IQVIA HOLDINGS INC. 10-K

Item 8. Financial Statements and Supplementary Data MANAGEMENT’S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING The management of IQVIA Holdings Inc. (the “Company”) is responsible for establishing and maintaining adequate internal control over financial reporting. Internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements. Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. Management assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 2024. In making this assessment, management used the framework established in Internal Control—Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (“COSO”). As a result of this assessment and based on the criteria in the COSO framework, management has concluded that, as of December 31, 2024, the Company’s internal control over financial reporting was effective. The effectiveness of the Company’s internal control over financial reporting as of December 31, 2024 has been audited by PricewaterhouseCoopers LLP, an independent registered public accounting firm, as stated in their report which appears herein. /s/ Ari Bousbib /s/ Ronald E. Bruehlman Ari Bousbib Ronald E. Bruehlman Chairman and Chief Executive Officer Executive Vice President and Chief Financial Officer (Principal Executive Officer ) (Principal Financial Officer) February 13, 2025 67 REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM To the Board of Directors and Stockholders of IQVIA Holdings Inc. Opinions on the Financial Statements and Internal Control over Financial Reporting We have audited the accompanying consolidated balance sheets of IQVIA Holdings Inc. and its subsidiaries (the “Company”) as of December 31, 2024 and 2023, and the related consolidated statements of income, of comprehensive income, of stockholders’ equity and of cash flows for each of the three years in the period ended December 31, 2024, including the related notes and financial statement schedules listed in the index appearing under Item 15(a)(2) (collectively referred to as the “consolidated financial statements”). We also have audited the Company's internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the Company as of December 31, 2024 and 2023, and the results of its operations and its cash flows for each of the three years in the period ended December 31, 2024 in conformity with accounting principles generally accepted in the United States of America. Also in our opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2024, based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO. Basis for Opinions The Company's management is responsible for these consolidated financial statements, for maintaining effective internal control over financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying Management’s Report on Internal Control over Financial Reporting. Our responsibility is to express opinions on the Company’s consolidated financial statements and on the Company's internal control over financial reporting based on our audits. We are a public accounting firm registered with the Public Company Accounting Oversight Board (United States) (PCAOB) and are required to be independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of the Securities and Exchange Commission and the PCAOB. We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error or fraud, and whether effective internal control over financial reporting was maintained in all material respects. Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall presentation of the consolidated financial statements. Our audit of internal control over financial reporting included obtaining an understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating the design and operating effectiveness of internal control based on the assessed risk. Our audits also included performing such other procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions. Definition and Limitations of Internal Control over Financial Reporting A company’s internal control over financial reporting is a process designed to provide reasonable assurance regarding the reliability of financial reporting and the preparation of financial statements for external purposes in accordance with generally accepted accounting principles. A company’s internal control over financial reporting includes those policies and procedures that (i) pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the assets of the company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being made only in accordance with authorizations of management and directors of the company; and (iii) provide reasonable assurance regarding prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect on the financial statements. 68 Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate. Critical Audit Matters The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements that was communicated or required to be communicated to the audit committee and that (i) relates to accounts or disclosures that are material to the consolidated financial statements and (ii) involved our especially challenging, subjective, or complex judgments. The communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, and we are not, by communicating the critical audit matter below, providing a separate opinion on the critical audit matter or on the accounts or disclosures to which it relates. Revenue Recognition – Estimating Costs to Complete for Clinical Research Services As described in Notes 1 and 20 to the consolidated financial statements, revenue of the Research & Development Solutions segment for the year ended December 31, 2024, is $ 8,527 million, the majority of which relates to service contracts for clinical research that represent a single performance obligation. The Company recognized revenue for these contracts over time using a cost-based input method. Revenue was recognized based on progress on the performance obligation, which was measured by the proportion of actual costs incurred to the total costs expected to complete the contract. Costs included in the measure of progress include direct labor and third-party costs (such as payments to investigators and other reimbursed expenses for the Company’s clinical monitors). This cost-based method of revenue recognition required management to make estimates of costs to complete its projects on an ongoing basis. The principal considerations for our determination that performing procedures relating to revenue recognition - estimating costs to complete for clinical research services is a critical audit matter are a high degree of auditor effort in performing audit procedures and evaluating audit evidence related to the cost estimates made by management when determining the total expected costs to complete its contracts, specifically the estimation of direct labor and third-party costs. Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on the consolidated financial statements. These procedures included testing the effectiveness of controls relating to the revenue recognition process, including controls over the estimation of the total costs to complete for clinical research service contracts. These procedures also included, among others, testing management’s process for determining the estimate of total costs to complete for a sample of clinical research contracts by evaluating the reasonableness of significant assumptions made by management related to direct labor and third-party costs, evaluating the appropriateness of changes to management’s estimate of total costs to complete the contracts, testing actual direct costs incurred, evaluating management’s ability to reasonably estimate the total expected costs to complete contracts by performing a comparison of management’s prior period cost estimates to actual costs, and testing the completeness and accuracy of underlying data used by management. /s/ PricewaterhouseCoopers LLP Raleigh, North Carolina February 13, 2025 We have served as the Company’s auditor since 2002. 69 IQVIA HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF INCOME Year Ended December 31, (in millions, except per share data) 2024 2023 2022 Revenues $ 15,405 $ 14,984 $ 14,410 Cost of revenues, exclusive of depreciation and amortization 10,030 9,745 9,382 Selling, general and administrative expenses 1,992 2,053 2,071 Depreciation and amortization 1,114 1,125 1,130 Restructuring costs 67 84 28 Income from operations 2,202 1,977 1,799 Interest income ( 47 ) ( 36 ) ( 13 ) Interest expense 670 672 416 Loss on extinguishment of debt — 6 — Other (income) expense, net ( 90 ) ( 124 ) 33 Income before income taxes and equity in earnings (losses) of unconsolidated affiliates 1,669 1,459 1,363 Income tax expense 301 101 260 Income before equity in earnings (losses) of unconsolidated affiliates 1,368 1,358 1,103 Equity in earnings (losses) of unconsolidated affiliates 5 — ( 12 ) Net income $ 1,373 $ 1,358 $ 1,091 Earnings per share attributable to common stockholders: Basic $ 7.57 $ 7.39 $ 5.82 Diluted $ 7.49 $ 7.29 $ 5.72 Weighted average common shares outstanding: Basic 181.3 183.8 187.6 Diluted 183.4 186.3 190.6 The accompanying notes are an integral part of these consolidated financial statements. 70 IQVIA HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME Year Ended December 31, (in millions) 2024 2023 2022 Net income $ 1,373 $ 1,358 $ 1,091 Comprehensive income adjustments: Unrealized gains (losses) on derivative instruments, net of income tax expense (benefit) of $ 17 , $( 3 ) and $ 13 53 ( 7 ) 40 Defined benefit plan adjustments, net of income tax expense (benefit) of $ 5 , $ 4 and $( 3 ) 7 7 ( 10 ) Foreign currency translation, net of income tax expense (benefit) of $ 77 , $( 55 ) and $ 106 ( 200 ) ( 89 ) ( 361 ) Reclassification adjustments: Reclassifications on derivative instruments included in net income, net of income tax (expense) benefit of $( 10 ), $( 17 ) and $ 2 ( 31 ) ( 51 ) 10 Comprehensive income $ 1,202 $ 1,218 $ 770 The accompanying notes are an integral part of these consolidated financial statements. 71 IQVIA HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED BALANCE SHEETS December 31, (in millions, except per share data) 2024 2023 ASSETS Current assets: Cash and cash equivalents $ 1,702 $ 1,376 Trade accounts receivable and unbilled services, net 3,204 3,381 Prepaid expenses 154 141 Income taxes receivable 36 32 Investments in debt, equity and other securities 141 120 Other current assets and receivables 592 546 Total current assets 5,829 5,596 Property and equipment, net 535 523 Operating lease right-of-use assets 238 296 Investments in debt, equity and other securities 108 105 Investments in unconsolidated affiliates 266 134 Goodwill 14,710 14,567 Other identifiable intangibles, net 4,499 4,839 Deferred income taxes 194 166 Deposits and other assets, net 520 455 Total assets $ 26,899 $ 26,681 LIABILITIES AND STOCKHOLDERS’ EQUITY Current liabilities: Accounts payable and accrued expenses $ 3,684 $ 3,564 Unearned income 1,779 1,799 Income taxes payable 156 116 Current portion of long-term debt 1,145 718 Other current liabilities 193 294 Total current liabilities 6,957 6,491 Long-term debt, less current portion 12,838 12,955 Deferred income taxes 196 202 Operating lease liabilities 173 223 Other liabilities 668 698 Total liabilities 20,832 20,569 Commitments and contingencies (Note 1 and 12) Stockholders’ equity: Common stock and additional paid-in capital, 400.0 shares authorized as of December 31, 2024 and 2023, $ 0.01 par value, 258.2 shares issued and 176.1 shares outstanding as of December 31, 2024; 257.2 shares issued and 181.5 shares outstanding as of December 31, 2023 11,143 11,028 Retained earnings 6,065 4,692 Treasury stock, at cost, 82.1 and 75.7 shares as of December 31, 2024 and 2023, respectively ( 10,103 ) ( 8,741 ) Accumulated other comprehensive loss ( 1,038 ) ( 867 ) Total stockholders’ equity 6,067 6,112 Total liabilities and stockholders’ equity $ 26,899 $ 26,681 The accompanying notes are an integral part of these consolidated financial statements. 72 IQVIA HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF CASH FLOWS Year Ended December 31, (in millions) 2024 2023 2022 Operating activities: Net income $ 1,373 $ 1,358 $ 1,091 Adjustments to reconcile net income to cash provided by operating activities: Depreciation and amortization 1,114 1,125 1,130 Amortization of debt issuance costs and discount 21 18 15 Stock-based compensation 206 217 194 Gain on disposals of property and equipment, net — — ( 10 ) (Earnings) losses from unconsolidated affiliates ( 5 ) — 12 (Gain) loss on investments, net ( 22 ) ( 20 ) 27 Benefit from deferred income taxes ( 129 ) ( 269 ) ( 115 ) Changes in operating assets and liabilities: Accounts receivable and unbilled services 182 ( 388 ) ( 421 ) Prepaid expenses and other assets 7 34 7 Accounts payable and accrued expenses 115 267 427 Unearned income 9 ( 29 ) 31 Income taxes payable and other liabilities ( 155 ) ( 164 ) ( 128 ) Net cash provided by operating activities 2,716 2,149 2,260 Investing activities: Acquisition of property, equipment and software ( 602 ) ( 649 ) ( 674 ) Acquisition of businesses, net of cash acquired ( 735 ) ( 876 ) ( 1,315 ) Purchases of marketable securities, net — ( 6 ) ( 5 ) Investments in unconsolidated affiliates, net of payments received ( 132 ) ( 39 ) ( 20 ) Investments in debt and equity securities ( 2 ) ( 38 ) — Proceeds from sale of property, equipment and software 25 — — Other 2 5 8 Net cash used in investing activities ( 1,444 ) ( 1,603 ) ( 2,006 ) Financing activities: Proceeds from issuance of debt — 4,000 1,250 Payment of debt issuance costs ( 1 ) ( 50 ) ( 5 ) Repayment of debt and principal payments on finance leases ( 172 ) ( 2,873 ) ( 634 ) Proceeds from revolving credit facility 1,685 2,384 2,350 Repayment of revolving credit facility ( 960 ) ( 2,709 ) ( 2,025 ) Payments related to employee stock incentive plans, net ( 64 ) ( 61 ) ( 71 ) Repurchase of common stock ( 1,350 ) ( 992 ) ( 1,168 ) Contingent consideration and deferred purchase price payments ( 16 ) ( 81 ) ( 26 ) Net cash used in financing activities ( 878 ) ( 382 ) ( 329 ) Effect of foreign currency exchange rate changes on cash ( 68 ) ( 4 ) ( 75 ) Increase (decrease) in cash and cash equivalents 326 160 ( 150 ) Cash and cash equivalents at beginning of period 1,376 1,216 1,366 Cash and cash equivalents at end of period $ 1,702 $ 1,376 $ 1,216 The accompanying notes are an integral part of these consolidated financial statements. 73 IQVIA HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY (in millions) Common Stock Shares Treasury Stock Shares Common Stock Additional Paid-In Capital Retained Earnings Treasury Stock Accumulated Other Comprehensive (Loss) Income Total Balance, December 31, 2021 255.8 ( 65.2 ) $ 3 $ 10,774 $ 2,243 $ ( 6,572 ) $ ( 406 ) $ 6,042 Issuance of common stock 0.6 — — ( 71 ) — — — ( 71 ) Repurchase of common stock — ( 5.5 ) — — — ( 1,168 ) — ( 1,168 ) Stock-based compensation — — — 192 — — — 192 Net income — — — — 1,091 — — 1,091 Unrealized gains on derivative instruments, net of tax — — — — — — 40 40 Defined benefit plan adjustments, net of tax — — — — — — ( 10 ) ( 10 ) Foreign currency translation, net of tax — — — — — — ( 361 ) ( 361 ) Reclassification adjustments, net of tax — — — — — — 10 10 Balance, December 31, 2022 256.4 ( 70.7 ) 3 10,895 3,334 ( 7,740 ) ( 727 ) 5,765 Issuance of common stock 0.8 — — ( 61 ) — — — ( 61 ) Repurchase of common stock, net of tax — ( 5.0 ) — — — ( 1,001 ) — ( 1,001 ) Stock-based compensation — — — 191 — — — 191 Net income — — — — 1,358 — — 1,358 Unrealized losses on derivative instruments, net of tax — — — — — — ( 7 ) ( 7 ) Defined benefit plan adjustments, net of tax — — — — — — 7 7 Foreign currency translation, net of tax — — — — — — ( 89 ) ( 89 ) Reclassification adjustments, net of tax — — — — — — ( 51 ) ( 51 ) Balance, December 31, 2023 257.2 ( 75.7 ) 3 11,025 4,692 ( 8,741 ) ( 867 ) 6,112 Issuance of common stock 1.0 — — ( 66 ) — — — ( 66 ) Repurchase of common stock, net of tax — ( 6.4 ) — — — ( 1,362 ) — ( 1,362 ) Stock-based compensation — — — 181 — — — 181 Net income — — — — 1,373 — — 1,373 Unrealized gains on derivative instruments, net of tax — — — — — — 53 53 Defined benefit plan adjustments, net of tax — — — — — — 7 7 Foreign currency translation, net of tax — — — — — — ( 200 ) ( 200 ) Reclassification adjustments, net of tax — — — — — — ( 31 ) ( 31 ) Balance, December 31, 2024 258.2 ( 82.1 ) $ 3 $ 11,140 $ 6,065 $ ( 10,103 ) $ ( 1,038 ) $ 6,067 The accompanying notes are an integral part of these consolidated financial statements . 74 IQVIA HOLDINGS INC. AND SUBSIDIARIES Notes to Consolidated Financial Statements 1. Summary of Significant Accounting Policies The Company IQVIA Holdings Inc. (together with its subsidiaries, the “Company” or “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. IQVIA is committed to using AI responsibly, ensuring that its AI-powered capabilities are grounded in privacy, regulatory compliance, and patient safety. With approximately 88,000 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. IQVIA is a global leader in protecting individual patient privacy. The Company uses 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. IQVIA’s 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. Principles of Consolidation The accompanying consolidated financial statements include the accounts and operations of the Company, its subsidiaries and investments in which the Company has control. Amounts pertaining to the non-controlling ownership interests held by third parties, if any, in the operating results and financial position of the Company’s majority-owned subsidiaries are reported as non-controlling interests. Intercompany accounts and transactions have been eliminated in consolidation. Use of Estimates The preparation of financial statements in accordance with generally accepted accounting principles in the United States of America (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and the disclosure of contingent assets and liabilities, at the date of the financial statements, as well as the reported amounts of revenues and expenses during the period. These estimates are based on historical experience and various other assumptions believed reasonable under the circumstances. The Company evaluates its estimates on an ongoing basis and makes changes to the estimates and related disclosures as experience develops or new information becomes known. Actual results may differ from those estimates. Foreign Currencies The Company’s consolidated financial statements are reported in United States dollars and, accordingly, the Company’s results of operations are impacted by fluctuations in exchange rates that affect the translation of its revenues and expenses denominated in foreign currencies into United States dollars for purposes of reporting its consolidated financial results. Assets and liabilities recorded in foreign currencies on the books of foreign subsidiaries are translated at the exchange rate on the balance sheet date. Revenues, costs and expenses are translated at average rates of exchange during the year. Translation adjustments resulting from this process are charged or credited to the accumulated other comprehensive (loss) income (“AOCI”) component of stockholders’ equity. The Company is subject to foreign currency transaction risk for fluctuations in exchange rates during the period of time between the consummation and cash settlement of a transaction. The Company earns revenues from its service contracts over a period of several months and, in some cases, over a period of several years. Accordingly, exchange rate fluctuations during this period may affect the Company’s profitability with respect to such contracts. For operations outside the United States that are considered to be highly inflationary or where the United States dollar is designated as the functional currency, monetary assets and liabilities are remeasured using end-of-period exchange rates, whereas nonmonetary accounts are remeasured using historical exchange rates, and all remeasurement and transaction adjustments are recognized in other (income) expense, net. 75 Cash Equivalents The Company considers all highly liquid investments with an initial maturity of three months or less when purchased to be cash equivalents. Derivatives The Company uses derivative instruments to manage exposures to interest rates and foreign currencies. Derivatives are recorded on the balance sheet at fair value at each balance sheet date utilizing pricing models for non-exchange-traded contracts. At inception, the Company designates whether or not the derivative instrument is an effective hedge of an asset, liability or firm commitment which is then classified as either a cash flow hedge or a fair value hedge. If determined to be an effective cash flow hedge, changes in the fair value of the derivative instrument are recorded as a component of AOCI until realized. The Company includes the impact from these hedges in the same line item as the hedged item on the consolidated statements of cash flows. Changes in fair value of effective fair value hedges are recorded in earnings as an offset to the changes in the fair value of the related hedged item. Hedge ineffectiveness, if any, is immediately recognized in earnings. Changes in the fair values of derivative instruments that are not an effective hedge are recognized in earnings. When it is probable that a hedged forecasted transaction will not occur, the Company discontinues hedge accounting for the affected portion of the forecasted transaction and reclassifies gains or losses that were accumulated in AOCI to earnings for foreign exchange derivatives and interest expense for interest rate derivatives on the consolidated statements of income. Cash flows are classified consistent with the underlying hedged item. The Company has entered, and may in the future enter, into derivative contracts (caps, swaps, forwards, calls or puts, warrants, for example) related to its debt and forecasted foreign currency transactions. The Company does not enter into derivative instruments for investment or speculative purposes. The Company designates its cross-currency swaps and a portion of its foreign currency denominated debt as a hedge of its net investment in certain foreign subsidiaries to reduce the volatility in stockholders’ equity caused by changes in the Euro exchange rate with respect to the United States dollar. Foreign exchange gains or losses on the remeasurement of the debt designated as part of a hedge of net investments is recognized in the cumulative translation adjustment component of AOCI with the related offset in long-term debt. Those amounts would be reclassified from AOCI to earnings upon the sale or substantial liquidation of the net investments. T he change in fair value of the cross-currency swaps are also recognized in the cumulative translation adjustment component of AOCI and would be reclassified from AOCI to earnings upon the sale or substantial liquidation of the net investments. The interest rate component of the cross-currency swaps is excluded from the assessment of hedge effectiveness and, thus, is recognized as a reduction to interest expense over the life of the cross-currency swaps. Business Combinations and Goodwill The Company uses the acquisition method to account for business combinations, and accordingly, the identifiable assets acquired, the liabilities assumed and any non-controlling interest in the acquiree are recorded at their estimated fair values on the date of the acquisition. The Company uses significant judgments, estimates and assumptions in determining the estimated fair value of assets acquired, liabilities assumed and non-controlling interests including expected future cash flows, and discount rates that reflect the risk associated with the expected future cash flows and estimated useful lives. The Company records and allocates to its reporting units the excess of the cost over the fair value of the net assets acquired, known as goodwill. On an annual basis, and if a triggering event occurs, the Company performs a qualitative analysis to determine whether it is more likely than not that the estimated fair value of a reporting unit is less than its carrying amount. This includes a qualitative analysis of macroeconomic conditions, industry and market considerations, cost factors, financial performance, fair value history and other company specific events. If this qualitative analysis indicates that it is more likely than not that the estimated fair value is less than the carrying value for the respective reporting unit, the Company would then need to calculate the fair value of the reporting unit. The Company may also choose to bypass the qualitative assessment for any or all reporting units and proceed directly to a quantitative assessment, which involves estimating the fair value of the Company's reporting units and comparing to the carrying value of the reporting units. If the reporting unit calculated fair value is less than the carrying amount, the Company would record an impairment charge for the difference, with the impairment charge not to exceed the carrying amount of goodwill. The Company reviews the carrying values of other identifiable definite-lived intangible assets if the facts and circumstances indicate a possible impairment. 76 Long-Lived Assets Property and equipment are stated at cost and are depreciated using the straight-line method over the shorter of the asset’s estimated useful life or the lease term, if related to leased property, as follows: Buildings and leasehold improvements 3 - 40 years Equipment 3 - 10 years Furniture and fixtures 5 - 10 years Transportation equipment 3 - 20 years Definite-lived other identifiable intangible assets are amortized primarily using an accelerated method that reflects the pattern in which the Company expects to benefit from the use of the asset over its estimated remaining useful life as follows: Client relationships and backlog 1 - 25 years Software and related assets 1 - 10 years Trademarks, trade names and other 1 - 17 years Databases 1 - 9 years Non-compete agreements 2 - 5 years Included in software and related assets is the capitalized cost of internal-use software used in supporting the Company’s business. Qualifying costs incurred during the application development stage are capitalized and amortized over their estimated useful lives. Costs are capitalized from completion of the preliminary project stage and when it is considered probable that the software will be used to perform its intended function, up until the time the software is placed into service. The Company recognized $ 472 million, $ 475 million and $ 419 million of amortization expense for the years ended December 31, 2024, 2023 and 2022, respectively, related to software and related assets. The carrying values of property, equipment and intangible and other long-lived assets are reviewed for recoverability at the asset grouping level to determine if the facts and circumstances suggest that a potential impairment may have occurred. If this review indicates that carrying values will not be recoverable, as determined based on undiscounted cash flow projections, the Company will record an impairment charge to reduce carrying values to estimated fair value. There were no significant impairments recognized in the years ended December 31, 2024, 2023 and 2022. Revenue Recognition The Company’s arrangements are primarily service contracts that range in duration from a few months to several years. The Company recognizes revenues when control of these services is transferred to the customer for an amount, referred to as the transaction price, that reflects the consideration to which the Company is expected to be entitled in exchange for those goods or services. The Company determines revenue recognition utilizing the following five steps: (1) identification of the contract with a customer, (2) identification of the performance obligations in the contract (promised goods or services that are distinct), (3) determination of the transaction price, (4) allocation of the transaction price to the performance obligations, and (5) recognition of revenues when, or as, the Company transfers control of the product or service for each performance obligation. Cash payments made to customers as incentives to induce customers to enter into service agreements with the Company are amortized as a reduction of revenues over the period the services are performed. The Company records revenues net of any tax assessments by governmental authorities, such as value added and sales taxes, that are imposed on and concurrent with specific revenues generating transactions. 77 The Company derives the majority of its revenues in the Technology & Analytics Solutions segment from various information and technology service offerings. Information offerings (primarily under fixed-price contracts) typically include multiple performance obligations including an ongoing subscription-based deliverable for which revenues are recognized ratably as earned over the contract period, and/or a one-time deliverable of data offerings for which revenues are recognized upon delivery. The customer is able to benefit from the provision of data as it is received. The Company’s subscription arrangements typically have terms ranging from one to three years and are generally non-cancelable and do not contain refund-type provisions. Technology services offerings may contain multiple performance obligations consisting of a mix of small and large-scale services and consulting projects, multi-year outsourcing contracts and Software-as-a-Service (“SaaS”) arrangements. These arrangements typically have terms ranging from several weeks to three years, with a majority having terms of one year or less. For arrangements that include multiple performance obligations, the transaction price is allocated to the identified performance obligations based on their relative standalone selling prices. For these contracts, the standalone selling prices are based on the Company’s normal pricing practices when sold separately with consideration of market conditions and other factors, including customer demographics and geographic location. Revenues for services engagements where the transfer of control occurs ratably over time are recognized on a straight-line basis over the term of the arrangement. Revenues from time and material contracts are recognized based on hours as the services are provided. Revenues from fixed price ad hoc services and consulting contracts are recognized over the contract term based on the ratio of the number of hours incurred for services provided during the period compared to the total estimated hours to be incurred over the entire arrangement (hours-based). Technology services offerings meet the over time criterion, as another party would not need to substantially re-perform the work already completed to satisfy the remaining obligations if the services were migrated. The majority of the Company’s contracts within the Research & Development Solutions segment are service contracts for clinical research that represent a single performance obligation. The Company provides a significant integration service resulting in a combined output, which is clinical trial data that meets the relevant regulatory standards and can be used by the customer to progress to the next phase of a clinical trial or solicit approval of a treatment by the applicable regulatory body. The performance obligation is satisfied over time as the output is captured in data and documentation that is available for the customer to consume over the course of the arrangement and furthers progress of the clinical trial. The Company recognizes revenues over time using a cost-based input method since there is no single output measure that would fairly depict the transfer of control over the life of the performance obligation. Progress on the performance obligation is measured by the proportion of actual costs incurred to the total costs expected to complete the contract. Costs included in the measure of progress include direct labor and third-party costs (such as payments to investigators and other reimbursed expenses for the Company’s clinical monitors). This cost-based method of revenue recognition requires the Company to make estimates of costs to complete its projects on an ongoing basis. Significant judgment is required to evaluate assumptions related to these estimates. The effect of revisions to estimates related to the transaction price or costs to complete a project are recorded in the period in which the estimate is revised. Most contracts may be terminated upon 30 to 90 days' notice by the customer; however, in the event of termination, most contracts require payment for services rendered through the date of termination, as well as for subsequent services rendered to close out the contract. The majority of revenues in the Company's Contract Sales & Medical Solutions segment is from contract sales force to the biopharmaceutical industry and broader healthcare market and recognized over time using a single measure of progress dependent on the performance obligation. Some of the Company's Contract Sales & Medical Solutions contracts contain multiple performance obligations with distinct promises including recruiting, sales force automation and deployment of sales representatives. The Company utilizes a single measure of progress for each performance obligation to recognize revenues, which includes deployment of sales representatives based on employee days worked; recruiting based on candidates recruited; sales force automation set-up based on hours worked; and sales force automation hosting and maintenance based on usage. These services meet the over time criterion as the customer consumes the benefit as activities are performed and another party would not need to substantially re-perform the work already completed to satisfy the remaining obligations if the services were migrated to another party. Variable Consideration In some cases, contracts provide for variable consideration that is contingent upon the occurrence of uncertain future events, such as performance incentives (including royalty payments, bonuses, or penalty clauses that can either increase or decrease the transaction price). Variable consideration is estimated at the expected value or at the most likely amount depending on the type of consideration. Estimated amounts are included in the transaction price to the extent it is probable that a significant reversal of cumulative revenues recognized will not occur when the uncertainty associated with the variable consideration is resolved. The estimate of variable consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of the Company's anticipated performance and all information (historical, current and forecasted) that is reasonably available to the Company and reevaluated each reporting period. 78 Reimbursed Expenses The Company includes reimbursed expenses in revenues and cost of revenues as the Company is primarily responsible for fulfilling the promise to provide the specified service, including the integration of the related services into a combined output to the customer, which are inseparable from the integrated service. These costs include such items as payments to investigators and travel expenses for the Company’s clinical monitors and sales representatives, over which the Company has discretion in establishing prices. The Company controls the good or service and has inventory risk on contractually reimbursable expenses, as sometimes the Company is unable to obtain reimbursement from the customer for costs incurred. Change Orders Changes in the scope of work are common, especially under long-term contracts, and generally result in a change in transaction price. Change orders are evaluated on a contract-by-contract basis to determine if they should be accounted for as a new contract or as part of the existing contract. Generally, services from change orders are not distinct from the original performance obligation. As a result, the effect that the contract modification has on the contract revenues, and measure of progress, is recognized as an adjustment to revenues when it occurs. Cost of Revenues Cost of revenues include (i) compensation and benefits for billable employees and personnel involved in production, data management and delivery, and the costs of acquiring and processing data for the Company’s information offerings; (ii) costs of staff directly involved with delivering technology-related services offerings and engagements, and the costs of data purchased specifically for technology services engagements; (iii) reimbursed expenses that are comprised principally of payments to investigators who oversee clinical trials and travel expenses for the Company’s clinical monitors and sales representatives; and (iv) other expenses directly related to service contracts such as courier fees, laboratory supplies, professional services and travel expenses. Trade Receivables, Unbilled Services and Unearned Income In general, billings and payments are established by contractual provisions including predetermined payment schedules, which may or may not correspond to the timing of the transfer of control of the Company’s services under the contract. In general, the Company’s intention in its invoicing (payment terms) is to maintain cash neutrality over the life of the contract. Generally, the payment terms are 30 to 90 days based on contracts. Upfront payments, when they occur, are intended to cover certain expenses the Company incurs at the beginning of the contract. Neither the Company nor its customers view such upfront payments and contracted payment schedules as a means of financing. Unbilled services primarily arise from long-term contracts when a cost-based or hours-based input method of revenue recognition is utilized and revenues recognized exceeds the amount billed to the customer. Unearned income consists of advance payments and billings in excess of revenues recognized. As the contracted services are subsequently performed and the associated revenues are recognized, the unearned income balance is reduced by the amount of the revenue recognized during the period. Unearned income is classified as a current liability on our consolidated balance sheets as the Company expects to recognize the associated revenues in less than one year. Restructuring Costs Restructuring costs, which primarily include termination benefits, are recorded at estimated value. Key assumptions in determining the restructuring costs include the terms and payments that may be negotiated to terminate certain contractual obligations and the timing of employees leaving the Company. Debt Fees Fees incurred to issue debt are generally deferred and amortized as a component of interest expense over the estimated term of the related debt using the effective interest rate method. 79 Contingencies The Company records accruals for claims, suits, investigations and proceedings when it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. The Company reviews claims, suits, investigations and proceedings at least quarterly and records or adjusts accruals related to such matters to reflect the impact and status of any settlements, rulings, advice of counsel or other information pertinent to a particular matter. Legal costs associated with contingencies are charged to expense as incurred. The Company is party to legal proceedings incidental to its business. While the outcome of these matters could differ from management’s expectations, the Company does not believe the resolution of these matters will have a material adverse effect to the Company’s financial statements. See Note 12 for additional information. Income Taxes The provision for income taxes includes federal, state, local and foreign taxes. Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the estimated future tax consequences of temporary differences between the financial statement carrying amounts and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the year in which the temporary differences are expected to be recovered or settled. The Company records U.S. deferred taxes based on the Federal corporate income tax rate of 21%. The Company accounts for tax related to Global Intangible Low-Taxed Income (“GILTI”) and Qualified Domestic Minimum Top-up Taxes ("QDMTT") in relation to the Organization for Economic Co-operation and Development's ("OECD") Pillar Two global corporate minimum tax rate of 15%, as period costs when and if incurred. Recognition of deferred income tax assets is based on management’s belief that it is more likely than not that the income tax benefit associated with certain temporary differences, income tax operating loss, capital loss carryforwards, and income tax credits, will be realized. The Company records a valuation allowance to reduce its deferred income tax assets for those deferred income tax items for which it was more likely than not that realization would not occur. The Company determines the amount of the valuation allowance based, in part, on the Company’s assessment of future taxable income and in light of the Company’s ongoing income tax strategies. If the estimate of future taxable income or tax strategies changes at any time in the future, the Company would record an adjustment to its valuation allowance. Recording such an adjustment could have a material effect on the Company’s financial condition or results of operations. Income tax expense is based on the distribution of profit before income tax among the various taxing jurisdictions in which the Company operates, adjusted as required by the income tax laws of each taxing jurisdiction. Changes in the distribution of profits and losses among taxing jurisdictions may have a significant impact on the Company's effective income tax rate. The Company does not consider the undistributed earnings of our foreign subsidiaries to be indefinitely reinvested outside of the United States. Pensions and Other Postretirement Benefits The Company provides retirement benefits to certain employees, including defined benefit pension plans. The determination of benefit obligations and expense is based on actuarial models. In order to measure benefit costs and obligations using these models, assumptions are made with regard to the discount rate, expected return on plan assets, cash balance crediting rate, lump sum conversion rate and the assumed rate of compensation increases. Stock-based Compensation The Company accounts for stock-based compensation for stock options and stock appreciation rights under the fair value method and uses the Black-Scholes-Merton model to estimate the value of such stock-based awards granted to its employees and non-executive directors. Expected volatility is based on an analysis that incorporates the historical volatility of the Company's stock since the Merger in October 2016 and reported data for selected reasonably similar publicly traded companies for which the historical information is available. The Company does not currently anticipate paying dividends. The expected term represents the period of time the grants are expected to be outstanding. The risk-free interest rate is based on the United States Treasury yield curve in effect at the time of the grant. 80 The Company values its stock-based compensation for restricted stock awards and restricted stock units based on the closing market price of the Company’s common stock on the date of grant. The Company accounts for its stock-based compensation for performance awards related to compound annual earnings per share (“EPS”) growth based on the closing market price of the Company’s common stock on the date of grant, and for performance awards related to relative total shareholder return (“TSR”) based on a Monte Carlo simulation model. Leases The Company determines if an arrangement is a lease at inception and reassesses if there are changes in terms and conditions of the contract. Operating leases are included in operating lease right-of-use (“ROU”) assets, other current liabilities, and operating lease liabilities on the Company's consolidated balance sheets. Finance leases are included in deposits and other assets, net, other current liabilities, and other liabilities on the Company's consolidated balance sheets. Lease assets and liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of future payments. Lease assets also include any lease payments made before lease commencement and initial direct costs and excludes lease incentives. In determining the lease term at lease commencement, the Company includes the noncancellable term and the periods, which the Company deems it is reasonably certain to exercise or not to exercise a renewal or cancellation option. Operating lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. Finance lease expense is recognized as a combination of depreciation expense for the leased asset and interest expense for the outstanding lease liabilities using the discount rate discussed above. The Company has lease agreements with lease and non-lease components that the Company has elected to account for as single lease components. Earnings Per Share The calculation of earnings per share is based on the weighted average number of common shares or common stock equivalents outstanding during the applicable period. The dilutive effect of common stock equivalents is excluded from basic earnings per share and is included in the calculation of diluted earnings per share. Potentially dilutive securities include outstanding stock options and unvested restricted stock units, restricted stock, performance awards and other stock-based awards. Diluted shares outstanding are calculated based on the average share price for each fiscal period using the treasury stock method. Under the treasury stock method, the amount the employee must pay for exercising stock options, and the amount of compensation cost for future service that the Company has not yet recognized are assumed to be used to repurchase shares. Investments in Unconsolidated Affiliates The Company’s investments in unconsolidated affiliates are accounted for under the equity method if the Company exercises significant influence or has an investment in a limited partnership that is considered to be greater than minor. These investments are classified as investments in unconsolidated affiliates on the accompanying consolidated balance sheets. The Company records its pro rata share of the earnings, adjusted for accretion of basis difference, of these investments in equity in earnings (losses) of unconsolidated affiliates on the accompanying consolidated statements of income. The Company reviews its investments in unconsolidated affiliates for impairment whenever events or changes in circumstances indicate that the carrying amounts may not be recoverable. Treasury Stock The Company records treasury stock purchases under the cost method. Upon reissuance of treasury stock, amounts in excess of the acquisition cost are credited to additional paid-in capital. If the Company reissues treasury stock at an amount below its acquisition cost and additional paid-in capital associated with prior treasury stock transactions is insufficient to cover the difference between the acquisition cost and the reissue price, this shortfall is recorded in retained earnings. 81 Recently Issued Accounting Standards Accounting pronouncements recently adopted In November 2023, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures , to improve reportable segment disclosure requirements. The new guidance requires disclosure of significant segment expenses that are regularly provided to the chief operating decision maker and included in the reported measure of segment profit or loss. It does not change the definition of a segment or the guidance for determining reportable segments. The Company adopted this new accounting guidance effective for the annual period beginning January 1, 2024, and will adopt it in 2025 for interim periods. The adoption of this new accounting guidance for the annual period beginning January 1, 2024 did not have a material effect on the Company's disclosures within the consolidated financial statements. Accounting pronouncements issued but not adopted as of December 31, 2024 In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , to enhance the transparency and decision usefulness of income tax disclosures. The amendments in this ASU require additional disclosures about income taxes, primarily focused on the disclosure of income taxes paid and the rate reconciliation table. The new guidance will be effective for the Company in the annual period beginning January 1, 2025. The Company is assessing the impacts of this ASU on its disclosures within the consolidated financial statements. In November 2024, the FASB issued ASU 2024-03, Disaggregation of Income Statement Expenses (DISE) , to improve the disclosures about an entity's expenses and address requests from investors for more detailed information about the types of expenses in commonly presented expense captions. The new guidance requires additional information about specific expense categories in the notes to financial statements at interim and annual reporting periods, and will be effective for the Company in the annual period beginning January 1, 2027, and interim periods beginning January 1, 2028. The Company is assessing the impacts of this ASU on its disclosures within the consolidated financial statements. 2. Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations The Company attributes revenues to geographical region based upon where the services are performed. The following tables represent revenues by geographical region and reportable segment for the years ended December 31, 2024, 2023 and 2022: December 31, 2024 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 3,182 $ 3,894 $ 280 $ 7,356 Europe and Africa 2,397 2,304 219 4,920 Asia-Pacific 581 2,329 219 3,129 Total revenues $ 6,160 $ 8,527 $ 718 $ 15,405 December 31, 2023 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 3,091 $ 4,157 $ 304 $ 7,552 Europe and Africa 2,156 2,103 200 4,459 Asia-Pacific 615 2,135 223 2,973 Total revenues $ 5,862 $ 8,395 $ 727 $ 14,984 82 December 31, 2022 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 2,947 $ 3,747 $ 354 $ 7,048 Europe and Africa 2,175 2,016 175 4,366 Asia-Pacific 624 2,158 214 2,996 Total revenues $ 5,746 $ 7,921 $ 743 $ 14,410 When attributing revenues to individual countries based upon where the services are performed, no individual country, except for the United States, accounted for 10% or more of total revenues for the years ended December 31, 2024, 2023 and 2022. For the years ended December 31, 2024, 2023 and 2022, revenues in the United States accounted for approximately 42 %, 45 %, and 42 % of total revenues, respectively, using this revenue attribution approach. No individual customer represented 10% or more of total revenues for the years ended December 31, 2024, 2023 and 2022. Transaction Price Allocated to the Remaining Performance Obligations As of December 31, 2024, approximately $ 33.5 billion of revenues are expected to be recognized in the future from remaining performance obligations. The Company expects to recognize revenues on approximately 30 % of these remaining performance obligations over the next twelve months , on approximately 85% over the next five years, with the balance recognized thereafter. Most of the Company's remaining performance obligations where revenues are expected to be recognized beyond the next twelve months are for service contracts for clinical research in the Company's Research & Development Solutions segment. The customer contract transaction price allocated to the remaining performance obligations differs from backlog in that it does not include wholly unperformed contracts under which the customer has a unilateral right to cancel the arrangement. 3. Trade Accounts Receivable, Unbilled Services and Unearned Income Trade accounts receivables and unbilled services consist of the following: December 31, (in millions) 2024 2023 Trade accounts receivable $ 1,390 $ 1,473 Unbilled services 1,856 1,942 Trade accounts receivable and unbilled services 3,246 3,415 Allowance for doubtful accounts ( 42 ) ( 34 ) Trade accounts receivable and unbilled services, net $ 3,204 $ 3,381 Unbilled services and unearned income were as follows: December 31, (in millions) 2024 2023 Change Unbilled services $ 1,856 $ 1,942 $ ( 86 ) Unearned income ( 1,779 ) ( 1,799 ) 20 Net balance $ 77 $ 143 $ ( 66 ) 83 Unbilled services, which is comprised of approximately 69 % and 68 % of unbilled receivables and 31 % and 32 % of contract assets as of December 31, 2024 and December 31, 2023, respectively, decreased by $ 86 million as compared to December 31, 2023. Contract assets are unbilled services for which invoicing is based on the timing of certain milestones related to service contracts for clinical research whereas unbilled receivables are billable upon the passage of time. Unearned income decreased by $ 20 million over the same period resulting in a decrease of $ 66 million in the net balance of unbilled services and unearned income between December 31, 2024 and 2023. The change in the net balance is driven by the difference in timing of revenue recognition in accordance with ASC 606, Revenue from Contracts with Customers, primarily related to the Company’s Research & Development Solutions contracts (which is based on the percentage of costs incurred) versus the timing of invoicing, which is primarily based on certain milestones. The majority of the unearned income balance as of the beginning of the year was recognized in revenues during the year ended December 31, 2024. Bad debt expense recognized on the Company’s receivables and unbilled services was immaterial for the years ended December 31, 2024, 2023 and 2022. Accounts Receivable Factoring Arrangements The Company has accounts receivable factoring agreements to sell certain eligible unsecured trade accounts receivable, either based on automatic arrangements or at its option, without recourse, to unrelated third-party financial institutions for cash. For the year ended December 31, 2024, through its accounts receivable factoring arrangements that the Company utilizes most frequently, the Company factored approximately $ 678 million of customer invoices on a non-recourse basis and received approximately $ 666 million in cash proceeds from the sales. For the year ended December 31, 2023, through these same accounts receivable factoring arrangements, the Company factored approximately $ 699 million of customer invoices on a non-recourse basis and received approximately $ 686 million in cash proceeds from the sales. The fees associated with these transactions were immaterial. The Company has other accounts receivable arrangements for which the activity associated with them is immaterial. 4. Investments Debt, Equity and Other Securities Current The Company’s short-term investments in debt, equity and other securities consist primarily of trading investments in mutual funds and are measured at fair value with realized and unrealized gains and losses recorded in other (income) expense, net on the accompanying consolidated statements of income. Long-term The Company’s long-term debt and equity investments (except those accounted for under the equity method, those that result in consolidation of the investee and certain other investments) are measured at fair value and any changes in fair value are recognized in net income at the end of each reporting period. For debt and equity investments that do not have readily determinable fair values and do not qualify for the existing practical expedient in ASC 820, Fair Value Measurement, to estimate fair value using the net asset value per share of the investment, the Company applies the measurement alternative and measures those investments at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer at each reporting period. 84 Unconsolidated Affiliates The Company accounts for its investments in unconsolidated affiliates under the equity method of accounting and records its pro rata share of its losses or earnings from these investments in equity in earnings (losses) of unconsolidated affiliates. The following is a summary of the Company’s investments in unconsolidated affiliates: December 31, (in millions) 2024 2023 NovaQuest Pharma Opportunities Fund V, L.P. (“NQ Fund V”) $ 36 $ 35 NostraData Pty Ltd. (“NostraData”) 17 18 NovaQuest Private Equity Fund I, L.P. (“NQ PE Fund I”) 11 10 NovaQuest Pharma Opportunities Fund IV, L.P. (“NQ Fund IV”) 4 6 Longwood Fund V, L.P. ("Longwood") 6 7 RxWare (formerly "Helparound") 2 2 NovaQuest Pharma Opportunities Fund III, L.P. (“NQ Fund III”) — 1 Other 190 55 $ 266 $ 134 Variable Interest Entities As of December 31, 2024, the Company’s investments in unconsolidated variable interest entities (“VIEs”) and its estimated maximum exposure to loss were as follows: (in millions) Investments in Unconsolidated VIEs Maximum Exposure to Loss NQ Fund V $ 36 $ 43 NQ PE Fund I 11 12 Longwood 6 8 NQ Fund IV 4 5 NQ Fund III — 5 Other 179 506 $ 236 $ 579 The difference between the carrying amount of the investments in unconsolidated VIEs and the maximum exposure to loss is primarily attributable to capital commitments that the Company anticipates will be called in the future. The Company is not the primary beneficiary of its VIEs and therefore does not consolidate the VIEs. The Company does not have the power to direct the activities that most significantly affect the VIEs’ economic performance. Additionally, the Company considers whether there are any rights to receive benefits or obligations to absorb losses of the VIE that could potentially be significant to the VIE. 5. Derivatives Interest Rate Risk Management The Company has entered into interest rate swaps for purposes of managing its exposure to interest rate fluctuations. The Company does not enter into interest rate swaps for investment or speculative purposes. On July 19, 2018, the Company entered into forward starting interest rate swaps with a total notional value of $ 500 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swaps began accruing on June 28, 2019 and the swaps expired on June 28, 2024. The Company paid an average fixed rate of 2.75 % and received a variable rate of interest equal to the three-month Term SOFR on these swaps. 85 On June 4, 2020, the Company entered into an interest rate swap with a notional value of $ 300 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swap began accruing on June 30, 2020 and the swa p expired o n June 28, 2024. The Company paid a fixed rate of 0.32 % and received a variable rate of interest equal to the three-month Term SOFR on the swap. On January 3, 2023, the Company entered into interest rate swaps with a combined notional value of $ 1,000 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swaps began accruing on December 30, 2022 and the swaps expire on December 31, 2025. The Company pays a fixed rate of 4.10 % and receives a variable rate of interest equal to one-month Term SOFR on the swaps. On November 17, 2023, the Company entered into interest rate swaps with a combined notional value of $ 1,500 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swaps began accruing on November 28, 2023 and the swaps expire on January 2, 2031. The Company pays a fixed rate of 6.11 % and receives a variable rate of interest equal to three-month Term SOFR plus 2.00 % on the swaps. The critical terms of the interest rate swaps noted above are substantially the same as the underlying borrowings. These interest rate swaps are accounted for as cash flow hedges as these transactions were executed to hedge the Company's interest payments and for accounting purposes are considered highly effective. As such, changes in the fair value of the interest rate swaps are recorded as unrealized gains (losses) on derivatives included in AOCI. The fair value of these interest rate swaps represents the present value of the anticipated net payments the Company will make to the counterparty, which, when they occur, are reflected as interest expense on the consolidated statements of income. These interest rate swaps result in a total debt mix of approximately 75 % fixed rate debt and 25 % variable rate debt. Foreign Exchange Risk Management The Company transacts business in more than 100 countries and is subject to risks associated with fluctuating foreign exchange rates. Accordingly, the Company enters into foreign currency forward contracts to hedge certain forecasted foreign exchange cash flows arising from service contracts (“Service Contract Hedging”). It is the Company’s policy to enter into foreign currency forward contracts only to the extent necessary to reduce earnings and cash flow volatility associated with foreign exchange rate movements. The Company does not enter into foreign currency forward contracts for investment or speculative purposes. The principal currency hedged in 2024 was the British Pound. Service Contract Hedging contracts are designated as cash flow hedges and are carried at fair value, with changes in the fair value recorded to AOCI. The change in fair value is reclassified from AOCI to earnings in the period in which the hedged transaction occurs. These contracts have various expiration dates through September 2025. As of December 31, 2024 and 2023, the Company had open Service Contract Hedging contracts to hedge certain forecasted foreign currency cash flow transactions occurring in 2025 and 2024 with notional amounts totaling $ 108 million and $ 121 million, respectively. For accounting purposes these hedges are considered highly effective. As of December 31, 2024 and 2023, the Company had recorded gross unrealized gains (losses) of $ — million and $( 2 ) million, and $ 2 million and $ — million, respectively, related to these contracts. Upon expiration of the hedge instruments in 2024, the Company reclassified the unrealized holding gains and losses on the derivative instruments included in AOCI into earnings. The unrealized gains (losses) are included in other current assets and other current liabilities on the accompanying consolidated balance sheets as of December 31, 2024 and 2023. 86 Net Investment Risk Management, Euro Denominated Notes As of December 31, 2024, the portion of the Company's foreign currency denominated debt balance that was designated as a hedge of its net investment in certain foreign subsidiaries totaled approximately € 2,732 million ($ 2,837 million). The amount of foreign exchange gains (losses) related to this net investment hedge included in the cumulative translation adjustment component of AOCI was $ 186 million, $( 102 ) million, and $ 332 million for the years ended December 31, 2024, 2023 and 2022, respectively. Net Investment Risk Management, Cross-Currency Swaps On November 15, 2023, in connection with the issuance of the 2029 Senior Secured Notes ( see Note 10 for additional information) , the Company entered into cross-currency swaps with a combined notional value of $ 1,250 million to effectively convert $ 1,250 million of the 2029 Senior Secured Notes into euro-denominated borrowings at prevailing euro interest rates through February 2029. The Company designated these agreements as a hedge of its net investment in certain foreign subsidiaries. These cross-currency swaps expire in February 2029. The Company will receive semiannual interest payments on February 1 and August 1 from the counterparties based on a fixed interest rate until maturity of these agreements. The effective net borrowing rate to the Company is approximately 4.8555 %, inclusive of the yield on the notes and the impact of the cross-currency swaps. On November 17, 2023, in connection with the allocation of the Term B-4 Dollar Loans ( see Note 10 for additional information) , the Company entered into cross-currency swaps with a combined notional value of $ 1,500 million to effectively convert $ 1,500 million of the Term B-4 Dollar Loans into euro-denominated borrowings at prevailing euro interest rates through January 2031. These cross-currency swaps expire in January 2031. The Company will receive quarterly interest payments from the counterparties based on a fixed interest rate until maturity of these agreements. The effective net borrowing rate to the Company is approximately 4.9015 %, inclusive of the yield on the loans, the impact of the cross-currency swaps and of the interest rate swaps entered o n November 17, 2023 as noted above. The Company does not enter into cross-currency swaps for investment or speculative purposes. For the years ended December 31, 2024 and 2023, the Company recorded gains (losses) of $ 147 million and $( 108 ) million, respectively, within AOCI as a result of these cross-currency swaps. The Company recognized $ 36 million and $ 3 million related to the excluded component as a reduction of interest expense for the years ended December 31, 2024 and 2023 , respectively. The fair values of the Company’s derivative instruments, on a gross basis, and the line items on the accompanying consolidated balance sheets to which they were recorded are summarized in the following table: December 31, 2024 December 31, 2023 (in millions) Balance Sheet Classification Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Interest rate swaps Other current assets, other assets and other current liabilities $ — $ 5 $ 2,485 $ 13 $ 51 $ 3,300 Cross-currency swaps Other assets and other current liabilities 39 — 2,735 — 108 2,750 Foreign exchange forward contracts Other current assets and other current liabilities — 2 108 2 — 121 Total derivatives $ 39 $ 7 $ 15 $ 159 The pre-tax effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table: Year Ended December 31, (in millions) 2024 2023 2022 Interest rate swaps $ 33 $ ( 80 ) $ 62 Foreign exchange forward contracts ( 4 ) 2 3 Total $ 29 $ ( 78 ) $ 65 87 The Company expects $ 3 million of pre-tax unrealized gains related to its foreign exchange contracts and interest rate derivatives included in AOCI as of December 31, 2024 to be reclassified into earnings within the next twelve months. The total amount, net of income taxes, of the cash flow hedge effect on the accompanying consolidated statements of income was $ 31 million, $ 51 million, and $( 10 ) million for the years ended December 31, 2024, 2023 and 2022, respectively. 6. Fair Value Measurements The Company records certain assets and liabilities at fair value. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. A three-level fair value hierarchy that prioritizes the inputs used to measure fair value is described below. This hierarchy requires entities to maximize the use of observable inputs and minimize the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: • Level 1—Quoted prices in active markets for identical assets or liabilities. • Level 2—Observable inputs other than quoted prices included in Level 1, such as quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar assets and liabilities in markets that are not active; or other inputs that are observable or can be corroborated by observable market data. • Level 3—Unobservable inputs that are supported by little or no market activity. This includes certain pricing models, discounted cash flow methodologies and similar techniques that use significant unobservable inputs. The carrying values of cash, cash equivalents, accounts receivable and accounts payable approximated their fair values as of December 31, 2024 and 2023 due to their short-term nature. As of December 31, 2024 and 2023, the fair value of total debt was $ 13,966 million and $ 13,597 million, respectively, as determined under Level 2 measurements for these financial instruments. Recurring Fair Value Measurements The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured and reported at fair value on a recurring basis as of December 31, 2024: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 170 $ — $ — $ 170 Derivatives — 39 — 39 Total $ 170 $ 39 $ — $ 209 Liabilities: Derivatives $ — $ 7 $ — $ 7 Contingent consideration — — 102 102 Total $ — $ 7 $ 102 $ 109 88 The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured and reported at fair value on a recurring basis as of December 31, 2023: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 146 $ — $ — $ 146 Derivatives — 15 — 15 Total $ 146 $ 15 $ — $ 161 Liabilities: Derivatives $ — $ 159 $ — $ 159 Contingent consideration — — 106 106 Total $ — $ 159 $ 106 $ 265 Below is a summary of the valuation techniques used in determining fair value: Marketable securities —The Company values trading and available-for-sale securities using the quoted market value of the securities held. Derivatives —Derivatives consist of foreign exchange contracts, interest rate swaps, and cross-currency swaps. The fair value of foreign exchange contracts is based on observable market inputs of spot and forward rates or using other observable inputs. The fair value of the interest rate swaps is the estimated amount that the Company would receive or pay to terminate such agreements, taking into account market interest rates and the remaining time to maturities or using market inputs with mid-market pricing as a practical expedient for bid-ask spread. The fair value of the cross-currency swaps is the estimated amount that the Company would receive or pay to terminate such agreements, taking into account the effective interest rates, foreign exchange rates and the remaining time to maturities. Contingent consideration —The Company values contingent consideration related to business combinations using a weighted probability calculation of potential payment scenarios discounted at rates reflective of the risks associated with the expected future cash flows. Assumptions used to estimate the fair value of contingent consideration include various financial metrics (revenues performance targets and operating forecasts) and the probability of achieving the specific targets. Based on the assessments of the probability of achieving specific targets, as of December 31, 2024 the Company has accrued approximately 61 % of the maximum contingent consideration payments that could potentially become payable. The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the year ended December 31: Contingent Consideration (in millions) 2024 2023 2022 Balance as of January 1 $ 106 $ 173 $ 76 Business combinations 77 64 134 Contingent consideration paid ( 10 ) ( 73 ) ( 22 ) Revaluations included in earnings and foreign currency translation adjustments ( 71 ) ( 58 ) ( 15 ) Balance as of December 31 $ 102 $ 106 $ 173 The current portion of contingent consideration is included within accrued expenses and the long-term portion is included within other liabilities on the accompanying consolidated balance sheets. Revaluations of contingent consideration are recognized in other (income) expense, net on the accompanying consolidated statements of income. A change in significant unobservable inputs could result in a higher or lower fair value measurement of contingent consideration. 89 Non-recurring Fair Value Measurements Certain assets are carried on the accompanying consolidated balance sheets at cost and are not remeasured to fair value on a recurring basis. As of December 31, 2024, assets carried on the balance sheet and not remeasured to fair value on a recurring basis totaled $ 19,554 million and were identified as Level 3. These assets are comprised of debt investments and cost and equity method investments of $ 345 million, goodwill of $ 14,710 million and other identifiable intangibles, net of $ 4,499 million. Cost and Equity Method Investments and Debt Investments —The inputs available for valuing investments in non-public portfolio companies are generally not easily observable. The valuation of non-public investments requires judgment by the Company due to the absence of quoted market values, inherent lack of liquidity and the long-term nature of such assets. When a triggering event occurs, the Company considers a wide range of available market data when assessing the estimated fair value. Such market data includes observations of the trading multiples of public companies considered comparable to the private companies being valued as well as publicly disclosed merger transactions involving comparable private companies. In addition, valuations are adjusted to account for company-specific issues, the lack of liquidity inherent in a non-public investment, and the fact that comparable public companies are not identical to the companies being valued. Such valuation adjustments are necessary because in the absence of a committed buyer and completion of due diligence similar to that performed in an actual negotiated sale process, there may be company-specific issues that are not fully known that may affect value. Further, a variety of additional factors are reviewed by the Company, including, but not limited to, financing and sales transactions with third parties, current operating performance and future expectations of the particular investment, changes in market outlook, and the third-party financing environment. Because of the inherent uncertainty of valuations, estimated valuations may differ significantly from the values that would have been used had a ready market for the securities existed, and the differences could be material. Goodwill —Goodwill represents the difference between the purchase price and the fair value of the identifiable tangible and intangible net assets resulting from business combinations. The recoverability of goodwill is evaluated annually for impairment, or if and when events or circumstances indicate a possible impairment. For the year ended December 31, 2024, the Company elected to perform a qualitative impairment assessment. This includes a qualitative analysis of macroeconomic conditions, industry and market considerations, cost factors, financial performance, fair value history and other company specific events. If this qualitative analysis indicates that it is more likely than not that the estimated fair value is less than the carrying value for the respective reporting unit, the Company would then need to calculate the fair value of the reporting unit. If the reporting unit calculated fair value is less than the carrying amount, the Company would record an impairment charge for the difference, with the impairment charge not to exceed the carrying amount of Goodwill. See Note 8 for additional information. Other Identifiable Intangibles, Net —If a triggering event occurs, the Company determines the estimated fair value of definite-lived intangible assets by determining the present value of the expected cash flows. See Note 8 for additional information. 7. Property and Equipment The major classes of property and equipment were as follows: December 31, (in millions) 2024 2023 Land, buildings and leasehold improvements $ 367 $ 376 Equipment 840 803 Transportation equipment 85 81 Furniture and fixtures 62 66 Property and equipment, gross 1,354 1,326 Less accumulated depreciation ( 819 ) ( 803 ) Property and equipment, net $ 535 $ 523 Property and equipment depreciation expense was as follows: Year Ended December 31, (in millions) 2024 2023 2022 Depreciation expense $ 149 $ 151 $ 160 90 8. Goodwill and Other Identifiable Intangible Assets As of December 31, 2024, the Company has $ 4,499 million of other identifiable intangible assets. Amortization expense associated with other identifiable definite-lived intangible assets was as follows: Year Ended December 31, (in millions) 2024 2023 2022 Amortization expense $ 965 $ 974 $ 970 Estimated amortization expense for existing other identifiable intangible assets is expected to be approximately $ 881 million, $ 738 million, $ 606 million, $ 485 million and $ 371 million for the years ending December 31, 2025, 2026, 2027, 2028 and 2029, respectively. Estimated amortization expense can be affected by various factors such as future acquisitions, divestitures, abandonments or impairments. The following is a summary of other identifiable intangible assets: December 31, 2024 December 31, 2023 (in millions) Gross Amount Accumulated Amortization Net Amount Gross Amount Accumulated Amortization Net Amount Definite-lived identifiable intangible assets: Client relationships and backlog $ 5,690 $ ( 2,966 ) $ 2,724 $ 5,688 $ ( 2,724 ) $ 2,964 Software and related assets 3,914 ( 2,358 ) 1,556 3,629 ( 2,005 ) 1,624 Trademarks, trade names and other 539 ( 350 ) 189 548 ( 320 ) 228 Databases 1,773 ( 1,751 ) 22 1,837 ( 1,819 ) 18 Non-compete agreements 14 ( 6 ) 8 16 ( 11 ) 5 $ 11,930 $ ( 7,431 ) $ 4,499 $ 11,718 $ ( 6,879 ) $ 4,839 The following is a summary of goodwill by reportable segment for the years ended December 31, 2024 and 2023: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2022 $ 11,520 $ 2,247 $ 154 $ 13,921 Business combinations 352 181 — 533 Impact of foreign currency fluctuations and other 104 11 ( 2 ) 113 Balance as of December 31, 2023 11,976 2,439 152 14,567 Business combinations 346 186 — 532 Impact of foreign currency fluctuations and other ( 365 ) ( 17 ) ( 7 ) ( 389 ) Balance as of December 31, 2024 $ 11,957 $ 2,608 $ 145 $ 14,710 There were no goodwill impairment losses for the years ended December 31, 2024, 2023 and 2022. 91 9. Accrued Expenses Accrued expenses consist of the following: December 31, (in millions) 2024 2023 Client contract related $ 1,458 $ 1,315 Compensation, including bonuses, fringe benefits and payroll taxes 905 968 Professional fees 75 112 Contingent consideration and deferred purchase price 49 27 Interest 81 66 Restructuring 21 36 Other 359 331 $ 2,948 $ 2,855 10. Credit Arrangements The following is a summary of the Company’s revolving credit facilities as of December 31, 2024: Facility Interest Rates $ 2,000 million (revolving credit facility) U.S. Dollar Term SOFR plus a margin of 1.25 % plus a 10 basis credit spread adjustment as of December 31, 2024 $ 110 million (receivables financing facility) U.S. Dollar Term SOFR plus a margin of 1.00 % plus a 10 basis credit spread adjustment as of December 31, 2024 92 The following table summarizes the Company’s debt at the dates indicated: December 31, (dollars in millions) 2024 2023 Revolving Credit Facility due 2026: U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 5.71 % $ 825 $ 100 Senior Secured Credit Facilities: Term A Loan due 2026—U.S. Dollar Term SOFR at floating rates of 5.71 % 1,197 1,270 Term A Loan due 2026—Euribor at floating rates of 3.93 % 272 306 Term A Loan due 2027—U.S. Dollar Term SOFR at floating rates of 5.86 % 1,094 1,156 Term B Loan due 2025—Euribor at floating rates of 4.68 % 542 576 Term B Loan due 2031—U.S Dollar Term SOFR at floating rates of 6.33 % 1,485 1,500 5.700 % Senior Secured Notes due 2028—U.S. Dollar denominated 750 750 6.250 % Senior Secured Notes due 2029—U.S. Dollar denominated 1,250 1,250 5.0 % Senior Notes due 2027—U.S. Dollar denominated 1,100 1,100 5.0 % Senior Notes due 2026—U.S. Dollar denominated 1,050 1,050 6.500 % Senior Notes due 2030—U.S. Dollar denominated 500 500 2.875 % Senior Notes due 2025—Euro denominated 436 464 2.25 % Senior Notes due 2028—Euro denominated 748 795 2.875 % Senior Notes due 2028—Euro denominated 739 785 1.750 % Senior Notes due 2026—Euro denominated 572 607 2.250 % Senior Notes due 2029—Euro denominated 935 993 Receivables financing facility due 2027—U.S. Dollar Term SOFR at floating rates of 5.69 % Revolving Loan Commitment 110 110 Term Loan 440 440 Principal amount of debt 14,045 13,752 Less: unamortized discount and debt issuance costs ( 62 ) ( 79 ) Less: current portion ( 1,145 ) ( 718 ) Long-term debt $ 12,838 $ 12,955 Contractual maturities of long-term debt as of December 31, 2024 are as follows: (in millions) 2025 $ 1,145 2026 3,904 2027 2,634 2028 2,252 2029 2,200 Thereafter 1,910 $ 14,045 Senior Secured Credit Facilities As of December 31, 2024, the Fifth Amended and Restated Credit Agreement (the “Credit Agreement”) provided financing through several senior secured credit facilities of up to $ 6,585 million, which consisted of $ 5,415 million principal amounts of debt outstanding (as detailed in the table above), and $ 1,170 million of available borrowing capacity on the $ 2,000 million revolving credit facility and standby letters of credit. The revolving credit facility is comprised of a $ 1,175 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. 93 2023 Financing Transactions On November 28, 2023, the Company entered into an amendment (the “Amendment”) to its Credit Agreement, among IQVIA Inc., a wholly owned subsidiary of the Company, the Company, IQVIA RDS Inc., a wholly owned subsidiary of the Company, the other guarantors party thereto, Bank of America, N.A. as administrative agent and as collateral agent, and the Lenders (as defined therein) party thereto. Pursuant to the Amendment, the Company borrowed $ 1,500 million in incremental Term B-4 Dollar Loans (as defined in the Credit Agreement) due January 2, 2031. The net proceeds from the Term B-4 Dollar Loans were used to repay certain of the outstanding term loans due in 2024 and in 2025 under the Company’s senior secured credit facilities, and to pay fees and expenses related to the Amendment and the offering of 2029 Senior Secured Notes (as defined below). In connection with this Amendment, the Company recognized a $ 6 million loss on extinguishment of debt, which includes fees and expenses. On April 17, 2023, the Company increased the capacity of the senior secured revolving credit facility by $ 500 million U.S. dollars, bringing the total capacity of the revolving credit facility to $ 2,000 million. At the same time, the Company also amended the benchmark rate of the U.S dollar revolving credit facility and the U.S dollar Term A Loans from U.S dollar LIBOR to U.S. dollar Secured Overnight Financing Rate term rates ("Term SOFR"), plus a 10 basis point Credit Spread Adjustment. Senior Secured Notes 2023 Financing Transactions On November 28, 2023, IQVIA Inc. (the “Issuer”), completed the issuance and sale of $ 1,250 million in gross proceeds of 6.250 % senior secured notes due 2029 (the “2029 Senior Secured Notes”). The 2029 Senior Secured Notes were issued pursuant to an Indenture, dated November 28, 2023, among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the 2029 Senior Secured Notes and as collateral agent, and the Company and certain subsidiaries of the Issuer as guarantors. The net proceeds from the 2029 Senior Secured Notes offering were used to repay certain of the outstanding term loans under the Company’s senior secured credit facilities due in 2024 and in 2025, and to pay fees and expenses related to the 2029 Senior Secured Notes offering and the Amendment. The 2029 Senior Secured Notes are secured obligations of the Company, will mature on February 1, 2029, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 6.250 % per year, with interest payable semi-annually on February 1 and August 1 of each year, beginning on February 1, 2024. The Company may redeem the 2029 Senior Secured Notes prior to January 1, 2029 subject to a customary make-whole premium, and thereafter subject to a redemption price equal to 100% of the principal amount thereof plus accrued and unpaid interest. On May 23, 2023, IQVIA Inc. (the “Issuer”) completed the issuance and sale of $ 750 million in gross proceeds of 5.700 % senior secured notes due 2028 (the “2028 Senior Secured Notes”). The 2028 Senior Secured Notes were issued pursuant to an Indenture, dated May 23, 2023, among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the 2028 Senior Secured Notes and as collateral agent, and the Company and certain subsidiaries of the Issuer as guarantors. The net proceeds from the 2028 Senior Secured Notes offering were used to repay existing borrowings under the Company’s revolving credit facility and to pay fees and expenses related to the 2028 Senior Secured Notes offering and offering of 2030 Senior Notes (as defined below). The 2028 Senior Secured Notes are secured obligations of the Company, will mature on May 15, 2028, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 5.700 % per year, with interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2023. The Company may redeem the 2028 Senior Secured Notes prior to April 15, 2028 subject to a customary make-whole premium, and thereafter subject to a redemption price equal to 100% of the principal amount thereof plus accrued and unpaid interest. Each of the Company's current direct and indirect material U.S. wholly owned restricted subsidiaries (excluding IQVIA Solutions Japan LLC and IQVIA Services Japan LLC) and IQVIA Holdings Inc., have jointly and severally, irrevocably and unconditionally, on a senior secured basis, guaranteed the obligations under the 2028 Senior Secured Notes and the 2029 Senior Secured Notes. 94 In February 2024, the Issuer completed an exchange offer in which it issued $ 1,250 million aggregate principal amount of 6.250 % Senior Secured Notes due 2029 registered under the Securities Act (the “2029 Registered Notes”) and $ 750 million aggregate principal amount of 5.700 % Senior Secured Notes due 2028 registered under the Securities Act (the “2028 Registered Notes” and, together with the 2029 Registered Notes, the 2029 Senior Secured Notes, and the 2028 Senior Secured Notes, the “Notes”) in exchange for the same principal amount and substantially identical terms of the 2029 Senior Secured Notes and 2028 Senior Secured Notes, respectively. Senior Notes 2023 Financing Transactions On May 23, 2023, IQVIA Inc. (the “Issuer”) completed the issuance and sale of $ 500 million in gross proceeds of 6.500 % senior notes due 2030 (the “2030 Senior Notes”). The 2030 Senior Notes were issued pursuant to an Indenture, dated May 23, 2023, among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the 2030 Senior Notes, and certain subsidiaries of the Issuer as guarantors. The net proceeds from the 2030 Senior Notes offering were used to repay existing borrowings under the Company’s revolving credit facility, and to pay fees and expenses related to the 2030 Senior Notes offering and 2028 Senior Secured Notes offering. The 2030 Senior Notes are unsecured obligations of the Company, will mature on May 15, 2030, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 6.500 % per year, with interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2023. The Company may redeem the 2030 Senior Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to May 15, 2026 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 3.250 % to 0.000 %. Receivables Financing Facility On October 1, 2024, the Company amended its receivables financing facility to extend the term of the $ 550 million facility to October 1, 2027. Under the receivables financing facility, certain of the Company's accounts receivable are sold on a non-recourse basis by certain of the Company's consolidated subsidiaries (each, an “Originator”) to another of the Company's consolidated subsidiaries, a bankruptcy-remote special purpose entity (the “SPE”). The SPE obtained a term loan and revolving loan commitment from a third-party lender, secured by liens on the assets of the SPE, to finance the purchase of the accounts receivable, which includes a $ 440 million term loan and a $ 110 million revolving loan commitment. As of December 31, 2024, no additional amounts of revolving loans were available under the receivables financing facility. The Company has guaranteed the performance of the obligations of existing and future subsidiaries that sell and service the accounts receivable under the receivables financing facility. The assets of the SPE are not available to satisfy any of the Company’s obligations or any obligations of its subsidiaries. As of December 31, 2024, approximately $ 1,609 million of the Company's trade accounts receivable and unbilled services were pledged as collateral to secure the facility. Restrictive Covenants The Company’s debt agreements provide for certain covenants and events of default customary for similar instruments, including a covenant not to exceed a specified ratio of consolidated senior secured net indebtedness to Consolidated EBITDA, as defined in the senior secured credit facility agreement and a covenant to maintain a specified minimum interest coverage ratio. If an event of default occurs under any of the Company’s or the Company’s subsidiaries’ financing arrangements, the creditors under such financing arrangements will be entitled to take various actions, including the acceleration of amounts due under such arrangements, and in the case of the lenders under the revolving credit facility and term loans, other actions permitted to be taken by a secured creditor. The Company’s long-term debt arrangements contain usual and customary restrictive covenants that, among other things, place limitations on the Company’s ability to declare dividends. As of December 31, 2024, the Company was in compliance in all material respects with the financial covenants under the Company’s financing arrangements. 95 11. Leases The Company has operating leases for corporate offices, data centers, motor vehicles and certain equipment, many of which contain renewal and escalation clauses. These operating leases expire at various dates through 2037 with options to cancel certain leases at various intervals. The Company also has finance leases for offices and lab spaces that expire at various dates through 2048. The components of lease expense were as follows: Year Ended December 31, (in millions) Classification 2024 2023 2022 Operating lease cost (1) Selling, general and administrative expenses $ 158 $ 160 $ 171 Finance lease cost (1) Depreciation and amortization, and Interest expense 18 18 12 Total lease cost $ 176 $ 178 $ 183 (1) Includes variable lease costs, which are immaterial. Other information related to leases was as follows: Year Ended December 31, (in millions) 2024 2023 2022 Supplemental Cash Flow: Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows for operating leases $ 160 $ 175 $ 173 Operating cash flows for finance leases $ 8 $ 8 $ 5 Financing cash flows for finance leases $ 5 $ 3 $ 4 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 58 $ 59 $ 79 Finance leases $ — $ — $ 54 Weighted Average Remaining Lease Term: Operating leases 4.58 years 4.61 years 4.72 years Finance leases 19.73 years 20.67 years 21.64 years Weighted Average Discount Rate: Operating leases 4.57 % 3.81 % 3.12 % Finance leases 3.90 % 3.88 % 3.87 % 96 Future minimum lease payments under non-cancellable leases as of December 31, 2024 were as follows: (in millions) Operating Leases Finance Leases 2025 $ 109 $ 13 2026 71 13 2027 49 14 2028 33 14 2029 14 14 Thereafter 22 269 Total future minimum lease payments 298 337 Less imputed interest ( 26 ) ( 113 ) Total $ 272 $ 224 Reported as of December 31, 2024: Other current liabilities $ 99 $ 6 Operating lease liabilities 173 — Other liabilities — 218 Total $ 272 $ 224 12. Contingencies The Company and its subsidiaries are involved in legal and tax proceedings, claims and litigation arising in the ordinary course of business. Management periodically assesses the Company’s liabilities and contingencies in connection with these matters based upon the latest information available. For those matters where management currently believes it is probable that the Company will incur a loss and that the probable loss or range of loss can be reasonably estimated, the Company has recorded an accrual in the consolidated financial statements based on its best estimates of such loss. In other instances, because of the uncertainties related to either the probable outcome or the amount or range of loss, management is unable to make a reasonable estimate of a liability, if any. However, even in many instances where the Company has recorded an estimated liability, the Company is unable to predict with certainty the final outcome of the matter or whether resolution of the matter will materially affect the Company’s results of operations, financial position or cash flows. As additional information becomes available, the Company adjusts its assessments and estimates of such liabilities accordingly. The Company routinely enters into agreements with third parties, including its clients and suppliers, all in the normal course of business. In these agreements, the Company sometimes agrees to indemnify and hold harmless the other party for any damages such other party may suffer as a result of potential intellectual property infringement and other claims. The Company has not accrued a liability with respect to these matters generally, as the exposure is considered remote. Based on its review of the latest information available, management does not expect the impact of pending legal and tax proceedings, claims and litigation, either individually or in the aggregate, to have a material adverse effect on the Company’s results of operations, cash flows or financial position. However, one or more unfavorable outcomes in any claim or litigation against the Company could have a material adverse effect for the period in which it is resolved. The following is a summary of certain legal matters involving the Company. 97 On January 10, 2017, Quintiles IMS Health Incorporated and IMS Software Services Ltd. (collectively “IQVIA Parties”), filed a lawsuit in the U.S. District Court for the District of New Jersey against Veeva Systems, Inc. (“Veeva”) alleging Veeva unlawfully used IQVIA Parties intellectual property to improve Veeva data offerings, to promote and market Veeva data offerings and to improve Veeva technology offerings. IQVIA Parties seek injunctive relief, appointment of a monitor, the award of compensatory and punitive damages and reimbursement of all litigation expenses, including reasonable attorneys’ fees and costs. On March 13, 2017, Veeva filed counterclaims alleging anticompetitive business practices in violation of the Sherman Act and state laws. Veeva claims damages in excess of $ 200 million, and is seeking punitive damages and litigation costs, including attorneys’ fees. The Company believes the counterclaims are without merit, rejects all counterclaims raised by Veeva and intends to vigorously defend IQVIA Parties’ position and pursue its claims against Veeva. Since the initial filings, the parties have filed additional litigations against each other, primarily concerning the use of IQVIA data with various other Veeva products. Trial has been continued from an early 2025 setting to a date to be determined by the Court. On May 7, 2021, the Court issued an order and opinion (the “Order”) in which it found significant evidence that Veeva had (1) misappropriated IQVIA data and unlawfully used it to improve Veeva data offerings, (2) engaged in a cover-up by deleting significant evidence of its theft of IQVIA’s trade secrets, and (3) improperly withheld certain evidence under privilege in furtherance of a crime and/or fraud against IQVIA. The Court imposed five sanctions against Veeva, including ordering three separate adverse inference instructions be issued to the jury and that IQVIA be permitted to present evidence to the jury of Veeva’s destruction efforts. Veeva appealed the Order. On March 30, 2024, the Court denied Veeva’s appeal with regard to its rejected privilege claims, while reserving ruling on the appropriate sanctions to be imposed for a later time. 13. Stockholders’ Equity Preferred Stock The Company is authorized to issue 1.0 million shares of preferred stock, $ 0.01 per share par value. No shares of preferred stock were issued and outstanding as of December 31, 2024 or 2023. Equity Repurchase Program On October 30, 2013, the Company’s Board of Directors (the “Board”) first approved the Company's equity repurchase program (the “Repurchase Program”), authorizing the repurchase of up to $ 125 million of the Company’s common stock. The Board increased the stock repurchase authorization under the Repurchase Program with respect to the repurchase of the Company's common stock by $ 600 million, $ 1.5 billion, $ 2.0 billion, $ 1.5 billion, $ 2.0 billion, $ 2.0 billion, and $ 2.0 billion in 2015, 2016, 2017, 2018, 2019, 2022, and 2023, respectively. On February 5, 2025, the Board increased the stock repurchase authorization under the Repurchase Program with respect to the repurchase of the Company's common stock by an additional $ 2,000 million, which increased the total amount that has been authorized under the Repurchase Program to $ 13,725 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. As of December 31, 2024, the Company had remaining authorization to repurchase up to $ 1,013 million of its common stock under the Repurchase Program. In addition, from time to time, the Company has repurchased and may continue to repurchase common stock through private or other transactions outside of the Repurchase Program. There were no equity offerings during the years ended December 31, 2024, 2023 and 2022. Summary Below is a summary of the share repurchases made under the Repurchase Program: Year Ended December 31, (in millions, except per share data) 2024 2023 2022 Number of shares of common stock repurchased 6.4 5.0 5.5 Aggregate purchase price $ 1,350 $ 992 $ 1,168 Average price per share $ 209.68 $ 196.89 $ 213.06 98 14. Business Combinations The Company completed several individually immaterial acquisitions during the years ended December 31, 2024 and 2023. The Company’s assessment of fair value, including the valuation of certain acquired intangibles and the purchase price allocation related to the acquisitions that occurred during the year ended December 31, 2024 is preliminary and subject to change upon completion. Further adjustments, largely related to acquired intangible assets and related deferred taxes, may be necessary as additional information related to the fair values of assets acquired and liabilities assumed is assessed during the measurement period (up to one year from the acquisition date). The Company recorded goodwill from these acquisitions, primarily attributable to assembled workforce, expected synergies and new client relationships. The consolidated financial statements include the results of the acquisitions subsequent to their respective closing dates. Pro forma information is not presented as pro forma results of operations would not be materially different to the actual results of operations of the Company. The following table provides certain preliminary financial information for these acquisitions: Year Ended December 31, (in millions) 2024 2023 Assets acquired: Cash and cash equivalents $ 28 $ 28 Accounts receivable 68 44 Other assets 60 9 Goodwill 532 533 Other identifiable intangibles 313 425 Liabilities assumed: Other liabilities ( 114 ) ( 44 ) Deferred income taxes, long-term ( 40 ) ( 18 ) Net assets acquired (1) $ 847 $ 977 (1) Net assets acquired include contingent consideration and deferred purchase price of $ 84 million and $ 73 million, respectively. The portion of goodwill deductible for income tax purposes was preliminarily assessed as $ 343 million and $ 379 million for the years ended December 31, 2024 and 2023, respectively. The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired: Year Ended December 31, (in millions) Amortization Period 2024 2023 Other identifiable intangibles: Client relationships 9 - 16 years $ 257 $ 324 Backlog 1 - 4 years 28 51 Software and related assets 3 - 5 years 10 44 Non-compete agreements 3 - 5 years 7 — Trade names 5 years 6 2 Databases 4 - 5 years 5 4 Total Other identifiable intangibles $ 313 $ 425 15. Restructuring The Company has continued to take restructuring actions in the year ended December 31, 2024 to align its resources and reduce overcapacity to adapt to changing market conditions and integrate acquisitions. These actions include consolidating functional activities, eliminating redundant positions, and aligning resources with customer requirements. These restructuring actions are expected to continue into 2025. 99 The management approved plans resulted in $ 67 million, $ 84 million and $ 28 million of restructuring expense, net of reversals, which consisted primarily of severance and other exit-related costs in the years ended December 31, 2024, 2023 and 2022, respectively. The following amounts were recorded for the restructuring plans: (in millions) Severance and Related Costs Balance as of December 31, 2022 $ 26 Expense, net of reversals 84 Payments ( 74 ) Balance as of December 31, 2023 $ 36 Expense, net of reversals 67 Payments ( 81 ) Foreign currency translation and other ( 1 ) Balance as of December 31, 2024 $ 21 The reversals were due to changes in estimates primarily resulting from the redeployment of staff and higher than expected voluntary terminations. Restructuring costs are not allocated to the Company’s reportable segments as they are not part of the segment performance measures regularly reviewed by management. The Company expects the majority of the restructuring accruals as of December 31, 2024 will be paid in 2025. 16. Income Taxes The components of income before income taxes and equity in earnings (losses) of unconsolidated affiliates are as follows: Year Ended December 31, (in millions) 2024 2023 2022 Domestic $ 214 $ 108 $ ( 45 ) Foreign 1,455 1,351 1,408 $ 1,669 $ 1,459 $ 1,363 The components of income tax expense attributable to continuing operations are as follows: Year Ended December 31, (in millions) 2024 2023 2022 Current expense: Federal and state $ 44 $ 21 $ 24 Foreign 386 349 358 430 370 382 Deferred (benefit) expense: Federal and state ( 116 ) ( 236 ) ( 94 ) Foreign ( 13 ) ( 33 ) ( 28 ) ( 129 ) ( 269 ) ( 122 ) $ 301 $ 101 $ 260 100 The differences between the Company’s consolidated income tax expense attributable to continuing operations and the expense computed at the United States statutory income tax rate of 21% were as follows: Year Ended December 31, (in millions) 2024 2023 2022 Federal income tax expense at statutory rate $ 351 $ 306 $ 286 State and local income taxes, net of federal effect 9 16 ( 15 ) Research and development ( 28 ) ( 25 ) ( 19 ) United States taxes recorded on foreign earnings(*) ( 79 ) ( 41 ) ( 4 ) Tax contingencies 14 17 14 Foreign Derived Intangible Income (“FDII”) ( 56 ) ( 53 ) ( 41 ) Foreign rate differential 87 45 38 Equity compensation 3 — 2 Valuation Allowance Release — ( 102 ) — Basis Difference Reversal — ( 61 ) — Other — ( 1 ) ( 1 ) $ 301 $ 101 $ 260 (*) Includes impact of GILTI, and other U.S. taxes on foreign earnings. The Company's effective income tax rate was 18.0 %, 6.9 %, and 19.1 % for the years ending December 31, 2024, 2023, and 2022, respectively. The Company's effective income tax rate for December 31, 2023, was favorably impacted due to the completion of an internal legal entity restructuring that resulted in a benefit of $ 125 million. Historically, the Company recorded deferred tax assets related to certain foreign tax credits, and a full valuation allowance in relation to these foreign tax credits was established as it was not expected the credits would be utilized prior to expiration. The Company now believes it is reasonably possible that these foreign tax credits will be utilized and therefore recorded a tax benefit of $ 64 million related to the valuation allowance release and establishing related uncertain tax positions. Additionally, due to the restructuring the Company also reversed a deferred tax liability of $ 61 million due to a basis difference that was recovered in a tax-free manner. The effective tax rate was also favorably impacted by a reversal of uncertain tax positions relating to tax credit carryforwards in the amount of $ 21 million due to an audit settlement. On December 12, 2022, the European Union member states agreed to implement the Organization for Economic Co-operation and Development’s (“OECD”) Pillar Two global corporate minimum tax rate of 15% on companies with revenues of at least $790 million, which went into effect in 2024. The Company has continued to evaluate the effect of this through the end of 2024 and determined that it did not have any material impacts for the current year. The Company will continue to assess the impact of this proposal as countries are actively considering changes to their tax laws to adopt certain parts of the OCED's proposal. Undistributed earnings of the Company’s foreign subsidiaries amounted to approximately $ 5,117 million as of December 31, 2024. The Company does not consider any of its foreign earnings as indefinitely reinvested. 101 The income tax effects of temporary differences from continuing operations that give rise to significant portions of deferred income tax assets (liabilities) are presented below: December 31, (in millions) 2024 2023 Deferred income tax assets: Net operating loss and other loss carryforwards $ 176 $ 132 Tax credit carryforwards 292 254 Accrued expenses and unearned income 106 103 Employee benefits 180 202 Lease liability 34 65 U.S. interest expense limitation 93 59 Other 52 81 Total deferred income tax assets 933 896 Valuation allowance for deferred income tax assets ( 196 ) ( 166 ) Total deferred income tax assets (net of valuation allowance) 737 730 Deferred income tax liabilities: Amortization and depreciation ( 545 ) ( 590 ) Lease right-of-use assets ( 19 ) ( 56 ) Foreign exchange on debt instruments ( 104 ) ( 48 ) Other ( 71 ) ( 72 ) Total deferred income tax liabilities ( 739 ) ( 766 ) Net deferred income tax assets (liabilities) $ ( 2 ) $ ( 36 ) During the year ended December 31, 2024, the net deferred income tax liabilities decreased due to amortization of intangibles related to the merger between Quintiles and IMS Health. The Company had federal, state and local, and foreign tax loss carryforwards and tax credits, the tax effect of which was $ 541 million as of December 31, 2024. Of this amount, $ 57 million has an indefinite carryforward period, and the remaining $ 484 million expires at various times beginning in 2025. Some of the federal losses are subject to limitations under the Internal Revenue Code, however, management expects these losses to be utilized during the carryforward periods. In the year ended December 31, 2024, the Company increased its valuation allowance by $ 30 million to $ 196 million as of December 31, 2024 from $ 166 million as of December 31, 2023. On December 10, 2024, the US Department of Treasury published final regulations related to foreign currency gains and losses that are effective as of January 1, 2025. These regulations require computation of pre-transition foreign currency gain or loss to be included in the determination of future taxable income or loss. The valuation allowance increased primarily as a result of these regulations. We recorded a one-time, non-cash deferred tax benefit related to the pre-transition foreign currency losses in the current year that will be fully offset by a valuation allowance. A reconciliation of the beginning and ending amount of gross unrecognized income tax benefits is presented below: Year Ended December 31, (in millions) 2024 2023 2022 Balance as of January 1 $ 140 $ 122 $ 116 Additions based on tax positions related to the current year 15 53 13 Additions for income tax positions of prior years 17 8 20 Impact of changes in exchange rates ( 2 ) 1 ( 2 ) Settlements with tax authorities ( 1 ) ( 6 ) ( 4 ) Reductions for income tax positions of prior years ( 18 ) ( 25 ) ( 11 ) Reductions due to the lapse of the applicable statute of limitations ( 5 ) ( 13 ) ( 10 ) Balance as of December 31 $ 146 $ 140 $ 122 102 As of December 31, 2024, the Company had total gross unrecognized income tax benefits of $ 132 million associated with over 100 jurisdictions in which the Company conducts business that, if recognized, would reduce the Company’s effective income tax rate. The Company’s policy for recording interest and penalties relating to uncertain income tax positions is to record them as a component of income tax expense in the accompanying consolidated statements of income. In the years ended December 31, 2024, 2023 and 2022, the amount of interest and penalties recorded as an addition to income tax expense in the accompanying consolidated statements of income was $ 6 million, $ — million and $ 2 million, respectively. As of December 31, 2024, and 2023, the Company had accrued approximately $ 26 million and $ 20 million, respectively, of interest and penalties. The Company believes that it is reasonably possible that a decrease of up to $ 8 million in gross unrecognized income tax benefits for federal, state and foreign exposure items may be necessary within the next 12 months due to lapse of statutes of limitations or uncertain tax positions being effectively settled. The Company believes that it is reasonably possible that a decrease of up to $ 13 million in gross unrecognized income tax benefits for foreign items may be necessary within the next 12 months due to payments. For the remaining uncertain income tax positions, it is difficult at this time to estimate the timing of the resolution. The Company conducts business globally and, as a result, files income tax returns in the United States federal jurisdiction and various state and foreign jurisdictions. In the normal course of business, the Company is subject to examination by taxing authorities throughout the world. The following table summarizes the tax years that remain open for examination by tax authorities in the most significant jurisdictions in which the Company operates: United States 2020 - 2023 India 2006 - 2024 Japan 2018 - 2023 United Kingdom 2022 - 2023 Switzerland 2020 - 2023 In certain of the jurisdictions noted above, the Company operates through more than one legal entity, each of which has different open years subject to examination. The table above presents the open years subject to examination for the most material of the legal entities in each jurisdiction. Additionally, it is important to note that tax years are technically not closed until the statute of limitations in each jurisdiction expires. In the jurisdictions noted above, the statute of limitations can extend beyond the open years subject to examination. Due to the geographic breadth of the Company’s operations, numerous tax audits may be ongoing throughout the world at any point in time. Income tax liabilities are recorded based on estimates of additional income taxes that may be due upon the conclusion of these audits. Estimates of these income tax liabilities are made based upon prior experience and are updated in light of changes in facts and circumstances. However, due to the uncertain and complex application of income tax regulations, it is possible that the ultimate resolution of audits may result in liabilities that could be materially different from these estimates. In such an event, the Company will record additional income tax expense or income tax benefit in the period in which such resolution occurs. 17. Employee Benefit Plans Pension and Postretirement Benefit Plans The Company sponsors both funded and unfunded defined benefit pension plans. These plans provide benefits based on various criteria, including, but not limited to, years of service and salary. The Company also sponsors an unfunded postretirement benefit plan in the United States that provides health and prescription drug benefits to retirees who meet the eligibility requirements. The Company uses a December 31 measurement date for all pension and postretirement benefit plans. 103 The following table summarizes changes in the benefit obligation, the plan assets and the funded status of the pension benefit plans: Pension Benefits United States Plans Non-United States Plans December 31, (in millions) 2024 2023 2024 2023 Obligation and funded status: Change in benefit obligation: Projected benefit obligation at beginning of year $ 434 $ 400 $ 525 $ 461 Service costs 10 10 35 35 Interest cost 22 22 17 17 Actuarial (gains) losses ( 9 ) 15 ( 2 ) 5 Benefits paid ( 14 ) ( 13 ) ( 26 ) ( 20 ) Contributions — — 3 3 Settlements — — ( 3 ) ( 3 ) Foreign currency fluctuations and other — — 4 27 Projected benefit obligation at end of year 443 434 553 525 Change in plan assets: Fair value of plan assets at beginning of year 486 419 379 355 Actual return on plan assets 62 75 ( 9 ) 2 Contributions 4 5 29 27 Benefits paid ( 14 ) ( 13 ) ( 26 ) ( 20 ) Settlements — — ( 3 ) ( 3 ) Foreign currency fluctuations and other — — 14 18 Fair value of plan assets at end of year 538 486 384 379 Funded status $ 95 $ 52 $ ( 169 ) $ ( 146 ) The following table summarizes the amounts recognized in the consolidated balance sheets related to the pension benefit plans: Pension Benefits United States Plans Non-United States Plans December 31, (in millions) 2024 2023 2024 2023 Deposits and other assets, net $ 121 $ 87 $ 43 $ 49 Accounts payable and accrued expenses $ 3 $ 4 $ 14 $ 12 Other liabilities $ 23 $ 31 $ 198 $ 183 Accumulated other comprehensive loss $ 64 $ 28 $ ( 49 ) $ ( 25 ) As of December 31, 2024, the benefit obligation and amount recognized in AOCI for other postretirement benefits were immaterial. The following table summarizes the accumulated benefit obligation for all pension benefit plans: Pension Benefits United States Plans Non-United States Plans December 31, (in millions) 2024 2023 2024 2023 Accumulated benefit obligation $ 441 $ 430 $ 500 $ 480 104 The following table provides the information for pension plans with an accumulated benefit obligation in excess of plan assets and projected benefit obligations in excess of plan assets: Pension Benefits United States Plans Non-United States Plans December 31, (in millions) 2024 2023 2024 2023 Plans with accumulated benefit obligation in excess of plan assets: Accumulated benefit obligation $ 34 $ 41 $ 287 $ 251 Fair value of plan assets $ 8 $ 7 $ 129 $ 101 Plans with projected benefit obligation in excess of plan assets: Projected benefit obligation $ 34 $ 41 $ 340 $ 295 Fair value of plan assets $ 8 $ 7 $ 129 $ 101 The components of net periodic benefit cost changes in plan assets and benefit obligations recognized in comprehensive income were as follows: Pension Benefits United States Plans Non-United States Plans Year Ended December 31, (in millions) 2024 2023 2022 2024 2023 2022 Service cost $ 10 $ 10 $ 13 $ 35 $ 35 $ 29 Interest cost 22 22 13 17 17 8 Expected return on plan assets ( 34 ) ( 30 ) ( 38 ) ( 15 ) ( 17 ) ( 18 ) Amortization of actuarial losses — — 1 — ( 2 ) 1 Settlement gain — — 1 — — ( 1 ) Net periodic benefit cost ( 2 ) 2 ( 10 ) 37 33 19 Other changes in plan assets and benefit obligations recognized in other comprehensive loss: Actuarial (gain) loss – current year ( 36 ) ( 30 ) 31 24 19 ( 18 ) Total recognized in other comprehensive income ( 36 ) ( 30 ) 31 24 19 ( 18 ) Total recognized in net periodic benefit cost and other comprehensive income $ ( 38 ) $ ( 28 ) $ 21 $ 61 $ 52 $ 1 All components of net periodic benefit cost other than service cost are recorded in other (income) expense, net on the accompanying consolidated statements of income. Gains (losses) affecting the benefit obligation for the year ending December 31, 2024 were primarily related to the changes in discount rates, as well as changes in other actuarial assumptions which are driven by changing market conditions . Assumptions The weighted average assumptions used to determine net periodic benefit cost were as follows for the years ended December 31: Pension Benefits United States Plans Non-United States Plans 2024 2023 2022 2024 2023 2022 Discount rate 5.35 % 5.65 % 3.08 % 3.52 % 3.59 % 1.46 % Rate of compensation increases 3.00 % 3.00 % 3.00 % 2.78 % 2.93 % 2.57 % Expected return on plan assets 7.20 % 7.20 % 7.23 % 3.70 % 4.53 % 4.22 % 105 The weighted average assumptions used to determine benefit obligations were as follows as of December 31: Pension Benefits United States Plans Non-United States Plans 2024 2023 2024 2023 Discount rate 5.83 % 5.35 % 3.67 % 3.52 % Rate of compensation increases 3.00 % 3.00 % 3.50 % 2.78 % The discount rate represents the interest rate used to determine the present value of the future cash flows currently expected to be required to settle the Company’s defined benefit plan obligations. The discount rates are derived using weighted average yield curves on AA-rated corporate bonds. The cash flows from the Company’s expected benefit obligation payments are then matched to the yield curve to derive the discount rates. The Company’s assumption for the expected return on plan assets was determined by the weighted average of the long-term expected rate of return on each of the asset classes invested as of the balance sheet date. For plan assets invested in government bonds, the expected return was based on the yields on the relevant indices as of the balance sheet date. There is considerable uncertainty for the expected return on plan assets invested in equity and diversified growth funds. Under the Company’s United States qualified retirement plan, participants have a notional retirement account that increases with pay and investment credits. The rate used to determine the investment credit (cash balance crediting rate) varies monthly and is equal to 1/12th of the yield on 30-year U.S. Government Treasury Bonds, with a minimum of 0.25 %. At retirement, the account is converted to a monthly retirement benefit. Plan Assets The Company’s pension plan target asset allocations and weighted average asset allocations, by asset category, were as follows: Plan Assets as of December 31, Target United States Plans Non-United States Plans Total Asset Category Allocation 2024 2023 2024 2023 2024 2023 Equity securities 40 - 65 % 76 % 73 % — % — % 45 % 42 % Debt securities 10 - 40 % 20 21 49 56 32 36 Real estate 0 - 5 % 4 4 — — 2 2 Other 10 - 30 % — 2 51 44 21 20 Total 100 % 100 % 100 % 100 % 100 % 100 % The following table summarizes United States plan assets measured at fair value: December 31, 2024 December 31, 2023 Asset Category Level 1 Level 2 Total Level 1 Level 2 Total (in millions) Domestic equities $ 37 $ — $ 37 $ 33 $ — $ 33 International equities 11 — 11 11 — 11 Corporate bonds 64 — 64 65 — 65 Real estate 21 — 21 21 — 21 Total assets in the fair value hierarchy 133 — 133 130 — 130 Assets measured at net asset value (“NAV”) (1) — — 405 — — 356 Total $ 133 $ — $ 538 $ 130 $ — $ 486 (1) Certain investments that are measured at fair value using the net asset value ("NAV") per share (or its equivalent) practical expedient have not been classified in the fair value hierarchy. The fair value amounts presented in the above plan asset tables are intended to permit reconciliation of the fair value of plan assets in the fair value hierarchy to the plan asset amounts presented in the above funded status table as of December 31, 2024 and 2023. 106 The following table summarizes non-United States plan assets measured at fair value: December 31, 2024 December 31, 2023 Asset Category Level 1 Level 2 Total Level 1 Level 2 Total (in millions) International equities $ — $ 1 $ 1 $ 1 $ 1 $ 2 Debt issued by national, state or local government 2 170 172 2 210 212 Corporate bonds — 18 18 — — — Investments funds — 10 10 — 10 10 Insurance contracts — 168 168 — 145 145 Other 8 7 15 3 7 10 Total $ 10 $ 374 $ 384 $ 6 $ 373 $ 379 Investments in mutual funds are valued at quoted market prices. Investments in common/collective trusts and pooled funds are valued at the NAV as reported by the trust. The NAV is based on the fair value of the underlying investments held by the fund less its liabilities. Insurance contracts are valued at the amount of the benefit liability. The Company has no Level 3 assets that rely on unobservable inputs to measure fair value. Investment Policies and Strategies The Company invests primarily in a diversified portfolio of debt and equity securities that provide for long-term growth within reasonable and prudent levels of risk. The asset allocation targets established by the Company are strategic and applicable to the plan’s long-term investing horizon. The portfolio is constructed and maintained to provide adequate liquidity to meet associated liabilities and minimize long-term expense and provide prudent diversification among asset classes in accordance with the principles of modern portfolio theory. The plan employs a diversified mix of actively managed investments around a core of passively managed index exposures in each asset class. Within each asset class, rapid market shifts, changes in economic conditions or an individual fund manager’s outlook may cause the asset allocation to fall outside the prescribed targets. The majority of the Company’s plan assets are measured quarterly against benchmarks established by the Company’s investment manager and the Company’s Investment Committee, who review actual plan performance and have the authority to recommend changes as deemed appropriate. Assets are rebalanced periodically to their strategic targets to maintain the plan’s strategic risk/reward characteristics. The Company periodically conducts asset liability modeling studies to ensure that the investment strategy is aligned with the obligations of the plans and that the assets will generate income and capital growth to meet the cost of current and future benefits that the plans provide. The pension plans did not have investments in Company stock as of December 31, 2024 and 2023. The portfolio for the Company’s United Kingdom pension plans seek to invest in a range of suitable assets of appropriate liquidity that will generate in the most effective manner possible, income and capital growth to ensure that there are sufficient assets to meet benefit payments when they fall due, while controlling the long-term costs of the plans, avoiding short-term volatility of investment returns, and managing risks in accordance with plan investment strategies. The plans seek to achieve these objectives by investing in a mixture of real (equities) and monetary (fixed interest) assets, which is expected to provide the level of returns required by the plans. The trustee periodically conducts asset liability modeling exercises to ensure the investments are aligned with the appropriate benchmark to better reflect the plans’ liabilities. The trustee also undertakes to review this benchmark on a regular basis. Cash Flows Contributions The Company expects to contribute approximately $ 30 million in required contributions to its pension and postretirement benefit plans during 2025. The Company may make additional contributions into its pension plans in 2025 depending on, among other factors, how the funded status of those plans change or in order to meet minimum funding requirements as set forth in employee benefit and tax laws, plus additional amounts the Company may deem to be appropriate. 107 Estimated future benefit payments The following benefit payments (net of expected participant contributions) for pension benefits are expected to be paid as follows: (in millions) 2025 $ 55 2026 56 2027 60 2028 62 2029 65 Years 2030 through 2034 361 $ 659 Benefit payments (net of expected participant contributions) for other postretirement benefits are expected to be immaterial over the years presented. Defined Contribution Plans Defined contribution or profit sharing plans are offered in various countries in which the Company operates. In some cases, these plans are required by local laws or regulations. In the United States, the Company has a 401(k) plan under which the Company matches employee deferrals at varying percentages and specified limits of the employee’s salary. For the years ended December 31, 2024, 2023 and 2022, the Company expensed $ 80 million, $ 81 million and $ 74 million, respectively, related to matching contributions. Certain key executives of the Company participate in an unfunded defined contribution executive retirement plan, assumed in the merger between Quintiles and IMS Health, which was frozen to additional accruals for future service contributions in 2012. Participants continue to receive an annual investment credit based on the average of the annual yields at the end of each month on the AA-AAA rated 10 plus year maturity component of the Merrill Lynch United States Corporate Bond Master Index. Plans Accounted for as Postretirement Benefits The Company provides certain executives with postretirement medical, dental and life insurance benefits. These benefits are individually negotiated arrangements in accordance with their individual employment arrangements. The above tables do not include the Company’s expense or obligation associated with providing these benefits. The obligation related to these benefits as of December 31, 2024 and 2023, and the Company’s expense for the years then ended, were not material. Stock Incentive Plans Stock incentive plans provide incentives to eligible employees, officers and directors in the form of non-qualified stock options, incentive stock options, stock appreciation rights (“SARs”), restricted stock awards, restricted stock units (“RSUs”), performance awards, covered annual incentive awards, cash-based awards and other stock-based awards, in each case subject to the terms of the stock incentive plans. In April 2017, the Company’s 2017 Incentive and Stock Award Plan (the “2017 Plan”) was approved by the Company’s stockholders. The 2017 Plan provides for the grant of stock options, SARs, restricted and deferred stock (including RSUs), performance awards, dividend equivalents, other stock-based awards and cash-based awards. The Company recognized stock-based compensation expense of $ 206 million, $ 217 million and $ 194 million in the years ended December 31, 2024, 2023 and 2022, respectively. Stock-based compensation expense is included in selling, general and administrative expenses on the accompanying consolidated statements of income. The associated future income tax benefit recognized was $ 36 million, $ 34 million and $ 28 million in the years ended December 31, 2024, 2023 and 2022, respectively. As of December 31, 2024, there was approximately $ 215 million of total unrecognized stock-based compensation expense related to outstanding non-vested stock-based compensation arrangements, which the Company expects to recognize over a weighted average period of 1.2 years. 108 As of December 31, 2024, there were 7.6 million shares available for future grants under all of the Company’s stock incentive plans. The Company used the following assumptions when estimating the value of the stock-based compensation for Stock Settled SARs granted as follows: Year Ended December 31, 2024 2023 2022 Expected volatility 28 – 35 % 29 – 35 % 28 – 34 % Weighted average expected volatility 32 % 32 % 30 % Expected dividends 0.0 % 0.0 % 0.0 % Expected term (in years) 2.6 – 5.6 2.4 – 5.4 3.3 – 6.3 Risk-free interest rate 4.07 – 4.56 % 3.38 – 4.75 % 1.84 – 4.22 % Stock Appreciation Rights – Stock Settled The exercise price of the stock-settled SARs (“SSRs”) is equal to the closing market price of the Company’s common stock as of the grant date and expire on the tenth anniversary of the date of grant. The SSRs are eligible to vest in three equal annual installments on each of the first three anniversaries of the date of grant. The Company’s SSR activity in the year ended December 31, 2024 is as follows: (in millions, except number of SSRs and exercise price) Number of SSRs Weighted Average Exercise Price Aggregate Intrinsic Value Outstanding as of December 31, 2023 3,862,710 $ 144.79 $ 342 Granted 426,430 214.37 Exercised ( 754,235 ) 120.01 Canceled ( 41,593 ) 233.29 Outstanding as of December 31, 2024 3,493,312 $ 157.58 $ 175 The weighted average fair value per share of SSRs granted in the year ended December 31, 2024 was $ 70.63 . The total intrinsic value of SSRs exercised was approximately $ 88 million, $ 51 million and $ 25 million in the years ended December 31, 2024, 2023 and 2022, respectively. The weighted average remaining contractual life of the SSRs outstanding and exercisable as of December 31, 2024 is 5.2 years and 4.2 years, respectively. The total aggregate intrinsic value of the exercisable SSRs and the SSRs expected to vest as of December 31, 2024 was approximately $ 175 million. Stock Options The option price is determined by the Board at the date of grant and the options expire 10 years from the date of grant. All outstanding stock options are fully vested. The Company’s stock option activity in the year ended December 31, 2024 is as follows: (in millions, except number of options and exercise price) Number of Options Weighted Average Exercise Price Aggregate Intrinsic Value Outstanding as of December 31, 2023 174,971 $ 62.35 $ 30 Exercised ( 88,006 ) 60.10 Outstanding as of December 31, 2024 86,965 $ 64.63 $ 11 109 The total intrinsic value of options exercised was approximately $ 15 million, $ 23 million and $ 9 million in the years ended December 31, 2024, 2023 and 2022, respectively. The Company received cash of approximately $ 5 million, $ 7 million and $ 2 million in 2024, 2023, and 2022, respectively, from options exercised. The weighted average remaining contractual life of the options outstanding and exercisable as of December 31, 2024 is 1.0 years. The total aggregate intrinsic value of the exercisable stock options as of December 31, 2024 was approximately $ 11 million. Performance Awards The Company awarded performance awards that contain service, performance-based and/or market-based vesting criteria. Vesting occurs if the recipient remains employed and depends on the degree to which performance goals are achieved during the three-year performance period (as defined in the award agreements). The Company’s performance award activity in the year ended December 31, 2024 is as follows: Number of Performance Awards Weighted Average Grant-Date Fair Value Outstanding as of December 31, 2023 746,070 $ 232.13 Granted 493,729 217.83 Additional goal achievement shares 172,658 189.94 Vested ( 387,288 ) 197.10 Canceled ( 32,691 ) 241.33 Outstanding as of December 31, 2024 992,478 $ 231.04 As of December 31, 2024, there are 992,478 performance awards outstanding with an intrinsic value of approximately $ 195 million. Restricted Stock Units – Stock Settled The Company’s RSUs will settle in shares of the Company’s common stock within 30 days of the applicable vesting date. In general, RSUs granted to employees vest either (i) one-third per year beginning on the first anniversary of the grant date or (ii) 100 % at the end of the three-year period following the grant date. Members of the Company’s Board receive RSUs that are fully vested when granted. The Company’s RSU activity in the year ended December 31, 2024 is as follows: Number of RSUs Weighted Average Grant-Date Fair Value Outstanding as of December 31, 2023 888,856 $ 228.55 Granted (1) 594,957 216.78 Vested ( 415,766 ) 223.45 Canceled ( 67,719 ) 225.00 Outstanding as of December 31, 2024 1,000,328 $ 223.91 (1) Pursuant to the IQVIA Holdings Inc. Non-Employee Director Deferral Plan (the “Director Deferral Plan”), non-employee directors may elect to defer receipt of their cash and/or equity retainers. If a director elects to defer his or her retainer, he or she will instead be credited with that value in deferred shares under the Director Deferral Plan. Deferred shares become payable in Company common stock following a termination of the director’s Board service or the director’s death, or upon a change in control of the Company. The Company granted 6,482 deferred RSUs in 2024. As of December 31, 2024, there are 1,000,328 RSUs outstanding with an intrinsic value of approximately $ 197 million. 110 Stock Appreciation Rights – Cash Settled The Company’s cash settled SARs (“CSRs”) require the Company to settle in cash an amount equal to the difference between the fair value of the Company’s common stock on the date of exercise and the grant price, multiplied by the number of CSRs being exercised. All outstanding CSRs are fully vested. As of December 31, 2024, 2023 and 2022, the weighted average fair value per share of the CSRs outstanding was $ 109.83 , $ 152.17 and $ 147.41 , respectively. The Company paid approximately $ 3 million, $ 11 million and $ 1 million to settle exercised CSRs in the years ended December 31, 2024, 2023 and 2022, respectively. The weighted average remaining contractual life of the CSRs outstanding and exercisable as of December 31, 2024 is 3.1 years. The total aggregate intrinsic value of the exercisable CSRs as of December 31, 2024 was approximately $ 4 million. Restricted Stock Units – Cash Settled The Company’s cash settled RSUs (“Cash RSUs”) require the Company to settle in cash an amount equal to the fair value of the Company’s common stock on the vest date multiplied by the number of vested Cash RSUs. These awards vest either (i) 100 % at the end of the three -year period following the date of grant, or (ii) one-third per year beginning on the first grant date anniversary. As of December 31, 2024, there are 5,808 Cash RSUs outstanding with an intrinsic value of approximately $ 1 million. Long Term Incentive Awards - Stock Settled During the year ended December 31, 2022, the Company entered into long term incentive award agreements with certain employees totaling a fixed monetary amount of $ 80 million to issue a variable number of common shares based on the fair market value when the awards vest on the third anniversary of the grant date. The Company accounts for the awards as liability-classified awards with the liability recorded in other current liabilities in the consolidated balance sheets as of December 31, 2024. The Company recorded approximately $ 26 million, $ 22 million and $ 9 million of stock-based compensation expense for these awards during the years ended December 31, 2024, 2023 and 2022, respectively. Other The Company sponsors a supplemental non-qualified deferred compensation plan, covering certain management employees, and maintains other statutory indemnity plans as required by local laws or regulations. 18. Related Party Transactions The Company has entered into transactions with related parties that are not deemed to be material, including investments in unconsolidated affiliates that are discussed in Note 4. 111 19. Property, Equipment and Software by Geography The following table represents the Company’s property, equipment and software, net, by geographic region, which is further broken down to show each country that accounts for 10% or more of the totals: December 31, (in millions) 2024 2023 Property, equipment and software, net: Americas: United States $ 1,803 $ 1,820 Other 54 97 Americas 1,857 1,917 Europe and Africa 184 193 Asia-Pacific 50 36 Total property, equipment and software, net $ 2,091 $ 2,146 20. Segments The following table presents the Company’s operations by reportable segment. The Company is 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 the Company’s 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 customers and the broader healthcare market. Certain costs are not allocated to the Company's 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, as well as certain general corporate and unallocated expenses. The Company also does not allocate restructuring costs, depreciation and amortization or impairment charges, if any, to its segments. Asset information by segment is not presented, as this measure is not used by the chief executive officer, who is the chief operating decision maker ("CODM"), to assess the Company’s performance. For all segments, the CODM uses segment revenue and segment profit in the annual budgeting and forecasting process. The CODM considers budget-to-actual variances on a monthly and quarterly basis for both segment revenue and profit when making decisions about allocating operating and capital resources to the segments. The CODM also uses segment revenue and profit to assess the performance for each segment by comparing the results of each segment with one another and in determining the compensation of certain employees. 112 The Company’s reportable segment information is presented below: Year Ended December 31, (in millions) 2024 2023 2022 Revenues Technology & Analytics Solutions $ 6,160 $ 5,862 $ 5,746 Research & Development Solutions 8,527 8,395 7,921 Contract Sales & Medical Solutions 718 727 743 Total revenues 15,405 14,984 14,410 Cost of revenues, exclusive of depreciation and amortization Technology & Analytics Solutions 3,721 3,496 3,348 Research & Development Solutions 5,698 5,629 5,395 Contract Sales & Medical Solutions 611 620 639 Total cost of revenues, exclusive of depreciation and amortization 10,030 9,745 9,382 Selling, general and administrative expenses Technology & Analytics Solutions 917 876 848 Research & Development Solutions 881 851 831 Contract Sales & Medical Solutions 60 58 62 Total selling, general and administrative expenses reportable segments 1,858 1,785 1,741 Segment profit Technology & Analytics Solutions 1,522 1,490 1,550 Research & Development Solutions 1,948 1,915 1,695 Contract Sales & Medical Solutions 47 49 42 Total segment profit 3,517 3,454 3,287 General corporate and unallocated expenses ( 134 ) ( 268 ) ( 330 ) Depreciation and amortization ( 1,114 ) ( 1,125 ) ( 1,130 ) Restructuring costs ( 67 ) ( 84 ) ( 28 ) Total income from operations 2,202 1,977 1,799 Interest income ( 47 ) ( 36 ) ( 13 ) Interest expense 670 672 416 Loss on extinguishment of debt — 6 — Other (income) expense, net ( 90 ) ( 124 ) 33 Income before income taxes and equity in earnings (losses) of unconsolidated affiliates $ 1,669 $ 1,459 $ 1,363 113 21. Earnings Per Share The following table presents the computation of basic and diluted earnings per share: Year Ended December 31, (in millions, except per share data) 2024 2023 2022 Numerator: Net income $ 1,373 $ 1,358 $ 1,091 Denominator: Basic weighted average common shares outstanding 181.3 183.8 187.6 Effect of dilutive stock options and share awards 2.1 2.5 3 Diluted weighted average common shares outstanding 183.4 186.3 190.6 Earnings per share attributable to common stockholders: Basic $ 7.57 $ 7.39 $ 5.82 Diluted $ 7.49 $ 7.29 $ 5.72 Stock-based awards will have a dilutive effect under the treasury method when the respective period’s average market value of the Company’s common stock exceeds the exercise proceeds. Performance awards are included in diluted earnings per share based on if the performance targets have been met at the end of the reporting period. For the years ended December 31, 2024, 2023 and 2022 the weighted average number of outstanding stock-based awards not included in the computation of diluted earnings per share because they are subject to performance conditions that have not been met at the end of the reporting period or the effect of including such stock-based awards in the computation would be anti-dilutive was 1.0 million, 1.0 million, and 0.5 million, million, respectively. 22. Accumulated Other Comprehensive (Loss) Income Below is a summary of the components of AOCI: (in millions) Foreign Currency Translation Derivative Instruments Defined Benefit Plans Income Taxes Total Balance as of December 31, 2021 $ ( 570 ) $ ( 21 ) $ 5 $ 180 $ ( 406 ) Other comprehensive (loss) income before reclassifications ( 255 ) 53 ( 13 ) ( 116 ) ( 331 ) Reclassification adjustments — 12 — ( 2 ) 10 Balance as of December 31, 2022 ( 825 ) 44 ( 8 ) 62 ( 727 ) Other comprehensive (loss) income before reclassifications ( 144 ) ( 10 ) 11 54 ( 89 ) Reclassification adjustments — ( 68 ) — 17 ( 51 ) Balance as of December 31, 2023 ( 969 ) ( 34 ) 3 133 ( 867 ) Other comprehensive (loss) income before reclassifications ( 123 ) 70 12 ( 99 ) ( 140 ) Reclassification adjustments — ( 41 ) — 10 ( 31 ) Balance as of December 31, 2024 $ ( 1,092 ) $ ( 5 ) $ 15 $ 44 $ ( 1,038 ) 114 Below is a summary of the adjustments for amounts reclassified from AOCI into the consolidated statements of income and the affected financial statement line item: Year Ended December 31, (in millions) Affected Financial Statement Line Item 2024 2023 2022 Derivative instruments: Interest rate swaps Interest expense $ 41 $ 47 $ ( 22 ) Foreign exchange forward contracts Revenues — 21 10 Total before income taxes 41 68 ( 12 ) Income taxes 10 17 ( 2 ) Total net of income taxes $ 31 $ 51 $ ( 10 ) 23. Supplemental Cash Flow Information The following table presents the Company’s supplemental cash flow information: Year Ended December 31, (in millions) 2024 2023 2022 Supplemental Cash Flow Information: Interest paid, net $ 589 $ 556 $ 379 Income taxes paid, net of refunds $ 295 $ 340 $ 255 115 Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure None.