Surely the other major difference in the valuation has to come...

Surely the other major difference in the valuation has to come down to the type of revenues as well as the margins; ALC arguably has mostly recurring revenues (although I was always a little confused with their announcements as some part of that was either hardware or 3rd party software) and in hospitals which are hard to get into, but also unlikely to change too quickly.

MDR revenues are mainly from the US business which are far from recurring (well it seems to be mainly pharma coy marketing/targeting initiatives), and also have lower margins. The Australia business (in terms of revenues and margins) is closer to the ALC business, but this Australia business now makes up a much smaller share of the overall business.

I believe what will make a huge difference in the valuation is (a) an indication that the US revenues are relatively stable from quarter to quarter rather than requiring winning/renewing/selling contracts, and (b) expansion of the Australia business with meaningful contributions from NZ and UK (currently its not clear that even this business with the market share it has in Oz is profitable)