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IQVIA Holdings Inc.: Q1 FY2026 earnings call

What management said about Q1 FY2026, from the documents filed with the SEC on 5 May 2026: press release. Guidance figures: 2 raised, 3 kept. The quarter’s numbers.

Key takeaways

  • Revenue rose 8.4 percent reported: Revenue was $4,151 million, against $3,829 million a year earlier, up 8.4% reported and 6.0% at constant currency. Management said organic growth accelerated more than anticipated. Source
  • Adjusted diluted EPS rose 7.4 percent: Adjusted diluted EPS was $2.90 against $2.70, up 7.4%. Adjusted Net Income was $492 million against $479 million a year earlier. Source
  • Commercial Solutions grew 11.6 percent: Commercial Solutions revenue was $1,754 million against $1,572 million, up 11.6% reported and 8.5% at constant currency. Prior periods are recast to the new segments. Source
  • Backlog reached $34.2 billion: Contracted backlog was $34.2 billion at March 31, 2026. The prior release gave $32.7 billion at December 31, 2025. Source
  • Net new bookings were $2.5 billion: Cancellations and the full-service/FSP mix were in line with historical averages. Reimbursed expenses were well below historical averages. Source
  • Free cash flow was $491 million: Operating cash flow was $618 million, up 9%. Free cash flow was $491 million, up 15%, which the company said equaled 100% of Adjusted Net Income. Source
  • Two reporting segments from 2026: The simplified model took effect January 1, 2026, with two reporting segments and prior periods recast to match the new structure. Source

“IQVIA delivered an outstanding start to the year, with organic revenue growth accelerating more than anticipated, Adjusted Diluted EPS exceeding the high-end of our expectations and Free Cash Flow at 100% of Adjusted Net Income”

Ari Bousbib, chairman and CEO of IQVIA

Guidance

AreaPeriodFigureAgainst last quarter
Revenue Sourcefull-year 2026$17,150 million to $17,350 millionKept
Adjusted EBITDA Sourcefull-year 2026$3,975 million to $4,025 millionKept
Adjusted diluted EPS Sourcefull-year 2026$12.65 to $12.95Raised from $12.55 to $12.85
Revenue growth contributions Sourcefull-year 2026about 150 basis points from acquisitions; approximately 100 basis points from foreign exchangeKept
R&DS backlog conversion Sourcenext twelve monthsapproximately $8.9 billionRaised from approximately $8.3 billion

What changed from last quarter

  • Guidance kept: Full-year 2026 revenue and Adjusted EBITDA guidance reaffirmed at the same ranges. Source
  • Guidance raised: Adjusted diluted EPS guidance raised to $12.65 to $12.95, from $12.55 to $12.85. Source
  • New: Results are reported in two segments, Commercial Solutions and R&DS, from the three months ended March 31, 2026. Source

Results and growth drivers

  • Revenue rose 8.4 percent reported: Revenue was $4,151 million, against $3,829 million a year earlier, up 8.4% reported and 6.0% at constant currency. Management said organic growth accelerated more than anticipated. Source
  • Adjusted diluted EPS rose 7.4 percent: Adjusted diluted EPS was $2.90 against $2.70, up 7.4%. Adjusted Net Income was $492 million against $479 million a year earlier. Source
  • GAAP diluted EPS was $1.61: GAAP net income was $274 million and GAAP diluted EPS $1.61, against $249 million and $1.40 a year earlier. Source
  • Adjusted EBITDA rose 5.5 percent: Adjusted EBITDA was $932 million against $883 million, a 5.5% increase year-over-year. Source

Segment revenue and growth

  • Commercial Solutions grew 11.6 percent: Commercial Solutions revenue was $1,754 million against $1,572 million, up 11.6% reported and 8.5% at constant currency. Prior periods are recast to the new segments. Source
  • R&DS grew 6.2 percent reported: R&DS revenue was $2,397 million against $2,257 million, up 6.2% reported and 4.2% at constant currency. Source
  • R&DS growth excluding reimbursed expenses: Excluding reimbursed expenses, R&DS revenue grew 6.6% on a reported basis, compared with 6.2% including them. Source

Products and customers

  • Patient solutions and analytics led: Management named patient solutions, analytics & consulting, and commercial engagement services among the areas of strength in Commercial Solutions. Source
  • AI-enabled offerings gaining traction: Management said its innovative AI-enabled offerings are gaining traction with customers. Source

Costs and margins

  • Cost of revenues rose in dollars: Cost of revenues, excluding depreciation and amortization, was $2,796 million against $2,531 million. Selling, general and administrative expenses were $502 million against $508 million. Source
  • Restructuring costs rose to $51 million: Restructuring costs were $51 million against $29 million. Restructuring and related expenses in the Adjusted EBITDA reconciliation were $53 million against $42 million. Source
  • Purchase accounting amortization increased: Purchase accounting amortization, excluded from Adjusted Net Income, was $137 million against $125 million. Source
  • Interest expense rose to $192 million: Interest expense was $192 million against $165 million. No loss on extinguishment of debt was recorded this quarter, against $4 million a year earlier. Source

Demand and the order book

  • Backlog reached $34.2 billion: Contracted backlog was $34.2 billion at March 31, 2026. The prior release gave $32.7 billion at December 31, 2025. Source
  • Net new bookings were $2.5 billion: Cancellations and the full-service/FSP mix were in line with historical averages. Reimbursed expenses were well below historical averages. Source
  • Book-to-bill ratio was 1.04x: Book-to-bill was 1.04x for the quarter and 1.11x on a trailing twelve-month basis, against 1.18x in the fourth quarter of 2025. Source
  • Demand indicators grew mid-to-high single digits: Management described forward-looking demand indicators as growing at mid-to-high single digits in a stabilizing market environment. Source

Capital, cash and shareholder returns

  • Free cash flow was $491 million: Operating cash flow was $618 million, up 9%. Free cash flow was $491 million, up 15%, which the company said equaled 100% of Adjusted Net Income. Source
  • Net debt of $13,886 million: Cash and cash equivalents were $1,947 million and debt $15,833 million at March 31, 2026. Net debt was $13,744 million at December 31, 2025. Source
  • Net leverage eased to 3.62x: Net leverage ratio was 3.62x trailing twelve-month Adjusted EBITDA, against 3.63x at December 31, 2025. Source
  • Repurchases totaled $552 million: The company repurchased $552 million of common stock in the quarter, against $375 million in first-quarter 2025. Source
  • $1,217 million repurchase authorization left: Remaining share repurchase authorization was $1,217 million at March 31, 2026, against $1,769 million at December 31, 2025. Source
  • Capital spending fell to $127 million: Acquisition of property, equipment and software used $127 million, against $142 million a year earlier. Source

Debt and financing

  • Debt issued and repaid in quarter: The company issued $650 million of debt and repaid $683 million of debt and finance lease principal. The revolver drew $550 million and repaid $350 million. Source
  • Gross leverage ratio 4.13x: Gross leverage ratio was 4.13x trailing twelve-month Adjusted EBITDA, against 4.15x at December 31, 2025. Source

Strategy and reorganization

  • Two reporting segments from 2026: The simplified model took effect January 1, 2026, with two reporting segments and prior periods recast to match the new structure. Source

Figures management reported

FigureReported
R&DS contracted backlog Source$34.2 billion
R&DS net new bookings Source$2.5 billion
R&DS book-to-bill ratio Source1.04x
R&DS trailing twelve-month book-to-bill ratio Source1.11x

Earlier plans management reported on

  • Ahead: Management said organic revenue growth accelerated more than anticipated, and Adjusted Diluted EPS exceeded the high end of its expectations. Source
  • Not stated: Management reaffirmed the full-year 2026 revenue and Adjusted EBITDA ranges in this release. Source
  • Not stated: Management said the simplified organizational model was disclosed previously and took effect January 1, 2026. 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.