Bull case
McKesson is supported by a scaled North American distribution moat, with 27 U.S. and 12 Canadian distribution centers, over one-third of medications distributed in North America, and roughly 99.9% order accuracy, which underpins resilient volume growth and customer stickiness. Its outlook is strengthened by specialty pharma expansion, as specialty already represents 54% of net U.S. manufacturer revenues, while McKesson’s specialty distribution revenue reached $90 billion in fiscal 2025 and its oncology and multispecialty segment is expected to grow at a 15.3% CAGR from fiscal 2026 through fiscal 2029. The company also benefits from high-margin services and strong capital generation, including 1.3x gross debt to adjusted EBITDA, about 120% free cash flow conversion, and a planned medical-surgical spin-off that should sharpen focus on higher-growth businesses.