IQVIA raises 2026 guidance as third-quarter revenue rises 8% to $4.43 billion

IQVIA Holdings Inc. (IQV) reported third-quarter 2026 revenue of $4,428 million, up 8.0% from a year earlier, and raised its full-year 2026 guidance.

The company released the results Tuesday in a press release attached to a regulatory filing. The quarter ended Sept. 30.

Third-quarter results

Here's how the company did:

• Revenue: $4,428 million vs. $4,100 million a year earlier
• Diluted earnings per share: $2.10 vs. $1.93 a year earlier
• Adjusted diluted earnings per share: $3.34 vs. $3.00 a year earlier
• Net income attributable to IQVIA Holdings Inc.: $350 million vs. $331 million a year earlier
• Adjusted EBITDA, or earnings before interest, taxes, depreciation and amortization adjusted for certain items: $1,032 million vs. $949 million a year earlier

Revenue grew 8.0% on a reported basis and 8.6% at constant currency, which strips out currency movements.

Adjusted EBITDA rose 8.7% from a year earlier, and Adjusted Net Income was $557 million, up from $515 million.

Restructuring costs were $36 million, up from $20 million a year earlier.

“IQVIA delivered another record quarter, with revenue, Adjusted EBITDA and Adjusted Diluted EPS all exceeding the high end of our expectations,” said Ari Bousbib, chairman and CEO of IQVIA.

Bousbib cited “strongest clinical quarterly bookings since 2022” and “over 400 AI agents deployed to date.”

Segments and bookings

Commercial Solutions revenue was $1,789 million, up 6.9% on a reported basis and 7.9% at constant currency.

Research & Development Solutions revenue was $2,639 million, up 8.7% on a reported basis and 9.1% at constant currency. Excluding reimbursed expenses, that segment's revenue grew 6.8% on a reported basis.

The company reports in two segments, Commercial Solutions and Research & Development Solutions (R&DS), after a reorganization effective Jan. 1, 2026. Prior-period segment amounts were recast to match.

Net new bookings were $3.2 billion in the quarter, up 15% from a year earlier, for a book-to-bill ratio of 1.2x. Last-twelve-month net new bookings were $11.7 billion, up 14%.

Backlog

The company reviewed inactive trials in its backlog estimates, resulting in an adjustment to backlog of approximately $2.1 billion. The company said the adjustment has no impact on historical financial results, 2026 guidance, book-to-bill, or next-twelve-month revenue from backlog estimates.

R&DS contracted backlog was $32.6 billion as of Sept. 30. The company expects about $9.4 billion of that backlog to convert to revenue in the next twelve months, growth of 10% year over year.

Cash flow and balance sheet

Operating cash flow was $825 million in the quarter, and free cash flow was $667 million, from $772 million a year earlier. Free cash flow represented 120% of Adjusted Net Income for the quarter.

As of Sept. 30, cash and cash equivalents were $2,249 million and debt was $16,067 million, for net debt of $13,818 million. The Net Leverage Ratio, or net debt divided by trailing twelve-month Adjusted EBITDA, was 3.45x.

For the first nine months, revenue was $12,947 million, up 8.4% on a reported basis, and the company repurchased $950 million of common stock.

Full-year 2026 guidance

The company raised its full-year 2026 guidance for revenue to between $17,350 million and $17,500 million. Adjusted EBITDA guidance is $4,025 million to $4,055 million, and Adjusted diluted EPS guidance is $12.90 to $13.00.

The filing does not give the prior ranges, so the size of each raise is not stated.

Revenue guidance includes 250 basis points of contribution from acquisitions, including deals the company expects to complete by year-end, and about 20 basis points of tailwind from foreign exchange.

All guidance assumes currency rates as of Oct. 26, 2026 remain in effect for the forecast period.

Investor Day

IQVIA will hold an Investor Day on Tuesday, Dec. 1, 2026. Presentations from senior executives start at 9:00 a.m. ET and conclude at about 12:30 p.m. ET. Registration is required.