Medpace Holdings, Inc. (MEDP) Earnings
Medpace Holdings, Inc. is expected to report next earnings on October 28, 2026 (in NaN days), with a consensus EPS estimate of $4.39. MEDP has beaten EPS estimates in 12 of its last 12 reported quarters (average surprise +8.6% over the last four).
| Report date | EPS est | EPS actual | Surprise | Revenue | Rev. surprise |
|---|---|---|---|---|---|
| Jul 23, 2026 | $3.98 | $4.25 | +6.8% | $707M | +2.6% |
| Apr 23, 2026 | $3.74 | $4.28 | +14.4% | $707M | +1.3% |
| Oct 22, 2025 | $3.53 | $3.86 | +9.3% | $660M | +2.9% |
| Jul 21, 2025 | $2.98 | $3.10 | +4.0% | $603M | +12.0% |
| Jul 22, 2024 | $2.54 | $2.75 | +8.3% | $528M | -0.1% |
| Jul 24, 2023 | $1.91 | $1.93 | +1.0% | $461M | +2.8% |
| Feb 13, 2023 | $1.79 | $2.12 | +18.4% | $394M | +2.1% |
| Jul 25, 2022 | $1.31 | $1.46 | +11.5% | $351M | +2.1% |
| Feb 14, 2022 | $1.25 | $1.32 | +5.6% | $309M | -0.2% |
| Feb 15, 2021 | $1.24 | $1.35 | +8.9% | $260M | +9.7% |
| Jul 27, 2020 | $0.41 | $0.68 | +65.9% | $205M | +56.1% |
| Apr 28, 2020 | $0.75 | $0.80 | +6.7% | $231M | +1.3% |
Source: company filings + earnings calendar. For informational purposes only — not investment advice.
Earnings call summary
Q2 FY2026 · July 23, 2026
AI summary of management’s prepared remarks and analyst Q&A. For informational purposes only — not investment advice.
Management highlights
### Business Environment & Bookings - Q2 2026 had a strong business environment with well-behaved cancellation levels, supporting a record quarter for net bookings - Requests for Proposals (RFPs) increased sequentially and year-over-year, with high quality new opportunities, particularly from a broader base of recently funded clients - Initial award notifications remained solid but declined sequentially from an extremely strong Q1 2026 - Cancellations dropped substantially from elevated levels in prior quarters, falling to a normal, healthy range; reduced cancellations drove over half of Q2 net booking growth sequential to Q1 - Pre-backlog (awarded programs not yet recognized in backlog) is larger than reported backlog and has grown faster than backlog over the past year ### Therapeutic Mix Shift - Recent growth in top customer concentration was tied to large metabolic programs, but the mix of new awards is shifting back toward historical averages - Oncology represented over half of Q2 2026 new bookings and initial award notifications, with cardiometabolic new award notifications dropping off significantly; management expects oncology to regain its historical share over the next 12 months ### Operational Updates - The company implemented competitive win rate improvement changes in late 2025/early 2026, which have already supported a strong win rate in Q1 2026, returning win rate to historical levels after a 2025 dip - Labor resources are aligned with demand: the company continues to see historically low employee turnover, and expects high single-digit full-year 2026 headcount growth - Headcount growth is predominantly in the U.S., with additional growth in Asia-Pacific (largely India) to support cost management objectives - In Q2 2026, the company repurchased 706,000 shares for $294.7 million, with $527 million remaining in the share repurchase authorization as of quarter end - Cash balance at the end of Q2 was $502.7 million, with $162 million in operating cash flow generated during the quarter
Guidance
- Full year 2026 total revenue guidance is updated to a range of $2.805 billion to $2.885 billion, representing 10.9% to 14% year-over-year growth over 2025's $2.53 billion revenue - Full year 2026 EBITDA guidance is updated to a range of $618 million to $642 billion, representing 10.8% to 15.1% year-over-year growth over 2025's $557.7 million EBITDA - Full year 2026 net income is guided to a range of $494 million to $514 million, with a forecast effective tax rate of 19% to 19.5% and expected interest income of $21.1 million; no additional share repurchases are assumed in the guidance - Diluted earnings per share for 2026 is guided to a range of $17.25 to $17.95 - Direct service reimbursable costs are expected to decline to 41% to 42% of revenue in the second half of 2026, down from slightly higher levels in H1 2026 - SG&A margin is expected to expand in the second half of 2026, as headcount growth will lag revenue growth after Q1 annual merit and equity program impacts are absorbed - Management expects gross and net bookings to ramp up sequentially in the second half of 2026, supported by an improving business environment and strong RFP pipeline
Segment performance
MedPace does not break out results into distinct product segments in this earnings call. Overall consolidated Q2 2026 performance: total revenue of $707.3 million, up 17.2% year-over-year; six-month ended June 30 2026 revenue of $1.41 billion, up 21.7% year-over-year. Q2 2026 EBITDA was $153.4 million, up 17.6% year-over-year, with an EBITDA margin of 21.7% (21.6% in prior year Q2). Year-to-date EBITDA was $302.8 million, up 21.5% year-over-year, with a flat margin of 21.4%. Q2 2026 net income was $121.4 million, up 34.5% year-over-year; year-to-date net income was $245.2 million, up 19.7% year-over-year. Diluted net income per share was $4.25 for Q2 2026 (vs. $3.10 prior year) and $8.53 year-to-date (vs. $6.79 prior year). Net new business awards entering backlog grew 28.2% year-over-year to $795.7 million, with a 1.13 net book to build ratio. Ending backlog as of June 30 2026 was ~$3 billion, up 4.9% year-over-year, with ~$1.96 billion expected to convert to revenue in the next 12 months. Q2 backlog conversion was 24.1% of beginning backlog. The top 5 customers represent 31% of the last 12 months revenue, and the top 10 customers represent 40%. Customer concentration growth has been driven primarily by large metabolic program work from top clients.
Risks & headwinds
- Forward-looking statements are subject to known and unknown risks and uncertainties that could cause actual results to differ materially from current expectations, as detailed in the company's SEC filings - Cancellations of client programs are inherently unpredictable and can occur unexpectedly, with the potential to cause sharp quarter-to-quarter swings in net bookings and revenue - Backlog conversion rates are subject to change based on program decision points, therapeutic mix, and gating policy enforcement, creating uncertainty around near-term revenue conversion - Competitive pricing and win rate dynamics can shift, impacting revenue growth and margin trajectories - Therapeutic area mix volatility can create uncertainty around long-term revenue and booking trends - Reimbursable direct cost levels have come in higher than initially expected in H1 2026, creating near-term margin pressure
Analyst Q&A
Q: Is the higher concentration of revenue among top 5 customers tied to metabolic work, and how long will this metabolic-heavy mix persist? What is the outlook for backlog conversion rates given the longer duration of oncology trials? /
A: The growth in top 5 concentration is indeed tied to large metabolic programs from those clients. However, the therapeutic mix is already shifting: in Q2 2026 oncology made up over half of new bookings and initial awards, while cardiometabolic new awards have dropped sharply. Management expects the mix to return to historical averages over the next 12 months. Contrary to common assumption, metabolic program speed is not the primary driver of the current elevated 24% backlog conversion rate. The main factor is more rigorous enforcement of existing backlog gating policies around program decision points, where backlog is only recognized up to the next interim approval step regardless of total trial duration.
Q: Can you provide perspective on Q2 cancellation trends, and an update on the win rate improvement initiatives you launched last year? /
A: Cancellations dropped substantially in Q2 2026, falling from the elevated levels seen in recent quarters to a normal, healthy range. Cancellations improved across both backlog and pre-backlog, and lower cancellations drove more than half of Q2's sequential net booking growth from Q1. The win rate improvement initiatives implemented in late 2025 are fully in place, and have already returned win rates to historical levels after a lower win rate in 2025. Management declined to share specific details of the competitive changes.
Q: What is driving the current elevated backlog conversion rate above the historical 18% average, and will it stay at 24% long-term? /
A: Management clarified that no formal change to standard operating procedures was made; the company simply increased enforcement of existing gating policies for backlog recognition in response to a prior period of high cancellations, to avoid unexpected large backlog reductions. Metabolic mix has a small incremental impact, but is not the primary driver. Management expects the conversion rate will gradually revert toward historical norms over time as the program portfolio and backlog composition normalizes, though no formal target for the decline is provided.
Q: Is there a trend of Phase 2 work moving to China, and what were Q2 gross bookings relative to expectations? /
A: Management stated they do not see meaningful movement of Phase 2 programs to China for the work MedPace pursues. Phase 3 volume has remained stable, while Phase 1 share has increased slightly, driven by growth in oncology programs. While cancellations remained elevated in prior quarters, the broader business environment has been improving, and Q2 2026 saw a meaningful drop in cancellations that brought it into line with healthy levels, aligning overall results with expectations.
Q: What is the outlook for bookings in H2 2026, and what is the trend for RFPs and initial awards? /
A: Management expects gross and net bookings will ramp up sequentially in H2 2026, so Q2 will not be the high watermark for the year. RFPs are up meaningfully both year-over-year and sequentially, with improved quality driven by a broader base of recently funded clients. Initial awards declined sequentially from a very strong Q1, but remain at healthy levels; quarterly volatility is common due to the impact of winning or losing one or two very large programs, so the metric should be viewed over longer time horizons.