Cardinal Health, Inc. (CAH)
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Bank of America Global Healthcare Conference 2025

Sep 24, 2025

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

We are ecstatic to have the Cardinal Health Management Team here. We have Jason Hollar, CEO, Aaron Alt, CFO, and Head of Investor Relations, Matt Sims. I think, Matt, you had a couple of comments before we get started.

Matt Sims
Head of Investor Relations, Cardinal Health

Yeah, thanks for hosting us, Allen. It's really great to be here. Just a little housekeeping before we begin. We will be making forward-looking statements today, which are subject to risks and uncertainties that could cause our actual results to differ materially from those projected or implied. For a description of these factors, please review our SEC filings, which can be found on our Investor Relations website at ir.cardinalhealth.com. Back to you.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

Perfect. Thanks, Matt. We were just talking and you were saying you haven't been to London in a few years. As we get started here, we'd love if you could give maybe a brief introduction for the people in the room, the people on the phone, a little bit about the Cardinal Health business and where the business has gone over the past couple of years.

Jason Hollar
CEO, Cardinal Health

Sure. Thanks again, Allen, for having us, and thank you all for attending here live as well as online. Cardinal Health, we are effectively the beginning, the middle, and the end of the U.S. healthcare supply chain. If you think about everything that connects the innovators, the manufacturers, all the way through the supply chain to the patients, we touch or drive the activity across that entire spectrum. There are even some instances where we act as a manufacturer of certain types of products, and we act as the provider in other types of products. We have a scope and scale, that breadth that is beyond what anyone else does in healthcare. This is anchored by our largest, most significant business, our pharmaceutical and specialty solutions business. This is well over the $200 billion of the $220 billion of revenue that we have as an enterprise.

It's very much, again, the cornerstone of our activities. Within that distribution business, we have other high-value services, manufacturer service or biopharma solutions business that provides unique value to manufacturers as well as providers in different ways. Beyond our pharma business, we have our other growth businesses of Nuclear & Precision Health Solutions , as well as our at-Home Solutions business and our OptiFreight Logistics b usiness. These are three relatively individually small businesses that aggregate to quite a nice segment in terms of revenue and profitability. They are uniquely positioned with individual secular growth trends, which I'm sure we'll get into in a few moments. They are our second priority within our enterprise for investments and growth, given the unique nature of their growth in their part of the industry, but also their leadership in the industry. Finally, our turnaround business, which is our Global Medical Products and Distribution.

You'll hear me refer to it as GMPD. That business is larger from a revenue perspective, lower profitability. We have done a nice job of turning it around from significant losses a few years ago when inflation impacted that business quite a bit. Even with tariffs, this is a business that we see being solidly profitable and growing over the next several years. That's the overall architecture of our primary businesses. Again, aggregating to over $200 billion in revenue, we have long-term growth plans of our earnings per share being at 12%- 14%, generating adjusted free cash flow of at least $10 billion, and solid plans that we've recently laid out at our Investor Day to drive that growth well into the future.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

Thank you for that. That leads really into my next question. You hosted an Investor Day a few months ago. Can you talk about some of the key takeaways that you want investors to leave with as it relates to that specific event? Maybe Jason and then Aaron to follow.

Jason Hollar
CEO, Cardinal Health

Yeah, let me start and see if I missed much, because there's a lot there at that event. I would put it all into three key categories. First of all, we're really big and focused on accountability and making sure we're measuring what we committed to in the past. The first thing we did is we laid out our performance versus our last Investor Day, which was two years before that. In the last two, three years, we've had now two different Investor Days to establish the strategy, and then we measured against it in this last meeting. The results are very strong. We exceeded the vast majority of our metrics, and the ones that are the overall enterprise results, we vastly exceeded those. Earnings per share, we had originally laid out the 12%- 14% EPS growth, and we achieved 18%.

Very strong performance of the two to three years prior to this Investor Day, and we wanted to demonstrate what those results were. Of course, what we did, and we focused most of our time and attention on, was the evolution of our strategy. We went through each of the five operating segments, again, the largest, most significant being our pharma and specialty solutions business, our other growth businesses of Nuclear , at-Home , and OptiFreight, and then finally the GMPD business. We went through each of those five businesses and laid out the strategy for each. Mostly, I would say it was an evolution strategy, because clearly that strategy was working over the prior two to three years. We wanted to tweak a few things. The primary tweak that we had was the ordering of our second and third priority.

Again, pharma and specialty solutions being so important, so significant, the recipient, the vast majority of our investment, organic and inorganic dollars, that continued to be our highest priority. The other growth businesses of Nuclear , at-Home , and OptiFreight are growing so substantially in such a strong part of the market that we wanted to demonstrate that by making it a higher priority within our strategy. The other part that we highlighted was the talent. Each of the five operating segments presented, and each of those five presidents of those segments participated in that, and we were able to showcase that talent.

When you step back from all that, what's really exciting about where Cardinal Health is, is each one of those five businesses has a very strong core, and we continue to invest in that core to drive, you know, relatively consistent, resilient, a little bit slower growth. We accelerate that through these growth initiatives, mostly focused on specialty, but then each of the other four businesses have their own version of those growth initiatives as well. For example, within our at-Home Solutions business, we continue to invest in our distribution network.

We've refreshed three new DCs out of our 11 in our network over the last three years, so about one a year, and we committed to another three over the next three years to refresh with the latest in automation technology, driving significant operational improvements. Within Nuclear , we committed to another $150 million of investment to increase our cyclotron capacity to produce various types of radiopharmaceutical isotopes, to continue that growth that we're seeing in theranostics and the precision health that is being driven by oncology and urology. Finally, OptiFreight will continue to grow and expand in new areas from MedSurg to include also the pharmacy types of products. GMPD, again, is all about the turnaround plan, focused on Cardinal Health volume growth, as well as our simplification of it.

You add that all up, and that got us to the 12%- 14% EPS growth. We raised our targets for our largest, most significant business with the pharma segment to 5%- 7% operating income growth. We also raised our other growth businesses to 10% earnings growth on a CAGR basis. They've got each a place in our portfolio, and are clearly laid out as to what needs to be done to continue to drive those above-market types of growth rates.

Aaron Alt
CFO, Cardinal Health

I'd just emphasize a couple of things in support of what Jason was saying. First, you heard Jason reference specialty. It's more than a $40 billion business for us. It's a CAGR of 14%+ as well. We're very focused on continuing to grow that business because it is a much higher margin part of the business, and that's evidenced by the acquisitions we've done in the last 18 months, particularly the most recent announcement of the acquisition of Solaris in the urology MSO space. We spent a fair bit of time talking to Dr. Weber, who's the lead in that enterprise for us, talking about that effort. We're able to do that. We're able to make the investments that Jason was just calling out because we did also call out or guide more than $10 billion of adjusted free cash flow over the next three years.

That's on top of having delivered $2.5 billion of adjusted free cash flow in a year in which we lost our second largest customer. I say that that way to just highlight the point that the team is very focused on the operational performance to generate the cash in support of creating the virtuous cycle of the investment so that we're able to continue that. We're able to continue the success as we carry forward. That's what we're also going to be very disciplined about, how we do it. While we are calling out that $10 billion+ number, what remains unchanged from Investor Day to Investor Day and now into our coming year, as well as the idea that our first and highest priority is to invest in our business. We'll invest about $600 million in capital. You heard Jason call out some of the projects.

During fiscal year 2026, we're just approaching the end of our first quarter, of course. We're going to protect our balance sheet. We are BBB rated at the moment, and we believe that's the right rating for us. By the end of this year, notwithstanding all of our acquisitions, we will be within our rating agency guidance to that respect. We prioritize returning capital to shareholders as well. We committed to return $750 million to our shareholders this year as a baseline return of capital to shareholders, and then we'll look for more opportunity to do more as we go through the year and see where our investment needs are as well. Of course, we pay a growing dividend. We're a dividend aristocrat.

Dollars that are left after all of that, we will go back to the cycle again, and we will look for both further return of capital to shareholders, and of course, we will always look at M&A as we have done for the last couple of years. While we haven't put a limit on the M&A, we're much more focused on tuck-in M&A given the deals we've done in the last 18 months. The team is very focused on achieving the synergies, driving the integration, getting the value of the deals that we've done.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

That's great. I really appreciate all those comments. Now, at your Investor Day, you raised pharma and specialty solutions EBIT growth. Even as, I guess, you and some of your peers have talked about industry growth trends maybe normalizing a bit into calendar 2026. You have Medicaid, you know, there's a Part D benefit, there's vaccines. You know, what gave you the confidence to raise the pharma and specialty solutions EBIT growth at even if growth is going to normalize a bit at the industry level going into next year?

Aaron Alt
CFO, Cardinal Health

Yeah, for the last several quarters, we have been pleased to report good progress within the pharma and specialty business, and indeed driven in no small part by strong demand. The demand, while we plan for and guide strong demand, has been outsized in strong demand as well. Part of what was driving our ability to take guidance up at Investor Day, and then actually we took our EPS guidance up again at our Q4 earnings call a couple of weeks later, was we continue to see a strong environment in which we are operating that's being driven by procedures. The scripts are certainly holding up as well. I also want to emphasize, though, that we're able to do that because of the operating performance that the team is delivering. We are relentlessly focused on how do we continue to raise our game and how we operate.

You heard Jason reference the investments in our at-Home business as well. It's a purposeful strategy really across our portfolio of we're making investments not just for the revenue growth, but even more importantly for the operating excellence. We are bringing our costs down because we're investing in technology, because we're doing acquisitions that we can layer on top of our existing platform. That's part of what's also driving our confidence in our ability to raise our guidance.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

As we think about the seasonality in fiscal 2026, you talked about bringing on $10 billion worth of new customers in the second half of last year. I think that's going to be $7 billion, you said, in the first half of fiscal 2026. There is some seasonality there. Can you talk about some of the, and you have a unique fiscal year-end as does each of your peers. Can you talk about some of the seasonality as you think about the back half of calendar 2025, the first half of calendar 2026, how you think about what the major swing factors in the seasonal cadence for your business?

Aaron Alt
CFO, Cardinal Health

We have a variety of different businesses, and the seasonality is a little bit different across each of them. Let me take a stab here at describing it. As you think about our largest business, the pharma business, we don't provide a guide on a quarterly basis, but we did provide some guidance on the first half, second half basis. You called out the first driver, which is last year in 2025, we did onboard $10 billion of new customer revenue. Now coming into the first half of fiscal 2026, we're one quarter, almost completely one quarter in. We are now getting the tailwind benefit of the first half, right, for those new customers. That is about $7 billion as well.

Historically, for our pharma and specialty business, Q3 is the highest dollar profit quarter for us because that's the quarter in which the manufacturers take their inflation as well. Within the GMPD business that Jason referenced, we tend to see, of course, our results are impacted by the flu season, right? They're also impacted by when people are doing procedures, which tends to be more calendar year-end focused as people's benefits are coming up on the renewals of their benefits as well. That drives some of the relative cadence of our overall guidance and our results. Jason, are you good?

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

No, that's a big piece.

Jason Hollar
CEO, Cardinal Health

The only other one I would call out is just we have also had the acquisitions within fiscal 2025. The annualization of those will be a tailwind within the first half of fiscal 2026 for pharma, and then within our other segment of the ADS acquisition, we'll annualize that in (Inaudible) of fiscal 2026.

Aaron Alt
CFO, Cardinal Health

We closed our GI acquisition on February 1. We closed ADS in April.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

One question we're getting a lot is around the vaccine and the evolution of the consumer's view of the COVID vaccine and maybe even the flu vaccine. Now we're a few more weeks since earnings. Can you talk about what's embedded in your guide for COVID vaccines and any high-level commentary on what you're observing quarter to date? How should we think about the cadence of vaccine revenue between fiscal 1Q and fiscal 2Q?

Aaron Alt
CFO, Cardinal Health

I don't think we're alone. Certainly, we were transparent when we provided our guide that in the past year, we had assumed that the COVID vaccine contribution would be a slight headwind relative to the prior year. Indeed, our guide for this year, for fiscal 2026, made the same assumption that it would be a slight headwind or less of a contribution year than the year before. It's also the case that the relative timing of the contribution is a little bit up in the year tied to the various approvals, happening at the federal and the state levels as well. One year it was early, last year it was a little bit later. While we don't provide a guide on a quarterly basis, we are all reading the newspapers and staying in contact with the administration as far as what their latest plans are for the COVID vaccines.

Jason Hollar
CEO, Cardinal Health

In terms of the, you had embedded within that question some timing aspects, I think just a reminder of the journey we've been on. As Aaron highlighted, you really got to go back to 2024 was the first time we really meaningfully participated in the COVID vaccine. That was a nice tailwind in 2024, started in Q1, but then accelerated in Q2 because it was a fairly late approval cycle that happened in 2024 as it related to when the FDA provided the clearance and then getting the supply chain up and running. Last year was a lot earlier. You saw that shift more so to an earlier start date, more of the contribution being in Q1 relative to what it was in the prior year. Now this year, it shifted back a little bit further and you have these other restrictions.

You got somewhere in between those two dates. That just creates a little bit of differences from a quarter to quarter. When I step back and think about the essence of the question, Allen, whether it's that or other moving pieces, let's go back to some of the opening comments both Aaron and I made. We remain in a pretty strong overall demand environment for the vast majority of the businesses we're talking about. I would, whether we're talking about COVID or any other specific question that we'll be getting into, there's always going to be puts and takes to that demand picture. While that was a nice tailwind two years ago, it has reduced, it did reduce last year, and we put in a lower driver of profitability this year as well.

Overall, those are all elements that will be puts and takes to our portfolio and not something that at the current moment that we're calling out any differently.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

Got it. I want to switch gears a little bit, talk about the MSO strategy. Obviously, a big focus and growth driver for you. You're now at $4.5 billion of revenue, of platform revenue post-Solaris. You're acquiring practices in autoimmune and urology. If I'm one of those practices, can you provide an example on the types of services and the value that you're providing to these physicians?

Jason Hollar
CEO, Cardinal Health

Yeah, the short answer is across all services, because when you think about our strategy, we are very focused on creating scale for these physicians across three key platforms. Yes, autoimmune and urology, as you mentioned, but also in oncology. We have acquired three separate large platforms for those three key spaces, and we have a great partner within each of those. That's the platform that you start with. Every physician that's on those platforms, and let's just take urology as the example, we have already acquired several other MSOs that we are then now going to combine once Solaris closes to create value for each one of those urologists. They get scale across the services that are provided, whether that's back office, you know, HR, IT, finance, that type of thing, or it's something more specialized, even in areas like revenue cycle management or payer negotiations or physician recruitment.

These are all areas that benefit all of the different physicians across all the different therapeutic areas. We're able to create scale across not just all the urologists, but then there's a lot of very similar services in urology as well as autoimmune. That's why we have prioritized those two areas specifically, and why our biggest investments have been in those areas is that there's a lot of synergies between those businesses. For example, they have very similar revenue profile. They use similar services like pathology, lab services, anesthesia, infusion centers, diagnostics, and imaging. There's a lot of the day-to-day services like that that they all use that we can now scale across different therapeutic areas while continuing to allow them to have the clinical differentiation within their therapeutic area.

We believe we built the best mousetrap here as it relates to giving the right balance of the scale across the therapeutic areas, but then also specifically with their own clinical independence. That's the short answer. A little bit longer is using urology as that continued example. What we're really excited about is our leadership throughout the rest of our enterprise. If you think about it, no one else that provides distribution services also has a key business within the Nuclear & Precision Health Solutions business. We are the leader in urology as well as in oncology for those therapeutic areas. We're also the leader in our at-Home Solutions business delivering oncology, I'm sorry, urology-related supplies to those patients in their home. Lastly, another key element that these physicians need is the data and technology support.

With our acquisition of specialty networks about 18 months ago, over 18 months ago, that business actually originated with urology and provides the AI IT engine behind managing the physician's practice, both downstream with the patient, but also upstream with manufacturers. We have very unique assets that are quite supportive to areas like urology, but then beyond all that, we have all the other scale that provides those benefits to those services.

Aaron Alt
CFO, Cardinal Health

This is all as a result of a very purposeful strategy that Jason laid out at our Investor Day three years ago now as well, where given where Cardinal was at the time, and from an industry context perspective, with oncology being 40% of specialty and the other ologies being 60%, our historical strength has been in the other ologies, the urology, the oncology, the gastroenterology.

To see us then do a series of transactions in gastroenterology, urology, and other areas, and to see the investments we're making in the areas supporting that parts of the business, it really just comes back to how we're approaching the business overall, which is we're going to tell you what we're going to do, we're going to go do it, we're going to report back, and then we're going to continue to reinforce the ecosystem around our competitive strengths.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

Aaron, you've put out a target for the amount of physicians that you want to have under MSO. You have strong growth ambitions within the MSO space. Can you talk about the level of fragmentation in the other ologies? Are there large assets out there? Are there a lot of smaller assets? How do you think about the roadmap there as we think about how Cardinal looks to augment the capabilities and scale there?

Jason Hollar
CEO, Cardinal Health

Let me start and then back there. Within oncology, there's more of a consolidation that has occurred within. There's another reason why we like the autoimmune and the urology space: it does remain quite fragmented. In both cases, we are the largest with our acquisitions in urology with Solaris Health and the other assets we've acquired. It's roughly 5% of that market; Solaris was almost 5% by itself. This is a good representation, similar in the GI space with GI Alliance. Very fragmented there. Of the community physicians that are in those therapeutic areas, it's roughly 80%- 90% remain independent, not associated with an MSO today. It's earlier in the consolidation cycle. With the value that we believe we are creating and that they will see through our MSO with those broad synergies and capabilities that I referenced earlier, we believe it will be attractive to have others come.

As Aaron highlighted earlier with more of the capital deployment comments, with the relatively large outlay of capital for these three platforms that we've completed over the last year, we recognize that there's perhaps more value for some of the more, a little bit smaller tuck-in acquisitions to benefit from the scale that we have there. In those therapeutic areas, there is no one larger than us. I'm not sure we'd be interested in that anyway, given that we are looking to use our platform to be able to consolidate onto that. We are always going to be open to the opportunities that can create value for the physicians and for ourselves. We just think naturally at this phase, given the fragmentation that's still there, that there's perhaps more value as it relates to more of the smaller mid-sized types of bolt-ons.

That's where we're focused more, but we'll certainly keep our eye open to anything else.

Aaron Alt
CFO, Cardinal Health

During our last earnings call, we acknowledged that we are quickly approaching 3,000 providers served by the platforms that we're in. While there is fragmentation, again, part of our focus from an M&A strategy was to acquire the assets that brought the scale to start with. It's easy for us to now add on and to drive that value creation for the doctors, importantly, because we want our incentives to be aligned, the value creation for the doctors and the value creation for the Cardinal ecosystem as well by then doing the tuck-in acquisitions and also finding the linkages to the rest of our portfolio.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

There's a difference in mix between urology and oncology, for example. For oncology, drug revenue is 96%, 97% of revenue. Urology, it's more of 1/3 , 1/3 , 1/3 between drug revenue and then procedures and visits. Does that matter at all as you think about your strategy, or is that just the way that it is?

Jason Hollar
CEO, Cardinal Health

I would, back to Aaron's point earlier, we started with a very intentional strategy. We looked at the marketplace. We did a lot of marketing field studies to understand what's important to physicians. They get good support from distributors as it is today. When you talk to them, it's not like, well, we have to have a distributor come in and own us because we need better distribution. That's not the message. The message is they need help in, yes, distribution and GPO contracting services. That is a component of it. What they're not getting as much is the cohesion with the other two key categories that they need to support on: data and technology, as well as the MSO back office, revenue cycle management, all those types of administrative services.

They need help with thinking about all the vendors and partners they need to bring around, wrap around them to be successful. Ultimately, they became a physician because they want to take care of patients. They don't necessarily want to run a business, but that's a necessary element to what they do. They work with us to run that business. When we had that and we looked at what was out there and the needs, we saw there was a big need in the autoimmune space. That's why we started looking there. We said, who is the best MSO? Who does that better than anyone else, irrespective of the therapeutic area? That was clearly GI Alliance. What Dr. Weber had built with that team was not only a large following of providers, but also they had the best process.

It wasn't like we were saying, hey, we think GI is the place to go. You know, it's not a bad spot. It's a very resilient therapeutic area, a lot of other services. It was all about the capability. That capability then crosses over rheumatology and neurology, as well as urology in different ways. That's where we started. We looked at the profile behind it and we said, okay, yeah, 1/3 of the revenue is drug spend. That's not bad. It's an element of the business case to continue to support that type of service. Ultimately, what we saw were these other 60%, those other services, roughly 1/3 into the procedures and roughly 1/3 into the physician office visits. That creates value opportunities for other physicians to help them scale those capabilities and the technology behind it and all the other services that go along with it.

It also gives us a diversified revenue stream. We already have over $200 billion of drug spend revenue as a company. Of course, we always want more. That's never a bad thing to grow your business. It's okay having other higher-margin service revenue behind it as well. While we don't think that the administration is focused on driving down profitability for these providers, because they do remain the lowest cost alternative in their communities relative to other options, we do think that that's more of an uncertainty on the drug side than on all the other services side. We're much better insulated and protected in this type of policy environment with this. That is secondary in nature. The primary reason was that there's a lot of value from the physician's perspective that we see we can help create.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

I want to ask kind of an overarching drug policy question, DC policy, MFN, IRA. Has anything or any of your thoughts evolved at all over the past couple of months as it relates to all the headlines we've been seeing around drug policy and the future of drug pricing?

Jason Hollar
CEO, Cardinal Health

No. Short answer is we continue to be very well- positioned as it relates to the fee-for-service distribution side of our business. Of course, that's by far the largest part of our business. We continue to believe that we'll be well- compensated for the value that we provide to safely, securely, and efficiently deliver those products. Nothing changes with the price point changes in the drug costs. We don't benefit when they go up. We should not be harmed when they come down. On the MSO side is the only other aspect that is different. Given the diverse revenue streams, only 1/3 of our MSO revenue and the government payers, Medicaid specifically, being a lower percentage of our payer mix, it's a small percent of a small percent, which gives us confidence that we'll not have any meaningful impact as a result of that.

Certainly, what's most important is that we advocate for all of our customers in D.C. to ensure that those types of potential unintended consequences are understood by the administration, because our highest priority is to make certain that we don't have any shortages in the marketplace.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

That's great. I want to switch gears again, a little bit about the P&L, SG&A growth versus gross profit dollar growth. You've done a great job over the past couple of years growing gross profit dollars faster than SG&A. Aaron, at Investor Day, you talked about some of the investments you've made in supply chain technology, three new distribution centers. With some of those investments, M&A, how should we think about your philosophy around gross profit dollar growth and SG&A growth? I guess as a start, maybe around fiscal 2026, and then maybe philosophically after that, how you think about it.

Aaron Alt
CFO, Cardinal Health

Thank you for noticing, because we are being very purposeful in a couple of respects. First, of course, you can attack SG&A, but it's better if you start at the top line and the gross margin line. As Jason has highlighted, we continue to invest in higher growth, higher margin parts of our business to help drive that gross margin growth to really fuel the overall P&L. Anything specialty related to it, the investments in our other growth businesses are certainly supportive of growing more rapidly the gross profit line of the P&L. SG&A, I really have to pay compliments to our team where really every part of the organization has been very focused on how do we get there, ranging from making the long-term investments in technology to drive efficiency, for which we are seeing the results, right?

Bringing transportation costs down is a good example, increasing the lines per hour, the higher pick rates, etc. , as well as just going after everywhere we can, just the core SG&A, the people costs, how do we operate more efficiently, how is our technology spend more efficient as well. We are really going after that as well. We were pleased in fiscal 2025 to see some good progress on the relative impact of SG&A relative to our gross profit. As we raised our guidance again at our Q4 earnings call, we continue to focus on driving that operational improvement and bringing our SG&A costs down.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

That makes sense. Around the generics business, how are you thinking about the possibility of tariffs? I know that's been a kind of a moving target. Related to that, has the supply chain evolved at all since the beginning of the year when tariffs were first discussed? Has it changed the way that any of the stakeholders, whether it's the way that pharmacies are bidding, the way that manufacturers are producing? Is there any change that you're seeing in the supply chain? Have prices evolved at all? I'm just curious if there's anything different that you're observing in the market.

Jason Hollar
CEO, Cardinal Health

Yeah, there's nothing different significantly in the overall marketplace. Of course, the vast majority of any potential implications just haven't occurred. When you think about tariffs, it's been pharma products that have largely been excluded from that. There's nothing that's had to be addressed in supply chain. Our model is such that we take possession, title of the product after it comes into the United States. We don't directly hold that exposure, that risk. We recognize that with tariffs, there will be additional, there would be under that scenario, additional cost pressure if that were to occur in that manner. With that said, we've highlighted continuously over the last several years consistent market dynamics, which you see as various forms of inflation and deflation that has occurred over the last several years.

You've seen that our margin spread, price per unit on these items have been largely consistent, meaning that even when we see inflationary impacts, we're not seeing impacts to our underlying profitability. What we want is a consistent margin per unit. We want to grow our profit through the utilization growth, the volume growth that we expect will continue in the United States, given the demographic trends that are still in our favor for the next couple of decades. We're well- positioned. We don't think anything is going to change with that. It's also just a little bit early to tell as to exactly what the administration is going to do, because we do think, especially as it relates to the generics products, they play an incredibly important role in the U.S. healthcare system. It's approximately 90% of the volume, but only 10% of the cost.

Even if there are some cost impacts to that 10%, it's going to be a relatively small part of the overall healthcare cost in the industry. It's one that we think makes sense to continue to protect in different ways.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

I believe at your Investor Day, you said that generics are going to contribute more over the next three years than over the past three years. There's more LOEs. Is there any way to size the contribution of generics to the growth algorithm of your business? Is it a primary driver of growth, a secondary, or a tertiary driver? How is that growth rate going to evolve over the next couple of years versus the prior three?

Jason Hollar
CEO, Cardinal Health

Yeah, you're right to call out that we did call out that the loss of exclusivity is expected to be higher over the next several years versus where it was in the past several. That is an opportunity, all things being equal. What you've seen us highlight over the last couple of years is generics as a component of our growth, but it's not the only one that we're calling out. What's so exciting about where Cardinal Health is and where the overall industry is, is that broad utilization. You've heard us in different quarters and different years call out not just generics, but branded products. We've called out, of course, specialty products. We've had broad contributions to just our pharma business. Of course, we've also been calling out significant growth in our other businesses as well. Overall, generics is a component of it.

What's in our long-term plans is that it will continue to be a component of it. We have modeled for industry growth of 2%-3 %. If it is able to grow faster than that, then that would be an opportunity. Part of the reason we didn't include more volume in those long-term projections is that while the LOE isn't, it almost certainly will be better. We know the math of when those products will lose their exclusivity. It is overweighted with a couple of larger products. The exact timing and nature of how that exclusivity rolls off and how many manufacturers of those generic products come to market are all questions that aren't answered yet. Once we get more of those specifics, we'll have a better understanding of the contribution to our underlying growth rates that we can then see within the generic space.

Aaron Alt
CFO, Cardinal Health

Probably worth just adding, given our partnership with CVS and Red Oak, and we are the largest, I believe, purchaser of generics into the U.S. healthcare system, we're able to achieve the cost that allows us to always call consistent market dynamics, our ability to manage both sides of that equation to drive the profitability there. That is part of why we have comfort that it's a good news story for us relative to generics carrying forward. I do want to emphasize the start of the conversation around specialty as well, because you asked about the relative drivers as well. Certainly, the only side of the impact of how aggressively we're looking to grow the specialty part of the business at higher margins.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

That's great. I think we only have a couple of minutes left here. I did not do a great job of pacing the questions appropriately. For the other segment here, you're expecting really strong profit growth through fiscal 2028. I would never ask you to rank your children here. You've talked about a lot of different things in these three subsegments here. You're investing $150 million in Nuclear. OptiFreight is growing quickly and there's, you know, within specialty pharmacy. At-Home , you have the ADSG acquisition. Would love if you could, don't rank your children, but what are the things you're most excited about here?

Jason Hollar
CEO, Cardinal Health

What I'm most, and I walked through a couple of those key drivers earlier, so I'll try not to be redundant. What I'm excited about is each of the three businesses has a strong core that we're investing in. The distribution capacity, just the manufacturing capacity for the isotopes in nuclear. We have a strong core, but they're also benefiting from the secular growth. With at-Home , it's the trend for more care being delivered to the home. That's a business that only supports the home. That part of the market is going to grow faster. With Nuclear , its industry is the precision health. These isotopes go along with the pharmaceutical products that target cancer cells and other therapies more specific so that the patient is harmed less. Think about it as something better, think chemotherapy, things of that nature.

With OptiFreight , every health system is looking to reduce their freight spend and we can help them with that. Each of these businesses are benefiting from growth in the industry. Each of the businesses are the leader in what they do. They're getting the added support by a broad organization that can afford to invest and not just focus on the day-to-day, quarter-to-quarter type of affordability for a small business. We can really lean in where it makes sense. $150 million for nuclear, but now six new DCs with new automation technology for our at-Home Solutions business. Things that they couldn't do on their own because we're taking a longer-term view.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

Last question for Aaron around capital deployment. You expect $10 billion of cumulative free cash over the next few years. How should we, so a lot of opportunity there to invest in the growth opportunities that you've talked about. Should we think about the capital deployment strategy being relatively static over the next couple of years, meaning you have this opportunity that's in front of you and that's going to be the opportunity that's there for the intermediate term, or would you expect the capital deployment strategy to evolve over the next 36 months or so?

Aaron Alt
CFO, Cardinal Health

The one thing that won't evolve is the core principle of discipline from a capital allocation perspective. As I called out, we're going to spend about $600 million this year. That's a good proxy for future years as well. Investing into the internal needs of the business, that's our internal CapEx. After that, we'll protect our balance sheet, but we'll be within our rating agency guidance this year, notwithstanding all the acquisitions we've already done. That leaves the rest of the $10 billion, if you will, for operating our business. Of course, our return to capital of shareholders through the dividend, the dividend aristocrat. We got at least $2.25 billion of return to capital to shareholders before we then look at further tuck-in acquisitions and additional opportunities for return to capital to shareholders. We're disciplined, we're pragmatic about it.

We are very focused on getting the right ROI so that we're returning that value to our stakeholders.

Allen Lutz
Healthcare Tech and Distribution Analyst, Bank of America

Okay, that's great. We don't have a timer, but I think we're out of time. Jason, Aaron, Matt, really appreciate the time. Thank you so much.

Jason Hollar
CEO, Cardinal Health

Thank you.

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