IQVIA Raises Full-Year 2026 Outlook After Record Quarter

The Tip Desk · October 30, 2026 · 3 min read

Third-quarter revenue reached $4,428 million, up 8.0% year-over-year, as the company lifted full-year revenue, Adjusted EBITDA and adjusted EPS.

IQVIA Holdings Inc. (IQV) reported third-quarter revenue of $4,428 million, up 8.0% year-over-year and 8.6% at constant currency, and raised its full-year 2026 outlook for revenue, Adjusted EBITDA and adjusted diluted earnings per share.

The global provider of clinical research services, commercial insights and healthcare intelligence said revenue, Adjusted EBITDA and Adjusted Diluted EPS all exceeded the high end of its expectations. Chairman and CEO Ari Bousbib said demand indicators including EBP funding, RFP flow, clinical trial starts, FDA approvals and outsourcing trends remained favorable, and that the company’s execution produced margin expansion, higher win rates and its strongest clinical quarterly bookings since 2022.

Commercial Solutions revenue was $1,789 million, up 6.9% year-over-year and 7.9% at constant currency. Research & Development Solutions revenue was $2,639 million, up 8.7% year-over-year and 9.1% at constant currency. Excluding reimbursed expenses, R&DS revenue grew 6.8% on a reported basis.

R&D Solutions net new bookings were $3.2 billion, up 15% year-over-year, for a book-to-bill ratio of 1.2x. Last-twelve-month net new bookings were $11.7 billion, up 14% year-over-year. A detailed review of inactive trials in backlog estimates produced an adjustment of approximately $2.1 billion. The company said the adjustment had no impact on historical results, 2026 guidance, book-to-bill, or next-twelve-month revenue from backlog estimates. As of September 30, 2026, R&DS contracted backlog was $32.6 billion. IQVIA expects approximately $9.4 billion of that backlog to convert to revenue in the next twelve months, representing growth of 10% year-over-year.

GAAP net income was $350 million, or $2.10 a share. Adjusted EBITDA was $1,032 million, up 8.7% year-over-year. Adjusted net income was $557 million and adjusted diluted EPS was $3.34, up 11.3% year-over-year.

Operating cash flow was $825 million and free cash flow was $667 million, representing 120% of adjusted net income. Cash and cash equivalents were $2,249 million and debt was $16,067 million, for net debt of $13,818 million and a net leverage ratio of 3.45x trailing twelve-month Adjusted EBITDA.

The company is raising full-year 2026 guidance for revenue to between $17,350 million and $17,500 million, Adjusted EBITDA to between $4,025 million and $4,055 million, and adjusted diluted EPS to between $12.90 and $13.00. Revenue guidance now anticipates 250 basis points of contribution from acquisitions, including deals the company expects to complete by year-end, and approximately 20 basis points of tailwind from foreign exchange. All financial guidance assumes foreign currency exchange rates as of October 26, 2026 remain in effect.

Effective January 1, 2026, IQVIA implemented a simplified organizational model and now reports in two segments, Commercial Solutions and R&DS, with prior periods recast. Bousbib said more than 400 AI agents have been deployed to date and that organic growth accelerated year-over-year to double the rate for commercial and nearly triple the rate for clinical.

IQVIA will host an Investor Day on December 1, 2026, with presentations from senior executives starting at 9:00 a.m. ET.