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What changed in IQVIA's 10-K — 2024 vs 2025

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Paragraph-level year-over-year comparison of IQVIA's 2024 and 2025 10-K annual filings, covering the Business, Risk Factors, Legal Proceedings, Cybersecurity, MD&A and Market Risk sections. Every new, removed and edited paragraph is highlighted side-by-side so you can see exactly what management changed in the 2025 report.

+300 added−279 removedSource: 10-K (2026-02-17) vs 10-K (2025-02-13)

Top changes in IQVIA's 2025 10-K

300 paragraphs added · 279 removed · 223 edited across 7 sections

Item 1. Business

Business — how the company describes what it does

52 edited+18 added−26 removed121 unchanged
Biggest changeThe employee engagement index has been stable across our surveys in 2024 with 79% of our employees who responded saying they feel engaged. 89% of employees who responded feel they are acquiring the knowledge and skills necessary to be effective in their roles, 7 points above the Fortune 500 Benchmark, with 9,700 employees participating in IQVIA’s Generative AI Masterclass Series. 83% of employees who responded see a clear link between their work and IQVIA’s vision, 2 points above the Fortune 500 Benchmark. 70% of employees who responded believe IQVIA encourages an environment where they can challenge the status quo, surpassing the Fortune 500 Benchmark by 3 points.
Biggest changeWe heard from 74,000 employees on average across our two surveys in 2025, equivalent to an average 84% response rate and maintained employee engagement across the organization. 91% of employees who responded feel they are acquiring the knowledge and skills necessary to be effective in their roles, 8 points above the Fortune 500 Benchmark. 85% of employees who responded see a clear link between their work and IQVIA’s vision, 6 points above the Fortune 500 Benchmark.
It can enable the industry to better understand patient needs, identify new approaches to treatment, and scale and democratize access to medicine. IQVIA has a rich history of developing Healthcare-grade AI™. We have steadily expanded our capabilities over the years in connection with machine learning, natural language processing and generative AI as technology evolves.
It can enable the industry to better understand patient needs, identify new approaches to treatment, and scale and democratize access to medicine. IQVIA has a rich history of developing Healthcare-grade AI ® . We have steadily expanded our capabilities over the years in connection with machine learning, natural language processing and generative and agentic AI as technology evolves.
We do this by promoting our One IQVIA, Multiple Careers approach, which helps employees build their skills using our curated learning content and uses technology to match employees to open roles and projects. 15 • Retention. We seek to develop a working environment where employees feel engaged and supported, wanting to stay and grow with us.
We do this by promoting our One IQVIA, Multiple Careers approach, which helps employees build their skills using our curated learning content and uses technology to match employees to open roles and projects. 15 • Retention. We develop a working environment where employees feel engaged and supported, wanting to stay and grow with us.
Our scaled information networks include more than 1.2 billion unique non-identified patient records globally, as well as access to profiles of over 4,100 real world data assets in more than 100 countries uniquely facilitating data discoverability for healthcare research via the IQVIA Health Data Catalog.
Our scaled information networks include more than 1.2 billion unique non-identified patient records globally, as well as access to profiles of over 4,600 real world data assets in more than 100 countries uniquely facilitating data discoverability for healthcare research via the IQVIA Health Data Catalog.
According to the IQVIA Institute, it is estimated that spending on pharmaceuticals in emerging markets will expand at a 5% to 8% compound annual growth rate (“CAGR”) through 2029. The growth of emerging markets demonstrates their strategic importance to global life sciences organizations along with the emergence of local and regional companies with similar operational and informational needs.
According to the IQVIA Institute, it is estimated that spending on pharmaceuticals in emerging markets will expand at a 5% to 8% compound annual growth rate (“CAGR”) through 2030. The growth of emerging markets demonstrates their strategic importance to global life sciences organizations along with the emergence of local and regional companies with similar operational and informational needs.
Human Capital Overview. Our approximately 88,000 employees drive our vision to power smarter healthcare for everyone, everywhere. They are comprised of specialists across multiple disciplines, including medical and life sciences, engineering, technology, data science and more. Investments in our people are aimed at attracting, developing, and retaining a talented workforce.
Human Capital Overview. Our approximately 93,000 employees drive our vision to power smarter healthcare for everyone, everywhere. They are comprised of specialists across multiple disciplines, including medical and life sciences, engineering, technology, data science and more. Investments in our people are aimed at attracting, developing, and retaining a talented workforce.
With approximately 88,000 employees in over 100 countries, including experts in healthcare, life sciences, data science, technology and operational excellence, we are dedicated to accelerating the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. We are a global leader in protecting individual patient privacy.
With approximately 93,000 employees in over 100 countries, including experts in healthcare, life sciences, data science, technology and operational excellence, we are dedicated to accelerating the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. We are a global leader in protecting individual patient privacy.
As a leader in the development and commercialization of new pharmaceutical therapies, we can empower our therapeutic, scientific and domain experts with expansive levels of information including product level tracking in 95 markets and information about treatments and outcomes on more than 1.2 billion unique non-identified patient records.
As a leader in the development and commercialization of new pharmaceutical therapies, we can empower our therapeutic, scientific and domain experts with expansive levels of information including product level tracking in 97 markets and information about treatments and outcomes on more than 1.2 billion unique non-identified patient records.
Our widely used reference database tracks over 25 million healthcare professionals in over 100 countries, providing a comprehensive view of health care practitioners that is critical for the commercial success of our clients’ marketing and sales initiatives. Our Research & Development Solutions offerings include: Project Management and Clinical Monitoring.
Our widely used reference database tracks over 22 million healthcare professionals in over 100 countries, providing a comprehensive view of health care practitioners that is critical for the commercial success of our clients’ marketing and sales initiatives. Our Research & Development Solutions offerings include: Project Management and Clinical Monitoring.
Other clients include payers, government and regulatory agencies, providers, pharmaceutical distributors, and pharmacies. Our client base is broad in scope and enables us to avoid dependence on any single client. No single client accounted for 10% or more of our total Company revenues in 2024, 2023 or 2022.
Other clients include payers, government and regulatory agencies, providers, pharmaceutical distributors, and pharmacies. Our client base is broad in scope and enables us to avoid dependence on any single client. No single client accounted for 10% or more of our total Company revenues in 2025, 2024 or 2023.
Not only do we make use of de-identification techniques with respect to the data we hold, but we also share our expertise in this area with policymakers, regulators and others to help them understand de-identification methodologies and practical considerations to avoid re-identification risk.
Not only do we make use of anonymization techniques with respect to the data we hold, but we also share our expertise in this area with policymakers, regulators and others to help them understand anonymization methodologies and practical considerations to avoid re-identification risk.
Within the time period required by the SEC and the New York Stock Exchange (“NYSE”), we will post on our website any amendment to the Code of Conduct or any waiver of such policy applicable to any of our senior financial officers, executive officers or directors. 18
Within the time period required by the SEC and the New York Stock Exchange (“NYSE”), we will post on our website any amendment to the Code of Conduct or any waiver of such policy applicable to any of our senior financial officers, executive officers or directors. 17
Our Market Opportunity We compete in a market of approximately $330 billion consisting of outsourced research and development, real-world evidence and connected health and technology enabled clinical and commercial operations markets for life sciences companies and the broader healthcare industry.
Our Market Opportunity We compete in a market of approximately $335 billion consisting of outsourced research and development, real-world evidence and connected health and technology enabled clinical and commercial operations markets for life sciences companies and the broader healthcare industry.
For the year ended December 31, 2024 the largest client based on its percentage of total Company revenues contributed approximately 5% . 10 Our Competition Our Technology & Analytics Solutions business competes with a broad and diverse set of businesses.
For the year ended December 31, 2025 the largest client based on its percentage of total Company revenues contributed approximately 5% . 10 Our Competition Our Technology & Analytics Solutions business competes with a broad and diverse set of businesses.
To facilitate the disclosure of comparable, consistent, and reliable sustainability information, the 2024 Sustainability Report will be aligned with the Sustainability Accounting Standards Board ("SASB") and the Global Reporting Initiative ("GRI") reporting frameworks by including therein and reporting against their respective reporting standards indexes.
To facilitate the disclosure of comparable, consistent, and reliable sustainability information, the 2025 Sustainability Report will be aligned with the Sustainability Accounting Standards Board ("SASB") and the Global Reporting Initiative ("GRI") reporting frameworks by including therein and reporting against their respective reporting standards indexes.
We receive approximately 120 billion healthcare records annually, and our infrastructure then connects complex healthcare data while applying a wide range of privacy, security, operational, legal and contractual protections for data in response to local law, supplier requirements and industry leading practices; • Analytics-driven clinical development, which improves clinical trial design, site identification and patient recruitment by empowering therapeutic, scientific, and domain experts with expansive levels of information, including product level tracking in 95 markets, and information about treatments and outcomes on more than 1.2 billion unique non-identified patient records globally; • Robust real world solutions ecosystem, with sophisticated retrospective database analytics, prospective real world data collection technology platforms and scientific expertise, which enables us to address critical healthcare issues of cost, value and patient outcomes; • A growing set of proprietary clinical and commercial applications, which helps our clients increase their clinical operations performance, supports their regulatory and compliance needs and orchestrates their sales operations, sales management, multi-channel marketing and performance management; 5 • Integration of information, analytics, technology, and domain expertise through IQVIA Connected Intelligence , which enables us to provide our clients with more effective options to address their needs from research and development through commercialization as well as truly innovative breakthroughs such as decentralized trials and global real-world evidence networks; and • A staff of approximately 88,000 employees across the globe , including over 29,000 Technology & Analytics Solutions employees, approximately 49,000 Research & Development Solutions employees and approximately 6,000 Contract Sales & Medical Solutions employees.
We receive approximately 120 billion healthcare records annually, and our infrastructure then connects complex healthcare data while applying a wide range of privacy, security, operational, legal and contractual protections for data in response to local law, supplier requirements and industry leading practices; • Analytics-driven clinical development, which improves clinical trial design, site identification and patient recruitment by empowering therapeutic, scientific, and domain experts with expansive levels of information, including product level tracking in 97 markets, and information about treatments and outcomes on more than 1.2 billion unique non-identified patient records globally; • Robust real world solutions ecosystem, with sophisticated retrospective database analytics, prospective real world data collection technology platforms and scientific expertise, which enables us to address critical healthcare issues of cost, value and patient outcomes; 5 • A growing set of proprietary clinical and commercial applications, which helps our clients increase their clinical operations performance, supports their regulatory and compliance needs and orchestrates their sales operations, sales management, multi-channel marketing and performance management; • Integration of information, analytics, technology, and domain expertise through IQVIA Connected Intelligence , which enables us to provide our clients with more effective options to address their needs from research and development through commercialization as well as truly innovative breakthroughs such as decentralized trials and global real-world evidence networks; and • A staff of approximately 93,000 employees across the globe , including over 31,000 Technology & Analytics Solutions employees, approximately 51,000 Research & Development Solutions employees and approximately 7,000 Contract Sales & Medical Solutions employees.
Drawing upon our years of experience, our site databases, our site relationships and our highly trained staff, our solutions and services enables the efficient conduct and coordination of multi-site clinical trials (generally Phase II-IV). Our service offerings include protocol design, feasibility and operational planning, site start up, patient recruitment and clinical site monitoring.
Drawing upon our years of experience, our site databases, our site relationships and our highly trained staff, our solutions and services enables the efficient conduct and coordination of multi-site clinical trials (Phase I-IV). Our service offerings include protocol design, feasibility and operational planning, site start up, patient recruitment and clinical site monitoring.
IQVIA employs a wide variety of policies, procedures, guidelines, training, communications, tools and other resources to support the responsible use of AI technologies, including generative AI, to use AI responsibly and comply with legislation such as the EU AI Act, including: • For higher risk AI activities, we have established procedures and methodologies to evaluate or test input, AI models, output and other aspects of AI use for error, bias, hallucinations and results that are not otherwise fit for the intended purpose. 14 • For lower risk activities, a variety of policies, standard operating procedures, guidance and training support our employees in the use of AI models — for example, the use of AI assistants to improve employee communications, and ensuring we have the necessary rights to use any non-IQVIA content with AI tools. • We have established private instances of certain public large language models.
IQVIA employs a wide variety of policies, procedures, guidelines, training, communications, tools and other resources to support the responsible use of AI technologies and comply with legislation such as the EU AI Act, including: • For higher risk AI activities, we have established procedures and methodologies to evaluate or test input, AI models, output and other aspects of AI use for error, bias, hallucinations and results that are not otherwise fit for the intended purpose. 14 • For lower risk activities, a variety of policies, standard operating procedures, guidance and training support our employees in the use of AI models — for example, the use of AI tools to improve employee communications, and to help our employees determine whether we have the necessary rights to use any non-IQVIA content with AI tools. • We have established private instances of certain public large language models.
Second, the addressable opportunity for connected healthcare is approximately $55 billion, and includes areas such as revenue cycle management, payer & provider analytics and clinical decision support services. • Technology enabled commercial operations: Total addressable market of approximately $82 billion in 2024 that includes information, data warehousing, IT outsourcing, software applications and other services in the broader market for IT services.
Second, the addressable opportunity for connected healthcare is approximately $55 billion, and includes areas such as revenue cycle management, payer & provider analytics and clinical decision support services. • Technology enabled commercial operations: Total addressable market of approximately $84 billion in 2025 that includes information, data warehousing, IT outsourcing, software applications and other services in the broader market for IT services.
A comprehensive suite of technology and site support services which create custom strategies to engage and retain patients. Included is our site management organization Avacare Clinical Research Network, which orchestrates the activities of over 200 investigators and extends solutions to patients across more than 20 therapeutic indications in nearly 40 locations.
A comprehensive suite of technology and site support services which create custom strategies to engage and retain patients. Included is our site management organization Avacare Clinical Research Network, which orchestrates the activities of over 180 investigators and extends solutions to patients across more than 20 therapeutic indications in nearly 50 locations.
First, the life sciences market for Real-World Evidence of approximately $30 billion includes post-launch evidence generation, market access, and medical affairs.
First, the life sciences market for Real-World Evidence of approximately $35 billion includes post-launch evidence generation, market access, and medical affairs.
Build upon our extensive client relationships and leverage our global presence . We have a diversified base of over 10,000 clients in over 100 countries and have expanded our client value proposition to address a broader market for research and development and commercial operations which we estimate to be approximately $330 billion in 2024.
Build upon our extensive client relationships and leverage our global presence . We have a diversified base of over 10,000 clients in over 100 countries and have expanded our client value proposition to address a broader market for research and development and commercial operations which we estimate to be approximately $335 billion in 2025.
Some of our larger competitors include ICON plc, Parexel International Corporation, Pharmaceutical Product Development, Inc., and Syneos Health, among others. Our Contract Sales & Medical Solutions business competes against the in-house sales and marketing departments of biopharmaceutical companies, other contract pharmaceutical sales and service organizations and consulting firms.
Some of our larger competitors include ICON plc, Parexel International Corporation, Pharmaceutical Product Development, Inc. (part of Thermo Fisher Scientific Inc.), and Syneos Health, among others. Our Contract Sales & Medical Solutions business competes against the in-house sales and marketing departments of biopharmaceutical companies, other contract pharmaceutical sales and service organizations and consulting firms.
The expanded use of AI is generating clear benefits, but also concerns about data security, privacy and trust. IQVIA is committed to implementing technology in a way that addresses these concerns.
The expanded use of AI in the life sciences industry is generating clear benefits, but also concerns about data security, privacy and trust. IQVIA is committed to implementing technology in a way that addresses these concerns.
Our scaled and growing information set contains approximately 64 petabytes of unique proprietary data sourced from approximately 150,000 data suppliers and covering over one million data feeds globally. Based on this data, we deliver information and insights on approximately 90% of the world’s pharmaceuticals, as measured by 2023 sales.
Our scaled and growing information set contains approximately 68 petabytes of unique proprietary data sourced from approximately 150,000 data suppliers and covering over one million data feeds globally. Based on this data, we deliver information and insights on approximately 90% of the world’s pharmaceuticals, as measured by 2024 sales.
The life sciences industry is a large and critical part of the global healthcare system and, according to the latest information available from the IQVIA Market Prognosis service, is estimated to have generated approximately $1.73 trillion in revenues in 2024.
The life sciences industry is a large and critical part of the global healthcare system and, according to the latest information available from the IQVIA Market Prognosis service, is estimated to have generated approximately $1.94 trillion in revenues in 2025.
We encourage IQVIANs to pursue multiple careers here, including unconventional career paths that bring new ways of thinking. This commitment fosters their professional development and, in an industry as competitive as ours, contributes to our favorable attrition and internal movement. Board Oversight of Human Capital Management.
We encourage IQVIANs to pursue multiple careers here, including unconventional career paths that bring new ways of thinking. This commitment fosters their professional development and, in a competitive industry, contributes to our favorable attrition. Board Oversight of Human Capital Management.
We have one of the largest and most comprehensive collections of healthcare information in the world, which includes more than 1.2 billion comprehensive, longitudinal, non-identified patient records spanning sales, prescription and promotional data, medical claims, electronic medical records, genomics, and social media.
We have one of the largest and most comprehensive collections of healthcare information in the world spanning sales, prescription, promotional and social media data, as well as medical claims, electronic medical records, and genomics data, including more than 1.2 billion comprehensive, longitudinal, unique non-identified patient records.
The following sets forth our estimates for the size of our principal markets: • Outsourced research and development: Biopharmaceutical spending on drug development totaled approximately $194 billion in 2024. Of that amount, we estimate that our addressable opportunity (clinical development spending excluding preclinical spending) was approximately $155 billion.
The following sets forth our estimates for the size of our principal markets: • Outsourced research and development: Biopharmaceutical spending on drug development totaled approximately $199 billion in 2025. Of that amount, we estimate that our addressable opportunity (clinical development spending excluding preclinical spending) was approximately $159 billion.
The portion of this addressable opportunity that was outsourced in 2024, based on our estimates, was approximately $73 billion. • Real-World Evidence and connected health: Total addressable market of approximately $85 billion in 2024 that consists of tightly coupled life sciences and healthcare markets.
The portion of this addressable opportunity that was outsourced in 2025, based on our estimates, was approximately $75 billion. • Real-World Evidence and connected health: Total addressable market of approximately $90 billion in 2025 that consists of tightly coupled life sciences and healthcare markets.
“Healthy You” is our global program focusing on building a healthy work environment where employees thrive and can maximize their potential, improving health outcomes for all. The program focuses on five pillars: work, finances, connections, minds and bodies.
Employee Health & Well-being. Our vision for a healthier world begins with our employees. “Healthy You” is our global program focusing on building a healthy work environment where employees thrive and can maximize their potential, improving health outcomes for all. The program focuses on five pillars: work, finances, connections, minds and bodies.
We are an industry leader in de-identifying data. Our capabilities allow us to render data non-identified while still maintaining data utility, thus protecting privacy while still advancing innovation.
We are an industry leader in anonymization and privacy-enhancing technologies. Our capabilities allow us to render data to be non-identified while still maintaining data utility, thus protecting privacy while still advancing innovation.
Certain IQVIA laboratories are certified to ISO 14001:2015 and ISO 45001:2018. Depending on the location and services provided accreditation also will include ANVISA, CAP ISO 15189, CDC Lipids, CLIA, ISO 9001, MOH Certified Laboratory, and NSGP Level 1. Available Information Our website address is www.iqvia.com , and our investor relations website is located at http://ir.iqvia.com .
Depending on the location and services provided, accreditation also will include ANVISA, CAP ISO 15189, CDC Lipids, CLIA, ISO 9001, MOH Certified Laboratory, and NSGP Level 1. Available Information Our website address is www.iqvia.com , and our investor relations website is located at http://ir.iqvia.com . Information on our website is not incorporated by reference herein.
IQVIA has extensive policies and practices addressing these topics, and substantial resources and experience relating to the responsible use of technology. • IQVIA employs an information security framework based on National Institute of Standards and Technology ("NIST"), Health Information Trust Alliance ("HITRUST") and other common standards to define the minimum security controls and safeguards that are appropriate for each type of content.
IQVIA has extensive policies and practices addressing these topics, and substantial resources and experience relating to the responsible use of technology. • IQVIA employs an information security framework based on National Institute of Standards and Technology ("NIST"), Health Information Trust Alliance ("HITRUST") and other common standards to define the minimum level of security controls and safeguards for each type of content (see Item 1C Cybersecurity in this Annual Report on Form 10-K).
We maintain a focus on building the strong leadership pipeline we need to ensure our long-term success, offering differentiated programs tailored to different levels and goals. In 2024, over 1,099 employees from 48 countries participated in our enterprise leadership programs for key talent.
We maintain a focus on building the strong leadership pipeline we need to ensure our long-term success, offering differentiated programs tailored to different levels and goals. In 2025, over 2,000 employees from 71 countries participated in our enterprise leadership programs.
The IQVIA Institute also estimates that approximately 350 new molecular entities (“NMEs”) are expected to be approved between 2025 and 2029, or 70 per year compared to 61 per year on average during the past decade.
The IQVIA Institute also estimates that approximately 375 new molecular entities (“NMEs”) are expected to be approved between 2026 and 2030, or 75 per year compared to 68 per year on average during the past decade.
See Part I, Item 1A, "Risk Factors” for additional detail. Good Clinical Practice Good Clinical Practice (“GCP”) regulations and guidelines are the industry standard for the conduct of clinical trials with respect to maintaining the integrity of the data and safety of the research subjects.
Good Clinical Practice Good Clinical Practice (“GCP”) regulations and guidelines are the industry standard for the conduct of clinical trials with respect to maintaining the integrity of the data and safety of the research subjects.
We standardize, curate, structure and integrate this information by applying our sophisticated analytics and leveraging our global technology infrastructure. This helps our clients run their organizations more efficiently and make better decisions to improve their clinical, commercial and financial performance.
We standardize, curate, structure and integrate this information by applying our sophisticated analytics and leveraging our global technology infrastructure. Longitudinal analysis across disparate datasets is enabled via internally developed fully compliant tokenization engines. This helps our clients run their organizations more efficiently and make better decisions to improve their clinical, commercial and financial performance.
Item 1. Business Our Company IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. IQVIA’s portfolio of solutions are powered by IQVIA Connected Intelligence™ to deliver actionable insights and services built on high-quality health data, Healthcare-grade AI™, advanced analytics, the latest technologies and extensive domain expertise.
IQVIA’s portfolio of solutions are powered by IQVIA Connected Intelligence™ to deliver actionable insights and services built on high-quality health data, Healthcare-grade AI ® , advanced analytics, the latest technologies and extensive domain expertise.
Also, we compete with certain government agencies, private payers and other healthcare stakeholders that provide their data directly to others. In addition to country-by-country competition, we have a number of regional and global competitors in the marketplace as well. Our offerings compete with various firms, including Accenture, Aetion, Panalgo (a Norstella company), Cognizant Technology Solutions, Deloitte, Pharmaceutical Product Development, Inc.
Also, we compete with certain government agencies, private payers and other healthcare stakeholders that provide their data directly to others. In addition to country-by-country competition, we have a number of regional and global competitors in the marketplace as well.
Sustainability We are committed to sustainable practices that further our corporate mission of accelerating innovation for a healthier world. Our sustainable business practices are organized under three pillars — People, Public and Planet. For further information on our sustainability program and achievements, see our 2024 Sustainability Report (the "2024 Sustainability Report"), which will be available on our website at https://www.iqvia.com/about-us/sustainability.
Sustainability We are committed to sustainable practices that further our corporate mission of accelerating innovation for a healthier world. Our sustainable business practices are organized under three pillars — People, Public and Planet.
This helps us to maintain high standards across the business and ensures we are well-placed to comply with emerging regulation such as the European Union’s Artificial Intelligence Act (the "EU AI Act") and the Colorado AI Act.
This helps us to maintain high standards across the business, and supports our compliance with existing laws (e.g., clinical, employment, intellectual property, consumer protection, competition) and emerging AI regulation such as the European Union’s Artificial Intelligence Act (the "EU AI Act") and the Colorado AI Act.
Plans may include medical, dental, and vision coverage; telemedicine and on-site medical care; critical illness coverage; disability, accidental death and dismemberment, pet and life insurance; tuition reimbursement; identity theft protection; commuter benefits; matching gift programs; and locally relevant savings and retirement plans such as pensions.
Complementing these initiatives is a comprehensive portfolio of benefits for employees and their families, tailored to location and country regulations, which may include medical, dental, and vision coverage; telemedicine; critical illness coverage; disability, accidental death and dismemberment, pet and life insurance; identity theft protection; commuter benefits; and locally relevant savings and retirement plans such as pensions.
It combines IQVIA's expertise across life sciences, data science, information management, and technology with AI models trained on our extensive, high quality, and diverse health data. Our ability to connect these powerful capabilities enables us to responsibly advance AI in healthcare and accelerate the delivery of solutions to improve patients’ lives.
Our ability to connect these powerful capabilities enables us to responsibly advance AI in healthcare and accelerate the delivery of solutions to improve patients’ lives.
Information in the 2024 Sustainability Report is not incorporated by reference in, and does not form part of, this Annual Report on Form 10-K.
For further information on our sustainability program and achievements, see our 2025 Sustainability Report (the "2025 Sustainability Report"), which will be available on our website at https://www.iqvia.com/about-us/sustainability . Information in the 2025 Sustainability Report is not incorporated by reference in, and does not form part of, this Annual Report on Form 10-K.
Accordingly, we maintain a robust compliance program aimed at ensuring we operate our business in compliance with all existing legal requirements material to the operation of our businesses. There are, however, occasionally uncertainties involving the application of various legal requirements, the violation of which could result in, among other things, fines or other sanctions.
Government Regulation Many aspects of our businesses are regulated by federal and state laws, rules and regulations. Accordingly, we maintain a robust compliance program aimed at ensuring we operate our business in compliance with all existing legal requirements material to the operation of our businesses.
We are committed to using artificial intelligence ("AI") responsibly, ensuring that our AI-powered capabilities are grounded in privacy, regulatory compliance, and patient safety.
We are committed to using artificial intelligence ("AI") responsibly, with AI-powered capabilities built on best-in-class approaches to privacy, regulatory compliance and patient safety, and delivering AI to the high standards of trust, scalability and precision demanded by the industry.
Our retention efforts focus on areas that are important to our employees, including community, career, health & well-being, and financial rewards. Employee Engagement. Maintaining regular and open channels of dialogue with employees and receiving and responding to their feedback with actionable and meaningful initiatives is critical to our human capital management strategy.
Our retention efforts focus on areas that are important to our employees, including career, health and well-being, community, and financial rewards. Employee Engagement. Listening and responding to our employees across the world enables us to continually strengthen our culture.
Given the sensitive and complex nature of health-related information, developing and implementing AI for healthcare requires additional safeguards, including privacy standards and regulatory compliance. IQVIA Healthcare-grade AI™ is embedded across our AI-powered offerings, engineered to meet the level of precision, speed, and trust needed by the industry.
Given the sensitive and complex nature of health-related information, developing and implementing AI for healthcare requires additional safeguards to address information governance requirements, including privacy and security, and clinical regulatory requirements, including good clinical practice, pharmacovigilance and the integrity and reliability of systems.
In addition to the benefits described above, our compensation programs include base salaries, annual bonuses, and long-term incentive awards. Talent & Learning. In a highly competitive industry, nurturing talent is both a priority and a necessity. Employee growth and development are key components of our Employee Value Proposition and our human capital management strategy.
In addition to the benefits described above, our compensation programs include base salaries, annual bonuses, and long-term incentive awards. Talent & Learning. At IQVIA, our people represent some of the smartest minds working at the intersection of healthcare, technology, and data science – complex domains that are constantly evolving.
We also provide paid leave for other life matters including sick time, bereavement, jury duty, military service, and time off for voting, depending on country specific policies. 16 Beyond health and welfare benefits, many regions also offer employee well-being programs.
In addition, we provide parental leave for all full-time employees for the birth or adoption of a child, with leave duration varying by location, as well as paid time off for other life matters, including sick time, bereavement, jury duty, military service, and voting, subject to country-specific policies. Our local Employee Assistance Programs ("EAPs") are available to our workforce worldwide.
Expansion to the Asia Pacific region is planned for 2025. Health and Safety. We are committed to maintaining a safe workplace that supports and promotes our employees’ health. We adopt a safety-first mindset and continually look for ways to strengthen our procedures and practice, striving for safety excellence.
We adopt a safety-first mindset and continually look for ways to strengthen our procedures and practices, striving for excellence in safety and service delivery. Our Code of Conduct outlines the procedures employees must follow to protect their own safety and that of their colleagues. Employees must complete mandatory health and safety training covering key risks and practical workplace safety guidance.
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The 2024 Sustainability Report also discusses our risks and opportunities related to environmental events and natural disasters in accordance with the recommended disclosures of the Task Force on Climate-related Financial Disclosures ("TCFD"). Government Regulation Many aspects of our businesses are regulated by federal and state laws, rules and regulations.
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Item 1. Business Our Company IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries.
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Our bi-annual companywide surveys provide a valuable opportunity to hear the perspectives of our workforce around the world. We heard from 71,000 employees on average across our two surveys in 2024, equivalent to an average 84% response rate.
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Effective January 1, 2026, our reportable segments consist of Commercial Solutions and Research & Development Solutions. See Note 20 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K for further details.
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Building Community. The scale and geographic reach of our business is a key asset that we leverage as we focus on building a connected community that celebrates both individual and cultural differences. This is a foundation of our approach to human capital management.
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Our offerings compete with various firms, including Accenture, Aetion (a Datavant company), Panalgo (a Norstella company), Cognizant Technology Solutions, Deloitte, Pharmaceutical Product Development, Inc.
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We create this culture for employees regardless of gender, race, color, creed, religion, marital status, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, citizenship, sexual orientation, gender identity or any other protected group status. Our global workforce operates in over 100 countries and represents approximately 90 different ethnicities.
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There are, however, occasionally uncertainties involving the application of various legal requirements, the violation of which could result in, among other things, fines or other sanctions. See Part I, Item 1A, "Risk Factors” for additional detail.
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Approximately 62% of our employees globally identify as female and approximately 53% of employees worldwide at a manager level identify as female.
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IQVIA Healthcare-grade AI ® supports our AI-powered offerings, engineered to meet the level of precision, speed, and trust needed by the industry. It combines IQVIA's expertise across life sciences, data science, information management, and technology with AI models trained on our extensive, high quality, and diverse health data.
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In the United States, approximately 39% identify as a minority, including 16% who identify as Asian, 12% who identify as Black or African American, 8% who identify as Hispanic or Latino and 3% who identify as a different minority.
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Healthy You comes to life through global initiatives and local champions who promote well-being year-round, offering activities from health and financial education sessions to social events and blood donation drives.
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Our growing network of Employee Resource Groups ("ERGs") provides a framework for employees to connect and collaborate with colleagues with similar interests. These groups support our values and business goals and foster the multifaceted thinking required for innovation, providing a forum for the exchange of ideas and opportunities for mentoring and professional development.
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In 2025, we strengthened this commitment by introducing programs that support employees at every stage of life, including resources for those managing chronic illness or cancer, and by expanding Hinge Health, our U.S. digital physical therapy program, with specialized guidance for women’s health.
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These groups also organize activities to engage and educate our wider employee community on different perspectives and experiences. There are eight global ERGs and all are employee-led, voluntary, and open to every employee. Each ERG has a mission that is aligned to our vision, values, and core operating principles.
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Our work demands continuous learning, and our people show a high level of commitment to upskilling. In fact, in 2025, they visited the IQVIA Talent and Learning Hub 867,000 times and completed 2.2 million e-learning programs.
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In 2024, we grew our ERG membership to 13,000 participants spanning 69 countries across the globe. Our second 2024 Employee Pulse Survey included a focus on belonging to enable us to understand employee needs in this area and align our approach to help employees do their best work.
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Taken as a whole, these efforts reflect a workforce evolving to meet the next era of work, where 91% of our employees agree that they are acquiring the knowledge and skills to be effective in their job.
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According to respondents, the most important elements of belonging include opportunities to learn and grow; working in a supportive team environment; and being involved in meaningful work. The most-selected actions that foster employees’ sense of belonging were regular manager feedback, formal and informal recognition for their contributions, and learning/development activities.
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Our One IQVIA, Multiple Careers approach provides an overarching framework to help employees direct their learning toward practical outcomes, supporting skill development in the context of career mobility and organizational agility.
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These insights are being incorporated into our plans to further reinforce our strengths and drive meaningful updates. Employee Health & Well-being. Investing in resources and incentives to promote the personal well-being of our employees and their families is an important way we support our people.
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Whether employees are exploring new paths, building new skills, applying those skills in real-world projects, or moving into a new role at IQVIA when they’re ready to take the next step, we are empowering them to build skills for the future while pursuing their passions.
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We provide a variety of market-competitive health and welfare benefit plans that are available to employees and their family members, based on their location and specific country regulations.
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As demand for AI capabilities in healthcare evolves, building AI literacy has become essential for everyone at IQVIA. We are committed to providing employees with the resources needed to develop their careers and leverage the AI applications we are deploying across our business.
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We provide parental leave for all full-time employees for the birth or adoption of a child, with variability in leave time dependent on location.
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These AI tools are intended not only to improve efficiency, but to elevate how we work, learn, and connect. By integrating these capabilities, we are building an AI-augmented workplace that empowers employees and accelerates progress. 16 To prepare employees for the skills of tomorrow, we launched the AI and Data Analytics Skills training series in 2025, available to all employees.
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In the United States, “Healthy You” offers employees a range of wellness benefits, including free flu shots, teledoc services, nutrition counseling, tobacco cessation support and reimbursement for wellness-related expenses. Our local Employee Assistance Programs ("EAPs") are available to our workforce worldwide.
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The series offers differentiated learning tracks: one for those eager to build a foundational understanding of AI and technology, and another for employees ready to deepen their expertise in advanced concepts. Participants have access to virtual instructor-led courses, curated e-learning paths, and short videos, giving employees hands-on experience with real-world tools.

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Item 1A. Risk Factors

Risk Factors — what could go wrong, per management

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Biggest changeOur certificate of incorporation and Delaware bylaws and the General Corporation Law of Delaware (the “DGCL”) contain provisions that could make it difficult for a third party to acquire IQVIA even if doing so might be beneficial to its stockholders, including: • the division of the board of directors into three classes (subject to gradual declassification which began at the 2023 annual meeting of stockholders, such that our board of directors will be fully declassified and each director will be elected to a one-year term beginning at the 2025 annual meeting of stockholders); • the sole ability of the board of directors to fill a vacancy created by the death or resignation of a director or the expansion of the board of directors; • advance notice requirements for stockholder proposals and director nominations; • limitations on the ability of stockholders to call special meetings and to take action by written consent; • the approval of holders of a majority of the outstanding shares of IQVIA entitled to vote on any amendment, alteration, change, addition or repeal of the Delaware bylaws is required to amend, alter, change, add to or repeal the Delaware bylaws; 42 • the required approval of holders of a majority of the outstanding shares of IQVIA to remove directors, which removal may only be for cause; and • the ability of the board of directors to issue new series of, and designate the terms of, preferred stock, without stockholder approval, which could be used to, among other things, institute a rights plan that would have the effect of significantly diluting the stock ownership of a potential hostile acquirer, likely preventing acquisitions that have not been approved by the board of directors.
Biggest changeOur certificate of incorporation and Delaware bylaws and the General Corporation Law of Delaware (the “DGCL”) contain provisions that could make it difficult for a third party to acquire IQVIA even if doing so might be beneficial to its stockholders, including: • the sole ability of the board of directors to fill a vacancy created by the death or resignation of a director or the expansion of the board of directors; • advance notice requirements for stockholder proposals and director nominations; • limitations on the ability of stockholders to call special meetings and to take action by written consent; • the approval of holders of a majority of the outstanding shares of IQVIA entitled to vote on any amendment, alteration, change, addition or repeal of the Delaware bylaws is required to amend, alter, change, add to or repeal the Delaware bylaws; • the required approval of holders of a majority of the outstanding shares of IQVIA to remove directors, which removal may only be for cause; and 42 • the ability of the board of directors to issue new series of, and designate the terms of, preferred stock, without stockholder approval, which could be used to, among other things, institute a rights plan that would have the effect of significantly diluting the stock ownership of a potential hostile acquirer, likely preventing acquisitions that have not been approved by the board of directors.
Restructuring presents significant potential risks of events occurring that could adversely affect us, including: • actual or perceived disruption of service or reduction in service standards to clients; 36 • the failure to preserve supplier relationships and distribution, sales and other important relationships and to resolve conflicts that may arise; • loss of sales as we reduce or eliminate staffing on non-core services; • diversion of management attention from ongoing business activities; and • the failure to maintain employee morale and retain key employees.
Restructuring presents significant potential risks of events occurring that could adversely affect us, including: • actual or perceived disruption of service or reduction in service standards to clients; • the failure to preserve supplier relationships and distribution, sales and other important relationships and to resolve conflicts that may arise; • loss of sales as we reduce or eliminate staffing on non-core services; • diversion of management attention from ongoing business activities; and • the failure to maintain employee morale and retain key employees.
Client Risks • Consolidation in the industries in which our clients operate may reduce the volume of services purchased by consolidated clients following an acquisition or merger. • We may be adversely affected by client or therapeutic concentration. • Our relationships with existing or potential clients who are in competition with each other may adversely impact the degree to which other clients or potential clients use our services. • There is a risk that we may initiate a clinical trial for a client, and then the client becomes unwilling or unable to fund the completion of the clinical trial, and we may be ethically bound to complete or wind down the clinical trial at our own expense. 19 Market Forces • Disruptions in the credit and capital markets and unfavorable general economic conditions could negatively affect our business, results of operations and financial condition. • Our effective income tax rate may fluctuate for a variety of reasons. • Due to the global nature of our business we are subject to international economic, political and other risks that could negatively affect our results of operations and financial condition. • Climate change may have an impact on our business.
Client Risks • Consolidation in the industries in which our clients operate may reduce the volume of services purchased by consolidated clients following an acquisition or merger. • We may be adversely affected by client or therapeutic concentration. • Our relationships with existing or potential clients who are in competition with each other may adversely impact the degree to which other clients or potential clients use our services. • There is a risk that we may initiate a clinical trial for a client, and then the client becomes unwilling or unable to fund the completion of the clinical trial, and we may be ethically bound to complete or wind down the clinical trial at our own expense. 18 Market Forces • Disruptions in the credit and capital markets and unfavorable general economic conditions could negatively affect our business, results of operations and financial condition. • Our effective income tax rate may fluctuate for a variety of reasons. • Due to the global nature of our business we are subject to international economic, political and other risks that could negatively affect our results of operations and financial condition. • Climate change may have an impact on our business.
Further restructuring or reorganization activities may also be required in the future beyond what is currently planned, which could further enhance the risks associated with these activities. Risks Relating to Our Industry The biopharmaceutical services industry is highly competitive and our business could be materially impacted if we do not compete effectively or rapidly adapt to technological change.
Further restructuring or reorganization activities may also be required in the future beyond what is currently planned, which could further enhance the risks associated with these activities. 36 Risks Relating to Our Industry The biopharmaceutical services industry is highly competitive and our business could be materially impacted if we do not compete effectively or rapidly adapt to technological change.
As a result, failure to comply with these rules could have an adverse effect on our future business, reputation, operating results and financial condition. 32 If we are unable to successfully develop and market new services or enter new markets, our growth, results of operations or financial condition could be adversely affected.
As a result, failure to comply with these rules could have an adverse effect on our future business, reputation, operating results and financial condition. If we are unable to successfully develop and market new services or enter new markets, our growth, results of operations or financial condition could be adversely affected.
Changes to these programs may adversely impact our ability to provide services to our clients or develop new products or services. Federal, state and foreign governments are contemplating or have proposed or adopted new Privacy Laws or modifications to existing Privacy Laws, including by amendment, replacement or interpretation through judicial or administrative decisions.
Changes to these programs may adversely impact our ability to provide services to our clients or develop new products or services. Federal, state and foreign governments are contemplating or have proposed or adopted new privacy laws and regulations or modifications to existing privacy laws and regulations, including by amendment, replacement or interpretation through judicial or administrative decisions.
In addition, the United States or other governments may seek to hold us liable for successor liability FCPA violations or violations of other anti-corruption laws committed by companies in which we invest or that we acquired or will acquire. We face risks related to sales to government entities.
In addition, the United States or other governments may seek to hold us liable for successor liability FCPA violations or violations of other anti-corruption laws committed by companies in which we invest or that we acquired or will acquire. 31 We face risks related to sales to government entities.
Our failure to identify potential acquisitions, complete targeted acquisitions and integrate completed acquisitions could have a material adverse effect on our business, financial condition and results of operations. Our results of operations may be adversely affected if we fail to realize the full value of our goodwill and acquired intangible assets.
Our failure to identify potential acquisitions, complete targeted acquisitions and integrate completed acquisitions could have a material adverse effect on our business, financial condition and results of operations. 35 Our results of operations may be adversely affected if we fail to realize the full value of our goodwill and acquired intangible assets.
Any of the above may result in lower demand for our services, which could result in a material adverse impact on our operating results and financial condition. Outsourcing trends in the biopharmaceutical industry and changes in aggregate spending and research and development budgets could adversely affect our operating results and growth rate.
Any of the above may result in lower demand for our services, which could result in a material adverse impact on our operating results and financial condition. 37 Outsourcing trends in the biopharmaceutical industry and changes in aggregate spending and research and development budgets could adversely affect our operating results and growth rate.
Such changes could result in a material adverse impact on our results of operations and financial condition. 35 Our relationships with existing or potential clients who are in competition with each other may adversely impact the degree to which other clients or potential clients use our services, which may adversely affect our results of operations.
Such changes could result in a material adverse impact on our results of operations and financial condition. Our relationships with existing or potential clients who are in competition with each other may adversely impact the degree to which other clients or potential clients use our services, which may adversely affect our results of operations.
As a result, we are subject to heightened risks inherent in conducting business internationally, including the following: • required compliance with a variety of local laws and regulations which may be materially different than those to which we are subject in the United States or which may change unexpectedly; for example, conducting a single clinical trial across multiple countries is complex, and issues in one country, such as a failure to comply with local regulations or restrictions, may affect the progress of the clinical trial in the other countries, resulting in delays or potential cancellation of contracts, which in turn may result in loss of revenues; • the United States or foreign countries have and could continue to enact legislation or impose regulations or other restrictions, including unfavorable labor regulations, tax policies, trade barriers, or economic sanctions, which could have an adverse effect on our ability to conduct business in or expatriate profits from the countries in which we operate, including hiring, retaining and overseeing qualified management personnel for managing operations in multiple countries, differing employment practices and labor issues, and tax-related risks, including the imposition of taxes and the lack of beneficial treaties, that result in a higher effective tax rate for us; • foreign countries are expanding or may expand their regulatory framework with respect to patient informed consent, protection and compensation in clinical trials, which could delay or inhibit our ability to conduct clinical trials in such jurisdictions; • the regulatory or judicial authorities of foreign countries may not enforce legal rights and recognize business procedures in a manner in which we are accustomed or would reasonably expect; • local, economic, political and social conditions, including sustained increases in inflation rates and/or potential hyperinflationary conditions, political instability, and potential nationalization, repatriation, expropriation, price controls or other restrictive government actions, including changes in political and economic conditions may lead to changes in the business environment in which we operate, as well as changes in foreign currency exchange rates; • immigration laws are subject to legislative change and varying standards of application and enforcement due to political forces, economic conditions or other events (including proposals in the U.S. to change limitations on temporary and permanent workers), and local immigration laws may require us to meet certain other legal requirements as a condition to obtaining or maintaining entry visas, which may impact our ability to provide services to our clients; • potential violations of local laws or anti-bribery laws, such as the United States Foreign Corrupt Practices Act (“FCPA”), and the UK Bribery Act, may cause difficulty in managing foreign operations, as well as significant consequences to us if those laws are violated; • clients in foreign jurisdictions may have longer payment cycles, and it may be more difficult to collect receivables in foreign jurisdictions; and 30 • natural disasters, public health emergencies and pandemics such as the COVID-19, including any variants, or international conflict, such as the ongoing conflict between Russia and Ukraine, or terrorist acts, could interrupt our services, endanger our personnel, lower patient visits and increase patient drop-out rates, cause delays in recruitment of new patients, decrease the productivity of our clinical research associates, cause other project delays or loss of clinical trial materials or results.
As a result, we are subject to heightened risks inherent in conducting business internationally, including the following: • required compliance with a variety of local laws and regulations which may be materially different than those to which we are subject in the United States or which may change unexpectedly; for example, conducting a single clinical trial across multiple countries is complex, and issues in one country, such as a failure to comply with local regulations or restrictions, may affect the progress of the clinical trial in the other countries, resulting in delays or potential cancellation of contracts, which in turn may result in loss of revenues; • the United States or foreign countries have and could continue to enact legislation or impose regulations or other restrictions, including unfavorable labor regulations, tax policies, trade barriers, tariffs, or economic sanctions, which could have an adverse effect on our ability to conduct business in or expatriate profits from the countries in which we operate, including hiring, retaining and overseeing qualified management personnel for managing operations in multiple countries, differing employment practices and labor issues, and tax-related risks, including the imposition of taxes and the lack of beneficial treaties, that result in a higher effective tax rate for us; • foreign countries are expanding or may expand their regulatory framework with respect to patient informed consent, protection and compensation in clinical trials, which could delay or inhibit our ability to conduct clinical trials in such jurisdictions; • the regulatory or judicial authorities of foreign countries may not enforce legal rights and recognize business procedures in a manner in which we are accustomed or would reasonably expect; • local, economic, political and social conditions, including sustained increases in inflation rates and/or potential hyperinflationary conditions, political instability, and potential nationalization, repatriation, expropriation, price controls or other restrictive government actions, including changes in political and economic conditions may lead to changes in the business environment in which we operate, as well as changes in foreign currency exchange rates; • immigration laws are subject to legislative change and varying standards of application and enforcement due to political forces, economic conditions or other events (including proposals in the U.S. to change limitations on temporary and permanent workers), and local immigration laws may require us to meet certain other legal requirements as a condition to obtaining or maintaining entry visas, which may impact our ability to provide services to our clients; • potential violations of local laws or anti-bribery laws, such as the United States Foreign Corrupt Practices Act (“FCPA”), and the UK Bribery Act, may cause difficulty in managing foreign operations, as well as significant consequences to us if those laws are violated; 29 • clients in foreign jurisdictions may have longer payment cycles, and it may be more difficult to collect receivables in foreign jurisdictions; and • natural disasters, public health emergencies and pandemics, or international conflict, such as the ongoing conflict between Russia and Ukraine, or terrorist acts, could interrupt our services, endanger our personnel, lower patient visits and increase patient drop-out rates, cause delays in recruitment of new patients, decrease the productivity of our clinical research associates, cause other project delays or loss of clinical trial materials or results.
Further, although no single individual data supplier is material to our business, if a number of suppliers collectively representing a significant amount of data that we use for one or more of our services were to impose additional contractual restrictions on our use of or access to data, fail to adhere to our quality-control standards, repeatedly fail to deliver data or refuse to provide data, now or in the future, our ability to provide those services to our clients could be materially adversely impacted, which may harm our operating results and financial condition. 21 Additionally, we depend on third parties for support services to our business.
Further, although no single individual data supplier is material to our business, if a number of suppliers collectively representing a significant amount of data that we use for one or more of our services were to impose additional contractual restrictions on our use of or access to data, fail to adhere to our quality-control standards, repeatedly fail to deliver data or refuse to provide data, now or in the future, our ability to provide those services to our clients could be materially adversely impacted, which may harm our operating results and financial condition. 20 Additionally, we depend on third parties for support services to our business.
Exchange rate fluctuations between local currencies and the United States dollar create risk in several ways, including: 31 • Foreign Currency Translation Risk. The revenues and expenses of our foreign operations are generally denominated in local currencies and translated into United States dollars for financial reporting purposes.
Exchange rate fluctuations between local currencies and the United States dollar create risk in several ways, including: • Foreign Currency Translation Risk. The revenues and expenses of our foreign operations are generally denominated in local currencies and translated into United States dollars for financial reporting purposes.
These laws are complex and there is no assurance that the safeguards and controls employed by us or our data suppliers will be sufficient to prevent a breach of these laws, or that claims will not be filed against us or our data suppliers despite such safeguards and controls.
These laws and regulations are complex, and there is no assurance that the safeguards and controls employed by us or our data suppliers will be sufficient to prevent a breach of these laws or regulations, or that claims will not be filed against us or our data suppliers despite such safeguards and controls.
Additionally, changes in Privacy Laws may limit our data access, use and disclosure, and may require increased expenditures by us or may dictate that we not offer certain types of services.
Additionally, changes in privacy laws and regulations may limit our data access, use and disclosure, and may require increased expenditures by us or may dictate that we not offer certain types of services.
A number of factors may affect backlog, including: • the size, complexity and duration of the projects; • the percentage of full services versus functional services; • the cancellation or delay of projects; and • change in the scope of work during the course of a project. 27 Although an increase in backlog will generally result in an increase in revenues to be recognized over time (depending on the level of cancellations), an increase in backlog at a particular point in time does not necessarily correspond directly to an increase in revenues during a particular period.
A number of factors may affect backlog, including: • the size, complexity and duration of the projects; • the percentage of full services versus functional services; • the cancellation or delay of projects; and • change in the scope of work during the course of a project. 26 Although an increase in backlog will generally result in an increase in revenues to be recognized over time (depending on the level of cancellations), an increase in backlog at a particular point in time does not necessarily correspond directly to an increase in revenues during a particular period.
Our inability to effectively manage the implementation and adapt to new processes designed into new or upgraded systems in a timely and cost-effective manner may result in disruption to our business and negatively affect our operations. 28 We have entered into agreements with certain vendors to provide systems development, integration services and hosting of IT platform(s) for programs to optimize our business processes.
Our inability to effectively manage the implementation and adapt to new processes designed into new or upgraded systems in a timely and cost-effective manner may result in disruption to our business and negatively affect our operations. 27 We have entered into agreements with certain vendors to provide systems development, integration services and hosting of IT platform(s) for programs to optimize our business processes.
Accordingly, we are subject to any flaw in or breaches to their computer and communications systems or those that they operate for us, which could result in a material adverse effect on our business, operations and financial results. 23 The risk of cyberattacks has increased in connection with geopolitical events and dynamics.
Accordingly, we are subject to any flaw in or breaches to their computer and communications systems or those that they operate for us, which could result in a material adverse effect on our business, operations and financial results. 22 The risk of cyberattacks has increased in connection with geopolitical events and dynamics.
For a more complete discussion of the material risk facing our business, see below. 20 Risks Relating to Our Business The potential loss or delay of our large contracts or of multiple contracts could adversely affect our results. Most of our Research & Development Solutions clients can terminate our contracts upon 30 to 90 days' notice.
For a more complete discussion of the material risk facing our business, see below. 19 Risks Relating to Our Business The potential loss or delay of our large contracts or of multiple contracts could adversely affect our results. Most of our Research & Development Solutions clients can terminate our contracts upon 30 to 90 days' notice.
Also, there are ongoing public policy discussions regarding whether the standards for de-identified, anonymous or pseudonymized health information are sufficient, and the risk of re-identification sufficiently small, to adequately protect patient privacy. These discussions may lead to further restrictions on the use of such information.
Also, there are ongoing public policy discussions and legal challenges regarding whether the standards for de-identified, anonymous or pseudonymized health information are sufficient, and the risk of re-identification sufficiently small, to adequately protect patient privacy. These discussions may lead to further restrictions on the use of such information.
In addition, negative publicity regarding regulatory compliance of our clients’ clinical trials, programs or drugs could have an adverse effect on our business and reputation. 22 Insufficient client funding to complete a clinical trial. As noted above, clinical trials can cost hundreds of millions of dollars.
In addition, negative publicity regarding regulatory compliance of our clients’ clinical trials, programs or drugs could have an adverse effect on our business and reputation. 21 Insufficient client funding to complete a clinical trial. As noted above, clinical trials can cost hundreds of millions of dollars.
New or modified Privacy Laws might, among other things, require us to implement new security measures and processes or bring within the scope of the Privacy Law other data not currently regulated, each of which may require substantial expenditures or limit our ability to offer some of our services.
New or modified privacy laws or regulations might, among other things, require us to implement new security measures and processes or bring within the scope of the privacy law or regulation other data not currently regulated, each of which may require substantial expenditures or limit our ability to offer some of our services.
These incidents and claims could harm our business, reduce revenues, increase expenses and harm our reputation. 26 We may be subject to claims by others that we are infringing on their intellectual property rights.
These incidents and claims could harm our business, reduce revenues, increase expenses and harm our reputation. 25 We may be subject to claims by others that we are infringing on their intellectual property rights.
Any of the foregoing may have a material adverse impact on our ability to provide services to our clients or maintain our profitability. 25 There is ongoing concern from privacy advocates, regulators and others regarding data protection and privacy issues, and the number of jurisdictions with Privacy Laws has been increasing.
Any of the foregoing may have a material adverse impact on our ability to provide services to our clients or maintain our profitability. 24 There is ongoing concern from privacy advocates, regulators and others regarding data protection and privacy issues, and the number of jurisdictions with privacy laws and regulations has been increasing.
Exchange rate fluctuations may affect our results of operations and financial condition. Because a large portion of our revenues and expenses are denominated in currencies other than the United States dollar and our financial statements are reported in United States dollars, changes in foreign currency exchange rates could significantly affect our results of operations and financial condition.
Because a large portion of our revenues and expenses are denominated in currencies other than the United States dollar and our financial statements are reported in United States dollars, changes in foreign currency exchange rates could significantly affect our results of operations and financial condition.
We subcontract into a network of facilities where Phase I clinical trials are conducted, which ordinarily involve testing an investigational drug on a limited number of healthy individuals, typically 20 to 80 persons, to determine such drug’s basic safety.
We both own a facility and subcontract into a network of facilities where Phase I clinical trials are conducted, which ordinarily involve testing an investigational drug on a limited number of healthy individuals, typically 20 to 80 persons, to determine such drug’s basic safety.
Climate change may have an impact on our business. While we have determined that, at this time, climate change does not present a material risk to our business given the nature of our activities, we continue to evaluate and mitigate our business risks associated with climate change, and we recognize that there are inherent climate-related risks wherever business is conducted.
Environmental events may have an impact on our business. While we have determined that, at this time, environmental events do not present a material risk to our business given the nature of our activities, we continue to evaluate and mitigate our business risks associated with environmental events, and we recognize that there are inherent climate-related risks wherever business is conducted.
This liability, particularly if it were to exceed the limits of any indemnification agreements and insurance coverage we may have, may adversely affect our financial condition, results of operations and reputation. 33 Our Contract Sales & Medical Solutions business could result in liability to us if a drug causes harm to a patient.
This liability, particularly if it were to exceed the limits of any indemnification agreements and insurance coverage we may have, may adversely affect our financial condition, results of operations and reputation. Our Commercial Solutions business could result in liability to us if a drug causes harm to a patient.
There is significant and increasing competition for qualified personnel, particularly those with higher educational degrees, such as a medical degree, a Ph.D. or an equivalent degree, or relevant experience in the industry, including highly technical specialties such as clinical research associates, project managers and technology developers, and in the locations in which we operate.
There is significant and increasing competition for qualified personnel, particularly those with higher educational degrees, such as a medical degree, a Ph.D. or an equivalent degree, cutting-edge skillsets, such as AI and machine learning, or relevant experience in the industry, including highly technical specialties such as clinical research associates, project managers and technology developers, and in the locations in which we operate.
Any of our office or IT systems locations may be vulnerable to the adverse effects of climate change. Furthermore, climate change may impact patients in our clinical trials and our employees, particularly where they work remotely.
Any of our office or IT systems locations may be vulnerable to the adverse effects of environmental events. Furthermore, environmental events may impact patients in our clinical trials and our employees, particularly where they work remotely.
Regulations relating to the use of AI and the interpretation of those regulations by regulators, courts and others are in the early stages of development and evolving, which may make it difficult to identify adequate compliance requirements or suitable governance practices to meet those requirements.
Regulations relating to the use of AI and the interpretation of those regulations by regulators, courts and others are in the early stages of development and evolving, which may make it difficult to identify or implement adequate compliance requirements or suitable governance practices to meet those requirements, including the activities described in Item 1.
Each of our Technology & Analytics Solutions information services is derived from data we collect from third parties. These data suppliers are numerous and diverse, reflecting the broad scope of information that we collect and use in our business.
Our Commercial Solutions information services are derived from data we collect from third parties. These data suppliers are numerous and diverse, reflecting the broad scope of information that we collect and use in our business.
Cyber threats are rapidly evolving and are becoming increasingly sophisticated. As cyber threats evolve and become more difficult to detect and successfully defend against, one or more cyber threats might defeat the measures that we or our vendors take to anticipate, detect, avoid or mitigate such threats.
Cyber threats are rapidly evolving and are becoming increasingly sophisticated, including through the use of AI-supported attacks. As cyber threats evolve and become more difficult to detect and successfully defend against, one or more cyber threats might defeat the measures that we or our vendors take to anticipate, detect, avoid or mitigate such threats.
In 2024, financial regulators in various jurisdictions, including where we have variable-rate indebtedness outstanding, cut interest rates modestly while signaling that interest rates could remain higher compared to recent years for an extended period of time in an effort to lower inflation.
In 2025, financial regulators in various jurisdictions, including where we have variable-rate indebtedness outstanding, cut interest rates modestly while signaling that interest rates could remain higher compared to the pre-2022 period for an extended period of time in an effort to lower inflation.
Failure to meet productivity objectives under our internal business transformation initiatives could adversely impact our competitiveness and harm our operating results. We are pursuing business transformation initiatives to update technology, increase innovation and obtain operating efficiencies.
Failure to meet productivity objectives under our internal business transformation initiatives could adversely impact our competitiveness and harm our operating results. We are pursuing business transformation initiatives to update technology, increase innovation and obtain operating efficiencies, including through the use of AI.
Further, if we are unable to develop new technologies and services, clients do not purchase our new technologies and services, our new technologies and services do not work as intended or there are delays in the availability or adoption of our new technologies and services, then we may not be able to grow our business or growth may occur slower than anticipated.
Further, if we are unable to develop new technologies and services or keep up with the rapid pace of change in technological development and innovation, clients do not purchase our new technologies and services, our new technologies and services do not work as intended or there are delays in the availability or adoption of our new technologies and services, then we may not be able to grow our business or growth may occur slower than anticipated.
In addition, certain environmental and sustainability disclosures and commitments we make may be reliant in part or in whole on third party information, which we cannot verify the quality of, and third party performance, which we cannot guarantee. We may fail to meet our environmental and sustainability commitments either entirely or on the schedule we commit to.
In addition, certain environmental and sustainability disclosures and commitments we make may be reliant in part or in whole on third party information, which we cannot verify the quality of, and third party performance, which we cannot guarantee.
If any large client decreases or terminates its relationship with us, our business, results of operations or financial condition could be materially adversely affected. 29 Additionally, conducting multiple clinical trials for different clients in a single therapeutic class involving drugs with the same or similar chemical action has in the past and may in the future adversely affect our business if some or all of the clinical trials are canceled because of new scientific information or regulatory judgments that affect the drugs as a class or if industry consolidation results in the rationalization of drug development pipelines.
Additionally, conducting multiple clinical trials for different clients in a single therapeutic class involving drugs with the same or similar chemical action has in the past and may in the future adversely affect our business if some or all of the clinical trials are canceled because of new scientific information or regulatory judgments that affect the drugs as a class or if industry consolidation results in the rationalization of drug development pipelines.
The departure of our key employees, or our inability to continue to identify, attract and retain qualified personnel or replace departed personnel in a timely fashion, may impact our ability to grow our business and compete effectively in our industry and may negatively affect our ability to meet financial and operational goals. 34 Disruptions in the credit and capital markets and unfavorable general economic conditions could negatively affect our business, results of operations and financial condition.
The departure of our key employees, or our inability to continue to identify, attract and retain qualified personnel or replace departed personnel in a timely fashion, may impact our ability to grow our business and compete effectively in our industry and may negatively affect our ability to meet financial and operational goals.
Any of the foregoing could have a material and adverse effect on our operating results and financial condition. 24 Data protection, privacy and similar laws in the United States and around the world restrict access, use and disclosure of personal information, and failure to comply with or adapt to changes in these laws could materially and adversely harm our business.
Data protection, privacy and similar laws and regulations in the United States and around the world restrict access, use and disclosure of personal information, and failure to comply with or adapt to changes in these laws could materially and adversely harm our business.
We operate in businesses that require sophisticated computer systems and software for data collection, data processing, cloud-based platforms, analytics, cryptography, statistical projections and forecasting, mobile computing, social media analytics and other applications and technologies, particularly in our Technology & Analytics Solutions and Research & Development Solutions businesses.
We may experience challenges with the acquisition, development, enhancement or deployment of technology necessary for our business. We operate in businesses that require sophisticated computer systems and software for data collection, data processing, cloud-based platforms, analytics, cryptography, statistical projections and forecasting, mobile computing, social media analytics and other applications and technologies.
In addition, the emergence of the use of Real World Evidence and new approaches such as machine learning and artificial intelligence that capitalize on the availability of large data sets may reduce the time and costs of the discovery and development process, may allow our clients to more readily perform for themselves clinical development tasks and services that we have typically provided, may cause even greater price competition or may render certain data offerings less valuable or relevant.
In addition, the emergence of the use of Real World Evidence and the advancements in new approaches such as machine learning and artificial intelligence (AI), including generative, agentic and foundation models that are increasingly accessible through third‑party or open‑source platforms, that capitalize on the availability of large data sets may reduce the time and costs of the discovery and development process, may allow our clients to more readily perform for themselves clinical development tasks and services that we have typically provided, may cause even greater price competition and/or reduce the perceived differentiation of certain of our information, analytics and insight‑based offerings.
Some of our services involve direct interaction with clinical trial subjects or volunteers and subcontracting into a network of Phase I clinical facilities, which could create potential liability that may adversely affect our results of operations, financial condition and reputation.
When such disclosures occur, there is a risk that we may fail to monitor and comply with applicable adverse event reporting obligations. 32 Some of our services involve direct interaction with clinical trial subjects or volunteers and subcontracting into a network of Phase I clinical facilities, which could create potential liability that may adversely affect our results of operations, financial condition and reputation.
From time to time, we have adopted restructuring plans to improve our operating efficiency through various means such as reduction of overcapacity, elimination of non-billable support roles or other realignment of resources.
From time to time, we have adopted restructuring plans to improve our operating efficiency through various means such as reduction of overcapacity, elimination of non-billable support roles or other realignment of resources. For example, starting in the first quarter of 2026, we have restructured our operations to reduce our reportable segments from three to two.
We also expect that competition will continue to increase as a result of consolidation among these various companies. Large technology companies with substantial resources, technical expertise and greater brand power could also decide to enter or further expand in the markets where our business operates and compete with us.
Large technology companies with substantial resources, technical expertise and greater brand power could also decide to enter or further expand in the markets where our business operates and compete with us.
Our operating results and the trading price of our shares may fluctuate in response to various factors, including: • market conditions in the broader stock market; • actual or anticipated fluctuations in our quarterly and annual financial and operating results; • introduction of new services by us or our competitors; • issuance of new or changed securities analysts’ reports or recommendations; • sales, or anticipated sales, of large blocks of our stock; • additions or departures of key personnel; • regulatory or political developments; 43 • litigation and governmental investigations; • changing economic conditions; and • exchange rate fluctuations.
Our operating results and the trading price of our shares may fluctuate in response to various factors, including: • market conditions in the broader stock market; • actual or anticipated fluctuations in our quarterly and annual financial and operating results; • introduction of new services by us or our competitors; • changes in investor perception regarding the role, effectiveness, risks or regulatory implications of artificial intelligence in our business or in the healthcare and life sciences industries more broadly; • concerns, whether or not substantiated, regarding the accuracy, reliability, ethical use, governance, or regulatory compliance of AI-enabled solutions; • issuance of new or changed securities analysts’ reports or recommendations; • sales, or anticipated sales, of large blocks of our stock; 43 • additions or departures of key personnel; • regulatory or political developments; • litigation and governmental investigations; • changing economic conditions; and • exchange rate fluctuations.
These types of failures could have a material adverse effect on our operating results, financial condition and reputation. Consolidation in the industries in which our clients operate may reduce the volume of services purchased by consolidated clients following an acquisition or merger, which could materially harm our operating results and financial condition.
Consolidation in the industries in which our clients operate may reduce the volume of services purchased by consolidated clients following an acquisition or merger, which could materially harm our operating results and financial condition. Mergers or consolidations among our clients have in the past and could in the future reduce the number of our clients and potential clients.
All of these items described above may cause fluctuations in our effective income tax rate through increased income tax liability and/or the loss of tax attributes in any given year that could adversely affect our results of operations and impact our earnings and earnings per share.
As the regulations and guidance evolve with respect to current and newly enacted tax law, our results may differ from previous estimates and may materially affect our consolidated financial statements. 34 All of these items described above may cause fluctuations in our effective income tax rate through increased income tax liability and/or the loss of tax attributes in any given year that could adversely affect our results of operations and impact our earnings and earnings per share.
New services, or enhancements to existing services, may not adequately meet our own requirements or those of current and prospective clients or achieve any degree of significant market acceptance.
We may experience difficulties that could delay or prevent the successful design, development, testing, introduction or marketing of our services. New services, or enhancements to existing services, may not adequately meet our own requirements or those of current and prospective clients or achieve any degree of significant market acceptance.
We are building artificial intelligence (AI) technologies into internal applications and solutions we use with others, including clients; we expect the use of AI to grow. We seek to address some of our technology risks by increasing our reliance on the use of innovations by cross-industry technology leaders and adapt these for our biopharmaceutical and healthcare industry clients.
We seek to address some of our technology risks by increasing our reliance on the use of innovations by cross-industry technology leaders and adapt these for our biopharmaceutical and healthcare industry clients.
Our continued success will depend on our ability to adapt to changing technologies, manage and process ever-increasing amounts of data and information and improve the performance, features and reliability of our services in response to changing client and industry demands. We may experience difficulties that could delay or prevent the successful design, development, testing, introduction or marketing of our services.
Moreover, the introduction of new services embodying new technologies could render certain of our existing services obsolete. Our continued success will depend on our ability to adapt to changing technologies, manage and process ever-increasing amounts of data and information and improve the performance, features and reliability of our services in response to changing client and industry demands.
For example, if we are unable to engage investigators to conduct clinical trials as planned or enroll sufficient patients in clinical trials, we might need to expend additional funds to obtain access to resources or else be compelled to delay or modify the clinical trial plans, which may result in additional costs to us.
For example, if we are unable to engage investigators to conduct clinical trials as planned or enroll sufficient patients in clinical trials, we might need to expend additional funds to obtain access to resources or else be compelled to delay or modify the clinical trial plans, which may result in additional costs to us. 33 If we lose the services of key personnel or experience sustained labor shortages and are unable to recruit additional qualified personnel, or we are required to substantially increase wage rates to attract or retain employees, our business could be adversely affected.
We have established frameworks, models, processes and technologies to manage privacy and security for many data types, from a variety of sources, and under a myriad of Privacy Laws. In addition, we rely on our data suppliers to deliver information to us in a form and in a manner that complies with applicable Privacy Laws.
We have established frameworks, models, processes and technologies to manage privacy, data protection and security for many data types, from a variety of sources, and under a myriad of privacy and data protection laws.
Health information about an identifiable person carries additional obligations under these laws, including obtaining the explicit consent from the individual for collection, use or disclosure of the information.
Processing health information carries additional obligations under these laws and regulations, often including the need to obtain the explicit consent of the individual for collection, use or disclosure of the information.
Although we did not have any client that represented 10% or more of our revenues in 2024, 2023 and 2022, we derive the majority of our revenues from a number of large clients.
Any of these developments could materially harm our operating results and financial condition. 28 We may be adversely affected by client or therapeutic concentration. Although we did not have any client that represented 10% or more of our revenues in 2025, 2024 or 2023, we derive the majority of our revenues from a number of large clients.
Our failure to develop and offer competitive services that address these and other technological advances in a timely, cost-effective manner or to keep pace with rapid technological change could adversely affect our competitive position and our results of operations. 37 Our future growth and success will depend on our ability to successfully compete with other companies that provide similar services in the same markets, some of which may have financial, marketing, technical and other advantages.
Our failure to develop and offer competitive services that address these and other technological advances in a timely, cost-effective manner or to keep pace with rapid technological change could adversely affect our competitive position and our results of operations.
Many Privacy Laws protect more than patient information, and although they vary by jurisdiction, these laws can extend to employee information, business contact information, provider information and other information relating to identifiable individuals. Failure to comply with these laws may result in, among other things, civil and criminal liability, negative publicity, damage to our reputation and liability under contractual provisions.
Many privacy laws and regulations protect more than patient information, and although they vary by jurisdiction, these laws can extend to employee information, business contact information, provider information and other information relating to identifiable individuals.
Our preventive and remedial actions may not be successful. We have acquired various companies, products, services and technologies over the years. While we make significant efforts to identify and address IT security issues with respect to these acquisitions, we may still inherit security risks associated with these activities.
While we make significant efforts to identify and address IT security issues with respect to these acquisitions, we may still inherit security risks associated with these activities.
In general, patient health information is among the most sensitive (and highly regulated) of personal information. Privacy Laws in the United States and around the world are designed to ensure that information about an individual’s healthcare is properly protected from inappropriate access, use and disclosure.
Privacy laws and regulations in all regions of the world are designed to ensure that information about an individual is properly protected from inappropriate access, use and disclosure.
There can be no assurance that those sources will be available in sufficient amounts to fund future growth opportunities when needed.
There can be no assurance that those sources will be available in sufficient amounts to fund future growth opportunities when needed. Any of the foregoing could have a material and adverse effect on our operating results and financial condition.
In addition, compliance with such laws may require increased costs to us or may dictate that we not offer certain types of services.
Failure to comply with these laws may result in, among other things, civil and criminal liability, negative publicity, damage to our reputation and liability under contractual provisions. In addition, compliance with such laws may require increased costs to us or may dictate that we not offer certain types of services.
Other services that were previously purchased by one of the merged or consolidated entities may be deemed unnecessary or cancelled. If our clients merge with or are acquired by other entities that are not our clients, or that use fewer of our services, they may discontinue or reduce their use of our services.
If our clients merge with or are acquired by other entities that are not our clients, or that use fewer of our services, they may discontinue or reduce their use of our services. There can be no assurance as to the degree to which we may be able to address the revenues impact of such consolidation.
Mergers or consolidations among our clients have in the past and could in the future reduce the number of our clients and potential clients. When companies consolidate, overlapping services previously purchased separately are usually purchased only once by the combined entity, leading to loss of revenues.
When companies consolidate, overlapping services previously purchased separately are usually purchased only once by the combined entity, leading to loss of revenues. Other services that were previously purchased by one of the merged or consolidated entities may be deemed unnecessary or cancelled.
As there are some instances where we are a HIPAA “business associate” of a “covered entity,” we can be directly liable for mishandling protected health information. Under HIPAA’s enforcement scheme, we can be subject to significant penalties in connection with HIPAA violations, along with the potential for significant other expenditures related to these activities.
Under HIPAA’s enforcement scheme, overseen by the US Department of Health and Human Services, covered entities and business associates may be subject to significant penalties and fines in connection with HIPAA violations, along with the potential for significant other expenditures related to these activities.
Privacy Laws also include the European Union’s (“EU”) General Data Protection Regulation, Canada’s Personal Information Protection and Electronic Documents Act and other data protection, privacy, data security, data localization and similar national, state/provincial and local laws. In the EU and in many other regions or countries, personal data includes any information that relates to an identifiable natural person.
Such laws and regulations also include the European Union’s (“EU”) General Data Protection Regulation (GDPR), Canada’s Personal Information Protection and Electronic Documents Act (PIPEDA), Brazil’s General Data Protection Law (LGPR), India’s Digital Personal Data Protection Act (DPDP Act), Japan’s Act on the Protection of Personal Information (APPI), China’s Personal Information Protection Law (PIPL) and many other data protection and privacy laws at the national, state/provincial and local level.
For example, United States federal regulations under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) create specific requirements for the protection of the privacy and security of individual health information. These provisions apply to both “covered entities” (primarily health care providers and health insurers) and their “business associates” or service providers.
The confidentiality, collection, use, retention, security, transfer and disclosure of personal information is subject to governmental regulation in the countries where the personal information was collected or processed. 23 For example, United States federal regulations under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) create specific requirements for the protection of the privacy and security of certain individually-identifiable health information, specifically protected health information (PHI).
Increasing focus on sustainability and other similar initiatives could increase our costs, and inaction could harm our reputation and adversely impact our financial results. There has been increasing public focus by investors, customers, environmental activists, the media, and governmental and nongovernmental organizations on a variety of environmental and sustainability matters.
The expectations and requirements of regulators and other key stakeholders on sustainability-related matters, continue to evolve and diverge, and our ability to meet these expectations and requirements could increase our costs, and inaction could harm our reputation and adversely impact our financial results .
Removed
The confidentiality, collection, use, retention, security, transfer and disclosure of personal data, including individually identifiable health information and clinical trial patient-specific information, are subject to governmental regulation generally in the country that the personal data were collected or used (collectively, "Privacy Laws").
Added
Our preventive and remedial actions, including the activities described in Item 1C Cybersecurity in this Annual Report on Form 10-K, may not be successful. We have acquired various companies, products, services and technologies over the years.
Removed
These rules require individuals’ written authorization in many situations, in addition to any required informed consent, before protected health information may be used for research.
Added
We are also investing significantly in our AI strategy by launching AI-enabled solutions across our business units, developing AI agents for internal use and external offerings, and developing relationships with key strategic partners across the health-tech sector to foster collaboration and facilitate interoperability amongst AI-enabled solutions.
Removed
We are both directly and indirectly affected by the privacy provisions surrounding individual authorizations because many investigators with whom we are involved in clinical trials are directly subject to them and because we obtain identifiable health information from third parties that are subject to such various Privacy Laws.
Added
These provisions apply to both “covered entities” (health care providers, health care plans, and clearinghouses) and their “business associates” (service providers who process PHI on behalf of the covered entity). When acting as a HIPAA covered entity or as a business associate of a covered entity, there can be liability for improper processing of PHI.
Removed
In addition, we are subject to EU rules with respect to cross-border transfers of such data out of the EU (along with similar data transfer requirements or data localization requirements in other countries).
Added
Under most laws and regulations around the world, any information that relates to an identifiable natural person is considered “personal information”. In general, health information related to an identifiable person is considered “sensitive personal information” and is highly regulated.
Removed
We may experience challenges with the acquisition, development, enhancement or deployment of technology necessary for our business.
Added
In many countries, there are restrictions related to the cross-border transfer of personal information to other countries, including the need to put measures in place to allow the data transfer to occur. For example, registration with the EU-US Data Protection Framework (DPF) allows the transfer of data from the EU to US.
Removed
Significant technological change could render certain of our services obsolete. Moreover, the introduction of new services embodying new technologies could render certain of our existing services obsolete.
Added
For companies not registering with the DPF, another means of legalizing the transfer is the use of standard contractual clauses. In addition, in several countries around the world there are requirements to maintain personal information or sensitive personal information within that particular country under their data localization laws.
Removed
There can be no assurance as to the degree to which we may be able to address the revenues impact of such consolidation. Any of these developments could materially harm our operating results and financial condition. We may be adversely affected by client or therapeutic concentration.

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Item 1C. Cybersecurity

Cybersecurity — threats and controls disclosure

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Biggest changeWe manage risk in our supply chain through engagement with suppliers and vendors, including vendor on-boarding risk assessments, ongoing oversight, and independent cyber-reputation score monitoring for key suppliers. 45 Our business strategy, results of operations and financial condition have not been materially affected by risks from cybersecurity threats, including as a result of previously identified cybersecurity incidents, but we cannot provide assurance that they will not be materially affected in the future by such risks or any future material incidents.
Biggest changeOur business strategy, results of operations and financial condition have not been materially affected by risks from cybersecurity threats, including as a result of previously identified cybersecurity incidents, but we cannot provide assurance that they will not be materially affected in the future by such risks or any future material incidents.
For more information on our cybersecurity related risks, see Item 1A Risk Factors in this Annual Report on Form 10-K.
For more information on our cybersecurity related risks, see Item 1A Risk Factors in this Annual Report on Form 10-K. 45
We continuously monitor for threats and unauthorized access. We learn of security threats through automated detection solutions as well as reports from users and business partners. We draw on the knowledge and insight of external cybersecurity experts and vendors and employ an array of third party tools to secure IQVIA information infrastructure and protect systems and information from unauthorized access.
We learn of security threats through automated detection solutions as well as reports from users and business partners. We draw on the knowledge and insight of external cybersecurity experts and vendors and employ an array of third party tools to secure IQVIA information infrastructure and protect systems and information from unauthorized access.
Additionally, our cybersecurity controls are regularly assessed as part of our global Internal Audit plan, and the maturity of our Information Security program is also regularly assessed on at least an annual basis with the help of independent consultants. Our internal Business Information Security Office ("BISO"), established in 2022, continues to streamline communications between our IT function and business units.
Additionally, our cybersecurity controls are regularly assessed as part of our global Internal Audit plan, and the maturity of our Information Security program is also regularly assessed on at least an annual basis with the help of independent consultants.
The BISO connects several key functions, including the Chief Information Officer Business Partnership, business continuity, governance, risk management, and compliance. Our cybersecurity program focuses on all areas of our business, including cloud-based environments, data centers, devices used by employees and contractors, facilities, networks, applications, vendors, disaster recovery / business continuity and controls and safeguards enabled through business processes and tools.
Our cybersecurity program focuses on all areas of our business, including cloud-based environments, data centers, devices used by employees and contractors, facilities, networks, applications, vendors, disaster recovery / business continuity and controls and safeguards enabled through business processes and tools. We continuously monitor for threats and unauthorized access.
Removed
In 2023, we conducted a mapping of the IISF with the NIST framework to make it easier for customers and other stakeholders to understand how IQVIA's cybersecurity program aligns with published frameworks.
Added
We manage risk in our supply chain through engagement with suppliers and vendors, including vendor on-boarding risk assessments and ongoing oversight.

Item 2. Properties

Properties — owned and leased real estate

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Biggest changeItem 2. Properties As of December 31, 2024, we had 305 offices and laboratories located in 86 countries. Our executive headquarters are located in Research Triangle Park, North Carolina. We own facilities in Buenos Aires, Argentina; Caracas, Venezuela; Los Ruices, Venezuela; and Bangalore, India. All of our other offices are leased.
Biggest changeItem 2. Properties As of December 31, 2025, we had 304 offices and laboratories located in 87 countries. Our executive headquarters are located in Research Triangle Park, North Carolina. We own facilities in Buenos Aires, Argentina; Caracas, Venezuela; Los Ruices, Venezuela; and Bangalore, India. All of our other offices are leased.

Item 5. Market for Registrant's Common Equity

Market for Common Equity — stock, dividends, buybacks

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Biggest changePeriod Total Number of Shares Purchased Average Price Paid per Share Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs Approximate Dollar Value of Shares That May Yet Be Purchased Under the Plans or Programs (in millions, except per share data) October 1, 2024 – October 31, 2024 — $ — — $ 2,163 November 1, 2024 – November 30, 2024 4.9 $ 206.15 4.9 $ 1,163 December 1, 2024 – December 31, 2024 0.7 $ 195.56 0.7 $ 1,013 5.6 5.6 Stock Performance Graph This performance graph shall not be deemed “filed” for purposes of Section 18 of the Exchange Act or incorporated by reference into any filing of IQVIA Holdings Inc. under the Exchange Act or under the Securities Act, except as shall be expressly set forth by specific reference in such filing.
Biggest changePeriod Total Number of Shares Purchased Average Price Paid per Share Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs Approximate Dollar Value of Shares That May Yet Be Purchased Under the Plans or Programs (in millions, except per share data) October 1, 2025 – October 31, 2025 — $ — — $ 1,981 November 1, 2025 – November 30, 2025 0.6 $ 211.85 0.6 $ 1,861 December 1, 2025 – December 31, 2025 0.4 $ 223.42 0.4 $ 1,769 1.0 1.0 Stock Performance Graph This performance graph shall not be deemed “filed” for purposes of Section 18 of the Exchange Act or incorporated by reference into any filing of IQVIA Holdings Inc. under the Exchange Act or under the Securities Act, except as shall be expressly set forth by specific reference in such filing.
For additional information regarding these restrictive covenants, see Part II, Item 7 “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources” and Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. Recent Sales of Unregistered Securities We did not sell any unregistered equity securities in 2024.
For additional information regarding these restrictive covenants, see Part II, Item 7 “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources” and Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. Recent Sales of Unregistered Securities We did not sell any unregistered equity securities in 2025.
The graph assumes that $100 was invested in IQVIA, the S&P 500, and our peer group as of the close of market on December 31, 2019, and assumes the reinvestments of dividends, if any. The S&P 500 and our peer group are included for comparative purposes only.
The graph assumes that $100 was invested in IQVIA, the S&P 500, and our peer group as of the close of market on December 31, 2020, and assumes the reinvestments of dividends, if any. The S&P 500 and our peer group are included for comparative purposes only.
For additional information regarding our equity repurchases, see Part II, Item 7 “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources” and Note 13 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. 47 As of December 31, 2024, we had remaining authorization to repurchase up to $1,013 million of our common stock under the Repurchase Program.
For additional information regarding our equity repurchases, see Part II, Item 7 “Management’s Discussion and Analysis of Financial Condition and Results of Operations—Liquidity and Capital Resources” and Note 13 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. 47 As of December 31, 2025, we had remaining authorization to repurchase up to $1,769 million of our common stock under the Repurchase Program.
The following table summarizes the monthly equity repurchase activity for the three months ended December 31, 2024 and the approximate dollar value of shares that may yet be purchased pursuant to the Repurchase Program.
The following table summarizes the monthly equity repurchase activity for the three months ended December 31, 2025 and the approximate dollar value of shares that may yet be purchased pursuant to the Repurchase Program.
Dividend Policy We do not currently intend to pay dividends on our common stock, and no dividends were declared or paid in 2024 or 2023.
Dividend Policy We do not currently intend to pay dividends on our common stock, and no dividends were declared or paid in 2025 or 2024.
The following graph shows a comparison from December 31, 2019 through December 31, 2024 of the cumulative total return for our common stock, the Standard & Poor’s 500 Stock Index (“S&P 500”), and our peer group set forth below.
The following graph shows a comparison from December 31, 2020 through December 31, 2025 of the cumulative total return for our common stock, the Standard & Poor’s 500 Stock Index (“S&P 500”), and our peer group set forth below.
Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities Market Information for Common Stock Our common stock trades on the NYSE under the symbol “IQV.” Holders of Record On February 5, 2025, we had approximately 15 stockholders of record as reported by our transfer agent.
Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities Market Information for Common Stock Our common stock trades on the NYSE under the symbol “IQV.” Holders of Record On February 6, 2026, we had approximately 11 stockholders of record as reported by our transfer agent.
In addition, from time to time, we have repurchased and may continue to repurchase common stock through private or other transactions outside of the Repurchase Program. From inception of the Repurchase Program through December 31, 2024, we have repurchased a total of $10,712 million of our securities under the Repurchase Program.
In addition, from time to time, we have repurchased and may continue to repurchase common stock through private or other transactions outside of the Repurchase Program. From inception of the Repurchase Program through December 31, 2025, we have repurchased a total of $11,956 million of our securities under the Repurchase Program.
During the year ended December 31, 2024, we repurchased 6.4 million shares of our common stock for $1,350 million under the Repurchase Program.
During the year ended December 31, 2025, we repurchased 7.4 million shares of our common stock for $1,244 million under the Repurchase Program.
Since the Merger between Quintiles and IMS Health in October 2016, we have repurchased 84.6 million shares of our common stock at an average market price per share of $122.23 for an aggregate purchase price of $10,338 million both under and outside of the Repurchase Program.
Since the Merger between Quintiles and IMS Health in October 2016, we have repurchased 92.0 million shares of our common stock at an average market price per share of $125.98 for an aggregate purchase price of $11,582 million both under and outside of the Repurchase Program.
They do not necessarily reflect management’s opinion that the S&P 500 and our peer group are an appropriate measure of the relative performance of the stock involved, and they are not intended to forecast or be indicative of possible future performance of our common stock. 48 12/31/2019 12/31/2020 12/31/2021 12/31/2022 12/31/2023 12/31/2024 IQVIA $ 100 $ 116 $ 183 $ 133 $ 150 $ 127 S&P 500 $ 100 $ 118 $ 152 $ 125 $ 158 $ 197 Peer Group $ 100 $ 140 $ 204 $ 161 $ 172 $ 174
They do not necessarily reflect management’s opinion that the S&P 500 and our peer group are an appropriate measure of the relative performance of the stock involved, and they are not intended to forecast or be indicative of possible future performance of our common stock. 48 12/31/2020 12/31/2021 12/31/2022 12/31/2023 12/31/2024 12/31/2025 IQVIA $ 100 $ 157 $ 114 $ 129 $ 110 $ 126 S&P 500 $ 100 $ 129 $ 105 $ 133 $ 166 $ 196 Peer Group $ 100 $ 146 $ 115 $ 123 $ 124 $ 133

Item 7. Management's Discussion & Analysis

Management's Discussion & Analysis (MD&A) — revenue / margin commentary

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Biggest changeThe following table contains summarized combined financial information from the Statements of Unaudited Condensed Consolidated Financial Position of the obligated group as of: (in millions) December 31, 2024 December 31, 2023 Total current assets (excluding amounts due from subsidiaries that are non-Guarantors) $ 935 $ 805 Total noncurrent assets $ 10,937 $ 9,622 Amounts due from subsidiaries that are non-Guarantors $ 4,952 $ 4,762 Total current liabilities $ 3,792 $ 3,471 Total noncurrent liabilities $ 12,333 $ 12,334 Amounts due to subsidiaries that are non-Guarantors $ 6,341 $ 5,556 The following table contains summarized combined financial information from the Statements of Unaudited Condensed Consolidated Operations of the obligated group: Twelve months ended Twelve months ended (in millions) December 31, 2024 December 31, 2023 Net revenues $ 6,661 $ 6,299 Costs and expenses applicable to net revenues $ 4,145 $ 4,190 Income from operations $ 1,259 $ 912 Net income $ 554 $ 86 Off-Balance Sheet Arrangements We do not have any material off-balance sheet arrangements. 61 Contractual Obligations and Commitments Below is a summary of our future payment commitments by year under contractual obligations as of December 31, 2024: (in millions) 2025 2026-2027 2028-2029 Thereafter Total Long-term debt, including interest (1) $ 1,801 $ 7,445 $ 4,852 $ 2,024 $ 16,122 Operating leases 109 120 47 22 298 Finance leases 13 27 28 269 337 Data acquisition 563 760 232 24 1,579 Purchase obligations (2) 113 59 11 1 184 Commitments to unconsolidated affiliates (3) — — — — — Benefit obligations (4) 30 33 34 100 197 Uncertain income tax positions (5) 13 32 17 — 62 Total $ 2,642 $ 8,476 $ 5,221 $ 2,440 $ 18,779 (1) Interest payments on our debt are based on the interest rates in effect as of December 31, 2024.
Biggest changeThe following table contains summarized combined financial information from the Statements of Unaudited Condensed Consolidated Financial Position of the obligated group as of: (in millions) December 31, 2025 December 31, 2024 Total current assets (excluding amounts due from subsidiaries that are non-Guarantors) $ 1,012 $ 935 Total noncurrent assets $ 11,876 $ 10,937 Amounts due from subsidiaries that are non-Guarantors $ 4,488 $ 4,952 Total current liabilities $ 5,053 $ 3,792 Total noncurrent liabilities $ 13,324 $ 12,333 Amounts due to subsidiaries that are non-Guarantors $ 6,672 $ 6,341 The following table contains summarized combined financial information from the Statements of Unaudited Condensed Consolidated Operations of the obligated group: Twelve Months Ended December 31, (in millions) 2025 2024 2023 Net revenues $ 7,137 $ 6,661 $ 6,299 Costs and expenses applicable to net revenues $ 4,630 $ 4,145 $ 4,190 Income from operations $ 1,276 $ 1,259 $ 912 Net income $ 286 $ 554 $ 86 61 Off-Balance Sheet Arrangements We do not have any material off-balance sheet arrangements.
Bank Trust Company, National Association, as trustee, be required upon the occurrence of any of the following: a. any sale, exchange, issuance, disposition or transfer (by merger, amalgamation, consolidation or otherwise) of (i) the capital stock of such Guarantor, after which the applicable Guarantor is no longer a Restricted Subsidiary, or (ii) all or substantially all of the assets of such Guarantor, in each case if such sale, exchange, issuance, disposition or transfer is made in compliance with the applicable provisions of this Indenture; b. the release or discharge of the guarantee by such Guarantor of indebtedness under the senior secured term loan facilities and the senior secured revolving credit facilities under that certain Fifth Amended and Restated Credit Agreement, or the release or discharge of such other guarantee that resulted in the creation of such Guarantee, except, in each case, a discharge or release by or as a result of payment of such Indebtedness or under such guarantee (it being understood that a release subject to a contingent reinstatement is still a release, and that if any such guarantee is so reinstated, such Guarantee shall also be reinstated to the extent that such Guarantor would then be required to provide a Guarantee pursuant to Section 4.11 of the Indenture); c. the designation of any Restricted Subsidiary that is a Guarantor as an Unrestricted Subsidiary in compliance with the applicable provisions of the Indenture; d. the exercise by the Issuer of its Legal Defeasance option or Covenant Defeasance option in accordance with Article VIII of the Indenture or the discharge of the Issuer’s obligations under the Indenture in accordance with the terms of this Indenture; e. the merger, amalgamation or consolidation of any Guarantor with and into the Issuer or a Guarantor that is the surviving Person in such merger, amalgamation or consolidation, or upon the liquidation of a Guarantor following the transfer of all or substantially all of its assets, in each case in a transaction that complies with the applicable provisions of this Indenture; or 60 f. as described in Article IX of the Indenture.
Bank Trust Company, National Association, as trustee, be required upon the occurrence of any of the following: a. any sale, exchange, issuance, disposition or transfer (by merger, amalgamation, consolidation or otherwise) of (i) the capital stock of such Guarantor, after which the applicable Guarantor is no longer a Restricted Subsidiary, or (ii) all or substantially all of the assets of such Guarantor, in each case if such sale, exchange, issuance, disposition or transfer is made in compliance with the applicable provisions of this Indenture; 60 b. the release or discharge of the guarantee by such Guarantor of indebtedness under the senior secured term loan facilities and the senior secured revolving credit facilities under that certain Fifth Amended and Restated Credit Agreement, or the release or discharge of such other guarantee that resulted in the creation of such Guarantee, except, in each case, a discharge or release by or as a result of payment of such Indebtedness or under such guarantee (it being understood that a release subject to a contingent reinstatement is still a release, and that if any such guarantee is so reinstated, such Guarantee shall also be reinstated to the extent that such Guarantor would then be required to provide a Guarantee pursuant to Section 4.11 of the Indenture); c. the designation of any Restricted Subsidiary that is a Guarantor as an Unrestricted Subsidiary in compliance with the applicable provisions of the Indenture; d. the exercise by the Issuer of its Legal Defeasance option or Covenant Defeasance option in accordance with Article VIII of the Indenture or the discharge of the Issuer’s obligations under the Indenture in accordance with the terms of this Indenture; e. the merger, amalgamation or consolidation of any Guarantor with and into the Issuer or a Guarantor that is the surviving Person in such merger, amalgamation or consolidation, or upon the liquidation of a Guarantor following the transfer of all or substantially all of its assets, in each case in a transaction that complies with the applicable provisions of this Indenture; or f. as described in Article IX of the Indenture.
Recently Issued Accounting Standards Information relating to recently issued accounting standards is included in Note 1 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K.
Recently Issued Accounting Standards Information relating to recently issued accounting standards is included in Note 1 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. 64
Industry Outlook For information about the industry outlook and markets that we operate in, refer to Part I, Item I, “Our Market Opportunity.” Business Combinations We have completed and will continue to consider strategic business combinations to enhance our capabilities and offerings in certain areas, including various individually immaterial acquisitions during the years ended December 31, 2024 and 2023.
Industry Outlook For information about the industry outlook and markets that we operate in, refer to Part I, Item I, “Our Market Opportunity.” Business Combinations We have completed, and will continue to consider, strategic business combinations to enhance our capabilities and offerings in certain areas, including various individually immaterial acquisitions during the years ended December 31, 2025 and 2024.
We perform our annual goodwill impairment evaluation as of July 31. 63 For the year ended December 31, 2024, we performed a qualitative impairment evaluation. The qualitative evaluation requires significant judgments, estimates and assumptions, including those related to macroeconomic conditions, industry and market considerations, cost factors, financial performance, fair value history and other company specific events.
We perform our annual goodwill impairment evaluation as of July 31. 63 For the year ended December 31, 2025, we performed a qualitative impairment evaluation. The qualitative evaluation requires significant judgments, estimates and assumptions, including those related to macroeconomic conditions, industry and market considerations, cost factors, financial performance, fair value history and other company specific events.
(2) Purchase obligations are defined as agreements to purchase goods or services that are enforceable and legally binding and that specify all significant terms, including fixed or minimum quantities to be purchased, fixed, minimum or variable pricing provisions and the approximate timing of the transactions. (3) We are currently committed to invest $678 million in private equity funds.
(2) Purchase obligations are defined as agreements to purchase goods or services that are enforceable and legally binding and that specify all significant terms, including fixed or minimum quantities to be purchased, fixed, minimum or variable pricing provisions and the approximate timing of the transactions. (3) We are currently committed to invest $752 million in private equity funds.
Due to the potential impact of future plan investment performance, changes in interest rates, changes in other economic and demographic assumptions and changes in legislation in foreign jurisdictions, we are not able to reasonably estimate the timing and amount of contributions that may be required to fund our defined benefit plans for periods beyond 2025.
Due to the potential impact of future plan investment performance, changes in interest rates, changes in other economic and demographic assumptions and changes in legislation in foreign jurisdictions, we are not able to reasonably estimate the timing and amount of contributions that may be required to fund our defined benefit plans for periods beyond 2026.
The following presents the summarized financial information on a combined basis for IQVIA Holdings Inc. (parent company), IQVIA Inc. (issuer of the guaranteed obligations) and the Guarantor subsidiaries, which are collectively referred to as the “obligated group.” Each Guarantor subsidiary is consolidated by IQVIA Holdings Inc. as of December 31, 2024 and December 31, 2023 .
The following presents the summarized financial information on a combined basis for IQVIA Holdings Inc. (parent company), IQVIA Inc. (issuer of the guaranteed obligations) and the Guarantor subsidiaries, which are collectively referred to as the “obligated group.” Each Guarantor subsidiary is consolidated by IQVIA Holdings Inc. as of December 31, 2025 and December 31, 2024 .
With approximately 88,000 employees in over 100 countries, including experts in healthcare, life sciences, data science, technology and operational excellence, IQVIA is dedicated to accelerating the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
With approximately 93,000 employees in over 100 countries, including experts in healthcare, life sciences, data science, technology and operational excellence, IQVIA is dedicated to accelerating the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.
As of December 31, 2024, we were in compliance with the financial covenants under our debt agreements in all material respects and do not have material uncertainty about ongoing ability to meet the covenants of our credit arrangements.
As of December 31, 2025, we were in compliance with the financial covenants under our debt agreements in all material respects and do not have material uncertainty about ongoing ability to meet the covenants of our credit arrangements.
A hypothetical increase of one percent in the estimated costs to complete these service contracts as of December 31, 2024 could have resulted in approximately a one percent reduction in total revenues for the year ended December 31, 2024, whereas, a hypothetical decrease of one percent could have resulted in a one percent increase in total revenues.
A hypothetical increase of one percent in the estimated costs to complete these service contracts as of December 31, 2025 could have resulted in approximately a one percent reduction in total revenues for the year ended December 31, 2025, whereas, a hypothetical decrease of one percent could have resulted in a one percent increase in total revenues.
Refer to Exhibit 22.1 to this Annual Report on Form 10-K for the detailed list of entities included within the obligated group as of December 31, 2024.
Refer to Exhibit 22.1 to this Annual Report on Form 10-K for the detailed list of entities included within the obligated group as of December 31, 2025.
We use significant judgments, estimates and assumptions in determining the estimated fair value of assets acquired, liabilities assumed and non-controlling interests including expected future cash flows and discount rates that reflect the risk associated with the expected future cash flows and estimated useful lives.
We use significant judgments, estimates and assumptions in determining the estimated fair value of assets acquired, liabilities assumed and noncontrolling interests including expected future cash flows and discount rates that reflect the risk associated with the expected future cash flows and estimated useful lives.
Business Combinations and Goodwill We use the acquisition method to account for business combinations, and accordingly, the identifiable assets acquired, the liabilities assumed and any non-controlling interests in the acquiree are recorded at their estimated fair values on the date of the acquisition.
Business Combinations and Goodwill We use the acquisition method to account for business combinations, and accordingly, the identifiable assets acquired, the liabilities assumed and any noncontrolling interests in the acquiree are recorded at their estimated fair values on the date of the acquisition.
Foreign Currency Translation In 2024, approximately 30% of our revenues were denominated in currencies other than the United States dollar, which represents approximately 60 currencies.
Foreign Currency Translation In 2025, approximately 30% of our revenues were denominated in currencies other than the United States dollar, which represents approximately 60 currencies.
The Repurchase Program does not obligate us to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time. As of December 31, 2024, we had remaining authorization to repurchase up to $1,013 million of our common stock under the Repurchase Program.
The Repurchase Program does not obligate us to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time. As of December 31, 2025, we had remaining authorization to repurchase up to $1,769 million of our common stock under the Repurchase Program.
(4) Amounts represent expected future benefit payments for our pension and postretirement benefit plans, as well as expected contributions for 2025 for our funded pension benefit plans.
(4) Amounts represent expected future benefit payments for our pension and postretirement benefit plans, as well as expected contributions for 2026 for our funded pension benefit plans.
Loss on Extinguishment of Debt Year Ended December 31, (in millions) 2024 2023 2022 Loss on extinguishment of debt $ — $ 6 $ — In 2023 we recognized a loss on extinguishment of debt of $6 million for fees and expenses incurred related to the refinancing of our Credit Agreement. No such activity occurred in 2024.
Loss on Extinguishment of Debt Year Ended December 31, (in millions) 2025 2024 2023 Loss on extinguishment of debt $ 6 $ — $ 6 In 2025 and 2023 we recognized a loss on extinguishment of debt of $6 million for fees and expenses incurred related to the refinancings of our Credit Agreement. No such activity occurred in 2024.
Restructuring Costs Year Ended December 31, (in millions) 2024 2023 2022 Restructuring costs $ 67 $ 84 $ 28 The restructuring costs incurred were due to ongoing efforts to streamline our global operations and reduce overcapacity to adapt to changing market conditions and integrate acquisitions.
Restructuring Costs Year Ended December 31, (in millions) 2025 2024 2023 Restructuring costs $ 105 $ 67 $ 84 The restructuring costs incurred were due to ongoing efforts to streamline our global operations and reduce overcapacity to adapt to changing market conditions and integrate acquisitions.
These restructuring actions are expected to occur throughout 2025 and are expected to consist of consolidating functional activities, eliminating redundant positions, and aligning resources with customer requirements. 52 Interest Income and Interest Expense Year Ended December 31, (in millions) 2024 2023 2022 Interest income $ (47) $ (36) $ (13) Interest expense $ 670 $ 672 $ 416 Interest income included interest received primarily from bank balances and investments.
These restructuring actions are expected to occur throughout 2026 and are expected to consist of consolidating functional activities, eliminating redundant positions, and aligning resources with customer requirements. 52 Interest Income and Interest Expense Year Ended December 31, (in millions) 2025 2024 2023 Interest income $ (45) $ (47) $ (36) Interest expense $ 729 $ 670 $ 672 Interest income included interest received primarily from bank balances and investments.
For a discussion of our results of operations comparison for 2023 and 2022, refer to our Annual Report on Form 10-K for the fiscal year ended December 31, 2023 filed on February 15, 2024.
For a discussion of our results of operations comparison for 2024 and 2023, refer to our Annual Report on Form 10-K for the fiscal year ended December 31, 2024 filed on February 13, 2025.
(5) As of December 31, 2024, our liability related to uncertain income tax positions was approximately $161 million, $99 million of which has not been included in the above table as we are unable to predict when these liabilities will be paid due to the uncertainties in the timing of the settlement of the income tax positions.
(5) As of December 31, 2025, our liability related to uncertain income tax positions was approximately $170 million, $112 million of which has not been included in the above table as we are unable to predict when these liabilities will be paid due to the uncertainties in the timing of the settlement of the income tax positions.
We have and expect to transfer cash from those subsidiaries to the United States and to other international subsidiaries when it is cost effective to do so. We had a cash balance of $1,702 million as of December 31, 2024 ($713 million of which was in the United States), an increase from $1,376 million as of December 31, 2023.
We have and expect to transfer cash from those subsidiaries to the United States and to other international subsidiaries when it is cost effective to do so. We had a cash balance of $1,980 million as of December 31, 2025 ($686 million of which was in the United States), an increase from $1,702 million as of December 31, 2024.
Contracted backlog was $27.2 billion as of December 31, 2022. Backlog represents, at a particular point in time, future revenues from work not yet completed or performed under signed contracts. Once work begins on a project, revenues are recognized over the duration of the project.
Contracted backlog was $29.7 billion as of December 31, 2023. Backlog represents, at a particular point in time, future revenues from work not yet completed or performed under signed contracts. Once work begins on a project, revenues are recognized over the duration of the project.
For information regarding the senior secured credit facilities, see Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. Senior Secured Notes and Senior Notes For information regarding the senior secured notes and senior notes, see Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K.
For information regarding the senior secured credit facilities, see Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. Senior Secured Notes and Senior Notes On June 4, 2025, IQVIA Inc.
Debt As of December 31, 2024, we had $14,045 million of total indebtedness, excluding $1,170 million of additional available borrowings under our revolving credit facility. See Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K for additional details regarding our credit arrangements.
Debt As of December 31, 2025, we had $15,800 million of total indebtedness, excluding $1,195 million of additional available borrowings under our revolving credit facility. See Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K for additional details regarding our credit arrangements.
Depreciation and Amortization Year Ended December 31, (dollars in millions) 2024 2023 2022 Depreciation and amortization $ 1,114 $ 1,125 $ 1,130 % of revenues 7.2 % 7.5 % 7.8 % The $11 million decrease in depreciation and amortization in 2024 as compared to 2023 was primarily the result of less amortization of certain intangible assets from the merger between Quintiles and IMS Health, offset by an increase in amortization of capitalized software and of intangible assets from acquisitions occurring in 2023 and 2024.
Depreciation and Amortization Year Ended December 31, (dollars in millions) 2025 2024 2023 Depreciation and amortization $ 1,144 $ 1,114 $ 1,125 % of revenues 7.0 % 7.2 % 7.5 % The $30 million increase in depreciation and amortization in 2025 as compared to 2024 was primarily the result of an increase in amortization of capitalized software and of intangible assets from acquisitions occurring in 2024 and 2025, offset by less amortization of certain intangible assets from the merger between Quintiles and IMS Health.
As of December 31, 2024, we have funded approximately $310 million of these commitments and we have approximately $368 million remaining to be funded which has not been included in the above table as we are unable to predict when these commitments will be paid.
As of December 31, 2025, we have funded approximately $339 million of these commitments and we have approximately $413 million remaining to be funded which has not been included in the above table as we are unable to predict when these commitments will be paid.
We also believe that the amount of cash available to us from our operations, together with cash from financing, will be sufficient for us to pay any known contingencies as they become due without materially affecting our ability to conduct our operations and invest in the growth of our business. 59 Information about our Guarantors and the Issuer of our Guaranteed Securities IQVIA Inc.
We also believe that the amount of cash available to us from our operations, together with cash from financing, will be sufficient for us to pay any known contingencies as they become due without materially affecting our ability to conduct our operations and invest in the growth of our business.
We record the expense amount of the EPS awards based on our estimates of the likelihood that the various performance targets will be achieved. The estimates are assessed on a quarterly basis.
We record the expense amount of the EPS awards based on our estimates of the likelihood that the various performance targets will be achieved. The estimates are assessed on a quarterly basis. For the TSR awards we record the expense amount evenly over the service period.
We made cash contributions totaling approximately $30 million to our defined benefit plans in 2024, and we estimate that we will make contributions totaling approximately $30 million to our defined benefit plans in 2025.
We made cash contributions totaling approximately $32 million to our defined benefit plans in 2025, and we estimate that we will make contributions totaling approximately $34 million to our defined benefit plans in 2026.
For more details regarding risks related to our backlog, see Part I, Item IA, “Risk Factors—Risks Related to our Business—The relationship of backlog to revenues varies over time.” Revenues 2024 compared to 2023 Research & Development Solutions’ revenues were $8,527 million in 2024, an increase of $132 million, or 1.6%, over 2023.
For more details regarding risks related to our backlog, see Part I, Item IA, “Risk Factors—Risks Related to our Business—The relationship of backlog to revenues varies over time.” Revenues 2025 compared to 2024 Research & Development Solutions’ revenues were $8,896 million in 2025, an increase of $369 million, or 4.3%, over 2024.
The constant currency revenue growth was impacted by a decrease in COVID-19 related work. Cost of Revenues, exclusive of Depreciation and Amortization 2024 compared to 2023 Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $69 million, or 1.2%, in 2024 as compared to 2023.
The constant currency revenue growth was impacted by a decrease in COVID-19 related work. 55 Cost of Revenues, exclusive of Depreciation and Amortization 2025 compared to 2024 Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $426 million, or 7.5%, in 2025 as compared to 2024.
Research & Development Solutions Year Ended December 31, Change (dollars in millions) 2024 2023 2022 2024 vs. 2023 2023 vs. 2022 Revenues $ 8,527 $ 8,395 $ 7,921 $ 132 1.6% $ 474 6.0% Cost of revenues, exclusive of depreciation and amortization 5,698 5,629 5,395 69 1.2 234 4.3 Selling, general and administrative expenses 881 851 831 30 3.5 20 2.4 Segment profit $ 1,948 $ 1,915 $ 1,695 $ 33 1.7% $ 220 13.0% Backlog Research & Development Solutions' contracted backlog increased from $29.7 billion as of December 31, 2023 to $31.1 billion as of December 31, 2024 and we expect approximately $7.9 billion of this backlog to convert to revenues in the next 12 months.
Research & Development Solutions Year Ended December 31, Change (dollars in millions) 2025 2024 2023 2025 vs. 2024 2024 vs. 2023 Revenues $ 8,896 $ 8,527 $ 8,395 $ 369 4.3% $ 132 1.6% Cost of revenues, exclusive of depreciation and amortization 6,124 5,698 5,629 426 7.5 69 1.2 Selling, general and administrative expenses 899 881 851 18 2.0 30 3.5 Segment profit $ 1,873 $ 1,948 $ 1,915 $ (75) (3.9)% $ 33 1.7% Backlog Research & Development Solutions' contracted backlog increased from $31.1 billion as of December 31, 2024 to $32.7 billion as of December 31, 2025 and we expect approximately $8.3 billion of this backlog to convert to revenues in the next 12 months.
Years ended December 31, 2024, 2023 and 2022 Cash Flow from Operating Activities Year Ended December 31, (in millions) 2024 2023 2022 Net cash provided by operating activities $ 2,716 $ 2,149 $ 2,260 2024 compared to 2023 Cash provided by operating activities increased $567 million in 2024 as compared to 2023.
Years ended December 31, 2025, 2024 and 2023 Cash Flow from Operating Activities Year Ended December 31, (in millions) 2025 2024 2023 Net cash provided by operating activities $ 2,654 $ 2,716 $ 2,149 2025 compared to 2024 Cash provided by operating activities decreased $62 million in 2025 as compared to 2024.
Technology & Analytics Solutions Year Ended December 31, Change (dollars in millions) 2024 2023 2022 2024 vs. 2023 2023 vs. 2022 Revenues $ 6,160 $ 5,862 $ 5,746 $ 298 5.1% $ 116 2.0% Cost of revenues, exclusive of depreciation and amortization 3,721 3,496 3,348 225 6.4 148 4.4 Selling, general and administrative expenses 917 876 848 41 4.7 28 3.3 Segment profit $ 1,522 $ 1,490 $ 1,550 $ 32 2.1% $ (60) (3.9)% Revenues 2024 compared to 2023 Technology & Analytics Solutions’ revenues were $6,160 million in 2024, an increase of $298 million, or 5.1%, over 2023.
Technology & Analytics Solutions Year Ended December 31, Change (dollars in millions) 2025 2024 2023 2025 vs. 2024 2024 vs. 2023 Revenues $ 6,626 $ 6,160 $ 5,862 $ 466 7.6% $ 298 5.1% Cost of revenues, exclusive of depreciation and amortization 4,076 3,721 3,496 355 9.5 225 6.4 Selling, general and administrative expenses 955 917 876 38 4.1 41 4.7 Segment profit $ 1,595 $ 1,522 $ 1,490 $ 73 4.8% $ 32 2.1% Revenues 2025 compared to 2024 Technology & Analytics Solutions’ revenues were $6,626 million in 2025, an increase of $466 million, or 7.6%, over 2024.
Selling, General and Administrative Expenses Year Ended December 31, (dollars in millions) 2024 2023 2022 Selling, general and administrative expenses $ 1,992 $ 2,053 $ 2,071 % of revenues 12.9 % 13.7 % 14.4 % 2024 compared to 2023 The $61 million decrease in selling, general and administrative expenses in 2024 as compared to 2023 included a constant currency decrease of approximately $33 million, or 1.6%, comprised of a $52 million increase in Technology & Analytics Solutions, a $42 million increase in Research & Development Solutions, and a $2 million increase in Contract Sales & Medical Solutions, offset by a $129 million decrease in general corporate and unallocated expenses.
Selling, General and Administrative Expenses Year Ended December 31, (dollars in millions) 2025 2024 2023 Selling, general and administrative expenses $ 1,999 $ 1,992 $ 2,053 % of revenues 12.3 % 12.9 % 13.7 % 2025 compared to 2024 The $7 million increase in selling, general and administrative expenses in 2025 as compared to 2024 included a constant currency decrease of approximately $7 million, or 0.4%, comprised of a $26 million increase in Technology & Analytics Solutions, an $18 million increase in Research & Development Solutions, and no constant currency change in Contract Sales & Medical Solutions, offset by a $51 million decrease in general corporate and unallocated expenses.
This increase was comprised of constant currency revenue growth of approximately $510 million, or 3.4%, reflecting a $333 million increase in Technology & Analytics Solutions, a $167 million increase in Research & Development Solutions, and a $10 million increase in Contract Sales & Medical Solutions. 51 Cost of Revenues, exclusive of Depreciation and Amortization Year Ended December 31, (dollars in millions) 2024 2023 2022 Cost of revenues, exclusive of depreciation and amortization $ 10,030 $ 9,745 $ 9,382 % of revenues 65.1 % 65.0 % 65.1 % 2024 compared to 2023 When compared to 2023, cost of revenues, exclusive of depreciation and amortization increased $285 million in 2024, or 2.9%.
This increase was comprised of constant currency revenue growth of approximately $737 million, or 4.8%, reflecting a $380 million increase in Technology & Analytics Solutions, a $298 million increase in Research & Development Solutions, and a $59 million increase in Contract Sales & Medical Solutions. 51 Cost of Revenues, exclusive of Depreciation and Amortization Year Ended December 31, (dollars in millions) 2025 2024 2023 Cost of revenues, exclusive of depreciation and amortization $ 10,880 $ 10,030 $ 9,745 % of revenues 66.7 % 65.1 % 65.0 % 2025 compared to 2024 When compared to 2024, cost of revenues, exclusive of depreciation and amortization, increased $850 million in 2025, or 8.5%.
For the TSR awards we record the expense amount evenly over the service period. 64 Pensions and Other Postretirement Benefits We provide retirement benefits to certain employees, including defined benefit pension plans. The determination of benefit obligations and expense is based on actuarial models.
Pensions and Other Postretirement Benefits We provide retirement benefits to certain employees, including defined benefit pension plans. The determination of benefit obligations and expense is based on actuarial models.
Contract Sales & Medical Solutions Year Ended December 31, Change (dollars in millions) 2024 2023 2022 2024 vs. 2023 2023 vs. 2022 Revenues $ 718 $ 727 $ 743 $ (9) (1.2)% $ (16) (2.2)% Cost of revenues, exclusive of depreciation and amortization 611 620 639 (9) (1.5) (19) (3.0) Selling, general and administrative expenses 60 58 62 2 3.4 (4) (6.5) Segment profit $ 47 $ 49 $ 42 $ (2) (4.1)% $ 7 16.7% Revenues 2024 compared to 2023 Contract Sales & Medical Solutions’ revenues were $718 million in 2024, a decrease of $9 million, or 1.2%, over 2023.
Contract Sales & Medical Solutions Year Ended December 31, Change (dollars in millions) 2025 2024 2023 2025 vs. 2024 2024 vs. 2023 Revenues $ 788 $ 718 $ 727 $ 70 9.7% $ (9) (1.2)% Cost of revenues, exclusive of depreciation and amortization 680 611 620 69 11.3 (9) (1.5) Selling, general and administrative expenses 60 60 58 — — 2 3.4 Segment profit $ 48 $ 47 $ 49 $ 1 2.1% $ (2) (4.1)% Revenues 2025 compared to 2024 Contract Sales & Medical Solutions’ revenues were $788 million in 2025, an increase of $70 million, or 9.7%, over 2024.
Revenues Year Ended December 31, Change 2024 vs. 2023 2023 vs. 2022 (dollars in millions) 2024 2023 2022 $ % $ % Revenues $ 15,405 $ 14,984 $ 14,410 $ 421 2.8 % $ 574 4.0 % 2024 compared to 2023 In 2024, our revenues increased $421 million, or 2.8%, as compared to 2023.
Revenues Year Ended December 31, Change 2025 vs. 2024 2024 vs. 2023 (dollars in millions) 2025 2024 2023 $ % $ % Revenues $ 16,310 $ 15,405 $ 14,984 $ 905 5.9 % $ 421 2.8 % 2025 compared to 2024 In 2025, our revenues increased $905 million, or 5.9%, as compared to 2024.
Contingencies We are exposed to certain known contingencies that are material to our investors. The facts and circumstances surrounding these contingencies and a discussion of their effect on us are included in Note 12 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K.
The facts and circumstances surrounding these contingencies and a discussion of their effect on us are included in Note 12 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. These contingencies may have a material effect on our liquidity, capital resources or results of operations.
We review the carrying values of other identifiable intangible assets if the facts and circumstances indicate a possible impairment. Any future impairment could have a material adverse effect on our financial condition or results of operations.
For the years ended December 31, 2025, 2024 and 2023, we determined that there was no impairment of goodwill. We review the carrying values of other identifiable intangible assets if the facts and circumstances indicate a possible impairment. Any future impairment could have a material adverse effect on our financial condition or results of operations.
These contingencies may have a material effect on our liquidity, capital resources or results of operations. In addition, even where our accruals are adequate, the incurrence of any of these liabilities may have a material effect on our liquidity and the amount of cash available to us for other purposes.
In addition, even where our accruals are adequate, the incurrence of any of these liabilities may have a material effect on our liquidity and the amount of cash available to us for other purposes. We believe that we have made appropriate arrangements in respect of the future effect on us of these known contingencies.
IQVIA’s portfolio of solutions are powered by IQVIA Connected Intelligence™ to deliver actionable insights and services built on high-quality health data, Healthcare-grade AI™, advanced analytics, the latest technologies and extensive domain expertise. We are committed to using AI responsibly, ensuring that our AI-powered capabilities are grounded in privacy, regulatory compliance, and patient safety.
IQVIA’s portfolio of solutions are powered by IQVIA Connected Intelligence™ to deliver actionable insights and services built on high-quality health data, Healthcare-grade AI ® , advanced analytics, the latest technologies and extensive domain expertise.
This increase included a constant currency increase of approximately $52 million, or 5.9%, reflecting an increase in compensation and related expenses.
This increase included a constant currency increase of approximately $59 million, or 9.7%, reflecting primarily an increase in compensation and related expenses and to a lesser extent in reimbursed expenses.
This increase was comprised of constant currency revenue growth of approximately $167 million, or 2.0%, reflecting revenue growth in the Asia-Pacific and Europe and Africa regions. The constant currency revenue growth was primarily the result of volume-related increases in clinical services and to a lesser extent from volume-related increases in lab testing.
This increase included constant currency revenue growth of approximately $59 million, or 8.2%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Asia-Pacific region. The constant currency revenue growth was primarily due to volume-related increases in services performed.
This increase included a constant currency increase of approximately $261 million, or 7.5%, reflecting primarily an increase in compensation and related expenses, and to a lesser extent increases in reimbursed expenses and costs of acquiring and processing data, all to support revenue growth. 54 Selling, General and Administrative Expenses 2024 compared to 2023 Technology & Analytics Solutions’ selling, general and administrative expenses increased $41 million, or 4.7%, in 2024 as compared to 2023.
This increase included a constant currency increase of approximately $315 million, or 8.5%, reflecting primarily an increase in compensation and related expenses, and to a lesser extent increases in reimbursed expenses and costs of acquiring and processing data, all to support revenue growth.
This decrease included constant currency revenue growth of approximately $10 million, or 1.4%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Asia-Pacific region.
This increase was comprised of constant currency revenue growth of approximately $380 million, or 6.2%, reflecting revenue growth primarily in the Americas and Europe and Africa regions, and to a lesser extent in the Asia-Pacific region.
This increase included a constant currency increase of approximately $643 million, or 6.6%, comprised of a $261 million increase in Technology & Analytics Solutions, a $374 million increase in Research & Development Solutions, and an $8 million increase in Contract Sales & Medical Solutions.
This increase included a constant currency increase of approximately $790 million, or 7.9%, comprised of a $315 million increase in Technology & Analytics Solutions, a $416 million increase in Research & Development Solutions, and a $59 million increase in Contract Sales & Medical Solutions.
Equity in Earnings (Losses) of Unconsolidated Affiliates Year Ended December 31, (in millions) 2024 2023 2022 Equity in earnings (losses) of unconsolidated affiliates $ 5 $ — $ (12) Equity in earnings (losses) of unconsolidated affiliates increased in 2024 compared to 2023 due to the results in the operations of our unconsolidated affiliates. 53 Segment Results of Operations Revenues and profit by segment are as follows: Segment Revenues Segment Profit (in millions) 2024 2023 2022 2024 2023 2022 Technology & Analytics Solutions $ 6,160 $ 5,862 $ 5,746 $ 1,522 $ 1,490 $ 1,550 Research & Development Solutions 8,527 8,395 7,921 1,948 1,915 1,695 Contract Sales & Medical Solutions 718 727 743 47 49 42 Total 15,405 14,984 14,410 3,517 3,454 3,287 General corporate and unallocated expenses (134) (268) (330) Depreciation and amortization (1,114) (1,125) (1,130) Restructuring costs (67) (84) (28) Consolidated $ 15,405 $ 14,984 $ 14,410 $ 2,202 $ 1,977 $ 1,799 Certain costs are not allocated to our segments and are reported as general corporate and unallocated expenses.
Segment Results of Operations Revenues and profit by segment are as follows: Segment Revenues Segment Profit (in millions) 2025 2024 2023 2025 2024 2023 Technology & Analytics Solutions $ 6,626 $ 6,160 $ 5,862 $ 1,595 $ 1,522 $ 1,490 Research & Development Solutions 8,896 8,527 8,395 1,873 1,948 1,915 Contract Sales & Medical Solutions 788 718 727 48 47 49 Total 16,310 15,405 14,984 3,516 3,517 3,454 General corporate and unallocated expenses (85) (134) (268) Depreciation and amortization (1,144) (1,114) (1,125) Restructuring costs (105) (67) (84) Consolidated $ 16,310 $ 15,405 $ 14,984 $ 2,182 $ 2,202 $ 1,977 Certain costs are not allocated to our segments and are reported as general corporate and unallocated expenses.
Our long-term debt arrangements contain customary restrictive covenants and, as of December 31, 2024, we believe we were in compliance with our restrictive covenants in all material respects. 57 Senior Secured Credit Facilities As of December 31, 2024, the Fifth Amended and Restated Credit Agreement (the " Credit Agreement") provided financing through several senior secured credit facilities (collectively, the “senior secured credit facilities”) of up to approximately $6,585 million, which consisted of $5,415 million principal amounts of debt outstanding and $1,170 million of available borrowing capacity on the revolving credit facility and standby letters of credit, with a total capacity of $2,000 million.
As of December 31, 2025, the Credit Agreement provided financing through several senior secured credit facilities (collectively, the “senior secured credit facilities”) of up to approximately $6,412 million, which consisted of $5,217 million principal amounts of debt outstanding and $1,195 million of available borrowing capacity on the revolving credit facility and standby letters of credit, with a total capacity of $2,000 million.
Cash Flow from Financing Activities Year Ended December 31, (in millions) 2024 2023 2022 Net cash used in financing activities $ (878) $ (382) $ (329) 2024 compared to 2023 Cash used in financing activities increased $496 million in 2024 as compared to 2023, primarily due to less cash provided by proceeds from debt issuances, net of payment of debt issuance costs ($3,951 million), more cash used to repurchase common stock ($358 million), and more cash payments related to employee stock option plans ($3 million), offset by less debt payments ($2,701 million), less cash used in repayments of revolving credit facilities, net of proceeds ($1,050 million), and less cash payments on contingent consideration and deferred purchase price accruals ($65 million).
Cash Flow from Financing Activities Year Ended December 31, (in millions) 2025 2024 2023 Net cash used in financing activities $ (150) $ (878) $ (382) 2025 compared to 2024 Cash used in financing activities decreased $728 million in 2025 as compared to 2024, primarily due to more debt payments ($5,021 million), more cash used in repayments of revolving credit facilities, net of proceeds ($750 million), more cash payments on contingent consideration and deferred purchase price accruals ($17 million), more cash used for other financing activities ($11 million), and more cash payments related to employee stock option plans ($3 million), offset by more cash provided by proceeds from debt issuances, net of payment of debt issuance costs ($6,424 million), and less cash used to repurchase common stock ($106 million). 59 Contingencies We are exposed to certain known contingencies that are material to our investors.
These transactions were accounted for as business combinations and the acquired results of operations are included in our consolidated financial information since their respective closing dates. See Note 14 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K for additional information with respect to these business combinations.
These transactions were accounted for as business combinations and the acquired results of operations are included in our consolidated financial information since their respective closing dates.
As of December 31, 2024, COVID-19 related work did not represent a material amount of our remaining performance obligations. We continue to maintain strong liquidity. As of December 31, 2024, cash and cash equivalents were $1,702 million and we had $825 million drawn under our $2,000 million revolving credit facility.
We continue to maintain strong liquidity. As of December 31, 2025, cash and cash equivalents were $1,980 million and we had $800 million drawn under our $2,000 million revolving credit facility.
Receivables Financing Facility For information regarding the receivables financing facility, see Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. As of December 31, 2024, no additional amounts of revolving loan commitments were available under the receivables financing facility.
For information regarding the senior secured notes and senior notes, see Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K. 58 Receivables Financing Facility For information regarding the receivables financing facility, see Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K.
Other (income) expense, net Year Ended December 31, (in millions) 2024 2023 2022 Other (income) expense, net $ (90) $ (124) $ 33 Other (income) expense, net for 2024 decreased compared to 2023 primarily due to less foreign currency gain on transactions.
Other Income, Net Year Ended December 31, (in millions) 2025 2024 2023 Other income, net $ (99) $ (90) $ (124) Other income, net for 2025 increased compared to 2024 primarily due to fair value related adjustments on investments offset by losses on foreign currency transactions.
This increase included a constant currency increase of approximately $374 million, or 6.6%, reflecting primarily an increase in compensation and related expenses and to a lesser extent an increase in other direct costs because of volume-related increases in clinical services and lab testing. 55 Selling, General and Administrative Expenses 2024 compared to 2023 Research & Development Solutions’ selling, general and administrative expenses increased $30 million, or 3.5%, in 2024 as compared to 2023.
Selling, General and Administrative Expenses 2025 compared to 2024 Research & Development Solutions’ selling, general and administrative expenses increased $18 million, or 2.0%, in 2025 as compared to 2024. This increase included a constant currency increase of approximately $18 million, or 2.0%, reflecting primarily an increase in compensation and related expenses.
The increase in 2024 as compared to 2023 is primarily a result of higher deposit rates. Interest expense during 2024 was lower than 2023 due primarily to lower base rate interest costs across the floating rate debt portfolio.
The decrease in 2025 as compared to 2024 is primarily a result of lower deposit rates. Interest expense during 2025 increased compared to 2024 as a result of higher outstanding debt balances.
The increase is primarily due to an increase in cash from accounts receivable and unbilled services ($570 million), an increase in cash-related net income ($129 million), more cash from unearned income ($38 million), and less cash used for income tax and other payables ($9 million), offset by more cash used for accounts payable and accrued expenses ($152 million) and more cash used for prepaid expenses and other assets ($27 million). 58 Cash Flow from Investing Activities Year Ended December 31, (in millions) 2024 2023 2022 Net cash used in investing activities $ (1,444) $ (1,603) $ (2,006) 2024 compared to 2023 Cash used in investing activities decreased $159 million in 2024 as compared to 2023, primarily due to less cash used for the acquisition of businesses, net of cash acquired ($141 million), less cash used for the acquisition of property, equipment, and software ($47 million), less cash used for investments in debt and equity securities ($36 million), less cash used for purchases of marketable securities ($6 million), and cash received from sale of property, equipment and software ($25 million), offset by more cash used for investments in unconsolidated affiliates, net ($93 million), and less cash from other sources ($3 million).
Cash Flow from Investing Activities Year Ended December 31, (in millions) 2025 2024 2023 Net cash used in investing activities $ (2,305) $ (1,444) $ (1,603) 2025 compared to 2024 Cash used in investing activities increased $861 million in 2025 as compared to 2024, primarily due to more cash used for the acquisition of businesses, net of cash acquired ($979 million), more cash used for investments in debt and equity securities ($18 million), more cash used for other investing activities ($3 million), and more cash used for the acquisition of property, equipment, and software ($1 million), offset by less cash used for investments in unconsolidated affiliates, net ($88 million), more cash received from sale of property, equipment and software ($50 million), and cash from marketable securities ($2 million).
Sources of Revenues Total revenues are comprised of revenues from the provision of our services. We do not have any material product revenues. 50 Costs and Expenses Our costs and expenses are comprised primarily of our cost of revenues including reimbursed expenses and selling, general and administrative expenses.
Costs and Expenses Our costs and expenses are comprised primarily of our cost of revenues including reimbursed expenses and selling, general and administrative expenses.
This increase included a constant currency increase of approximately $42 million, or 4.9%, reflecting an increase in compensation and related expenses.
This increase included a constant currency increase of approximately $416 million, or 7.3%, reflecting increases in reimbursed expenses, as well as compensation and related expenses, as a result of volume-related increases in clinical services.
This increase included a constant currency increase of approximately $2 million, or 3.4%. 56 Liquidity and Capital Resources Overview We assess our liquidity in terms of our ability to generate cash to fund our operating, investing and financing activities. Our principal source of liquidity is operating cash flows.
Selling, General and Administrative Expenses 2025 compared to 2024 Contract Sales & Medical Solutions’ selling, general and administrative expenses in 2025 remained consistent with 2024. 56 Liquidity and Capital Resources Overview We assess our liquidity in terms of our ability to generate cash to fund our operating, investing and financing activities. Our principal source of liquidity is operating cash flows.
The constant currency revenue growth for the year was impacted by a decrease in COVID-19 related work. Cost of Revenues, exclusive of Depreciation and Amortization 2024 compared to 2023 Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $225 million, or 6.4%, in 2024 as compared to 2023.
The constant currency revenue growth was primarily driven by an increase in Real-World services, as well as information and technology services. 54 Cost of Revenues, exclusive of Depreciation and Amortization 2025 compared to 2024 Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $355 million, or 9.5%, in 2025 as compared to 2024.
Contract Sales & Medical Solutions provides health care provider (including contract sales) and patient engagement services to both biopharmaceutical clients and the broader healthcare market.
Contract Sales & Medical Solutions provides health care provider (including contract sales) and patient engagement services to both biopharmaceutical clients and the broader healthcare market. Effective January 1, 2026, we will be updating our segment reporting to align with industry evolution, our updated operating model, and how internal reporting will be provided to the chief operating decision maker.
Income Tax Expense Year Ended December 31, (dollars in millions) 2024 2023 2022 Income tax expense $ 301 $ 101 $ 260 Effective income tax rate 18.0 % 6.9 % 19.1 % Our effective income tax rate was favorably impacted in 2023, due to the completion of an internal legal entity restructuring that resulted in a benefit of $125 million.
Income Tax Expense Year Ended December 31, (dollars in millions) 2025 2024 2023 Income tax expense $ 252 $ 301 $ 101 Effective income tax rate 15.8 % 18.0 % 6.9 % Our effective income tax rate for 2025 was favorably impacted due to changes in the geographic mix of earnings amongst the United States and foreign tax jurisdictions, compared to our effective income tax rate for 2024.
Selling, General and Administrative Expenses 2024 compared to 2023 Contract Sales & Medical Solutions’ selling, general and administrative expenses increased $2 million, or 3.4%, in 2024 as compared to 2023.
Cost of Revenues, exclusive of Depreciation and Amortization 2025 compared to 2024 Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $69 million, or 11.3%, in 2025 as compared to 2024.
This increase was comprised of constant currency revenue growth of approximately $333 million, or 5.7%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Americas region. The constant currency revenue growth was primarily driven by an increase in real world services and to a lesser extent by information and technology services.
This increase was comprised of constant currency revenue growth of approximately $298 million, or 3.5%, reflecting revenue growth in the Americas and Asia-Pacific regions. The constant currency revenue growth was primarily the result of volume-related increases in clinical services.
The revolving credit facility under the Credit Agreement matures in August 2026, the term A loans mature in August 2026 and June 2027, while the term B loans under the Credit Agreement mature in 2025 and 2031.
The revolving credit facility is comprised of a $2,000 million senior secured revolving facility available in U.S. dollars. The revolving credit facility under the Credit Agreement matures in December 2030, the term A loans mature in December 2030, while the term B loans under the Credit Agreement mature in 2031.
For a description of our service offerings within our segments, refer to Part I, Item 1, “Business.” We delivered another year of strong operating results in 2024 with our income from operations increasing over 11 percent and our cash flow from operating activities increasing over 26 percent from 2023.
For a description of our service offerings within our segments, refer to Part I, Item 1, “Business.” We delivered solid results in 2025, navigating a year of industry uncertainty resulting from a variety of macroeconomic factors that together slowed customer decision-making. Our Technology & Analytics Solutions business continued its growth trajectory, with revenue increasing 7.6% over 2024.
Cost of Revenues, exclusive of Depreciation and Amortization 2024 compared to 2023 Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, decreased $9 million, or 1.5%, in 2024 as compared to 2023. This decrease included a constant currency increase of approximately $8 million, or 1.3%, reflecting primarily an increase in costs associated with supporting revenue growth.
Selling, General and Administrative Expenses 2025 compared to 2024 Technology & Analytics Solutions’ selling, general and administrative expenses increased $38 million, or 4.1%, in 2025 as compared to 2024. This increase included a constant currency increase of approximately $26 million, or 2.8%, reflecting an increase in compensation and related expenses, as well as IT-related expenses.
Removed
Our Technology & Analytics Solutions segment revenues and profit growth improved in the second half of the year as we captured opportunities relating to our clients increasing their spending. Our Research & Development Solutions segment also produced revenues and segment profit growth in 2024.
Added
We are committed to using artificial intelligence ("AI") responsibly, with AI-powered capabilities built on best-in-class approaches to privacy, regulatory compliance and patient safety, and delivering AI to the high standards of trust, scalability and precision demanded by the industry.
Removed
Although we faced some challenges in our Research & Development Solutions segment in the latter half of 2024, and while we anticipate some of these challenges will persist into 2025, we consider these to be more short-term in nature. This segment overall is a long-cycle business.
Added
As a result, the Contract Sales & Medical Solutions segment, which has become more closely related operationally to the Technology & Analytics Solutions segment commercial offerings, will be incorporated into the Technology & Analytics Solutions segment, which is renamed Commercial Solutions.
Removed
We ended the year with our highest ever total company remaining performance obligations of approximately $33.5 billion as of December 31, 2024. While we experienced a decline in COVID-19 related work in 2024 versus 2023, overall COVID-19 related work was not material to operations.
Added
Additionally, Real-World Late Phase and certain other Real-World offerings that have become more closely related operationally to the clinical research business, will be moved from the Technology & Analytics Solutions segment to the Research & Development Solutions segment.
Removed
As a percentage of revenues, cost of revenues, exclusive of depreciation and amortization in 2024 remained relatively consistent with 2023.
Added
We will reflect the recast of segment information on this basis beginning with our Form 10-Q for the three months ended March 31, 2026.
Removed
Historically, we recorded deferred tax assets related to certain foreign tax credits, and a full valuation allowance in relation to these foreign tax credits was established as it was not expected the credits would be utilized prior to expiration.

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Item 7A. Quantitative and Qualitative Disclosures About Market Risk

Market Risk — interest-rate, FX, commodity exposure

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Biggest changeWe do not enter into cross-currency swaps for investment or speculative purposes. The contractual value of our cross-currency swaps was approximately $2,735 million as of December 31, 2024. The fair value of these cross-currency swaps is subject to change as a result of potential changes in foreign exchange rates.
Biggest changeOn February 3, 2025, the Company terminated its existing cross-currency swap agreements and entered into new cross-currency swap agreements for the same purpose and with substantially similar terms as the previous swaps. We do not enter into cross-currency swaps for investment or speculative purposes. The contractual value of our cross-currency swaps was approximately $2,720 million as of December 31, 2025.
Excluding debt covered by hedges, each quarter-point increase or decrease in the interest rate on our variable rate debt would result in our interest expense changing by approximately $9 million per year. Marketable Securities As of December 31, 2024, we held investments in marketable equity securities.
Excluding debt covered by hedges, each quarter-point increase or decrease in the interest rate on our variable rate debt would result in our interest expense changing by approximately $11 million per year. Marketable Securities As of December 31, 2025, we held investments in marketable equity securities.
The principal currency hedged in 2024 with foreign currency forward contracts was the British Pound. The contractual value of our foreign exchange forward contracts was approximately $108 million as of December 31, 2024. The fair value of these contracts is subject to change as a result of potential changes in foreign exchange rates.
The principal currency hedged in 2025 with foreign currency forward contracts was the British Pound. The contractual value of our foreign exchange forward contracts was approximately $127 million as of December 31, 2025. The fair value of these contracts is subject to change as a result of potential changes in foreign exchange rates.
These investments are classified as either trading securities or available-for-sale securities and are recorded at fair value. These securities are subject to price risk. As of December 31, 2024, the fair value of these investments was $170 million based on the quoted market value of the securities.
These investments are classified as either trading securities or available-for-sale securities and are recorded at fair value. These securities are subject to price risk. As of December 31, 2025, the fair value of these investments was $203 million based on the quoted market value of the securities.
The potential gain in fair value for foreign exchange forward contracts based on a hypothetical 10% decrease in the value of the United States dollar was $11 million as of December 31, 2024.
The potential gain in fair value for foreign exchange forward contracts based on a hypothetical 10% decrease in the value of the United States dollar was $13 million as of December 31, 2025.
The potential loss in fair value for cross-currency swaps based on a hypothetical 10% decrease in the value of the United States dollar was $300 million as of December 31, 2024.
The potential loss in fair value for cross-currency swaps based on a hypothetical 10% decrease in the value of the United States dollar was $339 million as of December 31, 2025.
The potential loss in fair value resulting from a hypothetical decrease of 10% in quoted market values was approximately $17 million as of December 31, 2024. 66
The potential loss in fair value resulting from a hypothetical decrease of 10% in quoted market values was approximately $20 million as of December 31, 2025. 66
Excluding the impacts from any outstanding or future hedging transactions, a hypothetical 10% change in average exchange rates used to translate all foreign currencies to the United States dollar would have impacted income before income taxes for 2024 by approximately $154 million.
Excluding the impacts from any outstanding or future hedging transactions, a hypothetical 10% change in average exchange rates used to translate all foreign currencies to the United States dollar would have impacted income from operations for 2025 by approximately $193 million.
We have continued to designate a portion of new issuances of foreign currency denominated debt as a hedge of our net investment in certain foreign subsidiaries. As of December 31, 2024, our total foreign currency denominated debt was €4,085 million ($4,244 million), with approximately 67% being designated as a hedge.
We have continued to designate a portion of new issuances of foreign currency denominated debt as a hedge of our net investment in certain foreign subsidiaries. As of December 31, 2025, our total foreign currency denominated debt was €3,128 million ($3,673 million), with approximately 94% being designated as a hedge.
However, this change in fair value would be offset by the change in value of the hedged portion of our net investment in foreign subsidiaries caused by the currency exchange rate fluctuation. 65 Commencing in 2016 we designated our foreign currency denominated debt as a hedge of our net investment in certain foreign subsidiaries to reduce the volatility in stockholders’ equity caused by changes in the Euro exchange rate with respect to the United States dollar.
Commencing in 2016 we designated our foreign currency denominated debt as a hedge of our net investment in certain foreign subsidiaries to reduce the volatility in stockholders’ equity caused by changes in the Euro exchange rate with respect to the United States dollar.
We assess our market risk based on changes in foreign exchange rates utilizing a sensitivity analysis. The sensitivity analysis measures the potential gain or loss in fair values based on a hypothetical 10% change in foreign currency exchange rates.
The fair value of these cross-currency swaps is subject to change as a result of potential changes in foreign exchange rates. We assess our market risk based on changes in foreign exchange rates utilizing a sensitivity analysis. The sensitivity analysis measures the potential gain or loss in fair values based on a hypothetical 10% change in foreign currency exchange rates.
Interest Rates Because we have variable rate debt, fluctuations in interest rates affect our business. We attempt to minimize interest rate risk and lower our overall borrowing costs through the utilization of derivative financial instruments, primarily interest rate swaps. We do not enter into interest rate swaps for investment or speculative purposes.
We attempt to minimize interest rate risk and lower our overall borrowing costs through the utilization of derivative financial instruments, primarily interest rate swaps. We do not enter into interest rate swaps for investment or speculative purposes. We have entered into interest rate swaps with financial institutions that have reset dates and critical terms that match the underlying debt.
A hypothetical 10% decrease in the value of the United States dollar would lead to a potential loss in fair value of $424 million. However, approximately 67% of this change in fair value would be offset by the change in value of the hedged portion of our net investment in foreign subsidiaries caused by the currency exchange rate fluctuation.
However, this change in fair value would be offset by the change in value of the hedged portion of our net investment in foreign subsidiaries caused by the currency exchange rate fluctuation.
As of December 31, 2024, we had approximately $5,965 million of variable rate indebtedness and interest rate swaps with a notional value of $2,485 million. Because we do not attempt to hedge all of our variable rate debt, we may incur higher interest costs for the portion of our variable rate debt that is not hedged.
Because we do not attempt to hedge all of our variable rate debt, we may incur higher interest costs for the portion of our variable rate debt that is not hedged.
We have entered into interest rate swaps with financial institutions that have reset dates and critical terms that match the underlying debt. Accordingly, any change in market value associated with the interest rate swaps is offset by the opposite market impact on the related debt.
Accordingly, any change in market value associated with the interest rate swaps is offset by the opposite market impact on the related debt. As of December 31, 2025, we had approximately $5,768 million of variable rate indebtedness and interest rate swaps with a notional value of $1,470 million.
Added
A hypothetical 10% decrease in the value of the United States dollar would lead to a potential loss in fair value of $367 million.
Added
However, approximately 94% of this change in fair value would be offset by the change in value of the hedged portion of our net investment in foreign subsidiaries caused by the currency exchange rate fluctuation. 65 Interest Rates Because we have variable rate debt, fluctuations in interest rates affect our business.