Cardinal Health Q2 2022 Earnings Report

Cardinal Health EPS Results

• Actual EPS: $1.27
• Consensus EPS: $1.23
• Beat/Miss: Beat by +$0.04
• One Year Ago EPS: $1.74

Cardinal Health Revenue Results

• Actual Revenue: $45.46 billion
• Expected Revenue: $45.32 billion
• Beat/Miss: Beat by +$138.54 million
• YoY Revenue Growth: +9.40%

Cardinal Health Announcement Details

• Quarter: Q2 2022
• Date: 2/3/2022
• Time: Before Market Opens
• Conference Call Date: Wednesday, February 2, 2022
• Conference Call Time: 9:40PM ET

Cardinal Health (NYSE:CAH) is a multinational healthcare services and products company headquartered in Dublin, Ohio. Tracing its roots to the early 1970s, the company has grown into a major provider of supply chain and distribution services for the healthcare sector. Cardinal Health operates across a range of service lines that support hospitals, health systems, pharmacies, physician offices and clinical laboratories.

The company's core activities include the wholesale distribution of branded and generic pharmaceuticals, the supply and distribution of medical-surgical products, and the provision of logistics and inventory management solutions. Cardinal Health also offers specialty services for pharmacies and health systems, including medication management, nuclear pharmacy services, clinical product offerings and solutions designed to improve operational efficiency. Its product portfolio spans consumables such as gloves and surgical supplies to capital equipment, diagnostic and laboratory products, and software-enabled supply chain services.

Cardinal Health serves customers across the United States and in international markets, delivering products and services through an extensive distribution network and logistics infrastructure. The company supports a broad set of healthcare stakeholders — from independent and chain pharmacies to large health systems and manufacturers — and emphasizes integrated supply chain solutions, regulatory compliance and operational support. Cardinal Health is managed by an executive leadership team and governed by a board of directors focused on delivering healthcare supply chain services and innovation for its clients.

Cardinal Health Q2 2022 Earnings Call Transcript

Key Takeaways

• Cost savings & pharma growth: Remains on track to achieve $750 million in enterprise cost savings by FY 23 and expects mid-single digit growth in its Pharma segment for FY 22.
• Medical segment headwinds: Facing $250 million–$300 million of incremental profit pressure in FY 22 due to unprecedented inflationary costs and global supply chain constraints, driving segment profit down 30 %–45 %.
• Strong second-quarter performance with 9 % revenue growth to $45 billion, EPS of $1.27, $1.2 billion in operating cash flow, and $800 million of share repurchases completed year-to-date; FY 22 EPS guidance set at $5.15–$5.25.
• Invests in growth and resilience: Expanding At Home Solutions (Medically Home), scaling OptiFreight and WaveMark digital platforms, and boosting North American manufacturing capacity for key medical products.
• Opioid settlement progress: 46 of 49 states intend to join a global agreement that would resolve the majority of governmental opioid claims and provide balance-sheet certainty.

Presentation

[Operator]

Good day, and welcome to the Cardinal Health, Inc. Q2 fiscal year 2022 earnings conference call. Today's conference is being recorded. At this time, I'd like to turn the conference over to Kevin Moran, Vice President of Investor Relations. Please go ahead.

[Kevin Moran, VP of Investor Relations at Cardinal Health]

Good morning and welcome. Today we will discuss Cardinal Health Q2 fiscal 2022 results, along with an update to our FY 2022 outlook. You can find today's press release and presentation on the IR section of our website at ir.cardinalhealth.com. Joining me today are Mike Kaufmann, Chief Executive Officer, and Jason Hollar, Chief Financial Officer. During the call, we will be making forward-looking statements. The matters addressed in the statement are subject to the risks and uncertainties that could cause actual results to differ materially from those projected or implied. Please refer to our SEC filings and the forward-looking statement slide at the beginning of our presentation for a description of these risks and uncertainties. Please note that during the discussion today, our comments will be on a non-GAAP basis unless they are specifically called out as GAAP.

[Kevin Moran, VP of Investor Relations at Cardinal Health]

GAAP to non-GAAP reconciliations for all relevant periods can be found in the schedules attached to our press release. During the Q&A portion of today's call, we please ask that you try and limit yourself to one question so that we can try and give everyone an opportunity. With that, I will now turn the call over to Mike.

[Mike Kaufmann, CEO at Cardinal Health]

Thanks, Kevin, and good morning, everyone. Today, Jason and my comments will be consistent with the update we provided a few weeks ago. Let me start with a few high-level thoughts. At an enterprise level, we continue to focus our efforts on three strategic priorities, optimizing our core businesses, investing for growth and innovation, and deploying capital efficiently. We continue to believe the long-term targets we announced in November are appropriate, and we remain on track to meet our $750 million enterprise cost savings target by FY 2023. Our pharma business is performing as planned. We've seen volumes continue to improve sequentially, and we are encouraged by the growth we saw again in Q2. Looking ahead, we continue to expect pharma to realize mid-single-digit growth in FY 2022.

[Mike Kaufmann, CEO at Cardinal Health]

In our Medical segment, we continue to experience unprecedented inflationary impacts and global supply chain constraints in our core U.S. medical and products distribution business. These impacts, combined with lower than expected offsets from pricing actions, will significantly impact Medical segment profit consistent with our update a few weeks ago. While we believe these impacts are temporary, the timing of when they will be remains difficult to predict. Consequently, we are urgently working to mitigate the effect of these external macroeconomic challenges on our business. We are seeing progress in other areas of the Medical segment, including our lab business and growth areas, and we recently extended several key acute care distribution customers. Looking ahead, I'll elaborate on the actions we are taking to drive performance, particularly for medical, after Jason reviews our Q2 results and updated outlook.

[Jason Hollar, CFO at Cardinal Health]

Thanks, Mike, and good morning, everyone. Beginning with total company results, Q2 revenue increased 9% to $45 billion, driven by sales growth from existing pharma customers. Total gross margin was $1.6 billion, a decrease of 9%, primarily due to the Cordis divestiture and elevated supply chain costs in medical. Consolidated SG&A was flat to the prior year at $1.2 billion as the Cordis divestiture and benefits from cost savings initiatives offset IT investments and higher operations expenses. Q2 operating earnings were $467 million. Outside of the incremental inflationary impacts in medical, these results were generally in line with our expectations. Moving below line, interest and other decreased by 30% to $24 million, driven primarily by lower interest expense from debt reduction actions.

[Jason Hollar, CFO at Cardinal Health]

Our Q2 effective tax rate finished at 19.4%, 6 percentage points higher than the prior year due to certain discrete items which primarily benefited the prior year period. Additionally, our Q2 rate this year included some timing favorability. Average diluted shares outstanding were 281 million, 5% lower than the prior year due to share repurchases. Of note, we initiated a $300 million share repurchase program in the quarter, which was recently completed and brings our total year-to-date repurchases to $800 million. The net result for the quarter was EPS of $1.27. Q2 operating cash flow was strong at $1.2 billion. As a reminder, the day of the week in which the quarter ends affects point-in-time cash flows.

[Jason Hollar, CFO at Cardinal Health]

We ended the quarter with a cash balance of $3.2 billion and no outstanding borrowings under our credit facilities. In the quarter, we also recorded a $1.3 billion non-cash pre-tax goodwill impairment charge related to the medical segment, which is excluded from our non-GAAP results. This accounting charge primarily resulted from additional inflationary impacts and global supply chain constraints I will discuss shortly. Now turning to segments, beginning with pharma on slide 5. Revenue increased 11% to $41 billion, driven primarily by branded pharmaceutical sales growth from large pharmaceutical distribution and specialty customers. Segment profit increased 3% to $426 million, driven by generics program performance. This was partially offset by our previously discussed investments in technology enhancements and higher operations expenses, including costs supporting sales growth such as transportation and labor.

[Jason Hollar, CFO at Cardinal Health]

During the quarter, we were encouraged to see continued broad-based improvements in pharmaceutical demand consistent with our expectations, including a return of generics volumes to approximately pre-pandemic levels. Our generics program continued to experience generally consistent market dynamics, including continued strong performance from Red Oak. Outside of generics, we've seen brand inflation trending in line with our expectations. Turning to Medical on slide 6. Q2 revenue decreased 5% to $4.1 billion, primarily due to the divestiture of the Cordis business. Segment profit decreased 79% to $50 million, primarily due to inflationary impacts and global supply chain constraints in products and distribution. This also reflects the timing of selling higher cost PPE, including the net positive impact from this dynamic in the prior year, and to a lesser extent, the divestiture of the Cordis business.

[Jason Hollar, CFO at Cardinal Health]

During the quarter, our products and distribution business continued to be impacted by significant inflationary pressures in the global supply chain, primarily in the areas of polypropylene and international freight. Additionally, in the quarter, we saw broader inflationary impacts across the business, such as domestic freight and other commodities, as well as global supply chain constraints affecting the volume of some of our higher margin Cardinal Health brand products. I'll discuss these impacts with respect to our full-year medical outlook momentarily, and Mike will elaborate on the actions we are taking to address these macro challenges and drive performance in our core medical business. With respect to COVID-19 and the Omicron variant, we continue to see strong performance from our lab business, including significant testing demand generally consistent with levels seen a year ago.

[Jason Hollar, CFO at Cardinal Health]

Despite some impacts from Omicron in various geographies, demand for surgical products related to elective procedures was comparable to both the Q1 and prior year. Now, transitioning to our updated fiscal 2022 outlook on slide 8, we now expect EPS in the range of $5.15-$5.50 per share, primarily reflecting our updated expectations for Medical. We also now expect an annual effective tax rate in the range of 23%-24.5%, and interest and other in the range of $140 million-$160 million, with the improvement in I&O including deferred compensation favorability, which, as a reminder, is fully offset above the line in corporate SG&A. As for the segments on slide 9, for Pharma, no changes to our outlook.

[Jason Hollar, CFO at Cardinal Health]

We continue to expect low double-digit revenue growth and mid-single digit segment profit growth. For medical, we now expect revenue to be down low single- to mid-single digits and segment profit to be down 30%-45%. Consistent with the financial update provided a few weeks ago, we expect increased inflationary impacts and global supply chain constraints, as well as lower than expected pricing offsets, to result in an estimated incremental $150 million-$175 million headwind to medical segment profit for the full year. This, in addition to our November ninth update regarding the pressures in international freight and polypropylene, now reflects a total net incremental headwind of approximately $250 million-$300 million to medical in fiscal 2022.

[Jason Hollar, CFO at Cardinal Health]

While these impacts have persisted for longer than previously anticipated, we continue to believe the majority will be temporary as global supply chain pressures eventually abate. While it will take time, we are committed to mitigating the impacts of inflationary pressures and will continue to work through these dynamics with our customers.

[Jason Hollar, CFO at Cardinal Health]

Now, a few other things to keep in mind in terms of the fiscal 2022 cadence. For pharma, we expect the year-over-year growth in the back half to be heavily weighted to the Q4 due to the lapping of some prior year items, including higher costs for the deployment of IT investments and the general sequencing of our growth initiatives. In medical, we continue to expect an unfavorable year-over-year impact due to timing of selling higher cost PPE in the H2 of fiscal 2022, though not to the same magnitude as in the Q2.

[Jason Hollar, CFO at Cardinal Health]

We also will be lapping the large prior year PPE inventory reserve in the Q4. Finally, to close, a few reminders on capital deployment. We continue to expect to pay down the approximate $280 million of remaining June 2022 notes at maturity and continue to expect approximately $1 billion in total share repurchases in fiscal 2022. As we've said, we see our increasing balance sheet flexibility supporting more opportunistic return of capital to shareholders as our debt pay down begins to moderate, enabled by our recent $3 billion share repurchase authorization. We continue to believe that capital deployment, along with the future growth that we expect in both our segments, will drive the long-term double-digit combined EPS growth and dividend yield that we are targeting. With that, I'll turn it back over to Mike.

[Mike Kaufmann, CEO at Cardinal Health]

Thanks, Jason. In medical, we're continuing to take action to drive performance and maximize the differentiated strengths we have in this business. We are vertically integrated with distribution through our comprehensive medical products portfolio, which is generally oriented around the operating room and the intensive care unit. We also have an advantaged lab products portfolio and higher margin growth businesses. With our diverse customer base, we cross-sell products and services spanning our portfolio. To address the challenges in our medical business, we're focused on three things. First, evolving our commercial contracting strategies and driving mix. Historically, costs have been relatively stable and industry participants have committed to longer-term multi-year contracts. However, the rapid escalation of today's inflationary pressures demonstrate that our contracting strategy needs to change.

[Mike Kaufmann, CEO at Cardinal Health]

We are in the process of working with our customers to adjust certain contracts to ensure we have more pricing flexibility for factors beyond our control. With regards to mix, as I noted in the prior quarter, we have made important changes to align our commercial organization structure and incentives. We are under-penetrated in Cardinal Health brand mix relative to our potential, which remains a significant mid to long-term profit opportunity as we move past the pandemic and associated supply chain challenges. Within our medical products portfolio, we are actively improving our key category product offerings. For example, in our incontinence product line, we have launched a new Cardinal Health brand stretch free and a comprehensive breathable platform. These enhancements directly support and meet our customers' needs. Second, we are simplifying our operating model and optimizing our international footprint.

[Mike Kaufmann, CEO at Cardinal Health]

We remain on track regarding the timing of the previously announced exits in certain commercial markets with 35 of the 36 completed to date. We are also focused on the modernization of our distribution facilities, including breaking ground on a new distribution center in the Midwest with nearly triple the space of the existing facility, enabling future growth. We believe that a diverse global sourcing network is important to remain competitive on cost and are investing in additional self-manufacturing capabilities, including increases in annual production of safety needles and syringes, isolation gowns, and surgical and procedure masks in our own North American facilities. Specifically for surgical gowns, we have efforts underway that will double our North American finished goods production and enhance our supply chain resiliency.

[Mike Kaufmann, CEO at Cardinal Health]

Third, we continue to invest across the medical segment, including in our growth businesses, at-home solutions and medical services, which are aligned with industry trends and positioned to grow double digits in FY 2022 and beyond. In at-home solutions, we continue to see strong demand as care continues to shift into the home. We recently announced an additional strategic investment in Medically Home, a technology company that enables health systems and other partners like Cardinal Health to safely bring the hospital home where patients increasingly prefer to receive their care.

[Mike Kaufmann, CEO at Cardinal Health]

Not only does this hospital at-home model benefit patients, it also provides needed capacity for hospitals and delivers care in a lower cost setting. In our higher margin medical services businesses, OptiFreight Logistics and WaveMark, we continue to enable clinically integrated and digitally automated supply chains and are seeing growth driven by an expanded customer base and diversified solutions.

[Mike Kaufmann, CEO at Cardinal Health]

We've invested in additional technology capabilities to increase our offerings in both businesses. In OptiFreight, we've invested in additional technology capabilities focused on building automated technology-driven solutions that innovate the way healthcare supply chain leaders manage shipping spend and take control over their transportation logistics. These efforts are connecting suppliers and customers at over 22,000 shipping locations. In WaveMark, we've launched a cutting-edge supply automation solution for clinical labs, which automates previously manual inventory management tasks. This enables clinical lab staff to focus on patient care and better manage increased testing demand due to COVID-19. Our pharma business remains on track to deliver mid-single-digit growth in FY 2022. We continue to make progress on our two primary objectives. First, strengthening our core pharma distribution or PD business.

[Mike Kaufmann, CEO at Cardinal Health]

This quarter segment profit was driven by the performance in our scale and expertise of Red Oak Sourcing, a partnership we also recently extended through FY 2029, which positions us well to meet customers' needs. In addition, our multi-year technology investment to modernize our systems is on track. We plan to complete the rollout by the beginning of our Q4 and look to benefit from the conversion in FY 2023 and beyond. Second, we're fueling our growth businesses, Specialty, Nuclear, and Outcomes. In Specialty, we continue to experience momentum in our oncology physician office business, driven in part by Navista TS, our technology platform for value-based care. Just this week, we announced a partnership with Ember Technologies to offer the world's first self-refrigerated cloud-based shipping box for temperature-sensitive medicines.

[Mike Kaufmann, CEO at Cardinal Health]

As biopharma continues bringing cold chain biologic products to market, including cell and gene therapies, this partnership will help ensure product integrity throughout the supply chain. This is a differentiated offering and one that will reduce landfill waste by millions of pounds annually. With biosimilars, we are well-positioned to support the next phase of growth as Biosimilars expand into new therapeutic areas and sites of care. In nuclear, we expect continued double-digit profit growth, which would result in a doubling of our profits in this business by FY 2026. We continue to build out our multimillion-dollar center for Theranostics advancement in Indianapolis, where we partner with several pharma companies to develop and commercialize novel Theranostics, and we're investing in our pet capabilities to support robust pet diagnostics.

[Mike Kaufmann, CEO at Cardinal Health]

For example, with the FDA approval of Telix's radio pharmaceutical in Q2, we are positioned to drive nationwide accessibility and broad adoption of prostate-specific pet imaging for physicians and eligible patients across the United States. In Outcomes, we are adding new payers and PBMs and expanding clinical solutions for both independent pharmacies and retail chains. Outcomes recently activated its 20 millionth user on its digital patient engagement platform, which enables two-way communication between pharmacies and patients to increase medication adherence. With respect to the enterprise, we continue to aggressively review our cost structure as we work to streamline, simplify, and strengthen our operations and execute our digital transformation. We're pairing cost reduction efforts with balanced discipline and shareholder-friendly capital allocation with a focus on investing in the business, maintaining a strong balance sheet, and returning cash to shareholders.

[Mike Kaufmann, CEO at Cardinal Health]

Long term, we're targeting a double-digit combined EPS growth and dividend yield. These expectations are driven by our growth targets for our segments, our commitment to our dividend, and our $3 billion share repurchase authorization. Now let me provide an update on the proposed opioid settlement agreement and settlement process. As of today, 46 out of 49 states have indicated their intent to join the global settlement. The sign-on period for political subdivisions within participating states concluded on January 26th. Now, each of the participating states are in the process of determining whether there is sufficient subdivision participation to proceed.

[Mike Kaufmann, CEO at Cardinal Health]

After we receive notice from the states regarding their decision, each of the distributors will make final determinations by February 25th. If all conditions are satisfied, this agreement would result in the settlement of a substantial majority of opioid lawsuits filed by the state and local governmental entities.

[Mike Kaufmann, CEO at Cardinal Health]

This is an important step forward for our company. As we've consistently said, we remain committed to being part of the solution to the U.S. opioid epidemic and believe that settlement will provide relief for our communities and increase certainty for our shareholders. In closing, our aspiration has been and continues to be that we are healthcare's most trusted partner. We will do this by focusing on our customers' needs and delivering the products and solutions that advance healthcare and improve the lives of people every day. We bring life-changing healthcare innovation to market, harnessing the power of technology, data, and insights to optimize care delivery. We're investing in technology and analytics to drive future growth in evolving areas of healthcare and address healthcare's most complicated challenges.

[Mike Kaufmann, CEO at Cardinal Health]

What we do matters, and we're focusing our resources on building solutions to meet the needs of our customers and their patients now and in the future. Now Jason and I will take your questions.

[Operator]

Thank you. If you would like to ask a question, please signal by pressing star one on your telephone keypad. If you're using a speakerphone, please make sure mute function is turned off to allow your signal to reach our equipment. We'll go ahead and take our first question from Charles Rhyee with Cowen and Company. Please go ahead.

[Charles Rhyee, Managing Director and Health Care Technology Research Analyst at TD Cowen]

Yeah. Thanks, guys. Mike and jason I wanna talk about the issues with supply costs here. You know, we're obviously challenged at the moment, but can you talk a little bit more about as let's say, these pressures ease, let's say hopefully later this year or whenever. Can you talk about how those expenses that you are incurring today roll off? Do they kinda roll off fairly quickly or is it that these kind of knock-on effects of delays and everything, for all your supplies and equipment kinda drag even further beyond if we were to see reports that, hey the ports are working as normal?

[Charles Rhyee, Managing Director and Health Care Technology Research Analyst at TD Cowen]

How long is that kind of follow-on effects before everything really would return to normal? From a P&L perspective are these kind of expenses kind of overshadowing, let's say, sort of the underlying performance of the division? Or, a little more color on that would be helpful. Thank you.

[Mike Kaufmann, CEO at Cardinal Health]

Sure. I'll definitely start here with Jason and then I'm sure Mike will have some thoughts as well. Generally speaking, the vast majority of these costs that we've outlined are product-related costs or costs to get the products shipped to the United States where our customers typically are. As such, most of those costs are included in inventory and then expensed as they're sold.

[Jason Hollar, CFO at Cardinal Health]

That means that there would be a 1-2 quarter delay in terms of when those costs begin to come down and when you would start to see that offset then in the PNL. I think that's fairly typical for what we saw with PPE as well last year in terms of that type of cadence. Now there's some of this, a smaller portion is related to the volume impacts of the supply chain constraints, so that's obviously going to be at the time that volume frees up. There's a small part that's a period cost, but it's much less significant. Again, the biggest buckets when you step back and think about the $250 million-$300 million, that's an aggregate that we're talking about.

[Jason Hollar, CFO at Cardinal Health]

It's that international freight is the biggest piece and is very much inventoried, as I just described. The second largest would be the general commodities we've talked about, commodities like oil-based commodities like polypropylene. That is a big driver that again, those would all be inventoried costs and then flowing through. As it relates to the overall impact to the business, just using Q2 as the example, from a year-over-year perspective, this overall aggregate impact of the inflation and net of pricing is the greatest driver of that year-over-year reduction. We did as a reminder, have favorability last Q2 as it relates to the timing of PPE pricing cost.

[Jason Hollar, CFO at Cardinal Health]

There's a little bit of a headwind on an absolute basis this quarter, but it's more significant, the comparison to the favorability of last year, and that's about $60 million in this quarter. That's a relevant piece to the year-over-year impact. Then the final piece, as you know, Cordis is running at roughly last year was roughly $20 million a quarter. The absence of that business as was divested is that last piece. I think that gives you most of the key pieces.

[Mike Kaufmann, CEO at Cardinal Health]

Yeah. The only thing I would add, Charles, is that while everything Jason said is true, the 1-2 quarters and all that, one thing I wanna make sure people understand is we're actively getting after this now, so we're not gonna have a strategy of just waiting for these to come down. We are evolving our commercial and contracting strategies. That is something we're actively doing, working with customers to be able to either pass on some of these prices, change our contracting, driving our mix as we talked about, and continuing to aggressively get after our cost and invest in our growth businesses. While we will hopefully see these come down 'cause we do believe these are temporary, we're also at the same time getting after things that we need to do to manage and operate the business aggressively.

[Mike Kaufmann, CEO at Cardinal Health]

Next question.

[Operator]

We'll go ahead and move on to our next question now from Lisa Gill with J.P. Morgan. Please go ahead.

[Lisa Gill, Managing Director and Senior Equity Research Analyst at J.P. Morgan]

Thanks very much. Mike, can I just first start with just a follow-up to what you just talked about. When we think about your medical business longer term, I know you previously had a goal of north of 5% operating margin for Med-Surg. I know that part of that was the higher margin of Cordis. When we get back to a more normalized basis, how do we think about what the margin should look like in that business?

[Mike Kaufmann, CEO at Cardinal Health]

Yeah. You know, it's a great question. We've not put that out there. I will give you a couple things. Obviously, as the inflation goes away, and as we said, we believe this 250-300, the vast majority of that is temporary, so you can add that back to our margin rates as the biggest driver. Second of all, the second thing I would add is we said we wanna drive mix, and what we mean by that is selling more of Cardinal Health branded products versus national brand. That's going to also drive our mix a positive way. We're getting after expenses. That's gonna, I'm sorry, that's gonna drive our margins too for the segment. You know, and we're growing our growth business, which do have higher margins.

[Mike Kaufmann, CEO at Cardinal Health]

All of our key initiatives not only will drive bottom line, but they all should drive margin rates up significantly. At this point in time, we've not put a target margin rate out there that we're going after.

[Operator]

We'll go ahead and move on to our next question from Eric Percher with Nephron Research. Please go ahead.

[Eric Percher, Senior Equity Research Analyst at Nephron Research]

Thank you. I wanna stay on this topic, and my question is, can we talk a little bit about your expectations for some of these specific items, maybe built into the year or your view on duration? I'd separate kind of freight, commodity, and then the sales volume and duration on how long you pass this on given the new contracting methodology. Can you just give us your take on either expectations today or based on prior experience and what you know today, the duration of those pressures? Yeah. Again, this is Jason. I'll start. So, to your point, it will potentially differ not only by type of cost, but also the magnitude of what we're talking about.

[Jason Hollar, CFO at Cardinal Health]

As it relates to, first of all, just the international freight, one thing to highlight is that that particular area of cost has remained at very elevated levels. At this point, we're not seeing much of a change from where we have been. That's something that is a clear part of our pricing focus is to make sure we can get at least a good portion of that recovered. As it relates to some of the other commodities, they've been more volatile. We have seen some that have started to appear to come down that cost curve. It looks like they may have plateaued and started to reduce, others that have been choppier.

[Jason Hollar, CFO at Cardinal Health]

In that environment where the costs are moving around a lot, it provides more challenges as it relates to getting that pricing more established. I think the key is, as you think about the cadence of what this impact is on a net basis.

[Jason Hollar, CFO at Cardinal Health]

That $250 million-$300 million, we have already incurred about $100 million of that year to date. That $150 million-$200 million that's remaining within our guidance, we see that peaking in the Q3, and that's a combination of not only the costs we expect to be at its highest, and then as they start to come down and it takes that delay to get it actually flowing through our inventory to our P&L, that then will start to benefit us later in the year. But also, that's also the timing of when we would start to see some of the pricing actions that we have already begun to start to come through. It is just the beginning.

[Jason Hollar, CFO at Cardinal Health]

It's not offsetting enough of that, and there's more activity that will need to still occur, but it all depends on exactly what that cadence is of cost, and the key is that we remain very close to both the GPOs as well as our customers to manage through that on a item by item customer basis to get to an answer then that will give us the right cadence exiting the year. With all that said, given the 1-2 quarter lag, even if costs do come down and even if we have more success with the pricing, we would expect there to be a carryover into fiscal 2023.

[Jason Hollar, CFO at Cardinal Health]

There will be some impact that carries over into that year, but we need to see the cadence of both the cost and the pricing before we can establish that more clearly.

[Operator]

We'll go ahead and move on to our next question from Ricky Goldwasser with Morgan Stanley. Please go ahead.

[Analyst at Morgan Stanley]

Hi, good morning. This is Dan on for Ricky. Two questions from us. One, as we think about your move to more finished goods production back to North America, how should we think about that in terms of margin, both sort of in a pre-COVID environment and then the impact to margin as we think about your margins in recent quarters? Then as a follow-up, just wanted to confirm, was the updated tax rate interest expense guidance that came out today included in the early January update, or is that incremental? Thank you.

[Mike Kaufmann, CEO at Cardinal Health]

I'll have Jason talk about the tax rate, and then I can talk about the margin.

[Jason Hollar, CFO at Cardinal Health]

Yeah. There were some small differences in this latest update. The tax rate was just bringing down the top end a little bit. The low end was the same. It's not much of a difference there. The interest and other change I highlighted was in part related to deferred comp. As a reminder, that's just geography between interest and other as well as corporate SG&A. Yes, it was largely considered in our prior assumptions, but as a lot of it is just geography anyway, there's no material difference in those other updates.

[Mike Kaufmann, CEO at Cardinal Health]

As far as moving capacity to, north of to our North American operations, I would say a couple things. Generally, I wouldn't say that we would expect much of a margin difference if it was manufactured outside of North America versus, manufactured here. That is not something I would say would be a margin driver. It's more about supply chain integrity, which is why we've moved them there. if there are disruptions in the future, we obviously then have certain key items closer here. We've chosen as items that can be highly automated, make a lot of sense, and freight is a big piece of it so that we can still stay cost competitive. Again, wouldn't say it's margin generating in and of itself.

[Mike Kaufmann, CEO at Cardinal Health]

However, by increasing the capacity on some of these items, like we've mentioned doubling our ability to manufacture our own gowns, that does give us more ability to sell our own product, which as we drive mix, that would increase our overall margin rate.

[Operator]

We'll move on to our next question from Jailendra Singh with Credit Suisse. Please go ahead.

[Jailendra Singh, MD at Credit Suisse]

Thank you, and good morning, everyone. With respect to this $250 million-$300 million impact in Medical segment, can you be a little bit more specific on how much impact did you see in fiscal H1 and how much is expected in H2? A follow-up to an earlier question, how should we model the split between Q3 and Q4 on the remaining impact? Trying to better understand if all these initiatives you're putting in place are more focused on positioning the company better next time you see these kind of pressure, or do you think there's a possibility these initiatives result in some near-term offsets, and are you capturing those in your outlook?

[Jason Hollar, CFO at Cardinal Health]

Yeah. If I understood the question right, Jailendra, I think I'd answered it before, but I'll go and repeat that. The $250-$300 million, $100 million has already been incurred in the H1. Think about it as kind of a sequential step up. Q2 was higher than Q1, and Q3 is expected to be higher than Q2. That's the period it peaks before it starts to come back down. There's you know, it depends on if we're talking sequential or year-over-year. From a sequential perspective Q2 to Q3, within the Medical business, there's just the ongoing cost reductions that we would expect to be always in place that continue.

[Jason Hollar, CFO at Cardinal Health]

Those initiatives we've talked fairly consistently about are there. You know, within the other type of PPE impacts, like I said, from a year-over-year perspective in the Q2, it was $60 million headwind. There was a small headwind in an absolute basis in the Q2 that we think will be less in the Q3. That's a bit of an offset, not significant. Generally speaking, it's the inflationary impact. The most pronounced from a year-over-year as well as expected to be a little bit greater than in the Q3.

[Mike Kaufmann, CEO at Cardinal Health]

The things I would add to be helpful here is, as Jason mentioned, as we expect some of the inflation impacts to start to hopefully come down some, and that'll give us a little bit of benefit in Q4. We also see our pricing actions

[Mike Kaufmann, CEO at Cardinal Health]

Ramping up some in Q4 too, because we are continuing to implement additional pricing actions. We have some going into effect here very soon that have been agreed to. We're working through those. I would say that what that would be a positive item going forward for us. Also, as we mentioned, we are working on our commercial contracting strategies.

[Mike Kaufmann, CEO at Cardinal Health]

As we work through those contracts, our goal is to give us more flexibility so that in the future, if there is another instance like this, we are able to react quicker and address our pricing and work with our partners in a very transparent and productive way because our customers are obviously something that we have to always have in the front of our mind, but we do need some more flexibility in the business, and we are working aggressively to work with the GPOs and our customers to do that.

[Jason Hollar, CFO at Cardinal Health]

Jailendra, as you do your modeling for the balance year, just remember in the prior year, we had the significant inventory charge in Q4 that would, of course, not be expected to replicate here this year.

[Operator]

We'll go ahead and move on to our next question from Michael Cherny with Bank of America. Please go ahead.

[Michael Cherny, Senior Managing Director and Senior Equity Research Analyst at Bank of America]

Good morning. Thanks for the details. Mike, you mentioned in your remarks how you had a few customer extensions with some of your key customers on the medical side, especially against this backdrop of your focus on recontracting. Would love to know a little more detail about how qualitatively those discussions went and in terms of your thought process about recontracting, were you able to test out what you were able to get through and not get through and what customers were willing to accept relative to that changed contracting dynamic, especially given that these are obviously extensions on customers that have worked with you, I assume, for at least a long time?

[Mike Kaufmann, CEO at Cardinal Health]

That's a great question. Yeah, we are working aggressively on that. It's not just the individual customers. In fact, it's just as important to be able to work with our GPO partners to allow us, because you really have to coordinate between all three of them. There's still absolutely work to do, but we're seeing some positive signs from both the GPOs and the customers that understand the importance of having a strong supply chain and strong supply chain partners in medical distribution, that these are things that we're gonna have to work together.

[Mike Kaufmann, CEO at Cardinal Health]

Key things that we've learned through those discussions that will be helpful is, one a willingness to be transparent with them so that they understand as costs come up, why are they going up, but also when costs come down so that they know that you're not continuing to charge a high price when things have got better. We're very willing to work with them on this transparency piece, which I think will help both parties understand the importance of what we need to do here from a pricing standpoint. I would say early indications have been positive, but still a lot of work to do as we work on changing our commercial strategies.

[Operator]

Our last question comes from Elizabeth Anderson with Evercore. Please go ahead.

[Elizabeth Anderson, Senior Managing Director and Senior Equity Research Analyst at Evercore]

Hi, guys. Thanks so much for the question. I was wondering if you could comment on, as we sort of have gone through a month of the new quarter, just how you're seeing sort of volumes come back, particularly on the surgical side and also on sort of home care, just as sort of we think about the cadence for that, going through the back half of the year.

[Jason Hollar, CFO at Cardinal Health]

Yeah. Maybe I'll just take the opportunity to talk about volumes in general because I think whether it's pharma or medical, the general response is about the same. Within medical, while there's been certain level of choppiness over the last 3, 6 months largely it's been very consistent with our expectations. We indicated before we are back to near pre-COVID levels, and this quarter was pretty consistent with our expectations. Sequentially from the Q1 as well as year-over-year, there were not many differences. So there's noise, but the key is that state by state, geography by geography, different regions are impacted at different times to different extents, but we're just not seeing big impacts.

[Jason Hollar, CFO at Cardinal Health]

That's because our customers continue to do a wonderful job of providing great service to their patients, and that's providing you know a better balance underneath the volume than what we saw earlier on in the pandemic. On the pharma side we continued to talk in today's prepared remarks as well as a couple of weeks ago, just that we continue to see that widespread improvement back to pre-COVID levels. We have largely gotten back to that point at the end of the Q2. We're just not seeing a lot of variability there as well.

[Operator]

With that does conclude our question and answer session for today. I would now like to turn the call back over to Mike Kaufmann for closing remarks.

[Mike Kaufmann, CEO at Cardinal Health]

Thanks, Allie. I want to thank everybody for taking the time to be on the call today and for all of your questions. I'd like to conclude by reiterating that we are taking action to mitigate these inflationary impacts and supply chain constraints, and we're laser focused on driving improved performance across all of our businesses. Please stay safe, and we'll speak with you again soon. Take care, everybody.

[Operator]

With that does conclude today's call. Thank you for your participation. You may now disconnect.

Participants

Executives

• Jason Hollar, CFO
• Kevin Moran, VP of Investor Relations
• Mike Kaufmann, CEO

Analysts

• Charles Rhyee, Managing Director and Health Care Technology Research Analyst at TD Cowen
• Elizabeth Anderson, Senior Managing Director and Senior Equity Research Analyst at Evercore
• Eric Percher, Senior Equity Research Analyst at Nephron Research
• Jailendra Singh, MD at Credit Suisse
• Lisa Gill, Managing Director and Senior Equity Research Analyst at J.P. Morgan
• Michael Cherny, Senior Managing Director and Senior Equity Research Analyst at Bank of America
• Analyst at Morgan Stanley