IQVIA (NYSE:IQV) executives said the company closed 2025 with a “strong” fourth quarter as revenue came in above the high end of management’s guidance range and clinical demand indicators improved as the year progressed. On the company’s fourth-quarter earnings call, management also introduced a simplified reporting structure for 2026, highlighted recent acquisitions and partnerships, and addressed investor questions about artificial intelligence and its potential impact on the business.
Fourth-quarter and full-year financial results
Chairman and CEO Ari Bousbib said full-year 2025 revenue increased 6%, adjusted diluted earnings per share grew 7%, and free cash flow totaled $2.1 billion, which he said represented about 100% of adjusted net income. He attributed early-year headwinds to macroeconomic and policy uncertainty, continued pressure from interest rates, slower customer decision-making, and tempered biotech funding, which affected R&D bookings and revenue earlier in the year. He said conditions stabilized later in the year as demand indicators improved and funding increased.
CFO Ron Bruehlman provided additional detail, reporting fourth-quarter revenue of $4.364 billion. For the full year, revenue was $16.31 billion, up 5.9% reported and 4.8% at constant currency. Bruehlman also reported fourth-quarter GAAP net income of $514 million (GAAP diluted EPS of $2.99) and full-year GAAP net income of $1.36 billion ($7.84 per diluted share). Adjusted net income was $588 million for the quarter and $2.068 billion for the year, translating to adjusted diluted EPS of $11.92 for 2025.
Segment performance and bookings trends
In the fourth quarter, Technology & Analytics Solutions (TAS) revenue was $1.821 billion, up 9.8% reported and 7.1% at constant currency. R&D Solutions (R&DS) revenue was $2.333 billion, up 9.1% reported and 8.2% at constant currency; excluding the step down in COVID-related work, R&DS grew over 8.5% at constant currency. Contract Sales & Medical Solutions (CSMS) revenue was $210 million, up 18.6% reported and 15.3% at constant currency, with about five points of growth attributed to an acquisition referenced on the prior quarter’s call.
On the clinical side, Bousbib said fourth-quarter net bookings totaled more than $2.7 billion, up 7% year over year and 5% sequentially, producing a net book-to-bill ratio of 1.18. He noted cancellations were “slightly above” the normal range due to “specific idiosyncratic aspects of certain trials” that were canceled. Bruehlman said R&DS backlog reached a record $32.7 billion at year-end, up 5.3% year over year, with next-twelve-month revenue from backlog of $8.3 billion.
Bousbib cited multiple demand indicators as positive, including a qualified pipeline up about 10% year over year, double-digit growth in RFP flow across segments (with the largest gains in large pharma and EBP), and improved win rates by “several percentage points.” He also cited BioWorld data indicating EBP funding of $33 billion in the fourth quarter.
Strategic initiatives, partnerships, and acquisitions
Management highlighted several 2025 investments and business actions, including acquisitions and new offerings. Bousbib referenced expansion of phase I trial capabilities via the acquisition of a facility in the U.K., and expansion of site management through the acquisition of Next Oncology. He also pointed to demand for the company’s DaaS Plus solution and said IQVIA recently launched the IQVIA Patient Experience Platform, which he said already has six new customers.
In the fourth quarter, the company announced a strategic collaboration with Amazon Web Services, naming AWS as its preferred “agentic cloud provider,” which management said is intended to accelerate digital transformation and expand access to AI across life sciences, medical affairs, and healthcare analytics. Bousbib also said Everest Group recognized IQVIA as the only CRO to receive a number one ranking for generative AI leadership in life sciences. He reiterated the company’s partnership with NVIDIA and said IQVIA has deployed more than 150 AI agents covering more than 30 use cases across clinical and commercial workflows.
In response to a question on the Cedar Gate Technologies acquisition, Bousbib said Cedar Gate helps transform healthcare data into insights and provides analytics to payers, adding scale to IQVIA’s payer-provider analytics efforts in the U.S. He said Cedar Gate generated about $125 million in revenue in 2024 with roughly $33 million to $35 million of adjusted EBITDA (he cited $32.7 million specifically), and management indicated 2025 results were “a little bit higher,” around $140 million in revenue and about $36 million to $37 million of adjusted EBITDA, with similar margins. Bousbib added that Cedar Gate utilizes customer data, citing “4 PB of data” and “about 60 million lives.”
2026 reporting changes and guidance
IQVIA said it will simplify reporting into two segments starting in 2026: Commercial Solutions and R&DS. Bousbib said CSMS, which has become more integrated with commercial offerings, will be incorporated into TAS, which will be renamed Commercial Solutions. In addition, he said certain real-world late phase and other clinically oriented real-world offerings currently in TAS will move into R&DS. CFO Mike Fedock said the company will provide a full recast of historical financials for the two segments beginning with the first-quarter 10-Q and the 2026 10-K, and noted that recast 2025 revenue was $6.74 billion for Commercial Solutions and $9.57 billion for R&DS.
For full-year 2026, Fedock guided revenue to $17.15 billion to $17.35 billion, including about 150 basis points of M&A contribution and about 100 basis points of foreign exchange tailwind. The company guided adjusted EBITDA to $3.975 billion to $4.025 billion and adjusted diluted EPS to $12.55 to $12.85. Guidance assumptions included about $610 million of operational depreciation and amortization, net interest expense of about $760 million (about $80 million higher than 2025 due to factors including the full-year impact of senior notes issued in June 2025, swap maturities, and anticipated refinancing activity), and an effective tax rate of just over 17%.
By segment under the new reporting, IQVIA expects 2026 Commercial Solutions revenue of $7.2 billion to $7.3 billion, representing growth of about 7% to 9%, and R&DS revenue of $9.9 billion to $10.0 billion, a little over 4% growth at the midpoint. For the first quarter of 2026, the company guided revenue to $4.05 billion to $4.15 billion, adjusted EBITDA to $920 million to $940 million, and adjusted diluted EPS to $2.77 to $2.87.
During Q&A, Bousbib repeatedly characterized AI as an “opportunity” rather than a threat, arguing that effective AI “agentification” in healthcare requires proprietary data at scale and deep domain expertise, along with technology tools that can be purchased. He emphasized that IQVIA’s data is proprietary, curated, and subject to regulatory and compliance frameworks, and said the company’s workflows and expertise are difficult to replicate with general-purpose models. He acknowledged that some “lower-level consulting and analytics work may be displaced,” but said IQVIA is seeing increasing demand for new AI-enabled offerings.
On profitability, management said strong pass-through growth in the quarter pressured gross margin, while productivity helped offset some impacts, including continued SG&A margin improvement. The company also said it expects pass-through growth to moderate in 2026 and guided to flat overall EBITDA margins.
The call also marked Bruehlman’s final earnings call as CFO, with Bousbib stating Bruehlman will transition into a senior advisory role.
About IQVIA (NYSE:IQV)
IQVIA (NYSE: IQV) is a global provider of advanced analytics, technology solutions and contract research services to the life sciences industry. The company combines clinical research capabilities with large-scale health data and analytics to support drug development, regulatory reporting, commercial strategy and real‑world evidence generation. IQVIA traces its current form to the combination of Quintiles and IMS Health announced in 2016 and subsequently rebranded as IQVIA, bringing together long-established clinical research operations and extensive healthcare information assets.
IQVIA’s principal activities include outsourced clinical development services (acting as a contract research organization for phases I–IV), real‑world evidence and observational research, regulatory and safety services, and a suite of technology platforms that enable data integration, analytics and operational management.
