M&A activity snapshot
The biggest medical and dental distribution deals covered here moved assets from public markets to private owners. Patient Square Capital agreed to buy Patterson Companies for $31.35 a share, a transaction value of about $4.1 billion including the refinancing of Patterson's receivables facilities. The deal closed on April 17, 2025. Patterson serves both dental and animal health, so it is not a pure dental comparable.
Owens & Minor exited its products and distribution business. It sold its Products & Healthcare Services segment and the Owens & Minor brand to Platinum Equity for $375 million in cash plus a 5% retained equity stake, closing December 31, 2025, and renamed the remaining company Accendra Health. In the same period, Medline completed its IPO on December 18, 2025, selling 248.4 million Class A shares for $29.00 per share net of underwriting discounts.
The market below the top tier is concentrated but tracked. HIDA's distributor members reported $57.5 billion of revenue in 2023, which HIDA says is 85% of all U.S. medical supply distribution revenue, across 1.65 million SKUs from 9,500 manufacturers. That figure is 2023 data. Under NAICS this vertical is code 423450, medical, dental, and hospital equipment and supplies merchant wholesalers.
Who is buying
Private equity has been behind several large recent deals, including Patient Square, a dedicated health care investment firm. Beyond Patterson and the Owens & Minor carve-out, KKR agreed to invest an additional $250 million in Henry Schein common stock to become its largest non-index-fund shareholder at 12%, with the ability to go to 14.9%.
Strategic buyers are the large distributors and manufacturer-distributors. Medline names McKesson, Cardinal Health, Owens & Minor, and Henry Schein as other distributors that connect the fragmented supplier and provider bases. For a regional or specialty distributor, those companies and their private-equity-owned peers are the natural acquirers, alongside sponsors building platforms in dental, surgery center, or physician-office supply.
What buyers look for
Contract position. In acute care, GPOs decide who sells. Medline sold about $19.7 billion, or 69% of consolidated 2025 net sales, to member hospitals under contract with Vizient, HealthTrust, and Premier, and it notes those contracts are awarded category by category through competitive bids. Buyers map which GPO, IDN, and DSO agreements a target holds and when they renew.
Non-acute exposure. Henry Schein says the non-acute market benefits from procedures and diagnostic testing moving to physicians' offices and ambulatory surgery centers. That segment is fragmented and ordered in frequent, small quantities, which favors distributors with local service density and dependable fill rates.
Private label. Medline reports it has historically earned higher margins when customers convert from national brands to like-for-like Medline Brand products, though net sales fall at constant volume because prices are lower. Buyers read a credible private-label program as margin upside.
What makes a strong company
A medical or dental distributor that draws competitive interest typically shows:
- Clean regulatory status. A domestic distributor that does not import devices does not need FDA registration, but initial importers and relabelers or repackagers do, so any kitting, relabeling, or direct import program must be registered correctly.
- Current state licensure if it sells prescription drugs. Wholesale drug distributors must be licensed and report licensure to FDA annually under DSCSA.
- Revenue spread across customers, without one health system, DSO, or GPO contract carrying the business.
- Documented fill rates and delivery performance for office-based customers.
- A defensible niche (dental consumables, surgery centers, labs, home care) rather than head-to-head competition with national med-surg distributors on commodity hospital lines.
Valuation and deal structure
Public valuation data for this vertical comes almost entirely from large-cap deals. In Patterson's merger proxy, Guggenheim Securities selected a reference range of 9.0x-10.0x LTM adjusted EBITDA for healthcare distribution precedents. The precedents behind that range include THL's purchase of Agiliti at 10.0x (2024), Patricia Industries' purchase of Sarnova at 13.6x (2018), and McKesson's purchase of PSS World Medical at 11.9x (2012).
The same analysis shows a wide spread among public peers. On calendar 2025 adjusted EBITDA estimates, Henry Schein traded at 11.5x, Owens & Minor at 5.3x, and McKesson at 13.1x, as presented in the February 2025 proxy. No major lower-middle-market data provider publishes a separate multiple for medical or dental distribution. A smaller private distributor should not assume large-cap multiples apply. For a general starting point, see the Axia valuation tool.
Carve-outs and minority stakes are common structures at the top of the market: the Owens & Minor sale included a 5% retained stake, and KKR's Henry Schein position is a minority investment. Earnouts and seller rollover are common in private-equity deals generally, but the sources above do not report their use in this vertical.
Outlook
Expect sponsor-owned platforms, including Patterson under Patient Square and the former Owens & Minor distribution business under Platinum Equity, to look for add-ons in the next 12-24 months. The shift of procedures toward offices and surgery centers that Henry Schein describes favors distributors built for small, frequent orders. GPO pricing pressure, which Medline lists as a continuing risk, will keep pushing margin toward private label and services.
Back to Wholesale Distribution M&A. Thinking about a sale? Run the valuation tool. See also: why vertical-specific buyers outperform generalists in outbound.