IQVIA (IQV) Q3 2026 Earnings Call: Q&A Summary

Q: Shlomo Rosenbaum from Stifel asked about the uniqueness of IQVIA's ability to deploy data and technology in an agentic world and how clients view this differentiation for pricing.

A: Ari Bousbib, Chairman and CEO, explained that successfully deploying AI requires proprietary content, context through life sciences expertise, and interpretation, noting that AI agents operate workflows within human loops and are changing relationships with clients.

Q: Elizabeth Anderson from Evercore ISI asked about the gross margin improvement and the pushes and pulls of pass-through mix.

A: Ari Bousbib, Chairman and CEO, stated that enterprise pass-throughs were a headwind of about 70 basis points on gross margin, while Mike Fedock, CFO, and Bousbib noted that operational improvements of 80 basis points more than offset nonoperational headwinds.

Q: Jailendra Singh from Truist Securities asked if there was anything unusual in the timing or mix of third quarter bookings or if it reflected broad-based market strength.

A: Ari Bousbib, Chairman and CEO, responded that the strength was broad-based across full-service and FSP, driven by increasing win rates with large pharma and strong EBP bookings, supported by last 12-month net new bookings reaching $11.7 billion.

Q: Eric Coldwell from Baird asked for the parameters used for the backlog scrub.

A: Ari Bousbib, Chairman and CEO, explained that the review removed inactive trials that had been in the backlog for over 18 months to two years with no near-term expectation of resumption, noting that if they resume, they will be added back directly without affecting future bookings.

Q: Luke Sergott from Barclays asked if the company is becoming more stringent on what is included in the backlog to avoid future adjustments.

A: Mike Fedock, CFO, and Ari Bousbib, Chairman and CEO, stated that nothing has changed and they remain comfortable with their contracted-basis backlog practice.

Q: Eric Coldwell from Baird asked whether the fourth quarter net interest expense run rate of $210 million should be annualized into 2027.

A: Mike Fedock, CFO, and Ari Bousbib, Chairman and CEO, confirmed that it is a good starting number to use alongside publicly available forward curves for debt refinancing and swaps.

Q: Luke Sergott from Barclays asked about the deceleration in Commercial Solutions revenue growth and the timing of conversion.

A: Ari Bousbib, Chairman and CEO, explained that Commercial Solutions is a shorter-cycle business without a traditional backlog, noted that pipelines are at record levels with shortening decision timelines, and pointed to product approvals being up over 40% as a strong market indicator.

Q: David Windley from Jefferies asked whether biotech funding is leading out of the trough and if large pharma is catching up with full-service outsourcing and reprocurement activity.

A: Ari Bousbib, Chairman and CEO, agreed with the assessment, noting that biotech funding reached $90 billion year-to-date and that large pharma partnerships and strategic review processes have concluded favorably for scaled providers.

Q: Michael Cherny from Leerink Partners asked how AI impacts contracting, pricing, and value-based savings over time.

A: Ari Bousbib, Chairman and CEO, explained that on the commercial side, AI represents an incremental subscription and revenue opportunity, while in R&D it acts as an enabler of faster timelines and accuracy, alongside driving internal productivity for IQVIA's own operations.