COSM vs MDLN: How Cosmos Health and Medline 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: COSM 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. COSM and MDLN 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 COSM and MDLN 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.

Cosmos Health Inc. is a small, vertically integrated global healthcare group headquartered in Greece and listed on Nasdaq under COSM. Its business has two broad parts. The larger, established part distributes pharmaceuticals and parapharmaceuticals, including branded generics and over-the-counter medicines, to retail pharmacies and wholesalers through subsidiaries in Greece and the UK. The second, higher-margin part is a portfolio of proprietary brands, most importantly the Sky Premium Life nutraceutical and supplement line, plus names like Mediterranation, bio-bebe, NOOR Collagen, and the C-Sept and C-Scrub lines. The strategy is to grow the branded, owned-product side, which carries better margins than pure distribution, while expanding into new markets and categories such as skincare and prescription medicines.

Full COSM guide

Medline makes and distributes the unglamorous consumables that hospitals, surgery centers, physician offices, and nursing homes go through every single day: gloves, gowns, surgical kits, wound care, incontinence products, exam-room supplies, and diagnostics. It reports in two segments. Medline Brand covers products the company manufactures and sells under its own label (surgical solutions, front-line care, laboratory and diagnostics), and it carries the better margin. Supply Chain Solutions distributes third-party manufacturers' brands and runs the prime-vendor logistics contracts that put Medline trucks on a health system's loading dock several times a week. Roughly 90 percent of revenue is domestic. The company employs about 45,000 people and is headquartered in Northfield, Illinois.

Full MDLN guide

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

• COSM drivers: Revenue growth and 2029 targets; Branded products and margin mix.
• MDLN drivers: Prime-vendor contracts in Supply Chain Solutions; Mix shift toward Medline Brand products.

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 overriding risks are financial and structural rather than operational. For MDLN, the clearest near-term risk is regulatory.

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 COSM if you believe its drivers more; MDLN 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 COSM and MDLN guides.

COSM. Figures are approximate and tied to the asOf date; verify live numbers before acting. Because Cosmos is lossmaking, price-to-earnings multiples do not apply, and the market values it mainly on revenue growth and the credibility of its 2029 targets rather than current profit. Share counts have shifted with past issuance and a prior reverse split, so market cap and per-share figures should be checked live. For a sub-$1 micro-cap facing a listing deadline, capital-structure and delisting risk matter more to the stock than any single quarter's sales.

MDLN. The trailing P/E near 46 times looks expensive until you notice that trailing net income is depressed by the Tracy fire, quality remediation spend, and post-IPO charges, which is why the market watches adjusted EBITDA instead. On enterprise value of roughly $58 billion against full-year adjusted EBITDA guidance of $3.3 to $3.4 billion, the multiple sits around 17 times. That guidance was cut from $3.5 to $3.6 billion in the August 2026 release even as organic growth guidance went up to 9 to 10 percent, and the shares fell roughly 13 percent on the day. Medline does not pay a dividend.

Headline figures (approximate, Jul 2026): COSM shows revenue (2025 full year) ~$65 million, up roughly 20% year over year, revenue (2026 quarterly) Q1 2026 ~$17.9 million, up ~31%; Q2 2026 guided to roughly $19 million, profitability Still net lossmaking; full-year 2025 net loss on the order of $19 million, long-term guidance Management targets ~$200 million revenue and positive adjusted EBITDA by 2029 (aspirational, far above current results); MDLN shows revenue (ttm) ~$29.9B, up ~12%, q2 2026 net sales ~$7.7B, up ~11.6%, gross margin (ttm) ~26%, net income (ttm) ~$693M, down ~45%.

COSM and MDLN 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 COSM and MDLN exposure against your real portfolio. It is not an investment adviser.