CSL Shares Double Off Lows: How Do They Stack Up Against TLX, SIG?

CSL shares‘ dramatic recovery from a multi-year low has been a hot topic this year, but there have been a couple of other notable health tech stocks that have shone through over an extended period. Zooming out can provide some perspective, and potentially even some outperformance. The other two names we are going to look at in the sector are Sigma Healthcare, and Telix Pharmaceuticals.

CSL vs Sigma Healthcare vs Telix Pharmaceuticals

CSL Ltd (ASX: CSL) has more than doubled off it’s 52 week low of A$90.00 to trade at A$186.90, back into positive territory YTD at 8.7%. Despite the rebound gathering pace, shares remain 15% lower on a TTM basis, and 37% lower where they traded five years ago. A mightily difficult period has a major bounce, and bulls will no doubt be looking for more.

The contrast with the other two stocks we are looking at has been as different as night and day. Sigma Healthcare shares (ASX: SIG) have delivered a five-year return of 410%, while Telix Pharmaceuticals (ASX: TLX) has gained 144% over the same period.

Telix has been the stronger performer in 2026 specifically, rising 32.75% YTD to A$15.08 after recovering well from the 52 wk low of A$8.26 in February. Sigma, meanwhile, has had a slight pullback of 4.42% YTD, trading at A$2.81, near the midpoint of its A$2.47 to A$3.20 annual range.

The Valuation Divide

The three companies remain quite different, despite sitting in the same sector of health tech, and their valuations reflect that.

CSL is the largest of the three by some way, with a market capitalisation of A$89.69 billion. The company trades at a trailing price-to-earnings ratio of 21x, the lowest it has been in well over a decade, and offers a dividend yield of ~1.5%. The pullback from peak multiples above 40x has been painful for holders, but it has also created a more attractive entry point in the process.

Telix Pharmaceuticals is the smallest of the three, but with a market cap of A$5.13 billion and a trailing P/E of 106x, the stock is priced for aggressive growth. The company has successfully commercialised Illuccix, its prostate cancer diagnostic imaging agent, in the United States, generating substantial commercial revenue and transitioning the company from a clinical-stage developer into a genuine commercial entity.

Sigma Healthcare sits in the middle ground. Its A$32.44 billion market cap reflects the impact of its integration with Chemist Warehouse, which has repositioned the company from a mid-tier pharmaceutical distributor into one of the most dominant forces in Australian retail pharmacy. The five-year return of 410% is almost entirely attributable to that corporate transformation, and the stock now trades at a P/E of 45.61x, a premium that reflects the scale of the combined entity but also demands ongoing execution. A dividend yield of approximately 1.4% provides modest income support.

CSL: The Defensive Play

The business is built around plasma-derived therapies, including immunoglobulins and iron-deficiency treatments, alongside its Seqirus influenza vaccines division. Demand for these products is largely inelastic, and the company’s global infrastructure represents a competitive moat that would be extraordinarily expensive for any rival to replicate.

Margin compression in plasma collection, which weighed heavily on the stock during the post-pandemic period, appears to be easing, with cost discipline and operational restructuring expected to support EPS expansion. Capital intensity remains a structural feature of the business, however, and cash-flow conversion has historically lagged that of lighter-asset peers.

CSL’s case as a defensive value play is clear, with the stock having undergone a multi-year de-rating that appears largely complete, its business fundamentals remain intact, and the 21x P/E multiple offers a meaningful margin of safety relative to the company’s historical trading range.

Telix: Momentum

Pipeline candidates, including those with FDA Fast Track designations, underpin a multi-year growth runway that analysts expect will rapidly compress the forward earnings multiple as revenue scales. Insider ownership remains high, which markets have historically interpreted as a signal of management confidence in the pipeline’s trajectory.

The risk, however, is significant. At 106x trailing earnings, Telix’s valuation leaves no margin for error. Any regulatory setback, clinical delay, or slowdown in commercial adoption could trigger a severe move. The stock pays no dividend and carries higher sensitivity to interest rate movements and broader risk-off sentiment. These all combine to make TLX more of a high-conviction, high-volatility holding rather than a defensive position.

So why Telix? The radiopharmaceutical sector is one of the fastest-growing segments in global oncology, and Telix has established an early-mover advantage in a space where regulatory approvals and manufacturing complexity create significant barriers to entry. The stock’s 32.75% year-to-date gain points to momentum firmly in place, and analysts broadly expect the earnings multiple to contract materially as commercial revenues continue to scale.

Sigma Health: Outperformer

The challenge for Sigma at current levels is one of margin sustainability. Despite higher aggregate revenues following the Chemist Warehouse merger, recent reporting periods have revealed narrowing margins, raising legitimate questions about integration costs and the pricing dynamics of pharmaceutical distribution at scale. For a business model that is fundamentally a distributor and franchisor, a 45x earnings multiple is a demanding benchmark, and it leaves limited room for operational disappointment.

The trading range at SIG has been the most stable of the three by quite some way, with the past couple of years largely taking place within the same range. Whilst that range has stretched lower in recent months, the current level has the stock challenging the momentum marker at the 200 day SMA. A break to the upside could be crucial, with the current technical setup of lower highs and lower lows otherwise pointing to near term pain. After a 410% gain in five years, there is plenty already in the stock up here.