Medpace NASDAQ: MEDP reported double-digit growth in second-quarter revenue and earnings, while management described the business environment as strong and said lower cancellations helped drive record net bookings.
CEO August Troendle said on the company’s second-quarter 2026 earnings call that cancellations were “well-behaved” in the period and supported a record quarter for net bookings. He added that requests for proposals increased both sequentially and year over year, producing what he called “high-quality opportunities.”
“Overall, the environment remains constructive into July,” Troendle said. “We are making good progress in positioning the business for 2027.”
Second-Quarter Revenue Rises 17.2%
CFO Kevin Brady said Medpace generated second-quarter revenue of $707.3 million, up 17.2% from the year-ago period. Revenue for the first six months of 2026 was $1.41 billion, an increase of 21.7%.
EBITDA for the quarter rose 17.6% to $153.4 million from $130.5 million in the second quarter of 2025. EBITDA margin was 21.7%, compared with 21.6% a year earlier. Year-to-date EBITDA was $302.8 million, up 21.5%, with the EBITDA margin flat at 21.4%.
Brady said the year-to-date margin reflected the impact of higher reimbursable costs, offset primarily by lower employee-related costs.
Net income increased 34.5% to $121.4 million from $90.3 million in the prior-year quarter. Brady attributed the stronger net income growth relative to EBITDA growth primarily to a lower effective tax rate and higher interest income. Diluted earnings per share were $4.25, compared with $3.10 in the second quarter of 2025.
For the first six months of 2026, net income was $245.2 million, up 19.7% from $204.9 million in the comparable prior-year period. Year-to-date diluted EPS was $8.53, compared with $6.79.
Bookings Reach Record Level as Cancellations Improve
Net new business awards entering backlog increased 28.2% year over year to $795.7 million, producing a net book-to-bill ratio of 1.13. Ending backlog as of June 30 was approximately $3 billion, up 4.9% from the prior year. Brady said Medpace expects roughly $1.96 billion of backlog to convert to revenue over the next 12 months.
Backlog conversion in the second quarter was 24.1% of beginning backlog. Brady also said Medpace’s top five and top 10 customers represented approximately 31% and 40%, respectively, of revenue over the last 12 months.
In response to analyst questions, Troendle said the improvement in net bookings from the first quarter was driven more by reduced cancellations than by gross bookings. He said cancellations had fallen to a “very good level,” though not an unusually low one.
“Cancellations are always a wild card,” Troendle said, adding that the company has limited ability to predict them. He said Medpace has been careful about what it recognizes in backlog when programs include interim analyses, regulatory decisions or other points that could affect whether a study continues.
Therapeutic Mix Shifts Back Toward Oncology
Troendle said recent growth among Medpace’s top customers had been driven “quite a bit” by metabolic work, including large programs within the company’s top five customers. However, he said the mix of new opportunities has shifted in recent quarters.
“Oncology has come back quite a bit in terms of both our award notifications” and bookings, Troendle said. He said oncology represented more than half of overall bookings and award notifications in the second quarter, while cardiometabolic had “dropped off quite a bit” in new award notifications.
Troendle said he expects the company’s therapeutic mix to move back toward historical averages over the next year or so, with oncology regaining a larger position in the mix. He said some of the very large metabolic programs are reducing, and new opportunities in that area are not as large as they were a year ago.
Management also addressed questions about backlog conversion and whether metabolic programs were responsible for a higher burn rate. Troendle said he would “challenge the very premise” that metabolic programs were the primary driver of increased conversion, noting that Medpace often limits backlog recognition beyond interim decision points across many types of programs, including oncology.
Cash Flow, Buybacks and 2026 Guidance
Medpace generated $162 million in cash flow from operating activities in the quarter, and Brady said net days sales outstanding were negative 59.6 days. The company ended the quarter with $502.7 million in cash.
During the second quarter, Medpace repurchased approximately 706,000 shares for $294.7 million. As of June 30, the company had $527 million remaining under its share repurchase authorization.
Medpace updated its full-year 2026 guidance. The company now expects:
- Total revenue: $2.805 billion to $2.885 billion, representing growth of 10.9% to 14% over 2025 revenue of $2.53 billion.
- EBITDA: $618 million to $642 million, representing growth of 10.8% to 15.1% compared with 2025 EBITDA of $557.7 million.
- Net income: $494 million to $514 million.
- Diluted EPS: $17.25 to $17.95.
Brady said the guidance assumes a full-year effective tax rate of 19% to 19.5%, interest income of $21.1 million and no additional share repurchases. The forecast is based on foreign exchange rates as of June 30, 2026.
Management Points to Stronger Funding Environment
On the broader market backdrop, Troendle said the environment has strengthened over the last several quarters. He said clients with recent funding are generating more opportunities and moving forward with programs.
Asked about competition and pricing, Troendle said he did not see notable changes in competitive dynamics. He said the profile of opportunities has moved back toward oncology being the largest category, compared with the metabolic drivers seen about a year ago.
Troendle also said the company had implemented changes intended to improve win rates after recognizing that its win rate in 2025 had been lower than in prior years. He declined to provide details on those competitive changes but said they may have influenced the company’s strong win rate in the first quarter.
On labor, Troendle said Medpace is “in a good place,” helped by continued low employee turnover. He said the company expects high-single-digit employee growth this year and suspects that trend will continue next year. Employee growth has been strongest in the U.S., followed by Asia Pacific, including India.
About Medpace (NASDAQ:MEDP)
Medpace Holdings, Inc NASDAQ: MEDP is a global contract research organization (CRO) that provides comprehensive clinical development services to biotechnology, pharmaceutical and medical device companies. The company supports clinical trials across all phases (I–IV), offering end-to-end solutions designed to streamline the development process and accelerate the delivery of new therapies to market.
Medpace's core service offerings include clinical pharmacology, regulatory affairs consulting, project management, central laboratory services, imaging, data management and biostatistics, pharmacovigilance and medical writing.
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