IQVIA Q1 2023 Earnings Call Transcript

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Provided by Quartr
April 27, 2023

Key Takeaways

  • IQVIA delivered 11% organic revenue growth in Q1 2023 (ex-FX and COVID), with $3.65 B in revenue, record $2.6 B net new bookings, and a 10.1% YoY increase in its $27.9 B backlog.
  • R&D Solutions saw 17% organic growth (constant currency, ex-COVID), driven by strong Clinical FSP and full-service wins, including a major oncology bispecific antibody partnership and a 1.28 book-to-bill ratio.
  • Technology & Analytics Solutions grew 6% organically (constant currency, ex-COVID) despite client caution on short-cycle analytics and consulting projects, which management expects to accelerate in H2 2023.
  • Operational improvements—attrition back to pre-pandemic levels, double-digit site selection growth, and rollout of cloud-based clinical tech—boosted site productivity and mitigated site labor shortages.
  • Full-year guidance was reaffirmed: 9–11% organic revenue growth (ex-COVID), 8.3–10.4% adjusted EBITDA growth, and 11–14% adjusted EPS growth (ex non-operational impacts), with Q2 targets of $3.68–$3.75 B revenue and $2.30–$2.44 EPS.
AI Generated. May Contain Errors.
Earnings Conference Call
IQVIA Q1 2023
00:00 / 00:00

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Operator

Ladies and gentlemen, thank you for standing by. At this time, I would like to welcome everyone to the IQVIA First Quarter 2023 Earnings Conference Call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you would like to ask a question during this time, simply press star followed by the number one on your telephone keypad. If you would like to withdraw your question, press the pound key. As a reminder, this call is being recorded. Thank you. I would now like to turn the call over to Nick Childs, Senior Vice President, Investor Relations and Treasury. Mr. Childs, please begin your conference.

Nick Childs
Nick Childs
SVP, Investor Relations and Treasury. at IQVIA

Thank you, Mike, good morning, everyone. Thank you for joining our first quarter 2023 earnings call. With me today are Ari Bousbib, Chairman and Chief Executive Officer. Ron Bruehlman, Executive Vice President and Chief Financial Officer. Eric Sherbet, Executive Vice President and General Counsel. Mike Fedock, Senior Vice President, Financial Planning and Analysis. Gustavo Perrone, Senior Director, Investor Relations. Today, we will be referencing a presentation that will be visible during this call for those of you on our webcast. This presentation will also be available following this call in the Events and Presentation section of our IQVIA Investor Relations website at ir.iqvia.com. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements.

Nick Childs
Nick Childs
SVP, Investor Relations and Treasury. at IQVIA

Actual results could differ materially from those stated or implied by forward-looking statements due to risks and uncertainties associated with the company's business, which are discussed in the company's filings with the Securities and Exchange Commission, including our annual report on Form 10-K and subsequent SEC filings. We will discuss certain Non-GAAP financial measures on this call, which should be considered a supplement to and not a substitute for financial measures prepared in accordance with GAAP. A reconciliation of these Non-GAAP measures to the comparable GAAP measures is included in the press release and conference call presentation. I would now like to turn the call over to our Chairman and CEO.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Thank you very much, Nick. Good morning, everyone. Thank you for joining us today to discuss our first quarter results. This was another quarter where we delivered again on all our financial targets. Our revenue grew 11% organic, excluding the impact of foreign exchange and COVID-related work. The diversification of our short and long cycle businesses allowed us to perform well in the quarter despite the broader macroeconomic dynamics. The demand environment for our industry continues to be healthy. Global clinical trial activity remains resilient, and the prospects for our commercial business remain favorable. A few encouraging signs I'd like to share with you this morning. The 15 largest pharmaceutical companies together spent a record-setting $138 billion on research and development in 2022. According to BioWorld, the Q1 EBP funding was $15.6 billion.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

That was up double-digit versus prior year and up sequentially versus Q4. March was a particularly strong month for EBP funding, despite concerns about the impact from the banking crisis. FDA approvals are off to a strong start in 2023. There were 13 approvals in the first quarter. That's up from an average of nine over the prior five years. That's a positive indicator for our commercial business. There was a significant M&A activity in Q1, which primarily is large pharma acquiring smaller companies, and the industry expects 2023 M&A spend to be one of the largest years in the last decade. This highlights the ongoing demand for molecules by large pharma. Internally, our Q1 demand metrics show continued healthy growth. I'll share a couple with you this morning. Net new bookings were $2.6 billion. That represented a quarterly book-to-bill of 128.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

As a result, our backlog reached a new record and grew 10.1% versus prior year on a reported basis and 11.3% excluding the impact of foreign exchange. Our RFP flow set a new quarterly record. It was up sequentially 15% versus Q4 2022. Operationally, attrition levels have continued to decline, and they are now, in fact, back to pre-pandemic levels or slightly below that. Site selection was up double digits year-over-year. This increased productivity helped mitigate the unfavorable impact of the staff shortages at investigator sites that we spoke about in prior calls. R&DS organic revenue growth at constant currency, excluding COVID-related work, was 17% in the quarter. That was well above the upper end of our expectations. Within TAS, we continue to see some client cautiousness related to discretionary spending.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

TAS growth for the quarter was 6% organic at constant currency, excluding COVID-related work, and that was within our expectations, but towards the lower end. In summary, industry demand remains healthy despite some cautiousness in discretionary spending, mostly in the short cycle businesses. The diversification of our businesses allows us to balance the current slower short cycle growth with the resilience of our long cycle businesses, demonstrating that IQVIA is a company that can operate effectively under different macro environments. With that, as context, let me review the first quarter results. Revenue for the first quarter grew 2.4% on a reported basis, 4.7% at constant currency. Compared to last year, and excluding COVID-related work from both periods, we grew the top line as a company 11% at constant currency on an organic basis.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

First quarter adjusted EBITDA increased 4.8%, driven by revenue growth and ongoing cost management discipline. First quarter adjusted diluted EPS of $2.45 declined slightly, as expected, driven by the one-time step up in interest rates. Excluding interest expense and the U.K. tax rate headwinds that we discussed in a prior call, our adjusted diluted EPS growth exceeded 9%. I'd like to share a few highlights of business activity in the quarter. Within TAS, a top 10 pharma awarded IQVIA our first omnichannel marketing deal in the Asia Pacific region. IQVIA's omnichannel marketing program provides client teams with AI ML-powered insights and recommendations to deliver effective personalized digital engagements with HCPs. In the quarter, IQVIA won an award for our in-home patient services offering.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

This biotech client is launching a new MS treatment and selected IQVIA based on our ability to deliver testing and monitoring to the patient's home. These differentiated capabilities ease the burden for patients with limited mobility. Moving to the real-world part of our TAS business, IQVIA was awarded a major post-authorization safety study to assess the impact and outcomes of prescribing a certain asthma drug to pregnant women with severe asthma. We won this large contract with a top 10 pharma client due to the breadth of our capabilities, including our relevant experience in safety trials, our strong data and analytics capabilities, and increased delivery efficiency with faster patient enrollment. Also in the quarter, we were awarded a large global intervention study with a top 10 pharma to identify high-risk cardiovascular patients by measuring the prevalence of high-sensitivity C-reactive protein.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

This protein is produced by the liver in response to inflammation in the body. Elevated levels of this protein in the blood are associated with an increased risk of cardiovascular disease, including heart attack and stroke. IQVIA was selected based on our ability to connect lab and clinical capabilities with therapeutic and real-world expertise in a cost-efficient manner. This study will have a significant impact on the future management of cardiovascular patients. Moving to R&DS. Continued strong momentum with our $2.6 billion of net new bookings in the quarter, translating into a book-to-bill of 128 in the quarter, which brings our LTM book-to-bill to 135. A few highlights in the quarter. Oncology continues to be our largest therapeutic area, and in the quarter, a high-profile, cutting-edge biotech company entered into a strategic partnership with IQVIA. This is a big deal.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

In fact, we were already awarded our first trial, which is for a novel bispecific antibody with potential development opportunities across several tumor types. Bispecific antibodies are designed to bind two different target molecules simultaneously. This project will leverage our end-to-end clinical trial solution, including protocol design, specialized medical and regulatory expertise, biomarker development, and our integrated clinical operations, analytics, and technology. We really are the only company with the ability to bring together these capabilities, which in turn help the client optimize trial design and reduce time to market. Importantly, going forward, this partnership creates multiple opportunities within this client's large oncology portfolio. We continue to have strong success with our clinical FSP trials business, with several recent notable wins, including a significant preferred provider award with a major pharma.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

This was a competitive win against two incumbents. It further diversifies our portfolio of FSP clients and increases our share in that segment. We continue to deploy innovations in our clinical technology suite. Most recently, we introduced a new cloud-based platform within our research site network that will streamline document workflows and allow real-time collaboration among study teams. We already deployed this new technology to approximately 15% of IQVIA network sites across 28 countries, and we expect to deploy to 40% of our sites in the next 12 months. The goal of deploying this technology at the site is to increase site productivity, which frees up more time for site support, compliance reviews, and continuous monitoring of patient safety and study quality, all of which are very important, especially in an environment where we experience staff shortages at the site.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

A couple of nice accolades for our global IQVIA team. I am proud to share that our lab business received the prestigious Singaporean President's Certificate of Commendation, which is awarded to organizations that had a significant impact in the fight against COVID-19. Five of our employees in Singapore received the Public Service Medal Award for their outstanding contributions to manage the impact of the pandemic. This is a nice recognition of the unique role we play in supporting public health. Our Scotland-based lab business recently achieved a Global Green Lab certification for its commitment to practicing sustainable science. This certification is recognized by the United Nations, quote-unquote, "Race to Zero global campaign as the international gold standard for lab sustainability best practices towards a zero-carbon future." I will now turn it over to Ron for more details on our financial performance.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Thanks, Ari. Good morning, everyone. Let's start by reviewing revenue. First quarter revenue of $3.652 billion grew 2.4% on a reported basis and 4.7% at constant currency. In the quarter, COVID-related revenues were approximately $150 million, which was down about $230 million versus the first quarter of 2022. In our base business, that is excluding all COVID-related work from both this year and last, organic growth at constant currency was 11%. Technology & Analytics Solutions revenue was $1.444 billion, up 0.3% reported and 2.9% at constant currency. Excluding all COVID-related work, organic growth at constant currency in TAS was 6%.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

R&D Solutions revenue of $2.026 billion was up 4.8% reported and 6.5% at constant currency. Excluding all COVID-related work, organic growth at constant currency in R&DS was 17%. Finally, Contract Sales & Medical Solutions or CSMS revenue of $182 million declined 6.7% reported and 1% at constant currency. Excluding all COVID-related work, the organic growth decline at constant currency was also 1% in CSMS. Let's move down to P&L. Adjusted EBITDA was $851 million for the first quarter. That's growth of 4.8%. GAAP net income was $289 million, and GAAP diluted earnings per share was $1.53.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Adjusted net income was $462 million, and adjusted earnings per share diluted was $2.45. As Ari highlighted, R&D Solutions continues its strong momentum. This graph shows the growth of our backlog over the past three years, which demonstrates the sustained growth of our clinical business. Our backlog at March 31 stood at a record $27.9 billion, which was up over 40% over the last three years and growing 10% year-over-year. Reviewing the balance sheet. At March 31, cash and cash equivalents totaled $1.494 billion. Gross debt was $13.176 billion, and that resulted in net debt of $11.682 billion. Our net leverage ratio ended the quarter at 3.4 times trailing 12 month adjusted EBITDA.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

First quarter cash flow from operations was strong at $417 million, and CapEx was $164 million, resulting in free cash flow of $253 million. In the quarter, we repurchased $129 million of our shares. That leaves us with slightly over $1.2 billion remaining under the current program. Let's go now to guidance. Guidance for the full year 2023 remains unchanged. We continue to expect revenue, excluding COVID-related work, to grow organically at constant currency between 9% and 11%. This revenue guidance continues to assume about 100 basis points of contribution from acquisitions and approximately $600 million of COVID-related revenue step down versus 2022.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

We're also reaffirming our guidance on adjusted EBITDA of $3.625 billion-$3.695 billion. That represents year-over-year growth of 8.3%-10.4%. Lastly, we're reaffirming our guidance on Adjusted Diluted EPS of $10.26-$10.56. This Adjusted Diluted Earnings Per Share guidance includes a year-over-year impact of the step up in interest rates and the increase in the U.K. corporate tax rate. Together, these non-operational items impact the year-over-year growth rate by approximately 10 percentage points. Excluding these items, Adjusted Diluted Earnings Per Share is expected to grow 11%-14%. Let's move to our second quarter guidance.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

In Q2, we expect revenue to be between $3.675 billion and $3.75 billion. That's growth of 3.7%-5.8% on a constant currency basis, and 3.8%-5.9% on a reported basis. Adjusted EBITDA is expected to be between $850 million and $875 million, which would be up 6.3%-9.4%. Adjusted Diluted EPS is expected to be between $2.30 and $2.44, declining 5.7% to flat on a year-over-year basis.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Keep in mind that the second quarter is the toughest compare for interest expense because we had a very favorable $1 billion swap roll off on March 31, and it was also a year ago that rates started rising. Excluding the step-up of an interest expense and the increased U.K. tax rate, we expect Adjusted Diluted EPS to grow between 8% and 13% in the second quarter. All of our guidance assumes that foreign currency rates as of April 25 continue for the balance of the year. To summarize, Q1 was another solid quarter of financial performance. We delivered revenue growth of 11% organic, excluding the impact of foreign exchange and COVID-related work. Underlying demand in the industry and in our business remains healthy, with our RFPs accelerating in Q1, up 15% sequentially versus Q4 2022.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Quarterly net new bookings were $2.6 billion, Our industry-leading backlog reached a new record of $27.9 billion, representing growth of over 10% year-over-year. We've been navigating well through the choppy macro environment and delivering on our numbers. Despite some of the cautiousness we've observed in the short cycle discretionary spend, thanks to the resilience in the rest of the portfolio, which is mostly long cycle and thus less affected by macro turbulence. Therefore, we are reaffirming our full year guidance of 9%-11% organic revenue growth at constant currency excluding COVID-related work, and 11%-14% Adjusted EPS growth excluding non-operational items. With that, let me hand it back over to the operator for Q&A.

Operator

Thank you. At this time, I would like to remind everyone in order to ask a question, press star, then one on your telephone keypad. We request that you please limit yourself to just one question so that others in the queue may participate as well. We'll pause for a moment to compile the Q&A roster. Your first question comes from the line of Shlomo Rosenbaum at Stifel. Your line is open.

Shlomo Rosenbaum
Shlomo Rosenbaum
Managing Director, Equity Research at Stifel

Hi. Thank you very much for taking my questions. Ari, can you talk a little bit about the nature of the backlog burn? You had very strong bookings. You got strong book-to-bill. The amount of revenue or backlog to convert to revenue, it seems kind of consistent for this quarter to last quarter. Is there a change of mix over there? Is that a rounding item, or is there something else that might be going on over there?

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Thank you, Shlomo. Look, we had very strong bookings. It was one of our highest bookings quarter. There's I wouldn't read anything. It's not the first time, by the way, that Q1 next 12 months revenue from bookings is essentially flat to Q4 next 12 months bookings. I can't detect any seasonality to that, but it's not the first time it happened, so I wouldn't read anything into it at all. It's just a question of mix, you know, months of passthroughs that are, you know, taken into the quarter and/or delayed. You know, we're reverting to more regular mix of projects with, as you know, an increasing share in oncology, which typically burn a little slower.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

You know, that might have a little bit at the margins of an impact. I wouldn't read anything into it.

Shlomo Rosenbaum
Shlomo Rosenbaum
Managing Director, Equity Research at Stifel

Okay. Thank you.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Thanks, Shlomo.

Operator

Thank you. Your next question comes from the line of Anne Samuel at J.P. Morgan. Your line is open.

Anne Samuel
Anne Samuel
Executive Director, Equity Research at J.P. Morgan

Hi. Thank you so much for taking the question. I was hoping maybe you could speak to some of the dynamics within the TAS business. You know, in the fourth quarter, the analytics and consulting business was impacted, but some of that maybe seemed like it was unique to December purchasing patterns. How much of this is carryover from what you saw in the fourth quarter? You know, what's driving your confidence that it's gonna come back in the remainder of the year so that you can hit your guidance?

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah. Thank you, Anne. It's a good question. TAS growth in the first quarter was within the range we expected. You are correct that the guidance we gave on an organic constant currency ex-COVID basis-

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

For the year, I think our guidance is 7%-9%. Therefore 6% clearly is right under that. We did, you know, tell you that we did fully expect Q1 to be just under that. Our expectations were more in the 6%-7%, 6%-8% for the first quarter. We expected a slower start, as you suggest, due to the cautiousness we saw in December, in customers' discretionary spending. We assumed this was gonna spill over, as you suggest, into the Q1. That's why we assumed a slower start in the year for this business. The reason why it's a little lower than our long-term growth expectation is due to the analytics and consulting business piece of TAS.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

That is about, I wanna say, just under 25% of the total business in TAS. As we said many times before, it's the shortest cycle and contains the most discretionary spend activity of the entire TAS portfolio. What we are seeing is not cancellations of projects, not decisions to not conduct the projects. For the most part, these are projects that need to be done. You know, pricing and market access studies, as an example, have to be done at some point, but the discretionary aspect applies to timing for the most part, okay? No one does projects that they don't need to do. These are projects that need to be done, but they don't need to be done right this second. We are seeing customers delaying decisions and pushing things to the right.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

That is what gives us confidence that, in the latter part of the year, those projects would have to be done. That's why we maintain our 7%-9% organic constant currency ex-COVID guidance for the year. We expect that cautiousness to continue into the second quarter. We're assuming growth so far in line with the first quarter. Again, we're not seeing any customers walking away from projects or canceling anything. It's just consistent with what we saw at the end of Q4, delaying a project. We do expect the situation to improve in the second half because the pipelines are stronger, and the customers eventually need to actually spend on those projects.

Anne Samuel
Anne Samuel
Executive Director, Equity Research at J.P. Morgan

That's extremely helpful, Caller. Thank you so much.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Thank you.

Operator

Your next question comes from the line of David Windley at Jefferies. Your line is open.

David Windley
David Windley
Managing Director, Equity Research Analyst at Jefferies

Well, thanks for taking my question. Good morning. Ari, I wondered if you could talk in the R&DS business, as you highlight strong bookings, I guess seasonally different from the fourth quarter. The thing that we're seeing, I guess in our data review is that a lot of studies similar to what you're describing in TAS in consulting, that a lot of studies are kind of sitting in a limbo point and not moving forward into first patient in and kind of more productive revenue stages of the trial. I wondered if you have some insights into that and if, you know, any of your tools can help to move those forward, or is it kind of a funding and financial issue that is keeping them from moving forward? Be curious your views there.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Okay. Well, David, good morning, and thanks for the question. I wanna use the opportunity to state as clearly and definitively as I can. We simply are not, I repeat, we are not seeing any of what you suggest. No one is. First of all, on the funding question, I don't know how many times I'm going to repeat it. I've been doing this for five quarters in a row. We are not seeing any funding issues. In my introductory remarks, I share some of the statistics. They actually, everything is up on the funding front. We are not seeing any delays, any unusual cancellations, any postponing of decision-making within our portfolio. It could be that others are seeing that. We just are not seeing it. Once again, the overall RFP flow is at a record high.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

It's up 15% sequentially versus Q4 of 2022. Both the mid and the EBP segments are up strong double digits. I said before, it's up 15%. The qualified pipeline, which is again an even earlier indicator, is up almost, you know, up 8%. It's actually over 8% year-over-year, it's almost $15 billion with, again, a record qualified pipeline. The total pipeline is over $25 billion. Mid, more than 5% growth year-over-year. $2.6 billion of net bookings in the quarter. You know, it's more than the entire backlog of the, you know, of some of our smaller competitors out there. Our book-to-bill 128 is extremely strong in the current environment.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

I think from what I've seen, the highest of any of our peers. Our backlog is up more than 10% year-over-year. That's on a reported basis. Excluding FX, it's up 11.3%. You know, again, what I'm trying to share some metrics with you here. If we look at by segment, again, it's across the board, large, mid, EBP, I've got a lot of numbers here, but everything is honestly, everything is green here. Nick, you have any other color to add to this?

Nick Childs
Nick Childs
SVP, Investor Relations and Treasury. at IQVIA

Yeah, I guess, Dave, I think the only thing I would say there is, you know, we saw your question, sort of earlier this week and talked to the team, and we're not seeing any sort of slowdown in terms of clients not wanting to start trials. I mean, as soon as they're signing and pushing and, you know, and getting ready, they are pushing trials forward. You know, we're not seeing any delays, clients trying to slow down starts. You know, we are seeing trials move forward and not, you know, and not seeing the dynamics that you're asking about.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah. Dave, if there's any slowness anywhere, it's just in some of the execution because of the labor issues at some of the sites. That would be the one place where we could burn faster and the industry could burn faster if there weren't the labor issues at the sites.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Right. As I mentioned in my introductory remarks, we have been able to offset some of that unfavorable impact of staff shortages that Ron just brought up and we talked about before, because site selection has been accelerating. I mentioned it was up double digits year-over-year, and that increased productivity helped us in the quarter, and we expect will continue to do so the rest of the year. I mentioned also in my introductory remarks, are introducing rapidly more technology at the site in order to free up personnel time and increase productivity. Thank you.

David Windley
David Windley
Managing Director, Equity Research Analyst at Jefferies

Yeah, very, very fulsome answer. If I could just add to that. I mean, there's been a lot of companies this week that have attributed, you know, weakness to bio. I mean, there are a lot of other companies seeing, you know, dramatic slowdowns. Maybe you could talk about how your positioning or your stage of the pipeline is different that also protects you from what they are seeing. Thermo, Danaher.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Well, you know.

David Windley
David Windley
Managing Director, Equity Research Analyst at Jefferies

Sartorius, et cetera.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Yeah. I mean, the answer is in your question. We have a very strong momentum. The vast majority of what we do is in the sweet spot of the clinical trial process. You know, it's Phase III stuff. We're not affected by the primate issue. Zero. Zero. Even if the primate issue continues for the next three years, you wouldn't see it at all in our numbers. We've already looked at that. We continue to gain share. I know I gave examples on the FSP segment. It's true across the board. In oncology, we just are winning in the marketplace. We displaced incumbents in a number of occasions with large clients. I think, you know, I don't see any really no issues whatsoever on the R&DS front.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

No, save for the execution and operational issues we have encountered. I mentioned that the attrition levels are coming down. I mean, I said before that the peak of the attrition, you know, a year ago or so, we had more than 20% attrition, which is horrendous. We're now back to, I said, pre-pandemic levels. Actually, we're below that. We're just barely over 10%, which is amazing, and very good. That enables us to do a lot more work a lot faster. Thank you, David.

David Windley
David Windley
Managing Director, Equity Research Analyst at Jefferies

Yeah, thank you.

Operator

Your next question comes from the line of Eric Coldwell at Baird. Your line is open.

Eric Coldwell
Managing Director, Senior Research Analyst at Robert W. Baird & Co.

Thanks. Good morning. I want to hit on reimbursables on a couple of fronts. First off, on revenue. With such a big COVID comp this quarter, I would have expected less reimbursable revenue. It looks like it actually grew quite a bit faster than service revenue. You know, what is the dynamic there? We're seeing mixed bag all over the industry in terms of the pass-through volatility. With that big COVID headwind, I would have expected less. You did more. Is there something underlying or outside of COVID exposure that's driving the reimbursables higher, or is it just company-specific contract timing?

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Okay. Well, look, on a full year basis, we're expecting actually obviously less reimbursable expenses because of the disappearance of the COVID work, which was as you suggest, very high pass-through expenses for those COVID vaccine trials. You know, I wouldn't read much in the quarter because it's volatility and depends on the mix of what you executed. I'm not. To be honest, the book-to-bill is more or less similar to. I read your note, right. I religiously do that before the call. Your first flash note and you know, ask why we only reported our 606, our book-to-bill at 1.28.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

By the way, I asked the same question to the team when they gave me the first draft, and I agree with their rationale. You know, as you've seen in recent quarters, essentially the numbers have tended to converge, which is essentially what we expected to happen. We will give you the breakdown or the, you know, ex reimbursable expenses book-to-bill when there is a big discrepancy and it is significant and helps give you understanding of what happened in the quarter in terms of bookings. If it's very close, as it was last quarter, as it is this quarter, we're just not going to do that.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

The change to ASC 606 standard happened more than five years ago. None of our competitors actually disclose that level of granularity or report any extra reimbursable expenses at book-to-bill. Again, I wouldn't read any much more here in the quarter. Nick Childs or Ron Bruehlman, Commentary or color on Eric Coldwell's question?

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah. Look, we did have a little bit higher revenue from pass-throughs in the quarter, but as Ari says, I wouldn't read too much into the quarter-to-quarter. Over a longer time period, your analysis is correct with COVID work rolling off, there should be a decline in pass-through revenues. Yeah, exactly on the book-to-bill, You know, we're five years in, six, seven years in now since the change in the accounting and, you know, we'll only talk to on the book-to-bill the services versus pass-through book-to-bill or the 605 versus 606, when there's a significant difference to talk about, and there wasn't this quarter.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Yeah. Eric, just on the pass-throughs again, I mentioned we did execute faster this past quarter on our MDS backlog. It's true, we burnt, we accelerated. That's, you know, this is why we recognize more revenue, and as a result, there was more pass-through during the first quarter. I don't think you'll see the same in the next few quarters based on the modeling I saw. Thank you.

Eric Coldwell
Managing Director, Senior Research Analyst at Robert W. Baird & Co.

Yeah. Could I have one follow-up?

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Normally no, but it's you, so I... You know. Go ahead.

Eric Coldwell
Managing Director, Senior Research Analyst at Robert W. Baird & Co.

Thank you. I just wanted to hit on cash flow and expectations for the year and we're juggling three overlapping reports here, so I'm sorry if I missed this. Did you mention what the DSO was in the quarter?

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

No, we didn't give an explicit DSO number. In fact, we don't typically give a DSO number. You guys can back calculate. We were happy with the cash flow in the quarter. One thing I would wanna remind everyone is in the first quarter, it's typically a weak quarter for cash flow because most of our incentive comp, annual incentive comp is paid in the first quarter. There's some tax impacts too. Incentive comp is probably the biggest, but,

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

That was very strong.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah. It was strong. We were happy with our cash flow. Not quite as strong as last year, but last year was an unusually strong first quarter for cash flow.

Eric Coldwell
Managing Director, Senior Research Analyst at Robert W. Baird & Co.

Okay.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Yes, if we look in the

Eric Coldwell
Managing Director, Senior Research Analyst at Robert W. Baird & Co.

Thank you very much.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

it improves. It's flattish, right?

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

DSOs on a quarter-to-quarter basis is fairly flattish. On a year-over-year basis, it's up a little bit, and a lot of that has to do with the burning through the COVID-related advances that we got. It was fully expected.

Eric Coldwell
Managing Director, Senior Research Analyst at Robert W. Baird & Co.

Got it. Thanks very much. I appreciate it.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Thank you.

Operator

Your next question comes from the line of Max Smock at William Blair. Your line is now open.

Max Smock
Max Smock
Equity Research Analyst at William Blair

Hi. I just wanted to clarify your comment in response to one of Dave's questions earlier about the NHP situation. Just wanted to clarify that you said that you would not see any impact from the NHP shortage, even if it continues for the next three years. Wondering, at some point, wouldn't it limit the number of drugs getting into later-stage trials here? Would be great to hear more about the work you've done internally to kind of evaluate your potential exposure over the next several years. Thanks.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Yeah. Again, in theory, yes. You know, we don't expect that to happen. I mean, there'll be eventually other models and they will become available. I mean, we're not worried about this at all.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah. The three years just related to the length of time it takes to get from the discovery work into Phase II and Phase III trials and there's a long delay between that. Yeah, of course, theoretically, if there's a protracted issue, it affects everybody in the industry. We don't expect that to happen.

Max Smock
Max Smock
Equity Research Analyst at William Blair

Okay, great. Thank you.

Operator

Your next question comes from the line of Sandy Draper at Guggenheim Securities. Your line is now open.

Sandy Draper
Sandy Draper
Senior Managing Director at Guggenheim Securities

Thanks very much. I think it sounds like I need to get on Eric's distribution list, so I can get his quick flash notes. I can't process fast enough to do that. My question, Ari, or maybe Ron, is on the backlog burn. I'm trying to reconcile with what you were talking about in answering this question. On my calculations, it looked like the backlog burn stepped down a little bit from the fourth quarter from 8% to 7.4%. My assumption was there's a little bit less sequentially in terms of reimbursables. I just wanted to verify that.

Sandy Draper
Sandy Draper
Senior Managing Director at Guggenheim Securities

Thinking about how you're expecting the backlog burn to play out as you have less COVID work, et cetera, which is faster burning, is it reasonable to think stable off of this 7.4, or would it sort of trend down over the course of the year? Thanks.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Look, I wouldn't put a lot of emphasis on quarter-to-quarter backlog burn as you calculate it there. It's not something that we pay a lot of attention to internally, I can tell you. You'll get variations like in the, you know, fourth quarter, we had very strong pass-through bookings, which, you know, pushes up the backlog some, but then those tend to burn later in the trial. You'll see impacts like that affect, you know, any one quarter's like, particularly the next quarter's burn rate. Overall, as Ari made the point, we tend to work on more complicated trials, and oncology trials in particular tend to be longer, slower burn trials.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

We may have slower burn on average than some of the others in the industry based upon our particular mix of projects. That's more a macro long-term consideration than it is a quarter-to-quarter sort of variation driver.

Sandy Draper
Sandy Draper
Senior Managing Director at Guggenheim Securities

Okay, great. That's helpful. Thanks, Ron.

Operator

Your next question comes from the line of Charles Rhyee with TD Cowen. Your line is now open.

Charles Rhyee
Charles Rhyee
Managing Director, Senior Equity Research Analyst at TD Cowen

Hi, this is Lucas on for Charles. Want to dig into the TAS segment. You guys talked about consulting and analytics seeing some softness in 1Q. You guys also called out some wins in Real-World Evidence. Can you talk more about the performance of the other offerings within TAS and how they performed in 1Q, more specifically Real-World Evidence and technology platforms?

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Look, our real-world in technology, we tend to talk about them together because they're the faster growers and continue to be very solid growers in the quarter. As Ari pointed out, it was the analytics and consulting business that really slowed down in the quarter because a lot of that is shorter cycle business and can be delayed. You know, we've always talked about information being a slower grower, so you know, you know about that. You kind of piece it together. The difference versus prior quarters really relates to the analytics and consulting business, some of that shorter cycle business being delayed. It's really as simple as that. That's why we saw a little bit of a slowdown in the underlying core growth rate in the TAS business. Next question.

Operator

Your next question comes from the line of Derik De Bruin at Bank of America. Your line is now open.

Wolf Chanoff
Wolf Chanoff
Investment Analyst at Bank of America

Hi, this is Wolf Chanoff on for Derik. Thanks for taking our question. I know in the prepared remarks, you flagged that there's been a pickup of biotech M&A, which obviously is helping the funding environment. I'm wondering what you're seeing in terms of the acquirer then reducing the R&D spend at the target. Is there any impact to you from that? Yeah, if you could just explore those dynamics, that'd be great. Thank you.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Yeah, thank you. Just to clarify, the M&A spend has nothing to do with funding. It's not included in the funding numbers. These are two different and independent points. The heightened M&A activity is a plus, obviously, and is a tailwind for us, as, you know, we've got large clients that are buying molecules for which work needs to be done. This is generally a favorable trend for us. Thank you.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Next question, please.

Operator

Your next question comes from the line of Dan Leonard at Credit Suisse. Your line is now open.

Dan Leonard
Dan Leonard
Managing Director, Research Analyst at Credit Suisse

Thank you. I was just hoping you could revisit that comment you made that RFPs grew 15% sequentially? I assume that's a volume number? And is there any difference between RFP volume trends and value trends? Thank you.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Thank you. No, your assumption is incorrect. The growth numbers we mentioned are in dollars.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah. All the growth numbers that we've given Dan on the call are all dollar based. It's not a volume.

Dan Leonard
Dan Leonard
Managing Director, Research Analyst at Credit Suisse

Got it. Perfect.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

That's how we tend to track it because that's what's important.

Dan Leonard
Dan Leonard
Managing Director, Research Analyst at Credit Suisse

Yes. Thank you.

Operator

Your next question comes from the line of Elizabeth Anderson at Evercore ISI. Your line is now open.

Elizabeth Anderson
Elizabeth Anderson
Managing Director, Equity Research at Evercore ISI

Hi, guys. Thanks so much for the question.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Thank you.

Elizabeth Anderson
Elizabeth Anderson
Managing Director, Equity Research at Evercore ISI

I know you said you just talked about it in terms of total dollar volumes. I was just wondering if you could comment on the contribution in terms of pricing in R&DS to the dollars this year. Secondly, just in terms of the pacing of CSMS revenue over the back half of the year, are you still thinking we should see that continue to accelerate and be in that like, mid to high single digit type range? Thank you.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Yeah. The comment on CSMS is just correct. That's our expectation currently based on the pipeline. What was the first question? I'm sorry.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah, I didn't hear your first question, Elizabeth. I'm sorry.

Elizabeth Anderson
Elizabeth Anderson
Managing Director, Equity Research at Evercore ISI

Sure. It was just in terms of the contribution of sort of increases in pricing that could have contributed to the first quarter revenue results on a year-over-year basis.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

It was no-nothing. It was negligible.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

I mean, I wouldn't say it's anything large, Elizabeth. I mean, again, you got to remember, trials are, you know, can anywhere from three to five years. It takes a while for all the pricing to, you know, pick up. You know, we don't get that all up, you know, and get it all up front. You know, the pricing has a, you know, leads in over the course of the trials.

Elizabeth Anderson
Elizabeth Anderson
Managing Director, Equity Research at Evercore ISI

Got it. Thank you.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Okay. We will take one more question, please.

Operator

Thank you. Your final question comes from the line of Justin Bowers at Deutsche Bank. Please go ahead.

Justin Bowers
Justin Bowers
Senior Equity Research Analyst at Deutsche Bank

Okay, thank you and good morning. Just, sort of a two-parter, one with RWE. Are you seeing any change in the velocity of demand, there for that business? Hearing in the marketplace that IRA, might be a bit of a tailwind for that. Then can you, also sort of educate us a little bit on the lead time between when market access and pricing studies are done and, you know, with respect to FDA approvals? Thank you.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Yeah. Thank you, Justin. On the first question, Nick, do you have any?

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

He said the growth on Real World Evidence-

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Nothing, nothing different.

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah. Yeah.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

No-

Ron Bruehlman
Ron Bruehlman
EVP and CFO at IQVIA

Yeah

Justin Bowers
Justin Bowers
Senior Equity Research Analyst at Deutsche Bank

Remains strong.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Remains very strong. Same. Nothing, really nothing changed on the real world side. It does. It really varies. There are clients who like to start even before the approval, sometimes well before, you know, when the early results are strong, the data is good in the trial. You know, they get. They wanna get prepared. We do those studies early. Sometimes it's around the time of the approval. Sometimes it's a little later. Again, it depends. By the way, it depends on the market. Sometimes it may decide to introduce a drug in Europe or in some markets in Europe before others, et cetera. It has to do, you know, with when the approvals in specific geographies occur. It really varies. There's no set lead time.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

That's why, again, quote-unquote, "It's discretionary." It's gonna have to be done, but you could delay when you do it.

Justin Bowers
Justin Bowers
Senior Equity Research Analyst at Deutsche Bank

Yeah, I appreciate it. Just on RWE, just some of the things we're picking up in the field is that sponsors are leaning into those more or are thinking about leaning into those more as it relates to, you know, the IRA legislation. If I may, just on RDS, just a quick follow-up there. Are you guys, on the market share gains that you're making there, is there any specific area or are you seeing it across the board in both full service and FSP?

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

Okay, Justin, thank you for your four questions. I'm just gonna answer briefly the last one, and then I suggest that, you know, the team will be available here the rest of the day and next few days to answer any further questions. On your questions about market share, there's no way around it. I've said it before, we again did it this quarter. We have the highest book-to-bill ratio around on the largest base of revenue. You can assume that there is a gain share that's ongoing. The specific segments I mentioned in my introductory remarks, in oncology, we know we are growing a lot faster and we are gaining share, that's by therapeutic area.

Ari Bousbib
Ari Bousbib
Chairman and CEO at IQVIA

In terms of the segments, you know, again, it's across the board, but it was particularly significant this past quarter, in FSP as well. That's the color I can give you on share. Thank you.

Justin Bowers
Justin Bowers
Senior Equity Research Analyst at Deutsche Bank

Thanks so much.

Operator

At this time, there are no further questions. Mr. Childs, I turn the call back over to you.

Nick Childs
Nick Childs
SVP, Investor Relations and Treasury. at IQVIA

Thank you everyone for joining us today. We look forward to speaking to you again on our second quarter earnings call. Myself and the team will be available the rest of the day to take any other follow-up questions you might have. Thanks, everyone.

Operator

Thank you. This concludes today's conference call. You may now disconnect.

Executives
    • Ari Bousbib
      Ari Bousbib
      Chairman and CEO
    • Nick Childs
      Nick Childs
      SVP, Investor Relations and Treasury.
    • Ron Bruehlman
      Ron Bruehlman
      EVP and CFO
Analysts
    • Anne Samuel
      Executive Director, Equity Research at J.P. Morgan
    • Charles Rhyee
      Managing Director, Senior Equity Research Analyst at TD Cowen
    • Dan Leonard
      Managing Director, Research Analyst at Credit Suisse
    • David Windley
      Managing Director, Equity Research Analyst at Jefferies
    • Elizabeth Anderson
      Managing Director, Equity Research at Evercore ISI
    • Eric Coldwell
      Managing Director, Senior Research Analyst at Robert W. Baird & Co.
    • Justin Bowers
      Senior Equity Research Analyst at Deutsche Bank
    • Max Smock
      Equity Research Analyst at William Blair
    • Sandy Draper
      Senior Managing Director at Guggenheim Securities
    • Shlomo Rosenbaum
      Managing Director, Equity Research at Stifel
    • Wolf Chanoff
      Investment Analyst at Bank of America
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