IQVIA (IQV) Q4 2025 earnings summary

Executive summary

• Achieved Q4 2025 revenue of $4.364 billion, up 10.3% year-over-year, and full-year revenue of $16.31 billion, up 5.9% year-over-year.

• Adjusted EBITDA for Q4 2025 was $1.046 billion, up 5%, and full-year Adjusted EBITDA was $3.788 billion, up 2.8%.

• Adjusted diluted EPS for Q4 2025 was $3.42, up 9.6% year-over-year; full-year Adjusted diluted EPS was $11.92, up 7.1%.

• Net income for Q4 2025 was $514 million; full-year net income was $1.36 billion.

• Strong R&D Solutions bookings and backlog, with a Q4 book-to-bill ratio of 1.18x and backlog of $32.7 billion, up 5.3% year-over-year.

Financial highlights

• Q4 free cash flow was $561 million; full-year free cash flow was $2.051 billion, representing 99% of adjusted net income.

• Q4 GAAP diluted EPS was $2.99, up 23.6% year-over-year; full-year GAAP diluted EPS was $7.84, up 4.7% year-over-year.

• Cash and cash equivalents at year-end were $1.98 billion; net debt was $13.744 billion.

• Share repurchases totaled $1.244 billion for the year, with $1.769 billion remaining authorized.

• Q4 net bookings were $2.7 billion, up 7% year-over-year, with a book-to-bill ratio of 1.18.

Outlook and guidance

• 2026 revenue guidance: $17.15–$17.35 billion, including 150 bps from M&A and 100 bps FX tailwind.

• 2026 adjusted EBITDA: $3.975–$4.025 billion; adjusted diluted EPS: $12.55–$12.85.

• Q1 2026 revenue expected at $4.05–$4.15 billion; adjusted EBITDA $920–$940 million; adjusted diluted EPS $2.77–$2.87.

• Commercial Solutions 2026 revenue expected at $7.2–$7.3 billion; R&D Solutions at $9.9–$10 billion.

• 2026 guidance includes ~$80 million higher interest expense from 2025 financing and expected 2026 refinancing.