Britt Vitalone
Executive Vice President & Chief Financial Officer at McKesson
Thank you, Brian. And I'm pleased to be here this afternoon to discuss our fiscal first quarter results, which, as you mentioned are tracking above the full-year guidance that we provided in May. It reflects solid progress against our long-term growth targets. Given the strong start to the year and momentum across the business, we're raising both our top and bottom line guidance today. I'll first start with a review of our first quarter results and provide an overview of our fiscal 2024 outlook, including our updated adjusted earnings per diluted share range. My comments today will refer to our fiscal 2024 adjusted results, unless I state otherwise.
Let me start with the review of our consolidated results. Consolidated revenues increased 11% to $74.5 billion, which was led by growth in US Pharmaceutical segment, resulting from increased prescription volumes, including higher volumes from retail national account customers, specialty products and weight-loss or GLP-1 drugs and they were partially offset by lower revenues in the International segment, resulting from completed divestitures within our European business during fiscal 2023. When excluding the impact of our European business operations, including completed divestitures, revenues increased 16%.
Gross profit was $2.9 billion for the quarter, a decrease of 2% and when excluding the impact of our European business operations and completed divestitures, gross profit increased 7% in the first quarter, primarily a result of growth in US Pharmaceutical and Prescription Technology Solutions segments. Operating expenses decreased 4% in the quarter. When excluding the impact of our European business operations, including completed divestitures, operating expenses increased 8% year-over-year.
Operating expenses during the quarter included integration costs related to our acquisition of Rx Savings Solutions and a joint-venture with Sarah Cannon Research Institute, both of which were completed in the second half of fiscal 2023. First quarter operating profit increased 3% to $1.2 billion, primarily driven by growth in our North American businesses, partially offset by the completed divestitures of our European business operations, which are within our International segment.
When excluding the impact of COVID-19-related items in fiscal 2023 and losses associated with McKesson Ventures equity investments in fiscal 2023 and 2024, operating profit increased 9% in the quarter. We're pleased with the strong operating results, which are above the long-range growth targets. We're delivering durable operating performance and sustained momentum and we're executing against our strategies.
Moving below the line, interest expense was $42 million, a year-over-year decrease driven by transactions within our long-term debt portfolio, which I'll discuss later in my remarks. The effective tax rate was 8.4%, driven by the recognition of a net discrete tax benefit of $147 million in the first quarter of fiscal 2024 related to the repatriation of certain intellectual property between wholly-owned legal entities that were based in different tax jurisdictions. As a reminder, the timing of discrete tax items is difficult to predict and therefore we do not provide quarterly effective tax rate guidance. Our effective tax rate guidance for the full-year remains unchanged.
First quarter diluted weighted average shares outstanding was 136.6 million, a decrease of 6% year-over-year. Adding it all-up, first quarter earnings per diluted share of $7.27, represents an increase of 25% over the prior year. When excluding COVID-19-related items during the first quarter of fiscal 2023 and losses within our McKesson Ventures portfolio in fiscal 2023 and 2024, first quarter earnings per diluted share was up 33% over the prior year.
Turning to our first quarter segment results, which could be found on slide 7 through 11 and I'll start with US Pharmaceutical. Revenue and operating profit results in the quarter exceeded our expectations. First quarter revenues were $67.2 billion, an increase of 18% year-over-year. Revenue growth reflected increased prescription transaction volumes, including higher volumes from retail national account customers, specialty products and GLP-1 drugs. These increases were partially offset by branded to generic conversions.
The growth of the weight-loss GLP-1 drug category provided a revenue tailwind in the quarter. We generally recognized lower-margin rates for the distribution of GLP-1 drugs. The growth of these products, similar to other new brand launches led to increased demand for our access and affordability support programs, such as our prior authorization services which are offered within Rx TS segment. The first quarter also marked further progress against our oncology growth strategy. We're pleased with the growth across all of our oncology assets. We saw growth in the US Oncology Network, supported by the strength of our GPO capabilities. And as Brian mentioned, recently we added Cancer Center of Kansas to the US Oncology Network, expanding the total number of providers in our network to over 2,400. During the quarter, we delivered solid performance and contribution from the US Oncology Network.
First-quarter fiscal 2024 total patient visits was 19% above the prior year. And on a same practice basis, US oncology patient visits grew approximately 7% above the prior year. The joint venture with Sarah Cannon Research Institute is progressing well, as we support the expansion and the advancement of clinical trials in clinical trial research and we continue to invest in and progress our data and insights business, Ontada. These oncology assets and capabilities are important pieces to long-term development of the segment. We're excited about the growth and the continued progress that we're seeing.
First quarter US Pharmaceutical operating profit increased 8% to $771 million, driven by growth in the distribution of specialty products to providers and health systems and increased contributions from our generics programs, which included new product launches within the quarter. When excluding the impact of COVID-19 vaccine distribution in the first quarter of fiscal 2023, the US Pharmaceutical segment delivered operating profit growth of 14% year-over-year, ahead of the segment's long-term growth target. US Pharmaceutical operating profit growth reflects increased prescription volumes and the breadth of capabilities that we provide, including solid generic volumes and sourcing contributions, operating discipline and the continued momentum from our oncology platform.
Let me move now to Prescription Technology Solutions. First quarter revenues were $1.2 billion, an increase of 17% year-over-year, driven by growth in our third-party logistics and technology services businesses due to increased prescription volumes. Operating profit increased 35% to $223 million, driven by increasing demand for access adherence and affordability solutions. As I mentioned earlier in my remarks, prescription transaction volumes showed solid improvement in the quarter. The increased transaction volume drove higher demand for our access programs, including our prior authorization products. During the quarter we noted strong new brand prescription volumes, which included the GLP-1 drug category. The strength of our program supporting access and affordability solutions positions us to capture the demand driven by the strong prescription utilization trends. Our products continue to receive positive feedback and recognition for the value that they deliver to our partners.
One example of this is CoverMyMeds Electronic Prior Authorization solutions. Historically, the prior authorization process was a tedious and time-consuming task for providers. Through the technology solutions that McKesson has, we automate this process, providing a faster and easier way to review complete and track prior authorization requests. CoverMyMeds is delivering value and returns for our partners by increasing connectivity between pharmacies, providers, payers and biopharma manufacturers through next-generation access, affordability and adherence solutions that are automated and integrated into provider workflows. First quarter results exemplify the success of our broad range of technology programs and support services.
In Medical Surgical Solutions, our first quarter performance was in line with our expectations. Our core business demonstrated revenue and operating profit growth. Revenues were $2.6 billion in the quarter, an increase of 1% year-over-year and operating profit was $235 million, a decrease of 12%. First quarter results were impacted by anticipated lower contributions from kitting, storage, and distribution of ancillary supplies for the US government's COVID-19 vaccine program and lower illness season testing, including flu and COVID-19 tests when compared to the prior year. As a reminder, the first quarter of fiscal 2023, saw an extension of the 2022 illness season, driving higher levels of illness testing and related products.
When excluding the impact of COVID-19 related items from the first quarter of fiscal 2023, the segment delivered operating profit growth of 7%, driven by growth in the extended in primary-care businesses, partially offset by a non-recurring expense of $12 million. Within the primary care market, we saw growth in lab solutions, equipment and specialty pharmaceuticals. In the extended care market, growth was led by sales to new customers, which included increased volumes of nutritional supplements. We are pleased with the continued solid results, which were in line with our expectations. Our leadership position combined with operating execution positions us for continued growth across the ultimate sites of care.
Next, let me address our international results. Revenues in the first quarter were $3.5 billion, a decrease of 47% year-over-year and operating profit was $90 million, a decrease of 35%. On an FX-adjusted basis, first quarter revenues were $3.7 billion, a decrease of 44% and operating profit was $95 million, a decrease of 31%. First quarter results reflect the year-over-year effects from the combined divestitures within our European businesses.
Let me wrap-up our segment review. Corporate expenses were $149 million in the quarter, an increase of 3% year-over-year. As a reminder, in the first quarter of fiscal 2023, corporate expenses included the receipt of a payment relating to a prior tax receivable agreement and our previous joint venture with Change Healthcare. During the quarter, we had losses of $7 million or $0.04 per share related to equity investments within the McKesson Ventures portfolio compared to losses of approximately $22 million or $0.11 per share in the first quarter of fiscal 2023.
As a reminder, the McKesson Ventures portfolio holds equity investments in several growth stage digital health and services companies. We're pleased with the insights and the results that we've obtained through this portfolio. The impacts our 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.
Turning now to our cash position, balance sheet and capital deployment on slide 12. We ended the quarter with $2.6 billion in cash and cash equivalents. We made $124 million of capital expenditures, which includes investments in new and existing distribution centers as well as investments in technology, data and analytics to support our growth priorities. For the first quarter, we had negative free cash flow of $1.2 billion. And as a reminder, our cash position, our working capital metrics and the resulting cash flows can each be impacted by timing, which includes the day of the week that a quarter ends on and therefore it can vary from quarter-to-quarter.
We returned $770 million of cash to shareholders, which included $696 million of share repurchases and $74 million in dividend payments. During the quarter, we successfully completed a public offering for $1 billion of notes with five and 10-year tenures. We currently we retired approximately $900 million of notes that were due March of 2024. These transactions reduced our interest expense and they further supported our strong credit profile as evidenced by our recent credit rating upgrades.
Our Board of Directors approved two actions in July. First, a 15% increase to our quarterly dividend to $0.62 per share. And second, the Board approved an additional $6 billion of share repurchase authorization, bringing the total remaining share repurchase authorization to approximately $9 billion. These actions demonstrate the confidence that the Board of Directors and management have in the execution of our strategic priorities.
Now, let me discuss our updated outlook. The guidance I'm providing today relates to fiscal 2024. As a reminder, we do not provide forward-looking guidance on a GAAP basis. The following metrics are provided on an adjusted non-GAAP basis. I'll discuss the key items beginning with additional details of our consolidated guidance and a full list of our assumptions can be found on slides 13 through 17 in our supplemental slide presentation. As we've talked about already today, we are encouraged by the strong performance in the first quarter of fiscal 2024 and as a result, we're increasing our earnings per diluted share outlook to a new range of $26.55 to $27.35. As a result of this, we now anticipate earnings per diluted share to increase 13% to 16% when excluding certain items.
As a reminder of what the certain items include, net gains and losses associated with McKesson Ventures equity investments in fiscal 2023 and 2024, a $0.65 benefit related to the early termination of the tax receivable agreement with Change Healthcare in fiscal 2023, and $1.90 related to COVID-19 related items in our US Pharmaceutical and Medical Surgical segments in fiscal 2023. And we anticipate the impact of COVID-19 related item to be immaterial to fiscal 2024. We anticipate operating profit will be flat to 4% decline compared to the prior year. When excluding certain items, we anticipate operating profit increase by 6% to 10% Year-over-Year.
Let me discuss the outlook for our segments. Our core distribution business within the US Pharmaceutical segment continues to demonstrate its strong value proposition to our customers. We anticipate further growth in specialty distribution, including our differentiated plasma and biologics business where our customers can access an expansive portfolio of plasma-derived products, biologics, oncology treatments and other specialty drugs at competitive prices from a single-source.
During the first quarter, we experienced revenue tailwind from higher volumes related to weight-loss or GLP-1 drugs. Our full-year outlook assumes that volumes related to GLP-1 drugs will remain elevated compared to the prior year and may vary quarter-to-quarter. We anticipate this class of drugs will continue to be a revenue tailwind for US Pharmaceutical as we support our customers through our distribution services. As I discussed earlier, these drugs have a lower distribution margin rate profile.
For the full-year, we now anticipate US Pharmaceutical revenues to increase 13% to 15% and operating profit to increase 3% to 5% year-over-year. Excluding the impact of COVID-19 vaccine distribution in fiscal 2023, we anticipate operating profit to increase 8% to 11%. The full year performance includes continued investment in our oncology platform and increase technology spend to support the growth of the segment. In the Prescription Technology Solutions segment, we anticipate revenue growth of 7% to 13% and operating profit growth of 15% to 19%, which reflects increased utilization and new brand prescription transaction volumes, including the GLP-1 drugs and strong demand for the access, adherence and affordability products and programs that we offer.
We anticipate that we may continue to see quarter-to-quarter variability in this segment, driven by transaction volumes, the pace and trajectory of new product drug launches and the annual verification programs that we provide for our customers that occur in our fiscal fourth quarter. In Medical Surgical Solutions segment, we anticipate revenues to be approximately a 1% decline to 3% growth and operating profit to decrease 5% to 11%. For the full-year, we anticipate volumes of COVID-19 tests to continue to decline compared to fiscal 2023 and the impact from COVID-19-related items will remain immaterial to fiscal 2024 results. Excluding the impact of COVID-19-related items from fiscal 2023 results, we anticipate operating profit to increase 11% to 15% year-over-year.
And finally in the International segment, we anticipate revenues to decline by 30% to 34% and operating profit to decline by 23% to 29%. This year-over-year decrease includes the loss of operating profit contribution from European businesses and transactions that we closed during fiscal 2023. As I previously discussed, we intend to deploy capital through share repurchases to offset the dilution resulting from European divestitures. In the Corporate segment, we anticipate expenses to be in the range of $580 million to $640 million, which includes losses associated with McKesson Ventures equity investments reported in the first quarter as well as elevated technology spend to support the growth of our businesses. Now, moving below the line. As a result of the debt transactions that I discussed earlier in my remarks, we anticipate lower interest expense in the range of $205 million to $225 million.
Let me now turn to cash flow and capital deployment. We anticipate free cash flow of approximately $3.7 billion to $4.1 billion, net of property acquisitions and capitalized software expense. Our outlook incorporates plans to repurchase approximately $3.5 billion of shares. As a result of the share repurchase activity, we estimate weighted average diluted shares outstanding to be in the range of approximately 133 million to 134 million. Our portfolio continues to generate strong free cash flow. We remain committed to operating profit growth and efficient capital deployment, and our 24% return on invested capital illustrates our focus on shareholder value creation.
In summary, our strong start to fiscal 2024 and our outlook for the remainder of the year results in an increase to adjusted earnings per diluted share to a new range of $26.55 to $27.35. Excluding the impact of certain items and the contribution from our European operations, we anticipate earnings per diluted share growth of 16% to 20% in fiscal 2024. Our outlook further demonstrates the shareholder value creation framework that we have discussed previously. We continue to be focused on sustainable growth and efficient deployment of capital. We're pleased with the strong start to the fiscal year. Our 50,000 Team McKesson associates continue to deliver exceptional performance. Our first quarter financial performance reflects their dedication, as well as the strength of our portfolio.
Through our expansive oncology and biopharma platforms, we're supporting customers and patients by advancing health outcomes for all, we're delivering faster time to therapy for patients, and we're accelerating the discovery, development and manufacturing of new therapies. Our services and solutions are at the forefront of improving patient outcomes and ensuring more patients have access to quality care. With our strong underlying momentum from the first quarter of fiscal 2024, and our aligned focus on our growth strategies, we remain confident that we'll continue to deliver long-term sustainable growth and value creation for our shareholders.
With that, let me turn it back over to the operator for your questions.