IQVIA Holdings, Inc.
IQV · NYSE
Next quarter
Expected to report Feb 4, 2027 — estimated from last year’s reporting date.
Consensus is $3.28 EPS for Dec 2026 across 5 estimates, ranging $3.25 to $3.36.
IQV Sep 2026
- 0.34%
- $2.94
- $2.95
- —
- $4.43B
Reported results
- $4.43B
- $572.00M
- 12.92%
- $350.00M
- $2.10
Highlights
- Growth accelerated: Q3 revenue was $4.428B, up 8.0% year over year (8.6% at constant currency); management put organic growth at approximately 6%, more than double the year-ago rate.
- Earnings topped guidance: Adjusted EBITDA was $1.032B, up 8.7%, and adjusted diluted EPS was $3.34, up 11.3%; both exceeded the high end of company expectations. The supplied consensus tracker shows EPS of $2.95 versus $2.94 expected, a 0.34% beat; the release separately reports GAAP diluted EPS of $2.10.
- Clinical bookings strengthened: R&D Solutions net new bookings rose 15% to $3.2B, with 1.2x book-to-bill; trailing-12-month bookings reached $11.7B, up 14% and higher for five consecutive quarters.
- Both segments grew: Commercial Solutions revenue increased 6.9% to $1.789B (7.9% at constant currency), while R&D Solutions rose 8.7% to $2.639B (9.1% at constant currency).
- 2026 guidance was raised: IQVIA now expects revenue of $17.350B–$17.500B, adjusted EBITDA of $4.025B–$4.055B, and adjusted diluted EPS of $12.90–$13.00.
- Margins expanded despite mix: Adjusted EBITDA margin increased 20 basis points for a second consecutive quarter; management said higher pass-through revenue and currency created about 60 basis points of net non-operational headwind, offset by roughly 80 basis points of operational improvement.
- Backlog was reset: A review of inactive trials reduced R&D contracted backlog by approximately $2.1B; backlog stood at $32.6B, with $9.4B expected to convert to revenue over the next 12 months, up 10% year over year.
- Cash generation remained solid: Operating cash flow was $825M and free cash flow was $667M, equal to 120% of adjusted net income; free cash flow was below the year-ago $772M.
- AI adoption broadened: IQVIA said it had deployed 415 AI agents, with the technology supporting clinical and commercial wins as well as internal productivity efforts.
Analysis
IQVIA delivered an accelerating-growth quarter, with revenue of $4.428B rising 8.0% year over year and 1.3% sequentially from Q2’s $4.37B. Growth was 8.6% at constant currency and approximately 6% organic, as management said organic growth accelerated to more than twice last year’s pace. GAAP operating income was $572M, up from $553M a year ago and $506M in Q2; attributable net income was $350M versus $331M and $256M, respectively. GAAP diluted EPS was $2.10 versus $1.93 a year ago and $1.53 in Q2. Separately, the supplied consensus tracker records EPS of $2.95 against $2.94 expected; the company reported adjusted diluted EPS of $3.34, up 11.3%, and adjusted EBITDA of $1.032B, up 8.7%, both above the high end of its expectations.
The defining signals were stronger clinical demand, growth in both segments, and margin execution despite a pass-through mix headwind. R&D bookings rose 15% to $3.2B, while trailing-12-month bookings reached $11.7B, up 14%. Commercial revenue grew 6.9% and R&D revenue 8.7%. Adjusted EBITDA margin expanded 20 basis points, and the company raised its full-year revenue, adjusted EBITDA and adjusted EPS ranges. The $2.1B inactive-trial backlog adjustment changes reported backlog visibility, but management said it does not affect guidance, bookings or next-12-month backlog revenue.
Clinical demand and bookings
R&D Solutions was the largest growth and forward-demand story. Revenue grew 8.7% to $2.639B (9.1% at constant currency); excluding reimbursed expenses, reported growth was 6.8%. Management attributed the increase primarily to higher volume in clinical services and lab testing. It described improving demand across biotech and large pharma, higher win rates, and strength in full-service awards, following a period of client reprocurement and weaker biotech funding.
- Bookings: Net new bookings were $3.2B, up 15% year over year, for 1.2x book-to-bill. Trailing-12-month net new bookings reached $11.7B, up 14%, and increased in each of the past five quarters.
- Demand indicators: Management cited biotech funding of $90B year to date, up more than 85% year over year and already above the prior full-year total; clinical trial starts and RFP flow were each up at high-single-digit rates.
- Backlog conversion: Contracted R&D backlog was $32.6B at September 30, with $9.4B expected to convert in the next 12 months, up 10% year over year.
Commercial growth and AI
Commercial Solutions revenue rose 6.9% to $1.789B, or 7.9% at constant currency. Management said organic growth was 4%, twice the year-ago pace, with growth across information, analytics and engagement offerings. It pointed to record pipelines, shorter customer decision timelines and new drug launches up more than 40% year to date as supportive demand signals. The third quarter marked a fourth consecutive quarter of strong commercial revenue growth.
- AI deployment: IQVIA reported 415 AI agents deployed. Management positioned its proprietary, curated healthcare data and life-sciences expertise as differentiators for agents that operate customer workflows, rather than generic AI tools alone.
- Use cases and monetization: Examples included AI-enabled clinical site and country selection intended to shorten one program by nine months, commercial insight platforms, and patient-support services. Management said commercial AI offerings can create incremental subscription or license revenue; in R&D, AI is being used to improve trial speed, accuracy and execution.
Margins and cash flow
Adjusted EBITDA increased 8.7% to $1.032B, with adjusted EBITDA margin expanding 20 basis points for a second consecutive quarter. Management said pass-through mix and currency together produced about 60 basis points of net non-operational margin headwind, more than offset by roughly 80 basis points of operational improvements, including cost containment and productivity initiatives. GAAP operating income rose to $572M from $553M a year earlier. Cash generation was healthy relative to adjusted earnings, although free cash flow was lower than in the prior-year quarter.
- Cash generation: Operating cash flow was $825M and capital expenditure was $158M, producing $667M of free cash flow, or 120% of adjusted net income; the year-ago quarter generated $908M and $772M, respectively.
- Leverage: Cash was $2.249B and debt was $16.067B, leaving net debt of $13.818B. Net leverage was 3.45x trailing-12-month adjusted EBITDA.
Backlog review
IQVIA removed approximately $2.1B from R&D backlog after reviewing inactive trials, generally work inactive for more than 18 months with no near-term resumption expected. Management said this was a refinement to improve visibility, not a change in contracting standards: only signed contracts enter backlog. If a removed trial resumes, its value will be added back without being counted as a new booking. The adjustment does not affect historical results, 2026 guidance, bookings, book-to-bill or the next 12 months of expected backlog revenue.
2026 outlook
The company raised its full-year 2026 guidance for revenue, adjusted EBITDA and adjusted diluted EPS. The updated revenue range includes acquisition contribution and a modest currency benefit; management cautioned that pass-through revenue can distort reported margins and emphasized EBITDA dollars as the more useful operational measure.
- Revenue: $17.350B–$17.500B, representing 6.4%–7.3% reported year-over-year growth. The outlook assumes approximately 250 basis points of acquisition contribution, including expected year-end completions, and about 20 basis points of foreign-exchange tailwind; management indicated FX would be a roughly 70-basis-point revenue headwind in Q4.
- Adjusted EBITDA: $4.025B–$4.055B, with management reaffirming approximately flat full-year margins at 23.2%.
- Adjusted diluted EPS: $12.90–$13.00, up 8.2%–9.1% year over year. Management said Q4 comparisons are difficult and provided a run-rate estimate of about $210M in net interest expense, just over $160M in depreciation and amortization, and approximately 169M diluted shares.
