Cencora, the drug wholesaler formerly known as AmerisourceBergen, said Wednesday it has agreed to buy American Oncology Network, a Fort Myers, Florida-based network of community cancer practices, in a deal that values the company at $2.4 billion.
AON brings more than 350 oncology providers working in 21 states. The companies said the purchase will expand Cencora’s oncology practice-support business into 12 additional states. It is Cencora’s second big bet on community oncology in less than a year.
“The acquisition of AON will expand our physician-led oncology MSO and support of care in communities across the country,” said Robert P. Mauch, Cencora’s president and CEO.
What is American Oncology Network?
AON was founded in 2018 as an alliance of oncologists and health care executives. It partners with community cancer practices and provides the business, technology and practice support behind them, so practices can stay in their communities instead of selling to a hospital system. Its shares trade over the counter under the ticker AONC.
Cencora has been an investor in AON since 2020 and already owns about 4% of it. The companies said clinical decisions will continue to rest with AON’s physicians after the deal closes.
“This is the next chapter of the same mission: high-quality, accessible cancer care delivered close to home, led by physicians who know their patients best,” said Todd Schonherz, AON’s chief executive.
How is the $2.4 billion deal structured?
Cencora agreed to buy all of the AON equity it does not already own. The $2.4 billion enterprise value includes $2.3 billion at closing plus up to $100 million in contingent value rights, which Cencora pays only if certain conditions are met.
Some AON stockholders can roll over up to 25% of their stake. If they do, Cencora expects to pay about $1.7 billion to bring its ownership to 75%. Cencora said the deal should add to its adjusted earnings per share in the second year after closing.
The deal still needs regulatory clearance and approval from AON stockholders. AON’s board has approved it on the unanimous recommendation of a special committee of independent directors. No closing date was given.
Alongside the announcement, Cencora raised its fiscal 2026 outlook, saying it now expects adjusted earnings of at least $17.90 a share, the high end of its prior range. It will discuss 2027 on Nov. 4.
What is a cancer MSO, and why do drug distributors want them?
MSO stands for management services organization. It is a company that takes on the business side of a medical practice so physicians can focus on patients. In oncology, that business side is large, because practices buy and give expensive infusion drugs in their own offices.
That is where drug distributors come in. Cancer practices are among the biggest buyers of specialty drugs, and owning the network that supports them gives a wholesaler a steady customer and a role in services from data to clinical trials.
Cencora is not alone. In December, it agreed to buy the rest of OneOncology, a larger physician-led network, in a deal that valued that company at $7.4 billion. Rival McKesson, which already runs The US Oncology Network, completed its purchase of a roughly 70% stake in Florida Cancer Specialists’ business arm, Core Ventures, for about $2.49 billion in 2025.
What does the deal mean for patients and independent practices?
For patients at AON practices, little should change right away. Doctors, clinics and appointments stay the same, and the companies say the goal is to keep cancer treatment in local offices rather than hospital outpatient departments, where the same treatment often costs more.
For independent oncologists, the deal shows how few truly standalone practices are left. Rising drug costs, staffing, payer rules and technology needs have pushed many groups to sell to hospitals or join larger networks. Distributor-backed MSOs pitch themselves as the way to stay independent while getting the scale of a big system.
The trend also raises questions that regulators and payers watch closely, including how much influence a drug supplier has over the practices that buy its products. Those questions are part of why deals of this size need antitrust clearance.
What are the business opportunities in community oncology?
Florida is a center of this market. AON is based in Fort Myers, and Florida Cancer Specialists is one of the largest independent oncology groups in the country. For vendors that sell to cancer practices, such as staffing firms, revenue cycle and technology companies, infusion equipment suppliers and real estate developers, consolidation means fewer, larger buyers with centralized purchasing.
For investors and health care operators, the deal sets another price marker for physician networks. We looked at where money is moving in health care in our report on health care business opportunities, and at why financing and procurement decide who wins.
Key takeaways
- Cencora agreed on Oct. 21, 2026 to acquire Fort Myers, Florida-based American Oncology Network at an enterprise value of $2.4 billion.
- AON has more than 350 oncology providers in 21 states and adds 12 new states to Cencora’s network.
- Cencora expects to pay about $1.7 billion at closing for a 75% stake if AON holders roll over 25%.
- The deal needs regulatory clearance and AON stockholder approval. Physicians will keep control of clinical decisions.
Frequently asked questions
Who is buying American Oncology Network?
Cencora, the Conshohocken, Pennsylvania-based drug distributor formerly known as AmerisourceBergen, announced on Oct. 21, 2026 that it signed a definitive agreement to acquire AON.
How much is Cencora paying for American Oncology Network?
The deal values AON at an enterprise value of $2.4 billion: $2.3 billion at closing plus up to $100 million in contingent payments. If some AON holders keep 25%, Cencora expects to pay about $1.7 billion for 75%.
Will AON patients have to change doctors?
No change was announced for patients. The companies said clinical decisions will continue to rest with AON’s physicians and practices will keep operating in their communities.
When will the Cencora and AON deal close?
No date was announced. The deal is subject to regulatory clearances, AON stockholder approval and other customary closing conditions.
