The French young beef bull sector presents a complex organisation. The more animals are mixed and subjected to long transports, the more likely they will be to develop bovine respiratory disease (BRD). We aimed to understand the vertical integration patterns in the young beef bull sector and how they influence public health issues (BRD and antibiotic use). Transaction costs analyses revealed a diversity of vertical integration patterns, from spot market to vertical integration. The “health issues” parameter is involved in different categories of transaction costs (risk, uncertainty, quality). When vertical integration is strong (weak), the risk of BRD is low (high), which thus have an indirect effect on antibiotic use.