Saluda’s IPO on ASX Points Up Vulnerability of SCS Market

by Jeremy Koff, senior consulting editor

As 2026 begins, the neuromodulation industry has never been more exciting with a significant number of startup companies, applications, and innovations attracting investor interest. However, one sector continues to drag on the investment and valuation side, specifically spinal cord stimulation, a market more than six decades in the making that has reached a level of maturity where sustaining growth and defending valuations has become increasingly difficult. While technological innovation continues, public and strategic investors are placing greater emphasis on capital efficiency, scalability, and profitability—metrics that have historically proven challenging for large, single-product active implantable device companies.

Saluda Medical was the last neuromodulation company to access the public markets in 2025, entering with a market capitalization of approximately A$359 million (about U.S. $240 million) and an enterprise value of A$1.18 billion (U.S. $790 million), which includes equity value as well as debt and other obligations. Despite Saluda’s unusually strong long-term randomized clinical data supporting its closed-loop SCS platform, early trading performance has been subdued. Shares priced at A$2.65 in the IPO were trading at A$1.44 on the first trading day of 2026, reflecting heightened public-market skepticism toward the SCS category. That skepticism has been amplified by the Nevro acquisition in 2025 for approximately $250 million—a valuation that surprised many observers given Nevro’s revenue scale, prior public-market capitalization, and brand recognition. The transaction reinforced a growing perception that even well-established SCS franchises struggle to deliver sustained EBITDA profitability, effectively resetting valuation benchmarks across the sector.

By contrast, peripheral nerve stimulation continues to attract outsized interest from both investors and strategics. With fewer entrenched commercial incumbents, lower procedural and infrastructure requirements, and faster adoption across pain and orthopedic indications, PNS is widely viewed as offering a more attractive growth profile than mature SCS markets. As a result, capital is increasingly flowing toward PNS platforms, even as companies like Saluda introduce meaningful step-function innovation within SCS. Under current market dynamics, Saluda’s ability to drive a higher valuation will depend not only on accelerating revenue growth, but also on demonstrating a credible and timely path to profitability—proving that a single-product SCS company can generate durable shareholder value in a post-Nevro landscape.

Saluda began trading on the Australian Securities Exchange earlier this month following the completion of its initial public offering. Under the IPO, Saluda raised A$230.8 million ($150 million) from new and existing securityholders through the issue of 87.1 million new CHESS Depositary Interests at A$2.65 per share. Funds raised will be used to expand Saluda’s sales team, marketing and commercial support and product development. Trading on the ASX commenced December 5, 2025, under ASX ticker “SLD.”.

“This IPO and capital raise mark an important moment for Saluda,” said Barry Regan, president & CEO of Saluda Medical. “With strong clinical evidence, a scalable commercial model, and the dedication of our team, we are now even better positioned to accelerate our mission globally. This funding enables us to expand our U.S. footprint, invest in innovation, and deliver on our commitment to transform patient care worldwide.”

Developed over 15 years, Saluda’s proprietary, FDA-approved Evoke system was the first SCS device capable of reading and responding to the spinal cord’s evoked compound action potentials in real time. A highly differentiated device, Evoke is supported by published three-year clinical data demonstrating superior long-term durability compared with traditional open-loop (fixed-dose) SCS therapies. Notably, at 36 months, 83% of patients achieved ≥50% pain reduction and there were zero explants due to loss of efficacy.

“Saluda’s technology is a true paradigm shift in the world of neuromodulation,” said Jason Pope, founder and CEO, Evolve Restorative Center, Santa Rosa, CA. “By delivering closed-loop stimulation, pulse by pulse, tailored to each individual patient’s physiology, it sets a new standard of care for personalized pain management. With Saluda’s IPO and expansion plans, I’m thrilled to see greater patient access to this objective and innovative therapy, elevating patient care worldwide by consistently delivering on meaningful and durable pain relief.”

The Saluda IPO was not the only financial news coming out of Australia this month. Neurosensing firm Epiminder raised $125 million with its new ASX listing.

And the Japanese firm Rohto Pharmaceutical invested US$6 million in Sydney-based neurotech startup Australis Scientific, which is developing a wearable tibial nerve stimulation patch to treat bladder disorders. In October, Australis was named the MedTech Innovator Asia Pacific Grand Prize for its Confidanz patch, and took home a $175 award.