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7th Annual Evercore ISI HealthCONx Healthcare Conference

Dec 4, 2024

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Thank you for joining us this morning. Appreciate you coming by. I'm Elizabeth Anderson. I'm the Healthcare Services Analyst here at Evercore. Very excited to be joined by Britt Vitalone from McKesson. So I think we'll get started with the time that we have. I know you wanted to say a couple of words before we get started with the Q&A.

Britt Vitalone
EVP and CFO, McKesson

Yeah, well, first of all, thank you for having us here. We're pleased to be here. Maybe just a few things that I would open up with. We continue to execute against our strategy in a very efficient way. Our focus is on starting with people and then focusing on our growth strategies where we have clear differentiation, clear differentiated assets and capabilities in oncology and biopharma services. We're also continuing to execute against our core North American distribution capabilities, our core distribution capabilities in pharmaceuticals and medical supply distribution. And we continue to focus on our portfolio and advancing and modernizing the business, focusing on investments in automation and AI to really help our customers, to help our customer centricity, as well as the efficiencies within our business. We reported our second quarter earnings at the beginning of November.

It doesn't feel like that long ago, but I guess it's been about a month now, and we are certainly pleased with the performance we had in the second quarter. It's just a reminder, we had revenue growth in the quarter of 21% over the prior year. We had adjusted operating profit growth of 7%, which led to adjusted earnings per share growth of 13%. We also delivered about $2.1 billion of operating cash flow, and then after making investments to support the growth in the business, we had free cash flow of about $1.9 billion, and for the first half of our fiscal year, we had adjusted operating growth of 9%, so really executing against the long-range targets that we've provided now for the last several years.

As we look at the back half of the year, certainly there's a lot of investments we're going to continue to make to support our growth. We're certainly excited about the back half of the year and closing out a really strong fiscal year, and one of the things that I talked about at our sell-side update was the tax rate would be between the third and fourth quarters. We would have some variability, so as I think about the third quarter, we continue to execute against our strategy. We've had a good first half, but from a tax rate perspective, we would assume that the tax rate will be much higher in the third quarter than the fourth quarter. Again, for the full year, 17%-19%, but for modeling purposes, we would anticipate that the tax rate would be closer to 23%-26% in the third quarter.

But again, continuing to execute very well against our strategy and continuing the momentum that we have in the first half of the year. And we're really pleased with that momentum. So we're excited about continuing to execute against our strategy and the diversification we have against our clear differentiated set of assets.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Yeah, no, that's a great setup. So if we think about maybe talking about your pharma business first, as sort of your largest business out there, we have the long-term AOI growth target of 5%-7%. If we think about the relative contribution, we usually think about utilization and sort of mix and how you're talking about biosimilars and these things as they wrap in. How do you think about the relative contribution of those different elements to the growth for the rest of this year and maybe as that shifts going forward into calendar 2025?

Britt Vitalone
EVP and CFO, McKesson

Yeah, it's a great question. So we've continued to perform very well in U.S. pharma. And our U.S. pharma business, there is a lot of diversification in that. There's diversification in the customers that we support. So we've got national retail customers, we've got independent customers, hospitals, and then a big provider component to that. And I'll come back to that in a minute. So we continue to invest in our capabilities here, and we think that we're doing quite well this year. In particular, we onboarded a new strategic partner where we're continuing to drive good distribution synergies, scale, and efficiencies.

Within that business, we continue to focus on, as I mentioned earlier, our oncology set of assets and our differentiated capabilities there and the platform that we have built over time to support the growth of distribution and distribution scale through our GPO, our specialty pharmacy capabilities, our practice management through USON . We now have over 2,750 providers within USON . Our capabilities with data, all of our providers within USON practice on the same EMR system. So that gives good data for clinical purposes as well as opportunities to commercialize that data to help support biopharma's investment in innovation and drug development. And then the investments that we've made to continue to grow clinical trials, clinical trial management, and so the research component of that. And that includes the joint venture that we did with Sarah Cannon Research Institute.

One of the things that we're seeing with clinical trials is as we've continued to grow our capabilities there and the partnership with Sarah Cannon continues to grow, we've seen an increase in patient accruals through clinical trials. We've seen an increase of about 25% this year. So that's all supportive of, again, the diversification across that platform. One of the things that I talked about in our investor update in November is if you look across all of the platform capabilities and assets within oncology, the revenue this year is about $35 billion. And we believe that across this platform, it represents higher growth capabilities and higher margin capabilities, again, that diversification across. So we're very excited about U.S. pharma generally, the growth that we've seen, the addition of a new strategic partner, the scale that we have, and within that, our focus on oncology.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

I think that that makes a lot of sense. Maybe digging into the biosimilar opportunity, I think with some of the large launches we've had this year, everyone on the investor side, at least one, has been learning new things in terms of how that impacts the different parts of the pharma supply chain. As we think about sort of the launch calendar for calendar 2025 and sort of your capability sets, what are the biggest incremental opportunities in terms of biosimilars? And what do you think that investors are not quite there in terms of understanding yet in terms of those opportunities?

Britt Vitalone
EVP and CFO, McKesson

Yeah, biosimilars continue to develop. We've seen 61 biosimilars now with about 41 that have launched. That number changes pretty frequently, but I think that's the last number that I saw. For McKesson, it's an opportunity for us to continue to serve the manufacturer and provide services in support of those drugs, and we believe that there's three important capabilities here. First of all, we think that it provides more choice, more clinical choice for the provider. Secondly, a better cost opportunity for the patient and for the wholesaler or the distributor, generally speaking, higher margin rates than we would have seen on the branded or specialty drugs. That really will depend on the channel that the biosimilar is launched into.

Where a biosimilar is launched into a channel or an area where we have more services and capabilities, such as oncology, where we have distribution, the GPO, we have the US Oncology Network, we will generally see higher margin rates there where we're providing more services than where we would see a biosimilar that goes through retail or Part D, where there's fewer services other than general distribution services that we would provide. But overall, generally speaking, biosimilars have higher margin rates than branded or specialty drugs. They may not have the same rate level as a generic. But again, that will depend on the channel and where we're providing additional services.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

No, that makes sense. And if we think about maybe turning to Med-Surg, you have the growth algorithm of 10%-12% AOI. If we think about primary care as being sort of 60% of the volume, that sort of grows maybe low, mid-single digit. So how do you get from sort of that portion of it to that 10%-12% that you guys have been delivering on?

Britt Vitalone
EVP and CFO, McKesson

So the way I think about this has been a great business for us for a long period of time. I started with the company almost 19 years ago, and I started in our medical supply business. And what we've been doing here for the last several years is continuing to follow the patient. Care has continued to move outside of the hospital setting into the alternate settings of care, whether that be primary care, ASCs, all the way through extended care, whether that be skilled nursing facilities, assisted living facilities, home care, and even now a consumer component to this. And we've continued to follow the patient. We've continued to develop capabilities and services around that, whether that would be lab solutions within a primary care setting, whether that be Rx distribution to support a primary care setting or an ASC, or the continued development of private brand.

We have over 5,000 products now in our private brand where we work with manufacturers in over 70 countries today to provide more choice and more flexibility for our customers. We don't manufacture any ourselves. We work with manufacturers from a quality perspective to a supply perspective to provide that choice and better economics for our customers. Over the last five years, this business has grown adjusted operating profit at a 10% compound annual growth rate. And so as we developed our long-term growth rate algorithm, we looked at first, what have we performed over time, where we see the patient moving, and where we see the opportunities, what assets and capabilities do we have, where are we making investments in. These are long-term for a reason.

As we develop these long-term growth rates, it's what we see over a long period of time, the ability of the business to generate these types of returns. We don't change these every quarter. We don't necessarily change these every year. And in some cases, we increase the long-term target rates. In our pharma business, as an example, our initial long-term target growth rate there is 4%- 6%. And as we continue to develop the business, as we continue to invest and see growth, we raise that to 5% to 7%. But we do that. We don't do that on a regular basis. We do that over time because they're long-term in nature. Our history has been very strong here.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

No, that makes sense, and you talked about $100 million in cost savings in Med-Surg. What are those opportunities? What are those costs that you've been taking out, and how do we think about the opportunity set for that going forward?

Britt Vitalone
EVP and CFO, McKesson

Yeah, so what we announced at the end of our second quarter to take effect beginning with our third fiscal quarter was we were looking at aligning our costs and aligning our service model and capabilities to where our customer was and the trends that we were seeing in the marketplace. And we took the opportunity to adjust, in some cases, our sales alignment, in some cases, our operational alignment, some of the investments that we were making in our operations for efficiency performances, some of the capabilities we had in our distribution centers. So really, it was across a lot of different areas, but it was to align the business and align our model to our customers to create more customer centricity. We announced a charge of $150 million, and we anticipate that we'll generate $100 million of savings in the back half of this year.

So the second fiscal year.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

So that's the $100 million. It's not an annual estimate. It's in this.

Britt Vitalone
EVP and CFO, McKesson

It is in this second half of this fiscal year. And I think we're making great progress against that. And we would anticipate that that $100 million of savings would be delivered in the second half of our fiscal year.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Got it. And presumably then there's some flow through to next year, although obviously you haven't guided for our fiscal year.

Britt Vitalone
EVP and CFO, McKesson

We haven't guided to that. But certainly, we anticipate that the payback on the $150 million is obviously quick. But again, it's for alignment. These are not one-time sort of charges and fixes. This is to have better alignment with our customer base.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Yeah. And I think in your opening comments, maybe on a similar vein, you talked about AI. And I know everybody's talking about AI, and that's obviously been a hot-button topic for a while. But how does it specifically benefit your business? Where are you using it most and seeing sort of most early return in terms of either customer experience or your internal operations?

Britt Vitalone
EVP and CFO, McKesson

So AI is certainly an opportunity for us. I don't want to get ahead of ourselves here. We're using it. There are some use cases that we're applying. What we're really focusing on is modernizing the business and automating certain parts of the business. So I think people sometimes use the term AI when it's really just an automation opportunity. It doesn't really matter to us. It's how can we advance and accelerate and modernize the business. There's a lot of places where we're using it today. So we use automation and AI capabilities to help us with working capital management, demand management, and supply management as an example. So those are internal capabilities that create efficiencies. There's also customer efficiency. So one of the things that we've talked about is if you think about the US

Oncology Network and the providers within the practice, certainly we have the EMR where they can capture a lot of the data that they're using to treat their patients. But a lot of times, providers have unstructured notes. And how can you use AI to take those unstructured notes and to use those through the EMR in a more efficient way? And that's an opportunity for us. There's many others, certainly, but that's what we're really trying to focus on is making those investments to create more customer centricity and more operating efficiencies on the back end.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Okay. No, that makes sense. Maybe turning to your international business, which is largely Canada, that has a higher AOI, longer-term growth rate than the U.S. in terms of how you guys have laid that out. What drives that differential in terms of that growth rate? I know you have a slightly different strategy there than you've been tweaking over the last year or so. But can you maybe dig into that a little bit more and help us understand those drivers?

Britt Vitalone
EVP and CFO, McKesson

Yeah, I'd be happy to. So first of all, we haven't really provided a long-term growth target rate for international. What I did provide at the sell-side update is what we've seen from the performance over the last several years, and that obviously has been higher. We have really a great footprint in Canada around distribution and distribution services, servicing a lot of the banner groups in Canada. We've continued to grow that business. We have a good sourcing operation, which in a lot of ways leverages the sourcing capabilities that we have with Clarus ONE, as an example, and so we've continued to really play this out in terms of capabilities that we've been using and expanding in North America, in the U.S. For example, biopharma services and helping with launch services around new drugs in Canada that are being launched.

We think that that's an opportunity for us to continue to grow those biopharma services capabilities in Canada like we have in the U.S. We have a good footprint. We have a strong history of operating performance. We're developing a lot of efficiencies. We think that that footprint will continue to drive good growth for us. I think just the last thing I would say here is we did announce the planned divestiture of Rexall. That is going to increase our focus back to our distribution assets and the capabilities that we have diversification, but differentiation in.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

That almost brings it a little bit back closer to sort of the U.S. strategy of focusing more on that distribution side.

Britt Vitalone
EVP and CFO, McKesson

Again, as we've done in the past, whether it was the change split off or was it with Europe, we're focusing on where we have differentiation and leading capabilities and allocating capital to those areas versus allocating capital to all areas that we could participate in.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Yep, that makes a ton of sense. Maybe just talking about a little bit more where you have been allocating capital on the oncology platform. I think we've seen you obviously announced the acquisition of Florida Cancer Center. And you've been continuing to add providers on that space. How do we think about what the growth strategy is going forward? That market now seems you were an early leader in sort of consolidating, bringing into the fold the broader community oncology market. So now that that's, I guess, largely sort of consolidated, where's the growth opportunity from here?

Britt Vitalone
EVP and CFO, McKesson

So again, I would take you back to sort of the strategy. And this will be very similar for biopharma services. What we're looking to do is to create a platform, a platform where we can use the differentiation that we have across many different areas in the company. So if you go back to around 2007, this is when we really started to build the platform. And what we did is we identified a therapeutic area where there was going to be a lot of investment in drug development. And that was sort of the foundation for this. And we acquired a company that helped us grow scale around drug distribution called OTN.

And over time, as we developed this opportunity and this strategy of developing the platform, again, oncology, the area where you're seeing the most investment, the most drug development, and that was an opportunity for us then to continue that scale opportunity by buying the US Oncology Network and getting into practice management. So now you have additional scale in drug distribution. You have GPO services around that. And now you have practice management. And the US Oncology Network has grown to over 2,750 providers today. So we continue to add providers. There's continued growth in drug spend around oncology. There's continued innovation and investment there. And we then continue to build out the platform, the capability. So we created this company called Ontada to utilize the data that's coming off of the US Oncology Network.

And how can we use that for better clinical purposes and better clinical outcomes, but also to create opportunities for commercialization with manufacturers as they're looking to develop new drugs and they're looking for innovation; they could utilize this data to be more efficient in that. And so there's a data business that comes off of that. And many of our US Oncology providers did clinical trials. And there's opportunities, obviously, with clinical trial research. So we continued to expand that. We partnered and created a JV with Sarah Cannon Research Institute to continue to expand access to clinical trials, to expand our capabilities around site management and clinical trial management. And that's been a great opportunity for us. And now we're able to see more providers that are accruing patients at a higher level. So the platform is drug distribution. It's data. It's GPO services.

We have specialty pharmacy services. We have, obviously, the management of the providers all the way across to clinical trials. It's a wide, expansive platform rather than getting into a therapeutic area and just managing providers or just managing distribution. We're looking for opportunities where there's higher growth, there's higher margin opportunities, there's drug spend and drug innovation. Oncology was that place. We still think that it is going to be that place, and we've been adding providers. We think that you can still add providers to this. We've added 185 providers to the network this year, so the opportunities there continue to add providers, continue to add scale to drug distribution, continue to add opportunities to clinical trial and site management. We think that oncology is that platform.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Yep. No, that makes sense. I think some of your competitors have been recently more focused in a slight butchering of the English language, other ologies. How do you think, are there sort of other places where you see an equally exciting incremental opportunity in those other ologies, or is that sort of you think of that as sort of like a distinct pathway?

Britt Vitalone
EVP and CFO, McKesson

So we service other ologies, whether that be neurology or cardiology or pick your ology. We support those through drug distribution and GPO services. And in some cases, other services that we do in oncology where needed. We haven't built a platform around this yet because, again, we're looking for areas where there's a lot of drug development, drug investment, and drug innovation. There will be other areas as other ologies continue to have drug investment innovation. There may be other opportunities for that. But we service many of those today through distribution. What we're really not focused on is getting into an ology to just manage providers. Managing providers is hard. And managing providers doesn't provide the same economics and growth as the platform of capabilities.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Got it. I think that's a key differentiating point. Maybe back on the FCS accretion. I think you talked about $0.40-$0.60 in year two and then up to sort of $1.40-$1.60 in year three. How do you think about where that incremental opportunity is coming from that drives that accretion?

Britt Vitalone
EVP and CFO, McKesson

We're excited about Florida Cancer. We think that it fits the platform. It's right on strategy for us. This is subject to regulatory review and approval. I think that's important. But when we get past that, we would anticipate that in the first 12 months post that regulatory approval, that we would see $0.40-$0.60 of accretion. And by the end of the third year, we would see $1.40-$1.60. Over time, as we get through the integration, there's obviously an opportunity for the drug distribution. We would anticipate that coming on. There's opportunities to create more efficiencies operationally within the practice management, but also opportunities within clinical trials and site management and clinical trial research as we bring on what is approximately 530 more providers.

So again, as you get through the integration, as you get through some of the efficiencies and some of the synergies that we will bring to the table, that's how you would continue to move that accretion number up.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Got it. No, that makes sense. And how do you sort of think about some of the Ontada capabilities and sort of where you could see some upside in that in terms of that pending transaction as well?

Britt Vitalone
EVP and CFO, McKesson

Yeah. Again, we think that this is a clear differentiation because, again, you got 2,750 providers all practicing on the same EMR. So you got a lot of data and the richness of the data to leverage not only for clinical purposes, but as you add insights and add other capabilities to that, there's an opportunity as manufacturers are looking to invest and they're looking to do innovation and commercialization to partner with them and provide this data to them. And we think that that will continue to grow as drug investment and drug innovation continues to grow. So we think that adding more providers adds more data. We can have more richness of data, add more capabilities to that data. And it's a flywheel effect.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Yeah. No, that makes sense. One thing you have also been talking about recently is increased sourcing benefits from ClarusONE . Is that sort of how much of that is a benefit from adding your new strategic partner this year onto the platform and sort of maybe some increased volume there versus sort of other initiatives? And can you sort of help us think through what those initiatives are and why that's driving sort of the upside results in that business?

Britt Vitalone
EVP and CFO, McKesson

Yeah. So ClarusONE is our sourcing engine for generics across the enterprise. We have a partnership here with Walmart that we're very proud of. Obviously, adding scale to this gives us more opportunity to work with manufacturers to utilize that scale to create opportunities for cost benefits for our customers, to create spread opportunities and economics for the wholesaler. But also really what we're focused on is surety of supply. And so as we've continued to add scale and mass to that, and we've continued to add manufacturers, we've continued to add diversification to the manufacturer base, what we're really focused on today is the surety of supply. You can't have somebody show up at the pharmacy counter and not have a product there. So we really focus on that. And we focus on the best low-cost opportunity around where that supply is.

Having more scale also gives us more insight, more insight into API, more insight into where the finished fill for the product is. Now having this almost 10 years in existence, we continue to create really good efficiencies and opportunities through that sourcing engine. We're really proud of it. We think that the surety of supply has been outstanding. Our service levels continue to improve. Our capabilities and number of partners continues to expand. We think that it creates good spread opportunities for McKesson, but good cost opportunities for our customers.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

That makes sense. And maybe sticking to the supply topic, one thing that's been a big question for investors since November is what's happening in sort of some trade policies. Are generic API costs going to go up because of the supply from China? How do we think through where you think there might be? And I know it's hard because there's not exactly a policy in place yet, but how do we think through if generic API prices were to go up? Or where else do you see the potential impact from some of the proposed changes to the trade policies?

Britt Vitalone
EVP and CFO, McKesson

I'd say no different than what we've seen over the last few years. Again, if there are tariffs or there's just increase of costs because of supply outages or shortages or whatever that might be, our focus is always going to be to make sure that we have the product available, to make sure that there's high quality around the development of that product, whether it be a medical surgical supply or whether it be a generic. We focus on quality of our partners, the quality of the product that comes out of our partners. So we'll always focus on quality and surety of supply. The fact that we don't manufacture ourselves gives, we believe, gives us more flexibility to utilize that flexibility across many different geographies, across many different suppliers.

And we continue to focus on that diversification, adding quality suppliers so that we can be more flexible to meet whatever challenges or policies come into place. So we think that if there are tariffs or there's an increase in tariffs, that continue to focus on diversification of where the products come from, diversification on the quality of those products, that we'll be in a good position. And generally speaking, those costs, we would pass on to our customers.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Right. That was my next question. Yeah. And that's happened in prior examples when we've seen that across the businesses. I guess you mentioned it, and I just want to clarify whether you're talking about it in terms of the broader business or specifically on the drug side, having that not focused on the manufacturing yourselves and having that flexibility. If we think about maybe Med-Surg in particular, there have been a diversity of strategies in that market. Can you talk about the thought about having the value of potentially having manufacturing footprint versus what you just talked about in terms of some of the broader flexibility by not being vertically integrated like that?

Britt Vitalone
EVP and CFO, McKesson

Yeah. Well, first of all, the private brand has grown over time. We think that our customers want choice. And there's an opportunity for us to give them that choice, but also do it in a low-cost quality way. We don't think that it's the right business for us to be in to manufacture that, whether it be the capabilities, the working capital piece, the additional quality constraints that would come on that. We think partnering with a number of manufacturers who do this on a regular basis, we can find the right quality, we can find the right geography, we can get that diversification. We think it also provides us good flexibility. And so that's a strategy that's worked very well for us. Our private brand portfolio has continued to grow. We have over 5,000 products now.

As I mentioned, we have hundreds of suppliers that we work with. So we think that we have a really good program here that is, again, quality-based, surety of supply, and diversification. We think that provides us really good flexibility.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Got it. No, that makes sense. If we talk about your new strategic partnership, I mean, it's been since July that that's been up and running, so still in early innings, I would say. If we think about what's been the biggest incremental learning so far, there's sort of things that are specific to that contract that's sort of applicable to the broader business or sort of any incremental learnings that you guys have had as you've onboarded that business?

Britt Vitalone
EVP and CFO, McKesson

Yeah, so we're proud to be able to serve this customer as all of our customers. Obviously, this is a large customer. Just as I mentioned here, we expect that the revenue from this customer this year will be about $31 billion, and that's the last three quarters of our fiscal year. Obviously, every customer has unique circumstances and challenges, but as we have with most of our customers, all of our customers, the transition has gone seamless, and we're really pleased with the ability to onboard this customer, to continue to do this in a seamless way, to bring it into our sourcing program from a generics perspective, so I don't know that there's any specific learnings. Again, the partnership has been great. The transition has gone very well. We're pleased with the efficiencies that we're seeing so far, but as you mentioned, we're five months into this.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Right. That's what I was going to say. With new contracts and sort of onboarding them, obviously, this was a very large one and one that executed, as you point, seamlessly. How do we think about when you get to sort of run rate profitability? Because I know there are some startup and transition expenses and that kind of thing. Is that something you expect has sort of gotten there already? Is that something that sort of takes a year or two to sort of iron out all the final bits? How do we think about that?

Britt Vitalone
EVP and CFO, McKesson

In this particular case where it's a distribution relationship, the cost of integration and onboarding are not material. The costs or the investment in working capital is significant to be ready for this transition. And we've talked about that. We're mostly through that now, six months in. So the costs of integration are really immaterial here. We are at run rate on this. The opportunities to continue to partner with a customer and to continue to find efficiencies and opportunities as a partner, those continue to exist. But I think we're really pleased with the transition so far and the seamless nature of it.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

That makes sense. If we think about where you guys have always had a sort of portfolio approach to capital deployment at different times, focusing on more or less on different portions of it, as you sort of sit here mid through your fiscal 2025, where do you see sort of the most interesting incremental opportunities? Obviously, you just purchased Florida Cancer Center. You obviously did some share repurchases recently. How do we think about sort of the go-forward state from here?

Britt Vitalone
EVP and CFO, McKesson

Yeah. There's three key pillars to how we think about capital deployment. And I'd say that the third one really just underpins the first two. What we're always trying to do is create value for our shareholders. We think that growing the business is the number one priority, continuing to grow the business on our growth strategies where we have clear differentiation, where we believe there's higher growth and higher margin opportunities. And that's oncology and that's biopharma services. So the number one priority for us is to grow the business, to grow it on those strategies, to grow it where we have higher margin and higher growth opportunities. So that's number one. We can do that through internal investment. We can do that through acquisition. Florida Cancer is a good example of an opportunity that's right on strategy where we think deploying that capital makes a lot of sense.

We're also going to continue to deploy capital back to our shareholders and return it back to our shareholders, whether that's a growing dividend, and we've grown our dividend now for the last seven years. We're committed to that. We're committed to growing the dividend in relation to earnings growth. Our board approved an increase to the dividend in July of 15%, so we're pleased to be able to do that and continue to do it through share repurchases, and we think that that's been a value-creating event for our shareholders over the last several years as well. We intend to do that in a consistent way, be in the market to return capital in that way. We think that doing both of those and we have the capacity and flexibility to do both of those is important.

Again, number one priority growth, but always looking for opportunities to return capital to shareholders. Underpinning all of that is the strength of our balance sheet, our financial foundation, and our credit metrics, which continue to improve and are strong. So we think that there's a lot of opportunities to do that. We're going to be very disciplined. We're not going to force acquisitions. We're going to look for those that have a high financial return on strategy. If we can't find those or they're not available and they don't meet our requirements, we'll just continue to return capital to our shareholders.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

That makes sense. I think one thing that people have talked about and probably talked about for the last 20 years is sort of the underlying strength of some of the core retail pharmacies in particular versus sort of the strength in terms of your results and those of your competitors as well. How do you think about the sort of troubles that those businesses have had in recent times and over the years versus sort of the opportunities that maybe that presents in certain ways? And obviously, you have a much more diversified business, so this is one portion of it. But how do you kind of think about that and sort of where there might be opportunities for you guys going forward?

Britt Vitalone
EVP and CFO, McKesson

Yeah. Look, we have great customer relationships across national retail as well as independent. And as I mentioned, also health systems. What we focus on is creating those partnerships where we can add value. We can add value through our sourcing capabilities, certainly through our generics programs, supporting biosimilars, and the clear cost advantage that provides for the patient and the flexibility of choice that it provides for the provider. We look for opportunities to utilize the scale that we have to create efficiencies. With independents, we can create more opportunities. That could be inventory tracking. It could be medication management capabilities. It could be a whole range of support services that we provide them.

So what we're looking to do is to find those partnerships, to find those opportunities where we can use the leverage and the scale that we have, the platforms that we have, like our oncology platform, and create more opportunities for our customers. That's what we focus on.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Yep. Okay. That's very fair. And as we think about the last couple of minutes, what do you think that the parts of McKesson that investors don't understand properly is? And maybe you have a whole laundry list, but maybe we focus on a couple of them.

Britt Vitalone
EVP and CFO, McKesson

I don't want to pretend that I know exactly what's on everybody's mind. But what I think is important is we have created two really successful growing platforms in our oncology business, which we've already talked about, and our biopharma services that differentiate. We didn't talk about our biopharma services capabilities, but if you think about the access and affordability programs and the suite of solutions that we have, they're differentiated. There are no solutions like that that touch 950,000 providers and 50,000 pharmacies and that have an asset like the Relay network that has an amount of transactions going through it, all of this going through and connected through workflow. So we have differentiated platforms that, again, are growing faster and have higher margins. Those two businesses are places we're going to continue to invest to create more value.

If you look at the return on invested capital in the business over the last several years, we've almost doubled the return on invested capital inside the last six or seven years. Again, focusing on value, focusing on where we can create differentiation and creating value for our shareholders. I think that's the piece that perhaps is not as well understood or well appreciated, is the scale of those businesses, the growth opportunities of those businesses, the growth that we've already captured, but the growth that we see coming ahead of us and the return on investment that those assets create.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

Yep. No, that makes sense. Maybe just to pivot one question off of that Relay portion. Obviously, we know of that as sort of serving pharmacies. What are the data opportunities I think you just sort of alluded to in the sort of broader platform opportunities, maybe specifically off of Relay?

Britt Vitalone
EVP and CFO, McKesson

Yeah. Maybe not specifically Relay, but across the entire platform. Again, if you think about the connectivity and the 950,000 providers that are in this network and the 50,000, I mean, you just have a scale of data going through, a scale of providers and payers and pharmacies that are leveraging this and putting data through this on a regular basis that I think is just clearly differentiated and supports the services capabilities that we're partnering with pharma on.

Elizabeth Anderson
Healthcare Services Analyst, Evercore

That makes sense. Well, thank you, Britt. It was a pleasure. And thanks to everyone for joining us this morning.

Britt Vitalone
EVP and CFO, McKesson

Thank you.

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