IQVIA Holdings Inc. (IQV) Earnings Call Transcript & Summary

Well, thank you, everybody, for joining. And for our next presentation, we have IQVIA. Joining us from IQVIA is Chief Financial Officer, Ron Bruehlman. I'm Dan Leonard, the life science tools, services and diagnostics analyst at UBS. So thank you for your time, and Ron, welcome.

Yes. Thank you, Dan.

So coming -- hosting you here off the back of Q3 results, I thought the best way to start the conversation would be asking you to reflect back on highlights from the third quarter.

Sure. Look, we had what I feel was a very solid Q3 from a financial standpoint. We were above the high end of our range on revenue and a lot of that driven by strength in Tech & Analytics Solutions, or TAS. And I know there have been a lot of concern about that part of our business because for the 4 preceding quarters it was on the slow side. We did see discretionary spend among customers slow down, but we were forecasting a comeback in the second half of the year, and I think everybody was kind of waiting to see whether that would happen. And in fact, in Q3, we had a revenue growth of over 8% in the business and very solid -- some acquisitions, but very solid organic growth there. And we see the same thing for Q4. So the recovery that we were anticipating is, in fact, materializing. We had margin expansion in the quarter. I think it was about 30 basis points. And for the first time in several quarters, anyway, we had double-digit EPS growth, it was over 14%. And not to ignore the balance sheet, we had strong cash flow. It came in at about 109% of adjusted net income, very good collections performance. So overall, we were really happy with the Q3 performance. I know you're going to ask about the R&DS side of the business in bookings, which we have a few bumps there. But fundamentally, the results were strong in Q3.

Before we jump to R&DS, I'll confess, I was one of those that wasn't entirely sure what to make of your rebound expectations in the TAS business that you delivered on in the Q3 result. And part of that is the tie-in to pharma discretionary spending, pharma budgets and pharma discretionary spending seems pretty tight in 2024. So can you elaborate a bit more on within TAS, because you have a number of different products and services within that business unit, really what performed up to expectation, what exceeded expectation? If you could speak to growth rates by any of the buckets, I think that would be helpful as well.

Yes, sure. I'd be happy to. But just to take a step back, we did see a slowdown in pharma discretionary spending in the back half of last year and into this year, and we said, look, we expect kind of a mirror image to last year, where we'll see higher growth at the end of the year, last year was higher growth at the beginning of the year. The reason that we saw the slowdown, we think, is probably twofold. One, you had pharma companies coming off of some fairly robust spending in the COVID period. And as revenue started to slow down for them, particularly those who had COVID-related products, you saw them pulling in the reins of discretionary spending. And also, we think that the interest rate environment and the IRA contributed to a slowdown in spending. Pharma, like any company, if you want to cut spending, will go after the fast cycle discretionary work first, and that's what happened. But we knew it would come back, one, because we've seen this kind of cycle happen many times in the past. And secondly, if you look at the underlying drivers of demand, one of the biggest being new product approvals by the FDA, it was at a record level last year. And this year, while not quite to last year's level, it's certainly trending towards the historic averages. So there's a lot of pent-up demand among our pharma customers to do work to support the commercialization of their drug. Now if you look by segment, we talk about 4 big buckets of spending within TAS or businesses within TAS. There are obviously many sub-businesses within them. And one is our information business, which is a solid low single-digit grower. It's not a fast grower. We're very penetrated in that market. But good business, good margins, good cash flow. It's just not going to grow a lot. It's very, very steady. And no surprises there. We saw the analytics and consulting business, which is our second bucket that I want to talk about, to come back in the third quarter with low single digits growth, which doesn't sound great, particularly for discretionary business, but you've got to compare that to actually flat in the first half, and we even had a down quarter or two in the mix, if you go back. So we are seeing that come back, and we expect it to continue. Our technology business was -- tech business was high single-digit growth. So that was nice growth there. That tends to be -- there is some discretionary there, but that tends to be a little steadier. And then the second real discretionary part of our business is real-world evidence. And I think if we got a surprise to the upside anywhere in Q3, it was in the real-world evidence business that came back -- we expected to come back, but it came back a little bit faster than what we thought and grew low double digits. So you put all those together, they blend to just over 8% revenue growth for TAS in the quarter.

Okay. And one of the things I was wondering about, some time ago, when you made the announcement of your relationship with Salesforce and plans to launch a new product with them a year from now, could that pause the market to any degree in the interim, but it sounds like that if tech grew high single digits, that did not occur.

No, we haven't seen that happen. But look, we have many components to the tech business, aside from the CRM business, and -- or OCE is the brand name we put on it, Orchestrated Customer Engagement. And no, we haven't seen -- we actually continue to sell that product, even though there is going to ultimately be a transition towards a new Salesforce-based platform. And we think the customers that we're selling to now as well as many of the existing customers that have been on the platform for a while will eventually transition over to the new Salesforce product but on their schedule. It could be later in the decade before that happens for many of them. Changing a CRM system is not a small exercise in any company with many salespeople. So they're going to do it when they're ready and not before. And yes, so we haven't seen anything fundamentally change there.

Okay. Well, with that, let's shift to the R&DS business. I don't know if you want to offer a couple of framing thoughts on the Q3 updates there before I dive into some details?

Well, look, you saw it was kind of a choppy quarter for us in R&DS, not so much on their revenue or profit or cash flow or anything like that, that was all pretty much as expected, but more on the bookings front. We had one very large cancellation on the order of $350 million. And that was kind of incremental to our normal level, largely incremental to our normal level of cancellation, which tend to be around, call it, $500 million, give or take, in any given quarter. And in prior quarters, maybe we would have been able to overcome that, but there's enough hesitancy on the part of large pharma customers are going -- a number of them are going through portfolio reevaluations and reprioritizations that are slowing the rate of decision-making or causing them to pull back on proceeding with certain trials that there just wasn't enough coming through to offset that in the quarter. But absent that, we would have been at -- that one big cancellation, we would have been at a very respectable 1.22 book-to-bill and end up, we were at 1.06, which I think is the lowest since the first quarter of 2019. So clearly, beneath the standard that we typically set, but it was a drug futility issue that caused that cancellation. It wasn't anything to do with funding or reevaluation of portfolio. Those things happen, and it just happened to be a big trial. So from time to time, you're going to get that. We also had 2 mega trials, very large trials, even larger than the cancellation that were delayed, one by 6 months and one by 12 months. And we found out about these literally in the last week of the quarter. So some out there saying, "Gee, you didn't signal this in September at conferences" or whatever. We really didn't know about it until the very end of the quarter. And these, again, are not related to portfolio reprioritization or any issues with the client pulling back. It's just that they weren't ready for various reasons. And I can't go into the details because we have confidentiality agreements with those clients, but it had nothing to do with IQVIA performance, had nothing to do with funding, had nothing to do with portfolio reprioritization, but they're big and they're fast-burning. So we were expecting a substantial amount of revenue in Q4 from these 2 trials and one was pushed out for 6 months and the other for 12 months. So eventually, the revenue is going to come. And we've talked to the clients there, and they're very positive on continuing with these trials, but it's just on a delayed basis. So it did affect Q4. So we had to adjust downward our revenue guidance in Q4. And then what you're going to see when we give quarterly guidance for 2025, which we're not going to do at this point. Probably, when we'll get into the quarterly guidance until we get to our fourth quarter earnings call. But what you're going to see is probably stronger growth in R&DS in the back half of the year than in the front half of the year just by virtue of these 2 big trials that got pushed off that were very fast-burning trials. But if -- okay, you put that aside, you say, okay, I know against the backdrop of the portfolio reprioritization that's going on in the industry, some of the noise that you hear, people are concerned about it. But these really were kind of isolated one-off events that could have happened at any time. It just doesn't relate to the environment at all. Now having said that, honestly, there is some churn going on in the industry because of customers reevaluating their portfolios. And it has taken -- has reduced the number of opportunities we and the rest of the industry have, near-term opportunities somewhat. But if you look at some of the statistics that we track, it's really still feels okay. I mean we had mid-single-digit RFP growth in the quarter. We ended the -- ended with record backlog. We're expecting 5.5% revenue growth over the next 12 months out of backlog. Our pipeline is up low double digits. Now in the spirit of balance, I should say, that there are times in the not-too-distant past when the pipeline was up high teens, 20%, or whatever. It isn't quite at that level. And I think that reflects some of what's going on in the industry. But it's still fundamentally a healthy environment out there that we expect when we get through a few bumpy quarters here, will be strong as it's always been.

Okay. And I know you don't want to be too specific on those mega trial pushouts. But speaking with investors, there seems to be a belief that these were vaccine-related. Could you even speak to that or not?

I don't want to narrow it down too much, but there have been a lot of guesses about them. And I'd say most of them have been wrong, both the nature of -- the customers and the nature of the trial.

Okay. All right. Another comment, just to elaborate a bit further on cancellations, as we were talking previously, you gave framing thoughts on the cancellation environment on the Q3 call, in particular, as it relates to your Q4 outlook as well. So could you just revisit that commentary for starters? And if I have a follow-up, I'll ask you.

You're talking about the bookings that we're expecting in Q4. Yes, and I would open up by saying, look, we typically avoid forecasting bookings. They're hard to forecast, and you can get moved around by decisions customers make at the very last moment in the quarter, either doing something we didn't expect them to do in terms of pulling work in or pushing work out or whatever. But Ari said on our earnings call that -- he was talking about cancellations, he said, look, we had an elevated level of cancellations in Q3, and we're expecting that again in Q4. We have pretty good visibility to what the cancellations are going to be. And that normal $500 million of cancellations will likely be double that in Q4. So that's a big headwind to overcome. Now we have a good pipeline. We have good opportunities that we're working on. But when you're overcoming $1 billion of cancellations rather than, say, $500 million of cancellations, that's a pretty big headwind. So I would not be surprised if Q4 overall book-to-bill were more similar to Q3 than it is to our history of putting up book-to-bills above 1.20 or even above 1.30.

Okay. Because I think the natural instinct for some folks following the company is when you have a couple of one-off items in a quarter, you give the book-to-bill excluding those items. They just take that book-to-bill figure and roll it forward. And so the Q3 book-to-bill, excluding the big cancellation of 1.22, somehow ended up in the Street numbers...

Yes. I wish it were that easy. In some quarters, it is. This quarter, just -- this quarter into next quarter, it just doesn't happen to be. There's enough going on in terms of the cancellations that you can't just do that simple math.

Yes. Okay. Just wanted to clarify that. And I think if I remember Ari's comments from the call, your view is that Q4 is the high watermark and things get progressively better from there? Is that correct?

Yes, exactly. Now as Ari was quick to point out, we don't have a crystal ball to know exactly what our clients are going to do. But we've seen, just by the quantum of activity we've seen come through from our large customers, where they've gone through this portfolio reevaluation or they've done strategic partnership reviews. There's just been a ton of activity like that. And so we see it kind of peaking as we exit the year and then trailing off. Now that isn't to say you won't get a client coming to you at some point during next year and saying, "Hey, we're canceling this trial because we're going in a different direction, different therapeutic area or whatever." That always happens. But we think the worst will be behind us by the end of the year. But again, that's kind of our view based on what we see. We don't have a really -- there's no like place to go to, to determine that exactly. It's more a feel based on our discussions we've had with customers over the past 6 to 9 months.

Okay. Well, let's talk a bit more about those discussions then because one of the things we could observe, and certainly, one-off issues are one-off issues, drug futility, cancellation is isolated, but it does seem to be occurring in a much more challenged backdrop. And I know Ari mentioned on the call that ICON's issues were coincidental, but I'm not sure because other companies in the supply chain have talked about challenges as well. So just -- and I don't even know the right way to ask the question, but can you give us an update on what the sort of end market environment is that you're operating in? And where do you go from here?

Look, I think it's a combination of very idiosyncratic events, which I've outlined that have hit us. And there is some, use the word, choppiness or choose your term in the industry because of the IRA and portfolio reevaluation. But we're still very comfortable looking forward that continued very solid growth in R&D spending by pharma. All the indicators we had are that it will continue. And pharma is in the business of developing new drugs. That's not going to change. And they have work through difficult environments in the past and come out the other side and continued to invest aggressively. And let's not forget, we have a new administration coming in. So that may, at some point, change elements of the IRA. We don't know right now. It's an unknown, but we'll see where it goes going forward.

And how is the pricing environment amongst the peer group currently behaving? And I wonder because there were a couple of very notable share donors over the past, call it, 12 to 24 months. And I'm wondering if there's been any price aggression and response. And if that's impacted you in any way.

Well, if you listen to some of our public competitors talk, some of the smaller ones, they're being very reasonable on price. We definitely have seen the price environment tighten up a little bit. And that's not surprising because, look, whenever the market as a whole shrinks a little bit or tightens up, then everybody is just a little bit more anxious to close deals. And it does have an impact on pricing. And we've seen that. It hasn't been dramatic, but it's definitely been there. Probably the bigger impact has been in the FSP area. And not surprisingly, because that tends to be more commoditized, it's harder to differentiate in that area and you go out here, you go after the work, but it's harder for you to demonstrate or to sell your expertise in a given therapeutic area or your expertise at protocol design or expertise at finding investigators and all those things that differentiate you and prevent you from having to giveaway as much on price in a tough environment, that's harder in FSP. And so we've seen probably a bigger impact there. But we don't expect it to last. It's just what happens when you go through a little bit tighter period, pricing inevitably gets a little tougher. And remember, too, for everybody out there, the nature of the clinical trial business is one where you book a job and it burns over 4 to 5 years. And particularly for full service. And so the ups and downs you see in pricing market demand, all of that, they tend to kind of get lost over time. It all evens out. If I go back and I looked at our booked margins and our delivered margins, it's been remarkably stable to slightly improving since the merger. There aren't a lot of sharp ups and downs, like you might get in a much shorter cycle industry.

Okay. Another topic within R&DS from the Q3 call was all the activity on the strategic partnership front. Could you revisit that?

Sure. Yes, we have seen a number of our large clients do reevaluations of their strategic partnerships. And some of them were they'll call in 6, 7 CROs and then maybe more. We had one client that had 12 that went down to 3, and it's a bit of a bake-off or beauty contest or whatever. But the good news is that in every strategic partnership we had in the past, we've maintained our position. And I think in probably half a dozen instances we've actually either expanded our position or added new strategic partnerships. So we feel good about how that is all shaken out and think that will actually be net beneficial for us in the future.

One of the questions I've gotten from investors on this front is, when it comes to strategic partnerships, how many of these wins actually result in a larger wallet opportunity for IQVIA and others that win these strategic partnerships versus in how many cases is the bake-off air cover for the sponsor to cut their total spend. And therefore, there's fewer dollars available for the winners.

Well, there's some of both to be sure. Where we've added strategic partners then -- or in some cases, added to the business we have under a strategic partnership like adding new areas or whatever, it's clearly net beneficial for us. Are there times where you go in and it becomes a bit of a pricing contest? Yes, that happens from time to time that you have that. But -- generally speaking, when we win a strategic partnership, we are picking up share of wallet. And it can happen by -- even in FSP where the pricing is tough, just by adding new areas or regions in full service, what we found is that we've had some clients come to us and say, "look, we want to enter or emphasize more a given strategic area. And previously, they had been FSP clients. And now we're adding full service to their FSP arrangements with us. So on the whole, I think it's been net beneficial for us. Have there been selected instances where you get beaten down on price a little bit? Sure, that happens.

Okay. And then shifting to biotech, why do you think it's taken so long for the improved biotech funding environment in 2024 to translate to improved demand for the CRO service providers?

Well, yes, it's a good question. We -- typically, what we see is that it takes, say, on average, 6 to 9 months for improved biotech funding to result in RFPs, the biotech funding with a given customer that result in an RFP coming to us and others. And then it takes another 6 to 9 months for that RFP to turn into a signed award. So you're talking about 12 to 18 months before the increased funding shows up in our bookings. So it's on a bit of a lag, to be sure. But when we look at what's happened this year, I think through the first 9 months, we're -- the way we count it anyway, which is taken from a publication called BioWorld, there's been over $80 billion of biotech funding, which is up 70-odd percent from last year, 9 months. And the 9 months for this year is higher than any year going back to 2014, except 2021, which were kind of crazy years, where there was a tremendous surge in funding. And that's just 9 months comparing to full years going backwards. So we have seen a definite pick up there, and we do expect that to come through ultimately first in RFPs and then in awards going forward. But it doesn't -- it's not like flipping a switch, for sure.

Okay. Appreciate that. And then moving on to the outlook. Ari gave some additional or at least initial framing thoughts for what 2025 could look like on the Q3 call. Could you elaborate and perhaps expand on those comments?

Well, I'm not sure I'm going to expand, but I'll certainly repeat the comments. Typically, in the Q3 time frame, we're not talking about next year yet. We decided we wanted to this time because we had a little bit of a rough quarter in bookings in R&DS, and it was going to raise a lot of questions. And we're also getting a little bit more certainty about how the TAS outlook is going forward. So what Ari said on the call is, look, let's focus on revenue for right now. We grew in TAS about 6% ex-COVID. COVID won't be a factor next year for TAS on comparisons. This year, on average, we expect it to be similar, give or take, next year. And we grew about 5% constant currency ex-COVID for R&DS this year on average. That's what it will be after the lower Q4 growth. And we expect that to be similar for next year. And we'll refine those as we go forward. We have our Analyst Meeting coming up in December. So the growth will be solid next year, even with some of the bumpiness that we've seen, for instance, in R&DS in the third quarter and going into the fourth quarter.

When do you start getting visibility on what your large pharma client budgets will look like for 2025?

Well, there are 2 places you can go for that visibility. One is just what they're saying in the public sector, and you all have access to the same information we do. The other we're already seeing through the pipeline because the early stage and even the qualified pipeline gives us visibility into what our pharma customers are planning to do next year. And as I mentioned, our qualified pipeline at the end of the third quarter was up about -- it was more than 10%, low double digits. And we see that along with our conversations with pharma customers and what we've been reading out in the market and so forth, that they've been saying that we should see at least mid-single-digit R&D growth for pharma next year, and that will fuel a solid level of demand.

Okay. Do you have any framing thoughts from a margin perspective as we think about 2025?

Yes. We deliberately tried to stay away from talking too much about profitability, which we'll do, hopefully, more at the Investor Day that we have. But I think there are 2 things working in opposite direction for margins. One, there is a little bit more pressure on margins because of some of the pricing pressures we've seen. We also have -- because of those delayed trials, we do have to keep some amount of resources warm, so to speak, for those trials. We'll redeploy most of them, but there is going to be some amount of stranded costs in those trials. So if you look at those 2 things, you'd say, okay, those would tend to pressure margins. On the other hand, we're going extra hard back after cause -- after cost, rather. And we'll see how this plays out going forward. But maybe a little bit more margin pressure going into next year than we've seen recently. On the other hand, that's above the EBITDA line. If you go below the EBITDA line, you see things moving in our direction. Obviously, interest rates coming down. You saw our interest expense has stabilized and should be roughly flat for the year. And our operating depreciation and amortization has stabilized as we've been, I think, more disciplined about our capital spending. We've done some nice things in terms of tax strategies in the tax area that have pulled down our effective tax rate, both on a book and a cash basis. So those should be helpful to EPS growth in relation to EBITDA growth. So there'll be a little bit more pressure on the EBITDA margin line, some offsetting good news below the EBITDA line. And we'll be more specific going forward.

Well, there's the massive share buyback, too.

Well, there's the massive share buyback that my boss announced on the third quarter call, and you're probably going to ask -- I'll anticipate the question, what is massive because I got it on every follow-up call that I participated on after the earnings release. And look, we're not quantifying that, obviously. But I will say that you can expect it to be meaningfully larger than what we've done to date, which is maybe not really going out on a limb because we haven't done a whole lot. When I say to date, through the end of the third quarter, we really didn't do a whole lot through the third quarter of this year. It will be meaningfully larger. And the reason is very simple. We -- as Ari said, we think our stock is a screaming by at these prices. And the acquisition pipeline a little bit thinner than we hoped that it would be. We've seen some stuff push off. And that tends to ebb and flow. That doesn't mean it's going to be thinner next year just for the next 3 months or so, there isn't quite as much that we anticipate doing.

Does the changing of the guard at the Federal Trade Commission impact your M&A view at all?

Well, I guess we'll see what happens. We would expect there'll be a changing of the guard, there typically is. And I think the incoming administration probably isn't aligned completely with the views of the current administration of the FTC. And we would hope it would be positive. It would loosen up a little bit. We had one what we thought was very good and very defensible deal in the digital marketing space in the U.S. that was struck down by the FTC or challenged by the FTC and then we end up losing in court, which actually kind of surprised me, but okay, these things happen when you go to court. And we would hope that the environment will be a little bit better going forward. It hasn't really been a constraint on us, except in very selective instances anyway, because we tend to do smaller kind of plug insight sort of deals, where we're enhancing the offerings we have, and there isn't much in the way of concern about market power or whatever. But every now and then, there's something that comes up that you say, "Gee, could we get this by the FTC -- the current FTC?" And hopefully, that will be easier in the future than it is now.

Okay. And one of the things, fully appreciating you don't want to be too specific about margins in 2025. But when you walked through some of the puts and takes, one of the things I don't think I heard was anything around revenue mix between FSP and full service. And I actually get this question from investors fairly frequently, whether there's an increasing trend towards FSP in the broader marketplace and what are the implications for margins. You didn't mention that. I'd love to hear that.

There is an increasing trend towards FSP, but it isn't a quick-increasing trend. With the size of the backlog we have and it's on the margins. We -- FSP currently represents about 15% of our service revenue about -- excuse me, about 20% of our service revenue, about 15% of our all-in revenue, including pass-throughs. And that's grown by a percentage point or 2 per year for the last several years. And if the trend towards FSP continues, that will be a similar kind of movement in the future. We find it is a little bit like a pendulum. No, it doesn't continue forever. You get a period of time where the industry is shifting towards FSP. And then you see it shift back more towards full service. And one of the reasons you might see more full service is the more complex the trial, the more likely clients are to outsource, oncology trials and things of that nature. They're very complex, hard to find patients, investigators and so forth, and require certain expertise, very often they'll come to us because we have that expertise.

Okay. But very incremental mix shift. It's not worth calling out from a margin perspective.

Incremental. It's incremental mix shift -- it isn't dramatic.

Okay. In the final 30 seconds, December 10 is coming up fast. What are the expectations for that event?

Well, look, we want to do a few things out there. First off, we haven't had an analyst meeting in 3 years. So it's time, it's probably past time. We want to make sure we highlight exciting offerings we have and growth opportunities, and we'll have some demos of those offerings to make them more tangible, come to light for you. We're going to make sure you all get a chance to meet our deeper management team. We've got a lot of questions about that. It isn't just me and Ari and Kerri, it's tons of people and give you a chance to meet all those folks. And we want to -- we're going to give you a tour of our labs down in North Carolina, which I think you'll find very interesting. And finally, we'll talk about the financials, which I know everybody cares about, and we'll give you a little bit more detail there as well.

Okay. A 3-year LRP is ish?

I don't think we'll probably won't put dollar targets out there. We'll see, maybe we'll give you some general growth rates in business, things of that nature.

Sounds great. Look forward to it. Thank Ron.

Appreciate it.