Cencora to Acquire Equity in OneOncology for $7.4B Enterprise Valuation

The acquisition represents a decisive step for Cencora in solidifying its presence in community oncology. By purchasing the remaining equity in OneOncology, in which it previously held a ~35% stake as part of earlier 2023 arrangements, Cencora transitions from minority partner to majority owner, gaining greater strategic control over a platform that now spans roughly 1,750 providers and 565 practice locations nationwide. This accelerates its ability to channel pharmaceutical solutions directly through physician-led networks. [3][9]

Financially, the structure places ~$5 billion of cash commitment on Cencora’s balance sheet—$3.6 billion for equity and $1.3 billion to clear corporate debt—funded via new debt financing while maintaining investment-grade ratings. Short-term earnings may be dampened; share repurchases are paused, and adjusted diluted EPS is expected to land toward the lower-end of the guidance range in fiscal 2026. However, long-term projections have been raised, suggesting management views OneOncology as an earnings and growth driver. [2][4]

Strategically, this move aligns with broader trends in U.S. health care where drug distributors are acquiring MSOs (management services organizations) and provider networks to capture value beyond distribution margins. Similar plays in specialty areas such as retina (with Retina Consultants of America) show Cencora’s focus on pharmaceutical-centric specialties that rely heavily on drug delivery, advanced clinical care and high margin services. [3][4]

Risks and open questions include regulatory approval—this deal will be scrutinized for competition and consolidation concerns given Cencora’s scale—and integration challenges. Retaining clinician leadership and management remains important for preserving OneOncology’s appeal to affiliated practices. Also, debt load uptick and pause in buybacks indicate an immediate trade-off in financial flexibility and shareholder returns. Questions also arise about whether the anticipated synergies—clinical trial enrollment, innovation, and patient access—will materialize at scale in diverse markets.