The companies on the Global 500 employ 70.2 million people, and their revenue represents more than one-third of the world’s GDP.

Fortune Global 500

With a combined revenue of $21 trillion and $2.1 trillion in profits, the 2026 Fortune 500 is the definitive list of America's largest companies.

Fortune 500

The corporations on our annual list of the world's 500 largest companies combined to generate $41.7 trillion in revenue over the past year.

Almost $20 trillion in revenue—and a record-breaking $1.87 trillion in profits. Introducing the 2025 Fortune 500, the definitive list of the biggest companies in America.

The corporations on our annual list posted aggregate revenues of $41 trillion for the second year in a row.

Industries included in the sector are insurance and managed care, medical products and facilities, pharmacy services, and pharmaceutical companies.

Fortune Sector Leaders: Health Care

The Fortune 500, in its 70th year in 2024, ranks the biggest U.S. companies by revenue.

The 25th Fortune World’s Most Admired Companies list suggests that tech giants’ peers respect them as much as ever.

World's Most Admired Companies

The corporations on our annual list of the world’s largest companies delivered a record $41 trillion in aggregate revenues.

G500-2023-AmerisourceBergen

The global wholesale drug distributor saw its revenue grow 11.5% in its most recent fiscal year, while profits rose by 10.3%. 
<ul> 
 	<li>Revenue in the company’s international health care solutions segment grew 130%, to $26.5 billion, reflecting its recent acquisition of Alliance Healthcare.</li> 
 	<li>Cencora (formerly AmerisourceBergen) played a role in monkeypox vaccine distribution efforts, receiving a $19.8 million contract from the Biden administration in September 2022 to help distribute doses.</li> 
</ul>

The Fortune 500, in its 69th year in 2023, ranks the biggest U.S. companies by revenue.

F500 2023-Amerisource Bergen

The global wholesale drug distributor fell one spot on this year’s list. But revenue grew 11.5% in its most recent fiscal year, while profits rose by 10.3%. 
<ul> 
 	<li>Revenue in the company’s international health care solutions segment grew 130%, to $26.5 billion, reflecting its recent acquisition of Alliance Healthcare.</li> 
 	<li>Cencora (formerly AmerisourceBergen) played a role in monkeypox vaccine distribution efforts, receiving a $19.8 million contract from the Biden administration in September 2022 to help distribute doses.</li> 
</ul>

Just as it dominates our economy, Big Tech now dominates Fortune’s annual ranking of corporate reputation.

Aggregate sales hit $37.8 trillion last year—an increase of 19%, the highest annual growth rate in the list’s history.

G500 2022-21-AmerisourceBergen

Drug distribution giant AmerisourceBergen fell four spots on the Global 500 from last year. Like its large rivals in the business, the company continues to wrestle with lawsuits regarding its alleged role in the opioid crisis while enduring criticism from shareholders. Still, revenue increased by 12.7% to $214 billion for the fiscal year ended September 2021. AmerisourceBergen also unveiled a new global headquarters in Conshohocken, Pa.

See which workplaces made this year's list.

GPTW Health Care Large 2022-AmerisourceBergen Corporation_1347602-1 copy

Employees say: 
 
“I am greatly impressed everyday. This company makes me feel included. It makes me feel accepted. My opinion matters and I am very happy with their response to real world situations. I have a great leadership team that is approachable and listens to any questions or concern I may have. I feel like there is a great work/personal life balance and I am proud to say I work for this company. I am extremely proud of the pandemic response and business continuity plan. I felt safe and taken care of.”

Best Large Workplaces in Health Care

This year’s Fortune 500 marks the 68th running of the list.

F500 2022 Amerisourcebergen

Drug distribution giant AmerisourceBergen fell two spots on the Fortune 500 from last year. Like its large rivals in the business, the company continues to wrestle with lawsuits regarding its alleged role in the opioid crisis while enduring criticism from shareholders. Still, the company increased its revenue by 12.7%, to $214 billion for the fiscal year ended September 2021. AmerisourceBergen added more than 18,000 new employees and unveiled a new global headquarters in Conshohocken, Pa.

After a year in which humanity leaned more heavily than ever on tech giants, see which companies topped Fortune's ranking of corporate reputation.

Total revenue for the world’s biggest companies fell 4.8% to $31.7 trillion this year—the first decline in half a decade.

The Pennsylvania-based pharmaceutical distributor moves up two spots on this year’s list; its revenues grew 5.7% in its last fiscal year, which ended in September 2020, owing to increased volume and higher prices of the medications it delivers to pharmacies across the country. The company’s veterinary division also recorded solid growth. Like other drug wholesalers, AmerisourceBergen faces legal challenges over its alleged role in America’s opioid epidemic.

The best U.S. health care companies with more than 1,000 employees, as ranked by their employees in the past year.

Best Workplaces Healthcare Large 2021-AmerisourceBergen Corporation

Employees say: 
“This organization fosters individual development and wants to see employees thrive.” 
Read Great Place to Work review .

This year’s Fortune 500 marks the 67th running of the list.

F500-2021-08-AmerisourceBergen

For an astounding 13th straight year, Apple claims the top spot in Fortune’s annual ranking of corporate reputation, based on a survey of almost 3,800 executives, directors, and analysts.

This year's Fortune Global 500 generated $33.3 trillion in revenues and $2.1 trillion in profits.

G500-2020-023-Amerisource-Bergen

The second largest drug distributor in the U.S. held steady on this year’s list with 6.9% revenue growth in its 2019 fiscal year, driven primarily by strong sales of pricey specialty drugs. Profits were down due to impairment charges taken on PharMEDium, the company’s troubled compounding unit; AmerisourceBergen announced it was shuttering the business earlier this year. Like its competitors, AmerisourceBergen faces thousands of lawsuits and a federal criminal investigation over its alleged role in the nation’s opioid epidemic. States rejected a proposed $18 billion settlement with the three major drug wholesalers in February.

This year's Fortune 500 marks the 66th running of the list.

F500-2020-010-Amerisource-Bergen

Here are the World's Most Admired Companies for 2019 as ranked in their industries. See who made the list.

This year's Fortune Global 500 generated $27.7 trillion in revenues and $1.5 trillion in profits.

This year's Fortune 500 marks the 65th running of the list.

Here are the World's Most Admired Companies for 2018 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 64th running of the list.

Here are the World's Most Admired Companies for 2017 as ranked in their industries. See who made the list.

This year's Fortune 500 marks the 63rd running of the list.

Here are the World's Most Admired Companies for 2016 as ranked in their industries. See who made the list.

This year's Fortune Global 500 generated $27.6 trillion in revenues and $1.5 trillion in profits.

This year's Fortune 500 marks the 62nd running of the list.

Business insiders have spoken: Asked which companies they most admire, more than 4,100 executives, directors, and analysts chose these top 50 All-Stars.

The world's 500 largest companies generated $31.2 trillion in revenues and $1.7 trillion in profits in 2014. Together, this year's Fortune Global 500 employ 65 million people worldwide and are represented by 36 countries.

This year's Fortune 500 marks the 61st running of the list. Wal-Mart claims the top spot again. See who made the list.

Global business is back. After limping through a worldwide financial crisis and economic slowdown, the 500 largest companies ranked by revenues shattered all sorts of performance records in 2013: They racked up combined revenues of $31.1 trillion, up 2.5% from 2012, and profits soared 27% to nearly $2 trillion. China’s 95 companies (up from 89 last year) posted $5.8 trillion in revenues. The U.S. has four fewer companies on the list than last year but remains (for now) the country leader, with 128 corporations on the list—including No. 1 Wal-Mart Stores—reporting $8.6 trillion in revenues. 

Wal-Mart stayed on top as its sales crept closer to half-a-trillion dollars. Apple moved into the top five. And UnitedHealth Group continued its steady climb. 

Sector

Industry

Industry Rank

Previous Industry Rank

Overall Score

Company Info

Founded

Industry Vertical

U.S. Employees

Worldwide Employees

Sites

HQ Location

Web Address

Date info provided (companies may opt to keep some data confidential)

Key Financials (last Fiscal Year)

Revenues ($M)

Profits ($M)

Assets ($M)

Total Stockholder Equity ($M)

Profit Ratios

Profit as % of Revenues

Profits as % of Assets

Profits as % of Stockholder Equity

Earnings Per Share (last Fiscal Year)

Earnings Per Share ($)

EPS % Change (from prior fiscal year)

EPS % Change (5 year annual rate)

EPS % Change (10 year annual rate)

Total Return

Total Return to Investors (last year)

Total Return to Investors (5 year, annualized)

Total Return to Investors (10 year, annualized)

Cencora, formerly AmerisourceBergen, is a global pharmaceutical-solutions company that sources, distributes, and supports prescription drugs, specialty medicines, over-the-counter products, medical supplies, and related services. Its U.S. Healthcare Solutions segment serves health systems, hospitals, physician practices, pharmacies, and other care sites through pharmaceutical distribution, specialty distribution, supply-chain, and pharmacy solutions. Cencora also provides biopharma and life-sciences services—including clinical-trial logistics, market access, regulatory support, commercialization, and patient-support services—and operates in more than 50 countries.

Q3 2026

Q2 2026

Q1 2026

Q4 2025

Q3 2025

Q2 2025

Q1 2025

Cencora (COR): Company Profile, Stock Price, News, Rankings

legacy

Cencora

cencora

Hello, everyone. Thank you for joining us, and welcome to the Cencora, Q3 fiscal year 2026 earnings call. After today's prepared remarks, we will host a question-and-answer session. If you would like to ask a question, please press star one to raise your hand. To withdraw your question, press star one again. I will now hand the conference over to Bennett Murphy. Bennett, please go ahead.

Good morning, good afternoon, thank you all for joining us for this conference call to discuss Cencora's fiscal 2026 third quarter results. I am Bennett Murphy, Senior Vice President of Investor Relations and Enterprise Productivity. Joining me today are Bob Mauch, President and CEO, and Eva Boratto, Executive Vice President and CFO. On today's call, we will be discussing non-GAAP financial measures. Reconciliations of these measures to GAAP are provided within 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. 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 have the opportunity to ask questions after today's remarks by management. We ask that you limit your questions to one per participant in order for us to get to as many as possible within the hour. With that, I will turn the call over to Bob.

Thank you, Bennett. Hi, everyone, and thank you for joining Cencora's fiscal 2026 third quarter earnings call. To start, I'd like to thank our Cencora team members for their continued commitment to providing valuable solutions for our customers. In our third quarter, we delivered strong results driven by execution across Cencora and investments to advance our specialty positioning and our pharmaceutical-centric strategy. Our business performance drove double-digit adjusted operating income growth and, supported by $1 billion of opportunistic share repurchases, we achieved 12% EPS growth in the quarter. We're pleased to be raising our fiscal 2026 EPS guidance, reflecting our confidence in our continued execution and the strength of our portfolio as we close out the fiscal year. I'm very happy Eva Boratto has joined us as Chief Financial Officer. She will provide details on our performance and continued confidence in our short and long-term expectations.

During my remarks today, I'll highlight how our strategy enables us to deliver on our growth priorities. First, our differentiated specialty pharmaceutical platform uniquely positions us to support innovation and patient care across our footprint. Second, through our digital transformation, we are modernizing how we operate and serve our partners. Finally, our focus on talent and culture is equipping our teams with the skills, resources, and leadership needed to continue advancing our pharmaceutical-centric strategy and delivering our purpose. I'll start with specialty, where our platform supports growth across the healthcare ecosystem. Our specialty platform builds on our strong foundation in pharmaceutical distribution and deep relationships with providers and manufacturers. Over time, we've expanded our capabilities into a broad set of services designed to address the needs of specialty care.

Over nearly three decades, Cencora has worked alongside community providers to advance our distribution, GPO, and practice solutions, helping physicians operate effectively and care for patients close to home. As specialty care has become more complex, these providers are seeking partners who can help them navigate access, reimbursement, and administrative demands while preserving their ability to deliver care in community-based settings. Our management services organizations are well-positioned to help oncology and retina practices manage the growing complexity of specialty care and broaden access to clinical trials and research while allowing physicians to remain focused on patient care. Importantly, our role across the specialty landscape gives us a clear view of what it takes for new therapies to reach patients. That unique perspective informs the work we do with manufacturers who increasingly need partners with the infrastructure, expertise, and connectivity to enable successful launches and protect product integrity.

Across Cencora, our specialty logistics, 3PL, and commercialization services help bring innovation to market and drive reliable access to therapies. Before moving to the next topic, I want to reiterate our confidence in the value Cencora provides and our ability to help all stakeholders navigate the impact of market dynamics as we've demonstrated. As the market continues to digest and annualize list price changes, the value proposition of the services we provide remains clear. We're well-positioned through our distribution footprint, sourcing scale, and end-to-end channel relationships. Importantly, Part B biosimilars will continue to be an opportunity for Cencora to drive value for all stakeholders while taking cost out of the healthcare system and improving patient access. Moving to our digital transformation, where we're combining business process improvement and technology advances to improve how we operate and work with partners across the healthcare system.

A tangible example of this is our work in demand forecasting. Our teams are using AI to better anticipate product needs across our network and identify key factors driving changes in demand. In a business like ours, these tools help improve planning, enhance product availability, and maintain reliable service for providers, pharmacies, and health systems. Across our organization, we're applying the same disciplined approach to simplify routine activities and give our team members better insights. That allows team members to spend less time on manual processes and more time using their expertise to work with partners and solve problems. Next, through our focus on talent culture, we're equipping our teams to continue advancing our pharmaceutical-centric strategy and delivering on our purpose. Across Cencora, our teams bring the expertise and commitment needed to serve providers, manufacturers, and patients in an evolving healthcare environment.

We're focused on ensuring our talent has clear career paths while strengthening our ability to execute for customers and partners. That focus extends to key roles across the organization. This quarter, in addition to Eva, we welcome Sam Hammock as Chief Human Resources Officer. Since joining the company, both Eva and Sam have brought valuable expertise and proven to be excellent enterprise leadership team members. I also want to recognize the significant contributions of James Cleary and Silvana Battaglia, who recently retired as CFO and CHRO. Both will continue as advisors through the end of the calendar year. With that, I'll turn the call over to Eva for a discussion of our financial results and updated fiscal 2026 guidance. We're glad to have her here with us today for her first earnings call as CFO. Eva?

Thanks, Bob, good morning, everyone. It's a pleasure to join the call today, and I look forward to engaging with the investor community in the coming weeks and months. Since joining Cencora in June, I've spent time with leaders across the enterprise and deepened my understanding of the strength of our businesses, the durability of our pharmaceutical-centric strategy, and the financial discipline that underpins our long-term growth algorithm. Today, I'll provide an overview of our consolidated fiscal 2026 third quarter results and segment-level results before turning to our updated guidance. Unless otherwise stated, my remarks will focus on our adjusted non-GAAP financial results. For further discussions of our GAAP results, please refer to our earnings press release and presentation. Our third quarter performance reflects the strength of our pharmaceutical-centric strategy, the breadth of our specialty platform, and our disciplined capital deployment.

Adjusted operating income grew 17%, driven by strong execution in our U.S. Healthcare Solutions segment, including the performance of our OneOncology acquisition and continued growth in our international segment. While share repurchases also contributed to the 12% adjusted earnings per share growth. Based on our year-to-date performance and confidence in continued execution, we are raising our adjusted EPS guidance for fiscal 2026 to a range of $17.75-$17.95. Turning now to consolidated revenue. Revenue was $84.8 billion, up 5%, driven by growth in both reportable segments and in other, which I will describe in more detail when discussing segment-level results. Moving to gross profit, consolidated adjusted gross profit was $3.5 billion, up 23%, primarily due to growth in the U.S. Healthcare Solutions segment. In the quarter, consolidated gross profit margin expanded by 61 basis points to 4.16%, largely due to our acquisition of OneOncology in February.

Consolidated adjusted operating expenses were $2.3 billion, an increase of 27%, which again reflects the impact of the February 2026 acquisition of OneOncology. Excluding both MSOs, operating expenses grew 5% on a constant currency basis. Turning now to operating income, consolidated adjusted operating income was $1.2 billion, an increase of 17% compared to the prior year, driven by double-digit growth across both reportable segments and other. Moving now to our net interest expense and effective tax rate for the third quarter. Net interest expense was $141 million, an increase of $59 million compared to the prior year quarter, primarily due to the debt raised in February to finance the OneOncology acquisition. We have made significant progress on our debt repayment commitments and have fully paid off our RCA financing related term loan balance of $800 million.

$400 million repaid in the June quarter, an additional $400 million repaid in July. Our effective income tax rate was 19.9% compared to 20.7% in the prior year quarter. Finally, diluted share count was 193.9 million shares, a 0.7% decrease compared to the prior year quarter as a result of $1 billion of share repurchases in the quarter at an average price of $268 per share. Regarding our cash balances and adjusted free cash flow, we ended June with $2.8 billion of cash and had strong free cash flow generation, which results in year-to-date adjusted free cash flow of $1.1 billion. Our full-year adjusted free cash flow guidance of approximately $3 billion remains unchanged. I'll turn to our segment results for the third quarter and key drivers of our performance, starting with the U.S. Healthcare Solutions segment.

Our U.S. Healthcare Solutions revenue was $74.9 billion, an increase of 5%. In the quarter, our revenue growth was supported by strength in specialty across both health systems and physician practices. We also saw continued growth in sales of GLP-1s, which increased by $2.3 billion year-over-year. The growth was offset by three items. First, manufacturer list price reductions that represented a $2.4 billion headwind to revenue growth. Second, the 2025 loss of an oncology customer. Lastly, lower sales to our large mail order customer, as expected and consistent with second quarter. Moving now to operating income. U.S. Healthcare Solutions segment operating income increased 16% to $966 million. In the quarter, we saw strong growth in specialty across our MSOs, health systems, and community provider businesses. We were particularly pleased with the performance of our MSO platform, with both OneOncology and RCA performing ahead of our expectations.

Our core business continued to demonstrate its strength and value, delivering double-digit organic operating income growth when excluding the OneOncology contribution and the loss of the oncology customer last July. I'll now turn to our International Healthcare Solutions segment. International Healthcare Solutions revenue was $7.7 billion, up 6% on both an as reported and constant currency basis, driven by growth in our European distribution and specialty logistics businesses, World Courier and European 3PL. In the quarter, International Healthcare Solutions operating income was $166 million, up 21% on an as reported basis and up 23% on a constant currency basis. In the quarter, our European distribution business continued to benefit from the shift in timing of manufacturer price adjustments in a developing market country, again in the third quarter. There was strength across our global specialty logistics and European 3PL businesses that delivered double-digit operating income growth.

Moving to Other, which reflects the businesses for which we are pursuing strategic alternatives. Revenue in Other was $2.3 billion, up 7%, largely due to growth at Profarma and MWI Animal Health. Operating income was $109 million, up 25% due to operating income growth at MWI Animal Health, which also benefited from being accounted for as held for sale. That completes the review of our segment-level results. I'll now discuss our updated fiscal 2026 guidance. Driven by our strong performance and opportunistic share repurchases, we are pleased to raise our full-year adjusted EPS guidance range to $17.75-$17.95, up from $17.70-$17.90. There is no change to our full-year guidance for consolidated or U.S. Healthcare Solutions revenue.

As you continue to refine your models for our full-year U.S. revenue, we would expect revenue to be in the lower half of our 4%-6% growth range, given current expectations. In the International Healthcare Solutions segment, we now expect revenue growth to be approximately 8% at the low end of our previous range as a result of the stronger dollar in the second half of the year. On a constant currency basis, we expect International Healthcare Solutions segment revenue growth to be approximately 7%. In Other, we anticipate revenue growth of approximately 6%. Moving to operating income, we are raising the bottom end of our guidance for consolidated operating income growth and now expect growth to be in the range of 13%-14%. At a segment level, we now expect U.S. Healthcare Solutions segment operating income growth to be in the range of 14.5%-15.5%.

This contemplates continued strong growth in the U.S. Healthcare Solutions segment as we have now fully lapped the loss of the oncology customer, continue to benefit from the OneOncology acquisition, and have an easier expense comparison in the fourth quarter. In the International Healthcare Solutions segment, we now expect both as reported and constant currency operating income growth to be approximately 9%. In Other, we now expect operating income growth to be approximately 10%, reflecting MWI's strong execution and performance. Moving now to our below-the-line items, we now expect net interest expense to be approximately $490 million, up from our previous expectations of approximately $485 million, primarily reflecting lower interest income following the $1 billion in share repurchases we completed in the quarter. As a result of these repurchases, we are also updating our expectations for full-year diluted shares outstanding to be approximately 194 million shares.

Looking ahead to fiscal 2027, we are currently in the midst of our fiscal 2027 planning process and will provide full fiscal year 2027 guidance on our November earnings call. That said, I wanted to offer some perspectives as you think about your models. First, as we announced in February, we have reached an agreement to merge MWI Animal Health with Covetrus. We are continuing to work through the regulatory process and have no update on timing. However, for modeling purposes, if the transaction were to close at the midpoint of our fiscal year, we would have a $150 million operating income headwind within Other. Given the structure of the transaction that includes upfront cash, preferred equity, and common equity, it would partially offset the earnings headwind, netting to an EPS headwind of approximately $0.35.

Second, we do not have an update on the expected timing of the EyeSouth retina carve-out acquisition. As a result, we would not suggest incorporating that into the models at this time. Cencora is well positioned across our core U.S. and International Healthcare Solutions segments, giving us confidence in our long-term guidance. Although I've only been the CFO for a month, I've been impressed by the strength of our talent, the clarity of our strategy, and the dedication to our purpose. As I look to fiscal 2027 and beyond, I'm excited to further Cencora's strong track record of execution and disciplined capital stewardship to drive durable shareholder value creation. Now, I'll turn the call back to Bob for some closing remarks before we move to Q&A. Bob?

Thank you, Eva. To close, we were pleased with our strong third-quarter performance, which supports our increased fiscal 2026 guidance as a testament to the power of our pharmaceutical-centric strategy. I look forward to closely working with Eva as we continue building upon our track record of execution, growth, and disciplined capital deployment to deliver on our long-term guidance. Powered by our purpose, we continue to execute against our growth priorities and performance drivers, positioning Cencora to deliver sustainable long-term value creation. As we look ahead, we remain confident in our ability to deliver continued growth in our U.S. and International Healthcare Solutions segments consistent with our long-term guidance, and we look forward to sharing our 2027 outlook on the November call. We'll now open the call for questions.

We will now begin the question and answer session. Please limit yourself to one question and one follow-up. 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 Lisa Gill with JPMorgan. Your line is open. Please go ahead.

Thanks very much, thanks for taking the question. Good to hear your voice, Eva. Just really want to understand two things a little bit better. One, would this be the re-acceleration that we saw in the U.S. pharma business for last quarter growing roughly 6%, this quarter growing double digits? Can you maybe just give a little more color around what you're seeing? Secondly, Bob, you did reiterate on fiscal 2027 you're comfortable with the long-term view. Just curious if you're comfortable with where the street currently is, which is about 14% growth for next year. Are you saying that's within the range, or is there anything else that we need to think about beyond the two things that Eva talked about?

Thanks for the question, Lisa, appreciate your kind words, and I'm super excited to have joined Cencora. I'll start with your Q3 question. We're really pleased with the performance and the execution in the quarter. On the outperformance, it was largely in the U.S. segment, with strength in our MSOs and underlying business trends in the core, with strength in specialty in both health systems as well as physician providers. OneOncology did outperform our expectations, demonstrating the strength of their platform and its ability to attract physicians to the MSO, which we've benefited from overall distribution and GPOs for some time. Excluding the loss, as you said, of Florida Cancer and the contribution from OneOncology, our operating income growth was up double digits, a meaningful acceleration from the 7% last quarter. I'll turn it over to Bob on 2027.

Yeah. Thanks, Eva. Hi, Lisa. Thank you for the question. We're really excited that Eva is here with us to help us continue to execute at a very high level. On your question about 2027, Eva gave some modeling guidance that will help everyone estimate where we should be for the year. I'm not going to take it any farther than that, I will reiterate what I was meaning to say in the remarks is that we are confident in our long-term guidance and feel like our execution, the market strength, and the strength of our portfolio will continue to have us within that range.

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

Yeah, thanks, good morning, and thank you for taking the question. Hey, Bob, I also wanted to follow up on the strength that you saw in the U.S. healthcare operating profit this quarter. To that end, I wanted to focus a bit more on the specialty business. Back in the March quarter, the company called out some weather-related disruptions. This quarter, in the prepared remarks, you're specifically calling out RCA and OneOncology as doing better than expected, implying that you've seen some re-acceleration this quarter. I want to separate specialty into Part D versus Part B, as I think there's a very important distinction here, and I suspect you're going to tell me the Part B is the much more meaningful driver. Maybe could you give us a little bit of additional color here in terms of what you saw in the quarter? I think that'd be helpful. Thanks.

Hey, Glen. Thanks for the question. It is important on a lot of levels, and I appreciate the opportunity to explain. We absolutely did call out the acceleration of the businesses in RCA and One Onc. The market absolutely performed well, and we have these amazing platforms in RCA and One Oncology that certainly were meeting the needs of patients through that market acceleration, and we believe will continue to do so. Eva can spend a little bit more time on expectations and where we were relative to those. I do want to spend a minute on the biosimilar part of your question and the Part D versus Part B, because I do think it's important for everyone to understand how we think about it. I'll start with Part D. Maybe I'll start with biosimilars are good. Biosimilars are good for patients.

They're good for cost. They're good for patient access. Anywhere in our business, it's an incremental positive from a profit standpoint. In Part D, it's less so because we provide less services, less wraparound services in the Part D space when a product goes from an innovator brand to a biosimilar. As we saw last quarter with our large mail order customer, that may be insourced. Then we have the revenue decrease, but not a meaningful profit increase. When we think about the Part D space, biosimilars are good, incrementally positive. For Part B, it's much more important, as you alluded to, and that is because the Part B buy and bill infusion space, which is where our MSOs, where our distribution and GPOs have such a long history of supporting physicians.

Within that history, I talked about distribution, GPO, and the MSO. When we talk about wraparound services, those are all the things that we do to support those products coming to market from a manufacturer perspective, and then support the physicians in understanding how they may choose to use those products. Therefore, there's a larger profit opportunity because we play a bigger role in how they're assessed and utilized. We should think, again, all the way back, biosimilars are good for Cencora. Part D, much less so, but still good, even though we'll have revenue pressure from time to time with those switches. Part B will always be good, and we feel very confident about the durability of that over the long term.

Okay. Just to add on the utilization trends, right? We did see a sequential rebound in the utilization trends from the March quarter. Strong sales in specialty products, as I said previously, to health systems and physician providers. Oncology clearly is the larger, but retina also contributed to that sequential improvement.

Your next question comes from the line of Elizabeth Anderson with Evercore ISI. Your line is open. Please go ahead.

Hi, guys. Thank you so much for the question, and welcome, Eva. Nice to hear you on the call. Could you talk about the operational improvements you're seeing in the OneOncology business, where do you think you are in the integration efforts, and how do we think about this, to help us understand the sustainability of that above average growth rate going forward?

Yeah. Hi, Elizabeth. It's Bob. I'll start that, then I'll hand it over to Eva. As we've explained, there really are three phases to the value creation thesis that we have for the MSOs. One is the integration of those MSOs into Cencora. We have significant progress on RCA, good progress on OneOncology, that's working very well. The value that Cencora can provide to those businesses we're providing, as we've talked about, you're seeing the results of their performance. The second phase is where we will share capabilities across the platform. The example that we've used throughout is the clinical trial space. I would say we're still early days there in that phase two of sharing capabilities. On track. We feel good about where we are, still early days there.

The third phase is where we will be developing new services. The excellent capabilities that we have at Cencora from a corporate standpoint, also within the MSOs of RCA and OneOncology, where we'll build new solutions for both physicians and for pharmaceutical manufacturers. You can think about analytics type solutions and insights that we'll be providing. That's in the future, in phase three. All of that is underpinned by the continuous addition of physicians to both platforms. Those additions come in the form of tuck-ins that will happen within either or both of the platforms, it also happens with individual physicians joining the platform, whether they're recently out of fellowship or moving from another side of care to the community setting.

All of that is working well. I would say we're on track. You see the results of that. Still early days in terms of the value creation that we believe that we can create. Now I'll hand it over to Eva.

Great. Thanks, Bob, and good morning to you as well, Elizabeth. As Bob said, and I said earlier, both OneOncology and RCA continue to perform well, and we're very pleased with these platforms. I'll go a little deeper on OneOncology. As you think about it on a 12-month basis, we continue to expect OneOncology to be neutral from an adjusted earnings per share net of financing. I would also note, as we continue to evaluate OneOncology's accounting for its UUG subsidiary as it relates to non-controlling interest, in the third quarter, we determined that there should not be a non-controlling loss add back to net income. There was no impact to operating income from this change. It's a complex area. Looking beyond this pretty modest accounting item, overall, OneOncology operating income is modestly better than our initial expectations.

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

Good morning, and thanks for taking the questions. I want to follow up on the strength in the U.S. Healthcare Solutions business. I think if we look at the sequential improvement in growth, you talked about, well, obviously, weather was an impact in 2Q. I think if you x that out, the rebound was maybe a little bit stronger than we expected. Is there anything else to call out as you think about the pockets of strength from your fiscal 2Q or that calendar 1Q quarter going into calendar 2Q? Was there any one-time dynamic around the IRA that impacted 1Q that is now normalized? Trying to understand if there's anything there that was maybe one time in that calendar 1Q that may be abating now. Then just a quick follow-up. Do any of the changes going on in 340B have any impact on your business? Thanks.

Thanks for the question. For fiscal quarter Q2 to Q3, really the driver of the acceleration was the underlying strength in the utilization as we called out, relative to the prior quarter. I would also note, as you look forward to Q4, our Q4 implied guidance also implies strong double-digit growth across our reportable segments. As you think about that in the U.S., we'll have fully lapped the OneOncology customer loss and we'll have an easier expense comp. When excluding OneOncology, we expect to see the strongest organic growth of the year at the midpoint of our guidance. Just underlying continued momentum of the business, strength in international as well. I'll turn it over to Bob for the 340B.

Hey, Allen. Thanks for the questions. I just want to reiterate what Eva was saying with the ramp is happening just as we planned. As we talked about the second quarter being our lowest growth quarter, which it was, and we talked about the ramp that we had in the second half of the year and got a lot of terrific questions about how we were going to do that. As you heard, we had a lot of confidence. It was mechanical, not aspirational. We continue to see the opportunities there. On 340B, Allen, as you know, there's recently been guidance on the 340B Drug Pricing Program test that will be out there. We're still assessing it. As you know, we stay very close to all things policy, spend a lot of time in Washington.

We will participate in continuing to monitor, talking to regulators and legislators about potential unintended consequences. Our focus in all these discussions is always patient access and having the most efficient access to care. Thank you for the question.

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

Thanks for taking the questions. Eva, great to hear you again. Bob, when you talked about OneOncology earlier, you talked a little bit about opportunities, particularly in research and clinical trials. Maybe can you talk a little bit about how much of that is already being done by OneOncology? Maybe how much of revenues or maybe some qualitative estimate of how important that is today, and how mature is that as an opportunity for OneOncology? Because, maybe are we still in early innings, and how big of an opportunity do you think that could really be?

Yeah. Hey, Charles. Thank you for the question. I'll connect One Oncology and RCA together. The answer of what inning we're in, it varies depending on which part of the MSO platform that you are. One, as we expand the clinical trial business within the MSOs, it's an absolute driver of profitability and growth. RCA is mature in the space. They've built a significant, well-respected platform that pharmaceutical manufacturers depend on when getting clinical trials done in the retina space. There is meaningful clinical trial activity within One Oncology. There's significant opportunity for growth. I would say, to use your innings analogy, I think we're in the later innings of the build-out of RCA. Now remember, the growth continues because products are always coming for clinical trial.

That doesn't mean that the growth slows. The maturity of the build-out is in the latter innings. In OneOncology it's in the earlier innings, which is why we have so much optimism about the opportunity. Obviously, the amount of innovation in the oncology space and the need for clinical trial support will only continue to grow and will be a great source of that. Just to add, this is true for RCA and OneOncology the community oncology, community specialty physician side of care, we talk about as being the most cost-effective side of care in almost all cases. It's also the most accessible side of care.

Having meaningful clinical trial access within the community physician space means that more patients will have access to those trials, which is really important for their healthcare and also for the accrual of the trials, which is one of the biggest challenges that the manufacturers have. Thank you for the question.

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

Yeah. Good morning, guys. Thanks for taking the question. Eva, again, welcome back to the healthcare services space. I guess I have two quick ones I'd like to bounce through is number one on the World Courier and the 3PL business. It seems like there's been a step up in competitiveness in that market over the last 12 months. Would just appreciate if you could comment on anything you've seen there. Then as it relates to the Q4 guidance, and as it relates to specialty and oncology with the pricing dynamics, there also seems to be a little bit of a dollar-based slowdown in the market given drug pricing and a little bit of a utilization slowdown. Just would be interesting if a slowdown in the oncology market is weighing on the Q4 results and the Q4 guidance in the U.S. business. Thanks.

Yeah. Hey, George. I'll take the first part of your question, then I'll hand over to Eva for the second. We are really well-positioned in the specialty logistics and on 3PL space. Remembering, and you know well, George, our World Courier business is the highest end specialized logistic services for pharmaceutical manufacturers, primarily with clinical trials, and we have differentiated capabilities that have been there over a long period of time. Within our 3PL business, the European part of the 3PL business came with the Alliance Healthcare acquisition. We have a U.S.-based part of that business called ICS, who also have very specialized capabilities for specialty product movement. I start with our capabilities, and that leads to differentiation because, George, there certainly are other players who are building healthcare 3PL logistics capabilities. Very credible players.

We play at a higher end of those services and also find that the pharmaceutical manufacturers often prefer someone who is health pharmaceutical focused. We talk about our pharmaceutical-centric strategy. That also is true for our 3PL and specialty logistics. When we're talking to pharmaceutical manufacturer, we're talking about capabilities, but also our expertise in the pharma channel, which allows us to compete very well. Even though there are well-known, credible competitors in the space, we continue to grow. I'll hand it over to Eva.

Great. Thanks, Bob. Good morning, George, and nice to hear your voice again. Listen, we've seen good utilization trends in specialty, including oncology as part of the market that we saw consistent growth throughout Q3, and it's continued to be a long-term growth driver. As you see by our implied 4Q guidance, there's a sequential improvement, the U.S. performing the strongest organic growth in the segment at the midpoint of our guidance. We're pleased with the underlying performance and the trends we're seeing.

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

Thanks for taking my question. Eva, good to hear from you again. My question's around some of the proposed changes in the ASP rules that came out recently and just how you're thinking about it or how we should think about it as a potential risk going forward or not a risk at all. Have you sort of explored how this might change ASPs and how to think about that for your MSO business or your GPO? If there's any way to sort of quantify it at this point.

Hey, Kevin. Thank you for that important question. We spend a lot of time evaluating and studying all of the policy ideas that are out there, and how that may or may not impact ASP risk. Where we land, in all cases, is that the policies that are under consideration or being tested are not intended to impact physician reimbursement. I've talked about today, we talk about often the community physician being the most accessible and the lowest cost site of care, and any policy that would negatively impact those physicians would impact their ability to care for patients and therefore decrease access for patients to those important physicians. When we're in Washington, those are the types of things that we talk about, and it's all about patient access and cost effectiveness within the healthcare system, which is where these community specialists really differentiate themselves.

How that plays through is you see things like in the GLOBE demonstration project that any discounts that are paid from the manufacturer to the government actually are not going to flow through reimbursement or impact ASP. They're going to be adjudicated in a direct payment from the manufacturer to the government. That is recognition that the policy makers understand the risk to impacting community physician reimbursement. I think it also demonstrates the fact that they do not want to do that, and they're therefore testing an alternate mechanism. Kevin, it's an important question. It's something that we spend a lot of time on. We do feel confident that as this plays out and as we get to 2028, in particular with IRA and Part B, that the reimbursement to physicians will not be negatively impacted. Thanks for the question.

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

Great. Thanks. I have a quick two-parter. Just in the context of what you were just talking about with the ASP changes and pricing dynamics from a regulatory perspective, do you anticipate that in that context, you can still invest more and lean more into the MSO businesses? I know there's not much left to do in oncology world on MSO side, but other ologies. In the context of everything from a regulatory perspective, is the biosimilar opportunity there, for instance, disproportionately greater in some of those certain areas? Just quickly, Eva, looking forward to working with you again. Since you've come on board, I guess any surprises? How do you think about any changes in terms of the philosophy around guidance or capital deployment?

We're already going through some right-sizing across the Cencora business with some divestitures. How do you think about the commitment to the various parts of the business, the mix of the business today at this juncture? Thanks.

Hi, Erin. Thanks for the question. I'll take the ASP and MSO question, and then I'll obviously hand it to Eva for your question to her. Yeah, we feel confident in the long-term outlook for the community physician space, and that includes reimbursement over the long term. We do intend to continue to invest in the MSO space. I'll note that our intention is to really focus on tuck-in acquisitions for RCA in the retina space and OneOncology in the oncology space. As it pertains to other ologies, we're very happy to service all specialty products in whatever side of care that they're intended to go, and our portfolio of services and customers allows us to do that. In terms of MSO investment, we intend to stay pharmaceutical centric.

Right now, oncology and retina are the only two specialties that we view as pharmaceutical centric per our assessment. You wouldn't see us getting into other disease states in terms of MSOs. I would say you never say never, right? Because there could be in the future an area where it would make sense, it would be more pharmaceutical centric, it would be specialty physician administered, and that is a place that we certainly would look to lead when that happens. We don't see anything in the near term. Our focus is on accretive tuck-in acquisitions within the retina and oncology space. Thanks for the question. I'll hand it over to Eva.

Great. Good morning, Erin. Thanks for the question. The guidance question, I'll start with my philosophies on guidance. I set guidance based on a disciplined internal process reflective of the businesses, our expectations of the business, and I'm supported by an amazing team here, long tenured with deep expertise in this business. I will look to continue Cencora's long track record of delivering or exceeding expectations.

Moving to capital deployment priorities. Overall, Cencora's had a great capital allocation strategy that's honestly allowed it to continue to invest in key growth initiatives while returning capital to shareholders. Our capital deployment strategy remains focused on internal investments in the business, strategic M&A, opportunistic share repurchase, as we just did in the third fiscal quarter, and maintaining a reasonable and growing dividend. Overall, I want to build on the framework to enhance our flexibility to invest in the business and drive shareholder value.

Yeah. Erin, I'll just add, I mentioned in my prepared remarks how excited I am to work closely with Eva, and you just heard one of the reasons why. Our philosophies in terms of how this will go forward are very aligned, very aligned to how we've done things in the past, and our performance and financial discipline has allowed us to have excellent performance and continue to implement and expand our strategy. I'm looking forward to continuing to work with Eva to do that. Thanks for the question.

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

Thanks very much. Most of the more important stuff was covered, but two quick ones, if I might. First, just if I missed it, the held-for-sale accounting benefit in the other segment, if you could quantify that for us, would be great. On GLP-1 sales, I know you said they were up $2.3 billion year-over-year. That looks like low to mid 20% growth, maybe up low double digits quarter-over-quarter. I'm curious how that stacked up versus your expectations, and then if you have any thoughts on the GLP-1 Bridge Program with Medicare. Thanks very much.

Good morning, Eric. On your held-for-sale, the benefit of the accounting impact, the majority of the growth in the other segment was driven by the held-for-sale accounting. Underlying MWI delivered about 10% growth and drove the change to our outlook for the year. In terms of the GLP-1s up 25%, that was generally in line with our expectations.

Your next question comes from the line of Daniel Grosslight with Citi. Your line is open. Please go ahead.

Hi, thanks for taking the question. I want to switch over to the International side a little bit, particularly the European distribution performer for the past few quarters now. I was hoping you could give us a little bit more color on which geographies or therapeutic categories are driving this growth. Is it broad-based or concentrated in any specific market or area? Perhaps more importantly, as we think about fiscal 2027, apart from it being a more difficult comp period, are there any things we should be aware of heading into fiscal 2027 on European distribution? Thanks.

Yeah. You cut out there a little bit in the beginning, I'm going to repeat the question for the benefit of everyone on the call. It sounded to me as though you're asking, the past couple of quarters, after the first quarter, we've had higher than expected performance out of the International segment. What are some of the drivers within that segment? Obviously we called out the European distribution, but Eva, if you could speak to some of those year-over-year drivers in the International segment.

Sure. Thanks for repeating the question. Daniel, thanks for the question. In our European business, it continued to benefit from the timing of manufacturer price increases in developing market country, consistent with previous quarters. Now, we wouldn't expect that impact in Q4 given some of the timing changes. In our specialty logistics business, I think Bob hit on this a little earlier. Both World Courier and the European 3PL businesses delivered double-digit operating income growth. In 3PL, we had strong renewals. We've been focused on growing our price pipelines, excuse me, that have supported new business wins. In World Courier, the business saw good momentum following a challenging market in fiscal 2025, the business continues to position itself for continued growth as the market has stabilized.

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

Thank you, Bob, and welcome, Eva. A question relative to the 340B comment earlier. One of your peers in the drug channel commented today that it is a headwind to a business that is more focused on the TPAs and contract pharmacy. Could you remind us, your business, the focus on covered entities and on pharma, what you are doing in 340B and what your value prop is to the various participants?

Eric, thank you for the question. I would just answer that with just we have such a broad portfolio of customers who are all providing amazing care for patients and their stakeholders. So, if something were to go through and be implemented, there would be different impacts to different parts of the business, which we haven't really spoken to. I wouldn't assume that that's all negative. I think there would be puts and takes, potentially. We're still obviously assessing what could be and then until there's something implemented, we wouldn't necessarily size it. Thanks for the question.

Your next question comes from the line of Michael Cherny with Leerink. Your line is open. Please go ahead.

Good morning. Thanks for taking the question. Eva, welcome back as well. Maybe just one quick question on the current market landscape. Obviously, you talked about some of the dynamics with your large mail customer. Your other large customer has gone through an ownership transition. As you think about your current customer construct, is it in a place that you want it to be? Are there any significant renewals, moves, anything outside the norm relative to the market that you're currently exploring or within your purview? Thanks.

Hey, Michael. Thanks for the question. We are very happy with our customer portfolio, and as I just said, it's very broad. We have a significant presence in really all sites of care, and our goal, as I've said before, is to support patient access, and we're supporting pharmacies and physicians and other providers. Wherever the patient needs care, Cencora will be making sure that that customer has the product at the right time and at the right price. We're happy with that. Our relationships with our large customers and our small customers are good and nothing to call out in terms of renewals. Thanks for the question.

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

Thank you. Thanks everyone for joining. We're proud of the strong results that we've posted today and our opportunistic repurchase of $1 billion in the quarter. Cencora is delivering on our long-term track record of execution. We're well-positioned by a robust specialty business and broad-based scale and solutions. We have confidence in our talent, our value proposition end-to-end in healthcare solutions, and our ability to continue driving long-term value for all stakeholders. Thanks everyone very much.

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

Cencora (COR) Q3 2026 Earnings Call Transcript

Company Participants