Cencora Q4 2026 Earnings Call Transcript

Cencora (NYSE:COR) reported fourth-quarter financial results on Wednesday. The transcript from the company’s fourth-quarter earnings call has been provided below.

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Summary

Cencora reported a 14% growth in adjusted operating income and a 12% increase in adjusted diluted EPS for fiscal 2026, showcasing strong performance in specialty pharmaceuticals.

Strategic initiatives included the acquisition of One Oncology and agreements to acquire ISOF’s retina business and a majority interest in American Oncology Network, strengthening their MSO platform.

The company introduced a new operating model with two segments: Specialty Pharmaceutical and Provider Services, and Pharmaceutical Distribution and Services, to enhance strategic execution and customer focus.

For fiscal 2027, Cencora expects EPS growth of 8% to 10%, with specialty distribution revenue projected to reach approximately $100 billion, driven by new specialty products and market demand.

Operational highlights included a 23% increase in adjusted gross profit for the fourth quarter, primarily due to the One Oncology acquisition, and strong performance in international healthcare solutions.

Management emphasized the importance of aligning with long-term growth targets and maintaining a balanced capital deployment strategy, including a 10% dividend increase and planned share repurchases.

Full Transcript

Bennett Murphy (Senior Vice President, Investor Relations and Enterprise Productivity)

Thank you for joining us for this conference call to discuss Cencora’s fiscal 2026 fourth quarter and full year results. I am Bennett Murphy, Senior Vice President, Investor Relations and Enterprise Productivity. Joining me today are Robert Mauch, President and Chief Executive Officer, and Eva Boratto, Executive Vice President and CFO. On today’s call, we’ll be discussing non-GAAP financial measures. Reconciliations of these measures to GAAP are provided in today’s press release, which is available on our website at investor.cencora.com.

We’ve also posted a slide presentation to accompany today’s press release on our investor website. Alongside these materials, we are providing recast financials in our new segments for fiscal 2025 and fiscal 2026 in Form 8-K that will also be available on our Investor Relations website. During this conference call we will discuss forward-looking statements about our business and financial expectations on an adjusted, non-GAAP basis, including but not limited to EPS, operating income and income taxes. Forward-looking statements are based on management’s current expectations and are subject to uncertainty and change. For a discussion of key risks and assumptions, we refer you to today’s press release and our SEC filings, including our most recent 10-Q. Cencora assumes no obligation to update any forward-looking statements, and this call cannot be rebroadcast without the permission of the company.

You’ll have an opportunity to ask questions after today’s remarks by management. We ask you to limit your questions to one per participant in order for us to get to as many as possible within the hour. With that, I’ll turn the call over to Bob.

Robert Mauch (President and Chief Executive Officer)

Thank you, Bennett. Hi everyone, and thank you for joining Cencora’s fiscal 2026 fourth quarter and full year earnings call. I want to begin by thanking our team members throughout the fiscal year. Their commitment to our purpose and dedication to our customers fueled our performance as we delivered adjusted operating income growth of 14% and adjusted diluted EPS of 17.97, up 12%. Our fiscal 2026 performance demonstrates the strength of our business and the progress we’ve made with leadership in specialty and a portfolio increasingly aligned to the areas where we can create the greatest long-term value.

We enter fiscal 2027 with momentum and greater operational and strategic focus. The outlook reflects our confidence and is aligned with our long-term targets. When excluding the businesses in Other, this morning I will focus on two areas: the strategic progress delivered in fiscal 2026 and how our updated operating model will strengthen execution, customer focus and visibility for investors. I’ll begin with the strategic progress delivered in fiscal 2026. Two years ago we introduced a refined strategy to lead with market leaders, strengthen our position in specialty and enhance patient access to pharmaceuticals.

In fiscal 2026, we advanced each priority, delivered another year of record results and expanded capabilities that support patient access to innovation in the specialty pharmaceutical market, where growth has been twice that of the broader market over the past five years. Our MSO platform is one important example. In February we completed our acquisition of One Oncology, expanding our position in one of healthcare’s fastest growing areas. Together, One Oncology and Retina Consultants of America deepen our relationships with community-based specialists and strengthen our ability to support pharmaceutical-centered care closer to where patients live. During the fiscal year, we continued to build the MSO platform, including the announced acquisition of ISOF’s retina business in March and, most recently, our agreement to acquire a majority interest in American Oncology Network.

These additions will expand the capabilities and reach of the platform built to help independent specialty practices thrive, improve patient access to high-quality care and create opportunities to support pharmaceutical companies across the product lifecycle. In fact, at RCA we participate in the vast majority of retina clinical trials, completing over 40,000 research-related visits annually, and One Oncology has supported more than 130 pharmaceutical partners with their clinical trials to date.

As we’ve invested in the businesses aligned with our pharmaceutical-centric strategy, we’ve also taken decisive action on businesses that do not align, concentrating our capital and leadership attention where Cencora is most differentiated. Over the course of the year, we entered into agreements or completed divestitures for all the businesses within Other. While these actions can cause near-term financial headwinds, they allow us to direct our resources towards the areas where we can create the greatest value for customers and shareholders over the long term.

The same discipline guiding our portfolio informs how we operate. This morning we introduced an updated operating model aligned with our strategy and the customers we serve. Our pharmaceutical-centric strategy is focused on strengthening our leadership in specialty and delivering greater value across pharmaceutical services. As the needs of manufacturers and providers evolve, we’re adapting our organization to better support them while preserving the benefits of Cencora’s scale, infrastructure and expertise.

I believe this operating model will make Cencora more effective in three ways: enhancing our strategic and operational execution, further elevating the voice of our customers and providing increased visibility for our shareholders. Informed by our updated operating model, we’ve created two new reporting segments: Specialty Pharmaceutical and Provider Services brings together our specialty capabilities in an integrated growth platform supporting innovation from pharmaceutical manufacturers to physician providers. Pharmaceutical Distribution and Services is organized around our broad portfolio of customers and the services we provide while leveraging our scale to deliver sustained growth and strong cash flow generation, powering investments across the enterprise.

Now I’ll share a bit more about each segment. Starting with Specialty Pharmaceutical and Provider Services, we are connecting capabilities across clinical trial logistics, commercialization, specialty distribution, GPO and practice management to support innovative therapies from development to delivery to patient. That role is becoming more important, with specialty biologics now accounting for more than half of all pharmaceutical spending in the United States, up 80% in five years, with over 100 new products expected to launch through 2030.

Oncology illustrates the growing need for specialized clinical logistics, distribution and provider support as the pipeline expands and therapies become more complex. These are capabilities Cencora has built at scale through focused investments. With specialty logistics operations across more than 50 countries and multinational 3PL solutions in the United States and Europe, we can support pharmaceutical partners as they bring complex therapies to patients across markets.

Our role does not end when a therapy reaches its destination. As more specialty care is delivered in community settings, providers are managing increasing clinical and administrative demands. Through our MSOs, we help independent specialty physicians manage clinical and administrative complexity, expand access to research and remain focused on patient care. Our agreement to acquire a majority interest in AON extends the platform through a physician-led network and a longstanding Cencora partner.

Bringing these businesses together deepens our relationships with manufacturers and providers while giving investors a clearer view of the growth potential of our specialty platform. Within Pharmaceutical Distribution and Services, our scale provides us with deep understanding of trends across the healthcare ecosystem, which we use to drive differentiated value to customers. We deliver over 100 million packages annually, shipping nearly 5 million units each day, giving our leaders firsthand insight into the needs of manufacturers and providers, pharmacies and patients. Combining our scale, our sourcing expertise and customer-centric partnerships with pharmacies and health systems large and small, we strengthen their operations, support their growth and ensure continued patient access.

Two recent customer events illustrate how their perspectives shape our priorities. At our Health Systems National Summit, health systems leaders discussed how connecting pharmacy supply chain, technology and care delivery leads to better decisions for patients and their organizations. These are all areas where our Accelerate pharmacy solutions help our health systems customers. At ThoughtSpot, our annual trade show for Good Neighbor independent pharmacies, we came together with more than 3,000 attendees, introducing novel solutions including AI-powered tools designed to help pharmacies run more efficiently, free up time for patient care and create new growth opportunities. At both our Health Systems National Summit and ThoughtSpot, I heard customers emphasize that specialty is becoming a larger and more complex part of patient care, reinforcing the importance of specialty growth and solutions across both reporting segments.

The scale of this opportunity is increasingly visible in our results. We expect specialty distribution revenue to reach approximately 100 billion in fiscal 2027. Combined with our broader manufacturer and provider capabilities, this makes specialty a central driver of Cencora’s long-term growth. In summary, we exit fiscal 2026 with record results and a stronger platform for growth supported by our scale, specialty capabilities and an operating model aligned to how we create value. With that, I’ll turn the call over to Eva to discuss our fourth quarter and fiscal 2026 results as well as our fiscal 2027 guidance.

Eva Boratto (EVP & Chief Financial Officer)

Thanks, Bob. Good morning, everyone. As Bob highlighted and we shared in our press release this morning, we have introduced a new organizational and financial reporting structure designed to strengthen our execution and provide additional performance visibility to our shareholders. Through our new segments, we will highlight the significant opportunity we have to utilize our end-to-end specialty capabilities to deliver value up and downstream while driving sustainable growth powered by our scale and efficient pharmaceutical distribution foundation.

In addition to reiterating Cencora’s long-term growth algorithm of 7% to 10% operating income growth and 10% to 14% EPS growth, we are introducing targets for our new segments. For the pharmaceutical distribution and services segment, we expect long-term operating income to grow in the mid-single digits, and for the specialty pharmaceutical and provider services segment, we expect long-term operating income growth in the mid-teens. Now I’ll provide an overview of our fiscal 2026 fourth quarter and full-year results and our fiscal 2027 financial guidance.

Unless otherwise stated, my remarks will focus on adjusted non-GAAP financial results. For further discussion of our GAAP results, please refer to our earnings press release and presentation. Beginning with fourth quarter, consolidated revenue was $88.4 billion, up 6%, driven by growth in both reportable segments and in Other, which I’ll describe in more detail when discussing segment-level results. Consolidated adjusted gross profit was $3.6 billion, up 23%, primarily due to growth in the U.S. Healthcare Solutions segment. Consolidated adjusted gross margin expanded by 57 basis points to 4.04%, largely due to our acquisition of OneOncology in February.

Consolidated adjusted operating expenses were $2.3 billion, an increase of 23%, again largely driven by the impact of the February 2026 acquisition of OneOncology. Excluding both OneOncology and RCA, operating expense growth was less than 3% as we lapped an easier expense comparison. Consolidated adjusted operating income was $1.2 billion, an increase of 22% compared to the prior-year quarter, with another quarter of double-digit growth across both reportable segments and Other.

Moving now to below-the-line items, net interest expense was $136 million, an increase of $58 million compared to the prior-year quarter, primarily due to debt raised to finance the OneOncology acquisition. Our effective tax rate was 20.2% compared to 20.6% in the prior-year quarter. Finally, diluted share count was 191 million shares, a 1.8% decrease compared to the prior-year quarter, largely due to the $1 billion of opportunistic share repurchases we completed in the June quarter.

Taken together, this resulted in adjusted diluted earnings per share of $4.66, an increase of 21%. Turning to our segment results for the fourth quarter, U.S. Healthcare Solutions revenue was $78.3 billion, an increase of 5%. Strength in specialty sales to health systems and physician practices and continued growth in GLP-1s, which increased by $2.8 billion year over year, drove the growth. The growth was partially offset by manufacturer list price reductions that represented a $2.8 billion headwind to revenue growth as well as lower sales to our large mail order customer.

Consistent with the past two quarters, U.S. Healthcare Solutions segment operating income was $998 million, up 22%, representing our strongest growth quarter of the fiscal year. This was driven by continued momentum in specialty across both health systems and physician practices, the contribution from OneOncology, and focused execution across our other pharmaceutical distribution businesses. The quarter also benefited from an easier expense comparison.

Turning now to our International Healthcare Solutions segment, revenue was $7.8 billion, up 5%, driven by growth in all business units. International Healthcare Solutions operating income was $152 million, up 16% on an as-reported basis and up 19% on a constant currency basis in the quarter. Our Canadian business delivered excellent performance driven by high program win rates. Our global specialty logistics and 3PL business continued to drive strong performance with double-digit operating income growth.

As Bob mentioned, we have been investing in these businesses to capitalize on the increasing complexity and the innovation pipeline and have been winning in these areas. Moving to Other, which reflects the businesses for which we are pursuing strategic alternatives. Revenue in Other was $2.3 billion, up 10%, largely due to growth at Profarma and MWI Animal Health. Operating income was $101 million, up 36% due to operating income growth at MWI Animal Health, also including the benefit from being accounted for as held for sale.

This completes the review of our fourth quarter results. I’ll now turn to a discussion of our full-year fiscal 2026 results. Our consolidated revenue was $337 billion, up 5%, driven by U.S. Healthcare Solutions segment growth of 5% and International Healthcare Solutions segment growth of 8%. Consolidated operating income was $4.8 billion, an increase of 14% driven by growth in both reportable segments. In the U.S. Healthcare Solutions segment, we benefited from strength in specialty volumes and our strategic investments in MSOs.

In the fiscal year, MSOs represented approximately 10% of enterprise operating income. When excluding the impact of our two large MSO acquisitions and the loss of an oncology customer, our core U.S. segment growth was about 13%, nicely ahead of our long-term growth algorithm. In the International Healthcare Solutions segment, we were pleased with the business’s return to growth this fiscal year, driven by operational improvements at our global specialty logistics business and increased demand.

Finally, as it relates to free cash flow and our balance sheet, during the fiscal year we generated $3.8 billion of adjusted free cash flow, stronger than our guidance. Due to a combination of year-end stronger volume mix and timing, we ended the year with a cash balance of $4.9 billion. Our strong free cash flow generation gives us significant flexibility to pursue our balanced capital deployment strategy while maintaining our strong investment-grade credit ratings.

During the fiscal year, we were pleased to return $1.5 billion to shareholders through a combination of opportunistic share repurchases and our dividend. And this morning we announced a 10% increase to our quarterly dividend, our 22nd consecutive increase. Turning now to our fiscal 2027 expectations, there are a few items I’ll highlight before we get into the details of our guidance. First, our guidance excludes the acquisitions of Isaus Retina Business and American Oncology Network, which we will incorporate upon the close of each transaction. Second, our guidance contemplates a mid–fiscal year close of the MWI merger with Covetris. The operating income headwind is expected to be partially offset by two below-the-line income items associated with the transaction, which would be approximately $40 million in the second half of fiscal 2027.

This contribution is expected to bring our other income/loss line to approximately $90 million compared to the approximate $26 million in fiscal 2026. Third, as we announced this morning, we reached an agreement to sell our equity stake in Profarma with the close expected to occur in our fiscal first quarter. Given the nature of our ownership, we consolidate the full Profarma income statement and eliminate our noncontrolling interest in the company, making it a much less meaningful contributor at the EPS level, which is fully reflected in our revenue, operating income, and EPS guidance.

With that as context, we expect adjusted diluted EPS to be in the range of $19.40 to $19.75, reflecting headline growth of 8% to 10%. Excluding the assumed $0.35 impact of the mid–fiscal year merger of MWI and Covetris, adjusted EPS growth would be 10% to 12%. We expect consolidated revenue growth to be in the range of 3% to 5%. Operating income growth is expected to be in the range of 4% to 6%. The businesses in Other are expected to have an approximate 5 percentage point negative impact on our growth, largely due to the assumed mid–fiscal year closing of the merger of MWI and Covetris.

Excluding the businesses in Other, our guidance would reflect adjusted operating income growth of 8.5% to 11%, ahead of our long-term targets. We expect interest expense to be in the range of $490 million to $510 million, reflecting debt we raised in connection with the OneOncology transaction. We expect to pay $1 billion on the remaining OneOncology term loan at the end of fiscal year 2027. We expect our effective tax rate to be approximately 20%. For fiscal 2027, we expect full-year diluted average shares outstanding to be approximately 190 million shares. This reflects the annualization of opportunistic share repurchases we completed in the third quarter of fiscal 2026 and an expectation of an additional $1.25 billion in repurchases in fiscal 2027.

We expect capital expenditures to be approximately $1 billion in fiscal 2027, which reflects continued investments in our supply chain, digital, and MSO infrastructure. We expect adjusted free cash flow to be approximately $3.5 billion. That completes the review of our consolidated fiscal 2027 expectations. I’ll now turn to segment-level expectations. In the pharmaceutical distribution and services segment, we expect revenue growth to be in the range of 4% to 6%. We expect pharmaceutical distribution and services segment operating income growth to be 2% to 4%, which includes the wraparound impact of a certain customer’s volume shift. As previously disclosed, the segment operating income growth expectations also include an approximate $20 million headwind related to our European distribution business resulting from the strengthening of the U.S. dollar.

Moving now to the specialty pharmaceutical and provider services segment, we expect revenue growth to be in the range of 9% to 14% and segment operating income growth to be in the range of 18% to 21%, ahead of our segment-level long-term operating income growth expectations of mid-teens, reflecting the wraparound contribution from the OneOncology acquisition that we closed in February 2026. Moving now to Other, we expect revenue in Other to be approximately $3.5 billion and operating income in Other to be approximately $200 million.

We are pleased with the significant progress we have made to simplify our portfolio, allowing us to better capitalize on growth opportunities aligned with our pharmaceutical-centric strategy. Before turning to my closing remarks, as you think about quarterly cadence, we expect adjusted diluted EPS in our first quarter to be approximately $4.55. In closing, fiscal 2026 marked a year of significant progress on our strategy as we delivered strong financial performance. As we look to fiscal 2027 and beyond, we are well positioned to deliver on our long-term targets and drive sustainable shareholder value creation, supported by our differentiated footprint in the high-growth specialty market, scaled and efficient foundation in pharmaceutical distribution, and strong free cash flows. I’ll turn the call back to Bob for some closing remarks before moving to Q&A.

Robert Mauch (President and Chief Executive Officer)

Thank you, Eva. Our fiscal 2027 guidance reflects our confidence in the strength of the business, in our team, our strategy, and our ability to deliver sustainable growth and long-term value for customers and shareholders. With that, we’ll open the call for questions.

OPERATOR

We will now begin the question-and-answer session. Please limit yourself to one question. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one. Again, we ask that you pick up your handset when asking a question to allow for optimum sound quality. If you are muted locally, please remember to unmute your device. Please stand by while we compile the Q&A roster. Your first question comes from the line of Elizabeth Anderson with Evercore ISI.

Your line is open. Please go ahead.

Elizabeth Anderson (Analyst)

Hi guys. Good morning. Thanks for all the details about the operating performance. I guess my question is maybe a little bit more philosophical in nature. Can you talk a little bit more about why the re-segmenting at this point makes sense? You’ve obviously had many specialty assets on the medical side for a while, but why is this the right opportunity to do that? And what does that provide for the business that the old setup did not?

Robert Mauch (President and Chief Executive Officer)

Elizabeth, thank you very much for that important question. You know, it starts with the market. As you mentioned, we’ve been in the specialty market for a long time. We have significant capabilities that we’ve been building over decades, frankly, but when you look at the growth in the market, the 80% growth that’s happened in biologics over the last five years—in fact, there’s going to be 100 new oncology products between now and 2030—that says to us that we need to be even more focused on that area.

The first place to start there is our operating model and the way that we approach our business, the way that we approach our customers, both upstream to manufacturers and downstream to providers. And while we did that very well, our specialty services assets were in different parts of the company and under different leaders. And so what we’ve done with the operating model change is taken all of those assets and put them under one leader. By doing that, that allows us to discuss a new external segmentation, but it’s driven by optimizing our performance.

The three things that I called out in prepared remarks that are advantages that I see as, one, which I just mentioned, is our enhanced ability to execute both strategically and operationally. It brings us closer to the customers for all of the reasons that I just described. And last but not least, it provides increased visibility to shareholders, which we also think is important. So the Specialty Pharmaceutical and Provider Services business puts everything under one leader, as I said, all the way from manufacturer to physician.

And they deal with one team at Cencora, which will make things easier and faster for the customers. It will also allow us to innovate even more quickly, which will be important as we go into the future and as products get more and more complex. Importantly, our Pharmaceutical Distribution and Services segment—that’s the foundation of all of this. It’s servicing health systems, pharmacies, alternate sites, wholesale in Europe with significant scale, demonstrated efficiency over decades, and cash flow that allows us to invest across the enterprise. So while we are separating the two, it’s an important takeaway for everyone that both are critically important to the growth platform of Cencora.

So I think that’s the rationale. Elizabeth, I appreciate the question and we’re excited to be able to talk about it today.

OPERATOR

Your next question comes from the line of Lisa Gill with J.P. Morgan. Your line is open. Please go ahead.

Lisa Gill (Analyst)

Thanks very much. Good morning, Bob and Eva. Bob, I want to follow up on specialty just from a couple of different perspectives. One, I absolutely appreciate the visibility that you’re giving us and shareholders around the specialty business, and clearly this is an important growth engine as we move forward. I want to understand really a couple of things. One, when we think about specialty going into next year—Eva laid out the numbers—can you talk about what the organic growth rate is?

I know there’s a number of transactions that impact the number. And then secondly, you talk about health systems, you talk about the MSO community practices, et cetera. How do you think about changes in reimbursement and the impact that that has in ’27 or even on a go-forward basis? We obviously had a big election last night. Any incremental thoughts on how you see the future around reimbursement and any impact it would have on you as you continue to serve these, from a specialty perspective, serving these practices?

Robert Mauch (President and Chief Executive Officer)

Thanks, Lisa, for the question. Maybe I’ll start with the end. And as you mentioned, we did have an election last night. It’s most important to note that through multiple cycles of administrations and leadership in Congress and leadership in the regulatory agencies, we have a long history of advocacy and making sure that Cencora is present and educating everyone about the services that we provide—the value, the very high-quality, low-cost services that we provide at Cencora.

But also importantly, we have visibility end to end to the pharmaceutical supply chain, so we’re someone who can advise on what the outcomes might be—the consequences might be—of any policy changes. So the way things look today, there’ll be lots of opportunity for conversations as we get the new Congress and Senate in place, and we’ll be right there to help them with that. I think a second piece, Lisa, is just the overall scale of our specialty business. And we broke out the Specialty Pharmaceutical and Provider Services, but it’s also important to note that there’s significant specialty distribution products that go into the Pharmaceutical Distribution and Services segment. So the number that we had in our prepared remarks—that more than $100 billion—is the combination of the two.

So very importantly, whether an oncology product, for example, is going into a community specialist setting or it’s going into a clinic within a health system, Cencora is very well positioned to support that patient wherever they may present and support that clinician in caring for that patient. I’ll pause there and hand it over to Eva to answer the other part of your question.

Eva Boratto (EVP & Chief Financial Officer)

Sure. Good morning, Lisa. The Specialty Pharmaceutical and Provider Services segment, as you saw in our materials, is expected to have operating income growth of 18% to 21%. That’s above our long-term growth algorithm. And I would remind you, we have the wraparound of OneOncology for the first four months of the fiscal year. So outside of that impact, our underlying growth would have been in line with our algorithm of mid-teens growth that we outlined today.

OPERATOR

Your next question comes from the line of Glenn Santangelo with Barclays. Your line is open. Please go ahead.

Glenn Santangelo (Analyst)

Yeah, thanks for taking my question. I also wanted to follow up on specialty. Bob, when I think about that mid-teens sort of long-term growth rate in specialty, and in your prepared remarks you just suggested there’s 100 new oncology products coming between now and 2030. So is it really volumes that are the primary driver of that mid-teens growth? I just want to separate organic from inorganic. And then just related to that, you generated a 3.7% margin in specialty this year.

Maybe help us think about the puts and takes on that margin given all the upcoming biosimilar conversions. Thanks so much.

Eva Boratto (EVP & Chief Financial Officer)

Sure, Glenn. Good morning. I’ll start. In the Specialty Pharmaceutical and Provider Services first, if you take a step back, this segment consists of end-to-end specialty businesses from our specialty distribution to practice management platforms to global clinical trials to multinational 3PL businesses. So that’s what’s encompassed in that segment. And as you think about our long-term growth algorithm of mid-teens, one, it reflects the fast-paced growth in the market, and as Bob outlined, two, continued growth at our MSOs through both organic physician acquisition as well as tuck-in M&A on these platforms.

OPERATOR

Your next question comes from the line of Charles Raye with TD Cowen. Your line is open. Please go ahead.

Charles Raye (Analyst)

Yeah, thanks for taking the question. Maybe I could ask the other side. In the Pharmaceutical Distribution Services, in the assumptions you give for long-term segment growth, can you talk about how you’re thinking about the cycle of small-molecule generics coming over the next several years? How much do you incorporate that? And obviously small-molecule generics were a huge driver of growth back in the 2000s and the 2010s. When we look at this next cycle coming up, it looks significantly bigger in terms of dollar volumes.

Maybe you could help us understand: have there been changes in that part of the market that should either make us be more excited? Maybe we should be a little bit more cautious on it. Just trying to get a better sense on the dynamics in this part given what looks to be a big cycle, particularly as we get to the back half of next calendar year. Any comments there on helping us size that would be helpful. Thanks.

Robert Mauch (President and Chief Executive Officer)

Thanks for the question, Charles. I’ll start and hand it to Eva if she wants to add anything as I finish up. So I think just take a step back—whether it’s a small-molecule generic or whether it’s a biosimilar, we keep a very close eye on all of those. Those launches of both types would be contemplated in our guidance. But I think the takeaway is just the reminder that that’s positive for Cencora. So whether it’s a small-molecule generic or biosimilar, that’s positive.

They’re different in different segments. The Part B biosimilar is the sweet spot for us. That’s where the services that we provide allow us to earn a higher margin. Within Part D, it’s much less impactful. That would be a revenue impact and not really a profit gain. And oral generics—small-molecule oral generics—are positive. They absolutely are. So to the extent that we have more or fewer launches, that has an impact. But you’ll note, Charles, you mentioned the historical driver of generic launches—they’re not that.

So we’re not calling either a significant increase or a decrease in launches as a driver of our performance. So I think the takeaway is that the assumptions are contemplated in our guidance, and we keep a very close eye on it.

OPERATOR

Your next question comes from the line of Alan Lutz with Bank of America. Your line is open. Please go ahead.

Alan Lutz (Analyst)

Good morning, and thanks for taking the question. Bob, you spoke a lot about upstream services in your prepared remarks. RCA and OneOncology are active in clinical trials. You also own the World Courier business. Could you take a moment to expand on the synergies between those two businesses? And then more broadly, as we think about the re-segmentation, how should we think about capital deployment and the strategy? Is there any evolution here as you’ve done that re-segmenting?

Thank you.

Robert Mauch (President and Chief Executive Officer)

Yeah, thanks for the question, Alan. I’ll speak to strategic synergy. You know, part of the purpose of bringing those businesses together was to be more effective, to be more efficient. And I’m sure some of that will come. But that’s not the, you know, financial synergy was not necessarily the thesis for putting them together. It’s really a growth thesis. And what we have, you know, as you said, if you take the pharmaceutical company-facing view, we have the very specialized global logistics to support them in clinical trials.

We have commercialization consulting services that can help them think about how they’re going to bring their product to market in multiple countries as they’re getting ready to launch. We have 3PL services that are going to be important as they launch in Europe. And then we have our specialty distribution and full-on distribution in the United States. And then as that continues to go downstream, as I follow that through, then you have, as I kind of transition from specialty distribution, you have the GPO, you have the MSO, all of that supporting the physician. And the purpose of all of that is to make sure that the physician has optimal opportunity to care for patients, to make the right clinical decisions and to care for patients. So there’s a strong thesis there of value from the manufacturer all the way to the provider and to the patient.

And the purpose of putting these businesses together inside the specialty, pharmaceutical and provider services segment is for us to continue to build that platform and innovate over the long term.

Eva Boratto (EVP & Chief Financial Officer)

And Bob, I’ll take the capital allocation part of the question. I would say there is no change in our capital deployment strategy. We remain focused in four key areas: internal investments in the business, strategic M&A, opportunistic share repurchases, and maintaining a reasonable and growing dividend. And I think you’ve seen us deliver on that. This morning we announced we’re increasing our dividend 10% for fiscal year 2027 and $1.25 billion in share repurchases.

And I think the portfolio optimization that’s been with some of the divestitures will enable us to execute on these priorities.

OPERATOR

Your next question comes from the line of Eric Percher with Nephron Research. Your line is open. Please go ahead.

Eric Percher (Analyst)

Thank you. Want to dig a little bit deeper into the pharma distribution and services new segmentation, and thank you for that segmentation. So in ’27, 4% to 6% growth, we would assume that there’s a headwind from IRA and GLP-1s, and then seeing the profit growth at 2% to 4%. I think we’ve been taught by you that the reductions to top line don’t necessarily translate at the op profit line. But can you just help us on factors impacting top line versus the op profit headwinds we’re seeing for ’27 specifically?

Eva Boratto (EVP & Chief Financial Officer)

Yeah, sure, sure. Eric, good morning. As you say, I’m going to start at the profit line. As you look at the 2% to 4% growth being below the long-term algorithm that we provided today, I would highlight two things. One, we have the wraparound impact of a customer volume shift that we talked about earlier in the year as well as about a point impact from FX now that our international distribution is part of that segment. Outside of those impacts, we expect to perform within our long-term targets.

On your revenue question, I’m going to go to the consolidated revenue at growth of 3% to 5%. What I would say the differentiator as you look at ’27 fiscal guidance versus the 5% we delivered in fiscal ’26 is really the headwind from the Profarma divestiture that we announced today as well as the assumed mid-year merger of Covetrus, and those two combined drive about a 150 basis point headwind to growth. I’d say the WAC decreases are pretty comparable to our estimate.

You get a little bit more from the wraparound impact, but pretty comparable to what we experienced in ’26.

OPERATOR

Your next question comes from the line of Erin Wright with Morgan Stanley. Your line is open. Please go ahead.

Erin Wright (Analyst)

Great, thanks. So a competitor of yours recently announced a transaction in the infusion space with Option Care. I guess is that an area that is interesting to you? Did you look at that asset? How do you think about other areas outside of oncology and retina? I mean you’re really weighting in on oncology, obviously. But are you still entertaining those other ideas, or how do you think about that in terms of the context of what you were just talking about from a capital deployment standpoint?

Robert Mauch (President and Chief Executive Officer)

Yeah. Hi Erin, thanks very much for the question. I’ll start with where it’s clear that we are focused because I do want to emphasize that we’ve made it very clear that we’re going to be focused in expanding our specialty capabilities. We’ve made it clear that we’re going to focus our portfolio in areas that we can create long-term customer and shareholder value. And you’re seeing us do that. That is our investments in the MSOs, the builds of the MSOs that we’re doing, and we’re going to continue to do that.

It’s important to note something that we said a few times, which is our pharmaceutical-centric strategy keeps us focused in the MSO space right now on oncology and retina, and we don’t see other therapeutic areas as areas that would be pharmaceutical-centric and therefore would have us interested in expanding into a different MSO outside of those two. Getting to your question, which is infusion-specific, we support infusion customers across our portfolio. We have that in our health systems business. We support infusion customers. We expect to continue to support them as customers. But that doesn’t mean that we need to own that capability. We’re a strong provider to them and we’ll continue to do that. Thanks for the question, Erin.

OPERATOR

Your next question comes from the line of George Hill with Deutsche Bank. Your line is open. Please go ahead.

George Hill (Analyst)

Yeah, good morning guys and thanks for taking the question. I’m going to delve a little bit more into the new specialty segment a little bit. I’m wondering if there’s a chance that you guys would tell us maybe the dollar or percentage contribution from the MSO segment versus wholesaling versus GPO. Would you talk at all about are there any more significant margin differences by therapeutic category, and should we think of what is a target margin profile for this segment given that operating earnings growth is expected to outpace revenue growth in the long-term algo?

Eva Boratto (EVP & Chief Financial Officer)

Good morning George, it’s Eva. So on your first question around breaking out the MSO contribution, for 2026 we indicated the MSOs were about 10% of our consolidated operating income. So that should give you a framework to think about that. On the margin side, our specialty is our higher-margin, higher-gross business. I would point out that it’s not just the specialty distribution. We have World Courier, the 3PL, the MSOs and the consulting businesses in there, so they’re carrying a higher margin profile. And I’d remind you that we consolidate RCA. So think about that as additive to margin.

OPERATOR

Your next question comes from the line of Eric Caldwell with Baird. Your line is open. Please go ahead.

Eric Caldwell (Analyst at Baird)

Thanks. I was hoping for a little more framing on the capex. I understand the drivers of the heightened capex, the billion dollar target. I’m hoping to put that in context of a figure that is effectively a double or more than a double over the last couple of years, and the 3% to 4% growth in the long-term growth targets — should we read that as start at a billion and then grow that 3% to 4% per year thereafter? I assume that’s a forward-looking basis.

I just want to make sure that there’s not a bit of a one-time spike, if you will, in fiscal ’27. Thanks very much.

Eva Boratto (EVP & Chief Financial Officer)

Yeah. Good morning Eric, this is Eva. Regarding our capex, as you said, we expect to spend approximately a billion dollars, and you’re right, the dollar spend is elevated to recent years. As a percentage of gross profit, it aligns with historical periods when we’ve made significant investments in our infrastructure. So I would just remind you we’re making investments in our U.S. supply chain infrastructure. We’re continuing to make investments in IT to support our digital transformation as well as SAP, as well as some investments in our MSO.

And the 3% to 4% that you’re referring to, I believe, is capital deployment. It was not intended to be capex growing at 3% to 4%.

OPERATOR

Your next question comes from the line of Kevin Caliendo with UBS. Your line is open. Please go ahead.

Kevin Caliendo (Analyst)

Thanks. Thanks for taking my question. Good morning. Just a couple of things. I just want to understand the inputs into 2027. OneOncology profitability — the run rate that you had for fiscal 4Q, is that the run rate going forward, or did you assume there would be improving OneOncology profitability in fiscal ’27 versus the run rate we saw exiting? And then, is there anything that you contemplated around Cigna’s new sort of wholesale distribution business that they announced? We don’t really know exactly what it’s going to be, but the perception was this could potentially impact you. I’m wondering if there was anything in when you thought about guidance that was an input relative to that business.

And then the last input is the Option Care relationship that you currently have. We don’t know when that contract expires, but is there anything built into fiscal ’27 for potentially losing the distribution part of the Option Care business, if that’s even an issue? Thanks.

Eva Boratto (EVP & Chief Financial Officer)

Yeah, thanks for the question. I’m going to go in reverse order, Kevin. On Option Care, you’re right. They are a Cencora customer and have been for some time. As it relates to the financial impact, I would think about it — it would move us within our guidance range of our Pharmaceutical Distribution & Services segment. Your point on MSOs, OneOncology more specifically. What I would say is first I want to reiterate that OneOncology and RCA are both continuing to perform well. They performed well in the quarter. We expect they’ll be significant contributors to our specialty growth. They have been in the past and we look forward to those continuing to grow nicely.

Robert Mauch (President and Chief Executive Officer)

And Kevin, I would just add, I think your question was how we have thought about our customer relationships in terms of guidance. You mentioned one specific one, but I’ll just say that all of our customer relationships are contemplated in our fiscal ’27 guidance, and we wouldn’t comment any further than that.

OPERATOR

This concludes the Q&A session. I will now turn the call back to Bob Mauch for closing remarks.

Robert Mauch (President and Chief Executive Officer)

Thank you, operator. Our fiscal 2026 performance demonstrates the strength of our business. We move into fiscal 2027 with significant momentum, and Cencora is focused on execution and advancing our strategy to continue creating long-term value for our customers and shareholders. Thanks everyone for your time today.

OPERATOR

This concludes today’s call. Thank you for attending. You may now disconnect.

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