All right, good morning. Thank you for being here. I'm Dave Windley with Jefferies Healthcare Equity Research. I'm based in the States, run our Nashville office in Tennessee. I have been with the firm for 24 years and have covered the CRO space for a few years, longer than that. And I was, I told Steve that, in fact, I've covered ICON since the 1900s. So it has been a while. So really appreciate ICON being here. They have been a very, I mean, if you don't know the history, you should spend some time learning the history. It's just, it's a fascinating success story from the founding of the company, and I think about 1991, and is obviously one of the leading clinical research organizations in the world. So we're going to get into some Q&A fireside. Steve has a couple of minutes of opening remarks here.
So I should also say, Nigel, the company's newly named CFO, is also joining us. He was saying three weeks on the job. So I'm going to give him all the hard questions here shortly. But Steve and Nigel, both here, thank you very much. And Steve, I'll let you take it away.
Thanks, Dave. And good morning, everybody. Nice to be here at the Jefferies Conference. I did want to just provide a little bit of context in terms of what's happened with ICON over the last quarter or so, particularly. We had a disappointing quarter three for some specific reasons relating to particularly our top two customers. And we'll talk about that a bit more in the fireside chat. And that's been an area that we've been aware of. But there were certainly confluence of circumstances that hit us rather hard and rather late in quarter three, leading to us reducing our guidance. I would say, though, the guidance we gave, or the revised guidance we gave in quarter three stands, and we reiterate that firmly for 2024. Nothing's changed in that respect.
We are a company that's had something like 50 quarters of good solid progression in terms of earnings and progress on revenues, and the last quarter was something of an anomaly, due, as I said, particularly to a couple of our larger customers, but we do feel that we are on the path back, and we'll be back within a couple of quarters going forward, so just to affirm, we are reiterating our guidance for 2024. That's the revised guidance that we gave on the Q3 call. We do believe we remain a strong partner to our customers. Our customers, of course, have ups and downs. Some are going up, some are going down in terms of budgets, in terms of development models, and we help them to navigate their clinical development environment, whether it be patent extensions or expirations, whether it be opportunities with the GLP-1 agonists.
There are plenty of those. We've been successful in bringing on three new strategic partners over the last 12 months. We believe they're already starting to give us some benefit going forward. We've talked about a target of low to mid-single-digit revenue growth in 2025. Now, that's not guidance. That's a target. Nothing that has happened over the last few weeks has changed that. We will be giving firm guidance for 2025 at the J.P. Morgan Conference in January. At that point, we'll give you a good indication of where we think we'll be. At the moment, we feel low to mid-single-digit growth on a revenue basis is what we're targeting, what we believe is possible.
We are seeing growth outside of our top two at around the mid-single digits and outside of our top 25 at a sort of similar number, even a slightly higher number, so there is good growth amongst the portfolio. Of course, we do, as we were fairly specific about, had some issues in terms of declining budgets and changing models in those top two customers. In terms of capital deployment, we've been active in the market from a share buyback perspective. We have spent $200 million in the fourth quarter, in addition to the $100 million we spent in Q3. So a total of $300 million has been spent in the share buyback capacity. We have approval from our board to spend $750 million, so we still have some opportunity in that market, and we continue to be active, and Nigel can address any questions that we have in that respect.
So overall, we see a very solid and constructive view of the industry going forward from a mid to long-term point of view. The next two to three quarters are where we're going to be working through some challenges as we get to the bottom of the budgets in terms of our top customer and work from there. So with that, Dave, I'll go to the fireside.
Great. Very much appreciate that. That sets up the questions quite well. Thank you. So I want to start on the large pharma side. As you just highlighted, you've gained three partnerships since the merger with PRA, which I believe closed in the second half of 2021. So we're talking about kind of a three-year period, one of those quite recently. And I guess there's a couple of questions here. So I'll try to take them in order.
First of all, as you think about the 16 now pharma companies with whom you have partnerships and these budget reprioritizations and, I'll call it austerity, that some of these companies are going through, how would you describe the kind of dividing line between those that feel like they've completed this activity and you have some amount of visibility about what awards may be coming out and those that still haven't completed that would be something of an opaque situation?
It's actually 17 of the top 20, Dave. We feel as we've actually, the vast majority of the top 20 we have strategic partnerships with. As you said, three in the last 12 months, we feel is a good vindication of what we did when we came together with PRA three-ish years ago. You know, in terms of those top customers and even across the industry, there are always companies that are spending more and some that are spending less. We look at our top 25, we see more than half going forward are spending more or we're foreseeing an increase in spend with us in the next 12 months or so. But there are always others that are coming down a little bit. You kind of look at it across the industry and across the sort of portfolio.
And we see in the large pharma space about a mid-single, 3%-5% sort of growth rate going forward on an annual basis. There's nothing that we've seen that would indicate that that's different. So overall, as I say, some of the opportunities within the GLP-1 agonist, some of the opportunities within cell and gene therapy and some of those areas are certainly going forward very rapidly and very exciting from our point of view. And there are other companies, and particularly perhaps in some of the vaccine areas, we've seen some sort of pullback. So it goes in fits and starts a little bit. There's perhaps a little bit more volatility in the market in the large pharma now than perhaps there has been in the past. But overall, we see a pretty constructive 3%-5% sort of growth rate in the medium term.
Okay. One of your, you talked about the challenges with the two larger customers, which I think perhaps what makes it slightly more painful is those two that are jockeying things more aggressively happen to be your two largest customers. One of those, I guess, has some fairly obvious and high-profile pending cuts, I'll say. There's debate with activist investor pushing on just how deep those cuts ought to go. Does your outlook and thought around this low to mid-single-digit growth in 2025 contemplate another fairly substantial step down in one of your top two customers?
We've made some projections on that. And that particular customer, we do expect it to continue to fall in 2025. And we've made some projections around that that are I think appropriate. They're not conservative. They're in the middle of the range. We understand. We talk to them on a regular basis. We understand what their challenges are. And we're helping them to work through them. I don't think, I don't feel even with potential budget cuts that they're going to actually push those into the more clinical development space. We've had some recent conversations with them. And we believe we've appropriately accrued for or covered that decline. On the other hand, the other large customer that had been falling over the last 12-24 months is now starting to move in the other direction, starting to move up in the low single digits.
So we're starting to get some compensation or some tailwind from that customer. And then there are some others that are moving in the right direction as well. And others come down. So overall, we do think we're appropriately covered. And we've forecast what we expect to happen from that particular customer, albeit we're still working out the timing of it and what the depth of that decline will be.
Okay. And on the second point, interesting, I think at the time of the conference call and our follow-up conversation that the second customer that we're referring to was a maybe you had indicated to me that you thought it was at the nadir. And so maybe it was more certain. But is this kind of starting to move up that you describe fairly recent?
Yeah. As I said, at the conference call, we thought we were at the bottom, and having continued, we're talking to them all the time, we're now seeing a modest uptick, so it is fairly recent, and we're optimistic about how that plays forward.
Okay. Great. You mentioned in your prepared remarks the cancellations in vaccine. Vaccine business does, I think, burn fairly quickly, sometimes has some fairly substantial pass-throughs to it. And so the absence of vaccine could have both the effect on a somewhat diminishing burn to the diminution to the burn rate, as well as just the absence of the dollar. So is, I guess I would, well, one more thing. You've also talked at ICON about vaccines being a fairly strong therapeutic suit for you. Is there something broader going on in vaccines, people walking away from some of these combo vaccines with COVID or otherwise that we should be aware of? Or is it just a one-off?
I think it's more a one-off. We are strong, I think, therapeutically in vaccines. But they're not a huge part of our portfolio in the vicinity of sort of mid-single digits, and while this year, they're probably low single digits, given some of those delays and cancellations. As we get into next year, of course, we've talked about the BARDA-funded studies that are on track and are moving forward, certainly for the first half of this year, and they'll run right through next year. We'll probably move up into sort of mid-single digits from a vaccine point of view, so while vaccines are very important, and we do believe we have a therapeutic advantage, I think it does wax and wane a little bit. We'll see what happens with the new administration in the U.S. in terms of what impact that has, if any.
I don't think it's going to have any impact on the BARDA work that we have already scheduled and we've already started. But who knows? Longer term, that's something that if that person, if Robert F. Kennedy Jr. actually gets confirmed, and I think that's speculative. But if he does, I mean, there's some discussion to be had there. But overall, we see vaccines remain an important part of our portfolio. We do them well. They can be a little bit margin diluted in that they have a large pass-through component. And so that's a little bit of a headwind for next year as we do those BARDA studies. But certainly, the burn rate is facilitated by that sort of work. And that's always welcome.
Interesting. So good kind of clarification and delineation that the BARDA work is actually not the source of the cancellations that you mentioned on the third quarter call. So it's elsewhere, commercial customers.
Yeah. And it's not just COVID work. There was some flu work that was canceled and delayed, and some sort of RSV work that got pushed back. So no, it wasn't just COVID work. We do work across a variety of sort of sub-therapeutic areas within the vaccine space.
Okay. Flipping to biotech, one of the three areas that you had called out on the call that were the source of softness in the quarter was, I think, slower activity in decision cycles and some delayed or slowed study starts in biotech, and I think also including maybe some award decisions that got pushed into the fourth quarter. You thought, how would you update us on how that's progressed since we last heard from you?
I don't think it's changed dramatically. I think we're still seeing the biotechs who have been able to access capital. And I think that's a little bit of a challenge for them. We've seen the capital markets be a little volatile up and down quarter to quarter. But generally, I think moving in the right direction. We're seeing RFPs or requests for proposals start to move in the right direction from a biotech point of view. That's encouraging. Although, as I think I called out in the quarter, some of that is around how much do I need to raise it's sort of more, it's not so much for the project, although that's important. It's really a sort of an indicator for how much they need to go to the markets to raise. Overall, I think we see the biotech market sort of moving forward constructively.
I think there's still a little bit of volatility there. There's still some uncertainty. We're certainly still seeing some delays in terms of how they allocate their capital and how they spend that money. And we certainly saw that in Q3. I don't anticipate that's going to change dramatically, even in the sort of short term. But as we get into next year and towards the end of next year, I'm optimistic that the biotech market will move back to sort of high single digits in terms of growth. And by 2026, we'll be in a good place. So I think the short-term volatility will probably remain. And some of those concerns around allocation of capital and conservatism in sort of decision-making will remain for a while yet. But overall, it's generally heading in the right direction, I think.
Got it. So another thing that you talked about related to this topic, biotech, the thing that you talked about at the investor day was a fairly substantial and deliberate rebranding of ICON Biotech. What impact do you think that has had, and is it even possible to disentangle rebranding and your company-specific efforts from a broader kind of biotech malaise?
Yeah. That's a good question. I mean, we have, I think, traditionally, and you talked about the history with ICON. We've been around the industry now for over 30 years, and I think traditionally, we have been known as a large company, a large pharma CRO. As we made the union with PRA effective, we focused their group, their phase two, phase three group very much in the biotech segment. That's where they had their center of gravity, although it wasn't exclusively biotech, and I think we recognized at that time that we needed to up our ante in terms of our branding and our marketing, and I think that's probably taken, to be very honest, a little longer than we thought would be the case, and so we continue to work that through. We continue to improve and to up our marketing and our branding strategy.
I think we're probably a year or two. That's more of a medium-term sort of opportunity for us or solution for us. And I think we're making good progress. We're certainly having a number of discussions with a number of biotechs, even at this conference. We're meeting with a number of biotechs who have very substantial programs to prosecute. And the old story of the small CRO and the small biotech really doesn't ring true terribly well when you have a biotech who want to spend tens and even hundreds of millions on programs that span across the world. And we're talking to several who have very substantial programs that they want to put forward. And so we are, I think, a very viable option for them. And I think it's the right strategy for us to push through on biotech.
We have something like 7,000 people focused in that area on biotech, people who understand the troubles and the travails of a biotech company, and I think that's a very powerful message to the biotech community and to our biotech customers, and it's starting to resonate very well, albeit perhaps a little slower than I would have liked.
Yeah. On another topic kind of adjacent to this at the investor day was your kind of business model evolution to pull some key functions, study startup-type functions. I'll get all this wrong, but patient recruitment, study startup type, and centralize those. How has that progressed? Is it still too early to tell? Or what impact have those changes made?
I think they've helped us to maintain and improve our margins up till now. We're a company that manages costs pretty well, and we're trying to get the balance in place between functions and activities that really are very biotech or large pharma specific versus those that are more generic. I mean, data management, for example, tends to be the same whether you're working for a biotech company or for a large pharma company. Now, there are some differences there in terms of agility and being able to respond very quickly to requests or to changes. But generally, having one group is a more efficient way of being able to do that. You can scale those resources. You can move those resources when you have particular deadlines on particular projects, whether they be biotech or large pharma. So overall, it's gone well.
We've started to really drive some efficiencies on that front. And I think we're a better operation. But there's a point at which we have to have very specific clinical, project management, medical, those sort of things remain very focused in the biotech segment. So we're getting the balance, I think, Dave, between efficiency and customization.
Okay. I'm going to stay on the cost efficiency topic. One of the things that I think you've done a really nice job of spelling out is the 2 million hours of automation followed by another 1.5 million per year for several years with, I think, a 2027 goal as part of your long-range plan. And that 1.5 million hours is a substantial number of heads, in my mind, that you don't have to hire as the top line grows and is a source of scaling for your business. As we're going through this more turbulent period from a bookings and revenue conversion standpoint, does that interrupt at all the ability to drive the 1.5 million hours? Or can you still go full steam ahead on that?
I think we still go full steam ahead on that. We'll do something like 3.5 million hours this year.
In the?
In the year.
That'll be the cumulative number.
No, no. That'll be for the year. Yeah, so we're moving very fast in that area. And that's translating to, in the vicinity of $70-$75 million in terms of costs that we would have incurred otherwise in the business had we not gone down that track. So it's starting to have a material impact on our business and on our efficiency. And it's a very important part of how we're driving the business in the long term. That continual need to be price competitive means we need to keep moving from a cost and efficiency point of view. And to call it AI in some areas is probably a little bit out on the edge. It's really around machine learning and OCR and those sorts of areas that basically can be filing documents and editing queries in a data management. So it's not all AI.
But it is very important. And it is saving us a lot of effort and a lot of time and a lot of money in terms of our, particularly on the SG&A side of things. But not just in SG&A, also in our direct costs as well.
Sure. And then going back to the prior question, is centralizing some of the functions that you talked about at the May investor day critical to being able to achieve some of those automation hours? Or is a substantial amount of that automation going into those areas?
It is. Yeah. Certainly around data management, around Trial Master File filing, even around medical writing, even around things like our RFIs and RFPs, requests for information. We're becoming more automated in that. You can imagine we have large numbers of people who put out proposals on a daily and weekly basis, and we're starting to automate that and to make that a more efficient process, so it's really going right across the organization to our site identification, our site selection. There's a number of areas it's starting to impact on, and not just making us able to do it with lower or fewer resources, but able to do the task better in the longer term as well.
And then that last part of what you said may fit right into this next question. But thinking about sales force efficiency or sales efficiency. So we talk about RFP flows, delays in decision-making, et cetera. We obviously care a lot about top line and what that signals for top line. But it also, you want to prevent your sales force from having to spin its wheels on opportunities that just never go to decision. Question being, we hear that that is a problem, that there's more RFPs floating around out there. One, that biotechs are fishing for more price. And so they're issuing to more CROs to try to get a better price. And then in some cases, the award just never goes to decision. Maybe they can't raise the money or whatever. How big of an issue is that right now?
I think that is an issue. And I think we have seen a trend. It's a little volatile quarter to quarter. So I'm hesitant to sort of call it a sort of overall trend. But anecdotally, certainly we've seen a number of projects or bids that we've made that really never have come to a decision. It tends to be around 20%-30% of the RFP dollars that we put out don't come to a decision. We call closed canceled. In other words, they're canceled before they even get to a contracting point. So it is an area, I think, that we're seeing some uptick in. But I'm not quite ready to call it a significant trend at this point. But it is something we certainly see on an anecdotal basis.
Okay. Great. Let's move to try to get Nigel in here. So, acquisition, you did make an acquisition of a European CRO. I think it was about an $80 million acquisition pretty much at the end of the third quarter. Maybe remind us how that fits into the business and what some of the kind of financial profile was or is.
Yeah, Dave. So it's an Eastern European-based business. So obviously fits very nicely into the efficiency play that Steve has already talked about. So it's pretty modest in scale. It's not a huge contributor to us this year, but just a sort of a normal course transaction for us, really.
Can I just jump in on that? Just to be absolutely crystal clear, we did not add the backlog of that to our backlog from a sales point of view. That's not what we do. It certainly came into our backlog, as you'd expect. But none of the sales, none of the awards in Q3 were related to that acquisition. It's an acquisition, as Nigel said, that's focused in Eastern Europe. It is a nice add on a functional basis. It also brings us some biotech customers and some emerging biotech customers, which we're happy, again, to build our biotech business. But just to be very clear, we did not add that. No part of our sales or awards number came from that acquisition.
Got it. And this is just a bulk presence in Eastern Europe where relative kind of labor costs and access to patients is benefited?
Yeah. Exactly. Exactly. Yeah.
Okay. Beyond that, I'm actually pleased to hear that you've been active in the equity markets since the quarter, since you talked about the $100 million, so $200 million more since then. I guess maybe give us a little bit of a temperature check on, as the stock sits where it is, your M&A pipeline that I know you're looking at and Simon's working on, but we don't know. How do you think about the balance between the two here forward?
I mean, they're both important, Dave. So obviously, given where the share price is right now, it's appropriate for us to be looking at using our balance sheet to buy back some shares. We have been doing that. And we'll continue to do that. Steve hit the headlines already. We've done $200 million since the Q3 results call. We've capacity from the board for up to $750 million. So we've done $300 million of that so far. And we'll continue to be active. At the same time, M&A, where strategically sensible, continues to be a priority for us as well. So we don't necessarily think it should be either/or. We will continue to look at both. But certainly, given where the share price is, we're continuing to look actively at the buybacks as well.
Well, good. So we got Nigel in on a question before we have to wrap. Steve and Nigel, thank you for being here. The light is flashing at me. I'm getting the hook. Thanks to everybody for hanging in with us for our 2024 15th anniversary, Jefferies London Healthcare Conference, as a matter of fact. So thanks a lot. Enjoy the rest of the day. Appreciate it.
Thanks, Dave.