Is my mic on? Yeah. Okay, good.
I guess, big picture, what do you reckon investors are potentially missing about where we are in the CRO cycle or anything, or anything we're kind of overlooking as big opportunities or risks?
Yeah, look, I think one of the things people are overlooking for IQVIA in particular is that we're not exclusively a CRO. 55% of our revenue, give or take, is CRO-related. 45% comes out of the TAS business and CSMS business. So I think that that's a big item that people overlook. I think they also tend to overlook the long-cycle nature of the industry sometimes and get overly focused on the short-term in particular, and kind of the quarter-to-quarter fluctuations in demand. And this business is one where you book something this quarter and it takes four or five. It takes six months before you get any revenue out of it at the minimum, and it takes 4+ years before you end up fully realizing the trial. So it's a business that has a lot of long-term momentum in it.
The fundamentals remain very good, even with some of the recent choppiness we've seen with portfolio reprioritization. So I guess what I would urge people to look at is kind of some of the longer-term trends. For instance, we went back and we did a study back to the year 2000 of all the publicly traded CROs to say, "What happened during that period?" This is a period where you had a couple of pretty significant recessions. And during that period, there was not a single year when the publicly traded CROs had negative revenue growth. Yet there were, I think, three years when the S&P as a whole did have negative revenue growth. So it's a business that has a lot of stability long-term.
Can you talk a little bit about cancellations? Because I think you said 50% cancellations this last quarter. And that may have been the first time I heard that number, whereas some of your competitors had sort of flagged that, I guess, probably earlier last year. So is there anything that sort of changed or why you all would, if you did see it later in the year, why that would be when some of your competitors are saying it early?
I'll make a comment about cancellations. We did see a very elevated level last year, about 50% above normal, as you say, over the course of the year. Now, there were two very large trials that we had that were canceled for futility, so that's very idiosyncratic. You're not going to say that that's necessarily indicative of any sort of trend, but having said that, we also did see some, particularly late in the year, portfolio reprioritization effect. We think a lot of it due to IRA and how pharma companies were reacting to that, and we see that continuing on, probably an elevated level of cancellations in the first or second quarter, why other people see different than we do, it's company to company, it's customer to customer, and there's a fairly big variation in policies around, I think, about cancellations.
I look at one of our competitors and saw they have very, very constant cancellations quarter to quarter. And that I just scratch my head about and say, "I don't know how that could be." So there is flexibility, I think, in when you recognize cancellations. And I think different companies take different approaches to that. I would make the overall point, while we're talking about quarter to quarter and cancellations and things of that nature, I'm going to go back to something that Ari talked about on our earnings call, which was that we think that there's too much focus on the quarter to quarter and the book-to-bill in particular. And let me give you some thoughts around that. First of all, like I say, it's a long-cycle business.
So any one quarter isn't going to tell you that much, particularly when a booking you get this quarter burns over four or five years. The other thing is that there's a significant variability in how different customers treat not just cancellations, but bookings. What we've seen is some people do it like us on a contracted basis. Some do it based on verbal awards. What goes into the backlog versus what doesn't go into the backlog varies. There are differences in how many years of FSP companies take. So there are all sorts of differences in that. So it's very hard to compare across companies. And then when you realize that there are only four companies out there out of all the CROs that report book-to-bill, you don't even have a very broad base of companies to which to compare that to.
The other thing I would say is I think the industry as a whole has done itself a bit of a disservice by emphasizing that too much because our, that is, the quarterly book-to-bill, because our customers have picked up on that. And they push you at the end of the quarter because they know everybody's trying to make the quarterly bookings numbers. And in our case, it's particularly frustrating too because we have a whole huge TAS business, which is practically half of the business. And everything seems to come down to what's going on with the book-to-bill in a given quarter. So I can tell you that we're actively having debates internally about, "Is this something we even want to continue reporting on a quarterly basis?" Because it just gets too much emphasis.
We put out a lot of other good metrics like next 12-month revenue from backlog, backlog growth, all those sorts of things. Anyway, I think it's worth making those points. Yeah.
What percentage of your revenue for backlog is from companies that are very much in the early stages and not yet profitable? How has that maybe changed over the last few years? Maybe lastly, are you seeing a slowdown there or?
About 10% of our revenue comes out of what we would consider to be pre-revenue or pre-commercial emerging biopharma companies, so it's a comparatively small percentage. Overall, we do about, call it roughly a little bit over 20% how we define EBP, and that's the other thing I'd be cautious about because everybody has a different definition. One of our big competitors talks about the Top 50, and everybody else goes into EBP. We have a little bit narrower definition, but in any event, it's relatively small in pre-commercial, and we tend to focus on EBP customers that have funding, that are in a better situation, more likely to go forward. We do more late-stage work that is phase two, phase three. We don't do much at all, and we do nothing in preclinical, and we do very little in phase one.
So we tend to get EBP companies that are a little bit further along in their cycle and are better funded. So in that sense, we don't feel like we have much exposure there. But we do do a substantial amount of our business with EBPs, for sure. Probably, if you want to put round numbers on it, it's probably 20% of our revenue the way we define it and 25% of our bookings because they're growing a little bit faster than large pharma is, mid and large pharma.
That's 20% of CRO, right?
Yeah, CRO. Exactly. Yeah.
Do you have thoughts on inorganic growth strategies and kind of, I know there's this trend of follow the molecule? Do you want to expand into earlier stage or potentially manufacturing?
Our inorganic growth strategy, I think our first emphasis is on filling in holes in our TAS portfolio where we have opportunities to grow. We haven't historically been as big in medical communications or affairs, for instance. We'd like to do more in the digital marketing area. There are a whole bunch of places that the TAS business and the commercialization of pharma is very broad. So there are all sorts of places we can fill in there. Now, in the R&DS area, we have done some acquisitions in the lab business. We've done selective acquisitions in the CRO business where we think we can add some particular capability. But it's probably weighted 2/3 towards TAS and 1/3 towards R&DS, roughly, in our inorganic activity.
Now, you asked, I think you were kind of poking at, "Would you want to get involved in the CDMO space or something?" It was a little earlier. I don't know. I mean, something we could look at. We would have to convince ourselves that there was a nice fit with our business, for instance, that it would feed our R&DS business or somehow enhance that business to be involved in. I wouldn't rule it out, but probably not likely.
The pharmas seem to want to consolidate their vendors. And I guess other CROs are saying they're winning this business. So in the CRO business, are you looking at a margin compression or even just a flat margin in the CRO business for the next four or five years, given the cancellation of the contracts, the fact that you have to try to get in as to be one of the exclusive ones, that type of thing? And then also, if you can say if the biopharmas, the smaller guys, are getting similar terms than the bigger guys?
We went through, I think, pretty much our entire large pharma portfolio last year. And we reaffirmed all the preferred partnerships we have. We have preferred partnerships with 22 of the 25 large pharma. And we actually even expanded our business some in new therapeutic areas. We got a little bit more FSO in the FSP business, and so I think in seven of those, we actually expanded the scope of the work we're doing. Hey, Charles.
I'm so sorry. I was recording a podcast for some reason. They were screwed on my calendar.
No problem. Let me finish the question. I think what you're asking here is, is there a long-term pressure, margin pressure on R&DS as a result of all that activity? And the short answer is we don't think so. It's been a little bit competitive in the FSP space. So there's been some pressure there on margins. We have some short-term margin pressures because we've had some trials that were delayed and have some stranded costs there. But long-term, I don't think we've seen things fundamentally change within that business. Now, that being said, at the time of the merger, we really plucked a lot of the low-hanging fruit on costs. So it gets harder and harder to take costs down. We do it through a combination of ways. But one of them is we're always looking for low-cost sourcing. When we do acquisitions, that allows us to reload.
And I think the next big frontier for us in terms of cost reduction is Agentic AI. And you heard that we re-upped our—not re-upped, but started a relationship with NVIDIA. And we're working with them very carefully, closely to identify areas where we can use Agentic AI to take costs out of our organization. And I think that that will bear fruit over time. Probably not a big 2025 impact. But going forward, I think there's a lot of opportunity there. Look, we have almost 90,000 employees in the business. So it's a very labor-intensive business. And I think the combination of labor and data lends itself very well to Agentic AI. So I think you should see some progress there overall. Charles, you want to pick up? And I'll tell you where we're going over old ground here.
And apologies because they had somehow double-booked me for something. So again, thanks for the patience. Ron, so maybe just picking up on that a little bit. You mentioned sort of margin pressures. And if we think about FSP adoption, I think depending on who you ask, right, we've seen maybe a little bit more pickup. Maybe it's slowing. But certainly, when you listen to some of the big restructurings that are occurring among large pharma, it does seem like there is a little bit more of a focus on bringing some capabilities in-house. The thought process behind that for pharma seems to be a little bit more having a little bit more control or a little bit more visibility on some, obviously, with big portfolio pipelines. Can you talk about how you guys can help support that?
And does that change the dynamics of what the role of sort of these large CROs or someone like an IQVIA would be providing in the future? I know in the past, you've talked about it tends to be cyclical and kind of comes back and forth. Do you still think that's the case? And sort of just where do you think we are in this kind of pendulum momentum, I guess?
Yeah. Look, we still think that's the case because we've seen the cycles of pharma getting more involved in FSO and outsourcing more on an FSP basis before. And we've seen it swing back. There's no question right now we're in a cycle that's towards a little bit more FSP. What I would say is, and we will participate in that for sure. The old Quintiles pre-merger did not want to do that. And when we had the merger, we changed our view on that. Said, "Look, we want to do all work, be it FSP or FSO." It's a gradual movement in that direction. It's roughly 15% of our total revenue in R&DS is FSP-related. That's up a couple of percentage points versus two or three years ago. So you're talking about a move of a percentage point or so per year.
If you looked at our bookings, it's probably more along the order of 20% or so. So there's a gradual shift. When will it shift back? I don't know. I can't call that. But what we're seeing in a lot of cases is they're actually participating in hybrid trials. It starts out as being FSP. And then the sponsor comes to us and says, "Well, we really want to do something in the safety monitoring area and want you guys to take that over. We want to do something here or there." And so it ends up being a hybrid of FSP and full-service work. So it's a continuum between the two. But net-net overall, it has been somewhat of a shift towards FSP, for sure.
Do you think hybrid then is probably more likely going to be a bigger piece of the market going forward, or at least over the next several years?
Yeah, I think it will be, for sure.
Yeah. And obviously, with this period of reprioritizations and pharma going through these restructurings, it's also come with sort of elevated levels of cancellations we've seen across sort of the space. Here we are partway through the first quarter. Any sort of commentary on what you're seeing in terms of that levels of cancellations?
I'll be real brief here because we already covered this with the group. But yeah, we do expect continued elevated level of cancellations in the first quarter and potential in the second quarter. We think we'll see a reversal in the second half. And TAS is very helpful, instructive to us here. You might ask, "TAS, R&DS, why?" Well, TAS, being a shorter-cycle business, saw the impact of pharma kind of pulling in the reins on spending first. And we predicted that this would last for a year or so. And then we would see a bounce back. And coming into last year, we said we expect a much stronger second half than first. And there was an understandable level of skepticism among the investors about that. And in fact, that's exactly what we saw.
And it was even a little bit more of a bounce back than what we expected. And we think that that informs what's going to happen in the R&D business. We see the first half of the year being a little slow, in part because we had trials at the end of last year that were delayed, some fast-burning mega trials that were delayed into the back part of 2025. But also because we see pharma now being about 2/3- 3/4 of the way through their portfolio rationalization. By the middle of the year, we think that will largely be behind us. And we expect to see things come back in the back half of the year. So the cycle for R&DS will, we think, take a shape pretty similar to TAS, just a year or so delayed.
Maybe sticking with TAS then. Obviously, you talked about sort of delayed decision-making. It's kind of bounced back here. Is that because of pent-up demand, or is it just we're kind of getting back to the normal kind of cycle, particularly as we think about maybe real-world evidence? I think the 2025 guidance, looking sort of constant currency growth, 5%-7%. Do you think that could end up being conservative then?
It could be. I mean, I think to answer your first question, I see both pent-up demand and just return to normal. I wish it were the world where everything that was deferred back when things were slow came roaring back immediately. Honestly, I don't think that's realistic. I think a lot of the work you got done internally by pharma or they just cut back on their spend. Some of it has to get done and got pushed. And we're picking that up now. But we're also seeing a recovery of normal work as the purse strings loosen up. The FDA approved 55 drugs in 2023 and 50 in 2024. And to put that into context, the average is about in the 40s, 45 or so. So there's a lot of work that needs to get done and will get done going forward.
Our indicators in the TAS business right now are very solid. To your question, we said 5%-7% constant currency growth. Could it be better than that? Sure. Could be better than that. It's a short-cycle business. It's tough to predict. We want to be prudent going into the year and give you what we were seeing at the time.
When we think about the different components within TAS, it sounds like we could look at RWE and sort of commercial tech as being kind of the faster-growing parts of it as we're kind of coming out of this cycle. Those tend to be a little bit lower margin than some of the other parts if we think about sort of the software and analytics or information systems. Should we think about that as lower margin?
Real-world, as lower margin has been, although the margins are improving there. The R&DS tends to be the highest margin, but the slowest growth. I think we've been fairly clear about that. Actually, analytics and consulting can be quite high margin when you get into an upswing period, and I think we're just getting into that right now. It's lagged a little bit behind real-world, but should come back, and the margins are actually improving in the tech part of the business. I wouldn't consider them low at all. In fact, as we get into more license revenue and away from so much in implementations in terms of weighting, the margins are improving there, so I think going forward for this year, margins should be fine in the TAS business. There are going to be pieces moving in different directions, and mix always plays into it.
But when you net it all out, I think we should be fine, particularly with analytics and consulting improving because that can be a really nice margin.
That shift away from implementation and being more focused on licensing, if we think about OCE, for example, and the partnership now with Salesforce and with them embedding OCE into their Life Sciences Cloud, can you just remind us what that relationship looks like going forward as they go to market? Sort of what role do you play? And how does that show up sort of in results?
The first thing is we're continuing to sell the old OCE platform. Salesforce is out selling the new platform, which is on their new cloud-based platform. And we'll get a license fee or a royalty on that. We haven't disclosed the terms, and we won't disclose the terms on that. So we're going to continue to service existing customers probably through at least 2029, maybe through the end of the decade. That business isn't going away anytime soon. There'll be a gradual shift over, we think, onto the new platform. And we'll pick up some royalty revenues on that. Yet net-net, it'll probably be a drag on our revenue in that part of the business. But it's really not that big. I've seen numbers that are thrown around. It's probably roughly a $150 million business for us this year. And we have a $1.4 billion commercial TAS business.
So you're never going to see it. It'll be a gradual taper down. And we're going to have growth in other areas. You'll never see it.
Yeah. Maybe lastly, within TAS, digital marketing, obviously, you tried to make an acquisition earlier and kind of got blocked. With the change in administration, maybe a change in FTC leadership, do you think this is an opportunity then to kind of go back to some of these areas?
It could be. The specific deal that we were looking at that got blocked by the FTC, which is unjust, which was DeepIntent. I don't know whether that'll come back or not. Sometimes those things, when they're gone, they're gone, but we certainly would be looking to do other things in the digital marketing area, and the overall comment I would make is we think the new administration will be more friendly to mergers and acquisitions than the old administration will be. Whether it be in digital marketing or another area, I think it's helpful to us overall. Now, most of what we were looking at, we didn't think we would have any issues with anyway, but there are always a few on the margin that you're concerned about, whether, if you have a particularly aggressive FTC, whether it's going to make it difficult to get the deals done.
We think that the pendulum has shifted back in the favor of business on that.
Okay. That's helpful. Maybe just in the last few minutes here, talk about sort of the long-term growth outlook. That algo, right, if we think about it, 6%- 9% top-line growth has typically contemplated sort of outsourcing kind of continuing to increase about a percent a year in pharma. Is that sort of still the right way to kind of conceptualize the market? Because obviously, we're talking about different mixes, hybrid kind of programs. But for investors, as you kind of build out kind of how to think of the market growth, how should we think about sort of the pace of outsourcing itself now that the complexity has changed a little bit?
Let me build that up, that number. We talked at our analyst day about 6%-9% growth. That's obviously a constant currency number. We don't know which way currency is going to go. And that consisted of four components. We see overall pharma spend, this is across R&D and the commercial space. And it's everything from EBP, mid to large pharma, so the whole thing, everything that we would play in, growing at about 3%-5%. On top of that, we think we'll pick up another percentage point or so due to outsourcing. And that's not just outsourcing in R&DS growth. It's also outsourcing growth in the commercial space because we've certainly seen that as well. Then another percentage point or so of share gain. That's historically what we've been able to do.
On top of that, looking at probably one to two points is what we typically per year is what we typically target in organic contribution. If you add that all up, that comes to the 6%-9% growth that we're talking about. Look, we're very bullish on the industry long-term. You go through rough periods in individual businesses. I think the tendency is to kind of get myopically fixed on those things. The underlying industry is very, very healthy. We see very, very solid growth going forward.
And I think you talked earlier, right? Do you think what you saw, experienced in TAS last year and change, you do see that for R&DS as well? So is it really just the first half? What are the KPIs that you're looking at internally that kind of give you more of this kind of confidence that in the back half of this year, we will see that sort of bounce back in demand?
If I start at the most aggregate level, we have relationships with everybody who's of any size in pharma. So we know where they are, give or take, within their portfolio rationalization. So that's number one. We come in very well-informed because we have thousands of touchpoints in pharma. In the EBP space, we've seen financing, the funds, fundraising continue to be strong. It was strong last year. It's the highest year other than 2020 and 2021. And it was up substantially year over year. So now some of the EBPs have been a little bit slower to spend that money than you might think. But the funding is definitely there. And we think it'll come back. We also look at, of course, the pipeline of what we see coming in. That was up year over year in fourth quarter. The RRFP flow was up mid-single digits.
We have a lot of indicators like that, some of them just based on conversations with our customers and the relationships we have, some of them more quantitative that give us confidence that we're going to see things improve in the second half of the year, and some of the second half is just the nature of our business and what got deferred late last year and when we expect it to restart.
That's really helpful. And then maybe just in the last couple of minutes here, the guidance for this year contemplates about $2 billion deployed between share repo and M&A. How should we think about that mix this year?
It's one of those things that it's a really important question, but it's also one that's always difficult to answer because it depends so much on opportunity. On balance, I think we would like to spend more on acquisitions than on share repurchase because acquisitions help us build our capabilities and give us a platform for growth. But you have to have willing sellers, and you have to have pricing that's reasonable. And it's always tough when you go into a year, even when you have a pipeline of potential opportunities built up, to know what's going to get done and what won't get done. It's just very difficult to predict.
The other part of the equation, too, on share repurchase is when the stock is depressed as it is right now, you say, "Gee, our stock may actually be the best buy of anything that we're looking at." So the combination of those two things, opportunities on both sides, will dictate where we're spending our money. All else being equal, I'd rather be spending on acquisitions than share repurchase. But you see we've been aggressive about doing share repurchase when we didn't spend the money on acquisitions and when we thought it was justified by the value we were getting repurchasing our own shares.
So, fair to think in the current environment, probably we'll tilt more to share repurchase. I guess the pipeline, though. Would you say the pipeline?
We came in with a pretty good pipeline into the year. It's still there. There's no question. The share price is awfully tempting right now.
Great. We'll stop it there. We're at the time, Ron.