<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0508</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2025-08-14</periodOfReport>

    <issuer>
        <issuerCik>0000885590</issuerCik>
        <issuerName>Bausch Health Companies Inc.</issuerName>
        <issuerTradingSymbol>BHC</issuerTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001394923</rptOwnerCik>
            <rptOwnerName>Paulson John</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerStreet1>180 LAKEVIEW AVENUE</rptOwnerStreet1>
            <rptOwnerStreet2></rptOwnerStreet2>
            <rptOwnerCity>WEST PALM BEACH</rptOwnerCity>
            <rptOwnerState>FL</rptOwnerState>
            <rptOwnerZipCode>33401</rptOwnerZipCode>
            <rptOwnerStateDescription></rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>true</isDirector>
        </reportingOwnerRelationship>
    </reportingOwner>

    <aff10b5One>false</aff10b5One>

    <nonDerivativeTable>
        <nonDerivativeTransaction>
            <securityTitle>
                <value>Common Stock, no par value</value>
            </securityTitle>
            <transactionDate>
                <value>2025-08-14</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>P</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>34721118</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>9</value>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>70755869</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>I</value>
                    <footnoteId id="F1"/>
                </directOrIndirectOwnership>
                <natureOfOwnership>
                    <value>By Managed Funds</value>
                    <footnoteId id="F1"/>
                </natureOfOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
    </nonDerivativeTable>

    <footnotes>
        <footnote id="F1">John Paulson, the controlling person of Paulson Capital Inc. (&quot;Paulson&quot;), serves on the board of directors of the Issuer. Paulson is the investment manager of investment funds (the &quot;Funds&quot;).  John Paulson may be deemed an indirect beneficial owner of the securities, which are directly owned by the Funds. Pursuant to Rule 16a-1(a)(4) under the Securities Exchange Act of 1934, as amended (the &quot;Act&quot;), the reporting person disclaims beneficial ownership of any securities reported herein, except to the extent that the reporting person has a pecuniary interest therein. This report shall not be deemed an admission that such reporting person is the beneficial owner of any securities not directly owned by such reporting person.</footnote>
    </footnotes>

    <remarks>Certain of the securities of the Issuer referred to herein as beneficially owned by the Funds are the same securities reported separately in the Form 3 filed by Paulson &amp; Co. on the date hereof.</remarks>

    <ownerSignature>
        <signatureName>JOHN PAULSON
 By:    /s/ John Paulson
 John Paulson</signatureName>
        <signatureDate>2025-08-14</signatureDate>
    </ownerSignature>
</ownershipDocument>
