The company announced that revenue in its European pharmaceutical solutions division – which includes Lloydspharmacy and wholesaler AAH – was $6.6 billion (£5.2bn) for July-September 2018, a 2% drop compared with the same period last year.

It follows a 9% year-on-year rise in revenue for the division for April-June, which the company attributed to its “restructuring programme”.

"Reduction in owned pharmacies"

In October 2017, Lloydspharmacy announced it would cease trading in around 190 “commercially unviable” pharmacies in England, “through a combination of store closures and divestments”. C+D has since identified 78 Lloydspharmacies that have closed, and 104 that have been sold.

The revenue drop in the three months to September 2018 was “primarily driven by the previously disclosed reduction in owned retail pharmacies and a challenging operating environment in the UK”, as well as “increased competition in France”, the company said in its latest financial report, published last week (October 25).

Speaking to journalists after the latest results were published, McKesson executive vice president and chief financial officer Britt Vitalone said the division’s operating profit after taxes was down 40% to $53m (£41.7m) for July-September.

This was “driven primarily” by the additional 17p-per-item category M clawback in July, “market conditions in our UK business, and increased competition in the French wholesale market”, he said.

“Facing a challenging market in the UK due to reimbursement cuts and declining prescription volumes, we took action last year to rationalise our store footprint and streamline our back office operations,” chief executive and chairman John Hammergren explained in the call.

“As these trends evolved in the UK, we continued to evaluate our footprint and cost structure, and our UK colleagues remain committed to stabilising the business and repositioning it for long-term profitability. All led by a newly appointed president [see below] with more than a decade of industry experience,” he added.

He admitted that the category M clawbacks “were in excess of historical levels and greater than we had planned for in our fiscal 2019 guide”.

“Difficulty predicting how cuts would affect us”

Also on the conference call, McKesson president and chief operating officer Brian Tyler said the company “continues to be in very active dialogue with regulators in the UK to champion” the sector.

“Community pharmacy plays an important role in the overall population health of the communities that they serve. And so we continue to evolve our model in that direction,” he explained.

“Clearly, the reimbursement landscape has been a challenging one for us, not just in the magnitude of the cuts we absorb, but in the difficulty of predicting when and how those cuts have hit us.”

Commenting on last week's funding announcement, Mr Tyler said he was “encouraged” that funding for pharmacies in England “will remain flat for the coming year, where the original intent had been to impose some more decline”.

“We view that as certainly incrementally positive news for us,” he said.