Britt J. Vitalone
Chief Financial Officer & Executive Vice President at McKesson
Thank you, Brian, and good afternoon. Today, I'll discuss our fourth quarter and full year fiscal 2022 results, then I'll outline our fiscal 2023 guidance. At our Investor Day in December, we discussed the transformation underway at McKesson. Distribution remains a core part of our company. However, we continue to advance and grow as a diversified health care services company built on differentiated assets and strategies we're executing, delivering sustainable earnings growth across our businesses.
As we articulated then, our confidence is based on three interconnected factors: the successful focus to advance McKesson's oncology and biopharma services ecosystem, leveraging our best-in-class assets and capabilities; effective allocation of capital, including streamlining our portfolio; and the momentum we've been generating through operating and working capital execution. We remain confident that we'll achieve the long-term targets that we've provided for fiscal 2023 and beyond. Let me start by discussing our focus to streamline the portfolio with an update on Europe. In early fiscal 2022, we announced our strategic intent to exit the European region. The transaction to complete a full exit of our European operations allow McKesson to streamline the portfolio, aligning future investments to our growth strategies in North America. We've made good progress, and we remain committed to the set of actions. In July of 2021, we announced the transaction with the PHOENIX Group to sell operations in six countries and other certain assets. The transaction is proceeding well, and we anticipate it will close in the second half of fiscal 2023. We have successfully closed the following transactions.
In the fourth quarter of fiscal 2022, we completed the sale of our Austrian business to Quadrifolia management, and the sale of McKesson's remaining share of our German joint venture to Walgreens Boots Alliance. Recently, we completed the sale of McKesson's U.K. retail and distribution businesses to AURELIUS, which closed on April 6. During the fourth quarter of fiscal 2022, we recorded a GAAP-only charge of $343 million related to our agreement to sell the U.K. retail and distribution business. Finally, we continue to explore strategic alternatives to exit our remaining operations in Norway and Denmark. In fiscal 2022, our European operations, including held-for-sale accounting treatment impacts, contributed $409 million of adjusted operating profit or $1.97 per diluted share. For fiscal 2023, we anticipate our remaining European operations will contribute approximately $0.85 to $1.15, which includes accretion resulting from the held-for-sale accounting for the transaction for the PHOENIX Group.
As I mentioned on our third quarter earnings call, we intend to deploy capital through share repurchases to offset the dilution resulting from the European divestitures. Let me now move to a review of our fiscal 2022 results. My comments today will refer to our adjusted results on a year-over-year basis, unless I state otherwise. Fiscal 2022 was another year of strong execution for McKesson. We're exiting the year with solid operating performance, delivering fiscal 2022 fourth quarter earnings per share of $5.83 and, for the full year, earnings per share of $23.69. Our full year results included revenue and profit growth across every business segment. In addition to growth in our core businesses, fiscal 2022 earnings per diluted share also included the following three items. The first is $1.79 related to the U.S. government's centralized COVID-19 vaccine and kitting distribution program, which included $0.89 related to COVID-19 vaccine distribution and $0.90 related to the kitting, distribution and storage of ancillary supplies.
$0.88 was related to COVID-19 tests, and finally, $0.47 related to net gains associated with McKesson Ventures equity investments. Excluding these items and the impact of fiscal 2021 inventory impairment charges related to personal protective equipment and other related products, fiscal 2022 earnings per diluted share increased 31% year-over-year. For the fourth quarter, consolidated revenues of $66.1 billion increased 12% driven by growth in the U.S. Pharmaceutical segment due to increased volumes of specialty products, including higher volumes from retail national account customers and market growth, partially offset by branded to generic conversions. Gross profit was $3.4 billion for the quarter, an increase of 6%, primarily driven by our Medical-Surgical Solutions segment, resulting from prior year inventory charges on PPE and related products and increases in patient care visits in our primary care business. Gross profit was also positively impacted by increased volume with new and existing customers in our Prescription Technology Solutions segment.
Operating expenses in the quarter increased 4% due to increased volumes in our Medical-Surgical Solutions segment, which were partially offset by the impact of held-for-sale accounting on announced divestitures in the International segment. Operating profit of $1.2 billion for the quarter was an increase of 3% led by solid operating performance across the segments, partially offset by the distribution of COVID-19 vaccines and ancillary supplies for the U.S. government and lower contribution related to COVID-19 tests. When excluding the impact related to the distribution of COVID-19-related products, net gains associated with McKesson Ventures equity investments and the prior year PPE impairments in the Medical-Surgical segment, operating profit increased 8%. Moving below the line, interest expense was $43 million in the quarter, a decrease of 17% due to the net retirement of approximately $1.1 billion of long-term debt in fiscal 2022, including a previously announced tender offer in the second quarter of fiscal 2022.
Our tax rate was 21.9% for the quarter. And ramping up our consolidated results, fourth quarter diluted weighted average shares outstanding were 149.2 million, a decrease of 7% year-over-year resulting from share repurchases throughout fiscal 2022. Moving now to fiscal fourth quarter and full year segment results, which can be found on slides seven through 12, and starting with U.S. Pharmaceutical. Revenues were $53.7 billion, an increase of 14%, driven by increased volume of specialty products, including higher volumes from retail national account customers and market growth, partially offset by branded to generic conversions. Operating profit decreased 4% to $780 million due to lower demand of COVID-19 vaccine distribution, partially offset by growth in distribution of specialty products to providers and health systems.
The contribution from our contract with the U.S. government for the distribution of COVID-19 vaccines declined sequentially, as demand continued to lessen along with continued easing of COVID-19 restrictions. COVID-19 vaccine distribution provided a benefit of approximately $0.06 per share in the fourth quarter compared to $0.26 in the third quarter of fiscal 2022. As a reminder, fiscal fourth quarter operating profit growth included previously announced investments made in response to the competitive labor market. On our earnings call in February, we reiterated our expectation for additional labor-related expenses to ensure continued service continuity through the second half of our fiscal year. When excluding the impact of COVID-19 vaccine distribution and the previously outlined labor investments, the U.S. Pharmaceutical segment delivered operating profit growth of 4%. For the full year, operating profit increased 8% to $2.9 billion, driven by growth in distribution of specialty products to providers and health systems and the contribution from COVID-19 vaccine distribution.
In the Prescription Technology Solutions segment, revenues were $1 billion, an increase of 29% as a result of volume growth related to biopharma services, including third-party logistics services and increased technology service revenue, partially resulting from the growth of prescription volumes. Operating profit increased 11% to $162 million driven by growth from access and adherence solutions. For the full year, operating profit was $590 million, an increase of 26%. Next, Medical-Surgical Solutions. Revenues were $2.9 billion, an increase of 6% due to growth in the primary care business. Operating profit increased 55% to $298 million. In the fourth quarter, operating profit in the Medical-Surgical Solutions segment included $0.22 of earnings per diluted share contribution related to COVID-19 tests and $0.20 of earnings per diluted share contribution related to the kitting, distribution and storage of ancillary supplies for COVID-19 vaccines for the U.S. government.
Excluding the impacts of these COVID-19 related items and the prior year inventory charges on PPE-related products, operating profit increased 26% due to growth in the primary care business. For the full year, operating profit increased 50% to $1.2 billion. When excluding the impacts of COVID-19-related items and prior year inventory charges on PPE and related products, operating profit increased 22%. During the fourth quarter, COVID-19 and the direction of the disease continued to demonstrate variability. The demand for COVID-19-related products and services has fluctuated over the course of the pandemic. However, the direction generally followed the volume of COVID-19 case levels. Forecasting COVID-19 vaccine distribution and testing demand more than a few months at a time remains difficult. We continue to track new guidance and variants. In the fourth quarter of fiscal 2022, we experienced increased demand in January related to a spike in cases due to the Omicron variant.
We experienced a 60% volume increase related to COVID-19 tests in January compared to the average in the third quarter. In February and March, COVID cases declined month-over-month with a corresponding decline in COVID test volumes. In March, experienced approximately a 90% decrease related to COVID-19 test volumes compared to the third quarter average. The declines in February and March led to lower earnings contribution from COVID-19 tests in our fiscal fourth quarter. We anticipate that the pace of COVID test volume and vaccine demand will follow a similar fluctuating pattern in fiscal 2023, and we anticipate that fiscal 2023 COVID volume and earnings per share contribution will be materially lower than fiscal 2022. Let me address our international results. Revenues were $8.5 billion on a reported basis. On an FX adjusted basis, revenues were $8.8 billion, an increase of 3%, driven by sales to new customers in the Canadian business and year-over-year volume recovery in our distribution businesses, partially offset by the divestiture of our Austrian business, which closed during the fourth quarter of fiscal 2022. Operating profit increased 7% to $147 million.
On an FX-adjusted basis, operating profit increased 10% to $152 million due to the reduction of depreciation and amortization on European assets under agreements to sell and increased volumes in the Pharmaceutical Distribution business. For the full year, operating profit on an FX-adjusted basis increased 40%. And in our Corporate segment, expenses were $183 million in the quarter, an increase of 46%. During the quarter, mark-to-market valuations related to our equity investments within our McKesson Ventures portfolio resulted in net losses of approximately $6 million compared to net gains of $44 million in fourth quarter of fiscal 2021. Corporate expenses were $579 million for the full year, which were approximately flat compared to the prior year. In fiscal 2022, McKesson had net gains related to our equity investments within our McKesson Ventures portfolio of approximately $98 million or $0.47 per share. This compares to net gains of approximately $132 million or $0.60 for the full year of fiscal 2021.
As a reminder, our McKesson Ventures portfolio holds equity investments in several growth-stage digital health and services companies, and we are pleased with the insights and the portfolio results that we've obtained. The impacts for a consolidated financials can be influenced by the performance of each individual investment quarter-to-quarter. And as a result, McKesson's investments may result in gains or losses, the timing and magnitude of which can vary for each investment. It's difficult to predict when gains and losses on our venture portfolio companies may occur. And therefore, our practice has been and will continue to not include ventures portfolio estimates in our guidance. And finally, in the fourth quarter, we incurred opioid-related litigation expenses of $26 million and incurred $130 million for the full year fiscal 2022. Turning now to our cash position and capital deployment on slide 13. For the fiscal year, we generated $3.9 billion in free cash flow, which included $535 million of capital expenditures.
We continue to focus capital deployment to drive value for our shareholders. Since fiscal 2018, we've returned $11 billion of cash to shareholders through share repurchases and dividends. Of this amount, over $9 billion has been returned through share repurchases, reducing our total average shares outstanding by nearly 31%. In fiscal 2022, we returned $3.5 billion through share repurchases, including $1.5 billion in the fiscal fourth quarter. Additionally, we paid dividends of $277 million for the full year. When combining share repurchases with dividends paid, we returned approximately 97% of free cash flow to shareholders in fiscal 2022. Our strong balance sheet and cash flow generation, along with disciplined capital allocation, continues to provide us with the financial flexibility to invest in our strategies, pursue strategic opportunities and return capital to shareholders, all while maintaining a strong capital structure.
Let me spend a few minutes now discussing our outlook for fiscal 2023. We entered fiscal 2023 with solid momentum, building upon the strong fiscal 2022 results. Rather than outlining each assumption, I'll instead walk you through the key items, beginning with additional details on our fiscal 2023 consolidated guidance. A full list of our assumptions can be found on slide s 14 through 19 in our supplemental slide presentation. We remain confident in the fundamentals of our North American health care services and distribution businesses. We'll continue to invest in innovative product offerings that further enhance our leading roles in the oncology and biopharma services ecosystems. Our fiscal 2023 guidance assumes flat to 4% reported revenue growth and 4% to 10% operating profit decline compared to fiscal 2022. Excluding the impacts related to the U.S. government's centralized COVID-19 vaccine and kitting distribution programs, COVID-19 tests and net gains associated with McKesson Ventures equity investments, which were recorded in fiscal year 2022, we anticipate operating profit to increase 3% to 9%.
We anticipate a full year tax rate of approximately 18% to 20% and corporate expenses in the range of $520 million to $590 million. In the fourth quarter of fiscal 2022, we finalized the broad settlement of opioid-related claims of states and municipalities. While we've reached a broad settlement, there are cases that remain open. As it relates to opioid litigation expenses, we previously communicated that we anticipate a substantial reduction in fiscal year 2023, resulting from the settlement. For fiscal 2023, our current approximation is $40 million, and it can vary based on a number of factors, including remaining nongovernmental suits, trials and pace of legal proceedings, and we'll continue to update you accordingly. Wrapping up our consolidated guidance, our fiscal 2023 earnings per diluted share outlook is $22.90 to $23.60, which includes $0.20 to $0.60 of contribution attributable to the following COVID-19-related items: $0.05 to $0.20 related to the U.S. government's vaccine distribution; less than $0.05 related to the kitting storage and distribution of ancillary supplies; and $0.15 to $0.35 related to COVID-19 tests.
Excluding the impacts of these COVID-19-related items from both fiscal 2023 guidance and fiscal 2022 results and the $0.47 related to net gains associated with McKesson Ventures equity investments in FY '22, our fiscal 2023 guidance indicates approximately 9% to 14% growth over the prior year. This estimated year-over-year growth is consistent with the long-term financial targets that we provided at our December Investor Day event and represents solid organic growth in our underlying businesses, disciplined capital deployment and continued expansion of our oncology and biopharma services ecosystem. Moving now to our segments. In the U.S. Pharmaceutical segment, our outlook reflects the efficiency and durability of our core distribution platform and continued expansion of our oncology ecosystem. We anticipate reported revenue to increase 7% to 10% and operating profit to approximately be flat to 4% decline year-over-year.
Our outlook includes approximately $0.05 to $0.20 related to COVID-19 vaccine distribution for the U.S. government in the first quarter of fiscal 2023, which is aligned to the current contract timing and volume distribution schedule provided by the CDC and the U.S. government. This compares to $0.89 in full year fiscal 2022. When excluding the impact of COVID-19 vaccine distribution for the U.S. government, we anticipate 3% to 5% operating profit growth, which is consistent with the long-term growth target we provided for the U.S. Pharmaceutical segment at our recent Investor Day event. In the Prescription Technology Solutions segment, we anticipate revenue growth of 17% to 23% and operating profit growth of 14% to 20%. This outlook reflects momentum of organic growth across our solutions and services as we expand partnerships with biopharma manufacturers, generate a higher transaction volume and increase the number of brands under access and adherence platforms.
In the Medical-Surgical Solutions segment, we anticipate reported revenues to decrease 7% to 11% and operating profit to decrease 15% to 21%. Our outlook includes approximately less than $0.05 related to the kitting storage and distribution of ancillary supplies for the U.S. government. And this compares to $0.90 in fiscal 2022. As a reminder, our contracts with the U.S. government are scheduled to end in July of 2022. We also anticipate approximately $0.15 to $0.35 related to COVID-19 tests in fiscal 2023. Excluding the impact of these COVID-19-related items, we anticipate operating profit to increase 8% to 14%, primarily as a result of growth in the primary care business. The Medical-Surgical business remains well positioned to leverage the breadth and depth of its services throughout the alternate site market, including growth from laboratory solutions and the government sector. Finally, in the International segment, we anticipate reported revenues to decline by 34% to 38% and operating profit to decline by 22% to 28%.
This year-over-year decrease includes the loss of operating profit contribution from businesses and transactions we've closed to date and that we expect to close during fiscal 2023. In Canada, we have a strong position as the leader in health care distribution. We anticipate continued organic growth in our pharmaceutical distribution business, including strategic sourcing efforts. Let me conclude our fiscal 2023 outlook with a few comments on cash flow and capital deployment. As I communicated at Investor Day, our capital allocation strategy prioritizes strategic growth complemented by a return of capital to our shareholders through share repurchases and a modest yet growing dividend. Our investment-grade credit rating remains a priority and underpins our financial flexibility. This flexibility positions us for the continuation of sustainable long-term value creation for our shareholders. In fiscal 2023, we anticipate free cash flow of approximately $3.2 billion to $3.6 billion, which is net of property acquisitions and capitalized software expenses.
As a reminder, our working capital metrics and resulting cash flows vary from quarter-to-quarter impacted by timing, which could include the timing of planned European divestiture activity. As discussed at Investor Day, we intend to offset the dilution related to our European divestitures with capital deployment. As indicated on slide 18, our fiscal 2023 outlook incorporates plans to repurchase approximately $3.5 billion of shares. A significant portion of the share buyback assumption is associated with offsetting the year-over-year impact of the European divestitures. As a result of the share repurchase activity, we estimate weighted average diluted shares outstanding for fiscal 2023 to be in the range of approximately 142 million to 144 million. The progress we're making across our strategic priorities, including our commitment to streamline the business, supports our strong cash flow. This cash flow provides us with the flexibility to deploy capital through organic and inorganic investments in our business and returning capital to shareholders through share repurchases and dividends. In closing, fiscal 2022 was another strong year for McKesson.
We continue to make great progress on our transformative journey from a distribution-focused company to a leading diversified health care services company, accelerating and expanding our oncology and biopharma services ecosystem. Our strategies are working, and we're delivering for our customers, partners, patients and our shareholders. We are well positioned to capture the vast opportunities in the growing markets of oncology and biopharma services. We have a strong financial outlook, and our financial framework and execution position us to deliver sustainable profit growth, cash flows and shareholder value creation. We have great confidence in our teams, in our products and services and in our strategy. Thank you. And with that, I'll turn it over to the operator for Q&A.