you can see what the portal is like.

All you have to do is like and restack this post. I’ll pick the winners and give away another couple of subscriptions next Monday, when I share with subscribers how the watchlist is being integrated with the portal.

Share

I hope you like the work we’ve put into this to make consuming finance content easier on Substack.

Thanks as always for your support,

Nico

Disclaimer: This is not a recommendation to buy or sell any securities. The Content does not constitute investment advice, financial advice, trading advice, or any other sort of advice. Nothing in this newsletter should be construed as a personal recommendation or advice to buy, sell, or hold any investment or security. All Content is provided for general informational purposes only and should not be relied upon for making investment decisions. You should not make any investment decision based solely on the Content without first consulting with qualified financial advisors, conducting your own research, and considering your individual financial circumstances, investment objectives, and risk tolerance. To read our full disclaimer, click here.

To read our full disclaimer, click here.

Ten of the nineteen companies I cover had news this week. Two sets of quarterly and full-year numbers, a pivotal trial readout followed the same day by a $50 million raise, a completed Phase 3 enrolment, a refinancing, a debt buyback and a reverse split ahead of a Nasdaq uplisting.

Everything below is what the companies announced, with the figures as reported. My own read on what it means for each thesis lives in the research portal.

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PMV Pharmaceuticals (PMVP)

The busiest week of any name on the list, and the two events are connected.

On 31 August PMV reported updated interim data from the pivotal Phase 2 portion of PYNNACLE, covering 76 platinum-resistant and refractory ovarian cancer patients. Overall response rate was 46%, or 35 of 76 patients, made up of 4 confirmed complete responses, 29 confirmed partial responses and 2 unconfirmed. Median time to response was 1.3 months and median duration of response was 10.0 months. Treatment-related adverse events were mostly Grade 1 to 2, with a 5% discontinuation rate.

The company also said it has FDA feedback supporting an NDA submission for accelerated approval of rezatapopt in TP53 Y220C mutant platinum-resistant and refractory ovarian cancer, targeted for Q1 2027. Primary analysis data from all Phase 2 cohorts is planned for a medical conference in Q4 2026.

Later the same day PMV announced a proposed public offering, then priced it: 22,055,000 shares plus pre-funded warrants over 19,900,000 shares, each with accompanying warrants covering 41,955,000 shares in aggregate, at $1.21 per share and accompanying warrant. The warrants carry a $1.21 exercise price, subject to adjustment following a specified regulatory milestone, and a five-year term. Gross proceeds were approximately $50.8 million before costs, described as oversubscribed, with TD Cowen sole book-running manager and closing expected around 2 September.

Pro-Dex (PDEX)

Fiscal 2026 fourth quarter and full-year results landed on 3 September.

Q4 net sales rose 17% year on year to $20.4 million, with net income of $2.9 million, or $0.87 per diluted share. Gross margin came in at 35%, against 20% in the same quarter last year.

For the full year, net sales rose 16% to $77.5 million and net income was $13.7 million, or $4.12 per diluted share, at a 31% gross margin against 29%. Growth came mainly from the largest customer’s next generation orthopedic handpiece, partly offset by a $6.0 million reduction in repair revenue from that same customer. The February 2026 acquisition of Advanced Precision Machining added $718,000 of revenue across the year.

Hydreight Technologies (NURS.V)

Record Q2 numbers on 31 August. Revenue rose 421% year on year to $28.0 million from $5.4 million, and 12.5% sequentially. Gross profit rose 182% to $5.4 million. Net income was $2.5 million against $0.05 million, and adjusted EBITDA $3.2 million against $0.2 million.

The VSDHOne virtual healthcare and direct-to-consumer platform produced $22.8 million of that quarterly revenue, up from $0.7 million a year earlier. Pharmacy sales reached $26.2 million from $4.5 million.

First-half revenue was $53.0 million, up 434%, with net income of $5.1 million and adjusted EBITDA of about $6.5 million. Cash stood at $20.0 million and working capital at $35.0 million at 30 June, after $8.7 million of operating cash used in the half. Management reaffirmed full-year guidance of approximately $150 million.

Covalon Technologies (COV.V)

Fiscal third quarter results on 27 August. Revenue rose 20% year on year to $10.0 million, gross margin expanded to 67.2% from 46.5%, and net income was $2.8 million against $0.06 million a year earlier, or $0.10 diluted. Adjusted EBITDA more than tripled to $3.0 million from $0.9 million.

Underneath that, Contamination Protection revenue grew 68% year on year and 34% sequentially, and the US Vascular Access channel grew 51%, which the company put at roughly ten times the underlying market growth rate. Cash closed the quarter at $19.4 million with no bank debt, up $2.8 million in three months.

Ion Beam Applications (IBAB)

Half year results on 27 August. Net sales rose 6% to €323.7 million, gross margin improved to 33.7% from 29.5%, and adjusted EBIT rose to €17.6 million from €10.6 million, with the Proton Therapy turnaround contributing €12.3 million of that. The net result swung to €9.3 million from a €2.6 million loss, giving EPS of €0.32. Full-year adjusted EBIT guidance of at least €32 million was reiterated.

Equipment order intake grew 64% to €176 million, with IBA Clinical more than doubling to €148 million on five proton therapy rooms sold. Backlog held stable at €1.6 billion. Net debt rose to €81 million at 30 June from €57 million at 31 March, mainly on working capital movements and temporary ERP-related invoicing delays, with the net financial position expected to improve over 2027.

Then on 2 September IBA joined PFAROS, a European research initiative funded under the Innovative Health Initiative Joint Undertaking bringing together 91 partners to reduce PFAS emissions across the life cycle of medical products. IBA and Bayer co-lead the work on end-of-life and waste management technologies, with IBA assessing its electron beam and Rhodotron technology for PFAS destruction in hospital and pharmaceutical wastewater. No financial terms were disclosed.

Emergent BioSolutions (EBS)

Four releases, two of them commercial.

On 31 August Emergent was awarded a Government of Canada standing offer for NARCAN Nasal Spray 4 mg, running from 1 October 2026 to 30 September 2029 with an option to extend by two further years. It allows federal departments, agencies, Crown corporations, provinces, territories and other designated public sector bodies to purchase the product, and follows an existing five-year standing offer expiring this September. No value was disclosed.

On 1 September came a BARDA contract modification worth approximately $24 million to supply CYFENDUS for anthrax preparedness under federal contract HHSO100201600030C. The release also referenced an earlier 2026 delivery order worth up to $21.5 million for BioThrax. Delivery timing was not disclosed.

On 3 September Emergent completed the repurchase of $75 million aggregate principal of its 3.875% Senior Unsecured Notes due 2028, for approximately $68 million in cash, an average of 90.6% of face value. That leaves approximately $364.7 million outstanding. The buyback was funded from cash, with $50 million still available under the asset-based revolving facility, and management said it will watch market conditions for refinancing the rest ahead of the August 2028 maturity.

The fourth was an International Overdose Awareness Day release with no commercial terms.

Verrica Pharmaceuticals (VRCA)

On 27 August Verrica completed enrolment in COVE-2, the first of two pivotal Phase 3 trials of YCANTH in common warts. The study is double-blind, randomised and vehicle-controlled, dosing once every 21 days for up to four applications in patients aged 2 and older.

A pre-specified interim analysis by an independent statistician confirmed no additional patients are needed for adequate statistical power. Topline COVE-2 data is expected in Q1 2027, with the rest of the programme, including COVE-3 which is more than 50% enrolled across US and Japanese sites, anticipated by mid-2027. Common warts affect approximately 22 million US patients and there are no FDA-approved prescription therapies.

CareRx Corporation (CRRX)

A new senior secured credit agreement with National Bank of Canada, announced 27 August. It comprises a $20 million revolving operating facility, a $40 million term loan and a $10 million acquisition and capex facility, giving $70 million available at closing and expandable by up to a further $20 million.

The full term loan was drawn at closing to repay and discharge the existing facility, which the new agreement replaces entirely. Management expects cost savings against the prior facility and framed it as lowering the overall cost of capital while adding dedicated capacity to invest.

Interpace Biosciences (IDXG)

A 1-for-5 reverse stock split took effect on 27 August, cutting shares outstanding from approximately 27.7 million to approximately 5.5 million, with fractional shares rounded up and proportional adjustments to options, RSUs and equity plans.

Stockholders approved it on 20 August. The purpose is to meet the Nasdaq Capital Market minimum bid price requirement ahead of a proposed uplisting from OTCID, where the stock trades temporarily as IDXGD for 20 trading days before reverting to IDXG. Other listing requirements still apply, including a $15 million market value of unrestricted publicly held shares, and the company cautioned there is no guarantee the uplisting completes.

Also this week

Eton Pharmaceuticals (ETON) confirmed it will present at the 2026 Wells Fargo Healthcare Conference, and Hydreight gave notice of its results date ahead of the numbers above.

Quiet this week: Fennec Pharmaceuticals, Innovotech, Journey Medical, NeuPath Health, Precipio, Sanara MedTech, SANUWAVE Health, Vaso Corporation and Viemed Healthcare.

Where the thesis behind each of these lives

A week like this is exactly the problem with following microcaps.

Ten companies moved, some of it genuinely mattering and some of it noise, and the release itself never tells you which is which. A 46% response rate means nothing until you know what the trial had to beat. A $24 million contract modification reads as good news until you check what the thesis was actually waiting for.

Next week I am opening the Healthcare Stock Ideas Research Portal to paid subscribers.

It is the live archive of everything I cover here.

• One page per company, holding the current thesis rather than a pile of old posts: what the business does, why it is an idea, what I think the market is missing, the risks, and what I am watching for next.

• Searchable and filterable by sector, geography and conviction.

• Each page carries a price chart at the top and an auto-updating filings timeline underneath, so every announcement in this roundup is already sitting on the relevant company’s page in date order.

It is not a screener and it is not a list of tips. It is the working file I keep for myself, opened up.

Which also means roundups like this one get more useful from next week.

Every company named above will have a page you can click straight through to, so instead of reading that Covalon’s gross margin went to 67.2% and wondering whether that is the thesis working, you can go and read what the thesis said should happen.

To mark the launch, I am running 25% off the annual plan. It applies to your first year and it is available for a limited time only.

Claim 25% Off the Annual Plan

Paid subscribers get every deep dive, the full archive, and from next week the research portal itself.

Thanks for reading,

Nico

Disclaimer: This is not a recommendation to buy or sell any securities. The Content does not constitute investment advice, financial advice, trading advice, or any other sort of advice. Nothing in this newsletter should be construed as a personal recommendation or advice to buy, sell, or hold any investment or security. All Content is provided for general informational purposes only and should not be relied upon for making investment decisions. You should not make any investment decision based solely on the Content without first consulting with qualified financial advisors, conducting your own research, and considering your individual financial circumstances, investment objectives, and risk tolerance. To read our full disclaimer, click here.

To read our full disclaimer, click here.

In May I wrote up a debt-free, cash-rich medical-consumables microcap that had just been marked down for a single soft quarter. Revenue was down 15%, and the market read that as the whole story.

My argument was that it was order timing sitting on top of a hospital customer base that had been built faster than the revenue line could show.

The company has now reported the quarter that answers the question.

• Revenue up 20%.

• Gross margin up more than 2,000 basis points.

• Operating expenses flat.

• Adjusted EBITDA more than triple a year ago.

• Earnings per share in one quarter greater than the previous five quarters combined.

• And the cash balance is higher than it was before the company paid out a $4 million special dividend.

The stock has moved roughly 50% since the original write-up, most of it in the days after the print.

For paid subscribers below: the numbers, what changed in the thesis, what didn’t, how the valuation looks after the move, and my updated view from here.

Read more

To read our full disclaimer, click here.

Every so often a position resolves the easy way.

On 29 July, MIMEDX Group agreed to acquire Sanara MedTech.

We initiated coverage on 6 January at $24.00. The deal values Sanara at $35.00 a share.

That is +45.8% in a little under seven months.

The path there was not a straight line.

In March, after an ugly Q4 print, the stock was $18, down 25% from initiation. I wrote an update at that price arguing the business had got cheaper for the wrong reasons and the thesis was intact.

From $18, the deal price is 94.4% higher, in four months.

The Deal

MIMEDX is paying $33.00 in cash plus 0.4735 MIMEDX shares for each Sanara share. On MIMEDX’s five-day average close of $4.22, that works out to $35.00 per share.

Total enterprise value is roughly $350 million, a 46% premium to Sanara’s 30-day volume-weighted average price as of 28 July.

Both boards approved unanimously. MIMEDX is funding the cash portion from existing cash plus a new $300 million term loan from Hayfin Capital Management, with its existing credit agreement repaid and terminated in full.

Closing is expected by the end of 2026, subject to Sanara shareholder approval and regulatory clearance.

One detail is worth pulling out. The March update ran Sanara at 3x forward sales - the low end of the surgical med-tech peer range - and got to roughly $36 a share.

MIMEDX paid $35.

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How It Played Out

The thesis in January was not complicated.

Sanara was a profitable, growing surgical products business. 93% gross margins, 22% revenue growth, trading at about 2.4x EV/Sales while comparable surgical med-tech changed hands at 3-6x.

Management had just done the hard thing, shutting down the loss-making Tissue Health Plus segment to become a clean surgical pure-play. The distributor model was scaling revenue on flat internal headcount: 22% growth on the same 40 field reps they had run for three years.

Sitting on top of that was OsStic, a synthetic injectable bone adhesive with FDA Breakthrough Device Designation, which the market valued at zero.

Then Q4 landed and the stock fell apart.

Revenue grew 5%. Operating income missed by 66%. A noncash impairment hit the P&L. And the debt balance, which the original thesis expected to come down, went up instead - from $30.7 million to $46 million, with interest expense more than doubling to $6.8 million.

The stock went to $18.

The March update argued the headline was hiding the progress.

The 5% growth was a hurricane comp, with Q4 2024 carrying roughly $1.8 million of one-off BIASURGE demand from a saline shortage. Strip it out and Q4 grew 13%. Strip the impairment and operating income grew 28%. The THP wind-down was complete and under budget. A Vizient contract had just opened roughly 1,800 new facilities for the fastest-growing product, close to doubling the addressable base overnight.

The one thing that update would not wave away was the debt. No credit until the April refinancing actually happened.

It never happened. A buyer refinanced the whole company instead.

What the Trade Teaches

The price fell 25%. The business didn’t.

Between the January thesis and the March update the stock lost a quarter of its value. Over the same stretch the business reported full-year revenue crossing $100 million for the first time, up 19%. Gross margin up 200 basis points to 93%. Adjusted EBITDA up 86% to $17 million. Operating cash flow moving from essentially nothing to $6.8 million, or roughly $16 million stripping out the THP wind-down. The distributor network went from 350 partners to over 450, facility customers to over 1,450, and the loss-making segment was shut.

Every operating line moved forward. The share price was the only thing that went backwards.

The work in that window was not deciding whether the stock looked cheap.

It was checking, line by line, whether anything in the thesis had actually broken. In my opinion nothing had.

Optical mess stops mattering the moment a buyer turns up.

What broke the stock in March was a hurricane-inflated prior-year comparison, a noncash impairment charge and a GAAP loss line. All three are screen-level artefacts. None of them changed how much collagen product Sanara sold, what it cost to make, or how many hospitals were buying it.

Four months later MIMEDX paid a 46% premium.

An acquirer normalises the comp, adds back the impairment and refinances the debt onto its own balance sheet, because it is buying the asset rather than the quarterly presentation of it.

Accounting ugliness is a discount available to whoever is willing to look underneath it.

This could have gone the other way, and the debt is the reason.

Debt went from $30.7 million to $46 million during 2025 and interest expense more than doubled to $6.8 million at a 13.5% rate.

The April 2026 refinancing the original thesis assumed would happen never did.

The March update flagged this as the open risk and declined to give credit for a refinancing until it landed.

We never found out how that resolved, because a buyer took the entire balance sheet out.

That is a good outcome arriving from outside the thesis.

Had no buyer turned up and growth come in at the low end of the 13-17% guide, the same balance sheet would have been exactly the problem the March note said it might be.

Leverage is what separates a thesis that is merely slow from one that does permanent damage, and the honest reading here is that the risk was correctly identified and then resolved by luck rather than by anything in the analysis.

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Where That Leaves Holders

The stock trades close to, but a shade below, the deal value. That is the usual arbitrage discount for time and completion risk.

A modest spread remains for holders willing to sit through closing and carry the regulatory and shareholder-vote risk. That is a merger-arb decision rather than the idea we underwrote in January, and it is a different game with different skills.

For our purposes the thesis has done its job. The gap we identified has closed. There is no mispricing here left to be right about.

The Bottom Line

Sanara did what we hoped, faster than expected and by a route we did not model.

A profitable, growing, 93%-gross-margin surgical business at half its peer multiple, bought in January, held through a quarter that read far worse than it was, and taken out at $35 in July.

The part I would repeat is watching the operating lines rather than the quote when the stock fell. The part I would not claim credit for is the debt, which was the one thing flagged as most likely to go wrong and which got solved by an acquirer rather than by management.

+45.8% from initiation in January. +94.4% from the March update. Coverage closed.

There will be no further updates on Sanara MedTech.

As always, this is not investment advice. Do your own research, consider your own risk tolerance, and make your own decisions.

Thanks for reading,

Nico

Disclaimer: This is not a recommendation to buy or sell any securities. The Content does not constitute investment advice, financial advice, trading advice, or any other sort of advice. Nothing in this newsletter should be construed as a personal recommendation or advice to buy, sell, or hold any investment or security. All Content is provided for general informational purposes only and should not be relied upon for making investment decisions. You should not make any investment decision based solely on the Content without first consulting with qualified financial advisors, conducting your own research, and considering your individual financial circumstances, investment objectives, and risk tolerance. To read our full disclaimer, click here.

To read our full disclaimer, click here.

In November, we published a thesis on a profitable healthcare company trading at 71% of cash per share.

Trading at 71% of Cash Per Share, Quality Compounder, Record Backlog Going Into Q4

In February, with the stock up 30%, we revisited after two key catalysts - a divestiture and a GE HealthCare contract extension - landed in rapid succession.

Trading at 91% of Cash Per Share, Up 30%, and the Biggest Risk Just Disappeared

In May, with Q1 in hand and the stock up 64%, I wrote that the thesis had played out as expected but the easy part was over.

Vaso Corporation (OTCQX: VASO) | Up 64% From Entry, First Operational Data Lands

The stock is now $0.26, up roughly 85% from our entry point.

It moved 38% yesterday alone.

On Monday, VASO announced it had completed the sale of NetWolves Network Services to COEO Solutions for $14.5 million in cash.

The market read that as a windfall. I read it as the end of the thesis I originally wrote.

This post is my reasoning why…

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Most investors have one label for this company, and it is two years out of date.

Failed launch.

The product got approved and then went nowhere. The stock lost more than 85% of its value in a year. A reverse split followed, then an emergency financing to clear the debt.

People filed it under broken biotech and moved on.

That label is the opportunity in my opinion.

Because what this is now is a turnaround, and it is already working. Management rebuilt the way the product reaches the customer, and the demand curve turned before anyone bothered to update the story. Volumes grew 51% year-over-year last quarter and set an all-time record in March. April beat March. Gross margins are 87%. The debt is gone.

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Here is what makes that interesting.

A turnaround that has already turned is a very different proposition to one you are still betting on. The evidence is in the numbers rather than in the pitch, and the market has not repriced it.

Then there is the second layer, and it is the part I like most.

Sitting on top of the commercial business are two late-stage programmes the market is currently valuing at zero. One goes after a market more than three times the size of the one the company sells into today, in a condition with no approved treatment anywhere in the world, and a partner is funding roughly 90% of the trial bill. The other already has an agreed path with the regulator.

Free optionality, on somebody else’s balance sheet.

So the category here is simple:

A microcap turnaround at the inflection point, with a partner-funded pipeline attached at no cost, in a stock still priced on the old story.

Here’s everything you need to know…

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For three years, one number kept this stock in a cage.

The province that funds most of its business kept threatening to cut the rate it pays per bed. So investors treated the whole company as a coin flip on a government decision, and the multiple stayed on the floor.

This spring, the cut was cancelled.

Not deferred. Cancelled, and the rate maintained going forward.

The biggest overhang on the stock was just removed - replaced by a much smaller, capped headwind - and I don't think the market has repriced it.

Here is what makes that interesting.

The overhang lifted at the exact moment the business hit its inflection. Last quarter, revenue, EBITDA, margin, and net income all moved up together, with profit growing faster than revenue. That is operating leverage finally showing through, and margins are now closing in on double digits.

Underneath it: a profitable, dividend-paying business that already holds about 18% of its market, with plenty of room to keep taking share, a demographic wave at its back, and a balance sheet cleaner than it has been in years.

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I think the setup is asymmetric.

My base case points to a double from here, the bull case to more than 3x, and even my bear case limits the downside to roughly -25%.

Those are illustrative scenarios I use to frame the range, not forecasts, promises, or investment advice. The full assumptions behind each one are laid out below, and you should do your own work before drawing any conclusions.

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Every deep dive you read here starts somewhere. Before the thesis, before the valuation work, before the risk section - there’s a list.

This is that list.

Each month going forward I’m now sharing my watchlist, the names I’m actively researching, where they sit in the pipeline, and what would move them up or knock them off.

Some of these will graduate to full deep dives. Some will fall away as I do the work. That’s the point - you’re seeing the funnel, not the finished product.

This month there are five names: a post-bankruptcy turnaround the market left for dead, a $5 million nano-cap with a founder who owns half of it, a botched pharma launch getting fixed by serious money, a quiet Canadian compounder about to show its operating leverage, and a medtech that just won a first-of-its-kind FDA approval.

Here’s what I’m watching, and why.

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The Clinical Edge has a new name. It’s now Healthcare Stock Ideas.

Same person writing it, same research, same process - so if this email looks like it’s from someone new, it isn’t. It’s still me.

Here’s the honest reason for the change.

With the old name, I never got the reach or the discoverability this page should have had. “The Clinical Edge” just didn’t tell anyone what they were actually getting.

“Healthcare Stock Ideas” does. There’s no mistaking what this page is about now 😂.

And I think it deserves the reach…

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Let me start with where the page is at:

• 17 ideas published.

• 50% average peak return since publication.

• 6 of the 17 - 35% - up 75% or more at some point.

• The average idea is 169 days old. About five and a half months. The newest is nine.

But I lead with peak return for a reason.

This page is built for asymmetric setups, where the mispricing sits in the optionality and the biggest move usually comes early, before the crowd catches on.

Peak return is the honest headline for what this approach is designed to produce. And this is what micro-cap healthcare can do when the research is right.

That track record is why the rest of this matters.

Now the part I told you to stick around for…

I’ll be honest with you: this page has been priced well below the substacks in this niche performing at the level we are. That changes Monday.

From Monday, it’s $699 a year or $85 a month.

Until then it stays exactly where it is now - $400 a year or $50 a month.

After Monday, it will never be cheaper than it is today.

If you’ve been sitting on the fence, this is the moment. Subscribe or upgrade before Monday and you lock in the current price for as long as you stay subscribed, even after it rises.

Lock in Today's Price

The goal is simple going forward, and I’m writing it down here so you can hold me to it:

I want to become the number one healthcare newsletter on Substack.

To everyone already supporting the page - thank you. It’s your support that makes all of this possible.

Have a great weekend,

Nico

Disclaimer: This is not a recommendation to buy or sell any securities. The Content does not constitute investment advice, financial advice, trading advice, or any other sort of advice. Nothing in this newsletter should be construed as a personal recommendation or advice to buy, sell, or hold any investment or security. All Content is provided for general informational purposes only and should not be relied upon for making investment decisions. You should not make any investment decision based solely on the Content without first consulting with qualified financial advisors, conducting your own research, and considering your individual financial circumstances, investment objectives, and risk tolerance. To read our full disclaimer, click here.

To read our full disclaimer, click here.

In 1993, Peter Lynch wrote a column called “A Chicken’s Guide to Biotech.”

It was written for people who liked the idea of biotech but couldn’t stomach the risk.

The premise was simple: here’s how to get exposure to the sector without betting on some tiny lab that might blow up overnight.

A chicken’s way out.

I’ve read that column more times than I can count.

And here’s the funny thing.

Buried inside Lynch’s “play it safe” advice is the exact framework I use to think about healthcare microcaps today.

He just told his readers not to use it.

Let me show you what I mean…

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The Setup Hasn’t Changed in 30 Years

Lynch was writing in the middle of a biotech sell-off.

Investors had lost faith. They’d lost money.

And the roughly 225 publicly traded biotech companies of the era suddenly couldn’t raise a dime.

In his words, they could no longer “depend on the public generosity to keep them solvent.”

The new-issue market had shut down. The eager crowd of buyers had vanished.

So the cash-poor labs were forced into mergers, joint ventures, and licensing deals with richer partners - mostly the pharmaceutical giants.

It’s worth reading that twice, because it describes the biotech market almost perfectly right now.

A brutal drawdown. A frozen financing window. Dozens of small companies trading for less than the cash sitting in their bank accounts, forced to do deals just to survive.

To most investors, that’s a horror story.

I tend to see it differently.

Distress is what creates the mispricing. When good science is forced to sell itself cheaply, that’s often when the most interesting opportunities appear.

Lynch’s Chicken’s Way Out

Lynch’s first piece of advice was to buy the pharmaceutical giants.

The logic was sound. The giants had a problem - their blockbuster patents (Cardizem, Procardia, Ceclor) were expiring, and generics were eating into their margins.

But the biotech sell-off handed them a gift: the chance to buy cutting-edge science, with fresh patents, on the cheap.

So Lynch pointed readers toward names like Schering-Plough, which was spending $125 million a year on biotech R&D and had a licensing deal with Biogen for alpha interferon. It traded at about 15 times earnings, growing 15% a year.

Safe. Sensible. Diversified.

And it’s a perfectly reasonable way to invest.

It’s just not where the most dramatic outcomes tend to come from.

A large pharma giant that adds a promising biotech partnership doesn’t usually re-rate by a factor of ten.

The small company on the other side of that deal is a different matter.

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The Part Almost Everyone Skips

Lynch then offered what he called the “reverse chicken’s approach.”

Look at the biotech companies being absorbed by the giants, or the ones doing the major joint ventures.

His reasoning is the most important idea in the whole column:

When Roche spent $2.1 billion to acquire 60% of Genentech, Lynch said it was “a pretty good sign there’s some value left in the remaining 40%.”

That’s the heart of it.

A deep-pocketed pharma giant, with armies of PhDs doing due diligence, validating the science by writing an enormous check - and the public market still pricing the rest at a discount.

Lynch said it was the Roche-Genentech deal in September 1990 that finally convinced him the biotech industry was for real.

It took four months for Genentech to begin climbing, from $21 to $39.

This is close to how I think about The Clinical Edge.

Let the giants and the specialists validate the science. Then look for the small, overlooked company where the market’s story still hasn’t caught up to the scientific reality.

Narrative dislocation. The market lags the science. That gap is the whole point.

The Real Blueprint: Amgen

The best part of Lynch’s column is the Amgen story, and it’s a masterclass in optionality.

Fidelity’s biotech analyst, Mike Gordon, spotted Amgen around 1989 and was begging the in-house managers to load up while it traded at $5 to $7.

When Amgen’s first real product, Epogen, got final FDA clearance, the stock hit $10.

By the end of 1991, it was $76.

Ten times your money in about two years.

But here’s the lesson Lynch wanted you to take away, and it’s one most investors get completely wrong:

“Just because the good news is already out doesn’t mean it’s too late to invest.”

Amgen roughly doubled again in 1991-92 - after it had already won its patent battles, after the FDA approval, after the “obvious” news was public.

The optionality didn’t disappear when the first catalyst hit. It carried on.

It’s a useful reminder that the instinct to sell the moment a thesis starts working is often the wrong one.

The Volatility Is Real

Lynch was honest about the pain, and it’s only fair to be the same.

Not long after Amgen reached $70, the entire biotech sector dropped - because one unrelated company failed an important clinical trial.

Amgen was dragged down in sympathy. $70 to $35. A $10 billion company cut to $5 billion, on news that had nothing to do with it.

In Lynch’s words:

“An investor in biotech shares has to have a strong stomach, and it helps to be farsighted as well.”

But what he says next is the part worth underlining, because it’s essentially a screen:

When the whole sector gets hit, look for bargains - “companies with share values close to their cash holdings.”

With one crucial filter to keep the risk contained.

Limit the search to companies that already have drugs on the market, or at least in clinical trials, with real revenue coming in.

Cash on the balance sheet. Real products. Actual revenue. Bought during a sector-wide panic.

Regular readers will recognise that, because it’s almost word for word how I screen for healthcare microcaps trading near or below their own cash.

Here is one here:

Lynch wrote the filter in 1993. It still works.

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Where I Personally Go the Other Way

The way Lynch closes the column is, more or less, the way the masses have always been advised on biotech.

It’s too volatile. Too complex. Leave it to the professionals. Buy a diversified fund and don’t try to pick the small names.

There’s nothing wrong with that advice. But it is what almost everyone is told - and when the whole crowd is funnelled toward the same safe options, the giants and the funds and the index, the small overlooked companies get left for dead.

That neglect is the opportunity.

So my strategy deliberately goes the other way. Into the undiscovered, unloved corner of healthcare the masses are steered away from.

But going against the crowd without protection is just recklessness with extra steps.

So I take the very things Lynch said to look for in biotech and turn them into my margin of safety:

• Cash on the balance sheet, a product on the market or in trials, and real revenue coming in - the exact filter Lynch laid out, so the downside is anchored to something tangible.

• Multiple shots on goal - pipeline diversity, platform technology, more than one way for the thesis to work.

• Real problems - genuine unmet medical need, a clear regulatory path, customers willing to pay.

• Founder-led teams with their own money on the line.

Then comes the part that ties it all together: how I actually build a position.

I start small. The initial position is deliberately modest - sized so that if the thesis is simply wrong, it does no real damage to the portfolio.

I only add as catalysts approach and the data backs up the story.

And once a position is working, I’m in no rush to trim it.

That combination - operating where the crowd won’t, but insisting on cash, revenue, optionality and alignment before I do, then starting small and adding into strength - is the margin of safety.

It’s what lets me take controlled positions in an area everyone else is told to avoid.

The Takeaway

Peter Lynch wrote a guide for people who were nervous about biotech.

But, for me, a far more interesting approach was sitting in the same column the whole time.

Buy good science during a panic. Insist on cash on the balance sheet, real products, and real revenue. Let the giants validate the breakthroughs. Hold through the volatility. And think hard before cutting a position the moment it starts to work.

Lynch’s column was the careful, conventional route - the one the masses are pointed toward.

My strategy takes the opposite path on purpose: into the small, overlooked names the crowd is told to avoid, with cash, revenue, optionality and alignment as the margin of safety, and small, controlled position sizes as the seatbelt.

That corner of the market - small and overlooked healthcare companies - is exactly where this newsletter goes looking each week.

The Clinical Edge exists to do that work: 2-4 healthcare microcaps a month with asymmetric risk-reward, multiple shots on goal, aligned management, and mispriced optionality.

Paid membership is available here:

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Thanks for reading,

Nico

Disclaimer: This is not a recommendation to buy or sell any securities. The Content does not constitute investment advice, financial advice, trading advice, or any other sort of advice. Nothing in this newsletter should be construed as a personal recommendation or advice to buy, sell, or hold any investment or security. All Content is provided for general informational purposes only and should not be relied upon for making investment decisions. You should not make any investment decision based solely on the Content without first consulting with qualified financial advisors, conducting your own research, and considering your individual financial circumstances, investment objectives, and risk tolerance. To read our full disclaimer, click here.

To read our full disclaimer, click here.

The company I’m sharing today first appeared last week over on Multibagger Ideas - but it deserves a second look here, because I think it’s genuinely one of the more interesting setups I’ve come across in a while.

It’s a rare one. The kind where several boxes get ticked at once - boxes I almost never find stacked together:

• A genuine world leader - an estimated 60-71% of the global proton therapy market - in a structurally growing corner of cancer care

• Toll-bridge economics: every machine sold turns into a multi-decade service annuity, now more than half of a €1.6 billion backlog

• Double-digit revenue growth - €620 million in 2025, up 24% - with profitability guided to roughly double by 2028

• That same €1.6 billion backlog set against barely €500 million of market cap - over 3x the whole company, already under contract

• Founder-rooted and insider-aligned, through the holding structure that controls the ~20% reference shareholder

• A self-funding balance sheet - just €57 million of net debt and a live buyback

• And the one that makes it rare: a 31.3% stake in the world’s largest emerging supply of actinium-225 - cancer’s next-wave isotope - sitting in none of the guidance, with a second free option in astatine-211 behind it

The company is…

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To read our full disclaimer, click here.

The track record so far:

• 16 ideas published.

• 47% average peak return since publication. Not the best one. The average.

• 6 of the 16 - 38% - up 75% or more at some point.

• Average idea is 155 days old. Five months. The newest is 26.

Below is a short thesis summary of my favourite 10 ideas in random order.

A few are free for everyone to read; most sit behind the paywall, where you also get every new idea as it’s published and ongoing coverage of all of them.

As a thank you, I’m giving away just two 25% discount codes on the annual plan - the first two subscribers to redeem them get the rate:

Claim now!

Stock 1

A telehealth infrastructure company building the regulatory and operational backbone that every distributed-healthcare business in America needs, in a market projected to grow from $6.3 billion in 2024 to $10.7 billion by 2033. The platform spans three verticals: a network of 3,000+ independent registered nurses operating under the company’s medical license, a franchise solution helping med spas and IV clinics navigate telehealth regulation, and its real growth engine - a direct-to-consumer platform that lets entrepreneurs launch a 50-state-compliant telehealth company for $5,000/month, with everything from GLP-1s to peptides, TRT, and hair loss running through it. Over 12,000 licenses have sold since launch, now live across all 50 states. Q1 2026 revenue hit a record C$24.9 million, up 449% year-over-year, while operating expenses collapsed from 36% to 9% of revenue and adjusted EBITDA margin expanded to 13.1% - the third consecutive quarter of margin expansion. Management reaffirmed full-year guidance of at least C$150 million in revenue. As regulation tightens across digital health, the compliance-heavy platform becomes more valuable, not less - the moat working exactly as designed.

Stock 2

A profitable, multi-segment healthcare company the market spent years valuing at less than the cash sitting on its balance sheet. The business is anchored by an exclusive professional sales and services relationship with a major imaging OEM - selling and servicing diagnostic equipment across the US - now contractually secured through 2030, removing the single biggest risk to the thesis. Roughly 87% of its IT-segment revenue is recurring, providing a defensive base, while deferred revenue (cash already collected for services not yet delivered) recently hit a record - future earnings effectively banked. After divesting its weakest subsidiary, core revenue is growing, gross profit is expanding, and losses are narrowing as the leaner cost structure flows through the P&L. The story has matured from a pure below-cash arbitrage into an operating turnaround: a debt-free, cash-rich microcap whose record backlog gives it a clear runway to convert demand into earnings, quarter by quarter.

Stock 3

A profitable medical device manufacturer that makes the precision-engineered powered surgical instruments - handpieces, drivers, and shavers with tolerances measured in microns - used to install orthopedic implants, rather than the implants themselves. For over a decade it has been the critical supplier to one of the world’s largest medical device companies, which accounts for roughly three-quarters of revenue. The market treats that concentration as a fatal flaw; the reality is that switching costs on an FDA-approved product line are enormous, customer relationships run for decades, and the supply agreement has now been extended for years, securing the core franchise. After co-developing a next-generation handpiece platform with that customer, the company has moved into full production, with a multi-month backlog providing real revenue visibility. The model throws off significant operating leverage - incremental volume runs through an existing ISO 13485-certified facility with minimal added investment - and recent results show it, with double-digit revenue growth, expanding operating income, and net income that quadrupled. A bolt-on machining acquisition added capacity, and a legacy equity stake in a surgical-robotics company - acquired by a major orthopedics player - delivered realized cash gains plus a long-term supply agreement that could make this the critical supplier to a top-tier robotic-orthopedics platform. It trades at a low-teens forward earnings multiple and a fraction of the sales multiple typical for medical device peers.

Stock 4

A single-product specialty pharma company whose drug is the only on-label therapy in the U.S. for protecting against the permanent hearing loss caused by cisplatin, one of the most widely used chemotherapy agents in oncology. The drug carries roughly 96% gross margins, so nearly every incremental sales dollar drops through a largely fixed cost base into operating leverage. The original pediatric indication built the company to its first ~$44.6 million in annual sales, but the real engine is the adolescent and young adult (AYA) and adult population - roughly ten times the size of pediatric - which is now outgrowing the pediatric base as adoption expands across testicular, cervical, and head-and-neck cancers. The field organization has scaled its prescriber target from ~1,300 to over 5,000, and the patient-support program is converting a high share of referrals into completed infusions. The company is now GAAP-profitable with positive operating cash flow, carries zero debt and a healthy cash position, and has delivered six consecutive quarters of sequential revenue growth. A patent settlement secures U.S. market exclusivity to at least September 2033, and an optionality stack sits on top of the core story: European launches through a partner, ongoing Japanese registration discussions, and a widening clinical evidence base in adult tumor types - none of which is yet in the revenue line.

Stock 5

A rare disease pharmaceutical company that acquires rights to orphan drugs - therapies for patient populations so small that Big Pharma can’t be bothered - and then does what the previous owners never did: actually invests in commercializing them. The model carries unusually attractive economics: 70–75% gross margins, high switching costs (once a pediatric patient is stable on a therapy, physicians don’t switch), strong reimbursement with few alternatives, limited competition, orphan-drug regulatory exclusivity, recession resistance, and operating leverage as a flat sales infrastructure scales across more products. The portfolio has grown to 10 commercial products plus a deep pipeline of late-stage assets, funded through disciplined, cash-financed acquisitions with no dilution. The company has now turned GAAP-profitable with EBITDA margins inflecting higher, on the back of a long streak of consecutive quarters of sequential revenue growth. Its newest approved drug landed an unexpectedly broad label - no age restriction - expanding the addressable population from a few thousand children to roughly 9,000–10,000 adults at ~$80,000 per patient per year, with patent protection running to 2044. A separate bolt-on product, the only FDA-approved treatment for a time-sensitive infant condition, was just relaunched through a streamlined specialty-pharmacy channel. Management is targeting the largest rare disease portfolio in the U.S. (13–14 products), a $200 million revenue run-rate exiting 2027, 50% adjusted EBITDA margins by 2028, and $500 million in revenue by 2030 - and has so far done what it said it would do.

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Stock 6

The operator of Canada’s largest network of dedicated chronic pain clinics - regulated medical facilities staffed by specialists, funded almost entirely (97–99%) by provincial government health insurance. This is a private provider of public health services, delivering hospital-grade pain treatment (nerve blocks, radiofrequency ablation, ketamine and lidocaine infusions, and newer high-margin procedures) in community clinic settings that give patients faster access while costing the system less. The demand is structural, not cyclical: one in five adults lives with chronic pain, specialist wait times can stretch 18 months, and clinic waitlists run into the thousands - a public system that simply cannot keep up with an aging population. Recent results show clear operating leverage, with revenue growing in the mid-20s percent while adjusted EBITDA nearly doubled as capacity utilization climbed past 80% across a right-sized clinic footprint. The company has now posted positive EBITDA for 27 consecutive quarters, carries minimal net debt with one of the cleanest cap structures on its exchange (no warrants, no convertibles), and trades at roughly half the EV/EBITDA multiple of comparable Canadian healthcare clinic operators. With acquisition financing secured and 10–12 targets under evaluation in a fragmented market, the CEO buying shares personally, and a buyback running, there are multiple independent paths to value: organic growth, geographic expansion into new provinces, higher-margin service mix, and accretive M&A.

Stock 7

A profitable, debt-free advanced medical-consumables company selling into hospitals across three areas - vascular access, advanced wound care, and surgical consumables - all built around reducing healthcare-associated infections. Its anchor products cover and protect IV line connections, addressing an enormous clinical problem: roughly 90% of hospital patients get an IV line, more than a billion are placed each year, and every one is a potential pathway for bloodstream infection that costs far more to treat than to prevent. The business runs at 58% gross margins - 500 to 1,000+ basis points above much larger med-tech peers - is completely debt-free with net cash worth roughly a third of its market cap, and is owned about 50% by insiders, with the board alone holding around half the shares. The model is land-and-expand: win an account through clinical evaluation, then spread product across units and buildings, an annuity-like consumables base reflected in 99% retention of its top-50 hospital accounts. The structural change is a shift from selling hospital-by-hospital to securing system-wide approvals at Integrated Delivery Networks - large health systems with hundreds of sites under one purchasing umbrella - including marquee wins at nationally known medical centers. Each network approval clears the institutional barrier once and then feeds years of facility-by-facility pull-through. Because new accounts start small and convert slowly, the customer base has been built ahead of the revenue, and the stock trades near 1x revenue while debt-free med-tech consumables peers with lower margins trade at multiples of that.

Stock 8

A multi-engine home-healthcare platform that keeps very sick patients out of the hospital by delivering the equipment and clinicians they need directly into their homes, paid a recurring monthly fee - mostly by Medicare - for as long as each patient stays on therapy, which for the sickest can run years. The core business places in-home ventilators for end-stage COPD patients, supported by respiratory therapists and proprietary adherence software, generating durable recurring revenue. Layered on top are three growth engines: a fast-growing sleep apnea franchise with printer-and-ink economics (rent the machine, resupply masks and tubing), tailwinded by GLP-1 adoption pushing more patients in front of doctors; a newly acquired maternal-health line (breast pumps) that plugs into the company’s nationwide insurance contracts to reach markets the target could never serve alone; and a supporting base of oxygen, airway-clearance, and clinical staffing that feeds hospital referrals. The real moat is the operational scaffolding underneath all of it - payer contracts in every state, billing and compliance systems that actually get paid, clinical technology - built over nearly two decades and hard to replicate, so each new product line rides on top without rebuilding it. Recent results showed ~20% revenue growth, record adjusted EBITDA, and free cash flow that more than doubled as the mix shifted toward less capital-intensive categories, all on a near-net-cash balance sheet with an active, renewed buyback. The biggest overhang of the prior two years - a tighter Medicare coverage standard for in-home ventilation - has shifted from active threat to improving setup, with the more objective new criteria arguably favoring scaled providers. It trades around 5x forward EBITDA while home-care and DME peers have historically fetched 8–10x.

Stock 9

A molecular diagnostics company that the market left for dead behind a misleading headline - reported revenue fell sharply after it lost Medicare reimbursement on one legacy test - while the core business underneath was quietly thriving. Having exited that test, it’s now a pure-play thyroid diagnostics company, with 100% of revenue from two proprietary thyroid cancer tests that help physicians avoid unnecessary surgery. The core franchise has been compounding at double-digit rates, driven by rising test volumes, more accounts, and higher revenue per test, while the shift to a thyroid-only model has expanded gross margins toward the mid-60s and pushed adjusted EBITDA margins higher. This is a profitable, cash-generating, debt-free business - it paid off 100% of its debt - not a cash-burning turnaround. The capital structure has been cleaned up: the two private-equity sponsors that control roughly 84% of the company voluntarily converted their preferred stock to common, giving up their liquidation preference - a clear signal they see the upside in the equity, not the safety of the preferred. Management has stated its intent to uplist to Nasdaq, which would open the door to institutional investors barred from the over-the-counter market, improve liquidity, and potentially bring analyst coverage. It trades at a low multiple of forward revenue while the thyroid diagnostics market leader trades many times higher, despite this company growing faster with strong margins. The risks are real - reimbursement exposure, concentrated ownership, and thin liquidity - but the business is executing on every leg of the thesis.

Stock 10

A nano-cap cancer diagnostics company that just quietly hit an inflection the market hasn’t priced in. It runs a CLIA-certified molecular and cytogenetic laboratory delivering academic-level diagnostic accuracy - every report reviewed by faculty-trained pathologists - to community oncologists who lack in-house testing, catching the diagnostic errors that generic reference labs miss. The model has two inherently recurring streams: pathology services (~90% of revenue), where onboarded oncology practices send biopsy and blood samples month after month with high switching costs from credentialing and insurance enrollment, and a faster-growing products division (~10%) selling proprietary reagent kits and assay panels that labs reorder as supplies deplete - at structurally higher (~60%) margins. After working through a billing disruption caused by a cyberattack on its clearinghouse vendor, the company turned positive on both EBITDA and operating cash flow for the first time in its history, while growing revenue ~30% year-over-year. Operating leverage is the story: revenue is climbing while operating expenses stay roughly flat, so each incremental test or kit falls heavily to margin - gross margins have risen toward the high-40s with management targeting 50%+, and the mix shift toward the higher-margin products division could reshape the margin profile as it scales to 20–25% of revenue. It trades at a fraction of the EV/Sales multiple of diagnostics peers, leaving room to re-rate on continued execution alone.

Thanks for reading,

Nico

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