Pinned straw:
@Strawman great summary - this is one of the most painful companies to sit on the sidelines and watch. I'd love to own $PME, but I can't see the return.
But one day, they'll have a slower half and the analyst scribblers will downgrade and the chartists will "sell". That will be the day. (I just regret I wasn't clear-sighted enough in 2020.)
The other thing I am mindful of is that today global medical imaging software market is about $3.5bn, so they have ample room with only about 3% market share. But as they get bigger the competitive pressure starts increasing, Today they are 3% market share. In ten years it looks more like 15-20% market share (of course they might expand their offering, and who known what the market actually is in 10 years). So, in broad brush terms, the level of growth in the valuation is doable if they retain their position as a product leader. It is entirely possible that they could still be growing strongly and justify a p/e of 35 in 10 years time.
So, all I am left with is to be patient.
Disc: Not held (sob)