ICON Public Limited Company (ICLR) Earnings Call Transcript & Summary

Welcome to day 1 of the UBS Healthcare conference. I'm Dan Brennan. I cover pharma services and life science tools. And apologize for the voice, a little bit of cold going around in my household. Really pleased to be joined here on the virtual podium with senior management from ICON. We have Brendan Brennan, CFO; and we have Jonathan Curtain, who is Head of Investor Relations. So I've got a series of questions to go through. Obviously, most of you are on the virtual webcast. I've done this before many times, but I believe you can send any questions through the link, which I'll hopefully see on screen, but if not, happy to tackle them as I see fit. With that, Jonathan and Brendan, thanks a lot for coming, really appreciate it.

Pleasure, Dan.

Excellent. So I thought we'd start just tactically, just looking at the last quarter. Obviously, we're going to spend a lot of time on the PRA deal and strategic benefits of that. But maybe just kicking off with some questions on the last quarter. I know in the last quarter, top line growth was very solid, 18%. I know Pfizer was a big contributor, I'm just trying to -- I think a question that came up on the call, but worth kind of revisiting. Could you help us think through the impact of COVID on the quarter, whether it be vaccines or therapeutics and I know you said other business wins that you were burning off prior wins and some launch passers. But just kind of unpack, if you will, the quarter and the COVID versus non-COVID impact?

Sure, Dan. Yes. No, it was good to have such a solid quarter. Obviously, we're very pleased with our progress into quarter 1. And we're supported by a very strong marketplace at the moment, both in terms of COVID and non-COVID work. So that's great to see that level of business went strongly through, I would say, the first quarter as well, which was very strong. And the signals as we go into Q2 are quite strong on that front as well. So a continued good set of numbers and good to see. In terms of unpacking the pieces between the COVID and non-COVID work. Obviously, we saw a big pickup in revenue year-over-year, particularly and indeed, quarter-over-quarter. And I think we made the point as well that there was a strong certainty of the pass-through related to acceleration as a result of some of the large vaccine trials that we're working on. And yet and likewise, you saw that little bit of pull back [indiscernible] the gross margin. A lot of the most pleasing things from my perspective, Dan, when I look at the numbers, was even when we kind of passed out what we were seeing from a Astra perspective, we saw a very, very strong underlying growth in our direct fee revenue pieces. Now we don't tend to talk too much to the split of revenues between the 2 modalities, revenue is revenue and it includes pass-through. But obviously, there's an [ advent ] of margin pullback and some of that revenue as it relates to pass-through. But what we have -- what we did see was very, very good strong growth, very, very similar percentages to what we publicly announced from a 606 perspective and in total perspective. And actually, if you look at the nature of COVID work because of the high prevalence of pass-through related costs, actually, that's probably disproportionately high [ advent ] of the growth in pass-through versus the underlying fee base. And so you're still seeing very, very solid growth ex COVID vaccine work. So you're talking about, [ fairly ] strong to mid-teens. And obviously, then obviously be the [indiscernible] excellent pieces of revenue growth coming through really on in relation to the vaccine work. So still very, very strong revenue growth. That's vaccine non-vaccine, if you like. I think the [indiscernible] COVID work is a smaller proportionality, so probably that -- that deals with the overall proportionality in terms of COVID or non-COVID growth, but still very, very good growth on both platforms, both vaccine, COVID, on non-vaccine related. So good, solid growth. We particularly expect to see that profile remain in Q2 as we get into Q2. I still see some of that, as I mentioned on the call. For Q1, we still expect to see in Q2, a pretty sizable amount of our pass-through hitting as we continue our vaccine work. Albeit in Q3 and Q4, good sequential revenue progress, however, less proportionately in pass-through with gross margin pickup in Q3 and Q4 as well as we get through the back end of the year. And supported by, as I said at the start good business wins environment. So I hope that gives some color down on that area.

Interesting. I know you just made the point there, Jonathan, about Q2 starting off strong as well, or half way through the quarter. Any -- would you want to flush out any comments there in terms of kind of tone of business that you're seeing thus far through the quarter?

It's been solid. It's been very good quarter-to-date. I think the mix is very, very good as well. It's very solid. We obviously still see COVID work as a decent proportion of that albeit we did say it's been -- it was at 20% in Q3, around that mark in Q4 and drop another mark in Q1. I think that progression is not dissimilar, so we're still seeing decreasing levels of COVID work in absolute terms, albeit, but it is still a real and meaningful part of business wins that we're seeing in Q2. And obviously, we're expecting that revenue platform to drive well into '22 at this stage as well. But it's a good mix of business. We see strong biotech funding, of course, still being a big part of the play. And the fact that the mRNA technology, it's been so successful with the development of -- in Moderna, and Pfizer, BioNTech of course, and their vaccine. [ Moderna, at least ], I think there is a lot of folks looking at how we can really use that mRNA technology. As we know, I mean, it was first developed exactly from the BioNTech perspective is an oncology company, so it's been looked at in terms of how you roll it out in that space in the oncology space. So really interesting work there, really interesting development. I think the fact that we know we've delivered such a significant pivotal trial from an mRNA perspective with the Pfizer vaccine, I think gives us a lot of experience in terms of running out these types of trials and certainly to highlight how those could be delivered in pretty exceptional timelines. So yes, so it was a lot of exciting stuff there, but a nice broad platform with some really nice exciting new technologies coming through as well. Of course, we mentioned it before, we'll mention it again. It's one of the big reasons for our deal with PRA is our excitement around decentralized trial and our excitement around really remote monitoring and using technology in a very different ways to deliver [indiscernible] .

Got it. Okay. Well, a lot in there, Jonathan. So maybe just kind of zooming it back up then maybe to a high level, just -- I think I'm not going to spend the whole call on COVID here. We'll ask a few questions and move on. But if you don't mind, so if you think about your full year revenue guidance, I don't know if you've broken this out already on the first quarter call or not. But just when you think about the top line growth, like what percent do you actually think would come from COVID within the full year number? And I know you said it's obviously going to diminish as we get through the year. But if we thought about the benefit in the first half or the second half within that growth, could you just kind of help us maybe bottom line it?

It's a hard one to call it out, I suppose [indiscernible], we are seeing, obviously as I said and particularly, when you're talking about as I said, pass-through related growth versus non pass-through related growth because that's the bit that's really coloring it, of course. And that's obviously going to have a much bigger impact in the first half of the year. Much, much less so in the second half of the year as we kind of move down the year and the vaccine. Since the continuation of vaccine work, it's not going away, but it's not the biggest proportion. And more of the COVID work is around antivirals and those pieces of backlog that we've developed. So I think if it's driving growth in the first half of the year, it certainly is driving growth in the first half of the year. And the second half, it's much more less notable as a sequential impact year-over-year. I think I've made the point that we're starting -- it drove in the first quarter drove probably I think incremental growth of about 5%, when we said we were mid-teens, we were about 20% reported. I think that's probably not dissimilar in H -- sorry, Q2, albeit, I think probably the smaller proportion in terms of absolute year-over-year growth being specifically driven on vaccine work in Q3, Q4 again in H2. So I think that's probably how I'd [ cross ] that.

Got it. Okay. Okay. Bookings weren't really healthy in Q1. Top line, I think the bookings year-over-year growth was strongest in years, north of 25%. What -- when you think about the book-to-bill that's kind of baked in your kind of guidance along with the conversion rate. How do we think about the toggle between those 2 factors? and how you're looking at the full year?

No, I think we're also very well -- bookings -- very happy with it in the first quarter. As I said, as we go into the second quarter, the outlook remains very solid. And we're very hopeful for our Q2 numbers at this point. As long as we think where conversion rates, obviously, that [ carries impact ] in terms of vaccine and the flow-through or pass-throughs. I think the way to look at it is the kind of high 8s at the moment, I think that will persist certainly into Q2, really strong business wins going through. Albeit sequential revenue growth in Q3 and Q4 from Q1 and Q2, probably not the same clip of increase, if you like, comparatively Q4 to Q1. And very big sequential [ jump up ] and a return to high 8s in terms of conversion levels. I think probably more normalized way to think about conversion at the back half of the year. It's probably in mid 8s as we still have seen very, very strong business wins coming in and some of that pass-through revenue falling back. As I said, sequential growth quarter-over-quarter, but probably not keeping pace with total level of backlog growth and sustaining the same [indiscernible] [ conversion ] levels if you like, quarter-over-quarter. So a little bit of a pull back in second half of the year on conversion in probably in the ballpark of the mid-8s, but albeit, we see that as a decent platform to work from as we go into '22 and put a very, very strong book of business to drive that off. And we'll do our absolute best obviously, as we always do to maximize our commercial levels on a quarterly basis.

So then I'm not -- I don't have a [indiscernible] in front of me, but if you put a mid 8 to the model, you'd look at like the midpoint of your guidance, what would that spit out for like your bookings like in the back half of the year, like on a book-to-bill basis, you think? What's kind of the right ZIP code?

Well, actually probably do a [indiscernible] Dan, as you well know, I think by the time you get to H2 of any year, you're talking about following years comparisons I suppose. So I'm not sure your math would change usually in terms of your business wins expectations for -- so you can put any number and it probably would have hit the [indiscernible]. However, that we're going to continue to listen, we'll make sure so -- hey, well this sunshine is right, so we've got a great business. We've got a great market right there at the moment, where we've seen obviously very strong book to bills right across the industry in Qs 4, Qs 1. I think Q2 is going to be another strong quarter. We can keep looking at those same numbers in Qs 3 and Qs 4. That's certainly what we'd be firing at and trying to achieve it as a combined business. And so that's very much where we're focused on, and keeping those numbers high. Albeit, as you [ know, is no, ] when we talked about -- we traditionally look at a 1.25. That's our kind of benchmark book-to-bill, we'd like to try to get on a quarterly basis, albeit to the point I made. We've got a very strong marketplace if we can get after [indiscernible] and that will be pleased to [indiscernible].

Got it. Maybe just high level, we can all see the biotech financing backlog, which is kind of a record, obviously, aided by COVID. There's a lot of new modalities today with all these immuno-oncology and Celgene therapy. So it appears like the environment is as robust as it's been. Any way if you could characterize just how you would talk about the demand environment today versus history? Give us a sense of are we at historic levels? Is it just a really strong environment? Just any qualitative way you might portray the environment today, giving us a sense of historically where it sits.

Yes. I mean, it's as strong as it has been. I think that's probably the way I would describe it. I mean, you go through different peaks and troughs, certainly, I mean, in this industry, a while now you certainly would start seeing peaks and troughs in terms of R&D development spends where those dollars are coming from. But the amount of funding that we've seen in biotech specifically has been phenomenal over the last 18 months to 2 years, I think, 18 months [indiscernible] probably would have said the same thing in terms of the levels of volume we were seeing at that point, but they were extraordinarily strong even at that point, and it just has continued. I think one of the -- there's a couple of interesting macro points here Dan, maybe are worth mentioning on a wee bit, obviously we've seen in a much more demonstrable way for the real-world impact of drug development as we viewed, obviously, during the course of 2020 into '21 [ as sort ] that has been the talking point on everybody's agenda regardless whether you're in health care or sits close to it as we do on a daily basis. So I think the globe has really exciting to appreciate the ability of drugs making a real difference in the -- [interest of humanity pulls up ]. I think that obviously brings more attention into health care, [indiscernible] and people are seeing relatively good returns on investment there as well in kind of an environment where investment is hard to -- or return on investment is hard to come by. So you've got a double whammy. You've got more money, additional money coming into the research and development space, looking for return on investments, where the world is market and the patients cohorts that are more aware of and willing to be involved in clinical research. I think this is a very strong period for clinical research. And I think the signs of tailwinds are very, very strong. And as I said, from a funding perspective, it's probably as strong as we have seen it. It's hard to point, or always hard to point -- to say what part of the mountain you're on in terms of when you're still climbing. It is hard to say whether we're nearing top or any of those points down, so I kind of hesitate to give another one, but I think what we're seeing at the moment is to going to change analogy, the tailwinds are still very significant in driving this industry forward, certainly in the short term.

Got it. Helpful, Jonathan. Excuse me, Brendan, sorry. So in terms of -- just one more just tactically, just in terms of impact of COVID. Obviously, just to say the demand environment is great. The outlook for '21 looks really solid. At the same time, you are still dealing with sites that are impacted due to the pandemic. I think at 1Q, you indicated 20% of sites are still impacted. Just how is that progressing? Is the vaccine rollout in the U.S. obviously is going by leaps and bounds. I think you're starting to play catch-up. Just how would you characterize the impact in terms of access that you saw at 1Q kind of proceeding as planned through Q2? Just what's the slope of that improvement, if you will, on access that is kind of baked in the guidance and kind of what you're seeing?

Yes. Just fusing it down, I'm going to bring Jonathan in to answer that. To answer that question [indiscernible].

Yes. It's [ Jonathan ]. I appreciate the [indiscernible]. I think what we're seeing at the moment is, in broad terms, a fairly similar level that we spoke about on the call. It is worth emphasizing though that's -- that most of the sites, despite the kind of the 20% impact, "most sites are open and recruiting reasonably well within that 20% bracket". So what you're seeing is very, very few sites at this stage closed kind [ of the ] research. I think maybe there was a partial or more kind of a -- still a residual element and in comparable terms to pre-COVID levels where they're still not operating at full capacity from a research perspective. But we expect to see as the vaccine has rolled out in the U.S. and Europe that continuing to improve. So still in baseline terms of very similar metric at 80% that fully over operational and that 20% impacted, albeit that the degree to the impact level is improving within that kind of 20% cohorts. So still improving as we go through the course of the year.

Got it. Okay. No, that's helpful. Maybe switching gears a bit just to PRA. So some time has passed since the deal was announced. But just wondering, how would you characterize from a high level since the deal was announced on a couple of planes, I'd be interested to get customer feedback, which obviously you guys have updated us on several times, but nonetheless, still love to get an update on customer feedback since the deal was announced. Importantly, we'd love to hear about employee retention. And then as well, I would love to understand some of the cost and revenue opportunities. Maybe just starting with customer feedback. I think you kind of characterized it. And I don't know what the word is, but obviously, very positive, receptive. But just maybe walk us through a little bit of what might be incremental or new or just the general level of impact that you -- or feedback you're hearing from customers?

Dan, it's -- I don't know if there's a [ huge bet ]. We could probably give you that's kind of [indiscernible] your understanding of the color that we have on that area at this stage. I mean, certainly, I've said it and I'll say it again, customers are obviously positive about the deal is the way I describe it. I think it's in a range. I think there's a range positive. There's folks who are fine, okay. That's great, good to hear it. Nice to have the additional services. By the way, stay focused on my project and get that across the line because that's all I care about really. So -- and that's somewhat understandable. And we're sure to say -- certainly say to all of our customers, whether on ICON or PRA side. Our primary focus is going to be on making sure that operational delivery does not slip during the process and that we will stay focused on delivering your workloads. So that is our kind of our primary response, and that's very important to us as organizations. So that's certainly been. I think there's been others who've been genuinely interested in the additional services. There's been folks who have seen the scale of the organization and now are thinking about it. And these will be existing customers. As you know, mainly counterparts in areas that they wouldn't have thought about either ICON or PRA as a counterparts in -- in the past, and that may be therapeutically, it might be geographically. And certainly, we've seen additional customers, or maybe large-scale of customers coming back to us and saying, okay, on the basis of your combined business, actually, you could probably do this. We hadn't given you this geography in the past [indiscernible] research because we had some reservations about your scale there. That's now an area where we want to have a follow-on conversation. And I think one of the main -- maybe the most interesting points as well is that we've been out to large customers, telling them about how excited we are about the transaction and about the traction that we feel it will make in terms of development process around the research, around things like decentralized trials, around all the pieces we want to bring to how we solve their problems. And that's actually gained some traction. So we've had some interesting feedback from 2 top [ tourney ] customers not large incumbents of either of us, either ICON or PRA at [ moat ]. And that's something where we're looking to recapitalize on and we'll be in having a conversations with those folks about larger scale relationships as we go forward. So that's something that's really exciting. And I think something that, certainly, people are really in that large pharma cohort are kind of picking up and taking notice of ICON and PRA and really going, this is -- these are 2 really good quality organizations being brought together. In a way that's going to be really additive and helpful. And does represent a really very [indiscernible] industry competitors as a counterpart to other large players in the industry. So I think that's been super interesting. So we've seen that traction continuing, and it's been really nice to have -- have that feedback from customers. And as I said, I think those folks who are -- kind of our long-term customers are very much getting used to the message. We're getting much more [indiscernible] obviously, in terms of our communication and our meetings with those customers. So I think that's all moving in a pretty positive direction so far. It will remain -- it would be naive of me to sit here and say that there is a risk around [indiscernible]. Of course, there is, but we will remain extraordinarily diligent to ensuring that we deliver for our customers as we consolidate these 2 organizations together, it will be our primary focus. Dig into that a little bit or we can go on to headcount, we'll talk about that.

Yes. No. So maybe, what would be the -- I mean, we'll dig back in a little bit on the revenue side because, I mean, obviously, you've laid out some distinct buckets. You just mentioned a few of them there. But it would be interesting to get a little more feedback. But just on the risk side, is it just -- obviously, you're putting 2 businesses together, and there's always risk of either some disruption internally or maybe a customer deciding they don't want to be as concentrated, but since you brought up risk, how would you characterize the main risks to the deal?

I mean there is obviously the risk around customers where you already have quite a large share of their book of business. [indiscernible] That's something that they need to decide whether they are happy with that proportionality or whether they need to further diversify their book of business between their CRO providers. And now we're in a lucky position because that doesn't happen much. It's been, as we said, and we've made a point. It's a very complementary customer book across the 2 organizations. And there's probably only about one major deal or one major customer, I should say, who -- in the top 10, where we feel that there is a significant overlap. And now in our relationship with that customer is extremely good. We've been having 3-way conversations with that customer at this point, nothing that's untoward, or noncommercial from that perspective. It's just more planning for when the deal is done and how things will operate at that point. And we are actually serving that customer in 2 different areas, if you like, to different service or predominant service lines. So we feel that at this point, the relationship is very good and it's ours to really maintain and to hopefully grow over time. That customer is obviously having just taking a look at the relationships and thinking about overall risk and counterparts. They have one other CRO outside of ourselves and PRA. At this point, we feel that they're probably satisfied with that, and it will be a kind of make sure that we continue to deliver, with the biggest challenge in terms of retaining all the proportionality of dollars that we're seeing on that account as we go forward. But similar conversations are having not quite that level or other levels in the organization where there is a little bit of overlap but as I said we will remain very very focused on customer delivery and on [ joined up ] delivery as we go through this process to make sure that one of the big things that is going to, and I've said it before in the past, as CROs, generally, their turnover comes when you're not delivering as a CRO, and that's the biggest [indiscernible] . So if you're looking at why CROs get turned over on [ pharma ] relationships, it's because incumbents aren't performing to the way that they should be. And I think that's one of our areas to focus to make sure that we obviously continue our operations with every one of our customers, 110%.

Got it. Jonathan and I have chatted a few times about the risk of employee turnover, I mean we had done some just one-off checks, and obviously we can't check with the whole company, but I'm just wondering what's to be expected? I mean, what are you seeing today? I mean, obviously, there's -- the CRA market is very tight as it is. So there's a typically higher turnover pie in the market than normal, just given how strong demand is. So I'm just wondering what's baked in? And how would you comment on how it's been going so far -- thus far in terms of the integration and in terms of the risk of this turnover?

Yes. Good question, Dan. I mean the way I characterize turnover in this business, is that it usually [ pops on performance ], right? So I think everybody in the U.S. market is [indiscernible] , maybe to some extent, focus on the U.S. market, which is hot at the moment, as we know, both in terms of project teams, some more senior project management delivery folks. As well as CRAs and CTAs at that level of the organization as well. And North America is hot market and I think that's true right across CROs. So we're seeing that, and there is a lot of sign-on bonuses going on in the marketplace, as we know at the moment, there's a lot of retention elements being paid to folks regardless of deals or deal structures as announced. Of course, let's bear in mind that we're not the only company in the CRA industry that is going through some form of a deal at the moment. It's quite common, or certainly the future of our strategic feature of assets are being reviewed as well. So I think there's a fair amount of flux there in North America at the moment. So it is elevated, but I don't know if that's deal specific. As I said, we really see that, it's a hot marketplace. I think if you went back 2 years ago and said the same was true of the Chinese market, we saw an awful hot market there in terms of [ rotation ] and people around that headed down a bit more stability in that marketplace. We've often talked about the fact that 15% is in and around the right long-term CRO industry turnover metric. And in pockets you will see that elevated in our organization, we see elevated pockets in North America would be one of the most. We also see areas where it's actually below 10% in our business as well in different geographic areas and different service lines. So I think there always is a mix of this. You will always have areas where it's elevated and managing that is a part and parcel of what we do as CROs. I think it has been elevated a little bit this year in North America, I think that is fair. However, I think that's right across the industry. Now it's peculiar to us as I said, because we're doing a deal. And we're [ far from the ] only being in organizations that have impacted by transactions and talk around transactions. So we don't feel like it's something that's unusual or specific. We do -- and we obviously keep a close eye to it. We're looking at retention, both financially, but also from all of the others that you would expect that. One of the things we are ready focused on is, is making sure there is good career development for our employees and making sure folks who are enrolled for a number of years are seeing career progress, particularly in those geographies where there's more intense pressure. I think that's one of the big elements is obviously working around retention. It's not just about hiring and new growth through our organization, which we're doing a good job at. And that certainly will be a net increase in our headcount every month. I'll be here as a combined organization as we go through the course of the year. So a lot of these organizations are going to be significantly larger by the end of this year than they were at the start. So that's good news, obviously. But obviously, trying to ensuring that we are doing all we can to retain the staff we've developed is extremely important and we're very focused on that. But as I said, it's not just about money in dollars and inflation, and those pieces are important, but there are -- there's also career development, environment, and making sure people have a good vision for that where that growth is going and that's super important to be [ delivered ].

Okay. Good. Good. It sounds good. In terms of the top line, you guys didn't bake in any formal revenue synergies. Obviously, you talked about some cost synergies. But on the rep synergy side, you obviously highlighted a number of different areas where you see the strategic benefits you've already touched upon them today. Just -- I mean, realistically, should there be some revenue -- enhanced revenue gains from the combined company, I would think so. And is it just out of conservatism you don't bake it in? And if so can you help us think through maybe one of the major buckets and if it's not formally in guidance like, help us think through what they potentially could be.

Sure, Dan. Yes. I mean, there's numerous ancillary services that either the scale of the combined organization brings to a customer base, I suppose, it's the core customer base is around our Phase II to III businesses, whether that be we're going to be introducing PRA customer base to our predominantly our central lab services, our imaging services, our language translation services aren't part of PRA offering of services. And of course, then on the other side, I think our large players, our large customers, certainly now have a Phase I [ biological ] offering. Our combined scale that's certainly wouldn't be the case that we were quite small in that area. As you guys know, prior to the deal -- gosh, post the deal, it will be a very, very significant player in that space, #3 in the marketplace. So that brings a whole new set of customers to us as a counterpart from that perspective in [ aiding clinical developments and ] biological analysis. So that's very exciting as well. I do think -- yes, I think it is conservatism, we'll be honest about that. We said it from the get-go. We said there's a risk of desynergies on revenue. We'll work hard to make sure that they're absolutely minimized, but there is that risk. And to the other side, there is obviously the potential for additional synergies from a cross-sell perspective on those services I highlight there. And I think it was conservatism that said, well, let's not put in one or the other. We think one will be minimized hopefully with the good work, with all that. But let's not put in the synergies out of a sense of just making sure that we deliver the numbers we say we're going to. You know Dan, from working with us for years, we're pretty good [indiscernible] financial managers here at ICON and that will be true of the combined entity and certainly, we want to hit all the numbers that we talk about. So that's certainly something that is just a [indiscernible]. I think as we look at that in terms of buckets and what we'd like to achieve, it's probably a little early to say, Dan, to give you a lot of specifics. I mean, to be honest, given the scale of the overall organization, and the amount of offering that we have on both sides of the gap, I think it would be -- certainly, we'd be targeting in the kind of $100 million mark of synergies, that will be over time. As I said, it's not part of our numbers, but it is something that we would think about from a longer-term perspective in terms of what is in the [ area of] [doable. It won't be in year 1. It will take time to ramp up to that level. We'll give you more color on that as we go into more formal guidance and are taking expands. So we get a little more integrated as organizations. But I think given the, as I said, the scale of the overall organization, certainly that kind of [ ilk ] of cross-sells is not beyond reason.

Certainly there's been a lot of interest in virtual trials. And I think you highlighted at the time of the deal and maybe just now as well. PRA might have kind of a leg up on maybe what ICON had on its own. Could you just flush out a little bit and [ move ] back in what the [ many ] acquisitions they had done? Just maybe flush out a bit what PRA has in virtual trials, maybe ICON didn't? And then from a higher level, if we think about the impact of virtual trials on the company and the industry, like at what pace could virtual trials become a more meaningful part of your business? And how does it impact the overall financial profile of the company? Obviously, there's some new revenue streams, but at the same time, you could be trading off some high revenue-generating services for something that isn't as lucrative. So maybe a 2-part question in terms of PRA's capabilities and then the overall opportunity.

Yes, obviously, PRA have done a little bit of a -- little acquisitions, I should say, [indiscernible]. And there's a couple more in there as well that really helped them build out a software platform for the management of decentralized trials, which I suppose was probably the big piece, that ICON had been previously working with partners around to deliver decentralized trials. So when we think of the kind of the software elements, be it the telemedicine, or the actual clinical trial management system that works to decentralized model. It's a different system to the one you would use on a normal conventional clinical trial process. And so they really had invested very much ahead of the curve in terms of acquiring and developing and further developing that model into a much more integrated solution. As I said, ICON will be working with partners, of course, what ICON brings to decentralize trial process is the site and patient relationship piece between both the owned sites where we could use our own sites to deploy that technology, a super site. Of course, the whole idea of decentralized trial is that one doctor many patients because you can now obviously look beyond the normal profile of that doctor's patients to deliver additional patients into the trial. So you can have this concept of the super site, where one doctor could be facing off against 50 or 60 patients as opposed to maybe what would have been more traditional is, [ I cope with ] a handful. So that's certainly an element where we bring a strength from our sites and obviously, the fact that we have some own sites and doctors we're working within close cooperation and ability to train them up on the software system so that they become expert in is very, very attractive to us. And then, of course, we have our Symphony organization, which was the home health care business, where we have the ability of putting nurses in the patient's homes. So that when we are getting patients on trial and they're using telemedicine, they've got an iPad in front of them, or one of the devices that they're using to communicate with the doctor. And any blood draws or additional things that need to happen directed with patient can be done through that home nurse and network, and we can get that nurse network out of the home as well as good logistics partnerships that we've developed over the years in relation to getting [ doctor ] home or any other equipment that needs to be at the home to actually [ around ] the clinical trial process. And then, of course, it can be managed and administered by the nurse visiting the home and that nurse can act as a linkage, if you like back into the site piece. I think once you think about this model of trial delivery, these are ancillary services that most CROs are dabbling in at the moment, I would say, or starting to develop real strength in. I think we're obviously one of the organization that's delivering real strength in developing out these models. These are additional services because, obviously, you're dealing directly with doctors, patients in this type of scenario. The novel being revenue pieces of clinical research is more in the back office [ order ] of what's going on. The clinical monitoring is effectively an [ honor process ]. And what the doctor is doing at the site, and as our data management, obviously, then is reviewing and creating data as it comes back into the dossier to be submitted to an FDA or an EMA. So the nature is that we will be doing monitoring, to your point, Dan, that it's probably more remote or can be more remote or, it certainly allows us to be a lot more centralized into fewer sites and so the kind of leg work that has to be done as well as the kind of amount of information, any one monitoring can get through should be a lot more efficient in this model as well. I think there will always be, Dan, an element or migrant elements to this. So for example, patients might be remote to an extent all the time on a trial, but it's unlikely that any trial will be done where a doctor and a patient don't get together right at some stage. And also, the uptake will be different depending on the trial type and the patient as well because we know from our own experience. Some patients want to spend 5 seconds with a doctor, if they've got chest pain, some patients want to talk about [indiscernible] 45 minutes, right? So I mean, it's very, very different depending on type of relationship of certain patients. So I don't think this is certainly something we bring to the development process as something that would be a hybrid element to nearly every trial. How lo3G that takes to get there? That's probably a longer, longer piece pickup in clinical trials, it's relatively slow. We've obviously seen an acceleration in remote monitoring over the last 12 to 18 months. And that now probably represents about probably 1/3 of all trial development is considered remote. And we'll probably -- that may decrease a little bit as we go forward. However, we still have a significant balance of what we're doing from a monitoring perspective. So I think this really is around, what, how it will play out over time. I do think it will take at least 4 to 5 years before it's ubiquitous. The same way remote monitoring is not yet ubiquitous, it will take time to develop as does any of new technology on the trial. But we have an element of the monitoring, obviously, decreasing as a proportion of the overall revenue mix, but these ancillary services should be ramping up to take that place. Will that be an absolute mixed balance, would be -- as I said, depending on the timing, it would be tricky to measure that over time. But we do see this as really adding value and I think that's the most important point. We want to go where the trial is going, right? So we want to be able to bring patients into the trial and keep them on the trial and keep the doctors on the trial and deliver a faster, more efficient trial process. And I think that's what DCC is all about. So I think that's very much something we're going to continue to pushing as it just creates additional value and better true pull for our customers in terms of their development processes.

Got it. Maybe just touching on the Symphony deal a bit. So I don't think it was a essential part of the acquisition during the deal discussion, it obviously came up, but it sounded like it was maybe an opportunity to create some value out of it as opposed to something that's more to the deal. Maybe just walk us through a little bit about what you know of that asset? Why it didn't really perform as well as expected under PRA and what opportunity you see now combined with ICON, do you think you could create for that data asset?

Yes. I think there's been a lot of work in front of us with that asset. I think there has been the -- they're doing a lot of investments both in the asset in the data lake and the management team, indeed, that's there. And they had a great quarter in quarter 1, which was really pleasing to see. Obviously, they had good -- really, really good, strong mid-teen revenue growth year-over-year. So it was great to see. I think that's maybe the overnight success has taken a couple of years, but that's going to be something that they've been working on developing for the last number of years. So it's great for that team to see that growth in quarter 1. I think it's interesting from the perspective, as we've always said, we're somewhat data agnostic, we don't think any one source of data is the best or absolute variant on data, I think that will be true, albeit we are very open to the idea of having as many data sets to make the data pool as rich as possible. And certainly, the Symphony data will be very much going into that data pool. I think one of the other pieces that are some of the other pieces that we've always said are probably as interesting. Certainly, we'll use this to continue our feasibility work and identifying patients and how we link those to clinical research the doctor site is getting [ charged on ] but one of the other interesting pieces as well, is more on the back end, we're around the concept of late-stage trials, and its overlap with late-stage trials and using data sets obviously, for elements of late-stage consulting and synthetic arm trials and all of those pieces, where we actually have quite a large business, our late-stage business, our eCOA business, is very significant, and has been working as a very well established consulting group there. And have been working with third-party databases. In terms of real-world evidence databases to this point. So I think the fact that we'll have now a very strong, real world evidence data base as well as a very strong consulting offering, really brings a whole different paradigm to what we can sell and value we can give to customers, particularly in that space, as well as using -- continuing to use all the Symphony information. That has been used by [ viewing ] to some extent in its Phase III trials and Phase II trials in the wider organization as well, of course, is the fact that we've seen, just for the underlying business model of Symphony on its own as a dataware [indiscernible] strong growth profile there. So I think all of those pieces will hopefully add the [indiscernible].

All right. Well, gentlemen, I think we're at the 45-minute mark. I had a few more, but in the interest of staying on schedule here, give everyone time to get to their next meetings. Obviously, appreciate Brendan and Jonathan being here at the conference. Good luck with Q2, look forward to hearing from you guys at that time. And hopefully, everyone who's listening to the webcast has a great conference. So thank you.

Thanks. Dan.

Thanks, Dan. See you soon.

Bye-bye.