Cencora, Inc.
CORBusiness Summary
Cencora is one of the largest global pharmaceutical sourcing and distribution services companies, helping both healthcare providers and pharmaceutical and biotech manufacturers improve patient access to products and enhance patient care. The company delivers innovative programs and services designed to increase the effectiveness and efficiency of the pharmaceutical supply chain in both human and animal health. Pharmaceutical sales in the United States, as recently estimated by IQVIA, are expected to grow at a compound annual growth rate of approximately 8.4% from 2024 through 2029 1. Factors impacting industry growth include an aging population, with the number of individuals aged 65 and over in the U.S. expected to be approximately 71 million by 2029 2; the introduction of new pharmaceuticals; the use of generic and biosimilar pharmaceuticals, which currently account for approximately 90% of the prescription volume in the U.S. 3; and the use of drug therapies, with pharmaceuticals currently accounting for approximately 9% of overall healthcare costs according to CMS 4.
Cencora operates in a highly competitive global environment. Its largest competitors are McKesson Corporation, Cardinal Health, Inc., and UPS Logistics, among others 5. The U.S. human health distribution businesses compete with both McKesson and Cardinal, as well as national generic distributors and regional distributors within pharmaceutical distribution 6. The company also competes with manufacturers who sell directly to customers, chain drugstores who manage their own warehousing, specialty distributors, and packaging and healthcare technology companies 7. Alliance Healthcare, MWI Animal Health, World Courier, and the consulting businesses also face competition from a variety of entities 8. Competitive factors include price, product offerings, value-added service programs, service and delivery, credit terms, and customer support 9.
Cencora generates revenue primarily through the distribution of pharmaceutical products, including brand-name, specialty brand-name, and generic pharmaceuticals, over-the-counter healthcare products, home healthcare supplies and equipment, and related services to a wide variety of healthcare providers 10. The company also generates revenues from global commercialization services, which include clinical trial support, post-approval and commercialization support, and global specialty transportation and logistics for the biopharmaceutical industry 11. Revenue is recognized at a point in time when title and control transfers to customers, while service revenue is recognized over the period that services are provided 12. The company is generally the principal in a transaction, so revenue is primarily recorded on a gross basis 13. The company's top 10 customers, including governmental agencies and group purchasing organizations, represented approximately 66% of revenue in fiscal 2025 14.
The U.S. Healthcare Solutions reportable segment distributes a comprehensive offering of brand-name, specialty brand-name and generic pharmaceuticals, over-the-counter healthcare products, home healthcare supplies and equipment, and related services to a wide variety of healthcare providers, including acute care hospitals and health systems, independent and chain retail pharmacies, mail order pharmacies, medical clinics, long-term care and alternate site pharmacies, and other customers 15. This segment also provides pharmaceutical distribution (including plasma and other blood products, injectable pharmaceuticals, vaccines, and other specialty pharmaceutical products) and additional services to physicians who specialize in a variety of disease states, especially oncology and retina, and to other healthcare providers, including hospitals, retinal practices, and dialysis clinics 16. Through its animal health business, the segment sells pharmaceuticals, vaccines, parasiticides, diagnostics, micro feed ingredients, and various other products to customers in both the companion animal and production animal markets 17. For fiscal 2025, U.S. Healthcare Solutions reported total revenue of $290,982,023 thousand 18 and segment operating income of $3,574,699 thousand 19.
The International Healthcare Solutions reportable segment consists of businesses that focus on international pharmaceutical wholesale and related service operations and global commercialization services 20. It distributes pharmaceuticals and other healthcare products and provides related services to healthcare providers, including pharmacies, doctors, health centers and hospitals primarily in Europe 21. It is a leading global specialty transportation and logistics provider for the biopharmaceutical industry 22. It also is a provider of specialized services, including regulatory affairs, market access, pharmacovigilance, development consulting and scientific affairs, and quality management and compliance, for the life sciences industry 23. In Canada, the business drives innovative partnerships with manufacturers, providers, and pharmacies to improve product access and efficiency throughout the healthcare supply chain 24. For fiscal 2025, International Healthcare Solutions reported total revenue of $30,366,323 thousand 25 and segment operating income of $648,274 thousand 26.
On January 2, 2025, Cencora acquired an 85% interest in Retina Consultants of America (RCA) for $4,042.0 million in cash 27, $694.4 million of contingent consideration related to equity units for certain RCA physicians and members of management that retained the remaining 15% interest in RCA 28, $545.7 million for the settlement of a net receivable resulting from a pre-existing commercial relationship 29, and $393.1 million for contingent consideration payable to the sellers associated with RCA's achievement of certain predefined business objectives in fiscal 2027 and fiscal 2028 30. In June 2023, the company invested $718.4 million (representing a 34.9% interest) in a joint venture to acquire OneOncology with TPG Inc. 31. During fiscal 2025, the company purchased 1.9 million shares of its common stock for $435.4 million under its March 2024 share repurchase program 32. The company also issued $1.8 billion of senior notes in December 2024 and €1.0 billion of senior notes in May 2025 33. A goodwill impairment of $723.9 million was recorded related to the PharmaLex reporting unit 34.
Revenue increased by $27.4 billion, or 9.3%, from the prior fiscal year to $321,332,819 thousand 35. Gross profit increased by $1,568.5 million, or 15.8%, from the prior fiscal year to $11,478,539 thousand 36. Operating income was $2,628,601 thousand 37, compared to $2,175,249 thousand 38 in the prior year. Net income attributable to Cencora, Inc. was $1,554,169 thousand 39, compared to $1,509,120 thousand 40 in fiscal 2024. Diluted earnings per share were $7.96 41, compared to $7.53 42 in the prior year. Net cash provided by operating activities was $3,875,120 thousand 43.
Business Outlook
Cencora's strategy is focused on optimizing and growing its U.S. Healthcare Solutions businesses, where it is well positioned in size and market breadth to continue to grow as it makes investments to improve operating and capital efficiencies 44. The company's U.S. human health distribution businesses, including specialty pharmaceuticals, anchor its growth and position in the pharmaceutical supply chain 45. The company is a leader in distribution and services to health systems, community oncologists, and retina specialists and has leading positions in other physician-administered products 46. It distributes plasma and other blood products, injectable pharmaceuticals, vaccines, and other specialty products and is well positioned to service and support biotechnology therapies and advanced technologies such as cell and gene therapies 47. The company has introduced strategies to enhance its position in the generic marketplace, including its generic product private label program based in Ireland 48.
Cencora is also focused on optimizing and growing its International Healthcare Solutions businesses, where it is well positioned in size and market breadth to continue to grow as it invests to improve operating and capital efficiencies 49. The International Healthcare Solutions reportable segment distributes pharmaceuticals and other healthcare products and provides related services to healthcare providers, including pharmacies, doctors, health centers and hospitals primarily in Europe 50. It is a leading global specialty transportation and logistics provider for the biopharmaceutical industry 51. It also is a provider of specialized services, including regulatory affairs, market access, pharmacovigilance, development consulting and scientific affairs, and quality management and compliance, for the life sciences industry 52. The Canada business drives innovative partnerships with manufacturers, providers, and pharmacies to improve product access and efficiency throughout the healthcare supply chain 53.
The company expects to spend approximately $900 million on capital expenditures during fiscal 2026 54. Larger fiscal 2026 capital expenditures will include investments relating to the continued expansion and enhancement of its distribution network and various technology initiatives 55. The company continues to seek opportunities to achieve increased productivity and drive operating income gains as it invests in and continues to implement warehouse automation technology, adopt best practices in warehousing activities, and increase operating leverage by increasing volume per full-service distribution facility 56. The company also continues to invest in cybersecurity capabilities as a key priority to improve and enhance its cyber resiliency 57.
The company continues to improve its entity-wide infrastructure environment to drive efficiency, capabilities, and speed to market, and it is seeking to use AI to improve its business operations, financial position, and results of operations 58. The company continues to make investments to enhance and upgrade the operating systems utilized by its International Healthcare Solutions operating segments, including, but not limited to, Alliance Healthcare 59. U.S. Healthcare Solutions has made significant investments in its electronic ordering systems, which are intended to strengthen customer relationships by helping customers to reduce operating costs and by providing them a platform for various basic and value-added services 60.
In March 2024, the company's Board of Directors authorized a share repurchase program allowing the company to purchase up to $2.0 billion of its outstanding common stock, subject to market conditions 61. As of September 30, 2025, the company had $882.2 million availability under this program 62. The company's Board of Directors approved quarterly dividend increases, including an 8% increase in November 2024 to $0.550 per share 63 and a 9% increase in November 2025 to $0.600 per share 64. The company anticipates that it will continue to pay quarterly cash dividends in the future, though the payment and amount of future dividends remain within the discretion of the Board of Directors 65.
The company faces headwinds from manufacturer pricing changes, as its contractual arrangements with pharmaceutical manufacturers for the purchase of brand-name pharmaceutical products in the United States generally use wholesale acquisition cost (WAC) as the reference price 66. If manufacturers change their pricing policies or practices with regard to WAC, or if prices charged by manufacturers do not align with prices negotiated to be paid by customers, the company's results of operations could be adversely affected 67. Additionally, there are a number of U.S. government policy initiatives being considered that, if enacted, could directly or indirectly regulate or impact WAC prices 68. The company also faces risks from competition and industry consolidation, which may erode its profit 69. The healthcare industry continues to experience increasing consolidation, including through the formation of strategic alliances among pharmaceutical manufacturers, retail pharmacies, healthcare providers and health insurers, which may create further competitive pressures 70.
The company faces risks associated with its international operations, as it conducts operations in over 50 countries and, in fiscal 2025, approximately 9% of its revenue was derived from its international operations 71. These operations are subject to various risks inherent in global operations, including local changes in laws, regulations, and political and economic environments, including inflation, recession, currency volatility, and competition 72. Turkey remains a highly inflationary economy, as defined under GAAP, which impacted the consolidated financial statements 73. The company also faces risks from geopolitical dynamics caused by changes or uncertainty in U.S. policies or the political, economic, social or other conditions or policies in foreign countries and regions in which it does business 74. During fiscal 2025, the company continued to experience increased costs, including for fuel, and it is possible that it could experience supply disruptions, shortages, or additional costs resulting from U.S. tariffs or other protective measures 75.
Risk Factors
Cencora faces material risks from customer concentration, as Walgreens and Boots together accounted for approximately 25% of revenue in fiscal 2025 and approximately 38% of accounts receivable, net as of September 30, 2025 76, while Evernorth Health Services accounted for approximately 13% of revenue 77. The loss of a key customer or renewal at less favorable terms could adversely affect revenue and results of operations 78. The company also faces significant litigation risk related to opioid lawsuits and investigations, with an accrued litigation liability of $4.3 billion as of September 30, 2025, expected to be paid over 13 years 79. The company estimates that $416.0 million will be paid prior to September 30, 2026 80. Additionally, the company faces risks from manufacturer pricing changes, as its contractual arrangements for brand-name pharmaceutical products generally use wholesale acquisition cost as the reference price, and changes in manufacturer pricing policies could adversely affect results of operations 81. The company also faces risks from the potential failure of acquisitions to achieve expected performance, including the $4,042.0 million acquisition of RCA 82 and the $718.4 million investment in OneOncology 83.
Management Priorities
Management's message emphasizes the company's strategy of driving executional excellence in its core distribution solutions business in the U.S. and internationally, while also investing in higher-margin, high-growth adjacencies where it provides solutions to pharmaceutical manufacturers to support the clinical development and commercialization of their therapies and support providers in driving efficiency and effectiveness of their operations 84. The company is well positioned to grow revenue and increase operating income through the execution of key elements of its business strategy, including optimizing and growing U.S. Healthcare Solutions businesses, optimizing and growing International Healthcare Solutions businesses, and pursuing acquisitions and investments 85. Management highlights the acquisition of Retina Consultants of America, which it believes allows the company to broaden its relationships with community providers and to build on its leadership in specialty pharmaceuticals within its U.S. Healthcare Solutions reportable segment 86. The company also undertook a strategic review of its business to ensure alignment with its growth priorities and strategic drivers, resulting in a reorganization of certain business components within its reporting structure beginning in the first quarter of fiscal 2026 87.
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References
- [1] Item 1, Business — Industry Overview
- [2] Item 1, Business — Industry Overview
- [3] Item 1, Business — Industry Overview
- [4] Item 1, Business — Industry Overview
- [5] Item 1, Business — Competition
- [6] Item 1, Business — Competition
- [7] Item 1, Business — Competition
- [8] Item 1, Business — Competition
- [9] Item 1, Business — Competition
- [10] Item 1, Business — Operations; Item 8, Note 1 — Revenue Recognition
- [11] Item 8, Note 1 — Revenue Recognition
- [12] Item 8, Note 1 — Revenue Recognition
- [13] Item 8, Note 1 — Revenue Recognition
- [14] Item 1, Business — Customers
- [15] Item 1, Business — U.S. Healthcare Solutions Segment
- [16] Item 1, Business — U.S. Healthcare Solutions Segment
- [17] Item 1, Business — U.S. Healthcare Solutions Segment
- [18] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
- [19] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
- [20] Item 1, Business — International Healthcare Solutions Segment
- [21] Item 1, Business — International Healthcare Solutions Segment
- [22] Item 1, Business — International Healthcare Solutions Segment
- [23] Item 1, Business — International Healthcare Solutions Segment
- [24] Item 1, Business — International Healthcare Solutions Segment
- [25] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
- [26] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
- [27] Item 1, Business — Strategy; Item 8, Note 2 — Acquisitions and Equity Method Investment
- [28] Item 8, Note 2 — Acquisitions and Equity Method Investment
- [29] Item 8, Note 2 — Acquisitions and Equity Method Investment
- [30] Item 8, Note 2 — Acquisitions and Equity Method Investment
- [31] Item 1A, Risk Factors; Item 8, Note 2 — Acquisitions and Equity Method Investment
- [32] Item 5, Market for Registrant's Common Equity; Item 7, MD&A — Liquidity and Capital Resources; Item 8, Note 7 — Stockholders' Equity
- [33] Item 7, MD&A — Liquidity and Capital Resources; Item 8, Note 6 — Debt
- [34] Item 7, MD&A — Results of Operations; Item 8, Note 5 — Goodwill and Other Intangible Assets
- [35] Item 7, MD&A — Executive Summary; Item 8, Consolidated Statements of Operations
- [36] Item 7, MD&A — Executive Summary; Item 8, Consolidated Statements of Operations
- [37] Item 8, Consolidated Statements of Operations
- [38] Item 8, Consolidated Statements of Operations
- [39] Item 8, Consolidated Statements of Operations
- [40] Item 8, Consolidated Statements of Operations
- [41] Item 8, Consolidated Statements of Operations
- [42] Item 8, Consolidated Statements of Operations
- [43] Item 7, MD&A — Liquidity and Capital Resources; Item 8, Consolidated Statements of Cash Flows
- [44] Item 1, Business — Strategy
- [45] Item 1, Business — Strategy
- [46] Item 1, Business — Strategy
- [47] Item 1, Business — Strategy
- [48] Item 1, Business — Strategy
- [49] Item 1, Business — Strategy
- [50] Item 1, Business — International Healthcare Solutions Segment
- [51] Item 1, Business — International Healthcare Solutions Segment
- [52] Item 1, Business — International Healthcare Solutions Segment
- [53] Item 1, Business — International Healthcare Solutions Segment
- [54] Item 7, MD&A — Liquidity and Capital Resources
- [55] Item 7, MD&A — Liquidity and Capital Resources
- [56] Item 1, Business — Strategy
- [57] Item 1, Business — Information Systems
- [58] Item 1, Business — Information Systems
- [59] Item 1, Business — Information Systems
- [60] Item 1, Business — Information Systems
- [61] Item 5, Market for Registrant's Common Equity; Item 8, Note 7 — Stockholders' Equity
- [62] Item 5, Market for Registrant's Common Equity; Item 8, Note 7 — Stockholders' Equity
- [63] Item 5, Market for Registrant's Common Equity
- [64] Item 5, Market for Registrant's Common Equity; Item 8, Note 16 — Subsequent Events
- [65] Item 7, MD&A — Liquidity and Capital Resources
- [66] Item 1A, Risk Factors — Industry and Economic Risks
- [67] Item 1A, Risk Factors — Industry and Economic Risks
- [68] Item 1A, Risk Factors — Industry and Economic Risks
- [69] Item 1A, Risk Factors — Industry and Economic Risks
- [70] Item 1A, Risk Factors — Industry and Economic Risks
- [71] Item 1A, Risk Factors — Business and Operational Risks
- [72] Item 1A, Risk Factors — Business and Operational Risks
- [73] Item 1A, Risk Factors — Business and Operational Risks
- [74] Item 1A, Risk Factors — Business and Operational Risks
- [75] Item 1A, Risk Factors — Business and Operational Risks
- [76] Item 1A, Risk Factors — Business and Operational Risks
- [77] Item 1A, Risk Factors — Business and Operational Risks
- [78] Item 1A, Risk Factors — Business and Operational Risks
- [79] Item 1A, Risk Factors — Litigation and Regulatory Risks; Item 8, Note 12 — Legal Matters and Contingencies
- [80] Item 1A, Risk Factors — Litigation and Regulatory Risks; Item 8, Note 12 — Legal Matters and Contingencies
- [81] Item 1A, Risk Factors — Industry and Economic Risks
- [82] Item 1A, Risk Factors — Business and Operational Risks; Item 8, Note 2 — Acquisitions and Equity Method Investment
- [83] Item 1A, Risk Factors — Business and Operational Risks; Item 8, Note 2 — Acquisitions and Equity Method Investment
- [84] Item 1, Business — Strategy
- [85] Item 1, Business — Strategy
- [86] Item 1, Business — Strategy
- [87] Item 1, Business — Strategy; Item 7, MD&A — Recent Development
- [88] Item 8, Consolidated Statements of Operations
- [89] Item 8, Consolidated Statements of Operations
- [90] Item 8, Consolidated Statements of Operations
- [91] Item 8, Consolidated Statements of Operations
- [92] Item 8, Consolidated Statements of Operations
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- [94] Item 8, Consolidated Statements of Operations
- [95] Item 8, Consolidated Statements of Operations
- [96] Item 8, Consolidated Statements of Operations
- [97] Item 8, Consolidated Statements of Operations
- [98] Item 8, Consolidated Statements of Cash Flows
- [99] Item 8, Consolidated Statements of Cash Flows
- [100] Item 7, MD&A — Results of Operations; Item 8, Note 5 — Goodwill and Other Intangible Assets
- [101] Item 7, MD&A — Results of Operations; Item 8, Note 5 — Goodwill and Other Intangible Assets
- [102] Item 7, MD&A — Results of Operations
- [103] Item 7, MD&A — Results of Operations
- [104] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
- [105] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
- [106] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
- [107] Item 7, MD&A — Results of Operations; Item 8, Note 14 — Business Segment Information
Analysis on 6/8/2026