IQVIA Holdings, Inc.

Net new bookings for the quarter were approximately $2.6 billion, representing a quarterly book-to-bill of 1.23. This included a substantial cancellation in the CNS area that is in the public domain, and I'm sure many of you are aware of. Excluding this large cancellation, which is well outside the typical cancellation size we see in a quarter, our first quarter book-to-bill ratio would have been over 1.3, actually closer to 135. Our quarterly RFP flow was up 6% year-over-year, and that's in value, meaning in dollar terms, and it was driven by mid- to high-single-digit growth in all customer segments, again, in dollar terms. Our qualified pipeline grew double digits versus prior year, again, in value, in dollar terms. Emerging biotech funding was very strong. According to Bioworld, which we use consistently as a source, first quarter EBP funding was $47.1 billion, which is more than triple the funding of Q1 last year. Shifting to TAS, our commercial side of our business revenue in the quarter grew as expected. With the modest uptick in activity anticipated for later this year, we continue to forecast an improvement in the back half of the year. We continue to see some favorable signs. For example, our pipeline remains strong. In our conversations with clients, there is more clarity on budgets. And we're starting to see faster decision timing with some clients compared to the second half of 2023. Now this say the tone overall with our clients remains cautious. And the fact is that the answer to macro environment persists as everyone can tell from the Fed remarks yesterday. Turning now to the results for this quarter. Revenue for the first quarter grew 2.3% on a reported basis and 2.9% at constant currency. Compared to last year and excluding COVID-related work from both periods, we grew the top line approximately 6% on a constant currency basis, including just over a point of contribution from acquisitions. First quarter adjusted EBITDA came in at $862 million, and first quarter adjusted diluted EPS was $2.54. I'd like to share a few highlights of business activity. Let's start with the TAS segment. You will have seen that we are expanding our global strategic partnership with Salesforce. The partnership will integrate innovations from IQ via OCE with Salesforce's Life Sciences Cloud to provide customers with a new, single end-to-end engagement platform, which is expected to be available late 2025. This is very exciting news for the industry as we expect to transform the engagements with HCPs and with patients with the next generation CRM platform that's built on OCE and that's powered by IQ via data, domain expertise, and advanced analytics. Separately, and as we discussed in the past, that continues to be an evolution on the way in how the industry manages HCP and patient engagement. For example, there's an ongoing shift in HCP engagement from in-person to digital interactions. On the patient side, there is increased emphasis on direct to patient solutions through patient support and market access programs, including financial support, hub services, medical education. As you know, we've been investing in building out these digital capabilities, and we are getting good market traction. For example, in the quarter, a top three pharma client awarded a QVL contract for our smart engagement solution to understand the healthcare provider online journey across therapeutic areas and factored that in earlier into the drug development process. The top five pharma bought IQVIA's omnichannel navigator solution to assess return on marketing investment, measure customer interactions and campaign performance, and make data-driven decisions to optimize marketing strategies. A global midsize pharma awarded IQVIA a multi-year contract to implement our commercial compliance solutions. These solutions will allow our clients interactions with healthcare professionals, to be in compliance with transparency regulatory obligations in over 30 countries. An EBP client bought IQVS Patient Relationship Manager offering, which provides a comprehensive real-time view of the patient's journey and helps maximize the impact of their patient support program. In general, the task segment is seeing more demand for our sophisticated technology-enabled analytic solutions. For example, in the quarter, A top 10 pharma client awarded IQVIA a contract to streamline clinical operation data management processes. IQVIA's technology provides real-time data sharing, eliminating unnecessary file processing, and improving the speed of data updates. Also in the quarter, a large medtech firm bought the IQVIA offering that enables better stakeholder targeting and go-to-market execution, ultimately enhancing the client's Moving to real world, a top 10 pharma company chose IQVIA to conduct a comparative study of the effectiveness of treatments against the standard of care in patients with a specific marker across 10 different cancers. The goal is to help the client gain market access and reimbursement for their treatment, which can be used for multiple types of cancer based on a single biomarker. IQVIA was awarded a contract by a top 10 pharma to demonstrate the effectiveness of a novel eye movement technology addressing a common symptom in patients with multiple sclerosis. The top 10 pharma client awarded IQVIA a large real-world respiratory infection vaccine effectiveness study. We were selected based on our strong epidemiologic, scientific, and therapeutic expertise, as well as our global footprint to augment site identification and operational execution. And finally, to conclude my commentary on the TAZ segment, I'd like to highlight the work we're doing in public health. It's been an increased area of focus for governments looking to extend life expectancy, reduce health inequalities, and improve overall quality of and access to care. Some examples of IQVIA's work in this area. One of the largest UN health agencies contracted IQVIA to help with a major initiative to eradicate all types of polio viruses in Africa and focused on children. IQVIA is deploying personnel to improve outbreak response with vaccines and to strengthen polio surveillance and response in hard to reach areas. So far, IQVIA's team conducted visits to more than 12,000 sites and trained over 122,000 health workers across 26 African countries. Another example of our work in this area, IQVIA was selected to conduct a large EU-funded project to create a national oncology network and database for one of the European Ministry of Health to improve the country's low cancer survival rates. A single IT platform will connect national hospitals and the reimbursement fund in that country. The platform will leverage curated oncology data and analytics to manage patient risk and improve treatments in a cost-efficient manner. Lastly, on public health, the Global Fund selected IQVIA to support 13 African countries to improve the visibility of their supply chain performance ensure the availability of commodities and services, mitigate service disruptions, and provide stronger assurance through more frequent on-site spot checks. The project focuses on pharmaceutical and diagnostics analytics from over 2,800 facilities for tracer health products in HIV, tuberculosis, and malaria. This work is very important to us in public health. It's also extremely important to our global pharma clients who are extremely active in this area as well. Moving to RNDS, let's start by highlighting two more distinguished vaccine development awards. The top 10 pharma selected IQVIA to support the development of a novel respiratory vaccine which could, which, could represent a significant breakthrough as the only vaccine targeting multiple respiratory viruses simultaneously. IQVIA laboratories secure the preferred strategic partnership with the top 10 pharma based on IQVIA's unique expertise, innovation, and delivery model. As we discussed in the past, there is stronger demand for FSP services and we continue to win our fair share in this segment as well. For example, in the quarter, we secured an extension of FSP data management services with the leading mid-sized pharma known for their innovative rare blood disease therapies. In the EBP segment, we secured two large awards where we displaced incumbent CROs based on our global scale and AI-enabled capabilities. We were selected by a U.S. West Coast EBP client to conduct two large Phase III oncology studies simultaneously. This is a big deal as the client is new to IQVIA and selected us based on our differentiated AI-enabled capabilities as the trial protocol includes complex inclusion-exclusion criteria and usually large patient cohorts and aggressive enrollment timelines. We also want another large EDP full-service phase three trial displacing the incumbent, again, by leveraging our AI-enabled startup site identification, activation, and enrollment capabilities. With that, I will turn it over to Ron for more details on our financial performance.

Thanks, Ari, and good morning, everyone. Let's start by reviewing revenue. First quarter revenue of $3,737,000,000 grew 2.3% on a reported basis and 2.9% at constant currency. COVID-related revenues were approximately $45 million, down about $105 million versus first quarter of 2023. Excluding all COVID-related work from both this year and last, constant currency growth was approximately 6%. As already mentioned, acquisitions contributed at just over 100 basis points to this growth. Technology and analytics solutions revenue for the first quarter was $1,453,000,000, up 0.6% reported and 1% at constant currency. Excluding all COVID-related work, constant currency growth in TAS was 3%. R&D solutions first quarter revenue was $2,095,000,000. That was up 3.4% reported and 3.8% in constant currency. And excluding all COVID-related work, constant currency growth in R&DS was 8%. Finally, contract sales and medical solutions, or CSMS, first quarter revenue, $189 billion was up 3.8% reported, and 7.1% at constant currency. Okay, let's move down the P&L. Adjusted EBITDA was $862 million. That's growth of 1.3%. First quarter GAAP net income was $288 million, down 0.3% year-over-year, and GAAP diluted earnings per share were $1.56, up 2% year-over-year. Adjusted net income was $468 million for the quarter, up 1.3% year-over-year, and adjusted diluted EPF grew 3.7% to $2.54. Now, as already reviewed, R&D Solutions delivered another strong quarter of bookings. Our backlog at March 31 stood at a record $30.1 billion, which was up 7.9% year over year, and next 12 months revenue from backlog increased to $7.7 billion, growing 6.1% year over year. Okay, let's turn to the balance sheet. As of March 31, cash and cash equivalents totaled $1,444,000,000. Gross debt was $13,536,000,000. And the result of those two is net debt of $12,092,000,000. Our net leverage ratio ended the quarter at 3.38 times trailing 12-month adjusted EBITDA. First quarter cash flow from operations was $522,000,000, and capital expenditures were $145,000,000, resulting in free cash flow of $377,000,000. Okay, turning now to guidance, we are reaffirming our full-year revenue guidance on a constant currency basis. We're adjusting revenue in actual currency downward by $75 million to reflect the strengthening of the U.S. dollar since we last guided. We now expect revenue to be between $15,325,000,000 and $15,575,000,000, representing year-over-year growth 3 to 3.9% on a reported basis. Now, this guidance now includes a year-over-year FX headwind of approximately 100 basis points. And I'll remind you that when we last guided, we were looking for about 50 basis points of FX headwind. We continue to assume approximately $300 million of step down in COVID-related work and about 100 basis points of contribution to revenue from M&A activity. We're reaffirming our adjusted EBITDA guidance of $3,700,000,000 to $3,800,000,000, which represents year-over-year growth 3.7 to 6.5 percent. The impact of FX changes to revenue had a negligible impact on EBITDA. We're also reaffirming our adjustability EPS guidance, which continues to be $10.95 to $11.25, up 7.4 to 10.3% versus the prior year. Okay, let me conclude by providing second quarter guidance. For the second quarter, we expect revenue to be between $3,740,000,000 and $3,815,000,000. This includes a year-over-year FX headwind of approximately 150 basis points, and we anticipate the second quarter will be the toughest quarterly FX compare of the year. As a reminder, the step-down in COVID-related work is weighted towards the first half of the year. Also, we continue to expect gradual improvement in cash revenue growth in the back half of the year. For the second quarter, adjusted EBITDA is expected to be between $870 million and $890 million in adjusted diluted EPS is expected to be between $2.54 and $2.64. And all the guidance I provided assumes that foreign currency rates as of April 30th continue for the balance of the year. So to summarize, Q1 was a strong start to the year. TAS revenue came in as expected, and we continue to look for improvement in the back end of the year. RNDS delivered $2.6 billion of net bookings, bringing backlog to over $30 billion for the first time in our history. We continue to see favorable forward-looking indicators in the clinical trial business, such as strong RFP flow, strong qualified pipeline growth, and strong biotech funding. And finally, we're reaffirming our earnings guidance for the year, including adjusted diluted EPS growth of 7.4% to 10.3%. With that, let me hand it back to the operator for Q&A.

Thank you. At this time, I would like to remind everyone, in order to ask a question, press star, then the number 1 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 take our first question from Elizabeth Anderson at Evercore ISI. Ms. Anderson, your line is open. You may have yourself muted.