CVS Health Corp (CVS) 2010 Q3 法說會逐字稿

Good morning my name is Cynthia and I will be your conference operator today.

At this time I would like to welcome everyone to the CVS Caremark third quarter 2010 earnings conference call.

All lines have been placed on mute to prevent any background noise.

After the speakers' remarks, there will be a question and answer session.

(Operator Instructions).

Thank you.

I would now like to turn today's call over to Nancy Christal, Senior Vice President of Investor Relations.

Please go ahead ma'am

Thanks, Cynthia.

Good morning, everyone, and thanks for joining us today.

I'm here with our senior management team, Tom Ryan Chairman and CEO of CVS Caremark, who will provide a brief business update, Dave Denton, Executive Vice President and CFO, who will provide a financial review, and Larry Merlo, President and COO and Per Lofberg, President of our PBM business, both of whom will participate in the question-and-answer session that follows our prepared remarks.

During the question-and-answer session, please limit your questions to no more than two including follow-ups so we can provide more analysts and investors a chance to ask a question.

This morning we'll discuss some non-GAAP financial measures when talking about our Company's performance, namely free cash flow, EBITDA, and adjusted EPS.

In accordance with SEC regulations, you can find the definitions of the non-GAAP items I mentioned as well as the reconciliations to comparable GAAP measures on the investor relations portion of our website at info.CVSCaremark.com/investor.

As always, today's call is being simulcast on our IR website, it will also be archived there following the call to make it easy for all investors to access it.

Please note that we expect to file our 10-Q by end of day today and it will be available through our website at that time.

Now before we continue, our attorneys have asked me to read the Safe Harbor Statement.

During this presentation, we will make certain forward-looking statements that are subject to risks and uncertainties that could cause actual results to differ materially.

Accordingly for these forward-looking statements, we claim the protection of the Safe Harbor for forward-looking statements contained in the Private Securities Litigation Reform Act of 1995.

We strongly recommend that you see the specific risks and uncertainties that are described in the risk factors section of the most recently filed annual report on form 10-K, and that you review the section entitled Cautionary Statements Concerning Forward-Looking Statements in our most recently filed quarterly report on Form 10-Q.

And now I'll turn this over to our CEO, Tom Ryan.

Thanks Nancy, and good morning everyone.

Today we reported adjusted earnings per share from continuing operations of $0.65, which was at the high end of our expectation.

And we generated $1.7 billion in free cash flow year to date, so we are well on track to meet all $2.5 billion target for the year.

Obviously we are very pleased with our third quarter results.

I thought I would keep my prepared remarks a bit shorter than usual today, since we provided a fairly in-depth update of our business at the recent--our recent analyst day.

For anyone who missed that, the slides and the video are still available on our website, so let me just jump right in.

I'll start with our retail business, which produced industry-leading same store sales growth, improved margins, and solid expense control, all of which led to a significant improvement in our retail operating margin.

As Larry mentioned at our analyst day, same store sales increased 2.5% with pharmacy comps up 3%, and front end comps up 1.4%.

This is especially strong obviously, given this economic environment.

We continue to gain share in pharmacy with our market share up 22 basis points nationally versus the same quarter last year.

And according to IMS, our growth has outpaced the chain drug industry by almost 170 basis points through September, year to date.

Our adherence initiatives at retail continue to drive industry-leading results.

We are now best in class retailer on adherence in key therapeutic classes, such as diabetes, hypertension and depression.

As you know in October, we completed the rollout of our consumer engagement engine to our stores, providing our pharmacy teams with unmatched capabilities to communicate with patients at the right time, with the right messages, and in a personal and confidential manner.

In the third quarter, our pharmacy comps were negatively impacted by about 280 basis points from new generics, a greater impact than 180 that we saw in the second quarter.

Now on the flip side, pharmacy comps were positively impacted by about 310 basis points on a gross basis, or 240 basis points on a net basis due to continued growth of Maintenance Choice.

So for the first time this quarter, we are providing the impact for Maintenance Choice on both a gross and net basis.

Because what we are seeing now is a greater conversion of existing 30 day scripts to 90 day scripts under Maintenance Choice.

As we expected, this is happening more as voluntary mail clients adopt Maintenance Choice.

As you know, the early adopters of Maintenance Choice were really mandatory mail programs so there are obviously fewer 30 day scripts at our stores that were really impacted.

In 2010, nearly 50% of the clients adopting maintenance choice previously had voluntary mail programs.

As more voluntary mail clients choose Maintenance Choice as a way to lower costs and improve outcomes, this will be a better measure, looking forward.

We are also beginning to reap the benefits of our front store initiatives.

We completed 2,800 consumables store conversions and are in the process of completing about 200 urban remodels for 2010.

Both of these initiatives are driving trips, improving sales and margin, and enhancing inventory productivity.

Now some of you have asked us what we are seeing in terms of the consumer sentiment, and we really haven't seen a pickup in confidence yet.

Consumers remain value conscious and cautious, maybe the election results will change that, last night.

But we think it's a pretty cautious consumer out there and in fact it's one of the reasons that's driving our private label and proprietary products, as well as our proximity to their home, and the value proposition overall.

Speaking of private label business, our private label business continues to grow with a penetration of front store sales of up 40 basis points to 17.4%.

Penetration across the enterprise is 17%.

Our ExtraCare loyalty card program continues to grow also.

We now have 66 million active cardholders.

Including about 5 million loyal Longs customers using the card.

Our data shows that our best customers are spending slightly more this year than last year.

So we're getting more from our best customers, which is exactly what we were aiming for.

With respect to Longs stores they are progressing nicely, both in traffic and ticket ring is up significantly from the second quarter.

Average weekly front store customers and ring improved in Longs stores by 260 and 215 basis points respectively.

Both our front and pharmacy comps at Longs were slightly accretive to overall comps this quarter, as we expected.

And we continue to see steady improvements in margin and SG&A productivity in the converted stores.

So overall I'm very pleased with our progress.

With regards to new stores we are right on track to meet our 2% to 3% square footage growth.

We opened up 67 new and relocated stores in the quarter, closed six, and we resulted in a 43 net new stores for the quarter.

MinuteClinic continue to post impressive growth this quarter.

Non-flu vaccination visits are up 27% in the quarter.

We reached an 8 million patient milestones this quarter and we really believe MinuteClinics continues strong growth, reflects our expansion of services , and improved awareness around the high quality healthcare that we provide.

And as we said at Analyst Day, next year we intend to add about 100 clinics, and will do about 100 clinics annually, we've begun planning the logistics, construction, recruitment and professional support that we need to expand.

We are excited obviously about this growth as we think MinuteClinic will play an important role in providing coverage to those 32 million that will be insured in 2014, especially in light of the shortage of primary care physicians.

So we want to be well-positioned by 2014 for the influx of these 32 million folks.

Let me turn to the PBM our 2011 PBM selling season continues to go very well.

We picked up $600 million in new business since our analyst meeting.

Largely from med D.

To date we have run $10.7 billion of gross new business, and $9.3 billion of net new business, which is including the $8.2 billion from Aetna, as we reported.

As I said, the change from our last meeting is mostly in Med D, when we will gain about 200,000 new auto enrollees for 2011, obviously slightly lower margin business, but good business overall.

We've completed 70% of our 2011 renewals to date and our retention is about 97%.

We are extremely pleased with our successful selling season with still more prospects in the pipeline.

I believe this new momentum should continue in the future as we maintain our focus on customer service and as more perspective clients take advantage of our unique breadth of clinical capabilities.

Pricing is always important and will continue to be important.

But it's more than pricing.

It's about service, it's about lowering overall healthcare costs and improving outcomes.

That really makes the difference in the long run, that's what we provide our clients.

We continue to be focused on clinical programs that lower overall healthcare costs.

Our unique Pharmacy Advisor program for diabetes will launch in 2011, in January.

The program is attracting significant interest from our clients.

We currently have 550 clients representing 10 million lives committed to the program.

We expect to expand pharmacy advisor to other conditions in a short period of time.

Since our analyst meeting, our recent analyst meeting, we signed up additional clients for Maintenance Choice, now totaling 7 million lives and 550 plans and we have a growing pipeline for 2011.

I'm also happy to report that we reached our target pilot population for our genetic benefit management program.

We have 1 million lives enrolled by September.

This program will be available probably in January of next year, we believe our investment in Generation Health will be a valuable asset to our clients and our Company in the years ahead.

Finally I remind you that we launched our PBM streamlining initiative that we talked about, which is expected to deliver over $1 billion in savings in the next four to five years.

We are streamlining operations, we are rationalizing capacity, we're enhancing technology to improve productivity and efficiently grow our PBM business in the coming years.

So in summary, our selling season is going great with strong retention and significant new business wins.

And we continue to see acceptance of our unmatched clinical programs.

The retail business continues to lead the industry as we continue to innovate and maintain our edge.

MinuteClinic is growing significantly and we have exciting plans to restart the rollout in January.

And we are focused on improving efficiency and productivity across our Company.

And lastly we've generated significant free cash flow and are on track to hit our target of $2.5 billion.

As Dave laid out in for you at the analyst day, we continue to exercise discipline around our capital allocation practices and return value to our shareholders through increased dividend and share repurchases.

So now I'll turn it over to Dave for our financial

Thank you Tom, and good morning everyone.

Today I'll provide a detailed review of our third quarter financial results, and then update our 2010 guidance for the full year.

I appreciate many of you taking the time to attend our 2010 analyst day.

At that time, I laid out the significant cash generation capabilities of the Company over the next five years, and the discipline we will utilize when deploying the substantial cash we generate to achieve the highest possible return for our shareholders.

We set a targeted dividend payout ratio of approximately 25% to 30% by 2015, versus our current level of about 13%.

This implies a compounded dividend growth rate of nearly 25%.

We will use the additional cash to invest in high ROIC efforts and absent internal projects, perhaps $3 billion to $4 billion of annual value enhancing share repurchases could be executed under normal conditions over the five-year time period.

During the third quarter we generated approximately $900 million in free cash, which compares to approximately $490 million in last year's third quarter.

The increase in free cash flow generation year over year was driven primarily by the reduction in the use of cash for inventory.

We did not repurchase shares this past quarter, as we are very mindful of our balance sheet and still focused on maintaining a high triple-B credit rating.

As most of you know, to do so, we are targeting an adjusted debt to EBITDA ratio of approximately 2.7 times.

Enhancing shareholder returns remains a high priority for us.

Year-to-date we've repurchased about $1.5 billion of our stock, combined with our dividend, we've returned more than $1.8 billion to our shareholders thus far in 2010.

Gross capital spending during the quarter was approximately $515 million down from $660 million last year, mostly due to the absence of integration expenses associated with the Longs acquisition.

Given sale-leaseback activity of approximately $125 million in the third quarter, our net capital spending was about $390 million.

Now turning to the income statement, as Tom said, we delivered adjusted earnings per share from continuing operations of $0.65 for the quarter.

GAAP diluted EPS from continuing ops came in at $0.60.

From a revenues perspective, our enterprise-wide net revenues decreased in the third quarter by 3% to $23.9 billion.

Drilling down by segment, net revenues dropped 9% in the PBM to $11.9 billion, a slightly larger decline than expected.

The decrease from last year was of course driven by the impact of previously announced client terminations, as well as the decrease in Med D lives resulting from the 2010 Med D bidding process.

In both mail and the retail networks, soft prescription utilization trends throughout the industry were the primary drivers behind the variance versus expectations.

PBM pharmacy network revenues in the quarter decreased 13% from 2009 levels to $7.6 billion, while pharmacy network claims also declined 13%.

Total mail choice revenues increased by 1% to $4.2 billion, while mail choice claims declined by 1%.

In addition to client terminations and utilization trends there were a bit softer than expected, the decline in network claims also reflect the growth in mail choice penetration.

As claims continue to move from network to mail choice, our overall mail choice penetration rate increased 250 basis points to 26.3% versus LY.

This is driven by the success of our Maintenance Choice program which gives our clients the ability to drive the savings provided by 90 day prescription without denying the members the choice and access to retail.

In our retail business we saw revenues increase by 4% to $14.2 billion in the quarter.

As expected.

This increase was primarily driven by our same-store sales increase of 2.5% as well as net revenues from new stores and relocations, which accounted for approximately 150 basis points of the increase.

Pharmacy revenues continued to benefit from incremental prescription volumes associated with our Maintenance Choice program.

As Tom explained, Maintenance Choice had a positive impact of 240 basis points on our pharmacy comps this quarter.

A weaker flu season, the H1N1 outbreak in last year's third quarter and a higher generic dispensing rate negatively impacted pharmacy revenue growth, all of which was somewhat offset by stronger allergy season compared to last year.

Turning to gross margin, compared to the third quarter of 2009, we saw enterprise-wide margin expand by approximately 70 basis points to 21%, in line with our expectations.

Within the PBM segment, gross margin was down about 50 basis points, again as expected.

This mainly reflects the elimination of retail differential within the Med D business that began on January 1 of this year, as well as pricing compression associated with the one-year extension of the FEP contract which we announced last year, and became effective this September.

Partially offsetting this was the positive margin impact from the 370 basis point increase in the PBM's generic dispensing rate, which grew from 68.3% to 72%.

Gross margin was up 50 basis points sequentially from the second quarter.

Our EBITDA per adjusted claim was $4.31 in the quarter, down 7% versus third quarter last year, but up 9% sequentially from the second quarter.

Gross margin in the retail segment increased by approximately 15 basis points in the third quarter, to 29.5%, within expectations.

This increase was due to several factors including the impact of an increased generic dispensing rate with our GDR increasing by 340 basis points to 73.5%.

The benefits we are seeing from various front store initiatives and increased private-label penetration, these positive factors were partially offset by continued pressure on pharmacy reimbursement rates .

The growth in Maintenance Choice which compressed with retail gross margin but helps the overall enterprise and the continued shift in the mix of our business toward pharmacy.

Overall operating expenses as a percent of revenues increased by approximately 85 basis points over last year's third quarter, again within expectations.

The PBM segment's rate increased by 15 basis points to 1.9%, primarily due to the cost related to the streamlining initiative, which amounted to more than 20% this quarter--to about $20 million this quarter These expenses were not included in our guidance we provided back in August, because we did not have a final streamlining plan in place.

SG&A leverage was also affected by PBM revenues that were a bit lower than expected in the quarter.

The retail segment saw improvement in SG&A leverage of approximately 50 basis points to 22.2%, surpassing our expectations.

Retail benefited from the absence of Longs integration expenses and disciplined expense controls throughout the segment.

Within the corporate segment, expenses were $168 million, or less than 1% of consolidated revenues, with growth of 15% year to date.

There were several puts and takes but the primary driver of growth was the increase in professional fees.

So with the change in SG&A as a percentage of sales more than offsetting the improvement in gross margin, operating margin for the total enterprise declined by approximately 15 basis points to 6.2%, within our expectations.

Operating margins in the PBM was 5.5%, down about 65 basis points, while operating margin at retail was a very healthy 7.3%, up about 65 basis points.

PBM profits declined by 18% below our guidance.

If adjusted for the streamlining expense, PBM profit growth was close to the low end of our guidance, while retail profits improved by 14%, well above our guidance.

Going below the line on the consolidated income statement we saw net interest expense the quarter increase by $14 million to $137 million, slightly below our expectations, while our effective income tax rate was 39.2%.

And our weighted average share count was just under 1.4 billion shares.

So now let me turn to our guidance for the fourth quarter and full year 2010.

We are narrowing our 2010 guidance for adjusted EPS from continued operations to a range of $2.68 to $2.70, from our previous range of $2.68 to $2.73.

The $2.68 to $2.70 guidance for 2010 compares to the $2.62 we earned last year, adjusting for the one-time benefit of $0.12 per share in 2009 for the tax benefit.

GAAP diluted EPS from continued operations is now expected to be in the range of $2.49 to $2.51 this year.

Please note that this guidance does not assume any additional share repurchases for the balance of this year.

In the fourth quarter, we expect adjusted EPS from continued operations to be between $0.78 and $0.80 per diluted share compared to last year's $0.78 per share.

GAAP EPS from continued operation is expected to be in the range of $0.73 to $0.75 per diluted share.

We expect the PBM segment operating profit to decrease 25% to 27% in the fourth quarter, impacted by the price compression from FEP extension for the full quarter as well as the Aetna integration and PBM streamlining costs.

We expect to spend an additional $35 million to $40 million in the fourth quarter on the PBM streamlining.

For the year we expect the PBM's operating profit to decrease of 16% to 17%, which now includes both the Aetna dilution and the PBM streamlining initiative costs.

And as we said on analyst day, we will spend approximately another $200 million on the PBM streamlining initiative over 2011 and 2012 with the majority of which will be spent in 2011.

We expect the retail segment operating profit to grow 12% to 14% in the fourth quarter and to grow 9% to 10% for the year.

For the PBM segment, we expect revenue to decline by 8.5% to 9.5% for the quarter.

For the retail segment we expect revenues to increase by 3% to 4% and same-store sales to increase 1.5% to 2.5%.

As a result for the total enterprise in the quarter, we expect revenues to be down 3% to 4% from 2009 levels.

That is after intercompany eliminations, which are projected to equal about 8.5% of combined segment revenues.

For the total Company, gross profit margins are expected to notably improved relative to last year's fourth quarter, as the higher-margin retail segment becomes a larger piece of our total company's business.

Expectations are that gross margin in the retail segment will be modestly up, while gross margin in the PBM segment will be notably down.

For the total Company, operating expenses now are expected to be approximately 15% of consolidated revenues in the fourth quarter, with the PBM modestly down, and the retail segment improving notably.

As we expect operating expenses in the corporate segment to be in the range of $155 million to $165 million, modestly delevering as a percent of consolidated revenues compared with 2009 levels.

As a result, we expect operating margins for the total company in the quarter to be modestly down from last year's fourth quarter.

The rest of this guidance I'm going to give is for the full-year so please keep that in mind.

We expect net interest expense of $540 million to $545 million, we are forecasting a tax rate of approximately 39.5%.

We anticipate that we will have approximately 1.375 billion weighted average shares for this year.

We expect total consolidated amortization to be roughly equivalent to the level in 2009.

Combined with estimated depreciation, we still project approximately $1.4 billion in D&A in 2010.

As for capital spending this year, we now expect gross capital expenditures to be between $2.1 billion and $2.3 billion and proceeds from sale leasebacks of approximately $500 million to $600 million for the year.

A reduction of about $200 million in our expectations for net capital expenditures.

We still expect to generate approximate $2.5 billion in free cash this year, and we continue to expect free cash flow to accelerate in 2011 and beyond.

And with that, I will turn it back over to

Okay, thanks Dave.

As Nancy said, Larry and Per are with us today so we will open it up for questions.

Your first question comes from the line of Lisa Gill with JPMorgan

Hi.

Thanks very much and good morning.

Thanks Dave for all the detail.

I was wondering if you could just dig in a little deeper.

I know you talked about the profitability on Maintenance Choice having an impact negatively on the gross margin for retail.

But, good overall for the Company.

Can you help us understand the magnitude of what you mean by good overall?

Well Lisa, I guess in total, I guess what you need to think about, is what is happening here.

Is your adjudicating essentially a mail order claim in the retail location, which carries a higher discount rate?

But with that, the enterprise in total captures more volume associated with that transaction, as a percent of the number spend.

So net net at the end of the end of the day, the economics prove out that the float to the enterprise is very productive.

Yes and Lisa, to the point where obviously the plan has to have a benefit program that drives folks to mail.

And we also saved on the mailing cost at the PBM side.

Lisa, the other thing that happens too, keep in mind, that over time the mail centers have -- the costs associated with the mail centers are quite variable, in the sense that the technicians and pharmacists in those centers, when a script moves from mail to retail, we can leverage the capacity that we have in our retail locations.

So we can fill that incremental script without flexing up cost in the retail setting.

Okay.

And then my second question is just really about the next big generic wave that will start in 2012.

Yesterday, one of the PBM competitors talked about Lipitor, and what a great opportunity this is, because in their book of business, it's 60% male penetration.

Are you comfortable at all giving us any kind of metric to think about how big the next generic label be, given especially your combination of having maintenance choice, and thinking about a big drug like Lipitor?

And what the potential impact could be as we start thinking about that next big generic wave?

We'll give you some more clarity around that in the fourth quarter call, as we talk about 2011 and 2012.

But in general, we've spoken about this at the analyst meeting, 2011 is clearly the weakest of the years we've seen for generic introductions.

Obviously albeit Lipitor will hit in the last quarter, in the last two months of the year.

And 2012, conversely, is going to be the top of the years that we've seen in recent history.

I think there's a little bit of maybe undue concern in the marketplace, that what we do after 2012 and 2013 .

We've done analysis, we've looked at the mix, and we see it as a significant opportunity going forward with generics.

Both in our mail business, and in our retail business, and as you indicated Lisa, in the mail choice.

So we won't get into specifics, but directionally, we're in pretty good shape and feel very optimistic about it.

And I'll just ask Per to comment on

I'll just add one other dimension, and it has to do with plan design.

The Main driver of the generic opportunity comes from the patent expirations.

But in addition to that, we now have the opportunity to design benefit plans where there's much greater emphasis on generics, and much more restrictions on the remaining branded prescriptions.

So when you have categories like cholesterol, or the hypertension category, and CCI's and so on, those types of categories can now really be very well supplied with only generic, or with generics first.

So that really creates an opportunity beyond just that is provided by the patent expirations themselves.

Per, can you put any kind of number -- we're analysts, right, we just wanted to understand numbers.

So can you help us at all, to think about programs that are going into place for 2011, and will obviously also benefit 2012?

What kind of uptake are you seeing in those kind of programs?

Do they dovetail into maintenance choice?

So are you -- is it that you're getting the Maintenance Choice and then you're offering these kind of step therapy programs with Maintenance Choice, or they're independent of each other?

They're independent of each other.

And it depends on the plans, and what they're able to do.There may be plans that are very actively focusing on the generic opportunity, because of geography, or whatever.

They can't be as aggressive with respect to 90-day supply.

Supply count.

So there are two paradigm opportunities for us, and they work sometimes in tandem and many times independent of each other.

Is there any percentage, or a number that you can give us to say we have penetrated this number of accounts today?

And just to give us what we believe the continued opportunity is?

And then I'll stop.

We showed a slide at the analyst day, which showed the current penetration of what's called a high-performance generic formulas.

I forgot the exact number there.

But, you know, we could --

Was it 43%?

Was that the right number?

No.

It's more in the 10% range today.

But they also have in it, what we thought was the aggressive opportunity in our capital base, which is multiple of that, it's like a fourfold multiple over where we are today.

So over the next couple years, we do believe that's a real win-win for us and our customers, as they modify their plan time.

Lisa, [inaudible], there is a leverage opportunity here.

We are going to have more drugs coming off patent in generic form, especially in 2012 and beyond.

And we have an opportunity to have higher penetration for existing customers, so it's a double-win here.

Okay great, I appreciate all the comments.

Thanks.

Your next question comes the line of Meredith Adler with Barclays Capital.

Thanks very much for taking my question.

I was wondering maybe just follow up a little bit on that question about Maintenance Choice.

And Dave, you were talking about the overall benefit of Maintenance Choice, even if the individual scripts produce a lower margin for the store.

Can you just talk, maybe update us a little bit, on to what extent you are seeing patients move all of their scripts, their acute scripts, when they move to Maintenance Choice?

And is there any way of tracking whether you're seeing an improvement in front end sales from those customers that move to Maintenance Choice.

Let me take this, I'll take this.

As you know, when a client signs up for Maintenance Choice, the client, obviously the payer, chooses the program.

And they're choosing the program, because obviously there's some options, and convenience, and ease for their members or their employees.

So they get the benefit of mail and the cost savings.

And then their members and employees have the ease of 90 day at the store.

It just stands to reason, as if a patient is picking the medication up in the store, and they use multiple pharmacies, we do get a lift.

It's really driven by the patient, not our stores, right?

The patient decides that they would like to move their medication, whether it's acute medication, or other maintenance medication that they have, to our stores.

So we do see a pick-up.

We do get a bigger share of that patient's pharmacy spend.

But once again, the first part, Maintenance Choice.

The idea of Maintenance Choice is driven by the client.

And second, the decision to move that medication to one of our stores, is really a patient decision.

And then, we know there's a correlation between spend, the front store customer coming in to our stores more than the pharmacy customer.

So we get a fair amount of our front end spend without a pharmacy transaction.

But once again, if they decided that the store is close enough for their maintenance medication, then the customer's now going to, obviously making the decision, to shop the front end of our store.

So it is a total --

And Meredith, just to be clear.

We do not attribute any incremental profit associated with any front store transactions to the Maintenance Choice program that we just talked about.

It's quite productive, just on a pharmacy-only basis, and that's how we think about it.

Okay, is it possible to quantify the benefits?

Because without people shifting the rest of their scripts to the store, then you run the risk that a person who's already filling three 30s.

and goes to one 90, it's actually negative for the profits of the store.

Unless you get something else.

Yes that's right, and you have to move them to, that's why it's all about the plan design also.

You have to have a client that's moving to a plan design that's going to drive 50% to 60% mail penetration.

So.

Okay.

It's a benefit over all to the Company.

Go ahead.

Sorry.

And then I have a totally unrelated question.

When you talked at your analyst meeting about reductions in inventory, you focused considerably on the benefits to cash flow.

But there wasn't really any conversation at all.

Any mention of what might happen to labor costs.

Maybe even a gross margin, but mostly labor costs, from reducing inventory at the stores and presumably at the distribution centers.

Other companies who've gone through a similar process, have seen a meaningful benefit in cuts in SG&A.

Is that something you guys have thought about?

Is it in your guidance at all?

Or is that just sort of an opportunity?

Yes, Meredith, it is Larry.

We think that there is some opportunity, when you think about, as you mentioned, the distribution costs as well as the back room management.

In our stores.

But as we stated, or least alluded to at the analyst meeting, we think that we have opportunities around some of our processes.

And we're not looking at our goals around inventory reduction to be largely through SKU rationalization, or SKU elimination.

And we'll pick up some efficiencies in labor as a result of our clustering efforts, which streamline some of the SKU rationalization.

But that's going to be a small incremental piece.

Thanks, Meredith.

Okay, thank you.

Thank you.

Your next question comes from the line of Tom Gallucci with Lazard Capital Markets.

Good morning.

I guess first, I just wanted to make sure Dave, I understood the streamlining costs.

So you're saying at Investor Day, that you're going to spend about $200 million over the next couple years., And now that number overall has gone up by $50 million or $60 million, for spending in the third and fourth quarters?

No, that's not exactly how we try to characterize it.

We were planning to spend about $200 million in 2011 and 2012.

There is going to be about $60 million spent this year.

So in total, we'd always expected to spend roughly that amount.

Okay.

And the near-term costs, I guess.

What sorts of things are they being invested in?

Well, it kind of runs the gamut of investments that we're making at this point in time from an expense perspective.

I guess first and foremost, as we go through this process, we are consolidating some facilities.

So there's some asset impairment right off that occur.

We're also ensuring that we have the right resources against all these initiatives.

So we're incurring some professional services fees to support that.

We're also supporting, I guess, realignment of our -- some of the staff and some of the staff expenses associated with those movements.

You mentioned some write-offs possibly.

Is all that 50 or 60 this year cash?

Or is a material portion of it non-cash?

Some of that is non-cash.

But I would say the majority of it, a high percentage of it, is cash.

Okay.

And then just shifting gears.

Per, I was wondering if, you know, you've obviously been through sort of the bulk of the selling season at this point.

It went a lot better than last year, at this stage.

Can you maybe talk a little bit about how the sales pitch or the conversation with the customer has changed?

And also, as a part of that, to what extent does the CVS retail piece of the equation come into play, as a benefit, or sort of neutral or detriment to those conversations?

Thank you.

Yes.

I should say first, that it certainly is not a detriment at all.

In fact it's just the opposite.

As I think I've said many times during the course of this year, when customers go out [inaudible], they go through the RSV and renewal process.

They are first and foremost focused on improving the economics of the drug plans.

So that is on the top of the agenda.

We are also getting, as you heard, very nice traction from the spectrum of clinical programs that have been built here.

And they continue to be built, in large part, as the result of a combination between CVS retail and Caremark PBM.

Those programs, I think resonate.

And we have a growing amount of evidence to show people how they work in practice, and what kind of benefits they can expect to see, both clinically and economically.

So they're a very attractive feature of the dialogue with our customers.

And just to clarify.

Those aren't really new programs, I don't think, in many instances.

So are you pitching them differently, or more pronounced, in your discussions?

Or what's changed, versus the last year or two?

No, some of them are quite new.

The Pharmacy Advisor program that was featured at the Analyst Day, and that you heard mentioned here just a few minutes ago, that program was really kind of in pilot, during the latter part of last year, and the early part of this year.

So we now have a very compelling evidence, in terms of how we improve the behavior decision-making process, regarding adherence, and filling gaps in care, and so forth, for the participants in the program.

And that, I think, is an important component of making companies prepare to sign on for a program like this.

And as you heard, we have about 10 million lives that are ready to go with this program in January.

The other area we focused on, that we also highlighted this year, is the whole specialty part of the business.

This is an incredibly important aspect of the drug spend for our customers.

And the programs there are just increasingly visible in the decision-making process, in terms of both controlling drug spend through utilization programs, and improving the outcome for the family members, through compliance driven initiatives.

So that's a very hot topic today when we and other PBMs talk about customers.

Thank you.

Your next question comes from the line of Mark Wiltamuth with Morgan Stanley.

Hi.

Good morning.

Could you give us a little update on what's happening in the flu season, and how the consumer up take has been on flu shots this year?

And what you're expecting as we roll into December-January, when the year ago comparisons on flu really collapsed.

Yes, Mark.

In terms of the flu program, we have across our retail business, which includes MinuteClinic, today we have about 13,000 immunizers.

That's more than double of a year ago.

And as of last week, we've administered about 1.7 million shots, well ahead of last year.

Slightly behind where we thought we'd be at this point in time.

We see that the -- I'll call it the inoculation season, probably continuing through the balance of the year, and perhaps even into January.

I think as you alluded to, we all recognize that we're comping up against the H1N1 at its peak period, probably now through the middle of December.

And then, I think once we hit January, we're looking at much more normalized comps, recognizing that we really did not have much of a flu season, at all, in 2010.

Both of the seasonal variety, and the H1N1.

And I think the impact to flu shots of our comps will probably be negligible, as we go through the fourth quarter.

Okay.

And maybe I can also ask on the pharmacy side of the house.

Any changes in the macking trends out there?

Because we did see a pretty sequential improvement on the Walgreens pharmacy margins, just from an easing of macking?

Yes.

I think that we have seen the year-over-year rate compression has softened from earlier in the year.

That being said, I don't think that margin compression has abated.

And we continue to work with both private payers, as well as state Medicaid groups, on ways that we can lower overall costs, without just a rate reduction.

Okay, great.

And any update on the AMP implementation?

I think we are still waiting for some of the rules in terms of how CMS will administer AMP.

I don't think, based on where we are at, I don't think we believe we're going to see anything much before the first quarter of next year.

But again, I want to emphasize, that I think that we have seen, going back to September of last year, the state Medicaid, as they were reducing reimbursement.

I think that throughout the course of this year, we have seen some of the margin compression, that I think we expect to see as a result of that.

So we think we've been incurring that, throughout 2010.

Thanks Mark.

Your next question comes from the line of Larry Marsh with Barclays Capital.

A quick follow-up.

Thanks.

For just kind of longer-term trends, I think on the Pharmacy Services business.

Going back to, I think the outlook you gave at the analyst meeting.

I think Per and Tom, which is top line growth in the PBM, and that's a 10% to 12% range including Aetna.

With some margin decline.

It seems like your peers are seeing less topline growth, but margin expansion.

So I guess I want to sort of think about how we reconcile those two, in that context.

And then in the environment of which you're going through with the streamlining, and some of the other initiatives there.

How do we think about customer retention, and growing share in this kind of marketplace, especially since we are little bit behind the curve already?

Thanks.

Larry, hi.

Yes, that is a fair point.

Obviously I can't speak on behalf of my competitors.

But certainly the way we look at it, if you take Aetna alone, that's a 20 percentage point increment to our book of business.

It obviously is a lower margin business reflecting the size of that kind of an account.

So that's one factor.

Likewise, as you know, we focused very much on the Medicare growth opportunities that we see in the market, both in terms of the PDP programs, and the so-called aggregate programs, where the employers are shifting their retirees into partially government-funded programs.

And those are good programs for us, they are slightly lower margin than the traditional PBM business.

But they are still very worthwhile and very productive from an overall standpoint.

So those are two of the drivers.

Okay.

Great.

And then just a follow-up on the Aetna dilution for this year.

I think you gave the $35 million to $40 million incremental costs with the streamlining program .

What's the Aetna dilution you're assuming for

$0.01 to $0.02.

$0.01 to $0.02.

Okay.

Thank you.

Your next question comes from the line of Ed Kelly with Credit Suisse.

Yes, hi.

Good morning.

And I apologize in advance here, because I'm just a little confused about the streamlining guidance.

But, it sounds like the $50 million that you're talking about this year, is different than $200 million laid out at the analyst meeting.

You know, is that right?

And if so, why not just highlight it then, and adjust guidance at that time?

Yes, let me just be clear .

We expect to spend $200 million between 2011 and 2012, with the majority of that spend being happening in 2011.

The spend for this year, which is about $60 million in the PBM for 2010, that I referenced earlier.

We did not, as of a few weeks ago, have a detailed plan on how that was going to occur, what the exact actions were going to be.

And so we were unable to quantify that specifically.

So now that we've been able to quantify it, we've laid it out.

I'm sorry for any confusion

Yes, okay thank you.

And then, second question really, is on inflation and the front end.

In 2011, we're hearing a lot of CPG companies talking about raising prices.

I was curious as to whether you've seen some of this yet?

Do you anticipate being able to price these price increases through if the consumer range remains weak?

And I guess if you could, it would be incremental to the front end comps.

I would just love your comments there.

Yes.

We have not seen, at this point, anything out of the ordinary.

Obviously, we regularly review our pricing, and make adjustments.

Always with the goal of ensuring that our customers receive the best value for our selection, and convenience and access our stores provide.

Some of the increase that you might be seeing is some of the new products that are coming out that enhanced products that are getting some premium pricing.

But Larry's point -- there's not a lot of pure inflation yet.

And I think if -- CPG companies obviously have to be careful.

And it's a balance, because they're obviously losing some share to store brands.

Okay, thank you.

Your next question comes from the line of Helene Wolk with Sanford Bernstein.

Frank, two quick questions.

First on the guidance for same-store sales in fourth quarter.

It looks like at the midpoint, it's a sequential deceleration?

Can you just give us the, sort of puts and takes, into how to think about same-store sales in the fourth quarter?

Yes, Helene.

I think the biggest impact, is the fact that were comping up against a spike of H1N1, largely through the fourth quarter last year.

Okay.

Any Longs or Maintenance Choice comp changes?

No.

I mean Longs, I think as Tom mentioned, continues to perform well, and was actually accretive to our third quarter comps.

And we expect that trend will continue through the fourth quarter.

Great.

And then lastly on the working capital front.

I know you had mentioned about $1 billion out of inventory, as a going forward goal.

Is this quarter, should we think about the change in inventory, as being sort of partway towards that goal, or how should we think about it?

I think we're making some progress in inventory.

But I wouldn't say that this is a substantial delivery against that $1 billion.

I think we still have a lot of opportunity against the $1 billion next year, and going forward after that.

Great, thank you.

Your next question comes from the line of John Heinbockel with Guggenheim.

Yes, Tom.

I wanted to drill down on profit margin for the two divisions.

If you look at retail, and you guys have done a very good job maximizing profit margins in the retail business.

You're close to 8% now.

How much more is there?

I know generic will be a help over the next 18 months of 2012.

But are we getting close to a comp and retail margin?

Or you don't see that?

We keep improving it, John.

Obviously the generics, to your point, will help.

It helps on both sides of our business, Pharmacy Services and the retail side.

Then our proprietary work, our private label work, it's obviously helping .

We continue to do a really great job around shrink control, when you think about margin in our store.

And then the work with ExtraCare.

Right?

We continue to tweak that.

As I said, 66 million customers.

I mean, ExtraCare has really been beneficial to us when we think about productivity.

You think about focusing on our best customers and spending our margin dollars wisely.

So, over the course of the next few years, we will be looking at how we go to market, what we do with our circulars, what we do with that spend on those circulars, and the margin associated with that.

I wouldn't say, listen it's not going to ramp up significantly.

But I wouldn't say it's over

And John, the only other element that I alluded to is the growth that we still have in terms of improving the profitability of the recent acquisition.

And we touched on that a little bit at the analyst meeting.

And we've made some very nice improvements, but there's still more opportunity there.

And John, I'd also go back to some of the things that both Larry and Tom, and I think, I referenced a bit, at Analyst Day, around the fact that over the next several years, is going to be an increase in utilization across prescription utilization across the US.

That increase in utilization will drive volume through our outlets.

That will increase our productivity.

Combine that with maybe the initiatives that we either have underway today, and our plan for the future, that also provide additional service and value to our consumers, that will allow them to choose our stores more and more.

And we gain share over time.

So I think we have progressed nicely to that over long-term.

Conversely, obviously the PBM is under earning.

You would think that there is, from the bottom we hit in 2011, you would think that there's 100, 150 basis point opportunity in the PBM profitability.

What do you think will happen with companies investing the generic benefit in pricing and renewals?

How much of that will take place?

And how do you think that compares to what happens in 2006?

Will there be more investment of that generic benefit away, less, the same, what do you think?

This is Per.

I think the PBM business shows no signs of abating in terms of its competitiveness.

It is a very competitive business, and they are big contracts that turn on relatively small differentials.

So, I do think the generic opportunity that we see, and that we are focused on from our own kind of internal standpoint.

That's also on the radar of our customers and our consultants.

So it certainly will be part of the negotiating process as we go forward.

And we have to be realistic, and assume that some of that opportunity will have to be shared with the customers in the competitive bidding process.

To that point, customers obviously want alignment, and they see that the generics have always been good for the payer and good for the patient.

And obviously they will be good for us .

So there is alignment around it.

And John, I also think we have opportunities, just like we continue to tweak the retail side and look for opportunities.

We have opportunities on the Pharmacy Services side, around improving our mail penetration, improving generic penetration, specialty business, and some other service businesses that we are looking at.

So I think it's right looking at all the little pieces, of every business.

And seeing where we can drive more margin opportunity.

And at the same time balancing the save we have for our

Okay, thanks.

Your next question comes from the line of Bob Willoughby with Banc of America.

Thanks.

It looks like Aetna's guiding to about 500,000 less ASO lives next year.

Was that part of your opportunity, or were the ASO lives never part of the deal?

Well, we picked up some of those were basically negotiated earlier in the year.

And some of those ASO lives were lost by Aetna to other PBM competitors.

So, some of it we have, and some of it, they lost through their normal competitive process.

And is your question, were we factoring that in?

Yes, that was a new data point for me.

Yes.

Obviously we do the due diligence.

We had some discussions on which contracts were questionable, and where they thought they might lose.

So that was part of the contractual relationship.

You know you're going to have some puts and takes.

We expect to have some obviously going the other way.

But, yes, it was all factored in.

The 1.1 net new business is the good number?

Yes.

Great, thank you.

Your next question comes from the line of Scott Mushkin with Jefferies & Co.

Hey guys.

During the end of the call, I just wanted to get back to what Ed was saying.

So the reduction of guidance, not the reduction, but the go to the low end, is the incremental streamlining costs?

Is that correct interpretation?

That's essentially -- that's the driver.

Yes.

Then I wanted to go back to what Meredith and Lisa started off the call with, and just try to understand Maintenance Choice a little bit better.

It seems like the marginal cost of dispense at retail, is about zero, or close to zero.

The marginal cost of dispense of mail, I think Dave, you said, is actually higher.

So if I taken non-CVS non-mandatory retail customer, and convert them to Maintenance Choice, it seems that the contribution margin should be really high.

Unless Caremark is using some of that money to encourage adoption, so I'm just trying to understand if I'm wrong in that type of thinking, or where I may be off?

We're investing obviously some of that, with the client.

But it's also offset by the point that was raised earlier.

That would be, you know, the existing -- you referring to the new customer, to CVS Caremark.

But it's also offset by the 30 day customer at retail, that goes to 90, right?

You take a little bit of a hit there.

So it's a wash.

It really is important to understand, that the plan design, you have to have a plan design.

If you have a situation where a client has 10% mail penetration, it's tough for the economics to work.

I don't care how much additional business you put in.

It's when you get a higher mail penetration that drives the economics here.

So it's back and forth.

But you're right on around the variable cost in the mail business, not only payroll, but also the mailing costs.

So Tom, as a follow-up.

Is the mix shifts in Maintenance Choice, to new wins, maybe people that weren't part of the Caremark network, or didn't do a mandatory mail program.

That should improve profitability as we move into 2011 and 2012, or is that not a good way to look at it?

That is absolutely the way to look at it

And typically, the main choice decision is something that customers put in after they have selected the PBM.

So it's sort of an upset opportunity margin, a margin improvement opportunity for us, You know, vis-a-vis our existing book of business.

Okay.

And then just one last one.

And maybe, there's going to be a decent amount of pressure put on the pharmacists as you roll out some of these pharmacy adviser program.

Maybe you could just give me 30 seconds on how we get comfort around that these pharmacist will be able to execute adequately for Caremark?

Yes Scott.

Thanks for asking that question.

Because I absolutely love answering that, because I think we have a great solution.

As we talked at Analyst Day, we have invested in technology, in the form of both RXConnect and the engagement engine, which we're branding internally as PCIConnect.

And this allows us to integrate the real-time clinical messaging as part of the workflow for pharmacists.

And that to me, is the absolute key to this.

Because we're delivering an intervention that is intended to last a couple minutes.

And the fact that we've been able to build it as part of the workflow, I think, is key.

I think there are some of our higher volume stores where we're working on an additional solution.

We talked about the work that we're doing with the call centers, because there is not as much capacity in those stores.

And that's work in progress.

But we are very confident in our ability to deliver the promise, so to speak.

Thanks guys.

Your next question comes from the line of John Ransom with Raymond James.

Hi.

Good morning.

This question is for Dave.

As we think about the PBM cost saves in the out years, let's say 2012, 2013, 2014.

What are the alliance costs, where the costs that you are incurring, are outweighed by the cost savings that you realize?

Really, probably, some of that's a little bit work in progress from a timing perspective.

And we will update you specifically as we get there.

But I would say it's probably some time in 2012.

That would be my guess at this point in time, as the plan currently lives today.

And I'm sorry --

It would definitely be in 2012 right?

You have to think about facility consolidations, and moving people around.

You want to make sure this is not disruptive to the clients.

And we have a plan for that.

So it's laid out across 2011.

And there's some costs to David's point, that the $200 million that we laid out is more in 2011, than 2012.

So the benefit we'll see is more in 2012.

Okay.

Thank you.

And my second question is on the part D business that you picked back up, is that material from an earnings standpoint as we think about our 2011 numbers?

It is definitely a good guy for us, it's a benefit.

And I don't have right in front of me, the increment it represents per se, but it's about $600 million of additional revenue, that we expect from that on assignment alone.

Add, I think to your -- the question.

It's lower margin business.

But it's still positive for us.

Okay.

And then, I guess, Tom.

Just the Caremark deal was announced in 2007.

It looks kind of like 2012 might be the year where you get your revenue synergies, and maybe some positive year-over-year EBIT growth.

I have to think that when you are thinking about that deal in 2007, you probably would have been surprised if it took five years.

Can you give us some perspective on maybe some of the positive and negative things that you've experienced as you move through this process?

We don't have enough time on this call.

Yes, I would say, and I talked a little bit about this.

The lead time, there was obviously a longer lead time.

And we got in the hole right away with the loss of a big client -- actually two big clients, within the first year.

And then the work that we did, was really around getting the synergies, getting the back end systems hooked up, the HR side the financials.

And that was the work.

We didn't really spend a lot of time initially on the new products.

And then you work on the new products, at the end 2008 and into 2009, and you're selling those for the 2010 season.

So it's got lead time, I'm sure if we look back on any deal that we've done, we've made some mistakes.

I will say this, that we don't make multiple mistakes.

And we look at it, and we corrected it and we moved on.

And you can see the changes that we've made in the PBM side of the business, across the business.

And so yes, I'm a little taken by the speed.

I think I had mentioned this, there's some benefit managers are maybe a little more risk-averse than I anticipated, because some of the products took a little longer in the uptake.

But as Per indicated, you can see people are reaching out for this.

And there is no question.

You can talk about some of the external issues that noise that's out there in the market place.

But from a client standpoint, there is no question that they see the benefit of this combined offering.

It saves money, it's easier for their members and it produces better outcomes.

At the end of the day, that's what this is about.

So you are right, we will see it.

Obviously in 2011, and more certainly so in 2012.

Thanks for that.

I could go on obviously.

Okay, thanks.

Two more questions.

Your next question comes from the line of Deborah Weinswig with Citigroup.

Great.

Just to follow on some of the questions earlier with regards to generic dispensing rates, etcetera.

One.

What you think is the potential longer-term?

And how do specialty generics figure into that?

We haven't made any real kind of quantification on specialty generics.

That's out there.

I mean, I think we have to look at our normal PBM book of business.

We see opportunities to continue to drive that up, certainly into the high 70s, and maybe across 80% -- over the next several years.

Okay.

And then, with Pharmacy Advisor rolling out in 2011.

How does that fit into Accordant?

Or is that two separate offerings?

And maybe if you could just talk about where Accordant fits into everything at this point in the game.

Two separate offerings, really.

Can you just talk about Accordant at this point in the game?

Well, Accordant is a disease management approach focused on rare diseases.

Up until now, it's pretty much sold quite independently of the PBM sale.

In the health plan it tends to bought by different part of the company, and different schedules and the PBM's business is contracted.

They run as pretty independent entities.

Is there any opportunity to bring that more -- since you -- and the Company has done an amazing job in terms of cross-fertilizing.

Is there any opportunity to bring that more into, or integrate that more into everything else?

It's possible.

It can't happen this year.

We haven't focused heavily on that.

We've have so many other important priorities to try to move into.

So it's on the list.

But it's not something that we've kind of given a tremendous amount of attention to in the near-term.

A valid point.

A valid question that we need to answer, because obviously it's a profitable business.

Accordant Rare does a great job.

It's a unique business offering in the marketplace.

The question is, what's the synergy for us around the PBM side and the specialty side of our business.

And do they -- is there ways that we can look at that to enhance our offering, and a better way, to Per's point.

But it's a valid question, and one that were working on.

Great.

Thanks so much, and best of luck.

One more please.

Your final question today comes from the line of Steve Halper with Stifel Nicolaus.

One more clarification on the streamlining cost.

The $60 million for 2010, is that part of the $200 million, or is it incremental?

It is incremental.

Incremental.

Okay.

That's all I needed to know.

Thank you.

Thank you.

And as always, if you have any questions or clarifications, Nancy is available, and so is Dave.

Thanks.

Ladies and gentlemen, this concludes today's conference.

You may now disconnect.