Cencora deal values Fort Myers cancer firm at $2.4B

Pharmaceutical distributor Cencora plans to buy Fort Myers-headquartered American Oncology Network in a deal valued at up to $2.4 billion, the companies announced Oct. 21.

The agreement would give Pennsylvania-based Cencora a larger stake in community cancer care. AON, founded in 2018, has grown to more than 350 oncology providers across 21 states. The purchase would extend Cencora’s physician-services operations into 12 additional states.

Cencora, which distributes medicines and provides services to healthcare providers, has more than $300 billion in annual revenue. It already owns about 4% of AON and has invested in the company since 2020.

The $2.4 billion enterprise valuation includes $2.3 billion at closing and up to $100 million in payments contingent on meeting certain conditions. Some AON shareholders could retain a combined ownership stake of as much as 25% rather than sell their interests outright. If they do, Cencora expects to pay approximately $1.7 billion in cash and emerge with a 75% stake.

“The acquisition of AON will expand our physician-led oncology MSO and support of care in communities across the country,” Cencora CEO Robert P. Mauch said in a statement.

The proposed purchase would add AON’s management-services operations to Cencora’s healthcare business. Cencora said the deal would give AON more resources to expand its technology, practice services and network of physicians.

The Fort Myers company supports independent oncology practices with billing, technology, pharmacy and laboratory services, allowing physicians to share administrative resources while retaining control over treatment decisions.

Cancer treatment requires expensive medications, specialized facilities and complex administrative work, making it difficult for smaller practices to operate independently. AON helps ease those burdens by providing shared services and resources across its network of physicians.

“For patients facing a cancer diagnosis, ensuring dependable access to advanced and innovative therapy is crucial to their survival,” said Dr. Stephen “Fred” Divers, AON’s chief medical officer. “This partnership will bolster AON’s mission of sustainably delivering the highest quality care to patients in their own communities.”

AON has also had an unusual path through the public markets.

In October 2022, AON announced plans to go public through a merger with Digital Transformation Opportunities Corp., a special purpose acquisition company, or SPAC. The proposed transaction valued the combined company at approximately $500 million.

AON shares began trading on Nasdaq on Sept. 21, 2023, under the symbol AONC. The listing lasted less than nine months. AON voluntarily left the exchange in June 2024, citing limited trading, little analyst coverage and the costs of complying with public-company reporting rules. Its stock began trading on the OTCQX market June 10, 2024.

At the time it announced its delisting, AON reported a network of more than 240 providers. The latest figure of more than 350 shows the company continued adding physicians after leaving Nasdaq.

“Our physicians, clinicians and care teams, and the patients they serve, have always been at the heart of AON, and this agreement is about giving them more support, more resources and more time for patient care,” AON CEO Todd Schonherz said in a statement.

The companies said clinical decisions would remain with AON physicians after the acquisition.

The acquisition would follow another large investment by Cencora in community oncology. In February, it paid about $4.6 billion to acquire majority control of OneOncology, another company that provides business services to independent cancer practices.

Cencora expects the AON acquisition to increase its adjusted earnings per share in the second year after the deal closes. Cencora also updated its fiscal 2026 adjusted earnings forecast Oct. 21 to at least $17.90 per share.

The purchase still needs regulatory clearance and AON shareholder approval. AON’s board has approved the agreement, but the companies have not announced a closing date or detailed any effects on staffing or operations in Fort Myers.