IQVIA (NYSE:IQV) reported third-quarter results that exceeded the high end of its guidance ranges, supported by accelerating organic growth in its Commercial Solutions and R&D Solutions businesses, higher clinical win rates and strong free cash flow.
Revenue totaled $4.43 billion, up 8.0% year over year on a reported basis and 8.6% at constant currency. Organic revenue growth was approximately 6%, more than twice the rate recorded a year earlier, according to Chairman and Chief Executive Officer Ari Bousbib.
Adjusted EBITDA rose 8.7% to $1.03 billion, while adjusted EBITDA margin expanded 20 basis points from the prior-year period. Adjusted diluted earnings per share increased 11.3% to $3.34. The company reported GAAP net income of $350 million, or $2.10 per diluted share.
Clinical bookings reach four-year high
R&D Solutions revenue rose 8.7% on a reported basis to $2.64 billion, or 9.1% at constant currency. Organic growth in the clinical business was nearly 7%, almost three times the prior-year rate, Bousbib said.
The segment generated $3.2 billion in net new bookings during the quarter, up 15% from a year earlier and representing a 1.2 book-to-bill ratio. The company said bookings strength was broad-based and included notable demand for full-service clinical work.
Last-12-month net new bookings reached $11.7 billion, up 14% year over year and increasing for the fifth consecutive quarter. As of Sept. 30, contracted R&D backlog stood at $32.6 billion, with $9.4 billion expected to convert into revenue over the next 12 months, up 10% from the prior year.
Chief Financial Officer Mike Fedock said cancellations remained within historical ranges. IQVIA also completed a review of inactive trials and reduced backlog by approximately $2.1 billion. The adjustment did not affect historical results, 2026 guidance, net new bookings or expected revenue from backlog over the next 12 months. Bousbib said the removed trials had generally been inactive for more than 18 months and lacked indications they would resume in the near term.
Management cited improving external demand indicators, including enterprise biotech and pharma funding that reached $90 billion year to date, up more than 85% from a year earlier, according to BioWorld. Clinical trial starts and request-for-proposal activity were both up high single digits year to date, Bousbib said.
Commercial growth and AI adoption
Commercial Solutions revenue increased 6.9% to $1.79 billion, or 7.9% at constant currency. Organic growth was 4%, double the rate in the year-ago quarter. Bousbib said the business recorded growth across information offerings, analytics and consulting, and services designed to help customers engage with patients, healthcare providers, payers and channels.
The company said its commercial pipeline remains at record levels, while customer decision timelines have shortened. Management also pointed to new drug launches, which were up more than 40% year to date, as a favorable indicator for demand for commercial services.
IQVIA said artificial intelligence is increasingly contributing to its commercial and clinical momentum. The company has deployed 415 AI agents to date. Bousbib said the company’s approach combines proprietary healthcare data, life-sciences expertise and interpretation of data within customer workflows, often with humans involved in the process because of healthcare-specific compliance, transparency and traceability requirements.
The company described several recent customer wins involving AI-enabled capabilities, including clinical trial country and site modeling, protocol and site optimization, real-world healthcare data platforms, patient-support programs and its IQVIA Explorer solution. Bousbib said an AI-enabled country and site modeling program for a large pharmaceutical client was designed to shorten a multicountry Phase III autoimmune program by nine months.
Margins, cash flow and outlook
Fedock said pass-through revenue created an approximately 70-basis-point headwind to gross margins during the quarter. Bousbib said the company offset non-operational margin headwinds with approximately 80 basis points of operational improvement, including cost-containment efforts, productivity programs and the use of AI in internal processes.
Cash flow from operations was $825 million, and capital expenditures were $158 million, resulting in free cash flow of $667 million, or 120% of adjusted net income. IQVIA ended the quarter with $2.25 billion in cash and equivalents, $16.07 billion in gross debt and a net leverage ratio of 3.45 times trailing 12-month adjusted EBITDA.
The company raised its full-year 2026 outlook. IQVIA now expects:
- Revenue of $17.35 billion to $17.50 billion, representing growth of 6.4% to 7.3%.
- Adjusted EBITDA of $4.025 billion to $4.055 billion, representing growth of 6.3% to 7.0%.
- Adjusted diluted earnings per share of $12.90 to $13.00, up 8.2% to 9.1% from the prior year.
The revenue outlook assumes roughly 250 basis points of contribution from acquisitions completed or expected to close by year-end, along with a 20-basis-point foreign-exchange tailwind for the full year. Fedock said the outlook implies an approximately 70-basis-point foreign-exchange headwind in the fourth quarter.
IQVIA plans to provide a broader framework for 2027 at its Investor Day on Dec. 1, with detailed 2027 guidance expected alongside fourth-quarter and full-year 2026 results in February 2027.
About IQVIA (NYSE:IQV)
IQVIA Holdings Inc is a global provider of technology, analytics and contract research services for the life sciences industry. The company helps pharmaceutical, biotechnology and medical device organizations develop, commercialize and improve products by combining healthcare data with advanced analytics, consulting and technology-enabled services.
Its offerings include clinical research and trial management, real-world evidence, healthcare data and analytics, regulatory and safety services, technology platforms, and commercial solutions.
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