Pro Medicus Ltd Posts FY26 Revenue Growth and $1.34bn Contract Book

FY26 results show broad-based growth across earnings and contracted revenue

In its FY26 full-year results presentation, Pro Medicus reported strong growth across revenue, earnings and contracted revenue for the year ended 30 June 2026. The health imaging technology company recorded reported revenue of $261.7M, up 22.9%, and underlying net profit after tax (NPAT) of $144.7M, up 24.1%.

Underpinning the result was a materially larger forward book, with contracted recurring revenue now standing at $1.34bn over the next five years, up 41.3% in 12 months. The following coverage summarises the key financial, contractual and strategic highlights outlined by management.

FY26 financial performance in numbers

On a reported basis, Pro Medicus delivered revenue of $261.7M (+22.9%), underlying earnings before interest and tax (EBIT) of $196.1M (+24.4%), and an underlying EBIT margin of 74.9%. Underlying NPAT reached $144.7M (+24.1%).

Adjusting for currency movements, the underlying constant-currency growth rates were notably higher. On this basis, revenue rose +28.4% underlying, underlying EBIT increased +30.6% underlying, and underlying NPAT grew +32.5% underlying. These figures strip out the impact of foreign exchange and fair value movements on financial assets.

North America remained the primary growth engine, generating reported revenue of $236.8M, up 24.0%, representing the bulk of group revenue. Australia contributed $19.0M and Europe $5.9M.

Reported NPAT of $265.3M (+130.3%) was significantly inflated by a $174.2M fair value gain on financial assets. This gain, which relates largely to the unrealised value of the company’s holding in 4DMedical, is non-operating and does not reflect underlying operating performance.

Balance sheet and shareholder returns

Pro Medicus ended the period with a strengthened capital position and no debt. Key balance sheet and shareholder return metrics reported for the year include:

• Cash reserves of $216.1M, up 23.8%

• Cash and financial assets of $252.3M, up 19.7%

• Nil borrowings

• Net tangible assets (NTA) per share of $4.10, up 81.4%

• Total fully franked dividend of 69.0c, up 25.5% (interim 32.0c plus final 37.0c)

• Cash conversion of 91%

A record contracted revenue book and 16 go-lives

Growing revenue visibility was a central theme of the presentation. Forward contracts now stand at $1.34bn over the next five years, up 41.3% in 12 months, providing an increasingly deep base of recurring revenue.

During FY26, Pro Medicus signed total contract value (TCV) of $548m, comprising 10 new contracts and 6 renewals. This represented the second highest year on record, behind an exceptional FY25 that included the Trinity Health agreement. New contract wins totalled $407m, with renewals and additions contributing $144m.

All 6 renewals were extended for 5-year terms at higher per-transaction fees, with the company renewing 6 of 6 contracts up for renewal. A total of 16 go-lives were completed during the year, all on or ahead of schedule.

Marquee new wins for the year included:

1. UCHealth Colorado — $170m / 10 years, a “Full Stack + 1” deal including Cardiology, described as the second largest in company history and live from May 2026, within 10 months of signing.

2. Beth Israel Lahey Health — $90m / 7 years, a “Full Stack” deal, the fourth largest in company history, which includes the Dana-Farber Cancer Institute.

3. Radiology Associates North Texas (RANT) — $44m / 5 years, strengthening the company’s private-market presence.

4. University of Maryland — $23m / 5 years, won from a former reference site of a Visage competitor.

Competitive positioning (RSNA 2025)

“Underpins our belief that our technology is 18 to 24 months ahead of competitors, if not more.”

Understanding the enterprise imaging opportunity

Pro Medicus develops software for medical imaging. Its core Visage 7 platform acts as a single viewer for all medical images, spanning radiology, cardiology and pathology, across the patient’s health record, an approach the company terms “Enterprise Imaging.”

A key technical differentiator is its streaming technology. Legacy picture archiving and communication systems (PACS) typically rely on a “compress and send” method, whereas Visage 7 streams data, enabling faster access to increasingly large imaging datasets.

The company outlined three structural demand drivers supporting adoption:

• Data explosion — modern scans are enormous, with Photon-Counting CT producing 10,000+ images and digital pathology files reaching up to 30GB.

• Radiologist burnout and a global shortage — a growing volume of images alongside fewer specialists is driving demand for efficiency tools.

• Cloud shift — Visage 7 CloudPACS is fully cloud-native, which management described as a significant strategic advantage.

For investors, the model generates recurring, transaction-based revenue that grows as exam volumes rise. Notably, Visage customers are growing at roughly 8% against a US market growing at around 3%.

The investment case: AI, new products and a large runway

Pro Medicus framed its growth strategy around four pillars: winning new clients, growing existing clients, launching new products and entering new geographies. Management pointed to a large runway, citing a total addressable market (TAM) of 690 million US exams per annum, with current penetration at approximately 11% and around 85% of the market addressable from a commercial perspective.

The company also highlighted a network effect, noting that more than half of the top-20 US hospitals (11 of 20) use Visage 7 for PACS. New products are broadening the offering, including Visage 7 Reporting, an AI-optimised module announced at SIIM 2026 with first implementations expected during 2026, alongside Digital Pathology and growing traction in Cardiology Imaging at UCHealth, Vancouver Clinic and MedStar.

On artificial intelligence (AI), the company detailed a breast cancer detection algorithm co-developed with NYU, with commercialisation pending FDA clearance. Its capital-light strategy focuses on sourcing best-in-breed algorithms.

Two strategic investments, which are distinct from operating revenue, were also outlined:

• 4DMedical (ASX:4DX) — a $10m hybrid debt and equity investment carrying a 12.5% pa coupon, with an unrealised gain of approximately $172m as at 30 June 2026. This unrealised gain drove the inflated reported NPAT.

• Echo iQ (ASX:EIQ) — an initial A$10m investment in secured unlisted convertible notes at A$1.05 per note, with an option to invest a further A$10m upon Echo iQ receiving FDA clearance of EchoSolv HF.

What comes next

Management pointed to several disclosed forward indicators. The Trinity Health implementation is progressing, with 5 of 7 cohorts complete (87%) and the remaining 13% due by October 2026. The North American pipeline was described as robust in both quality and quantity, supported by an increased number of inbound requests for proposals (RFPs) across all segments.

Several upcoming go-lives remain on schedule, including Beth Israel Lahey, University of Maryland, TidalHealth and St Luke’s, with certain targets set for the first quarter of CY27. With nil debt, a strong cash position and a growing forward book, the company enters FY27 with an expanding base of contracted revenue visibility.

Cloud-native CloudPACS deployments, such as the TidalHealth implementation targeting Q1 2027, demonstrate how the cloud-first architecture is translating from a competitive talking point into contracted go-lives across a range of health system sizes, from large academic medical centres down to regional providers.

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