Ladies and gentlemen, thank you for standing by. At this time, I would like to welcome everyone to the IQVIA Fourth Quarter 2021 Earnings Conference Call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question-and-answer session. If you would like to ask a question during that time, simply press star followed by the number one on your telephone keypad. If you would like to withdraw your question, press the pound key. As a reminder, this call is being recorded. Thank you. I would now like to turn the call over to Nick Childs, Senior Vice President, Investor Relations and Corporate Communications. Mr. Childs, you may begin your conference.
Thank you. Good morning, everyone. Thank you for joining our Fourth Quarter 2021 Earnings Call. With me today are Ari Bousbib, Chairman and Chief Executive Officer, Ron Bruehlman, Executive Vice President and Chief Financial Officer, Eric Sherbet, Executive Vice President and General Counsel, Mike Fedock, Senior Vice President, Financial Planning & Analysis, and Bryan Stengel, Associate Director, Investor Relations. Today, we will be referencing a presentation that will be visible during this call for those of you on our webcast. This presentation will also be available following this call in the Events and Presentation section of our IQVIA Investor Relations website at ir.iqvia.com. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements.
Actual results will differ materially from those stated or implied by forward-looking statements due to risks and uncertainties associated with the company's business, which are discussed in the company's filings with the Securities and Exchange Commission, including our annual report on Form 10-K and subsequent SEC filings. In addition, we will discuss certain non-GAAP financial measures on this call, which should be considered a supplement to, and not a substitute for, financial measures prepared in accordance with GAAP. A reconciliation of these non-GAAP measures to the comparable GAAP measures is included in the press release and conference call presentation. I would now like to turn the call over to our Chairman and CEO, Ari Bousbib.
Thank you, Nick, and good morning, everyone. Thank you for joining today for our Fourth Quarter Results. It was great to see many of you in person at our Analyst and Investor Conference in November. As you will recall, we shared our expectations that we would meet or exceed our three-year Vision 2022 targets. We also laid out our plans to make 2022 yet another inflection point in our growth trajectory and further accelerate the company's growth rate in the next three-year phase of our journey to 2025. The team highlighted the power of connected intelligence, which brings together IQVIA's differentiated capabilities and drives our leadership position in the clinical and commercial markets. This underpins our new 20by25 strategy, which alludes to our plans to achieve at least $20 billion of revenue by 2025.
We're excited about this next phase of growth for IQVIA, and we are busy refining our strategies and action plans, and you will hear more about it as the year progresses. Two weeks ago, IQVIA was named to Fortune's list of the World's Most Admired Companies for the fifth consecutive year. Importantly, we earned a first-place ranking within the healthcare, pharmacy, and other services category for the first time. We ranked number one in the categories of innovation, capital deployment, global competitiveness, quality of product and services, and long-term investment value. I want to thank our nearly 80,000 employees worldwide, for this recognition is a tribute to their innovation and drive. Turning now to our results. We ended 2021 on a high note, despite COVID-19's continued impact on many parts of the world.
We delivered robust top and bottom-line growth in the quarter, which, as you know, was against a much tougher year-over-year comparison than earlier in the year. These results reinforce our confidence that we will achieve our 2022 guidance, and of course, it sets us up well to meet our ambitious 20by25 targets. Let's review the fourth quarter. Revenue for the fourth quarter grew 10.2% on a reported basis and 11.6% at constant currency. The $62 million beat above the midpoint of our guidance range was driven by stronger operational performance across all three segments, as well as higher passthroughs, partially offset by FX headwinds.
Compared to prior year and excluding COVID-related work, our core businesses, meaning R&DS and TAS, grew mid-teens at constant currency on an organic basis. Ron will provide a lot more detail in his remarks, including additional COVID-adjusted numbers for each segment. Fourth quarter adjusted EBITDA grew 12.7%, reflecting our revenue growth as well as ongoing productivity initiatives. The $27 million beat above the midpoint of our guidance range was entirely due to our operational performance. Fourth quarter adjusted diluted EPS of $2.55 grew 20.9%. That was $0.13 above the midpoint of our guidance, with the majority of the beat coming from the adjusted EBITDA drop through. Let me now provide an update on the business.
On the commercial side of the business, it was a strong year for new molecules and launches as the industry continued its recovery from the COVID-19 pandemic disruption. This year, 50 new molecules were approved by the FDA and 72 new commercial launches took place. IQVIA supported nearly 80% of launches by top 20 pharma and approximately 60% of all launches. This highlights our scale globally and across all customer segments in applying advanced technology and analytics capabilities to enhance launch planning, engagement, and measurement. Overall, we've seen significant momentum and continued demand for our technology solutions. There are now over 3,000 clients who have adopted one or more of our technology platforms, including Human Data Science Cloud, Orchestrated Analytics, E360, Omnichannel Navigator, Engage, and of course, Orchestrated Customer Engagement or OCE.
In fact, the footprint of our OCE platform itself has continued to grow with over 350 clients having adopted one or more modules on the platform since launch. Early in 2021, we launched IQVIA Next Best Action, which is an AI-driven omnichannel customer engagement decision engine. Two top 20 pharma clients have successfully rolled out this intelligence engine to orchestrate customer engagements in over 30 countries and across more than 40 brands each. Two` other top 20 pharma are currently in the implementation phase. Another highlight in our CAS business has been the success of DMD Marketing Solutions, a leading provider of data and digital marketing solutions that help brands deliver personalized digital content to healthcare professionals.
In the quarter, we entered into an enterprise agreement with a top ten pharma client to utilize DMD's advanced analytic capabilities to power omnichannel engagement across all eight of their brand franchises. To date, 18 of the top 20 have adopted at least one of DMD's solutions. We're very excited for the future growth of this business within IQVIA. Real-world evidence. Another highlight of the year. IQVIA continues to play a leading role in the use of secondary data to answer key questions for life science customers. In the fourth quarter, we won two large post-authorization safety studies in an autoimmune area with a top 10 pharma. These studies use existing healthcare data to observe patients over a period of 10 years to better understand long-term effects of the treatments. We were also recently awarded a disease re-registry project for an upcoming novel gene therapy.
Here, we will recruit a broad population of patients with a specific disease to understand how they are currently managed in clinical practice. This information is vital to our life science sponsors to inform the design of subsequent clinical trials so they can target patient groups with the highest unmet need. Moving to clinical technology, we saw increased adoption of our Orchestrated Clinical Trials, OCT platform, which supports trial planning, site management, patient engagement, trial management, and clinical data analytics. During the year, we added 90 new OCT clients, bringing the total to over 350 clients who have adopted one or more modules within our clinical technology suite since launch, including all of the top 10 and 18 of the top 20.
Within OCT's digital patient suite this year, we secured three preferred provider partnerships with top 30 pharmaceutical clients to provide our interactive response technology, IRT capabilities to support site operations across their entire clinical trial portfolios. This technology facilitates patient randomization to ensure protocol adherence and streamlines site supply chain management to reduce drug wastage and to drive significant cost reductions. Our solution was awarded a top ranking by industry leaders in a recent ISR report for randomization and trial supply management capabilities. We also saw increased demand for our industry-leading decentralized clinical trial offering. Approximately 1/3 of our active full-service clinical trials incorporate one or more of our DCT technology or services capabilities, and we expect these to continue to grow as the need for these capabilities in complex studies becomes more evident. For example, we are for treatment of multiple system atrophy, a severe degenerative neuro.
We are deploying our full suite of capabilities, including eCOA, eConsent, and home to significantly reduce the travel burden on these patients who have significant mobility challenges. Finally, our overall R&DS business continues to build on its strong momentum with over $2.4 billion of net new business, including pass-throughs, and it set a record for quarterly over $1.9 billion of service bookings. This resulted in a fourth quarter contracted net book-to-bill ratio of 1.36, excluding pass-throughs, and 1.24 including pass-throughs. For the calendar year, we delivered over $10 billion of total net new bookings for the first time ever, an increase of 14.6% compared to 2020. This led to an LTM contracted net book-to-bill ratio of 1.35, excluding pass-throughs, and 1.34 including pass-throughs.
Our contracted backlog in R&D grew 10.2% year-over-year to a record $24.8 billion as of December 31, 2021. Now I will turn it over to Ron for more details on our financial performance.
Thanks, Ari, and good morning, everyone. Let's start by reviewing revenue. Fourth quarter revenue of $3.636 billion grew 10.2% on a reported basis and 11.6% at constant currency. You'll recall that last year's fourth quarter was a much tougher comparison than earlier quarters as we picked up incremental demand from mega vaccine studies in R&DS and government-related COVID work within TAS. Also, the core business began to rebound from the effects of COVID-19. In this year's fourth quarter, COVID-related revenues were approximately $325 million, down about 25% versus the fourth quarter of 2020. In our base business, that is excluding COVID-related revenues, growth at constant currency was mid-teens.
Technology & Analytics Solutions revenue for the fourth quarter was $1,496 million, up 5% reported and 6.6% at constant currency. Year-over-year, TAS experienced just over 400 basis points of headwind due to a step down in COVID-related work. Excluding all COVID-related work, organic R&DS fourth quarter revenue of $1,944 million was up 15.4% at actual FX rates and 16.3% at constant currency. Excluding all COVID-related work, organic growth at constant currency in R&DS was approximately 25%. Contract Sales and Medical Solutions, or CSMS, fourth quarter revenue of $196 million grew 3.7% reported and 7.4% at constant currency. Excluding all COVID-related work, organic growth at constant currency in CSMS was low single- digits.
For the full year, revenue was $13.874 billion. COVID-related revenues in 2021 were approximately $1.8 billion, with just under 80% of that attributable to R&DS, about 20% due to TAS, and the remainder in CSMS. The incremental COVID-related revenues in 2021 versus 2020 accounted for approximately half of our growth in 2021. Technology & Analytics Solutions revenue was $5.534 billion, up 13.9% reported. Excluding COVID-related work, organic growth at constant currency in TAS was high single- digits. Full-year revenue in R&DS was $7.556 billion, growing at 31.4% at constant currency. Excluding COVID-related work, R&DS organic growth at constant currency for both total revenue and services revenue was low double- digits.
Full-year CSMS revenue was $784 million, representing 5.8% growth on a reported basis and 5.7% at constant currency. Excluding COVID-related work, organic growth at constant currency in CSMS was low single- digits. Now move down to P&L. Adjusted EBITDA was $828 million for the fourth quarter, which was 12.7% growth on a reported basis. Full year adjusted EBITDA was $3.022 billion, up 26.8% year-over-year on a reported basis. Fourth quarter GAAP net income was $318 million, and GAAP diluted earnings per share was $1.63. Full year GAAP net income was earnings per diluted share.
Adjusted net income was $496 million for the fourth quarter, up 20.7% year-over-year, and adjusted diluted earnings per share of $0.55. For the full year, adjusted net income was $1.76 billion, or $9.03 per share, up 41%. As already reviewed, R&DS delivered another outstanding quarter of net new business. R&DS backlog now stands at a record $24.8 billion. Full year 2021 net new bookings, including pass-throughs, rose over $10 billion for the first time, and that's 14.6% growth compared to 2020. Okay, let's move to the balance sheet now.
Cash flow from operations was $692 million, and CapEx was $184 million to a record $2.3 billion, up 70% versus the prior year. At December 31, cash and $1,366 million, and gross debt was $12.125 billion, resulting in net debt of $10.759 billion.
Our net leverage ratio at December 31 was 3x. Now, it's worth highlighting that our improved free cash flow over the last two years allowed us to deploy approximately $4.5 billion of capital to internal investments, acquisitions, and share repurchase, while at the same time high of 4.8 x in Q2 2020, which you recall was the height of the pandemic, to nearly 3.5x net leverage ratio target of 3.5x-4x a full year early. In the quarter, we repurchased $174 million of our shares, which resulted in full year share repurchase of $395 million.
We ended the year with 195 million fully diluted shares outstanding, and $523 million of share repurchase authorization remaining under our existing program. Last week, our Board of Directors approved share repurchase authorization, which increases our remaining authorization to just over $2.5 billion. Let's turn to the guidance. As you saw, we're reaffirming the full-year 2022 revenue guidance that we issued at our Analyst and Investor Conference in November. Initially guided in November. Additionally, we're raising our full-year 2022 profit guidance versus what we provided you in November.
To summarize the overall guidance for the full year, we expect $15.7 billion and $15 billion, which represents year-over-year growth of 7.1%-9.2% at constant currency and 6%-8.1% on a reported basis compared to 2021. Now, we expect adjusted EBITDA to be between $3.33 billion and $3.405 billion, representing year-over-year growth of 10.2%-12.7%. We also now expect adjusted Diluted EPS to be between $9.95 and $10.25, which represents year-over-year growth of 10.2%-13.5%.
Now, our full year 2022 guidance assumes a December 31, 2021 foreign currency exchange rate headwind of 110 basis points to our full year revenue growth. Now, at our Analyst and Investor Conference in November, we told you to anticipate that our COVID-related revenue will step down by approximately $1 billion in 2022. We'll more than compensate for that headwind with strong growth in our base business. Let me give you some additional detail around this that I think will be helpful. Excluding COVID-related revenue, the FX headwind, and the contribution of acquisitions, our total company revenue guidance implies organic growth at constant currency in the low- to mid-teens. At the segment level, we 7%.
Excluding COVID-related work, we expect organic revenue growth at constant currency in TAS to be in the high single- digits. Research & Development Solutions revenue growth is expected to be between 8% and 10%. Excluding COVID-related work, we expect organic revenue growth at constant currency in R&DS to be in the upper- teens. Contract Sales and Medical Solutions revenue is anticipated to be down, but excluding COVID-related work, we expect organic revenue growth at constant currency in CS. Let's move to the first quarter now. As you all know, the first quarter of last year marked a continued rebound in our base business after the 2020 pandemic-related decline. In addition, Q1 and Q2 of last year represented our peak COVID-related revenues. As a result of this, the first half of the year will have the most challenging year-over-year compares.
For the first quarter, our revenue is expected to be between $3.55 billion, representing growth of 4.8%-6.6% on a constant currency basis and 3.1%-4.9% on a reported basis. Now, organic revenue growth at constant currency to be in the mid-teens. Expected to be between $800 million and $815 million, up 7.5%-9.5%. Finally, adjusted diluted EPS is expected to be between $2.40 and $2.46, growing 10.1%-12.8%. To summarize, fourth quarter results on both the top and bottom line against what was 2020.
R&DS recorded its largest-ever quarter of service bookings, and for the first time had over $10 billion of total net new bookings in a year. A contracted backlog improved to a record of nearly $25 billion in the full year to a record $2.3 billion. We closed 2021 with net leverage of 3.6x. Our board approved a $2 billion increase to our share repurchase authorization. Finally, we're reaffirming the full-year 2022 guidance that we provided in November for revenue, and we're raising our adjusted EBITDA and adjusted diluted EPS guidance. With that, let me turn it back over to the operator for questions and answers.
At this time, I would like to remind everyone in order to ask a question, press star, then the number one on your telephone keypad, and we'll pause for just a moment to compile the Q&A roster. Your first question is from Jack Meehan with Nephron Research.
Thank you and good morning. I wanted to talk a little bit more about COVID and appreciate all the color you gave, Ron, during the prepared remarks on this. At the end of this year, 2021, can you talk about, you know, the balance of the COVID work and just how you feel about the duration of COVID, you know, kinda over the next few years? Do you think there's some aspect that might prove stickier in TAS, you know, or some ongoing work in R&DS? Just any color there would be great.
Yeah. Look, continue to burn off over the next two years. I think it'll be a gradual decline during the course of 2022, but it's gonna continue on into 2023. Yeah, it's hard to foresee, Jack, you know, how much additional COVID work there might be. You know, we've all been surprised by the ups and downs of the pandemic. Right now, we're based on what we currently have in the backlog, and we'll see where it goes from there and see what other work might come along.
Yeah, Jack, I mean, this is exactly right. You know, well, all we can do is look at the situation today. If anything, we've learned anything about this pandemic is we just can't predict the evolution. We do have, you know, in our RFP pipeline, especially on the R&DS side, you know, proposals to assist in new therapies to address COVID. There are even, you know, large, you know, top 10 pharmas that we are talking to about potential therapeutics. I do anticipate there will be some residual amount of COVID work ongoing. Unless things change dramatically based on the picture today, you know, it's just gonna gradually taper down. That's what we have here, you know, through 2023 and maybe the beginning of 2024.
Unless something else happens, you know, which no one here hopes for. That's what we have. It's all largely based on burning off the work, both commercial and clinical.
Great. Just as a follow-up, would be great to get your latest thinking on labor and maybe wage inflation. Has your view changed at all related to when you initially gave guidance around just wage inflation and the impact that might have on the forecast for 2022?
Yeah, I mean, look, that's a good question. That's the single most important challenge, operational challenge we have is people management. I mean, look, it's wonderful to be the leader in this space and to have, you know, such a, you know, $25 billion backlog to execute and strong commercial demand as well. The result of that is we need a lot of people. You know, even though technology is gradually taking over more and more of the work that we deliver, but we still need a lot of people. At 80,000 people, we know we have to recruit many thousands more this coming year. We have attrition, which is an issue really for everybody. There's the great resignation is affecting us post-pandemic.
We've become, and that's you know, the price of our success, I might say we have become an academic company. A lot of people, you know, recruit talent from IQVIA. Look, we're adjusting to this. We're creating all kinds of flexible work arrangements, compensation arrangements, loyalty building programs, training programs, back to work, the future of work, which is an initiative that we have to redefine roles and what's expected from our employees. We're being very innovative in terms of our workspace, really working on a lot of multiple fronts. With respect to the numbers and how it affects our numbers, obviously, it's challenging when you have to raise compensation costs and generally.
However, I would point to you that our margins, our adjusted EBITDA margins growing more than, and they are expected to grow more than ever before. We're getting the leverage on the massive restructuring and cost improvement initiatives that we launched immediately post-merger. We're now getting the benefit of that leverage, and that's more than offsetting the wage inflation headwinds. Again, I point to the growth of our profit numbers relative to the growth of our revenue numbers, and you see that we significantly, materially grow our profits materially higher than our revenue growth, which implies significant margin growth. Ron?
Yeah, I'd also say, Jack, that we do have the ability in a lot of instances to raise prices, to adjust prices. We have some, you know, provisions for improvement in our MSA agreements. We also have some short cycle businesses. Wherever we have the ability to adjust prices, we are doing so, and there as well.
Great.
Our next with Baird.
Thank you. Probably the number one topic here, funding environment and any potential knock-on impacts to the group. Your competitor, who also reported at the same time this morning, and is very exposed to pre-commercial biotech, said their RFP volumes were down 4%-10% in the fourth quarter. No business impact so far. One, talk about your mix of pre-commercial biotech as a percent of R&D backlog or bookings. And two, talk about what you're seeing in real-time in terms of business demand, bookings, other related activity in that pre-commercial biotech space. That'd be very helpful. Thank you.
Yeah. Thanks, Eric. Well, as you can imagine, we track these numbers pretty tightly. There are, as you know, many definitions of what's biotech funding and so on. We are not seeing in the actual RFP pipeline any changes versus what has been, as you know, a very strong demand environment for the EBP segment in general. In terms of percent of our bookings, what do we give you? We don't have the backlog, but we have the bookings. Let me see. I have got a few numbers here for you. I think, look, in terms of the actual bookings, large pharma still represents the majority, right? A little bit over half.
Correct.
Is that correct?
That's correct.
We, you know, maybe, you know, the mid-size is perhaps about, you know, somewhere around 10-ish percent of our bookings.
Yeah.
The rest, so again, I'd say, you know, 35% + is EBP. That has been the case. It fluctuates, as you can imagine. These things, these numbers go up and down. Now, if you compare where we are here in terms of the pipe, of the RFP flow, okay, it still continues to grow double-digit in volume. I mean, it's really, really high, more than double- digits. I don't know if we give you the numbers, but the pipeline is very, very strong. I mean, actually it's about our pipeline is about equal to our backlog as we speak right now, okay? Again, as I said before, COVID is basically a percentage of the total pipeline here.
A lot of it is oncology, which is up more than 20%, CNS more than 33% up. Across therapeutic, I think very good EBP growth in the pipeline. I'm talking now, okay? Not the books. I'm talking the pipeline to your question, what do we see going forward, okay? Which would be normally a lagging indicator of the funding. We see that EBP in the pipeline actually represents a majority of our pipeline right now. Again, we don't see any significant changes. Look, I wouldn't. Yes, it's true. For example, the month of January was lower in terms of EBP funding, but I wouldn't extrapolate from one month and/or from one quarter for that matter. As you know, generally, the levels of EBP funding are very, very high.
I mean, we must be in the top three years ever in terms of funding. Okay, maybe this year will be a little lower than last year, which again, these were record years. We're talking about orders of magnitude greater in terms of multiples of the funding if you just go back three, four, five, six years. Yeah, I mean, a step down in funding wouldn't concern us. We continue to see very, very good both bookings and even higher-
Just do one follow-up. Could you remind everyone what your technical definition is, what it takes for a client to fit into that category versus-
Well, we look at how much they spend in terms of clinical development of R&D spend, okay? Below a certain number-
[crosstalk]
I'm sorry?
Go ahead. I was just gonna say some of that client base would actually be companies that have a commercial pipeline.
Yeah.
That's correct.
Yeah.
Yeah. That encompasses what you might call small pharma as well that has commercialized product-
Right.
In addition to pre-commercial.
You know, let's say if a company spends less than $200 million, I don't know exactly the number and how we segment it. We have, as you know, tons of analytics and segmentation definitions. Broadly speaking, a company that spends less than $200 million in a given year in its R&D budget for us is an EBP, okay? You know, that's just one definition. We've got others also. We triangulate, as you can imagine, but that's one definition that I happen to like.
All right. Last one. If you had to guess, and maybe you're not willing to do so, but if you had to guess, just off the cuff, not holding your feet to the fire, would 10% of your backlog be pre-commercial biotech, 20%?
You know, I don't know if I can give you these numbers, but you know what? Why don't we do this? Why don't we give you know, on follow-up questions, we'll try to give you a little bit more clarity or range on what's in the backlog. We will try to do that. I'll ask the finance team here to. I'll try to prevail and use my executive privilege to prepare all these guys.
But, but-
I don't know at this point, you know, you put me on the spot here. I don't know exactly what I'm gonna give you.
But, but-
I will give you something.
Eric, it's helpful to give you a partial answer to that, to say the last two years, large pharma bookings have been slightly over 50% of our bookings. That gives you at least a start at what you're looking at anyway.
Right. Yeah.
Yeah.
Correct.
All right. Well, look, I appreciate it, and I thought you had a great quarter, so good job. Keep it up, and look forward to the rest of the call. Thanks so much.
Well, thank you, Eric. Usually, you tell us this at the beginning of the question, so I was concerned. Thanks for telling it at the end. All right.
It's all good.
All right. Next question.
Your next question is from Tycho Peterson with JP Morgan.
Hey, thanks. You know, Ari, given that most of the questions we're getting are on RFPs and wage inflation, I wanna go back to the wage inflation discussion and EBITDA margins because it is notable you're guiding for expansion here. You talked about, you know, benefits from the original merger, you know, integration plan. You talked about digitization and maybe some price increases. But can you maybe just give us a little bit more color on how you're, you know, planning to drive margin expansion in this environment this year? Are you pulling forward any, you know, additional cost actions?
No. Not at all. As I said before, just to make myself clear again, you know, largely, the main driver of our margin expansion is simply leveraging the benefit of all the cost actions that we took post-merger, okay? You will recall, you know, go back and look at the numbers. We had significant restructuring amounts every year, which obviously affected our cash flow. And we are now benefiting and leveraging those overhead optimizations, outsourcing actions, consolidation of infrastructure, merging of IT systems, et cetera. In addition to this, part of the reason you see margin expansion actually probably accelerate in 2022 versus 2021 in a quite significant way. I think some of it is what I just said, and some of it is a mix benefit.
I want to remind everyone that the COVID-related work, which was quite significant portion, over the past year or two, was at a lower margin than we would otherwise have our base business at. Okay? Lots of it was government work, whether it's on the commercial side, very small margins, or on the R&D side, where we also contributed to the global effort to address the pandemic by pricing our, COVID-related clinical trials, you know, not at the same level as we would otherwise have for traditional, work. In terms of mix, as this COVID-related work, gradually tapers down and the base business continues to grow, as a proportion of the total, then of course you've got a benefit on the margin side. I might add further that the amount of pass-throughs on COVID-related work was unusually high.
You know, vaccine trials came also earlier on than it would under normal trial timelines. The combination of lower margin service margins to start with, plus a higher proportion, an unusually high proportion of pass-throughs, all of that contributed to, you know, an adverse impact, mixed impact on our margins. As this work gradually tapers down, then obviously, the mix impact on margins is going to be more favorable. That's the other reason you see an acceleration of our margin growth.
Okay. That's helpful. Then a follow-up on APAC. Your long-term guidance is 11%-13% growth through 2025. Obviously within China, there's been a lot of noise. WuXi Biologics is getting placed on the unverified list. They're a CDMO, you're a CRO, so very different markets. Can you just talk on your view on China here in the near term? Does any of this kind of noise potentially benefit you?
Well, I mean, I don't know if we disclosed this, but you know, we've got a $200 million business in China. It's been growing double digits over the last few years. We have a fully owned CRO subsidiary in addition to IQVIA. We have a core IQVIA business, and we've got a fully owned CRO subsidiary that's called Kun Tuo, which is designed for local Chinese regulatory requirements and largely caters to the local market, the local biotechs, while IQVIA parent deals with the work of multinational sponsors for their piece of the clinical trials in China when it exists. It's a unique setup, which in combination with our global CRO platform, allows us to capture higher growth opportunities with China.
You know, again, we feel good about our capabilities in this market and about our prospects to continue this growth trend. Look, there are local CROs that are emerging, there are formidable competitors that are gaining share. You know, there are hundreds literally of outfits in China. As you know, you know, I don't need to belabor the point that China is a complex market. There are lots of, you know, factors external to our industry that can affect, you know, how market dynamics play out. But we're not worried, we're not concerned. We continue to invest as required. We have a good market position, and it's a small piece of our total business.
Okay. One last quick one before I hop off. On OCE, on your retention, you know, you talked about 350 clients using over one module. Your biggest competitor did, I think, talk about winning back Roche. Are you able to comment on that, you know, dynamic at all?
Anyone? I don't want to be the-
No, look, we don't comment on individual customers and dynamics with individual customers. You know, the Roche win was a very big win and, you know, the large majority of that is outside the U.S., I think about 90% or so.
Yeah, 90% of the work of the project is outside the U.S. I think the other, an independent subsidiary, was it Genentech, by the way?
Yeah.
Yeah. That had its own program. Yeah, no, you know. Roche has reaffirmed their commitment and is looking to accelerate the rollout actually after the successful implementations we had in several regions. Plus, they've also expressed interest in purchasing other modules. We're very, you know, pleased with our collaboration with this client. Beyond that, we're not gonna comment.
Yeah.
Okay.
Next question.
Your next question is from John Kreger with William Blair.
Hi. Thanks very much.
I wanted to come back to, you guys made the comment that you expect your R&DS revenue growth this year, I think, to be in the upper teens if you ignore COVID work, which is a very impressive number. Just curious, what do you think that business can do longer term?
Long-term growth.
Yeah, I think. Look, I think that the double-digit growth was a marker that we have achieved and strive to achieve. If you remember at the beginning of the merger, the growth was very low in the single- digits. You know, we think the continued acceleration will continue, and certainly that double-digit sort of mark in the longer term is something that we're looking forward to maintain that acceleration.
Yeah. I mean, look, at our Investor Conference, we gave you even 25 targets for our company as a whole, and we said that the company as a whole will grow 10%-12% annually, which presumably from a $15 billion base. R&DS has to be growing in double- digits in order to achieve that. You know, that's kind of where we. Didn't we give guidance also by segment?
Yeah.
For 25? Do you have those numbers? While the team here is bringing this up. But again, I bring your attention to what we gave as longer-term growth trends just a couple of months ago in November in New York, when we were all together in person. We gave you long-term goals and growth trends, all of which represented a significant acceleration versus what we've had over the 19 to 22-
It was double- digits at the Investor Conference.
Yeah. Strong double- digits. Yeah. That's the long-term trend of the business. Again, I point to you that these are large-scale businesses.
Yeah, absolutely. Very, very impressive. Thanks. A quick follow-up, Ron, I think this one's probably best for you. In the quarter, can you remind us what the acquisition contribution was to growth, and did you buy anything notable in the fourth quarter?
Yeah. The acquisition contribution to the growth was relatively minimal. It was a little over 150 basis points. We made a couple of acquisitions in the quarter, the largest of which was a payer analytics company in Europe, but nothing terribly large.
Great. Thank you.
Your next question is from Shlomo Rosenbaum from Stifel.
Hi. Good morning. Thank you. Hey, Ari, can you talk a little bit about the breakdown of the upper single- digit revenue growth in TAS when you exclude COVID? What's driving the growth there? Is it real world evidence? Is it technology? You know, the information part of the business doesn't grow much at all, so maybe you can just help us with the composition and what are some of the, you know, really big drivers there.
Yeah. Thank you, Shlomo. Well, we've done this before. We've told you what it's comprised of. You know, if you look at TAS, I mean, I like to look at it in terms of three tiers. You've got the basic core information solutions, which is the old IMS business, essentially the data. That's about, I want to say, 30% of the business, give or take. That's a flattish growth rate business, okay? No. You know, that's strategic. That's the way we do it. We just sell the data with very little price increases. It's a flattish business. Then you've got the moderately growing piece of the business, which is let's call it another quarter at this point, maybe a quarter of the business.
That's analytics, consulting, various services. That grows, you know, double- digits now. It's been growing, you know, strong double digits in past two, three years. It used to grow mid- to- high single- digits. Now it's growing, you know, low- to- mid double- digits the past few years.
Low teens.
Yeah, low teens. Yeah. Then you've got the higher growth businesses, and that's the real world and, of course, the technology businesses, which will grow, you know, good mid-teens. That's about the balance. It's like 45% of the business today. You know, obviously, we used to say it's a third, a third, a third. Now, obviously, because real world, the fastest growing piece of TAS, real world and technology are growing at a much faster rate, so they now represent already 45% of the total. If you do the math, that should get you to high single- digits underlying growth for the segment.
Okay, great. Thank you. Then maybe this is for Ron. How much is the incremental FX headwinds impacting EBITDA and EPS guidance for 2022? You talked about, you know, absorbing the $70 million-$80 million of revenue. If I were to normalize, how much is that impacting the guidance? Can you give us a little bit of color on that?
Well, we offset the entire $70 million in maintaining our revenue guidance. I mean, another way of looking at it is we raised our constant currency revenue guidance by $70 million. I'm not sure I understand your question beyond that.
Oh, just the EBITDA. Yeah, EBITDA, and you went up, like, $10 million on each side and EPS, like, $0.05 on each side.
Yeah, look, our FX typically doesn't have a big impact on our EBITDA. You know, we've had a little bit of negative drag from FX, not like we did with the revenue that we absorbed in our numbers. You know, we have more offsets on the EBITDA side than we do on the revenue side, so you don't see as much impact there.
Okay, great. Thank you.
Your next question is from Patrick Donnelly with Citi.
Hey, guys. Thanks for taking the questions. Maybe just to follow up on the M&A question earlier. Can you just talk a little bit about the outlook? Obviously, cash flow really strong, leverage is pretty reasonable at 3.6x. You know, are you seeing more activity in the pipeline given some of the volatility in the public markets, or does that take a little bit longer to play a role in kind of rattling out the potential sellers?
Well, that's a good question. Look, obviously, we're always looking, and even if you weren't looking, people call us to see where there are lots of assets that are in the market. We haven't been that active over the past couple of years in terms of numbers of acquisitions. We've done a little bit more in dollars this year, largely driven by our largest ever deal, which was simply the consolidation of our lab business. We bought 40 % that we didn't own from Q2—from Quest. That was our Q2 lab joint venture, and we paid, I think, $760 million for that. We did a couple more larger acquisitions.
As you know, the multiple valuations in this space in where we operate in the healthcare technology information space, the multiples are really very high. The reason for that is that private equity essentially is trading those assets from one private equity firm to another. They keep you know bumping up the valuations. We look at these assets, but we are always going to continue to be very reasonable and conservative. If we see value that we can create, then we will certainly look at these assets. No major changes versus what you have seen us do before. We will be opportunistic.
If there are things, assets that we would like to own, we will make a reasonable bid, and we won't get excited by what we're told the market is. Plus, I've got a you know a good balancing CFO here with financing that you know we have healthy discussions with the business heads. Again, I hope that you could see from our history that our capital deployment has been prudent. We've been willing to have more debt, and we may be willing to have more debt if necessary because we believe our business model is very different. You know, leverage for us at the peak of the pandemic was 4.8x.
As a company, or even if you go back to legacy companies, we've lived with leverage ratios that were even 6x. The reasons for why we were willing to live with those leverage ratios is simply because our business profile, our cash flow generation model, our business visibility profile, where you know the vast majority of our business is already booked you know early in the year, both commercial and clinical. All of that you know makes us comfortable that we can live with those, especially in an environment where I know there's a lot of talk about rising rates.
I would remind you that, you know, the bulk of our debt is at essentially fixed rates, largely because of hedges and the alignment between our euro debt and euro profits and dollars versus dollar profits. All of that makes us comfortable. Rates continue to be at historic lows. We you know will do what's right for the business. We will allocate capital to first internal investments, secondly to acquisitions, and thirdly to share repurchase. You will see us go back and forth depending on opportunities. Again, we intend to try to continue to reduce debt as is prudent within the limits of what makes sense from a management standpoint. It doesn't make sense to eliminate our debt at the current rates.
I mean, I would view that as negligence on our part. That's, I guess, the best answer I can give to your question. Thank you very much. We done?
Yeah.
Yeah. Thanks, Ari. If I could just squeeze in one follow-up if you have a minute. I just wanted to follow up on kind of the funding backdrop. You know, obviously, you've talked a little bit about the R&DS strength going out multiple years, double-digit growth. I guess when you think about the funding, I mean, it seems like you were never underwriting the type of record strength we saw last year in order to hit those numbers. If we did see some prolonged softness in the funding environment relative to last year's levels, it's still more than sufficient to support that growth outlook, I guess. I just wanted to make sure that's kind of the way you're framing it.
I cannot overemphasize that we are not seeing that translate into our sales pipeline. I mean, again, I gave you some numbers earlier, and biotech, I'm not giving you the numbers here because I don't know if I should give them to you or not. A big majority of the RFP dollar pipeline and numbers, volume and dollars, is actually EBP. We are not seeing any impact from potential slowdown of the funding into our pipeline. Not at all. The pipeline is at record high levels. Again, it won't affect us one bit. By the way, again, I'm not seeing that happening. You know, we talk to EBP all the time.
Okay. That's encouraging to hear. Thanks.
Thank you.
Thank you. That's gonna be our last question. Thank you for taking the time. We look forward to speaking again next quarter. Myself and the team will be available for any follow-up questions you might have the rest of the day. Thanks.
This concludes today's conference call. You may now disconnect.