IQVIA Holdings, Inc.

Ladies and gentlemen, thank you for standing by. At this time, I would like to welcome everyone to the IQVIA first quarter 2026 earnings conference call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you would like to ask a question during this time, simply press star followed by the number one on your telephone keypad. If you would like to withdraw your question, press star followed by the number one again. As a reminder, this call is being recorded. Thank you. I would now like to turn the call over to Kerry Joseph, Senior Vice President, Investor Relations and Treasury. Mr. Joseph, please begin your conference.

Thank you all for it. Good morning, everyone. Thank you for joining our first quarter 2026 earnings call. With me today are Ari Boosley, Chairman and Chief Executive Officer, Mike Fedot, Executive Vice President and Chief Financial Officer, Eric Sherbert, Executive Vice President and General Counsel, Katie Ward, Vice President, Investor Relations, and Gustavo Peroni, Senior Director, Investor Relations. Today, we will be referencing a presentation that will be visible Before we begin, I would like to caution listeners that certain information discussed by the management In addition, we will discuss certain non-GAAP financial measures on this call, which should be considered a supplement to, and not a substitute for, financial measures prepared in accordance with GAAP. A reconciliation of these non-GAAP measures to the comparable GAAP measures is included in the press release and conference call presentation. As previously disclosed, we implemented a new segment reporting structure effective January 1, 2026, In conjunction with this change, prior period segment amounts have been recast to conform to this new report instruction. I would now like to turn the call over to our Chairman and CEO, Ari Neesby.

Thank you, Gary, and good morning, everyone. Thank you for joining us today to discuss our first quarter results. Acuvia delivered outstanding financial results, achieving record first quarter revenue and adjusted diluted earnings per share, that exceeded the high end of our guidance, reflecting solid top and bottom line performance. We are seeing continued positive year over year momentum across the portfolio with strong acceleration of organic revenue growth. In fact, year over year, our organic revenue growth rate in commercial solutions doubled and our organic revenue growth rate in RMDS tripled. On the commercial side, revenue growth accelerated as clients continue to launch new products and increase the breadth of services they utilize from IQVIA. We saw particular strength in patient solutions, which is the part of real world that remained in the commercial segment. Also, particular strength in analytics and consulting, which had the highest growth we've seen in three years, and strength as well in our commercial engagement services, which includes the former CSMS segment. We feel good about demand on the commercial side, with pipelines growing to record levels, and we think AI has something to do with it. AI is causing our clients to have more questions. It's causing them to increase their demand for IQVIA's differentiated AI capabilities and for the innovation we are embedding across our commercial offerings. On the critical side, we also delivered very strong performance in the first quarter with better than expected reported and organic revenue growth. We had solid bookings with double-digit growth year-over-year, both as reported and as recast. In particular, we had solid growth in net service fee bookings, that is, excluding pass-throughs. Net service bookings growth in the quarter were solid year-over-year, as well as sequential, both as reported and as recast. And I should note cancellations in the quarter were within the normal range. So why was our book-to-be ratio 1.04 in the quarter despite solid service fee bookings growth and no more cancellations? And no, AI has nothing to do with it. What happened was that pass-through bookings were unusually low in the quarter. simply due to the particular mix of indications of the clinical trials we booked in the quarter, which included more full-service trials with lower pass-throughs than usual. And I want to note that the proportion of FSP in our bookings this quarter was consistent with historic levels. Now, regarding the overall demand environment, Forward-looking demand metrics continue to point in the right direction. Our backlog reached a new record of $34.2 billion at the end of the quarter. And noteworthy is the amount of dollars from our backlog that will convert to revenue in the next 12 months. We have $8.9 billion out of our backlog, representing nearly 8% growth year-over-year versus the recast numbers last year. A qualified pipeline grew mid-single digits year-over-year, with notable strength in EBP. RFP flow grew high single digits year-over-year, driven by growth both in large pharma and in EBP. All of these comparisons are, of course, apples to apples, that is, versus prior year numbers that have been recast to reflect the new segment reporting. Finally, you may have noticed EBP funding was very strong in the first quarter, reaching $25 billion, according to Bayou World, which is almost double the funding in Q1 2025. Now, let's turn to the results in the quarter. We delivered outstanding revenue and profit results. Total revenue for the first quarter exceeded the high end of our guidance range, representing year over year of 8.4% on a reported basis, 6% at constant currency. First quarter adjusted EBITDA was up 5.5%. First quarter adjusted diluted EPS of $2.90 also exceeded the high end of our guidance range, and it increased 7.4% year over year. Let's now review a few highlights of business activity. Let me begin with an update on AI. As a quick reminder, IQVIA's AI solutions are built on our unparalleled proprietary data foundation. Based in class compliance with the privacy, regulatory, and integrity standards, healthcare-grade AI demands and are connected to our deep life sciences and healthcare expertise. We've been integrating AI into our operations and solutions at scale for nearly a decade. It's part of who we are and what we do. We already function as an AI native company in life sciences. A few weeks ago, we unveiled IQVIA.AI at NVIDIA's GTC conference. This is our agentic AI portal and marketplace, purpose-built for life sciences. It provides clients a single access point to their purchased IQVIA AI solutions, enabling centralized control with their internal user base, while also enabling visibility to a broader AI portfolio to support future solution adoption. Our deployment of highly specialized life science industry AI agents is progressing as planned. To date, we have 192 agents deployed in the field covering 64 use cases across both our commercial solutions and R&DF businesses. 19 of the top 20 pharma companies are already using IQVIA agents in some of their workflows, underscoring broad industry trust in IQVIA's AI capabilities. Let me now switch to client activity first in commercial solutions. This quarter, we saw clients increasingly selecting IQVIA to build AI-ready data foundations, which facilitates the incorporation of AI agents, including IQVIA's agents, into their workflows. These new services expand the scope of our partnerships with clients. A few examples. of wins in the quarter. The top 10 pharma clients awarded IQVIA a contract to modernize performance reporting on markets and therapeutic areas using an AI-driven analytics platform. The engagement replaces hundreds of disconnected reports and dashboards from multiple vendors with a centralized managed AI-powered IQVIA insight solution. IQVIA secured a multi-year partnership with a mid-size client to provide a scalable AI-ready data foundation. The win demonstrates IQVIA's plug-and-play capabilities within a client's multi-provider technology ecosystem. Pfizer and IQVIA entered into a strategic regional promotion agreement covering selected Pfizer products across 23 countries in Europe. This collaboration brings together Pfizer's scientific leadership with IQVIA's promotional expertise, market intelligence, and AI-supported technology to support long-term impact. We entered into a strategic long-term collaboration with Boehringer Ingelheim to transport the Global Commercial Intelligence Foundation. Boehringer selected IQVIA's data as a service TAS Plus platform as the core accelerator to harmonize and upgrade global commercial operations, enabling more scalable analytics and a single version of the truth across therapeutic areas and geography. This collaboration will support upcoming product launches and market reporting across 59 countries. IQVIA was awarded a multi-year agreement to serve as the primary patient information and analytics partner across an EVP's full portfolio, including our data as a service platform. This partnership is designed to drive strong visibility into existing grants, step change improvements in analytics, insights, and pipeline assets, and more intelligent commercial and portfolio decisions. Let me now turn to R&D solutions. Our strategy in R&D is has been to leverage our AI solutions to optimize trial design and execution to reduce timelines for our clients. Of course, we've been doing this for years through protocol optimization, site identification, and operational risk mitigation. We're taking this to the next level with AI agents, which leads to much faster study execution and increases quality by reducing errors and rework. For example, the AI agentification of the complex database setup process in a study startup, or the AI agentification of tasks involved in finding multiple documents in the trial master file. We are increasingly embedding these AI agents in our delivery model. Let me share a few examples of recent wins on the back of these capabilities. The top five pharma companies selected IQVIA to provide AI-enabled global medical safety and pharmacovigilance services, building on a decade-long relationship and strong performance across both FSP and clinical delivery models. The deal consolidates safety operations under a single, scalable model to improve efficiency and reliability while enabling ongoing innovation. A top 10 pharma client awarded IQVIA a multi-year agreement to serve as the primary partner for delivering full-service global clinical trials. We differentiated ourselves through AI-enabled innovation that accelerates development and improves execution quality. IQVIA won a contract on a global midsize pharma to deliver a phase three clinical study supporting a high-profile oncology asset. In this case, We were selected based on our experience running similar studies, as well as our ability to deliver AI-enabled trial design, protocol optimization, and site identification. A top 20 pharma company selected IQVIA to support a late-stage clinical program in asthma in overweight patients. The win highlighted AI-enabled clinical solutions, including in protocol and design strategy optimization, regulatory compliance, and study document finance. For an EVP, we are delivering a global late-stage clinical program that integrates clinical and laboratory services within a single operating model with a gentrified analytics embedded across site feasibility and selection, enrollment, and performance forecasting. Lastly, in the quarter, we announced a strategic collaboration with the Duke Clinical Research Institute to advance clinical research in obesity and related cardiometabolic conditions. The collaboration brings together IQVIA's global operational scale and execution capabilities with Duke's academic rigor and scientific leadership, creating an integrated end-to-end model for large, complex clinical trials. The partnership is designed to accelerate trial startup, improve execution efficiency, and support regulatory submissions and commercialization. IQVIA contributes deep expertise in obesity and metabolic disease, having supported more than 120 obesity trials and enrolled more than 90,000 patients, including work across all FDA-approved GLP-1 therapies to date. providing sponsors with a proven operational foundation. This partnership with Duke has already resulted in a significant pipeline of opportunities and a few wins in the second quarter. Now to Mike for more details on our financial performance.