Q1 2023 IQVIA Holdings Inc Earnings Call

April 27, 2023

Ari Bousbib: excluding the impact of foreign exchange and COVID-related work, the diversification of our short and long cycle businesses allowed us to perform well in the quarter, despite the broader macroeconomic dynamics. The demand environment for our industry continues to be healthy. Global clinical trial activity remains resilient, and the prospects for our commercial business remain favorable. A few encouraging signs I'd like to share with you this morning: the 15 largest pharmaceutical companies together spent a record-setting $138 billion on research and development in 2022. According to BioWorld, the Q1 EBP funding was $15.6 billion. That was up double digit versus prior year and up sequentially versus Q4. March was a particularly strong month for EBP funding, despite concerns about the impact from the banking crisis. FDA approvals are off to a strong start in 2023.

Speaker 1: including the impact of foreign exchange and COVID-related work.

Speaker 1: The diversification of our short and long cycle businesses allowed us to perform well in the quarter despite the broader macroeconomic dynamics.

Speaker 1: The demand environment for our industry continues to be healthy.

Speaker 1: global clinical trial activity remains resilient and the prospects for our commercial business remain favorable. A few encouraging signs I'd like to share with you this morning the 15 largest

A few encouraging signs I'd like to share with you this morning: the 15 largest pharmaceutical companies together spent a record-setting $138 billion on research and development in 2022. According to BioWorld, the Q1 EBP funding was $15.6 billion. That was up double digit versus prior year and up sequentially versus Q4. March was a particularly strong month for EBP funding, despite concerns about the impact from the banking crisis. FDA approvals are off to a strong start in 2023.

Speaker 1: spent a record-setting $138 billion on research and development in 2022.

Speaker 1: According to BioWorld, the Q1 EBP funding was $15.6 billion. That was a double-digit versus prior year and up sequentially versus Q4.

Speaker 1: March was a particularly strong month for EBP funding, despite concerns about the impact from the banking crisis. FDA approvals are off to a strong start in 2023. There were 13 approvals in the first quarter. That's up from an average of 9.

Ari Bousbib: There were thirteen approvals in the first quarter. That's up from an average of nine over the prior five years. That's a positive indicator for our commercial business. There was significant M&A activity in Q1, which primarily is large pharma acquiring smaller companies, and the industry expects 2023 M&A spend to be one of the largest years in the last decade. This highlights the ongoing demand for molecules by large pharma. Internally, our Q1 demand metrics show continued healthy growth. I'll share a couple with you this morning. Net new bookings were $2.6 billion. That represented a quarterly book-to-bill of 1.28. As a result, our backlog reached a new record and grew 10.1% versus prior year on a reported basis, and 11.3%, excluding the impact of foreign exchange. Our RSP flow set a new quarterly record.

There were thirteen approvals in the first quarter. That's up from an average of nine over the prior five years. That's a positive indicator for our commercial business. There was significant M&A activity in Q1, which primarily is large pharma acquiring smaller companies, and the industry expects 2023 M&A spend to be one of the largest years in the last decade. This highlights the ongoing demand for molecules by large pharma.

Speaker 1: over the prior five years.

Speaker 1: That's a positive indicator for our commercial business.

Speaker 1: There was a significant M&A activity in Q1, which primarily is large pharma acquiring small companies.

Speaker 1: The industry expects 2023 M&A spend to be one of the largest years in the last decade.

Internally, our Q1 demand metrics show continued healthy growth. I'll share a couple with you this morning. Net new bookings were $2.6 billion. That represented a quarterly book-to-bill of 1.28. As a result, our backlog reached a new record and grew 10.1% versus prior year on a reported basis, and 11.3%, excluding the impact of foreign exchange. Our RSP flow set a new quarterly record.

Speaker 1: This highlights the ongoing demand for molecules by large pharma.

Speaker 1: Internally, our Q1 demand metrics show continued healthy growth. I'll share a couple with you this morning. That new bookings were $2.6 billion.

Speaker 1: That represented a quarterly book to bill of 128. As a result, our backlog reached a new record and grew 10.1% versus prior year on a reported basis.

Speaker 1: and 11.3% excluding the impact of foreign exchange.

Ari Bousbib: It was up sequentially 15% versus Q4 2022. Operationally, attrition levels have continued to decline, and they are now, in fact, back to pre-pandemic levels or slightly below that. Site selection was up double digits year over year. This increased productivity helped mitigate the unfavorable impact of the staff shortages at investigator sites that we spoke about in prior calls. R&DS organic revenue growth at constant currency, excluding COVID-related work, was 17% in the quarter. That was well above the upper end of our expectations. Within TAS, we continue to see some client cautiousness related to discretionary spending. TAS growth for the quarter was 6% organic at constant currency, excluding COVID-related work, and that was within our expectations, but towards the lower end. In summary, industry demand remains healthy, despite some cautiousness in discretionary spending, mostly in the short cycle businesses.

It was up sequentially 15% versus Q4 2022. Operationally, attrition levels have continued to decline, and they are now, in fact, back to pre-pandemic levels or slightly below that. Site selection was up double digits year over year. This increased productivity helped mitigate the unfavorable impact of the staff shortages at investigator sites that we spoke about in prior calls. R&DS organic revenue growth at constant currency, excluding COVID-related work, was 17% in the quarter.

Speaker 1: RFP flow set a new quarterly record. It was up sequentially 15% versus Q4 2022.

Speaker 1: Operationally, attrition levels have continued to decline and they are now in fact back to pre-pandemic levels or slightly below that.

Speaker 1: Site selection was up double digits year over year.

Speaker 1: the unfavorable impact of the staff's shortages at investigators sites that we spoke about in prior calls. R&D's organic revenue growth at constant currency excluding COVID related work was 17%.

That was well above the upper end of our expectations. Within TAS, we continue to see some client cautiousness related to discretionary spending. TAS growth for the quarter was 6% organic at constant currency, excluding COVID-related work, and that was within our expectations, but towards the lower end. In summary, industry demand remains healthy, despite some cautiousness in discretionary spending, mostly in the short cycle businesses.

Speaker 1: in the quarter. That was well above the

Speaker 1: Within TAAS, we continue to see some client consciousness related to discretionary spending.

Speaker 1: Task growth for the quarter was 6% organic at constant currency, excluding COVID-related work and that was within our expectations but towards the lower end.

Speaker 1: In summary, industry demand remains healthy despite some cautiousness in discretionary spending mostly in the short cycle businesses.

Ari Bousbib: The diversification of our businesses allows us to balance the current slower short cycle growth with the resilience of our long cycle businesses, demonstrating that IQVIA is a company that can operate effectively under different macro environments. And with that, as context, let me review the first quarter results. Revenue for the first quarter grew 2.4% on a reported basis, 4.7% at constant currency. And compared to last year, and excluding COVID-related work from both periods, we grew the top line as a company 11% at constant currency on an organic basis. First quarter adjusted EBITDA increased 4.8%, driven by revenue growth and ongoing cost management discipline. First quarter adjusted diluted EPS of $2.45 declined slightly, as expected, driven by the one-time step up in interest rates.

The diversification of our businesses allows us to balance the current slower short cycle growth with the resilience of our long cycle businesses, demonstrating that IQVIA is a company that can operate effectively under different macro environments. And with that, as context, let me review the first quarter results. Revenue for the first quarter grew 2.4% on a reported basis, 4.7% at constant currency.

Speaker 1: The diversification of our businesses allows us to balance the current slower short-cycle growth with the resilience of our long-cycle businesses.

Speaker 1: demonstrating that IQVIA is a company that can operate effectively under different macro environments.

And compared to last year, and excluding COVID-related work from both periods, we grew the top line as a company 11% at constant currency on an organic basis. First quarter adjusted EBITDA increased 4.8%, driven by revenue growth and ongoing cost management discipline. First quarter adjusted diluted EPS of $2.45 declined slightly, as expected, driven by the one-time step up in interest rates.

Speaker 1: Revenue for the first quarter grew 2.4% on a reported basis, 4.7% at constant currency, and compared to last year, and excluding COVID-related work from both periods, we grew the top line As a company, 11% at constant currency

Speaker 1: on an organic basis.

Speaker 1: and ongoing cost management discipline.

Speaker 1: First quarter adjusted diluted EPS of $2.45 declined slightly, as expected, driven by the one-time step up in interest rates.

Ari Bousbib: Excluding interest expense and the UK tax rate headwinds that we discussed in a prior call, our adjusted diluted EPS growth exceeded 9%. I'd like to share a few highlights of business activity in the quarter. Within TAS, a top 10 pharma awarded IQVIA our first omnichannel marketing deal in the Asia Pacific region. IQVIA's omnichannel marketing program provides client teams with AI, ML-powered insights and recommendations to deliver effective, personalized digital engagements with HCPs. In the quarter, IQVIA won an award for our in-home patient services offering. This biotech client is launching a new MS treatment and selected IQVIA based on our ability to deliver testing and monitoring to the patient's home. These differentiated capabilities ease the burden for patients with limited mobility.

Excluding interest expense and the UK tax rate headwinds that we discussed in a prior call, our adjusted diluted EPS growth exceeded 9%. I'd like to share a few highlights of business activity in the quarter. Within TAS, a top 10 pharma awarded IQVIA our first omnichannel marketing deal in the Asia Pacific region. IQVIA's omnichannel marketing program provides client teams with AI, ML-powered insights and recommendations to deliver effective, personalized digital engagements with HCPs.

Speaker 1: the prior call, our adjusted diluted EPS growth exceeded 9%.

Speaker 1: I'd like to share a few highlights of business activity in the quarter.

Speaker 1: A top 10 pharma awarded IQVIA our first omnichannel marketing deal in the Asia-Pacific region. IQVIA's omnichannel marketing program provides client teams with AI ML-powered insights.

In the quarter, IQVIA won an award for our in-home patient services offering. This biotech client is launching a new MS treatment and selected IQVIA based on our ability to deliver testing and monitoring to the patient's home. These differentiated capabilities ease the burden for patients with limited mobility.

Speaker 1: recommendations to deliver effective personalized digital engagements with

Speaker 1: HCPs in a whole.

Speaker 1: Iqvya won an award for our in-home patient services offering.

Speaker 1: This biotech client is launching a new MS treatment.

Speaker 1: and selected IQ via based on our ability to deliver testing and monitoring to the patient's home.

Ari Bousbib: Moving to the real-world part of our task business, IQVIA was awarded a major post-authorization safety study to assess the impact and outcomes of prescribing a certain asthma drug to pregnant women with severe asthma. We won this large contract with a top ten pharma client due to the breadth of our capabilities, including our relevant experience in safety trials, our strong data and analytics capabilities, and increased delivery efficiency with faster patient enrollment. Also, in the quarter, we were awarded a large global intervention study with a top ten pharma to identify high-risk cardiovascular patients by measuring the prevalence of high sensitivity C-reactive protein. This protein is produced by the liver in response to inflammation in the body. Elevated levels of this protein in the blood are associated with an increased risk of cardiovascular disease, including heart attack and stroke.

Moving to the real-world part of our task business, IQVIA was awarded a major post-authorization safety study to assess the impact and outcomes of prescribing a certain asthma drug to pregnant women with severe asthma. We won this large contract with a top ten pharma client due to the breadth of our capabilities, including our relevant experience in safety trials, our strong data and analytics capabilities, and increased delivery efficiency with faster patient enrollment.

Speaker 1: This differentiated capability is the burden for patients with limited mobility.

Speaker 1: Moving to the real world part of our task business, IQVIA was awarded a major post-authorization safety study to assess the impact and outcomes of prescribing a certain asthma drug to pregnant women with severe asthma.

Speaker 1: We won this large contract with the top 10 pharma clients due to the breadth of our capabilities.

Speaker 1: including our relevant experience in safety trials, our strong data and analytics capabilities, and increased delivery efficiency with faster patient enrollment.

Also, in the quarter, we were awarded a large global intervention study with a top ten pharma to identify high-risk cardiovascular patients by measuring the prevalence of high sensitivity C-reactive protein. This protein is produced by the liver in response to inflammation in the body. Elevated levels of this protein in the blood are associated with an increased risk of cardiovascular disease, including heart attack and stroke.

Speaker 1: Also in the quarter, we were awarded a large global intervention study with a top 10 pharma to identify high-risk cardiovascular patients by measuring the prevalence of high-sensitivity C-reactive protein.

Speaker 1: This protein is produced by the liver in response to inflammation in the body.

Speaker 1: Elevated levels of this protein in the blood are associated with an increased risk of cardiovascular disease including

Ari Bousbib: IQVIA was selected based on our ability to connect lab and clinical capabilities with therapeutic and real-world expertise in a cost-efficient manner. This study will have a significant impact on the future management of cardiovascular patients. Moving to R&DS. Continued strong momentum with our $2.6 billion of net new bookings in the quarter, translating into a book-to-bill of 1.28 in the quarter, which brings our LTM book-to-bill to 1.35. A few highlights in the quarter: oncology continues to be our largest therapeutic area, and in the quarter, a high-profile, cutting-edge biotech company entered into a strategic partnership with IQVIA. This is a big deal. In fact, we were already awarded our first trial, which is for a novel bispecific antibody with potential development opportunities across several tumor types. Bispecific antibodies are designed to bind two different target molecules simultaneously.

IQVIA was selected based on our ability to connect lab and clinical capabilities with therapeutic and real-world expertise in a cost-efficient manner. This study will have a significant impact on the future management of cardiovascular patients. Moving to R&DS. Continued strong momentum with our $2.6 billion of net new bookings in the quarter, translating into a book-to-bill of 1.28 in the quarter, which brings our LTM book-to-bill to 1.35.

Speaker 1: IKIVIA was selected based on our ability to connect lab and clinical capabilities with therapeutic and real-world expertise in a cost-efficient manner.

Speaker 1: This study will have a significant impact on the future management of cardiovascular patients.

Speaker 1: moving to our to Rnds

Speaker 1: Continued strong momentum with our 2.6 billion of net new bookings in the quarter, translating into a book to build of 128 in the quarter, which brings our LTM book to build to 135.

A few highlights in the quarter: oncology continues to be our largest therapeutic area, and in the quarter, a high-profile, cutting-edge biotech company entered into a strategic partnership with IQVIA. This is a big deal. In fact, we were already awarded our first trial, which is for a novel bispecific antibody with potential development opportunities across several tumor types. Bispecific antibodies are designed to bind two different target molecules simultaneously.

Speaker 1: A few highlights in the quarter.

Speaker 1: Oncology continues to be our largest therapeutic area and in the quarter, a high-profile cutting-edge biotech company entered into a strategic partnership with IQVIA.

Speaker 1: This is a big deal. In fact, we were already awarded our first trial, which is for a novel bispecific antibody with potential development opportunities across several tumor types.

Ari Bousbib: This project will leverage our end-to-end clinical trial solution, including protocol design, specialized medical and regulatory expertise, biomarker development, and our integrated clinical operations, analytics, and technology. We really are the only company with the ability to bring together these capabilities, which in turn help the client optimize trial design and reduce time to market. Importantly, going forward, this partnership creates multiple opportunities within this client's large oncology portfolio. We continue to have strong success with our clinical FSP trials business, with several recent notable wins, including a significant preferred provider award with a major pharma. This was a competitive win against two incumbents, and it further diversifies our portfolio of FSP clients and increases our share in that segment. We continue to deploy innovations in our clinical technology suite.

This project will leverage our end-to-end clinical trial solution, including protocol design, specialized medical and regulatory expertise, biomarker development, and our integrated clinical operations, analytics, and technology. We really are the only company with the ability to bring together these capabilities, which in turn help the client optimize trial design and reduce time to market. Importantly, going forward, this partnership creates multiple opportunities within this client's large oncology portfolio.

Speaker 1: Vise-specific antibodies are designed to bind two different target molecules simultaneously.

Speaker 1: This project will leverage our end-to-end clinical trial solution, including protocol design, specialized medical and regulatory expertise, biomarker development, and the creation of the elastoc DHCP microscope.

Speaker 1: and our integrated clinical operations analytics and technology.

Speaker 1: We really are the only company with the ability to bring together these capabilities, which in turn, help the client optimize trial design and reduce time to market. Importantly, going forward, this partnership creates multiple opportunities within this client's large oncology.

We continue to have strong success with our clinical FSP trials business, with several recent notable wins, including a significant preferred provider award with a major pharma. This was a competitive win against two incumbents, and it further diversifies our portfolio of FSP clients and increases our share in that segment. We continue to deploy innovations in our clinical technology suite.

Speaker 1: portfolio. We continue to have strong success with our clinical FSP trials business with several recent notable wins including a significant preferred provider award with a major pharma. This was a competitive win against two

Ari Bousbib: Most recently, we introduced a new cloud-based platform within our research site network that will streamline document workflows and allow real-time collaboration among study teams. We already deployed this new technology to approximately 15% of IQVIA network sites across 28 countries, and we expect to deploy to 40% of our sites in the next 12 months. The goal of deploying this technology at the site is to increase site productivity, which frees up more time for site support, compliance reviews, and continuous monitoring of patient safety and study quality, all of which are very important, especially in an environment where we experience staff shortages at the site. Finally, a couple of nice accolades for our global IQVIA team.

Most recently, we introduced a new cloud-based platform within our research site network that will streamline document workflows and allow real-time collaboration among study teams. We already deployed this new technology to approximately 15% of IQVIA network sites across 28 countries, and we expect to deploy to 40% of our sites in the next 12 months.

Speaker 1: segment. We continue to deploy innovations in our clinical technology suite. Most recently, we introduced a new cloud-based platform within our research site network that will streamline document workflows and allow real-time collaboration among study teams.

Speaker 1: We already deployed this new technology to approximately 15% of IQVIA network sites across 28 countries and we expect to deploy to 40% of our sites in the next 12 months.

The goal of deploying this technology at the site is to increase site productivity, which frees up more time for site support, compliance reviews, and continuous monitoring of patient safety and study quality, all of which are very important, especially in an environment where we experience staff shortages at the site. Finally, a couple of nice accolades for our global IQVIA team.

Speaker 1: The goal of deploying this technology at the site is to increase site productivity, which frees up more time for site support, compliance reviews, and continuous monitoring of patient safety and study quality, all of which are very important, especially in an environment where...

Speaker 1: that we experience staff shortages at the site.

Ari Bousbib: First, I am proud to share that our lab business received the prestigious Singaporean President's Certificate of Commendation, which is awarded to organizations that had a significant impact in the fight against COVID-19. In fact, five of our employees in Singapore received the Public Service Medal Award for their outstanding contributions to manage the impact of the pandemic. This is a nice recognition of the unique role we play in supporting public health. Second, our Scotland-based lab business recently achieved a global green lab certification for its commitment to practicing sustainable science. This certification is recognized by the United Nations, quote unquote, "Race to Zero global campaign," as the international gold standard for lab sustainability best practices towards a zero-carbon future. I will now turn it over to Ron for more details on our financial performance.

First, I am proud to share that our lab business received the prestigious Singaporean President's Certificate of Commendation, which is awarded to organizations that had a significant impact in the fight against COVID-19. In fact, five of our employees in Singapore received the Public Service Medal Award for their outstanding contributions to manage the impact of the pandemic.

Speaker 1: Finally, a couple of nice accolades for our global IQVIA team. First, I am proud to share that our lab business received the prestigious Singaporean President's Certificate of Commendation, which is awarded to organizations that had a significant impact in the fight against COVID-19. In fact, we are very proud to share that our lab business received the prestigious Singaporean Certificate of Commendation, which is awarded to organizations that had a significant impact in the fight against COVID-19.

This is a nice recognition of the unique role we play in supporting public health. Second, our Scotland-based lab business recently achieved a global green lab certification for its commitment to practicing sustainable science. This certification is recognized by the United Nations, quote unquote, "Race to Zero global campaign," as the international gold standard for lab sustainability best practices towards a zero-carbon future. I will now turn it over to Ron for more details on our financial performance.

Speaker 1: their outstanding contributions to manage the impact of the pandemic.

Speaker 1: This is a nice recognition of the unique role we play in supporting public health.

Speaker 1: practicing sustainable science.

Speaker 1: This certification is recognized by the United Nations' Race to Zero Global Campaign as the international gold standard for lab sustainability best practices towards a zero carbon future.

Ronald Bruehlman: Thanks, Henri, and good morning, everyone. Let's start by reviewing revenue. Q1 revenue of $3.652 billion grew 2.4% on a reported basis and 4.7% at constant currencies. In the quarter, COVID-related revenues were approximately $150 million, which was down about $230 million versus Q1 2022. In our base business, that is excluding all COVID-related work from both this year and last, organic growth at constant currency was 11%. Technology and Analytics Solutions revenue was $1.444 billion, up 0.3% reported and 2.9% at constant currency. Excluding all COVID-related work, organic growth at constant currency in TAS was 6%.

Speaker 1: I will now turn it over to Ron for more details on our financial performance.

Speaker 2: Thanks Ari and good morning everyone. Let's start by reviewing revenue.

Speaker 2: First quarter revenue of $3,652,000,000 grew 2.4% on a reported basis and 4.7% at constant prices.

Speaker 2: In the quarter, COVID-related revenues were approximately $150 million, which was down about $230 million versus the first quarter of 2022. In our base business, that is excluding all COVID-related work from both this year and last, organic growth at constant currency was 11%. Technology and analytics solutions revenue was $1,444,000,000.

In our base business, that is excluding all COVID-related work from both this year and last, organic growth at constant currency was 11%. Technology and Analytics Solutions revenue was $1.444 billion, up 0.3% reported and 2.9% at constant currency. Excluding all COVID-related work, organic growth at constant currency in TAS was 6%.

Ronald Bruehlman: R&DS revenue of $2.026 billion was up 4.8% reported and 6.5% at constant currency, and excluding all COVID-related work, organic growth at constant currency in R&DS was 17%. Finally, contract sales and medical solutions, or CSMS, revenue of $182 million declined 6.7% reported and 1% at constant currency. And excluding all COVID-related work, the organic growth decline at constant currency was also 1% in CSMS. Let's move down to P&L. Adjusted EBITDA was $851 million for Q1. That's growth of 4.8%. GAAP net income was $289 million, and GAAP diluted earnings per share was $1.53.

R&DS revenue of $2.026 billion was up 4.8% reported and 6.5% at constant currency, and excluding all COVID-related work, organic growth at constant currency in R&DS was 17%. Finally, contract sales and medical solutions, or CSMS, revenue of $182 million declined 6.7% reported and 1% at constant currency.

Speaker 2: point five percent of constant currency and excluding all covered related work organic growth at constant currency and RDS with 17 percent. Finally, contract sales and medical solutions or CSM, that's revenue of one hundred and eighty two million dollars declined six point seven percent reported and one percent of constant currency.

And excluding all COVID-related work, the organic growth decline at constant currency was also 1% in CSMS. Let's move down to P&L. Adjusted EBITDA was $851 million for Q1. That's growth of 4.8%. GAAP net income was $289 million, and GAAP diluted earnings per share was $1.53.

Speaker 2: And excluding all COVID related work, the organic growth declined at constant currency was also 1% of CSMS. Smooth down the P and L adjusted EBITDA was 851Million dollars for the 1st quarter. That's growth at 4.8%.

Ronald Bruehlman: Adjusted net income was $462 million, and adjusted earnings per share diluted was $2.45. Now, as already highlighted, R&D Solutions continues its strong momentum. This graph shows the growth of our backlog over the past three years, which demonstrates the sustained growth of our clinical business. Our backlog at 31 March 2024 stood at a record $27.9 billion, which was up over 40% over the last three years and growing 10% year over year. Okay, reviewing the balance sheet. At 31 March 2024, cash and cash equivalents total $1.494 billion. Gross debt was $13.176 billion, and that resulted in net debt of $11.682 billion. Our net leverage ratio ended the quarter at 3.4x trailing twelve-month adjusted EBITDA.

Adjusted net income was $462 million, and adjusted earnings per share diluted was $2.45. Now, as already highlighted, R&D Solutions continues its strong momentum. This graph shows the growth of our backlog over the past three years, which demonstrates the sustained growth of our clinical business. Our backlog at 31 March 2024 stood at a record $27.9 billion, which was up over 40% over the last three years and growing 10% year over year. Okay, reviewing the balance sheet.

Speaker 2: Gap net income was $289 million and gap diluted earns per share was $1.53.

Speaker 2: Adjusted net income was $462 million and adjusted earnings per share diluted was $2.45.

Speaker 2: Now as Ari highlighted, R&D Solutions continues its swang-lam manner. This graph shows the growth of our backlog over the past three years, which demonstrates the sustained growth of our clinical business.

Speaker 2: Our backlog at March 31 stood at a record $27.9 billion, which was up over 40% over the last three years.

At 31 March 2024, cash and cash equivalents total $1.494 billion. Gross debt was $13.176 billion, and that resulted in net debt of $11.682 billion. Our net leverage ratio ended the quarter at 3.4x trailing twelve-month adjusted EBITDA.

Speaker 2: and growing 10% year over year. Okay, reviewing the balance sheet at March 31, cash and cash equivalents total $1,494,000,000. Gross debt was $13,176,000,000 and that resulted in net debt of $11,000,000,000.

Speaker 2: 682 million dollars. Our net leverage ratio ended the quarter 3.4 times trailing 12 month adjusted EBITDA.

Ronald Bruehlman: First quarter cash flow from operations was strong at $417 million, and CapEx was $164 million, resulting in free cash flow of $253 million. In the quarter, we repurchased $129 million of our shares, and that leaves us with slightly over $1.2 billion remaining under the current program. Okay, let's go now to guidance. Guidance for the full year 2023 remains unchanged. We continue to expect revenue, excluding COVID-related work, to grow organically at constant currency between 9% and 11%. Now, this revenue guidance continues to assume about 100 basis points of contribution from acquisitions and approximately $600 million of COVID-related revenue step down versus 2022.

First quarter cash flow from operations was strong at $417 million, and CapEx was $164 million, resulting in free cash flow of $253 million. In the quarter, we repurchased $129 million of our shares, and that leaves us with slightly over $1.2 billion remaining under the current program. Okay, let's go now to guidance. Guidance for the full year 2023 remains unchanged.

Speaker 2: First quarter cash flow from operations was strong at $417 million and CapEx was $164 million, resulting in free cash flow of $253 million.

Speaker 2: In the quarter, we repurchased $129 million in those shares.

Speaker 2: And that leaves us with slightly over 1.2Billion dollars remaining under the current program. Okay, let's go now to guidance guidance for the full year. 2023 remains unchanged. We continue to expect revenue.

We continue to expect revenue, excluding COVID-related work, to grow organically at constant currency between 9% and 11%. Now, this revenue guidance continues to assume about 100 basis points of contribution from acquisitions and approximately $600 million of COVID-related revenue step down versus 2022.

Speaker 2: Excluding COVID-related work to go organically at constant currency between 9 and 11 percent.

Speaker 2: Now this revenue guidance continues to assume about 100 basis points of contribution from acquisitions.

Ronald Bruehlman: We're also reaffirming our guidance on adjusted EBITDA of $3.625 to 3.695 billion, and that represents year-over-year growth of 8.3% to 10.4%. Lastly, we're reaffirming our guidance on adjusted diluted EPS of $10.26 to $10.56. And this adjusted diluted earnings per share guidance includes a year-over-year impact of the step up in interest rates and the increase in the UK corporate tax rate. Together, these non-operational items impact the year-over-year growth rate by approximately 10 percentage points. Excluding these items, adjusted diluted earnings per share is expected to grow 11% to 14%. Let's move to our Q2 guidance.

We're also reaffirming our guidance on adjusted EBITDA of $3.625 to 3.695 billion, and that represents year-over-year growth of 8.3% to 10.4%. Lastly, we're reaffirming our guidance on adjusted diluted EPS of $10.26 to $10.56. And this adjusted diluted earnings per share guidance includes a year-over-year impact of the step up in interest rates and the increase in the UK corporate tax rate.

Speaker 2: And approximately 600M dollars of COVID related revenue step down versus 2022.

Speaker 2: We're also reaffirming our guidance on adjusted EBITDA of $3,625,000,000 to $3,695,000,000, and that represents year-over-year growth of 8.3% to 10.4%.

Speaker 2: Lastly, we're reaffirming our guidance on adjusted diluted EPS of $10.26 to $10.56.

Speaker 2: And this adjusted diluted earnings per share guidance includes a year over year impact of the step up in interest rates in the increase in the UK corporate tax rate. Together these non-operational items impact the year over year growth rate by approximately 10 percentage points.

Together, these non-operational items impact the year-over-year growth rate by approximately 10 percentage points. Excluding these items, adjusted diluted earnings per share is expected to grow 11% to 14%. Let's move to our Q2 guidance.

Speaker 2: excluding these items, adjusted diluted earnings per share.

Ronald Bruehlman: Now, in Q2, we expect revenue to be between $3.675 billion and $3.75 billion. That's growth of 3.7% to 5.8% on a constant currency basis and 3.8% to 5.9% on a reported basis. Adjusted EBITDA is expected to be between $850 million and $875 million, which would be up 6.3% to 9.4%. And, adjusted diluted EPS is expected to be between $2.30 and $2.44, declining 5.7% to flat on a year-over-year basis.

Now, in Q2, we expect revenue to be between $3.675 billion and $3.75 billion. That's growth of 3.7% to 5.8% on a constant currency basis and 3.8% to 5.9% on a reported basis. Adjusted EBITDA is expected to be between $850 million and $875 million, which would be up 6.3% to 9.4%. And, adjusted diluted EPS is expected to be between $2.30 and $2.44, declining 5.7% to flat on a year-over-year basis.

Speaker 2: is expected to grow 11 to 14 percent.

Speaker 2: Let's move to our second quarter guidance. In Q2, we expect revenue to be between $3,675,000,000 and $3,750,000,000. That's growth of 3.7 to 5.8 percent on a constant currency basis and 3.8 to 5.9 percent on a reported basis. We expect revenue to be between $3,750,000 and $3,750,000.

Speaker 2: Adjustity EBITDA is expected to be between $850 million and $875 million.

Speaker 2: which would be up 6.3 to 9.4 percent. And adjusted diluted EPS is expected to be between $2.30 and $2.44, declining 5.7 percent to flat on a year-over-year basis.

Ronald Bruehlman: Now, keep in mind that the second quarter is the toughest compare for interest expense because we had a very favorable $1 billion swap roll off on 31 March, and it was also a year ago that rates started rising. So excluding the step up of an interest expense and the increased UK tax rate, we expect adjusted diluted EPS to grow between 8% and 13% in the second quarter. Now, all of our guidance assumes that foreign currency rates as of 25 April continue for the balance of the year. So to summarize, Q1 was another solid quarter of financial performance. We delivered revenue growth of 11% organic, excluding the impact of foreign exchange and COVID-related work. Underlying demand in the industry and in our business remains healthy, with our RFPs accelerating in Q1, up 15% sequentially versus Q4 2022.

Now, keep in mind that the second quarter is the toughest compare for interest expense because we had a very favorable $1 billion swap roll off on 31 March, and it was also a year ago that rates started rising. So excluding the step up of an interest expense and the increased UK tax rate, we expect adjusted diluted EPS to grow between 8% and 13% in the second quarter. Now, all of our guidance assumes that foreign currency rates as of 25 April continue for the balance of the year.

Speaker 2: And keep in mind the second quarter is the toughest compare for interest expense because we had a very favorable 1 billion dollars swap Roll off on March 31, and it was also a year ago that rates started riding rising So excluding the step up of an interest expense and the increased UK tax rate we expect

Speaker 2: adjusted the rooted EPS to grow between 8 and 13 percent in the second quarter. Now all of our guidance assumes that foreign currency rates as of April 25th continue for the balance of the year.

So to summarize, Q1 was another solid quarter of financial performance. We delivered revenue growth of 11% organic, excluding the impact of foreign exchange and COVID-related work. Underlying demand in the industry and in our business remains healthy, with our RFPs accelerating in Q1, up 15% sequentially versus Q4 2022.

Speaker 2: So to summarize, Q1 was another solid quarter of financial performance. We delivered revenue growth of 11 percent organic, excluding the impact of foreign exchange and COVID-related work.

Speaker 2: Underlying demand in the industry and in our business remains healthy with our RFPs accelerating in Q1 up 15% sequentially versus Q4 2022.

Ronald Bruehlman: Quarterly net new bookings were $2.6 billion, and our industry-leading backlog reached a new record of $27.9 billion, representing growth of over 10% year over year. We've been navigating well through the choppy macro environment and delivering on our numbers. Despite some of the cautiousness we've observed in the short cycle discretionary spend, thanks to the resilience and the rest of the portfolio, which is mostly long cycle and thus less affected by macro turbulence. Therefore, we are reaffirming our full year guidance of 9% to 11% organic revenue growth at constant currency, excluding COVID-related work, and 11% to 14% adjusted EPS growth, excluding non-operational items. And with that, let me hand it back over to the operator for Q&A.

Quarterly net new bookings were $2.6 billion, and our industry-leading backlog reached a new record of $27.9 billion, representing growth of over 10% year over year. We've been navigating well through the choppy macro environment and delivering on our numbers. Despite some of the cautiousness we've observed in the short cycle discretionary spend, thanks to the resilience and the rest of the portfolio, which is mostly long cycle and thus less affected by macro turbulence.

Speaker 2: representing growth of over 10% year over year. We've been navigating well through the choppy macro environment and delivering on our numbers. Despite some of the cautiousness we've observed in the short cycle discretionary span, thanks to the resilience and the rest of the portfolio, which is mostly the long cycle and that's less affected by macro turbulence. Therefore, we are reaffirming our full year guidance of nine to 11% organic revenue growth at constant currency excluding COVID related work and 11 to 14% adjusted EPS growth excluding non-operational items. And with that.

Therefore, we are reaffirming our full year guidance of 9% to 11% organic revenue growth at constant currency, excluding COVID-related work, and 11% to 14% adjusted EPS growth, excluding non-operational items. And with that, let me hand it back over to the operator for Q&A.

Operator: Thank you. At this time, I would like to remind everyone, in order to ask a question, press Star, then the number One on your telephone keypad. We request that you please limit yourself to just one question so that others in the queue may participate as well. We'll pause for a moment to compile the Q&A roster. Your first question comes from the line of Shlomo Rosenbaum at Stifel. Your line is open.

Speaker 2: Let me hand it back over to the operator for Q&A.

Speaker 3: Thank you. At this time, I would like to remind everyone in order to ask a question, press star then the number one on your telephone keypad. We request that you please limit yourself to just one question so that others in the queue may participate as well.

Speaker 3: Thank you. At this time, I would like to remind everyone in order to ask a question, press star, then the number one on your telephone keypad. We request that you please limit yourself to just one question so that others in the queue may participate as well. We'll pause for a moment to compile the Q&A roster.

Shlomo Rosenbaum: Hi, thank you very much for taking my questions. Ari, can you talk a little bit about the nature of the backlog burn? You had very strong bookings, you got strong book-to-bill, but the amount of revenue expected to or backlog to convert to revenue, it seems kind of consistent for this quarter to last quarter. Or is there a change of mix over there? Is that a rounding item, or is there something else that might be going on over there?

Speaker 4: Hi, thank you very much for taking my questions.

Speaker 4: bookings, you got strong book to bill, but the amount of revenue expected to convert to revenue seems kind of consistent for this quarter to last quarter. Is there a change of mix over there? Is that a rounding item or is there something else that might be going on over there? Yeah, thank you, someone. Look, we had very strong…

Ari Bousbib: Yeah, thank you, Shlomo. No, look, we had very strong bookings. It was one of our highest bookings quarter. And there's I wouldn't read anything. It's not the first time, by the way, that Q1 next twelve months revenue from bookings is essentially flat to Q4, next twelve months bookings. I can't detect any seasonality to that, but it's not the first time it happened, so I wouldn't read anything into it at all. It's just a question of mix, you know, months of pass-throughs that are, you know, taken into the quarter and/or or delayed. And you know, we're reverting to more regular mix of projects with, as you know, an increasing share in oncology, which typically burn a little slower.

It's just a question of mix, you know, months of pass-throughs that are, you know, taken into the quarter and/or or delayed. And you know, we're reverting to more regular mix of projects with, as you know, an increasing share in oncology, which typically burn a little slower. You know, that might have a little bit at the margins of an impact, but I wouldn't read anything into it.

Speaker 1: seasonality to that but it's not the first time it happens so I wouldn't read anything into it at all it's just a question of mix

Speaker 1: You know, months of pass-throughs that are taken into the quarter or delayed. And we're reverting to more regular mix of projects with, as you know, an increasing share in oncology, which typically burn a little slower.

Ari Bousbib: You know, that might have a little bit at the margins of an impact, but I wouldn't read anything into it.

Shlomo Rosenbaum: Okay. Thank you.

Ari Bousbib: Thanks, Shlomo.

Operator: Thank you. Your next question comes from the line of Anne Samuel at J.P. Morgan. Your line is open.

Anne Samuel: Hi, thank you so much for taking the question. I was hoping maybe you could speak to some of the dynamics within the TAS business. You know, in Q4, the analytics and consulting business was impacted, but some of that maybe seemed like it was unique to December purchasing patterns. So how much of this is carryover from what you saw in Q4? And then, you know, what's driving your confidence that it's gonna come back in the remainder of the year so that you can hit your guidance?

Anne Samuel: Hi, thank you so much for the question. I was hoping maybe you could speak to some of the dynamics within the TAS business. You know, in Q4, the analytics and consulting business was impacted, but some of that maybe seemed like it was unique to December purchasing patterns. So how much of this is carryover from what you saw in Q4? And then, you know, what's driving your confidence that it's gonna come back in the remainder of the year so that you can hit your guidance?

Speaker 5: Your line is open. Hi, thank you so much for taking the question. I was hoping maybe you could speak to some of the dynamics within the TAS business. In the fourth quarter, the analytics and consulting business was impacted, but some of that maybe seemed like it was unique to December purchasing pattern. So how much of this is carryover from what you saw in the fourth quarter? And then what's driving your confidence that it's going to come back in the remainder of the year so that you can.

Ari Bousbib: Yeah. Thank you, Anne. It, it's a good question. Look, TAS growth in the first quarter was within the range we expected. You are correct that the guidance we gave on an organic, constant currency, ex-COVID basis, for the year, I think our guidance is 7 to 9%, and therefore, 6% clearly is right under that. But we did, you know, tell you that we did fully expect Q1 to be just under that. So our expectations were more in the 6 to 7, 6 to 8% for the first quarter. And we expected a slower start, as you suggest, due to the cautiousness we saw in December, in customers' discretionary spending.

Speaker 6: basis.

But we did, you know, tell you that we did fully expect Q1 to be just under that. So our expectations were more in the 6 to 7, 6 to 8% for the first quarter. And we expected a slower start, as you suggest, due to the cautiousness we saw in December, in customers' discretionary spending.

for the year, I think our guidance is 7 to 9 percent. And therefore, 6 percent clearly is right under that. But we did tell you that we did fully expect Q1 to be just under that. So our expectations were more in the 6 to 7, 6 to 8 percent for.

Ari Bousbib: And so we assumed this was gonna spill over, as you suggest, into the Q1, and that's why we assumed a slower start in the year for this business. The reason why it's a little lower than our long-term growth expectation is due to the analytics and consulting business piece of TAS. That is about, I wanna say, just under 25% of the total business in TAS. As we said many times before, it's the shortest cycle and contains the most discretionary spend activity of the entire TAS portfolio. So what we are seeing is not cancellations of projects, not decisions to not conduct the projects. For the most part, these are projects that need to be done.

And so we assumed this was gonna spill over, as you suggest, into the Q1, and that's why we assumed a slower start in the year for this business. The reason why it's a little lower than our long-term growth expectation is due to the analytics and consulting business piece of TAS. That is about, I wanna say, just under 25% of the total business in TAS.

or as you suggest, into the Q1, and that's why we assume a slower start in the year for this business. The reason why it's a little lower than our long-term growth expectation is due to the analytics and consulting business.

piece of TAZ. That is about, I want to say, just under 25% of the total business in TAZ. And as we said many times before, it's the shortest cycle and contains the most discretionary spend.

As we said many times before, it's the shortest cycle and contains the most discretionary spend activity of the entire TAS portfolio. So what we are seeing is not cancellations of projects, not decisions to not conduct the projects. For the most part, these are projects that need to be done.

activity of the entire TAS portfolio.

So what we are seeing is not cancellations of projects, not decisions to not conduct the project. For the most part, these are projects that need to be done. Pricing and market access studies, as an example, have to be done at some point. But the discretionary aspect applies to timing.

Ari Bousbib: You know, pricing and market access studies, as an example, have to be done at some point, but the discretionary aspect applies to timing, for the most part, okay? No one does projects that they don't need to do. These are projects that need to be done, but they don't need to be done right this second. We are seeing customers delaying decisions and pushing things to the right. That is what gives us confidence that in the latter part of the year, those projects will have to be done. So that's why we maintain our 7% to 9% organic constant currency ex-COVID guidance for the year. Now, we expect that cautiousness to continue into the second quarter, and we are assuming growth so far in line with the first quarter.

You know, pricing and market access studies, as an example, have to be done at some point, but the discretionary aspect applies to timing, for the most part, okay? No one does projects that they don't need to do. These are projects that need to be done, but they don't need to be done right this second. We are seeing customers delaying decisions and pushing things to the right.

for the most part. Okay, no one does projects that they don't need to do. These are projects that need to be done, but they don't need to be done right this second. And we are seeing customers delaying decisions and pushing things to the right. That is what gives us confidence that in the latter part of the year, those projects will have to be done.

That is what gives us confidence that in the latter part of the year, those projects will have to be done. So that's why we maintain our 7% to 9% organic constant currency ex-COVID guidance for the year. Now, we expect that cautiousness to continue into the second quarter, and we are assuming growth so far in line with the first quarter.

So that's why we maintain our 7 to 9% organic constant currency ex-COVID guidance for the year. Now we expect that consciousness to continue into the second quarter and we are assuming growth so far in line with the first quarter.

Ari Bousbib: Again, we're not seeing any customers walking away from projects or canceling anything. It's just consistent with what we saw at the end of Q4, delaying a project. We do expect the situation to improve in the second half because the pipeline are stronger, and the customers eventually need to actually spend on those products.

Again, we're not seeing any customers walking away from projects or canceling anything. It's just consistent with what we saw at the end of Q4, delaying a project. We do expect the situation to improve in the second half because the pipeline are stronger, and the customers eventually need to actually spend on those products.

Anne Samuel: That's extremely helpful, caller. Thank you so much.

and the customers eventually need to actually spend on those products. That's extremely helpful, Caller. Thank you so much.

Ari Bousbib: Thank you.

Ronald Bruehlman: Your next question comes from the line of David Windley at Jefferies. Your line is open.

Operator: Your next question comes from the line of David Windley at Jefferies. Your line is open.

David Windley: Well, thanks for taking my question. Good morning, Ari. I wondered if you could talk in the R&DS business, as you highlight strong bookings, I guess, seasonally different from the fourth quarter. The thing that we're seeing, I guess, in our data review, is that a lot of studies, similar to what you're describing in TAS, in consulting, that a lot of studies are kind of sitting in a limbo point and not moving forward into first patient in, and kind of more productive revenue stages of the trial. And I wondered if you have some insights into that and if, you know, any of your tools can help to move those forward, or is it kind of a funding and financial issue that is keeping them from moving forward? Be curious your views there.

Your next question comes from the line of David Winley at Jefferies. Your line is open. Well, thanks for taking my question. Good morning. Ari, I wondered if you could talk in the RDS business as you highlight strong bookings, I guess, seasonally different from the fourth quarter. The thing that we're seeing, I guess, in our data review is that —

And I wondered if you have some insights into that and if, you know, any of your tools can help to move those forward, or is it kind of a funding and financial issue that is keeping them from moving forward? Be curious your views there.

if any of your tools can help to move those forward, or is it kind of a funding and financial issue that is keeping them from moving forward? Be curious your views there. OK, well, David, good morning, and thanks for the question. I want to use the opportunity to

Ari Bousbib: Okay. Well, David, good morning, and thanks for the question. I, I want to use the opportunity to state as clearly and definitively as I can, we simply are not, I repeat, we are not seeing any of what you suggest. And no one is. First of all, on the funding question, I, I don't know how many times I'm going to repeat it. I've been doing this for five quarters in a row. We are not seeing any funding issues. In my introductory remarks, I share some of the statistics, that actually everything is up on the funding front. So we are not seeing any delays, any unusual cancellations, any postponing of decision-making within our portfolio. It could be that others are seeing that, we just are not seeing it. Once again, the overall RFP flow is at a record high.

state as clearly and definitively as I can. We simply are not, I repeat, we are not seeing any of what you suggest.

First of all, on the funding question, I don't know how many times I'm going to repeat it. I've been doing this for five quarters in a row. We are not seeing any funding issues in my introductory remarks. I share some of the statistics. Maybe everything is up.

We are not seeing any funding issues. In my introductory remarks, I share some of the statistics, that actually everything is up on the funding front. So we are not seeing any delays, any unusual cancellations, any postponing of decision-making within our portfolio. It could be that others are seeing that, we just are not seeing it. Once again, the overall RFP flow is at a record high.

on a public front.

So we are not seeing any delays, any unusual cancellations, any postponing of decision-making within our portfolio. It could be that others are seeing that we just are not seeing it. Once again, the overall RFP flow is not seeing any delays.

Ari Bousbib: It's up 15% sequentially versus Q4 2022. Both the mid and the EBP segments are up strong double digits. I said before, it's up 15%. The qualified pipeline, which is again, an even earlier indicator, is up almost, you know, 8%. It's actually over 8% year over year, and it's almost $15 billion, with, again, a record qualified pipeline. The total pipeline is over $25 billion. Also, mid, more than 5% growth year over year. $2.6 billion of net bookings in the quarter. You know, it's more than the entire backlog of, you know, of some of our smaller competitors out there.

It's up 15% sequentially versus Q4 2022. Both the mid and the EBP segments are up strong double digits. I said before, it's up 15%. The qualified pipeline, which is again, an even earlier indicator, is up almost, you know, 8%. It's actually over 8% year over year, and it's almost $15 billion, with, again, a record qualified pipeline. The total pipeline is over $25 billion.

I said before it's up 15%. The qualified pipeline, which is again an even earlier indicator, is up almost 8%. It's actually over 8% year over year, and it's almost $15 billion with, again, a record qualified pipeline. The total pipeline is over...

Also, mid, more than 5% growth year over year. $2.6 billion of net bookings in the quarter. You know, it's more than the entire backlog of, you know, of some of our smaller competitors out there.

Ari Bousbib: Our book-to-bill 1.28 is extremely strong in the current environment, and I think from what I've seen, the highest of any of our peers. Our backlog is up more than 10% year over year. That's on a reported basis. Excluding effects, it's up 11.3%. So, you know, again, what I'm trying to share some metrics with you here. If we look at by segment, again, it's across the board, large, mid, EBP. I've got a lot of numbers here, but everything is, honestly, everything is green here. Nick, you have any other color to add to this?

Our book-to-bill 1.28 is extremely strong in the current environment, and I think from what I've seen, the highest of any of our peers. Our backlog is up more than 10% year over year. That's on a reported basis. Excluding effects, it's up 11.3%. So, you know, again, what I'm trying to share some metrics with you here.

and I think from what I've seen, the highest of our peers.

Our backlog is up more than 10% year over year. That's on a reported basis, excluding FX, it's up 11.3%. So again, I'm trying to share some metrics with you here. If we look at by segment, again, it's across the board, large, mid, EDP.

If we look at by segment, again, it's across the board, large, mid, EBP. I've got a lot of numbers here, but everything is, honestly, everything is green here. Nick, you have any other color to add to this?

I've got a lot of numbers here, but everything is, honestly, everything is green here. Nick, do you have any other comments to add to this? Yes, Dave, I think the only thing I would say there is, you know, we saw your question sort of earlier this week and talked to the team, and we're not seeing any sort of slowdown in terms of clients not wanting to start trials. I mean, as soon as they're signing and pushing, you know, and getting ready, they are pushing trials.

[Company Representative] (IQVIA Holdings): Yeah, I guess, Dave, I think the only thing I would say there is, you know, we saw your question sort of earlier this week and talked to the team, and we're not seeing any sort of slowdown in terms of clients not wanting to start trials. I mean, as soon as they're signing and pushing and, you know, and getting ready, they are pushing trials forward. So, you know, we're not seeing any delays, clients trying to slow down starts. You know, we are seeing trials move forward and, not, you know, and not seeing the dynamics that you're asking about.

Nick Childs: Yeah, I guess, Dave, I think the only thing I would say there is, you know, we saw your question sort of earlier this week and talked to the team, and we're not seeing any sort of slowdown in terms of clients not wanting to start trials. I mean, as soon as they're signing and pushing and, you know, and getting ready, they are pushing trials forward.

So, you know, we're not seeing any delays, clients trying to slow down starts. You know, we are seeing trials move forward and, not, you know, and not seeing the dynamics that you're asking about.

Ronald Bruehlman: Yeah, and Dave, if there's any slowness anywhere, it's just in some of the execution because of the labor issues at some of the sites. But that would be the one place where we could burn faster, and the industry could burn faster if there weren't the labor issues at the sites.

Ari Bousbib: Right. As I mentioned in my introductory remarks, we have been able to offset some of that unfavorable impact of staff shortages that Ron just brought up and we talked about before, because site selection has been accelerating. I mentioned it was up double digits year over year, and that increased productivity helped us in the quarter, and we expect will continue to do so the rest of the year. We also, I mentioned also in my introductory remarks, are introducing rapidly more technology at the site in order to free up personnel time and increase productivity. Thank you.

the one place where we could burn faster and the industry could burn faster if there weren't the labor issues at the sites. Right, and as I mentioned in my introductory remarks, we have been able to offset some of that unfavorable impact, the star shortages that Ron just brought up and we talked about before.

because site selection has been accelerating. I mentioned it was up double digits year over year, and that increased productivity helped us in the quarter, and we expect we'll continue to do so the rest of the year. We also, I mentioned also in my introductory remarks, are introducing rapidly more technology at the site in order to free up minus

We also, I mentioned also in my introductory remarks, are introducing rapidly more technology at the site in order to free up personnel time and increase productivity. Thank you.

David Windley: Yeah, very, very fulsome answer. If I could just add to that, I mean, there's been a lot of companies this week that have attributed, you know, weakness to bio. I mean, there are a lot of other companies seeing, you know, dramatic slowdowns. Maybe you could talk about how your positioning or your stage of the pipeline is different, that also protects you from what they are seeing, Thermo, Danaher, Sartorius, et cetera.

personnel time and increased productivity. Thank you. Yeah, very, very fulsome answer. If I could just add to that, I mean, there's been a lot of companies this week that have attributed weakness to biotech. I mean, there are a lot of other companies seeing, you know, dramatic, you know,

Ari Bousbib: Yeah. I mean, the answer is in your question. We have a very strong momentum. We operate, the vast majority of what we do is in the sweet spot of the clinical trial process. You know, it's phase three stuff. We're not affected by the primate issue, zero, zero. And even if the primate issue continues for the next three years, you wouldn't see it at all in our numbers. We've already looked at that. And we continue to gain share. I know I gave examples on the FSP segment. It's true across the board. In oncology, we just are winning in the marketplace. We displaced incumbents in a number of occasions with large-...

question, we have a very strong momentum. We operate the vast majority of what we do is in the sweet spot of the clinical trial process. You know, it's phase three stuff.

We're not affected by the primate issue, zero, zero. And even if the primate issue continues for the next three years, you wouldn't see it at all in our numbers. We've already looked at that. And we continue to gain share. I know I gave examples on the FSP segment. It's true across the board in oncology.

And we continue to gain share. I know I gave examples on the FSP segment. It's true across the board. In oncology, we just are winning in the marketplace. We displaced incumbents in a number of occasions with large-...

Ari Bousbib: The clients, I think, you know, I don't see any, really, no issues whatsoever, on the R&DS front, you know, save for the execution and operational issues we have encountered. I mentioned that the attrition levels are coming down. I mean, I said before that the peak of the attrition, you know, a year ago or so, we had more than 20% attrition, which is horrendous. And we're now back to, I said, pre-pandemic levels, actually, we're below that, which is barely over 10%, which is amazing, and very good. And that enables us to do a lot more work a lot faster. Thank you, David.

The clients, I think, you know, I don't see any, really, no issues whatsoever, on the R&DS front, you know, save for the execution and operational issues we have encountered. I mentioned that the attrition levels are coming down. I mean, I said before that the peak of the attrition, you know, a year ago or so, we had more than 20% attrition, which is horrendous.

We just are winning in the marketplace. We displaced incumbents in a number of occasions with large clients. I think, you know, I don't see any, really no issues whatsoever on the R&D front, save for the execution and operation issues.

we have encountered. I mentioned that the attrition levels are coming down. I mean, I said before that the peak of the attrition, you know, a year ago, so we had more than 20% attrition, which is horrendous. And we're now back to, I said, pre-pandemic levels, actually we're below that, we're just barely over 10%, which is amazing.

And we're now back to, I said, pre-pandemic levels, actually, we're below that, which is barely over 10%, which is amazing, and very good. And that enables us to do a lot more work a lot faster. Thank you, David.

[Company Representative] (IQVIA Holdings): Yeah, thank you.

David Windley: Yeah, thank you.

and very good. That enables us to do a lot more work a lot faster. Thank you, David. Yeah, thank you.

Operator: Your next question comes from the line of Eric Coldwell at Baird. Your line is open.

Eric Coldwell: Thanks. Good morning. I wanna hit on reimbursables, on a couple of fronts. First off, on revenue. With such a big COVID comp this quarter, I would've expected less reimbursable revenue. It looks like it actually grew quite a bit faster than service revenue. So, you know, what is the dynamic there? We're seeing mixed bag all over the industry in terms of the pass-through volatility. With that big COVID headwind, I would've expected less. You did more. Is there something underlying or outside of COVID exposure that's driving the reimbursables higher, or is it just company-specific contract timing?

Your next question comes from the line of Eric Coldwell at Baird. Your line is open.

Thanks good morning. I want to hit on reimbursables on on a couple of fronts. 1st off on revenue was such a big cobit comp this quarter. I would have expected. Less reimbursable revenue, it looks like it actually grew quite a bit faster. Then service revenue, so. You know, what is the dynamic there? We're seeing mixed bag all over the industry in terms of the pass through volatility.

We're seeing mixed bag all over the industry in terms of the pass-through volatility. With that big COVID headwind, I would've expected less. You did more. Is there something underlying or outside of COVID exposure that's driving the reimbursables higher, or is it just company-specific contract timing?

With that big COVID headwind, I would have expected less. You did more. Is there something underlying or outside of COVID exposure that's driving the reimbursables higher, or is it just company-specific contract timing? Oh, OK. Well, look, on a full year basis, we're expecting actually obviously less.

Ari Bousbib: Oh, okay. Well, look, on a full year basis, we're expecting actually, obviously, less reimbursable expenses, because of the disappearance of the, of the COVID work, which was, as you suggest, very high pass-through expenses, for those COVID vaccine trials. In the quarter, you know, I wouldn't read much in the quarter because there's volatility, and depends on the mix of what you executed. So I don't- I'm not... To be honest, the book-to-bill is more or less similar to- We- I think you, I read your note, right? I religiously do that before the call, your first flash note, and you know ask why we only reported our 606, our book-to-bill at 1.28.

reimbursable expenses.

because of the disappearance of the COVID work, which was, as you suggest, very high pass-through expenses.

for those COVID vaccine trials. I wouldn't read much in the quarter because this volatility depends on the mix of what you executed. So I don't.

So I don't- I'm not... To be honest, the book-to-bill is more or less similar to- We- I think you, I read your note, right? I religiously do that before the call, your first flash note, and you know ask why we only reported our 606, our book-to-bill at 1.28.

To be honest, the book to read is more or less similar. I read your note Friday, as I religiously do that before the call, your first flash note, and you ask why we only reported our 606, which still seeks our...

Ari Bousbib: I, by the way, I asked the same question to the team when they gave me the first draft, and I agree with their rationale. You know, as you've seen in recent quarters, essentially, the numbers have tended to converge, which is essentially what we expected to happen. We will give you the breakdown or the, you know, ex-reimbursable expenses book-to-bill, when we think there is, when there is a big discrepancy, and it is significant and helps give you understanding of what happened in the quarter in terms of bookings. But if it's very close, as it was last quarter, as it is this quarter, we're just not gonna do that.

I, by the way, I asked the same question to the team when they gave me the first draft, and I agree with their rationale. You know, as you've seen in recent quarters, essentially, the numbers have tended to converge, which is essentially what we expected to happen.

Book to be that 128 and I by the way, I asked the same question to the team when they gave me the first draft and I agree with their rationale. As you've seen recent quarters, essentially the numbers are tended to converge, which is essentially what we expected to happen. We will give you.

We will give you the breakdown or the, you know, ex-reimbursable expenses book-to-bill, when we think there is, when there is a big discrepancy, and it is significant and helps give you understanding of what happened in the quarter in terms of bookings. But if it's very close, as it was last quarter, as it is this quarter, we're just not gonna do that.

the breakdown or the X, reimbursable expenses, book to bill, when we think there is a big discrepancy and it is significant and helps give you understanding of what happened in the quarter in terms of bookings. But if it's very close, as it was last quarter, as it is this quarter.

Ari Bousbib: The change to 606 standards happened more than five years ago, and none of our competitors actually disclose that level of granularity or report any extra reimbursable expenses at book-to-bill. But again, I wouldn't read any much more here in the quarter. Nick or Ron, any commentary or color on Eric's question?

The change to 606 standards happened more than five years ago, and none of our competitors actually disclose that level of granularity or report any extra reimbursable expenses at book-to-bill. But again, I wouldn't read any much more here in the quarter. Nick or Ron, any commentary or color on Eric's question?

Ronald Bruehlman: Yeah. Look, we did have a little bit higher revenue from pass-throughs in the quarter, but as Ari says, I wouldn't read too much into the quarter to quarter. And over a longer time period, your analysis is correct. With COVID work rolling off, there should be a decline in pass-through revenues. And yeah, exactly on the book-to-bill, we just, you know, we're what? You know, five years in, six, seven years in now since the change in the accounting and, you know, we'll only talk to, on the book-to-bill, the services versus pass-through book-to-bill, or the six oh five versus six oh six, when there's a significant difference to talk about, and there wasn't this quarter.

Comment of your color on Eric's question. Yeah, look, we did have a little bit higher revenue from past throughs in the quarter, but as Ari says, I wouldn't read too much into the quarter to quarter and in over a longer time period, your, your analysis is correct with code work, rolling off. There should be a decline in in past through revenues and yeah, exactly on the book that bill we just, you know, we're what. You know, 5 years in 6, 7 years in now, since the change in the accounting and, you know, we'll only talk to on the book to build the services versus pass through book to bill or the 6 or 5 versus 6 or 6.

And yeah, exactly on the book-to-bill, we just, you know, we're what? You know, five years in, six, seven years in now since the change in the accounting and, you know, we'll only talk to, on the book-to-bill, the services versus pass-through book-to-bill, or the six oh five versus six oh six, when there's a significant difference to talk about, and there wasn't this quarter.

Ari Bousbib: Yeah, and Eric, just on the pass-throughs again, I mentioned we did execute faster this past quarter on our R&DS backlog. It's true, we burnt, we accelerated. That's, you know, this is why we recognize more revenue, and as a result, there was more pass-through during the first quarter. I don't know that it's going. I don't think you'll see the same in the next few quarters based on the modeling I saw. Thank you.

Eric Coldwell: Could I have one follow-up?

Ari Bousbib: Normally, no, but it's you, so what? You know, go ahead.

Eric Coldwell: Thank you. I just wanted to hit on cash flow, and expectations for the year, and we're juggling three overlapping reports here, so I'm sorry if I missed this. Did you, did you mention what the DSO was in the quarter?

Thank you. I just wanted to hit on cash flow and expectations for the year and we're juggling three overlapping reports here. So I'm sorry if I missed this. Did you did you mention what the DSO was in the quarter?

Ronald Bruehlman: No, we didn't, we didn't give an explicit DSO number. In fact, we don't typically give a DSO number. You guys can back calculate. We were happy with the cash flow in the quarter. One thing I would wanna remind everyone is, in Q1, it's typically a weak quarter for cash flow because most of our incentive comp, annual incentive comp, is paid in Q1.

No, we didn't give an explicit DSO number. In fact, we don't typically give a DSO number. You guys can back calculate. We were happy with the cash flow in the quarter. One thing I would want to remind everyone is in the first quarter, it's typically a week quarter for cash flow because most of our incentive comp, annual incentive comp is paid in the first quarter. Yeah, there's some tax impacts too. Incentive comp is probably the biggest. Yeah.

Ari Bousbib: Tax season.

Ronald Bruehlman: Yeah, there's some tax impacts, too. Incentive comp is probably the biggest, but,

Ari Bousbib: That was very strong.

Ronald Bruehlman: Yeah, it was strong. We were happy with our cash flow, and not quite as strong as last year, but last year was an unusually strong first quarter for cash flow.

That was very strong. Yeah, it was strong. We were happy with our cash flow and not quite as strong as last year, but last year was an unusually strong first quarter for cash flow.

Eric Coldwell: Okay.

Ari Bousbib: Yes, so then we can understand, so it improved. It's flattish, right?

Ronald Bruehlman: Our DSOs, on a quarter-to-quarter basis, it's fairly flattish. On a year-over-year basis, it's up a little bit, and a lot of that has to do with the burning through the COVID-related advances that we got. So it was fully expected.

Okay. Yes. So then you can improve its flattish, right? I think on a quarter to quarter basis, it's fairly flat on a year-over-year basis. It's up a little bit and a lot of that has to do with the burning through the COVID-related advances that we got. So.

Eric Coldwell: Got it. Thanks very much. I appreciate it.

Ari Bousbib: Thank you.

It was fully expected. Got it. Thanks very much. I appreciate it. Thank you. Your next question comes from the line of Max Smock at William Blair. Your line is now open.

Operator: ... Your next question comes from the line of Max Smalk at William Blair. Your line is now open.

[Analyst] (William Blair): Hi, I just wanted to clarify your comment in response to one of Dave's questions earlier about the NHP situation. Just wanted to clarify that you said that you would not see any impact from the NHP shortage, even if it continues for the next three years. Just wondering, at some point, wouldn't it limit the number of drugs getting into later-stage trials here? Just would be great to hear more about the work you've done internally to kind of evaluate your potential exposure over the next couple of years. Thanks.

Max Smock: Hi, I just wanted to clarify your comment in response to one of Dave's questions earlier about the NHP situation. Just wanted to clarify that you said that you would not see any impact from the NHP shortage, even if it continues for the next three years. Just wondering, at some point, wouldn't it limit the number of drugs getting into later-stage trials here? Just would be great to hear more about the work you've done internally to kind of evaluate your potential exposure over the next couple of years. Thanks.

I just wanted to clarify your comment in response to one of Dave's questions earlier about the NHP situation. And I just wanted to clarify that you said that you would not see any impact from the NHP shortage, even if it continues for the next three years. Just wondering, at some point, wouldn't it limit the number of drugs getting into later stage trials here? Just would it be great to hear more about the work you've done internally to kind of evaluate your potential exposure over the next couple of weeks? Thanks.

Ari Bousbib: Yeah, it's again, in theory, yes, but you know, we don't expect that to happen. I mean, there'll be eventually other models and they will become available. I mean, I don't. We're not worried about this at all.

Again, in theory, yes, but we don't expect that to happen. I mean, there will be eventually other models and they will become available.

Ronald Bruehlman: Yeah, the three years just related to the length of time it takes to get from the discovery work into phase two and phase three trials, and there's a long delay between that. So yeah, of course, theoretically, if there's a protracted issue, it affects everybody in the industry. We don't expect that to happen.

We're not worried about this at all. Yeah, the three years just related to the length of time it takes to get from the discovery work into phase two and phase three trials. And there's a long delay between that. So yeah, of course, theoretically, if there's a protracted issue, it affects everybody in the industry. We don't expect that to happen.

[Analyst] (William Blair): Okay, great. Thank you.

Max Smock: Okay, great. Thank you.

Operator: Your next question comes from the line of Sandy Draper at Guggenheim Securities. Your line is now open.

Okay, great. Thank you. Your next question comes from the line of Sandy Draper at Guggenheim Securities. Your line is now open.

Sandy Draper: Thanks very much. I think it sounds like I need to get on Eric's distribution list, so I can get his quick flash notes. I can't process fast enough to do that. So my question, Ari, or maybe Ron, is on the backlog burn. I'm trying to reconcile with what you were talking about in answering his question. On my calculations, it looked like the backlog burn stepped down a little bit from Q4, from 8% to 7.4%. My assumption was there's a little bit less sequentially in terms of reimbursables, so I just wanted to verify that.

Thanks very much. I think it sounds like I need to get on Eric's distribution list so I can get his quick flash notes. I can't process fast enough to do that. So my question Ari or maybe Ron is on the backlog burn. I'm trying to reconcile.

with what you were talking about and answer his question. On my calculation did look like the backlog burn stepped down a little bit from the fourth quarter from 8% to 7.4. My assumption was there's a little bit less sequentially in terms of reimbursables. So I just wanted to verify that, but then thinking about how you're expecting the backlog burn to play out.

Sandy Draper: But then thinking about how you're expecting the backlog burn to play out as you have less COVID work, et cetera, which is faster burning, do you think, is it reasonable to think stable off of this 7.4, or would it sort of trend down over the course of the year? Thanks.

But then thinking about how you're expecting the backlog burn to play out as you have less COVID work, et cetera, which is faster burning, do you think, is it reasonable to think stable off of this 7.4, or would it sort of trend down over the course of the year? Thanks.

as you have less COVID work, et cetera, which is fast for Bernie. Do you think, is it reasonable to think stable after this 7.4 or would it sort of trend down over the course of the year? Thanks.

Ronald Bruehlman: Look, I wouldn't put a lot of emphasis on quarter-to-quarter backlog burn as you calculate it there. It's not something that we pay a lot of attention to internally, I can tell you. You'll get variations like in the, you know, fourth quarter, we had very strong pass-through bookings, which, you know, pushes up the backlog some, but then those tend to burn later in the trial. And you'll see impacts like that affect, you know, any one quarter's, like, particularly the next quarter's, burn rate. So, overall, as Ari made the point, we tend to work on more complicated trials, and oncology trials, in particular, tend to be longer, slower burn trials.

Look, I wouldn't put a lot of emphasis on quarter-to-quarter backlog burn as you calculate it there. It's not something that we pay a lot of attention to internally, I can tell you. You'll get...

variations like in the fourth quarter we had very strong pass-through bookings, which pushes up the backlog some, but then those tend to burn later in the trial. And you'll see impacts like that affect any one quarter's, particularly the next quarter's burn rate.

And you'll see impacts like that affect, you know, any one quarter's, like, particularly the next quarter's, burn rate. So, overall, as Ari made the point, we tend to work on more complicated trials, and oncology trials, in particular, tend to be longer, slower burn trials.

Overall, as Ari made the point, we tend to work on more complicated trials. In oncology trials in particular tend to be longer slower burn trials. So we may have slower burn on average than some of the others in the industry based upon a particular method.

Ronald Bruehlman: So we may have slower burn on average than some of the others in the industry based upon our particular mix of projects. But, that's more a macro long-term consideration than it is a quarter-to-quarter sort of variation driver.

So we may have slower burn on average than some of the others in the industry based upon our particular mix of projects. But, that's more a macro long-term consideration than it is a quarter-to-quarter sort of variation driver.

Sandy Draper: Okay, great. That's helpful. Thanks, Ron.

Operator: Your next question comes from the line of Charles Wright with TD Cowen. Your line is now open.

[Analyst] (William Blair): Hi, this is Lucas on for Charles. Want to dig into the TAS segment. You guys talked about consulting and analytics seeing some softness in Q1. You guys also called out some wins in real-world evidence. Can you talk more about the performance of the other offerings within TAS and how they performed in Q1, more specifically, real-world evidence and technology platforms?

[Analyst] (TD Cowen): Hi, this is Lucas on for Charles. Want to dig into the TAS segment. You guys talked about consulting and analytics seeing some softness in Q1. You guys also called out some wins in real-world evidence. Can you talk more about the performance of the other offerings within TAS and how they performed in Q1, more specifically, real-world evidence and technology platforms?

Your next question comes from the line of Charles Wright, TD Cowen, your line is now open.

Hi, this is Lucas on for Charles. Want to dig into the task segment. You guys talked about consulting and analytics, seeing some softness in one cue. You guys also called out some wins in real-world evidence. Can you talk more about the performance of the other offerings?

within CAF and how they performed in one queue, more specifically real world evidence and technology platforms. Look, our real world in technology, we tend to talk about them together because they're the faster growers and continue to be very solid growers in the quarter as Ari pointed out.

Ronald Bruehlman: Look, our real world in technology, we tend to talk about them together because they're the faster growers and continued to be very solid growers in the quarter. As Ari pointed out, it was the analytics and consulting business that really slowed down in the quarter, because a lot of that is shorter cycle business and can be delayed. You know, we've always talked about information being a slower grower, so you know, you know about that. So you kind of piece it together. The difference versus prior quarters really relates to the analytics and consulting business, some of that shorter cycle business being delayed. It's really as simple as that. That's why we saw a little bit of a slowdown in the underlying core growth rate in the TAS business. Next question?

So you kind of piece it together. The difference versus prior quarters really relates to the analytics and consulting business, some of that shorter cycle business being delayed. It's really as simple as that. That's why we saw a little bit of a slowdown in the underlying core growth rate in the TAS business. Next question?

prior quarters really relates to the analytics and consulting business, some of that shorter cycle business being delayed. It's really as simple as that. That's why we saw a little bit of a slowdown in the underlying core growth rate in the TAS business. And that's why we saw a little bit of a slowdown in the underlying core growth rate in the TAS business.

Next question.

Operator: Your next question comes from the line of Derek Dabruin at Bank of America. Your line is now open.

[Analyst] (Bank of America): Hi, this is Wolf Shannon on for Derek. Thanks for taking our questions. So I know in the prepared remarks, you flagged that there's been a pickup of biotech M&A, which obviously is helping the funding environment. But I'm wondering what you're seeing in terms of the larger, of the acquirer then reducing the R&D spend at the target. Is there any impact to you from that? Yeah, if you could just explore those dynamics, that'd be great. Thank you.

Your next question comes from the line of Derek DeBruin at Bank of America. Your line is now open.

Hi, this is Wolf Chanoff on for Derek. Thanks for taking our questions. So I know in the prepared remarks you flagged that there's been a pickup of biotech M&A which obviously is helping the funding environment. But I'm wondering what you're seeing in terms of the larger of the acquirer than reducing the R&D spend at the target.

Ari Bousbib: Yeah, thank you. Just to clarify, the M&A spend has nothing to do with funding. It's not included in the funding numbers. So these are two different and independent points. The heightened M&A activity is a plus, obviously, and is a tailwind for us, as you know, we've got large clients that are buying molecules for which work needs to be done. So this is generally a favorable trend for us. Thank you.

Is there any impact to you from that? If you could just explore those dynamics, that'd be great. Thank you. Thank you. Just to clarify, the M&A span has nothing to do with funding. It's not included in the funding numbers.

So these are two different and independent points. The heightened M&A activity is a plus obviously and is a tailwind for us as you know the large clients that are buying molecules for

[Company Representative] (IQVIA Holdings): Next question, please.

Nick Childs: Next question, please.

Operator: Your next question comes from the line of Dan Leonard at Credit Suisse. Your line is now open.

Dan Leonard: Thank you. I was just hoping you could revisit that comment you made that RFPs grew 15% sequentially. I assume that's a volume number, and is there any difference between RFP volume trends and value trends? Thank you.

Thank you. I was just hoping you could revisit that comment you made that RFPs grew 15% sequentially. I assume that's a volume number. And is there any difference between RFP volume trends and value trends? Thank you. Thank you. No, your assumption is incorrect.

Ari Bousbib: Thank you. No, your assumption is incorrect. The growth numbers we mentioned are in dollars.

[Company Representative] (IQVIA Holdings): Yeah. So all the growth numbers that we've given Dan on the call are all dollar-based. It's not a volume-

Nick Childs: Yeah. So all the growth numbers that we've given Dan on the call are all dollar-based. It's not a volume-

growth numbers we mentioned are in dollars.

Dan Leonard: Got it. Perfect.

Yeah, so all the growth numbers that we've given Dan on the call are all dollar based.

[Company Representative] (IQVIA Holdings): That's how we tend to track it, because that's what's important. Yes.

Ronald Bruehlman: That's how we tend to track it, because that's what's important. Yes.

Dan Leonard: Thank you.

It's not a volume. Perfect discussion. And that's how we tend to track it because that's what's important. Yes. Thank you.

Operator: Your next question comes from the line of Elizabeth Anderson at Evercore ISI. Your line is now open.

Elizabeth Anderson: Hi, guys. Thanks so much for the question. I know you said you just talked about it in terms of total dollar volumes. I was just wondering if you could comment on the contribution in terms of pricing and R&DS to the dollars this year. And then secondly, just in terms of the pacing of CSMS revenue over the back half of the year, are you still thinking we should see that continue to accelerate and be sort of in that, like, sort of mid to high single digit type range? Thank you.

Your next question comes from the line of Elizabeth Anderson at Evercore ISI. Your line is now open.

Hi guys, thanks so much for the question. I know each of you just talked about it in terms of total dollar value. I was just wondering if you could comment on the contribution in terms of pricing in R&DS to the dollars this year. And then secondly, just in terms of the total dollar value, I'm just wondering if you could

Ari Bousbib: Yeah, the comment on CAS is just correct. That's our expectation currently, based on the pipeline. What was the first question? I'm sorry.

[Company Representative] (IQVIA Holdings): Yeah, I didn't hear your first question, Elizabeth. I'm sorry.

Nick Childs: Yeah, I didn't hear your first question, Elizabeth. I'm sorry.

Elizabeth Anderson: Sure. It was just in terms of the contribution of sort of increases in pricing that could have contributed to the first quarter revenue results on a year-over-year basis.

Ari Bousbib: Nothing. It was negligible.

[Company Representative] (IQVIA Holdings): Yeah, I mean, I wouldn't say it's anything large, Elizabeth. I mean, again, you gotta remember, trials are, you know, can anywhere from three to five years. It takes a while for all the pricing to, you know, pick up. You know, we don't get that all up, you know, and get it all up front. So, you know, the pricing has a, you know, bleeds in over the course of the trials.

Nick Childs: Yeah, I mean, I wouldn't say it's anything large, Elizabeth. I mean, again, you gotta remember, trials are, you know, can anywhere from three to five years. It takes a while for all the pricing to, you know, pick up. You know, we don't get that all up, you know, and get it all up front. So, you know, the pricing has a, you know, bleeds in over the course of the trials.

Elizabeth Anderson: Got it. Thank you.

[Company Representative] (IQVIA Holdings): Okay. We will take one more question, please.

Nick Childs: Okay. We will take one more question, please.

Operator: Thank you. Your final question comes from the line of Justin Bowers at Deutsche Bank. Please go ahead.

Justin Bowers: Okay, thank you, and good morning. Just, sort of a two-parter, one with RWE. Are you seeing any change in the velocity of demand, there for that business, hearing in the marketplace that IRA might be a bit of a tailwind for that? And then, can you also sort of educate us a little bit on the lead time between when market access and pricing studies are done and, and, you know, with respect to FDA approvals? Thank you.

Ari Bousbib: Yeah. Thank you, Justin. On the first question, Nick Giovanni-

[Company Representative] (IQVIA Holdings): He said the growth on real-world evidence, it's-

Nick Childs: He said the growth on real-world evidence, it's-

Ari Bousbib: Nothing different.

[Company Representative] (IQVIA Holdings): Yeah.

Nick Childs: Yeah.

Ari Bousbib: Yeah. No.

[Company Representative] (IQVIA Holdings): Remains strong. Remains very strong.

Nick Childs: Remains strong. Remains very strong.

Ari Bousbib: Same, same. Nothing, really nothing changed on the real world side. On the ... It really, really varies. There are clients who like to start even before FDA approval, sometimes well before, you know, when the early results are strong, the data is good in the trial, you know, they want to get prepared. And we do those studies early. Sometimes it's around the time of the FDA approval, sometimes it's a little later. Again, it depends. By the way, it depends on the market. Sometimes it may decide to introduce a drug in Europe or in some markets in Europe before others, et cetera. And it has to do, you know, with when the approvals in specific geographies occur. So it really varies.

Sometimes it's around the time of the FDA approval, sometimes it's a little later. Again, it depends. By the way, it depends on the market. Sometimes it may decide to introduce a drug in Europe or in some markets in Europe before others, et cetera. And it has to do, you know, with when the approvals in specific geographies occur. So it really varies.

Ari Bousbib: There's no set lead time, and that's why, again, quote-unquote, "It's discretionary," it's gonna have to be done, but you could delay when you do it.

There's no set lead time, and that's why, again, quote-unquote, "It's discretionary," it's gonna have to be done, but you could delay when you do it.

Q1 2023 IQVIA Holdings Inc Earnings Call

Request a DemoDemo

IQV

IQVIA Holdings

Earnings