Cosmos HealthCOSM -3.58%29 Debt-to-EBITDA is -2.65 as of Mar. 2026. GuruFocus rates COSM with a GF Score™ of 29/100 and a GF Value™ of $0.36 (Possible Value Trap). The stock has 6 warning signs investors should review. Among 90 Medical Distribution companies, Cosmos Health ranks worse than 1111110% on this metric.
Debt-to-EBITDA measures a company's ability to pay off its debt.
A high Debt-to-EBITDA ratio generally means that a company may spend more time to paying off its debt. According to Joel Tillinghast's BIG MONEY THINKS SMALL: Biases, Blind Spots, and Smarter Investing, a ratio of Debt-to-EBITDA exceeding four is usually considered scary unless tangible assets cover the debt.
The historical rank and industry rank for Cosmos Health's Debt-to-EBITDA or its related term are showing as below:
COSM'
s Debt-to-EBITDA Range Over the Past 10 Years
Min: -19.5 Med: -1.8 Max: 7.3
Current: -1.06
During the past 13 years, the highest Debt-to-EBITDA Ratio of Cosmos Health was 7.30. The lowest was -19.50. And the median was -1.80.
COSM's Debt-to-EBITDA is ranked worse than 100% of 90
companies
in the Medical Distribution industry
Industry Median: 2.45
vs COSM: -1.06
Cosmos Health (NAS:COSM) Debt-to-EBITDA Explanation
A high Debt-to-EBITDA ratio generally means that a company may spend more time to paying off its debt.
According to Joel Tillinghast's BIG MONEY THINKS SMALL: Biases, Blind Spots, and Smarter Investing, a ratio of Debt-to-EBITDA exceeding four is usually considered scary unless tangible assets cover the debt.
Cosmos Health Debt-to-EBITDA Related Terms
Cosmos Health Debt-to-EBITDA Historical Data
* Premium members only.
The historical data trend for Cosmos Health's Debt-to-EBITDA can be seen below:
* For Operating Data section: All numbers are indicated by the unit behind each term and all currency related amount are in USD. * For other sections: All numbers are in millions except for per share data, ratio, and percentage. All currency related amount are indicated in the company's associated stock exchange currency.
For the Medical Distribution subindustry, Cosmos Health's Debt-to-EBITDA, along with its competitors' market caps and Debt-to-EBITDA data, can be viewed below:
* Competitive companies are chosen from companies within the same industry, with headquarter located in same country, with closest market capitalization; x-axis shows the market cap, and y-axis shows the term value; the bigger the dot, the larger the market cap. Note that "N/A" values will not show up in the chart.
Cosmos Health Debt-to-EBITDA vs Medical Distribution Industry
For the Medical Distribution industry and Healthcare sector, Cosmos Health's Debt-to-EBITDA distribution charts can be found below:
* The bar in red indicates where Cosmos Health's Debt-to-EBITDA falls into.
* For Operating Data section: All numbers are indicated by the unit behind each term and all currency related amount are in USD. * For other sections: All numbers are in millions except for per share data, ratio, and percentage. All currency related amount are indicated in the company's associated stock exchange currency.
In the calculation of annual Debt-to-EBITDA, the EBITDA of the last fiscal year is used. In calculating the annualized quarterly data,
the EBITDA data used here is four times the quarterly (Mar. 2026) EBITDA data.
Cosmos Health (COSM) has a Debt-to-EBITDA of -2.65 as of Mar. 2026. Debt-to-EBITDA ratio represents the ratio of total debt to total earnings before interest, taxes, depreciation and amortization. View historical data on Cosmos Health. According to the industry distribution chart, Cosmos Health ranks #999999 out of 90 companies in the Medical Distribution industry.
Is Cosmos Health's Debt-to-EBITDA too high?
Cosmos Health's current Debt-to-EBITDA is -2.65. Based on the distribution chart, Cosmos Health ranks #999999 out of 90 companies in the Medical Distribution industry, which is in the bottom quartile relative to peers. Overall, Cosmos Health has a GF Score™ of 29/100 and is considered Possible Value Trap, reflecting its overall financial health beyond just this single metric.
How does Cosmos Health's Debt-to-EBITDA compare to HKPD and SNYR?
According to the Medical Distribution industry distribution chart, Cosmos Health ranks #999999 out of 90 companies for Debt-to-EBITDA. This places Cosmos Health in the lower half of its industry. The industry median Debt-to-EBITDA is 2.45. See the competitive comparison table and distribution chart on this page for a detailed peer-by-peer breakdown.
What is a good Debt-to-EBITDA for a Medical Distribution company?
The median Debt-to-EBITDA among Medical Distribution companies is 2.45, based on 90 companies in the industry. Companies in the top quartile (top 25%) have a Debt-to-EBITDA significantly above this median, while those in the bottom quartile fall well below. However, Debt-to-EBITDA should not be evaluated in isolation — investors should consider it alongside profitability, growth, and financial strength metrics. Use the industry distribution chart on this page to see where any company falls relative to its peers.
What does a high Debt-to-EBITDA mean?
A high Debt-to-EBITDA can signal that a stock is expensive relative to its fundamentals. Debt-to-EBITDA ratio represents the ratio of total debt to total earnings before interest, taxes, depreciation and amortization. View historical data on Cosmos Health. For the Medical Distribution industry, the median Debt-to-EBITDA is 2.45 — values significantly above this may indicate overvaluation, while values below may suggest a bargain or underlying issues. Cosmos Health's current Debt-to-EBITDA is -2.65. However, context matters — high-growth companies often justify higher valuations. Always evaluate alongside other metrics like GF Score™ and GF Value™.
Is Cosmos Health stock overvalued right now?
Based on GuruFocus' analysis, Cosmos Health (COSM) is currently considered Possible Value Trap. The stock's GF Value™ is $0.36, compared to a current price of $0.25 — trading 31.9% below its estimated fair value. The current Debt-to-EBITDA is -2.65. Cosmos Health's overall GF Score™ is 29/100 with 6 warning signs to review. Investors should evaluate multiple metrics — including profitability, growth, and financial strength — before making a decision.
How is Debt-to-EBITDA calculated?
Debt-to-EBITDA is calculated from a company's financial statements. For Cosmos Health (COSM), the current Debt-to-EBITDA is -2.65 as of Mar. 2026. GuruFocus calculates this using data sourced from SEC filings and annual reports. See the calculation section and 30-year financial data on this page for the full breakdown.
Is Cosmos Health (COSM) Overvalued in 2026?
Based on GuruFocus' analysis, Cosmos Health stock appears to be undervalued.
The current stock price of $0.25 is trading 31.9% below its estimated GF Value™ of $0.36.
GuruFocus considers Cosmos Health to be Possible Value Trap.
Key valuation signals for COSM:
Debt-to-EBITDA: -2.65
GF Value™: $0.36 vs. price of $0.25 (31.9% below fair value)
No single metric tells the full story. See the COSM stock analysis page for a complete view including 30-year financials, guru trades, and insider activity.
Cosmos Health Inc is a diversified, vertically integrated healthcare group, owner of proprietary pharmaceutical and nutraceutical brands, generics, manufacturer and distributor of healthcare products, engaged in research & development of medicines and repurposing drugs as well as operator of a telehealth platform. The company has developed its own proprietary branded nutraceutical products, named 'Sky Premium Life' and 'Mediterranation'. Its product portfolio includes generics and over-the-counter pharmaceutical products, medicines, as well as nutraceuticals and biocides. The company's Reportable segments are Wholesale, Pharma manufacturing, and Nutraceutical and pharmaceuticals, with the majority of revenue generated from the Wholesale segment.
29GF Score
Get the complete analysis for COSM
Debt-to-EBITDA is just one metric. See GF Value™, 30-year financials, guru trades, warning signs, and more.
Quick Browse
Personalize
Premium Gurus 
Create New Portfolio
COSM has been successfully added to your 
