Revenue growth accelerated to 41.2% in 2026Q1, yet thin gross margins of 14.7% and negative operating margins of -4.4% suggest that high pharmaceutical procurement costs continue to impede profitability.
| Sales/Revenue | 545.76M | 502.73M | 393.41M | 324.24M | 252.48M | 203M | 187.51M | 155.41M |
| Revenue Growth % | 35.37% | 27.79% | 21.33% | 28.42% | 24.37% | 8.26% | 20.66% | - |
| Cost of Goods Sold | 464.88M | 426.29M | 339.42M | 264.67M | 200.39M | 162.16M | 150.64M | 125.46M |
| COGS % of Revenue | - | 84.8% | 86.27% | 81.63% | 79.37% | 79.88% | 80.33% | 80.73% |
| Gross Profit | 80.89M | 76.44M | 54M | 59.57M | 52.09M | 40.85M | 36.88M | 29.94M |
| Gross Margin % | 14.82% | 15.2% | 13.73% | 18.37% | 20.63% | 20.12% | 19.67% | 19.27% |
| Gross Profit Growth % | - | 41.55% | -9.36% | 14.36% | 27.53% | 10.76% | 23.17% | - |
| Operating Expenses | 113.57M | 112.52M | 114.11M | 136.59M | 134.04M | 86.71M | 45.07M | 32.59M |
| OpEx % of Revenue | - | 22.38% | 29.01% | 42.13% | 53.09% | 42.71% | 24.04% | 20.97% |
| Selling, General & Admin | 81.5M | 105.57M | 0 | 0 | 0 | 0 | 41.9M | 29.64M |
| SG&A % of Revenue | - | 21% | - | - | - | - | 22.34% | 19.07% |
| Research & Development | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| R&D % of Revenue | - | - | - | - | - | - | - | - |
| Other Operating Expenses | 3M | 6.94M | 114.11M | 136.59M | 134.04M | 86.71M | 3.18M | 2.94M |
| Operating Income | -32.69M | -36.08M | -60.12M | -77.02M | -81.95M | -45.86M | -8.2M | -2.64M |
| Operating Margin % | -5.99% | -7.18% | -15.28% | -23.75% | -32.46% | -22.59% | -4.37% | -1.7% |
| Operating Income Growth % | - | 39.98% | 21.94% | 6.02% | -78.71% | -459.52% | -209.89% | - |
| EBITDA | -25.91M | -29.14M | -53.83M | -71.14M | -77.54M | -42.52M | -5.02M | 297.11K |
| EBITDA Margin % | -4.75% | -5.8% | -13.68% | -21.94% | -30.71% | -20.94% | -2.68% | 0.19% |
| EBITDA Growth % | 43.03% | 45.87% | 24.34% | 8.25% | -82.37% | -747.31% | -1788.91% | - |
| D&A (Non-Cash Add-back) | 6.78M | 6.94M | 6.29M | 5.87M | 4.41M | 3.34M | 3.18M | 2.94M |
| EBIT | -37.9M | -49.46M | -60.12M | -60.15M | -72.01M | -45.38M | -14.47M | -2.63M |
| Net Interest Income | -7.64M | -11.28M | -7.5M | -6.78M | -4.08M | -320K | -347K | -3.38K |
| Interest Income | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Interest Expense | 7.64M | 11.28M | 7.5M | 6.78M | 4.08M | 320K | 347K | 3.38K |
| Other Income/Expense | -10.96M | -24.65M | -4.54M | -6.09M | 81.86M | 34.26M | -6.62M | 6.63K |
| Pretax Income | -43.64M | -60.74M | -64.66M | -83.1M | -91K | -11.6M | -14.81M | -2.64M |
| Pretax Margin % | -8% | -12.08% | -16.44% | -25.63% | -0.04% | -5.71% | -7.9% | -1.7% |
| Income Tax | -131K | -131K | 0 | -36K | -243K | -671K | -492.82K | 1.38M |
| Effective Tax Rate % | 0.3% | 0.22% | 0% | 0.04% | 267.03% | 5.79% | 3.33% | -52.43% |
| Net Income | -43.51M | -60.61M | -64.66M | -83.07M | 152K | -10.93M | -14.32M | -4.02M |
| Net Margin % | -7.97% | -12.06% | -16.44% | -25.62% | 0.06% | -5.38% | -7.64% | -2.59% |
| Net Income Growth % | 32.39% | 6.27% | 22.16% | -54750% | 101.39% | 23.7% | -256.13% | - |
| Net Income (Continuing) | -43.51M | -60.61M | -64.66M | -83.07M | 152K | -10.93M | -14.32M | -4.02M |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| EPS (Diluted) | -0.04 | -0.54 | -0.71 | -0.92 | -0.21 | -0.16 | -0.24 | -0.06 |
| EPS Growth % | 50% | 23.94% | 22.83% | -338.1% | -31.25% | 33.33% | -284.62% | - |
| EPS (Basic) | - | -0.54 | -0.71 | -0.92 | 0.00 | -0.16 | -0.24 | -0.06 |
| Diluted Shares Outstanding | 1.02B | 923.89M | 75.04M | 73.75M | 80.61M | 66.23M | 59.12M | 64.45M |
| Basic Shares Outstanding | 1.02B | 923.89M | 75.04M | 73.75M | 72.79M | 66.23M | 59.12M | 64.45M |
| Dividend Payout Ratio | - | - | - | - | - | - | - | - |
Insufficient liquidity for expansion
According to the latest quarterly data, TOI has achieved a notable revenue growth acceleration, reaching 41.2% year-over-year in 2026Q1, which suggests that the company's strategy of rapid geographic footprint expansion is successfully driving top-line volume despite the inherent volatility of the oncology care market.
The recent surge in revenue growth indicates that the company is successfully capturing market share in new territories like Texas and Florida. However, investors should monitor whether this growth is sustainable or if it is primarily driven by the high-cost procurement of oncology pharmaceuticals that offer minimal contribution to the bottom line.
As reported in financial statements, TOI maintains a thin gross margin profile, hovering around 14.7% in 2026Q1, which highlights the significant burden of pharmaceutical procurement costs that appear to limit the company's ability to retain meaningful profit from its high-volume patient services and infusion segments.
The inability to expand gross margins despite significant revenue growth suggests that the company lacks substantial pricing power over its primary input costs. This structural limitation implies that the business model remains highly sensitive to pharmaceutical price inflation, which could further compress margins if payer capitation rates do not adjust accordingly.
Based on the provided income statement data, TOI's operating margin of -4.4% in 2026Q1 indicates that administrative and clinical overhead continues to outpace gross profit generation, suggesting that the company has yet to achieve the necessary economies of scale required to reach operational break-even at its 67 locations.
While the operating loss has narrowed from the -19.0% seen in 2024Q1, the persistent negative operating income suggests that the current cost structure is not yet optimized for profitability. Investors should investigate whether the recent SG&A fluctuations reflect a permanent reduction in overhead or merely a temporary deferral of necessary clinical support costs.
Data from recent filings reveals a precarious cash position of $33.5M, which, when viewed alongside ongoing quarterly operating losses, suggests that the company may face significant liquidity constraints if it cannot achieve cash-flow neutrality or secure additional financing in the near term to fund its growth.
The reliance on aggressive de-novo clinic openings to drive growth creates a high-burn environment that leaves little room for operational error. If the company fails to demonstrate a clear path to positive EBITDA, the market may increasingly focus on the risk of dilutive financing or the potential for a liquidity crunch.
Quick answers to the most common questions about buying TOI stock.
For fiscal year 2025, The Oncology Institute, Inc. (TOI) reported total revenue of $502.7M. This represents a 223.5% increase compared to $155.4M in 2019.
The Oncology Institute, Inc. (TOI) reported a net loss of $60.6M for the fiscal year ending 2025.
The Oncology Institute, Inc. (TOI) reported an operating income of $-36.1M, resulting in an operating profit margin of -7.2%. This margin reflects the operational efficiency of the business before interest and taxes.
The Oncology Institute, Inc. (TOI) generated $76.4M in gross profit for the year, representing a gross profit margin of 15.2%. This demonstrates the company's core pricing power and production efficiency.