COR · Q4 2025 Earnings

Bullish

Cencora

Reported November 5, 2025

30-second summary

30-second take: Cencora closed FY25 with Q4 revenue of $83.7B (+5.9% YoY) and adjusted EPS of $3.84, capping a year of $321.3B revenue and $16.00 adjusted EPS. Management used the print to announce strategic alternatives for animal health (MWI), legacy U.S. hub services, the Pro Farma stake, and parts of PharmaLex — and to commit $1B through 2030 to U.S. distribution capacity. The FY26 guide tells the real story: U.S. Healthcare Solutions OI growth set at 9–11% versus 20–21% in FY25, International OI inflecting from a ~6% decline to +5–8% growth, and consolidated adjusted EPS of $17.45–$17.75 (+9–11%).

Headline numbers

EPS

Q4 FY2025

$3.84

Revenue

Q4 FY2025

$83.70B

+5.9% YoY

Gross margin

Q4 FY2025

3.5%

Operating margin

Q4 FY2025

0.0%

Key financials

Q4 FY2025

Metric	Q4 FY2025	YoY	Q3 FY2025	QoQ
Revenue	$83.70B	+5.9%	$80.70B	+3.7%
EPS	$3.84	—	$4.00	-4.0%
Gross margin	3.5%	—	3.6%	-7bps
Operating margin	0.0%	—	1.1%	-106bps

Guidance

Guidance is issued for the full year only, refreshed each quarter. Prior and new below are the same FY updated this quarter.

New guidance

Metric	Period	Guide	YoY
Revenue	FY2026	$338.6B to $343.6B	5% to 7%
Adjusted Diluted EPS	FY2026	$17.45 to $17.75	9% to 11%
Adjusted Operating Income Growth	FY2026	8% to 10%	—
Net Interest Expense	FY2026	$315M to $335M	—
Diluted Weighted Average Shares Outstanding	FY2026	~194M	—
Adjusted Free Cash Flow	FY2026	~$3.0B	—
Capital Expenditures	FY2026	~$900M	—
Other Segment Revenue Growth	FY2026	0% to 4%	—

Changes to prior guidance

Metric	Period	Prior guide	New guide	Δ	Result
Adjusted Effective Tax Rate	FY2026	20.5% to 21%	20% to 21%	Low end narrowed/raised by 50bps	Raised
U.S. Healthcare Solutions Revenue Growth	FY2026	9% to 10%	5% to 7%	-4 to -3 percentage points	Lowered
International Healthcare Solutions Revenue Growth	FY2026	6% to 7%	6% to 8%	+1 percentage point at high end	Raised
U.S. Healthcare Solutions Operating Income Growth	FY2026	20% to 21%	9% to 11%	-11 to -10 percentage points	Lowered
International Healthcare Solutions Operating Income Growth	FY2026	down approximately 5% to 6%	5% to 8% growth	Return to growth of +5–8%; prior was -5 to -6%	Raised

Segment KPIs

Q4 FY2025

Segment	Q4 FY2025	YoY
U.S. Healthcare Solutions	$75.8B	+5.7%
International Healthcare Solutions	$7.9B	+7.6%
U.S. Healthcare Solutions Segment Operating Income Growth	25.1%	—
International Healthcare Solutions Segment Operating Income Change	-2.0%	—

Other KPIs

Q4 FY2025

Segment	Q4 FY2025
Adjusted Gross Profit Margin	3.47%
Adjusted Operating Income Margin	1.22%
Adjusted Operating Income Growth YoY	20.2%
Dividend Per Share Increase	$0.60 (+9%)
Share Repurchase Reduction in Diluted Shares	-2.1%
Full Year Adjusted Free Cash Flow	$3.0B

Management tone

Customer optimization hangover → AI-era pivots elsewhere; here: U.S. specialty acceleration → MSO platform deepening → Portfolio pruning and capacity commitment.

Three quarters ago specialty was an emerging growth lever; two quarters ago it was the segment driving the U.S. raise; this quarter it is the explicit operating identity around which the rest of the portfolio is being reshaped. Management announced strategic alternatives for animal health (MWI), legacy U.S. hub services, the Pro Farma equity stake in Brazil, and parts of PharmaLex. The anchor quote: "By evaluating alternatives for these businesses, we will identify the right long-term partners to help the businesses within other capitalize on the strength of their offerings while we focus on executing against that core strategy." This is a meaningful change from the diversified-distributor framing of prior years — Cencora is now explicitly a pharmaceutical-centric specialty platform, with everything else either funding that focus or being moved out.

Long-term guidance was raised on the back of two consecutive quarters of U.S. outperformance, ending the Q3 hedge. Last quarter when pressed by UBS, management declined to raise the 5–8% / 8–12% long-term ranges and pointed to FY26 comp pressure as a normalization trigger. This quarter the ranges moved: OI to 6–9%, EPS to 9–13%. The anchor: "we are pleased to be raising our long-term guidance for adjusted operating income growth to 6% to 9%, and our adjusted EPS growth to 9% to 13%." Significant because it converts the FY25 outperformance from a tactical comp story into a structural framework reset — even as the FY26 number embeds the deceleration.

Capital allocation moved from measured to assertively committed. Last year capex commentary was incremental; this quarter management announced $1B in distribution infrastructure investment through 2030, including a second national distribution center and specialty capacity expansion. The anchor: "significant investments totaling $1 billion through 2030 to amplify our distribution network." Combined with the planned divestitures, the message is portfolio reshape plus reinvestment — not just trimming.

MSO platform shifted from acquisition rationale to consolidation strategy. RCA was framed as a deal in earlier quarters; this quarter it's a template alongside the disclosed path to full ownership of One Oncology: "we have the successful acquisition of RCA, which is going really well, and the pathway to full ownership of One Oncology." Management is signaling more MSO consolidation is coming.

The specialty positioning is being framed as deliberate, not opportunistic. "the specialty market has become what it is, is not a surprise to us…we've been very carefully working and investing to make sure that we were well positioned for…this moment." This is the language of a company claiming credit for thesis execution, not a beneficiary of mix tailwinds.

Recurring themes management leaned on this quarter:

Portfolio simplification and strategic focus on high-growth pharmaceutical-centric businessesSpecialty and MSO platform as structural margin-accretive growth driverInfrastructure investment to support specialty growth and supply chain resilienceOperating earnings growth outpacing revenue growth trajectoryConfidence in long-term guidance based on demonstrated execution and market positioning

Risks management surfaced:

Pharmalex persistent demand challenges and goodwill impairment ($724 million)Loss of oncology customer in June 2025 creating headwind for first three quarters of fiscal 2026Execution risk on strategic alternatives for divested businessesPotential short-term dilution from asset sales in 'other' segmentLaw of large numbers impacting growth rate sustainability

Answers to last quarter's watch list

Did Int'l HC Solutions OI print positive YoY in Q4 as templated? No. OI came in at -2.0% YoY — a meaningful sequential improvement from Q3's -12.9% but short of the inflection management templated for the Q4 exit rate. The FY26 +5–8% OI growth guide implies the positive inflection now lands in FY26.

Resolved negatively

Specialty logistics sequential OI improvement in Q4 vs Q3? Direction confirmed at the segment level — International OI improved sequentially as promised — though the company didn't break out specialty logistics OI separately on the print.

Continue monitoring

Initial FY26 U.S. OI growth — inside 5–8% long-term range or above? Above. FY26 U.S. HC Solutions OI growth guided to 9–11%, which sits above the prior 5–8% long-term range and inside the newly-raised 6–9% range. The oncology customer loss and RCA comp pressures management itemized in Q3 are absorbed into the 9–11% range rather than pulling it below long-term.

Resolved positively

GLP-1 trajectory and ex-GLP-1 growth at ~8%? Not disclosed at this level of granularity on the Q4 print. Management did not quantify Q4 GLP-1 contribution or ex-GLP-1 growth as they did in Q3.

Continue monitoring

FY26 biosimilar / U.S. revenue-vs-OI divergence calibration? Partially answered. FY26 U.S. revenue guide of 5–7% with OI growth of 9–11% maintains the divergence pattern (OI growth outpacing revenue), though the gap narrows materially from FY25's actual divergence (5.7% Q4 revenue vs 25.1% OI). Biosimilar mix not separately quantified.

Resolved positively

What to watch into next quarter

Q1 FY26 U.S. HC Solutions OI growth — the oncology customer headwind hits the first three quarters of FY26; watch whether Q1 OI growth is meaningfully below the 9–11% FY range or whether RCA and specialty offsets keep it within band.

Pace and structure of the divestiture process for MWI animal health, U.S. hub services, Pro Farma, and PharmaLex components — specifically whether any of these are announced as completed transactions in Q1 and at what proceeds, given the FY26 "other" segment guide of 0–4% revenue with 1–4% OI decline already embeds some uncertainty.

International HC Solutions OI inflection actually printing positive in Q1 FY26 (the FY26 guide of +5–8% implies Q1 should be at or near growth); a second quarter of "improvement but not yet positive" would mark the second time management's inflection timing has slipped.

One Oncology path-to-full-ownership disclosure — any update on the structure, timing, or cost of buying out the remaining stake, given management explicitly flagged the pathway this quarter.

Whether the $1B distribution capacity commitment shows up in Q1 capex run rate — the FY26 capex guide of ~$900M is consistent with prior years, so watch how the $1B-through-2030 envelope phases in.

Sources

Cencora Q4 FY2025 press release (Exhibit 99.1, filed 2025-11-05): https://www.sec.gov/Archives/edgar/data/1140859/000114085925000128/exhibit991-q42025.htm
Cencora Q4 FY2025 prepared remarks (as extracted)
Cencora Q3 FY2025 brief (Tapebrief, 2025-08-06) for prior-guide reference points

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