Here's why I'd buy and hold CSL and Cochlear shares for 10 years

The market is focused on the problems, but I think the decade-long opportunity still looks attractive.

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CSL Ltd (ASX: CSL) and Cochlear Ltd (ASX: COH) have both tested investors' patience recently.

That may be discouraging for existing shareholders, but I think it has also created an opportunity for investors willing to look well beyond the next result.

Here is why I would buy and hold both ASX healthcare shares.

Scientist looking at a laptop thinking about the share price performance.

Image source: Getty Images

CSL shares

Many investors see CSL simply as a collection of medicines. I think its real strength is the global biological supply chain it has built over decades.

Collecting plasma at scale, turning it into specialist therapies, meeting demanding regulatory standards, and reliably supplying patients around the world requires infrastructure and expertise that cannot be created quickly.

The biotechnology company's recent performance has clearly fallen short of expectations. CSL lowered its FY26 outlook in May and acknowledged problems including weaker financial returns, operational complexity, disappointing research productivity, and the underperformance of the Vifor acquisition.

Those issues explain why confidence has fallen so sharply. Management now needs to simplify the organisation, improve plasma and manufacturing efficiency, and become more disciplined with capital.

I still think the foundations are attractive. CSL expects immunoglobulin demand to grow at a mid to high single-digit rate, supported by significant unmet medical need. Its May update suggested only around 35% of potential patients across major immunoglobulin indications are diagnosed, which leaves a large long-term opportunity if CSL can improve execution.

The next few years may be more about repairing the business than returning immediately to its former growth rate. But I think the company's plasma network, rare disease franchise, scientific capabilities, and global reach still give it the ingredients for a recovery over time.

Cochlear shares

Cochlear is another ASX healthcare share I'd buy and hold. 

The appeal of the global leader in implantable hearing solutions goes well beyond selling industry-leading products.

A recipient can remain connected to the company for years through sound processor upgrades, accessories, digital services, clinical support, and new technology. That creates a relationship that can deepen long after the original procedure.

Cochlear has also spent years developing its next generation of products. The Nucleus Nexa System, launched in 2025 after two decades of research and development, is the first cochlear implant system with upgradeable firmware.

The current year has been challenging. Cochlear reduced its FY26 underlying profit guidance after softer implant demand in developed markets, hospital capacity constraints, weaker referrals, Middle East disruption, currency movements, and restructuring costs.

I see those pressures as important near-term obstacles rather than a reason to abandon the long-term story. Ageing populations, improving awareness, and better referral pathways could help more people receive treatment over time.

Foolish takeaway

Healthcare compounders rarely reward investors evenly.

Years of research, infrastructure investment, regulatory work, and market development can be followed by periods when growth slows and confidence disappears.

I think that is where CSL and Cochlear currently sit. Their immediate problems are highly visible, while the capabilities built over decades are easier for the market to overlook.

Both companies need to execute better from here, and patience could be required. But I believe their positions in global healthcare remain difficult to recreate.

That is why I would be comfortable buying CSL and Cochlear shares today and holding them through the next stage of their development.

Motley Fool contributor Grace Alvino has positions in CSL. The Motley Fool Australia's parent company Motley Fool Holdings Inc. has positions in and has recommended CSL and Cochlear. The Motley Fool Australia has recommended CSL and Cochlear. The Motley Fool has a disclosure policy. This article contains general investment advice only (under AFSL 400691). Authorised by Scott Phillips.

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