Cencora, Inc. (COR) Earnings Call Transcript & Summary

All right. Great. Thanks. Good afternoon, everyone. My name is Eric Coldwell. I cover the pharma services and related outsourcing logistics distribution type names with Baird, and have been a long-time analyst and long-time fan of Cencora. I think it took a few years, but I get your name right, most of the time these days. It's a great pleasure to have James Cleary here with us, of course, EVP and CFO; and also Bennett Murphy, and Bennett, I'll screw up your title because it keeps changing. But EVP of Enterprise productivity.

Yes. Only S. Don't give me [indiscernible].

SVP. Only S. We need to have a conversation. It's pretty good. Obviously, covering IR and Treasury as well. And kind of a man about town, knows a lot about the company. So Jim, watch out, he's going to be gaming for your job one day. This has been -- I've said this -- I said this every year, except I add a number. This will be, what, 4 out of the last 5 years. You've been one of my best ideas, if not the best idea. And I told Jim earlier, I should have made it that way all 5 years. So my bad on that 1 year, we screwed up. I love the story came into this year, a big fan of distributors and labs were the other subsector and the distributors have been -- they've both been great. The distributors have been particularly great, and you've been among the greatest of the greats. So thank you for keeping up the awesome performance.

We're going to jump straight in. I have a bit of a zinger to throw at Jim to start us off. So we'll see how he responds, and we may need to call a paramedic. So I remember last year, vividly sitting here, you went to a conference the week before us, I believe it was, and you told the audience at that conference that there were some headwinds and tailwinds, but we should focus on a few headwinds. You named 3. And you told us that we should focus on AOI growth being at the low end of the LRP, which are lower end. So I'll just leave it a little loose, but that would be somewhere in the ZIP code of 5%. And then you reported numbers a few weeks ago. And your guidance is for 15% plus AOI growth, which last time I did math was 3x what you told us a year ago. So I am curious, do you have any headwinds and tailwinds to talk about for next year? And probably more importantly, just tell us when the beat and raise story is going to come to an end and make everybody's life easier.

Well, Eric, thank you very much for that ribbing. That's the type of ribbing that I can take. But also before I get started, I also want to thank you for the great job you do covering our company and our industry and the really phenomenal modeling work that you and your team do also sincerely appreciate it. Yes, so we really have exceeded our expectations this year. Our most recent guidance for operating income growth is 15% to 16% for the fiscal year. And actually, in our U.S. segment, it's 20% to 21% operating income growth guidance for the fiscal year. But part of that beat is due to the RCA acquisition, which we acquired at the beginning of our second quarter. So we have that for 3 quarters during the year. But of course, even without that, it's a significant beat. And it really just has been a very strong year that's been driven by continued strong utilization trends, growth in sales of specialty products to physician practices and health systems and just really broad-based strong performance in our U.S. Healthcare Solutions segment. As we look to next fiscal year, and of course, we won't give guidance for next fiscal year until we announce our fourth quarter results in November. But just a couple of the puts and takes and these are things that we've talked about is -- we'll have, of course, RCA for the first quarter, which will be a nice growth tailwind for us for the first quarter. And then for the first, second and third quarter, we'll have a little bit of a year-over-year headwind because of the loss of an oncology customer that was acquired by a competitor. And so those are kind of a couple of the puts and takes that I'm sure you're very much aware of. But I'll say overall, we just have a lot of confidence in our long-term guidance as a company. And of course, our long-term guidance is 5% to 8% organic operating income growth with another 3 to 4 percentage points of growth from capital deployment. And so earnings per share growth of 8% to 12%, and that is, again, our long-term guidance that we've had in place, so we have a good deal of confidence in. So thank you very much for that question.

Yes. So when I think about U.S. health care AOI growth, I believe it's -- and I should be -- I should have my glasses on when I'm doing this because I've already said an E instead of an S for Bennett, but 18% to 22% growth this quarter, I think, is the implied math, it's high, whatever it is, it's very high. And this is the first quarter without Florida Cancer, first full quarter, but you do have RCA. So I was hoping to maybe nudge out of you a little bit just how big of -- has RCA been at all a surprise? I mean it's obviously highly accretive. It was a deal that was touted day 1 as a positive transaction. But have you been able to find some other upside elsewhere in the model? Or is it just -- you took a big established account that was acquired and point to another channel participant and yet you raised the number and you're looking at an incredibly high growth rate this quarter?

Yes. I'll start and then I'll give it to Jim to talk about some of the recent discussions with RCA, particularly in our headquarters. But as you think about our modeling of the business, no, I wouldn't say anything is dramatically different. I think it's in line with our expectations, and that is a good contributor to our year-over-year growth. It's a business we've known really well. It's been a customer for a number of years, and we've had deep relationships with leadership there. But I know Jim was just in some good meetings with RCA on-site in the last couple of weeks, you might want to talk to that.

Yes, sure. We've been really pleased with the MSO strategy. And of course, you asked about RCA. And we're just very, very pleased with the business. And when we look at the MSOs where we've invested in oncology and the retina space. Of course, we've been doing distribution to these businesses for decades. And then, of course, we've been providing higher-value services over time, like the GPO services. Now they provide even higher value services, the MSO services. It's very much in line with our pharmaceutical-centric strategy. And Bennett was mentioning that RCA had some meetings in our office. And it was just fantastic to have the medical leadership and the doctors and the management team in our office and get to spend time with the team. And I would say probably one of the areas where I've been surprised is just how strong the clinical trial site part of the business is. Of course, it's a very strong business and very strong medical practices in the retina space. But I've really been surprised by just how many of the retina oriented clinical trials are happening at RCA sites. And every chance I had -- every time I had a chance to talk to one of the young doctors that I saw because they're getting a lot of doctors to join RCA as why they joined RCA. And it's because of the chance that they not only get to practice medicine there, but they get to participate in the clinical trials also. And so I would just say that's probably been one part of the business that has been a surprise. But overall, we're very pleased with the acquisition.

I've dabbled in covering CROs for a few years, too. So I don't want people to think that this is exactly a proxy for the CRO market. It's a little bit different business, but it is a big selling point with the MSOs and what they can bring to the table from the site perspective in terms of clinical research. And there are -- I actually had a question later. There's actually a tremendous amount of work happening in ophthalmology right now. I think some of the market stats I've seen is that it is one of the growth categories. I'd love your insights into this. If you differ from what data points you've seen, let me know, but I did just see a report that we're looking at about 6% plus growth and there have been a number of new trials initiated in the category in recent years. So I'll come back to that in a minute. Okay. I'm going to ask a few high-level macro things and be -- frankly, I would almost prefer it if we could gloss over them because I do feel like we need to check some boxes here. But there is one that I don't think you get asked much about. I thought it interesting and maybe it's just not in the moment is exciting to talk about is tariffs. But the Drug Supply Chain Security Act is something that's been evolving and rolling out in waves over the last year. And I know this is more than just table stakes. But to be fair, everybody has to do it or they're not going to participate. But I'd like to get just any comments you have on the kind of heavy lift, the investments you've been making. And then probably more importantly is have you learned anything through this process, and you can give a one liner on the process. But can you -- have you learned anything? Or does it change anything about your operating model moving forward that is an additional headwind or tailwind or something that you had an aha moment in getting ready for the DSCSA?

No, I would say -- I don't think I'd call it an aha moment. I think what I'd level set back to is the U.S. is the most secure supply chain in the -- pharmaceutical supply chain in the world. The DSCSA is something we've been preparing for, for years. And we were ready for it to go into effect a couple of years ago. And it's been delayed a couple of times to your point because a couple of the upstream players have not -- particularly the small ones have not been prepared. I think it further cements our value proposition in terms of the ability to -- or the difficulty or the moat that exists and provide being a pharmaceutical distributor is -- the bar is getting higher and higher. It was already quite high with the significant regulations and automation and reach that we have logistically, but the DSCSA is something that we've spent -- you see a lot of -- you've seen it in -- well, you guys might not have been able to see it. The more recent that we've seen in our CapEx numbers. So we know what we've been doing to prepare for that because there is some on the technology side. But we're ready for it. And we think it, to your point, does provide -- it does add to our value proposition in the supply chain. And it probably does create some opportunities down the road given the significant amount of information that we're going to capture throughout the process.

And we have a lot to talk about today, but I just want to quickly say that let's just emphasize exactly what Bennett was saying that these sorts of things just enable us to shine. We really don't shy away from these sorts of investments. We just love this opportunity, and it's great for the supply chain. And it's just a great opportunity for us from a technical standpoint and from a customer service standpoint to show that we're very strong at this sort of thing.

It may not be the way these questions normally get asked on stage, but I'd actually be happy if you say no change and we move on. But tariffs, most favored nation, all of the other noise in D.C., other than one big beautiful bill, where I'm going to jump in with another question. Is there -- you do so many updates. You just had your call. I know the news changes daily, but is there anything you'd want to highlight that's happened in the last month?

No, it would purely be like repetition of what we said during our earnings call.

Well, repetition is reputation. So you can just say we're good to go more of the same.

Yes. Yes.

Okay. And then one big beautiful bill. You highlighted or acknowledged, I think it was in Q&A on the earnings call that, yes, there would likely be some benefits, but you didn't go into great detail, and I don't know if great detail is available, but is there anything you'd want to share in terms of cash flows, taxes? Any kind of update that's worth getting into on?

Yes. I'll just briefly say that there are some incremental benefits for us. I don't think there's anything that's at a level that requires a lot of conversation, but they're -- I mean, obviously, we're a large business, and there are a couple of incremental things on the tax front that benefit us. I think there are some incremental things as it relates to the IRA that some of the manufacturers have talked about. And so it is incrementally good for us, but not substantially.

Fair enough. Okay. I'm going to make -- I'm going to go another hard one. This could be my perception, but obviously, Bob stepped formally into the role about a year ago, right? It was...

October 1.

Yes.

Yes, really just about to annualize that. And Bob's been with the company forever, and you're all on pretty much the same page. So there was no big surprise or change. But I did notice in the -- at least to me, it seemed that in the way he would maybe preview a conversation or respond to a topic. It felt like a few times there was a signal that you were possibly doing some additional portfolio review that maybe you additionally highlighted the pharma-centric nature of the company, talked about proactively being always on top of looking at all businesses. There haven't been big changes, but I'm going to lob it out there. Is there something more to read into that? Or is Bob just being cautious as a first year CEO?

Yes. Thank you very much for asking about that. And of course, Bob is about to hit his 1-year anniversary as CEO. And as Eric mentioned, Bob was COO for several years before becoming CEO. And of course, Bob has worked with Cencora. He sold his company to Cencora, a market access consulting firm, which he sold to Cencora in 2007. So he's been with the company for many years and run all the businesses over a period of time. And thank you for asking that question. And Bob has kind of 4 strategic drivers that he is kind of talking about and really focused on. And one of the strategic drivers that you're asking about is prioritizing growth-oriented investments. And I'll come back to that, but I'll just quickly say that the other 3 strategic drivers are digital transformation, productivity and talent and culture. But with regard to prioritizing growth-oriented investments, we're just getting very intentional about, as we look across the company, and we have very good free cash flow and where do we want to deploy that free cash flow. And of course, you're seeing us deploying capital into MSOs that we've talked about, that would be an example of prioritizing a growth-oriented investment. And a second example would be what we're doing from a capital expenditure standpoint. We're really investing our internal capital expenditures in our infrastructure because of the strong volumes we've had across our business, we're making additional investments into infrastructure. And we're making additional investments into technologies which will enable us to continue to grow. But that's something that I'd expect to continue to hear from Bob is that really kind of focus on prioritizing growth-oriented investments.

Before I come back to the MSO because I do want to spend a couple of more minutes on that. You've had -- and I hear this so many times, if you didn't break out a subsegment and just report it in a black box, we'd never even know it, but you've had some market-related growth challenges with PharmaLex and World Courier, both in reported and international. And those are, I guess, maybe a little closer to -- at some level tied to the CRO space, and -- obviously. And I'm just curious, what are you seeing in the moment on those 2 businesses? And what's the outlook for turnaround? And is it getting back to growth, getting back to a more level footing in those relatively small businesses? Is it more just waiting for the market to come back? Or is there something more proactive you're doing on your end?

Yes. Great. Thank you very much for asking about that. And as all of you know, we have 2 segments that we report on at Cencora. We have U.S. Healthcare Solutions segment and International Healthcare Solutions segment. Our U.S. Healthcare Solutions segment is 85% of our operating income. And our International Healthcare Solutions segment is 15% of our operating income. And while we've far outperformed in the U.S. Healthcare Solutions segment this year, we have underperformed in the International Healthcare Solutions segment. And while it's 15% of our operating income, we're very focused on it and the kind of 2 areas that we've called out for underperformance in international is our global specialty logistics business, which is also called World Courier, and our global consulting services business, which is called PharmaLex. And then the global specialty logistics business, it's really been a great performer for the past decade, but it's having a weak year this year. It, along with global consulting services, has really been impacted by a subdued clinical trials market, which has caused underperformance. We have seen a couple of months of signs of improvement and the external data that we're seeing with regard to clinical trials. And so we are planning for a stabilization of that business. And also, I'll just say that the comps get easier in the International segment also.

Right this quarter.

Yes. Yes.

Very much.

Yes.

Okay. I definitely want to come back to MSO. Retina Consultants would be a good place to start. You actually spoke a little bit about some of the positive attributes and the growth in the site management, the clinical exposure there. Maybe 2 areas that I want to hit on. First, I bring this up every year, you never take the vape, but you have a very large position in ophthalmology and retina relative to the U.S. marketplace. I clearly believe you're the leader in that space. And that was before doing the deal. You've won some really interesting engagements with manufacturers, some semi exclusives and specialty distributions and at least 1 exclusive that I've seen here in the last couple of years. Could you talk about how -- bring this full circle. So now you have the MSO, before you were a high-quality specialty and traditional distributor. Now you have both. Does it create a bit more of a virtuous cycle? Or is it just a better way to leverage -- I hate to put you on the spot, but to generate more profit because of the extra even more buying power and knowledge you have of that space? I'm just -- I'm curious on how you look at this. You win more deals because you have the MSO? Or was that going to happen naturally anyway?

So as you'd expect, I'll answer that, not exactly how you want but how I want to. And I think that as you look at those examples, I think you're right. So we've had -- we've been a leader in retina for a long time. We have differentiated assets, both on the commercialization and distribution side. Interestingly, for that product, and you can actually tie back to this, but the first doctor to administer that product was an RCA position, actually their Chairman of Research. So...

The cell and gene, exclusive.

Yes, that's right. The -- I think it further demonstrates the value that we can drive for pharma. So the tieback to the research, the physician -- the access to the physician led MSO, the commercialization services that we have that are appropriate. The distribution that we've already long demonstrated. I think it further demonstrates that we are a strategic partner to pharma, particularly with the specialty products coming to market and more and more innovation coming. There's going to be different ways, particularly in the cell and gene front or even on the traditional specialty product front that we can leverage our vast infrastructure to really be a differentiated solution provider for biotechs and pharma.

And one of the things I just want to quickly add there is that when you look at Cencora and what we do at Cencora, you'll see in our strategy that everything we do is pharmaceutical-centric. And so as you look at the MSOs that we've invested in there in the 2 areas, retina and oncology that are the most pharmaceutical centric, which really kind of enables the synergies that you referred to.

All right. Well, I'm going to take that and run with it. So pharma-centric. You also came to the company via an acquisition, as did Bob. And you were -- for those who don't know, you were previously with MWI, the veterinary health business. Do you consider that a pharma-centric business?

Yes. So it's -- of course, the Animal Health business is selling pharmaceuticals, distributing pharmaceuticals to veterinary practices and food producers. It's both branded and generic pharmaceuticals. A lot of the generic pharmaceuticals used in companion animal health are human generics. And then the branded pharmaceuticals are principally made by animal health manufacturers. There's really only 2 human health pharma companies that are in the animal health market. Now it's Merck and Boehringer and the others have spun them off, like Pfizer spun off their business as Zoetis. Of course, Lilly spun off their business as Elanco. But I'll just quickly say, that our Animal Health business is performing very well. In the most recent quarter, it had 7% top line growth. So it's outperforming the market and steadily gaining market share because we have the right customers. We have -- one of the growth priorities for Cencora is lead with market leaders, and we do that across our business, including having the right corporate accounts in the animal health market.

You probably know the setup on this, but I think year-to-date, you've been at something like 6.3% or 6.4% growth. Last year was within a few basis points of that, and the 5-year average before that was right at 6% growth. So would we just be better off to model 6% growth and go home?

What I will say is that, that growth rate is outperforming the market. And of course, the growth rate is not anything like it's been for us in the specialty market. But our team in the animal health market is continuing to gain share and performing very well.

One of the other areas that I probably am a bit of an oddity on this question as well. It wouldn't be the only time, but I've always believed that Wall Street was a little too worked up about the demise of the independent pharmacy. And there were stats out there in the 1980s, 1990s, 2000s, always independents are going away. They can't survive. They won't make it. Somehow they've made it all this time. And I think one of the drivers of that is that companies like yourself, you bring value-added services and support solutions to them. And for you, it's one of those areas is Good Neighbor Pharmacy, GNP. I'd love to have you talk -- you just had the trade show what a couple of months ago, 1 month or 2 ago. And I'd love to have you talk about that. I think you've now been named the #1 pharmacy chain in the U.S. by customer satisfaction and basically every other metric for, what, 8 years in a row now by J.D. Power. You also got in another big award. I think it was Chain Store News or one of the other big trade regs groups. But I've had this -- I have 2 questions, a lot of set up for 2 questions. One, maybe, Jim, you want to take a second and tell people what you do there. But one, are you growing and taking share because I can Google search and find 1,000 different answers on how big the business is. And even the 2 big awards you won this year, one said a little over 2,500 members and the other said over 5,000. So which is it?

Yes. So Googling is always fun, especially when you get an AI answer that you know is wrong.

By the way, pay attention to hallucinations in AI. I think the Internet is doing quite a bit of that.

For anybody who cooks, you can get some really bad recipes using an AI. I think the -- Eric, you always love fun with numbers on stage on a mic, which is obvious fun. But I think the -- what I would say is they are performing. And I would say that you've seen a rationalization of some other -- of some larger retail pharmacy operations and what you're seeing happen in parallel to that is that the local independent operators are moving to fill gaps where they exist. And you can look at that anecdotally through news articles, you can look at that through the number -- the total numbers in the independent pharmacy count. I think that our customers are leveraging the solutions that we give them to help grow their own businesses, right? So gone are the days of single store, single operator. As we look now, you're seeing single operator with multiple stores. So they're leveraging those services to then have a store here -- a store in one location and then a second or third or fourth within driving distance, but an uncomfortable driving distance for patients who are looking for that local solution. And if you're leveraging from us from PBM negotiations to merchandising to marketing, you can run -- you can really focus on the patient experience and the independents do really strong in patient experience. And that's one of the reasons that we've seen them be so steady in terms of their store count and market share.

I mean, very specifically, I subscribe to way too many esoteric trade regs, but I am increasingly seeing articles of Walgreens had a big shutdown. CVS had a big shutdown. Rite Aid, obviously had a big shutdown. And next thing you know, an independent is opening up on the corner where the Walgreens used to sit or the Rite Aid used to sit.

That's right. Because the person in the community knows that there's someone who runs a pharmacy 15 minutes away and they say, "Hey, there's an unmet need here. You should look at it." And they have connections. They have local pharmacies and they look to move and add to their footprint.

It's probably not enough to be material at this point so I don't want to get ahead of my skates, but it feels like a small positive possibly.

So I would say what's most important is it's not a negative. So...

No. And I was just going to add, we had our independent pharmacy annual conference as Eric was referencing recently at ThoughtSpot Conference. And we had a few thousand plus pharmacists show up and the level of engagement was incredibly high.

Yes. And when I -- not a negative, the -- what you'd be concerned about, right, Cencora is a purpose-driven organization, united our responsibility to create healthier futures. What we'll be really concerned about is pharmacy deserts, right? And the nimbleness of local independents being able to quickly make the -- fill those gaps is really important in ensuring that patients have access.

I'm going to give you a softball to finish it up. I didn't see any questions on the iPad. Well, I saw a question, it was the one I sent at the diabetes panel at lunch. So that was never opened. But -- so yes, I'll just make this easy. Great balance sheet, great cash flow. You've talked about your strategy. You've built your platforms on the pharma-centric categories in MSO. You're going to take out 1 oncology at some point unless something goes south. So you're probably building up some dry powder. But what do you do with capital for the next 1, 3 years because there's a lot of it. And if I ran my math correctly, you're going to generate somewhere between $15 billion and $20 billion of free cash flow between this quarter and the end of the decade. It's a good problem to have. What are you going to do with it?

Well, that's an excellent question because one of the really good things about our business is we are a very strong free cash flow business. We generate very good free cash flow. So how we deploy capital is just extremely important. And we do have balanced capital employment -- deployment. We'll continue to invest in the business, and we are making increased capital expenditures right now because of our volume growth and the utilization trends. We're increasingly investing in infrastructure and technologies. We'll continue to do strategic acquisitions and be very focused there and MSOs are a great example of that. We'll look at doing opportunistic share repurchases. We're really able to benefit shareholders as we bought back stock opportunistically, and we'll grow our dividend over time, most recently, we've been growing it at 8% in the most recent year. So thank you very much for the time on stage. And again, thank you for the great work that your team and that you do, Eric.

Thanks, Jim. Thanks, Bennett. Great to have you guys. Everyone, that's a wrap for today. So thank you very much.