To become the Costco of the healthcare industry, Medline raised $6.26 billion, creating the largest IPO of the year, with an intraday increase of over 30% on debut

Medical supplies supplier Medline Inc. surprised the new stock market at the end of the year, completing a fundraising of $6.26 billion, creating the largest IPO globally in 2025, and receiving enthusiastic support from investors on its first day of trading.

On Wednesday, the 17th Eastern Time, Medline debuted on NASDAQ under the stock code MDLN, opening at $35, nearly a 21% increase from the issue price of $29. During the day, it rose above $38, with an increase of over 30%.

Aiming to be the "Costco of the healthcare industry," Medline sold 216 million shares in this IPO transaction, with the issue price close to the upper limit of the guidance range. Based on the opening price, Medline's valuation after listing reached $47 billion, nearly 40% higher than the company's valuation when private equity firms like Blackstone acquired a majority stake four years ago.

Medline's IPO fundraising scale surpassed the $5.26 billion raised by battery giant CATL during its Hong Kong listing, making it the largest IPO globally this year. It is also the largest IPO in the U.S. stock market since Rivian, a rival to Tesla, went public with $13.7 billion in 2021. This transaction is the fifth largest IPO in the U.S. market in the past decade, following Rivian, Uber Technologies Inc., Lineage Inc., and Arm Holdings Plc.

Medline's successful listing marks a perfect conclusion to the U.S. IPO market in 2025, with the total IPO fundraising for the year exceeding $46 billion. Medline's listing performance has boosted market optimism for the IPO prospects in 2026, potentially setting the tone for heavyweight IPOs like SpaceX that may emerge in 2026. Recent reports indicate that the market expects SpaceX to conduct a record-breaking IPO transaction next year.

Expanded issuance scale attracts cornerstone investors

Medline's IPO received over 10 times oversubscription. The company initially planned to issue 179 million shares, with a pricing range of $26 to $30, ultimately increasing to 216 million shares, priced at $29, close to the upper limit of the range.

Medline secured commitments from cornerstone investors totaling up to $2.35 billion, including Baillie Gifford, Capital Group, Morgan Stanley's Counterpoint Global, Durable Capital Partners, Singapore's sovereign wealth fund GIC Pte, Janus Henderson Investors, Viking Global Investors, and WCM Investment Management As part of the incremental transaction, Medline allocated over 37 million shares of funds from the stock sale to repurchase shares from pre-IPO shareholders. This synthetic secondary transaction structure allows private equity firms and long-term supporters to gain returns without directly selling shares.

Private Equity Giants Backing a Medical Supply Giant

Medline manufactures and distributes medical supplies such as gloves, surgical gowns, and examination tables, serving hospitals and clinics. The company was founded in 1966 by brothers Jon and Jim Mills. It offers approximately 335,000 medical surgical products and has a supply chain capable of providing next-day delivery service to 95% of U.S. customers, employing over 43,000 people globally.

Blackstone, Carlyle Group, and Hellman & Friedman acquired a majority stake in Medline in 2021 at a valuation of up to $34 billion, marking one of the largest leveraged buyouts in history. The Mills family remains the largest individual shareholder of Medline after the acquisition, holding 17.8% of the voting rights post-IPO. The three private equity firms each hold 18% of the voting rights after the transaction.

Based on the offering price, Medline's IPO brings the company an estimated valuation of about $39 billion, with a significant opening surge post-listing raising its market value to approximately $47 billion, reflecting a notable increase in company value since the private acquisition in 2021. This is also the largest U.S. IPO ever supported by private equity, surpassing last year's $5.1 billion listing of Lineage Inc.

"The Costco of Healthcare"

Medline's CEO Jim Boyle stated in a recent interview, "My aspiration is to be the Costco of the healthcare industry." He pointed out the similarities between Medline and retail giant Costco, including membership fees paid by customers, a strong supply chain, private labels, and a loyal customer base.

Boyle is the first CEO of the company who is not a member of the Mills family and has served at Medline for 28 years. In addition to its private label medical and surgical products, Medline also distributes products from third parties. A key differentiator from its peers is that Medline seeks to replace many third-party products with its own over time.

The prospectus shows that for the nine months ending September 27, Medline achieved a net income of $977 million and revenue of $20.6 billion, compared to a net income of $911 million and revenue of $18.7 billion in the same period last year. The net sales for the full year 2024 are expected to reach $25.5 billion.

Boyle stated that Medline faces challenges in the healthcare sector, including complexity, reimbursement cuts, and rising costs, but the company is capable of addressing these issues. "We tend to perform better in times of crisis because we are value players in the market," he said

The Twisted Path to Going Public

From acquisition to IPO, Medline's journey has not been smooth sailing. The company secretly submitted its IPO application to the U.S. Securities and Exchange Commission (SEC) at the end of last year, but the uncertainty of the Trump administration's tariff policies led to a delay in its planned IPO for the first half of this year. The federal government shutdown in the second half of the year further disrupted the IPO preparations, and the company ultimately publicly submitted its documents during the government shutdown on November 12.

Most of Medline's products are sourced or manufactured in Asian countries, particularly China. The company expects that tariffs will result in a pre-tax income loss of $150 million to $200 million in fiscal year 2026.

Since the private equity acquisition, the company has made strategic investments under new leadership. In 2024, Medline acquired Ecolab Inc.'s surgical solutions business for approximately $905 million and invested $1.6 billion in capital expenditures in its distribution network over the past five years.

2025 IPO Market Warms Up

Medline's successful IPO marks a satisfying conclusion to the 2025 IPO market. According to data compiled by Bloomberg, excluding "shell" special purpose acquisition companies (SPACs), the total IPO financing in the U.S. this year has exceeded $46 billion. Even with Medline included, this total is still slightly below the nearly $50 billion average annual level of the decade before the COVID-19 pandemic.

This spring, tariffs from the Trump administration caused market volatility, and in the fall, the U.S. experienced the longest federal government shutdown in history, lasting 43 days. Nevertheless, the U.S. IPO market has remained stable, with over 200 companies completing IPO pricing this year.

Goldman Sachs, Morgan Stanley, Bank of America, and JP Morgan served as the lead underwriters for Medline's offering, with 21 co-book managers and 21 co-managers participating.

Medline's IPO transaction has boosted expectations that private equity firms will push more portfolio companies to go public next year. Blackstone-backed Copeland and EQT AB's Reworld are expected to seek a U.S. IPO in 2026.

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