Cencora Q3 2021 Earnings Call Transcript

Participants

Corporate Executives

• Bennett S. Murphy, Senior Vice President-Investor Relations
• Steven H. Collis, Chairman, President and Chief Executive Officer
• James F. Cleary, Chief Financial Officer and Executive Vice President

Analysts

• Charles Rhyee, Cowen and Company
• Lisa Christine Gill, JPMorgan Chase & Co.
• Rivka Regina Goldwasser, Morgan Stanley
• Steven James Valiquette, Barclays Bank
• Jailendra P. Singh, Credit Suisse Group AG
• Eric R. Percher, Nephron Research
• Kevin Caliendo, UBS Investment Bank
• George Robert Hill, Deutsche Bank Aktiengesellschaft

Presentation

[Operator]

Good morning, and welcome to the AmerisourceBergen Third Quarter Fiscal Year 2021 Earnings Conference Call. [Operator Instructions] Please note, this event is being recorded. I would now like to turn the conference over to Bennett Murphy, Head of Investor Relations. Please go ahead.

[Bennett S. Murphy, Senior Vice President-Investor Relations at Cencora]

Thank you. Good morning, and thank you all for joining us for this conference call to discuss AmerisourceBergen's fiscal 2021 third quarter results. I'm Bennett Murphy, Senior Vice President, Investor Relations. Joining me today are Steve Collis, Chairman, President and CEO; and Jim Cleary, 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 in today's press release, which is available on our website at investor.amerisourcebergen.com.

We have also posted a slide presentation to accompany today's press release on our investors website. During this conference call, we'll make 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 to today's press release and our SEC filings, including our most recent 10-K. AmerisourceBergen assumes no obligation to update any forward-looking statements, and this call cannot be rebroadcast without the expressed permission of the company. You have an opportunity to ask questions after today's remarks by the 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 Steve.

[Steven H. Collis, Chairman, President and Chief Executive Officer at Cencora]

Thank you, Bennett, and good morning to everyone joining us today. Before we discuss our results for the quarter, I want to comment on the distribution industry's recent milestone regarding the proposed settlement agreement to address opioid-related claims of U.S. state attorneys generals and political subdivisions in participating states. Throughout the litigation process, we have been consistent in stating our desire to address the normalcy of the opioid challenge by bringing solutions to the table. If the industry's proposed agreement and settlement process leads to a final settlement, it would collectively provide thousands of communities across the United States with substantial financial support.

Clearly, the process is in an advanced stage, and we will not comment deeply at this time. We take our role in the supply chain seriously and continue to close with stakeholders concerning these complex matters. AmerisourceBergen will continue to work diligently and, alongside partners, combat drug diversion while supporting real solutions to help address the crisis in the communities where we live, work and serve. Turning now to our results for the third quarter of fiscal 2021. AmerisourceBergen delivered yet another quarter of exceptional results driven by a high level of execution, purpose-minded team members and continued focus on delivering differentiated value. As we announced earlier this morning, we had revenues of over $53 billion representing growth of 18% from the same period last year, and we grew our adjusted EPS by 17% year-over-year.

These results reflect continued strong performance across AmerisourceBergen's businesses as we capitalize on our differentiated pharmaceutical-centric value proposition and as our team successfully executes on our key strategic initiatives. This strength and execution continue to create value for our shareholders. And today, we are again raising our fiscal 2021 full year guidance, which Jim will discuss later in greater detail. I will focus my remarks today on the key strategic pillars that are driving our strong performance, as well as how, with the addition of Alliance Healthcare, AmerisourceBergen continues to be well positioned to create value for all our stakeholders. AmerisourceBergen remains next-minded, and we are focused on continuing to enhance our ability to provide global healthcare solutions as we support pharmaceutical innovation and access, both in the United States and internationally. In the United States, our Pharmaceutical Distribution business continues to benefit from our industry-leading customer relationships, our leadership in specialty distribution and commercialization services and strong end market trends, including an earlier than expected return to pre-COVID prescription utilization trends in the June quarter.

Our leading customer base includes our Good Neighbor Pharmacy and Elevate Provider Network members. They are proving daily that community pharmacies are at the forefront of providing quality and equitable care and maintaining deep levels of trust with their patients and communities. In fact, for the fifth year in a row, Good Neighbor Pharmacy was ranked highest amongst brick-and-mortar chain drug store pharmacies by J.D. Power. This is the tenth time we have received that honor in the past 12 years, and it is a testament to community awareness of the value of the quality care and experience patients receive at GNP member pharmacies.

We held our annual Thoughtspot Conference last week, and I was touched and inspired by the stories that our members shared through the entrepreneurship, expertise and deep community roots, community pharmacies prove that they do more than just [draw] prescriptions. They are critical promoters of health equity across the U.S., often driving above and beyond to provide holistic care and health education at the local level, particularly in under-resourced communities. Since beginning of the pandemic, community pharmacies have stepped up fearlessly to meet the unprecedented challenges of a global health crisis and show the world why community pharmacies are integral to our communities.

The value proposition of community-based care has never been clearer. Another relevant example is on the animal side. The growth in pet ownership has increased demand for our veterinarian customers as pets are a cherished part of the family and the care a veterinarian provides is valued. This positive trend over the last year has long-term benefits for our business as MWI is well positioned with key anchor customers and services. On the human health side, access to local trusted expertise care remains vital, particularly for those dealing with complex health challenges that bring them into the care of specialty physician providers.

As I've said from the onset of the pandemic, we are conscious of the negative impact that restricted measures have on patients when they have less access to screenings and tests that help doctors identify serious health issues. This has particularly impacted patients who are used to a doctor or health care facility. But now our customers have begun to see a normalization in new patient trends. And as a result, patients are more effectively being diagnosed and gaining access to treatment.

This is a clear positive for patient care. As the leading provider of specialty distribution and commercialization services, we will continue to play our role in supporting pharmaceutical innovation and access as patients visit volumes continues to normalize. Our specialty physician services business had strong performance this quarter and continues to differentiate AmerisourceBergen with leading value-added services, such as those through our physician GPOs. Additionally, bio centers continue to be a positive for our customers, our business and the healthcare system overall as they provide room for new innovative products to come to market. The innovations in CAR T and cell and gene therapies and the potential applications of the new mRNA technology offers the medical community new potential tools in the treatment of serious diseases that previously alluded truly effective care.

AmerisourceBergen is well positioned to support all these innovations through our specialty distribution and manufacturer services offerings. Our unique ability to provide value-added expertise in conjunction with innovative solutions and quality service enhance our partnerships and grow our business. With strong partnerships, relationships and a leading portfolio of solutions to support a wide pipeline of practices and products, AmerisourceBergen is uniquely positioned to capitalize on the market opportunities provided by global pharmaceutical innovation as we drive growth in our business and help our partners tackle some of the most critical challenges based in healthcare. We have a strong foundation in place across our businesses.

And in June, we took another significant step forward by closing the Alliance Healthcare transaction and welcoming their talented team to the AmerisourceBergen family. The acquisition of Alliance Healthcare is the next evolution of enhancing our ability to provide innovative and global healthcare solutions and is a critical component to our future success. Alliance Healthcare is a strong and diversified pharmaceutical distribution and manufacturer services company with leading market positions across an attractive portfolio of both established European markets and high-growth emerging markets. In addition to their traditional wholesale business, Alliance Healthcare operates a range of leading higher-margin innovation businesses serving both upstream partners and downstream customers.

The acquisition of Alliance Healthcare extends our distribution reach built by our market-leading services capabilities and expands on our key differentiators. Specifically, AmerisourceBergen's leading portfolio of key anchor customers now includes a long-term relationship with Boots in the U.K. and a network of independent pharmacies across Europe through the Alphega pharmacy network. Since the completion of the transaction, we have gotten the chance to know about the business and the people and Alliance Healthcare better, and we remain very positive about the opportunity that this landmark achievement provides AmerisourceBergen as we are positioned for a differentiated global growth platform.

This includes our dedication to further strengthen our portfolio of solutions and customer relationships to lead with market leaders in every segment and to supporting patient access wherever a prescription is needed. Second, AmerisourceBergen's leadership in specialty is further enhanced with key commercialization services in new markets. By leveraging the expertise and capabilities of our World Courier business, along with Alliance's Alloga and Alcura, we elevate our ability to be a differentiated solution provider for global manufacturers as they develop and commercialize pharmaceuticals around the world.

This is complementary to the solutions that we provide at World Courier, which continues to play a key role of providing global specialty logistics through growth traditional commercial offerings and direct-to-patient clinical trial capabilities. We remain dedicated to expanding on our leadership in specialty and to enhancing our capabilities to support global pharmaceutical innovation. Third, AmerisourceBergen focuses on delivering best-in-class services and efficiency, and this transaction enhances our ability to develop innovation solutions that are fundamental to our success operationally and commercially.

Our innovative mindset means that we embrace the advanced technologies, data and analytics, and now we can further support positive outcomes through our expanded global platform. This fiscal quarter, we were selected as the industry leader award winner at the 2021 SAP Innovation Awards for our work in developing SAP Advanced Track and Trace for Pharmaceuticals. This technology tracks millions of daily shipments at the batch level and further strengthens the pharmaceutical supply chain in the U.S. The value of a resilient and sustainable global pharmaceutical supply chain is vital and the ability to support pharmaceutical innovation to a global footprint with broad leadership and local expertise provide differentiated value for our partners.

AmerisourceBergen stakeholders recognize the value we create, the importance of our purpose and the critical nature of the service and the infrastructure that we provide. Fourth, AmerisourceBergen continues to build upon our history of corporate stewardship, which focuses on advancing our people and culture, protecting the company's financial health and ensuring the long-term sustainable value creation. With Alliance Healthcare, we are now an even more global [Indecipherable] company, and we are committed more than ever to advancing the value of our talent and culture. Over the past year, we have invested in enhancing our talent and diversity and inclusion strategies to enable more growth opportunities within our increasingly inclusive workplace.

We recently launched our executive leadership initiative to accelerate the advancement and ongoing success of high potential black, Hispanic and Latinx team members at the mid and senior levels, addressing the most pronounced leadership and representation gaps identified over the last several months, following best-in-class research-based approaches. In the future, we plan to provide dedicated development opportunities for high-potential employees of additional underrepresented groups. Investing in our leadership development and talent and culture is important to our long-term sustainable growth, which is supported by diverse and inclusive teams.

This focus is important to ensuring we capture the value of our collective differences and reflect our social commitment as we continue to strategically focus on delivering on all elements of ESG. Our ESG strategy is foundational to AmerisourceBergen, our leadership, our Board and our people. Recently, AmerisourceBergen joined the Science-based Targets initiative as we continue to line our business with best practice organizations around the world. At the local level, we continue to be deeply committed to our communities. This past year, we launched myCommunityImpact, Matching Gifts and Dollars for Doers Program, and we recently made it available to all global employees. Our philanthropic efforts have been recognized by DiversityInc, ranking us 8th in their annual 50 [list] in philanthropy rankings. As I closed my prepared remarks today, I remain truly inspired by the commitment and performance of our team members who are now numbering 41,000.

With their unwavering passion and support, AmerisourceBergen is well positioned to capitalize on our global footprint to provide leading pharmaceutical distribution services and to leverage our expertise as an innovative commercialization services provider internationally. We remain confident in our pharmaceutical-centric strategy, our capabilities as partner of choice with market-leading manufacturer services and our role in continuing the acceleration of pharmaceutical innovation. By providing differentiated value to our stakeholders, focusing on our customers, expanding on our leadership in specialty and executing, innovating and supporting pharmaceutical innovation globally, we are well positioned to create long-term stakeholder value as we remain united in our responsibility to create healthier futures.

Now I will turn the call over to Jim for a more in-depth review of our results and updated financial guidance. Jim?

[James F. Cleary, Chief Financial Officer and Executive Vice President at Cencora]

Thanks, Steve. Good morning, everyone. Before I discuss our third quarter results, I want to comment on the Pharmaceutical Distribution industry's continued progress towards reaching a negotiated resolution to substantially address the nationwide opioid litigation. The proposed settlement agreement represents an important step towards achieving a broad resolution of governmental opioid claims and aligns with the legal accrual the company recorded in the fourth quarter of its fiscal year ended September 30, 2020. AmerisourceBergen appreciates the enormity of the opioid epidemic, and this broad industry resolution is an important step towards delivering a meaningful relief to communities across the United States.

Turning now to our business. AmerisourceBergen remains focused on our differentiated and innovative value proposition to deliver long-term growth and value creation to our stakeholders. Powered by our purpose-driven team members, we will continue to execute on our pharmaceutical-centric strategy on an enhanced global platform to serve both upstream partners and downstream customers. As we recently completed the acquisition of Alliance Healthcare in the quarter, I would like to welcome the Alliance Healthcare team to AmerisourceBergen. Having joined AmerisourceBergen myself through an acquisition and experience several acquisitions during my tenure, I have seen firsthand a thoughtful and strategic approach AmerisourceBergen takes to successfully integrate acquired companies.

We enjoy working with our incredibly talented new team members and learning more not only about their businesses, but also about how much we culturally have in common. As we have said since announcing the acquisition, Alliance Healthcare is a strong and efficient business, and we look forward to working together to continue to provide innovative solutions to our customers and stakeholders. My remarks today will focus on our adjusted non-GAAP financial results unless otherwise stated. Growth rates and comparisons are made against the prior year June quarter. For a detailed discussion of our GAAP results, please refer to our earnings release. I will provide commentary in two main areas this morning. First, I will review our adjusted quarterly consolidated results and our segment performance.

Second, I will cover the upward revision to our fiscal 2021 guidance. Turning now to discuss our third quarter results. We finished the quarter with adjusted diluted EPS of $2.16, an increase of 17%, which was driven by the continued strong performance across AmerisourceBergen's businesses and also benefited from the one month contribution from the Alliance Healthcare acquisition. Our consolidated revenue was $53.4 billion, up 18%, driven by revenue growth in both the Pharmaceutical Distribution Services segment and Other, which includes Alliance Healthcare and our Global Commercialization Services and Animal Health businesses.

Consolidated gross profit increased 32% to $1.6 billion, driven by increases in gross profit in each operating segment. In the quarter, gross profit margin increased 33 basis points from the prior year quarter to 3.05%. This was primarily due to the acquisition of Alliance Healthcare, which has a higher gross profit margin and increase in sales of specialty products in Pharmaceutical Distribution Services and growth in some of our higher-margin businesses. Regarding consolidated operating expenses, operating expenses were $996 million, up 38% year-over-year due to the addition of the Alliance Healthcare business and also includes the internal investments we are making across our business with a focus on continuing to offer innovative services and solutions to our partners.

These investments are important as they ensure we continue to create differentiated value and support our long-term growth. Turning now to consolidated operating income. Our operating income was $631 million, up 24% compared to the prior year quarter. This increase was driven by increases in both the Pharmaceutical Distribution Services segment and Other, which I will discuss in more detail when I review segment-level performance. Operating income margin grew six basis points to 1.18% as a result of the contribution from the Alliance Healthcare acquisition and growth in higher-margin businesses. Moving now to our net interest expense and effective tax rate for the third quarter.

The net interest expense was $51 million, up 36% due to debt related to the Alliance Healthcare acquisition. Our effective income tax rate was 21%, up from 18.8% in the third quarter of fiscal 2020, which benefited from a discrete tax item. Our diluted share count was 208.9 million shares, a 1.6% increase due to the dilution related to employee stock comp and the weighted average saving impact of the June issuance of two million shares delivered to Walgreens as a part of the Alliance Healthcare acquisition. Turning now to adjusted free cash flow and cash. Our adjusted free cash flow was strong in our fiscal third quarter, bringing our year-to-date free cash flow number to $1.2 billion, while our cash balance was $2.6 billion. This completes the review of our consolidated results. Now I'll turn to our segment results. Pharmaceutical Distribution Services segment revenue was $49.3 billion, up 13% for the quarter driven by increased sales of specialty products and solid performance broadly across our Pharmaceutical Distribution businesses.

Across our distribution businesses, we are seeing better and earlier-than-expected utilization trends as there have been more normalized physician interaction patterns leading to new patient starts. Pharmaceutical Distribution Services segment's operating income increased about 13% to $484 million. AmerisourceBergen continues to benefit in the quarter from our leadership in specialty, where there has been a notable return to pre-COVID strength and continued positive biosimilar trends.

I will now turn to Other, which includes Alliance Healthcare MWI, World Courier and AmerisourceBergen Consulting. Alliance Healthcare is in our results for the month of June and had strong performance out of the gate. In the quarter, Other segment's revenue was $4.1 billion, up 128%, driven by the Alliance Healthcare acquisition and growth across the remaining operating segments. Excluding the impact of Alliance Healthcare, Global Commercialization Services and Animal Health revenue was up 22%. Other segment's operating income was $147 million, up 77% primarily due to the Alliance Healthcare acquisition and strong performance at both MWI and World Courier. Excluding the impact of Alliance Healthcare, Global Commercialization Services and Animal Health operating income was up 21%, reflecting the solid fundamentals of the businesses. World Courier has continued its exceptional performance, providing high- specialty logistics around the globe. Despite challenges in global logistics due to limited international cargo space, the team has delivered industry-leading solutions and expertise to support our customers and partners.

Looking ahead, the business is highly complementary to Alliance Healthcare's Alloga and Alcura businesses, and we are excited to offer an integrated suite of solutions on our enhanced global platform to serve our manufacturer customers. Turning now to MWI. The pandemic has truly encouraged all of us to focus on the health and wellbeing of our communities and families. And this includes our animal companions. Over 12 million families in the U.S. have gained pets since the pandemic began, and since pet owners view their pets as family members, the focus on health and wellbeing is a positive market trend for our MWI companion business.

In the production animal market, our investments in technology solutions and the unique offering of value-added services position the business to support long-term global demand for protein. MWI's strong execution and customer relationships have allowed the business to remain a best-in-class provider that is well positioned to capture these positive market trends. That concludes our segment-level discussion, and I will now turn to our 2021 guidance. Following the closing of the Alliance Healthcare acquisition back in June, we updated our 2021 guidance for revenue, adjusted diluted EPS and weighted average shares to reflect the expected contribution from Alliance Healthcare and the weighted average share count impacted the two million shares of stock that we delivered to Walgreens. Given the continued strong performance of AmerisourceBergen's businesses, we are again raising our EPS guidance from a range of $8.90 to $9.10, up to a range of $9.15 to $9.30, reflecting growth of 16% to 18% from the previous fiscal year. We are also updating other financial guidance metrics for fiscal 2021, including a meaningful increase to our expectations for consolidated and segment adjusted operating income. First, I'll begin with operating expenses.

Operating expenses are now expected to be approximately $3.9 billion due to the Alliance Healthcare acquisition. As a reminder, when you consider your models, Alliance Healthcare has higher margins for gross profit, operating expenses and operating income as evidenced by the update to our fiscal 2021 guidance for consolidated operating expenses to reflect the four months of Alliance Healthcare. Next, turning to operating income. We now expect operating income to be approximately $2.6 billion. This is a result of raising our Pharmaceutical Distribution operating income guidance to the low double-digit growth range given the strong trends we have continued to see in our business, including specialty, which was further bolstered by patient referral activity this quarter.

This rate also reflects our expectation for operating income in Other of approximately $610 million to $620 million. Excluding the contribution from Alliance Healthcare, operating income growth for Global Commercialization Services and Animal Health group is expected to be in the low double-digit range for fiscal 2021, driven by the strong performance of the World Courier and MWI. Finally, turning to free cash flow, we have raised our free cash flow guidance to be approximately $1.7 billion, up from approximately $1.5 billion. As it pertains to fiscal 2022, our corporate planning process remains unchanged. We will provide comprehensive financial guidance at the end of our current fiscal year.

This approach allows for guidance to be fully informed by the output of our year-end business planning process. That being said, we want to remind you three important items from fiscal 2021 as you consider your models. First, through the end of June, the financial contribution from sales of COVID-19 therapies has declined in line with the expectations we have shared since the first quarter. COVID therapy distribution contributes roughly $0.25 to our fiscal 2021 adjusted EPS guidance, and the benefit from that exclusivity is not expected to repeat in fiscal 2022. Second, we will have higher interest expense in fiscal 2022 driven by the debt related to the Alliance Healthcare acquisition. Third, for the fourth quarter of fiscal 2021, we expect our weighted average shares to be almost 211 million shares due primarily to the fully planned impact of the two million shares of our stock delivered to Walgreens at the close of the Alliance Healthcare acquisition.

Our share count will continue to tick higher in 2022 due to normal employee stock comp-related solution and the fact that we have committed to prioritize paying down $2 billion in total debt over the next two years and [lower] shareholder purchases. Moving past these modeling reminders. The strength of AmerisourceBergen is undeniable and is exemplified by our continued exceptional results quarter-after-quarter. This is the sixth quarter since the pandemic began and our results demonstrate the resilience and strength of our company. I am thoroughly impressed by the execution and performance across our businesses that has positioned us for continued success.

Our pharmaceutical-centric foundation, market-leading talent and competitive positioning enable us to capitalize on market trends and continue to deliver strong results. Before I conclude my prepared remarks this morning, I would like to touch on our ESG and diversity and inclusion numbers. AmerisourceBergen remains focused on creating long-term financial value, and we continue to work diligently to build our corporate stewardship initiatives to ensure the work we are doing benefits all stakeholders.

We are focused on continuing to build robust talent development programs so that all our team members feel they have opportunities to grow and learn. In our communities, we're supporting nonprofit partners through our foundation to expand access to quality healthcare, promote health equity and provide resources to ensure prescription drug safety. In addition, we aim to be environmental stewards in the communities where we live and work through initiatives like our commitment to using sustainable packaging to reduce the use of single-use plastics and working closely with our partners to optimize delivery routes to minimize our greenhouse gas emission footprint.

We look forward to providing further updates on our ESG progress as we continue to find ways to make a positive impact on the people, planet and communities where we live and work. As we focus in on the end of our fiscal year with strong momentum and continued outperformance across our business, it is important to take a moment to reflect on the important accomplishments we have already had this year. First, our teams continue to execute and leverage our capabilities to create differentiated value for our stakeholders. Second, our future growth has been further solidified by our acquisition of Alliance Healthcare. Third, our purpose-driven culture continues to empower our team members that think, plan and act decisively to do what is right for our people, partners and communities.

And finally, we continue our long-term commitment to strategically invest in our businesses and talent to ensure that AmerisourceBergen will continue to deliver long-term sustainable value for all our stakeholders. As we look to the future, I'm proud of the resilient foundation we have built while we facilitate pharmaceutical innovation and remain united in our responsibility to create healthier futures. Thank you for your interest in AmerisourceBergen.

Now I will turn the call over to the operator to start our Q&A. Operator?

Questions and Answers

[Operator]

[Operator Instructions] And the first question will be from Charles Rhyee with Cowen. Please go ahead.

[Charles Rhyee, Analyst at Cowen and Company]

I want to ask, last quarter, there was a lot of concerns around generic deflation and the impact it might be having on you and the other distributors. Given the performance of the quarter, how should we think about the issue of generic deflation really in the context here of strong results in distribution, both from a top line and an operating profit perspective.

[James F. Cleary, Chief Financial Officer and Executive Vice President at Cencora]

Yes, Charles, this is Jim, and thanks a lot for that question. Generic deflation is trending relatively in line with our expectations and overall generic deflation rates are relatively in line with the last couple of years. But I think the key point I'd like to make in answering the question that you asked is that looking at our business model, our business model is not as reliant on generic pricing that it once was in the past. And several years ago, leadership of the company recognized the need to have more balanced profitability across the portfolio of pharmaceuticals and that rebalancing ensures that AmerisourceBergen receives fair compensation for the value we provide across brands, generics and specialty especially, as the market continues to shift to include more specialty. And so our alignment with strategic key anchor customers and our leadership in specialty continue to serve as positive differentiators for our positioning in results. And just like you were saying and asking in your question, it's really kind of evidenced in this quarter's results as we talked about in our prepared remarks this quarter, adjusted operating income was up 24% year-over-year. But we really, in particular, look at Pharmaceutical Distribution. Pharmaceutical Distribution operating income was up 13% year-over-year, and we increased our guidance for the full year for Pharmaceutical Distribution operating income from high single digits to low double digits. And this is just one of the many drivers that enabled us to have the increase in EPS guidance of $0.20 to $0.25.

[Operator]

And the next question will be from Lisa Gill with JPMorgan. Please go ahead.

[Lisa Christine Gill, Analyst at JPMorgan Chase & Co.]

Congratulations on a great quarter. Just want to understand a couple of things. One would be the comments around utilization. Did you have any pent-up demand? Or do you feel like this is back to more normalization when we think about utilization. And then secondly, Jim, when we think about the Alliance, the original guidance that you gave around accretion and what we saw in the quarter, I know it was only a partial quarter impact for Alliance, but how did that come in versus your expectations?

[James F. Cleary, Chief Financial Officer and Executive Vice President at Cencora]

Yes, great. And so I'll answer both of those. And so as we said in our remarks, we're seeing better and earlier-than-expected utilization trends. We're seeing patients are returning to physicians' offices, which is resulting in patient referrals to specialists and new patient starts. When we look at year-over-year retail Rx trends, we see that the year-over-year growth rates are higher in our third quarter compared to the year-over-year growth rates in the first half. And so we think it's a combination of pent-up demand and return to normal. And with regard to the Alliance question that you asked. Alliance had a strong start out of the gate when we initially announced the completion of the acquisition. In early June, we updated our EPS guidance to include $0.45 to $0.50 contribution from the business during the last four months of our fiscal year. And we now expect that Alliance will contribute approximately $0.50 in those four months of fiscal 2021.

[Lisa Christine Gill, Analyst at JPMorgan Chase & Co.]

Thanks.

[Operator]

And the next question will be from Ricky Goldwasser with Morgan Stanley. Please go ahead.

[Rivka Regina Goldwasser, Analyst at Morgan Stanley]

So from everything we are hearing today, fundamentals are stable to positive and you have increased visibility, you have the sort of the building blocks across all your portfolios and you referred to a very balanced portfolio. So my first question is, with all this kind of like now in place in the increased visibility, one, how should we think about sort of steady-state EBIT or EPS growth beyond the 2022 headwinds and tailwinds? And then my second question that relates to that long-term outlook. We just recently saw a biosimilar approval with an interchangeable status. I think that's something that we've been waiting for, the industry have been waiting for a very long time. So how do you see this as kind of like long-term implication of this approval? And what areas do you think interchangeability could impact biosimilar adoption the most?

[James F. Cleary, Chief Financial Officer and Executive Vice President at Cencora]

Yes. Great. I'll start off. And as we kind of think about the longer term, I think, it's kind of key to look at what we've been seeing in our businesses over the last quarters and several quarters. We're really saying just brand-based performance across our businesses. And we have been talking about some time about specialty physician services and health systems. We're continuing to see really good performance there and also in community and specialty pharmacy, World Courier and WI. Some of the things that have benefited us and will continue to benefit us are our industry-leading customers. It's really a differentiator for AmerisourceBergen, and it's really across most of our businesses that we have these industry-leading customers that help with our long-term growth. It's the leadership in specialty that is really benefiting us, has been benefiting us and will continue to benefit us as we look at market trends, the biosimilar trends, the improvement in utilization, but really just kind of a strong end market trend, whether it be in oncology, biosimilars, companion animals. So those are the sorts of things which will really continue to benefit us over the longer term, Ricky.

[Steven H. Collis, Chairman, President and Chief Executive Officer at Cencora]

Ricky, so biosimilars -- AmerisourceBergen is proud of the role that we've played in being a really early promotor of biosimilars for patient choice and affordability. It's a clear opportunity for us. Part B is the most impactful for us, especially in oncology with now 40% share for Avastin and Herceptin among other key products. What's interesting, of course, in oncology is the well-developed portfolio, services we have through our ION GPO and the strong access we have to community oncology practices and leaders. Also biosimilars, we pointed out, is a positive driver for our services businesses including Lash and Xcenda, where we focus on patient access, home economics and [hearing] solutions. Biosimilars are also becoming more positive in the health systems area. So I just noted and talked about the first interchangeable product. That isn't a Part B product. It's in an important therapeutic area, which is diabetes. And of course, interchangeability will be more important for us when there's more than one product, but it's a positive development. And we are impressed on, take note, of the FDA's flexibility and willingness to consider interchangeability. We think that it bodes well for the efficacy and the role that biosimilars will play in pharmaceuticals in the future. So again, that Part B biosimilars are our sweet spots. Thanks.

[Operator]

And the next question will be from Steven Valiquette with Barclays. Please go ahead.

[Steven James Valiquette, Analyst at Barclays Bank]

Great. So with the updated free cash flow guidance from $1.5 billion to $1.7 billion, do you have any color on how much of that is stemming from the Alliance Healthcare assets versus the core operations? I might have missed that. Also when thinking about the annual run rates, can you remind us of the approximate annualized operating cash flow contribution and also just any capex you expect tied to the just the acquired Alliance Healthcare assets on a go-forward basis once all the dust settles?

[James F. Cleary, Chief Financial Officer and Executive Vice President at Cencora]

Yes. So with regard to free cash flow, we are very pleased that we've raised guidance on so many fronts and one of them that's [coursed] on adjusted free cash flow, which is just a really important metric and value driver for us in the increase from $1.5 billion $1.7 billion. And we're seeing good performance at both AmerisourceBergen and Alliance, but most of that increase is due to AmerisourceBergen because if you look at Alliance during the four months, we have nice contribution of free cash flow but that's really largely offset by deal fees and expenses that to a large extent offset the Alliance free cash flow during the four months. And so most of that increase is attributable to AmerisourceBergen. And as we look at Alliance long term on the free cash flow front, the statement that we made at the closing of the deal is that we expect our combined free cash flow to be 1.25 times what it would have been stand-alone for AmerisourceBergen. And then on -- you talked about that capex and our capex guidance for the year remains at approximately $400 million.

[Steven James Valiquette, Analyst at Barclays Bank]

Thanks.

[Operator]

And the next question will be from Jailendra Singh with Credit Suisse. Please go ahead.

[Jailendra P. Singh, Analyst at Credit Suisse Group]

Congrats on a good quarter. Last quarter, you guys called out seeing up to 40% utilization for biosimilars on the oncology side. Curious how that trended in the current quarter and what some of your near- to medium-term expectations are for utilization trend.

[Steven H. Collis, Chairman, President and Chief Executive Officer at Cencora]

Yes. We expect that the trends will continue. I just answered to Ricky's question. We talked about that same 40% market share for two of the most prominent oncology products. And we believe that this will continue to be a positive trend. And the innovative products continue to play a role and through contracting. And that's where organizations like our ION GPO are very important. But no doubt that the trend for biosimilar adoption is intact and physicians are expecting biosimilars as a key patient opportunity and also financial opportunity to lower costs.

[Operator]

And the next question will be from Eric Percher with Nephron Research. Please go ahead.

[Eric R. Percher, Analyst at Nephron Research]

Appreciate the initial commentary on fiscal year '22 and the fiscal year '21 considerations. I'm curious, when you look at '21 and think about core growth and core growth as you come out of the pandemic and some of the puts and takes around generics and biosimilars, do you believe that core growth is actually higher as we look into '22 than it was pre-pandemic? And my follow-up there would be, when we look at the other business in MWI, certainly -- or World Courier certainly benefited during the pandemic, does -- is there a headwind going forward? Or does that begin to -- or does that sustain?

[James F. Cleary, Chief Financial Officer and Executive Vice President at Cencora]

Okay. Yes. So with regard to growth rates and with regard to fiscal year '22, Eric, we'll provide comprehensive guidance at the end of our fiscal year after we completed our year-end business planning process. And we won't be getting into that in any sort of detail today. I went through some puts and takes in my prepared remarks. I won't go through those again. I will just comment that we're seeing good strength and momentum across our businesses and really the special thing is just how broad based it is across our businesses, both in Pharmaceutical Distribution and in Other, being driven by the industry-leading customers, leadership in specialty, biosimilars, improvements we're seeing in utilization, and that will all inform the guidance that we put out at the end of our fiscal year. I'll talk a little bit about Other and then I'm sure Steve will want to get into more detail. In one of the businesses in Other is our MWI business. And I think some of the benefits that we've seen there during the pandemic of increased pet ownership. I mean, that's going to have legs and continue to enable growth in that business over the longer term. Steve?

[Steven H. Collis, Chairman, President and Chief Executive Officer at Cencora]

Yes. Yes, Eric, thanks for the question on World Courier. We cannot underscore enough what a fabulous job they're doing. The environment for them is really challenging. If you think about the global context that they operate in and all the different pandemic restrictions, and a lot of the business that they do there is based on international trade, which is not as easy to obtain as a [Indecipherable]. So we recently visited with the team and that there was -- we had a short visit to the U.K. when the restrictions were lifted. It was wonderful to not only meet the Alliance team but also to see our World Courier leadership team and really give them a pat on the back because they have done a fabulous job growing the business and meeting the needs of their global clients throughout this very difficult period, and, in many cases, shifting the business model to at-home. We've owned the business for 8, nine years now. And I have to tell you that this is a wonderful part of AB that keeps on growing and keeps on finding new ways to maximize their expertise in clinical trial logistics and help the global pharma partners meet their innovation needs. And the last thing I'll say is it's a wonderful opportunity to share knowledge between Alliance Healthcare and World Courier. So we're very positive on that business.

[Operator]

And the next question will be from Kevin Caliendo with UBS. Please go ahead.

[Kevin Caliendo, Analyst at UBS Investment Bank]

Sure. First, I was -- we've got a lot of questions about freight and shipping costs and those increasing. Wondering if you're seeing any impact from that in any way, shape or form or how that might impact guidance going forward. And just a sort of a follow-on to the biosimilar question. Are you seeing any change in the spreads or the profitability on biosimilars going forward? Are you expecting that to happen?

[Steven H. Collis, Chairman, President and Chief Executive Officer at Cencora]

I think I can take part of it. On the biosimilars part, honestly, we have -- we've said that somewhere between brand and generic pricing, and of course, every single product is different, depending on the number of competitors, the setting in which the product is administered. So it's a large category. It's becoming a larger and more interesting category for us. And Jim can give more comments about that. But as expected, we expect that the positive trends will continue, and this is becoming an important driver for patients and for physicians and for AmerisourceBergen.

[James F. Cleary, Chief Financial Officer and Executive Vice President at Cencora]

Yes, and you just asked about some of the input costs. And yes, there is some inflation in things like labor and transportation. And that's, I think, evident throughout the economy and something that all businesses are experiencing. And I mean we certainly see it. But I think it's really important to say that that's something that we've been experiencing this past quarter. And of course, this past quarter, we saw the 24% increase in operating income, 13% in Pharmaceutical Distribution. If we exclude Alliance commercialization in Animal Health, which is a labor-intensive group, the 21% increase in operating income and those sorts of input costs are all taken into account in our guidance increase that we did today.

[Operator]

And the next question is from George Hill with Deutsche Bank. Please go ahead.

[George Robert Hill, Analyst at Deutsche Bank Aktiengesellschaft]

Steve, I was just hoping that you could talk a little bit more about the opportunities you see in the manufacturer services business and kind of where you think about the white spaces there post the close of the Alliance acquisition?

[Steven H. Collis, Chairman, President and Chief Executive Officer at Cencora]

Thank you, George. We're tremendously excited because just meeting with the team after spending so much time, pre close and negotiations, when we get together, the intense discussions we have about opportunities and how do we take all the combinations of businesses that we have and really make one and one equal 3. I mean, that's old fashioned, but that's essentially what we're trying to do. And there's tremendous knowledge. If you look at our corporate team is focused in Weybridge in the U.K., and that is the headquarters. The U.K. is also the headquarters for World Courier. But if you look at how AmerisourceBergen is positioning ourselves with Alliance, we have a good mixture of developed European markets and higher-growth emerging markets. It's a very important priority for us to develop the services and innovative lines in those markets. Our World Courier has a small expertise and a small presence in almost all the markets that Alliance is already in. But we set up a lot of our commercialization businesses to help smaller companies launch products globally. And I sincerely feel that this acquisition is going to give us opportunity to really have the presence, have the boots on the ground, the local market knowledge to look at both the innovative side, the distribution side and the commercialization side to benefit the patients we serve and the manufacturers that want global partners with the expertise of AmerisourceBergen.

[Operator]

Thank you. Ladies and gentlemen, this concludes our question-and-answer session. I would like to conference back over to Steve Collis for any closing remarks.

[Steven H. Collis, Chairman, President and Chief Executive Officer at Cencora]

So thank you for your time today. AmerisourceBergen is a purpose-driven leading global healthcare company with a foundation in distribution, and we continue to advance our role as a key pillar of pharmaceutical innovation and access. Our expanded reach and solutions in Pharmaceutical Distribution and added breadth and depth in manufacturer services further strengthens our ability to provide innovative and global healthcare solutions for our partners. Our results and guidance clearly exemplify our performance, the execution and how we continue to benefit from leading with market leaders. Our company is well positioned for long-term growth. Thanks, again, for your time today, and great job to our worldwide associates.

[Operator]

[Operator Closing Remarks]