IQVIA HOLDINGS INC. 10-Q

Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations Cautionary Statement for Forward-Looking Information You should read the following discussion and analysis of our financial condition and results of operations together with our condensed consolidated financial statements and the related notes included elsewhere in this Quarterly Report on Form 10-Q and with our audited consolidated financial statements and the notes thereto included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022 (our “2022 Form 10-K”). In addition to historical condensed consolidated financial information, the following discussion contains or incorporates by reference forward-looking statements within the meaning of the federal securities laws, including Section 27A of the Securities Act of 1933, as amended (“Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), that are not historical facts but reflect, among other things, our current expectations, our forecasts and our anticipated results of operations, all of which are subject to known and unknown risks, uncertainties and other factors that may cause our actual results, performance or achievements, market trends, or industry results to differ materially from those expressed or implied by such forward-looking statements. Therefore, any statements contained herein that are not statements of historical fact may be forward-looking statements and should be evaluated as such. Without limiting the foregoing, the words “assumes,” “anticipates,” “believes,” “estimates,” “expects,” “intends,” “may,” "forecasts," “plans,” “projects,” “should,” “seeks,” “sees,” “targets,” “will,” “would” and similar words and expressions, and variations and negatives of these words are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. We assume no obligation to update any such forward-looking information to reflect actual results or changes in our outlook or the factors affecting such forward-looking information. We caution you that any such forward-looking statements are further qualified by important factors that could cause our actual operating results to differ materially from those in the forward-looking statements, including without limitation, business disruptions caused by natural disasters, pandemics such as the COVID-19 (coronavirus) outbreak, including any variants, and the public health policy responses to the outbreak, and international conflicts or other disruptions outside of our control such as the current situation in Ukraine and Russia; most of our contracts may be terminated on short notice, and we may lose or experience delays with large client contracts or be unable to enter into new contracts; the market for our services may not grow as we expect; we may be unable to successfully develop and market new services or enter new markets; imposition of restrictions on our use of data by data suppliers or their refusal to license data to us; any failure by us to comply with contractual, regulatory or ethical requirements under our contracts, including current or future changes to data protection and privacy laws; breaches or misuse of our or our outsourcing partners’ security or communications systems; failure to meet our productivity or business transformation objectives; failure to successfully invest in growth opportunities; our ability to protect our intellectual property rights and our susceptibility to claims by others that we are infringing on their intellectual property rights; the expiration or inability to acquire third party licenses for technology or intellectual property; any failure by us to accurately and timely price and formulate cost estimates for contracts, or to document change orders; hardware and software failures, delays in the operation of our computer and communications systems or the failure to implement system enhancements; the rate at which our backlog converts to revenues; our ability to acquire, develop and implement technology necessary for our business; consolidation in the industries in which our clients operate; risks related to client or therapeutic concentration; government regulators or our customers may limit the number or scope of indications for medicines and treatments or withdraw products from the market, and government regulators may impose new regulatory requirements or may adopt new regulations affecting the biopharmaceutical industry; the risks associated with operating on a global basis, including currency or exchange rate fluctuations and legal compliance, including anti-corruption laws; risks related to changes in accounting standards; general economic conditions in the markets in which we operate, including financial market conditions, inflation and risks related to sales to government entities; the impact of changes in tax laws and regulations; and our ability to successfully integrate, and achieve expected benefits from, our acquired businesses. For a further discussion of the risks relating to our business, see Part I—Item 1A—“Risk Factors” in our 2022 Form 10-K, as updated in our subsequently filed Quarterly Reports on Form 10-Q. Overview IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry. IQVIA creates intelligent connections across all aspects of healthcare through its analytics, transformative technology, big data resources and extensive domain expertise. IQVIA Connected Intelligence™ delivers powerful insights with speed and agility — enabling customers to accelerate the clinical development and commercialization of innovative medical treatments that improve healthcare outcomes for patients. With approximately 87,000 employees, we conduct operations in more than 100 countries. 22 Table of contents We are a global leader in protecting individual patient privacy. We use a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. Our insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors and scientific advances, in an effort to advance their path toward cures. We are managed through three reportable segments: Technology & Analytics Solutions, Research & Development Solutions and Contract Sales & Medical Solutions. Technology & Analytics Solutions provides mission critical information, technology solutions and real world insights and services to our life science clients. Research & Development Solutions, which primarily serves biopharmaceutical customers, provides outsourced clinical research and clinical trial related services. Contract Sales & Medical Solutions provides health care provider (including contract sales) and patient engagement services to both biopharmaceutical clients and the broader healthcare market. Sources of Revenue Total revenues are comprised of revenues from the provision of our services. We do not have any material product revenues. Costs and Expenses Our costs and expenses are comprised primarily of our cost of revenues including reimbursed expenses and selling, general and administrative expenses. Cost of revenues includes compensation and benefits for billable employees and personnel involved in production, trial monitoring, data management and delivery, and the costs of acquiring and processing data for our information offerings; costs of staff directly involved with delivering technology-related services offerings and engagements, related accommodations and the costs of data purchased specifically for technology services engagements; and other expenses directly related to service contracts such as courier fees, laboratory supplies, professional services and travel expenses. Reimbursed expenses, which are included in cost of revenues, are comprised principally of payments to investigators who oversee clinical trials and travel expenses for our clinical monitors and sales representatives. Selling, general and administrative expenses include costs related to sales, marketing and administrative functions (including human resources, legal, finance, quality assurance, compliance and general management) for compensation and benefits, travel, professional services, training and expenses for information technology and facilities. We also incur costs and expenses associated with depreciation and amortization. Foreign Currency Translation In the first six months of 2023, 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 is wholly attributable to the effects of foreign currency rate fluctuations. Consolidated Results of Operations For information regarding our results of operations for Technology & Analytics Solutions, Research & Development Solutions and Contract Sales & Medical Solutions, refer to “Segment Results of Operations” later in this section. 23 Table of contents Revenues Three Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 3,728 $ 3,541 $ 187 5.3 % For the second quarter of 2023, our revenues increased $187 million, or 5.3%, as compared to the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $196 million, or 5.5%, reflecting a $48 million increase in Technology & Analytics Solutions and a $148 million increase in Research & Development Solutions. Contract Sales & Medical Solutions constant currency results for the second quarter of 2023 were consistent with the same period in 2022. Six Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 7,380 $ 7,109 $ 271 3.8 % For the first six months of 2023, our revenues increased $271 million, or 3.8%, as compared to the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $362 million, or 5.1%, reflecting a $90 million increase in Technology & Analytics Solutions, a $274 million increase in Research & Development Solutions, and a $2 million decrease in Contract Sales & Medical Solutions. Cost of Revenues, exclusive of Depreciation and Amortization Three Months Ended June 30, Six Months Ended June 30, (in millions) 2023 2022 2023 2022 Cost of revenues, exclusive of depreciation and amortization $ 2,443 $ 2,331 $ 4,841 $ 4,654 % of revenues 65.5 % 65.8 % 65.6 % 65.5 % The $112 million increase in cost of revenues, exclusive of depreciation and amortization, for the three months ended June 30, 2023 as compared to the same period in 2022 included a constant currency increase of approximately $165 million, or 7.1%, reflecting a $55 million increase in Technology & Analytics Solutions, a $111 million increase in Research & Development Solutions, and a $1 million decrease in Contract Sales & Medical Solutions. The $187 million increase in cost of revenues, exclusive of depreciation and amortization, for the six months ended June 30, 2023 as compared to the same period in 2022 included a constant currency increase of approximately $350 million, or 7.5%, reflecting a $107 million increase in Technology & Analytics Solutions, a $247 million increase in Research & Development Solutions, and a $4 million decrease in Contract Sales & Medical Solutions. Selling, General and Administrative Expenses Three Months Ended June 30, Six Months Ended June 30, (in millions) 2023 2022 2023 2022 Selling, general and administrative expenses $ 482 $ 483 $ 995 $ 971 % of revenues 12.9 % 13.6 % 13.5 % 13.7 % The $1 million decrease in selling, general and administrative expenses for the three months ended June 30, 2023 as compared to the same period in 2022 included a constant currency increase of approximately $7 million, or 1.4%, reflecting an $18 million increase in Technology & Analytics Solutions and a $10 million increase in Research & Development Solutions, offset by a $1 million decrease in Contract Sales & Medical Solutions and a $20 million decrease in general corporate and unallocated expenses. The $24 million increase in selling, general and administrative expenses for the six months ended June 30, 2023 as compared to the same period in 2022 included a constant currency increase of approximately $55 million, or 5.7%, reflecting a $37 million increase in Technology & Analytics Solutions, a $17 million increase in Research & Development Solutions, and a $3 million increase in general corporate and unallocated expenses, offset by a $2 million decrease in Contract Sales & Medical Solutions. 24 Table of contents Depreciation and Amortization Three Months Ended June 30, Six Months Ended June 30, (in millions) 2023 2022 2023 2022 Depreciation and amortization $ 259 $ 270 $ 512 $ 525 % of revenues 6.9 % 7.6 % 6.9 % 7.4 % The $11 million and $13 million decrease in depreciation and amortization for the three and six months ended June 30, 2023 compared to the same periods in 2022 was primarily the result of less accelerated amortization related to the abandonment of certain software assets and to a lesser extent less amortization from certain intangible assets from the merger between Quintiles and IMS Health, offset by an increase in amortization of intangible assets from acquisitions occurring in 2022 and 2023 and capitalized software. Restructuring Costs Three Months Ended June 30, Six Months Ended June 30, (in millions) 2023 2022 2023 2022 Restructuring costs $ 20 $ 4 $ 37 $ 11 The restructuring costs incurred during 2023 and 2022 were due to ongoing efforts to streamline our global operations and reduce overcapacity to adapt to changing market conditions and integrate acquisitions. These restructuring actions are expected to occur throughout 2023 and into 2024 and are expected to consist of consolidating functional activities, eliminating redundant positions and aligning resources with customer requirements. Interest Income and Interest Expense Three Months Ended June 30, Six Months Ended June 30, (in millions) 2023 2022 2023 2022 Interest income $ (4) $ (2) $ (10) $ (3) Interest expense $ 169 $ 94 $ 310 $ 180 Interest income includes interest received primarily from bank balances and investments. The increase for the three and six months ended June 30, 2023 as compared to the same periods in 2022 is primarily a result of higher deposit rates. Interest expense during the three and six months ended June 30, 2023 increased compared to the same periods in 2022 primarily due to higher base rate interest costs across the floating rate debt portfolio as well as from an increase in our net debt. Other (Income) Expense, Net Three Months Ended June 30, Six Months Ended June 30, (in millions) 2023 2022 2023 2022 Other (income) expense, net $ (16) $ 33 $ (42) $ 43 Other (income) expense, net for the three months ended June 30, 2023 increased compared to the same period in 2022 primarily due to less foreign currency loss and gains on investments. Other (income) expense, net for the six months ended June 30, 2023 increased compared to the same period in 2022 primarily due to foreign currency gain and gains on investments. 25 Table of contents Income Tax Expense Three Months Ended June 30, Six Months Ended June 30, (in millions) 2023 2022 2023 2022 Income tax expense $ 81 $ 71 $ 152 $ 142 Our effective income tax rate was 21.6% and 21.6% in the second quarter of 2023 and 2022, and 20.6% and 19.5% in the first six months of 2023 and 2022, respectively. Our effective income tax rate in the second quarter and in the first six months of 2023 and 2022 was favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards. For the second quarter of 2023 and 2022 this impact was $2 million and $1 million, respectively, and for the first six months of 2023 and 2022 this impact was $10 million and $14 million, respectively. Segment Results of Operations Revenues and profit by segment are as follows: Three Months Ended June 30, 2023 and 2022 Segment Revenues Segment Profit (in millions) 2023 2022 2023 2022 Technology & Analytics Solutions $ 1,456 $ 1,408 $ 370 $ 384 Research & Development Solutions 2,096 1,950 468 398 Contract Sales & Medical Solutions 176 183 12 13 Total 3,728 3,541 850 795 General corporate and unallocated (47) (68) Depreciation and amortization (259) (270) Restructuring costs (20) (4) Consolidated $ 3,728 $ 3,541 $ 524 $ 453 Six Months Ended June 30, 2023 and 2022 Segment Revenues Segment Profit (in millions) 2023 2022 2023 2022 Technology & Analytics Solutions $ 2,900 $ 2,847 $ 731 $ 770 Research & Development Solutions 4,122 3,884 896 799 Contract Sales & Medical Solutions 358 378 25 25 Total 7,380 7,109 1,652 1,594 General corporate and unallocated (108) (110) Depreciation and amortization (512) (525) Restructuring costs (37) (11) Consolidated $ 7,380 $ 7,109 $ 995 $ 948 Certain costs are not allocated to our segments and are reported as general corporate and unallocated expenses. These costs primarily consist of stock-based compensation and expenses related to integration activities and acquisitions. We also do not allocate depreciation and amortization or impairment charges, if any, to our segments. 26 Table of contents Technology & Analytics Solutions Three Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 1,456 $ 1,408 $ 48 3.4 % Cost of revenues, exclusive of depreciation and amortization 876 828 48 5.8 Selling, general and administrative expenses 210 196 14 7.1 Segment profit $ 370 $ 384 $ (14) (3.6) % Six Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 2,900 $ 2,847 $ 53 1.9 % Cost of revenues, exclusive of depreciation and amortization 1,734 1,662 72 4.3 Selling, general and administrative expenses 435 415 20 4.8 Segment profit $ 731 $ 770 $ (39) (5.1) % Revenues Technology & Analytics Solutions’ revenues were $1,456 million for the second quarter of 2023, an increase of $48 million, or 3.4%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $48 million, or 3.4%, reflecting revenue growth in the Americas and Asia-Pacific regions. Technology & Analytics Solutions’ revenues were $2,900 million for the first six months of 2023, an increase of $53 million, or 1.9%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $90 million, or 3.2%, reflecting revenue growth in the Americas and Asia-Pacific regions. The constant currency revenue growth for the three and six months ended June 30, 2023 was driven by an increase in real world services and information and technology services. The constant currency revenue growth was impacted by a decrease in COVID-19 related work. Cost of Revenues, exclusive of Depreciation and Amortization Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $48 million, or 5.8%, in the second quarter of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $55 million, or 6.6%. Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $72 million, or 4.3%, in the first six months of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $107 million, or 6.4%. The constant currency increase for the three and six months ended June 30, 2023 was related to an increase in compensation and related expenses and an increase in costs of acquiring and processing data to support revenue growth. Selling, General and Administrative Expenses Technology & Analytics Solutions’ selling, general and administrative expenses increased $14 million, or 7.1%, in the second quarter of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $18 million, or 9.2%. Technology & Analytics Solutions’ selling, general and administrative expenses increased $20 million, or 4.8%, in the first six months of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $37 million, or 8.9%. The constant currency increase for the three and six months ended June 30, 2023 was primarily related to an increase in compensation and related expenses. 27 Table of contents Research & Development Solutions Three Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 2,096 $ 1,950 $ 146 7.5 % Cost of revenues, exclusive of depreciation and amortization 1,417 1,348 69 5.1 Selling, general and administrative expenses 211 204 7 3.4 Segment profit $ 468 $ 398 $ 70 17.6 % Six Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 4,122 $ 3,884 $ 238 6.1 % Cost of revenues, exclusive of depreciation and amortization 2,803 2,670 133 5.0 Selling, general and administrative expenses 423 415 8 1.9 Segment profit $ 896 $ 799 $ 97 12.1 % Backlog Research & Development Solutions’ contracted backlog increased from $27.2 billion as of December 31, 2022 to $28.4 billion as of June 30, 2023, and we expect approximately $7.3 billion of this backlog to convert to revenue in the next twelve months. Revenues Research & Development Solutions’ revenues were $2,096 million for the second quarter of 2023, an increase of $146 million, or 7.5%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $148 million, or 7.6%, reflecting revenue growth in the Americas and Asia-Pacific regions. Research & Development Solutions’ revenues were $4,122 million in the first six months of 2023, an increase of $238 million, or 6.1%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $274 million, or 7.1%, reflecting revenue growth in the Americas and Asia-Pacific regions. The constant currency revenue growth for the three and six months ended June 30, 2023 was primarily the result of volume-related increases in clinical services and to a lesser extent from volume-related increases in lab testing. The constant currency revenue growth was impacted by a decrease in COVID-19 related work. Cost of Revenues, exclusive of Depreciation and Amortization Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $69 million, or 5.1%, in the second quarter of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $111 million, or 8.2%. Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $133 million, or 5.0%, in the first six months of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $247 million, or 9.3%. The constant currency increase for the three and six months ended June 30, 2023 was primarily related to an increase in compensation and related expenses as a result of volume-related increases in clinical services and lab testing. Selling, General and Administrative Expenses Research & Development Solutions’ selling, general and administrative expenses increased $7 million, or 3.4%, in the second quarter of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $10 million, or 4.9%. 28 Table of contents Research & Development Solutions’ selling, general and administrative expenses increased $8 million, or 1.9%, in the first six months of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $17 million, or 4.1%. The constant currency increase for the three and six months ended June 30, 2023 was primarily related to an increase in compensation and related expenses. Contract Sales & Medical Solutions Three Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 176 $ 183 $ (7) (3.8) % Cost of revenues, exclusive of depreciation and amortization 150 155 (5) (3.2) Selling, general and administrative expenses 14 15 (1) (6.7) Segment profit $ 12 $ 13 $ (1) (7.7) % Six Months Ended June 30, Change (in millions) 2023 2022 $ % Revenues $ 358 $ 378 $ (20) (5.3) % Cost of revenues, exclusive of depreciation and amortization 304 322 (18) (5.6) Selling, general and administrative expenses 29 31 (2) (6.5) Segment profit $ 25 $ 25 $ — 0.0 % Revenues Contract Sales & Medical Solutions’ revenues were $176 million for the second quarter of 2023, a decrease of $7 million, or 3.8%, over the same period in 2022, which is wholly attributable to the effects of foreign currency rate fluctuations. Contract Sales & Medical Solutions’ revenues were $358 million in the first six months of 2023, a decrease of $20 million, or 5.3%, over the same period in 2022. This decrease included a constant currency revenue decrease of approximately $2 million, or 0.5%. Cost of Revenues, exclusive of Depreciation and Amortization Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, decreased $5 million, or 3.2%, in the second quarter of 2023 as compared to the same period in 2022, which included a constant currency decrease of approximately $1 million, or 0.6%. Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, decreased $18 million, or 5.6%, in the first six months of 2023 as compared to the same period in 2022. This decrease included a constant currency decrease of approximately $4 million, or 1.2%. Selling, General and Administrative Expenses Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $1 million, or 6.7%, in the second quarter of 2023 as compared to the same period in 2022, which included a constant currency decrease of approximately $1 million, or 6.7%. Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $2 million, or 6.5%, in the first six months of 2023 as compared to the same period in 2022, which included a constant currency decrease of approximately $2 million, or 6.5%. 29 Table of contents Liquidity and Capital Resources Overview We assess our liquidity in terms of our ability to generate cash to fund our operating, investing and financing activities. Our principal source of liquidity is operating cash flows. In addition to operating cash flows, other significant factors that affect our overall management of liquidity include: capital expenditures, acquisitions, investments, debt service requirements, equity repurchases, adequacy of our revolving credit and receivables financing facilities, and access to the capital markets. We manage our worldwide cash requirements by monitoring the funds available among our subsidiaries and determining the extent to which those funds can be accessed on a cost-effective basis. The repatriation of cash balances from certain of our subsidiaries could have adverse tax consequences; however, those balances are generally available without legal restrictions to fund ordinary business operations. We have and expect to transfer cash from those subsidiaries to the United States and to other international subsidiaries when it is cost effective to do so. We had a cash balance of $1,382 million as of June 30, 2023 ($568 million of which was in the United States), an increase from $1,216 million as of December 31, 2022. Based on our current operating plan, we believe that our available cash and cash equivalents, future cash flows from operations and our ability to access funds under our revolving credit and receivables financing facilities will enable us to fund our operating requirements, capital expenditures, contractual obligations, and meet debt obligations for at least the next 12 months. We regularly evaluate our debt arrangements, as well as market conditions, and from time to time we may explore opportunities to modify our existing debt arrangements or pursue additional financing arrangements that could result in the issuance of new debt securities by us or our affiliates. We may use our existing cash, cash generated from operations or dispositions of assets or businesses and/or proceeds from any new financing arrangements or issuances of debt or equity securities to repay or reduce some of our outstanding obligations, to repurchase shares from our stockholders or for other purposes. As part of our ongoing business strategy, we also continually evaluate new acquisition, expansion and investment possibilities or other strategic growth opportunities, as well as potential dispositions of assets or businesses, as appropriate, including dispositions that may cause us to recognize a loss on certain assets. Should we elect to pursue any such transaction, we may seek to obtain debt or equity financing to facilitate those activities. Our ability to enter into any such potential transactions and our use of cash or proceeds is limited to varying degrees by the terms and restrictions contained in our existing debt arrangements. We cannot provide assurances that we will be able to complete any such financing arrangements or other transactions on favorable terms or at all. Equity Repurchase Program As of June 30, 2023, the total stock repurchase authorization under the Company's equity repurchase program (the "Repurchase Program") was $9,725 million. The Repurchase Program does not obligate the Company to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time. During the six months ended June 30, 2023, we repurchased 3.2 million shares of our common stock for $619 million under the Repurchase Program. As of June 30, 2023, we had remaining authorization to repurchase up to $736 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. On July 31, 2023, our Board of Directors increased the stock repurchase authorization under the Repurchase Program with respect to the repurchase of our common stock by an additional $2,000 million, which increased the total amount that has been authorized under the Repurchase Program to $11,725 million. After this $2,000 million increase in stock repurchase authorization, we have remaining authorization to repurchase up to $2,736 million of our common stock under the Repurchase Program. Debt As of June 30, 2023, we had $13,839 million of total indebtedness, excluding $1,795 million of additional available borrowings under our revolving credit facility. Our long-term debt arrangements contain customary restrictive covenants and, as of June 30, 2023, we believe we were in compliance with our restrictive covenants in all material respects. 30 Table of contents Senior Secured Credit Facilities As of June 30, 2023, the Company’s Fifth Amended and Restated Credit Agreement provided financing through the senior secured credit facilities of up to $8,095 million, which consisted of $6,295 million principal amounts of debt outstanding, and $1,795 million of available borrowing capacity on the revolving credit facility and standby letters of credit. On April 17, 2023, we increased the capacity of the Company's senior secured revolving credit facility by $500 million U.S. dollars, bringing the total capacity of the revolving credit facility to $2,000 million. Senior Notes On May 23, 2023, we completed the issuance and sale of $750 million in gross proceeds of 5.700% senior secured notes due 2028 (the “Senior Secured Notes”) and $500 million in gross proceeds of 6.500% senior notes due 2030 (the “Senior Notes” and, together with the Senior Secured Notes, the “Notes”). The net proceeds from the notes offering were used to repay existing borrowings under our revolving credit facility and to pay fees and expenses related to the Notes offering. 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. Receivables Financing Facility As of June 30, 2023, no additional amounts of revolving loan commitments were available under the receivables financing facility. Six months ended June 30, 2023 and 2022 Cash Flow from Operating Activities Six Months Ended June 30, (in millions) 2023 2022 Net cash provided by operating activities $ 819 $ 837 Cash provided by operating activities decreased $18 million during the first six months of 2023 as compared to the same period in 2022. The decrease was primarily due to a decrease in cash from cash-related net income ($44 million) and unearned income ($23 million), offset by an increase in cash from accounts receivable and unbilled services ($32 million) and other operating assets and liabilities ($17 million). Cash Flow from Investing Activities Six Months Ended June 30, (in millions) 2023 2022 Net cash used in investing activities $ (818) $ (812) Cash used in investing activities increased $6 million during the first six months of 2023 as compared to the same period in 2022, primarily driven by more cash used in investments in debt and equity securities ($36 million), investments in unconsolidated affiliates, net ($3 million) and purchases of marketable securities, net ($1 million), offset by less cash used for acquisitions of businesses ($20 million) and acquisitions of property, equipment and software ($14 million). Cash Flow from Financing Activities Six Months Ended June 30, (in millions) 2023 2022 Net cash provided by financing activities $ 182 $ 115 Cash provided by financing activities increased $67 million during the first six months of 2023 as compared to the same period in 2022, primarily due to a decrease in cash used to repurchase common stock ($274 million) and cash payments related to employee stock option plans ($11 million), offset by an increase in cash payments on revolving credit facilities, net of proceeds ($125 million), contingent consideration and deferred purchase price accruals ($50 million), debt and principal payments on finance leases ($30 million) and debt issuance costs ($13 million). 31 Table of contents Off-Balance Sheet Arrangements We do not have any material off-balance sheet arrangements. Contractual Obligations and Commitments We have various contractual obligations, which are recorded as liabilities in our consolidated financial statements. There have been no material changes, outside of the ordinary course of business, to our contractual obligations as previously disclosed in our 2022 Form 10-K. Application of Critical Accounting Policies There have been no material changes to our critical accounting policies as previously disclosed in our 2022 Form 10-K. Item 3. Quantitative and Qualitative Disclosures About Market Risk There have been no material changes to our quantitative and qualitative disclosures about market risk as compared to the quantitative and qualitative disclosures about market risk described in our 2022 Form 10-K.