Starling Oncology Inc (NAS:STLN)

Q2 2026 Oncology Institute Inc Earnings Call Transcript

Aug 6, 2026 / 09:00 PM GMT

Release Date Price: $5 (-0.60%)

Transcript 10-Q8-K

Key Points

Positve

Starling Oncology Inc (STLN) reported a strong second quarter with revenue of approximately $161 million, a 35% year-over-year increase, and achieved positive adjusted EBITDA for the second consecutive quarter.
The company completed a strategic refinancing with OrbiMed, replacing an $86 million convertible note with a $75 million term loan, extending debt maturities to 2031 and improving liquidity without diluting shareholders.
Starling Oncology Inc (STLN) is expanding its capitated contracts significantly, adding three new contracts in Nevada and Oregon (80,000 lives, ~$50 million annualized revenue) and achieving exclusivity in California (230,000 lives, ~$6 million annualized revenue).
The specialty pharmacy segment showed strong growth, with revenue up 57.6% year-over-year and gross margin improving to 21.6% from 18.4%, driven by scale, procurement optimization, and clinical pathway management.
The company raised its full-year revenue and gross profit guidance, and expects free cash flow to remain positive, reflecting improved operational efficiency and strong momentum in the first half of 2026.
Starling Oncology Inc (STLN) is launching a new provider portal, Starling Nexus, which is expected to drive clinical pathway adherence, ancillary service adoption, and provide valuable data insights for MLR performance.

Negative

Patient services gross profit declined 57% year-over-year to $2.1 million, due to increased clinical labor costs, a conservative fee-for-service approach, and a natural increase in MLR as new lives are onboarded.
The medical loss ratio (MLR) increased significantly to 85.5% in Q2 2026 from 71% a year ago, and is expected to fluctuate in the 80%-90% range over the next 12 months as delegated members are onboarded.
The statewide payer relationship in Florida was pushed from Q3 to Q4, which will impact third-quarter capitated revenue and reflects process-related delays at the payer level.
Third-quarter adjusted EBITDA is expected to be muted at $500,000 to $1.5 million due to the onboarding of 230,000 new members in California, which will temporarily pressure profitability.
The company's rebrand to Starling Oncology may cause temporary confusion among existing partners and patients, requiring a targeted communication campaign to ensure smooth brand recognition.
Specialty pharmacy gross margin improvements are partly driven by temporary procurement initiatives, and management expects margins to come down slightly in future quarters, indicating the current level may not be sustainable.

Refinitiv StreetEvents Event Transcript
E D I T E D V E R S I O N

STLN.OQ - Starling Oncology, Inc.
Q2 2026 Oncology Institute Inc Earnings Call
Aug 06, 2026 / 09:00PM GMT

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Presentation
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Unidentified_1 [1]
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Please stand by, your meeting is about to begin.

Hello and welcome everyone joining today's Starling Oncology's second quarter 2026 earnings call.

At this time, all participants are in a listen-only mode.

Later, you will have the opportunity to ask questions during the question-and-answer session.

To register to ask a question at any time, please press star one on your telephone keypad. Please note this call is being recorded.

We are standing by if you should need any assistance.

It is now my pleasure to turn the meeting over to Minh Merchant. Please go ahead.

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Unidentified_2 [2

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