Investors choosing between high-growth healthcare innovators must weigh specialized diagnostics against therapeutic platforms. Choosing between HeartFlow Inc. (HTFL +2.38%) and NovoCure Ltd. (NVCR +4.67%) depends on your appetite for risk and market adoption.
HeartFlow focuses on non-invasive diagnosis of coronary artery disease using artificial intelligence. NovoCure develops innovative electric fields to disrupt cancer cell division. Both companies aim to modernize standards of care in their respective fields, yet they face distinct regulatory and commercial hurdles as they scale their global operations.
The case for HeartFlow
HeartFlow provides medical technology that utilizes software and artificial intelligence to diagnose coronary artery disease. By analyzing a single heart scan, the system helps physicians manage patient care without invasive procedures. The company maintains an installed base of 1,465 accounts in the United States and currently holds no major customer concentration risk.
In FY 2025, revenue reached approximately $176 million, representing a 40% increase over the prior year. Despite this strong top-line expansion, the business reported a net loss of $116.8 million for the period. This indicates that while the company is expanding its reach among medical device stocks, it has not yet reached profitability.
As of its December 2025 balance sheet, the debt-to-equity ratio is approximately 0.1x. This ratio compares total debt to shareholders’ equity, indicating a low level of borrowing relative to shareholders’ equity. Free cash flow, calculated as cash from operations minus capital expenditures, was nearly negative $59.0 million for the year.
The case for NovoCure
NovoCure is a global oncology firm that commercializes Tumor Treating Fields therapy, a treatment using electric fields to disrupt cancer cell division. The company serves roughly 4,620 active patients and manages a critical strategic partnership with Zai Lab to enter the Greater China market. It operates a direct-to-patient model in many regions to ensure specialized delivery of its therapy while relying on hospital-based contracts in Japan.
For FY 2025, the company generated revenue of approximately $655.4 million, which is an increase of 8.3% over the previous year. However, the business recorded a net loss of nearly $136.2 million during this period. The firm remains in a stage of significant investment to support its clinical pipeline.
Based on the December 2025 balance sheet, the debt-to-equity ratio is roughly 0.8x. Free cash flow for the period was nearly negative $75.7 million.
Risk profile comparison
HeartFlow faces significant product concentration risk because nearly 98% of its revenue comes from its core diagnostic analysis tool. The company is also navigating a Civil Investigative Demand from the Department of Justice regarding its marketing practices. Additionally, ongoing patent litigation against Cleerly, Inc., and potential reimbursement cuts by regulators could affect future revenue.
NovoCure relies heavily on its Optune product family, making it vulnerable to regulatory or clinical setbacks affecting those devices. Its reliance on Zai Lab for expansion in China introduces collaboration risks if the partner underperforms. Furthermore, the company faces complex global reimbursement policies and geopolitical risks due to its manufacturing facilities located in Israel.
Valuation comparison
Neither business makes money, so there is no forward price-to-earnings ratio to weigh. NovoCure presents a more conservative valuation profile with a lower P/S ratio.
MetricHeartflow Inc. Common StockNovoCureSector BenchmarkForward P/EN/AN/A24.6xP/S ratio15.5×2.5x
Sector benchmark uses the SPDR XLV sector ETF.
Valuation metrics sourced from Financial Modeling Prep (FMP) and may differ from other data providers.
Which stock would I buy in 2026?
Upstart biotech companies can be exciting, and NovoCure is no exception. The company recently got FDA approved for its Optune Pax, to treat patients with advanced localized pancreatic cancer. Its core product, Optune Gio, treats glioblastoma in people 22 or older. Both use alternating electrical fields, called Tumor Treating Fields, or TTF, to disrupt cancer growth and slow disease progression. That’s exciting.
But as a business to invest in, NovoCure shows some red flags. For one, Wall Street doesn’t anticipate the company generating any free cash flow until fiscal 2028, meaning NovoCure will be under pressure to finance operations until then. While the company has real revenue, with $704 million projected for 2026, it’s not growing as fast as other biotech stocks.
HeartFlow, meanwhile, is also a money-loser in the early stages of its commercialization. HeartFlow’s use of AI to assist doctors in detecting heart blood flow blockages non-invasively is real-world proof of AI’s ability to improve patients’ lives. The company boasts the largest proprietary set of medical images on which to base its forthcoming autonomous diagnostic tool. HeartFlow says it has 200 million doctor-annotated images to teach its AI. It, too, however, isn’t expected to generate positive free cash flow until 2028.
Both companies are compelling potential winners. Novocure’s higher projected revenue for fiscal 2026, at $704 million compared to $230 million for HeartFlow, suggests the business has greater heft and market interest than HeartFlow. NVCR’s low price-to-sales ratio is a relative bargain compared to HeartFlow’s. The choice for long-term investors here is Novocure.
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