Cosmos Health (COSM)


Market Price (9/6/2026): $0.2741 | Market Cap: $16.4 MilSector: Health Care | Industry: Health Care Distributors

Cosmos Health (COSM)


Market Price (9/6/2026): $0.2741
Market Cap: $16.4 Mil
Sector: Health Care
Industry: Health Care Distributors

Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.

0

Strong revenue growth
Rev Chg LTMRevenue Change % Last Twelve Months (LTM) is 34%

Megatrend and thematic drivers
Megatrends include Health & Wellness Trends, and Aging Population & Chronic Disease. Themes include Nutritional Supplements, and Geriatric Care.

Weak multi-year price returns
2Y Excs Rtn is -113%, 3Y Excs Rtn is -148%

Penny stock
Mkt Price is 0.3

Not profitable at operating income level
Op Inc LTMOperating Income, Last Twelve Months is -18 Mil, Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is -25%

Debt is significant
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is 87%

Not cash flow generative
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is -13%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is -13%

Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -155%

Key risks
COSM key risks include [1] a history of unprofitability and reliance on equity and debt financing, Show more.

0 Strong revenue growth
Rev Chg LTMRevenue Change % Last Twelve Months (LTM) is 34%
1 Megatrend and thematic drivers
Megatrends include Health & Wellness Trends, and Aging Population & Chronic Disease. Themes include Nutritional Supplements, and Geriatric Care.
2 Weak multi-year price returns
2Y Excs Rtn is -113%, 3Y Excs Rtn is -148%
3 Penny stock
Mkt Price is 0.3
4 Not profitable at operating income level
Op Inc LTMOperating Income, Last Twelve Months is -18 Mil, Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is -25%
5 Debt is significant
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is 87%
6 Not cash flow generative
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is -13%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is -13%
7 Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -155%
8 Key risks
COSM key risks include [1] a history of unprofitability and reliance on equity and debt financing, Show more.

Valuation & Metrics

Price Chart

Why The Stock Moved

Qualitative Assessment

AI Analysis | Feedback

Updated on 9/3/2026

Cosmos Health (COSM) stock has gained about 10% since 5/31/2026 because of the following key factors:

1. Cosmos Health achieved record revenue in the second fiscal quarter of 2026 (ended June 30, 2026) and for the first half of fiscal year 2026.

The company reported Q2 2026 revenue of $18.99 million, representing a 28.8% year-over-year increase, and first-half 2026 revenue of $36.91 million, up 29.7%. This strong performance builds on fiscal year 2025 revenue of $65.27 million, which was a 20% annual increase. Cosmos Health reaffirmed its guidance for over $90 million in revenue for fiscal year 2026 and projects $200.6 million by fiscal year 2029.

2. The company significantly improved its balance sheet and streamlined its capital structure.

Cosmos Health repaid an $8 million senior secured convertible note to ATW on August 28, 2026, 12 months ahead of its August 2027 maturity, which eliminated further dilution from conversions. This early repayment contributed to a 13.3% decline in total liabilities, reducing them by $6.27 million in the first half of fiscal year 2026, while stockholders' equity increased by 12.2%. Additionally, the company withdrew its Form S-1 and Form S-3 registration statements, simplifying its capital structure with no active shelf registration or at-the-market offering program.

Show more
Updated on 9/3/2026

Cosmos Health (COSM) stock has gained about 10% since 5/31/2026 because of the following key factors:

1. Cosmos Health achieved record revenue in the second fiscal quarter of 2026 (ended June 30, 2026) and for the first half of fiscal year 2026.

The company reported Q2 2026 revenue of $18.99 million, representing a 28.8% year-over-year increase, and first-half 2026 revenue of $36.91 million, up 29.7%. This strong performance builds on fiscal year 2025 revenue of $65.27 million, which was a 20% annual increase. Cosmos Health reaffirmed its guidance for over $90 million in revenue for fiscal year 2026 and projects $200.6 million by fiscal year 2029.

2. The company significantly improved its balance sheet and streamlined its capital structure.

Cosmos Health repaid an $8 million senior secured convertible note to ATW on August 28, 2026, 12 months ahead of its August 2027 maturity, which eliminated further dilution from conversions. This early repayment contributed to a 13.3% decline in total liabilities, reducing them by $6.27 million in the first half of fiscal year 2026, while stockholders' equity increased by 12.2%. Additionally, the company withdrew its Form S-1 and Form S-3 registration statements, simplifying its capital structure with no active shelf registration or at-the-market offering program.

3. Cosmos Health expanded its market presence and proprietary product portfolio globally.

The company secured product placements for its C-Scrub brand in major UK retailers, Tesco and Superdrug. It also entered Saudi Arabia through a five-year exclusive distribution agreement with Innova Healthcare, securing an initial purchase order of 126,000 units and projecting over 5 million units over the term. A distribution agreement was also signed in Qatar for Sky Premium Life products, with an initial order of 31,000 units. Furthermore, a subsidiary, Cana Laboratories, filed an international patent application for a hydrogel weight management product on June 25. The company projects its Oliv18™ product to generate over $6 million in incremental annual U.S. revenue within 12 to 18 months.

4. The company continued its share repurchase program, reflecting management's belief in undervalued shares.

Cosmos Health repurchased 5.1 million shares for approximately $1.11 million under an authorized $5 million buyback program. This ongoing program indicates management's conviction that the company's shares are trading below their intrinsic value and growth prospects.

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Stock Movement Drivers

Fundamental Drivers

The 10.6% change in COSM stock from 5/31/2026 to 9/5/2026 was primarily driven by a 32.7% change in the company's P/S Multiple.
(LTM values as of)53120269052026Change
Stock Price ($)0.250.2710.6%
Change Contribution By: 
Total Revenues ($ Mil)69746.1%
P/S Multiple0.20.232.7%
Shares Outstanding (Mil)4760-21.4%
Cumulative Contribution10.6%

LTM = Last Twelve Months as of date shown

Market Drivers

5/31/2026 to 9/5/2026
ReturnCorrelation
COSM10.6% 
Market (SPY)1.8%26.3%
Sector (XLV)14.7%-19.9%

Fundamental Drivers

The -30.5% change in COSM stock from 2/28/2026 to 9/5/2026 was primarily driven by a -48.9% change in the company's Shares Outstanding (Mil).
(LTM values as of)22820269052026Change
Stock Price ($)0.390.27-30.5%
Change Contribution By: 
Total Revenues ($ Mil)607423.3%
P/S Multiple0.20.210.2%
Shares Outstanding (Mil)3160-48.9%
Cumulative Contribution-30.5%

LTM = Last Twelve Months as of date shown

Market Drivers

2/28/2026 to 9/5/2026
ReturnCorrelation
COSM-30.5% 
Market (SPY)12.6%24.5%
Sector (XLV)7.5%-9.0%

Fundamental Drivers

The -65.4% change in COSM stock from 8/31/2025 to 9/5/2026 was primarily driven by a -52.0% change in the company's Shares Outstanding (Mil).
(LTM values as of)83120259052026Change
Stock Price ($)0.790.27-65.4%
Change Contribution By: 
Total Revenues ($ Mil)557433.8%
P/S Multiple0.40.2-46.1%
Shares Outstanding (Mil)2960-52.0%
Cumulative Contribution-65.4%

LTM = Last Twelve Months as of date shown

Market Drivers

8/31/2025 to 9/5/2026
ReturnCorrelation
COSM-65.4% 
Market (SPY)20.4%22.9%
Sector (XLV)26.4%-3.8%

Fundamental Drivers

The -77.2% change in COSM stock from 8/31/2023 to 9/5/2026 was primarily driven by a -81.9% change in the company's Shares Outstanding (Mil).
(LTM values as of)83120239052026Change
Stock Price ($)1.200.27-77.2%
Change Contribution By: 
Total Revenues ($ Mil)497451.1%
P/S Multiple0.30.2-16.6%
Shares Outstanding (Mil)1160-81.9%
Cumulative Contribution-77.2%

LTM = Last Twelve Months as of date shown

Market Drivers

8/31/2023 to 9/5/2026
ReturnCorrelation
COSM-77.2% 
Market (SPY)77.1%19.6%
Sector (XLV)34.7%3.4%

Return vs. Risk

Price Returns Compared

 202120222023202420252026Total [1]
Returns
COSM Return0%-91%-69%-53%-26%-47%-99%
Peers Return25%34%20%11%45%-4%210%
S&P 500 Return27%-19%24%23%16%13%106%

Monthly Win Rates [3]
COSM Win Rate0%33%50%33%33%44% 
Peers Win Rate56%62%62%56%67%56% 
S&P 500 Win Rate75%42%67%75%67%56% 

Max Drawdowns [4]
COSM Max Drawdown0%-98%-85%-66%-67%-69% 
Peers Max Drawdown-15%-20%-17%-19%-15%-24% 
S&P 500 Max Drawdown-5%-25%-10%-8%-19%-9% 


[1] Cumulative total returns since the beginning of 2021
[2] Peers: COR, CAH, MEDS, MCK, HSIC.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2026 data is for the year up to 9/4/2026 (YTD)

How Low Can It Go

EventCOSMS&P 500
2025 US Tariff Shock
  % Loss-50.4%-18.8%
  % Gain to Breakeven101.4%23.1%
  Time to Breakeven95 days79 days
2024 Yen Carry Trade Unwind
  % Loss-16.0%-7.8%
  % Gain to Breakeven19.0%8.5%
  Time to Breakeven14 days18 days
Summer-Fall 2023 Five Percent Yield Shock
  % Loss-41.8%-9.5%
  % Gain to Breakeven71.7%10.5%
  Time to Breakeven10 days24 days
2020 COVID-19 Crash
  % Loss-17.9%-33.7%
  % Gain to Breakeven21.9%50.9%
  Time to Breakeven1 days140 days

Compare to COR, CAH, MEDS, MCK, HSIC

In The Past

Cosmos Health's stock fell -50.4% during the 2025 US Tariff Shock. Such a loss loss requires a 101.4% gain to breakeven.

Preserve Wealth

Limiting losses and compounding gains is essential to preserving wealth.

Asset Allocation

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EventCOSMS&P 500
2025 US Tariff Shock
  % Loss-50.4%-18.8%
  % Gain to Breakeven101.4%23.1%
  Time to Breakeven95 days79 days
Summer-Fall 2023 Five Percent Yield Shock
  % Loss-41.8%-9.5%
  % Gain to Breakeven71.7%10.5%
  Time to Breakeven10 days24 days

Compare to COR, CAH, MEDS, MCK, HSIC

In The Past

Cosmos Health's stock fell -50.4% during the 2025 US Tariff Shock. Such a loss loss requires a 101.4% gain to breakeven.

Preserve Wealth

Limiting losses and compounding gains is essential to preserving wealth.

Asset Allocation

Actively managed asset allocation strategies protect wealth. Learn more.

About Cosmos Health (COSM)

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Cosmos Health Inc. is a vertically integrated pharmaceutical company that focuses on identifying, acquiring, developing, and commercializing a diverse range of health-related products. Its extensive portfolio includes proprietary branded and generic pharmaceuticals, nutraceuticals, and over-the-counter (OTC) medications, all designed to enhance patients' lives and outcomes.

In addition to its core pharmaceutical offerings, the company also provides various health care products, baby products, and medical devices. Cosmos Health distributes these products through its own established channels, which include distribution centers in Greece and the United Kingdom, a dedicated warehousing facility, and an e-commerce marketplace. The primary customers for Cosmos Health's wide array of products are wholesale pharmaceutical distributors and independent retail pharmacies.

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AI Analysis | Feedback

Here are 1-3 brief analogies for Cosmos Health:
  • It's like a smaller, vertically integrated company combining the diverse health product manufacturing of Perrigo (known for OTCs and generics) with the robust distribution capabilities of a Cardinal Health.
  • Imagine a pharmacy chain's private label brand (like CVS Health's store brand) but expanded to include branded and generic pharmaceuticals, medical devices, and with its own extensive distribution and e-commerce network.

AI Analysis | Feedback

  • Branded Pharmaceuticals: Proprietary drugs marketed under specific brand names.
  • Generic Pharmaceuticals: Cost-effective versions of existing drugs once their patents expire.
  • Nutraceuticals: Products derived from food sources that are believed to provide extra health benefits in addition to their basic nutritional value.
  • Over-the-Counter (OTC) Medications: Drugs that can be purchased without a prescription.
  • Health Care Products: A general category encompassing various items designed for maintaining or improving health.
  • Baby Products: Specialized goods designed for the care and needs of infants and young children.
  • Medical Devices: Instruments, apparatus, implants, in vitro reagents, or similar articles used to diagnose, prevent, monitor, treat, or alleviate disease.

AI Analysis | Feedback

Cosmos Health (COSM) primarily sells its products to other companies (B2B). Based on the provided background information, the specific names of its major customer companies are not disclosed. However, the company serves two main categories of business customers:
  • Wholesale pharmaceutical distributors
  • Independent retail pharmacies

AI Analysis | Feedback

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Grigorios Siokas, Chairman & Chief Executive Officer

Mr. Grigorios Siokas has served as the Chairman and Chief Executive Officer of Cosmos Health Inc. since February 2016. He brings over 15 years of experience in the pharmaceutical industry. Prior to his current role, he was the CEO and Operations Manager of SkyPharm S.A., a wholly-owned subsidiary of Cosmos Health, since 2014. Mr. Siokas has also held ownership and operating roles in European pharmaceutical distribution and was a major shareholder in several pharmaceutical companies before 2014, including Ippokratis Pharmaceuticals, Thrakis Pharmaceuticals, Thessalias Pharmaceuticals, and ZED Pharma SA. He briefly served as acting CFO for Cosmos Health until November 2020. Mr. Siokas holds a Bachelor's degree in Geology from Aristotle University of Thessaloniki and a Master's degree in management and finance from the University of Stuttgart and the University of Tuebingen. He has consistently demonstrated his commitment to the company by increasing his ownership through various stock purchases and debt exchange agreements, having invested over $18 million since Cosmos Health's inception.

Georgios Terzis, Chief Financial Officer

Mr. Georgios Terzis is the Chief Financial Officer and Principal Accounting Officer of Cosmos Health Inc. In this role, he is responsible for managing the company's financial operations and capital structure. Mr. Terzis has also increased his stake in the company through share purchases, indicating his confidence in Cosmos Health's future.

Nikolaos Bardakis, Chief Operating Officer

Mr. Nikolaos Bardakis serves as the Chief Operating Officer for Cosmos Health Inc. He is responsible for overseeing the company's day-to-day business operations and ensuring operational efficiency.

Dimitris Moraitis, Vice President of Strategy & Operations

Mr. Dimitris Moraitis was appointed as the Vice President of Strategy & Operations for Cosmos Health Inc. in February 2025. He brings over 25 years of extensive experience in strategic planning, operations, and business development within the pharmaceutical sector. Throughout his career, Mr. Moraitis has held key leadership positions at prominent pharmaceutical companies such as DEMO, MENARINI, the VIANEX Group, and TIKUN OLAM Europe. He has also served as a leader and board member for several well-known pharmaceutical associations.

AI Analysis | Feedback

The key risks to Cosmos Health's business (NASDAQ: COSM) include its ongoing financial instability and lack of profitability, significant regulatory and compliance challenges particularly within its nutraceutical segment, and substantial exposure to the volatility of digital assets.

The most significant risk to Cosmos Health is its **financial instability and persistent lack of profitability**. The company has consistently reported negative operating margins and a negative return on invested capital (ROIC), indicating that it is losing money. Cosmos Health has an accumulated deficit and a weak balance sheet, facing large current liabilities and often requiring additional financing to meet its obligations, leading to "going concern" disclosures. Its financial strength has been rated as poor, with a negative Altman Z-Score, which places the company in the distress zone and suggests a potential risk of bankruptcy within the next two years. The stock has also experienced high volatility and a significant decline in share price.

Secondly, Cosmos Health faces considerable **regulatory and compliance risks**, particularly concerning its nutraceutical business, which is a primary financial driver. While its pharmaceutical operations are subject to stringent regulations from bodies like the FDA, the nutraceutical industry is less regulated, which can lead to issues with product claims, safety, and efficacy. Failure to comply with these regulations can result in severe legal and financial penalties, including product recalls and liability. Additionally, a specific "drug preclusion provision" under FDA rules for nutraceuticals can create coverage gaps for certain products.

Lastly, Cosmos Health's **exposure to cryptocurrency volatility** presents a notable risk. The company has a significant digital financing facility and has invested in digital assets, including Ethereum and Bitcoin. This strategy means the company's financial health and balance sheet are directly influenced by the highly volatile cryptocurrency market, which could lead to unpredictable and substantial swings in its financial position.

AI Analysis | Feedback

The increasing market penetration and potential vertical integration of large technology and e-commerce giants into the pharmaceutical and healthcare product distribution space. Companies like Amazon have already launched online pharmacies and are continually expanding their logistics and direct-to-consumer capabilities. This trend threatens traditional pharmaceutical distribution channels, including those relied upon by Cosmos Health, and could put significant pressure on its customer base of independent retail pharmacies and wholesale distributors by offering more streamlined and potentially lower-cost alternatives. This parallels the disruption seen in other industries where tech companies have leveraged their scale and efficiency to displace established intermediaries.

AI Analysis | Feedback

Cosmos Health (symbol: COSM) operates in several key addressable markets primarily within Europe, encompassing pharmaceuticals, nutraceuticals, over-the-counter (OTC) medications, and medical devices.

Addressable Markets for Cosmos Health's Main Products and Services in Europe:

  • Generic Pharmaceuticals: The European generic pharmaceuticals market was valued at approximately USD 136.17 billion in 2025 and is projected to reach around USD 235.82 billion by 2033. Within this, the Europe branded generics market was valued at USD 39.15 billion in 2023 and is projected to reach approximately USD 70.84 billion by 2033.
  • Branded Pharmaceuticals: The broader European pharmaceutical market, which includes branded pharmaceuticals, was estimated at USD 488.05 billion in 2024 and is projected to grow to USD 820.05 billion by 2034. The branded segment held a dominant revenue share of 66.49% in this market in 2024.
  • Nutraceuticals: The Europe nutraceuticals market size was calculated to be USD 143.74 billion in 2025 and is anticipated to be worth USD 286.63 billion by 2034.
  • Over-the-Counter (OTC) Medications / OTC Health Products: The Europe OTC Health Product Market was valued at USD 125.4 billion in 2025 and is projected to reach USD 209.8 billion by 2032.
  • Medical Devices: The European medical devices market was valued at approximately USD 193.9 billion in 2024 and is projected to hit USD 305.01 billion by 2033.

AI Analysis | Feedback

Expected Drivers of Future Revenue Growth for Cosmos Health (COSM)

Over the next 2-3 years, Cosmos Health (NASDAQ: COSM) anticipates several key drivers to fuel its revenue growth:

  1. Expansion into Higher-Margin Products and Services: Cosmos Health is strategically shifting its focus towards higher-margin pharmaceutical products, branded nutraceuticals, and technology-enabled services. This includes the continued global expansion of its flagship nutraceutical brand, Sky Premium Life, which added over 60 new formulations in 2025, bringing its total to over 150 products.
  2. Growth of Distribution Network and Customer Base: The company's pharmaceutical distribution subsidiary, Cosmofarm, is expanding its reach. In 2025, it added nearly 100 new pharmacy customers, increasing its active customer base by approximately 20%, and anticipates similar or higher growth rates in 2026. This expansion is further bolstered by a disciplined acquisition strategy, such as the recently announced Letter of Intent to acquire a pharmacy distribution network in Greece, which is expected to add approximately $11.5 million in annual gross revenue.
  3. Investments in Automation and Logistics Infrastructure: Cosmos Health is enhancing its operational efficiency and capacity through significant investments in automation. Cosmofarm's multi-year, multi-million dollar investments in advanced robotic systems, including ROWA and A-frame technologies, are projected to increase processing capacity, improve accuracy, and support an incremental annual revenue potential of approximately $40 million.
  4. Launch of New Pharmaceutical Products and R&D Advancements: The company is actively developing and commercializing new products. Its research and development efforts include advancing an obesity treatment, CCX0722, towards clinical trials with a potential launch in 2026, and expanding its pipeline in therapeutic areas such as autoimmune diseases, neurology, oncology, and allergies. Cosmos Health is also focused on developing novel patented nutraceuticals, specialized root extracts, proprietary complex generics, and innovative over-the-counter products.
  5. U.S. Market Expansion and Domestic Manufacturing: Cosmos Health is strategically entering the U.S. market and establishing domestic manufacturing capabilities through an agreement with DolCas Biotech. This move is designed to reduce exposure to tariff volatility, strengthen supply-chain resilience, and produce products where they are sold, representing a structural shift in its market approach.

AI Analysis | Feedback

Share Issuance

  • Cosmos Health's CEO, Grigorios Siokas, acquired approximately $339,999 worth of shares in January and February 2026 through debt exchange agreements, where the company issued shares to settle its debt.
  • The company plans to implement a reverse stock split if necessary to regain compliance with Nasdaq's minimum bid price requirement by mid-2026.
  • Cosmos Health had 35 million shares outstanding in Q3 2025, marking a 15.6% increase from the prior quarter.

Inbound Investments

  • In August 2025, Cosmos Health secured a financing facility of up to $300 million from a U.S. institutional investor through senior secured convertible promissory notes.
  • Approximately 72.5% of the net proceeds from this financing facility are allocated to building a digital treasury reserve, including cryptocurrencies like Ethereum, Bitcoin, and Solana, with the remainder supporting working capital and growth initiatives.
  • The company partnered with Prime Ledger LLC to manage this $300 million treasury facility and to digitally transform its financial operations.

Outbound Investments

  • Cosmos Health acquired ZipDoctor, a U.S. telehealth subscription business, in 2023, and Cloudscreen, an AI-enabled drug-repurposing and R&D platform, in early 2024.
  • The company has built a digital treasury reserve, with total digital asset investments exceeding $3.1 million as of March 2026, through purchases of Ethereum and Bitcoin.
  • In March 2026, Cosmos Health entered into a Letter of Intent to acquire an extensive pharmacy distribution network in Greece, which is expected to generate approximately $11.5 million in annual gross revenue.

Capital Expenditures

  • An investment program of approximately $1 million is currently underway at Cosmofarm, its Greek subsidiary, to expand robotic capacity and throughput for its logistics platform as of January 2026.
  • Cana Laboratories completed Phase I upgrades to its 54,000-square-foot manufacturing facility in Athens.
  • Cosmofarm's 29,000-square-foot property in Athens is undergoing upgrades including modernized office space, expanded distribution areas, and enhanced temperature-controlled storage.

Better Bets vs. Cosmos Health (COSM)

Peer Outperformance in Health Care Distributors

COSM has trailed 100% of its 6 Health Care Distributors peers over 5Y. Among the peers that beat it is MCK. Health Care Distributors ranks 1st of 10 industries in Health Care by median 5Y return. That makes it one of the strongest corners of the sector.
Share of Health Care Distributors constituents that COSM has outperformed, by holding period. Peers without a full price history over a given window are excluded from that window.
1Y
33%
of 6 industry peers · -57.9% return
3Y
17%
of 6 industry peers · -76.4% return
5Y
0%
of 6 industry peers · -99.4% return
Health Care Distributors peers with revenue growth within 4pp of COSM's that beat it on at least 2 of 3 windows, and by at least 20pp over 5Y. Growth is matched by construction, so the gap is largely a re-rating gap. The multiple column is the context for it.
Ticker Name Rev Growth 3Y Avg P/E 1Y3Y5Y 5Y Gap
COSM Cosmos Health 15.7% -0.7x -57.9%-76.4%-99.4%
MCK McKesson 13.2% 23.5x 32.6%123.4%351.1% +450pp
Price returns, excluding dividends. P/E shown for context only and not used for matching.
Median price return by industry across the Health Care sector, ranked by 5Y. Health Care Distributors is COSM's own industry. Use this to see which corners of the sector have carried the returns.
Industry Names 1Y med3Y med5Y med Top 3 by 5Y
Health Care Distributors ← 7 14.0%94.3%127.8% CAH 414% · MCK 351% · COR 179%
Managed Health Care 8 32.5%0.9%3.3% OSCR 77% · HQY 48% · ELV 16%
Health Care Services 20 19.7%53.1%-1.5% HIMS 238% · RDNT 134% · DGX 68%
Health Care Facilities 24 -1.0%7.5%-19.0% THC 249% · NHC 244% · ENSG 108%
Health Care Equipment 50 -4.5%-4.9%-24.0% POCI 10775% · UFPT 318% · GKOS 200%
Health Care Supplies 12 27.9%-14.2%-35.5% LNTH 272% · HAE 59% · MMSI 23%
Pharmaceuticals 63 -1.5%1.9%-36.4% LQDA 2406% · INDV 1148% · ETON 1022%
Life Sciences Tools & Services 109 1.6%-27.8%-73.9% SNWV 1688% · MEDP 203% · AXGN 178%
Biotechnology 363 5.6%-26.4%-76.8% BRTX 73900% · DNTH 1558% · CELZ 1486%
Health Care Technology 20 -24.5%-57.0%-78.6% SPOK 68% · HSTM -2% · VEEV -13%
Median of constituents with a full price history over each window. Top names are unfiltered by size in this render.

Latest Trefis Analyses

TitleDate
0DASHBOARDS 
1null10/17/2025
Title
0ARTICLES

Recent Active Movers

Peer Comparisons

Peers to compare with:

Financials

COSMCORCAHMEDSMCKHSICMedian
NameCosmos H.Cencora Cardinal.DataMEDS.McKesson Henry Sc. 
Mkt Price0.27330.95247.180.92907.9989.81168.50
Mkt Cap0.063.957.6-107.810.257.6
Rev LTM74332,771254,2488410,98313,602133,925
Op Inc LTM-184,5293,173-586,7927781,976
FCF LTM-104,0604,525-156,1455132,287
FCF 3Y Avg-103,0113,209-75,0224471,729
CFO LTM-104,8215,174-146,8537002,760
CFO 3Y Avg-83,6253,778-65,7956352,130

Growth & Margins

COSMCORCAHMEDSMCKHSICMedian
NameCosmos H.Cencora Cardinal.DataMEDS.McKesson Henry Sc. 
Rev Chg LTM33.8%5.1%14.2%-78.2%8.8%6.5%7.7%
Rev Chg 3Y Avg15.7%9.4%7.7%-13.2%2.6%9.4%
Rev Chg Q28.8%5.1%5.8%-77.2%7.7%6.7%6.3%
QoQ Delta Rev Chg LTM6.1%1.2%1.4%-42.8%1.9%1.6%1.5%
Op Inc Chg LTM-26.3%22.0%36.6%-36.3%43.0%0.9%11.4%
Op Inc Chg 3Y Avg-19.2%19.6%21.6%-15.4%0.2%15.4%
Op Mgn LTM-24.6%1.4%1.2%-719.3%1.7%5.7%1.3%
Op Mgn 3Y Avg-29.3%1.2%1.1%-1.4%5.5%1.2%
QoQ Delta Op Mgn LTM1.1%0.1%0.1%-321.2%0.1%0.1%0.1%
CFO/Rev LTM-13.3%1.4%2.0%-171.2%1.7%5.1%1.6%
CFO/Rev 3Y Avg-12.0%1.2%1.6%-1.6%4.9%1.6%
FCF/Rev LTM-13.5%1.2%1.8%-182.7%1.5%3.8%1.4%
FCF/Rev 3Y Avg-16.3%1.0%1.3%-1.3%3.5%1.3%

Valuation

COSMCORCAHMEDSMCKHSICMedian
NameCosmos H.Cencora Cardinal.DataMEDS.McKesson Henry Sc. 
Mkt Cap0.063.957.6-107.810.257.6
P/S0.20.20.2-0.30.70.2
P/Op Inc-0.914.118.2-15.913.114.1
P/EBIT-0.815.522.8-16.014.315.5
P/E-0.724.433.6-23.525.324.4
P/CFO-1.613.311.1-15.714.613.3
Total Yield-150.8%4.8%3.8%-4.6%4.0%4.0%
Dividend Yield0.0%0.7%0.9%-0.4%0.0%0.4%
FCF Yield 3Y Avg-71.1%6.0%8.8%-5.8%5.1%5.8%
D/E1.00.20.2-0.10.40.2
Net D/E0.90.10.1-0.10.40.1

Returns

COSMCORCAHMEDSMCKHSICMedian
NameCosmos H.Cencora Cardinal.DataMEDS.McKesson Henry Sc. 
1M Rtn23.6%2.0%4.0%-65.3%4.3%1.8%3.0%
3M Rtn8.9%20.6%20.4%-74.4%17.2%16.0%16.6%
6M Rtn-26.2%-7.3%14.0%-74.4%-1.0%15.7%-4.1%
12M Rtn-57.9%14.0%67.0%-74.4%32.6%29.4%21.7%
3Y Rtn-76.4%94.3%196.7%-74.4%123.4%21.2%57.7%
1M Excs Rtn23.5%1.9%3.9%-65.4%4.2%1.7%2.9%
3M Excs Rtn4.4%16.0%15.9%-78.9%12.6%11.4%12.0%
6M Excs Rtn-40.7%-21.8%-0.5%-88.9%-15.5%1.2%-18.7%
12M Excs Rtn-75.8%-4.8%48.5%-93.1%13.1%13.8%4.2%
3Y Excs Rtn-147.8%18.7%123.1%-145.4%47.3%-55.1%-18.2%

Comparison Analyses

null

Financials

Segment Financials

Revenue by Segment
$ Mil20252024202320222021
Wholesale595251  
Nutraceuticals & Pharmaceuticals422  
Pharma manufacturing210  
Other000  
Single Segment   5056
Total6554535056


Net Income by Segment
$ Mil20252024
Wholesale0-2
Pharma manufacturing-2-2
Nutraceuticals & Pharmaceuticals-5-6
Other-12-6
Total-19-16


Assets by Segment
$ Mil2023
Single Segment66
Total66


Price Behavior

Price Behavior
Market Price$0.27 
Market Cap ($ Bil)0.0 
First Trading Date12/13/2013 
Distance from 52W High-78.1% 
   50 Days200 Days
DMA Price$0.23$0.35
DMA Trenddowndown
Distance from DMA16.5%-22.8%
 3M1YR
Volatility113.9%95.8%
Downside Capture42.15246.71
Upside Capture72.8394.60
Correlation (SPY)25.4%24.6%
COSM Betas & Captures as of 8/31/2026

 1M2M3M6M1Y3Y
Beta-0.302.441.851.521.621.29
Up Beta1.143.082.441.701.180.70
Down Beta-8.276.593.932.202.441.54
Up Capture73%183%70%46%41%107%
Bmk +ve Days10213268138427
Stock +ve Days11223260112341
Down Capture-204%39%87%168%163%112%
Bmk -ve Days11213259113324
Stock -ve Days10203267137395

[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with COSM
COSM-57.2%95.6%-0.46-
Sector ETF (XLV)26.5%16.0%1.28-3.6%
Equity (SPY)19.7%12.8%1.1324.6%
Gold (GLD)24.6%29.2%0.7511.4%
Commodities (DBC)43.8%20.3%1.67-8.4%
Real Estate (VNQ)9.1%13.6%0.395.7%
Bitcoin (BTCUSD)-28.1%43.8%-0.6320.2%

Smart multi-asset allocation framework can stack odds in your favor. Learn How
Based On 5-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with COSM
COSM-68.8%162.8%-0.13-
Sector ETF (XLV)6.6%15.1%0.251.7%
Equity (SPY)12.8%17.2%0.5710.4%
Gold (GLD)19.1%18.8%0.823.9%
Commodities (DBC)10.7%19.5%0.43-1.9%
Real Estate (VNQ)1.7%18.9%-0.017.5%
Bitcoin (BTCUSD)10.2%52.6%0.3811.2%

Smart multi-asset allocation framework can stack odds in your favor. Learn How
Based On 10-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with COSM
COSM-43.2%158.4%-0.06-
Sector ETF (XLV)10.8%16.7%0.531.1%
Equity (SPY)15.3%17.9%0.729.0%
Gold (GLD)12.4%16.3%0.622.3%
Commodities (DBC)7.9%18.1%0.35-2.5%
Real Estate (VNQ)4.8%20.7%0.196.2%
Bitcoin (BTCUSD)63.7%66.2%1.038.4%

Smart multi-asset allocation framework can stack odds in your favor. Learn How

Short Interest

Short Interest: As Of Date8142026
Short Interest: Shares Quantity3.8 Mil
Short Interest: % Change Since 7312026-7.0%
Average Daily Volume2.8 Mil
Days-to-Cover Short Interest1.3 days
Basic Shares Quantity59.9 Mil
Short % of Basic Shares6.3%

Earnings Returns History

Updated 8/31/2026
Expand for More
 Forward Returns
Earnings Date1D Returns5D Returns21D Returns
8/20/20264.2%1.7% 
5/22/2026-1.1%-3.3%-17.7%
11/17/20250.0%-1.6%-27.6%
11/22/20230.5%-1.0%36.9%
8/15/20233.1%0.0%-0.8%
4/18/2023-0.6%3.1%9.4%
11/16/20225.7%158.3%642.9%
8/23/20225.6%-0.6%-29.7%
...
SUMMARY STATS   
# Positive975
# Negative245
Median Positive3.1%1.7%9.4%
Median Negative-0.9%-1.3%-27.6%
Max Positive11.1%158.3%642.9%
Max Negative-1.1%-3.3%-42.8%
Collapse to Preview
 Forward Returns
Earnings Date1D Returns5D Returns21D Returns
8/20/20264.2%1.7% 
5/22/2026-1.1%-3.3%-17.7%
11/17/20250.0%-1.6%-27.6%
11/22/20230.5%-1.0%36.9%
8/15/20233.1%0.0%-0.8%
4/18/2023-0.6%3.1%9.4%
11/16/20225.7%158.3%642.9%
8/23/20225.6%-0.6%-29.7%
5/18/202211.1%16.7%-42.8%
5/18/20210.0%0.0%0.0%
11/17/20200.0%0.0%0.0%
SUMMARY STATS   
# Positive975
# Negative245
Median Positive3.1%1.7%9.4%
Median Negative-0.9%-1.3%-27.6%
Max Positive11.1%158.3%642.9%
Max Negative-1.1%-3.3%-42.8%

SEC Filings

Expand for More
Report DateFiling DateFiling
06/30/202608/18/202610-Q
03/31/202605/20/202610-Q
12/31/202504/15/202610-K
09/30/202511/14/202510-Q
06/30/202508/18/202510-Q
03/31/202505/15/202510-Q
12/31/202404/15/202510-K
09/30/202411/14/202410-Q
06/30/202408/19/202410-Q
03/31/202408/19/202410-Q
12/31/202308/05/202410-K
09/30/202311/20/202310-Q
06/30/202308/15/202310-Q
03/31/202305/16/202310-Q
12/31/202204/12/202310-K
09/30/202211/14/202210-Q
Collapse to Preview
Report DateFiling DateFiling
06/30/202608/18/202610-Q
03/31/202605/20/202610-Q
12/31/202504/15/202610-K
09/30/202511/14/202510-Q
06/30/202508/18/202510-Q
03/31/202505/15/202510-Q
12/31/202404/15/202510-K
09/30/202411/14/202410-Q
06/30/202408/19/202410-Q
03/31/202408/19/202410-Q
12/31/202308/05/202410-K
09/30/202311/20/202310-Q
06/30/202308/15/202310-Q
03/31/202305/16/202310-Q
12/31/202204/12/202310-K
09/30/202211/14/202210-Q
06/30/202208/19/202210-Q
03/31/202205/17/202210-Q
12/31/202104/15/202210-K
09/30/202111/15/202110-Q
06/30/202108/16/202110-Q
03/31/202105/17/202110-Q
12/31/202004/15/202110-K
09/30/202011/16/202010-Q
06/30/202008/13/202010-Q
03/31/202005/15/202010-Q
12/31/201904/14/202010-K
09/30/201911/14/201910-Q

Recent Forward Guidance

Updated 8/21/2026

Latest: Q2 2026 Earnings Reported 8/20/2026

Forward GuidanceGuidance Change
MetricSourceLowMidHigh% Chg% DeltaChangePrior
2026 Annualized Revenue Run-rateReported 75.00 Mil    
2026 EU Expansion RevenueReported 7.40 Mil    
2026 EU Expansion Gross ProfitReported 5.30 Mil    
2026 Operating Expense ReductionReported 0.3    

null

Insider Activity

Updated 7/30/2026
Expand for More
#OwnerTitleHoldingActionFiling DatePriceSharesTransacted
Value
Value of
Held Shares
Form
1Siokas, GrigoriosChief Executive OfficerDirectBuy73020260.18766,284140,0002,603,126Form
2Siokas, GrigoriosChief Executive OfficerDirectBuy71820260.5385,71445,0002,160,534Form
3Terzis, GeorgiosChief Financial OfficerDirectBuy61720260.25168,13542,000558,402Form
4Siokas, GrigoriosChief Executive OfficerDirectBuy61220260.21218,44745,0002,777,252Form
5Siokas, GrigoriosChief Executive OfficerDirectBuy61220260.23701,447160,0003,025,373Form
Collapse to Preview
#OwnerTitleHoldingActionFiling DatePriceSharesTransacted
Value
Value of
Held Shares
Form
1Siokas, GrigoriosChief Executive OfficerDirectBuy73020260.18766,284140,0002,603,126Form
2Siokas, GrigoriosChief Executive OfficerDirectBuy71820260.5385,71445,0002,160,534Form
3Terzis, GeorgiosChief Financial OfficerDirectBuy61720260.25168,13542,000558,402Form
4Siokas, GrigoriosChief Executive OfficerDirectBuy61220260.21218,44745,0002,777,252Form
5Siokas, GrigoriosChief Executive OfficerDirectBuy61220260.23701,447160,0003,025,373Form
6Siokas, GrigoriosChief Executive OfficerDirectBuy40920260.49132,57265,0001,975,707Form
7Siokas, GrigoriosChief Executive OfficerDirectBuy31520260.6476,36049,0004,145,372Form
Core Cache Last Updated: 9/5/2026