沃博聯公司 (WBA) 2023 Q3 法說會逐字稿

Good morning. My name is Rob, and I will be your conference operator today. At this time, I would like to welcome everyone to the Walgreens Boots Alliance Third Quarter 2023 Earnings Conference Call. (Operator Instructions)

早上好。我叫羅布，今天我將擔任你們的會議操作員。此時此刻，我歡迎大家參加沃爾格林博姿聯盟 2023 年第三季度收益電話會議。 （操作員說明）

Tiffany Kanaga, Vice President of Global Investor Relations. You may begin your conference.

蒂芙尼·卡納加 (Tiffany Kanaga)，全球投資者關係副總裁。您可以開始您的會議了。

Good morning. Thank you for joining us for the Walgreens Boots Alliance Earnings Call for the third quarter of fiscal year 2023. I'm Tiffany Kanaga, Vice President of Global Investor Relations.

早上好。感謝您參加沃爾格林博姿聯盟 2023 財年第三季度收益電話會議。我是全球投資者關係副總裁蒂芙尼·卡納加 (Tiffany Kanaga)。

Joining me on today's call are Roz Brewer, our Chief Executive Officer; James Kehoe, our Chief Financial Officer; and John Driscoll, President of U.S. Healthcare; Rick Gates, Senior Vice President and Chief Pharmacy Officer at Walgreens, will participate in Q&A.

參加今天電話會議的還有我們的首席執行官 Roz Brewer； James Kehoe，我們的首席財務官；和美國醫療保健總裁約翰·德里斯科爾（John Driscoll）；沃爾格林高級副總裁兼首席藥房官里克·蓋茨(Rick Gates)將參加問答。

All references to the COVID-19 headwind on today's call include U.S. vaccines, drive-through tests and OTC tests. As always, during the conference call, we anticipate making projections and forward-looking statements based on our current expectations. Our actual results could differ materially due to a number of factors, including those listed on Slide 2 and those outlined on our latest forms 10-K and 10-Q filed with the Securities and Exchange Commission. We undertake no obligation to publicly update any forward-looking statement after this presentation, whether as a result of new information, future events, changes in assumptions or otherwise. You can find our press release and the slides referenced on this call in the Investors section of the Walgreens Boots Alliance website. The slides and the press release also contain further information about the non-GAAP financial measures that we will discuss during this call.

今天的電話會議中所有提到的 COVID-19 逆風都包括美國疫苗、免下車測試和 OTC 測試。與往常一樣，在電話會議期間，我們預計會根據當前的預期做出預測和前瞻性陳述。由於多種因素的影響，我們的實際結果可能會存在重大差異，包括幻燈片 2 中列出的因素以及我們向美國證券交易委員會提交的最新表格 10-K 和 10-Q 中概述的因素。我們沒有義務在本次演示後公開更新任何前瞻性聲明，無論是由於新信息、未來事件、假設變化還是其他原因。您可以在沃爾格林博姿聯盟網站的投資者部分找到我們的新聞稿和本次電話會議引用的幻燈片。幻燈片和新聞稿還包含有關我們將在本次電話會議中討論的非公認會計準則財務措施的更多信息。

I will now turn the call over to Roz.

我現在將把電話轉給羅茲。

Thanks, Tiffany, and good morning, everyone. I'd like to start today's call with an acknowledgment that our performance in the third quarter did not meet our overall expectations, and we are disappointed to have to change our fiscal 2023 guidance.

謝謝蒂芙尼，大家早上好。在今天的電話會議開始時，我想承認我們第三季度的業績沒有達到我們的總體預期，並且我們對不得不改變 2023 財年指導感到失望。

While we achieved good sales growth and return to adjusted earnings growth in the quarter, several dynamics created margin pressures that we are factoring into our full year outlook. We have seen changing market trends that have consumers prioritizing value in response to a more uncertain and challenging economic environment. There has been a steeper drop off in COVID vaccines and testing with the end of the public health emergency. We are also experiencing a slower profit ramp for U.S. health care.

雖然我們在本季度實現了良好的銷售增長並恢復了調整後的盈利增長，但一些動態造成了利潤率壓力，我們將其納入全年展望中。我們看到不斷變化的市場趨勢，消費者優先考慮價值以應對更加不確定和更具挑戰性的經濟環境。隨著公共衛生緊急狀態的結束，新冠疫苗和檢測數量急劇下降。我們還經歷了美國醫療保健行業利潤增長放緩的情況。

Importantly, we remain committed to our strategy through immediate actions to accelerate our path to profitability and unlock long-term value. I remain confident in the long-term trajectory of our transformation, which is underpinned by significant progress against each of our 4 strategic priorities. We are continuing to transform and align our core business with advancements in our tech-enabled pharmacy operating model.

重要的是，我們仍然致力於我們的戰略，立即採取行動，加速我們的盈利之路並釋放長期價值。我對我們轉型的長期軌跡仍然充滿信心，我們的 4 個戰略重點中每一項都取得了重大進展，為這一軌跡奠定了基礎。我們正在繼續改造我們的核心業務，使我們的核心業務與技術驅動的藥房運營模式的進步保持一致。

Today, we are announcing a scalable partnership with TelePharm to expand telepharmacy services, improve access to care, and provide flexibility for how and when patients engage with our pharmacists. Our model is also supported by our micro fulfillment centers, covering over 40% of our Walgreens store footprint.

今天，我們宣布與 TelePharm 建立可擴展的合作夥伴關係，以擴大遠程藥房服務，改善獲得護理的機會，並為患者與我們藥劑師接觸的方式和時間提供靈活性。我們的模式還得到了我們的微型履行中心的支持，覆蓋了我們超過 40% 的沃爾格林商店足跡。

In U.S. retail, our flat year-to-date comp sales have successfully lapped last year's record 8.8% growth, and retail gross margin is up over 100 basis points, yet again. We have also made significant progress on building our next growth engine in health care, rapidly establishing our portfolio of assets across the care continuum. VillageMD acquired Summit to create a leading independent care delivery platform, and we accelerated the full acquisition of Shield and CareCentrix. This segment has gone from 0 sales contribution just 2 years ago to a run rate of $8 billion in the third quarter of 2023. To fund our transformation and focus the portfolio, we have realized $4.1 billion in proceeds from the sale of ABC shares this fiscal year and also exited our Option Care Health position for $800 million in proceeds. Finally, we have continued to invest in strategic talent and capabilities, most recently strengthening VillageMD's bench to welcome CFO, Rich Rubino.

在美國零售業，我們年初至今持平的同業銷售成功超越了去年創紀錄的 8.8% 增長，零售毛利率再次增長超過 100 個基點。我們在打造醫療保健領域的下一個增長引擎方面也取得了重大進展，迅速建立了我們在整個醫療保健領域的資產組合。 VillageMD 收購了 Summit，以創建領先的獨立護理服務平台，我們加速了對 Shield 和 CareCentrix 的全面收購。該細分市場的銷售貢獻從兩年前的 0 增長到 2023 年第三季度的 80 億美元。為了為我們的轉型提供資金並集中投資組合，我們在本財年通過出售 ABC 股票獲得了 41 億美元的收益今年，我們還退出了 Option Care Health 頭寸，獲得了 8 億美元的收益。最後，我們繼續投資於戰略人才和能力，最近加強了 VillageMD 的替補陣容，迎來了首席財務官 Rich Rubino。

Turning to the third quarter. WBA returned to adjusted EPS growth up nearly 4%. Third quarter sales were solid, growing almost 9% in constant currency. U.S. comp sales were up 7%. Let me call out U.S. retail digital sales up 19% on top of a 25% gain last year with 3.7 million same-day pickup orders. International was also notable, up 6.9% in the quarter. It is clear that consumers continue to appreciate the value, convenience and range of services delivered by Walgreens and Boots.

轉向第三季度。 WBA 恢復調整後每股收益增長近 4%。第三季度銷售額穩健，按固定匯率計算增長近 9%。美國公司銷售額增長 7%。我要指出的是，美國零售數字銷售額在去年增長 25% 的基礎上增長了 19%，當天收到的訂單達到 370 萬份。國際業務也引人注目，本季度上漲 6.9%。顯然，消費者繼續欣賞沃爾格林和博姿提供的價值、便利性和服務範圍。

Our increased expense discipline in the quarter only partly offset outsized margin pressure and earnings growth was held back by 3 external factors. First, we saw lower-than-expected COVID-related demand. We had called out COVID as a wildcard heading into the quarter and have unfortunately seen less patient willingness to vaccinate. Walgreens administered 800,000 COVID-19 vaccines in the quarter, down 83% year-on-year, and testing volumes are also down sharply.

本季度我們加強的支出紀律僅部分抵消了巨大的利潤壓力，而盈利增長則受到 3 個外部因素的阻礙。首先，我們看到與新冠病毒相關的需求低於預期。我們曾將新冠病毒視為進入本季度的通配符，但不幸的是，患者接種疫苗的意願較低。沃爾格林本季度接種了 80 萬劑 COVID-19 疫苗，同比下降 83%，檢測量也大幅下降。

We are, in turn, taking a prudent step of further reducing our expectations for COVID contributions going forward. We are currently projecting to administer 9 million to 10 million COVID vaccines next year in line with the typical flu season and compared to 12.5 million COVID vaccines expected in fiscal 2023. Second, and similar to other retailers, we've been impacted by the rapid softening of the macro environment and a more cautious and value-driven consumer. Our customer is feeling the strain of higher inflation and interest rates, lower SNAP benefits and tax refunds and an uncertain economic outlook. They are pulling back on discretionary and seasonal spend and responding strongly to promotional activity. For example, promotional unit growth is running up 10% in the retail channel, including a sharp increase over just a 5-week period while nonpromotional units fell 8%.

反過來，我們正在採取謹慎的步驟，進一步降低我們對未來新冠疫情貢獻的預期。目前，我們預計明年將根據典型的流感季節接種 900 萬至 1000 萬劑新冠疫苗，而 2023 財年預計將接種 1250 萬劑新冠疫苗。其次，與其他零售商類似，我們也受到了快速增長的影響。宏觀環境的疲軟以及消費者更加謹慎和價值驅動。我們的客戶正感受到通脹和利率上升、SNAP 福利和退稅下降以及經濟前景不確定的壓力。他們正在削減可自由支配的季節性支出，並對促銷活動做出強烈反應。例如，零售渠道的促銷單位增長了 10%，其中僅 5 週內就大幅增長，而非促銷單位則下降了 8%。

Let me add that we see the retail pricing environment as remaining rational. We have also seen some pressure on industry script volume, excluding COVID, which may be related to these broader consumer headwinds. Day fall adjusted market growth, excluding immunizations, has slowed almost 2 percentage points from February to May. Our core retail pharmacy business is resilient and relatively well positioned in times of volatile consumer confidence. However, we're not immune to these external pressures and have trimmed our expectations accordingly, while at the same time, ramping up our efforts around cost savings.

讓我補充一點，我們認為零售定價環境仍然理性。我們還看到了行業腳本量的一些壓力（不包括新冠疫情），這可能與這些更廣泛的消費者逆風有關。經秋季調整後的市場增長（不包括免疫接種）較 2 月至 5 月放緩了近 2 個百分點。我們的核心零售藥房業務具有彈性，並且在消費者信心波動的時期處於相對有利的地位。然而，我們也不能倖免於這些外部壓力，並相應地調整了我們的預期，同時加大了節約成本的力度。

Third, we've experienced a drag from a recent weaker respiratory season. We are feeling the effects through our script volume through our front of store sales, especially in the higher-margin cough cold flu category and in CityMD's traffic trends. These trends are likely to persist into the fourth quarter against last year's category strength.

第三，我們經歷了最近較弱的呼吸道季節的拖累。我們通過商店銷售前台的腳本量感受到了影響，特別是在利潤較高的咳嗽感冒流感類別和 CityMD 的流量趨勢中。相對於去年的類別優勢，這些趨勢可能會持續到第四季度。

Importantly, we achieved strong quality of earnings considering a 4.7% adverse net impact to adjusted EPS from COVID, the sell of ABC shares, sell and leaseback, incentive accruals and tax. This strength gives us line of sight to accelerating adjusted operating income growth in the fourth quarter.

重要的是，考慮到新冠疫情、ABC 股票出售、售後回租、應計獎勵和稅收對調整後每股收益產生 4.7% 的不利淨影響，我們實現了強勁的盈利質量。這種優勢使我們能夠加快第四季度調整後營業收入的增長。

Let me turn to our updated guidance. We now expect fiscal 2023 adjusted EPS at to $4 to $4.05, reflecting consumer and category trends, lower COVID-19 contribution and a more cautious macroeconomic forward view. This guidance represents core earnings to be flat to up 1%, excluding COVID and currency.

讓我談談我們的最新指南。我們現在預計 2023 財年調整後每股收益為 4 美元至 4.05 美元，反映了消費者和類別趨勢、較低的 COVID-19 貢獻以及更加謹慎的宏觀經濟前景。該指引表明，不包括新冠肺炎和貨幣因素的核心盈利將持平至增長 1%。

We are also providing preliminary fiscal 2024 commentary. Let me be clear, there are some factors impacting us today that are likely to extend into next year, namely the macroeconomic-driven consumer pressure and COVID headwinds. We are closely watching emerging challenges to consumer spending and sentiment such as the end of fiscal stimulus and the resumption of student loan payments.

我們還提供 2024 財年的初步評論。讓我明確一點，今天影響我們的一些因素可能會延續到明年，即宏觀經濟驅動的消費者壓力和新冠疫情的逆風。我們正在密切關註消費者支出和情緒面臨的新挑戰，例如財政刺激措施的結束和學生貸款支付的恢復。

There are other factors that are more specific to our business today and should not be annualized into fiscal 2024, such as the weaker respiratory season. Most importantly, we have undertaken several aggressive initiatives to enhance profitability and cash flow into next year, especially in our health care business. We expect low to mid-single-digit adjusted operating growth in fiscal 2024 with the U.S. retail pharmacy and U.S. health care businesses more than offsetting headwinds from COVID sell and leaseback and ABC.

還有其他因素對於我們今天的業務來說更為具體，不應將其年化至 2024 財年，例如呼吸季節較弱。最重要的是，我們採取了多項積極舉措，以提高明年的盈利能力和現金流，特別是在我們的醫療保健業務方面。我們預計 2024 財年調整後的運營增長將達到低至中個位數，美國零售藥店和美國醫療保健業務將足以抵消新冠肺炎售後回租和 ABC 帶來的不利影響。

AOI growth should outpace adjusted EPS due to offsets from higher tax and noncontrolling interest. We will provide a more detailed discussion of 2024 guidance when we report fourth quarter and full year 2023 results. The positive operating growth trends with improving quality of earnings support our continued confidence in building to sustainable, long-term, low teens adjusted EPS growth over time.

由於較高的稅收和非控股權益的抵消，AOI 的增長應該超過調整後的每股收益。當我們報告 2023 年第四季度和全年業績時，我們將更詳細地討論 2024 年指導。積極的運營增長趨勢和盈利質量的提高支持了我們對隨著時間的推移建立可持續、長期、低青少年調整後每股收益增長的持續信心。

To drive shareholder value, we are taking the following immediate actions to enhance profitability and accelerate our journey. First, we are raising our transformational cost management program savings goal to $4.1 billion. This includes $800 million of savings in fiscal 2024. Second, we have implemented capital and project spend reductions, and we've launched a working capital optimization program. Third, we are pursuing portfolio simplification at an even faster pace. Fourth, we are announcing several specific actions to accelerate U.S. health care's path to profitability, focused on VillageMD and Summit Health. We are also accelerating the synergies between our U.S. Healthcare segment and our core Walgreens business.

為了提高股東價值，我們正在立即採取以下行動來提高盈利能力並加速我們的進程。首先，我們將轉型成本管理計劃的節省目標提高到 41 億美元。這包括 2024 財年節省 8 億美元。其次，我們實施了資本和項目支出削減，並啟動了營運資本優化計劃。第三，我們正在以更快的速度追求投資組合簡化。第四，我們宣布了幾項具體行動，以加速美國醫療保健的盈利之路，重點是 VillageMD 和 Summit Health。我們還正在加速美國醫療保健部門與沃爾格林核心業務之間的協同效應。

We have a unique opportunity to improve local health care and well-being in this country. The fly role of health care and retail pharmacy working together will deliver more affordable, accessible quality health care to our communities and will also deliver sustainable shareholder value. It starts with our trusted brand and pharmacists, national footprint and digital offerings. 58% of Americans are likely to visit their local pharmacy as a first step when faced with a nonemergency medical issue.

我們有一個獨特的機會來改善這個國家的當地醫療保健和福祉。醫療保健和零售藥房的共同作用將為我們的社區提供更實惠、更容易獲得的優質醫療保健服務，並將帶來可持續的股東價值。它始於我們值得信賴的品牌和藥劑師、全國足跡和數字產品。 58% 的美國人在遇到非緊急醫療問題時可能會首先前往當地藥房。

Add to that, our leading assets across the care continuum, VillageMD, Summit, Shield and CareCentrix and our early work with health corners and clinical trials. We've created a platform at scale that is absolutely proving to help health plans and patients improve outcomes and lower cost. Our teams are expanding partnerships and driving greater market access, which is the next step to getting our will to turn. As health care and retail pharmacy jointly serve consumers, we will deepen engagement and reinforce our trusted brand.

除此之外，我們在護理連續體、VillageMD、Summit、Shield 和 CareCentrix 方面的領先資產，以及我們在健康角落和臨床試驗方面的早期工作。我們創建了一個大規模平台，事實證明，它絕對可以幫助健康計劃和患者改善結果並降低成本。我們的團隊正在擴大合作夥伴關係並推動更大的市場准入，這是扭轉我們意志的下一步。隨著醫療保健和零售藥房共同為消費者服務，我們將加深參與並強化我們值得信賴的品牌。

Let's look at a few tangible examples of how we're driving that value through our integrated portfolio. In partnering with VillageMD, our team-based health care delivery enhances adherence. We are building digital connections and stand-alone clinics. More than 30 in Arizona and Texas are now supported by Walgreens pharmacies virtually with more coming online in Georgia this summer. To make the virtual experience seamless, we're piloting a health care concierge program to provide extra care coordination. We are also exploring an integrated pharmacist ambulatory care model. The pilot has driven over 40% reduction in hospital readmissions over 30 days and a material A1c reduction in diabetic patients.

讓我們看一些具體的例子，說明我們如何通過我們的綜合產品組合來推動這一價值。通過與 VillageMD 合作，我們基於團隊的醫療保健服務提高了依從性。我們正在建立數字連接和獨立診所。亞利桑那州和德克薩斯州的 30 多家藥店現已獲得沃爾格林藥店的虛擬支持，今年夏天，佐治亞州將有更多藥店上線。為了使虛擬體驗變得無縫，我們正在試行醫療保健禮賓計劃，以提供額外的護理協調。我們還在探索綜合藥劑師門診護理模式。該試點項目在 30 天內使再入院率減少了 40% 以上，糖尿病患者的糖化血紅蛋白也大幅降低。

Remember also that roughly 50% of patients had co-located VillageMD clinics opt to get their prescription field at Walgreens. VillageMD co-located sites that have been open for over 2 years continue to drive approximately 40 incremental scripts per site per day. CareCentrix and a leading national health care services provider are partnering to offer a turnkey durable medical equipment benefit management solution and point-of-care platform for health plans. This should drive medical and administrative savings while improving the overall member experience.

還請記住，大約 50% 的 VillageMD 診所位於同一地點的患者選擇在沃爾格林 (Walgreens) 獲取處方。 VillageMD 共址站點已開放 2 年多，每天每個站點繼續驅動約 40 個增量腳本。 CareCentrix 與一家領先的國家醫療保健服務提供商合作，提供交鑰匙耐用醫療設備福利管理解決方案和健康計劃護理點平台。這應該會節省醫療和行政費用，同時改善整體會員體驗。

Shield and Walgreens are working together to establish Walgreens as a single contract pharmacy for health systems. Walgreens is also converting existing specialty pharmacy locations to Shield's partners to increase access to specialty drugs and services.

Shield 和 Walgreens 正在共同努力將 Walgreens 打造為衛生系統的單一合同藥房。沃爾格林還將現有的專業藥房轉變為 Shield 的合作夥伴，以增加獲得專業藥物和服務的機會。

Finally, at Walgreens Health, we are exploring new health care service lines such as additional diagnostic services and data analytics and insights. We've already seen strong results with our at-home testing programs, such as the one we conducted last fall with Blue Shield of California to boost patient access to colorectal cancer screening. Members due for screening had the opportunity to visit Walgreens pharmacy locations across the state to pick up an at-home kit. The test completion rate was 50 percentage points higher when members chose pharmacy pickup compared to those that received the kit in the mail. Based on these successful results, we are launching similar at-home testing programs with other payer partners.

最後，在沃爾格林健康公司，我們正在探索新的醫療保健服務線，例如額外的診斷服務以及數據分析和見解。我們的家庭檢測項目已經取得了顯著成果，例如我們去年秋天與加利福尼亞州 Blue Shield 合作開展的一項旨在提高患者接受結直腸癌篩查的機會。需要進行篩查的會員有機會前往全州的沃爾格林藥房領取家用工具包。與通過郵寄方式收到試劑盒的會員相比，選擇藥房自取的會員的測試完成率高出 50 個百分點。基於這些成功的結果，我們正在與其他付款合作夥伴啟動類似的家庭測試計劃。

In summary, our health care and retail pharmacy businesses are working together to improve outcomes and lower costs as only Walgreens can do. I am not satisfied by today's headline guidance revisions. However, I see the enterprise approach coming together to deliver sustainable value to consumers, to our partners, and to shareholders. We have the right strategy. We are driving good progress across each of our strategic priorities, and we are taking appropriate measures to account for the recent macroeconomic challenges and uncertainty. Through the necessary actions discussed today, we are pushing harder toward profitability with a strong sense of urgency while continuing to reimagine local health care and wellness for all.

總之，我們的醫療保健和零售藥房業務正在共同努力改善結果並降低成本，只有沃爾格林才能做到。我對今天的標題指引修訂並不滿意。然而，我看到企業方法齊心協力，為消費者、我們的合作夥伴和股東提供可持續的價值。我們有正確的策略。我們正在推動每項戰略重點取得良好進展，並採取適當措施應對近期的宏觀經濟挑戰和不確定性。通過今天討論的必要行動，我們將以強烈的緊迫感更加努力地實現盈利，同時繼續重新構想當地的醫療保健和全民健康。

With that, I'll hand it over to James to provide more color on our results and our outlook.

有了這個，我將把它交給詹姆斯，為我們的結果和前景提供更多的色彩。

Thank you, Roz, and good morning. In summary, while we returned to adjusted EPS growth in the third quarter, earnings were below our expectations as we encountered lower COVID contributions, shifting consumer behaviors and a recent slowdown in respiratory incidences. Overall, we delivered 8.9% sales growth on a constant currency basis ahead of our plan, led by our U.S. pharmacy business, up 10%; our Boots U.K. retail business, which delivered a solid 13% comp and our scaling Health Care business, which added $1.4 billion in sales versus the prior year.

謝謝你，羅茲，早上好。總而言之，雖然我們在第三季度恢復了調整後每股收益的增長，但由於新冠疫情貢獻減少、消費者行為轉變以及近期呼吸道疾病發病率放緩，盈利低於我們的預期。總體而言，按固定匯率計算，我們的銷售額提前實現了 8.9% 的增長，其中美國製藥業務增長了 10%；我們的 Boots 英國零售業務實現了 13% 的穩定增長，我們的醫療保健業務規模不斷擴大，銷售額比上年增加了 14 億美元。

Adjusted EPS increased 3.6% on a constant currency basis despite a 19 percentage point headwind due to a lower COVID-19 contribution and 8 percentage points from reduced ownership of AmerisourceBergen. These were partly offset by favorabilities from sale and leaseback, incentive accruals and tax. All of these items net out to be a 4.7 percentage point headwind to EPS growth and this demonstrates overall good quality of earnings in the quarter.

調整後每股收益按固定匯率計算增長了 3.6%，儘管由於 COVID-19 貢獻減少而帶來了 19 個百分點的阻力，並且因 AmerisourceBergen 所有權減少而帶來了 8 個百分點的阻力。這些收益部分被售後回租、應計獎勵和稅收優惠所抵消。所有這些項目最終都會對每股收益增長產生 4.7 個百分點的阻力，這表明本季度盈利的整體質量良好。

As Roz discussed, we are lowering our fiscal '23 adjusted EPS guidance to $4 to $4.05. This updated outlook reflects consumer and category trends, a lower contribution from COVID and an overall more cautious forward view given the continued macroeconomic uncertainty. Later, I will provide more color around the key assumptions underpinning our revised guidance.

正如 Roz 所討論的，我們將 23 財年調整後每股收益指引下調至 4 至 4.05 美元。這一更新的展望反映了消費者和品類趨勢、新冠疫情的貢獻較低以及鑑於宏觀經濟持續不確定性，總體上更加謹慎的前瞻性觀點。稍後，我將圍繞支持我們修訂後的指導的關鍵假設提供更多信息。

But first, let's look at the third quarter results in more detail. Adjusted operating income increased 0.6% on a constant currency basis. This included a 22 percentage point headwind from COVID-19 and a 7% drag from reduced AmerisourceBergen ownership, partly offset by sale and leaseback gains and incentive accruals. All of these items net out to an approximately 6% headwind to AOI growth.

但首先，讓我們更詳細地看一下第三季度的業績。按固定匯率計算，調整後營業收入增長 0.6%。其中包括 COVID-19 帶來的 22 個百分點的阻力，以及 AmerisourceBergen 所有權減少帶來的 7% 的拖累，但部分被售後回租收益和應計獎勵所抵消。所有這些項目最終都會對 AOI 增長產生大約 6% 的阻力。

GAAP net earnings of $118 million declined $171 million compared to prior year. The current quarter included a $323 million after-tax impairment charge related to pharmacy licenses in the U.K. Adjusted net earnings increased 3.4% on a constant currency basis to $860 million.

GAAP 淨利潤為 1.18 億美元，比上年減少 1.71 億美元。本季度包括與英國藥房許可證相關的 3.23 億美元稅後減值費用。按固定匯率計算，調整後淨利潤增長 3.4%，達到 8.6 億美元。

Now let's move to the year-to-date highlights. Year-to-date sales increased 4.8% on a constant currency basis. Adjusted EPS was down 20.7%, reflecting a lower COVID 19 contribution of 20 percentage points and reduced the AmerisourceBergen ownership of 3 percentage points. GAAP earnings were a loss of $2.9 billion compared to net earnings of $4.8 billion in 2022. With the current year including a $5.5 billion after-tax charge for opioid-related claims and lawsuits.

現在讓我們來看看今年迄今為止的亮點。按固定匯率計算，年初至今銷售額增長了 4.8%。調整後每股收益下降 20.7%，反映出 COVID 19 的貢獻降低了 20 個百分點，並使 AmerisourceBergen 的所有權減少了 3 個百分點。與 2022 年淨利潤 48 億美元相比，公認會計準則收益虧損 29 億美元。本年度包括阿片類藥物相關索賠和訴訟的 55 億美元稅後費用。

Now let's move to the U.S. Retail Pharmacy segment. Sales increased 4.4% in the quarter with comp sales up 7%. Adjusted gross profit declined 3.2% year-on-year, reflecting a 5 percentage point negative impact from COVID-19. A 5% reduction in SG&A expense more than offset the gross profit decline and led to AOI growth of 8.4% before the inclusion of AmerisourceBergen equity income. The sell-down of our ABC stake led to a slight AOI decline of 0.4%.

現在讓我們轉向美國零售藥房領域。本季度銷售額增長 4.4%，其中同類產品銷售額增長 7%。調整後毛利潤同比下降 3.2%，反映出 COVID-19 帶來的 5 個百分點的負面影響。 SG&A 費用減少 5%，足以抵消毛利潤的下降，並導致 AOI 在計入 AmerisourceBergen 股權收入之前增長 8.4%。 ABC 股份的拋售導致 AOI 略有下降 0.4%。

Let me now turn to U.S. pharmacy. Pharmacy sales increased 6.3% and advanced 9.8% on a comparable basis, driven by both script growth and brand inflation. Excluding immunizations, comp scripts grew 2.8%, a slight deceleration from the prior quarter and reflecting broader prescription market trends. As expected, adjusted gross profit declined year-on-year, although excluding COVID, gross profit increased as script growth and lower cost of goods sold more than offset reimbursement pressure.

現在讓我談談美國藥房。在處方增長和品牌膨脹的推動下，藥品銷售額增長 6.3%，同比增長 9.8%。不包括免疫接種在內，處方藥增長了 2.8%，較上一季度略有放緩，反映了更廣泛的處方市場趨勢。正如預期的那樣，調整後的毛利潤同比下降，儘管不包括新冠疫情，毛利潤有所增加，因為劇本的增長和銷售成本的降低足以抵消報銷壓力。

Turning next to our U.S. retail business. Following several quarters of very good performance, the retail business encountered some headwinds in the third quarter as the consumer navigated through a difficult macroeconomic backdrop. Excluding tobacco, comp sales grew 0.2%, held back by 90 basis points due to holiday seasonal weakness as consumers pulled back on discretionary spending and 80 basis points due to lower sales of COVID-19 OTC test kits. We saw solid growth in grocery and household, up 4.7% and Beauty up 3.7%. Cough, cold flu sales were flat, but slowed significantly in May due to a decline in respiratory incidences. IQVIA FAN data shows flu, cold and respiratory activity, down 8% in the third quarter versus a 15% increase in the second quarter, with May down in the mid-20% range.

接下來談談我們的美國零售業務。在經歷了幾個季度的良好表現之後，零售業務在第三季度遇到了一些阻力，因為消費者在困難的宏觀經濟背景下度過了難關。不包括煙草在內，公司銷售額增長了 0.2%，由於消費者減少可自由支配支出而導致假期季節性疲軟，同比增長了 90 個基點；由於 COVID-19 OTC 測試套件銷量下降，銷售額增長了 80 個基點。我們看到食品雜貨和家庭用品增長了 4.7%，美容品增長了 3.7%。咳嗽、感冒流感銷售持平，但由於呼吸道疾病發病率下降，5 月份銷售明顯放緩。 IQVIA FAN 數據顯示，流感、感冒和呼吸道活動在第三季度下降了 8%，而第二季度則增長了 15%，其中 5 月份下降幅度在 20% 左右。

Following several consecutive quarters of year-on-year margin expansion, retail gross margin came under modest pressure in the third quarter. We've seen similar trends as the broader market with our promotional units up around 7% in the most recent 13-week period. However, on a year-to-date basis, gross margin has increased by more than 100 basis points, driven by effective margin management.

繼連續幾個季度利潤率同比擴張後，零售毛利率在第三季度面臨適度壓力。我們看到了與大盤類似的趨勢，我們的促銷單位在最近 13 週內上漲了約 7%。然而，在有效的利潤管理的推動下，年初至今，毛利率增長了100多個基點。

Turning next to the International segment. And as always, I'll talk to constant currency numbers. The International segment continues to perform very well. Sales increased 7% with good growth across all international markets, Boots U.K. was up 10% and Germany wholesale grew 4%. Adjusted operating income of $208 million increased 21% despite a $40 million year-on-year headwind from sale and leaseback transactions.

接下來轉向國際部分。和往常一樣，我將討論恆定的貨幣數字。國際業務繼續表現出色。所有國際市場的銷售額均實現良好增長，銷售額增長 7%，Boots 英國增長 10%，德國批發增長 4%。儘管售後回租交易帶來了 4,000 萬美元的同比阻力，但調整後營業收入仍達到 2.08 億美元，增長了 21%。

Let's now look in more detail at Boots U.K. Boots U.K. sales advanced 10%, pharmacy comp sales increased 6%, and comp retail sales grew 13%, and this comes on top of a 24% comp in the same quarter last year. Boots grew market share for the ninth consecutive quarter with gains across all categories. We successfully launched Future Renew, a range of innovative new skin care with very positive consumer response. This product line was recently launched in Walgreens. Boots.com sales grew 25% year-on-year and have more than doubled versus the equivalent pre COVID quarter. Over 14% of our U.K. retail sales now comes from boots.com.

現在讓我們更詳細地了解 Boots U.K. Boots U.K. 銷售額增長了 10%，藥品銷售額增長了 6%，零售銷售額增長了 13%，而去年同期銷售額增長了 24%。 Boots 的市場份額連續第九個季度增長，所有品類均有所增長。我們成功推出了Future Renew，這是一系列創新的新型護膚品，受到了消費者非常積極的反響。該產品線最近在沃爾格林推出。 Boots.com 銷售額同比增長 25%，與新冠疫情爆發前的同期相比增長了一倍多。目前，我們英國零售額的 14% 以上來自 boots.com。

Turning next to U.S. health care. The U.S. health care business continues to rapidly scale with sales reaching $2 billion, more than doubling from the prior year. Pro forma sales growth was 22%. VillageMD sales were $1.5 billion, up 22% on a pro forma basis. Legacy VillageMD growth was driven by expansion of the clinic footprint with an additional 93 clinics opened in the past year and the ongoing maturation of existing clinics. Summit Health was, however, impacted by a weaker respiratory season that led to fewer CityMD visits and fewer referrals across the Summit Health network.

接下來轉向美國的醫療保健。美國醫療保健業務繼續快速擴張，銷售額達到 20 億美元，比上年增長了一倍多。預計銷售額增長 22%。 VillageMD 銷售額為 15 億美元，預計增長 22%。 Legacy VillageMD 的增長是由於診所規模的擴大（去年新增了 93 家診所）以及現有診所的不斷成熟而推動的。然而，Summit Health 受到呼吸季節較弱的影響，導致 CityMD 就診次數減少，以及 Summit Health 網絡的轉診次數減少。

Shields delivered another strong quarter, up 35% and driven by contract wins, including the addition of 6 new health system partners and further expansion of existing partnerships. CareCentrix sales were approximately $360 million with pro forma sales growth of 15%. Adjusted EBITDA reflects weaker-than-expected results at VillageMD and Summit Health, partly offset by continued growth at Shields. CityMD has been impacted by lower visit volume, whereas the VillageMD EBITDA loss reflects new clinic expansions. We anticipate improvement in the fourth quarter as we build patient panels and traffic and align the cost profile with sales.

Shields 在贏得合同（包括增加 6 個新的醫療系統合作夥伴以及進一步擴大現有合作夥伴關係）的推動下，再次實現了強勁的季度業績，增長了 35%。 CareCentrix 銷售額約為 3.6 億美元，預計銷售額增長 15%。調整後的 EBITDA 反映出 VillageMD 和 Summit Health 的業績低於預期，但部分被 Shields 的持續增長所抵消。 CityMD 受到就診量減少的影響，而 VillageMD EBITDA 損失則反映了新診所的擴張。我們預計第四季度會有所改善，因為我們建立了患者樣本組和流量，並使成本狀況與銷售額保持一致。

Let's now look at some of the key metrics for the U.S. health care business. VillageMD managed 850,000 value-based lives at quarter end, reflecting year-over-year growth of approximately 27% in the Legacy VillageMD business and the addition of 309,000 value-based lives from Summit. Total value-based lives include 179,000 full risk lives. Our clinical trials business continues to expand with 8 contracts signed and a robust pipeline.

現在讓我們看一下美國醫療保健行業的一些關鍵指標。截至季度末，VillageMD 管理了 850,000 個基於價值的生活，反映了 Legacy VillageMD 業務同比增長約 27%，以及 Summit 增加了 309,000 個基於價值的生活。基於價值的生命總數包括 179,000 個完全風險生命。我們的臨床試驗業務持續擴張，已簽署 8 份合同並擁有強大的產品線。

Turning next to cash flow. We generated $1.2 billion of operating cash flow with free cash flow of $116 million. The year-over-year decline reflected lower earnings due to COVID-19, a lower contribution from working capital and increased capital expenditures related to growth initiatives. Looking ahead, we are reprioritizing capital projects to reduce planned spend and are rolling out a comprehensive set of working capital optimization initiatives to enhance our cash generation.

接下來轉向現金流。我們產生了 12 億美元的運營現金流，其中自由現金流為 1.16 億美元。同比下降反映了新冠肺炎 (COVID-19) 導致的收入下降、營運資本貢獻減少以及與增長計劃相關的資本支出增加。展望未來，我們正在重新調整資本項目的優先順序，以減少計劃支出，並推出一套全面的營運資本優化舉措，以增強我們的現金生成能力。

Turning now to guidance. We are updating our full year '23 adjusted EPS guidance to $4 to $4.05, a constant currency decline of around 20%. Excluding the impact of COVID-19 and ForEx, core adjusted EPS is flat to up 1%. The EPS contribution from COVID-19 is $0.23 lower than our original assumptions at the start of the year. At the beginning of the fiscal year, we expected 16 million vaccinations. And despite the spring booster recommendation, we have reduced our full year expectations to 12.5 million vaccinations. COVID testing has decelerated at an even faster pace. Additionally, we have incorporated the impacts of a more cautious consumer outlook leading to a $0.20 to $0.25 impact as we realign our fourth quarter sales and margin goals to reflect recent trends. Finally, while reducing our ownership stake in AmerisourceBergen has improved our debt position, it has, however, led to a $0.05 headwind.

現在轉向指導。我們將 23 年全年調整後每股收益指導值更新為 4 至 4.05 美元，匯率持續下跌約 20%。排除 COVID-19 和外彙的影響，核心調整後每股收益持平至增長 1%。 COVID-19 對每股收益的貢獻比我們年初的最初假設低 0.23 美元。在本財年之初，我們預計將有 1600 萬例疫苗接種。儘管提出了春季加強接種建議，我們仍將全年疫苗接種預期降低至 1,250 萬例。新冠病毒檢測速度放緩得更快。此外，在我們重新調整第四季度的銷售和利潤目標以反映最新趨勢時，我們還考慮了消費者前景更加謹慎的影響，從而導致 0.20 至 0.25 美元的影響。最後，雖然減少我們在 AmerisourceBergen 的股權改善了我們的債務狀況，但也導致了 0.05 美元的逆風。

Let me now walk you through our assumptions for each of our business segments. Starting with U.S. retail pharmacy. We now project sales of around $110 billion, up low single digits year-on-year. AOI is projected at $3.8 billion to $3.9 billion, a decline of 22% to 24%, reflecting a 23 percentage point headwind from COVID-19 and 3 percentage points from our reduced ownership stake in AmerisourceBergen. Excluding these 2 impacts, AOI growth is up 2% to 4%.

現在讓我向您介紹我們對每個業務部門的假設。從美國零售藥店開始。我們目前預計銷售額約為 1,100 億美元，同比低位個位數增長。 AOI 預計為 38 億美元至 39 億美元，下降 22% 至 24%，反映出 COVID-19 帶來的 23 個百分點的阻力，以及我們減少的 AmerisourceBergen 股權帶來的 3 個百分點的阻力。排除這 2 個影響，AOI 增長了 2% 到 4%。

Turning next to the International segment, which is performing well this year. Sales are projected to grow 6% to 8% on a constant currency basis, reflecting strong execution, especially in the U.K. Adjusted operating income of around $900 million represents constant currency growth of approximately 30%. This performance is towards the top end of our original expectations. Our revised outlook for U.S. health care reflects lower visits at CityMD, the continued ramp-up of new VillageMD sites and the slower integration of prior acquisitions into Summit's multi-specialty business.

接下來是國際業務，今年表現良好。按固定匯率計算，銷售額預計將增長 6% 至 8%，這反映出強大的執行力，尤其是在英國。調整後營業收入約為 9 億美元，相當於按固定匯率計算約 30% 的增長。這個表現已經接近我們最初預期的上限了。我們修訂後的美國醫療保健前景反映出 CityMD 的就診人數減少、VillageMD 新站點的持續增加以及之前收購的公司與 Summit 多專業業務的整合速度放緩。

We expect sales of $6.3 billion to $6.8 billion, an increase of $4.8 billion versus prior year and growing approximately 25% on a pro forma basis. We are projecting an adjusted EBITDA loss of $340 million to $380 million, including the factors I mentioned earlier. While the profit performance so far this year has been below plan, rapid correction actions are underway and we expect to drive sequential adjusted EBITDA improvement in the fourth quarter and beyond.

我們預計銷售額為 63 億至 68 億美元，比上年增加 48 億美元，預計增長約 25%。我們預計調整後 EBITDA 損失為 3.4 億至 3.8 億美元，其中包括我之前提到的因素。雖然今年迄今為止的利潤表現低於計劃，但快速修正行動正在進行中，我們預計將推動第四季度及以後調整後的 EBITDA 環比改善。

Turning now to our corporate assumptions. Our full year tax rate is now expected to be around 12%, and this basically reflects the favorability we have seen so far in fiscal '23, with some of the benefits reversing in the fourth quarter. More specifically, we expect the fourth quarter tax rate of around 23%. Full year guidance of $4 to $4.05 implies fourth quarter EPS of approximately $0.70 to $0.75. The result is weighed down by a much higher average tax rate, and the fourth quarter typically is the lowest quarter of the year.

現在轉向我們的公司假設。目前，我們的全年稅率預計為 12% 左右，這基本上反映了我們在 23 財年迄今為止所看到的有利情況，其中一些好處將在第四季度逆轉。更具體地說，我們預計第四季度稅率為23%左右。全年指引為 4 美元至 4.05 美元，意味著第四季度每股收益約為 0.70 美元至 0.75 美元。結果受到平均稅率高得多的影響，第四季度通常是一年中最低的季度。

As such, it would be incorrect to extrapolate the quarter as a proxy for 2024. First, normalizing for the tax rate would result in an additional $0.08 in the quarter. Second, seasonality impacts all of our businesses. Looking back over the past 5 years and excluding the impact from COVID-19 and ABC, approximately 20% of our adjusted operating income comes in the fourth quarter.

因此，將該季度作為 2024 年的代理進行推斷是不正確的。首先，稅率正常化將導致該季度額外增加 0.08 美元。其次，季節性影響我們所有的業務。回顧過去 5 年，排除 COVID-19 和 ABC 的影響，我們調整後營業收入的約 20% 來自第四季度。

To conclude, adjusting the fourth quarter for tax rate and accounting for seasonality would result in annual adjusted EPS of around $4 per share.

總而言之，調整第四季度的稅率和季節性因素將導致年度調整後每股收益約為 4 美元。

Next, I would like to cover the key factors that will influence 2024 performance. Overall, we expect the long-term tailwinds to outweigh the near-term pressures. Some of the challenges we faced in fiscal '23 are expected to continue into '24. We do expect to see some continued weakness in consumer spending, together with moderate increases in labor costs. While reimbursement pressure has eased somewhat over the past 18 months, it is not going away, and we will continue to identify ways to offset the pressure.

接下來我想談談影響2024年業績的關鍵因素。總體而言，我們預計長期有利因素將超過近期壓力。我們在 23 財年面臨的一些挑戰預計將持續到 24 財年。我們確實預計消費者支出將持續疲軟，同時勞動力成本將適度上漲。雖然報銷壓力在過去 18 個月中有所緩解，但它不會消失，我們將繼續尋找抵消壓力的方法。

In addition, we expect lower sale and leaseback activity in fiscal '24, and the tax rate will be higher as we lap a very favorable fiscal '23 performance and higher statutory tax rates are introduced in both the U.K. and Switzerland. However, we have multiple profit drivers and initiatives that will drive sustainable profit growth. Our U.S. health care business will be a significant profit driver, including the first full year of Summit Health, a maturing VillageMD clinic profile and strong actions to accelerate their path to profitability. We expect continued script volume growth and strong contribution from front-of-store initiatives. These include own brand penetration gains and the further expansion of our successful category performance improvement program. Lastly, the transformational cost management program will deliver at least $800 million of savings next year.

此外，我們預計 24 財年的售後回租活動將會減少，而且稅率將會更高，因為我們在 23 財年的業績非常有利，而且英國和瑞士都引入了更高的法定稅率。然而，我們有多種利潤驅動因素和舉措可以推動可持續利潤增長。我們的美國醫療保健業務將成為重要的利潤驅動因素，包括 Summit Health 的第一個全年、日漸成熟的 VillageMD 診所概況以及加速其盈利之路的強有力行動。我們預計腳本量將持續增長，並且店面計劃將做出強勁貢獻。其中包括自有品牌滲透率的提高以及我們成功的品類績效改進計劃的進一步擴展。最後，轉型成本管理計劃明年將節省至少 8 億美元。

Next, let's take a deeper look into 2024. We expect fiscal 2024 adjusted operating income to grow low to mid-single digits, led by the U.S. health care segment and solid execution in U.S. retail pharmacy. We are expecting U.S. health care to be the largest driver of total company AOI growth, as the business is rapidly gaining scale, and we will now accelerate the path to profitability. John Driscoll will provide much more color on the immediate actions we are taking to accelerate EBITDA delivery. We expect U.S. retail pharmacy AOI to be flat to down slightly due to lower COVID contributions of approximately $290 million and a $260 million step down in sale and leaseback gains. Absent these items, we anticipate solid core growth, led by transformational cost management program savings and expanding gross profit.

接下來，讓我們更深入地展望 2024 年。我們預計 2024 財年調整後營業收入將實現低至中個位數增長，這主要得益於美國醫療保健領域和美國零售藥房的穩健執行。我們預計美國醫療保健將成為公司 AOI 整體增長的最大推動力，因為該業務正在迅速擴大規模，我們現在將加快盈利之路。約翰·德里斯科爾 (John Driscoll) 將為我們為加速 EBITDA 交付而立即採取的行動提供更多信息。我們預計，由於新冠疫情貢獻減少約 2.9 億美元，以及售後回租收益減少 2.6 億美元，美國零售藥房 AOI 將持平或略有下降。如果沒有這些項目，我們預計在轉型成本管理計劃節省和毛利潤擴大的帶動下，核心業務將實現穩健增長。

Finally, we expect international AOI to decline year-on-year as we lap sizable real estate gains and lose the relatively small AOI contribution from the sale of our business in Chile. Core profit growth will be flat as the business manages through high levels of cost and labor inflation. That being said, our international business is well positioned for long-term success with market share gains and an advantaged and growing e-commerce presence. We do expect AOI growth to outpace EPS due to a higher tax rate and noncontrolling interest.

最後，我們預計國際 AOI 將同比下降，因為我們失去了相當大的房地產收益，並失去了出售智利業務所帶來的相對較小的 AOI 貢獻。隨著企業應對高水平的成本和勞動力通脹，核心利潤增長將持平。話雖如此，我們的國際業務憑藉市場份額的增長以及優勢且不斷增長的電子商務業務，已做好了長期成功的準備。由於較高的稅率和非控股權益，我們預計 AOI 的增長將超過每股收益。

Next, we'll look at U.S. pharmacy in more detail. Excluding COVID, we expect to grow pharmacy gross profit. Underpinning the growth is our differentiated tech-enabled operating model, which frees up capacity for pharmacists to spend more time on clinical programs and supporting our expanding pharmacy service offerings. We are projecting solid script growth benefiting from improved operating hours, increased access to lives and growth in specialty. We are integrating AllianceRx, community-based specialty pharmacies and Shields under a new go-to-market strategy with a payer-agnostic provider-centric approach. In addition, we have launched multiple programs across our pharmacy and U.S. health care business and continue to see engagement from payers and partners for clinical quality initiatives that leverage our integrated assets.

接下來，我們將更詳細地了解美國藥房。排除新冠疫情，我們預計藥房毛利潤將會增長。支撐這一增長的是我們差異化的技術支持運營模式，這使藥劑師能夠將更多時間花在臨床項目上並支持我們不斷擴大的藥房服務產品。我們預計劇本的穩健增長將受益於運營時間的改善、生活接觸機會的增加以及專業領域的發展。我們正在將 AllianceRx、基於社區的專業藥房和 Shields 整合到新的市場進入戰略中，採用與付款人無關的以提供商為中心的方法。此外，我們在藥房和美國醫療保健業務中啟動了多個計劃，並繼續看到付款人和合作夥伴參與利用我們的綜合資產的臨床質量計劃。

Moving now to our U.S. retail business. Gross profit growth will be driven by low single-digit comp growth and continued margin improvement. We are creating significant value through category performance management, where assortment decisions should deliver at least $200 million of savings in fiscal 2024. We are accelerating our own brand penetration through innovation and increased points of distribution and display. Our own brands have margins that are significantly higher than national brands. We are creating more value for consumers as we scale our e-commerce platform and evolve our store formats including a new digital forward store concept and a health and wellness-focused store with favorable early feedback on both concepts.

現在轉向我們的美國零售業務。毛利潤增長將由低個位數的複合增長率和持續的利潤率改善推動。我們正在通過品類績效管理創造巨大價值，其中分類決策應在 2024 財年節省至少 2 億美元。我們正在通過創新以及增加分銷和展示點來加速我們自己的品牌滲透。我們自主品牌的利潤率明顯高於國產品牌。隨著我們擴展電子商務平台並發展我們的商店格式，包括新的數字轉發商店概念和以健康和保健為重點的商店，我們正在為消費者創造更多價值，這兩個概念都獲得了良好的早期反饋。

Let me now hand it over to John to discuss our U.S. health care strategy and profit growth drivers.

現在讓我把它交給約翰來討論我們的美國醫療保健戰略和利潤增長動力。

Good morning. As Roz and James outlined, while we're confident in the range and scale of our health care business, we are disappointed with the pace of our path to profitability. U.S. healthcare missed targets due to VillageMD and CityMD underperformance, directly related to reduced COVID, cold and flu season and softer market demand. We're taking immediate actions to drive improved profitability. We anticipate this year will remain a transition year as we take action to deliver value and drive profitability. We're rightsizing our cost structure through optimizing overhead and revenue synergies to better match market demand. We're raising and accelerating synergy capture goals.

早上好。正如羅茲和詹姆斯概述的那樣，雖然我們對醫療保健業務的範圍和規模充滿信心，但我們對盈利之路的步伐感到失望。由於 VillageMD 和 CityMD 表現不佳，美國醫療保健未能實現目標，這與新冠​​肺炎疫情減少、感冒和流感季節以及市場需求疲軟直接相關。我們正在立即採取行動來提高盈利能力。我們預計今年將仍然是過渡年，因為我們將採取行動創造價值並提高盈利能力。我們正在通過優化管理費用和收入協同效應來調整成本結構，以更好地滿足市場需求。我們正在提高並加速實現協同目標。

We believe that we can enhance Village growth and value by focusing on gaining density in existing markets to accelerate VillageMD's path to profitability and supporting the integration of our digital assets with our VillageMD platform and we continue to enhance our village management team.

我們相信，通過專注於增加現有市場的密度，加速 VillageMD 的盈利之路，支持我們的數字資產與 VillageMD 平台的整合，我們可以增強 Village 的增長和價值，並且我們將繼續增強我們的 Village 管理團隊。

We've recruited Rich Rubino, a seasoned health care CFO to be the Chief Financial Officer of the combined VillageMD Summit business. Longer term, we're implementing a high-impact, 3-year plan to improve performance through an intense focus on operational excellence and cost optimization. Achieving our health care vision depends on each of our companies, delivering on their respective plans and relentless execution of harvesting growth synergies across the Walgreens portfolio. We're building a differentiated, value-based care delivery model that successfully integrates pharmacy and medical care for a value-based care market that will more than double by 2027.

我們聘請了經驗豐富的醫療保健首席財務官 Rich Rubino 擔任合併後的 VillageMD Summit 業務的首席財務官。從長遠來看，我們正在實施一項高影響力的三年計劃，通過重點關注卓越運營和成本優化來提高績效。實現我們的醫療保健願景取決於我們的每家公司，落實各自的計劃並堅持不懈地執行，以收穫整個沃爾格林投資組合的增長協同效應。我們正在構建一種差異化的、基於價值的護理服務提供模式，成功地將藥房和醫療護理整合在一起，打造一個基於價值的護理市場，到 2027 年，該市場將增長一倍以上。

Walgreens has a unique right to win with our reach, consumer engagement and enterprise investments in primary care, specialty and care to the home. We continue to see the enhanced value of our individual health care assets connected to our core Walgreens pharmacy to create value for patients, providers and plans. A great example of that is our quickly scaling clinical trials recruiting business.

沃爾格林憑藉我們在初級保健、專業護理和家庭護理方面的影響力、消費者參與度和企業投資，擁有獨特的獲勝權利。我們繼續看到與我們的核心沃爾格林藥房相關的個人醫療保健資產的價值不斷增加，為患者、提供者和計劃創造價值。一個很好的例子就是我們快速擴展的臨床試驗招募業務。

Next, let me turn to Summit Health, where we see opportunity to drive meaningful AOI in U.S. health care. While we are obviously disappointed with the pace of unlocking the full value of Summit and CityMD, we expect Summit to contribute materially to profit growth in fiscal year '24. Leveraging WBA, we will invest in targeted marketing campaigns to increase the patient base at CityMD sites. Our continued focus on operational excellence and cost optimization should continue to improve growth and synergies from prior acquisitions. Finally, we are raising and accelerating the synergy capture goal from $150 million in 2027 to $200 million in calendar year 2026.

接下來，讓我談談 Summit Health，我們看到了在美國醫療保健領域推動有意義的 AOI 的機會。雖然我們顯然對 Summit 和 CityMD 充分發揮價值的速度感到失望，但我們預計 Summit 將為 24 財年的利潤增長做出重大貢獻。利用 WBA，我們將投資有針對性的營銷活動，以增加 CityMD 站點的患者基礎。我們對卓越運營和成本優化的持續關注應該會繼續改善先前收購的增長和協同效應。最後，我們正在提高並加速實現協同效應獲取目標，從 2027 年的 1.5 億美元提高到 2026 年的 2 億美元。

Turning to VillageMD. Over the last few months, we've slowed the pace of clinic openings in new markets. As we've studied their performance, we have refocused our growth plans to leverage regional density to support more profitable growth. To achieve our strategic objectives of better engagement and lower cost of care in a more cost-effective manner, we are launching new virtual and asset-light models. We've expanded our marketing efforts to support patient panel growth in our clinics and are working with new leadership to accelerate cost control. We continue to be impressed by the performance of our more mature VillageMD markets risk performance and are focused on continuing to accelerate the conversion of our fee-for-service lives to our proven risk-based model.

轉向 VillageMD。在過去的幾個月裡，我們放慢了在新市場開設診所的步伐。在研究他們的業績後，我們重新調整了增長計劃的重點，以利用區域密度來支持更有利可圖的增長。為了以更具成本效益的方式實現更好的參與和更低的護理成本的戰略目標，我們正在推出新的虛擬和輕資產模型。我們擴大了營銷力度，以支持診所患者群體的增長，並與新領導層合作以加快成本控制。我們仍然對更成熟的 VillageMD 市場風險表現印象深刻，並致力於繼續加速我們的按服務收費壽命向我們經過驗證的基於風險的模型的轉變。

VillageMD is a high-quality care delivery model. As James mentioned, most of our newer VillageMD clinics are at an early stage of development. But if we focus on the performance of our more mature Medicare Advantage markets, where we've achieved an appropriate level of market density, including Arizona, Georgia and Houston, VillageMD has demonstrated the ability to bend the cost curve. We will focus on replicating this performance in other markets as we convert fee-for-service volume to our risk-based model, and we will also leverage our integrated care models with pharmacy and our other health care assets across the U.S. health care business. As part of our refocused U.S. health care approach, we aligned our go-to-market products for health systems and health plans under one team of seasoned health care executives with some encouraging short-term sales results noted on the slide.

VillageMD 是一種高質量的護理服務模式。正如 James 提到的，我們大多數新的 VillageMD 診所都處於發展的早期階段。但如果我們關注更成熟的 Medicare Advantage 市場的表現，我們已經實現了適當的市場密度水平，包括亞利桑那州、佐治亞州和休斯頓，VillageMD 已證明有能力扭轉成本曲線。當我們將按服務付費的模式轉變為基於風險的模式時，我們將專注於在其他市場複製這種表現，並且我們還將在美國醫療保健業務中利用我們與藥房和其他醫療保健資產的綜合護理模式。作為我們重新調整美國醫療保健方法的一部分，我們在經驗豐富的醫療保健高管團隊的領導下，調整了用於醫療系統和健康計劃的上市產品，並在幻燈片中指出了一些令人鼓舞的短期銷售結果。

In summary, Walgreens remains the independent partner of choice for health plans and health systems through the combination of our legacy pharmacy platform with our portfolio of health assets. Our portfolio consistently delivers better outcomes at lower cost for plans, systems and patients, which we believe is well suited to meet the demands of a health care market that is quickly moving from fee-for-service to fee for value. While there is clearly work to be done, we now have the leadership, plans and organizational structure in place to rapidly advance our priorities.

總之，通過將我們的傳統藥房平台與我們的健康資產組合相結合，沃爾格林仍然是健康計劃和健康系統的首選獨立合作夥伴。我們的產品組合始終以更低的成本為計劃、系統和患者提供更好的結果，我們相信這非常適合滿足醫療保健市場的需求，該市場正在迅速從按服務收費轉向按價值收費。雖然顯然還有很多工作要做，但我們現在已經有了適當的領導、計劃和組織結構來快速推進我們的優先事項。

Now let me turn it back over to James.

現在讓我把它轉回給詹姆斯。

Thanks, John. Capital allocation priorities remain focused on core business investments, debt paydown and our dividend. We will continue to pursue disciplined returns-based organic investment in our core business, and we are simplifying our portfolio to unlock value and provide financial flexibility. We are very committed to maintaining our investment-grade rating and our dividend.

謝謝，約翰。資本配置的重點仍然集中在核心業務投資、債務償還和股息上。我們將繼續在我們的核心業務中追求基於回報的嚴格有機投資，並且我們正在簡化我們的投資組合以釋放價值並提供財務靈活性。我們非常致力於維持我們的投資級評級和股息。

Now let's take a quick look at the transformational cost management program. We are raising the cumulative 2024 savings target to $4.1 billion, and this is the sixth target increase since the program began. With $3.3 billion saved by the end of this year, we are projecting at least $800 million of savings in '24.

現在讓我們快速瀏覽一下轉型成本管理計劃。我們將 2024 年累計節省目標提高到 41 億美元，這是該計劃啟動以來第六次提高目標。到今年年底可節省 33 億美元，我們預計 2024 年至少可節省 8 億美元。

Let me talk to a couple of the cost-saving initiatives. We just completed an organization restructuring, which included transforming our headquarters to better align our resources with our strategic priorities. This led to the elimination of more than 500 roles, representing around 10% of our corporate and U.S. support office workforce. Our pharmacy of the future operating model will drive significant savings. We are optimizing the model through our micro fulfillment centers, tech-enabled centralization of in-store activities and telepharmacy solutions. These initiatives will also elevate the role of the pharmacist and improve patient engagement.

讓我談談一些節省成本的舉措。我們剛剛完成了組織重組，其中包括對總部進行改造，以便更好地將我們的資源與我們的戰略重點結合起來。這導致 500 多個職位被裁減，約占我們公司和美國支持辦公室員工隊伍的 10%。我們的藥房未來的運營模式將帶來大量的節省。我們正在通過微型履行中心、技術支持的店內活動集中化和遠程藥房解決方案來優化該模式。這些舉措還將提升藥劑師的作用並提高患者的參與度。

Finally, we will continue to optimize our locations and opening hours and expect to close an additional 300 locations in the U.K. and 150 locations in the U.S. As you have seen, we are accelerating our portfolio optimization to further simplify the business. We have fully exited from our Option Care Health position with overall proceeds of $1.2 billion since August 2022.

最後，我們將繼續優化我們的門店和營業時間，並預計將關閉英國的另外 300 個門店和美國的 150 個門店。正如您所看到的，我們正在加速我們的產品組合優化，以進一步簡化業務。自 2022 年 8 月以來，我們已完全退出 Option Care Health 頭寸，總收益為 12 億美元。

Let me also highlight our recent monetization of AmerisourceBergen shares using a variable prepaid forward structure. Under the VPF approach, there is no EPS dilution until the contracts mature. We continue to receive dividends and we retain some share price upside. Please note that the remaining stake in AmerisourceBergen is worth approximately $5 billion.

我還要強調一下我們最近使用可變預付遠期結構對 AmerisourceBergen 股票進行貨幣化的情況。根據 VPF 方法，在合同到期之前，每股收益不會被稀釋。我們繼續收到股息，並且保留了一些股價上漲空間。請注意，AmerisourceBergen 的剩餘股份價值約 50 億美元。

With that, let me now pass it back to Roz for her closing comments.

現在，讓我將其轉回給羅茲，徵求她的結束語。

Thank you, James. Before we kick off Q&A, let me sum up what you've heard. WBA has the right to win through our differentiated model, and we have the right strategy in place. We are now entering the next phase of our health care transformation with aggressive actions in motion to improve profitability. We are addressing current challenges head on and moving at a pace to deliver long-term shareholder value. We have the scale, we have the skill, we have the sense of urgency, and we have the right plans to drive sustainable profit growth ahead.

謝謝你，詹姆斯。在我們開始問答之前，讓我總結一下您所聽到的內容。 WBA 有權通過我們的差異化模式獲勝，並且我們制定了正確的戰略。我們現在正進入醫療保健轉型的下一階段，並採取積極行動來提高盈利能力。我們正在正面應對當前的挑戰，並加快步伐，以實現長期股東價值。我們有規模、有技能、有緊迫感，並且有正確的計劃來推動可持續的利潤增長。

Now I'd like to open the line for questions. Operator?

現在我想開通提問熱線。操作員？

(Operator Instructions) And your first question comes from the line of Lisa Gill from JPMorgan.

（操作員說明）您的第一個問題來自摩根大通的 Lisa Gill。

Thanks for all the detail. The first area I just want to focus on is around your U.S. health care business. There is substantial growth as we think about going both into the fourth quarter and then into next year. John commented on the miss by both VillageMD and CityMD around performance, but also talked about utilization. We've heard on the opposite end where managed care is talking about utilization from a negative side, so can you help me to square that, one, when we think about VillageMD and we think about your Medicare Advantage lives and what you're seeing for utilization there. Is that a current headwind?

感謝您提供所有詳細信息。我想關注的第一個領域是美國醫療保健業務。當我們考慮進入第四季度和明年時，將會出現大幅增長。 John 評論了 VillageMD 和 CityMD 在性能方面的失誤，但也談到了利用率。我們聽說管理式醫療從負面角度討論利用率，所以您能幫我解決這個問題嗎？一，當我們考慮 VillageMD 並考慮您的 Medicare Advantage 生活以及您所看到的情況時以便在那裡使用。這是當前的逆風嗎？

And then secondly, when you think about things like CityMD that's not seeing respiratory or COVID visits, what do you think are the opportunities there? And is that part of the synergy pull forward that you're talking about for the $200 million as we think about 2026?

其次，當你想到像 CityMD 這樣沒有看到呼吸道疾病或新冠肺炎就診的事情時，你認為那裡有什麼機會？當我們考慮到 2026 年時，這是否是您所說的 2 億美元協同效應的一部分？

Thanks, Lisa. I think it's -- utilization is actually sort of a mixed blessing for us. We're seeing consistently solid performance in terms of bending the cost curve at Village, and I think that positions us better and better as a managed care partner. We were hit with the CityMD utilization.

謝謝，麗莎。我認為，利用率實際上對我們來說是喜憂參半。我們看到 Village 在降低成本曲線方面始終表現穩健，我認為這使我們作為管理式醫療合作夥伴的地位越來越好。 CityMD 的利用率給我們帶來了打擊。

I think that we're at the early stages of harvesting the embedded profitability of Summit and City. And the City hit on utilization in this quarter also hit our lab and ancillary business a bit, but we think that there's an opportunity on both the value-based side to integrate some of the lessons from Village at Summit and City because both of them have very high NPS. They are demonstrating the ability to reduce cost over time. And as we get at some of the cost synergies, I think you're going to see a significant improvement. I mean we are expecting a quarter-over-quarter improvement in health care EBITDA of 70% looking at Q4. So I think we've got opportunities on the cost side, but also on the value side to optimize our model.

我認為我們正處於收穫 Summit 和 City 的內在盈利能力的早期階段。本季度城市利用率的提高也對我們的實驗室和輔助業務造成了一些影響，但我們認為基於價值的方面都有機會整合峰會村和城市的一些經驗教訓，因為它們都有非常高的 NPS。他們正在展示隨著時間的推移降低成本的能力。當我們獲得一些成本協同效應時，我認為您將會看到顯著的改進。我的意思是，我們預計第四季度醫療保健 EBITDA 環比將提高 70%。所以我認為我們在成本方面有機會，而且在價值方面也有機會優化我們的模型。

Your next question comes from the line of George Hill from Deutsche Bank.

您的下一個問題來自德意志銀行的喬治·希爾。

James, I guess a couple targeted at you. With OCF earnings below the dividend through 3 quarters, and there's lots of moving pieces that OP not expected to grow meaningfully next year. And we know there's the cash for ACA. I guess. So can you talk about, a, how the company is thinking about the dividend; and b, as it relates to Rx reimbursement pressure, I guess, can you talk about what the early expectations are for calendar '24? And are we expecting kind of the leg down in pharmacy reimbursement pressure to look like prior years?

詹姆斯，我猜有幾個人針對的是你。由於 OCF 收益連續三個季度都低於股息，而且有很多變動因素預計 OP 明年不會出現有意義的增長。我們知道 ACA 有足夠的現金。我猜。那麼你能談談，a，公司是如何考慮股息的； b，因為它與 Rx 報銷壓力有關，我想，您能談談對日曆 '24 的早期期望是什麼嗎？我們是否預計藥品報銷壓力會像前幾年一樣有所下降？

Let me cover dividend first. And just I want to emphasize in '24, we are giving commentary that operating income will grow low to mid-single digit. We clearly have a lot of work to do on cash flow, and first one is EBITDA, so we see strong growth next year. And the second one is we're building out incremental working capital programs and we're significantly curtailing our capital expenditures.

讓我先談談股息。我想強調的是，在 24 年，我們發表評論稱營業收入將增長到低至中個位數。顯然，我們在現金流方面還有很多工作要做，第一個是 EBITDA，因此我們預計明年將出現強勁增長。第二個是我們正在製定增量營運資本計劃，並且我們正在大幅削減資本支出。

So I want to make it crystal clear, we are absolutely committed to the dividend, absolutely committed both to the dividend and/or investment-grade rating. And I would point out, we did highlight specifically in the prepared comments that our stake in ABC is still worth $5 billion. So we -- while we're going through the short-term transformation, we do have plenty of firepower going forward. Bear in mind, as you look at our numbers on cash flow, we're investing approximately $1 billion of free cash flow in health care this year. And as we move forward into the future, and it starts breaking even on an EBITDA basis, that $1 billion quickly becomes a cash flow generation, too. But we are getting into incremental and much more aggressive actions on capital and working capital in the short term.

因此，我想明確表示，我們絕對致力於股息，絕對致力於股息和/或投資級評級。我想指出的是，我們確實在準備好的評論中特別強調，我們在 ABC 的股份仍價值 50 億美元。因此，雖然我們正在經歷短期轉型，但我們確實擁有充足的火力前進。請記住，當您查看我們的現金流數據時，我們今年將在醫療保健領域投資約 10 億美元的自由現金流。當我們邁向未來時，它開始在 EBITDA 基礎上實現盈虧平衡，這 10 億美元也很快就會產生現金流。但短期內我們將在資本和營運資本方面採取漸進且更加積極的行動。

Your second question then was on calendar '24. The reimbursement -- okay, sorry about that. Reimbursement, as looking back over the last 18 months, the environment has been much more positive. I would say that we did comment and we've actually come in similar to that. We said that this year, the current fiscal year is an 85%. I saw a 15% step down on the previous year, so that is the net reimbursement pressure on the P&L has improved.

你的第二個問題是關於日曆'24。報銷——好吧，對此感到抱歉。回報，回顧過去 18 個月，環境要積極得多。我想說的是，我們確實發表了評論，而且我們實際上也提出了類似的意見。我們說今年，當前財年是85%。我看到比上一年下降了 15%，所以損益表的淨報銷壓力有所改善。

We actually don't want to give too much comments on future negotiations, but we see much more productive discussions with payers and providers in general, because we're bringing more value to the table, our ability to do medical adherence and other such activities and improve outcomes for payers has improved significantly over the last 2 years and it's starting to be more recognized in productive discussions.

實際上，我們不想對未來的談判給出太多評論，但我們看到與付款人和提供者的討論總體上更加富有成效，因為我們正在為談判帶來更多價值，我們有能力進行醫療依從性和其他此類活動在過去的兩年裡，“改善付款人的成果”有了顯著改善，並且開始在富有成效的討論中得到更多認可。

Maybe I'll ask Rick Gates, our Head of pharmacy to make some comments for repayments.

也許我會請我們的藥房主管 Rick Gates 對還款發表一些評論。

Yes. Obviously, we're in the middle of negotiations, so we can't comment a lot going into '24 at this moment through Medicare Part D and through commercial contracts, which are going on currently and into Q4. But just to reemphasize what James is saying, we're generally in line with expectations on reimbursement this year. We are benefiting from conversations across U.S. health care and pharmacy as they're looking at us as a holistic solution within the health care ecosystem. And we're continuously working on offsets for reimbursement pressure that we're seeing through improved procurement, increased prescriptions, obviously, are important ancillary services, but then also reducing cost to fill.

是的。顯然，我們正處於談判之中，因此我們目前無法通過 Medicare D 部分和商業合同對進入 24 年的情況發表太多評論，這些合同目前正在進行並進入第四季度。但再次強調詹姆斯所說的，我們今年的報銷總體上符合預期。我們受益於美國醫療保健和藥房的對話，因為他們將我們視為醫療保健生態系統中的整體解決方案。我們正在不斷努力抵消報銷壓力，我們看到通過改進採購、增加處方顯然是重要的輔助服務，但同時也降低了填充成本。

And I just want to reemphasize the other point that James said is that we are overperforming or performing better in pay-for-performance-based contracts, which are obviously part of the reimbursement we get back as well. So I can't comment on '24, but we are in line with expectations for '23 at this moment.

我只是想再次強調詹姆斯所說的另一點，那就是我們在基於績效的合同中表現出色或表現更好，這顯然也是我們獲得的報銷的一部分。所以我無法對 24 年發表評論，但目前我們對 23 年的預期是一致的。

And your next question comes from the line of Ann Hynes from Mizuho Securities.

您的下一個問題來自瑞穗證券的 Ann Hynes。

Great. So given health care is the main driver of growth next year, what do you think is the biggest risk embedded within that guidance? And then secondly, you commented in your prepared remarks that scripts were lower than expectations. Can you just decide for what is driven by maybe market weakness versus market share weakness versus maybe pharmacy hours now coming back to what were in your expectations?

偉大的。鑑於醫療保健是明年增長的主要推動力，您認為該指導中包含的最大風險是什麼？其次，你在準備好的發言中評論說劇本低於預期。您能否決定什麼是由市場疲軟、市場份額疲軟以及藥房營業時間現在回到您的預期驅動的？

Ann, thanks for that question. I'm going to ask John to hit the first piece on health care, and then Rick and I will talk to you about the scripts business.

安，謝謝你提出這個問題。我將請約翰講第一部分有關醫療保健的內容，然後我和里克將與您討論腳本業務。

Yes. Ann, I am really encouraged by the core growth across the portfolio. We've laid out exactly where the challenge is, which is in cost and profit opportunity, and we are laser-focused on executing to unlocking that value. So look for us, as I mentioned in the earlier answer to continue to unlock the embedded profitability of that part of the business. We see positive signs from all of the buyers. It's our responsibility to grow but also to grow and focus on profitable growth, and we will continue to kind of dig in there, and I'm confident that you will see consistent improved performance on that over time.

是的。安，我對整個投資組合的核心增長感到非常鼓舞。我們已經準確地列出了挑戰所在，即成本和利潤機會，並且我們專注於執行以釋放該價值。因此，正如我在之前的回答中提到的那樣，請尋找我們，以繼續釋放該部分業務的內在盈利能力。我們看到所有買家的積極跡象。我們有責任成長，但也有責任成長並專注於盈利增長，我們將繼續深入挖掘，我相信隨著時間的推移，您會看到這方面的業績持續改善。

Ann. Let me start off first, just give you a little bit of detail on where we are in our store performance. So at the end of the quarter, we had 1,600 locations on reduced operating hours. And we've recently optimized those hours in about 500 stores, bringing our current stores on reduced operating hours to roughly 1,100. We're continuing to see improvements in pharmacy staffing, resulting in almost 1,100 new pharmacists hired in the quarter.

安.讓我首先向您介紹一下我們商店的業績狀況。因此，到本季度末，我們有 1,600 個地點的營業時間縮短了。我們最近優化了大約 500 家商店的營業時間，將目前營業時間縮短的商店數量減少到大約 1,100 家。我們繼續看到藥房人員配置的改善，本季度僱用了近 1,100 名新藥劑師。

And then to the extent that the incremental pharmacists are hired in our most challenged markets, we've been returning stores to their regular full operating hours. One of the things that we're seeing is that the initial incentives worked, we're at the point now where we're seeing the limitation of available pharmacists.

然後，在我們最具挑戰性的市場僱用增量藥劑師的情況下，我們一直在讓商店恢復正常的完整營業時間。我們看到的一件事是，最初的激勵措施發揮了作用，但現在我們看到了可用藥劑師的限制。

And so Rick, can you go into a little bit more detail on the actual script improvement?

Rick，你能更詳細地介紹一下實際的腳本改進嗎？

Yes. And I think, Ann, you're trying to get at the 3% growth that we're talking about through fiscal year '23. I think we've always walked through, there's kind of 4 key drivers to that script comp growth for us. One is market growth. And I think what we've seen in Q3 is that we've seen a slowing of aggregate market growth from Q2 to Q3, which is impacting, obviously, a big part of our underlying performance is there. Roz talked about store hours returning to normal hours, which are lagging a little bit the pace that we had set, given what Roz talked through.

是的。我認為，Ann，您正試圖在 23 財年實現我們正在談論的 3% 的增長。我認為我們一直都在經歷，我們的腳本補償增長有 4 個關鍵驅動因素。一是市場增長。我認為我們在第三季度看到的是，從第二季度到第三季度，我們看到總體市場增長放緩，這顯然影響了我們基本業績的很大一部分。羅茲談到商店營業時間恢復正常，考慮到羅茲所說的內容，商店營業時間比我們設定的速度有點滯後。

But we are seeing some positives as well. The market access that we've contracted coming into this year is flowing through in a very positive way. We continue to have good conversations heading into next year. The adherence and care programs, we are seeing year-over-year growth. They are stagnated a little bit given some of the store hour operation impacts, but we are seeing positive growth year-over-year when you look at access and adherence as well. So although 3% is down from where we earlier guided to, I think the 2 things that are most impacting it are market growth, which has slowed quarter-over-quarter, and the store average returning to normal.

但我們也看到了一些積極的一面。我們今年簽訂的市場准入合同正在以非常積極的方式進行。進入明年，我們將繼續進行良好的對話。我們看到堅持和護理計劃逐年增長。考慮到商店營業時間的一些影響，它們有點停滯，但當你看看訪問量和遵守情況時，我們看到同比正增長。因此，儘管 3% 比我們之前的指導值下降了，但我認為對其影響最大的兩件事是市場增長（季度環比放緩）以及商店平均水平恢復正常。

And then maybe I could add. We actually believe there will be significant core growth in the U.S. business next year as well because we'll be absorbing a year-on-year nonoperating headwind from lower sale and leaseback. And then in addition, we mentioned the $290 million headwind on COVID.

然後也許我可以補充一下。事實上，我們相信明年美國業務也將出現顯著的核心增長，因為我們將吸收銷售和回租減少帶來的同比非經營性逆風。此外，我們還提到了新冠疫情帶來的 2.9 億美元的逆風。

And maybe go back to the tailwinds and headwinds in short. We have a couple of items you mentioned correctly, U.S. health care. There's a couple more transformational cost management program is at least $800 million of savings, and we've basically identified those savings already. Two, on the front of store business. We have $200 million on -- of CPI, and that's essentially more cost optimization and margin improvement. And then we have synergies in the U.S. health care business, so our cost optimization and savings next year as well in excess of $1 billion, so it's much more controllable and already defined.

簡而言之，也許會回到順風和逆風。我們有幾個你正確提到的項目，即美國醫療保健。還有幾個轉型成本管理計劃至少可以節省 8 億美元，而且我們基本上已經確定了這些節省。二、在門店經營方面。我們有 2 億美元用於 CPI，這本質上是更多的成本優化和利潤率提高。然後我們在美國醫療保健業務方面具有協同效應，因此明年我們的成本優化和節省也將超過 10 億美元，因此它更加可控並且已經確定。

Now some of that will be eaten up by wages and inflation plus reimbursement pressure, but we're well advanced on savings -- controllable savings of over $1 billion, and a lot of that is in the U.S. business. We basically gave some examples of the cost reduction, just the headquarter restructuring. This was done on the corporate head office, and it was done on the U.S. support office. And those 500 reductions were done in the space of about 4 months, and the savings are in excess of $100 million, so we're moving at pace to address the challenges and really going after the cost envelope.

現在，其中一些將被工資、通貨膨脹以及報銷壓力所消耗，但我們在儲蓄方面取得了很大進展——可控儲蓄超過 10 億美元，其中很大一部分來自美國企業。我們基本上舉了一些降低成本的例子，只是總部重組。這是在公司總部完成的，也是在美國支持辦公室完成的。這 500 項削減是在大約 4 個月的時間內完成的，節省的費用超過 1 億美元，因此我們正在加快步伐應對挑戰，並真正追求成本範圍。

Your next question comes from the line of Michael Cherny from Bank of America.

您的下一個問題來自美國銀行的 Michael Cherny。

Maybe, James, to stay on that thread, I understand the increase in cost savings targets, that's something I know that the company has been really focused on. When you look at that, you look at still what you have from the sale-leaseback contribution and ABC contribution. What does that mean for what the core underlying earnings of this business should be? And how does that factor into where underlying growth should continue versus your previously assume multiyear targets.

也許，詹姆斯，為了繼續這個話題，我理解成本節約目標的增加，這是我知道公司一直真正關注的事情。當你看到這一點時，你仍然會看到售後回租貢獻和 ABC 貢獻。這對於該業務的核心基本收益意味著什麼？與您之前假設的多年目標相比，這一因素如何影響潛在增長應繼續的情況。

I know we're not getting into more specific guidance on '24, but you do have the long-term targets already out there. So how does -- what you're doing now and especially how the core is growing factor into achieving those previously reported targets?

我知道我們不會就 24 小時制定更具體的指導，但您確實已經制定了長期目標。那麼，您現在正在做的事情，尤其是核心因素如何不斷增長，以實現之前報告的目標？

Yes. Maybe I'll take it from another direction. And if we look forward to the fourth quarter, we've got a bunch of headwinds in the fourth quarter, and you could actually call out COVID, which is probably 20 points of a headwind and sale and leaseback another 20. So the guide we're basically giving is a slight decline in EPS, but the core growth is more like 30%, 40% growth in the fourth quarter, so we're seeing that the flywheel is working. We've had some pressure on margins in the short term in retail, but the flywheel is starting to perform.

是的。也許我會從另一個方向來考慮。如果我們展望第四季度，我們會在第四季度遇到很多逆風，你實際上可以說是新冠疫情，這可能是 20 個點的逆風，而售後回租又是 20 個點。所以我們的指南基本上帶來的是每股收益略有下降，但第四季度的核心增長更像是 30%、40% 的增長，所以我們看到飛輪正在發揮作用。短期內，我們零售業的利潤率面臨一些壓力，但飛輪已經開始發揮作用。

Then the second data point is we give -- as we discuss a low to mid-single-digit operating income growth over the entire course of next year, absorbing sale and leaseback and absorbing COVID and any other headwinds that are on the horizon. So if you subtract out those 2, the low to mid-single digit is more like a low teens growth in adjusted operating income, so where we see the flywheel coming back and coming back quickly.

然後第二個數據點是我們給出的——當我們討論明年整個過程中低至中個位數的營業收入增長時，吸收銷售和回租以及吸收新冠疫情和任何其他即將出現的不利因素。因此，如果你減去這兩個數字，低至中個位數更像是調整後營業收入的低十幾歲增長，因此我們看到飛輪正在恢復，並且很快就會恢復。

If you project that forward, you're right, the sale and leaseback gains run out in '24, so it is the last year. But by then, the improved profit prospects on the health care business, plus the flywheel working in the U.S. business more consistently should get us to those previous targets of low single digit. Now we're not guiding to that. We're not confirming guidance, but we see that the core earnings power is successively improving every quarter. And I think people will be very positively surprised by the quality of earnings, particularly in the fourth quarter of this year. And then going into the next year.

如果你預測這一點，你是對的，售後回租收益將在 24 年耗盡，所以這是最後一年。但到那時，醫療保健業務利潤前景的改善，加上美國業務的飛輪更加穩定地發揮作用，應該會讓我們實現之前的低個位數目標。現在我們不做指導。我們沒有確認指引，但我們看到核心盈利能力每個季度都在不斷提高。我認為人們會對盈利質量感到非常驚訝，尤其是今年第四季度。然後進入明年。

And your next question comes from the line of Lucas Romanski from TD Cowen.

您的下一個問題來自 TD Cowen 的 Lucas Romanski。

This is Lucas on for Charles. Wanted to ask about the U.S. health care business and your appetite for taking on risk there. Last October, you talked about adding health plan partnerships and how the platform -- would enable you to take on risk eventually. Now you have 4 health plan partnerships and you've been able to show the ability to lower MLR from high 80s to low mid-70s in some regions. What are you guys seeing in terms of appetite from health plans in the market now that you have the bulk of your health care delivery assets in place?

這是盧卡斯替查爾斯發言。想詢問美國醫療保健行業的情況以及您願意承擔風險的意願。去年十月，您談到了增加健康計劃合作夥伴關係以及該平台如何使您最終能夠承擔風險。現在，您擁有 4 個健康計劃合作夥伴關係，並且您已經能夠在某些地區將 MLR 從 80 多歲降低到 70 多歲左右。既然你們已經擁有大部分醫療保健提供資產，你們對市場上健康計劃的興趣有何看法？

And then two, how are you thinking about increasing your exposure to risk over time and if you see that as a path to driving earnings growth for the U.S. Healthcare segment moving forward?

第二個問題，您如何考慮隨著時間的推移增加風險敞口，以及您是否認為這是推動美國醫療保健行業未來盈利增長的一條途徑？

Lucas, thanks for the question. It's John. We are seeing a remarkably robust appetite for risk of 2 different sorts. One is the per member per month capitated risk in your -- on the MA population, but whether it is performance risk on closing gaps in care or performance opportunities to earn and enhance the delivery of our specialty pharmacy business with the Shields. There is a consistent interest in products and services that in total, lower the cost of care and improve outcomes. And we are very encouraged by the demand across every constituency for every product we've got, whether it's Health Corners, VillageMD, City or Shields or CareCentrix, that the opportunity -- that the track record of performance around delivering on lower cost to care while keeping up a high NPS on the part of the patients and providers and delivering those results will allow us to honestly deliver a portfolio of risk-based and performance-based products that I think are going to be -- are going to build on our notion of being the independent partner of choice for health plans and health systems. So I think we will -- you'll see more and more news about that. and that's part of unlocking the embedded profitability of the assets we own.

盧卡斯，謝謝你的提問。是約翰。我們看到人們對兩種不同類型的風險的胃口非常強勁。一是每個會員每月在 MA 人群中的人均風險，但無論是縮小護理差距的績效風險，還是通過 Shields 賺取和增強我們的專業藥房業務交付的績效機會。人們對總體上能夠降低護理成本並改善結果的產品和服務有著一致的興趣。無論是 Health Corners、VillageMD、City、Shields 還是 CareCentrix，每個群體對我們提供的每一種產品的需求都讓我們深受鼓舞，因為機會——圍繞降低護理成本的績效記錄同時保持患者和提供者的高 NPS 並提供這些結果將使我們能夠誠實地提供基於風險和基於績效的產品組合，我認為這些產品將建立在我們的基礎上成為衛生計劃和衛生系統首選的獨立合作夥伴的理念。所以我想我們會——你會看到越來越多的相關新聞。這是釋放我們所擁有資產的內在盈利能力的一部分。

And your next question comes from the line of A.J. Rice from Credit Suisse.

你的下一個問題來自 A.J.瑞士信貸的大米。

Maybe quickly, I know it's been missed a couple of times the goal for working capital optimization. Can you maybe expand a little bit more on what you think over time, the incremental cash flow opportunity might be there? And then as you talk about prioritizing debt paydown, what is -- can you give us any updated thoughts on how far you need to -- you feel like you need to go on debt pay down, maybe a leverage target? Any comments on either of those?

也許很快，我知道它已經錯過了營運資本優化目標的好幾倍。您能否進一步闡述您對隨著時間的推移可能存在的增量現金流機會的看法？然後，當您談論優先償還債務時，您覺得您需要繼續償還債務，也許是一個槓桿目標，您能給我們提供關於您需要多遠的最新想法嗎？對其中任何一個有什麼評論嗎？

Yes. I think on working capital, if you look back over, I'd say, a 5-year period, we've probably reduced working capital by $2.5 billion. Hopefully, it's not as if we haven't done it, but we're sitting on fairly high levels of inventory. We run a front of store above 90 days, which is on the high side. And the second part on pharmacy, we're above 30 days, and both of those for me personally are quite high.

是的。我認為就營運資本而言，如果你回顧過去 5 年的時間，我們可能會減少 25 億美元的營運資本。希望我們不是沒有這樣做，但我們的庫存水平相當高。我們店面的運營時間超過 90 天，這個數字偏高了。第二部分是關於藥房的，我們已經超過 30 天了，這對我個人來說都相當高了。

We've put in place big initiatives to address those. One is the micro fulfillment centers, which effectively will take a fair amount of inventory out of the 8,800 stores as we centralize into less than 20 centers. When we put together the program that was identified at almost $1 billion of working capital opportunity, we've probably captured 40% of that. And I just want to emphasize, this is a multiyear program we're running, but it's hundreds and hundreds of millions every year on working capital optimization driven by micro fulfillment centers. We have new forecasting systems going in. We're putting in a new inventory management system and perpetual inventory for pharmacy for the first time, and that's rolling out even as we speak. So we have huge initiatives rolling out that will really drive benefits next year.

我們已經採取了重大舉措來解決這些問題。其中之一是微型配送中心，當我們集中到不到 20 個中心時，它實際上將從 8,800 家商店中消耗大量庫存。當我們將被確定為近 10 億美元營運資金機會的計劃放在一起時，我們可能已經抓住了其中的 40%。我只是想強調，這是我們正在運行的一個多年計劃，但每年有數以億計的資金用於由微型履行中心驅動的營運資本優化。我們正在使用新的預測系統。我們正在首次為藥房安裝新的庫存管理系統和永續庫存系統，就在我們說話的時候，它正在推出。因此，我們推出了巨大的舉措，這些舉措將真正推動明年的效益。

On debt, we're targeting investment-grade rating. We're not within our metrics right now. The target with Moody's is, I think it's [475]. And we have work to do to both improve our operating cash flow, which we just talked about. And then secondly, targeted paydown of debt to get within the metrics. And we expect to do so confidently expect to do so during the course of fiscal '24.

在債務方面，我們的目標是投資級評級。我們現在不在我們的指標之內。我認為穆迪的目標是[475]。我們還有很多工作要做，以改善我們剛才談到的運營現金流。其次，有針對性地償還債務以達到指標範圍。我們預計將在 24 財年期間充滿信心地做到這一點。

Your next question comes from the line of Elizabeth Anderson from Evercore ISI.

您的下一個問題來自 Evercore ISI 的 Elizabeth Anderson。

I was wondering if you could talk through how you're thinking about the potential impact of 340B maybe both on the core -- U.S. pharmacy business and sort of what the potential impact could be there. But then also, if you could just really talk about how you're thinking about the potential opportunity in fiscal '24 from Shields in that business.

我想知道您是否可以談談您如何看待 340B 對美國製藥業務的核心潛在影響以及可能產生的潛在影響。但是，如果您能真正談談您如何看待 Shields 在該業務中 24 財年的潛在機會。

Yes. This is Rick, and I'll start and see, John must join me here. But as you look at 340B, we are very comfortable with our prior guidance and do expect 340B to actually be a slight up and production year-over-year in fiscal '23. Current assumptions still taking into account latest manufacturer actions and restrictions.

是的。我是瑞克，我先看看，約翰必須和我一起來。但當你看到 340B 時，我們對之前的指導感到非常滿意，並且確實預計 23 財年 340B 的產量實際上會略有上升。當前的假設仍然考慮了製造商的最新行動和限制。

I think there's 3 things to think about as we look at in Q4 is that we do know obviously and have a line of sight since October and the continued developments and restrictions and litigation that can negatively impact the business itself. However, we are working with covered entities who are starting to share data back in a more proactive way, which is opening up their impact to continue to get 340B value back to the governed entities. And third, we continue to work very proactively in the marketplace with covered entities that are still very active and signing up for contract pharmacy. So we do think that we can offset some of the headwinds as we're looking at it, but do still see a good line of sight into what we projected for this year, which is a slight growth.

我認為，在第四季度，我們需要考慮三件事：我們確實清楚地知道，並且自 10 月份以來一直有視線，以及可能對業務本身產生負面影響的持續發展、限制和訴訟。然而，我們正在與所覆蓋的實體合作，他們開始以更主動的方式共享數據，這將發揮他們的影響力，繼續為受治理實體返還 340B 價值。第三，我們繼續在市場上與仍然非常活躍並簽約合同藥房的涵蓋實體積極合作。因此，我們確實認為我們可以抵消一些不利因素，但我們仍然對今年的預期有良好的預期，即略有增長。

And John, I don't know if you want to add...

約翰，我不知道你是否想補充...

I think the Shields is actually -- turns out to be an advantaged position because it's not in the contract pharmacy business. It's really a specialty pharmacy services business for hospital based 340B related specialty pharmacies. And we continue to see strong demand and the sustainability of those contracts. And so we're highly confident that Shields is actually in a great position because of a just core growth of specialty pharmacy drugs and the need for hospitals to partner with a services platform that delivers a best-in-class adherence and integrates really well with hospitals that are -- even to manage those high need chronic patients.

我認為 Shields 實際上是一個優勢地位，因為它不從事合同藥房業務。它實際上是一家以醫院為基礎的340B相關專業藥房的專業藥房服務業務。我們繼續看到強勁的需求和這些合同的可持續性。因此，我們非常有信心 Shields 實際上處於有利地位，因為特種藥房藥物的核心增長以及醫院需要與一個服務平台合作，該平台提供一流的依從性並與醫院甚至可以管理那些高需求的慢性病患者。

And your final question comes from the line of Eric Percher from Nephron Research.

你的最後一個問題來自 Nephron Research 的 Eric Percher。

It's been difficult to piece together the U.S. health care ramp from what was a $350 million loss to significant profit next year. Now looking at $600 million to $650 million, can you tell us net of the actions you're taking, how does fiscal year '24 look relative to the outlook 6 months ago when you closed? And then any insight on the contributions, which businesses and how they're coming together for the fiscal year '24 outlook?

很難拼湊出美國醫療保健從 3.5 億美元的虧損到明年的巨額盈利的過程。現在看看 6 億至 6.5 億美元，您能否告訴我們，扣除您正在採取的行動後，24 財年的前景與 6 個月前您關閉時的前景相比如何？然後對 24 財年展望的貢獻、哪些企業以及它們如何整合有任何見解嗎？

Yes. Eric, the base year -- so what we're looking at here is the base year has come in about 300 light versus the original expectations 9 months ago, and we've talked extensively about Summit and the some slowness at building patient panels at Village, and we have a series of actions to go address that.

是的。埃里克，基準年——所以我們在這裡看到的是基準年與 9 個月前的最初預期相比已經達到了約 300 倍，我們已經廣泛討論了 Summit 以及在建立患者小組方面的一些緩慢村莊，我們有一系列行動來解決這個問題。

I think the best way you could model this out is versus the original goals, the year-on-year change, we believe is absolutely intact. So you might want to think of it in this way, we're probably 6 to 12 months behind, but it will be in 2024, it's unlikely we'll recover the $300 million loss in the base here, but the build year-on-year is intact and probably we would do slightly more.

我認為最好的模擬方式是與最初的目標相對比，我們認為逐年變化絕對完好無損。所以你可能想這樣想，我們可能落後了 6 到 12 個月，但那是在 2024 年，我們不太可能彌補這里基地的 3 億美元損失，但逐年增加- 年完好無損，可能我們會做得更多一些。

John, is that a fair...

約翰，這公平嗎……

I think that's the right way to look at it. I think, Eric, you should expect that we will -- we laid out that Q4 target of a 70% improvement over Q3. We're not prepared right now to give extensive '24 guidance. And I think we'd probably be [aloof] to give subsegment segment guidance because I think that would even be more confusing. But we are seeing, as I said, the revenue ramp and the demand in each of our markets for each of our companies. And we have taken and are taking swift action to unlock the embedded profitability and a lot of that is a line of sight. So on cost synergies, integration opportunities with solid demand. So I think you'll -- we'll be comfortable giving you more guidance, I think, in Q4, but we see incremental improvement month-over-month in each of these categories towards those targets.

我認為這是正確的看待它的方式。我認為，埃里克，你應該預料到我們會——我們制定了第四季度的目標，即比第三季度提高 70%。我們現在還沒有準備好提供廣泛的 '24 指導。我認為我們可能會[冷漠]提供子細分市場指導，因為我認為這會更加令人困惑。但正如我所說，我們看到每個公司的收入和每個市場的需求都在增長。我們已經並正在採取迅速行動來釋放內在的盈利能力，其中很多都是視線範圍內的。因此，關於成本協同效應、與穩定需求的整合機會。因此，我認為，我們會很樂意在第四季度為您提供更多指導，但我們看到每個類別在實現這些目標方面都在逐月逐步改進。

Yes. And just to reemphasize that, Eric, I think when John says the 70%, that means you take the EBITDA loss in Q3, multiply by 30%, and that's -- we will deliver, so we're getting very close to EBITDA breakeven in the fourth quarter, and we have decent line of sight to positive EBITDA for the segment in the first half of next year.

是的。再次強調一下，埃里克，我認為當約翰說 70% 時，這意味著你將第三季度的 EBITDA 損失乘以 30%，那就是——我們將實現目標，所以我們非常接近 EBITDA 盈虧平衡點第四季度，我們對明年上半年該部門的 EBITDA 為正值抱有良好的預期。

And we have reached the end of our question-and-answer session. I will now turn the call back over to Roz Brewer for some final closing remarks.

我們的問答環節已經結束。現在我將把電話轉回羅茲·布魯爾（Roz Brewer）進行最後的總結髮言。

Listen, thank you for your questions this morning on the next phase of our health care transformation, the evolution of our pharmacy retail business and also our capital allocation priorities. I hope you heard from us, we have a strong commitment to move swiftly to address our challenges head on and better executing on our priorities and moving at a faster pace to deliver the value to our employees, our shareholders and our local communities. That's important to us.

聽著，感謝您今天早上就我們醫療保健轉型的下一階段、我們的藥房零售業務的演變以及我們的資本配置優先事項提出的問題。我希望您聽到我們的消息，我們堅定地致力於迅速採取行動，應對正面挑戰，更好地執行我們的優先事項，並以更快的速度為我們的員工、股東和當地社區提供價值。這對我們很重要。

The next phase of our health care transformation requires aggressive actions. And these actions are already in motion and they're focused on improving our profitability against our quality assets. And I want to reinforce that, that we're really committed, we feel good and strong about our investments we've made so far. So we're focused on turning the inherent growth of our assets into profitable growth, where we have embedded profitability in our portfolio already. So we have the scale and the skills and the next phase for us is to operate with urgency, the right plans and drive the growth ahead.

我們醫療保健轉型的下一階段需要採取積極行動。這些行動已經開始實施，重點是提高我們優質資產的盈利能力。我想強調的是，我們真的很投入，我們對迄今為止所做的投資感到良好和堅定。因此，我們專注於將資產的固有增長轉化為盈利增長，我們已經將盈利能力嵌入到我們的投資組合中。因此，我們擁有規模和技能，下一階段我們就是緊急行動、制定正確的計劃並推動未來的增長。

So thank you for your time today.

謝謝您今天抽出時間。

This concludes today's conference call. Thank you for your participation. You may now disconnect.

今天的電話會議到此結束。感謝您的參與。您現在可以斷開連接。