Cencora Q2 2025 Earnings Call Transcript

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Provided by Quartr
May 7, 2025

Key Takeaways

  • Q2 Financial Outperformance: Syncora delivered 10% revenue growth and 16% adjusted diluted EPS growth in Q2 and raised its full‐year guidance for adjusted operating income and EPS based on strong first‐half results.
  • US Healthcare Solutions revenue rose 11%, driven by a 36% year-over-year increase in GLP-1 sales totaling $2.2 billion and broad specialty product volume gains across physician practices and health systems.
  • International Healthcare Solutions revenue grew just 1% (6% constant currency) while operating income plunged 17%, leading to lowered guidance for international revenue and income amid ongoing specialty logistics softness.
  • RCA Acquisition Lift: Full consolidation of Retina Consultants of America boosted gross and operating margins, and an accounting change treating physician equity as a liability added roughly $0.14 to EPS guidance for the year.
  • Syncora highlighted its focus on deepening partnerships and patient access by leveraging analytics and active learning at industry events to support independent pharmacies and specialty care providers.
AI Generated. May Contain Errors.
Earnings Conference Call
Cencora Q2 2025
00:00 / 00:00

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Operator

Hello, everyone, and thank you for joining the Cencora fiscal 2025 second quarter results conference call. My name is Lucy, and I'll be coordinating your call today. During the presentation, you can register a question by pressing star followed by one on your telephone keypad. If you change your mind, please press star followed by two on your telephone keypad. I will now hand over to your host, Bennett Murphy, Senior Vice President, Head of Investor Relations and Treasury, to begin. Please go ahead.

Bennett Murphy
Bennett Murphy
SVP and Head of Investor Relations and Treasury at Cencora

Thank you. Good morning, good afternoon, and thank you all for joining us for this conference call to discuss Cencora Fiscal 2025 second quarter results. I am Bennett Murphy, Senior Vice President, Head of Investor Relations and Treasury. Joining me today are Bob Mauch, President and CEO, and Jim Cleary, 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. During this conference call, we'll 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.

Bennett Murphy
Bennett Murphy
SVP and Head of Investor Relations and Treasury at Cencora

For discussion of key risks and assumptions, we refer 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 express permission of the company. You will 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 participants as possible within the hour. With that, I'll turn the call over to Bob.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Thank you, Bennett. Hi, everyone, and thank you for joining Cencora's fiscal 2025 second quarter earnings call. To begin, I want to thank our global Cencora team members. It is due to their purpose-driven execution that I have the privilege of reporting our second quarter performance. In our second quarter, Cencora delivered strong results with revenue growth of 10% and adjusted diluted EPS growth of 16%. We are once again raising our guidance for the fiscal year to reflect our first half results and expectations for continued execution in the second half. Rooted in our pharmaceutical-centric strategy, enabled by active learning and powered by the collective strength of our enterprise, Cencora is building on our position as a leading end-to-end healthcare solutions provider. We continue to expand our capabilities in key markets, supporting pharmaceutical innovation and access. Today, I will highlight three areas advancing our business to power growth.

Bob Mauch
Bob Mauch
President and CEO at Cencora

First, we are creating value by leveraging our expertise and insights to enhance patient care. Second, we are successfully deepening our customer partnerships by actively learning and anticipating their needs. Third, we are strengthening our global leadership in specialty medications by deepening our offering across geographies and customer channels. I will begin with how we are creating value by leveraging our leading expertise and insights from our end-to-end solutions to support our customers, partners, and patients. Cencora is uniquely and intentionally positioned to support pharmaceutical commercialization and access across the healthcare ecosystem, from leading pharmaceutical and biopharma innovators to healthcare providers. The breadth and scale of our services give us access to extensive data that our teams transform into actionable insights, enabling increased efficiency and innovation. There are two examples I would like to mention that demonstrate our progress to engage with industry stakeholders and strengthen our partnerships.

Bob Mauch
Bob Mauch
President and CEO at Cencora

First is how we're working to support the resiliency in the independent pharmacy space to ensure patient access to care. Through our advanced analytics capabilities and leading Good Neighbor Pharmacy network of independent pharmacies, we've been able to provide pharmacies with heightened visibility into their communities, allowing them to identify new business opportunities, address populations that may experience gaps in care, and tailor their service offering to specific patient populations. Our work has also highlighted that an estimated 30 million people in the United States live in pharmacy deserts, threatening access to medication, vaccines, screenings, and other services necessary for healthy communities. By leveraging these insights, we are better able to advocate on behalf of our customers to ensure community providers remain vital sites of care. The second example is using dispensing insights from our relationships with providers to inform biopharma partners on key product trends.

Bob Mauch
Bob Mauch
President and CEO at Cencora

One recent initiative provided actionable insights into the treatment of bladder cancer, where Cencora combined clinical and market research to show how community oncologists were implementing new treatment paradigms. We are expanding the areas in which we offer these data insights, providing valuable services to our partners as they navigate the ever-changing healthcare landscape. Next, we are deepening our strategic relationship with customers and partners by taking an active approach to learning from them. Through Cencora's industry-leading portfolio, we've built a premier customer base end-to-end throughout the pharmaceutical supply chain dedicated to driving positive pharmaceutical outcomes. Executing on our strategic priority of leading with market leaders, we are committed to deeply understanding our customer strategies and, in turn, anticipating their needs and enhancing our capabilities.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Just this past week, teams from across Cencora were actively engaged at a number of industry events, ranging from community pharmacies and oncology practices to the largest chain drug stores as well as biopharma companies, allowing our team members to return to our offices equipped with insights to share with colleagues. I'm proud of our significant presence at these prominent industry events, where the scope of Cencora's capabilities and expansive partnerships were on full display. At a leading conference focused on specialty pharma, our team members spent time actively learning from partners across the healthcare landscape while also providing thought leadership through their participation on panels addressing policy and healthcare access. We were also highly engaged in the largest gathering of chain pharmacies working to deepen our partnerships.

Bob Mauch
Bob Mauch
President and CEO at Cencora

In Washington, D.C., a group of our leaders joined community pharmacists from across the country for meetings with legislators to bring attention to the critical role pharmacists play in their local communities as trusted providers of care. The teams attended over 100 meetings with legislators. Additionally, we gathered with our community oncology partners, where the focus was on the continuous evolution of care and need for empowered advocates to ensure the best patient outcomes in the community setting. By engaging in these forums, we develop a deeper understanding of our partners' needs and gain valuable perspective to allow us to better serve them and their patients. Finally, we are strengthening our global leadership in specialty medications by deepening our offering across customer channels.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Executing our strategic imperative of expanding leadership in specialty, our internationally scaled 3PL service is differentiated as we serve pharmaceutical manufacturers who are increasingly seeking partners that can support products across multiple geographies. We've integrated our U.S. and European 3PL businesses, creating an internationally unified network. By doing this, we offer manufacturers deep local expertise along with multinational reach for their products, driving successful launches and positioning Cencora as the partner of choice. We are increasing our capabilities in key markets in Europe, enhancing our pharmaceutical logistics offering, which will power our leadership in specialty across the continent. We're also strengthening our leadership in specialty in the United States by deepening our offerings across provider channels.

Bob Mauch
Bob Mauch
President and CEO at Cencora

One example is our approach with health systems, paving the way for us to build upon our critical role in distribution and offering an ecosystem of services health systems increasingly require as the use of specialty medications rise. Our teams have developed solutions to address the needs of health systems large and small. Our solutions, designed in partnership with leading health systems, support comprehensive patient-centric care. By investing in end-to-end solutions across sites of care, we strengthen our capabilities to support providers, manufacturers, and patients. In closing, and before I hand it over to Jim, the financial strength we are reporting today is powered by the size and organic growth of our U.S. segment, resulting from many years of strategic investments, strong execution, and leading partnerships. In our international segment, we are navigating a period of market softness for some of our businesses.

Bob Mauch
Bob Mauch
President and CEO at Cencora

However, we are confident we are well-positioned and expect to capture opportunities as demand rebounds. I hope each of you take away from my prepared remarks today that while we are performing well, there is no complacency at Cencora. While we execute driving performance in the short term, we are laser-focused on building end-to-end capabilities and partnerships that will enable continued growth over the long term, strategically deploying capital, investing in talent, digital capabilities, and enterprise productivity. I want to end with another thank you to the Cencora team members who, guided by our purpose, drive a differentiated customer experience, actively learn and apply insights to drive innovation, and deliver value for all of our stakeholders. We are united in our responsibility to create healthier futures.

Bob Mauch
Bob Mauch
President and CEO at Cencora

With that, I will turn the call over to Jim for an in-depth review of our second quarter results and our updated fiscal 2025 guidance. Jim?

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Thanks, Bob. Good morning and good afternoon, everyone. As a reminder, before I turn to my prepared remarks, my remarks today will focus on our adjusted non-GAAP financial results. For a detailed discussion of our GAAP results, please refer to our earnings press release and presentation. In our second fiscal quarter, Cencora delivered strong financial performance as our teams capitalized on our pharmaceutical-centric strategy. We benefited from our positioning and continued investment in attractive growing areas of the market like specialty, driving adjusted diluted EPS growth of 16%. To reflect our strong U.S. Healthcare Solutions earnings performance to date and expectations for continued growth in the second half of the year, we are raising our full-year guidance for adjusted operating income and adjusted diluted EPS. Before reviewing the revised guidance details, I'll first turn to a review of our consolidated second quarter results, starting with revenue.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Our consolidated revenue was $75.5 billion, up 10%, primarily driven by revenue growth in the U.S. Healthcare Solutions segment as we continue to benefit from volume growth, including continued growth in GLP-1 products. Excluding sales of GLP-1s, our consolidated revenue growth would have been 8%. Turning now to gross profit, consolidated gross profit was $2.9 billion, up 15%, due to growth in the U.S. Healthcare Solutions segment. Consolidated gross profit margin was 3.86%, an increase of 16 basis points, primarily driven by the gross profit contribution from our acquisition of Retina Consultants of America. Moving now to operating expenses. In the quarter, consolidated operating expenses were $1.7 billion, up 15%, driven primarily by the RCA acquisition. Excluding RCA, operating expense growth was modest as we continue to focus on identifying and implementing productivity initiatives while also investing in our business and operations to support our customers' growth.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Consolidated operating income was $1.2 billion, an increase of 15% compared to the prior year quarter, due to excellent performance in our U.S. Healthcare Solutions segment, which I will discuss in more detail in the segment-level results. Moving now to our net interest expense and effective tax rate for the second quarter. Net interest expense was $104 million, an increase of $40 million versus the prior year quarter. This increase primarily reflects the interest expense associated with the $3.3 billion in recently issued senior notes and a term loan to finance a portion of the RCA acquisition, on top of our inter-period short-term borrowings associated with typical seasonal factors, minus the repayment of senior notes that matured in March, which we have not yet refinanced. Turning now to income taxes, our effective income tax rate was 20.8%.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Given our year-to-date effective income tax rate, we would expect our full-year tax rate to be slightly below 21%. Finally, our diluted share count was 195.1 million shares, a 3% decrease compared to the prior year quarter, driven by approximately $1.0 billion in opportunistic share repurchases over the past year, including $50 million in February in concurrence with Walgreens Boots Alliance's sale of shares. As we look to the balance of the fiscal year, we do not anticipate further share repurchases as we focus on deleveraging following the RCA acquisition. Regarding our cash balance and adjusted free cash flow, we ended March with $2 billion of cash and year-to-date adjusted free cash flow slightly below $200 million as a result of strong adjusted free cash flow in our second quarter. We continue to expect full-year adjusted free cash flow to be in the range of $2 billion-$3 billion.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

This completes the review of our consolidated results. Now I'll turn to our segment results for the second quarter. In the U.S. Healthcare Solutions segment, revenue was $68.3 billion, up 11%, as we continue to see strong utilization trends, including growth in GLP-1s and growth in sales of specialty products to specialty physician practices and health systems, where we are particularly benefiting from our strategy of partnering with market leaders. In the quarter, sales of GLP-1 products increased $2.2 billion, or 36% year-over-year. While this is clearly a significant year-over-year increase, I will note that this represents a 10% sequential decline in GLP-1 sales from the first quarter. Excluding sales of GLP-1 products, U.S. segment revenue growth would have been 9% for the quarter. Separately, I will note that, as previously contemplated, there is no significant increase in U.S.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Healthcare solutions revenue resulting from the acquisition of RCA, as sales from our specialty physician services business to RCA are now being eliminated in consolidation. U.S. Healthcare Solutions segment operating income increased 23% to $1.0 billion, driven by growth across our human and animal health distribution businesses and the contribution from RCA, offset by a smaller-than-expected COVID vaccine headwind. In the quarter, we saw particularly strong performance in specialty, as utilization across health systems and specialty physician practices was robust, and we benefited from the continued uptake of biosimilars in these customer channels. As it relates to COVID, in the quarter, we saw higher-than-expected sales of COVID-19 vaccines that resulted in our COVID-related headwind being approximately half the size we indicated on our first quarter earnings call. I will now turn to our international healthcare solutions segment.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

In the quarter, international healthcare solutions revenue was $7.2 billion, up approximately 1% on an as-reported basis and up 6% on a constant currency basis due to our growth at our European distribution business. International healthcare solutions operating income was $159 million, down 17% on an as-reported basis and down 14% on a constant currency basis. The decline was driven by continued softness for our global specialty logistics business as clinical trial activity remained subdued, and we had a difficult comparison for our European distribution business due to manufacturers' price adjustments in a developing market country in the prior year, which we called out on our second quarter earnings call last year. Excluding the impact of the manufacturers' price adjustments, we saw solid operational performance within our European distribution business, particularly in 3PL. That completes the review of our segment-level results.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

I will now discuss our updated fiscal 2025 guidance expectations. As a reminder, we do not provide forward-looking guidance for certain metrics on a GAAP basis, so the following information is provided on an adjusted non-GAAP basis, except with respect to revenue and share count. I will also provide certain guidance metrics on a constant currency basis. I will start with adjusted diluted EPS guidance and then provide detail on the income statement items contributing to the increase. We are raising and narrowing our fiscal 2025 EPS guidance and now expect EPS to be in the range of $15.70-$15.95, up from our previous range of $15.30-$15.60, and representing growth of 14%-16%. The updated guidance reflects our strong second quarter operating income performance in the U.S. Healthcare Solutions segment and a lower expected contribution from the international healthcare solutions segment.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Additionally, in connection with consolidating the operating results of RCA, we made the accounting determination that the approximately 15% of equity that is owned by RCA physicians and management represents a contingent liability to Cencora as opposed to a non-controlling interest. Cencora will be consolidating the entirety of RCA with no non-controlling interest elimination at the net income and EPS level. Our prior guidance assumed a non-controlling interest reduction in EPS. Therefore, this determination will result in a higher-than-expected EPS contribution from RCA for the fiscal year, but has no impact on our operating income results or operating income guidance. We are pleased with the integration progress we are making with the RCA team and are excited about the opportunities we have to drive positive patient outcomes by leveraging our collective strengths.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Now moving to revenue, our consolidated revenue guidance is unchanged, and we expect growth to be in the range of 8%-10%. At the segment level, we are updating our international healthcare solutions segment revenue growth outlook and now expect as-reported revenue growth to be in the range of 3%-4%, down from our previous range of 4%-5%. On a constant currency basis, we now expect international healthcare solutions segment revenue growth to be in the range of 6%-8%, down from the previous range of 7%-9%. While we are leaving our revenue guidance unchanged at both the consolidated and U.S. Healthcare Solutions segment level, we anticipate our growth will be at the bottom end of the respective ranges.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

In the second half of the year, we will see revenue growth impacted by a couple of factors, including beginning to lap tougher GLP-1 growth comparisons in the second half when the market saw product supply constraints subside in the prior year and declining sales of high-priced mail-order products, which now have biosimilar competition in PBM formulas. These dynamics contribute to the lower revenue growth expected in the second half of the year, but are positive for our profit margins. Moving to operating income, we expect consolidated operating income growth to be in the range of 13.5%-15.5%, up from our previous guidance of 11.5%-13.5%. In the U.S. Healthcare Solutions segment, we now expect operating income growth to be in the range of 17.5%-19.5%, up from our prior range of 14.5%-16.5%.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

The updated guidance reflects our strong business performance to date and continued good pharmaceutical utilization. Turning now to International Healthcare Solutions segment, on an as-reported basis, we now expect operating income to be down 4% to down 1% versus our prior expectations for operating income to be flat. The updated guidance range reflects the continued demand softness in the clinical trial and outsourced pharma services markets, impacting our full-year expectations for our higher-margin businesses in this segment, offset in part by the positive impact of the weakening of the U.S. dollar against other currencies. On a constant currency basis, we now expect segment operating income to be down 3% to flat. Moving to share count, we now expect diluted weighted average shares outstanding to be in the range of $195 million-$195.5 million based on our current share count. That concludes our updated full-year guidance assumptions.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

In closing, the Cencora team has delivered another strong quarter of financial performance as our team members worked collaboratively with our customers and partners to drive a differentiated experience through their expertise and solutions-oriented approach. Our team members and our strategic partnerships are foundational to our success. Our continued investment in the team's development, our focus on enhancing capabilities, and emphasis on productivity will further enhance our ability to drive value for all our stakeholders. Now I will turn the call over to the operator to open the line for questions. Operator?

Operator

Thank you. To ask a question, please press star followed by one on your telephone keypad now. If you change your mind, please press star followed by two. When preparing to ask your question, please ensure your device is unmuted locally. We ask participants to limit their questions to one question per person.

Operator

Our first comes from Elizabeth Anderson of Evercore ISI. Your line is now open. Please go ahead.

Elizabeth Anderson
Elizabeth Anderson
Senior Managing Director at Evercore ISI

Hi, guys. Thanks so much for the quick question and congrats on the quarter. Maybe I just wanted to dig into the strength and the AOI of the U.S. healthcare business. Given that strength that we saw in the quarter, how do you kind of see that playing out for the rest of the year? If we talk about some of the drivers on a longer-term basis, how do we see the sort of continuation of those over the longer period? Thanks.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Hi, Elizabeth. Thanks for the question. This is Bob. I'll take that one. I think where you got in your question in terms of the drivers are how I'll answer.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Because when you think about Cencora, I think there are three things to think about when you're looking at kind of long-term performance. We do believe our strong performance will continue. One is how well we're positioned in the growing parts of the pharmaceutical market. Obviously, we talk a lot about how well we're positioned in the specialty market. That is where most of the innovation in the pharmaceutical industry is happening. We're very well positioned there with the biopharma manufacturers. We certainly expect our positioning to continue and the innovation to continue. The second piece is how well we're positioned with providers. We spend a lot of time, again, talking about our strength in the independent community specialty practices, which is excellent, and we expect that to continue.

Bob Mauch
Bob Mauch
President and CEO at Cencora

We are also very well positioned across the continuum of sites of care, from the largest pharmacies to the smallest community pharmacies to specialty pharmacy, highlighted health systems today in the prepared remarks. We look at the market growth in terms of product innovation and specialty. We are well positioned there. When you think about the provider base, we are very well positioned there. The third and important piece is just the excellent purpose-driven team members that we have here at Cencora, who are spending a lot of time thinking about not just how do we execute in the short term, but how are we going to continue to innovate, build services, and build partnerships for the long term.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Also referencing back to my prepared remarks, I made a specific point of the amount of time that Cencora leaders are spending out with industry stakeholders, whether that is in Washington, D.C., or our provider customers, once again. The intention there is to make sure that we are listening carefully, we are learning, we bring that back to the organization. That allows us to be meeting the needs and exceeding the needs of those provider customers. I think when you think about the market growth, how well we are positioned, and then honestly the growth mindset that we have at Cencora and our commitment to actively learning and continuing to innovate, it is what gives us belief that the performance will continue over the long term.

Operator

Our next question comes from Michael Cherny of Leerink Partners. Your line is now open. Please go ahead.

Michael Cherny
Michael Cherny
Senior Managing Director and Healthcare Technology and Distribution Equity Research Analyst at Leerink Partners

Thanks for taking the question.

Michael Cherny
Michael Cherny
Senior Managing Director and Healthcare Technology and Distribution Equity Research Analyst at Leerink Partners

Again, congrats on another strong beat and raise. Maybe about to parse through Elizabeth's question a little bit more and particularly dive in more on specialty. Cencora has a long history of being a market leader on all things specialty-oriented. As you think about the contributors of specialty to growth, how much can you unpack in terms of what you see as market growth versus share gains versus additional value-added services and add-ons that you've been able to build out? You're very much—we'd agree with the fact that you're in the right place on a go-forward basis relative to the market's growing, but curious, as the market continues to grow in various different pacing, where you see the best opportunities for outperformance beyond that?

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Yeah. Thanks a lot for the question, Michael. I'll take a shot at it.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

We saw terrific results, really extraordinary results in the first half in our U.S. business. In fact, if we kind of look at our Q2 beat, really, all of the U.S. Q2 beat versus our internal expectations is due to organic growth from our core U.S. distribution business. Of course, we've talked about for some time that that's driven by utilization trends. It's driven by broad-based performance. In particular, it's driven by sales of specialty products to physician practices and health systems. I would say as we look at specialty, it's really been broad-based performance, and it's been very good results both with regard to physician practices and health systems. Our recent acquisition of RCA and our investment in 2023 of OneOncology, we look at that as really the natural evolution of our specialty business.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Because, of course, we're very strong in distribution. We're very strong in wrap-around services like GPO. We view the MSO space as adding additional value-added services to the same customer base that we've had terrific success with for quite some time. Thanks a lot for the question. I think Bob has something he'd like to add.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Yeah. Thanks, Jim. Michael, I would just add our commitment to continuing to invest in the strengths that we have. You've seen over a period of time we're investing in services. The MSO expansion is a good example of that. We're going to continue to make those investments as we move forward to make sure that we're positioned well to support the biopharma manufacturers as well as the providers.

Bob Mauch
Bob Mauch
President and CEO at Cencora

We think that intention to do that, the commitment that we have to do that will allow us to continue to perform well.

Operator

Our next question is from Lisa Gill from JPMorgan. Your line is now open. Please go ahead.

Lisa Gill
Lisa Gill
Managing Director at JPMorgan

Great. Thanks very much. And good morning. Congrats on the quarter. I wanted to focus on D.C. and the thoughts around tariffs. It's believed that the Trump administration will come out with something in the next week or so. Can you just remind us on each side of your business? My understanding would be on the branded side, kind of similar to what we saw on the flip side with insulin. When prices go down, your economics kind of stay the same. Is there any variability if we were to think that prices go up? And then there's been a lot of questions on the generic side.

Lisa Gill
Lisa Gill
Managing Director at JPMorgan

If we think back to when there was generic price inflation, and again, a tariff could add some kind of inflationary component to this, how do we think about each of those components and how it impacts your business and how you're thinking about it for your customer?

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Yeah, sure. I'll take a stab at that, Lisa. Thanks a lot for the question. Of course, we continue to monitor the evolutions around tariffs in the pharmaceutical market. We have teams in place that are analyzing the impact of tariffs on our business and, very importantly, on the supply chain. To answer your question, what I'll say is, as it relates to our business, we have not called out any material impacts as a result of tariffs. As a reminder, we're pharmaceutical-centric, and the manufacturers are the importer of record for pharmaceuticals.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Now, to get to part of your question, our main focus is ensuring patients have access to lifesaving medications, and we're supporting our upstream and downstream partners as they navigate the uncertainty. Additionally, we'll continue to advocate on behalf of our customers to ensure that they receive adequate reimbursement for the valuable healthcare services that they provide. Just to reiterate, as it relates to our business, we haven't called out any material impacts as a result of tariffs. Thank you for the question.

Operator

Next question comes from George Hill of Deutsche Bank. George, your line is now open. Please go ahead.

George Hill
George Hill
Managing Director and Equity Research Analyst at Deutsche Bank

Yeah. Good morning, guys. Thanks for taking the questions. I've kind of got a two-parter.

George Hill
George Hill
Managing Director and Equity Research Analyst at Deutsche Bank

Number one, James, if you could kind of quickly walk through the RCA impact on gross margin expansion in the quarter, I think that would be helpful because there's some moving pieces there relating to the way the non-owned equity stub is being treated and the eliminations from the sales into the practices. My second part would be just kind of the growth where you guys have set yourselves up in specialty is amazing. I was just hoping you might give us any quantitative color on how much of the U.S. drug business is now like the part B business versus the part D business, and maybe kind of the growth characteristics you're seeing in each of those, kind of trying to think of the business in the two big segments from a distribution perspective. Thanks.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Okay. I'll take the first half of that.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

That is on RCA. You asked initially about gross profit. Yeah, as we look at our consolidated results, RCA does add meaningfully to gross profit margin and operating margin. One reason why is that it is a higher margin business than our core distribution business. Of course, the other reason why is that now that it is a subsidiary of Cencora, we eliminate the sales from our specialty physician services business to RCA so that we do not double-count those sales. As a result of that, it adds meaningfully to our gross profit margin and our operating margin. I think the second part of the business kind of got to the accounting. Let me just kind of address that for you also.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Our prior guidance, when we talked in February, incorporated 100% of the operating income for RCA and contemplated a reduction in EPS due to an expected non-controlling interest reduction. As I said in my prepared remarks, after closing and consolidating the RCA business, we made the accounting determination that the approximately 15% of equity that's owned by RCA physicians and management represents a contingent liability to Cencora as opposed to a non-controlling interest. The result of that is that there's a higher-than-expected EPS contribution for the fiscal year, but it has no impact on our operating income results or guidance. Just to give you a little bit more detail there for EPS, approximately $0.14 of the increase in EPS guidance is a result of the RCA accounting determination. The rest is from our core U.S. distribution business.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

If you look at our increase in EPS guidance, the significant majority of the increase in EPS guidance comes from our core U.S. distribution business, which more than offsets a decrease in guidance for international. Just one final thing is that the $0.14 increase in EPS from the RCA accounting determination may be higher than some of you are initially modeling. The reason for that is that the 85% of operating income covers all of the interest expense. The incremental 15% of operating income falls right to pre-tax income. I think that fully answers your question. One other thing I will add is that as it relates to the guidance update, kind of everything from the standpoint of revenue, GP, and OI for RCA is the same as previously guided.

Operator

The next question comes from Charles Rhyee of TD Cowen.

Operator

Charles, your line is now open. Please go ahead.

Charles Rhyee
Charles Rhyee
Managing Director at TD Cowen

Yeah. Thanks for taking the questions and congrats on the quarter, guys. I actually want to ask about international real quickly here. Obviously, the guidance is taken down a little bit here. Just wanted to maybe dive a little bit into more about your comments about softness in the specialty logistics business. You mentioned that trial activity is subdued. Can you talk a little bit more about what you're seeing here? Obviously, there's a lot going on in the pharma market, particularly with potential tariffs and a lot of things that the administration is undertaking here currently. Maybe you can give us a sense for what you're hearing from clients, from pharma companies in terms of sort of what they're seeing currently and how they're approaching sort of business development here and clinical trial starts in particular.

Charles Rhyee
Charles Rhyee
Managing Director at TD Cowen

When you're saying it's subdued, does that mean you're just seeing a lot of delays? Maybe you could just kind of give us a little bit more details on that. That'd be great. Thank you.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Yeah. Thanks a lot for the question. As we and other players in the market have been calling out, clinical trial activity has been subdued, which has been pressuring some of our businesses in the international healthcare solutions segment, particularly demand for global specialty logistics and earlier-stage pharma consulting projects. The rebound's been slower than we would have expected, resulting in segment performance for our global specialty logistics business to be below the expectations we outlined in February. We really haven't seen demand begin to ramp materially for our consulting business.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

As a result of the performance to date and to incorporate a wider range of recovery paths for demand in global specialty logistics, we reduced our international healthcare solution segment operating income guidance. I will say that our end-to-end service offering is resonating with manufacturers, and we feel confident in our ability to capitalize on a rebound in demand when it occurs, given our unique positioning in the market.

Operator

The next question comes from Eric Percher of Nephron Research. Eric, your line is now open. Please go ahead.

Eric Percher
Co-founder at Nephron Research

Thank you. Appreciate the detail on RCA. I'd like to ask a question kind of about the MSO operations more broadly. I know that each of them looks quite different, and the share of income can be quite different. Can you help us with kind of your view of the profit stream?

Eric Percher
Co-founder at Nephron Research

We have talked a lot about the opportunity. When we think about how much of that opportunity is tied to drug versus medical or government versus commercial, can you provide a general framework for that, both to think about the opportunity and the risk of some of what is occurring in the market?

Bob Mauch
Bob Mauch
President and CEO at Cencora

Eric, it's Bob. Thanks for the question. I would begin with we are excited and confident about the income streams within the MSO space. As you said, they are different. The services that an MSO, OneOncology, would provide to an oncology practice are similar and different than RCA would provide to a retina specialist. When you put that together, we believe it is a really good fit for our expansion of services in both of those spaces.

Bob Mauch
Bob Mauch
President and CEO at Cencora

As we've discussed and as you know well, Eric, the strength that we have in both distribution and the GPO was there. By adding the MSO services, we're able to build on our capabilities in supporting those physicians. One thing to reinforce is something else that we're excited about in terms of a future growth proposition is the clinical trial services that are provided now at RCA and that we believe we can expand into OneOncology. That's another example of how we'll be well-positioned with both the biopharma partners as well as the providers.

Operator

The next question comes from Steven Valiquette of Mizuho Securities. Steven, your line is now open. Please go ahead.

Steven Valiquette
Steven Valiquette
Equity Research Analyst at Mizuho Securities

Yeah. Thanks. Good morning. Congrats on these results. Yeah.

Steven Valiquette
Steven Valiquette
Equity Research Analyst at Mizuho Securities

I had a question that was kind of similar to Charles, just on the international solutions and your comments about the clinical trial activity remaining subdued. Really, the only kind of follow-up questions there were just I can't recall off the top of my head just how fragmented versus how concentrated your customer base is in that business. So were there maybe just some customers where activity on clinical trials was subdued, or was it definitely widespread phenomenon across the majority of your book? And then is there any chance you're able to put a number just on the approximate % decline in clinical trial activity you're seeing across your book? I mean, we're talking single-digit decline, double-digit. Just want to get just some rough sense for that. Thanks.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Yeah. Thanks for the question. It's market-based.

Bob Mauch
Bob Mauch
President and CEO at Cencora

What we are seeing are the very same things that you are seeing across the market from other players. Our customer base is broad. As we are seeing, there has been a decline in clinical trial starts over the past few years that we all in the space are eagerly awaiting a bit of a rebound there. Within our specialty logistics business, it is part of our end-to-end service. When we are talking to biopharma companies about commercialization and them bringing services to market, we are talking to them about lots of different services from consulting to 3PL services to the specialty logistics services that we are talking about here. We would not call it anything different than what is being observed across the market. I think there was a peak in trial activity during the COVID pandemic that has been reduced. We are all working through that.

Bob Mauch
Bob Mauch
President and CEO at Cencora

As Jim said earlier, as I said in my prepared remarks, we're well-positioned with our services, with our partners and customers, and expect to be a partner of choice as that market rebounds.

Operator

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

Allen Lutz
Allen Lutz
Equity Research Analyst at Bank of America

Good morning. Thanks for taking the question. Congrats on the really strong results here. Bob, you called out really good growth in the specialty provider channel. Can you talk a little bit about growth in your different verticals there? Was there any standout as we think about growth in oncology versus retina? Are there any other specific areas to call out?

Allen Lutz
Allen Lutz
Equity Research Analyst at Bank of America

As you think about the utilization rate from 2024 into the first quarter of 2025, was there any deceleration, any acceleration, either at the top level or within any of the specific verticals you operate in? Thanks.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Yeah. Thanks for the question, Alan. We do not break out the specific commercial components of the business. I will say, and Jim mentioned this earlier, the performance is broad-based. We often talk about the community specialty space for very good reason. I made a specific point in prepared remarks to talk about the health system space and others because we are well-positioned for specialty growth across all sites of care. We are seeing them all grow. It is something that we are, again, happy to be well-positioned there.

Bob Mauch
Bob Mauch
President and CEO at Cencora

We're working hard to make sure that we're adding value to our biopharma partners as well as the providers, but wouldn't comment specifically on any differences in growth across those segments. I would go back to the reason that we're often focused on specialty physicians and oncology is the oncology space continues to be the area of largest growth and largest opportunity.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Bob, just the only thing I'll add, and this goes, of course, back to our results in our press release and my prepared remarks is, I mean, we did have just had very strong performance in the first half. We're just so pleased to be able to increase our operating income guidance for the year by three percentage points at the bottom end of the range and the top end of the range in the U.S., 17.5% growth and 19.5% growth.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Really driven by the things you were asking about, utilization and our broad-based strength in specialty.

Operator

The next question comes from Daniel Grosslight of Citi. Daniel, your line is now open. Please go ahead.

Daniel Grosslight
Daniel Grosslight
Senior Research Analyst of Healthcare Technology at Citi

Thanks for taking the question in. Congrats on the quarter here. I had a similar question to Alan's, but maybe I'll ask it in a bit of a different way. Health systems seems to be getting a lot more airtime this quarter than previous quarters. I am just curious why that is. Are you seeing anything particularly strong in health systems this quarter on the provider side? As we think about the investments that you need to make to support health systems, is there anything that you would call out as kind of a near-term investment in that channel? Thank you.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Yeah. Thanks for the question.

Bob Mauch
Bob Mauch
President and CEO at Cencora

From my perspective, the reason that we're focusing a bit on health systems here is for the simple reason that we want the investor base to understand how well-positioned we are for specialty growth across sites of care. Again, for very good reason, we focus on the community practices, and we're making investments there. We are also working very closely with our health systems customers and other customers to make sure that we have capabilities and a solution set that help them continue to capture the specialty growth that is happening within their site of care. No, it's not anything in particular. It's not anything that's changed. It is something that we're trying to explain, which is the broad-based positioning that we have for specialty growth. Again, that's what gives us confidence in the continuing growth that we will have.

Operator

Our next question comes from Kevin Caliendo of UBS. Kevin, your line is now open. Please go ahead.

Kevin Caliendo
Kevin Caliendo
Healthcare Equity Research at UBS

Thanks. Thanks for taking my question. I just had a quick first one, which is just trying to understand the math on the EPS guide increase. So $0.14 came from HCA, or RCA, excuse me. And can you remind us when you said that there was a better than sort of the loss of COVID was half, what was the expectation? What did that actually mean in terms of EPS? I apologize. I could not find it in my notes. The real question is of the remaining sort of upside to guidance. I know you keep saying better specialty. Are you actually getting better economics anywhere through the portfolio than you had been before?

Kevin Caliendo
Kevin Caliendo
Healthcare Equity Research at UBS

Is it a reflection of your fixed costs and the fact that you've kept your operating expenses X RCA flat? I'm just trying to understand, or is it simply mixed? I'm just trying to understand where the upside is coming from. If it's specific to, "Hey, you know what? We're actually generating better economics on similar drugs," or if it's, "Our cost base is lower and utilization's higher, and we're able to run that through," or, "Our overall mix is better such that the margin is better."

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Okay. Great. Thank you for the question. Let me try to address those things. You're asking about what's impacting the increase in guidance. Of course, our increase in EPS guidance was $0.40 at the bottom end of the range and $0.35 at the top end of the range.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

You asked about COVID, and the COVID headwind in the most recent quarter was about half of what we had previously expected. We had expected a headwind in the $30 million range, and it was a headwind more like in the $15 million range. About half of our expectation. You asked a number of questions with regard to things that are benefiting us. I would say mix is one of the things that I see us benefiting from as we see just the specialty part of our business growing faster. That is really benefiting us from a mix standpoint. We see biosimilar growth, and that is benefiting us from a mix standpoint.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

One of the things that you see in our guidance is, and there are a couple of different reasons for it, one of which we called out earlier on the call, but is that we see operating income growth that's exceeding revenue growth. Some of those mixed things and higher margin businesses are benefiting us there. We are, of course, very pleased with the increase in guidance that we've put out today. Thank you very much for asking about it.

Operator

The last question comes from Erin Wright of Morgan Stanley. Erin, your line is now open. Please go ahead.

Erin Wright
Erin Wright
Senior Equity Research Analyst at Morgan Stanley

Great. Thanks. I understand you don't have future share buybacks in the guide, and the focus is on deleveraging near-term.

Erin Wright
Erin Wright
Senior Equity Research Analyst at Morgan Stanley

Just as you think about the rationale behind RCA and other potential MSO-type deals, I guess, will the RCA deal help to explain your future focus from an M&A standpoint as we think about your learning so far there? A second part of my question, maybe this is somewhat related to Kevin's too, but in terms of the economics, is there any sort of change from a GLP-1 perspective? I mean, you mentioned the dynamic into the second half, which should be just more of a revenue dynamic from my understanding. Any sort of potential in terms of improved economics or presumably oral solids could be more favorable for you as well. How are you thinking about that segment too? Thanks.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

Yeah. Let me start off with both of those things, MSOs and capital deployment and GLP-1s.

Jim Cleary
Jim Cleary
EVP and CFO at Cencora

We've been very pleased with our entrance into MSOs, both with regard to the investment in OneOncology and the acquisition of RCA. As you know, we own 35% of OneOncology, but there is a put-call structure with our partners there, which makes it likely that from a capital deployment standpoint, we would own all of that business at some point in time, which speaks to a good deal of our capital deployment over the next few years. Of course, we've been, as I said, very pleased with our experiences thus far. On GLP-1s, no, there's really no change from an economic standpoint. It's clearly been a driver of our revenue. As we've indicated in the past, it is profitable for us. They are profitable for us, but they are minimally profitable for us. I think that addresses your questions, Erin. Thank you.

Operator

We currently have no further questions. I will hand back to Bob Mauch, CEO, for closing remarks.

Bob Mauch
Bob Mauch
President and CEO at Cencora

Thank you very much. Thanks all for joining the call today. We are very proud of the strong performance and guidance raise that we have been able to announce today. You can count on us to continue focusing on building on our strengths, learning and leading from market leaders, driving efficiency through productivity, investing in our talent, data capabilities, and all of that will further differentiate Cencora to biopharma partners and providers. Thank you very much, all.

Operator

This concludes today's call. Thank you for joining. You may now disconnect your lines.

Executives
    • Bob Mauch
      Bob Mauch
      President and CEO
    • Bennett Murphy
      Bennett Murphy
      SVP and Head of Investor Relations and Treasury
    • Jim Cleary
      Jim Cleary
      EVP and CFO
Analysts
    • Kevin Caliendo
      Healthcare Equity Research at UBS
    • Allen Lutz
      Equity Research Analyst at Bank of America
    • Daniel Grosslight
      Senior Research Analyst of Healthcare Technology at Citi
    • Erin Wright
      Senior Equity Research Analyst at Morgan Stanley
    • Elizabeth Anderson
      Senior Managing Director at Evercore ISI
    • Eric Percher
      Co-founder at Nephron Research
    • George Hill
      Managing Director and Equity Research Analyst at Deutsche Bank
    • Steven Valiquette
      Equity Research Analyst at Mizuho Securities
    • Charles Rhyee
      Managing Director at TD Cowen
    • Michael Cherny
      Senior Managing Director and Healthcare Technology and Distribution Equity Research Analyst at Leerink Partners
    • Lisa Gill
      Managing Director at JPMorgan
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