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    IQV
    Earnings call· Mar 2026(Q1 FY26)

    IQVIA HOLDINGS Q1 FY26 earnings call IQV

    May 5, 2026 Source

    Executive summary

    IQVIA Q1 FY26 — Strong Organic Growth and AI Adoption Drive Record Performance

    IQVIA delivered a strong first quarter, surpassing expectations with accelerated organic revenue growth across both Commercial and R&D Solutions, driven by increasing client demand for AI-enabled services and new product launches. The company reaffirmed its full-year revenue and adjusted EBITDA guidance while raising adjusted diluted EPS, reflecting confidence in its operational execution and the strategic integration of AI across its offerings.

    Highlights

    5

    • Record Q1 revenue of $4.11 billion, up 8.4% reported and 6.0% constant currency.

    • Adjusted diluted EPS of $2.90, exceeding high end of guidance and up 7.4% year-over-year.

    • Organic revenue growth doubled in Commercial Solutions to 5% and tripled in R&DS to 3% year-over-year.

    • R&D Solutions net new bookings grew double-digits year-over-year to $2.5 billion, with backlog reaching a record $34.2 billion.

    • 192 AI agents deployed across 64 use cases, with 19 of top 20 pharma companies using IQVIA's AI capabilities.

    Concerns

    2

    • Q1 R&DS book-to-bill ratio of 1.04, impacted by unusually low pass-through bookings due to mix of clinical trials.

    • Large pharma clients continue a more deliberate approach to capital deployment, slowing decision-making speed compared to pre-disruption levels.

    Guidance & targets

    6
    CategoryTargetConfidence
    Full-year 2026 Revenue
    $17.150 billion to $17.350 billion
    high materiality
    High
    Full-year 2026 Adjusted EBITDA
    $3.975 billion and $4.025 billion
    high materiality
    High
    Full-year 2026 Adjusted Diluted EPS
    $12.65 and $12.95
    high materiality
    High
    Q2 2026 Revenue
    $4.280 billion and $4.340 billion
    medium materiality
    High
    Q2 2026 Adjusted EBITDA
    $955 million to $975 million
    medium materiality
    High
    Q2 2026 Adjusted Diluted EPS
    $2.98 and $3.08
    medium materiality
    High

    Segment performance

    2
    SegmentRevenueYoYQoQMargin
    Commercial Solutions
    Revenue growth accelerated as clients launched new products and increased service utilization. Particular strength in patient solutions, analytics and consulting, and commercial engagement services. AI is driving increased demand for IQVIA's differentiated AI capabilities and innovation.
    Constant currency growth: 8.5%Organic growth: 5% (doubled year-over-year)Patient solutions growth: very strong double-digit growthAnalytics and consulting growth: highest in 3 yearsCommercial engagement services growth: mid- to high single digitsInfo business growth: low single digits
    		$1.75 billion11.6% on a reported basis——
    R&D Solutions
    Delivered very strong performance with better-than-expected reported and organic revenue growth. Solid bookings with double-digit growth year-over-year, despite unusually low pass-through bookings due to trial mix. Forward-looking demand metrics point in the right direction.
    Constant currency growth: 4.2%Organic growth: 3% (tripled year-over-year from 1%)Net new bookings: $2.5 billionNet new bookings growth: double-digit year-over-yearBacklog: $34.2 billionBacklog growth: mid-single digit year-over-yearNext 12-month revenue from backlog: $8.9 billionNext 12-month revenue from backlog growth: high single digits year-over-yearQualified pipeline growth: mid-single digits year-over-yearRFP flow growth: high single digits year-over-year
    		$2.397 billion6.2% on a reported basis——

    Operational metrics

    23
    Adjusted diluted EPS
    $2.90up 7.4% year-over-year
    Q1 FY26

    Exceeded the high end of guidance range.

    Total Revenue
    $4.11 billionup 8.4% reported, 6.0% constant currency
    Q1 FY26

    Exceeded the high end of guidance range.

    GAAP Net Income
    $274 million
    Q1 FY26
    GAAP Diluted EPS
    $1.61
    Q1 FY26
    Cash and cash equivalents
    $1.947 billion
    March 31
    Net Debt
    $13.886 billion
    March 31
    Net Leverage Ratio
    3.62x
    Q1 FY26
    Capital expenditures
    $127 million
    Q1 FY26
    Free cash flow conversion
    100%
    Q1 FY26
    Shares repurchased
    $552 million
    Q1 FY26
    Remaining share repurchase authorization
    $1.2 billion
    current program
    EP funding
    $25 billionalmost double Q1 FY25
    Q1 FY26

    Indicative of renewed confidence in the industry's pipeline.

    Historical Q4 to Q1 bookings decline
    16%-17%
    sequential

    Historical average sequential decline in net new bookings.

    Q1 FY26 sequential bookings decline
    13%down from Q4 FY25
    Q1 FY26

    Lower than usual sequential decline.

    R&DS organic revenue growth
    3%tripled year-over-year from 1%
    Q1 FY26
    Commercial Solutions organic revenue growth
    5%doubled year-over-year
    Q1 FY26
    Enterprise organic revenue growth
    4%
    Q1 FY26
    AI agents deployed
    192
    To date

    Across Commercial Solutions and R&D businesses.

    Top pharma companies using AI agents
    19 out of 20
    To date

    19 of the top 20 pharma companies are already using IQVIA agents in some of their workflows.

    Pass-through bookings
    about 1/3 lower
    Q1 FY26

    Compared to historic average, due to mix of indications in clinical trials booked.

    Hypothetical normal Q1 pass-through bookings
    $750 million
    Q1 FY26

    Analyst's estimate for normal pass-through bookings based on 30% of $10B annual awards.

    Hypothetical Q1 pass-through bookings (1/3 below normal)
    $250 million
    Q1 FY26

    Analyst's estimate for Q1 FY26 pass-through bookings, 1/3 below normal.

    Clinical side AI at discovery stage
    90%+
    Current

    Percentage of AI use in clinical side at the discovery stage.

    Industry KPIs

    6
    MetricValueDetails
    FCF conversion ROIC100%%
    Revenue EPS guidance$17.150 billion to $17.350 billionUSD
    M a contribution synergiesapproximately 2 pointspoints
    Clinical research cro bookings$2.5 billionUSD
    Segment organic revenue growth3%%
    End market demand funnel commentarymid-single digits%

    Deals & partnerships

    10
    Top 10 pharma clientContract to modernize performance reporting

    Awarded IQVIA contract to modernize performance reporting on markets and therapeutic areas using an AI-driven analytics platform. Replaces hundreds of disconnected reports and dashboards with a centralized, managed, AI-powered IQVIA Insight solution.

    Midsize clientPartnership for scalable AI-ready data foundationMultiyear

    Secured a multiyear partnership to provide a scalable AI-ready data foundation, demonstrating IQVIA's plug-and-play capabilities within a client's multi-provider technology ecosystem.

    PfizerStrategic regional promotion agreement

    Entered into a strategic regional promotion agreement covering selected Pfizer products across 23 countries in Europe. Collaboration brings together Pfizer's scientific leadership with IQVIA's promotional expertise, market intelligence, and AI-supported technology.

    Boehringer IngelheimStrategic long-term collaboration to transform global commercial intelligenceLong-term

    Selected IQVIA's Data as a Service (DAS) platform as the core accelerator to harmonize and upgrade global commercial operations, enabling more scalable analytics and a single version of the truth across therapeutic areas and geography.

    [indiscernible]Multiyear agreement as primary patient information and analytics partnerMultiyear

    Awarded a multiyear agreement to serve as the primary patient information and analytics partner across [indiscernible] full portfolio, including our Data as a Service platform.

    Top 5 pharma companyAI-enabled global medical safety and pharmacovigilance services

    Selected IQVIA to provide AI-enabled global medical safety and pharmacovigilance services, building on a decade-long relationship and strong performance across both FSP and clinical delivery models.

    Top 10 pharma clientMultiyear agreement for full-service global clinical trialsMultiyear

    Awarded IQVIA a multiyear agreement to serve as the primary partner for delivering full-service global clinical trials. Differentiated through AI-enabled innovation.

    Global midsize pharmaContract to deliver Phase III clinical study

    Awarded contract to deliver a Phase III clinical study supporting a high-profile oncology asset. Selected based on experience and ability to deliver AI-enabled trial design, protocol optimization, and site identification.

    Top 20 pharma companySupport for late-stage clinical program

    Selected IQVIA to support a late-stage clinical program in asthma in overweight patients. Win highlighted AI-enabled clinical solutions, including protocol and design strategy optimization, regulatory compliance, and study document filings.

    Duke Clinical Research InstituteStrategic collaboration to advance clinical research

    Collaboration to advance clinical research in obesity and related cardiometabolic conditions. Brings together IQVIA's global operational scale and Duke's academic rigor, creating an integrated end-to-end model for large complex clinical trials.

    Risks & headwinds

    2
    Unusually low pass-through bookings in R&DSQ1 FY26

    About 1/3 lower than historic average

    Mitigation: Due to particular mix of indications in clinical trials booked; no impact on profitability or future margins.

    Slower decision-making speed from large pharma clientsOngoing, post 3-4 years of macro headwinds

    More deliberate approach to capital deployment

    Mitigation: Environment is improving, but not yet returned to pre-disruption speed. Offset by strong EP funding and AI-driven demand.

    Q&A highlights

    6

    How does the mix of services vs. pass-through bookings impact margin progression, especially with more full-service wins in R&DS?

    Ari Bousbib clarified that pass-throughs have zero profitability and are irrelevant to margins. The low pass-through bookings in Q1 were due to a specific mix of indications in trials won, not a change in customer dynamics. He noted that pure service fee bookings were up significantly and that quarterly book-to-bill is a poor predictor of future growth. Mike Fedock added that productivity programs offset adverse mix, leading to operational margin expansion.

    “pass has 0 profitability drop through, right? I mean that's clear. So pass-throughs are irrelevant to profitability.”

    asked by Michael Cherny · answered by Ari Bousbib

    2 min read6 chapters

    Detailed Narrative

    01

    AI Integration and Client Adoption

    IQVIA is leveraging its AI solutions, built on proprietary data and healthcare compliance, across its operations. The company unveiled IQVIA AI at NVIDIA's GTC Conference, an agentic AI portal and marketplace purpose-built for life sciences. Currently, 192 agents are deployed across 64 use cases in Commercial Solutions and R&D, with 19 of the top 20 pharma companies utilizing these agents in their workflows, underscoring broad industry trust in IQVIA's AI capabilities.

    02

    Commercial Solutions Momentum

    The Commercial Solutions segment saw significant acceleration in revenue growth, driven by clients adopting AI-ready data foundations and expanding service utilization. Key wins included a top 10 pharma client modernizing performance reporting with an AI-driven analytics platform and a multi-year partnership with a midsize client for a scalable AI-ready data foundation. Strategic collaborations with Pfizer and Boehringer Ingelheim were also secured for regional promotion and global commercial intelligence transformation, respectively.

    03

    R&D Solutions Performance and Strategy

    R&D Solutions delivered strong performance, with AI solutions optimizing trial design and execution to reduce timelines. AI agents are increasingly embedded in the delivery model, leading to faster study execution and improved quality. Examples include a top 5 pharma company selecting IQVIA for AI-enabled global medical safety and pharmacovigilance services, and a top 10 pharma client awarding a multi-year agreement for full-service global clinical trials based on AI-enabled innovation.

    04

    Strategic Partnerships

    IQVIA announced a strategic collaboration with the Duke Clinical Research Institute to advance clinical research in obesity and cardiometabolic conditions. This partnership combines IQVIA's operational scale with Duke's academic rigor, creating an integrated end-to-end model for large complex clinical trials, particularly leveraging IQVIA's experience in over 120 obesity trials and GLP-1 therapies. This collaboration has already generated a significant pipeline of opportunities.

    05

    Demand Environment and Funding

    Forward-looking demand metrics, including a record backlog of $34.2 billion and mid-single-digit growth in the qualified pipeline, indicate a positive trend. RFP flow grew high single digits year-over-year, driven by both large pharma and emerging biopharma (EP). EP funding reached $25 billion in Q1 2026, nearly double Q1 2025, signaling renewed confidence in the industry's pipeline.

    06

    Bookings Context and Interpretation

    Management emphasized that the Q1 R&DS book-to-bill ratio of 1.04 was influenced by an unusual mix of clinical trials with lower pass-through bookings, which have no impact on profitability. They highlighted that net service fee bookings grew significantly year-over-year and sequentially, and that quarterly book-to-bill is not a reliable predictor of future growth, citing past examples where low book-to-bill did not correlate with poor revenue growth.

    AI-generated summary of the company’s earnings call. Not investment advice.