James F. Cleary
Executive Vice President and Chief Financial Officer at Cencora
Thanks, Steve. Good morning and good afternoon, everyone. AmerisourceBergen delivered another quarter of strong results as our team members' execution continues to create significant value for all our stakeholders. Our results speak to the strength of our business and our continued work to drive efficiencies. In the quarter, we also strategically deployed capital, closing our minority investment in OneOncology, an example of investing to further our strengths and we continue to opportunistically repurchase shares to also return capital to our shareholders. Before I turn to our third quarter results, as a reminder, my remarks today will focus on our adjusted non-GAAP financial results unless otherwise stated. For a detailed discussion of our GAAP results, please refer to our earnings press release.
Turning now to our third quarter results. AmerisourceBergen had adjusted diluted EPS of $2.92, an increase of 11% over the prior year quarter, driven by growth in both segments and a lower share count due to opportunistic share repurchases over the past year. Our consolidated revenue was $66.9 billion, up 11.5% driven by growth in both segments, particularly in the US Healthcare Solutions segment, which had broad-based growth across our customer base, including growth in sales of products labeled for diabetes and weight loss in the GLP-1 class. Without this increase in GLP-1 products, our consolidated revenue growth would have been more in line with our consolidated gross profit growth.
Consolidated gross profit was $2.2 billion, up 8% due to growth in both segments. Consolidated gross profit margin was 3.33%, a decline of 11 basis points due primarily to lower contribution from COVID-19 treatments, which have higher gross profit margins and continued volume growth in GLP-1s which have lower gross profit margins. Both these margin impacts are to be expected given the unique characteristics of each of these product groups.
Consolidated operating expenses were $1.4 billion, up 7.6%, primarily due to higher expenses in our international healthcare solutions segment. We continue to focus on creating efficiencies and working collaboratively to drive value for our stakeholders, which contributed to the sequential year-over-year moderation of growth in operating expenses in the quarter, particularly in our US Healthcare Solutions segment as a result of actions we have taken.
Consolidated operating income was $822 million, an increase of nearly 9% compared to the prior year quarter. Our operating income growth was driven by solid performance in both segments and I will provide more detailed business drivers when discussing segment level results. Moving now to our net interest expense. For the third quarter, net interest expense was $58 million, an increase of 9.5% versus the prior year quarter. As we look to the fourth quarter, we expect net interest expense to be at its highest level this fiscal year given cash use in the past few months.
Now turning to income taxes. Our effective income tax rate was 21.5% compared to 20.2% in the prior year quarter. As we called out last quarter, we continue to expect our full year fiscal 2023 effective tax rate to be towards the bottom end of our guidance range of 20% to 21%. Turning to diluted share count. Our diluted share count was 204.4 million shares, a 3.5% decrease compared to the third quarter of fiscal 2022, driven by share repurchases we completed over the last 12 months. This included a $100 million of repurchases in the third quarter in conjunction with transactions Walgreens Boots Alliance executed. Going forward, we expect transactions to continue to occur and we anticipate continuing to collaborate and coordinate with Walgreens Boots Alliance as we have done over the past year.
Regarding our cash balance and free cash flow, we ended the quarter with approximately $1.4 billion of cash. Our adjusted free cash flow for the nine months ended June 30th was $1.5 billion and we are now slightly improving our adjusted free cash flow guidance to be at least $2 billion for the fiscal year, up from approximately $2 billion. This completes the review of our consolidated results.
Now, I will turn to our segment results for the third quarter. US Healthcare Solutions segment revenue was $59.9 billion, up 12% for the quarter with broad-based growth across our customer base, including sales of products in the GLP-1 class and also sales of specialty products to physician practices and health systems. US Healthcare Solutions segment operating income increased by 9.5% to $635 million as we saw a good pharmaceutical utilization trends across our business. And our Animal Health business had another good quarter with growth in both the companion and production animal markets.
Our operating income growth also benefited from an easier expense comparison as we lapped inflationary pressures that began in the March quarter of fiscal 2022 and from efficiency initiatives that we have taken, both of which we called out last quarter. This combination of operating expense items helped improve our operating expense margin in the quarter, offsetting most of the gross profit margin pressure from lower COVID-19 treatment contributions and increased volumes of GLP-1s.
In the quarter, US Healthcare Solutions segment operating income margin did still have a year-over-year decline of 3 basis points to 1.06% as a result of our mix of those two product groups. As a reminder, COVID-19 product volume has continued to decline as expected and we are earning a fee for distributing government-owned products and GLP-1s are a big driver of revenue growth, but not a meaningful driver of operating income growth.
I will now turn to our International Healthcare Solutions segment. In the quarter, International Healthcare Solutions revenue was $7.0 billion, up 5.6% on a reported basis or up 12.4% on a constant-currency basis. In this segment, we saw growth in all our businesses. International Healthcare Solutions operating income was $187 million, up 6% on a reported basis or 7% on a constant-currency basis, driven by solid performance in our global logistics business and the inclusion of PharmaLex in the quarter, which offset the impact of the divestiture of our Brazilian specialty business in June of 2022. As a reminder, this divested business contributed nearly 2% of segment level operating income in the third quarter of fiscal 2022.
That completes the review of our segment level results. I will now discuss our updated fiscal 2023 guidance expectations. As a reminder, we do not provide forward-looking guidance on a GAAP basis. So, the following metrics are provided on an adjusted non-GAAP basis. Full details of our fiscal 2023 guidance can be found on pages 8 and 9 of our earnings presentation on our Investor Relations website.
Starting with revenue, we are raising our consolidated revenue guidance and now expect our revenue growth to be at least 8% to reflect stronger revenue growth in the US Healthcare Solutions segment and favorable currency movements in the International Healthcare Solutions segment relative to our prior guidance. In the US Healthcare Solutions segment, we now expect revenue growth to be at least 9%, which reflects strong pharmaceutical utilization trends and also the increase in volume of GLP-1 products. In the International Healthcare Solutions segment, we are raising our as reported revenue growth guidance to be in a range of 1% to 4%, up from our previous expectation of a 3% decline to flat due to favorable currency movements relative to our May guidance.
Moving to operating income, we are narrowing our consolidated operating income guidance to a range of 3% to 4% growth from the previous range of 2% to 4% growth, primarily to reflect the strong performance we have seen in the US Healthcare Solutions segment and to reflect favorable currency movements in the International Healthcare Solutions segment. In the US Healthcare Solutions segment, we now expect segment operating income growth to be in the range of 4% to 5% from our previous range of 3% to 5%.
Excluding the contributions related to COVID-19 treatment distribution, we now expect operating income growth to be in the range of 7% to 8% from our previous range of 6% to 8% and we are more likely to be near the top end of that 7% to 8% range. In the third quarter, COVID-19 treatments contributed $0.06 to our consolidated EPS with about $0.05 in the US and $0.01 in the International segment. This brings our total COVID-19 treatment contribution year-to-date to $0.29.
Our full-year expectations for COVID-19 treatment contributions remain generally unchanged and we expect only a $0.01 or $0.02 of COVID-19 related contributions in the fourth quarter with the contribution occurring in the US Healthcare Solutions segment. In the International Healthcare Solutions segment, we now expect as reported segment operating income growth to be in the range of flat to 4% growth, which reflects favorable FX rates relative to our previous guidance.
As a result of these updates, we are raising our full-year diluted EPS guidance from our prior range of $11.70 to $11.90 to a new range of $11.85 to $11.95, representing growth of 7% to 8% on an as reported basis or 12% to 13% excluding COVID-19 treatment contributions. As you turn to your models, there are few items we wanted to remind you of as you think about the fourth quarter and the year ahead.
In the fourth quarter of fiscal 2022, we had $0.17 of contribution from distributing COVID-19 treatments, $0.16 of which was in the US Healthcare Solutions segment. As I mentioned, this year we expect to only have a $0.01 or $0.02 of COVID-19 treatment contributions in this year's fourth quarter, which will impact year-over-year growth rates.
It's also important to keep in mind that in the fourth quarter of fiscal 2022, the dollar was at historically strong levels versus most major currencies. This should create a tailwind in the International Healthcare Solutions segment on an as reported basis as we lap that easier comparison and as reported growth is expected to be higher than constant currency growth in the fourth quarter of fiscal 2023. This dynamic is reflected in our increased as reported operating income guidance at the International Healthcare Solutions segment level and in our constant currency operating income guidance, which remains unchanged at the international healthcare solutions segment level.
We are in the middle of our planning process and feel confident that the strength and resilience of our core business and our value-creating approach to capital deployment will allow us to deliver on our long-term growth guidance. While it remains early in our planning process, at this point, we would expect contributions related to COVID-19 treatment distribution to be minimal in fiscal 2024. As usual, we will provide full fiscal 2024 guidance in November when it can be fully informed by our detailed planning process.
Before I turn to my closing remarks, I would like to provide a brief update on one of our key ESG initiatives. As we have discussed in fiscal 2023, we introduced an ESG metric within our executive compensation program that includes three quantifiable components focused on business resiliency, female representation in leadership roles and employee inclusion and engagement. During the quarter, we successfully completed the business resiliency target by completing business impact assessments across our locations. This exercise informs our resilience planning and ensures we are able to continue operating in the face of natural disasters and a changing climate.
To this end, we were also proud to be recognized by Forbes on their first ever Net Zero Leader's list. This list recognizes businesses that are leading the way, not only in transitioning to a low-carbon economy by 2050, but also are embedding sustainability practices into their business and working to achieve sustainability targets. Companies were evaluated across industries for the robustness of the company's climate governance, strategy and risk management principles. We continue to focus on maintaining strong business resilience practices to allow us to deliver on a role at the center of the pharmaceutical supply chain.
Reflecting on this being our last earnings call with the corporate name AmerisourceBergen, I am impressed by our company's track record of adapting and evolving over the years. We have executed on our pharmaceutical centric strategy, building on our foundation in pharmaceutical distribution and expanding our suite of solutions for both our customers and manufacturer partners.
Looking ahead, I'm excited that on August 30th, we will begin trading under the ticker symbol COR on the New York Stock Exchange. This ticker is more meaningful and reflective of our business and role in the supply chain. As we begin our next chapter as Cencora, I am confident that our team members will build upon the legacy we have created and continue to drive long-term growth for our stakeholders.
Now. I will turn the call over to the operator to open the line for questions. Operator?