What changed in this filing

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Item 2. Management’s Discussion and Analysis

2024-07-22 compared with 2024-05-02 · 125 added, 68 removed, 214 unchanged (47% of the section changed)

54 unchanged sentences

Foreign Currency Translation

In the first three months of 2024, approximately 30% of our revenues were denominated in currencies other than the United States dollar, which represents approximately 60 currencies.

In the first six months of 2024, 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.

6 unchanged sentences

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.

Three Months Ended March 31, Change

Three Months Ended June 30, Change

(in millions)

Revenues $ 3,814 $ 3,728 $ 86 2.3 %

For the first quarter of 2024, our revenues increased $85 million, or 2.3%, as compared to the same period in 2023.

For the second quarter of 2024, our revenues increased $86 million, or 2.3%, as compared to the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $130 million, or 3.5%, reflecting a $56 million increase in Technology & Analytics Solutions, a $69 million increase in Research & Development Solutions, and a $5 million increase in Contract Sales & Medical Solutions.

Six Months Ended June 30, Change

(in millions)

Revenues $ 7,551 $ 7,380 $ 171 2.3 %

For the first six months of 2024, our revenues increased $171 million, or 2.3%, as compared to the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $235 million, or 3.2%, reflecting a $70 million increase in Technology & Analytics Solutions, a $147 million increase in Research & Development Solutions, and a $18 million increase in Contract Sales & Medical Solutions.

Cost of Revenues, exclusive of Depreciation and Amortization

Three Months Ended March 31,

Three Months Ended June 30, Six Months Ended June 30,

(in millions) 2024 2023 2024 2023

1 unchanged sentence

% of revenues 65.2 % 65.5 % 65.3 % 65.6 %

The $46 million increase in cost of revenues, exclusive of depreciation and amortization, for the three months ended March 31, 2024 as compared to the same period in 2023 included a constant currency increase of approximately $168 million, or 7.0%, reflecting a $43 million increase in Technology & Analytics Solutions, a $113 million increase in Research & Development Solutions, and a $12 million increase in Contract Sales & Medical Solutions.

The $45 million increase in cost of revenues, exclusive of depreciation and amortization, for the three months ended June 30, 2024 as compared to the same period in 2023 included a constant currency increase of approximately $156 million, or 6.4%, reflecting a $41 million increase in Technology & Analytics Solutions, a $110 million increase in Research & Development Solutions, and a $5 million increase in Contract Sales & Medical Solutions.

The $91 million increase in cost of revenues, exclusive of depreciation and amortization, for the six months ended June 30, 2024 as compared to the same period in 2023 included a constant currency increase of approximately $324 million, or 6.7%, reflecting a $84 million increase in Technology & Analytics Solutions, a $223 million increase in Research & Development Solutions, and a $17 million increase in Contract Sales & Medical Solutions.

Selling, General and Administrative Expenses

Three Months Ended March 31,

Three Months Ended June 30, Six Months Ended June 30,

(in millions)

2024 2023 2024 2023

Selling, general and administrative expenses $ 509 $ 482 $ 1,017 $ 995

1 unchanged sentence

13.3 % 12.9 % 13.5 % 13.5 %

The $5 million decrease in selling, general and administrative expenses for the three months ended March 31, 2024 as compared to the same period in 2023 included no constant currency change at the consolidated level, reflecting a $6 million increase in Technology & Analytics Solutions, a $12 million increase in Research & Development Solutions, and a $1 million increase in Contract Sales & Medical Solutions, offset by a $19 million decrease in general corporate and unallocated expenses.

The $27 million increase in selling, general and administrative expenses for the three months ended June 30, 2024 as compared to the same period in 2023 included a constant currency increase of approximately $45 million, or 9.3%, reflecting a $23 million increase in Technology & Analytics Solutions, a $16 million increase in Research & Development Solutions, a $1 million increase in Contract Sales & Medical Solutions, and a $5 million increase in general corporate and unallocated expenses.

The $22 million increase in selling, general and administrative expenses for the six months ended June 30, 2024 as compared to the same period in 2023 included a constant currency increase of approximately $45 million, or 4.5%, reflecting a $29 million increase in Technology & Analytics Solutions, a $28 million increase in Research & Development Solutions, and a $2 million increase in Contract Sales & Medical Solutions, offset by a $14 million decrease in general corporate and unallocated expenses.

Depreciation and Amortization

Three Months Ended March 31,

Three Months Ended June 30, Six Months Ended June 30,

(in millions) 2024 2023 2024 2023

1 unchanged sentence

% of revenues

The $11 million increase in depreciation and amortization for the three months ended March 31, 2024 compared to the same period in 2023 was primarily the result of an increase in amortization of capitalized software and of intangible assets from acquisitions occurring in 2023 and 2024.

7.1 % 6.9 % 7.1 % 6.9 %

The $10 million and $21 million increase in depreciation and amortization for the three and six months ended June 30, 2024 compared to the same periods in 2023 was primarily the result of an increase in amortization of capitalized software and of intangible assets from acquisitions occurring in 2023 and 2024.

Restructuring Costs

Three Months Ended March 31,

Three Months Ended June 30, Six Months Ended June 30,

(in millions) 2024 2023 2024 2023

3 unchanged sentences

Interest Income and Interest Expense

Three Months Ended March 31,

Three Months Ended June 30, Six Months Ended June 30,

(in millions) 2024 2023 2024 2023

2 unchanged sentences

Interest income includes interest received primarily from bank balances and investments.

The increase for the three months ended March 31, 2024 as compared to the same period in 2023 is primarily a result of higher deposit rates.

Interest expense during the three months ended March 31, 2024 increased compared to the same period in 2023 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 Expense (Income), Net

Three Months Ended March 31,

The increase for the three and six months ended June 30, 2024 as compared to the same period in 2023 is primarily a result of higher deposit rates.

Interest expense during the three months ended June 30, 2024 decreased compared to the same period in 2023 primarily due to lower debt balances.

For the six months ended June 30, 2024, interest expense increased as a result of higher base rate interest costs across the floating rate debt portfolio.

Other Income, Net

Three Months Ended June 30, Six Months Ended June 30,

(in millions) 2024 2023 2024 2023

Other expense (income), net $ 11 $ (26)

Other expense (income), net for the three months ended March 31, 2024 increased compared to the same period in 2023 primarily due to more foreign currency loss on transactions.

Other income, net $ (67) $ (16) $ (56) $ (42)

Other income, net for the three months ended June 30, 2024 increased compared to the same period in 2023 primarily due to revaluations of contingent consideration arrangements and to a lesser extent from foreign currency gain on transactions.

Other income, net for the six months ended June 30, 2024 increased compared to the same period in 2023 primarily due to revaluations of contingent consideration arrangements.

Income Tax Expense

Three Months Ended March 31,

Three Months Ended June 30, Six Months Ended June 30,

(in millions) 2024 2023 2024 2023

Income tax expense $ 75 $ 81 $ 124 $ 152

Our effective income tax rate was 14.4% and 19.6% in the first quarter of 2024 and 2023, respectively.

Our effective income tax rate in the first quarter of 2024 was favorably impacted compared to the first quarter of 2023 due to changes in the geographical mix of earnings amongst the United States and foreign tax jurisdictions.

Our effective income tax rate in the first quarter of 2024 and 2023 was also favorably impacted by $9 million and $8 million, respectively, as a result of excess tax benefits recognized upon settlement of share-based compensation awards.

Our effective income tax rate was 17.2% and 21.6% in the second quarter of 2024 and 2023, and 16.0% and 20.6% in the first six months of 2024 and 2023, respectively.

Our effective income tax rate in the second quarter and in the first six months of 2024 was favorably impacted compared to the second quarter and first six months of 2023 due to changes in the geographical mix of earnings amongst the United States and foreign tax jurisdictions.

Our effective income tax rate in the second quarter and in the first six months of 2024 and 2023 was also favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards.

For the second quarter of 2024 and 2023 this impact was $3 million and $2 million, respectively, and for the first six months of 2024 and 2023 this impact was $12 million and $10 million, respectively.

Numerous foreign jurisdictions have agreed to implement the OECD's Pillar 2 global corporate minimum tax rate of 15% on companies with revenues of at least €750 million, which went into effect in 2024.

We have evaluated the effect of this for the first quarter of 2024 and do not expect any material impacts for 2024.

We have evaluated the effect of this for the second quarter of 2024 and do not expect any material impacts for 2024.

We will continue to monitor as additional jurisdictions enact Pillar 2 legislation.

1 unchanged sentence

Revenues and profit by segment are as follows:

Three Months Ended March 31, 2024 and 2023

Three Months Ended June 30, 2024 and 2023

Segment Revenues Segment Profit

8 unchanged sentences

Consolidated $ 3,814 $ 3,728 $ 520 $ 524

Six Months Ended June 30, 2024 and 2023

Segment Revenues Segment Profit

(in millions) 2024 2023 2024 2023

Technology & Analytics Solutions $ 2,948 $ 2,900 $ 696 $ 731

Research & Development Solutions 4,242 4,122 972 896

Contract Sales & Medical Solutions 361 358 22 25

Total 7,551 7,380 1,690 1,652

General corporate and unallocated (88) (108)

Depreciation and amortization (533) (512)

Restructuring costs (43) (37)

Consolidated $ 7,551 $ 7,380 $ 1,026 $ 995

Certain costs are not allocated to our segments and are reported as general corporate and unallocated expenses.

2 unchanged sentences

Technology & Analytics Solutions

Three Months Ended March 31, Change

Three Months Ended June 30, Change

(in millions) 2024 2023 $ %

3 unchanged sentences

Segment profit $ 361 $ 370 $ (9) (2.4) %

Technology & Analytics Solutions’ revenues were $1,453 million for the first quarter of 2024, an increase of $9 million, or 0.6%, over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $14 million, or 1.0%, reflecting revenue growth primarily in the Americas region.

The constant currency revenue growth for the three months ended March 31, 2024 was driven by an increase in information and technology services.

The constant currency revenue growth was impacted by a decrease in COVID-19 related work.

Six Months Ended June 30, Change

(in millions) 2024 2023 $ %

Revenues $ 2,948 $ 2,900 $ 48 1.7 %

Cost of revenues, exclusive of depreciation and amortization 1,798 1,734 64 3.7

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $31 million, or 3.6%, in the first quarter of 2024 over the same period in 2023.

Selling, general and administrative expenses 454 435 19 4.4

Segment profit $ 696 $ 731 $ (35) (4.8) %

Technology & Analytics Solutions’ revenues were $1,495 million for the second quarter of 2024, an increase of $39 million, or 2.7%, over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $56 million, or 3.8%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Americas region.

Technology & Analytics Solutions’ revenues were $2,948 million for the first six months of 2024, an increase of $48 million, or 1.7%, over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $70 million, or 2.4%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Americas region.

The constant currency revenue growth for the three and six months ended June 30, 2024 was primarily driven by an increase in information and technology services and to a lesser extent by real world services.

The constant currency revenue growth for the six months ended June 30, 2024 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 $33 million, or 3.8%, in the second quarter of 2024 over the same period in 2023.

This increase included a constant currency increase of approximately $41 million, or 4.7%.

The constant currency increase for the three months ended March 31, 2024 was mainly related to an increase in costs of acquiring and processing data to support revenue growth.

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $64 million, or 3.7%, in the first six months of 2024 over the same period in 2023.

This increase included a constant currency increase of approximately $84 million, or 4.8%.

The constant currency increase for the three and six months ended June 30, 2024 was mainly related to 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 $4 million, or 1.8%, in the first quarter of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $6 million, or 2.7%.

The constant currency increase for the three months ended March 31, 2024 was primarily related to an increase in compensation and related expenses.

Technology & Analytics Solutions’ selling, general and administrative expenses increased $15 million, or 7.1%, in the second quarter of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $23 million, or 11.0%.

Technology & Analytics Solutions’ selling, general and administrative expenses increased $19 million, or 4.4%, in the first six months of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $29 million, or 6.7%.

The constant currency increase for the three and six months ended June 30, 2024 was primarily related to an increase in compensation and related expenses.

Research & Development Solutions

Three Months Ended March 31, Change

Three Months Ended June 30, Change

(in millions)

3 unchanged sentences

Segment profit $ 493 $ 468 $ 25 5.3 %

Research & Development Solutions’ contracted backlog increased from $29.7 billion as of December 31, 2023 to $30.1 billion as of March 31, 2024, and we expect approximately $7.7 billion of this backlog to convert to revenues in the next twelve months.

Research & Development Solutions’ revenues were $2,095 million for the first quarter of 2024, an increase of $69 million, or 3.4%, over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $78 million, or 3.8%, reflecting revenue growth primarily in the Europe and Africa and Asia-Pacific regions.

The constant currency revenue growth for the three months ended March 31, 2024 was primarily the result of volume-related increases in clinical services and to a lesser extent from volume-related increases in lab testing.

Six Months Ended June 30, Change

(in millions)

Revenues $ 4,242 $ 4,122 $ 120 2.9 %

Cost of revenues, exclusive of depreciation and amortization 2,826 2,803 23 0.8

Selling, general and administrative expenses 444 423 21 5.0

Segment profit $ 972 $ 896 $ 76 8.5 %

Research & Development Solutions’ contracted backlog increased from $29.7 billion as of December 31, 2023 to $30.6 billion as of June 30, 2024, and we expect approximately $7.8 billion of this backlog to convert to revenues in the next twelve months.

Research & Development Solutions’ revenues were $2,147 million for the second quarter of 2024, an increase of $51 million, or 2.4%, over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $69 million, or 3.3%, reflecting revenue growth primarily in the Americas region and to a lesser extent in the Europe and Africa region.

Research & Development Solutions’ revenues were $4,242 million in the first six months of 2024, an increase of $120 million, or 2.9%, over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $147 million, or 3.6%, reflecting revenue growth across all regions.

The constant currency revenue growth for the three and six months ended June 30, 2024 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 $9 million, or 0.6%, in the first quarter of 2024 over the same period in 2023.

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $14 million, or 1.0%, in the second quarter of 2024 over the same period in 2023.

This increase included a constant currency increase of approximately $110 million, or 7.8%.

The constant currency increase for the three months ended March 31, 2024 was primarily related to an increase in compensation and related expenses as a result of volume-related increases in clinical services and lab testing.

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $23 million, or 0.8%, in the first six months of 2024 over the same period in 2023.

This increase included a constant currency increase of approximately $223 million, or 8.0%.

The constant currency increase for the three and six months ended June 30, 2024 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 $9 million, or 4.2%, in the first quarter of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $12 million, or 5.7%.

The constant currency increase for the three months ended March 31, 2024 was primarily related to an increase in compensation and related expenses.

Research & Development Solutions’ selling, general and administrative expenses increased $12 million, or 5.7%, in the second quarter of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $16 million, or 7.6%.

Research & Development Solutions’ selling, general and administrative expenses increased $21 million, or 5.0%, in the first six months of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $28 million, or 6.6%.

The constant currency increase for the three and six months ended June 30, 2024 was primarily related to an increase in compensation and related expenses.

Contract Sales & Medical Solutions

Three Months Ended March 31, Change

Three Months Ended June 30, Change

(in millions)

3 unchanged sentences

Segment profit $ 9 $ 12 $ (3) (25.0) %

Contract Sales & Medical Solutions’ revenues were $189 million for the first quarter of 2024, an increase of $7 million, or 3.8% over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $13 million, or 7.1%, reflecting revenue growth in the Europe and Africa and Asia-Pacific regions.

Six Months Ended June 30, Change

(in millions)

Revenues $ 361 $ 358 $ 3 0.8 %

Cost of revenues, exclusive of depreciation and amortization 308 304 4 1.3

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $6 million, or 3.9%, in the first quarter of 2024 as compared to the same period in 2023.

Selling, general and administrative expenses 31 29 2 6.9

Segment profit $ 22 $ 25 $ (3) (12.0) %

Contract Sales & Medical Solutions’ revenues were $172 million for the second quarter of 2024, a decrease of $4 million, or 2.3%, over the same period in 2023.

This decrease was comprised of constant currency revenue growth of approximately $5 million, or 2.8%, reflecting similar revenue growth in the Europe and Africa and Asia-Pacific regions.

Contract Sales & Medical Solutions’ revenues were $361 million in the first six months of 2024, an increase of $3 million, or 0.8%, over the same period in 2023.

This increase was comprised of constant currency revenue growth of approximately $18 million, or 5.0%, reflecting revenue growth in the Europe and Africa region and to a lesser extent the Asia-Pacific region.

The constant currency revenue growth for the three and six months ended June 30, 2024 was primarily due to volume-related increases in services performed.

Cost of Revenues, exclusive of Depreciation and Amortization

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, decreased $2 million, or 1.3%, in the second quarter of 2024 as compared to the same period in 2023.

This decrease included a constant currency increase of approximately $5 million, or 3.3%.

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $4 million, or 1.3%, in the first six months of 2024 as compared to the same period in 2023.

This increase included a constant currency increase of approximately $17 million, or 5.6%.

The constant currency increase for the three months ended March 31, 2024 was primarily related to an increase in costs associated with supporting revenue growth.

The constant currency increase for the three and six months ended June 30, 2024 was primarily related to an increase in costs associated with supporting revenue growth.

Selling, General and Administrative Expenses

Contract Sales & Medical Solutions’ selling, general and administrative expenses increased $1 million, or 6.7%, in the first quarter of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $1 million, or 6.7%.

Contract Sales & Medical Solutions’ selling, general and administrative expenses increased $1 million, or 7.1%, in the second quarter of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $1 million, or 7.1%.

Contract Sales & Medical Solutions’ selling, general and administrative expenses increased $2 million, or 6.9%, in the first six months of 2024 as compared to the same period in 2023, which included a constant currency increase of approximately $2 million, or 6.9%.

Liquidity and Capital Resources

7 unchanged sentences

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 $1,444 million as of March 31, 2024 ($567 million of which was in the United States), an increase from $1,376 million as of December 31, 2023.

We had a cash balance of $1,545 million as of June 30, 2024 ($663 million of which was in the United States), an increase from $1,376 million as of December 31, 2023.

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.

6 unchanged sentences

Equity Repurchase Program

As of March 31, 2024, the total stock repurchase authorization under our equity repurchase program (the “Repurchase Program”) was $11,725 million.

As of June 30, 2024, the total stock repurchase authorization under our equity repurchase program (the “Repurchase Program”) was $11,725 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 three months ended March 31, 2024, we did not repurchase any shares of our common stock under the Repurchase Program.

As of March 31, 2024, we had remaining authorization to repurchase up to $2,363 million of our common stock under the Repurchase Program.

During the six months ended June 30, 2024, we did not repurchase any shares of our common stock under the Repurchase Program.

As of June 30, 2024, we had remaining authorization to repurchase up to $2,363 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 March 31, 2024, we had $13,611 million of total indebtedness, excluding $1,895 million of additional available borrowings under our revolving credit facility.

Our long-term debt arrangements contain customary restrictive covenants and, as of March 31, 2024, we believe we were in compliance with our restrictive covenants in all material respects.

As of June 30, 2024, we had $13,328 million of total indebtedness, excluding $1,995 million of additional available borrowings under our revolving credit facility.

Our long-term debt arrangements contain customary restrictive covenants and, as of June 30, 2024, we believe we were in compliance with our restrictive covenants in all material respects.

Senior Secured Credit Facilities

As of March 31, 2024, our Fifth Amended and Restated Credit Agreement provided financing through the senior secured credit facilities of up to $6,743 million, which consisted of $4,848 million principal amounts of debt outstanding, and $1,895 million of available borrowing capacity on the revolving credit facility and standby letters of credit.

As of June 30, 2024, our Fifth Amended and Restated Credit Agreement provided financing through the senior secured credit facilities of up to $6,695 million, which consisted of $4,700 million principal amounts of debt outstanding, and $1,995 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.

Receivables Financing Facility

As of March 31, 2024, no additional amounts of revolving loan commitments were available under the receivables financing facility.

Three months ended March 31, 2024 and 2023

As of June 30, 2024, $110 million of additional amounts of revolving loan commitments were available under the receivables financing facility.

Six months ended June 30, 2024 and 2023

Cash Flow from Operating Activities

Three Months Ended March 31,

Six Months Ended June 30,

(in millions) 2024 2023

Net cash provided by operating activities $ 1,110 $ 819

Cash provided by operating activities increased $105 million during the first three months of 2024 as compared to the same period in 2023.

The increase was due to an increase in cash from unearned income ($116 million) and accounts receivable and unbilled services ($56 million), offset by a decrease in cash from cash-related net income ($54 million) and other operating assets and liabilities ($13 million).

Cash provided by operating activities increased $291 million during the first six months of 2024 as compared to the same period in 2023.

The increase was due to an increase in cash from accounts receivable and unbilled services ($325 million) and from cash-related net income ($58 million), offset by a decrease in other operating assets and liabilities ($88 million) and unearned income ($4 million).

Cash Flow from Investing Activities

Three Months Ended March 31,

Six Months Ended June 30,

(in millions) 2024 2023

Net cash used in investing activities $ (535) $ (818)

Cash used in investing activities increased $92 million during the first three months of 2024 as compared to the same period in 2023, primarily driven by more cash used for acquisitions of businesses ($124 million) and investments in unconsolidated affiliates, net ($17 million) and less cash from other ($7 million), offset by less cash used for investments in debt and equity securities ($34 million), acquisitions of property, equipment and software ($19 million) and purchases of marketable securities, net ($3 million).

Cash used in investing activities decreased $283 million during the first six months of 2024 as compared to the same period in 2023, primarily driven by less cash used for acquisitions of businesses ($223 million), acquisitions of property, equipment and software ($36 million), investments in debt and equity securities ($34 million), purchases of marketable securities, net ($4 million) and cash received from sale of property, equipment and software ($25 million), offset by more cash used in investments in unconsolidated affiliates, net ($36 million) and less cash from other ($3 million).

Cash Flow from Financing Activities

Three Months Ended March 31,

Six Months Ended June 30,

(in millions) 2024 2023

Net cash (used in) provided by financing activities $ (366) $ 182

Cash used in financing activities increased $193 million during the first three months of 2024 as compared to the same period in 2023, primarily due to less cash from revolving credit facilities, net of repayments ($375 million), more cash payments on debt and principal payments on finance leases ($4 million) and cash payments related to employee stock incentive plans ($2 million), offset by less cash used to repurchase common stock ($129 million) and less cash payments for contingent consideration and deferred purchase price accruals ($59 million).

Cash used in financing activities increased $548 million during the first six months of 2024 as compared to the same period in 2023, primarily due to less cash from debt issuance, net ($1,232 million), more cash payments on debt and principal payments on finance leases ($9 million) and cash payments related to employee stock incentive plans ($2 million), offset by less cash used for repurchase of common stock ($619 million), payments for contingent consideration and deferred purchase price accruals ($61 million) and for revolving credit facilities, net of repayments ($15 million).

Information about our Guarantors and the Issuer of our Guaranteed Securities

7 unchanged sentences

Each Guarantor subsidiary is consolidated by IQVIA Holdings Inc.

as of March 31, 2024 and December 31, 2023.

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 March 31, 2024.

as of June 30, 2024 and December 31, 2023.

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 June 30, 2024.

The guarantee of a Guarantor subsidiary with respect to the Notes will be automatically and unconditionally released and discharged and shall terminate and be of no further force and effect, and no further action by such Guarantor subsidiary, the Issuer, or U.S.

14 unchanged sentences

The following table contains summarized combined financial information from the Statements of Unaudited Condensed Consolidated Financial Position of the obligated group as of:

(in millions) March 31, 2024 December 31, 2023

(in millions) June 30, 2024 December 31, 2023

Total current assets (excluding amounts due from subsidiaries that are non-Guarantors) $ 821 $ 805

5 unchanged sentences

The following table contains summarized combined financial information from the Statements of Unaudited Condensed Consolidated Operations of the obligated group:

Three months ended Twelve months ended

(in millions) March 31, 2024 December 31, 2023

Six months ended Twelve months ended

(in millions) June 30, 2024 December 31, 2023

Net revenues $ 3,350 $ 6,299

12 unchanged sentences

Compared sentence by sentence after normalising whitespace, quotation marks, case and digits, so re-formatting and restated figures do not read as changed language. Wording changes appear as one removal and one addition. The current filing and the prior one are authoritative.

What changed 10-Q

Item 2. Management’s Discussion and Analysis