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4DMedical vs Telix Pharmaceuticals shares: which health innovator wins?
If you're weighing up a buy between 4DMedical Ltd (ASX: 4DX) and Telix Pharmaceuticals Ltd (ASX: TLX), you're comparing two ambitious Australian medical technology companies. Both are at the forefront of healthcare innovation, but their financial profiles and recent growth stories offer very different investment prospects. Let's dig in to see how these two stack up.
The case for 4DMedical
4DMedical is breaking new ground in respiratory imaging. Its flagship CT:VQ software turns CT scans into detailed lung maps, giving doctors advanced tools for diagnosing diseases like pulmonary embolism and emphysema. The tech's already in use at top US hospitals like Mayo Clinic and Stanford, with a recent European expansion thanks to its acquisition of Contextflow.
Looking at the numbers, 4DMedical carries a sizeable market cap of $2.07 billion but has yet to become profitable, posting negative earnings per share of -0.405. There's no dividend on offer, and no price/earnings (P/E) ratio available yet; this signals it's still firmly in growth mode. The year-to-date return sits at -14.5%, indicating a tough recent run for shareholders. This makes 4DX more of a high-risk, high-potential play, especially for those backing new technology looking to disrupt established medical imaging markets.
The case for Telix Pharmaceuticals
Telix Pharmaceuticals is a commercial-stage biotech pushing the boundaries of cancer diagnostics and treatment. Its main product, Illuccix, has approvals from regulators including the TGA, FDA and Health Canada, making it a global force in prostate cancer imaging. Beyond Illuccix, Telix is running more than 20 clinical trials worldwide, chasing breakthroughs in cancer types ranging from kidney to brain to bone marrow.
Telix stands out for having already turned the corner into profitability. Its market cap dwarfs 4DMedical's at $6.03 billion. Earnings per share are positive (0.099), which is rare for an ASX biotech this size. The company trades on an eye-watering P/E ratio of 118.40—sky-high, but not unusual for fast-growing pharmaceutical businesses. Like 4DMedical, Telix pays no dividend, pouring resources back into growth. But the real highlight is a stellar year-to-date share price return of 45.89%, signalling momentum.
Valuation comparison
Here's a side-by-side look at the major valuation and fundamental metrics:
| Metric | 4DMedical (4DX) | Telix Pharmaceuticals (TLX) |
|---|---|---|
| Market Cap | $2.07 billion | $6.03 billion |
| P/E Ratio | N/A | 118.40 |
| Earnings per Share | -0.405 | 0.099 |
| Dividend Yield | 0.00% | 0.00% |
| Year to Date Return | -14.50% | 45.89% |
There's a clear gap in scale and financial maturity. Telix is both far larger by market cap and actually generating earnings, whereas 4DMedical is still burning through capital to develop its market. Neither pays a dividend, so both are pure growth plays.
Recent share price performance
Share prices can be volatile in the health tech sector, but the difference here is striking. As of the latest data (mid-September 2026), 4DMedical shares sit at $3.44, having dropped 14.5% year to date. Its weekly moves have often swung several percent either way, showing volatility without a clear upward momentum.
Telix, meanwhile, is on a tear. As of 15 September 2026, shares closed at $17.75 and are up a hefty 45.89% for the year. The stock has seen sharp daily moves—like an 8.63% gain on one recent day—but the overall trend has been strongly positive. Telix's growth story is, at least so far, being rewarded by the market.
Which is the better buy?
Weighing up these two, my pick would be Telix Pharmaceuticals. The company has global regulatory runs on the board, it's already doing solid revenue, and it's delivered real profit. Yes, it does trade on a huge earnings multiple, but I'd see that as justified given the momentum: 45% year-to-date gains, and more than 20 clinical trials in the pipeline.
4DMedical clearly has exciting technology and major growth aspirations, but as of now, it's loss-making and suffering negative share price performance.
In short: if I'm backing an Aussie health innovator today, I'd go with Telix.
