Good morning, welcome to the Perrigo first quarter 2020 financial results conference call. All participants will be in listen-only mode. Should you need assistance, please signal a conference specialist by pressing the star key followed by zero. After today's presentation, there will be an opportunity to ask questions. To ask a question, you may press star then one on your telephone keypad. To withdraw from the question queue, please press star then two. Please note this event is being recorded. I would now like to turn the conference over to Brad Joseph, Perrigo Investor Relations. Please go ahead.
Good morning, welcome to Perrigo's first quarter 2020 earnings conference call. We hope everyone is healthy and safe during these times. As safety is our top priority, we are conducting this call virtually from different locations adhering to social distancing guidelines. I hope you all had a chance to review the press release we issued earlier this morning. A copy of the release is available on our website. Joining today's call are President and CEO, Murray Kessler, and CFO, Ray Silcock. I'd like to remind everyone that during this call, participants will make certain forward-looking statements. Please refer to the important information for shareholders and investors and safe harbor language regarding these statements in our press release issued earlier this morning. When discussing the business, Murray will reference only non-GAAP adjusted numbers for the quarter unless otherwise noted.
Comparisons to prior periods will also exclude exited businesses and currency changes unless otherwise noted. Ray's discussion of financial results during this call will address both GAAP and non-GAAP results, and where noted, comparisons to the prior year will exclude exited businesses and currency changes. In the appendix for today's call, we have provided reconciliations for all non-GAAP financial measures presented. A few other logistics to mention before we get started. First, excluding exited businesses excludes contributions from the exited animal health business previously included in the Consumer Self-Care Americas segment and the divested Cannaderm business previously included in the Consumer Self-Care International segment from Q1 2019. Second, organic growth excludes Ranir, the exited animal health and Cannaderm businesses and currency. Third, as a reminder, Worldwide Consumer includes the Consumer Self-Care Americas and Consumer Self-Care International segments, as well as Corporate Unallocated.
With that, I'd like to turn the call now over to Murray.
Good morning, everyone. I want to begin today's call by recognizing the obvious. We are living in unprecedented and challenging times. I also want to recognize and acknowledge that I feel blessed to be surrounded by such a seasoned leadership team and over 11,000 dedicated employees who are making tremendous sacrifices while giving it their all to keep our essential products flowing to consumers and patients who need them. These Perrigo employees are making sure that consumers have access to Perrigo's broad portfolio of cold cough medicines, analgesics like acetaminophen and electrolytes to treat flu and COVID-19 flu-like symptoms, allergy medicine as we head into the allergy season, infant formula to feed babies, albuterol inhalers to help asthma patients, and many other essential products. In this environment, it has been our first priority to focus on keeping employees safe while they keep these essential products flowing to market.
Second, to reward employees on the front lines, whether in production or in the labs, for their work and dedication. Third, to support the communities in which we operate during these challenging times. Here are some examples of how we have accomplished each of these. We restricted access to our facilities worldwide to essential employees only and implemented a multi-step pre-screening process before anyone can enter into our facilities. We prioritized production to essential products. We eliminated non-essential travel even before the federal travel bans went into place in the U.S. We regularly communicated with our workforce, providing education about social distancing and handwashing and other appropriate measures over and over again. We doubled frontline production employee first quarter bonuses. We made over $1 million worth of cash and in-kind product donations, like hand sanitizer, to our communities, and much, much more.
What is amazing to me is how our employees responded to the unprecedented challenges and delivered a strong first quarter, all while making significant progress on our transformation plan. To all Perrigo employees, and especially our frontline colleagues, thank you again for all you are doing for our company and for society. Now let's take a look at what the Perrigo team accomplished during the first quarter. The team identified five key global investment areas going forward, including core OTC, oral health, science-based naturals, nutrition, and smoking cessation, and shared them with our global leadership team through our first ever virtual leadership conference. We acquired Dr. Fresh Oral Care for $113 million, acquired Steripod early in the quarter and successfully integrated it into Ranir.
We transitioned Prevacid from GSK to Perrigo and initiated a supportive advertising campaign. We received FDA approval of the store brand OTC version of Voltaren Gel, received FDA approval of and successfully launched the first generic albuterol HFA product. We launched a number of new products in Europe prior to COVID-19. We continued to implement key capability upgrades such as data analytics, enhanced sales and inventory operational systems, and central finance, to name a few. We developed and launched a hand sanitizer product from start to finish in three weeks, restored our winning culture, protected the company's liquidity, and delivered financial results well ahead of expectations, despite the constant set of challenges we faced. Please understand, the team pulled it off, but it was a lot of heavy lifting. A lot.
Now let's take a closer look at Perrigo's first quarter 2020 financial results, starting with a quick overview, followed by a deeper dive into net sales and business drivers. Ray will walk you through the rest of the P&L. All net sales comparisons are to first quarter a year ago. Total Perrigo consolidated first quarter reported net sales were $1.34 billion, up 14%, with organic revenues up 11%. Adjusted operating income finished at $225 million, up 11%, and adjusted diluted EPS was $1.14 versus $1.07 last year. All segments contributed to the consolidated 18% revenue growth, including a 25% increase in Consumer Self-Care Americas, CSCA, a 14% increase in Consumer Self-Care International, CSCI, and a 6% increase in generic Rx.
We estimate that customer and consumer reactions to COVID-19 added about $90 million-$110 million to consolidated net sales in the quarter, with the most prominent benefit about 80% coming from the U.S. consumer and Rx businesses, and a smaller benefit from Europe. At this time, we cannot realistically estimate the amount of product that was bought and used for COVID-19 or flu or allergy symptoms as opposed to consumer pantry loading. We are watching this closely and using our best efforts to ensure our retail and online customers have the proper amount of product on their shelves and/or in their warehouses. Our Worldwide Consumer businesses delivered a solid performance with net sales growth of 21%, including Ranir. First quarter organic growth compared to a year ago was very strong and more than 12%, led by CSCA organic growth of 15% and CSCI organic growth of 8%.
While the balance of the year may be a bit lumpy due to COVID-19 pantry loading and normalization, as well as our product prioritization efforts, we believe we will meet or exceed our stated 3% organic growth objective as long as, among other things, that we can keep our facilities around the world running. It reminds me of a saying from a former boss who once said to me, "You don't make the plan the way you plan to make the plan." Boy, was he right. This is certainly an example of that. Let's take a closer look at the drivers within each of our business segments, starting with Consumer Self-Care Americas.
First quarter reported net sales increased 20%, or $119 million versus a year ago, benefiting from strong tailwinds entering the year, as described during our last conference call, a surge in consumer demand for our products as a result of the COVID-19 pandemic in March, and accelerated growth in e-commerce, which benefited from the investments we undertook last year. The quarter also benefited significantly from the addition of Ranir, but was partially offset by the Animal Health exit. Excluding exited businesses, CSCA grew 25% compared to the year ago quarter. Let's take a closer look at the COVID-19 related impact to CSCA. As just covered, we exited Q4 last year with tremendous strength, having made significant gains in penetration versus national brands, that's share versus national brands, and winning market share from other store brand competitors as a result of new products, distribution gains, and other favorable trends.
That momentum continued in Q1 as CSCA grew organically 8% through February versus a year ago. Then came March, and we saw a large surge in demand related to COVID-19, which led to year-over-year organic net sales growth of 28% in that month. That growth came from the categories you'd expect. Cold cough, infant formula, analgesics, electrolytes, just to name a few examples. We also saw strong results in allergy, as a relatively warm winter triggered a higher incidence rate of allergy. Nicotine cessation also showed strength in the quarter. We hypothesize this as a side effect of COVID-19. This is not a particularly good time to be smoking. In any event, all of this resulted in a market-wide penetration gain versus a year ago of 60 basis points for store brands versus national brands. The other area worth mentioning is our e-commerce business.
Our e-commerce investments are paying off. CSCA e-commerce net sales grew from 3% of total revenue in Q4 2019 to 5% of total revenues in Q1 2020. That was an increase year-over-year of +112%. This is being reflected in the marketplace with some pretty meaningful channel shifts from brick and mortar to online. CSCA net sales were obviously very strong in Q1. The big question that you, and frankly, all of us are trying to determine is, what does that mean for the balance of the year? That's a good question, and it is a question that we honestly cannot answer at this time, as there are just too many open-ended variables for us to make an informed assessment.
For example, we do not know how much of March's surge in sales was consumed, how much was incrementally purchased by consumers that wouldn't normally buy store brands, or how much was a result of consumer pantry loading. We also do not know if illnesses associated with COVID-19 have peaked, will taper off, will continue in Q2, or spike again later in the year. It is certainly possible that we might ultimately experience a short-term sales trough. Conversely, we believe that there is a likelihood that any short-term trough will be offset by retailers restocking their shelves and warehouse inventories, the launch of our recently approved store brand version of Voltaren Gel, which we expect to launch later this year, and the fact that store brands historically have done well in a recessionary period, which may well be our new reality going forward.
Simply stated, this is still speculation. At this point, we do not yet have a good handle on what will happen going forward. On balance, we think CSCA is in pretty good shape at this time. I again say this cautiously, as there are just so many moving pieces. In addition, there's another variable, our ability to continue manufacturing. As I noted earlier, we have implemented many measures to ensure employee safety and the ongoing manufacture of our product. As I sit here today, all, I repeat, all of our facilities are running, and we have only had a few brief interruptions so far. Despite our precautions, there are no guarantees, and that can change on any day. It is for these reasons, including the same around business continuity that all businesses are facing, that we did not update our fiscal 2020 guidance.
We hope to have a better handle on projections by the end of Q2. Turning to CSCI. Reported net sales increased 9% versus a year ago. We are up 14% on a constant currency basis. Excluding the divested Cannaderm product, which impacted the top line by 120 basis points, net sales were driven by strong new product launches, mainly sell-in efforts in our weight loss and skincare categories and the addition of Ranir. Just like in CSCA, we experienced a surge in CSCI demand due to COVID-19, primarily in our U.K. store brand business and our branded cough, cold, VMS, and pain products. While almost all CSCA's products are consumer healthcare-focused, only approximately half of the CSCI portfolio treats ailments, while the other half is self-care, focused on preventative health and wellness. These include categories such as weight management, anti-parasites, and sun care.
While we expect lower pull-through from these products until Europe returns to a more normal way of life, this headwind may be offset by tailwinds for our pain, upper respiratory, and VMS products. The same issues I described for CSCA apply here, as we are unsure of how much of these products were driven by pantry loading in the first quarter versus COVID-19-related consumption. Again, we'll need to see how the next few months play out before making any further comments on the full year. Turning to Rx. Reported net sales grew 6% in the quarter due to the successful launch of generic albuterol, which the FDA approved in February. Because we had anticipated the approval last year, we had product immediately ready to ship.
With strong demand out of the gate benefiting from COVID-19, Rx shipped almost 44 million of albuterol, which more than offset the expected year-over-year decline in Rx from testosterone 1.62%. We have included about 75% of these albuterol sales in our $90 million-$110 million COVID-19 impact estimate. Importantly, we believe there is consumer demand for all of the generic albuterol product that Perrigo and its partner, Catalent, can manufacture this year. To be clear, no deload is expected here. Before I offer a final summary of the quarter, I wanted to briefly touch on the status of the Irish tax matter. As you know, we have taken several measures to challenge what we believe to be an unwarranted assessment. This includes appealing the original assessment and obtaining approval from the Irish High Court to challenge the assessment in a judicial review proceeding.
While the judicial review hearing was scheduled to begin on April 21st, the court postponed that hearing in the interest of public safety and the current restrictions imposed by the Irish government. While no new hearing date has been set, we continue to believe in the strength of our position. To summarize, it was a strong quarter top and bottom line. All three business segments contributed to revenue growth. Fundamentals were solid before the COVID-19 related surge in March, obviously even stronger after. While OTC Voltaren Gel, Dr. Fresh, and albuterol all offer potential upside, we are taking the prudent approach and not updating our guidance at this time, given uncertainties related to COVID-19, which could impact all of our businesses. Business continuity remains critical, employee safety comes first, it will continue to be a balancing act.
I will note, we have gained experience over the last month or so on how to handle the issues that confront us, and we are in much better shape today than we were at the beginning of the crisis. Our transformation to a consumer-focused self-care company last year could not have come at a better time for us at Perrigo in order to prepare us for what we are facing and the new normal world going forward. We believe Perrigo is very well positioned for the future, leveraging three key drivers in a new normal world, self-care, value, and e-commerce. Bottom line, in a quarter with plenty of strong financial results to be proud of, I could not be more proud of our team, and I mean everyone at Perrigo.
They are delivering on our vision to make lives better by bringing quality, affordable self-care products that consumers trust everywhere they are sold. They are doing it right now. I'll now turn the call over to Ray to walk us through the rest of the P&L and key balance sheet items. We'll open it up to questions. Ray?
Thank you, Murray, and good morning, everyone. Now that Murray has gone through the revenue and business drivers for the quarter, I'd like to walk you through the rest of the P&L. Consolidated reported GAAP net income for the quarter was $106 million, and reported diluted earnings per share was $0.77. On an adjusted basis, consolidated net income for the quarter was $157 million, and earnings per share were $1.14, the sixth consecutive quarter in which we have met or exceeded market expectations. Adjusted net income for the quarter includes $50 million of non-GAAP adjustments, primarily amortization of $71 million, which we always add back, partially offset by a $16 million prior period tax benefit as a result of the CARES Act. The GAAP reported consolidated effective tax rate for Q1 was 7.2%. This was generated from tax expense of $8 million on pre-tax income of $115 million.
Tax expense was low this quarter, primarily due to $20 million of Q1 tax benefit from the CARES Act. $16 million of those tax benefits related to 2019 and were adjusted out for non-GAAP purposes, leaving $4 million in Q1 and bringing the first quarter adjusted effective tax rate to 19.8%. Full details of these adjustments can be found in the non-GAAP reconciliation table attached to this morning's press release. From this point forward, all dollar numbers, basis points, and margin percents will be on an adjusted basis, while growth percentages will exclude the impact of currency and of exited businesses. The Worldwide Consumer first quarter net sales growth of 21% versus prior year resulted in a gross profit of $416 million, up $38 million from last year, a 16% increase excluding the impact of currency and exited businesses.
Gross margin was down 220 basis points from 40.6% to 38.4%, primarily due to an increased proportion of store brands, including Ranir, as well as operational inefficiencies and the impact of exited businesses. Worldwide Consumer operating income improved by $30 million versus prior year, primarily due to gross profit flow-through offset by higher administrative costs, including the impact of a $4 million special bonus paid to our frontline employees, most of them working in various manufacturing plants around the world, who had to physically go into work despite the COVID-19 related lockdowns to continue to provide our essential products to customers and consumers.
Operating margin improved 100 basis points over last year as we were able to leverage gross margin from increased sales, savings from Project Momentum, together with Ranir's higher operating margin, all partially offset by higher compensation costs, including share-based compensation from our annual incentive plan, as well as the special bonus. For CSCA, gross profit of $220 million was up $30 million from last year, an increase of 23% excluding currency and exited businesses, driven by sales growth. Gross margin for Q1 declined 110 basis points versus last year, due primarily to higher operating costs. CSCA operating income for Q1 amounted to $137 million, an increase of $31 million versus prior year, up 33%, excluding currency and exited businesses as we leveraged sales growth for the quarter and achieved Project Momentum savings. The result was a 130 basis point improvement in operating margins to 19.6%.
CSCI gross profit was $197 million, an improvement of $7 million over prior year, +9%, excluding currency and exited businesses, driven by increased sales. Gross margin, however, declined 250 basis points to 51.4%, primarily due to a higher proportion of store brand sales, including the addition of oral care products, which have relatively lower gross margins, although similar operating margins. CSCI operating income of $64 million was up $10 million, +28% excluding currency and exited businesses, while operating margins improved by 130 basis points to 16.7% due to operating leverage. Turning now to the Rx segment. We said last quarter that we expected a decline in Rx sales and profits in Q1, similar to the one we saw last quarter, primarily due to lower pricing on testosterone 1.62% as a result of our having lost exclusivity on that product.
On February 24th, we received FDA approval for generic albuterol, and even though the demand was substantially higher than anticipated due to COVID-19, the team did a great job getting this much-needed product to our customers. We were able to achieve $44 million in albuterol sales in Q1, resulting in an overall RX net sales increase versus prior year of 6%. Moving on to gross profit. In Q1, we sold albuterol, which had been produced in 2019, and expensed as pre-commercialization product. As a result, albuterol gross profit this quarter was modestly higher than it will be in future. Including the additional gross profit from albuterol sales, RX gross profit decreased by $9 million in Q1. Gross margin of 42.3% was down from 48.6% last year, as we felt the impact of adverse pricing.
Operating income declined by $8 million to $74 million, also primarily from the same adverse pricing. Consolidated cash flow from operations in Q1 was $172 million, a 110% cash conversion on adjusted net income, in line with what we said on our last earnings conference call. This strong cash conversion was driven by a reduction in inventories due to very high demand in the quarter, as well as by strong collections in our Rx business as compared to Q4. Offsetting this were increases in accounts receivable in our Americas business due to the high demand, which was most strong at the end of March. On March 28th, at the end of the first quarter, we had $510 million in cash on our balance sheet, including $100 million we drew from our revolving credit facility in March as a precautionary measure.
Since then, we paid just over $100 million for the oral care assets of High Ridge Brands, on top of $11 million we had paid previously as a deposit. Total outstanding debt at the end of Q1 was $3.5 billion, including the $100 million drawdown on our revolver. We have an additional $900 million of available capacity on this $1 billion revolving credit facility, which expires in March 2023. We believe our balance sheet continues to be strong. We are closely watching our cash collections, but to date have not experienced any disruptions in cash receipts in the U.S. and only a few minor deferrals internationally. We continue to pay our suppliers on a timely basis to ensure continued supply of critical materials and components. We also closely monitor inventories, expecting that our sales mix could be impacted by the lockdown and other measures.
Our cash position in Q2 will also benefit from the CARES Act, which legislated an increase in the 2019 and 2020 interest expense deduction, thereby reducing the amount of tax due in April, as well as deferring payment of 2019 taxes to July. In light of our strong balance sheet, we remain committed to maintaining dividend payments to our valued shareholders. I'd now like to talk a little bit about what we see so far as future earnings. At this time, we do not have sufficient information about the broader economic outlook, nor about the impacts of lockdowns and other COVID-19 measures to justify updating the 2020 guidance we announced on our last earnings conference call in February. The COVID-19 impacts on our business in Q1 are difficult to enumerate and for the balance of the year, difficult to predict.
Factors that could benefit our results include continued success of generic albuterol, the addition of our recently acquired Dr. Fresh business, and the future potential of OTC Voltaren Gel, for which we recently received FDA approval. We could also benefit from consumers choosing our lower cost, same efficacy store brand products during a possible extended recession, as well as from potential additional surges in demand later this year. There could be a deterioration of sales in the wake of pantry loading in March, economic impacts from the lockdowns and social distancing measures, as well as possible disruptions in our manufacturing facilities and supply chains around the world. It is simply impossible to estimate these at this time. There are too many moving pieces that literally change every day, we will continue to closely monitor the impacts in and on our businesses.
Hope to be in a position to provide more clarity next quarter. In closing, I too want to take this opportunity to thank Perrigo's wonderful employees for their dedication in continuing to work both in and outside of our facilities as normally as possible during these truly abnormal times. Operator, please can we now open the line for questions?
We will now begin the question and answer session. To ask a question, you may press star then one on your touch-tone phone. If you are using a speakerphone, please pick up your handset before pressing the keys. To withdraw from the question queue, please press star then two. Our first question comes from Louise Chen of Cantor. Please go ahead.
Hi. Thanks for taking my questions here.
Good morning, Louise.
Good morning. There seems to be some confusion in the marketplace when you say Perrigo is not updating this guidance at this time. Are you pulling your guidance? What does this mean? It sounds like there could be potential for upside, but it's just not clear how to put that all out there now. It would be interesting to hear what you think here. Then second question I had for you was just on the channel shift from bricks and mortar to e-commerce. Do you expect that to continue? Do you have the relationships in place to affect that? Thank you.
Okay, first one, we're absolutely not pulling guidance. We changed the word of unchanged to not updated, for a very clear reason. In my mind, unchanged means we're reconfirming what we had on the street in February, which was the best information that we had at the time. I got to tell you, coming out of a very strong quarter with albuterol as upside, Dr. Fresh as upside, potential for extended illnesses as upside, a strong allergy season as upside, Voltaren Gel as an upside. The fact that we have to rebuild all of our warehouse, customers' warehouse inventories that are weeks below what they normally would be. If it was any other circumstance, I'd be raising guidance right now. Given the business uncertainty out there in the world, it's just not prudent to be raising guidance at this moment.
Not updating reflects the fact that I look at it and say, "I don't think the guidance is right at this point." Because if you had some kind of significant business interruption, sure, it could hurt you, but on the other hand, given all the positives on the business, we'd likely be updating. The implication of unchanging says we'd have to have a pretty rough balance of the year in order to stay at the existing guidance. I've left it unchanged from where we are. I left it at where it was in February. We're not pulling guidance. There's a lot of good things happening, but it's a very uncertain world. Hopefully that clarifies anything for anyone. Perrigo's not pulled guidance. The second one on channel shift.
That one's really interesting, because if you saw some of the retailers, the traditional retailers, they talked about store traffic coming down, and our stock reacted a little bit to that in each of those cases. The reality is, as our demand was strong, we were more than making that up in the e-commerce channel. I think I highlighted the 112% growth in the U.S. It was even stronger than that in Europe. I think it's up to 8%. When you look at the omni-channel reports, which some of the sell side and buy side buys IRI data, you're not seeing the Costcos of the world, you're not seeing Costco online, you're not seeing Target online, you're not seeing a lot of those other areas. We saw share point changes. To me, I think that's going to be a new normal way of life.
I'm glad we made the significant investments we've made over the past couple of years to put Perrigo at an advantage in the e-commerce area. Yes, we are taking advantage of that from all angles, and that investment's been paying off very quickly. Yeah, I think you're going to see online sales stay strong going forward and continue to grow, and it's obviously one of our strategic areas of focus. I hope that answers your questions.
Yes. Thank you.
The next question is from Chris Schott of JPMorgan . Please go ahead.
Great. Thanks very much for the questions.
Morning, Chris.
Good morning. Just had two here. First, can you expand on the gross margin performance in the quarter, particularly for the Americas business? I guess, is this all just mix-related, or are we also seeing higher manufacturing costs due to the shutdowns? I guess what I'm trying to get at is directionally, should we think about the CSCA gross margins kind of rebounding from here as look out the remainder of the year, or is this kind of a new normal? My second question is kind of a bigger picture one of, what does a recession mean for Perrigo's business? I think if I go back to 2008 and 2009, I think you saw some fairly meaningful share gains as consumers traded from national brands to store brands.
I guess the business may be in a different place today in terms of market penetration, but just as you think about if we do head into a recession, what does that mean for the portfolio over the next one or two years as we go through this process? Thanks so much.
Well, let me start on the first one, then I'll turn it to Ray, and then Ray, you can give it back to me on the recession question. Gross margin, honestly, mostly mix. For sure, there is a component that I don't think affected the first quarter very much where the greatest demand. Listen, we are prioritizing our products along with what our customers and consumers and society as a whole need. That means that right now, we're more than 50% of the U.S. supply of acetaminophen, and that's a lower gross margin item, and we're running that. Although I don't think that had a big deal impact on the first quarter. I think gross margins, in general, are mixed, but I'm pleased with our margins when you take it down to the operating margin line. You've got a lot of moving factors.
Ray, can you go into that in a little bit more detail?
Sure. Murray's right. You've really got to look at operating margin, especially with respect to the fact that we saw increases in our store brand business where our gross margins are lower, but our operating margins are similar. We saw that in the CSCA specifically, which you referenced. Our margin this year at around, operating margin around 19.6% contrasts positively by about 130 basis points versus what we got in 2019 first quarter. We are seeing some improvements in our operating margin. The impact of the dislocations that happened really didn't have a big impact on Q1, because they happened late in March or in the middle of March, early to middle March, and we didn't see all that much impact coming through from that.
We did see, as I say, some impact at the end of the month, and we saw operating leverage from the sharp increase in sales that came in March.
Going back to the recession question. You're right, Chris. We'll see how it plays out, but our product category, and I already think we're seeing some share shifting now, but the fact is our products are of equal efficacy, and they're 30%-40% cheaper than the national brand. The other benefit you get in a surge is that a lot of times the national brands are not on sale. Besides the longer-term benefits that you get of the price issue, you also get people trying. You get a much higher level of trial right now. There's a lot more people that have tried a store brand, who are buying both or who were normally national brand only consumers that are trying and buying our products and seeing for themselves that they work just as well.
Listen, going into an extended risk recession period, private label always performs well. There's no guarantees, history says we benefit from that, we think that we're well-positioned with our self-care focus, our value, and also the e-commerce. Yeah, it's a great point. These are uncertain times, I think the company's in a real good position right now to help society but also benefit from it.
Thank you.
The next question is from Randall Stanicky of RBC Capital Markets. Please go ahead.
Good morning, Randall.
Hey, Murray. Good morning. Hey, just to put this guidance question to rest, because there's a lot of questions around it. It sounds like if I'm hearing you correctly, there's several upside drivers. You're looking for better clarity around those before addressing guidance. Are there factors that would pressure that range, or is this just about being prudent given that we're in the first quarter of a pandemic? My second question, can you just quantify the e-commerce business and what that margin is relative to the overall CSCA margin? That would be helpful. Thanks.
Okay, let me do the second part of that first. I believe the margins are equal. We're all sitting in different rooms and maybe somebody can send me the absolute number in e-commerce. Either way, the margins are roughly equal or even slightly better in our e-commerce business. That ship doesn't hurt us in any way. Listen, I don't know how to be any clearer. What I worry about is business interruption. My team, like as a crisis committee, Randall, we were meeting in the beginning every day. We get better at it, but we've had hits of employees. Thank goodness we were ahead of the world on precautionary measures, and we've caught most of those, the vast majority of those. We've got good trace and track. We've got all of that. We handle it in a calm manner. We've had hits.
My fear is business interruption. I worry. I worry that when the world starts loosening up and states start loosening up, that at any given time you could get a plant hit. I think we're more experienced now with the precautionary measures, with the temperature checks, with the questionnaires, with the restrictions we have in place, and our experience. Hell, we have been able to keep a facility running in the Bronx, in New York, throughout all of this, and they've had hits. That's your biggest downside concern is business interruption, and I believe that's what every single company in the world is facing right now.
For that big concern, even with some pantry de-loading, and I'm not sure there's going to be a huge pantry de-load, even with some of that, with all the positive things, I'd normally be raising guidance right now. I would. We beat the heck out of it. The SEC says to give as much transparency as possible right now. I'll tell you, we haven't seen orders let up in April yet. We're still struggling. We are not filling all the orders that we have. We are prioritizing products that society needs. On a cumulative basis through the middle of April, the pain category with the last few weeks, and I'm referring to IRI numbers, is up strong double digits. Cough cold up strong double digits. Allergy is up strong double digits. Topicals up strong double digits. Infant formula up double digits.
Nutrition drinks up strong double digits. Electrolytes up strong double digits in consumption all the way through April 19th. We're not pulling guidance. I think that the word unchanged meant we were sure that we were right, and I don't have data to say we were right at the current range. If it wasn't for the potential of business interruption, I'd probably be raising at the moment.
That's helpful. Thank you.
Operator?
I'm sorry. The next question is from Ami Fadia of SVB Leerink. Please go ahead.
Good morning, Ami.
Hi. Good morning. Congratulations on the strong quarter.
Thank you.
I think you've made the point on guidance very clear. I will not repeat that. I wanted to get some color on just e-commerce channel and your ability to Maybe what you're seeing on the ground. There has been some discussion around reduction in foot traffic at pharmacies. Are you seeing that impacting the demand? It doesn't sound like it, but is that being sort of taken care of or offset by increase in e-commerce? Can you sort of confirm that? With regards to ProAir, what's your full capacity in regards to how much demand you can fulfill for this year, and how should we think about increasing that capacity into next year? Thank you.
Let me just write down the second part so I don't forget it. In terms of e-commerce, the answer is no, we haven't seen demand slow. Maybe the orders have slowed a little bit in the past couple of weeks, but the backlog of orders is tremendous. We're not close yet to filling all the orders that we have and the unshipped orders that we have in hand today. Just to be clear, when we ship to most of our major customers that are getting big surges in their e-commerce business, we just ship it to them, and then they sell it, right? From us, it's an order to Costco, as an example, or to Walmart, and then they fulfill it on a online basis, and it shows up in our regular numbers, and we tease those numbers out because we have a line of sight.
So far, we've been more than offsetting any slowdown. It's almost hard for us to see a slowdown that some of the retailers report in foot traffic. For, I get the IRI numbers, and I've seen that those have slowed down in certain categories. Slow down in infant formula. You'd expect that. Your baby's not going to eat more. On the other hand, pain hasn't slowed down. acetaminophen, ibuprofen, those products haven't slowed down at all. Bottom line is, yeah, I think there's channel shifting going on, and on a personal, I don't have any data to support that. I think that there's enough time going by here that people are learning. Where they might have been reluctant before, they're learning the power of e-commerce. In a more cautious world going forward, I think online will continue to get more and more important.
We're working pretty hard on omnichannel reports, our ability to just not report the shares based on IRI, but on a total mass merch and traditional retailers that report, and on a e-commerce basis. Hopefully we'll get to that point. We're confident in those numbers to share those soon. On ProAir, the generic ProAir, that's a good question because our ongoing rate, we can't satisfy at the level that we did initially. We'll be well ahead of our projections that we had internally for the year, but it'll get back to a normal level, and I'm not prepared to speak at whether Catalent, who is our partner, can expand capacity or not, or how fast or how big the real demand is on an ongoing basis. There'll be more competitors, et cetera. We had pre-built that inventory in anticipation of an approval earlier.
We had a good amount on hand, and we still are working our way through that. It'll get to sort of a more normalized level, and then we'll see how the market shakes out. There'll be no giveback on albuterol. Albuterol was probably 30% of what we attributed to sort of the spike in demand on COVID-19. You can just subtract that out when you're trying to estimate impact. I look at it and say, at about $100 million of COVID-19 impact, we think you subtract out the 30, you got 70, probably. A good portion of that was consumed. You have some you'll give back, but on the other hand, we got to rebuild, all those store shelves have to get full again. All of the customer warehouses have to get full again.
We also have to start. We're not making all of our products right now, and we've got to re-engage and make those when we can, make the products that are less important to society right now as well. I think we'll weather the storm pretty well, barring any massive business interruption.
Got it. Thank you, Murray. Maybe if I could just ask a follow-up. Can you talk about the current capacity utilization at your plant? Thank you.
Yeah. We're not operating at our normal levels. That's what I was trying to make the point on people understanding how much a challenge it is for any manufacturer right now. You see it in the news. If you get a hit in a facility of somebody who gets COVID, it scares people. We're very cautious. If there is somebody who happened to get into the plant, we trace them, if they even modestly come into contact with them in or 12 or 14 people, we send them home for two weeks. Bottom line, that results in a meaningfully higher level of absenteeism worldwide than we would normally deal with. That varies, right? It may happen for a week or two, then come right back to normal again.
There's parts of the world where local governments mandate certain people that are in a high-risk category not to come to work at all. That creates less people in the facilities. Bottom line, though, is through this, we've been able to keep 38 manufacturing facilities globally running. They're all running today, and I would say on average at about 80% productivity.
Great. Thank you.
The next question is from David Risinger of Morgan Stanley. Please go ahead.
Hey, David.
Hi, Murray. Congrats on the performance during these difficult times. I have a couple questions, please. First with respect to cost and just what's happening with supply, could you just help us better understand, is the right way to think about Perrigo's cost structure this year that higher COGS due to COVID are going to be offset by lower SG&A due to less travel and less commercialization costs? I guess that's the first question at a high level. Second, with respect to supply, could you comment on whether there are any API or intermediate supply issues for either the consumer or the RX business? Third, with respect to the dermatology RX business, so obviously derm is a big component of Perrigo's RX leadership. Stay-at-home orders have impacted patient visits dramatically. I was just hoping you could comment on that as well. Thank you.
Okay. Ray, did you want to do the cost one?
Sure. I think you basically described it to a certain extent, David, but we are seeing increase in some of our costs. As Murray described, we've got absenteeism in the plant that we still pay people for the most part, even when they're absent under COVID-19. We do see some higher costs there. We are getting operational leverage on all three businesses. It's quite significant, but that's because of the increased sales, certainly in the first quarter. We're seeing Momentum savings continuing. We paid the special bonus we talked about, which obviously resulted in higher overall compensation costs. I think on balance, if you look at operating margin and operating income, as I mentioned earlier in the call. If you look through to that, our operating expenses are down slightly. We would expect that trend to continue.
We're also expecting probably less advertising and promotional cost for the time being. Plus, as you mentioned, less travel and less of those other expenses. We are seeing just a small down in the Q1 on our operating margin, but a big increase, obviously, in our operating income.
Yeah. Thank you, Ray. David, it's a bit hard to measure, right? A lot of this all happened in the last couple weeks of March, so we'll get a much better handle. This is a good area of where I'd like to tell you we have a good handle on it, but there's so many moving pieces, and we'll see how it shakes out. I don't think it'll be a severe movement one way or the other. We didn't non-GAAP out the employee bonuses. Those were my decision to do those. I think that was money well spent. People are proud at Perrigo right now of what they're doing for society, and they know that myself and my leadership team put their safety first, and I'm proud of that. In fact, that's one of the things I'm most proud about in my career.
We will continue to do that. There are other efficiencies too, right? We'll have some less absorption when we're running more acetaminophen, on the other hand, you're going to have more efficiencies because we have partnered and our customers have been unbelievable through this. John Furner, President, EVP, Head of North America for Walmart, calls me on the phone and says, "All rules are off right now. How can we help you to do what's right for society? Just focus on your big SKUs, and we're doing that with all of our manufacturers." We're doing longer runs of the bigger item than we would normally done, and with agreement that we're just going to leave some of the smaller secondary items out of distribution right now. We'll get efficiencies on that.
I need to see how all of that, Ray needs to see how all of that shakes out. Yeah, there'll be less travel. There'll be less advertising. There'll be some expenses delayed on clinical trials and things like that. Boy, it's hard to get a real good handle on it, but it'll normalize. Ray talked about the other areas. API, we've been able to work through it pretty well. We never really had any significant interruptions. We were fortunate that we keep strategic inventories of API on hand. We had sufficient API to weather the storm in any places where there were interruptions. For the most part, we worked through that. There was an interruption for a while with India and paracetamol.
Another point I guess I'd like to make is that for the U.S., which is our biggest business, we have 24 facilities in the U.S. The API was in the inventory in the U.S. While sometimes that hurts us on the cost side, it was sure good to be primarily a U.S. manufacturer product servicing the U.S. market through this storm. It highlights a Perrigo advantage. The answer is, so far, so good on API. On RX, we did have some third-party suppliers we rely on who had some interruption. They're back up and running again. Yeah, RX could have had a stronger quarter without some of the interruption in their supply. Hopefully that's back on track now. It appears to be or soon to be.
Yeah, there's a little bit of softness in some of the areas, not just in Rx, but you're not selling a lot of weight loss products or sun care products or head lice products and all that in Europe right now until things open back up again. On the other hand, we have surges on the other side. There's a lot of moving pieces. In general, we are not having significant interruption. We have fires every day. It's a lot of heavy lifting. It's much more than people understand who aren't living the daily fires. That's why I made the point, David, how proud I am of my team. We get 100 problems a day or 1,000 problems a day, and they work through it, and they solve it, and it's been remarkable to watch.
That's great additional color. Much appreciated. On the derm demand?
I don't have the exact numbers in front of me. Brad, maybe you can get back to David after that. I think we said we were a little bit softer in some of those areas. I just don't have the numbers at my hand, David, Brad will get back to you.
Okay. Thank you, and congrats again.
Thank you.
The next question is from David Steinberg of Jefferies. Please go ahead.
Yeah, thanks. I had a question about some recent OTC reform legislation. One of the stimulus bills seemingly buried in it was some legislation related to OTCs and monograph OTCs. It sounds like it might benefit the company, some of the headlines relating to user fees and encouraging innovation. I was curious, does that legislation benefit Perrigo? If so, how does it, if so, does it shift some of the prioritization of your projects? Secondly, on your generics business, I know you've been intending for a while to either sell it or divest it or spin it. We haven't heard much recently. Just curious, given the recent approval for albuterol, does that change the dynamics in terms of potential value received or in timelines relating to potential divestiture? Thanks.
Yeah, well, the recent approval makes it more expensive. The bottom line is, I've said it here for almost a year now that our focus is primarily on the consumer business, but the Rx business is performing much better, and it's throwing off a lot of cash, and I am a, and now entire management team are stewards of shareholder value, and the multiples are just so depressed in the Rx industry right now. I believe it would destroy shareholder value to sell at the kind of multiples that are out there right now. Our strategic focus remains Consumer Self-Care. We are proud of what our Rx team is doing there, and they're generating a ton of cash. When the opportunity is right, we still intend to sell or spin it.
Nothing's really changed on it, but I just don't see that happening in the short term. On the first part of your question, there were a number of things. Ray already talked about the CARES Act tax benefit, that's been covered. There are two other important components of it. The OTC Monograph Reform Act, which finally got passed and something we've been pushing for. That will make it easier for us in the future to bring our kinds of products, our OTC products to market faster. That's the good news. The reality is though it's probably three years before the agency gets that up and running. It is another positive for the long-term benefit of Perrigo, but it's not going to have an immediate impact. That's great news. It's not good news, it's great news, it's out there a little ways.
I think the other one that's immediate is the restoration of the OTC eligibility under the FSA/HSA accounts. When the Affordable Care Act was signed into law 10 years ago, an unintended consequence was no longer allowing OTC products to be eligible for FSA/HSA reimbursement. The CARES Act reversed this decision, which is a win for the industry and consumers alike. Hope I've answered your question. Operator, any other questions?
The next question is from Gregg Gilbert of SunTrust. Please go ahead.
Good morning.
Hey, Gregg.
Murray, and Ray, I can see certainly the Rx to OTC switch of Voltaren Gel as a long-term positive, I was hoping you could help us understand how much you're selling on the Rx side currently of that product and how that would wind down. Does that come to an abrupt end and then the OTC that comes in? Maybe help us envision that, what goes away and what comes in. Murray, on the bolt-on front, curious what your appetite is now. I imagine you have a long list of things that are potentially actionable, is now the time to hit the pause button in light of the pandemic and putting out fires daily, or is it all systems go on the bolt-on front? Thanks.
Good question. I will tell you, we closed on the Dr. Fresh deal, that deal was a done deal prior to the whole COVID-19 issue. I am being more cautious at the moment. We didn't know how this thing was going to play out or shake out, we were very conservative with cash. We threw down $100 million on the revolver, we sit here now, five or six weeks later, we, so far, knock on wood, have come through it very well. Yeah, we have lots of things under evaluation. We slowed it down a little bit, I'm no less committed to bolt-ons than I was. It's a key part of our strategy, maybe this will present us even additional opportunities at even a better value going forward.
For the short term here, we're taking a more cautious stance. Yeah, we've slowed it down a bit right now. I'm not too concerned about that given the strength of the core business, however, and the fact that we already have Dr. Fresh and Steripod that we're already done this year, and we're just launching Prevacid. The second question was on Voltaren. I think it's a bit early for me to do that. I know there'll be some abrupt halt of the sales within Rx, and we were able to get our application in within 72 hours, which was remarkable and get the approval, and we'll be launching. Then I also think there'll still be an OTC/Rx component of the sales as well. We'll give you more details as we get closer on the size of the market and how big we think Voltaren is.
I'm not prepared to elaborate more than that today.
Okay, thanks.
The next question is from Elliot Wilbur of Raymond James. Please go ahead.
Thanks. Good morning. I wanted to ask an initial question or line of questions directed towards Ray, specifically with respect to cash flow performance and cash flow conversion. You called out the strong performance in the quarter. As I think about ARs likely moving higher and inventory build increasing over the balance of the year, how do we think about operating cash flow performance over the balance of the year and cash flow conversion? Is essentially operating cash flow equal to adjusted net income, kind of the right metric to think about for the full year? Could we actually be expecting something less than given the strong performance in the first quarter? Just real quickly, wanted to ask too about trade inventory levels.
Just wanted to get some insight into where those may stand, whether or not there's significant differences between Rx and the OTC side there. If I may, wanted to ask one question of Murray as well. Murray, I did check, and hell is not one of George Carlin's seven words, so you're covered there. I wanted to ask specifically, you called out increased store brand share versus other store brands in the last two quarters as a source of strength in the business. I'm just wondering what is driving that and what's the relative opportunity, obviously, versus taking share versus a national brand. Is this just a product issue or is it more of a structural issue? Thanks.
Ray, why don't you do the first part?
Okay. With respect to the first quarter, we saw the cash flow was strong for two major reasons. One, we had very high demand, which resulted in our inventory being drawn down. Two, we saw a recovery in our Rx AR, which was an issue in the fourth quarter of last year, where we saw it going the wrong way for us. It was improving as we came into the first quarter and contributed to our strong cash flow conversion. That was despite the fact that the surge that resulted from the COVID-19 really occurred from the second and third weeks of March on and was most heavy at the very end of March. That resulted in a buildup of our CSCA AR and CSCI, too.
With respect to how to think cash flow going forward through the year, clearly, we do have capital expenditures that we had planned for that may not happen quite as heavily. We're not permitting outsiders in our plants at the moment. We're running flat out as we talked about earlier on the call, Murray talked about in the plants, we're running flat out. The likelihood is that we're going to spend less capital, and that will obviously be cash flow positive for the year. I don't think we'll see cash flow equal to operating income for the balance of the year. We are going to continue to spend on projects. We obviously are going to continue to pay dividends, and that's very important to us.
I would say that we haven't changed our guidance for the year, and we're probably not going to change our cash flow guidance either at this point in time.
Yeah. I would say that on the share, I went into great detail, and really there's nothing that's changed in the first quarter in the explanations I gave on the conference call on February 27th. We win store brand share either by gaining distribution. We try not to do it on price. I had talked about how we had won a big piece of gum business from a major customer because we had lost it the year earlier and their business fell off because we had a product in blind taste testing, a nicotine gum that was preferred two to one . They reinstated that product, and now their business is growing again. We win share that way. We had a major new customer, although we're the bulk of the store brand business in infant formula.
Lots of other new products were driving those. It was in the Mucinex-like, guaifenesin-type products. That was an area where we were not as strong. We finally got the right products in place, and won accounts and won share with that. We had done the same thing in the allergy business, and we had won share. We had this odd dynamic, which is still continuing to play out very strongly in the discontinuance of ranitidine. That was a segment where we had a low share. When that product was pulled from the market, even though the total market didn't grow, a lot of it switched to, for example, omeprazole as one of the areas where it switched to, where we have a very high share. Just those consumers changing.
Those were the big three drivers, consumer products, new products driven, and then a beneficial mix shift in the digestive area, in the GI area. Answer your question?
Yes. Thank you.
Okay. Any other operators?
This concludes our questions. No, there are no other questions. I would like to turn it back to Murray Kessler for closing remarks.
I'll leave you saying, one more time, I keep hammering it over and over again. This is something like I've never seen. The Perrigo business is strong. The team is incredible. They're confident. My leadership team is very seasoned. They handle everything in a calm and deliberate manner, and they've been able to handle crisis. I'm confident that, while there could be some shorter-term bumps, I think the outlook for Perrigo is very strong. I never anticipated this coming into the company, but I think price value store brand product will play a bigger role going forward. I think that self-care will play a bigger role in a new normal world where consumers are a little bit more reluctant to run to the emergency room or hospitals, and I certainly think e-commerce will be a bigger role, and we're strong in each of those. We'll get through this.
We'll have some uncertainty. I know that's hard for everybody who's trying to cover the stock. I think if you look where Perrigo stands today versus most companies in the world, I think we're performing pretty darn well. I'll just end it one more time, thanking all the employees who I know it's nervous to come into the facilities, but you're doing good for society, and you should be very proud, and we're very proud of you. Thank you for your interest in Perrigo.
The conference has now concluded. Thank you for attending today's presentation. You may now disconnect.