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.

Okay, let's move on to the next one, the queue operator.

Sure. We'll go to Shlomo Rosenbaum at Stiefel.

hi thank you for taking uh my questions i want to ask ari a little bit about that large cancellation that you um that you called out uh you absorbed it into the numbers could you um give us a little bit more uh specificity in terms of uh highlighting what that impact would be to revenue uh or and also to bookings because you're lowering the revenue due to FX, but you're also absorbing an incremental cancellation that's unusual, and maybe that can help us a little bit with the context over there and then also on the booking side.

Yeah, thank you, Shlomo. Well, look, we don't normally speak to cancellations. As you know, we just provide net new bookings. I might point out, by the way, that we never speak to it, but our gross bookings were the highest, the second highest in our history. before cancellations now um the reason we highlighted this cancellation is because look a typical cancellation is normally in the 15 20 million dollar kind of range and this one is very very large it's uh almost it's about a quarter billion dollars okay so we have done that in the past whenever we've had an unusual cancellation this one has been in the news i think everyone knows what we are talking about. And we wanted to reassure everyone that the underlying business continues to be very strong. With respect to absorbing it, yes. I mean, look, we are a large company. We are, at any given point in time, working on around 2,500 clinical trials. These are, you know, staggered and staged through the year and revenue flows over several years for each one of those trials. So we are large enough, global enough that we can absorb even such a large cancellation. No change to the guidance. And as Ron pointed out, and you reminded us in your question, the adjustment is entirely due to FX.

Just one thing I would jump in there. I think you're asking about revenue, too. And obviously, because with an ongoing trial, it does have some impact. our revenue in the current year but we're we're absorbing that in our normal numbers and this is a these this is a series of trials actually a program that would play out over many years so there isn't an outsized impact in this year thank you we'll take our next question question from max smock at william blair hi good morning thanks for taking our questions maybe just following up on

rfp flows that you saw in the quarter you mentioned up mid to high single digits across all customer groups i think last quarter you had called out up double digits across all customer groups so just wanted to get a sense for whether what you saw in terms of rfp flows going into this quarter was in line with your expectations and then any thoughts on how we should think about book to build moving forward thank you again i wouldn't read um a lot you know in the variation quarter to quarter you know just as a

As an example, the RFP flow last year was flat versus the 22 number. So we think this is very good. It's consistent with our expectations. You know, the large segment, the large pharma was up more in the high single digits in terms of RFP flow. um ebp was a little bit higher than you know that was a kind of mid-single uh growth um you know depends on the therapies we had a lot of bookings infection diseases and internal medicine which drove a lot of the growth there the awards grew you know, well into the teams. So, you know, we often look at awards. We report contracted bookings, as you know. Some of our peers report awards, which is at an earlier stage in the process. And maybe just to reassure you that we haven't come down from what we said that the last quarter, as a leading indicator, if you will, awards were up in the double digits, and that was driven by large, you know, full-service trials, strong EBP as well. We look at the qualified pipeline, and the qualified pipeline is up double digits, actually very strong double digits, and it's up, again, at a record high. So nothing here that has changed versus our expectations.

We'll go next to Ann Samuel at JPMorgan.

Hi, thanks for taking the question. You know, in the TAS business, you talked about strength in the pipeline and some positive signs and maybe some more positive conversations there. As you're moving through the year, are you seeing your pipeline convert, you know, kind of at the same rate that you had initially expected? And with the macro, you know, maybe slightly more stable, can you just maybe speak to any potential areas of upside if things are starting to loosen up there?

Yeah, well, I mean, I wouldn't talk about upside here so far, and then the macro is not really stabilizing, unless you call stabilizing the fact that we now know there won't be a rate cut anytime soon. So, look, the task business is exactly performing exactly as we expected it. Same type of performance that we telegraphed in our prior guidance. Same growth rate that we anticipated when you exclude the COVID and the currency impact. And we continue to see, again, based on our pipeline, based on, you know, budgets firming up, based on the conversation with clients, continue to expect upside towards the back of the year, second half of the year and more in the back of the year. Large pharma companies, as you know, have introduced significant cost reduction programs, and that has driven a lot more cautiousness and scrutiny uh in the budgets than um in prior years and we've discussed this is driven by the overall micro environment um maybe some uh concerns related to ira long term and preservation of margins um as you know our client base generally is doing fairly well and is reporting very good numbers um so we think that also is an encouraging sign Um, and usually, um, our clients have more propensity to spend money when they, um, when they are doing well, and we see that they are doing well. So all of those signs are encouraging. I can give you a little bit of color on the business and tabs, you know, just for. A perspective. You know, the data business continues to perform exactly as expected. No surprises. They are flattish to app below single digits. The real-world business, which we signaled in the prior quarter earnings call, was slowing down, had actually gone from being a very strong double-digit growth performer to meet single digits to then negative growth in the fourth quarter. has rebounded somewhat and is now flourished so we see that we think that we bottom out there um and the the tech business continues to perform as expected good and strong and the analytics and consulting business which is our shortest cycle business you know ebbs and flows in the quarter it had started to do a little better last quarter this quarter it went back backwards And that's why we didn't perform even better than our expectations in that. So all in all, real world doing better than we thought. Analytics consulting doing a little less well than we thought. But that's kind of to be expected. It has more variability by definition. And we still have a strong pipeline there. So we think that that will continue to improve quarter over quarter. and that's what gives us confidence that the back end of the year on TAS will be good. Again, upside, I don't know. I can't promise that.

Thank you, Ari. That was extremely helpful.

We'll move to our next question from David Windley at Jefferies.

Thanks. I wanted to transition you to R&DS. Ari, thanks for taking the question. You highlighted in your your prepared remarks about some of the business wins. You highlighted some FSP deals. I also heard you say, though, that your RFP flow was strong on the full service side. So given that you've talked in the past about how that FSP does present some margin headwinds, I thought maybe you'd update us on the state of play between those two models and maybe we've reached some kind of equilibrium there. So just your thoughts on FSP versus FSO. Thanks.

Very much, yeah, I mean look. As a percentage of our total RDS revenue. FSP comprise about 15%. So now if you that's in in totality, if you look only at the services portion of the business, meaning excluding pass throughs, which as you know in FSP, they typically is no pass throughs. So that percentage is a little higher and continues. It's a little less, somewhere between 20 and 25%, I would say. And it continues to grow, you know, a point or two, you know, every year. So, of course, it has an impact on margins because FSP margins, FSP contracts come at lower margins. But again, we are a large global company, and that just puts more pressure on us to continue to operate with more efficiency, find new areas of productivity, contain costs, and offset those margin, those mix, those unfavorable mix impacts on margins with cost reductions. And we continue to work well on our usual playbook, which is to grow our EBITDA faster than our revenue and consequently increase margins.

We'll go next to Jolando Singh at Truist Securities.

Thank you, and good morning, and thanks for taking my questions. I want to follow up on the Salesforce partnership comments. Just curious if you can share any initial reaction from your OC customers post that announcement or is it still early? Also just curious, like what were the conversations leading up to the partnership? Trying to understand what drove the decision to partner with Salesforce given what IQAC, what HCPs prefer for engagement in terms of digital marketing, etc.? ?

Thank you. Well, look, as you know, we've carved out a nice position in the global CRM market for life sciences. We came from behind much later in the game. I guess we entered the market more than 10 years after the large dominant incumbent in this market. And today we have a footprint of over 400 clients and about 100,000 seats. in the business, which is quite impressive in a few short years. Now, what happened here is that the dominant competitor has announced a replatforming of their product from Salesforce to their own in-house platform. Now, OCE is based on a Salesforce platform. It's the result of a strategic partnership that has been in the market for over five years. And we at Salesforce want to ensure that we continue to have the best product in the market. And we've agreed that it is time to develop the next generation product. We also agreed that it should be based on Salesforce's new Life Science Cloud, which is much more advanced. And it will be based on the current OCE application to be replatformed. Now, it takes time to do that. It makes sense for Salesforce to take the lead in developing this next generation application. and it will be based on IQVIA IP. Our existing customers understand all of that. They will continue to be supported for at least the next five years, and they're very happy. I can even say yesterday we won a very significant award on OCE with a large, well-known client, pharma client, and we actually displaced the large dominant player in the space, which had been the incumbent for a long time. So our clients are reacting very favorably. They understand the need for the next generation transition, and we are going to shepherd that process together with Salesforce. When the product is ready in the next two years or so, we will go to market jointly with Salesforce with this new product platform, and we will help transition customers who wish to do so when they are ready to do so. Thanks, Ari. Strong and positive reaction from the customer base.

We'll go next to Anne Hines at Mizuho Securities.

Hi, good morning. Ari, what surprised you on the upside most in the quarter and maybe on the downside? And just following up on the last FSP question, thank you for that clarity you gave us about its 20% to 25% ex-pass-throughs. What do you think the max would be over time?

Thanks.

What surprised you on the multiple quarters?

I hate to be boring. I had zero surprises this quarter. I mean, for lack of better words, I think this was a boring quarter. It came in exactly as we thought. Look, the nature of it is pretty predictable. The, you know, the last cancellation was kind of, you know, it's based on really on the results and on the assessment of the environment by the client. This all has been very well reported. And so it usually takes time to unwind a study, and so we knew it was coming, so we didn't know the exact timing when all of this would be finalized, but it was in the quarter. But other than that, frankly, no surprises, up or down. Everything came in pretty much on expectations. There always are moving parts, but this was one of the most boring quarters I've seen, and nothing, no drama. That's the way we like it, by the way. In terms of your FSP question, you know, it ebbs and flows. I remember my first contacts with this business now almost eight years ago. I was told, you know, FSP is going to be replacing full service clients are shifting to FSP. And indeed there was, very similar to today. an effort by some of the large pharma companies, many of them, to bring project management in-house and to essentially shift to these types of models. So I think it's a pendulum, it swings back and forth. In highly specialized studies, it's very hard for a client not to do full service because they don't always have all the competencies in-house. Again, I think we're seeing similar trend as we saw eight years ago. What we're seeing also might be to add a little bit more to this. We're seeing a trend towards what we call hybrid models where the client starts out with wanting an FSP program. And as we progress in defining the parameters of the study, we end up taking on more of the tasks. It's kind of an in-between full service, and it's not fully outsourced, but it's not 100% FSP either. There are parts of the program that we continue to manage. So it's really more integration with the client, and it becomes more of a closer partnership. So I don't see this as a long-term permanent trend. to the point where theoretically it could become 100% FSP. I don't see that happening. Plus, remember, FSP is virtually nonexistent for EBP or midsize pharma.

Great. Thank you.

We'll take our next question from Michael Ryskin at Bank of America.

Hi. Good morning. This is John Kim on for Mike. I appreciate the SST comment there. I'll just ask a quick one. On that swing pendulum comment, do you expect that percentage to go down at some point? And in terms of the RFP flows, that sounds great, solid, solid flows. But is there anything that may hinder or delay that turning into sales in the second half? Yeah, thank you.

Okay, thank you. Well, on the FSP comment, I don't know, you know, when any things will, you know, this is a long cycle business. I remind you that it takes on average four or five years to execute a contract. So, you know, we have a very large book of business. I think in our backlog, what is the proportion of FSP in our backlog? Is it also about 15%? Yeah. So our backlog is over $30 billion and about like somewhere worth four, four and a half billion dollars of that is is $4.5 billion of that is FSP. So you see the vast majority of the revenue we're going to deliver over the next four or five years is going to continue to be full-service programs. And it's not about to, you know, influence one way or the other. It's a slow-moving business. It takes a lot to move the needle one way or the other. We've been continuously on an upward momentum. And that's the way we like it. So, no, I don't see that happening. And then certainly same similar type of commentary on your question about affecting the second half. It is just too short horizon, you know, to have an impact. These swings, you know, will have an impact four years from now.

Gotcha. That makes sense. Thank you.

We'll go next to Charles Wright at TD Callen.

Yeah, thanks for taking the question. Ari, you mentioned earlier about winning an ADP client that's going to do two simultaneous studies in oncology. And I'm curious whether, you know, the decision to do two trials at once could be a function of terms in the IRA that you know, kind of benefit companies to do, you know, multiple trials at once, sort of to maximize revenue before potential negotiating on pricing with Medicare. I'm curious if that could be part of the reason, and in general, I guess, you know, as you think about the structure of IRA, do you foresee more companies engaging in multiple trials at the start, and how do you think that could be benefiting for IQVIA in the future? Thanks.

Yeah, well, I mean, that's a clever, that's a clever thought here, you know, why it was two simultaneous studies, but it happens to be not the case over here. But I see what you're thinking about, but that's not the case here. These are two different, it's addressing two different diseases with different, I think it's different molecules. Again, we can give you in post-core, some more color on this, but I don't think it's because of the IRA. Look, what is true is that clients are, with respect to the IRA, are trying to accelerate timelines because one of the possible impacts of the IRA is that it will reduce the um the period of time during which uh protection will apply um intellectual property protection will apply and as a result you want to maximize the revenues then that if anything um and again that's probably the context for your question if anything that kind of would um induce clients to launched several programs simultaneously. So, in this particular case, we're replacing an incumbent, and I think one of them is a rescue study, if I'm correct. So, that's the context there. Thank you.

We'll go next to Tejas Zava at Morgan Stanley.

Hey, guys. Good morning, and thanks for the time here. Ari, I have a few questions here on R&D solutions. First, just broadly on the pricing environment, are you starting to see more pricing discipline from your peers versus what you saw in the back half of 23? Second, on the cancellation in CNS, given the faster burn nature of that work, is there any implication from that for the phasing of R&D revenue through the remainder of 24? And then last on AI enablement, you highlighted that as a driver of some of your EBP wins in the quarter, which I thought was quite interesting. Can you just share some color on why it's translating into share gain for you and what is it that you can do with AI that your peers aren't offering yet? Thank you.

Okay, there are three questions, totally independent. So first on pricing, look, there's no... change in pricing here. There continues to be pressure from clients, and price negotiations are always tough. You know, we mentioned before that we're having maybe more pressure than we had before on pricing from large pharma clients as they're working on their savings initiatives, but it's not that different than history, maybe a little more than usual. Uhm, but I think you know nothing with respect to competitors. I can't speak to what they do. I just have no idea and I want to know. But look, it's it comes to reason that the smaller competitors which have failed largely and then have that have led to them being required. Uhm, you know, are struggling to to book business and as a result could put on pricing, but nothing there that I can signal that's unusual versus what we spoke about in the past. Your second question was on cancellation. We spoke before and we addressed that. No. Look, it's a very large cancellation. Yeah, it has an impact on revenues over the next few years, including in this year. But we said earlier that we are a large company and we are absorbing it in our guidance. It's fine. So yes, if you will, it would have been better if we hadn't, if the program hadn't canceled, but it's okay. We're not changing the guidance for that. Our only guidance adjustment, again, is 100% related to foreign currency. With respect to your third question on AI, look, AI has not saying anything shocking here. AI has a massive amount of opportunity in general. And I would say perhaps more limited than people think in healthcare because data and the ingredients, if you will, are not readily available publicly. You can search for medical literature, for diagnostics. You could look for jurisprudence, for legal opinions. But frankly, to identify patients that are best suited for trials, sites that need to be identified for maximum effectiveness and fastest enrollment, That's really, really tough to get information. And if you ask those questions to a chat bot, you are not going to get the answers. However, once you are within our environment, then that's a lot more possible. And so if you think about it, the entire premise of what we set out to do when we merged Quintiles and IMS eight years ago was precisely to leverage massive amounts of data and analytics and technology to accelerate clinical development timelines, particularly applicable to oncology, rare disease, and difficult to enroll patients. With the advent of AI, that set of initiatives becomes even easier. And we've been at it for a while. This is not new to us, but some of the new tools, as you can imagine, are put to good use within our environment. And some of the wins we've had are the direct results of those capabilities. Thank you.

Our next question comes from Luke Stergot at Barclays.

Great, thanks. I just kind of want to get a better sense of how to think about the TAS recovery and more on the discretionary and the commercial side and how it relates to drug approvals and things like that. So we only had 10 approvals in this quarter versus 15 last quarter, but we're already starting to see a strong start to April. I'm just trying to get a sense of what When pharma starts engaging you guys for work and when you start seeing those bookings and then ultimately when it starts flowing through, I know it's different for particular regions, but as the approvals start coming in and accelerating, how to think about the growth in the discretionary pieces that have been slower?

Look, I wish I had a crystal ball here, and I've been wrong before on predicting a comeback, if you will, of the DAS business. So be cautious in my commentary. You're right to point to the approvals. I mean, you know, the number of approvals, as you know, in last year, I think there were 55 approvals last year and that's. That that was I think a record year. It was certainly a very high level. Almost 50% more than than the prior year and the highest level I think since must be 17 or 18. Now the new launches and the spend associated with these new launches usually is up significantly for the five years um that follow these approvals so um you know we do expect the task business to to be strong um you know the the the the wild card is is you know when those launches occur what clients decide to do um you know the the about 50 of the new launch spend usually occurs within the first two years So again, it happens over the following five years and usually the first two years. I mean, yeah, quarter to quarter, it was only 10 this quarter, but we think in general, just with the approvals of last year, we should see a rebound coming in. And that's one of the reasons we are somewhat confident that the task business will be rebounding more strongly and, you know, The real uptick will come next year, but we see given that he has bottomed out here and we think we think it has reached the bottom and we anticipate an improvement. The balance of the year. The pipeline is higher than he has ever been, frankly, and we scrub this pipeline continuously. We continue to see improvement in customer sentiment. You know, in Q1, um the tone is better there are more opportunities that have surfaced there's increased optimism for the outlook in 24. um you know the the what happened the the second half of last year in conversations with clients is you know the budgets became um you know we are aware of what clients can spend because they're pretty certain budgets but the the the budget got trimmed sometime towards the end of the year and there was quite a bit of a certainty as people were negotiating internally we feel there is more clarity now on budgets and that helps a lot with um with confidence for awards you know in the balance of the year also decisions we measure decision timeline and that those timelines have started to come down and get reduced, which is a favorable sign.

All right. So I guess there's like basically between, obviously there's going to be a big difference there in timing, but like, you know, safe to assume between like six and 12 months lag post and approval of when you actually start working on the launch with the drug company and the commercialization efforts.

That's correct.

Okay, cool.

Thank you. All right. Thank you.

Okay, that was our... Yes, that does conclude our Q&A at this time. Mr. Joseph, I'll turn the call back over to you.

Thank you for taking the time to join us today, and we look forward to speaking with you again in our second quarter 2024 earnings call. The team will be available the rest of the day to take any follow-up questions that you'll have. Thank you.

This concludes today's conference call. Again, thank you for your participation. You may now disconnect.