AstraZeneca PLC vs Cardinal Health, Inc.: Strategic Comparison

This in-depth comparison examines AstraZeneca PLC and Cardinal Health, Inc. across revenue, market value, business model, competitive positioning, and long-term growth strategy. Whether you are researching AstraZeneca PLC on its own, evaluating Cardinal Health, Inc., or weighing the two companies side by side, the breakdown below highlights where each company leads and where the gap between AstraZeneca PLC and Cardinal Health, Inc. is widest.

On the headline numbers, AstraZeneca PLC reports annual revenue of $58.7B against $254.2B for Cardinal Health, Inc., while their respective market capitalizations stand at $254.6B and $56.0B. AstraZeneca PLC is headquartered in United Kingdom and Cardinal Health, Inc. in United States, and those different home markets shape how each company competes.

AstraZeneca PLC: AstraZeneca is a British-Swedish biopharmaceutical company best known to the public for the COVID-19 vaccine it developed with the University of Oxford, but most of its revenue comes from medicines for cancer, cardiovascular and metabolic disease, respiratory and immune conditions, and rare diseases. It is headquartered on the Cambridge Biomedical Campus in England and runs strategic research centres in the UK, Sweden, the United States and China; the Beijing centre announced in March 2025 was its sixth.

Cardinal Health, Inc.: Cardinal Health, based in Ohio, is one of the three large US pharmaceutical distributors, along with McKesson and Cencora. It does not invent drugs or treat patients. It runs the regulated supply chain that moves medicines and medical devices from manufacturers to pharmacies and hospitals, so a prescription collected at a local pharmacy has often passed through its network.

AstraZeneca PLC and Cardinal Health, Inc. pursue distinct approaches to generating revenue, and understanding how each company operates is the foundation of any fair comparison between AstraZeneca PLC and Cardinal Health, Inc..

AstraZeneca PLC business model: AstraZeneca discovers, develops and sells prescription medicines, and the economics turn on patent-protected pricing funded by heavy research spending. It invested $14.2 billion in research and development in 2025, about a quarter of Total Revenue, and reported gross profit of $48.1 billion on cost of sales of $10.6 billion. Because most drug candidates fail, the company supplements internal discovery with licensing and acquisitions, from the $39 billion Alexion deal to the Daiichi Sankyo antibody-drug conjugate alliance, and shares development costs and profits with partners including Daiichi Sankyo, Amgen and Merck.

Cardinal Health, Inc. business model: The business model is large, high-volume logistics divided into two segments: Pharmaceutical and Medical. In the Pharma segment, they buy billions of dollars of drugs from manufacturers (like Pfizer) and distribute them daily to tens of thousands of pharmacies and hospitals, taking a tiny markup. In the Medical segment, they actually manufacture and distribute low-cost, high-volume medical supplies (like surgical gloves, gowns, and syringes), acting as the large central supply closet for the entire American hospital system.

The durability of a company's moat often decides long-term winners. Here is how the competitive advantages of AstraZeneca PLC stack up against those of Cardinal Health, Inc..

AstraZeneca PLC competitive advantage: AstraZeneca's main advantage is the depth of its oncology portfolio and the Phase III evidence behind it. Tagrisso, Imfinzi, Enhertu, Lynparza and Calquence each rest on trials that changed treatment practice, and the company had more than 100 Phase III studies running at the end of 2025 after 16 positive Phase III readouts during the year. Scale matters too: $58.7 billion of Total Revenue and $14.2 billion of annual R&D spending let it fund late-stage trials that smaller biotechs cannot, which is why partners such as Daiichi Sankyo and Amgen co-develop medicines with it. Its commercial reach in emerging markets, where China alone is about 12% of revenue, is wider than that of most US-based rivals.

Cardinal Health, Inc. competitive advantage: Cardinal Health's advantage is physical scale and regulatory standing. Moving regulated, temperature-sensitive drugs and biologics across the country overnight takes a network of specialized distribution centers and security procedures that cost billions of dollars and take decades to build. The barrier to entry is high, so drug distribution is concentrated among a few large companies.

Future prospects matter as much as current results. The growth strategies below explain how AstraZeneca PLC and Cardinal Health, Inc. each plan to expand from here.

AstraZeneca PLC growth strategy: AstraZeneca's growth strategy relies on extending its existing cancer drugs into earlier stages of treatment, before the cancer spreads, which increases the number of patients who can be treated. The $39 billion acquisition of Alexion Pharmaceuticals in 2021 also took it into rare diseases, where drugs treat small patient populations, carry high prices and face little generic competition.

Cardinal Health, Inc. growth strategy: Cardinal Health's growth plan rests on three levers. First, specialty pharmaceuticals and physician practice platforms: it bought a 71% stake in GI Alliance for about $2.8 billion (announced November 2024) and funded The Specialty Alliance's roughly $1.9 billion acquisition of urology MSO Solaris Health (completed November 2025). Second, the Other segment: Nuclear and Precision Health Solutions (radiopharmaceuticals and theranostics), at-Home Solutions (expanded with ADSG in 2025, Strive Medical, and the announced AdaptHealth diabetes business), and OptiFreight Logistics, which together grew revenue 26% to $6.8 billion in fiscal 2026. Third, improving GMPD profitability through its Cardinal Health brand products and cost actions.

A closer look at the financial trajectory of AstraZeneca PLC and Cardinal Health, Inc. rounds out the comparison.

AstraZeneca PLC: AstraZeneca's Total Revenue fell from $33.6 billion in 2011 to a trough of $22.1 billion in 2018 as Seroquel, Nexium and Crestor lost exclusivity. Under Pascal Soriot the company redirected spending into oncology and specialty medicines, and revenue then grew every year to $58.7 billion in 2025, with profit for the year of $10.2 billion and gross profit of $48.1 billion on cost of sales of $10.6 billion. R&D investment reached $14.2 billion in 2025, about a quarter of Total Revenue, and the $39 billion Alexion acquisition added a rare disease business the company did not have before 2021.

Cardinal Health, Inc.: Cardinal Health combines very large revenue with thin margins. Fiscal 2026 revenue was $254.2 billion, up 14% from $222.6 billion in fiscal 2025, driven by brand and specialty drug volume from existing customers. GAAP operating earnings were $2.6 billion, GAAP diluted EPS was $7.23, and net earnings attributable to Cardinal Health were about $1.7 billion. Non-GAAP diluted EPS rose 37% to $11.26 ($10.95 excluding the IEEPA tariff refund). Operating cash flow was $5.2 billion and adjusted free cash flow was $5.0 billion. The company repurchased $1.4 billion of stock in fiscal 2026 and the board added $5.0 billion to the buyback authorization in August 2026. Fourth-quarter fiscal 2026 revenue was $63.7 billion, up 6%.