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Business Segment Information
6 Months Ended
Mar. 31, 2024
Segment Reporting [Abstract]  
Business Segment Information Business Segment Information
    The Company is organized geographically based upon the products and services it provides to its customers and reports its results under two reportable segments: U.S. Healthcare Solutions and International Healthcare Solutions.
The following illustrates reportable and operating segment disaggregated revenue as required by Accounting Standards Codification 606, "Revenue from Contracts with Customer," for the periods indicated:
Three months ended
March 31,
Six months ended
March 31,
(in thousands)2024202320242023
U.S. Healthcare Solutions:
Human Health$59,984,359 $55,453,964 $123,882,524 $110,530,577 
Animal Health1,308,538 1,239,492 2,594,175 2,399,458 
Total U.S. Healthcare Solutions61,292,897 56,693,456 126,476,699 112,930,035 
International Healthcare Solutions:
Alliance Healthcare5,754,980 5,560,936 11,480,544 11,021,627 
Other Healthcare Solutions1,368,405 1,203,999 2,713,068 2,354,586 
Total International Healthcare Solutions7,123,385 6,764,935 14,193,612 13,376,213 
Intersegment eliminations(1,975)(1,186)(3,171)(2,211)
Revenue$68,414,307 $63,457,205 $140,667,140 $126,304,037 
The following illustrates reportable segment operating income information for the periods indicated:
Three months ended
March 31,
Six months ended
March 31,
(in thousands)2024202320242023
U.S. Healthcare Solutions$841,064 $756,137 $1,539,188 $1,328,553 
International Healthcare Solutions192,720 175,991 380,315 337,273 
Total segment operating income$1,033,784 $932,128 $1,919,503 $1,665,826 
The following reconciles total segment operating income to income before income taxes for the periods indicated:
Three months ended
March 31,
Six months ended
March 31,
(in thousands)2024202320242023
Total segment operating income$1,033,784 $932,128 $1,919,503 $1,665,826 
Gains from antitrust litigation settlements8,714 — 56,962 49,899 
LIFO credit (expense)22,835 (54,270)71,280 (79,320)
Turkey highly inflationary impact(23,053)(4,855)(40,279)(8,439)
Acquisition-related intangibles amortization(164,799)(140,114)(330,523)(211,992)
Litigation and opioid-related expenses, net(225,985)(15,813)(147,068)(28,519)
Acquisition-related deal and integration expenses(22,610)(59,113)(43,673)(80,109)
Restructuring and other expenses(75,627)(97,444)(110,068)(113,684)
Operating income553,259 560,519 1,376,134 1,193,662 
Other loss (income), net22,063 (15,720)20,976 (22,048)
Interest expense, net64,130 64,109 104,694 110,125 
Income before income taxes$467,066 $512,130 $1,250,464 $1,105,585 
Segment operating income is evaluated by the Chief Operating Decision Maker of the Company before gains from antitrust litigation settlements; LIFO credit (expense); Turkey highly inflationary impact; acquisition-related intangibles amortization; litigation and opioid-related expenses, net; acquisition-related deal and integration expenses; and restructuring and other expenses. All corporate office expenses are allocated to the operating segment level.
Litigation and opioid-related expenses, net in the three and six months ended March 31, 2024 includes a $214.0 million litigation accrual for ongoing litigation related to the distribution of prescription opioid medications (see Note 10). The six-month period ended March 31, 2024 also includes a net $92.2 million opioid litigation settlement accrual reduction primarily as a result of the Company's prepayment of the net present value of a future obligation as permitted under its settlement agreements.