Ion Beam Applications SA (IBA)

I came across a Belgian company called Ion Beam Applications (IBA), ticker IBAB on Euronext Brussels. (€365.32M market cap)

They’re a niche player in medical technology, I’m curious what you think about their outlook.

What they do:

• Global market leader in proton therapy (used for advanced cancer treatment).
• Active in dosimetry (radiation QA), radio-pharma cyclotrons, and industrial accelerators (sterilization, polymers, even PFAS destruction tech).
• Installed base: 44 proton therapy sites, 700+ accelerators sold, 150k+ patients treated.

Moat / Strengths:

• ~60% market share in proton therapy equipment.
• Strong IP portfolio (500+ patents).
• Recurring revenue from long-term service contracts (€158m in FY24).
• Expanding into high-growth niches like theranostics (Actinium-225, Astatine-211) for targeted cancer therapies.
• One of the few B-Corp certified medtechs, ESG positioning.

Growth drivers:

• Proton therapy still in early adoption (0.5–1.5% of radiotherapy patients treated with it vs. ~20% potential).
• Big upside in China and the US, plus clinical trial momentum that could expand reimbursed indications.
• Industrial sterilization market shifting from Ethylene Oxide/Gamma → X-ray & e-beam (IBA’s strength).
• New ventures like PanTera (225Ac) and semiconductor applications.

Financials / Outlook:

• FY24 revenue: ~€498m, backlog €1.5bn.
• Service revenues and installed base scaling expected to improve margins.
• Management guides to ~10% REBIT margin by 2028 (currently low single digits).
• Capital-light growth in new ventures could add upside.

Risks:

• Competes with giants like Varian (Siemens Healthineers), Hitachi, Sumitomo, Mevion.
• High capex projects → revenues lumpy, margins volatile.
• High level of non-cash earnings
• Dependence on clinical trials and reimbursement for broader proton therapy adoption.
• Geopolitical & supply chain risks (tariffs, China exposure).

Do you see IBA as a hidden gem in medtech with strong long-term tailwinds, or too risky given the capex intensity and competition? Would love to hear your take on whether this is worth adding to a growth/medtech portfolio.