Business Segment Information
The Company is organized geographically based upon the products and services it provides to its customer and reports its results under two reportable segments: U.S. Healthcare Solutions and International Healthcare Solutions.
The chief operating decision maker (“CODM”) of the Company is its President & Chief Executive Officer, whose function is to allocate resources to, and assess the performance of, the Company’s operating segments. The CODM does not review assets by operating segment for the purpose of assessing performance or allocating resources.
The U.S. Healthcare Solutions reportable segment distributes a comprehensive offering of brand-name, specialty brand-name and generic pharmaceuticals, over-the-counter healthcare products, home healthcare supplies and equipment, and related services to a wide variety of healthcare providers, including acute care hospitals and health systems, independent and chain retail pharmacies, mail order pharmacies, medical clinics, long-term care and alternate site pharmacies, and other customers. The U.S. Healthcare Solutions reportable segment also provides pharmaceutical distribution (including plasma and other blood products, injectable pharmaceuticals, vaccines, and other specialty pharmaceutical products) and additional services to physicians who specialize in a variety of disease states, especially oncology and retina, and to other healthcare providers, including hospitals, specialty retinal practices, and dialysis clinics. The U.S. Healthcare Solutions reportable segment also provides pharmacy management, staffing and additional patient access and adherence support, and supply management software to a variety of retail and institutional healthcare providers. Additionally, it delivers packaging solutions to institutional and retail healthcare providers. Through its animal health business, the U.S. Healthcare Solutions reportable segment sells pharmaceuticals, vaccines, parasiticides, diagnostics, micro feed ingredients, and various other products to customers in both the companion animal and production animal markets. It also offers demand-creating sales force services to manufacturers.
The International Healthcare Solutions reportable segment consists of businesses that focus on international pharmaceutical wholesale and related service operations and global commercialization services. The International Healthcare Solutions reportable segment distributes pharmaceuticals and other healthcare products and provides related services to healthcare providers, including pharmacies, doctors, health centers and hospitals primarily in Europe. It is a leading global specialty transportation and logistics provider for the biopharmaceutical industry. It also is a provider of specialized services, including regulatory affairs, market access, pharmacovigilance, development consulting and scientific affairs, and quality management and compliance, for the life sciences industry. In Canada, the business drives innovative partnerships with manufacturers, providers, and pharmacies to improve product access and efficiency throughout the healthcare supply chain.
The following illustrates reportable segment and disaggregated revenue as required by ASC 606, “Revenue from Contracts with Customers,” for the periods indicated:
 Fiscal Year Ended September 30,
(in thousands)202520242023
U.S. Healthcare Solutions
Human Health$285,287,506 $259,973,909 $229,716,669 
Animal Health5,694,517 5,365,518 5,042,549 
Total U.S. Healthcare Solutions290,982,023 265,339,427 234,759,218 
International Healthcare Solutions
Alliance Healthcare24,394,833 23,061,721 22,349,278 
Other Healthcare Solutions5,971,490 5,565,821 5,069,401 
Total International Healthcare Solutions30,366,323 28,627,542 27,418,679 
Intersegment eliminations(15,527)(8,370)(4,486)
Revenue$321,332,819 $293,958,599 $262,173,411 
The following illustrates reportable segment cost of goods sold information for the periods indicated:
 Fiscal Year Ended September 30,
(in thousands)202520242023
U.S. Healthcare Solutions$283,076,597 $258,916,313 $228,938,102 
International Healthcare Solutions27,050,982 25,306,564 24,227,832 
Intersegment eliminations (9,622)(5,322)(4,486)
Total segment cost of goods sold$310,117,957 $284,217,555 $253,161,448 
The following illustrates reportable segment operating expenses information for the periods indicated:
 Fiscal Year Ended September 30,
(in thousands)202520242023
U.S. Healthcare Solutions$4,330,727 $3,488,237 $3,224,557 
International Healthcare Solutions2,667,067 2,607,599 2,498,285 
Intersegment eliminations(5,905)(3,048)— 
Total segment operating expenses$6,991,889 $6,092,788 $5,722,842 
The following illustrates reportable segment operating income information for the periods indicated:
 Fiscal Year Ended September 30,
(in thousands)202520242023
U.S. Healthcare Solutions$3,574,699 $2,934,877 $2,596,559 
International Healthcare Solutions648,274 713,379 692,562 
Total segment operating income$4,222,973 $3,648,256 $3,289,121 
The following reconciles total segment operating income to income before income taxes for the periods indicated:
 Fiscal Year Ended September 30,
(in thousands)202520242023
Total segment operating income$4,222,973 $3,648,256 $3,289,121 
Gains from antitrust litigation settlements236,372 170,904 239,092 
LIFO credit (expense) 76,876 52,168 (204,595)
Turkey highly inflationary impact(49,571)(54,087)(86,967)
Acquisition-related intangibles amortization(553,028)(660,292)(551,046)
Litigation and opioid-related (expenses) credit, net(60,671)(227,070)24,693 
Acquisition-related deal and integration expenses(291,044)(103,001)(139,683)
Restructuring and other expenses(229,422)(233,629)(229,884)
Goodwill impairment(723,884)(418,000)— 
Operating income2,628,601 2,175,249 2,340,731 
Other loss (income), net78,717 14,283 (49,036)
Interest expense, net291,548 156,991 228,931 
Income before income taxes$2,258,336 $2,003,975 $2,160,836 
Segment operating income is evaluated by the CODM of the Company and excludes gains from antitrust litigation settlements; LIFO credit (expense); Turkey highly inflationary impact; acquisition-related intangibles amortization; litigation and opioid-related (expenses) credit, net; acquisition-related deal and integration expenses; restructuring and other expenses; and goodwill impairment. All corporate office expenses are allocated to the operating segment level.
Litigation and opioid-related (expenses) credit, net in fiscal 2024 includes $263.1 million of litigation expense accruals (see Note 12), offset in part by a net $92.2 million opioid litigation settlement accrual reduction primarily as a result of the Company’s prepayment of the net present value of a future obligation as permitted under its opioid settlement agreements.
Litigation and opioid-related (expenses) credit, net in fiscal 2023 includes the receipt of $83.4 million from the H.D. Smith opioid litigation indemnity escrow.    
Other loss (income), net includes a $113.5 million impairment of an equity investment that was made in fiscal 2021 and a $35.5 million loss on the divestiture of non-core businesses, offset in part by the Company’s portion of an equity method investment’s gain on the sale of a business of $39.7 million and a $14.1 million gain on the remeasurement of an equity investment in fiscal 2025.
Other loss (income), net, includes a $40.7 million net gain on the divestiture of non-core businesses in fiscal 2023.
The following illustrates depreciation and amortization by reportable segment for the periods indicated:
Fiscal Year Ended September 30,
(in thousands)202520242023
U.S. Healthcare Solutions$352,602 $298,683 $292,814 
International Healthcare Solutions145,445 132,999 120,044 
Acquisition-related intangibles amortization553,028 660,292 551,046 
Total depreciation and amortization$1,051,075 $1,091,974 $963,904 
                
Depreciation and amortization related to property and equipment and intangible assets excludes amortization of deferred financing costs and other debt-related items, which are included in interest expense, net.
The following illustrates capital expenditures by reportable segment for the periods indicated:
Fiscal Year Ended September 30,
(in thousands)202520242023
U.S. Healthcare Solutions$399,518 $273,715 $268,069 
International Healthcare Solutions268,463 213,458 190,290 
Total capital expenditures$667,981 $487,173 $458,359 

Historical Timeline

Fiscal YearFiled
2025Nov 25, 2025Showing above
2024Nov 26, 2024
2023Nov 21, 2023
2022Nov 22, 2022
2021Nov 23, 2021
2020Nov 19, 2020
2019Nov 19, 2019
2018Nov 20, 2018
2017Nov 21, 2017
2016Nov 22, 2016
2015Nov 24, 2015

About Segments Disclosures

Segment disclosures break a company into its reportable operating units, revealing revenue, profit, and asset allocation that consolidated financial statements obscure. Under ASC 280, segments must match how the chief operating decision maker views the business, providing a window into internal management structure and resource allocation priorities.

Key signals: compare segment margins to identify which units drive profitability and which destroy value. Watch for changes in the number of reportable segments — segment aggregation or disaggregation often coincides with strategic shifts or attempts to obscure declining performance. Intersegment elimination patterns reveal internal pricing practices. The reconciliation between segment totals and consolidated figures exposes corporate overhead allocation and unallocated items. Geographic revenue concentration highlights regulatory and currency exposure. Compare segment-level capital expenditure against segment revenue to assess where management is investing for future growth versus harvesting existing assets.