센코라(COR) 2026 회계연도 4분기 실적 발표회: 2027 회계연도 스페셜티 성장 전망
센코라는 2026 회계연도 4분기 매출이 전년 동기 대비 6% 증가한 884억 달러를 기록했으며, 조정 영업이익은 22% 증가한 12억 달러를 기록했다고 발표했다. 조정 희석 주당순이익(EPS)은 21% 증가한 4.66달러로 집계됐다. 연간 매출은 5% 증가한 3,370억 달러, 조정 영업이익은 14% 증가한 48억 달러를 기록했다. 경영진은 2027 회계연도 조정 희석 EPS가 8%~10% 성장한 19.40달러~19.75달러를 기록할 것으로 예상하고 있으며, MWI-코베트러스 합병 영향을 제외하면 성장률은 10%~12%에 이를 것으로 전망한다. 센코라는 향후 특수 의약품 및 의료진 서비스 부문의 장기 영업이익 성장률을 10%대 중반으로 설정했다.
핵심 요약
- 센코라는 2026 회계연도 4분기 매출이 전년 동기 대비 6% 증가한 884억 달러를 기록했으며, 조정 영업이익은 22% 증가한 12억 달러를 기록했다고 발표했습니다.
- 4분기 조정 희석 주당순이익(EPS)은 21% 증가한 4.66달러를 기록했습니다. 조정 매출총이익률은 57bp 확대된 4.04%를 기록했으며, 이는 주로 2026년 2월 원 온콜로지(One Oncology) 인수 효과가 반영된 결과입니다.
- 연간 매출은 5% 증가한 3,370억 달러를 기록했습니다. 조정 영업이익은 14% 증가한 48억 달러, 조정 희석 EPS는 12% 증가한 17.97달러를 기록했습니다.
- 2026 회계연도 조정 잉여현금흐름은 38억 달러에 달했습니다. 센코라는 주주에게 15억 달러를 환원하고 분기 배당금을 10% 인상하여 22년 연속 배당 인상을 기록했습니다.
- 경영진은 2027 회계연도 조정 희석 EPS를 8%~10% 성장한 19.40달러~19.75달러로 예상하고 있습니다. MWI-코베트러스(Covetrus) 합병에 따른 추정 영향 0.35달러를 제외하면 성장률은 10%~12%가 될 것입니다.
- 센코라는 2개의 보고 부문을 도입했습니다. 경영진은 특수 의약품 및 의료진 서비스(Specialty Pharmaceutical and Provider Services) 부문의 장기 영업이익 성장률 목표를 10%대 중반으로, 의약품 유통 및 서비스(Pharmaceutical Distribution and Services) 부문은 한 자릿수 중반으로 설정했습니다.
핵심 재무 실적
| 지표 | 2026 회계연도 4분기 | 전년 동기 대비 변동 | 주요 배경 |
|---|---|---|---|
| 매출 | 884억 달러 | +6% | 보고 대상 2개 부문 및 기타 부문 전체의 성장 |
| 조정 매출총이익 | 36억 달러 | +23% | 주로 미국 헬스케어 솔루션 부문이 견인 |
| 조정 매출총이익률 | 4.04% | +57bp | 주로 원 온콜로지에 기인 |
| 조정 영업이익 | 12억 달러 | +22% | 2개 부문 및 기타 부문 모두 두 자릿수 성장 |
| 조정 희석 EPS | $4.66 | +21% | 희석 주식 수 1.8% 감소가 일부 기여 |
| 순이자 비용 | 1억 3,600만 달러 | +5,800만 달러 | 원 온콜로지 인수 관련 부채 증가 |
| 지표 | 2026 회계연도 | 전년 대비 변동 |
|---|---|---|
| 매출 | 3,370억 달러 | +5% |
| 조정 영업이익 | 48억 달러 | +14% |
| 조정 희석 EPS | $17.97 | +12% |
| 조정 잉여현금흐름 | 38억 달러 | — |
| 기말 현금 잔액 | 49억 달러 | — |
| 주주 환원 자본 | 15억 달러 | — |
사업 및 영업 실적
미국 헬스케어 솔루션 부문의 4분기 매출은 전년 동기 대비 5% 증가한 783억 달러, 영업이익은 22% 증가한 9억 9,800만 달러를 기록했습니다. 의료 시스템 및 전문의 의원에 대한 특수 의약품 매출이 주요 성장 동력이었습니다. GLP-1 매출은 전년 동기 대비 28억 달러 증가했습니다.
이러한 이익은 제약사의 표시 가격 인하 및 대형 우편 주문 고객사에 대한 매출 감소로 인한 28억 달러의 매출 압박으로 일부 상쇄되었습니다. 원 온콜로지와 레티나 컨설턴츠 오브 아메리카(Retina Consultants of America)를 제외한 연결 영업비용 증가율은 3% 미만이었습니다.
인터내셔널 헬스케어 솔루션 부문 매출은 5% 증가한 78억 달러를 기록했습니다. 영업이익은 보고 기준 16%, 고정 환율 기준 19% 증가한 1억 5,200만 달러를 기록했습니다. 경영진은 캐나다 프로그램 수주율 호조와 글로벌 특수 물류 및 3PL 부문의 두 자릿수 영업이익 성장을 원인으로 꼽았습니다.
기타 부문은 전년 동기 대비 10% 증가한 23억 달러의 매출과 36% 증가한 1억 100만 달러의 영업이익을 거두었습니다. 성장은 주로 프로 파마(Pro Pharma)와 MWI 애니멀 헬스(MWI Animal Health)에서 비롯되었으며, 여기에는 매각예정자산 처리에 따른 회계상 이익이 포함되어 있습니다.
연간 기준으로 경영진은 MSO(병의원 경영지원회사)가 전체 기업 영업이익의 약 10%를 차지했다고 밝혔습니다. 2건의 대형 MSO 인수와 종양학 고객사 손실을 제외하면 미국 핵심 부문의 성장률은 약 13%였습니다.
센코라는 2개 신규 부문 전체의 특수 의약품 유통 매출이 2027 회계연도에 약 1,000억 달러에 달할 것으로 예상합니다. 회사는 특수 의약품 및 의료진 서비스 부문 내에서 임상시험 물류, 상업화, 특수 의약품 유통, GPO 및 병의원 경영 관리 역량을 결합하고 있습니다.
경영진 가이던스
| 2027 회계연도 지표 | 경영진 가이던스 |
|---|---|
| 연결 매출 성장률 | 3%~5% |
| 조정 영업이익 성장률 | 4%~6% |
| 기타 부문 제외 조정 영업이익 성장률 | 8.5%~11% |
| 조정 희석 EPS | $19.40~$19.75 |
| 조정 EPS 성장률 | 8%~10% |
| MWI-코베트러스 추정 영향 제외 조정 EPS 성장률 | 10%~12% |
| 조정 잉여현금흐름 | 약 35억 달러 |
| 자본적 지출(CAPEX) | 약 10억 달러 |
| 이자 비용 | 4억 9,000만 달러~5억 1,000만 달러 |
| 실효 세율 | 약 20% |
| 평균 희석 주식 수 | 약 1억 9,000만 주 |
| 자사주 매입 계획 | 12억 5,000만 달러 |
| 1분기 조정 희석 EPS | 약 $4.55 |
의약품 유통 및 서비스 부문의 경우, 경영진은 2027 회계연도 매출 성장률을 4%~6%, 영업이익 성장률을 2%~4%로 예상합니다. 이 전망에는 고객 물량 이동의 이월 영향과 유럽 유통 부문의 약 2,000만 달러에 달하는 환율 악재가 반영되어 있습니다.
특수 의약품 및 의료진 서비스 부문의 경우 매출 성장률 9%~14%, 영업이익 성장률 18%~21%를 예상하고 있습니다. 이 전망치에는 원 온콜로지로부터의 4개월간 추가 기여분이 포함되어 있습니다. 경영진은 이 효과를 제외한 기저 성장률이 해당 부문의 장기 목표인 10%대 중반에 부합할 것이라고 밝혔습니다.
가이던스에는 아이사우스(EyeSouth)의 망막 사업부 및 아메리칸 온콜로지 네트워크(American Oncology Network) 인수건은 제외되어 있습니다. 또한 회계연도 중반경 MWI-코베트러스 합병이 완료되고 1분기 중 센코라의 프로 파마 지분 매각이 완료되는 것을 전제로 합니다.
리스크 및 주요 관전 포인트
- 기타 부문으로 분류된 사업은 주로 회계연도 중반으로 추진 중인 MWI-코베트러스 거래 종료 영향으로 2027 회계연도 영업이익 성장률을 약 5%포인트 감소시킬 것으로 예상됩니다.
- 의약품 유통 및 서비스 부문은 이전에 공개된 고객 물량 이동과 강달러 현상으로 인한 압박에 직면해 있습니다.
- 4분기 매출 성장은 제약사의 표시 가격 인하 및 대형 우편 주문 고객사에 대한 매출 감소로 인해 제한되었습니다.
- 경영진은 특수 의료진에 영향을 미치는 잠재적 수가 및 정책 변화를 계속 모니터링하고 있으나, 2027 회계연도에 미칠 구체적인 영향은 수치화하지 않았습니다.
- 센코라는 옵션 케어(Option Care)와 관련된 잠재적 변화가 있더라도 실적은 기존 의약품 유통 및 서비스 가이던스 범위 내에서 움직일 것이라고 밝혔습니다.
애널리스트 Q&A 주요 내용
경영진은 새로운 보고 체계가 제약 제조사부터 전문의 의료진에 이르는 서비스를 아우르며 센코라의 특수 자산을 단일 리더 산하에 배치한다고 설명했습니다. 주된 목적은 비용 시너지 확보보다는 실행력, 고객 조율 및 투자자 가시성을 향상시키는 데 있습니다.
회사는 시장 확대, MSO의 자체적인 전문의 추가 및 소규모 보충형 인수에 힘입어 특수 의약품 장기 영업이익 성장률이 10%대 중반을 기록할 것으로 예상합니다. 경영진은 특수 의약품 사업을 월드 쿠리어(World Courier), 3PL, MSO, 컨설팅 및 특수 유통을 포함하는 고성장·고마진 사업으로 설명했습니다.
제네릭 및 바이오시밀러와 관련해 경영진은 두 분야 모두 센코라에 긍정적이며 가이던스에 반영되어 있다고 밝혔습니다. 파트 B 바이오시밀러는 더 높은 마진 기회를 제공하는 반면, 파트 D 바이오시밀러는 이익보다 매출에 더 큰 영향을 미칠 것으로 예상됩니다.
센코라는 자사의 MSO 확장이 제약 중심 전략에 부합하는 종양학 및 망막 분야에 계속 집중될 것임을 재확인했습니다. 경영진은 수액 치료 고객사에 지속적으로 서비스를 제공할 것이나 수액 치료 역량을 직접 소유할 필요는 없다고 밝혔습니다.
자본 배분 우선순위는 내부 투자, 전략적 M&A, 기회주의적 자사주 매입, 배당 확대 등으로 기존과 동일합니다. 2027 회계연도 자본 지출은 미국 공급망 인프라, 디지털 전환, SAP 및 MSO 인프라에 집중될 예정입니다.
실적 발표 전화회의 전체 녹취록
전체 실적 발표 컨퍼런스 콜 녹취록
경영진 발표
Operator
[indiscernible] 2026 Fourth Quarter Earnings Call. [Operator Instructions] I will now hand the conference over to Bennett Murphy. Bennett, please go ahead.
Bennett Murphy
Good morning, good afternoon, and thank you all for joining us for this conference call to discuss Cencora's fiscal 2026 Fourth quarter and full year results. I am Bennett Murphy, Senior Vice President, Investor Relations and Enterprise Productivity. Joining me today are Bob Mauch, President and CEO; and Eva Boratto, Executive Vice President and CFO.
On today's call, we'll be discussing non-GAAP financial measures. Reconciliations of these measures to GAAP are provided in today's press release, which is available on our website at investor.incor.com. We've also posted a slide presentation to accompany today's press release on our investor website. Alongside these materials, we are providing recast financials in our new segments for fiscal 2025 and fiscal 2026 in Form 8-K that will also be available on our Investor Relations website.
During this conference call, we will discuss forward-looking statements about our business and financial expectations on an adjusted non-GAAP basis, including, but not limited to, EPS, operating income and income taxes. Forward-looking statements are based on management's current expectations and are subject to uncertainty and change. For a discussion of key risks and assumptions, we refer you to today's press release and our SEC filings, including our most recent 10-Q. Cencora assumes no obligation to update any forward-looking statements, and this call cannot be broadcast without the permission of the company.
You'll have an opportunity to ask questions after today's remarks by management. We ask you limit your questions to one per participant in order for us to get to as many as possible within the hour.
With that, I'll turn the call over to Bob.
Robert Mauch
Thank you, Bennett. Hi, everyone, and thank you for joining Cencora's Fiscal 2026 Fourth Quarter and Full Year Earnings Call. I want to begin by thanking our team members. Throughout the fiscal year, their commitment to our purpose and dedication to our customers fueled our performance as we delivered adjusted operating income growth of 14% and adjusted diluted EPS of $17.97, up 12%. Our fiscal 2026 performance demonstrates the strength of our business and the progress we've made with leadership in specialty and a portfolio increasingly aligned to the areas where we can create the greatest long-term value. We enter fiscal 2027 with momentum and greater operational and strategic focus. The outlook reflects our confidence and is aligned with our long-term targets when excluding the businesses and other.
This morning, I will focus on 2 areas: The strategic progress delivered in fiscal 2026 and how our updated operating model will strengthen execution, customer focus and visibility for investors. I'll begin with the strategic progress delivered in fiscal 2026. Two years ago, we introduced a refined strategy to lead with market leaders strengthen our position in specialty and enhanced patient access to pharmaceuticals. In fiscal 2026, we advanced each priority, delivered another year of record results and expanded capabilities that support patient access to innovation in the specialty pharmaceutical market where growth has been twice that of the broader market over the past 5 years.
Our MSO platform is one important example. In February, we completed our acquisition of One Oncology, expanding our position in one of health care's fastest-growing areas. Together, One Oncology and Retina Consultants of America, deepen our relationships with community-based specialists and strengthen our ability to support pharmaceutical-centric care closer to where patients live. During the fiscal year, we continued to build the MSO platform, including the announced acquisition of EyeSouth's retina business in March and most recently, our agreement to acquire a majority interest in American Oncology network. These additions will expand the capabilities and reach of the platform built to help independent specialty practices thrive, improve patient access to high-quality care and create opportunities to support pharmaceutical companies across the product life cycle.
In fact, at RCA, we participate in the vast majority of retina clinical trials, completing over 40,000 research-related visits annually and One Oncology has supported more than 130 pharmaceutical partners with their clinical trials to date. As we've invested in the businesses aligned with our pharmaceutical-centric strategy, we've also taken decisive action on businesses that do not align concentrating our capital and leadership attention where Cencora is most differentiated. Over the course of the year, we entered into agreements or completed divestitures for all the businesses within other. While these actions can cause near-term financial headwinds, they allow us to direct our resources towards the areas where we can create the greatest value for customers and shareholders over the long term. The same discipline guiding our portfolio informs how we operate.
This morning, we introduced an updated operating model aligned with our strategy and the customers we serve. Our pharmaceutical-centric strategy is focused on strengthening our leadership in specialty and delivering greater value across pharmaceutical services. As the needs of manufacturers and providers evolve, we're adapting our organization to better support them while preserving the benefits of Cencora's scale, infrastructure and expertise. I believe this operating model will make Cencora more effective in 3 ways: Enhancing our strategic and operational execution, further elevating the voice of our customers and providing increased visibility for our shareholders.
Informed by our updated operating model, we've created 2 new reporting segments. Specialty Pharmaceutical and Provider Services brings together our specialty capabilities in an integrated growth platform, supporting innovation from pharmaceutical manufacturers to physician providers. Pharmaceutical Distribution and Services organized around our broad portfolio of customers and the services we provide, while leveraging our scale to deliver sustained growth and strong cash flow generation, powering investments across the enterprise.
Now I'll share a bit more about each segment, starting with Specialty Pharmaceutical and Provider Services. We are connecting capabilities across clinical trial logistics, commercialization, specialty distribution, GPO and practice management to support innovative therapies from development to delivery to patients. That role is becoming more important with specialty biologics now accounting for more than half of all pharmaceutical spending in the United States, up 80% in 5 years. With over 100 new products expected to launch through 2030, Oncology illustrates the growing need for specialized clinical logistics, distribution and provider support as the pipeline expands and therapies become more complex.
These are capabilities Cencora has built at scale through focused investments with Specialty Logistics operations across more than 50 countries and multinational 3PL solutions in the United States and Europe. We can support pharmaceutical partners as they bring complex therapies to patients across markets. Our role does not end when a therapy reaches its destination. As more specialty care is delivered in community settings, providers are managing increasing clinical and administrative demands. Through our MSOs, we help independent specialty physicians manage clinical and administrative complexity, expand access to research and remain focused on patient care. Our agreement to acquire a majority interest in AON extends the platform through a physician-led network and a long-standing Cencora partner.
Bringing these businesses together deepens our relationships with manufacturers and providers while giving investors a clearer view of the growth potential of our specialty platform. Within pharmaceutical distribution and services, our scale provides us with deep understanding of trends across the health care ecosystem, which we use to drive differentiated value to customers. We deliver over 100 million packages annually, shipping nearly 5 million units each day, giving our leaders firsthand insight into the needs of manufacturers, providers, pharmacies and patients. Combining our scale, our sourcing expertise and customer-centric partnerships with pharmacies and health systems, large and small, we strengthen their operations, support their growth and ensure continued patient access.
Two recent customer events illustrate how the prospective shape our priorities. At our Health Systems National Summit, health systems leaders discussed how connecting pharmacy, supply chain, technology and care delivery leads to better decisions for patients and their organizations. These are all areas where our accelerate pharmacy solutions help our health systems customers. At ThoughtSpot, our annual trade show for good neighbor independent pharmacies, we came together with more than 3,000 attendees introducing novel solutions, including AI-powered tools designed to help pharmacies run more efficiently, free up time for patient care and create new growth opportunities. At both our Health Systems National Summit and ThoughtSpot, I heard customers emphasize that specialty is becoming a larger and more complex part of patient care, reinforcing the importance of specialty growth and solutions across both reporting segments. The scale of this opportunity is increasingly visible in our results. We expect specialty distribution revenue to reach approximately $100 billion in fiscal 2027. Combined with our broader manufacturer and provider capabilities, this make specialty a central driver of Cencora's long-term growth.
In summary, we exit fiscal 2026 with record results and a stronger platform for growth, supported by our scale specialty capabilities and an operating model aligned to how we create value.
With that, I'll turn the call over to Eva to discuss our fourth quarter and fiscal 2026 results as well as our fiscal 2027 guidance. Eva?
Eva Boratto
Thanks, Bob. Good morning, everyone. As Bob highlighted, and we shared in our press release this morning, we have introduced a new organizational and financial reporting structure designed to strengthen our execution and provide additional performance visibility to our shareholders. Through our new segments, we will highlight the significant opportunity we have to utilize our end-to-end specialty capabilities to deliver value up and downstream, while driving sustainable growth powered by our scale and efficient pharmaceutical distribution foundation.
In addition to reiterating Cencora's long-term growth algorithm, of 7% to 10% operating income growth and 10% to 14% EPS growth, we are introducing targets for our new segments. For the Pharmaceutical Distribution and Services segment, we expect long-term operating income to grow in the mid-single digits. And for the Specialty Pharmaceutical and Provider Services segment, we expect long-term operating income growth in the mid-teens.
Now I'll provide an overview of our fiscal 2026 fourth quarter and full year results and our fiscal 2027 financial guidance. Unless otherwise stated, my remarks will focus on adjusted non-GAAP financial results. For further discussion of our GAAP results, please refer to our earnings press release and presentation. Beginning with fourth quarter, consolidated revenue was $88.4 billion, up 6%, driven by growth in both reportable segments and in other, which I'll describe in more detail when discussing segment level results.
Consolidated adjusted gross profit was $3.6 billion, up 23%, primarily due to growth in the U.S. Healthcare Solutions segment. Consolidated adjusted gross margin expanded by 57 basis points to 4.04%, largely due to our acquisition of One Oncology in February. Consolidated adjusted operating expenses were $2.3 billion, an increase of 23%, again, largely driven by the impact of the February 2026 acquisition of One Oncology. Excluding both One Oncology and RCA, operating expense growth was less than 3% as we lapped an easier expense comparison. Consolidated adjusted operating income was $1.2 billion, an increase of 22% compared to the prior year quarter, with another quarter of double-digit growth across both reportable segments and other.
Moving now to below the line items. Net interest expense was $136 million, an increase of $58 million compared to the prior year quarter, primarily due to debt raised to finance the One Oncology acquisition. Our effective tax rate was 20.2% compared to 20.6% in the prior year quarter.
Finally, diluted share count was 191.7 million shares, a 1.8% decrease compared to the prior year quarter, largely due to the $1 billion of opportunistic share repurchases we completed in the June quarter. Taken together, this resulted in adjusted diluted earnings per share of $4.66, an increase of 21%.
Turning to our segment results for the fourth quarter. U.S. Healthcare Solutions revenue was $78.3 billion, an increase of 5%. Strength in specialty sales to health systems and physician practices and continued growth in GLP-1, which increased by $2.8 billion year-over-year, drove the growth. The growth was partially offset by manufacturer list price reductions that represented a $2.8 billion headwind to revenue growth as well as lower sales to our large mail order customer, consistent with the past 2 quarters.
U.S. Healthcare Solutions segment operating income was $998 million, up 22%, representing our strongest growth quarter of the fiscal year. This was driven by continued momentum in specialty across both health systems and physician practices, the contribution from One Oncology and focused execution across our other pharmaceutical distribution businesses. The quarter also benefited from an easier expense comparison.
Turning now to our International Healthcare Solutions segment. Revenue was $7.8 billion, up 5%, driven by growth in all business units. International Healthcare Solutions operating income was $152 million, up 16% on an as-reported basis and up 19% on a constant currency basis. In the quarter, our Canadian business delivered excellent performance, driven by high program win rates. Our Global Specialty Logistics and 3PL business continued to drive strong performance with double-digit operating income growth. As Bob mentioned, we have been investing in these businesses to capitalize on the increasing complexity in the innovation pipeline and have been winning in these areas.
Moving to Other, which reflects the businesses for which we are pursuing strategic alternatives. Revenue in Other was $2.3 billion, up 10% and largely due to growth at Pro Pharma and MWI Animal Health. Operating income was $101 million, up 36% due to operating income growth at MWI Animal Health, also including the benefit from being accounted for as held for sale.
This completes the review of our fourth quarter results. Now I'll turn to a discussion of our full year fiscal 2026 results. Our consolidated revenue was $337 billion, up 5%, driven by U.S. Healthcare Solutions segment growth of 5% and International Healthcare Solutions segment growth of 8%. Consolidated operating income was $4.8 billion, an increase of 14%, driven by growth in both reportable segments. In the U.S. Healthcare Solutions segment, we benefited from strength in specialty volumes and our strategic investments in MSOs. In the fiscal year, MSOs represented approximately 10% of enterprise operating income. When excluding the impact of our 2 large MSO acquisitions and the loss of an oncology customer, our core U.S. segment growth was about 13%, nicely ahead of our long-term growth algorithm. In the International Healthcare Solutions segment, we were pleased with the business' return to growth this fiscal year, driven by operational improvements at our global specialty logistics business and increased demand.
Finally, as it relates to free cash flow and our balance sheet, during the fiscal year, we generated $3.8 billion of adjusted free cash flow, stronger than our guidance due to a combination of year-end stronger volume/mix and timing. We ended the year with a cash balance of $4.9 billion. Our strong free cash flow generation gives us significant flexibility to pursue our balanced capital deployment strategy while maintaining our strong investment-grade credit ratings. During the fiscal year, we were pleased to return $1.5 billion to shareholders through a combination of opportunistic share repurchases and our dividend. And this morning, we announced a 10% increase to our quarterly dividend, our 22nd consecutive increase.
Turning now to our fiscal 2027 expectations, there are a few items I'll highlight before we get into the details of our guidance. First, our guidance excludes the acquisitions of EyeSouth's retina business and American Oncology Network, which we will incorporate upon the close of each transaction.
Second, our guidance contemplates a mid-fiscal year close of the MWI merger with Covetrus. The operating income headwind is expected to be partially offset by 2 below-the-line income items associated with the transaction, which would be approximately $40 million in the second half of fiscal 2027. This contribution is expected to bring our other income loss line to approximately $90 million compared to the approximate $26 million in fiscal 2026.
Third, as we announced this morning, we reached an agreement to sell our equity stake in Pro Pharma with the close expected to occur in our fiscal first quarter. Given the nature of our ownership we consolidate the full Pro Forma income statement and eliminate our noncontrolling interest in the company, making it a much less meaningful contributor at the EPS level, which is fully reflected in our revenue, operating income and EPS guidance.
With that as context, we expect adjusted diluted EPS to be in the range of $19.40 to $19.75, reflecting headline growth of 8% to 10%. Excluding the assumed $0.35 impact of the mid-fiscal year merger of MWI and Covetrus, adjusted EPS growth would be 10% to 12%. We expect consolidated revenue growth to be in the range of 3% to 5%. Operating income growth is expected to be in the range of 4% to 6%. The businesses in Other are expected to have an approximate 5 percentage point negative impact on our growth, largely due to the assumed mid-fiscal year closing of the merger of MWI and Covetrus. Excluding the businesses in Other, our guidance would reflect adjusted operating growth of 8.5% to 11% ahead of our long-term targets.
We expect interest expense to be in the range of $490 million to $510 million, reflecting debt we raised in connection with the One Oncology transaction. We expect to pay $1 billion on the remaining One Oncology term loan at the end of fiscal year 2027. We expect our effective tax rate to be approximately 20% for fiscal 2027. We expect full year diluted average shares outstanding to be approximately 190 million shares. This reflects the annualization of opportunistic share repurchases we completed in the third quarter of fiscal 2026 and an expectation of an additional $1.25 billion in repurchases in fiscal 2027. We expect capital expenditures to be approximately $1 billion in fiscal 2027, which reflects continued investments in our supply chain, digital and MSO infrastructure. We expect adjusted free cash flow to be approximately $3.5 billion.
That completes the review of our consolidated fiscal 2027 expectation. I'll now turn to segment level expectations. In the Pharmaceutical Distribution and Services segment, we expect revenue growth to be in the range of 4% to 6%. We expect Pharmaceutical Distribution and Services segment operating income growth to be 2% to 4%, which includes the wraparound impact of a certain customer's volume shift as previously disclosed. The segment operating income growth expectation also includes an approximate $20 million headwind related to our European distribution business, resulting from the strengthening of the U.S. dollar.
Moving now to the Specialty Pharmaceutical and Provider Services segment, we expect revenue growth to be in the range of 9% to 14% and segment operating income growth to be in the range of 18% to 21%, ahead of our segment level long-term operating income growth expectations of mid-teens, reflecting the wraparound contribution from the One Oncology acquisition that we closed in February 2026.
Moving now to Other. We expect revenue in Other to be approximately $3.5 billion and operating income in Other to be approximately $200 million. We are pleased with the significant progress we have made to simplify our portfolio, allowing us to better capitalize on growth opportunities aligned with our pharmaceutical-centric strategy.
Before turning to my closing remarks, as you think about quarterly cadence, we expect adjusted diluted EPS in our first quarter to be approximately $4.55. In closing, fiscal 2026 marked a year of significant progress on our strategy as we delivered strong financial performance. As we look to fiscal 2027 and beyond, we are well positioned to deliver on our long-term targets and drive sustainable shareholder value creation, supported by our differentiated footprint in the high-growth specialty market scaled and efficient foundation in pharmaceutical distribution and strong free cash flows.
I'll turn the call back to Bob for some closing remarks before moving to Q&A. Bob?
Robert Mauch
Thank you, Eva. Our fiscal 2027 guidance reflects our confidence in the strength of the business in our team, our strategy and our ability to deliver sustainable growth and long-term value for customers and shareholders.
With that, we'll open the call for questions. Operator?
Operator
[Operator Instructions] Your first question comes from the line of Elizabeth Anderson with Evercore ISI.
질의응답
Elizabeth Anderson
Thanks for all the details about the operating performance. I guess my question is maybe a little bit more philosophical in nature. Can you talk a little bit more about like why the resegmenting at this point makes sense? You obviously had many specialty assets on the medical side for a while, but why is this the right opportunity to kind of do that? And what does that provide for the business that the old setup did not?
Robert Mauch
Elizabeth, thank you very much for that important question. It starts with the market. As you mentioned, we've been in the specialty market for a long time. We have significant capabilities that we've been building over decades, frankly. But when you look at the growth in the market, the 80% growth that's happened in biologics over the last 5 years. In fact, there's going to be 100 new oncology products between now and 2030. That says to us that we need to be even more focused on that area.
And so the first place to start there is our operating model and the way that we approach our business, the way that we approach our customers, both upstream to manufacturers and downstream to providers. And while we did that very well, our specialty services assets were in different parts of the company and under different leaders. And so what we've done with the operating model change is taken all of those assets and put them under one leader. By doing that, that allows us to discuss a new external segmentation, but it's driven by optimizing our performance. The 3 things that I called out in prepared remarks that are advantages that I see is, one, which I just mentioned, is our enhanced ability to execute both strategically and operationally. It brings us closer to the customers for all of the reasons that I just described. And last but not least, it provides increased visibility to shareholders, which we also think is important.
So the Specialty Pharmaceutical and Provider Services business puts everything under one leader, as I said, all the way from manufacturer to physician, and they deal with one team at Cencora, which will make things easier and faster for the customers. It will also allow us to innovate even more quickly, which will be important as we go into the future and as products get more and more complex. Importantly, our Pharmaceutical Distribution and Services segment, that's the foundation of all of this. It's servicing health systems, pharmacies, alternate sites, wholesale in Europe with significant scale, demonstrated efficiency over decades and cash flow that allows us to invest across the enterprise. So while we are separating the 2, it's an important takeaway for everyone that both are critically important to the growth platform of Cencora. So I think that's the rationale, Elizabeth. I appreciate the question, and we're excited to be able to talk about it today.
Operator
Your next question comes from the line of Lisa Gill with JPMorgan.
Lisa Gill
Bob, I want to follow up on Specialty, just from a couple of different perspectives. One, I absolutely appreciate the visibility that you're giving us and shareholders around the Specialty business. And clearly, this is an important growth engine as we move forward. I want to understand really a couple of things. One, when we think about Specialty going into next year, Eva laid out the numbers, can you talk about what the organic growth rate is? I know there's a number of transactions that impact the number?
And then secondly, you talk about health systems, you talked about the MSO, community practices, et cetera. How do you think about changes in reimbursement and the impact that, that has in '27 or even on a go-forward basis, we obviously had a big election last night. And any incremental thoughts on how you see the future around reimbursement and any impact it would have on you as you continue to serve these -- from a Specialty perspective, serving these practices.
Robert Mauch
Thanks, Lisa, for the question. Yes, maybe I'll start with the end. And as you mentioned, we did have an election last night, it's most important to note that through multiple cycles, the administrations and leadership in congress and leadership in the regulatory agencies, we have a long history of advocacy and making sure that Cencora is present and educating everyone about the services that we provide, the value -- the very high-quality, low-cost services that we provide at Cencora. But also importantly, we have visibility end-to-end to the pharmaceutical supply chain. So we're someone who can advise on what the outcomes might be, the consequences might be of any policy changes.
So the way things look today, there'll be lots of opportunity for conversations as we get the new Congress and Senate in place, and we'll be right there to help them with that.
I think a second piece, Lisa, is just the overall scale of our of our Specialty business. And we broke out the Specialty Pharmaceutical and Provider Services. But it's also important to note that there's significant Specialty Distribution products that go into the Pharmaceutical Distribution and Services segment. So the number that we had in our prepared remarks that more than $100 billion is the combination of the 2. So very importantly, whether an oncology product, for example, is going into a community specialist setting or it's going into a clinic within a health system, Cencora very well positioned to support that patient wherever they may present and support that clinician and caring for that patient. So I'll pause there and hand it over to Eva to answer the other part of your question.
Eva Boratto
Sure. Lisa, the Specialty and Pharmaceutical Distribution and Provider Services segment, as you saw in our materials expected operating income growth of 18% to 21%. And that's above our long-term growth algorithm. And I would remind you, we have the wraparound of One Oncology for the first 4 months of the fiscal year. So outside of that impact, our underlying growth would have been in line with our algorithm of mid-teens growth that we outlined today.
Operator
Your next question comes from the line of Glen Santangelo with Barclays.
Glen Santangelo
I also want to follow up on specialty. Bob, when I think about that mid-teens sort of long-term growth rate in specialty, in your prepared remarks, you just suggested there's 100 new oncology products coming between now and 2030. So is it really volumes that are the primary driver of that mid-teens growth? I just want to separate organic from inorganic.
And then just sort of related to that, you generated a 3.7% margin in Specialty this year. How do you maybe help us think about the puts and takes on that margin given all the upcoming biosimilar conversions?
Eva Boratto
Sure, Glenn. It's Eva. I'll start in the Specialty Pharmaceutical and Provider Services. First, if you take a step back, this segment consists of end-to-end specialty businesses. from our Specialty Distribution, to Practice Management Platform, to global clinical trials, multinational 3PL businesses. So that's what's encompassed in that segment. And as you think about our long-term growth algorithm of mid-teens, one, it reflects the fast paced growth in the market, and as Bob outlined; two, continued growth at our MSOs through both organic physician acquisition as well as tuck-in M&A on these platforms.
Operator
Your next question comes from the line of Charles Rhyee with TD Cowen.
Charles Rhyee
Maybe I could ask the other side in the pharmaceutical distribution services, in the assumptions you kind of give for long-term segment growth, can you talk about how you're thinking about the cycle of small molecule generics coming over the next several years. How much do you incorporate that? And obviously, small molecule generics were a huge driver of growth back in the 2000s and the 2010. When we look at this next cycle coming up, it looks significantly bigger in terms of dollar volumes. Maybe you could help us understand, have there been changes in that part of the market that should either make us be more excited. Maybe we should be a little bit more cautious on it. Just trying to get a better sense on the dynamics in this part given what looks to be a big cycle, particularly as we get to the back half of next calendar year? Any comments there on helping us size that would be helpful.
Robert Mauch
Thanks for the question, Charles. I'll start, and head at Eva if she wants to add anything as I finish up. So I think just take a step back, whether it's a small molecule generic or whether it's a biosimilar, we keep a very close eye on all of those. Those launches of both types would be contemplated in our guidance. But I think the takeaway is just a reminder that, that's positive for Cencora. So whether it's a small molecule generic or biosimilar, that's positive. They are different in different segments. The Part B biosimilar is the sweet spot for us. That's where the services that we provide allow us to earn a higher margin. Within Part D, it's much less impactful. That would be a revenue impact and not really a profit gain.
And oral generics, small molecule oral generics are positive. They absolutely are. So to the extent that we have more or less launches, that has an impact. But you'll know, Charles, not -- you mentioned the historical driver of generic launches, they're not bad. So we're not calling either a significant increase or a decrease in launches as a driver of our performance. So I think the takeaway is that the assumptions are contemplated in our guidance, and we keep a very close eye on it.
Operator
Your next question comes from the line of Allen Lutz with Bank of America.
Allen Lutz
Bob, you spoke a lot about upstream services in your prepared remarks. RCA and 1 oncology are active in clinical trials. You also own the World Courier business. could you take a moment to expand on the synergies between those 2 businesses?
And then more broadly, as we think about the resegmentation, how should we think about capital deployment and the strategy? Is there any evolution here as you've done that resegmenting?
Robert Mauch
Yes. Thanks for the question, Allen. I'll speak to strategic synergy. Part of the purpose of bringing those businesses together was to be more effective, to be more efficient, and I'm sure some of that will come. But that's not the -- financial synergy was not necessarily the thesis for putting them together. It's really a growth thesis. And what we have, as you said, so if you take the pharmaceutical company facing view, we have the very specialized global logistics to support them in clinical trials. We have commercialization, consulting services that can help them think about how they're going to bring their product to market in multiple countries. As they're getting ready to launch, we have 3PL services that are going to be important as they launch in Europe, and then we have our specialty distribution and full-line distribution in the United States. And then as that continues to go downstream, as I follow that through, then you have -- as I kind of transition from specialty distribution, you have the GPO, you have the MSO, all of that supporting the physician, and the purpose of all of that is to make sure that the physician has optimal opportunity to care for patients -- to make the right clinical decisions and to care for patients. So there's a strong thesis there of value from the manufacturer all the way to the provider and to the patient. And the purpose of putting these businesses together inside the Specialty Pharmaceutical and Provider Services segment is for us to continue to build that platform and innovate over the long term.
Eva Boratto
And Bob, I'll take the capital allocation part of the question. I would say there is no change in our capital deployment strategy. We remain focused in 4 key areas: Internal investments in the business, strategic M&A, opportunistic share repurchases and maintaining a reasonable and growing dividend. And I think you've seen us deliver on that. This morning, we announced we're increasing our dividend 10% for fiscal year 2027 and $1.25 billion in share repurchases. And I think the portfolio optimization that's been done with some of the divestitures will enable us to execute on these priorities.
Operator
Your next question comes from the line of Eric Percher with Nephron Research.
Eric Percher
Want to dig a little bit deeper into the pharma distribution and services, new segmentation and thank you for that segmentation. So in '27, 4% to 6% growth, we would assume that there's a headwind from IRA and GLP-1. And then seeing the op profit growth at 2% to 4% and I think we've been taught by you that the reductions to top line don't necessarily translate at the op profit line, but can you just help us on factors impacting top line versus the op profit headwinds we're seeing for '27 specifically?
Eva Boratto
Yes. Sure, Eric. As you -- I'm going to start at the profit line. As you look at the 2% to 4% growth being below the long-term algorithm that we provided today, I would highlight 2 things. One, we have the wraparound impact of a customer volume shift that we talked about earlier in the year as well as about a point impact from FX now that our international distribution is part of that segment. Outside of those impacts, we expect to perform within our long-term targets.
On your revenue question, I'm going to go to the consolidated revenue at growth of 3% to 5%. What I would say, the differentiator, as you look at '27, fiscal guidance versus the 5% we delivered in fiscal '26 is really the headwind from the Pro Forma divestiture that we announced today as well as the assumed midyear merger of Covetrus. And those 2 combined drive about 150 basis point headwind to growth. I'd say the WACC decreases and it's pretty comparable is our estimate. You get a little bit more from the wraparound impact but pretty comparable to what we experienced in '26.
Operator
Your next question comes from the line of Erin Wright with Morgan Stanley.
Erin Wilson Wright
Great. So a competitor of yours recently announced a transaction in the infusion space with Option Care. I guess is that an area that is interested to you? Did you look at that asset? How do you think about, I guess, other areas outside of oncology and retina, I mean you're really weighing in on oncology, obviously, but are you still entertaining those other ideas? Or how do you think about that in terms of the context of what you were just talking about from a capital deployment standpoint?
Robert Mauch
Erin, thanks very much for the for the question. I'll start with where it's clear that we are focused because I do want to emphasize that. We've made it very clear that we're going to be focused on expanding our specialty capabilities. We've made it clear that we're going to focus our portfolio in areas that we can create long-term customer and shareholder value. And you're seeing us do that. That is our investments in the builds of the MSOs that we're doing, and we're going to continue to do that. It's important to note something that we've said a few times, which is our pharmaceutical-centric strategy keeps us focused in the MSO space right now on oncology and retina. And we don't see other therapeutic areas as areas that would be pharmaceutical-centric and therefore, would have us interested in expanding into a different MSO outside of those 2.
Getting to your question, which is infusion specific, we support infusion customers across our portfolio. We have that in our health systems business, we support infusion customers. We expect to continue to support them as customers, but that doesn't mean that we need to own that capability. We're a strong provider to them, and we'll continue to do that.
Operator
Your next question comes from the line of George Hill with Deutsche Bank.
George Hill
I'm going to delve a little bit more into the new specialty segment a little bit. I'm wondering if there's a chance that you guys would tell us maybe the dollar percentage contribution from like the MSO segment versus wholesaling versus GPO. Would you talk at all about are there any more significant margin differences by therapeutic category? And should we think of like what is a target margin profile for this segment, given that operating earnings growth is expected to outpace revenue growth in the long-term algo.
Eva Boratto
George. It's Eva. So on your first question around breaking out the MSO contribution, for 2026, we indicated the MSOs were about 10% of our consolidated operating income. So that should give you a framework to think about that. On the margin side, right, our specialty is our higher margin, higher growth business. I would point out that it's not just the Specialty Distribution. We have the World Courier, the 3PL, the MSOs and the consulting businesses in there. So they're carrying a higher margin profile. And I'd remind you that we consolidate RCA. So think about that as additive to margin.
Operator
Your next question comes from the line of Eric Coldwell with Baird.
Eric Coldwell
I was hoping for a little more framing on the CapEx. I understand the drivers of the heightened CapEx, the $1 billion target. I'm hoping to put that in context of a figure that is effectively a double or more than a double over the last couple of years. And the 3% to 4% growth in the long-term growth targets, should we read that as started $1 billion and then grow that 3% to 4% per year thereafter. I assume that's a forward-looking basis. So I just want to make sure that there's not a bit of a onetime spike, if you will, in fiscal '27.
Eva Boratto
Yes. Eric, this is Eva. Regarding our CapEx, as you said, we expect to spend approximately $1 billion. And you're right, the dollar spend is elevated to recent years. As a percentage of gross profit, it aligns with historical periods when we've made significant investments in our infrastructure. So I would just remind you, we're making investments in our U.S. supply chain infrastructure. We're continuing to make investments in IT to support our digital transformation as well as SAP as well as some investments in our MSO. And the 3% to 4% that you're referring to, I believe, is capital deployment. It was not intended to be CapEx growing at 3% to 4%.
Operator
Your next question comes from the line of Kevin Caliendo with UBS.
Kevin Caliendo
Just a couple of things, I just want to understand the inputs into 2027. One oncology profitability that -- the run rate that you had for fiscal 4Q. Is that the run rate going forward? Or did you assume there would be improving One Oncology profitability in fiscal '27 versus the run rate we saw exiting?
And then is there anything that you contemplated around Cigna's new sort of wholesale distribution business that they announced. We don't really know exactly what it's going to be, but the perception was it could potentially impact you? I'm wondering if there was anything when you thought about guidance that was an input relative to that business.
And then the last input is the Option Care relationship that you currently have. We don't know when that contract expires, but is there anything built into fiscal '27 for potentially losing the distribution part of the Option Care business, if that's even an issue.
Eva Boratto
Yes. Thanks for the question. I'm going to go in reverse order, Kevin. On Option Care, you're right, they are a Cencora customer and have been for some time. As it relates to the financial impact, I would think about it, it would move us within our guidance range of our Pharmaceutical Distribution and Services segment.
Your point on MSOs, One Oncology more specifically, what I would say is, first, I want to iterate that One Oncology and RCA both continuing to perform well. They performed well in the quarter. We expect there'll be significant contributors to our specialty growth. They have been in the past, and we look forward to those continuing to grow nicely.
Robert Mauch
And Kevin, I would just add, I think your question was how we have thought about kind of our customer relationships in terms of guidance. You mentioned one specific one, but I'll just say that all of our customer relationships are contemplated in our fiscal '27 guidance, and we wouldn't comment any further than that.
Operator
This concludes the Q&A session. I will now turn the call back to Bob Mauch for closing remarks.
Robert Mauch
Thank you, operator. our fiscal 2026 performance demonstrates the strength of our business. We move into fiscal 2027 with significant momentum and Cencora is focused on execution and advancing our strategy to continue creating long-term value for our customers and shareholders. Thanks, everyone, for your time today.
Operator
This concludes today's call. Thank you for attending. You may now disconnect.
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