ABBV vs ESTA: How AbbVie and Establishment Labs Holdings Inc. Compare (2026)

Same yardstick, side by side (as of August 2026). Valuation lined up like this is most meaningful for two names in the same corner of the market, which these are. Figures are approximate; verify before investing.

Reading it: ABBV is the cheaper of the two on forward earnings, but cheaper is not the same as better. Pair the valuation with growth (how far the forward P/E sits below the trailing P/E) and risk (beta) before you decide.

The metrics above tell you which is the marginally better business. The bigger risk for most people is not picking the slightly worse stock, it is over-concentrating. ABBV and ESTA share themes, so owning both, or adding either to what you already hold, can quietly push a large share of your portfolio into one bet.

This is the part a generic comparison page cannot answer, because it depends on what you own. Connect your brokerage and Walnut shows your real, combined ABBV and ESTA exposure, flags overlap with your existing positions, and tells you if adding one would tip you past a concentration you are comfortable with, read-only by default, with your login staying at your broker. Walnut is not an investment adviser.

AbbVie is a North Chicago-based research-driven biopharmaceutical company spun off from Abbott Laboratories in 2013. It focuses on discovering and commercializing medicines for immunology, oncology, neuroscience, and aesthetics. Its immunology franchise anchors the business: historically through Humira (adalimumab), and increasingly through Skyrizi (risankizumab) and Rinvoq (upadacitinib), which treat conditions such as plaque psoriasis, Crohn's disease, rheumatoid arthritis, and ulcerative colitis. Oncology contributes through Imbruvica (developed in collaboration with Johnson and Johnson) and Venclexta (in collaboration with Roche), while the 2020 acquisition of Allergan added Botox Therapeutic, Vraylar, and the aesthetics portfolio including Botox Cosmetic and Juvederm. Revenue is generated by selling branded pharmaceuticals at negotiated prices to wholesale distributors, specialty pharmacies, and health systems across more than 175 countries.

Full ABBV guide

Establishment Labs designs and manufactures silicone breast implants and related devices under the Motiva brand, made at two company-owned plants in Costa Rica and sold in roughly 85 countries. The core product is a family of implants built around SmoothSilk, a proprietary nanotextured shell surface intended to reduce friction and bacterial attachment and, by extension, the rate of capsular contracture. Around that implant the company has built a set of procedures rather than just a product line: Mia Femtech, a minimally invasive breast harmonization procedure done under local anesthesia with no visible breast scar, and Preservé, a tissue-preserving minimally invasive approach for primary augmentation and mastopexy augmentation that works across a wider range of cases and larger sizes. Motiva Flora, a tissue expander with an integrated radio-frequency port for post-mastectomy reconstruction, extends the same platform into the reconstructive market. More than five million Motiva devices have been placed globally since launch.

Full ESTA guide

Both fit overlapping themes, but they are not interchangeable. The useful comparison is which set of drivers and risks you want exposure to.

• ABBV drivers: Skyrizi and Rinvoq replacing Humira faster than expected; Neuroscience becoming a meaningful second growth engine.
• ESTA drivers: United States share gain against a two-brand incumbency; The minimally invasive platform as a margin and category lever.

A faster-growing, richer-valued name usually swings harder, so it suits a longer horizon and a higher tolerance for volatility; a steadier, more cash-generative business suits a more conservative or income-minded investor. The honest test is which set of risks you could hold through a drawdown: The single largest structural risk is portfolio concentration: Skyrizi and Rinvoq together account for a rapidly growing share of total revenue, meaning any clinical setback, competitive entry in atopic dermatitis (where Regeneron's Dupixent holds a strong position), or government-mandated price cut under the Inflation Reduction Act could materially impair the growth outlook. For ESTA, the balance sheet is the first thing to weigh: roughly $264 million of debt against about $71 million of cash, secured by a first-priority lien on substantially all assets, at a company that has not yet generated positive free cash flow.

Growth-minded investors who believe the theme has years to run tend to accept the richer multiple for more upside; value-minded investors lean toward the cheaper forward earnings and steadier profile. Pick ABBV if you believe its drivers more; ESTA if you believe its. Many investors hold both, but since they share themes, that is a concentrated bet, not diversification. Decide deliberately and check overlap. For the full detail, see the ABBV and ESTA guides.

ABBV. The large gap between the trailing GAAP P/E (elevated, reflecting non-cash acquired IPR and D charges on recent deals) and the forward P/E of roughly 15.7x illustrates why analysts and management prefer adjusted metrics: large upfront licensing and milestone payments depress reported earnings without reducing cash generation. On a free cash flow basis, AbbVie trades at a more modest multiple, and the PEG ratio near 0.91 suggests the consensus earnings growth rate is tracking faster than the headline valuation implies. The 2026 revenue guidance of roughly $67 billion and adjusted EPS of $14.37 to $14.57 would, if achieved, represent meaningful upward re-rating from 2025 reported figures.

ESTA. There is no meaningful earnings multiple here because there are no earnings, so the stock is valued on sales and on the credibility of the US ramp. At roughly 9 times trailing revenue, ESTA prices at a premium to most profitable medtech peers, which is the market's way of paying forward for a company growing above 30% with gross margins above 70%. Full-year 2026 guidance of $269 million to $271 million implies roughly 28% growth, and the sell side has clustered targets between about $76 and $117, a wide band that reflects genuine disagreement about how fast a duopoly cracks.

Headline figures (approximate, 2026-06-27): ABBV shows revenue (fy 2025, reported) ~$61.2 billion, adjusted diluted eps (fy 2025) $10.00, gaap diluted eps (fy 2025) $2.36, forward p/e (consensus fy 2026 estimate) ~15.7x; ESTA shows revenue (ttm) ~$246 million, up ~39% year over year, q2 2026 revenue ~$67.5 million, up ~31.7%, with Motiva USA at ~$24.7 million, gross margin / adjusted ebitda ~70.6% gross margin, adjusted EBITDA ~$3.7 million (third straight positive quarter), gaap net loss ~$11.7 million in Q2 2026 (~$0.39 a share), ~$38.9 million over the trailing twelve months.

ABBV and ESTA are related but distinct: same themes, different businesses and risks. Neither wins in the abstract; the right pick is whichever thesis you actually believe, sized so you are not over-concentrated in one theme. Walnut can show your combined ABBV and ESTA exposure against your real portfolio. It is not an investment adviser.