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JPMorgan Healthcare Conference

Jan 10, 2023

Lisa Gill
Healthcare Services Analyst, JPMorgan

Good morning. My name is Lisa Gill, and I'm the Healthcare Services analyst with . It is with great pleasure this morning that we have McKesson. Presenting for McKesson is CEO Brian Tyler. Also with us this morning is CFO Britt Vitalone. Brian and Britt will join me over here at the table for a Q&A post Brian's presentation. Brian?

Brian Tyler
CEO, McKesson

Thank you.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Welcome back to San Francisco.

Brian Tyler
CEO, McKesson

Yes, welcome back. Happy New Year, everybody. Condolences to any TCU fans, including Lisa. Well, good morning, everybody. It really is great to be back, be in person, and on behalf of the 40,000-ish employees of McKesson, have the chance to share a little bit of our story with you. Before I begin, just the standard reference to our disclosures and caution you that I will be making comments that could be forward-looking, may refer to non-GAAP metrics. I encourage you all to read our statement, if you desire more information, you can find it on mckesson.com in the investor section of our website. We all know healthcare is a large, growing, dynamic market. You're gonna hear throughout the conference about aging demographics and the trends that support the growth of that market.

When people think of McKesson, they often first think of us for our very relevant and scaled distribution businesses in North America, our pharmaceutical distribution, and our medical distribution businesses. They deserve that thought and that recognition. They are scaled, enduring businesses. We deliver over a third of the prescription medicines in the U.S. each year.

What really excites team McKesson and motivates us when we get up is the opportunity to innovate and to solve, working with our customers and our partners across the supply chain, some of healthcare's biggest problems, particularly problems that relate to accessing medications or improving cancer outcomes and quality of care. We think those are really big problems that working together, McKesson has a relevant role to play, and they're an important part of our growth strategy that I'm gonna share with you today.

About three years ago, we put together our corporate strategy and our company priorities. For those of you who track McKesson, not a lot of this will be new, and we think that's actually a good thing, 'cause we've been very focused on sticking to our playbook, if you will, sticking to these company priorities. I'll go through each of them in detail, but quickly, they really start with a focus on our people and our culture.

We very much have a best talent mindset and wanna create an organization where we allow that talent to work at its very best level every day across the company. We've been focused on our portfolio of capabilities in two ways. One, the mix of those capabilities, making sure that our capital deployment is tightly aligned to where we have the best growth opportunities.

That's led us to do a series of things like exiting the European region. We exited a handful of other smaller businesses. We've invested in technology to modernize the business. We've been simplifying internal processes so we could go faster. Recently, we've begun to supplement some of our capabilities in our oncology ecosystem and our biopharmacy ecosystem, which we think will further support and expand and open growth markets for us. Our third key priority is to invest into and develop and win in oncology and biopharma services. We have differentiated capabilities, deep and long expertise in fast-growing markets, we're excited by that.

This is all anchored, of course, in those distribution businesses I referenced, which have good growth in them, among themselves and generate the free cash flow that provides a strong balance sheet and the ability to invest internally and externally in the business. Let me talk first about our first priority, our people. This is really the foundation of everything we do. It's anchored in our ICARE values, integrity, inclusion, customer centered, accountability, respect and excellence. Those have been core parts of our culture for a very, very long time. What really motivates team McKesson is taking all these capabilities we have and bringing them to bear and impact on real patients' lives every single day. That is our purpose, to advance health outcomes for all. We care deeply about the communities that we live and work in.

We care about the world more broadly. I'm very proud of the recognition we've received for our diversity, equity, and inclusion efforts. That includes women, that includes disability, that includes military. We think of this quite holistically. Inclusion means everyone to us. Our foundation has been very active in supporting the development of clinical professionals with a diversity lens on that, I'm quite pleased with our efforts in sustainability. In fact, we now have officially approved SBTI targets. That target is to reduce Scope 1 and 2 emissions by 50% over a baseline year of FY'20 by our fiscal 2032. That's our first priority, people and talent, I really could talk the entire time about it, 'cause I do think it's underappreciated. Our second priority, though, is to really think about the portfolio.

In many ways, this is not just capital allocation, but it's intellectual allocation, it's time allocation. It's focus on the things and the areas that we markets we play and where we think we can drive superior growth. I talked about the exit of the European business. We're out of 11 of 12 of those businesses in the European region. We will exit Norway at some point in time. We're very focused on North America. That focus in North America is now on improving efficiencies, driving efficiencies through the business, leveraging a modernized technology platform to allow us to go with speed and more quickly.

Most recently, in the past several quarters, we've been able to use our balance sheet to further invest into our growth platforms, RxSaving Solutions in our biopharma services ecosystem, Genospace, and a really exciting joint venture with Sarah Cannon Research Institute in the community clinical oncology space. I'll talk about each of those a little bit more. Our two growth platforms are oncology. We call them ecosystems 'cause it's a collection of assets, and I'll show you that. First and foremost, as we shared in our investor day, we think this is about a $55 billion market opportunity for us.

A little over half of that you'll see on the left part of this chart, which is the supply chain related services, distribution, GPO services, where we are a clear leader in community oncology and other specialty therapies. We've been in this business a long time. We have a leading footprint of community practitioners there, that's the real anchor that has allowed us to grow and expand our services across to the right side of this page. The first differentiated asset that we really have is The U.S. Oncology Network. This represents over 2,000 providers. To give you a sense of the scale of that business, in this past year, we believe we've treated 15% of all new cancer presentations in the U.S. This, to our knowledge, is the largest community practice management business focused on oncology.

It gives us great deep insight into how clinical care really happens. We provide the tools that enable our clinicians to provide that world-class care in the community setting, which is the low-cost setting. Building off of that insight and that knowledge, we've built the clinical trial business that I just talked about. Again, this is a joint venture between the US Oncology Research Network that we've had for a long time and the Sarah Cannon Research Institute. The collection of these businesses together give us over 250 locations that are accruing patients into clinical trials. This is really important because, you know, it's difficult to find patients and get them enrolled in clinical trials. We know these settings are in the community, they're closer to patients.

With the data that we have flowing, we think we can help accelerate that and bring even more diversity into the clinical research trial programs that are so important. Lastly, taking the data and the information and the insights that come from the distribution, come from running the largest oncology network, come from having the clinical trial business. We have developed, largely internally, a data and insights business we call Ontada. It's anchored off our oncology-focused EMR we call iKnowMed. Using that practice data and practice insights, we have access to over 10 million patient visits.

Ontada really takes those kinds of insights, works with manufacturers to help them understand how their products can be better used in the community setting, how they can get markets, get their research, get products out of the lab, into the community setting more quickly, to figure out how to commercialize and accelerate the adoption and ultimately drive better cancer outcomes for patients. We built this collection of assets over a long period of time. You can see we started in 2007. I think the takeaway I'd like you to have here is these are businesses we have been in for a long time.

We have very methodically invested and expanded our capabilities to continue to open up new adjacent growth markets, and that will continue to be a key part of our strategy in our oncology ecosystem over time. We think that really supports the long-term growth targets that we've talked about for this segment. The second growth strategy I wanna talk about is biopharma services.

That's how we call it and how we talk about it. This business is fundamentally about helping patients get access to medications so they can live better lives. We're targeted on three sub-parts of this market right now: affordability, access, and adherence. How do we help patients access their medications? How do we help patients afford their medication? We know there are a lot of abandoned prescriptions at the pharmacy counter because people are shocked by the copay.

Last year, using our networks, our connectivity to workflow in pharmacy, our partnership with manufacturers, we helped facilitate over $6 billion of out-of-pocket cost relief to customers at the pharmacy counter, allowing them to afford their medications. This business is fundamentally a technology and a network business. We started building this business in 2006 with the acquisition of RelayHealth, which gave us connectivity to over 50,000 pharmacies right into the workflow so that we can message and help their workflow management be more seamless to give the customer the experience that they need. We augmented that with CoverMyMeds, a long-time partner, that brought us the network and connectivity to over 750,000 providers.

RxCrossroads brought us scale into a business we had already been in around hub services and patient support programs, expanded our clinical expertise across many new therapeutic areas. In 2020, we brought these businesses together into Prescription Technology Solutions so that we could migrate from being a great set of point solutions to a more comprehensive end-to-end solution for medication access and adherence for patients. Most recently, we acquired RxSaving Solutions, which is a prescription price and transparency, provides benefit insights. McKesson was actually a customer of theirs. We have real-world experience with them. Any large employers in the room, I would encourage you to check them out. It both saves your employee population on their prescription costs. It saves the employer plan as well. We're really excited to welcome RxSaving Solutions to our family.

Just a couple of the key common themes, I think, from our two growth areas that I wanted to underscore. One is we have a long track record of innovation and value creation. We have deep and lasting expertise. These are large and growing markets with unmet needs, so there's a great opportunity to innovate. We're operating platforms at scale. We transacted over 19 billion transactions last year in this business. It has broad reach and depth, 50,000 pharmacies, 750,000 providers. Fundamentally, this is a differentiated portfolio of solutions targeted at markets that we think have good growth prospects for the long term. That's a little bit about our strategy. Talk about how we roll that into a value creation framework for our shareholders. It really starts with organic growth.

We've got good organic growth opportunities across our businesses. We want all our businesses to grow at or slightly above what we would consider to be market rates. We wanna bring that operational excellence, that operating efficiency that McKesson has long been known for, and real discipline around how we think about managing margins in the business. We combine that with a strong balance sheet and our ability to allocate capital. The ROIC in our business today is over 20%, so we think we've been good stewards on capital allocation. When you put that together, organic growth, operating leverage, capital allocation, we think this allows us to deliver double-digit, sustainable, adjusted EPS growth. I'll talk for a minute about our FY'23 adjusted EPS outlook. You can see it's $24.45-$24.95.

If you were to exclude the contributions from COVID, kitting, and vaccine, and you were to exclude our McKesson Ventures gains and losses, this would be FY'23 guidance that would indicate 11%-14% adjusted EPS growth when you make those adjustments. You might recall, if you were at Investor Day with us, two Decembers ago, we rolled out our long-term segment targets. I wanted to just revisit on this slide and put into context the fact that each of our segments this year are tracking to be on or ahead of that long-term segment guidance. In the case of Prescription Technology Solutions, some of the strong growth this year is probably a normalization from COVID effects that we saw last year as scripts have rebounded.

it's kind of constructive to look on the far right side and look at our FY'19 to FY'23 compound annual growth. Again, looking forward to the end of FY'23. you can see these are pretty consistent in line, if not slightly ahead, of what we provided as long-term growth targets for these segments. we're very proud of what the businesses are accomplishing this year. Once again, our long-term financial framework is to combine organic growth, operating discipline, and leverage and capital allocation to deliver sustainable 12%-14% baseline adjusted EPS growth. we're very excited about what we've been able to accomplish the last few years. We are committed to and very dedicated and focused on executing this strategy. I'm pleased with the way the company has executed over the last few years.

We're excited about the portfolio of capabilities we have. Both our core distribution, more, as importantly, if not more, the work we're doing in our Prescription Technology Solutions and our oncology ecosystem to impact patients, to improve healthcare in this country and in Canada. We are a purpose-driven organization. We have an incredibly dedicated team that's committed to delivering on this strategy. I hope you find this to be a compelling shareholder value creation, and I hope you're excited about the growth markets that we're operating in today and will continue to expand into the future. Thank you very much. We very much appreciate your interest in McKesson.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Thanks. Thanks, Brian, and thanks for all the detail. You know, as we think about McKesson and think about them over the last few years, a lot of things happened in the calendar year of 2022, right? We finally got opioid settlement behind you. You sold the most of the assets in Europe, right? Kinda putting that divestiture behind you. At your Analyst Day a year ago December, then again today, talked a lot about the opportunities in both oncology as well as biopharma. As we think about the future of McKesson, clearly you did talk about that drug distribution is still important. As we think about the future of McKesson, do you have the assets today? Are there tuck-ins that you need to make?

Is there another potential leg to the stool that you need to add as we think about the growth areas?

Brian Tyler
CEO, McKesson

It has been a crazy last year or two or maybe even three, you could say. I would say one of the reflections I had as I prepared for this was really just a great sense of accomplishment on behalf of the team. I mean, that's a lot of possible distractions exiting of, you know, Europe, resolving opioids, standing up a national response to COVID pandemic on both the medical and the pharma side, yet still executing on the strategy and the, and the core and delivering on our commitments in the business. Very, very proud of what the team has done. If I think about, you know, the growth strategy that we just walked through, we've got great conviction that we're in the right areas, that we have the right sets of assets to win today.

We also believe, though, we can continue to build and expand, and you saw the timeline of, you know, the last 15 years, how we've built out both of these platforms. We would hope to continue to expand like that in near adjacencies, but I wouldn't characterize it as we're missing a leg of the stool or, you know, I think you'll continue to see us deploy capital internally and externally through M&A on things that would be very tightly aligned to the strategy that we outlined. That would, by the way, could include investments in the core. I mean.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Right.

Brian Tyler
CEO, McKesson

Those are still very important businesses. You know, while we may not always see as many opportunities there, we have executed some in the recent past, like MSD and others that we would continue to do to support their long-term growth as well.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Britt, a question for you. When I think about the fact that we're more than halfway through, a lot more than halfway through your FY'23, a reminder for everybody, their fiscal year ends March 31st. I saw that Brian talked about, you know, the core guidance of 11%-14%, excluding COVID items, in the McKesson Ventures. Can you maybe just talk about, you know, kind of the upper end and lower end and some of the things to think about within that number?

Britt Vitalone
CFO, McKesson

Yeah, sure. As Brian mentioned, we're really excited about the execution that we've had. We manage this business for the long term, and that's why we're able to give the long-term guidance that we have, and we're executing against that. As we think about the rest of the year and as we think about early indications for next year, there are a number of things that can be drivers for this business going forward. Brian talked a lot about the momentum that we have within our core businesses, and I would point out a couple of those. Within our U.S. Pharmaceutical segment, we're still seeing very strong growth in oncology, as Brian mentioned. Good momentum there. We're adding providers to The U.S. Oncology Network. We've continued to do that over multiple years.

We think that the platform that we have is attractive to continue to add providers, which reinforces other parts of the ecosystem. It reinforces our ability to use data in a very powerful way, upstream and downstream. It reinforces the ability to expand our clinical trial capabilities and solutions. We've got really good oncology momentum, and as Brian talked about, it's a very large market, the opportunities there are great. Also, within U.S. Pharmaceutical, we continue to see strength within specialty providers and the solutions and capabilities that we have there, the growth has been good. We expect that that's gonna continue certainly through the rest of this year. Our U.S. Pharmaceutical business has really solidified, we're seeing good growth there. In fact, last quarter, we raised our FY '23 guidance, which is reflective of that.

Within our medical business, we continue to have a very strong set of capabilities and solutions. We've talked about that. We're well positioned, whether that be in private brand or our ability to offer pharmaceuticals in office to physicians, you know, the breadth of services that we have, our lab capabilities. You know, I'd also point out within our RXTS business, Brian talked about all the opportunities that we have there. You know, we certainly have been investing in that business on an organic basis.

Over the last three years, on average, we have organically invested $100 million a year. Very significant. Again, the opportunities are great there. We think that, you know, to continue to have sustainable growth in this segment, given the opportunities that we have and the assets that we have, we're gonna continue to invest in this business.

It won't be on a straight line, but we think investing in this business has driven some of the growth and the opportunity that we have, and we're gonna continue to do that. We've also done it inorganically, as Brian pointed out, with our recent acquisition. We certainly have opportunities for incremental capital deployment. We have a very strong balance sheet, good financial position. Our free cash flows continue to be quite strong, so we have opportunity for incremental capital deployment. I think there's a number of things that just are great momentum within the business that we're just gonna continue to capitalize on.

Lisa Gill
Healthcare Services Analyst, JPMorgan

When we think about overall drug utilization, it feels, based on IQVIA data, that we're somewhat back to normal. One, would you say that that's a fair characterization? Two, we've talked a lot about flu. If I remember historically for drug distribution, not a huge tipping point, maybe a little bit on the fringe. Can you talk about flu? Thirdly, generally, when we're together this week, we get pricing from the pharma manufacturers, right? I also know that's a much smaller component to your profit, but just curious if pricing has come in generally what was in your expectations.

Brian Tyler
CEO, McKesson

Okay. Scripts, flu, and I'll let you do pricing. I can only juggle two things at once. Yeah, I think, you know, we see the IQVIA data that you do, and certainly, you know, I'd say taking out the volatility and the COVID prescriptions themselves, I think that prescription development's been in line with how we thought it would be when we gave our initial guidance, and that is that it would recover to pre-COVID levels. It's really kind of right where we thought it would be. As it relates to the flu, you sort of led the witness to the answer. You know, flu, sure, it helps drive traffic in stores. It could help drive some physician visits.

Flu vaccine distribution in and of itself is probably not gonna be material or a needle mover around the variations that we have. you know, the flu season this year was earlier than it has been, but if you track this every year, you know, you can see it always comes at a different time. It spikes at a different time. It has a little bit different durations. Look, we track flu closely. you know, we distribute it both through our medical business and through our pharmaceutical. We're the largest flu distributor in the U.S., we believe, so we've got all the capabilities. yeah, it's not gonna materially be a swinger up or down for the company.

Britt Vitalone
CFO, McKesson

As it relates to pricing, the short answer is what we've seen to date, of course, it's very early in our fourth quarter, what we've seen to date is in line with what we have expected. You know, I'd break this up maybe into 2 points here. First, on the branded side. As we've talked about now for many years, you know, our reliance on pricing is lower than it's been at any point in time in the company's history. You know, less than 5% of the operating profits generated is a result of pricing, you know, pricing changes, brand pricing changes.

We are very focused on giving our manufacturer services, a wide variety of services and being compensated a fair value for those services. On the generic side, you know, what we have seen is over time, you'll see pockets of inflation and pockets of deflation. If you look over a long period of time, generics generally do deflate. There'll be certain quarters where it'll deflate more than you've seen in a prior year. We're focused on having a strong set of sourcing capabilities, which we have with our ClarusONE operation, which is scaled, which is delivering a stability of supply at a low cost for our customers, then being very disciplined about how we price that on the sell side of the market, and that's delivering a spread for us, and that spread is growing.

Our ability to be very focused on, you know, who we source with, how we source, the mechanism that we do that with, our partners, and then being very disciplined is driving spread. If you think about a change in generic inflation or deflation, a 1% change doesn't drive a material impact to spread whatsoever. We still remain just very focused on having a scaled operation, delivering, you know, stability of supply and being very disciplined in the marketplace on the sell side.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Just to that point, you said pockets of inflation, pockets of deflation. You know, one of the things that has surprised us is that everywhere else, there's inflation these days, and, you know, how is it that these manufacturers can continue to stay in business? Do you see some of the generic manufacturers potentially pulling out of the market, just because from a cost perspective, as we think about 2023? You know, you look at a number of them that way, there's a number of drugs they're not making money on those.

Britt Vitalone
CFO, McKesson

You know, I think if you look over a long period of time, what you see with manufacturers, they just manage their various products and product lines. There's lots of things that go into the pricing of a generic. I'm not, you know, I'm not on that side, but certainly the number of manufacturers, where the molecule is sourced from, those are all factors that go into that. We've seen over years that manufacturers are gonna be disciplined about how they manage their own product lines. I don't see anything in today's environment that is really materially different than what we've operated in over the last, you know, decade or so. We're gonna continue to see manufacturers be thoughtful about what products they wanna offer and what products that they wanna manufacture.

Our job for our customers is to go out and source with good partners and make sure that we have stability of supply, and we're delivering that low cost, and we've been able to do that.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Yeah, Brian, you touched a little bit on it today, and in the past, you've talked about the oncology business, which has been such a growth driver for McKesson. Can you spend a few minutes? You touched on some of these new partnerships like Sarah Cannon and how Ontada kinda fits into all of this, but can you spend just a few more minutes helping people to understand kinda the long-term strategy and how these relationships work?

Brian Tyler
CEO, McKesson

Sure.

Lisa Gill
Healthcare Services Analyst, JPMorgan

On a go-forward basis?

Brian Tyler
CEO, McKesson

Well, you know, I think this strategy starts and is anchored in our leading presence in community oncology distribution and GPO services. That gives us access to a lot of community providers. In many ways, it can be our first introduction to recruit someone into our network. You migrate from the great distribution footprint, the scale you have in GPO services and in distribution. I point to our network, the 2,000 community oncologists that I referenced, all operating on a common IT platform called iKnowMed, which delivers us tremendous, you know. I'd say the goal here is two things. One, we wanna use our technology and our insights to help our oncologists practice better medicine and drive better outcomes for the patients that walk in our doors every day. Oncology care is complicated today, right?

I mean, The science is evolving so quickly that drugs are becoming more and more targeted. There's more and more testing and ancillary things that have to go around the treatment of them. What we can do is sorta standardize through our clinician groups, you know, a standard review of the literature, clinical formularies and protocols, and then push them through that network very quickly and get adoption and adherence to the right way to practice that medicine. That's enabled through our tools. As we do that, we get great insight into the way these novel therapies and our competing therapies get used in the real-world setting, in a real community oncologist's office.

That insight we wanna gather and take and scale and point back upstream to the innovators to help them understand how they get products out of the lab more quickly through clinical trials and other things, how they get used in the real world so they can better market and educate and communicate, and then ultimately, what kinds of outcomes do they really get? So that, we call it an ecosystem, and it's a weird word, but that's why we call it that, because we all see these as sorta self-reinforcing. As we build more of those relationships and get more of those insights, develop partnerships like we have with Merck and Amgen and BeiGene and the MyLUNG Consortium, that is ultimately then more provider and better outcomes through our provider network.

You know, we've grown this fairly methodically over the years, you know, from distribution to GPO to the provider relationships to our own oncology research to now scaling that through this JV, which we're very excited about because we think these are, you know, geographically complementary. The services we offer are complementary, and the scale we've now aggregated will be important to recruiting patients, to pushing some of this work into the communities where it's needed.

We all read about, you know, social determinants of health and lack of access, and so we think this is gonna be a big part of addressing those issues too. You know, Ontada is still a growth part of the business. We've built that organically. We've been investing into that business. We will continue to invest in that business as we innovate and create new solutions.

You know, frankly, as we go and develop, you keep getting more insight and see more opportunities to continue to expand. That's a little bit how we think about it.

Lisa Gill
Healthcare Services Analyst, JPMorgan

And you talked about innovation, and you talked about, you know, kinda newer drugs, et cetera, but doesn't this also present an opportunity when we think about biosimilars and really knowing and understanding the practice of that oncologist in the community setting? Can you spend a couple minutes talking about the next wave of biosimilars? I know, for example, like Humira is not as big.

Brian Tyler
CEO, McKesson

Yeah.

Lisa Gill
Healthcare Services Analyst, JPMorgan

a drug distributor as, say, an oncology product would be. maybe Britt can talk to us about how to think about the margin profile.

Brian Tyler
CEO, McKesson

First, you're right. I mean, the channel matters. Biosimilars that go through Part D, you know, We have a lot more services that we can offer manufacturers, starting with our footprint in distribution and our GPO. We can help educate, which can help drive adoption. In U.S. Oncology, we have, you know, clinical teams that are charged to review best practice in medicine. If they are to decide the biosimilar's best practice in medicine, that can get pushed out through our network, and we see adoption in our network because of the way we're formulated quicker than the market in average, because we can move more together based on that clinical review that was done. We had a lot of services in Part D.

You know, if it goes specialty pharmacy, Part D, we're gonna have less services we can offer there. We do potentially have services to offer there 'cause we offer services in our biopharma services business that help adherence, medication access, patient education. So the follow on biosimilars may decide to adopt those sort of similar programs as well. You know, I think we can kinda play on both sides, but much more directly on Part B.

Britt Vitalone
CFO, McKesson

Yeah. I think Brian really answered it. The channel does matter, and it matters about what services can and do we provide and what kind of access can we provide, not only the innovator, but access down to the provider. In those areas where we have more services to offer, and oncology clearly is one of those, we would expect that those margins will be certainly higher than a brand or a specialty drug. You know, they're probably not gonna be at the same level of a generic. Where we have less services to provide, we still anticipate that we're gonna have margins profile that'll be, you know, at or above a brand or a specialty drug, but certainly not at the same level where we have more services to provide. You know, we like the margin profile.

We think certainly where we have more services to provide, and it reinforces a lot of what we're building, like in oncology. You know, our margin profile will certainly be much higher than brand or specialty, but still really not quite at the level from a margin rate perspective as a generic drug.

Brian Tyler
CEO, McKesson

I, the only thing I'd add is we still see this as an emerging market in many ways. I mean, there's only 40 approvals. There's only 25 products in the market today.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Right.

Brian Tyler
CEO, McKesson

Yes, you know, as this grows over time, you know, we're excited that there'll be a role for us to support the adoption. We do think ultimately, they're lower cost, they're equal quality. They help the healthcare system. They help patient affordability, so.

Britt Vitalone
CFO, McKesson

We have seen, and we would expect to see in those channels where we have more services to provide, like an oncology channel, that the adoption rates, they'll be faster and they'll be higher. That also adds to the biosimilar contribution profile.

Lisa Gill
Healthcare Services Analyst, JPMorgan

I wanted to spend a couple of minutes talking about your medical supply business. you know, I know this was 2006 when

Britt Vitalone
CFO, McKesson

It's been very-

Lisa Gill
Healthcare Services Analyst, JPMorgan

Sold the hospital business to Owens & Minor, and really focused on the alternate site of care, which we look today, and we continue to see that shift towards the alternate site of care. 2 things I just really wanna better understand on the medical side of the business. 1, my understanding is that you serve, for example, retail-based clinics, ambulatory surgery centers, standalone physician offices. How do you view the competition in the marketplace today versus, for example, when you made that decision in 2006 to exit the hospital marketplace? 2, do you see incremental opportunities in that physician office market or alternate site for McKesson?

Brian Tyler
CEO, McKesson

Yeah. You know, if I start with the competitive landscape, I mean, one thing that we've done really well in the medical business over the years, and I expect we will continue to do well, is to sort of follow the patient, right? As primary care or sites of care have changed, we've been able to take what we've done in the physician office setting traditionally and translate that very directly, 'cause the service requirements are very, very similar into these other settings. It was retail clinics, it was urgent care clinics, it was surgery centers, it's home care now. Just continue to leverage the infrastructure and capability and deliver that high-touch service that you need to run these kind of small businesses and small operations.

We've been very effective at doing that and very effective at expanding the product portfolio. You know, when we started in that business, we were pretty much commodity medical supplies. You know, now we're equipment and we're lab and generics and pharmaceuticals and reagents and so we've been able to grow a bigger share of wallet over time. The competitors are still a little bit fragmented. If you think about home care, there's a different set of competitors. Long-term care, we have some scaled historic competitors. Primary care, we've got. It's a landscape, but we think our business is very well-positioned because we have sort of presence and scale across all of those channels that leverage a common infrastructure.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Right.

Brian Tyler
CEO, McKesson

I forgot the second part of your question. I'm sorry.

Lisa Gill
Healthcare Services Analyst, JPMorgan

I forgot what it was too.

Brian Tyler
CEO, McKesson

Oh.

Lisa Gill
Healthcare Services Analyst, JPMorgan

I guess we're all set. No, I think, are there other services that you think you could bring to that community from a McKesson perspective?

Brian Tyler
CEO, McKesson

I think-

Lisa Gill
Healthcare Services Analyst, JPMorgan

You've talked a lot about what you've done recently, but other than.

Brian Tyler
CEO, McKesson

Yeah, I think generally, yes. I mean, you know, or look at infusion, we can look at specialty products. I mean, our goal in that business is to make the business of providing care easy.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Right.

Brian Tyler
CEO, McKesson

Anything that leverages the infrastructure we have for distribution, for pricing, for delivery.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Right

Brian Tyler
CEO, McKesson

you know, we could add that in and continue to expand.

Lisa Gill
Healthcare Services Analyst, JPMorgan

We don't have tons of time left, but, you know.

Brian Tyler
CEO, McKesson

Oh.

Lisa Gill
Healthcare Services Analyst, JPMorgan

The other unique opportunity is the biopharma services assets within Prescription Technology Solutions. You've talked about that this can be lumpy in the marketplace. Britt, I think that you've talked about that in the past. When we think about that from an investor perspective, Is there any way to have visibility around that lumpiness? Is it just more of we've got good visibility in a year and it could be lumpy quarter to quarter? Maybe just help us understand, like, what drives that variability.

Britt Vitalone
CFO, McKesson

Yeah. There's 2 parts to this business. Obviously, really big opportunity here across, you know, several parameters of access, adherence, and affordability. We also have a third-party logistics business. That is the large part of the revenue within that segment today. Certainly growing at a slower rate than our technology assets are. That business typically is the lumpy part from a revenue perspective. It also has a large, a lower margin profile. The contributions that we see from our 3PL business while good, they're certainly at a lower profile than our technology assets. You combine the fact that you've got this mixed profile with a larger part of the revenue coming from third-party logistics and the services we provide there at a lower margin profile, that's gonna create some quarter-to-quarter variability.

If you look over the last several years and as we project into the future with the long-term targets that we gave you, we're very comfortable that this business is going to continue to expand into the areas that Brian talked about, which are higher growth from a revenue perspective. They're higher margin opportunities as well. They're using more of our technology capabilities. Over the long term, we expect that we're gonna have sustainable operating profit contribution in the, you know, the low teens area. Quarter to quarter, there's gonna be some variability. We talked about on our earnings call that we do have some seasonality in terms of the services that we provide certain programs for biopharma, which generates more of the operating profit in typically within our fourth fiscal quarter.

We hired ahead of that a little sooner than we had in the past, and that created some labor variability, if you will.

Lisa Gill
Healthcare Services Analyst, JPMorgan

We only have one minute left, and so what are we gonna learn in the next 12 months about McKesson, which by the way, I think might have been one of the best, if not the best performing stocks last year for 2022. Between now and when we sit together again in 2024.

Brian Tyler
CEO, McKesson

Honestly, I would hope that you won't see anything surprising, that you will see a set of core distribution businesses that continue to perform. You'll see a continued investment and expansion along our growth strategies. You'll see a team that is staying very focused and disciplined in its approach to running the business, allocating capital, and then I'll have the ability to brag about the most talented workforce in healthcare and the best place to work in healthcare.

Lisa Gill
Healthcare Services Analyst, JPMorgan

Great. Thank you so much. Appreciate it.

Brian Tyler
CEO, McKesson

Thank you.

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