IQV 10-K & 10-Q changes, risk factors and insider trading

EachOur of our Technology & AnalyticsCommercial Solutions information services isare derived from data we collect from third parties. These data suppliers are numerous and diverse, reflecting the broad scope of information that we collect and use in our business.

We rely upon the security of our computer and communications systems infrastructure to protect us from cyberattacks and unauthorized access. Cyberattacks can include malware, computer viruses, hacking or other significant disruption of our computer, communications and related systems. Third parties may attempt to improperly persuade customers, suppliers, vendors, partners, employees or others to disclose sensitive information such as user names, passwords or other information that can be used to gain unauthorized access to systems or data. Cyber threats are rapidly evolving and are becoming increasingly sophisticated.sophisticated, including through the use of AI-supported attacks. As cyber threats evolve and become more difficult to detect and successfully defend against, one or more cyber threats might defeat the measures that we or our vendors take to anticipate, detect, avoid or mitigate such threats. Certain techniques used to obtain unauthorized access, introduce malicious software, disable or degrade service, or sabotage systems may be designed to remain dormant until a triggering event and we may be unable to anticipate these techniques or implement adequate preventative measures since techniques change frequently or are not recognized until launched, and because cyberattacks can originate from a wide variety of sources. Our preventive and remedial actionsactions, including the activities described in Item 1C Cybersecurity in this Annual Report on Form 10-K, may not be successful. We have acquired various companies, products, services and technologies over the years. While we make significant efforts to identify and address IT security issues with respect to these acquisitions, we may still inherit security risks associated with these activities. The size and complexity of our IT and information security systems, and those of our vendors (and the large amounts of confidential information that is present on them), make such systems potentially vulnerable to service interruptions or to security breaches from inadvertent or intentional actions including, but not limited to, by our employees, contingent workers, service providers, business partners, customers or malicious attackers. Such attacks, whether successful or unsuccessful, could result in our incurring costs related to, for example, rebuilding internal systems, defending against litigation, responding to regulatory inquiries or actions, paying damages or fines, or taking other remedial steps with respect to third parties. Publicity about vulnerabilities and attempted or successful incursions could damage our reputation with clients and data suppliers and reduce demand for our services.

We are pursuing business transformation initiatives to update technology, increase innovation and obtain operating efficiencies.efficiencies, including through the use of AI. As part of these initiatives, which include accelerating site start-up timelines and improving our customer buying experience, we seek to improve our productivity, flexibility, quality, functionality and cost savings by investing in the development and implementation of global platforms and integration of our business processes and functions to achieve economies of scale. These various initiatives may not yield their intended gains, or be completed in a timely manner, which may impact our competitiveness and our ability to meet our growth objectives and, as a result, materially and adversely affect our business, operating results and financial condition.

We continue to invest significantly in growth opportunities, including the development and acquisition of new data, technologies and services to meet our clients’ needs. For example, we are expanding our services and technology offerings, such as the development of a cloud-based platform with a growing number of applications to support commercial and clinical operations for life sciences companies (e.g., multi-channel marketing, marketing campaign management, customer relationship management, incentive compensation management, targeting and segmentation, performance management, site engagement payments, trial master file, risk based monitoring, in-home nursing and other services, clinical trial management and decentralized trials and other applications). We are also investing significantly in our AI strategy by launching AI-enabled solutions across our business units, developing AI agents for internal use and external offerings, and developing relationships with key strategic partners across the health-tech sector to foster collaboration and facilitate interoperability amongst AI-enabled solutions. We also continue to invest significantly in growth opportunities in emerging markets, such as the development, launch and enhancement of services in China, India, Turkey, and other countries. We consider our presence in these markets to be an important component of our growth strategy.

There is no assurance that our investment plans or growth strategy will be successful or will produce a sufficient or any return on our investments. Further, if we are unable to develop new technologies and services,services or keep up with the rapid pace of change in technological development and innovation, clients do not purchase our new technologies and services, our new technologies and services do not work as intended or there are delays in the availability or adoption of our new technologies and services, then we may not be able to grow our business or growth may occur slower than anticipated. Additionally, although we expect continued growth in healthcare spending in emerging markets, such spending may occur more slowly or not at all, and we may not benefit from our investments in these markets.

Data protection, privacy and similar laws and regulations in the United States and around the world restrict access, use and disclosure of personal information, and failure to comply with or adapt to changes in these laws could materially and adversely harm our business.

The confidentiality, collection, use, retention, security, transfer and disclosure of personal data, including individually identifiable health information and clinical trial patient-specific information, are subject to governmental regulation generally in the country that the personal data were collected or used (collectively, "Privacy Laws"). For example, United States federal regulations under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) create specific requirements for the protection of the privacy and security of individualcertain individually-identifiable health information.information, specifically protected health information (PHI). These provisions apply to both “covered entities” (primarilyhealth care providers, health care providersplans, and health insurersclearinghouses) and their “business associates” or (service providers.providers Aswho thereprocess arePHI someon instancesbehalf whereof wethe arecovered entity). When acting as a HIPAA “covered entity or as a business associate” of a “covered entity,” wethere can be directly liableliability for mishandlingimproper protectedprocessing healthof information.PHI. Under HIPAA’s enforcement scheme, weoverseen canby the US Department of Health and Human Services, covered entities and business associates may be subject to significant penalties and fines in connection with HIPAA violations, along with the potential for significant other expenditures related to these activities. These rules require individuals’ written authorization in many situations, in addition to any required informed consent, before protected health information may be used for research. We are both directly and indirectly affected by the privacy provisions surrounding individual authorizations because many investigators with whom we are involved in clinical trials are directly subject to them and because we obtain identifiable health information from third parties that are subject to such various Privacy Laws.

We have established frameworks, models, processes and technologies to manage privacyprivacy, data protection and security for many data types, from a variety of sources, and under a myriad of Privacyprivacy Laws.and data protection laws. In addition, we rely on our data suppliers to deliver information to us in a form and in a manner that complies with applicable Privacyprivacy Laws.laws and regulations. These laws and regulations are complexcomplex, and there is no assurance that the safeguards and controls employed by us or our data suppliers will be sufficient to prevent a breach of these laws,laws or regulations, or that claims will not be filed against us or our data suppliers despite such safeguards and controls. Failure to comply with such laws, certain certification/registration and annual re-certification/registration provisions associated with these data protection and privacy regulations, and similar rules in various jurisdictions, or to resolve any serious privacy complaints, may result in, among other things, regulatory sanctions, criminal prosecution, civil liability, negative publicity, damage to our reputation, or data being blocked from use or liability under contractual provisions.

Laws and expectations relating to privacy continue to evolve, and we continue to adapt to changing needs. For example, the definition of “personally identifiable information” and “personal data” continues to evolve and broaden and many new laws and regulations are being enacted. In addition, certain established programs have been (or are at risk of being) declared invalid (such as the EU-U.S. Privacy Shield framework that operated for several years but was struck down by the European Court of Justice in July, 2020). While the replacement for the EU-U.S. Privacy Shield (the EU-U.S. Data Privacy Framework or “DPF”) has been approved for the transfer of personal data from the EU to certified companies in the U.S., the DPF is also subject to legal challenges and potential invalidation, thereby rendering data transfers from the EU to the US legally uncertain and keeping the area of data transfers in a state of flux. Changes to these programs may adversely impact our ability to provide services to our clients or develop new products or services. Federal, state and foreign governments are contemplating or have proposed or adopted new Privacyprivacy Lawslaws and regulations or modifications to existing Privacyprivacy Laws,laws and regulations, including by amendment, replacement or interpretation through judicial or administrative decisions. New or modified Privacyprivacy Lawslaws or regulations might, among other things, require us to implement new security measures and processes or bring within the scope of the Privacyprivacy Lawlaw or regulation other data not currently regulated, each of which may require substantial expenditures or limit our ability to offer some of our services. Additionally, changes in Privacyprivacy Lawslaws and regulations may limit our data access, use and disclosure, and may require increased expenditures by us or may dictate that we not offer certain types of services. Any of the foregoing may have a material adverse impact on our ability to provide services to our clients or maintain our profitability.

There is ongoing concern from privacy advocates, regulators and others regarding data protection and privacy issues, and the number of jurisdictions with Privacyprivacy Lawslaws and regulations has been increasing. Also, there are ongoing public policy discussions and legal challenges regarding whether the standards for de-identified, anonymous or pseudonymized health information are sufficient, and the risk of re-identification sufficiently small, to adequately protect patient privacy. These discussions may lead to further restrictions on the use of such information. There can be no assurance that these initiatives or future initiatives will not adversely affect our ability to access and use data or to develop or market current or future services.

Many Privacyprivacy Lawslaws and regulations protect more than patient information, and although they vary by jurisdiction, these laws can extend to employee information, business contact information, provider information and other information relating to identifiable individuals. Failure to comply with these laws may result in, among other things, civil and criminal liability, negative publicity, damage to our reputation and liability under contractual provisions. In addition, compliance with such laws may require increased costs to us or may dictate that we not offer certain types of services.

We operate in businesses that require sophisticated computer systems and software for data collection, data processing, cloud-based platforms, analytics, cryptography, statistical projections and forecasting, mobile computing, social media analytics and other applications and technologies, particularly in our Technology & Analytics Solutions and Research & Development Solutions businesses.technologies. We are building artificial intelligence (AI) technologies into internal applications and solutions we use with others, including clients; we expect the use of AI to continue to grow. The development, deployment, and commercialization of certain AI‑enabled offerings and services involve significant uncertainty, including risks that models may not perform as intended, may produce incomplete, misleading, or biased outputs, or may not be adopted by customers at the pace or scale we expect. We seek to address some of our technology risks by increasing our reliance on the use of innovations by cross-industry technology leaders and adapt these for our biopharmaceutical and healthcare industry clients. Some of these technologies supporting the industries we serve are changing rapidly and we must continue to adapt to these changes in a timely and effective manner at an acceptable cost. We also must continue to deliver data to our clients in forms that are easy to use while simultaneously providing clear answers to complex questions. There can be no guarantee that we will be able to develop, acquire or integrate new technologies, that these new technologies will meet our needs or those of our clients’ needs or achieve expected investment goals, or that we will be able to do so as quickly or cost-effectively as our competitors. Significant technological change could render certain of our services obsolete. Moreover, the introduction of new services embodying new technologies could render certain of our existing services obsolete. Our continued success will depend on our ability to adapt to changing technologies, manage and process ever-increasing amounts of data and information and improve the performance, features and reliability of our services in response to changing client and industry demands. We may experience difficulties that could delay or prevent the successful design, development, testing, introduction or marketing of our services. New services, or enhancements to existing services, may not adequately meet our own requirements or those of current and prospective clients or achieve any degree of significant market acceptance. Regulations relating to the use of AI and the interpretation of those regulations by regulators, courts and others are in the early stages of development and evolving, which may make it difficult to identify adequate compliance requirements or suitable governance practices to meet those requirements. These types of failures could have a material adverse effect on our operating results, financial condition and reputation.

Although we did not have any client that represented 10% or more of our revenues in 2024,2025, 20232024 andor 2022,2023, we derive the majority of our revenues from a number of large clients. If any large client decreases or terminates its relationship with us, our business, results of operations or financial condition could be materially adversely affected.

•the United States or foreign countries have and could continue to enact legislation or impose regulations or other restrictions, including unfavorable labor regulations, tax policies, trade barriers, tariffs, or economic sanctions, which could have an adverse effect on our ability to conduct business in or expatriate profits from the countries in which we operate, including hiring, retaining and overseeing qualified management personnel for managing operations in multiple countries, differing employment practices and labor issues, and tax-related risks, including the imposition of taxes and the lack of beneficial treaties, that result in a higher effective tax rate for us;

•natural disasters, public health emergencies and pandemics such as the COVID-19, including any variants,pandemics, or international conflict, such as the ongoing conflict between Russia and Ukraine, or terrorist acts, could interrupt our services, endanger our personnel, lower patient visits and increase patient drop-out rates, cause delays in recruitment of new patients, decrease the productivity of our clinical research associates, cause other project delays or loss of clinical trial materials or results.

ClimateEnvironmental changeevents may have an impact on our business.

While we have determined that, at this time, climateenvironmental changeevents doesdo not present a material risk to our business given the nature of our activities, we continue to evaluate and mitigate our business risks associated with climateenvironmental change,events, and we recognize that there are inherent climate-related risks wherever business is conducted. Any of our office or IT systems locations may be vulnerable to the adverse effects of climateenvironmental change.events. Furthermore, climateenvironmental changeevents may impact patients in our clinical trials and our employees, particularly where they work remotely. Changing market dynamics, global policy developments, and the increasing frequency and impact of extreme weather events on critical infrastructure have the potential to disrupt our business, the business of our third-party suppliers, and the business of our customers, and may cause us to experience losses and additional costs to maintain or resume operations.

IncreasingThe focusexpectations onand sustainabilityrequirements of regulators and other similarkey initiativesstakeholders on sustainability-related matters, continue to evolve and diverge, and our ability to meet these expectations and requirements could increase our costs, and inaction could harm our reputation and adversely impact our financial results.

Furthermore, any actual or perceived failure to achieve our current and future sustainability goals, including those which result from customer expectations or requirements, or to act responsibly with respect to such matters or to effectively respond to new or additional sustainability-related legal or regulatory requirements, could result in adverse publicity and adversely affect our business and reputation. There is no assurance that we will be able to successfully achieve any sustainability-related goal or execute on any sustainability-related strategy, or adequately meet stakeholder expectations with respect to such matters. In addition, certain environmental and sustainability disclosures and commitments we make may be reliant in part or in whole on third party information, which we cannot verify the quality of, and third party performance, which we cannot guarantee. We may fail to meet our environmental and sustainability commitments either entirely or on the schedule we commit to.

We both own a facility and subcontract into a network of facilities where Phase I clinical trials are conducted, which ordinarily involve testing an investigational drug on a limited number of healthy individuals, typically 20 to 80 persons, to determine such drug’s basic safety. Failure to operate such a facility in accordance with applicable regulations could result in that facility being shut down, which could disrupt our operations. Additionally, we face risks associated with adverse events resulting from the administration of such drugs to healthy volunteers and the professional malpractice of medical care providers. Any professional malpractice or negligence by such investigators, nurses or other subcontracted employees could potentially result in liability to us in the event of personal injury to or death of a healthy volunteer in clinical trials, and could also cause us reputational harm. This liability, particularly if it were to exceed the limits of any indemnification agreements and insurance coverage we may have, may adversely affect our financial condition, results of operations and reputation.

Our Contract Sales & MedicalCommercial Solutions business could result in liability to us if a drug causes harm to a patient. While we are generally indemnified and insured against such risks, we may still suffer financial losses.

Our success substantially depends on the collective performance, contributions and expertise of our personnel including senior management and key personnel, qualified professional, scientific and technical operating staff and qualified sales representatives for our contract sales services. There is significant and increasing competition for qualified personnel, particularly those with higher educational degrees, such as a medical degree, a Ph.D. or an equivalent degree, cutting-edge skillsets, such as AI and machine learning, or relevant experience in the industry, including highly technical specialties such as clinical research associates, project managers and technology developers, and in the locations in which we operate. Increases in inflation, competition and shortages of qualified personnel in certain specialty areas may make it more difficult to hire and retain our key employees and could result in substantial increased costs, such as increased wage rates to attract and retain employees. Our efforts to attract, develop and retain highly skilled employees may be compounded by intensified restrictions on immigration particularly if fees are increased significantly on the transfer, renewal or extension of work visas. The departure of our key employees, or our inability to continue to identify, attract and retain qualified personnel or replace departed personnel in a timely fashion, may impact our ability to grow our business and compete effectively in our industry and may negatively affect our ability to meet financial and operational goals. We continue to hire personnel in countries where exceptional technical knowledge and other expertise are offered at lower costs, which increases the efficiency of our global workforce structure and reduces our personnel-related expenditures. Nonetheless, as globalization continues, competition for talent in those countries has increased, which may impact our ability to retain these employees and increase our compensation-related expenses.

From time to time, we have adopted restructuring plans to improve our operating efficiency through various means such as reduction of overcapacity, elimination of non-billable support roles or other realignment of resources. For example, starting in the first quarter of 2026, we have restructured our operations to reduce our reportable segments from three to two. Restructuring presents significant potential risks of events occurring that could adversely affect us, including:

In addition, the emergence of the use of Real World Evidence and new approaches such as machine learning and artificial intelligence that capitalize on the availability of large data sets may reduce the time and costs of the discovery and development process, may allow our clients to more readily perform for themselves clinical development tasks and services that we have typically provided, may cause even greater price competition or may render certain data offerings less valuable or relevant. More broadly, our current competitors or other businesses might develop technologies or services that are more effective or commercially attractive than, or render obsolete, our current or future technologies and services. We may also fail to fully leverage the technologies available to us or develop technologies quickly enough to be competitively useful. Our failure to develop and offer competitive services that address these and other technological advances in a timely, cost-effective manner or to keep pace with rapid technological change could adversely affect our competitive position and our results of operations.

The United States Congress continues to consider healthcare reform legislation and impose health industry cost containment measures, which may significantly impact the biopharmaceutical industry. In addition, numerous government bodies are considering or have adopted various healthcare reforms and may undertake, or are in the process of undertaking, efforts to control growing healthcare costs through legislation, regulation and voluntary agreements with medical care providers and biopharmaceutical companies. We are uncertain as to the effects of these recent reforms on our business and are unable to predict what legislative proposals, if any, will be adopted in the future. If regulatory cost containment efforts limit the profitability of new drugs by, for example, continuing to place downward pressure on pharmaceutical pricing and/or increasing regulatory burdens and operating costs of the biopharmaceutical industry, our clients may reduce their research and development spending or promotional, marketing and sales expenditures, which could reduce the business they outsource to us. ForAny example,significant change in Augustregulations, 2022,such as the Inflation Reduction Act wasof signed2022 into(IRA), lawwhich contains drug price negotiation provisions, or change in the Unitedinterpretation States,of existing regulations, could reduce demand for our offerings or increase our expenses. For example, in May 2025, the Trump administration issued an executive order entitled “Delivering Most-Favored-Nation Prescription Drug Pricing to American Patients,” which, among other things, requiresdirects the HHS and other agencies to communicate most-favored-nation price targets to pharmaceutical manufacturers ofto certainbring drugsprices for U.S. patients in line with comparably developed nations and to engagefacilitate indirect-to-consumer pricepurchasing negotiationsprograms. withIt Medicareis (beginningcurrently inunclear 2026), imposes rebates under Medicare Part Bwhether and Medicare Part D to penalizewhat priceextent increasesthese thatmeasures outpacewill inflationbe (first due in 2023),implemented and replaceswhat theimpact Partany Dsuch coverageimplementation gapwould discounthave programon withour a new discounting program (beginning in 2025).business. In addition, changes to the Medicaid program or the federal 340B drug pricing program, which imposes ceilings on prices that drug manufacturers can charge for medications sold to certain health care facilities, could have a material impact on our customers, which could reduce demand for our services. Similarly, if regulatory requirements are relaxed or simplified drug approval procedures are adopted, the demand for our services could decrease.

In 2024,2025, financial regulators in various jurisdictions, including where we have variable-rate indebtedness outstanding, cut interest rates modestly while signaling that interest rates could remain higher compared to recentthe yearspre-2022 period for an extended period of time in an effort to lower inflation. Because we have variable rate debt, increases in interest rates will lead to increases in our borrowing costs and may adversely affect our results of operations and financial condition. We attempt to minimize interest rate risk and lower our overall borrowing costs through the utilization of derivative financial instruments, primarily swaps. We have entered into and will continue to enter into swaps with financial institutions that have reset dates and critical terms that match those of our senior secured term loan credit facility. Accordingly, any change in market value associated with the swaps may be offset by the opposite market impact on the related debt. Because we do not attempt to hedge all of our variable rate debt, we may incur higher interest costs for the portion of our variable rate debt which is not hedged.

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. IQVIA’s portfolio of solutions are powered by IQVIA Connected Intelligence™ to deliver actionable insights and services built on high-quality health data, Healthcare-grade AI™®, advanced analytics, the latest technologies and extensive domain expertise. We are committed to using artificial intelligence ("AI") responsibly, ensuring that ourwith AI-powered capabilities arebuilt groundedon inbest-in-class approaches to privacy, regulatory compliance,compliance and patient safety.safety, and delivering AI to the high standards of trust, scalability and precision demanded by the industry. With approximately 88,00093,000 employees in over 100 countries, including experts in healthcare, life sciences, data science, technology and operational excellence, IQVIA is dedicated to accelerating the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide.

We ended the year with our highest ever total company remaining performance obligations of approximately $33.5$34.2 billion as of December 31, 2024.2025.

We have completedcompleted, and will continue to considerconsider, strategic business combinations to enhance our capabilities and offerings in certain areas, including various individually immaterial acquisitions during the years ended December 31, 20242025 and 2023.2024. These transactions were accounted for as business combinations and the acquired results of operations are included in our consolidated financial information since their respective closing dates. See Note 14 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K for additional information with respect to these business combinations.

When compared to 2023,2024, cost of revenues, exclusive of depreciation and amortizationamortization, increased $285$850 million in 2024,2025, or 2.9%.8.5%. This increase included a constant currency increase of approximately $643$790 million, or 6.6%,7.9%, comprised of a $261$315 million increase in Technology & Analytics Solutions, a $374$416 million increase in Research & Development Solutions, and ana $8$59 million increase in Contract Sales & Medical Solutions.

The $61$7 million decreaseincrease in selling, general and administrative expenses in 20242025 as compared to 20232024 included a constant currency decrease of approximately $33$7 million, or 1.6%,0.4%, comprised of a $52$26 million increase in Technology & Analytics Solutions, aan $42$18 million increase in Research & Development Solutions, and ano $2constant millioncurrency increasechange in Contract Sales & Medical Solutions, offset by a $129$51 million decrease in general corporate and unallocated expenses.

The $11$30 million decreaseincrease in depreciation and amortization in 20242025 as compared to 20232024 was primarily the result of less amortization of certain intangible assets from the merger between Quintiles and IMS Health, offset by an increase in amortization of capitalized software and of intangible assets from acquisitions occurring in 20232024 and 2024.2025, offset by less amortization of certain intangible assets from the merger between Quintiles and IMS Health.

Interest income included interest received primarily from bank balances and investments. The increasedecrease in 20242025 as compared to 20232024 is primarily a result of higherlower deposit rates.

Interest expense during 20242025 wasincreased lower than 2023 due primarilycompared to lower2024 baseas ratea interestresult costsof acrosshigher the floating rateoutstanding debt portfolio.balances.

In 2025 and 2023 we recognized a loss on extinguishment of debt of $6 million for fees and expenses incurred related to the refinancingrefinancings of our Credit Agreement. No such activity occurred in 2024.

Other (income)Income, expense, netNet

Other (income) expense,income, net for 20242025 decreasedincreased compared to 20232024 primarily due to lessfair value related adjustments on investments offset by losses on foreign currency gain on transactions.

Equity in Earnings (Losses) of Unconsolidated Affiliates

Equity in earnings (losses) of unconsolidated affiliates increased in 20242025 compared to 20232024 due to the results in the operations of our unconsolidated affiliates.

Technology & Analytics Solutions’ revenues were $6,160$6,626 million in 2024,2025, an increase of $298$466 million, or 5.1%,7.6%, over 2023.2024. This increase was comprised of constant currency revenue growth of approximately $333$380 million, or 5.7%,6.2%, reflecting revenue growth primarily in the Americas and Europe and Africa regionregions, and to a lesser extent in the AmericasAsia-Pacific region. The constant currency revenue growth was primarily driven by an increase in realReal-World worldservices, servicesas andwell to a lesser extent byas information and technology services. The constant currency revenue growth for the year was impacted by a decrease in COVID-19 related work.

Technology & Analytics Solutions’ selling, general and administrative expenses increased $41$38 million, or 4.7%,4.1%, in 20242025 as compared to 2023.2024. This increase included a constant currency increase of approximately $52$26 million, or 5.9%,2.8%, reflecting an increase in compensation and related expenses, as well as IT-related expenses.

Research & Development Solutions’ revenues were $8,527$8,896 million in 2024,2025, an increase of $132$369 million, or 1.6%,4.3%, over 2023.2024. This increase was comprised of constant currency revenue growth of approximately $167$298 million, or 2.0%,3.5%, reflecting revenue growth in the Asia-PacificAmericas and Europe and AfricaAsia-Pacific regions. The constant currency revenue growth was primarily the result of volume-related increases in clinical services and to a lesser extent from volume-related increases in lab testing.services. The constant currency revenue growth was impacted by a decrease in COVID-19 related work.

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $69$426 million, or 1.2%,7.5%, in 20242025 as compared to 2023.2024. This increase included a constant currency increase of approximately $374$416 million, or 6.6%,7.3%, reflecting primarily an increaseincreases in reimbursed expenses, as well as compensation and related expensesexpenses, and toas a lesser extent an increase in other direct costs becauseresult of volume-related increases in clinical services and lab testing.services.

Research & Development Solutions’ selling, general and administrative expenses increased $30$18 million, or 3.5%,2.0%, in 20242025 as compared to 2023.2024. This increase included a constant currency increase of approximately $42$18 million, or 4.9%,2.0%, reflecting primarily an increase in compensation and related expenses.

Contract Sales & Medical Solutions’ revenues were $718$788 million in 2024,2025, aan decreaseincrease of $9$70 million, or 1.2%,9.7%, over 2023.2024. This decreaseincrease included constant currency revenue growth of approximately $10$59 million, or 1.4%,8.2%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Asia-Pacific region. The constant currency revenue growth was primarily due to volume-related increases in services performed.

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, decreasedincreased $9$69 million, or 1.5%,11.3%, in 20242025 as compared to 2023.2024. This decreaseincrease included a constant currency increase of approximately $8$59 million, or 1.3%,9.7%, reflecting primarily an increase in costscompensation associatedand withrelated supportingexpenses revenueand growth.to a lesser extent in reimbursed expenses.

Contract Sales & Medical Solutions’ selling, general and administrative expenses increased $2 million, or 3.4%, in 20242025 asremained comparedconsistent towith 2023. This increase included a constant currency increase of approximately $2 million, or 3.4%.2024.

As of December 31, 2024,2025, the Fifth Amended and Restated Credit Agreement (the "Credit Agreement") provided financing through several senior secured credit facilities (collectively, the “senior secured credit facilities”) of up to approximately $6,585$6,412 million, which consisted of $5,415$5,217 million principal amounts of debt outstanding and $1,170$1,195 million of available borrowing capacity on the revolving credit facility and standby letters of credit, with a total capacity of $2,000 million. The revolving credit facility is comprised of a $1,175$2,000 million senior secured revolving facility available in U.S. dollars, a $600 million senior secured revolving facility available in U.S. dollars, Euros, Swiss Francs and other foreign currencies, and a $225 million senior secured revolving facility available in U.S. dollars and Yen.dollars. The revolving credit facility under the Credit Agreement matures in AugustDecember 2026,2030, the term A loans mature in AugustDecember 2026 and June 2027,2030, while the term B loans under the Credit Agreement mature in 2025 and 2031. We are required to make scheduled quarterly payments on the term A loans equal to 1.25% of the original principal amount, with the remaining balance paid at maturity. The US dollars term B loan requires us to make scheduled quarterly payments equal to 0.25% of the original principal balance amount, with the remaining principal balance due at maturity. In addition, beginning with fiscal year ending December 31, 2017, we were required to apply 50% of excess cash flow (as defined in the Credit Agreement), subject to a reduction to 25% or 0% depending upon our senior secured first lien net leverage ratio, for prepayment of the term loans, with any such prepayment to be applied toward principal payments due in subsequent quarters. We are also required to pay an annual commitment fee that ranges from 0.20% to 0.35% in respect of any unused commitments under the revolving credit facility. The senior secured credit facilities are collateralized by substantially all of our assets and the assets of our material domestic subsidiaries including 100% of the equity interests of substantially all of our material domestic subsidiaries and 66% of the equity interests of substantially all of our first-tier material foreign subsidiaries and their domestic subsidiaries.

Cash provided by operating activities increaseddecreased $567$62 million in 20242025 as compared to 2023.2024. The increasedecrease is primarily due to an increase in cash from accounts receivable and unbilled services ($570 million), an increase in cash-related net income ($129 million), more cash from unearned income ($38 million), and less cash used for income tax and other payables ($9 million), offset by more cash used for accounts payable and accrued expenses ($152$211 million), more cash used for income tax and other payables ($144 million), a decrease in cash from accounts receivable and unbilled services ($122 million), and a decrease in cash-related net income ($29 million), offset by more cash from unearned income ($233 million), and less cash used for prepaid expenses and other assets ($27$211 million)., which includes $42 million in cash received during 2025 related to the termination of our previous cross-currency swaps.

Cash used in investing activities decreasedincreased $159$861 million in 20242025 as compared to 2023,2024, primarily due to lessmore cash used for the acquisition of businesses, net of cash acquired ($141$979 million), lessmore cash used for investments in debt and equity securities ($18 million), more cash used for other investing activities ($3 million), and more cash used for the acquisition of property, equipment, and software ($47$1 million), offset by less cash used for investments in debtunconsolidated andaffiliates, equity securitiesnet ($36$88 million), less cash used for purchases of marketable securities ($6 million), andmore cash received from sale of property, equipment and software ($25 million), offset by more cash used for investments in unconsolidated affiliates, net ($93$50 million), and less cash from othermarketable sourcessecurities ($3$2 million).

Cash used in financing activities increaseddecreased $496$728 million in 20242025 as compared to 2023,2024, primarily due to less cash provided by proceeds frommore debt issuances, net of payment of debt issuance costspayments ($3,951$5,021 million), more cash used toin repurchaserepayments commonof stockrevolving credit facilities, net of proceeds ($358$750 million), more cash payments on contingent consideration and deferred purchase price accruals ($17 million), more cash used for other financing activities ($11 million), and more cash payments related to employee stock option plans ($3 million), offset by lessmore cash provided by proceeds from debt payments ($2,701 million), less cash used in repayments of revolving credit facilities,issuances, net of proceedspayment of debt issuance costs ($1,050$6,424 million), and less cash paymentsused onto contingentrepurchase considerationcommon and deferred purchase price accrualsstock ($65$106 million).

We use the acquisition method to account for business combinations, and accordingly, the identifiable assets acquired, the liabilities assumed and any non-controllingnoncontrolling interests in the acquiree are recorded at their estimated fair values on the date of the acquisition. We use significant judgments, estimates and assumptions in determining the estimated fair value of assets acquired, liabilities assumed and non-controllingnoncontrolling interests including expected future cash flows and discount rates that reflect the risk associated with the expected future cash flows and estimated useful lives.

In the first threesix months of 2026, approximately 30% of our revenues were denominated in currencies other than the United States dollar, which represents approximately 60 currencies. Because a large portion of our revenues and expenses are denominated in foreign currencies and our financial statements are reported in United States dollars, changes in foreign currency exchange rates can significantly affect our results of operations. The revenues and expenses of our foreign operations are generally denominated in local currencies and translated into United States dollars for financial reporting purposes. Accordingly, exchange rate fluctuations will affect the translation of foreign results into United States dollars for purposes of reporting our condensed consolidated results. As a result, we believe that reporting results of operations that exclude the effects of foreign currency rate fluctuations on certain financial results can facilitate analysis of period to period comparisons. This constant currency information assumes the same foreign currency exchange rates that were in effect for the comparable prior-year period were used in translation of the current period results. As such, the differences noted below between reported results of operations and constant currency information are wholly attributable to the effects of foreign currency rate fluctuations. For the three and six months ended June 30, 2026, foreign currency exchange rate fluctuations had an immaterial impact on our income from operations.

For the firstsecond quarter of 2026, our revenues increased $322$351 million, or 8.4%,8.7%, as compared to the same period in 2025. This increase was comprised of constant currency revenue growth of approximately $228$343 million, or 6.0%,8.5%, reflecting a $134$139 million increase in Commercial Solutions and a $94$204 million increase in Research & Development Solutions.

The $23$16 million and $39 million increase in depreciation and amortization for the three and six months ended MarchJune 31,30, 2026 compared to the same periodperiods in 2025 is mainly related to an increase in amortization of capitalized software costs and intangible assets from acquisitions occurring in 2025 and 2026.

Interest income includes interest received primarily from bank balances and investments. Interest income during the three and six months ended MarchJune 31,30, 2026 decreased as compared to the same periodperiods in 2025, primarily as a result of lower deposit rates.rates and balances.

Interest expense during the three and six months ended MarchJune 31,30, 2026 increased compared to the same periodperiods in 2025 as a result of higher outstanding debt balances.

Other expense, net for the three months ended MarchJune 31,30, 2026 decreasedincreased compared to the same period in 2025 primarily due to morefair value investments adjustments, offset by less foreign currency gainloss on transactions, offset by adjustments in investment balances.transactions.

Our effective income tax rate was 18.0%19.9% and 18.9%17.3% in the firstsecond quarter of 2026 and 2025, respectively. Our effective income tax rate was 18.9% and 18.1% in the first six months of 2026 and 2025. Our effective income tax rate in the second quarter and in the first six months of 2026 and 2025 was favorably impacted due to changes in the geographical mix of earnings amongst the United States and foreign tax jurisdictions.

On December 12, 2022, the European Union member states agreed to implement the Organization for Economic Cooperation and Development’s (“OECD”) Pillar Two global corporate minimum tax rate of 15% on companies with revenues of at least €750 million, which went into effect in 2025. In January 2026, the OECD released Administrative Guidance establishing a “side‑by‑side” system that is intended to reduce the compliance burden of calculating the Pillar 2two top-up-tax amounts for jurisdictions with similar regimes with minimum tax requirements for fiscal years beginning on or after January 1, 2026, subject to adoption by relevant jurisdictions. This is achieved by deeming a top-up tax amount of zero as it relates to Income Inclusion Rules and Undertaxed Profits Rules for MNEMultinational Enterprise groups with an ultimate parent entity in such jurisdictions; however, this guidance does not affect the application of local minimum or qualified domestic top‑up taxes in foreign jurisdictions. During the threesix months ended MarchJune 31,30, 2026, we evaluated enacted and substantively enacted Pillar Two legislation and performed calculations under applicable safe harbor frameworks to identify jurisdictions with effective tax rates below 15%, and any resulting top‑up tax was recorded as a period cost in the annual effective tax rate. We continue to monitor global developments and are assessing the potential impact of these rules on our income tax provision.

Equity in earnings (losses) of unconsolidated affiliates for the three and six months ended MarchJune 31,30, 2026, increased compared to the same periodperiods in 2025 due to the results in the operations of our unconsolidated affiliates.

In the tables below, the Company is reflecting the recast of segment information for the three and six months ended MarchJune 31,30, 2025 based on the changes described in Note 14 included elsewhere in this Quarterly Report on Form 10-Q. Revenues and profit by segment are as follows:

Commercial Solutions’ revenues were $1,754$1,793 million for the firstsecond quarter of 2026, an increase of $182$142 million, or 11.6%,8.6%, over the same period in 2025. This increase was comprised of constant currency revenue growth of approximately $134$139 million, or 8.5%,8.4%, reflecting revenue growth primarily in the Americas region and to a lesser extent in the Europe and Africa region.

Cost of Revenues, exclusive of Depreciation and Amortization Commercial Solutions’ costrevenues were $3,547 million for the first six months of revenues,2026, exclusivean increase of depreciation and amortization, increased $141$324 million, or 14.4%, in the first quarter of 202610.1%, over the same period in 2025. This increase includedwas acomprised of constant currency increaserevenue growth of approximately $108$273 million, or 11.0%.8.5%, reflecting revenue growth primarily in the Americas region and to a lesser extent in the Europe and Africa region.

The constant currency increaserevenue growth for the three and six months ended MarchJune 31,30, 2026 was primarily relateddriven toby an increase in compensationpatient andsolutions related(formerly expensesincluded in real-world solutions), and to a lesser extent by commercial engagement services (formerly included in reimbursedcontract expensessales and costsmedical of acquiring and processing data to support revenue growth.solutions).

Commercial Solutions’ selling, general and administrative expenses increased $15$12 million, or 6.3%,5.2%, in the firstsecond quarter of 20262026, as compared to the same period in 2025, whichand includedincreased a constant currency increase of approximately $6$27 million, or 2.5%.5.8%, in the first six months of 2026, as compared to the same period in 2025. The increase for the three and six months ended June 30, 2026 was primarily related to an increase in compensation and related expenses.

Research & Development Solutions’ contracted backlog increased from $34.0 billion (recast amount to reflect segment changes noted above) as of December 31, 2025 to $34.2 billion as of MarchJune 31,30, 2026, and we expect approximately $8.9$9.2 billion of this backlog to convert to revenues in the next twelve months.

Research & Development Solutions’ revenues were $2,397$2,575 million for the firstsecond quarter of 2026, an increase of $140$209 million, or 6.2%,8.8%, over the same period in 2025. This increase was comprised of constant currency revenue growth of approximately $94$204 million, or 4.2%,8.6%, reflecting revenue growth primarily in the Europe and Africa region, and to a lesser extent in the Asia-Pacific and Americas region.regions.

Cost of Revenues, exclusive of Depreciation and Amortization Research & Development Solutions’ costrevenues were $4,972 million for the first six months of revenues,2026, exclusivean increase of depreciation and amortization, increased $124$349 million, or 8.0%, in the first quarter of 20267.5%, over the same period in 2025. This increase includedwas acomprised of constant currency increaserevenue growth of approximately $77$298 million, or 5.0%.6.4%, reflecting revenue growth primarily in the Americas region, and to a lesser extent in the Europe and Africa and Asia-Pacific regions.

The constant currency increaserevenue growth for the three and six months ended MarchJune 31,30, 2026 was primarily related to an increase in compensation and related expenses and to a lesser extent in reimbursed expenses as athe result of volume-related increases in clinical services.services and lab testing.

Research & Development Solutions’ selling, general and administrative expenses increased $20$7 million, or 8.7%,2.9%, in the firstsecond quarter of 20262026, as compared to the same period in 2025, whichand includedincreased a constant currency increase of approximately $18$27 million, or 7.8%.5.7%, in the first six months of 2026, as compared to the same period in 2025. The increase for the three and six months ended June 30, 2026 was primarily related to an increase in compensation and related expenses.

We had a cash balance of $1,947$1,909 million as of MarchJune 31,30, 2026 ($635$627 million of which was in the United States), a decrease from $1,980 million as of December 31, 2025.

As of March 31, 2026, the total stock repurchase authorization under our equity repurchase (the "Repurchase Program") was $13,725 million. The Repurchase Program does not obligate us to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time. During the threesix months ended MarchJune 31,30, 2026, we repurchased 3.25.5 million shares of our common stock for $552$950 million under the Repurchase Program. As of MarchJune 31,30, 2026, we had remaining authorization to repurchase up to $1,217$2,819 million of our common stock under the Repurchase Program. In addition, from time to time, we have repurchased and may continue to repurchase common stock through private or other transactions outside of the Repurchase Program.

As of MarchJune 31,30, 2026, we had $15,908$16,081 million of total indebtedness, excluding $995$1,195 million of additional available borrowings under our revolving credit facility. Our long-term debt arrangements contain customary restrictive covenants and, as of MarchJune 31,30, 2026, we believe we were in compliance with our restrictive covenants in all material respects.

As of MarchJune 31,30, 2026, our Fifth Amended and Restated Credit Agreement provided financing through the senior secured credit facilities of up to $6,371$6,333 million, which consisted of $5,376$5,138 million principal amounts of debt outstanding, and $995$1,195 million of available borrowing capacity on the revolving credit facility and standby letters of credit. See Note 7 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding our credit arrangements.

On March 11, 2026, we entered into a 364-Day Term A Loan Agreement to borrow $650 million in U.S. Dollar denominated Term A loans due 2027 (the “Term Loan due 2027”). The Term Loan due 2027 bearsbore interest based on the Secured Overnight Financing Rate term rates (“Term SOFR”), plus a margin ranging from 1.125% to 2.00%, with a Term SOFR floor of 0.00% per annum. The proceeds from the Term Loan due 2027 were used to repay approximately €550 million of the 1.750% senior notes due 2026 (the “1.750% Notes”) at maturity, including the payment of fees and expenses related to the offering, and for general corporate purposes. The Term Loan due 2027 was repaid in full on June 11, 2026 with proceeds from the 4.625% senior notes due 2033 described below.

As of MarchJune 31,30, 2026, no additional amounts of revolving loans were available under the receivables financing facility.

ThreeSix months ended MarchJune 31,30, 2026 and 2025

Cash provided by operating activities increased $50$165 million during the first threesix months of 2026 as compared to the same period in 2025. The increase was primarily driven by increases in cash from other operating assets and liabilities ($106 million), cash-related net income ($44 million), cash from unearned income ($41$89 million), and cash from accounts receivable and unbilled services ($24$40 million), offset by a decrease in cash from otherunearned operating assets and liabilitiesincome ($59$70 million).

Cash used in investing activities decreased $109$74 million during the first threesix months of 2026 as compared to the same period in 2025, primarily driven by less cash used for acquisitions of businessesbusinesses, net of cash acquired ($97$115 million), less cash used for investments in debt and equity securities ($19 million), more cash usedfrom for acquisitions of property, equipment and softwareother ($15$2 million), and more cash from othersales of marketable securities, net ($1 million), offset by more cash used for acquisitions of property, equipment and software ($32 million) and cash used for investments in unconsolidated affiliates, net ($22 million) and cash from sales of marketable securities, net ($1$31 million).

Cash used in financing activities increased $175$534 million during the first threesix months of 2026 as compared to the same period in 2025, primarily due to less proceeds from issuance of debt, net ($1,333$2,212 million), more cash used for repurchase of common stock ($177 million), less proceeds from revolving credit facilities, net of repayments ($75 million), and more cash used for payments related to employee stock incentive plans ($5$6 million), offset by less repayments on the revolving credit facilities, net of proceeds ($825 million), less cash payments for debt and principal payments on finance leases ($1,413$770 million), andless cash used for repurchase of common stock ($82 million), less cash payments for contingent consideration and deferred purchase price accruals ($5 million), and less cash used for other ($2 million).

The following presents the summarized financial information on a combined basis for IQVIA Holdings Inc. (parent company), the Issuer and the Guarantor subsidiaries, which are collectively referred to as the “obligated group.” Each Guarantor subsidiary is consolidated by IQVIA Holdings Inc. as of MarchJune 31,30, 2026 and December 31, 2025. Refer to Exhibit 22.1 to this Quarterly Report on Form 10-Q for the detailed list of entities included within the obligated group as of MarchJune 31,30, 2026.