Key Highlights

  • Adjusted diluted EPS was $3.34, up 11.3% from $3.00, against $3.28 as screened; GAAP EPS was $2.10 versus $1.93.
  • Revenue was $4,428 million, up 8.0% and 8.6% at constant currency.
  • R&D Solutions net new bookings were $3.2 billion, up 15%, for a book-to-bill ratio of 1.2.
  • 2026 adjusted EPS guidance is $12.90 to $13.00, with revenue of $17,350 million to $17,500 million.
  • Free cash flow was $667 million, down from $772 million, and net leverage was 3.45 times.

IQVIA Earnings: Why Did a $2.1 Billion Backlog Cut Come With a Raised Outlook?

IQVIA Holdings (NYSE:IQV) reported third-quarter results on Tuesday, October 27, with adjusted diluted EPS of $3.34, up 11.3% from $3.00, and GAAP diluted EPS of $2.10 versus $1.93. The screened estimate was $3.28, a surprise of 1.96% as screened. Revenue rose 8.0% to $4,428 million, or 8.6% at constant currency.

The company raised its 2026 guidance to revenue of $17,350 million to $17,500 million, adjusted EBITDA of $4,025 million to $4,055 million and adjusted diluted EPS of $12.90 to $13.00.

The reduction followed a review of inactive trials. Management lowered R&D Solutions contracted backlog by about $2.1 billion to $32.6 billion, while bookings and revenue conversion rose.

IQVIA Segments: Is Clinical Research Demand Accelerating?

R&D Solutions revenue was $2,639 million, up 8.7% and 9.1% at constant currency, or 6.8% excluding reimbursed expenses. Commercial Solutions revenue was $1,789 million, up 6.9% and 7.9% at constant currency.

Net new bookings in R&D Solutions were $3.2 billion, up 15%, a book-to-bill ratio of 1.2. Last-twelve-month bookings were $11.7 billion, up 14%. About $9.4 billion of backlog is expected to convert to revenue over the next twelve months, up 10%.

The chief executive said multiple demand indicators continue to validate a strengthening market and that organic growth accelerated to double the prior rate in commercial and nearly triple in clinical. Clinical bookings were the strongest since 2022, which management linked to higher win rates.

IQVIA Margins and Cash: How Much Did Profit Grow?

Adjusted EBITDA rose 8.7% to $1,032 million from $949 million, a calculated margin of about 23.3% versus 23.1%. Adjusted net income was $557 million versus $515 million.

Operating cash flow was $825 million and free cash flow was $667 million, equal to 120% of adjusted net income. Free cash flow was lower than the $772 million of a year earlier.

Cash was $2,249 million against debt of $16,067 million, for net debt of $13,818 million. Net leverage was 3.45 times and gross leverage was 4.01 times.

IQVIA Capital Allocation and Guidance: What Is Implied for the Fourth Quarter?

The company repurchased $950 million of stock in the first nine months, versus $1,032 million a year earlier. Shares outstanding fell to 164.8 million from 169.6 million at the end of 2025.

Full-year revenue guidance includes about 250 basis points from acquisitions, including deals expected to close by year-end, and about 20 basis points from currency. There is no separate fourth-quarter guidance. Subtracting nine-month actuals, the guidance implies fourth-quarter revenue of about $4,403 million to $4,553 million, adjusted EBITDA of about $1,067 million to $1,097 million and adjusted EPS of about $3.52 to $3.62 (calculated).

The company said it has deployed more than 400 AI agents to date.

IQVIA Earnings: What Should Investors Watch Next?

The next dated event is the company's investor day on December 1, when management will present from about 9:00 a.m. to 12:30 p.m. Eastern. Investors can watch whether bookings stay above a book-to-bill ratio of 1.0, whether acquisitions close by year-end as assumed, and whether free cash flow recovers from this quarter's decline.