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TOIThe Oncology Institute, Inc.
$5.44$5.5B
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The Oncology Institute, Inc. (TOI) Financial Ratios

Latest Ratios: P/E Ratio -10.1x · EV/EBITDA N/A · ROE N/A. (2019–2025 historical series)

Income StatementBalance SheetCash FlowRatios
AnnualQuarterly

TOI Valuation Multiples

Price-based multiples — how expensive the stock is relative to earnings, sales, book value, and cash flow

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
Market Cap$5.5B$3.3B$23M$150M$133M$646M$638M—
Enterprise Value$5.6B$3.4B$97M$237M$227M$532M$644M—
P/E Ratio →-10.07———————
P/S Ratio11.026.540.060.460.533.183.40—
P/B Ratio——6.462.641.086.2022.72—
P/FCF————————
P/OCF——————1256.83—

P/E links to full P/E history page with 30-year chart

TOI EV Ratios

Enterprise-value multiples — capital-structure-neutral measures of total business value

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
EV / Revenue—6.680.250.730.902.623.44—
EV / EBITDA————————
EV / EBIT————————
EV / FCF————————

TOI Profitability

Margins and return-on-capital ratios measuring operating efficiency

Margins

Full margin charts and quarterly trend are on the Earnings History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
Gross Margin15.2%15.2%13.7%18.4%20.6%20.1%19.7%19.3%
Operating Margin-7.2%-7.2%-15.3%-23.8%-32.5%-22.6%-4.4%-1.7%
Net Profit Margin-12.1%-12.1%-16.4%-25.6%0.1%-5.4%-7.6%-2.6%

Return on Capital

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
ROE——-213.4%-92.2%0.1%-16.5%-40.7%-9.5%
ROA-35.9%-35.9%-33.9%-35.3%0.1%-8.1%-22.9%-6.8%
ROIC-41.2%-41.2%-40.9%-32.0%-59.3%-285.7%-16.7%-5.0%
ROCE-33.7%-33.7%-40.8%-37.9%-40.4%-43.5%-19.7%-5.8%

TOI Leverage & Debt

Solvency and debt-coverage ratios — lower is generally safer

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
Debt / Equity——34.312.100.880.000.42—
Debt / EBITDA————————
Net Debt / Equity——20.471.510.76-1.100.21-0.06
Net Debt / EBITDA———————-8.23
Debt / FCF———————-1.01
Interest Coverage-4.39-4.39-8.02-8.88-17.64-141.82-41.69-780.67

TOI Liquidity & Efficiency

Short-term solvency ratios and asset-utilisation metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
Current Ratio1.591.592.154.124.395.171.041.60
Quick Ratio1.351.351.963.734.084.950.891.32
Cash Ratio0.470.470.952.382.483.840.210.18
Asset Turnover—3.052.281.550.961.002.852.61
Inventory Turnover25.2625.2633.8119.3521.6425.1934.6032.26
Days Sales Outstanding—43.0745.1748.3158.4538.2033.5934.61

TOI Shareholder Yields

Earnings, FCF, buyback, and dividend yields — total returns to shareholders

Dividends

Full dividend history and growth charts are on the Dividend History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
Dividend Yield————————
Payout Ratio————————

Total Shareholder Return Metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019
Earnings Yield————————
FCF Yield————————
Buyback Yield0.0%0.0%0.0%0.7%6.8%0.0%0.0%—
Total Shareholder Yield0.0%0.0%0.0%0.7%6.8%0.0%0.0%—
Shares Outstanding—$924M$75M$74M$81M$66M$59M$64M

Key Metrics

Growth RegimeAccelerating
ProfitabilityNegative
Balance SheetVulnerable
Cash FlowBurning
Top Statement Risk

Insufficient liquidity for expansion

Verified Source

Metrics are mathematically derived from official filings.

SEC 10-K (2026Q1)

Market Valuation Reflects Growth Uncertainty

According to recent market data, TOI trades at a price-to-sales multiple of 10.91, a valuation that appears disconnected from the company's persistent negative net margins and suggests investors are pricing in a significant, yet unproven, long-term pivot toward high-margin clinical trial revenue streams.

The current P/S multiple implies a growth-oriented valuation that is difficult to justify given the company's inability to demonstrate consistent profitability at the operating level. Investors should monitor whether this premium valuation is sustainable if the company fails to convert its 67-location footprint into a scalable, data-driven platform for pharmaceutical partnerships.

Capital Efficiency Remains Deeply Negative

Based on reported financial figures, TOI's ROIC has remained consistently negative, bottoming out at -23.4% in 2025Q3, which indicates that the capital deployed into clinic expansion is currently destroying shareholder value rather than compounding returns on invested capital over the observed period.

The persistent negative ROIC suggests that the company's aggressive de-novo strategy has yet to reach the critical mass required to offset the high fixed costs of its clinical infrastructure. This trend warrants further investigation into whether the current model can ever achieve positive returns without a fundamental shift in its payer-contracting strategy.

Working Capital Cycles Show Strain

As reported in quarterly filings, TOI's cash conversion cycle has fluctuated significantly, reaching 18 days in 2026Q1, which suggests that while the company is managing its payables more aggressively, the underlying volatility in its receivables remains a potential drag on operational liquidity.

The reduction in the cash conversion cycle appears to be driven by a tactical extension of days payable outstanding, which may not be sustainable if supplier relationships are pressured. Analysts should interpret this efficiency gain with caution, as it may mask underlying difficulties in collecting capitated payments from payers in a timely manner.

Liquidity Position Limits Strategic Flexibility

According to the latest balance sheet data, TOI's current ratio has compressed to 1.47 in 2026Q1, a level that, when combined with ongoing operating losses, suggests the company has limited room for error in managing its near-term cash requirements and potential debt service obligations.

The decline in the current ratio from its 2023Q4 peak of 4.12 indicates a rapid consumption of liquid assets to fund operational deficits. This trend suggests that the company may face a liquidity crunch if it cannot achieve cash-flow neutrality before its existing cash reserves are exhausted.

Misapplication of Revenue-Based Valuation Metrics

The most commonly misapplied metric for TOI is the price-to-sales ratio, which obscures the company's high-cost pharmaceutical procurement model and fails to account for the fact that a significant portion of top-line revenue is essentially pass-through volume with minimal contribution to gross profit.

Investors should instead focus on gross profit per member or net premium revenue to better understand the true unit economics of the company's risk-based contracts. Relying on P/S multiples in this context may lead to an overestimation of the company's intrinsic value by ignoring the structural margin constraints inherent in oncology drug management.

Download Financial Ratios Data

Includes 30+ ratios · 7 years · Updated daily

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TOI — Frequently Asked Questions

Quick answers to the most common questions about buying TOI stock.

What is The Oncology Institute, Inc.'s P/E ratio?

The Oncology Institute, Inc.'s current P/E ratio is -10.1x. This places it at the 50th percentile of its historical range.

Is TOI stock overvalued?

Based on historical data, The Oncology Institute, Inc. is trading at a P/E of -10.1x. This is at the 50th percentile of its historical P/E range. Compare with industry peers and growth rates for a complete picture.

What are The Oncology Institute, Inc.'s profit margins?

The Oncology Institute, Inc. has 15.2% gross margin and -7.2% operating margin.