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IQVIA reported record first-quarter revenue and adjusted diluted earnings per share for 2026, citing accelerating organic growth across its Commercial Solutions and R&D Solutions businesses. Management attributed the momentum to increased demand tied to artificial intelligence offerings and continued strength in forward-looking clinical development metrics.
Chairman and Chief Executive Officer Ari Bousbib said the company’s first-quarter revenue and adjusted diluted EPS exceeded the high end of guidance, reflecting “solid top and bottom-line performance.” He said organic revenue growth doubled year over year in Commercial Solutions and tripled in R&D Solutions.
Total first-quarter revenue was $4.151 billion, up 8.4% on a reported basis and 6.0% at constant currency. Adjusted EBITDA increased 5.5% to $932 million. GAAP net income was $274 million, or $1.61 per diluted share, while adjusted net income was $492 million. Adjusted diluted EPS was $2.90, up 7.4% year over year.
Commercial Solutions revenue was $1.754 billion in the quarter, up 11.6% on a reported basis and 8.5% at constant currency. Bousbib said organic growth in the segment was 5%, compared with about 2.5% in the prior-year period.
Management attributed the improvement to continued product launches by clients, increased use of IQVIA services, and strength in areas including Patient Solutions, analytics and consulting, and commercial engagement services. Bousbib said analytics and consulting posted its highest growth in three years.
He also linked demand to AI, saying: “AI is causing our clients to have more questions,” and that the technology is increasing demand for IQVIA’s AI capabilities and innovation embedded across its commercial offerings.
Management highlighted commercial wins during the quarter, including an agreement with Pfizer covering selected products across 23 countries in Europe, and a long-term collaboration with Boehringer Ingelheim to transform its global commercial intelligence foundation using IQVIA’s Data-as-a-Service platform. IQVIA also won agreements to modernize performance reporting for a top 10 pharma client and provide patient information and analytics services across an emerging biopharma company’s portfolio.
R&D Solutions revenue was $2.397 billion, up 6.2% on a reported basis and 4.2% at constant currency. Bousbib said the segment’s organic growth was 3%, compared with 1% a year earlier.
R&D Solutions net new bookings totaled $2.5 billion, representing double-digit year-over-year growth on the company’s recast basis. Backlog reached a record $34.2 billion at March 31, up mid-single digits year over year. Expected revenue from backlog over the next 12 months was $8.9 billion, up high single digits on a recast basis.
Bousbib said the company’s first-quarter book-to-bill ratio of 1.04 was affected by unusually low pass-through bookings due to the mix of clinical trials booked in the quarter. He said cancellations were within the normal range and that service fee bookings grew solidly year over year and sequentially.
During the question-and-answer session, Bousbib said pass-throughs are not relevant to profitability, noting that pass-through costs have “zero profitability drop-through.” He said the quarter’s pass-through level was about one-third lower than the historical average, but that the mix did not indicate a change in customer behavior or future margins.
Management said RFP flow grew high single digits year over year, driven by large pharma and emerging biopharma clients. The qualified pipeline grew mid-single digits, with notable strength in emerging biopharma. Bousbib also cited BioWorld data showing first-quarter emerging biopharma funding reached $25 billion, almost double the year-earlier level.
Executives emphasized IQVIA’s use of AI across commercial and clinical workflows. Bousbib said IQVIA has been integrating AI into its operations and solutions “at scale for nearly a decade” and described the company as “AI-native” in life sciences.
The company recently unveiled IQVIA.ai at NVIDIA’s GTC conference. Bousbib described it as an agentic AI portal and marketplace built for life sciences, designed to give clients a single access point to purchased IQVIA AI solutions and visibility into a broader portfolio.
Bousbib said IQVIA has deployed 192 AI agents covering 64 use cases across Commercial Solutions and R&D Solutions. He added that 19 of the top 20 pharmaceutical companies are already using IQVIA agents in some workflows.
In R&D Solutions, Bousbib said AI is being used to optimize trial design and execution, including protocol optimization, site identification, operational risk mitigation, database setup, and trial master file document tasks, with the goal of accelerating study execution and reducing errors and rework.
Clinical wins cited on the call included AI-enabled global medical safety and pharmacovigilance services for a top five pharma company, a multi-year full-service global clinical trials agreement with a top 10 pharma client, and a phase III oncology study for a global mid-sized pharma company.
IQVIA reaffirmed its full-year 2026 revenue and adjusted EBITDA guidance and raised its adjusted diluted EPS outlook. The company continues to expect revenue of $17.15 billion to $17.35 billion, representing growth of 5.2% to 6.4%. Fedock said the guidance assumes about 150 basis points of contribution from acquisitions and about 100 basis points of foreign exchange tailwind.
Adjusted EBITDA is still expected to range from $3.975 billion to $4.025 billion, implying year-over-year growth of 4.9% to 6.3%. IQVIA raised its adjusted diluted EPS guidance to $12.65 to $12.95, representing growth of 6.1% to 8.6%.
For the second quarter, IQVIA expects revenue of $4.28 billion to $4.34 billion, adjusted EBITDA of $955 million to $975 million, and adjusted diluted EPS of $2.98 to $3.08.
Fedock said first-quarter operating cash flow was $618 million and capital expenditures were $127 million, resulting in free cash flow of $491 million. Free cash flow was equal to 100% of adjusted net income and was up 15% year over year. The company repurchased $552 million of shares during the quarter and had approximately $1.2 billion remaining under its repurchase authorization.
In the analyst Q&A, Bousbib said the demand environment has stabilized after several years of industry headwinds, including post-COVID budget pressure and policy uncertainty. He said large pharma clients remain more deliberate in capital deployment than before the disruption, but the environment is “much improved” from the prior year.
Bousbib also pushed back on concerns that AI could reduce demand for IQVIA’s services, saying the company has not lost any trials to AI tools and that AI is creating new opportunities, particularly in commercial analytics and consulting. He said large pharma clients are using AI in discovery to identify more targets, which could increase the number of assets entering development over time.
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