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    IQV
    Earnings call· Dec 2025(Q4 FY25)

    IQVIA HOLDINGS Q4 FY25 earnings call IQV

    Feb 5, 2026 Source

    Executive summary

    IQVIA Holdings Q4 FY25 — Strong Finish to the Year with Robust Bookings and AI Momentum

    IQVIA concluded FY25 with strong fourth-quarter results, driven by robust demand indicators and significant progress in AI integration across its clinical and commercial offerings. The company is reorganizing into two reporting segments, Commercial Solutions and R&DS, to better align with evolving client purchasing behaviors and industry trends. Management remains confident in its strategic investments and ability to leverage proprietary data and domain expertise for continued growth, despite broader macroeconomic challenges.

    Highlights

    5
    • Fourth quarter revenue of $4.364 billion exceeded guidance, growing 10.3% reported and 8.1% at constant currency.

    • Full year 2025 free cash flow reached $2.51 billion, representing 99% of adjusted net income.

    • R&DS net bookings totaled over $2.7 billion in Q4, growing 7% year-over-year, resulting in a net book-to-bill ratio of 1.18.

    • Backlog reached a new record of $32.7 billion at year-end, growing 5.3% compared to the prior year.

    • Full year adjusted diluted EPS grew 7.1% to $11.92, with Q4 adjusted diluted EPS up 9.6% to $3.42.

    Concerns

    3
    • Full year adjusted EBITDA growth was 2.8% to $3.788 billion, lower than revenue growth.

    • Net interest expense is expected to increase by approximately $80 million in FY26 to $760 million due to senior notes, swap maturities, and refinancing.

    • Q4 cancellations were slightly above the normal range due to idiosyncratic aspects of certain trials.

    Guidance & targets

    12
    CategoryTargetConfidence
    Full-year 2026 Revenue
    $17.150 billion to $17.350 billion
    high materiality
    High
    Full-year 2026 Adjusted EBITDA
    $3.975 billion to $4.025 billion
    high materiality
    High
    Full-year 2026 Adjusted Diluted EPS
    $12.55 to $12.85
    high materiality
    High
    Full-year 2026 Operational D&A
    $610 million
    medium materiality
    High
    Full-year 2026 Net Interest Expense
    $760 million
    medium materiality
    High
    Full-year 2026 Effective Income Tax Rate
    just over 17%
    medium materiality
    High
    Full-year 2026 Average Diluted Share Count
    just over 171 million
    medium materiality
    High
    Full-year 2026 Commercial Solutions Revenue
    $7.2 billion to $7.3 billion
    high materiality
    High
    Full-year 2026 R&DS Revenue
    $9.9 billion to $10 billion
    high materiality
    High
    Q1 2026 Revenue
    $4.050 billion to $4.150 billion
    medium materiality
    High
    Q1 2026 Adjusted EBITDA
    $920 million to $940 million
    medium materiality
    High
    Q1 2026 Adjusted Diluted EPS
    $2.77 to $2.87
    medium materiality
    High

    Segment performance

    8
    SegmentRevenueYoYQoQMargin
    Technology & Analytics Solutions (TAS)
    Q4 FY25 revenue, grew 7.1% at constant currency. Performed very well despite anticipated tougher year-over-year comparisons.
    $1.821 billion9.8%
    R&D Solutions (R&DS)
    Q4 FY25 revenue, grew 8.2% at constant currency. Excluding step-down in COVID-related work, R&DS revenue grew over 8.5% at constant currency.
    $2.333 billion9.1%
    Contract Sales and Medical Solutions (CSMS)
    Q4 FY25 revenue, grew 15.3% at constant currency. Approximately 5 points of growth due to acquisition mentioned in Q3 call.
    $210 million18.6%
    Technology & Analytics Solutions (TAS)
    Full year FY25 revenue, grew 6.2% at constant currency.
    $6.626 billion7.6%
    R&D Solutions (R&DS)
    Full year FY25 revenue, grew 3.5% at constant currency.
    $8.896 billion4.3%
    Contract Sales and Medical Solutions (CSMS)
    Full year FY25 revenue, grew 8.2% at constant currency.
    $788 million9.7%
    Commercial Solutions (Recast)
    Full year FY25 revenue on a recast basis for the new segment structure. This segment now includes the former CSMS segment ($788M FY25 revenue) and excludes $674M of clinically oriented real-world offerings that moved to R&DS.
    $6.740 billion
    R&D Solutions (Recast)
    Full year FY25 revenue on a recast basis for the new segment structure. This segment now includes $674M of real-world late phase and real-world clinical-related offerings from the former TAS segment.
    $9.570 billion

    Operational metrics

    30
    Adjusted EBITDA
    $1.046 billion5% YoY
    Q4 FY25

    Fourth quarter adjusted EBITDA.

    Adjusted EBITDA
    $3.788 billion2.8% YoY
    Full Year FY25

    Full year adjusted EBITDA.

    GAAP Net Income
    $514 million
    Q4 FY25

    Fourth quarter GAAP net income.

    GAAP Diluted EPS
    $2.99
    Q4 FY25

    Fourth quarter GAAP diluted earnings per share.

    GAAP Net Income
    $1.360 billion
    Full Year FY25

    Full year GAAP net income.

    GAAP Diluted EPS
    $7.84
    Full Year FY25

    Full year GAAP diluted earnings per share.

    Adjusted Net Income
    $588 million
    Q4 FY25

    Fourth quarter adjusted net income.

    Adjusted Diluted EPS
    $3.429.6% YoY
    Q4 FY25

    Fourth quarter adjusted diluted earnings per share.

    Adjusted Net Income
    $2.68 billion
    Full Year FY25

    Full year adjusted net income.

    Adjusted Diluted EPS
    $11.927.1% YoY
    Full Year FY25

    Full year adjusted diluted earnings per share.

    R&DS Net Bookings
    over $2.7 billion7% YoY, 5% sequentially
    Q4 FY25

    Reflecting continued improvement in customer trends and solid execution.

    R&DS Net Book-to-bill Ratio
    1.18
    Q4 FY25

    Reflecting continued improvement in customer trends and solid execution.

    R&DS Backlog
    $32.7 billion5.3% YoY
    Q4 FY25

    Reached a new record at the end of the quarter.

    Next 12 Months Revenue from Backlog
    $8.3 billion
    Year-end FY25

    Expected revenue from backlog for the next 12 months.

    Cash and Cash Equivalents
    $1.980 billion
    December 31, 2025

    Balance at year-end.

    Gross Debt
    $15.724 billion
    December 31, 2025

    Balance at year-end.

    Net Debt
    $13.744 billion
    December 31, 2025

    Balance at year-end.

    Net Leverage Ratio
    3.63x
    December 31, 2025

    Ended the year at 3.63x trailing 12-month adjusted EBITDA.

    Capital Expenditures
    $174 million
    Q4 FY25

    Fourth quarter capital expenditures.

    Share Repurchases
    $212 million
    Q4 FY25

    Amount of shares repurchased in the fourth quarter.

    Share Repurchases
    $1.244 billion
    Full Year FY25

    Total share repurchase activity for the full year at an average price of $159 per share.

    Qualified Pipeline
    10% higherYoY
    Q4 FY25

    Qualified pipeline grew across all customer segments.

    RFP Flow
    double digitsYoY
    Q4 FY25

    RFP flow grew across all segments, with largest gains in large pharma and EBP.

    Win Rates
    several percentage pointsYoY
    Q4 FY25

    Win rates improved year-over-year.

    EBP Funding
    $33 billion
    Q4 FY25

    EBP funding was strong in Q4, according to BioWorld.

    AI Agents Deployed
    over 150
    Current

    Deployed across the business, clinical and commercial workflows.

    Revenue Growth (Reported)
    10.3%YoY
    Q4 FY25

    Fourth quarter revenue growth on a reported basis.

    Revenue Growth (Constant Currency)
    8.1%YoY
    Q4 FY25

    Fourth quarter revenue growth at constant currency.

    Revenue Growth (Reported)
    5.9%YoY
    Full Year FY25

    Full year revenue growth on a reported basis.

    Revenue Growth (Constant Currency)
    4.8%YoY
    Full Year FY25

    Full year revenue growth at constant currency.

    Industry KPIs

    3
    MetricValueDetails
    Revenue EPS guidance$17.150B-$17.350B (Revenue), $12.55-$12.85 (Adj. EPS)USD
    M a contribution synergies150 bpsbps
    End market demand funnel commentary10% higher%

    Product announcements

    2
    ProductTypeDetails
    IQVIA Patient Experience platformlaunch
    DaaS (Data-as-a-Service)update

    Deals & partnerships

    5
    NEXT Oncologyacquisition

    Expanded science management organization with the acquisition of NEXT Oncology, a network of specialized sites serving patients enrolled in early-stage oncology trials.

    Cedar Gate Technologiesacquisition

    Enhanced capabilities in patient solutions and payer analytics with the acquisition in the fourth quarter. It transforms healthcare data into insights for improved patient outcomes and provides analytics to payers.

    Amazon Web Services (AWS)partnership

    Announced a strategic collaboration, naming AWS as IQVIA's preferred agentic cloud provider to accelerate the industry's digital transformation. This partnership aims to make AI more readily available across life sciences, medical affairs, and healthcare analytics.

    Sabin Vaccine Institutepartnership

    Provided more than 640 Marburg Vaccine doses to Ethiopia for a Phase II trial during the nation's first Marburg Vaccine virus disease outbreak, partnering with local health authorities to evaluate safety and efficacy.

    Large Pharma Client (Asia)customer contract

    Won the first full-service commercial outsourcing deal in Asia with a large pharma client.

    Risks & headwinds

    3
    Macroeconomic and Government Policy UncertaintyEarlier in 2025

    Impacted R&DS bookings and revenue earlier in the year.

    Mitigation: Environment stabilized somewhat and demand indicators became more favorable as the year progressed.

    Interest Rate PressureThroughout 2025

    Led to slower customer decision-making and tempered biotech funding.

    Mitigation: Biotech funding increased as the year progressed.

    Trial CancellationsQ4 FY25

    Slightly above the normal range in Q4 FY25.

    Mitigation: Due to specific idiosyncratic aspects of certain trials, not a systemic issue.

    Q&A highlights

    5

    Can you address concerns about AI disrupting established businesses and explain why IQVIA views AI as an enabling technology rather than a threat?

    Management clarified that IQVIA has been on the AI journey for a long time, viewing it as an opportunity. They emphasized that their proprietary, dynamic, and regulatory-compliant healthcare data, combined with deep domain expertise, makes their business resilient to generic AI disruption. They explained that AI agents are embedded in existing workflows to enhance productivity and that IQVIA's scale across clinical and commercial justifies the significant investment in AI.

    Overall, I would say AI agentification is a positive for our business across both clinical and commercial, and I understand it's hard to distinguish between us and other CROs, us and other information services provider.

    asked by Shlomo Rosenbaum · answered by Ari Bousbib

    2 min read6 chapters

    Detailed Narrative

    01

    Strategic Reorganization into Two Segments

    IQVIA is simplifying its organizational structure in 2026, moving from three segments to two: Commercial Solutions and R&DS. This change aims to strengthen collaboration, enhance efficiency, and align with evolving client purchasing behaviors. The former CSMS segment, with $788 million in FY25 revenue, is now incorporated into Commercial Solutions. Additionally, $674 million of clinically oriented real-world offerings from the former TAS segment have been moved to R&DS, reflecting their closer ties to clinical trial dynamics. This recast has a negligible impact on segment growth rates.

    02

    AI Leadership and Strategic Partnerships

    IQVIA announced a strategic collaboration with Amazon Web Services (AWS), naming AWS as its preferred agentic cloud provider to accelerate digital transformation in life sciences. The company was recognized by Everest Group as the #1 leader in generative AI for life sciences. IQVIA has been working with NVIDIA for over a year to embed AI agents into workflows, deploying over 150 agents across more than 30 use cases in clinical and commercial operations. This long-standing investment in AI is now gaining significant momentum with clients, particularly large pharma.

    03

    AI as an Opportunity, Not a Threat

    Management strongly emphasized that AI agentification is a positive for IQVIA's business, not a challenge. They highlighted three key requirements for AI agents: significant ready-to-consume data at scale, deep domain expertise, and technology. IQVIA possesses proprietary, dynamic, regulatory-compliant healthcare data and decades of industry expertise that are difficult to replicate. While some lower-level consulting work might be displaced, the company is seeing increased demand for new AI-enabled offerings like Data-as-a-Service (DaaS) and believes AI will augment, not replace, its services.

    04

    Strong Demand Indicators in R&DS

    Despite earlier macroeconomic headwinds🌐, demand indicators for R&DS became more favorable as 2025 progressed. The qualified pipeline is up approximately 10% year-over-year across all customer segments. RFP flow grew double digits year-over-year, with the largest gains in large pharma and emerging biotech and pharma (EBP). Win rates improved by several percentage points year-over-year, and EBP funding was strong in Q4, reaching $33 billion according to BioWorld.

    05

    Commercial Solutions Performance

    The Technology & Analytics Solutions (TAS) business, now part of Commercial Solutions, performed well in Q4, achieving better-than-expected results despite anticipated tougher year-over-year comparisons. TAS delivered 9.8% reported growth and 7.1% constant currency growth, highlighting the resilience of IQVIA's broader commercial portfolio. Demand for AI-driven innovations is gaining momentum with clients, with several top pharma companies selecting IQVIA for comprehensive AI-enabled information and analytics solutions.

    06

    Acquisition of Cedar Gate Technologies

    In the fourth quarter, IQVIA acquired Cedar Gate Technologies, enhancing its capabilities in patient solutions and payer analytics. Cedar Gate transforms healthcare data into insights for improved patient outcomes and provides analytics to payers, utilizing 4 petabytes of data covering approximately 60 million lives. This acquisition expands IQVIA's solutions in the payer-provider analytics space, an area where the company previously lacked significant scale in the U.S.

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