Key financial results
- Revenue: Total revenue for the third quarter was $4.428 billion, representing 8% growth on a reported basis and 8.6% growth at constant currency.
Third quarter revenue of $4.428 billion grew 8% on a reported basis and 8.6% at constant currency.
- Organic growth: Organic revenue growth for the quarter was approximately 6% year-over-year.
Organic revenue growth within the quarter was strong at approximately 6%.
- EBITDA: Third quarter adjusted EBITDA was $1.032 billion, up 8.7% year-over-year.
Third quarter adjusted EBITDA was $1.032 billion, representing growth of 8.7% year-over-year
- Margins: Adjusted EBITDA margin expanded by 20 basis points in the third quarter.
And in the quarter, adjusted EBITDA margins expanded by 20 basis points.
- GAAP earnings: Third quarter GAAP net income was $350 million, with GAAP diluted earnings per share of $2.10.
Third quarter GAAP net income was $350 million and GAAP diluted earnings per share was $2.10.
- Adjusted EPS: Adjusted diluted earnings per share reached $3.34, representing an increase of 11.3% year-over-year.
Third quarter adjusted net income was $557 million and adjusted diluted earnings per share was $3.34, representing growth of 11.3% year-over-year.
Business segment results
- Commercial Solutions: Commercial Solutions revenue for the third quarter was $1.789 billion, up 6.9% on a reported basis and 7.9% at constant currency.
Commercial Solutions revenue for the third quarter was $1.789 billion, up 6.9% on a reported basis and 7.9% at constant currency.
- Commercial Solutions: Commercial Solutions organic revenue growth was 4% year-over-year.
In Commercial Solutions, revenue grew 6.9%, of which 4% was organic
- R&D Solutions: R&D Solutions third quarter revenue was $2.639 billion, up 8.7% on a reported basis and 9.1% at constant currency.
R&D Solutions third quarter revenue was $2.639 billion, up 8.7% on a reported basis and 9.1% at constant currency.
- R&D Solutions: R&D Solutions organic revenue growth was almost 7% year-over-year.
On the clinical side, revenue grew 8.7% reported, of which almost 7% was organic year-over-year
- Bookings: R&D Solutions generated $3.2 billion of net new bookings in the quarter, representing a 15% increase year-over-year and a book-to-bill of 1.2.
- Bookings: Last 12 months net new bookings reached $11.7 billion, up 14% year-over-year.
reaching $11.7 billion, which is up 14% year-over-year.
- Backlog: R&DS contracted backlog stood at $32.6 billion as of September 30, 2026, with next 12 months revenue from backlog at $9.4 billion.
As of September 30, 2026, R&DS contracted backlog was $32.6 billion and the next 12 months revenue from this backlog was $9.4 billion
Capital allocation
- Balance Sheet: Cash and cash equivalents were $2.249 billion and gross debt was $16.67 billion as of September 30, 2026, resulting in net debt of $13.818 billion.
As of September 30, cash and cash equivalents was $2.249 billion and gross debt was $16.67 billion, resulting in net debt of $13.818 billion.
- Leverage: The net leverage ratio ended the quarter at 3.45x trailing 12-month adjusted EBITDA.
Our net leverage ratio ended the quarter at 3.45x trailing 12-month adjusted EBITDA.
- Cash Flow: Cash flow from operations was $825 million and capital expenditures were $158 million, resulting in free cash flow of $667 million.
Third quarter cash flow from operations was $825 million and capital expenditures were [ $158 million ], resulting in free cash flow of $667 million
Industry trends and dynamics
- Funding: The emerging biopharma funding environment reached $90 billion year-to-date, up over 85% year-over-year.
The EVP funding environment continues to be very strong. Funding has reached $90 billion year-to-date, up more than 85% year-over-year
- Trial Starts: Clinical trial starts year-to-date are up high single digits.
Similarly, clinical trial starts year-to-date are up high single digits.
- Drug Launches: New drug launches are up more than 40% year-to-date.
with new drug launches up more than 40% year-to-date.
Competitive landscape
- Win Rates: Win rates improved during the quarter, contributing to the strongest clinical bookings in four years.
Our win rates were higher in the quarter, which led to our strongest clinical bookings in 4 years.
- Artificial Intelligence: Differentiated artificial intelligence offerings continue to drive momentum, with IQVIA deploying 415 agents to date.
Our differentiated AI offerings are increasingly contributing to that momentum, with continued adoption of our agentic solutions. In fact, IQVIA has now deployed 415 agents to date.
Macroeconomic environment
- Foreign Exchange: Foreign exchange is assumed to provide approximately 20 basis points of tailwind for full-year revenue, while implying a 70 basis point headwind for the fourth quarter.
Growth opportunities and strategies
- AI Solutions: Management highlighted multiple client wins utilizing AI-enabled capabilities, such as an autoimmune Phase III study shortened by 9 months using site modeling solutions.
Here, our AI-enabled country and site modeling solution optimizes patient identification and enrollment, shortening the overall program time line by 9 months.
- Commercial AI: A top 5 pharma client selected IQVIA to build an agentic platform for real-world healthcare data insights.
a top 5 pharma client selected IQVIA to build and maintain an agentic platform that provides on-demand insights from complex real-world health care data.
Financial guidance and outlook
- EBITDA Guidance: Full-year adjusted EBITDA guidance was raised to between $4.025 billion and $4.055 billion.
We are also raising adjusted EBITDA to be between $4.025 billion and $4.055 billion, growing 6.3% to 7% year-over-year
- EPS Guidance: Full-year adjusted diluted EPS guidance was raised to between $12.90 and $13.00.
And finally, we are also raising adjusted diluted EPS to be between $12.90 and $13, up 8.2% to 9.1% versus prior year
- Q4 Assumptions: For the fourth quarter, net interest expense is expected to be around $210 million, depreciation and amortization just over $160 million, and weighted average diluted share count approximately 169 million shares.
Backlog review and adjustments
- Backlog Adjustment: Management conducted a detailed review of inactive trials in the backlog resulting in an adjustment of approximately $2.1 billion.
the company conducted a detailed review of inactive trials in our backlog, resulting in an adjustment to backlog of approximately $2.1 billion.
- Backlog Impact: The backlog adjustment has no impact on historical financial results, 2026 guidance, net new bookings, or next 12 months revenue from backlog.
This backlog adjustment has no impact on historical financial results, 2026 guidance, net new bookings for next 12 months revenue from backlog testing.
Q3 2026 results
| Metric | Result | Change |
|---|---|---|
| Total Revenue | $4.428 billion | up 8% reported |
| Commercial Solutions Revenue | $1.789 billion | up 6.9% reported |
| R&D Solutions Revenue | $2.639 billion | up 8.7% reported |
| Adjusted EBITDA | $1.032 billion | up 8.7% year-over-year |
| Adjusted Diluted EPS | $3.34 | up 11.3% year-over-year |
| R&D Solutions Net New Bookings | $3.2 billion | up 15% year-over-year |
How management sounded
Balanced (+35 on our -100 to +100 scale). Management expressed strong confidence driven by accelerating organic growth, higher win rates, and record clinical bookings. Management sounded more upbeat than on 20% of the 302 calls we cover; most companies sound positive on their own calls, so the comparison says more than the label.
Read the analyst Q&A summary and guidance and outlook for this call.
What to watch before the next call
- Conversion rates and demand trends in Commercial Solutions pipelines.
- Biotech funding environment and clinical trial start metrics.
- Adoption rates of AI-enabled agentic solutions across customer bases.
Earlier calls
- Q2 2026 (Jul 28, 2026), tone Positive: IQVIA reported an outstanding second quarter with revenue, adjusted EBITDA, and adjusted diluted earnings per share exceeding the high end of its guidance, driven by strong operational execution and improving market conditions.
