Starling Oncology (STLN) Investor presentation summary

Strategic positioning and business model

• Operates a national value-based care (VBC) oncology platform with a balanced model combining at-risk VBC and fee-for-service (FFS) ancillary services.

• Addresses a large and growing total addressable market (TAM) driven by rising cancer incidence and oncology care costs.

• Delivers care through community oncologists, specialty pharmacy, and a delegated provider network, uniting benefits management and direct care.

• Proprietary Starling Oncology Nexus platform centralizes utilization management, clinical pathways, and analytics, driving >98% formulary adherence and >95% same-day order approvals.

• Demonstrates strong differentiation through integrated care delivery, direct drug procurement, and incentive alignment for cost-effective treatment.

Financial performance and outlook

• Achieved consistent revenue growth, with FY2026 revenue guidance of $650–670M and Adjusted EBITDA of $2–7M.

• Revenue mix in FY2025: 54% specialty pharmacy, 29% FFS, 16% capitation, and ~1% clinical/other.

• Recurring, visible revenue supported by multi-year capitation contracts and recurring treatment cycles.

• SG&A as a percentage of revenue declined to 18.6% in 2Q26, supporting margin expansion.

• Free cash flow guidance for FY2026 is $5–15M, with EBITDA margin expected to scale to mid-single digits by 2028.

Operational highlights and growth drivers

• Patient reach exceeds 2.3M VBC lives, with over 300K encounters projected for 2025.

• Non-California markets are the primary growth engine, with lives up 272% and revenue up 44% since 2024.

• Recent milestones include refinancing debt, rebranding, California exclusivity, and launching the Nexus provider portal.

• Growth strategy focuses on expanding into new markets, deepening customer relationships, adding ancillary services, and strategic M&A.

• Maintains stable medical loss ratio (MLR) at scale, with industry-leading utilization management and cost control.