NEW YORK / NORTHFIELD, Ill. — December 9, 2025 — Medical‑supply giant Medline Inc. has set the terms for a U.S. initial public offering that could raise up to $5.37 billion and value the company at as much as $55.3 billion, positioning it as the largest U.S. IPO of 2025 and one of the biggest private‑equity‑backed listings on record. [1]
The Illinois‑based manufacturer and distributor of medical‑surgical supplies plans to sell 179 million shares on the Nasdaq under the ticker MDLN at a price range of $26 to $30 per share, with Goldman Sachs, Morgan Stanley, BofA Securities and J.P. Morgan leading a syndicate of more than 40 underwriters. [2]
If the stock prices at the top of the range, Medline’s equity could be valued around $55.3 billion, versus the $34 billion leveraged buyout (LBO) price that Blackstone, Carlyle and Hellman & Friedman paid in 2021 — a paper uplift of roughly 63% in just over four years, before factoring in any prior dividends or debt paydown. [3]
Medline IPO at a Glance
- Issuer: Medline Inc. (medical‑surgical products and healthcare supply‑chain services) [4]
- Deal size: Up to $5.37 billion in gross proceeds from 179 million shares at $26–$30
- Implied valuation: Up to $55.3 billion market capitalization at the top of the range [5]
- Listing venue & ticker: Nasdaq Global Select Market, symbol MDLN [6]
- Owners selling down: Private‑equity sponsors Blackstone, Carlyle, Hellman & Friedman and co‑investors; founding Mills family remains largest single shareholder with roughly a quarter of the company. [7]
- Cornerstone demand: Up to $2.35 billion from institutional investors including Baillie Gifford, Capital Group, Janus Henderson, GIC, Viking Global Investors, Durable Capital Partners and Morgan Stanley’s Counterpoint Global; the Mills family and affiliates may buy up to $250 million of shares. [8]
- Expected pricing: Around December 16, 2025, subject to market conditions. [9]
Why the Medline IPO Matters for Markets and Private Equity
A flagship listing in a fragile IPO market
After a stop‑start year for new issues — hampered by a prolonged U.S. government shutdown and regulatory backlog — Medline’s offering is widely viewed as a bellwether for the late‑2025 IPO window and for 2026 deal flow. [10]
Analysts note that:
- It is poised to be the largest U.S. IPO since the 2021 boom, and the biggest this year by proceeds. [11]
- It sits outside the currently fashionable themes of AI, crypto and fintech, making it a purer test of appetite for large, cash‑generative, non‑tech issuers. [12]
- A strong reception would likely embolden other private‑equity‑owned companies to finally come to market after years of “IPO winter.” [13]
One of private equity’s biggest exits on record
Private Equity Insights describes Medline’s float as “one of the largest private‑equity‑backed listings ever launched in the United States,” potentially eclipsing even the landmark 2011 IPO of HCA Healthcare in gross proceeds. [14]
Key exit math:
- Entry: $34bn LBO in 2021 led by Blackstone, Carlyle and Hellman & Friedman, with the Mills family rolling a significant minority stake. [15]
- Potential equity value: Up to $55.3bn at the top of the range. [16]
- Paper value creation: About $21bn in additional equity value versus the original deal price, before considering leverage reduction or any interim distributions. (55.3 – 34 = 21.3).
Such a result would be a powerful marketing story for large‑cap buyout funds — evidence that sponsors can still exit club mega‑deals via IPO at premium valuations despite higher rates and geopolitical uncertainty. [17]
Inside Medline’s Business: A Healthcare Infrastructure Giant
Medline is not a flashy biotech or med‑device innovator. It’s a scale infrastructure player in the healthcare ecosystem, supplying hospitals, surgery centers, doctors’ offices and post‑acute providers with everyday essentials.
According to its S‑1 and trade press:
- The company offers around 335,000 medical products, from gloves and gowns to wheelchairs and surgical tools. [18]
- It operates 69 distribution centers worldwide, backed by over 2,000 trucks, providing next‑day delivery to roughly 95% of U.S. healthcare customers. [19]
- Medline runs more than 30 manufacturing sites and increasingly pushes its high‑margin Medline‑branded products, which account for just under half of sales but more than four‑fifths of segment EBITDA. [20]
- It employs about 43,000 people and serves customers in over 100 countries. [21]
In an era when hospitals and health systems obsess over supply‑chain resilience and cost, that physical footprint and private‑label mix are central to Medline’s pitch.
The Numbers: Growth Story with Real Scale
Revenue and profit trajectory
Medline has posted steady growth through COVID, supply‑chain shocks and trade‑policy swings:
- 2022 net sales: $21.45bn
- 2023 net sales: $23.23bn
- 2024 net sales: $25.5bn (around 20% growth over two years). [22]
- 2024 net income: $1.2bn; adjusted EBITDA: $3.4bn (13.2% margin). [23]
Momentum has continued into this year:
- First half of 2025: net sales $13.5bn, net income $655m, up 9.7% year over year. [24]
- First nine months of 2025: net sales about $20.6bn and profit near $1bn, according to recent deal documentation. [25]
At the proposed top‑end valuation of $55.3bn, investors would be paying a trailing price‑to‑earnings multiple in the mid‑40s based on 2024 net income of $1.2bn — a premium to many other large healthcare distributors and med‑tech suppliers. [26]
Business mix: brands vs. supply chain
Per the S‑1 and secondary analysis, Medline’s performance is shaped by two main segments: [27]
- Medline Brand (private‑label products)
- ~49% of net sales
- ~83% of segment adjusted EBITDA
- Supply Chain Solutions (third‑party products and logistics services)
- ~51% of net sales
- ~17% of segment adjusted EBITDA
This mix means incremental growth in branded products can disproportionately lift profits — a dynamic that both underpins the bull case and adds execution risk if hospital purchasing patterns shift.
Heavy Leverage and the Path Toward Investment Grade
A $16.8bn debt stack
Like many PE‑backed giants, Medline comes to market with a hefty debt load from its LBO days. The S‑1 shows: [28]
- Total debt: about $16.8bn as of June 28, 2025, including senior notes and U.S. dollar and euro term loans.
- Net debt: just over $16bn after accounting for cash and equivalents, based on IPO financial summaries.
Rating agencies have been watching Medline closely as it prepares to go public:
- Fitch Ratings has assigned Medline Inc. a ‘BB-’ long‑term Issuer Default Rating and kept the company on Rating Watch Positive ahead of the IPO. [29]
- Fitch expects to consider a multi‑notch upgrade to ‘BBB-’ — pushing Medline into investment‑grade territory — if around $4bn of debt reduction is completed post‑IPO, bringing gross EBITDA leverage below 4x. [30]
- S&P Global Ratings similarly affirms a ‘BB-’ issuer credit rating and keeps Medline on CreditWatch positive, highlighting expected deleveraging once IPO proceeds are used to pay down loans. [31]
In simple terms: Medline is still a leveraged credit today, but if management follows through on debt repayment, it has a credible path to crossing into the investment‑grade club, which would lower borrowing costs and broaden its investor base.
Use of proceeds
According to the prospectus and deal commentary: [32]
- Medline Inc. will use IPO proceeds to buy newly issued common units from Medline Holdings LP, the operating partnership.
- Medline Holdings will then allocate the cash primarily to repay existing debt, as well as fund general corporate purposes and offering expenses.
- If underwriters exercise their over‑allotment option (c. 15% extra shares), additional proceeds may go to repurchase or redeem equity from some pre‑IPO owners.
That structure is standard for “Up‑C” style IPOs and underscores that balance‑sheet repair, not cashing out the Mills family entirely, is a central objective.
The Mills Family: From 1910 Aprons to a $6 Billion‑Plus IPO Stake
Medline’s story is, at its core, a family business saga that stretches back more than a century:
- The company traces its roots to a garment manufacturer founded in 1910, which initially made butcher’s aprons, before pivoting to medical textiles.
- Medline Industries itself was founded in 1966 by brothers James and Jon Mills and went public in 1972 before the family took it private again in 1977. [33]
Despite the 2021 LBO, the Mills family remains Medline’s largest single shareholder, retaining roughly a quarter of the company after rolling equity into the PE deal. [34]
On current IPO terms:
- The family’s stake is expected to be worth more than $6 billion, based on the projected valuation, according to reporting by Forbes’ Amy Feldman. [35]
- Feldman’s social‑media summary pegs the broader Mills family net worth at around $20 billion following the listing, placing them among America’s wealthier dynasties. [36]
Members of the family and their affiliates have also signaled interest in purchasing up to $250 million of stock in the IPO — a gesture likely intended to reassure new investors that insiders remain committed. [37]
Cornerstone Investors Signal Confidence
A standout feature of the Medline float is the scale of pre‑committed institutional demand:
- A roster of global asset managers — including Baillie Gifford, Capital Group, Janus Henderson, GIC, Viking Global Investors, Durable Capital Partners, WCM Investment Management and Morgan Stanley’s Counterpoint Global — has indicated interest in buying up to $2.35bn of shares as cornerstone investors. [38]
Such anchor orders can:
- De‑risk bookbuilding by locking in a large chunk of demand ahead of pricing.
- Provide a “stamp of approval” that may sway other institutional and retail buyers.
- Help stabilize aftermarket trading if big holders are willing to take a long‑term view.
At the same time, this structure means a significant portion of the free float could sit with a relatively small group of large funds, potentially concentrating ownership and limiting early liquidity.
Key Risks: Tariffs, Valuation and Healthcare Cycles
Tariffs and supply‑chain exposure
Medline sources products and materials from across Asia and the Americas, leaving it exposed to U.S. trade policy. The company has warned that: [39]
- It expects $325m to $375m in tariff‑related costs in fiscal 2025, with an additional $150m to $200m hit expected in 2026, depending on how trade disputes evolve.
Those figures are material relative to 2024 net income of $1.2bn and highlight how policy swings can erode margins, especially if hospitals resist price increases.
High valuation and leverage
Several analysts have flagged that investors are being asked to pay premium multiples for a company that still carries double‑digit billions of debt:
- Seeking Alpha’s IPO analysis emphasizes that while growth is solid, Medline’s “heavy debt weighs” on the story. [40]
- With total debt near $16.8bn and net debt around $16bn going into the deal, the company will remain highly leveraged even after using IPO proceeds to repay loans. [41]
Investors effectively have to underwrite both:
- Continued mid‑single‑digit to high‑single‑digit revenue growth in core medical‑surgical supplies, and
- Management’s ability to execute on aggressive deleveraging targets to unlock the credit‑rating upgrade story.
Cyclical and structural healthcare risks
While demand for basic medical supplies is more stable than elective procedures, Medline is not entirely immune to:
- Hospital budget pressures and consolidation, which can squeeze pricing.
- Shifts in care from in‑patient to outpatient and home settings.
- Competition from other distributors and manufacturers, including Owens & Minor and broader med‑tech giants. [42]
Any missteps in operations — such as supply‑chain disruptions or quality issues — could quickly show up in margins given the scale and thinness of distribution economics.
How Analysts and Commentators Are Framing the Deal
Equity market perspective
Market commentators broadly frame Medline as:
- A “quality” industrial‑healthcare name with long operating history, recurring revenue from prime‑vendor contracts and a leading market share in medical‑surgical supplies. [43]
- A test case for private‑equity exits, with CTOL Digital calling it “a $50 billion test of private equity’s exit strategy” in public markets. [44]
- A potential turning point for large healthcare IPOs, which have been relatively rare compared with tech listings in recent years. [45]
Retail‑investor angle
Personal‑finance outlets urge caution, particularly for smaller investors:
- Kiplinger notes that Medline is expected to be the largest U.S. IPO since electric‑vehicle maker Rivian in 2021, and reminds readers that large, high‑profile IPOs can be volatile in early trading. [46]
- The publication suggests that retail investors, if they participate at all, consider small, manageable positions and be prepared for wide price swings as institutions establish holdings. [47]
That tone is echoed by other commentators who highlight that IPO allocations are often skewed toward institutional accounts, meaning many individuals may first encounter MDLN shares only after an initial trading spike or drop.
What to Watch Next
As Medline moves toward its planned pricing date later in December, several milestones will shape how this blockbuster deal lands:
- Final pricing and valuation:
- Does the deal price at, above or below the indicated $26–$30 range?
- Do sponsors and the company prioritize a strong aftermarket “pop” or maximum proceeds?
- Scale of debt repayment and rating actions:
- How much debt is actually paid down with IPO proceeds?
- Will Fitch and S&P quickly move Medline into investment‑grade territory, or wait for more execution proof? [48]
- Secondary market performance:
- Does MDLN trade more like a steady cash‑flow compounder or more like the high‑beta IPOs of the last tech wave?
- How active are cornerstone investors in the aftermarket?
- Signal for the broader IPO and PE pipeline:
- A successful Medline debut could unlock a queue of other sponsor‑backed offerings in healthcare, business services and industrials through 2026; a flop might send many of them back to the sidelines. [49]
Bottom Line
The Medline IPO sits at the crossroads of three big stories: the tentative revival of the U.S. IPO market, private equity’s need to crystallize returns on mega‑deals, and the ongoing industrialization of healthcare supply chains.
For investors, MDLN offers:
- Exposure to a dominant, scaled player in mission‑critical medical supplies with a decades‑long growth record.
- A leveraged, tariff‑exposed balance sheet that management promises to de‑risk using IPO cash.
- A valuation that already bakes in a lot of optimism about future growth and margin resilience.
As always, anyone considering the stock should treat this information as context, not personal financial advice, and weigh Medline’s fundamentals, valuation and risk profile against their own investment horizon and risk tolerance.
References
1. www.reuters.com, 2. www.reuters.com, 3. www.reuters.com, 4. www.fiercebiotech.com, 5. www.reuters.com, 6. www.fiercebiotech.com, 7. www.fiercebiotech.com, 8. pe-insights.com, 9. pe-insights.com, 10. www.reuters.com, 11. www.reuters.com, 12. www.reuters.com, 13. pe-insights.com, 14. pe-insights.com, 15. www.reuters.com, 16. www.reuters.com, 17. pe-insights.com, 18. www.fiercebiotech.com, 19. www.fiercebiotech.com, 20. www.sec.gov, 21. www.kiplinger.com, 22. distributionstrategy.com, 23. www.sec.gov, 24. www.reuters.com, 25. pe-insights.com, 26. www.tradingcalendar.com, 27. www.sec.gov, 28. www.sec.gov, 29. www.tradingview.com, 30. www.tradingview.com, 31. www.spglobal.com, 32. www.sec.gov, 33. www.reuters.com, 34. www.fiercebiotech.com, 35. www.forbes.com, 36. www.linkedin.com, 37. pe-insights.com, 38. pe-insights.com, 39. pe-insights.com, 40. seekingalpha.com, 41. www.sec.gov, 42. seekingalpha.com, 43. www.medline.com, 44. www.ctol.digital, 45. www.red94.net, 46. www.kiplinger.com, 47. www.kiplinger.com, 48. www.tradingview.com, 49. pe-insights.com
