Health Care Distributors Sector Outlook — September 2026
A sector view of Health Care Distributors — scaled wholesalers, specialty/generic manufacturers and a home-based care provider — comparing public valuation, precedent transactions and the strategic questions the pricing gap raises for owners, boards and acquirers.
Key figures
- 10.4x
- Sector median multiple EV / EBITDA, CY2027E consensus
- 12.6x
- Top-of-range multiple Two highest-rated companies, EV / EBITDA CY2027E
- 6.8x
- Bottom-of-range multiple Two lowest-rated companies, EV / EBITDA CY2027E
- 18.5x
- Services-attach deal multiple Services-and-software-weighted precedent transaction, LTM EBITDA at announcement
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1 / 21 · HEALTH CARE › HEALTH CARE EQUIPMENT AND SERVICES › HEALTH CARE DISTRIBUTORS
Executive summary
Health Care Distributors trades as two markets: scaled wholesalers price at the top of the range (12.6x EV/EBITDA CY2027E) while channel-adjacent manufacturers sit at the bottom (6.8x). The sector median of 10.4x already assumes a profit build still to be delivered, and growth pace alone does not explain the premium — faster growers in this set trade lower, not higher. Precedent deals show density, services attach and geography priced on different terms, with the services-weighted transaction recorded at 18.5x.
Key findings
- Two business models sit inside Health Care Distributors, priced apart.
- Today's forward price already assumes the profit build gets delivered.
- Scaled wholesalers hold the premium; pace of growth isn't the driver here.
- Precedent deals price density, services attach and geography differently.
What each page shows
The analyst’s walkthrough of the deck, page by page.
- 01
HEALTH CARE › HEALTH CARE EQUIPMENT AND SERVICES › HEALTH CARE DISTRIBUTORS
This is the cover slide for the Health Care Distributors sector outlook, dated September 2026.
We open with the Health Care Distributors sector as of September 2026, valued primarily on EV / EBITDA for CY2027E. This sets up the two-market story the rest of the deck walks through.
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HEALTH CARE › HEALTH CARE EQUIPMENT AND SERVICES › HEALTH CARE DISTRIBUTORS Health Care Distributors: Two Markets, One Label What the priced names show about how scaled wholesale, channel supply and care delivery are valued today. September 2026 · Prepared by NeuraCap AI · Confidential Market data as of 2026-09-28 · primary valuation basis EV / EBITDA (CY2027E) Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 1
- 02CONTENTS
What This Report Covers
This slide lists the report's five sections plus an appendix.
We lay out the five sections ahead — the bottom line, the landscape, valuation and situations, precedent transactions and strategic implications — plus the appendix. We put the bottom line first on purpose, so a reader who only has a few minutes still leaves with the full story. That's the structure we'll walk through together.
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CONTENTS What This Report Covers 01 The Bottom Line Two Markets Under One Sector Label 02 The Landscape Three Models Sit Inside Health Care Distributors 03 Valuation & Situations The Range Runs from Scaled Wholesale Down to Product Supply 04 Precedent Transactions Buyers Have Paid for Density, Services and Geography 05 Strategic Implications What This Set Says About Where Value Is Earned 06 Appendix Comparables Detail, Methodology, Sources and Assumptions Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 2
- 0301 · THE BOTTOM LINE
Health Care Distributors Trades as Two Markets: Scaled Wholesalers and Channel-Adjacent Manufacturers
This slide summarizes the report's central finding that the sector splits into two differently priced markets.
We find that Health Care Distributors is really two markets in one label: scaled wholesalers priced at the top of the range and channel-adjacent manufacturers priced at the bottom. On a CY2027E EV/EBITDA basis the sector median sits at 10.4x, but that median masks a real split — 12.6x at the top against 6.8x at the bottom. That gap holds even though the faster-growing names in this set trade lower, not higher, so growth pace alone doesn't explain it. This is the one page a reader needs if they read nothing else, and everything that follows builds from it.
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01 · THE BOTTOM LINE Health Care Distributors Trades as Two Markets: Scaled Wholesalers and Channel-Adjacent Manufacturers The full story on one page · figures on EV / EBITDA (CY2027E), market data as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. Primary valuation basis: EV / EBITDA on CY2027E consensus (6 of 9 companies eligible; multiples failing the platform's plausibility gates are excluded, never plotted). Qualitative characterisations are NeuraCap views. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 3 1 Today's Price Already Banks the Profit Build The set is priced at 11.6x on 2025 earnings and 10.4x on 2027, so the forward figure already credits a profit build that still has to be delivered. The two periods do not hold the same names — 4 companies carry the 2025 figure and 6 carry the 2027 figure — so part of that step sits with membership as well as with expectations. 2 The Same Sector Trades at Two Very Different Prices The two names at the top of the range are priced at 12.6x forward EV / EBITDA, against 6.8x for the two at the bottom. Each end rests on two names, so the gap is worth testing name by name rather than treated as a sector-wide rule. 3 Pace of Growth Is Not Where the Premium Sits Here Of the 6 names with a forward estimate, the 3 growing at 10% or more sit at 7.0x, against 12.4x for the 3 growing more slowly. In this set the higher rating sits with the large scaled wholesalers, and pace on its own is not where the premium is. 4 One Label Covers Suppliers, Wholesalers and Their Customers 5 of the 9 companies are medical-surgical distributors serving acute and alternate-site providers; the other 4 sit either side of them — 3 manufacture specialty and generic product into the channel, and 1 delivers home-based and facility care. Buyers read pass-through wholesale economics and manufacturing economics on different terms, so peer choice matters before any multiple is argued. 10.4x Sector median EV/EBITDA CY2027E consensus · 6 rated of 9 companies 12.6x Premium end EV/EBITDA vs 6.8x at the discount end top quartile (n=2) against bottom quartile (n=2) on EV/EBITDA — the spread the report explains 15 Transactions with disclosed terms 32 recorded in this tier · 1 told as case studies, the full list in the appendix
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This is the section divider introducing the market map of the three business models.
This section maps the three business models inside Health Care Distributors — who ships product, who supplies the channel and who buys from it. That map is what lets us compare the right names against each other.
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SECTION 02 02 THE LANDSCAPE Three Models Sit Inside Health Care Distributors Who ships product, who supplies the channel and who buys from it. 02 of 06 Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 4
- 0502 · MARKET MAP
Most of the Set Ships Product; The Rest Supplies or Buys from the Channel
This slide groups the approved companies by business segment with median EV/EBITDA for CY2027E per group.
We group the covered companies by what they actually do — ship product, supply the channel, or buy from it — rather than by the single sector label. Most of the set ships product, and the rest sit either side supplying or buying from the channel. Grouping this way is what lets the multiples that follow be read against the right peer set, not the sector average. So what matters next is which group your own business resembles.
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02 · MARKET MAP Most of the Set Ships Product; The Rest Supplies or Buys from the Channel 9 approved companies grouped by business segment · median EV / EBITDA (CY2027E) per group · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. Segment grouping follows the platform's classification; group medians on rated names only. "Why it matters" lines are NeuraCap views. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 5 MEDICAL-SURGICAL DISTRIBUTION TO ACUTE AND ALTERNATE-SITE PROVIDERS 5 cos median 12.6x McKesson (MCK) Cencora (COR) Cardinal Health (CAH) Henry Schein (HSIC) Great Elm Group (GEG) The weight of the set and the top of the price range: contracted volume moving through scaled networks. ADJACENT: SPECIALTY AND GENERIC DRUG MANUFACTURING (CHANNEL SUPPLIER) 3 cos median 7.0x Amneal (AMRX) Tilray Brands (TLRY) Kamada (KMDA) The supply side of the same channel, priced on manufacturing economics rather than route density. ADJACENT: HOME-BASED AND FACILITY CARE DELIVERY (DISTRIBUTION CUSTOMER) 1 cos 10.2x · 1 rated Aveanna (AVAH) The customer end, where reimbursement setting rather than procurement scale shapes the economics.
- 0602 · LANDSCAPE
Three Business Models Sit Under One Sector Label, and They Are Priced Apart
This slide describes what each business model does and why its valuation differs.
Three business models sit under one sector label, and the market prices them apart. We walk through what each group does — medical-surgical distribution, specialty and generic manufacturing into the channel, and care delivery that buys from it — and why that difference in economics shows up in the multiple. The full company-level detail sits in the appendix for anyone who wants to check a specific name. So the peer group a company sits in matters as much as the sector it's labelled under.
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02 · LANDSCAPE Three Business Models Sit Under One Sector Label, and They Are Priced Apart Segment view of the approved universe · EV / EBITDA (CY2027E) medians on rated names · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. "What they do / why it matters" is a NeuraCap view. Full company-level detail in the appendix and companion tables. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 6 Segment n Share of universe Median EV/EBITDA Names to know What they do — and why it matters Medical-surgical distribution to acute and alternate-site providers 5 56% 12.6x McKesson Corporation (MCK) · Cencora, Inc. (COR) · +3 more The scale core of the set. 5 of the 9 companies ship product to acute and alternate-site providers — McKesson Corporation (MCK), Cencora, Inc. (COR), Cardinal Health, Inc. (CAH), Henry Schein, Inc. (HSIC) and Great Elm Group, Inc. (GEG) — 56% of the set. These are the gross-profit-dollar engines: procurement scale, negative working capital and fee-for-service arrangements with manufacturers. Adjacent: specialty and generic drug manufacturing (channel supplier) 3 33% 7.0x Amneal Pharmaceuticals, Inc. (AMRX) · Tilray Brands, Inc. (TLRY) · +1 more Supply into the same channel. 3 companies, 33% of the set, make specialty and generic product rather than distribute it: Amneal Pharmaceuticals, Inc. (AMRX), Tilray Brands, Inc. (TLRY) and Kamada Ltd. (KMDA). They carry manufacturing margin structures and generic deflation exposure, and the market prices them apart from the wholesalers they supply. Adjacent: home-based and facility care delivery (distribution customer) 1 11% 10.2x n=1 Aveanna Healthcare Holdings Inc. (AVAH) The customer end of the channel. Aveanna Healthcare Holdings Inc. (AVAH) is the single home-based and facility care name here, 11% of the set, priced at 10.2x forward EV / EBITDA. Its economics sit with reimbursement setting in home and alternate-site channels rather than with procurement scale or route density.
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This is the section divider introducing public market valuation across the range.
This section walks the valuation range from scaled wholesale down to product supply, across nine companies with six carrying a forward EBITDA estimate. That range is where the premium and the discount both sit.
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SECTION 03 03 VALUATION & SITUATIONS The Range Runs from Scaled Wholesale Down to Product Supply The page holds 9 companies, 6 of them with a forward EBITDA estimate. 03 of 06 Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 7
- 0803 · PUBLIC MARKET VALUATION
Scaled Wholesalers Hold the Top of the Range; Product Suppliers Hold the Bottom
This slide ranks the six rated companies by EV/EBITDA CY2027E, sorted descending against the sector median.
Scaled wholesalers hold the top of this range and product suppliers hold the bottom, with all six rated companies shown against a sector median of 10.4x. The tier zones are cut at the rated set's quartiles, so the split is a read on this specific group, not a rule for the wider sector. That ordering is the anchor for every situation and every deal comparison that follows. So what a name actually does, not just what sector it sits in, is what sets its multiple here.
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03 · PUBLIC MARKET VALUATION Scaled Wholesalers Hold the Top of the Range; Product Suppliers Hold the Bottom EV / EBITDA (CY2027E) · all 6 rated companies, sorted descending · sector median 10.4x · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. Primary valuation basis: EV / EBITDA on CY2027E consensus (6 of 9 companies eligible; multiples failing the platform's plausibility gates are excluded, never plotted). Tier zones are NeuraCap groupings cut at the rated set's quartiles; every multiple quoted on this page is a median on the same EV / EBITDA (CY2027E) basis. Panel commentary is a NeuraCap view. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 8 PREMIUM · median 12.6x CORE · median 10.4x DISCOUNT · median 6.8x Sector median 10.4x WHAT SEPARATES THE TWO ENDS The top sells contracted volume. The two names at the premium end run scaled wholesale networks: procurement scale, negative working capital and fee-for-service arrangements with manufacturers. What buyers are paying for there sits with gross profit dollars per line and contract duration rather than with reported margin percentage. A forward multiple already credits growth. The lens is EV / EBITDA on CY2027E, so forecast profit growth is already inside the number. A premium that survives that test points to durability in the earnings rather than to a faster ramp, on the 6 names with a forward estimate. The bottom carries product economics. The lower end of the range holds specialty and generic manufacturers, where generic deflation, approval timing and single-product concentration sit inside the earnings. They supply the channel rather than hold the customer contract, and the two ends of the range are priced apart.
- 0903 · VALUATION DRIVERS
The Faster Growers Sit at the Lower End of the Range in This Set
This slide splits the median EV/EBITDA by revenue-growth cohort and by EBITDA-margin cohort.
We cut the rated names by growth and by margin, and the three faster growers in this set trade at 7.0x against 12.4x for the three growing more slowly. That's an association we observe in this data, not a rule about growth and value generally — here the higher rating tracks with the large scaled wholesalers, not with pace. So before crediting growth as the reason for a premium, we'd want to check which cohort a company's own numbers put it in.
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03 · VALUATION DRIVERS The Faster Growers Sit at the Lower End of the Range in This Set Median EV / EBITDA (CY2027E) by revenue-growth cohort and by EBITDA-margin cohort (each split at its covered median) · rated names with estimates · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. Cohort medians on rated names with the required estimates (faster n=3; slower n=3; higher-margin n=3; lower-margin n=3). Driver readings are NeuraCap views on the supplied data — association, not causation. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 9 EV/EBITDA, median per cohort · growth split at 10% · EBITDA-margin split at 10% Growth Above 10% Is Associated with the Lower Multiples Here Of the 6 names with a forward estimate, the 3 growing at 10% or more sit at 7.0x, while the 3 growing more slowly sit at 12.4x. That is 3 names either side, so read it as a pointer to what buyers are weighting, not as a sector law. Reported Margin Percentage Sorts the Other Way from Price The two names at the top of the range report EBITDA margins near 2%, while the lower end reports 7% and 25%. In pass-through wholesale the percentage is a function of drug acquisition cost sitting in revenue, so gross profit dollars and cost-to-serve are the comparable unit across these models. Cash Conversion and Channel Overhang Are Judged Name by Name Negative working capital, forward-buy positions and days payable are a funding source in this sector rather than a use, and they are read alongside the earnings. Settlement, licensure and reimbursement exposure sit ahead of equity cash flow, and this set gives no single answer for how they are weighted. Three of the Nine Companies Sit Outside the Priced Set Cencora, Inc. (COR), Henry Schein, Inc. (HSIC) and Great Elm Group, Inc. (GEG) carry no forward EBITDA estimate in this run, so the range rests on 6 names with a forward estimate. Peer choice therefore matters as much as the multiple argued on top of it.
- 1003 · SITUATION MAP
Where the Premium Sits: Scaled Wholesalers Priced up on Thin Reported Margins
This slide plots companies on EV/EBITDA versus EBITDA margin relative to sector medians to characterise situations.
We cut the set on EV/EBITDA against the sector median of 10.4x and on EBITDA margin against the covered median of 10%, and the premium sits with scaled wholesalers priced up on thin reported margins. These are observations on where companies sit, not recommendations to buy or sell anything. So the read here is about which quadrant a business's own margin and multiple put it in, not a call on any single name.
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03 · SITUATION MAP Where the Premium Sits: Scaled Wholesalers Priced up on Thin Reported Margins Cut on EV / EBITDA vs the sector median (10.4x) (rows) and EBITDA margin vs the covered median (10%) (columns) · observations, not recommendations Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. Situation boundaries are the cohort's own medians (Directional, NeuraCap view). This page characterises situations; it does not recommend buying or selling any security. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 10 Paid for Profitability Above-median multiple · above-median EBITDA margin 1 names Amneal Pharmaceuticals, Inc. (AMRX) Amneal Pharmaceuticals, Inc. (AMRX) sits above the middle on both measures, with a 24% reported EBITDA margin. On a single name, read it as a manufacturing margin structure being priced inside a distribution peer set rather than as a wholesale result. Premium on Thin Reported Margin Above-median multiple · below-median EBITDA margin 2 names McKesson Corporation (MCK) · Cardinal Health, Inc. (CAH) McKesson Corporation (MCK) and Cardinal Health, Inc. (CAH) carry above-middle multiples on reported EBITDA margins near 2%. In pass-through wholesale the percentage is a function of drug acquisition cost in revenue, so the pricing here is associated with gross profit dollars, contract duration and cash conversion. Margin Without the Rating Below-median multiple · above-median EBITDA margin 2 names Aveanna Healthcare Holdings Inc. (AVAH) · Kamada Ltd. (KMDA) Aveanna Healthcare Holdings Inc. (AVAH), at a 14% reported EBITDA margin, and Kamada Ltd. (KMDA) show margin above the middle with multiples below it. Reimbursement setting in home and alternate-site channels and single-product concentration are the exposures a buyer would test first on these two names. Below the Middle on Both Below-median multiple · below-median EBITDA margin 1 names Tilray Brands, Inc. (TLRY) Tilray Brands, Inc. (TLRY) sits below the middle on both measures while carrying 24% expected growth. Pace on its own is not where the rating sits in this set, so the question is which part of the earnings a buyer would underwrite.
- 1103 · THE AGENDA
What Sits with the Top of the Range, and What Sits with the Bottom
This slide frames the questions an owner or acquirer should resolve based on where a company sits in the range.
We frame this as the questions worth resolving depending on where a company sits — what supports the top of the range, and what explains the bottom. This is directional judgment grounded in the cohort data shown earlier, not investment advice. So the next step is testing which set of questions applies to your own position.
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03 · THE AGENDA What Sits with the Top of the Range, and What Sits with the Bottom NeuraCap view · framed as the questions an owner or acquirer should resolve · observations, not recommendations Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. All content on this page is Directional — NeuraCap advisory judgment grounded in the cohort data shown earlier. It does not constitute investment advice. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 11 Which Gross Profit Dollars Carry the Higher Rating Across the 6 names with a forward estimate, the upper end of the range holds scaled wholesalers and the lower end holds product supply. Work through which part of your own gross profit — specialty handling, own-brand penetration, manufacturer services, pure logistics — a buyer would place alongside each group. What changes the answer: A shift in the specialty, biosimilar or own-brand share of gross profit dollars. Contract Concentration and Renewal Cadence In this sector the earnings stream is contractual rather than asset-based, so customer concentration and change-of-control terms in customer, group purchasing and distribution service agreements carry real weight. Staggering renewals and widening the account base is an operating move, not a presentation one. What changes the answer: A large group purchasing or health-system renewal moving inside twelve months. Cash Conversion as a Funding Source Days payable, inventory turns and forward-buy positions fund this model, and generalist buyers price them with care. Decide whether that cash is funding own-brand penetration and services attach, or simply cycling through the working capital line. What changes the answer: Days payable or inventory turns moving against plan for two consecutive quarters. Build Versus Buy on Services Attach The services-and-software-weighted transaction in this record, Clayton, Dubilier & Rice, TPG for Covetrus, was recorded at 18.5x EBITDA, above the density-led wholesale deals alongside it. That frames the arithmetic on building ordering systems and manufacturer services in-house against acquiring them. What changes the answer: A regional or category specialist in your served geography coming to market.
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04
This is the section divider introducing nine precedent transactions from 2015 to 2026.
This section walks nine transactions from 2015 to 2026 and what each one priced — density, services or geography. Those deals are the evidence behind the strategic questions that follow.
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SECTION 04 04 PRECEDENT TRANSACTIONS Buyers Have Paid for Density, Services and Geography Nine transactions from 2015 to 2026, and what each one priced. 04 of 06 Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 12
- 1304 · DEAL CASE STUDIES
Recent Transactions Cluster Around Density, Services and Geography
This slide presents one precedent transaction as a case study with disclosed multiples on LTM financials at announcement.
We walk one of the transactions with disclosed terms as a case study, on LTM financials at announcement, with the complete list held in the appendix. These deal multiples sit on a different basis than the CY2027E public multiples shown earlier, so we're not claiming a spread between the two. Our read on why each deal happened is our own view of the recorded evidence. So the pattern across these deals is what frames the strategic questions in the next section.
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04 · DEAL CASE STUDIES Recent Transactions Cluster Around Density, Services and Geography 1 of 15 transactions with disclosed terms, told as case studies · multiples on LTM financials at announcement where disclosed · the complete list is in the appendix · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. 57 precedent record(s) carry data-quality flags (deal value unit unresolved; divestiture roles reassigned; duplicate precedent id); figures are shown as recorded in the filing. 17 recorded transactions with neither a disclosed value nor a multiple are omitted from the precedent list and the case studies (kept in the companion workbook). Deal multiples are LTM at announcement (Definitive, from filings); they are not directly comparable to the CY2027E public basis and no spread is claimed. "Why the deal happened" is a NeuraCap read of the recorded evidence. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 13 Feb-2026 $3.5B Covetrus Covetrus takes MWI Animal Health at $3.5B, consolidating animal-health distribution into one network. EV / LTM revenue n/a EV / LTM EBITDA n/a WHY THE DEAL HAPPENED Covetrus runs animal-health distribution alongside practice ordering systems and has been sponsor-owned since the 2022 transaction with Clayton, Dubilier & Rice, TPG. Adding MWI Animal Health suggests a play for route density, purchasing scale and services attach in a channel the buyer already serves. HOW THE TARGET WAS VALUED The transaction is recorded at $3.5B in enterprise value, as shown in the filing. The closest read across in this record is the 2018 combination of Vets First Choice and Henry Schein Animal Health at 8.8x EBITDA, which frames what animal-health distribution earnings have been valued at here.
- 14SECTION 05
05
This is the section divider introducing the strategic implications of where value is earned.
This section turns to what the pricing pattern says about where value is earned operationally. Those are the moves that sit behind the gap between the two ends of the range.
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SECTION 05 05 STRATEGIC IMPLICATIONS What This Set Says About Where Value Is Earned The operating moves that sit behind the gap between the two ends. 05 of 06 Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 14
- 1505 · STRATEGIC IMPLICATIONS
Where the Higher Multiples Sit in This Market, and What Owners Can Do About It
This slide sets out the questions this data raises for owners over the next twelve months.
We set out where the higher multiples sit in this market and the questions that puts on the table for owners, boards and acquirers over the next twelve months. This is our directional view drawn from the analysis in the report, not a recommendation. So the practical next step is deciding which of these questions applies to your own business.
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05 · STRATEGIC IMPLICATIONS Where the Higher Multiples Sit in This Market, and What Owners Can Do About It NeuraCap view · the questions this data puts on the table for the next twelve months Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. This page is Directional — NeuraCap views drawn from the analysis in this report. Observations, not recommendations. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 15 FOR OWNERS Know Which End of the Range Your Gross Profit Resembles The upper end of this set is contracted volume through scaled networks; the lower end is product supply. Mix is the lever that moves a company between those profiles: specialty handling, own-brand penetration, manufacturer services and cost-to-serve per delivery. FOR BOARDS The Forward Price Assumes Delivery, so Capital Allocation Is the Test On a CY2027E lens the profit build is already inside today's prices. The board conversation sits with what delivers it — route utilisation, distribution centre density, fill rate against contract — and with whether cash is funding services attach or simply the working capital cycle. FOR ACQUIRERS Density, Geography and Services Attach Priced on Different Terms Across the 9 transactions shown, buying volume into an existing network, buying into a licensed geography and buying software-attached distribution were valued differently. Diligence settles on contract assignability, change-of-control provisions and the working capital peg.
- 16SECTION 06
06
This is the section divider introducing the full comparables universe and methodology.
This final section carries the full comparables universe, the valuation basis and where each underlying disclosure lives. It's the reference material behind every figure shown earlier in the deck.
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SECTION 06 06 APPENDIX The Full Universe, Methodology and Sources Comparables detail behind every figure in the body, the valuation basis, and where each underlying disclosure lives. 06 of 06 Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 16
- 1706 · PUBLIC COMPARABLES (1 OF 1)
Public Comparables on EV / EBITDA (CY2027E), Grouped by Valuation Tier
This slide lists all rated and unrated public comparables grouped by valuation tier against the sector median.
We list all nine companies here, the six rated ones grouped by valuation tier against the sector median of 10.4x, and the three without an eligible multiple. Every rated row here also sits in the companion workbook alongside the complete field set. So this page is the full reference underneath every multiple quoted earlier.
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06 · PUBLIC COMPARABLES (1 OF 1) Public Comparables on EV / EBITDA (CY2027E), Grouped by Valuation Tier Teal shading marks a EV/EBITDA above the sector median (10.4x); amber marks below · 6 rated companies; 3 not rated (no eligible EV/EBITDA) · tickers link to the underlying source · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. All 6 rated rows are in this appendix and in the companion workbook, which carries the complete field set. Names without an eligible multiple are listed in the companion workbook. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 17 Company Ticker Segment EV EV/EBITDA (CY2027E) Rev growth EBITDA margin Rule of 40 PREMIUM — ≥11.9x · median 12.6x · 2 companies McKesson Corporation MCK Medical-surgical distribution to acute and… $109B 12.9x 7% 2% 8 Cardinal Health, Inc. CAH Medical-surgical distribution to acute and… $56.7B 12.4x 6% 2% 6 CORE — 7.8x–11.9x · median 10.4x · 2 companies Amneal Pharmaceuticals, Inc. AMRX Adjacent: specialty and generic drug manufacturing… $8.9B 10.6x 4% 24% 34 Aveanna Healthcare Holdings Inc. AVAH Adjacent: home-based and facility care delivery… $4.1B 10.2x 12% 14% 21 DISCOUNT — <7.8x · median 6.8x · 2 companies Tilray Brands, Inc. TLRY Adjacent: specialty and generic drug manufacturing… $557M 7.0x 24% 7% 18 Kamada Ltd. KMDA Adjacent: specialty and generic drug manufacturing… $436M 6.6x 13% 25% 40
- 1806 · PRECEDENT TRANSACTIONS (1 OF 2)
All Precedent Transactions with Disclosed Terms, Newest First
This slide lists all disclosed-terms precedent transactions in this tier, newest first, page one of two.
We list the transactions with disclosed terms here, newest first, on an LTM-at-announcement basis where disclosed. These multiples sit on a different basis to the CY2027E public multiples shown earlier, so no spread is claimed between them. So this is the transaction evidence a reader can check name by name.
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06 · PRECEDENT TRANSACTIONS (1 OF 2) All Precedent Transactions with Disclosed Terms, Newest First 15 transactions with disclosed terms in this tier (32 recorded) · multiples on LTM financials at announcement where disclosed · deal values link to the underlying filing · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. 57 precedent record(s) carry data-quality flags (deal value unit unresolved; divestiture roles reassigned; duplicate precedent id); figures are shown as recorded in the filing. 17 recorded transactions with neither a disclosed value nor a multiple are omitted from the precedent list and the case studies (kept in the companion workbook). Deal multiples are LTM at announcement (Definitive, from filings); they are not directly comparable to the CY2027E public basis and no spread is claimed. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 18 Date Transaction EV EV/LTM Rev EV/LTM EBITDA Why it matters Feb-2026 Covetrus → MWI Animal Health $3.5B n/a n/a Covetrus is recorded acquiring MWI Animal Health at $3.5B in enterprise value, as shown in the filing. The move reads as route density and purchasing scale inside one channel rather than entry into a new business model. Dec-2024 Patient Square Capital → Patterson Companies, Inc. n/a n/a 9.9x Patient Square Capital is recorded acquiring Patterson Companies, Inc. at 9.9x EBITDA. That sits toward the lower end of the multiples recorded here, which is where mixed distribution platforms have tended to price. May-2022 Clayton, Dubilier & Rice, TPG → Covetrus n/a 0.9x 18.5x Clayton, Dubilier & Rice, TPG acquired Covetrus at 18.5x EBITDA and 0.9x revenue, the highest EBITDA multiple recorded here. The asset pairs distribution with practice ordering systems, the kind of switching cost sponsors have paid up for in this record. Jan-2021 AmerisourceBergen → WBS (Alliance Healthcare) n/a n/a 11.2x AmerisourceBergen is recorded acquiring WBS (Alliance Healthcare) at 11.2x EBITDA. National licensure means acquirers typically buy into a geography rather than export a model into it, and this transaction fits that pattern. Jan-2021 AmerisourceBergen Corporation → Majority of Alliance Healthcare Business from Walgreens Boots Alliance, Inc. n/a n/a 12.0x AmerisourceBergen Corporation is recorded acquiring the Majority of Alliance Healthcare Business from Walgreens Boots Alliance, Inc. at 12.0x EBITDA. Corporate carve-outs are a recurring source of supply as diversified owners prune categories. Apr-2018 Vets First Choice → Henry Schein Animal Health n/a 0.7x 8.8x Vets First Choice completed its combination with Henry Schein Animal Health at 8.8x EBITDA and 0.7x revenue. The revenue multiple shows how little pass-through distribution revenue is worth on its own; the earnings multiple is the comparable unit here. Mar-2018 Patricia Industries → Sarnova n/a n/a 13.6x Patricia Industries is recorded acquiring Sarnova at 13.6x EBITDA, toward the upper half of this record. Category-focused distribution with specialised handling has been valued above broad full-line wholesale in these transactions. Nov-2017 AmerisourceBergen → H.D. Smith Holding Company n/a n/a 15.4x AmerisourceBergen is recorded acquiring H.D. Smith Holding Company at 15.4x EBITDA. Folding regional wholesale volume into an existing network is the density trade in this sector, and the recorded multiple sits at the upper end of this record. Jul-2015 Madison Dearborn → Patterson Medical (Performance Health) n/a 10.6x 10.6x Madison Dearborn is recorded acquiring Patterson Medical (Performance Health) at 10.6x EBITDA. A rehabilitation-products category separated from a diversified distributor, priced below the services-weighted transactions in this record.
- 1906 · PRECEDENT TRANSACTIONS (2 OF 2)
All Precedent Transactions with Disclosed Terms, Newest First
This slide continues the list of disclosed-terms precedent transactions, newest first, page two of two.
We continue the same list of disclosed-terms transactions here, newest first, on the same LTM-at-announcement basis. As on the prior page, these multiples aren't directly comparable to the CY2027E public basis shown earlier. So together the two pages give the complete disclosed-terms record behind the deal commentary.
Everything on this page
06 · PRECEDENT TRANSACTIONS (2 OF 2) All Precedent Transactions with Disclosed Terms, Newest First 15 transactions with disclosed terms in this tier (32 recorded) · multiples on LTM financials at announcement where disclosed · deal values link to the underlying filing · as of 2026-09-28 Source: NeuraCap analytics platform; market data and consensus estimates as of 2026-09-28; company disclosures via SEC EDGAR where linked. 57 precedent record(s) carry data-quality flags (deal value unit unresolved; divestiture roles reassigned; duplicate precedent id); figures are shown as recorded in the filing. 17 recorded transactions with neither a disclosed value nor a multiple are omitted from the precedent list and the case studies (kept in the companion workbook). Deal multiples are LTM at announcement (Definitive, from filings); they are not directly comparable to the CY2027E public basis and no spread is claimed. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 19 Date Transaction EV EV/LTM Rev EV/LTM EBITDA Why it matters Jul-2015 Madison Dearborn Partners → Patterson Companies, Inc. n/a n/a 10.6x Jun-2015 Cardinal Health → Harvard Drug n/a 11.6x 11.6x Value shown as recorded in the filing; deal value unit unresolved. May-2015 Patterson Companies → Animal Health International n/a 16.2x 16.2x Value shown as recorded in the filing; deal value unit unresolved. Jan-2015 AmerisourceBergen → MWI Veterinary Supply n/a 19.7x 19.7x Value shown as recorded in the filing; deal value unit unresolved. Oct-2013 McKesson → Celesio n/a 10.4x 10.4x Value shown as recorded in the filing; deal value unit unresolved. Oct-2012 McKesson → PSS World Medical n/a 11.9x 7.3x Value shown as recorded in the filing; deal value unit unresolved.
- 2006 · METHODOLOGY
Sources, Assumptions and Data Quality
This slide explains the sources, assumptions and data-quality treatment behind the report.
This page sets out how the analysis was built — the valuation basis, what was excluded, and where each underlying disclosure sits. Every figure in the deck links back to the record it was taken from, and where a figure has no link, this page names the source and the basis on which it was read. That transparency is what lets a reader trace any number in the deck back to its filing or estimate. So this is the reference point when a client wants to check a figure for themselves.
Everything on this page
06 · METHODOLOGY Sources, Assumptions and Data Quality How this report was built, what was excluded, and where every underlying disclosure lives · as of 2026-09-28 Every figure in this report links to the record it was taken from. Where a figure has no link, the appendix names its source and the basis on which it was read. Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice 20 VALUATION BASIS Primary valuation basis: EV / EBITDA on CY2027E consensus (6 of 9 companies eligible; multiples failing the platform's plausibility gates are excluded, never plotted). EV / EBITDA on CY2027E is the lead convention: it is the sector-appropriate prior for Health Care Distributors and it clears the coverage gate with 6 of 9 companies (67%). EV / Revenue, P / E are carried as a cross-check. The set earns: 6 of the 6 companies with a reported forward EBITDA carry a meaningful one, so the profit multiple leads and a revenue multiple would understate what the market is pricing. DATA QUALITY & EXCLUSIONS 8 records were excluded or quarantined by the platform's validation gates (unit errors, implausible ratios, ineligible securities and classification failures); the full ledger ships in the companion tables and never feeds a statistic in this report. DEFINITIVE VS DIRECTIONAL Definitive content is disclosed or consensus data passed through stated arithmetic. Directional content — tier boundaries, situation cuts, "why it matters" commentary, the agenda pages — is NeuraCap analyst judgment and is labeled as such where it appears. WHAT THIS REPORT IS NOT This report characterises a sector. It does not recommend buying, selling or holding any security, and no statement in it should be read as investment advice or a price target. WHERE THE DATA LIVES 398 registered source documents stand behind the figures in this report. Metric hyperlinks throughout the deck open the specific filing or data record; by publisher: sec.gov (397) · home.treasury.gov (1). The companion workbook beside this deck carries the complete source index.
- 21
Across the 9 Companies, the Forward Price Already Carries the Profit Build.
This is the closing slide restating that the forward price across the nine companies already reflects the anticipated profit build.
Across the nine companies, the forward price already carries the profit build that still has to be delivered. The companion tables alongside this deck carry the full universe and source index for any figure worth tracing further.
Everything on this page
Across the 9 Companies, the Forward Price Already Carries the Profit Build. NeuraCap AI — Health Care Distributors Coverage September 2026 · Prepared by NeuraCap AI · Confidential Health Care Distributors Coverage | September 2026 | Confidential | Not investment advice Sources & methodology 21
Sources and methodology
This report covers Health Care Distributors (Health Care › Health Care Equipment and Services › Health Care Distributors) with market data and consensus estimates as of September 28, 2026. The company universe is the 9 listed companies whose core business is Health Care Distributors according to NeuraCap's industry classification of each company's reported business segments (a company is included only when this industry is central to what it does, not merely adjacent to it). Companies in the set: Amneal Pharmaceuticals, Inc. (AMRX), Aveanna Healthcare Holdings Inc. (AVAH), Cardinal Health, Inc. (CAH), Cencora, Inc. (COR), Great Elm Group, Inc. (GEG), Henry Schein, Inc. (HSIC), Kamada Ltd. (KMDA), McKesson Corporation (MCK), Tilray Brands, Inc. (TLRY). The market map groups them by business vertical — Medical-surgical distribution to acute and alternate-site providers: 5 companies (MCK, COR, CAH, HSIC, GEG); Adjacent: specialty and generic drug manufacturing (channel supplier): 3 companies (AMRX, TLRY, KMDA); Adjacent: home-based and facility care delivery (distribution customer): 1 company (AVAH). 6 of the 9 companies carry a valid multiple on the primary valuation basis and form the rated set behind every cohort statistic; the others are shown but do not enter the statistics.
Scope and company universe
This report covers Health Care Distributors (Health Care › Health Care Equipment and Services › Health Care Distributors) with market data and consensus estimates as of September 28, 2026. The company universe is the 9 listed companies whose core business is Health Care Distributors according to NeuraCap's industry classification of each company's reported business segments (a company is included only when this industry is central to what it does, not merely adjacent to it). Companies in the set: Amneal Pharmaceuticals, Inc. (AMRX), Aveanna Healthcare Holdings Inc. (AVAH), Cardinal Health, Inc. (CAH), Cencora, Inc. (COR), Great Elm Group, Inc. (GEG), Henry Schein, Inc. (HSIC), Kamada Ltd. (KMDA), McKesson Corporation (MCK), Tilray Brands, Inc. (TLRY). The market map groups them by business vertical — Medical-surgical distribution to acute and alternate-site providers: 5 companies (MCK, COR, CAH, HSIC, GEG); Adjacent: specialty and generic drug manufacturing (channel supplier): 3 companies (AMRX, TLRY, KMDA); Adjacent: home-based and facility care delivery (distribution customer): 1 company (AVAH). 6 of the 9 companies carry a valid multiple on the primary valuation basis and form the rated set behind every cohort statistic; the others are shown but do not enter the statistics.
What was excluded and why
8 records failed a validation gate and never feed a statistic in this report (8 excluded from aggregate). Each exclusion, with its reason: GEG — EBITDA is non-positive; EV/EBITDA is n/m (effect: excluded from aggregate) · GEG — Non-positive EPS; P/E is n/m (effect: excluded from aggregate) · GEG — Non-positive EPS; P/E is n/m (effect: excluded from aggregate) · GEG — Non-positive EPS; P/E is n/m (effect: excluded from aggregate) · TLRY — Non-positive EPS; P/E is n/m (effect: excluded from aggregate) · TLRY — Non-positive EPS; P/E is n/m (effect: excluded from aggregate) · TLRY — Non-positive EPS; P/E is n/m (effect: excluded from aggregate) · TLRY — Non-positive EPS; P/E is n/m (effect: excluded from aggregate)
Primary valuation basis and how it was chosen
Primary valuation basis: EV / EBITDA on CY2027E consensus (6 of 9 companies eligible; multiples failing the platform's plausibility gates are excluded, never plotted). EV / EBITDA on CY2027E is the lead convention: it is the sector-appropriate prior for Health Care Distributors and it clears the coverage gate with 6 of 9 companies (67%). EV / Revenue, P / E are carried as a cross-check. The set earns: 6 of the 6 companies with a reported forward EBITDA carry a meaningful one, so the profit multiple leads and a revenue multiple would understate what the market is pricing. The basis is selected in two steps: the industry's customary valuation conventions set the order of preference, and each convention is then tested for coverage — the share of companies with a valid, plausibility-checked multiple on the chosen period. A convention is used only when enough companies carry it; the best-covered convention is used, and disclosed, when none clears the threshold. Coverage measured for this report — EV / EBITDA: 6 of 9 companies; EV / rEVenue: 8 of 9 companies; P/E: 7 of 9 companies. 1 company shows a non-meaningful P / E denominator and is excluded from that statistic.
How the multiples and statistics are computed
Enterprise value (EV) is market capitalisation at the as-of date plus total debt minus cash and equivalents from the latest reported balance sheet, reconciled against the platform's stored value and disclosed where the two differ. Forward multiples divide EV (or the share price for P/E) by the consensus estimate for the stated calendar period; trailing multiples use the last twelve months of reported figures from SEC filings. A multiple with a negative or immaterial denominator is treated as not meaningful and excluded from every statistic. Cohort statistics are medians and quartiles over the rated set only; a group median with fewer than three observations is shown as the single company's figure and labelled as such. Valuation tiers cut the rated set at its quartiles (tiers cut at the rated set's quartiles: Premium ≥11.9x, Core 7.8x–11.9x, Discount <7.8x — NeuraCap groupings). Revenue growth compares consecutive calendar-year consensus revenue; EBITDA margin divides consensus EBITDA by consensus revenue for the same period. Figures shown in this report and the calculation behind each: 10.4x = median(ev_ebitda CY2027E) (6 rated companies) · 12.6x = median(ev_ebitda CY2027E) within Premium tier (n=2) · 10.4x = median(ev_ebitda CY2027E) within Core tier (n=2) · 6.8x = median(ev_ebitda CY2027E) within Discount tier (n=2) · 7.0x = median(ev_ebitda CY2027E) | growth ≥ 10% (n=3) · 12.4x = median(ev_ebitda CY2027E) | growth < 10% (n=3) · 10.2x = median(ev_ebitda CY2027E) | EBITDA margin ≥ 10% (n=3) · 12.4x = median(ev_ebitda CY2027E) | EBITDA margin < 10% (n=3) · 27% = median Rule of 40 score (revenue growth + EBITDA margin) (n=6)
Precedent transactions: what is in the record and why
The precedent record holds the M&A transactions in Health Care Distributors recorded from SEC filings (8-K announcements and the documents they reference), newest first, with each value and multiple linked to the exact passage in the filing that states it. 32 transactions were recorded for this industry; 15 are shown. 17 recorded transactions with neither a disclosed value nor a multiple are omitted because they say nothing about price; they remain in the companion workbook. Deal multiples are enterprise value over the target's last-twelve-month revenue or EBITDA at announcement, as disclosed; they are not restated to the public basis and no spread to the public multiples is claimed. Before a transaction reaches the record it passes a screen for mirrored or duplicate filings of the same deal, for divestitures where the filer is the seller rather than the buyer, for carve-outs recorded under the parent's name, and for values whose citation describes something other than the price paid (a debt raise, a termination fee); such records are corrected or excluded and the correction is noted. Data-quality notes on this record: 18 × deal value unit unresolved; 36 × no evidence record; 2 × duplicate precedent id; 1 × divestiture roles reassigned. Case studies lead with the 1 richest stories — disclosed value, a readable multiple, newest first.
Sources
Company financials and transaction terms come from the companies' own SEC filings on EDGAR (10-K, 10-Q and 8-K documents), linked from each figure in the report. Forward figures are analyst consensus estimates for the calendar periods shown. Share prices and market capitalisations are market data as of September 28, 2026. Treasury yields are published by the U.S. Department of the Treasury. 402 source documents stand behind this report; by publisher domain: sec.gov, home.treasury.gov (1). Every figure on every page is traceable to one of these records; nothing in the report is derived from outside data.
Interpretation and important notice
Tier labels, situation maps, the agenda and the implications pages are NeuraCap analytical views drawn from the recorded evidence and are labelled as such. The report is informational: it is not investment advice, not a recommendation to buy or sell any security, not an opinion of value and not an offer of any kind. Readers should perform their own diligence before acting on anything described here.
This report is published for information only. It is not a recommendation to buy or sell any security, an offer or solicitation, an appraisal or a fairness opinion, and no fiduciary relationship is created by reading it. Multiples that fail NeuraCap’s plausibility gates are excluded and never plotted. See the full methodology and the disclaimer.
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