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IQVIA Holdings Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 5 February 2026: press release. Guidance figures: 6 new. The quarter’s numbers.

Key takeaways

  • Fourth-quarter revenue rose 10.3%: Fourth-quarter revenue was $4,364 million, up 10.3% reported and 8.1% at constant currency. Full-year revenue was $16,310 million, up 5.9% reported and 4.8% at constant currency. Source
  • R&DS growth excluding pass-throughs was 4.9%: R&DS revenue was $2,333 million in the fourth quarter, up 9.9% reported and 8.2% at constant currency. Excluding pass-throughs, R&DS revenue grew 4.9% reported. Full-year R&DS revenue was $8,896 million, up 4.3%. Source
  • Book-to-bill was 1.18x in quarter: R&DS quarterly bookings were over $2.7 billion in the fourth quarter. The trailing-twelve-month book-to-bill ratio was 1.12x. Source
  • Backlog reached $32.7 billion: R&DS contracted backlog, including reimbursed expenses, was $32.7 billion, up 5.3% reported and 3.7% at constant currency. The third-quarter release reported $32.4 billion. Source
  • Full-year free cash flow was $2,051 million: Operating cash flow was $735 million in the fourth quarter against $885 million, and free cash flow $561 million against $721 million. For 2025 free cash flow equalled 99% of Adjusted Net Income. Source
  • Net leverage was 3.63x at year-end: Cash was $1,980 million and debt $15,724 million at December 31, 2025, giving net debt of $13,744 million. Gross leverage was 4.15x trailing twelve-month Adjusted EBITDA. Source
  • CSMS folded into TAS, renamed: From 1 January 2026, CSMS, with $788 million of 2025 revenue, is incorporated into TAS, which is renamed Commercial Solutions. Source

“We delivered near double digit revenue and EPS growth, and the strongest quarter of the year in R&DS net bookings.”

Ari Bousbib, chairman and CEO of IQVIA

Guidance

AreaPeriodFigureAgainst last quarter
Revenue Sourcefull year 2026$17,150 million to $17,350 millionNew
Adjusted EBITDA Sourcefull year 2026$3,975 million to $4,025 millionNew
Adjusted diluted earnings per share Sourcefull year 2026$12.55 to $12.85New
Revenue contribution from acquisitions Sourcefull year 2026about 150 basis pointsNew
Revenue contribution from foreign exchange Sourcefull year 2026approximately 100 basis pointsNew
Interest expense Sourcefull year 2026step up of approximately $80 millionNew

What changed from last quarter

  • New guidance: Full-year 2026 guidance was issued for revenue, Adjusted EBITDA and adjusted diluted EPS. The prior release contained 2025 guidance only. Source
  • Ended: CSMS ceases to be a separately reported segment from 1 January 2026. Source
  • New: TAS is renamed Commercial Solutions from 1 January 2026, with CSMS incorporated into it. Source
  • New: Real-World Late Phase and certain other Real-World offerings move from TAS to R&DS from 1 January 2026. Source

Fourth-quarter and full-year results

  • Fourth-quarter revenue rose 10.3%: Fourth-quarter revenue was $4,364 million, up 10.3% reported and 8.1% at constant currency. Full-year revenue was $16,310 million, up 5.9% reported and 4.8% at constant currency. Source
  • Full-year adjusted EPS rose 7.1%: Full-year adjusted diluted EPS was $11.92, up 7.1%, and adjusted net income was $2,068 million, up 1.3%. GAAP net income was $1,360 million, down 0.9%, and GAAP diluted EPS $7.84, up 4.7%. Source
  • Fourth-quarter GAAP earnings grew: Fourth-quarter GAAP net income was $514 million, up 17.6%, and GAAP diluted EPS was $2.99, up 23.6%. Adjusted net income was $588 million, up 4.3%, and adjusted diluted EPS was $3.42, up 9.6%. Source
  • Adjusted EBITDA rose in quarter and year: Adjusted EBITDA was $1,046 million in the fourth quarter, up 5.0%, and $3,788 million for 2025, up 2.8%. Source
  • 2026 guidance rests on currency date: The company issued full-year 2026 guidance on 5 February 2026. Financial guidance assumes exchange rates as of February 4, 2026 hold for the forecast period. Source

Segment revenue growth

  • TAS revenue rose 9.8% in quarter: TAS revenue was $1,821 million in the fourth quarter, up 9.8% reported and 7.1% at constant currency. Full-year TAS revenue was $6,626 million, up 7.6% reported. Source
  • R&DS growth excluding pass-throughs was 4.9%: R&DS revenue was $2,333 million in the fourth quarter, up 9.9% reported and 8.2% at constant currency. Excluding pass-throughs, R&DS revenue grew 4.9% reported. Full-year R&DS revenue was $8,896 million, up 4.3%. Source
  • CSMS revenue grew 18.6% in quarter: CSMS revenue was $210 million in the fourth quarter, up 18.6% reported and 15.3% at constant currency. Source

“In a challenging environment, IQVIA’s expanded go-to-market strategy, operational discipline, and investments in AI innovations led to clear differentiation”

Ari Bousbib, chairman and CEO of IQVIA

Bookings, backlog and conversion

  • Book-to-bill was 1.18x in quarter: R&DS quarterly bookings were over $2.7 billion in the fourth quarter. The trailing-twelve-month book-to-bill ratio was 1.12x. Source
  • Backlog reached $32.7 billion: R&DS contracted backlog, including reimbursed expenses, was $32.7 billion, up 5.3% reported and 3.7% at constant currency. The third-quarter release reported $32.4 billion. Source
  • About $8.3 billion expected to convert: Management expects about $8.3 billion of backlog to convert to revenue in the next twelve months, against $8.1 billion in the third-quarter release. Source

Costs, interest and tax

  • Cost of revenues rose to $2,928 million: Cost of revenues, excluding depreciation and amortization, was $2,928 million in the fourth quarter against $2,580 million, and $10,880 million for 2025 against $10,030 million. SG&A was $1,999 million for 2025, against $1,992 million. Source
  • Restructuring costs higher for the year: Restructuring costs were $105 million for 2025 against $67 million in 2024. Fourth-quarter restructuring costs were $24 million, against negative $4 million a year earlier. Source
  • Interest expense rose to $729 million: Interest expense was $193 million in the fourth quarter against $171 million, and $729 million for 2025 against $670 million. The company recorded a $6 million loss on extinguishment of debt for 2025. Source
  • Income tax expense declined: Income tax expense was $59 million in the fourth quarter against $112 million, and $252 million for 2025 against $301 million. Equity in earnings of unconsolidated affiliates was $36 million in the quarter. Source

“This momentum positions us well for 2026 and beyond.”

Ari Bousbib, chairman and CEO of IQVIA

Cash flow and balance sheet

  • Full-year free cash flow was $2,051 million: Operating cash flow was $735 million in the fourth quarter against $885 million, and free cash flow $561 million against $721 million. For 2025 free cash flow equalled 99% of Adjusted Net Income. Source
  • Net leverage was 3.63x at year-end: Cash was $1,980 million and debt $15,724 million at December 31, 2025, giving net debt of $13,744 million. Gross leverage was 4.15x trailing twelve-month Adjusted EBITDA. Source
  • Acquisitions drove 2025 investing outflow: Acquisitions of businesses used $1,714 million of cash in 2025, against $735 million a year earlier. Debt issuance proceeds were $6,465 million and debt repayments were $5,193 million. Source
  • Capital spending nearly flat: Acquisition of property, equipment and software was $174 million in the fourth quarter against $164 million, and $603 million for 2025 against $602 million. Source

Share repurchases and shares

  • Repurchases totalled $1,244 million: The company repurchased $212 million of common stock in the fourth quarter, bringing 2025 repurchases to $1,244 million. Source
  • Authorization remaining at year-end: IQVIA had $1,769 million of share repurchase authorization remaining at December 31, 2025. Source
  • Shares outstanding declined: Shares outstanding were 169.6 million at December 31, 2025, against 176.1 million a year earlier. Fourth-quarter diluted weighted average shares were 171.9 million, against 180.8 million. Source

Segment reporting change

  • CSMS folded into TAS, renamed: From 1 January 2026, CSMS, with $788 million of 2025 revenue, is incorporated into TAS, which is renamed Commercial Solutions. Source
  • Real-World Late Phase moves to R&DS: Real-World Late Phase and certain other Real-World offerings, with $674 million of 2025 revenue, move from TAS to R&DS as more closely related to clinical research. Source
  • Recast 2025 and 2024 segment revenue: Recast full-year 2025 revenue is $6,740 million for Commercial Solutions and $9,570 million for R&DS, against $6,234 million and $9,171 million for 2024. Source
  • Negligible effect on growth rates: The company said the new segment reporting has a negligible impact on segment revenue growth rates and reflects its updated operating model. Source

Products, AI, privacy and workforce

  • Portfolio built on Connected Intelligence: Solutions are powered by IQVIA Connected Intelligence, delivering insights and services built on high-quality health data, with Healthcare-grade AI and advanced analytics. Source
  • AI use grounded in privacy and safety: The company says its AI-powered capabilities are grounded in privacy, regulatory compliance and patient safety. Source
  • Privacy protection described as leadership: The company describes itself as a global leader in protecting individual patient privacy, using privacy-enhancing technologies and safeguards. Source
  • About 93,000 employees across 100 countries: The company reports approximately 93,000 employees in over 100 countries, against approximately 91,000 in the third-quarter release. Source

Coming up, as management said on 5 February 2026

  • Segment information recast in Q1 10-Q: Segment information will be recast on the new basis from the Form 10-Q for the three months ended March 31, 2026. Source
  • Refinancing expected during 2026: Management expects a refinancing to be completed in 2026, included in the guided interest expense step-up. Source

Figures management reported

FigureReported
R&DS contracted backlog Source$32.7 billion
R&DS quarterly bookings Sourceover $2.7 billion
Book-to-bill ratio, fourth quarter Source1.18x
Backlog expected to convert in next twelve months Source$8.3 billion

Risks management discussed

  • Financial: Management cited a step-up in interest expense of about $80 million in 2026, from 2025 financing and expected refinancing. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.