Starling Oncology Earnings Call Transcripts
Fiscal Year 2026
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Q3 revenue grew 24.3% YoY to $169.8M, with positive Adjusted EBITDA of $3.4M and improved sequential MLR. 2026 guidance was updated, while 2027 capitation growth and high-teens normalized pharmacy margins remain key expectations.
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Achieved first fully profitable year, doubled down on capital-light growth, and expanded delegated contracts across multiple states. Pharmacy now drives over 60% of revenue with rising margins, and robust pipeline supports a 2027 goal to double capitated revenue.
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Q2 2026 saw record revenue, positive adjusted EBITDA, and a successful refinancing that improved liquidity. New capitation contracts in Nevada, Oregon, and California drove growth, while guidance for 2026 was raised on strong specialty pharmacy performance.
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Q1 2026 saw 41% revenue growth, record specialty pharmacy performance, and profitability in Florida. Guidance for revenue, adjusted EBITDA, and free cash flow was reaffirmed or raised, with ongoing expansion in value-based contracts and AI-driven efficiencies.
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A value-based oncology provider is expanding rapidly through delegated contracts, especially in Florida, and expects significant growth in capitated revenue and profitability through 2028. The dispensary segment has become the largest revenue driver, and AI initiatives are set to enhance efficiency and margins.
Fiscal Year 2025
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Achieved first profitable quarter on adjusted EBITDA in Q4 2025, with revenue up 28% year-over-year and strong growth in pharmacy and capitated care. 2026 guidance projects continued revenue and margin expansion, with positive free cash flow expected by year-end.
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Q3 2025 saw 36.7% revenue growth, record Pharmacy results, and improved adjusted EBITDA, with the first profitable month in September. Guidance for 2025 was raised, and operational momentum is strong, supported by new contracts, AI initiatives, and expanding payer relationships.
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Oncology care costs are rising unsustainably, but a value-based model with employed clinicians and proprietary care pathways is delivering significant cost savings, high patient satisfaction, and robust financial growth. Expansion focuses on existing high-utilization markets, with profitability projected in Q4.
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Q2 2025 saw over 20% revenue growth, strong pharmacy expansion, and improved margins, with new value-based contracts and a path to positive adjusted EBITDA by Q4. Leadership changes and AI initiatives support further efficiencies and growth.
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Q1 2025 saw 10% revenue growth and a 44% increase in gross profit, driven by strong dispensary performance and new capitated contracts. Guidance for 2025 is reaffirmed, with positive adjusted EBITDA and cash flow targeted for Q4. Balance sheet strengthened through debt reduction and capital raise.
Fiscal Year 2024
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Revenue grew 21% in 2024, driven by value-based contracts and pharmacy expansion, while cost controls and capital actions improved cash flow and reduced debt. 2025 guidance targets 17–22% revenue growth, margin expansion, and profitability by year-end, with Florida as a key growth market.
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Q3 2024 saw 21.8% revenue growth year-over-year, driven by strong pharmacy and capitation contract expansion, while cost controls improved margins and reduced SG&A as a percentage of revenue. Net loss improved, and new radiopharmaceutical services are set to boost 2025 results.
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Q2 2024 saw 23% revenue growth and strong pharmacy expansion, but gross margins were pressured by DIR fees and low reimbursement. Strategic alternatives are under review, with improved profitability expected in the second half as new contracts go live.
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Record value-based contract growth and operational efficiency are driving improved margins and cash flow. New contracts in high-value markets and a comprehensive care model position the company for sustainable expansion, with a focus on profitability and disciplined cost management.