Aug 5, 2026 earnings call — Raised full-year adjusted earnings guidance
Raised fiscal 27 adjusted EPS guidance to $44.20 to $45 after Q1 adjusted EPS of $9.93.
Revenue $105.4B (est $103.9B) · EPS $9.93 (est $9.56)
Key quotes
"Which gives us the confidence to raise full year adjusted earnings per diluted share guidance to $44.20 to $45."
"Revenues increased 33% to $14.2 billion driven by growth across our platform, including organic and new business growth and provider solutions."
"Once a prior authorization request is submitted to the payer, 95% of them receive a determination within 30 minutes."
Analyst Q&A 9
North America pharma growth and margins
Q (George Hill · Deutsche Bank): He asked what drove the North America Pharma outperformance this quarter and what explains the organic growth and margin expansion. He also asked if there were any one-time items to consider.
A: Management said North America Pharma had strong top-line and margin performance driven by higher prescription transaction volume and specialty product volume. They noted branded pricing declines affected revenue but had very little impact on operating profit, and AOP rose due to specialty distribution and timing of new product launches. They expect momentum to continue into future quarters.
"So on the top line, overall, 5% growth really driven by the increased prescriptions transaction volume, including higher volume specialty products." — Kenny K. Cheung (CFO)
Confidence in full-year guidance
Q (Stephen Baxter · Wells Fargo): He asked whether the Q1 outperformance is timing-related or repeatable and how confident management is in the raised guidance. He wanted to know if the guide reflects a conservative view.
A: Management said the guide improvement is mainly driven by North America Pharmaceutical being on the high end of the EOP range of 9.5%. They said they guided 40¢ above because they are pleased with momentum across businesses and view the guide as a balanced, not best-case, view of the year.
"and that is the reason why we guided 40¢ above." — Kenny K. Cheung (CFO)
Oncology growth and Florida Cancer deal
Q (Elizabeth Anderson · Evercore): She asked what drove the strong oncology and multispecialty growth and whether Florida Cancer (FCS) performed as expected or exceeded expectations. She wanted details on drivers of accelerated growth.
A: Management said oncology and multispecialty revenue grew roughly 33% driven by penetration of existing provider solutions and specialty distribution, new business wins, and contribution from the Core Ventures acquisition. Normalizing for Core Ventures the top-line growth was about 24%, AOP grew 41% and normalized AOP was roughly 15%; Florida Cancer integrated well and performed at the high end of guidance.
"If you normalize for core ventures of the 33%, it is roughly 24%." — Kenny K. Cheung (CFO)
GLP-1 market and coverage
Q (Brian Tanquilut · Jefferies): He asked what they are seeing in GLP-1 market dynamics, especially employer coverage versus direct-to-consumer demand. He wanted how they balance those channels going forward.
A: Management said there remains a vibrant cash market for GLP-1s and they are also seeing very strong growth in the covered segment, as shown by CoverMyMeds and related technology revenue. They said debate about coverage has not moved much and overall category growth remains healthy and robust.
"There is a vibrant cash market for GLP ones." — Brian S. Tyler (CEO·CHAIR)
Policy risks: 340B and IRA Part B
Q (Lisa Gill · JPMorgan): She asked whether recent policy changes around March affected North America business and what other policy risks management is watching. She referenced GLOBE and physician-practice impacts.
A: Management said the 340B proposal is preliminary and they will let the comment process play out; any reform could create opportunities and challenges across stakeholders and it is premature to speculate on financial impact. They noted IRA Part B does not go into effect until January 2028 and has many unknowns, and they expect to help customers navigate changes using their scale and expertise; management also said WAC pricing moves affect revenue but GP and operating profit are far less sensitive and they achieved GP growth despite WAC decreases.
"So it would be premature to speculate on the financial impact." — Brian S. Tyler (CEO·CHAIR)
Quarterly cadence for distribution
Q (Erin Wilson Wright · Morgan Stanley): She asked if there are quarterly cadence patterns to be aware of within North America distribution given investments and the guide. She wanted mapping for the rest of the year.
A: Management said seasonality matters: Q4 is the biggest quarter from a dollar standpoint and RxTS has an annual verification season in Q4, while cadence can vary with investments, product launch timing, and product life cycles. They also noted Apollo minority interest closure affects NCI modeling, the Norway divestiture completed in January 2026 and phased about $25 million year-over-year, and they are lapping a $51 million gain in US oncology and multispecialty from a prior sale.
"If you look at prior years, Q4 will be the biggest quarter for us from a dollar standpoint." — Kenny K. Cheung (CFO)
Long-term oncology growth drivers
Q (Eric Percher · Nephron): He asked whether oncology and multispecialty growth is market-driven or McKesson-driven and how they can extend that growth with more providers or services.
A: Management said, adjusting for the last quarter FCS impact, the segment grew 24% driven by organic market growth, patient visit increases, physician recruitment, and geographic expansion; they expect technology and AI to expand capacity. They added the 15% growth outlook is all organic, they expect tuck-in M&A and throughput gains, and noted they support 3.4 thousand providers directly and a larger basket of 14 thousand in the GPO/distribution side.
"The 15% growth I mentioned earlier that is all organic." — Kenny K. Cheung (CFO)
Free cash flow trend and outlook
Q (Kevin Caliendo · UBS): He asked why free cash flow has lagged earnings over recent years and when free cash flow might accelerate. He wanted to know if this is structural or timing.
A: Management said Q1 free cash flow is usually negative due to working capital and inventory timing, though this year improved versus last year when they were down a billion dollars; this quarter they were roughly $370 million, showing structural improvement. They said they are using technology and AI to improve working capital and believe some benefits should flow through the rest of the year while maintaining the current guide.
"with that said, though, this year was much improved." — Kenny K. Cheung (CFO)
NAP comps, utilization, and launches
Q (Michael Cherny · Leerink Partners): He asked about back-half comp dynamics in North America Pharma, utilization trends, and how product launch timing affects the path forward.
A: Management said utilization remains steady but they had some favorability in generics earlier in the year that benefited Q1 and could reduce later quarters. They noted new product launch timing (new branded and branded-to-generic) contributed to Q1 AOP strength, the updated outlook assumes stable utilization and specialty growth, and they are accelerating investments in the second half focused on growth and AI with return timing most likely the beginning of 28.
"I would say Michael, that we probably had some favorability in the generics portion of the business that came earlier in the year than we would have expected it to." — Brian S. Tyler (CEO·CHAIR)