IQVIA Holdings (IQV) Q3 2026 Earnings Report

The call was strongly positive. IQVIA reported revenue, adjusted EBITDA, and adjusted EPS above guidance; accelerating organic growth across clinical and commercial solutions; record four-year clinical bookings; improving win rates; strong demand indicators; expanding AI adoption; strong free cash flow; and raised full-year guidance. The principal challenges were the $2.1 billion inactive-trial backlog adjustment, pass-through and foreign-exchange headwinds, difficult fourth-quarter comparisons, leverage, and historical market uncertainty, but management explicitly stated that the backlog adjustment did not affect financial results or guidance and emphasized continued operational momentum.

Management raised full year 2026 guidance, expecting revenue to be between 17.350 billion and $17.5 billion, representing year over year growth of 6.4% to 7.3%, with >1 point constant currency or revenue growth acceleration versus prior year, approximately 200 to 250 basis points of contribution from acquisitions, and approximately 20 basis points of tailwind from foreign exchange; adjusted EBITDA is expected to be between 4.025 billion and $4.055 billion, growing 6.3 to 7% year over year with flat margins year over year at approximately 23.2%; adjusted diluted EPS is expected to be between $12.90 and $13, up 8.2 to 9.1% versus prior year or 8.6% at the midpoint; fourth-quarter run rate assumptions include net interest expense around $210 million, just over $160 million in depreciation and amortization, and a weighted average diluted share count of approximately 169 million shares, with foreign currency rates as of October 26th continuing for the balance.