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McKesson Corp.: Q4 FY2026 earnings call

What management said about Q4 FY2026, from the documents filed with the SEC on 7 May 2026: press release. Guidance figures: 1 raised, 2 new, 4 kept. The quarter’s numbers.

Key takeaways

  • Fourth-quarter revenue rose 6%: Revenues were $96.3 billion, up 6%, led by oncology and multispecialty distribution, including acquisitions. Source
  • Quarterly adjusted EPS rose 16%: Adjusted EPS was $11.69, up 16%, on operational growth including oncology acquisitions, a lower share count and a lower tax rate. Source
  • Full-year adjusted EPS rose 18%: Full-year adjusted EPS was $39.11, up 18%, driven by operational growth across the business and a lower share count. Source
  • GAAP quarter included Norway gain: GAAP diluted EPS was $13.71 for the quarter and $38.38 for the year; the quarter included a $480 million pre-tax net gain on the Norway sale. Source
  • Oncology and multispecialty profit rose 53%: Quarterly adjusted segment profit was $385 million, up 53%. Full-year revenues were $48.4 billion, up 31%, and adjusted segment profit $1.4 billion, up 53%. Source
  • Pharmacy revenue rose 3% on volumes: Revenues were $79.1 billion, up 3%, on higher prescription transaction volumes, including specialty products, partly offset by lower branded pharmaceutical contributions. Source
  • Full-year free cash flow was $5.4 billion: Full-year cash from operations was $6.2 billion and capital expenditures were $745 million, compared with free cash flow of $5,226 million a year earlier. Source
  • Separation charges of $77 million: Fiscal 2026 pre-tax charges of $77 million relate to the planned separation of Medical-Surgical Solutions, recorded in that segment and Corporate expenses. Source

“McKesson's fourth quarter results reflect the strength of our diversified portfolio and disciplined execution against our strategic priorities.”

Brian Tyler, chief executive officer

Guidance

AreaPeriodFigureAgainst last quarter
Adjusted EPS guidance range SourceFiscal 2027$43.80 to $44.60New
Implied adjusted EPS growth SourceFiscal 202712% to 14%New
Long-term adjusted EPS growth target SourceLong-term13% to 16%Kept
North American Pharmaceutical adjusted segment profit growth target SourceLong-term5% to 8%Kept
Oncology & Multispecialty adjusted segment profit growth target SourceLong-term13% to 16%Kept
Prescription Technology Solutions adjusted segment profit growth target SourceLong-term10% to 13%Kept
Share repurchase authorization SourceAs of April 2026$7.7 billion total authorizationRaised

What changed from last quarter

  • New guidance: Fiscal 2027 adjusted EPS guidance range established. Source
  • Guidance kept: Long-term adjusted EPS growth target and segment profit growth targets reaffirmed. Source
  • New: Brian Tyler elected Board Chair and Dominic J. Caruso named Lead Independent Director, effective May 1, 2026. Source
  • New: Apollo Global agreed to acquire an approximately 13% minority interest in the Medical-Surgical Solutions segment, subject to approvals. Source
  • New: Initial financing for the Medical-Surgical separation completed in April 2026: a secured term loan and a revolving credit facility, each of $1.0 billion. Source

Results and growth drivers

  • Fourth-quarter revenue rose 6%: Revenues were $96.3 billion, up 6%, led by oncology and multispecialty distribution, including acquisitions. Source
  • Full-year revenue rose 12%: Full-year revenues were $403.4 billion, up 12% from $359.1 billion in the prior fiscal year. Source
  • Quarterly adjusted EPS rose 16%: Adjusted EPS was $11.69, up 16%, on operational growth including oncology acquisitions, a lower share count and a lower tax rate. Source
  • Full-year adjusted EPS rose 18%: Full-year adjusted EPS was $39.11, up 18%, driven by operational growth across the business and a lower share count. Source
  • GAAP quarter included Norway gain: GAAP diluted EPS was $13.71 for the quarter and $38.38 for the year; the quarter included a $480 million pre-tax net gain on the Norway sale. Source

Segments and regions

  • North American Pharmaceutical profit rose 11%: Fourth-quarter adjusted segment operating profit was $980 million, up 11%, from specialty distribution to health systems. Full-year adjusted profit was $3.5 billion, up 10%. Source
  • Oncology and multispecialty profit rose 53%: Quarterly adjusted segment profit was $385 million, up 53%. Full-year revenues were $48.4 billion, up 31%, and adjusted segment profit $1.4 billion, up 53%. Source
  • Prescription Technology profit rose 13%: Adjusted segment operating profit was $322 million, up 13%, on higher demand for access solutions. Full-year adjusted profit was $1.1 billion, up 17%. Source
  • Medical-Surgical profit fell 5%: Adjusted segment operating profit was $271 million, down 5%, on lower ambulatory care contributions. Full-year adjusted profit was $1.0 billion, up 1%, on cost optimization. Source

“Looking ahead to fiscal 2027, we are well-positioned to build upon this momentum,”

Brian Tyler, chief executive officer

Oncology networks and customers

  • Oncology network added Cancer Care Northwest: In April 2026 The US Oncology Network added Cancer Care Northwest, strengthening its position in community oncology practices. Source
  • Ophthalmology network added a practice group: PRISM Vision Group added the Retina Macula Institute in Southern California, further aligning with ophthalmology practices nationwide. Source
  • Specialty provider support expanded: Management cited expanded specialty provider support and faster patient access through scaled, integrated biopharma support services. Source

Demand and prescription volumes

  • Pharmacy revenue rose 3% on volumes: Revenues were $79.1 billion, up 3%, on higher prescription transaction volumes, including specialty products, partly offset by lower branded pharmaceutical contributions. Source
  • Full-year pharmacy volumes rose on national accounts: Full-year North American Pharmaceutical revenues were $336.7 billion, up 11%, driven by volumes from retail national account customers and specialty products. Source
  • Prescription Technology revenue rose 12%: Quarterly revenues were $1.5 billion, up 12%, on higher prescription volumes in third-party logistics and technology services. Source

“We remain committed to executing with discipline across the portfolio, investing in high-growth and high-margin areas in Oncology and Biopharma Services.”

Brian Tyler, chief executive officer

Costs and margins

  • Adjusted gross profit rose 14%: Adjusted gross profit was $3,862 million, up 14% from $3,388 million; full-year adjusted gross profit was $14,322 million, up 10%. Source
  • Adjusted operating expenses rose 14%: Quarterly adjusted operating expenses were $2,141 million, up 14%; full-year adjusted operating expenses were $8,093 million, up 4%. Source
  • Selling and administrative expenses fell: GAAP selling, distribution, general and administrative expenses were $1,796 million in the quarter, down 9%, and $8,096 million for the year, down 5%. Source
  • Restructuring charges recorded across segments: Pre-tax restructuring, impairment and related charges were $99 million in the quarter and $245 million for the year, mainly in Medical-Surgical, North American Pharmaceutical, Prescription Technology and Corporate. Source

Cash flow and shareholder returns

  • Full-year free cash flow was $5.4 billion: Full-year cash from operations was $6.2 billion and capital expenditures were $745 million, compared with free cash flow of $5,226 million a year earlier. Source
  • Quarterly free cash flow was $3.2 billion: Quarterly cash from operations was $3.4 billion and capital expenditures were $185 million, leaving free cash flow of $3.2 billion. Source
  • Full-year cash returns of $5.1 billion: Full-year returns to shareholders were $5.1 billion, including $4.8 billion of common stock repurchases and $381 million of dividend payments. Source
  • Accelerated repurchase within quarter's buybacks: A $2.25 billion accelerated share repurchase, entered in the quarter, was part of $2.7 billion of repurchases completed in the quarter. Source
  • Diluted share count fell 3%: Diluted weighted-average shares were 122.7 million in the quarter, down 3%, and 124.1 million for the year, also down 3%. Source

Portfolio, separation and acquisitions

  • Separation charges of $77 million: Fiscal 2026 pre-tax charges of $77 million relate to the planned separation of Medical-Surgical Solutions, recorded in that segment and Corporate expenses. Source
  • Oncology acquisitions carried integration charges: Fiscal 2026 acquisitions of controlling interests in PRISM Vision and Core Ventures carried $96 million of transaction and integration charges in Oncology & Multispecialty. Source
  • Acquisition cash spending rose sharply: Acquisitions used $3,416 million of cash in fiscal 2026, against $24 million a year earlier. Source

Coming up, as management said on 7 May 2026

  • Medical-Surgical separation continues: Management described the planned separation of its Medical-Surgical business as a continuing step in portfolio optimization. Source
  • BofA healthcare conference on May 12: Management will take part in the BofA Securities 2026 Healthcare Conference on May 12, 2026. Source
  • Board transition at annual meeting: Donald R. Knauss completes his board service at the 2026 Annual Stockholders meeting, under the company's governance policy. Source

Risks management discussed

  • Financial: Certain fiscal 2027 items, including LIFO adjustments and litigation contingencies, are hard to estimate and could vary materially. Source
  • Demand: Lower contributions from the ambulatory care channel offset specialty pharmaceutical volume growth in Medical-Surgical Solutions. Source

Earlier plans management reported on

  • Met: Management said the Norway divestiture fulfills its commitment to exit Europe.
  • Ahead: Management said fiscal 2026 performance exceeded its long-range growth targets. Source
  • Not stated: Management said it remains committed to its disciplined capital allocation framework. 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.