IQVIA Holdings Inc. Q1 FY2026 earnings call

• Acuvia delivered outstanding financial results with record first quarter revenue and adjusted diluted earnings per share exceeding guidance. - Continued positive year over year momentum across portfolio with organic revenue growth doubling in commercial solutions and tripling in RMDS. - AI integration progress: Unveiled IQVIA.AI, 192 life science industry AI agents deployed covering 64 use cases, 19 of top 20 pharma companies using IQVIA agents. - Commercial solutions highlights: Strength in patient solutions, analytics and consulting, commercial engagement services; pipelines at record levels. - R&D solutions highlights: Leveraging AI to optimize trial design and execution; recent wins in medical safety, global clinical trials, etc.; collaboration with Duke Clinical Research Institute. - Financials: Adjusted EBITDA up 5.5%, adjusted diluted EPS $2.90, up 7.4% year over year. Cash and cash equivalents $1.947 billion, net debt $13.886 billion, net leverage ratio 3.62 times trailing 12 months adjusted EBITDA. Free cash flow $491 million, repurchased $552 million of shares

Total revenue for the first quarter exceeded the high end of guidance range, up 8.4% on reported basis and 6% at constant currency. Commercial solutions revenue was $754 million, up 11.6% reported and 8.5% constant currency. R&D Solutions' first quarter revenue was $2,397 million, up 6.2% reported and 4.2% constant currency. Adjusted EBITDA was $932 million, up 5.5% year over year. R&D Solutions net new bookings in Q1 2026 was $2.5 billion, double-digit increase year over year. RDS backlog at March 31st was $34.2 billion, increase of mid-single digit year over year. Next 12-month revenue from backlog was $8.9 billion, up high single digits on recast basis

• Reaffirm full year 2026 guidance for revenue and adjusted EBITDA. - Raise adjusted diluted EPS guidance. - Full year revenue expected between $17,150 million and $17,350 million, growth 5.2 - 6.4% or 5.8% midpoint. - Adjusted EBITDA expected between $3,975 million and $4,025 million, growth 4.9 - 6.3% or 5.6% midpoint. - Adjusted diluted EPS raised to between $12.65 and $12.95, growth 6.1 - 8.6% or 7.4% midpoint. - Q2 revenue expected between $4,280 million and $4,340 million, growth 6.5 - 8.0% year over year. - Q2 adjusted EBITDA expected between $955 million and $975 million, growth 4.9 - 7.1% versus prior year. - Q2 adjusted diluted EPS expected between $2.98 and $3.08, growth 6.0 - 9.6% year over year

• Quarterly book-to-bill metric is a bad predictor of future growth. - Unusual mix of trials in Q1 with lower pass-throughs, but no impact on margins as pass-throughs have zero profitability drop-through. - Past quarter's booking mix not indicative of long-term trends or margin changes

Q: Dive in more on services versus pass-through bookings, demand dynamic and margin progression.

A: Pass-throughs have zero profitability impact. Q1 had lower pass-throughs due to trial indication mix. Quarterly book-to-bill metric not predictive of growth. No impact of AI on bookings.

Q: FSO dynamics and margin impact.

A: One quarter's bookings not indicative of trend. No change in customer dynamic. Productivity programs offset mix effects.

Q: Upside in commercial solutions, surprising areas and recurring vs discretionary revenue.

A: Commercial solutions underappreciated. Organic growth in commercial solutions doubled year over year. Patient solutions growing double digits, analytics and consulting mid to high single digits.

Q: Market stabilization, growth acceleration and win rates.

A: Coming out of industry turmoil, demand environment stabilizing. Large pharma and EVP funding showing improvement.

Q: Margin drivers and second quarter guide.

A: EBITDA progression consistent with history. Q1 has largest FX tailwind, moderating later. Productivity programs expected to improve margins.

Q: Bookings and constant dollar organic growth.

A: Book-to-bill affected by pass-through mix. Commercial solutions organic growth 5%, R&D Solutions organic growth 3%