Cencora Raises Full-Year Outlook on Strong Q1, Bolstered by OneOncology Acquisition

In a clear sign of strategic momentum, Cencora (NYSE: COR) kicked off its 2026 fiscal year with stronger-than-expected earnings, prompting management to raise key financial targets for the full year. The upward revision follows the company's completed acquisition of a majority stake in OneOncology, a national network of community oncology practices, further solidifying its push into physician practice management.

"Our integrated strategy is delivering tangible results," said President and CEO Bob Mauch during the earnings call. He positioned the OneOncology deal as a cornerstone move, analogous to last year's acquisition of Retina Consultants of America (RCA), enhancing Cencora's role as a critical support partner for independent physicians. These Management Service Organizations (MSOs) provide back-office infrastructure, allowing doctors to focus on patient care while Cencora strengthens ties with drug manufacturers.

The financials underscored the growth narrative. First-quarter adjusted earnings per share rose 9% year-over-year to $4.08, on consolidated revenue of $85.9 billion, a 5.5% increase. A significant driver was an 11% surge in U.S. sales of GLP-1 products, reflecting the booming demand for weight-loss and diabetes drugs. The U.S. Healthcare Solutions segment saw operating income jump 21%, largely credited to the contribution from RCA.

However, the quarter wasn't without its headwinds. Profitability in the International Healthcare Solutions segment declined, which CFO Jim Cleary attributed to timing differences in manufacturer price adjustments in a key developing market. He emphasized this was a quarterly phasing issue, not a structural decline, and expects a reversal in subsequent periods.

Bolstered by the OneOncology integration, Cencora now expects full-year revenue growth between 7% and 9%, up from prior guidance of 5% to 7%. Operating income growth guidance was lifted to a range of 11.5% to 13.5%. The company paused share repurchases to prioritize debt repayment from the acquisition but reaffirmed its commitment to returning capital to shareholders over the long term, noting a recent 9% dividend hike.

Analyst & Investor Commentary:

"The raised guidance is a powerful statement. Cencora isn't just distributing drugs anymore; it's embedding itself into the care delivery fabric through these MSOs. The scalability of this model, especially in high-cost specialty areas like oncology, is a major differentiator." – David Chen, Portfolio Manager at Horizon Capital

"I'm skeptical. They're loading up on debt to buy physician groups in a fragmented, low-margin business. The 'timing issue' overseas smells like a cover for deeper pricing pressures. This feels like a company trying to buy growth while core distribution faces relentless margin compression." – Sarah J. Miller, Independent Market Analyst

"The strategic logic is sound. In an era of drug price scrutiny and provider consolidation, offering a lifeline to independent practices creates a sticky, value-added partnership. The RCA success story gives the OneOncology playbook credibility." – Dr. Arjun Patel, Healthcare Consultant

Cencora's performance highlights a broader trend in healthcare, where distributors are evolving beyond logistics to become essential service partners, aiming to capture more value across the pharmaceutical supply chain.