My name is Mike Ryskin. I'm on the Bank of America Life Science Tools and Diagnostics team, and I'm pleased to host IQVIA. Joining me for our next chat is Ron Broman, CFO. Ron, thanks for being here.
Thanks, Mike.
Kick things off, let's maybe take a recap of the first quarter you reported a couple of weeks ago. Key puts and takes of the results, what stood out to you? What was most surprising from how it played out?
Look, I think the results overall were really strong. We were above the high end of our guidance on revenue. We came in above the midpoint of our guidance on EBITDA and at the high end of our guidance on EPS. So earning results strong, particularly pleased with the performance in TAS that had a growth of over 7.6% in constant currency. And so good P&L performance, cash flow strong. First quarter is typically the softest quarter for cash flow and actually came in up 13% year- over- year and 89% of adjusted net income, which is kind of at the high end of what we forecast for the full year. So really encouraged by that. You saw we took up our revenue guidance by $275 million. Now, that was for FX.
We left our profit guidance unchanged because what you typically see is we do not have much impact on the bottom line from FX, even with movements on the top line. The only thing that I suppose was a bit soft in the quarter was our bookings. I know you guys all focus a lot on book to bill more than we like to, but it was 1.02 in the quarter. You know the interesting thing was, unlike last year where we saw an elevated level of cancellations as clients, particularly large pharma, reprioritized their portfolios. In this year's fourth quarter, I mean first quarter, we saw a normal, within normal range of cancellations, nothing out of the ordinary. It was really that we saw certain clients delaying decision-making towards the end of the quarter.
We did see a lengthening of the time between when we got an RFP and when we got an award. It was up about 10% sequentially and year- over- year. That can have an impact in the quarter because a lot of the decisions get made towards the end of the quarter. We also had an unusual number of EBP, biotech contracts that we signed that we did not take into orders or backlog because they did not yet have the funding. We have a signed contract, but our policy is we will not put something in backlog unless it has the funding. I think those two things together combined to make it a little bit softer in bookings. If you look at some of the other underlying demand indicators, our RFP flow was up, I think, 6%. We had low single-digit qualified pipeline growth.
Our backlog is up over 4% year- over- year. The other indicators were fine. We just saw a little bit slower decision-making than we normally saw. We attribute that to some of the uncertainty that's been generated by recent actions by the current administration.
That slower decision-making, you talked about some of the difference between emerging biopharma and maybe large pharma. What do you think are the various pushes and pulls and what is driving that?
In the between large pharma and emerging biopharma? In the emerging biopharma area, clearly you've seen some slowdown in funding levels. It's actually pretty good growth in funding of biopharma last year, particularly in the first half, but then we saw it trail off a little bit and it was not particularly strong in the first quarter or even in the month of April. I think that probably we saw it happen with us, that it slowed down putting certain orders into backlog and also just decision-making on the part of EBPs. In large pharma, obviously, funding's not an issue. I think it was just more an issue of pulling the trigger on some trials that they want to do. It's happening a little bit slower than we normally would see it.
Okay. Maybe sticking with the biotech angle first. You talked about the funding environment, yeah. Year to date, not off to a great start. April seemed a little bit quieter as well. I think macro plays a big part in that. Any sign from your customers in terms of how they're responding to that longer term? I mean, you called out that RFPs are still, contracts are solid, but it's not showing up in orders. Is it really just a matter of funding coming back? Is that the one factor we're looking for here?
That certainly would be helpful. We actually saw decent, we saw growth in biotech, emerging biopharma RFP flow in the quarter. It is not like the demand is not there. I would say the better funded firms, obviously, and those that are later stage are the ones that have more activity. That is typically where we participate is in later stage work and better funded work. I think about 10% of our backlog is pre-commercial EBP. Not a huge percentage point. I would draw that distinction between the two. Look, we always see biotech funding go through cycles. It goes up and down, and I am sure it is going to come back. It is just a matter of time.
When you talk about large pharma, some of the policy of what's going on with the administration, more specifically, is it about the risk of pharma tariffs? Is it ongoing IRA conversations? Is it some of the senior agency heads and announcements and things like that? What are the biggest pressure points?
We talked about this some on our call, and I think you can group it broadly into three areas. One would be agency change. The other would be tariffs, and the third would be pricing actions. On the agency, changes in the agency and funding and so forth, we do not see a big impact there. First off, I know some of our competitors have been affected by BARDA contracts going away. We do not have any business currently with BARDA. In fact, we do actually comparatively little business contracting directly with the U.S. government, some in our TAS business that really has not been affected. On the NIH side, most of the cuts there have been to overhead rates, pulling down the maximum rate to 15% on overhead reimbursement to make some of the private universities and foundations and so forth in line with other parts of the market.
No big impact there. FDA, most of the cuts we have seen have been to support administrative personnel, not to the people who directly participate in trials. In fact, that trial work is funded by PDUFA, by the pharma industry, and we have seen no slowdown in trials whatsoever, decision-making or getting FDA's attention. I mean, every now and then you'll hear about an anecdotal incident that somebody will bring up, but for us, really no impact there at all. I'd say that the agency stuff is more noise than signal. Now, you go to the tariffs, we are not directly affected by tariffs. It was a little bit of lab business that we thought might be, does not look like it's going to be much affected at all. With our customers, it could be a different story.
Obviously, if there were tariffs on pharma, they would be directly affected. We just do not know where that is going to go right now. I think I suspect if I see what is going on with other things in the administration, the administration is going to take a practical approach towards that. Obviously, nobody wants to see no drug availability because you cannot import certain drugs or certain precursors or whatever. You have seen a lot of pharma companies respond by announcing big investment programs in the U.S. They are certainly sensitive to the issue that the administration raises about producing more molecules here in the States. I suspect that is going to be worked out, but we are going to have to see. It has not even been announced yet exactly what these tariffs will be. There is a bit of unknown there still. The pricing issue is one, I would say.
We had this recent executive order come out of the Trump administration, and it's very recently. There are a lot more questions than answers right now, like exactly how that's going to be implemented, what timeline, what drugs, how does it dovetail with the getting rid of the pill penalty issues like that. There are broader issues like, does it need congressional approval? What are the legality? Back in 2020, there was a similar executive order that was struck down by the courts unchallenged. A lot of questions there. We don't know exactly where that's going to end up going. We would say this. I think the pharma industry is going to make a point to point out to the administration just how important the biopharma sector is in the U.S.
I mean, just to quote a few numbers, U.S. biopharma firms spend $200 billion a year in R&D. They're responsible for almost $1.7 trillion in annual economic output, 5 million direct or indirect jobs, and an average salary of close to $160,000, which is 2x plus the national average. The U.S. biopharma industry is dominant in both sales and in new drug development. There are a lot of reasons to think this is a very critical sector to the U.S., and this whole issue will get worked out over time in a practical manner.
Do you feel on the R&DS, given what you just talked about in terms of large pharma, do you think it's just a matter of time until sort of the pharma companies get a lot of, get their heads around the agency change, the tariff impact, pricing, and things sort of normalize a little bit?
Oh, of course. Look, we've been through any number of, we call them crises in the industry, and every one has its own unique dynamics. I mean, when you look back over time, the pharma industry always works its way through these issues and emerges on the other side stronger. It's really one of the most powerful forces in our economy, and we expect the same will be the case. Some of the uncertainty that's been created recently is obviously slowing down decision-making. We saw it in our Q1 bookings as did others, but we don't expect it to be persistent.
Okay. Maybe let's pivot a little bit to TAS. As you said, that was a little bit better than expected in the quarter, mid to high single-digits, constant currency growth. On the other hand, that's been a little bit choppier over the last couple of quarters prior to that. You talked about TAS being shorter cycle and expecting a recovery. Is this a good sign of things to come? And sort of what drove that, given the pharma cautions elsewhere?
When we were in the beginning of last year and our sales growth in TAS was pretty anemic, we told everybody, look, we expect it to come back in the second half of the year. Pharma cut back first post-IRA on discretionary spending, but there's been a huge amount of new drug approvals by the FDA over the last few years. Ultimately, a lot of work needs to get done around that, be it launch planning to pricing and market access to real-world evidence to support drugs going on to formularies and things of that nature. Some of it can be brought internal within pharma, but not that much. Ultimately, it needs to get done and the work's going to come back because it supports the commercialization of drugs and the growth in sales and profits in the industry.
In fact, that's exactly what happened in the second half of the year. It carried on into the first quarter of this year. The question I've been getting in some of our private meetings today is, okay, but given all the atmospherics around the pharma industry, could that change in the second half of the year? All I can say is, look, all our indicators right now in that business are green. I mean, we track very carefully our pipeline of work, how that compares to prior years, our win rate, how that compares to prior years, how much we have in the backlog versus how much is yet to come, what our customers are telling us. We have no reason to believe that the growth is going to slow down in the second half of the year.
The comparison will get a little tougher, but the actual absolute level of revenue progression will deteriorate. Okay, okay, it's a short-cycle business. Things can always change, but right now, all the indicators look really quite positive.
I mean, to exactly that point, the shorter-cycle business, what's the visibility like there?
It depends on the part of the business. If you take the information business, we're a data business. We're about a third of our business. Visibility is very good there. We sign, in many cases, multi-year contracts or at worst, you're signing a year at a time out in front. There are other parts of the business like real-world late phase that are contracted business that stands out for multiple years. You have technology solutions where you have extended license contracts. Then there's a portion of it, particularly a portion of real-world and analytics and consulting that is more short-cycle and can change very quickly. Maybe you're looking in some cases at contracts that last months rather than quarters or years. It's a mix of the two.
As opposed to R&DS, where you have a backlog that's going to burn over the next five years, clearly there's a mixture of longer cycle and shorter cycle there. You can get some volatility. You'll see a little bit choppier levels of revenue growth there, sometimes very high, sometimes lower, whereas the R&DS business is kind of a smooth flow.
Okay. Within TAS, one of the things you called out was the strength in real-world evidence. Can you talk about sort of what's the driver there? Is that a structural change? Is that just some timing of contracts, customer decisions?
I don't think it's, I think a lot of it relates to the introduction of new drugs and doing work to support commercialization of those drugs, proving to payers, be they private payers or governments, that the drugs are effective in real-world settings. It helps with use of new indications. This kind of, it just has to do with the overall strength of new introductions, new drug introductions into the market. It's a sector that I think structurally is going to continue to grow because as we and others have increasing amount of data, there's a lot that you can do with that data. We're really in kind of the catbird seat as far as data goes and being able to use that for real-world evidence. While we have competition in that space, there's plenty of growth for everybody. It's a real nice area.
Look, there are elements of real-world that people are less familiar with that we include in the real-world category, like patient engagement and so forth, that have been sources of growth for us as well.
That work to support the new drugs, is that projected to continue? Is there sort of like once you work through that, is there a pause until the next project start?
There is always new things starting. When you have the FDA approving 50-55 drugs per year, there always seems to be a pipeline there. Yeah, maybe it does not go away entirely, but it shifts from one drug to another drug in terms of the locus of the spending.
I guess my question is, the new drugs that are driving that growth now, is there anything unusual about them that's making them more RWE intensive, or is it a pharma decision?
I don't think so per se, that there's anything that makes them more RWE intensive per se, but there is certainly more scrutiny from payers than there used to be. There is more, I think, pressure on providing evidence in real-world use. With the FDA now, that's one thing that I suppose is a, you could call a structural change. The new FDA Commissioner, Marty Makary, has said that this is important to him. HHS Secretary Robert F. Kennedy Jr. has said the same thing, that proving safety and efficacy over long-term studies in real-world groups is good, is important. They're going to put more emphasis on it. That would be something I would say would be kind of a tailwind for the real-world business going forward. Now, did we see that in our Q1 results already? No, because probably that dated back to decisions that were made in the past.
I think going forward, that's a good harbinger.
How should we think about TAS margins, specifically RWE margins relative to total company?
RWE margins are a little bit lower on average than other parts of TAS, although they have been improving over time. You could say that there is a little bit of mixed drag in that part of the business growing faster than other parts of the business, but you will not see it.
Okay. Back to R&DS. Hate asking the quarterly backlog question, quarterly book to bill question, but maybe we can think about it on a trailing 12-month basis or just sort of some of the factors impacting that. Why do you think that metric or that value has sort of not been as predictive of revenue growth as it has in the past?
I don't know that it's ever been the best metric. It is a metric. I understand why people focus on it because it gives you some new information about bookings. It also has a lot of issues with it. One being that it's a single-quarter metric in a long-cycle business. That's probably the biggest issue. It's a snapshot in time, and you're trying to compare it to a movie over four or five years because the average clinical trial lasts four or five years. The other thing I would say is that every company has slightly different policies on bookings. That's an issue. You can't necessarily compare one to the other that well. If there's a numerator-denominator problem in that if your revenues happen to be low, that's going to help your book to bill.
If your revenues happen to be high, that's going to hurt your book to bill. Look, Ari cited this example on our Q1 call, and it was we have a competitor who has almost exactly the same quarterly and trailing 12-month book to bill as we do, actually exactly the same on a trailing 12-month basis. And we're growing our R&DS business 4%, or if you take out the COVID, add the COVID impact back in, 3% this year. And that's probably eight points better than what they're doing in their business, which is entirely clinical trial. So it's just an indicator that this metric is something you got to be very careful with. It can lead you to the wrong conclusions if you focus on it too much.
Okay. You mentioned one of your competitors in the space. I mean, I think ironically, a lot of companies put up a 1.02 and a 1.14 trailing 12-month this quarter. Maybe you could touch on the competitive dynamics, what you've seen over the last couple of months, last couple of quarters, touch on pricing environment.
Look, any time that the market tightens up a little bit, you could expect to see pricing get a little keener. That is just the nature of business. I do not care what business that you are in. I think we have seen it a little bit more in the FSP business, and that is understandable because the FSP business is one where it is harder to differentiate yourself than it is in the full-service business. It has crept over, I think, to a little extent in the full-service business. It is our job as management team to offset pricing pressure with cost reductions. I will also say that this is a metric that tends to, or a phenomenon that tends to move. When things loosen up, so does the pricing pressure. Over a backlog that is going to burn over five years, you will never see it.
The goods and the bads tend to even themselves out, and you do not see all that much movement in gross margins as a result of it.
Okay. Are you seeing more competitive pressures, whether it's from the top three, four CRO players or maybe from some of the smaller competitors?
I think there are a few with the smaller. First off, there are several thousand CROs. If you're going to talk about the really small guys, we don't probably bump into some of these guys. If you're talking about kind of the next tier down from the top three, they're probably hurting a little bit more for business. I don't know. I hate to single out individual competitors, but naturally, the more you're fighting for business, probably the keener you're going to be on price. Let's just leave it at that.
Okay. That makes sense. Maybe we could talk about a little bit on the margin profile and how we should think about it over the course of this year and beyond. Where do you see operating leverage this year, given your assumptions for top-line growth?
If you look at our adjusted EBITDA margin, I think we are projecting coming into the year about 20 basis points of growth, and we're probably projecting about 20 basis points of contraction now. I say, "Well, gee, what's going on?" It is very simple. It is FX. We've increased our guidance on revenue by $275 million. We do not get a, due to FX, we do not get a significant or the same benefit on the bottom line, and it causes some margin contraction. If you are looking at that, it is just noise as FX. If FX goes the other direction, that will come back. There are some mixed pressures that I talked about, like faster growth in the RWE business that weigh upon us a little bit.
We still have a small amount of stranded costs from the projects that were previously delayed, but I don't think that's a big deal anymore. We're working really hard to take out costs across the organization. We always do. Any margin pressures that we're feeling, we're going to offset with cost takeout. That's just our commitment. I think that's what you'll see going forward. Of course, FX, we can do nothing about, but that's noise.
If you think about those moving pieces for this year versus sort of going forward, most of it is tied to this year, right? Is there any change in terms of how you think about the long-term margin algorithm?
No. I don't think there's any change in the long-term margin algorithm. We expect to modestly improve margins on an annual basis going forward. Most of where we're going to get our profit growth is from revenue growth. We said at our analyst meeting, expect 6-9% constant currency revenue growth going forward. Even in a year where we're a bumpy year, we're close to that this year. We don't have any reason to believe that's going to be different. Where do we think that's going to come from? Just to recap, 3-5% growth in pharma spend, a point of market share expansion per year, a point of outsourcing expansion per year, and one to two points of M&A growth. We continue to think that that kind of growth is achievable over the medium to long haul.
Okay. Since you just touched on it, Ron, maybe I'll switch to capital deployment, M&A, relative to debt paydown or buybacks. How do you think about the market opportunities are now today and capital deployment plans for the rest of the year?
Look, I'd say we tend to focus on two things, as you guys have seen in the past. One would be M&A, and one would be share repurchase. We're less concerned about debt paydown. We're comfortable with our debt levels where they are. Our net leverage ratio has been in kind of the 3.3-3.5 range, and we're very comfortable with it at that range. I mean, we could be comfortable at a higher range, but it's kind of in that range. We're looking at, and we generate, call it $2 billion of free cash flow, and spending that split between M&A and share repurchase. It just depends on the comparative attractiveness of the opportunities we have. M&A is nice because you can provide a platform for growth.
If we feel that our shares are out of line in terms of valuation, like I think they are now, they're cheap, it obviously becomes more attractive to repurchase shares. We would tilt a little bit that way. It certainly sets a different bar for M&A and will scrutinize M&A transactions more carefully. Not saying we won't do them. We will. We have at least right now a higher bar for those because our shares are so attractive.
Okay. In terms of M&A, between R&DS and TAS, between scale versus new capabilities, sort of how do you think about the various options?
I would say count on us spending more on TAS and R&DS typically because there are more opportunities there and areas where we can fill in to enhance our growth. In the R&DS area, you might see us do some in the lab area or to enhance certain capabilities, perhaps in we've done a few in the area of clinical trial staffing and so forth. In the case of TAS, we've recently been looking at areas like patient engagement and digital marketing and medical and scientific communications and areas that are growing and real-world evidence that are growing real well within the industry. There are more opportunities there. That is most likely where we're going to be putting our money. I would call that more new growth areas than scale expansion, although in some cases, we've already built a little bit of a base there.
I guess it's a little bit of both. But we're putting our money where we feel we have the need to both the opportunity and the need to grow.
Okay. With that, we're almost out of time. Maybe we'll go to our standing closing question. What do you think is most underappreciated or misunderstood about IQVIA?
Since we're short on time, I'll limit it to one thing. That's that we're not a pure CRO. We have a TAS business that represents 40% of our business. I think because we have CRO comps out there in the public market, we tend to be compared purely against them. If you look at our comparative performance versus some of our CRO peers this year, not only are we outperforming in the R&D area, but we have the TAS business, which is doing very well. I think that's an underappreciated part of our business. I try to focus everybody back on that, that we're servicing pharma across research and development and commercialization. It's a nice place to be having that kind of breadth with our customers.
Great. Thanks so much, Ron. Thanks everyone for joining us, and appreciate it.
Thank you, Mike.
Thanks for being here.
Thanks for coming.