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Cencora, Inc.: Q4 FY2026 earnings call

What management said about Q4 FY2026, from the documents filed with the SEC on 4 November 2026: press release. Guidance figures: 14 new, 1 kept. The quarter’s numbers.

Key takeaways

  • Quarterly revenue rose 5.5 percent: Revenue was $88.4 billion, up 5.5 percent. U.S. Healthcare Solutions rose 5.4 percent and International Healthcare Solutions rose 5.1 percent. Full-year revenue was $337.4 billion, up 5.0 percent. Source
  • Adjusted quarterly EPS rose 21.4 percent: Adjusted diluted EPS was $4.66, up from $3.84 a year earlier. Adjusted operating income was $1.2 billion, up 22.1 percent. Source
  • Gross margin rose 55 basis points: Gross profit was $3.6 billion, up 21.9 percent. The gross margin was 4.08 percent, up 55 basis points, mainly from the OneOncology acquisition and partly offset by product mix. Source
  • OneOncology remeasurement gain recorded: A $1.1 billion remeasurement gain on the earlier OneOncology stake was recorded in fiscal 2026 and excluded from adjusted results. Source
  • Operating cash flow rose to $4.79 billion: Net cash from operating activities was $4.79 billion in fiscal 2026, up from $3.88 billion. Capital expenditures were $909.5 million. Source
  • Three new reporting segments from fiscal 2027: Beginning in the first quarter of fiscal 2027, reporting moves to Pharmaceutical Distribution and Services, Specialty Pharmaceutical and Provider Services, and Other. Source
  • American Oncology Network deal pending: The AON acquisition, announced October 21, 2026, is subject to customary closing conditions, regulatory clearances and AON stockholder approvals.

“Fiscal 2026 was a pivotal year for Cencora, as we expanded our MSO platform through the acquisition of OneOncology, sharpened the focus of our portfolio and delivered record results,”

Robert P. Mauch, President and Chief Executive Officer of Cencora

Guidance

AreaPeriodFigureAgainst last quarter
Consolidated revenue Sourcefiscal 20273% to 5% growthNew
Pharmaceutical Distribution and Services revenue Sourcefiscal 20274% to 6% growthNew
Specialty Pharmaceutical and Provider Services revenue Sourcefiscal 20279% to 14% growthNew
Other revenue Sourcefiscal 2027~$3.5BNew
Adjusted operating income Sourcefiscal 20274% to 6% growthNew
Pharmaceutical Distribution and Services operating income Sourcefiscal 20272% to 4% growthNew
Specialty Pharmaceutical and Provider Services operating income Sourcefiscal 202718% to 21% growthNew
Other operating income Sourcefiscal 2027~$200MNew
Adjusted diluted EPS Sourcefiscal 2027$19.40 to $19.75New
Net interest expense Sourcefiscal 2027$490M to $510MNew
Adjusted effective tax rate Sourcefiscal 2027~20%New
Diluted weighted average shares Sourcefiscal 2027~190MNew
Adjusted free cash flow Sourcefiscal 2027~$3.5BNew
Capital expenditures Sourcefiscal 2027~$1.0BNew
Long-term adjusted operating income and adjusted diluted EPS growth Sourcelong term7% to 10% operating income growth; 10% to 14% adjusted diluted EPS growthKept
Capital deployment Sourcelong term3% to 4%

What changed from last quarter

  • New guidance: Fiscal 2027 adjusted diluted EPS and segment-level expectations were given for the first time in this release. Source
  • New: Management announced a new organizational and financial reporting structure to strengthen execution and improve visibility. Source
  • New: A definitive agreement to sell the Profarma stake was signed, with closing expected in the first quarter of fiscal 2027. Source
  • New: Quarterly dividend increased 10 percent, from $0.60 to $0.66 per common share. Source

Fourth-quarter and full-year results

  • Quarterly revenue rose 5.5 percent: Revenue was $88.4 billion, up 5.5 percent. U.S. Healthcare Solutions rose 5.4 percent and International Healthcare Solutions rose 5.1 percent. Full-year revenue was $337.4 billion, up 5.0 percent. Source
  • Adjusted quarterly EPS rose 21.4 percent: Adjusted diluted EPS was $4.66, up from $3.84 a year earlier. Adjusted operating income was $1.2 billion, up 22.1 percent. Source
  • GAAP quarterly EPS turned positive: GAAP diluted EPS was $2.71, against a loss of $(1.75) a year earlier. The prior-year quarter included a $723.9 million PharmaLex goodwill impairment charge. Source
  • Full-year GAAP EPS rose 125.5 percent: Full-year GAAP diluted EPS was $17.95, and adjusted diluted EPS was $17.97, up 12.3 percent. Diluted shares fell 0.6 percent on share repurchases. Source

Segment revenue and operating income

  • U.S. segment operating income up 22.0 percent: U.S. Healthcare Solutions revenue was $78.3 billion, up 5.4 percent. Segment operating income was $997.6 million, up 22.0 percent, on higher gross profit partly offset by higher operating expenses. Source
  • International profit rose on Canada and logistics: International Healthcare Solutions revenue was $7.8 billion, up 5.1 percent. Operating income was $152.1 million, up 16.4 percent, mainly from Canadian and global specialty logistics. Constant-currency revenue rose 7.8 percent. Source
  • Other operating income up 35.8 percent: Other revenue was $2.3 billion, up 10.1 percent. Operating income was $101.1 million, up 35.8 percent, mainly from MWI Animal Health, which is held for sale and had lower depreciation. Source
  • Consulting sales fell after divestiture: Sales in consulting businesses declined, mainly because U.S. Consulting Services was divested in April 2026. Source

“As we enter fiscal 2027, our new operating model is designed to strengthen our execution and provide visibility to our progress,”

Robert P. Mauch, President and Chief Executive Officer of Cencora

Gross profit and margin

  • Gross margin rose 55 basis points: Gross profit was $3.6 billion, up 21.9 percent. The gross margin was 4.08 percent, up 55 basis points, mainly from the OneOncology acquisition and partly offset by product mix. Source
  • Adjusted gross margin up 57 basis points: Adjusted gross profit margin was 4.04 percent in the quarter, up 57 basis points from the prior year quarter. Source
  • Adjusted operating margin reached 1.41 percent: Adjusted operating income was $1.2 billion, up 22.1 percent. Adjusted operating margin was 1.41 percent, up 19 basis points. Source

Operating expenses, interest and tax

  • Adjusted operating expenses rose 23.5 percent: Adjusted operating expenses were $2.3 billion, driven by the OneOncology acquisition. Source
  • GAAP expenses fell on prior impairment: GAAP operating expenses of $2.7 billion fell 8.2 percent, because last year’s quarter carried the PharmaLex goodwill impairment charge. Source
  • Interest expense rose on new borrowing: Net interest expense was $136.3 million, up $58.5 million, due to new senior notes and variable-rate term loans and lower interest income. Source
  • Adjusted tax rate slightly lower: The adjusted effective tax rate was 20.2 percent, against 20.6 percent a year earlier. Source
  • MWI divestiture tax benefit recorded: GAAP tax expense was $258.1 million and included discrete items, with a $87.1 million tax benefit tied to the pending MWI Animal Health divestiture. Source

“By uniting our specialty businesses and elevating the voices of our customers, we are better able to advance our purpose and deliver sustained value for our shareholders.”

Robert P. Mauch, President and Chief Executive Officer of Cencora

Products, customers and demand

  • Unit volume and specialty sales drove U.S. growth: U.S. revenue growth was primarily driven by unit volume growth, including sales of specialty products to health systems and physician practices. Source
  • GLP-1 class sales increased: Sales of products labeled for diabetes and/or weight loss in the GLP-1 class increased and contributed to U.S. revenue growth. Source
  • Brand prices and mail order offset growth: Revenue growth was partly offset by lower manufacturer prices on certain brand pharmaceutical products and lower sales to the large mail order customer. Source

Full-year items and deal adjustments

  • OneOncology remeasurement gain recorded: A $1.1 billion remeasurement gain on the earlier OneOncology stake was recorded in fiscal 2026 and excluded from adjusted results. Source
  • LIFO credit and antitrust gains in gross profit: Full-year gross profit included a $387.5 million LIFO credit, $72.5 million of antitrust settlement gains, and $53.9 million of Türkiye remeasurement expense. Source
  • Opioid and derivative credits booked: Litigation results included a $102.0 million reduction of opioid liability after the dismissal of opioid litigation, and an $86.8 million derivative lawsuit credit. Source
  • Equity unit adjustments for RCA and OneOncology: Adjustments to RCA and OneOncology equity units totaled $246.7 million in fiscal 2026, against $121.7 million in fiscal 2025. Source
  • Consulting impairment booked full-year: Full-year impairment of assets, including goodwill, was $249.5 million and related to the U.S. Consulting Services business. Source

Cash flow and borrowing

  • Operating cash flow rose to $4.79 billion: Net cash from operating activities was $4.79 billion in fiscal 2026, up from $3.88 billion. Capital expenditures were $909.5 million. Source
  • Adjusted free cash flow of $3.8 billion: Free cash flow was $3,881 million. Excluding a $73 million antitrust settlement gain, adjusted free cash flow was $3,808 million. Source
  • Debt rose to finance OneOncology: Long-term debt rose to $11.06 billion from $7.54 billion, reflecting senior notes and term loans issued for the OneOncology acquisition. Source
  • Cash balance increased year over year: Cash and cash equivalents were $4.88 billion at September 30, 2026, against $4.36 billion a year earlier. Source

Capital returns to shareholders

  • Share repurchases rose to $1.0 billion: Share repurchases were $1.0 billion in fiscal 2026, against $435.5 million a year earlier. Cash dividends paid were $476.8 million. Source
  • Diluted share count declined: Fiscal 2026 diluted weighted shares fell 0.6 percent, and fourth-quarter diluted shares fell 1.1 percent, both attributed to repurchases. Source
  • Dividend payment and record dates: The quarterly dividend is payable November 30, 2026, to holders of record at the close of business on November 13, 2026. Source

Strategy, portfolio and reporting

  • Three new reporting segments from fiscal 2027: Beginning in the first quarter of fiscal 2027, reporting moves to Pharmaceutical Distribution and Services, Specialty Pharmaceutical and Provider Services, and Other. Source
  • Pharmaceutical Distribution segment scope: The new distribution segment covers U.S. and international wholesale distribution and related services for health systems, retail pharmacies and alternate sites of care. Source
  • Specialty segment scope: The specialty segment covers distribution to physician practices and management services organizations, plus World Courier, 3PL services, Innomar and strategic PharmaLex components. Source
  • Other businesses under strategic review: Other is not a reportable segment and holds businesses exploring strategic alternatives, including MWI Animal Health and Profarma. Source
  • American Oncology Network deal pending: The AON acquisition, announced October 21, 2026, is subject to customary closing conditions, regulatory clearances and AON stockholder approvals.

Coming up, as management said on 4 November 2026

  • Profarma stake sale closing: The sale of the Profarma equity interest is expected to close in the first quarter of fiscal 2027. Source
  • MWI Animal Health merger with Covetrus: Fiscal 2027 expectations assume the MWI Animal Health merger with Covetrus closes on March 31, 2027. Source
  • AON acquisition expected accretion: Cencora expects the AON acquisition to be accretive to adjusted diluted EPS in the second year after closing.
  • Segment restatement filing: Revised fiscal 2026 reportable segment information is to be furnished in a Form 8-K on November 4, 2026. Source

Risks management discussed

  • Operational: Higher GLP-1 sales carry lower gross profit margins, which partly offset the gross margin gain from the acquisition. Source
  • Financial: An unfavorable valuation adjustment of $146.8 million on Swiss deferred tax assets was recorded in the quarter. Source
  • External: Antitrust settlement gains, LIFO and Türkiye items are excluded from adjusted results because management cannot control their amounts or timing. Source

Earlier plans management reported on

  • Not stated: The earlier release gave this floor for fiscal 2026 adjusted EPS; this release reports $17.97 for the year.
  • Not stated: The earlier release said fiscal 2027 expectations would be discussed on this call, and this release provides them.
  • Not stated: Management reaffirmed the long-term growth target for adjusted operating income and adjusted diluted EPS. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.