Key Highlights

  • Revenue rose 8.0% to USD 4.428 billion, and adjusted diluted EPS rose 11.3% to USD 3.34.
  • R&D Solutions net new bookings rose 15% to USD 3.2 billion, a 1.2 times book-to-bill ratio.
  • Adjusted EBITDA rose 8.7% to USD 1.032 billion, while free cash flow reached USD 667 million.
  • Management raised 2026 revenue guidance to USD 17.35 to 17.5 billion and adjusted diluted EPS to USD 12.90 to 13.00.

Bookings Strengthen Across Clinical and Commercial

IQVIA (NYSE:IQV) reported third-quarter revenue of USD 4.428 billion on Tuesday, up 8.0% as reported and 8.6% at constant currency. Commercial Solutions revenue rose 6.9% to USD 1.789 billion, and R&D Solutions revenue rose 8.7% to USD 2.639 billion, or 6.8% excluding reimbursed expenses. GAAP net income was USD 350 million, or USD 2.10 per diluted share, and adjusted net income was USD 557 million, or USD 3.34 per diluted share.

Adjusted EBITDA rose 8.7% to USD 1.032 billion with margin expansion of 20 basis points. Management cited 80 basis points of underlying operational improvement, offset by currency and about 70 basis points of pressure on gross margin from pass-through revenue. Chairman and Chief Executive Ari Bousbib said revenue, adjusted EBITDA and adjusted EPS all exceeded the high end of expectations.

R&D Solutions net new bookings were USD 3.2 billion, up 15%, with five consecutive quarters of rising bookings and, according to management, the strongest clinical quarter since 2022. Trailing 12-month bookings were USD 11.7 billion, up 14%.

Backlog Adjustment and Demand Signals

The company reviewed inactive trials in its backlog and removed about USD 2.1 billion of trials that had shown no progress for 18 months or longer. The adjustment does not change historical results, 2026 guidance, book-to-bill or next-twelve-month revenue from backlog. Contracted backlog stood at USD 32.6 billion, and about USD 9.4 billion is slated to convert to revenue over the next 12 months, up 10%.

Management pointed to demand indicators including emerging biopharma funding of about USD 90 billion year to date, up more than 85%, new drug approvals up more than 40%, and high single-digit growth in clinical trial starts. It reported 415 AI agents deployed, which it linked to win-rate gains of two to three points.

Cash, Debt and Guidance

Operating cash flow was USD 825 million and free cash flow USD 667 million, or 120% of adjusted net income. Cash was USD 2.249 billion against debt of USD 16.067 billion, leaving net debt of USD 13.818 billion, or 3.45 times trailing adjusted EBITDA.

Nine-month revenue was USD 12.947 billion, up 8.4%, with GAAP net income of USD 880 million, or USD 5.24 per share, and adjusted EPS of USD 9.38, up 10.4%.

Management raised 2026 guidance to revenue of USD 17.35 billion to USD 17.5 billion, adjusted EBITDA of USD 4.025 billion to USD 4.055 billion and adjusted diluted EPS of USD 12.90 to USD 13.00. The revenue range includes about 250 basis points from acquisitions, including deals management expects to complete by year end, and about 20 basis points from currency. Fourth-quarter assumptions include net interest expense of USD 210 million and about 169 million shares. An Investor Day is set for Dec. 1.

Research Services Markers to Follow

Tracking points include R&D Solutions bookings against USD 3.2 billion, backlog conversion relative to the USD 9.4 billion expected over 12 months, and adjusted EBITDA margin after pass-through effects.

Further items are net leverage against 3.45 times, acquisition contribution relative to 250 basis points, and fourth-quarter comparisons that management said are difficult.