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Item 2. Management’s Discussion and Analysis

2025-10-28 compared with 2025-07-22 · 100 added, 100 removed, 259 unchanged (44% of the section changed)

55 unchanged sentences

Foreign Currency Translation

In the first six months of 2025, approximately 30% of our revenues were denominated in currencies other than the United States dollar, which represents approximately 60 currencies.

In the first nine months of 2025, approximately 30% of our revenues were denominated in currencies other than the United States dollar, which represents approximately 60 currencies.

Because a large portion of our revenues and expenses are denominated in foreign currencies and our financial statements are reported in United States dollars, changes in foreign currency exchange rates can significantly affect our results of operations.

3 unchanged sentences

This constant currency information assumes the same foreign currency exchange rates that were in effect for the comparable prior-year period were used in translation of the current period results.

As such, the differences noted below between reported results of operations and constant currency information is wholly attributable to the effects of foreign currency rate fluctuations.

As such, the differences noted below between reported results of operations and constant currency information are wholly attributable to the effects of foreign currency rate fluctuations.

Consolidated Results of Operations

For information regarding our results of operations for Technology & Analytics Solutions, Research & Development Solutions and Contract Sales & Medical Solutions, refer to “Segment Results of Operations” later in this section.

Three Months Ended June 30, Change

Three Months Ended September 30, Change

(in millions)

Revenues $ 4,100 $ 3,896 $ 204 5.2 %

For the second quarter of 2025, our revenues increased $203 million, or 5.3%, as compared to the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $139 million, or 3.6%, reflecting a $101 million increase in Technology & Analytics Solutions, a $27 million increase in Research & Development Solutions, and an $11 million increase in Contract Sales & Medical Solutions.

Six Months Ended June 30, Change

For the third quarter of 2025, our revenues increased $204 million, or 5.2%, as compared to the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $150 million, or 3.9%, reflecting a $52 million increase in Technology & Analytics Solutions, a $73 million increase in Research & Development Solutions, and a $25 million increase in Contract Sales & Medical Solutions.

Nine Months Ended September 30, Change

(in millions)

Revenues $ 11,946 $ 11,447 $ 499 4.4 %

For the first six months of 2025, our revenues increased $295 million, or 3.9%, as compared to the same period in 2024.

For the first nine months of 2025, our revenues increased $499 million, or 4.4%, as compared to the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $418 million, or 3.7%, reflecting a $263 million increase in Technology & Analytics Solutions, a $123 million increase in Research & Development Solutions, and a $32 million increase in Contract Sales & Medical Solutions.

Cost of Revenues, exclusive of Depreciation and Amortization

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

Three Months Ended September 30, Nine Months Ended September 30,

(in millions) 2025 2024 2025 2024

1 unchanged sentence

% of revenues 66.5 % 64.6 % 66.6 % 65.1 %

The $206 million increase in cost of revenues, exclusive of depreciation and amortization, for the three months ended June 30, 2025 as compared to the same period in 2024 included a constant currency increase of approximately $171 million, or 6.9%, reflecting an $84 million increase in Technology & Analytics Solutions, a $78 million increase in Research & Development Solutions, and a $9 million increase in Contract Sales & Medical Solutions.

The $293 million increase in cost of revenues, exclusive of depreciation and amortization, for the six months ended June 30, 2025 as compared to the same period in 2024 included a constant currency increase of approximately $308 million, or 6.2%, reflecting a $159 million increase in Technology & Analytics Solutions, a $141 million increase in Research & Development Solutions, and an $8 million increase in Contract Sales & Medical Solutions.

The $209 million increase in cost of revenues, exclusive of depreciation and amortization, for the three months ended September 30, 2025 as compared to the same period in 2024 included a constant currency increase of approximately $183 million, or 7.3%, reflecting a $77 million increase in Technology & Analytics Solutions, an $82 million increase in Research & Development Solutions, and a $24 million increase in Contract Sales & Medical Solutions.

The $502 million increase in cost of revenues, exclusive of depreciation and amortization, for the nine months ended September 30, 2025 as compared to the same period in 2024 included a constant currency increase of approximately $491 million, or 6.6%, reflecting a $236 million increase in Technology & Analytics Solutions, a $223 million increase in Research & Development Solutions, and a $32 million increase in Contract Sales & Medical Solutions.

Selling, General and Administrative Expenses

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

Three Months Ended September 30, Nine Months Ended September 30,

(in millions)

3 unchanged sentences

12.5 % 13.4 % 12.8 % 13.4 %

Selling, general and administrative expenses for the three months ended June 30, 2025 were consistent with the same period in 2024.

At constant currency, selling, general and administrative expenses decreased approximately $7 million, or 1.4%, reflecting a $1 million increase in Technology & Analytics Solutions, a $4 million increase in Research & Development Solutions, no change in Contract Sales & Medical Solutions, and a $12 million decrease in general corporate and unallocated expenses.

Selling, general and administrative expenses for the six months ended June 30, 2025 were consistent with the same period in 2024.

At constant currency, selling, general and administrative expense increased approximately $1 million, or 0.1%, reflecting a $13 million increase in Technology & Analytics Solutions, a $1 million increase in Research & Development Solutions, a $2 million decrease in Contract Sales & Medical Solutions, and an $11 million decrease in general corporate and unallocated expenses.

The $8 million decrease in selling, general and administrative expenses for the three months ended September 30, 2025 as compared to the same period in 2024 included a constant currency decrease of approximately $14 million, or 2.7%, reflecting a $14 million increase in Technology & Analytics Solutions, a $9 million increase in Research & Development Solutions, a $1 million increase in Contract Sales & Medical Solutions, and a $38 million decrease in general corporate and unallocated expenses.

The $8 million decrease in selling, general and administrative expenses for the nine months ended September 30, 2025 as compared to the same period in 2024 included a constant currency decrease of approximately $13 million, or 0.8%, reflecting a $27 million increase in Technology & Analytics Solutions, a $10 million increase in Research & Development Solutions, a $1 million decrease in Contract Sales & Medical Solutions, and a $49 million decrease in general corporate and unallocated expenses.

Depreciation and Amortization

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

Three Months Ended September 30, Nine Months Ended September 30,

(in millions) 2025 2024 2025 2024

2 unchanged sentences

7.0 % 7.1 % 6.9 % 7.1 %

The $7 million and $8 million increase in depreciation and amortization for the three and six months ended June 30, 2025 compared to the same periods in 2024 is mainly related to an increase in amortization of capitalized software costs.

The $8 million and $16 million increases in depreciation and amortization for the three and nine months ended September 30, 2025 compared to the same periods in 2024 are mainly related to an increase in amortization of capitalized software costs.

Restructuring Costs

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

Three Months Ended September 30, Nine Months Ended September 30,

(in millions) 2025 2024 2025 2024

3 unchanged sentences

Interest Income and Interest Expense

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

Three Months Ended September 30, Nine Months Ended September 30,

(in millions) 2025 2024 2025 2024

2 unchanged sentences

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

Interest income during the three and six months ended June 30, 2025 decreased compared to the same periods in 2024 primarily as a result of lower interest rates.

Interest expense during the three and six months ended June 30, 2025 increased compared to the same periods in 2024 as a result of higher outstanding debt balances.

Other Expense (Income), Net

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

Interest income during the three months ended September 30, 2025 remained consistent as compared to the same period in 2024, and for the nine months ended September 30, 2025 decreased compared to the same period in 2024 primarily as a result of lower interest rates.

Interest expense during the three and nine months ended September 30, 2025 increased compared to the same periods in 2024 as a result of higher outstanding debt balances.

Other (Income) Expense, Net

Three Months Ended September 30, Nine Months Ended September 30,

(in millions) 2025 2024 2025 2024

Other expense (income), net $ 11 $ (67) $ 26 $ (56)

Other expense (income), net for the three and six months ended June 30, 2025 increased compared to the same periods in 2024 primarily due to less revaluations of contingent consideration arrangements and to a lesser extent from foreign currency loss on transactions.

Other (income) expense, net $ (31) $ 44 $ (5) $ (12)

Other (income) expense, net for the three months ended September 30, 2025 increased compared to the same period in 2024 primarily due to foreign currency gain on transactions.

Other (income) expense, net for the nine months ended September 30, 2025 decreased compared to the same period in 2024 primarily due to less revaluations of contingent consideration arrangements and adjustments in investment balances, offset by less foreign currency loss on transactions.

Income Tax Expense

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

Three Months Ended September 30, Nine Months Ended September 30,

(in millions) 2025 2024 2025 2024

Income tax expense $ 76 $ 65 $ 193 $ 189

Our effective income tax rate was 17.3% and 17.2% in the second quarter of 2025 and 2024, respectively.

Our effective income tax rate was 18.1% and 16.0% in the first six months of 2025 and 2024, respectively.

Our effective income tax rate in the second quarter and in the first six months of 2025 and 2024 was favorably impacted due to changes in the geographical mix of earnings amongst the United States and foreign tax jurisdictions.

Our effective income tax rate in the second quarter and in the first six months of 2024 was also favorably impacted by $3 million and $12 million, respectively, as a result of excess tax benefits recognized upon settlement of share-based compensation awards.

Our effective income tax rate in the second quarter and in the first six months of 2025 was unfavorably impacted by $0 million and $3 million, respectively, of tax expense recognized upon settlement of share-based compensation awards.

Our effective income tax rate was 18.6% and 18.6% in the third quarter of 2025 and 2024, respectively.

Our effective income tax rate was 18.3% and 16.8% in the first nine months of 2025 and 2024, respectively.

Our effective income tax rate in the third quarter and in the first nine months of 2025 and 2024 was favorably impacted due to changes in the geographical mix of earnings amongst the United States and foreign tax jurisdictions.

Our effective income tax rate in the third quarter and in the first nine months of 2024 was also favorably impacted by $2 million and $14 million, respectively, as a result of excess tax benefits recognized upon settlement of share-based compensation awards.

Our effective income tax rate in the third quarter and in the first nine months of 2025 was unfavorably impacted by $0 million and $3 million, respectively, of tax expense recognized upon settlement of share-based compensation awards.

On July 4, 2025, the U.S.

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federal income tax law, including the temporary and permanent extension, of expiring provisions of the Tax Cuts and Jobs Act of 2017.

We are assessing these impacts on our consolidated financial statements.

The impacts of the OBBBA are not expected to be material to the 2025 consolidated financial statements, however we will continue to evaluate impacts to future periods.

On December 12, 2022, the European Union member states agreed to implement the Organization for Economic Cooperation and Development’s (“OECD”) Pillar Two global corporate minimum tax rate of 15% on companies with revenues of at least €750 million, which went into effect in 2024.

We have continued to evaluate the effect of this through the second quarter of 2025 and determined that it did not have any material impacts for the current year.

We have continued to evaluate the effect of this through the third quarter of 2025 and determined that it did not have any material impacts for the current year.

We 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 OECD's proposal.

Equity in (Losses) Earnings of Unconsolidated Affiliates

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

Equity in Earnings (Losses) of Unconsolidated Affiliates

Three Months Ended September 30, Nine Months Ended September 30,

(in millions) 2025 2024 2025 2024

Equity in (losses) earnings of unconsolidated affiliates $ (1) $ 2 $ (14) $ (1)

Equity in (losses) earnings of unconsolidated affiliates for the three and six months ended June 30, 2025, increased compared to the same periods in 2024, due to the results in the operations of our unconsolidated affiliates.

Equity in earnings (losses) of unconsolidated affiliates $ — $ 1 $ (14) $ —

Equity in earnings (losses) of unconsolidated affiliates for the three and nine months ended September 30, 2025, decreased compared to the same periods in 2024, due to the results in the operations of our unconsolidated affiliates.

Segment Results of Operations

Revenues and profit by segment are as follows:

Three Months Ended June 30, 2025 and 2024

Three Months Ended September 30, 2025 and 2024

Segment Revenues Segment Profit

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Consolidated $ 4,100 $ 3,896 $ 553 $ 550

Six Months Ended June 30, 2025 and 2024

Nine Months Ended September 30, 2025 and 2024

Segment Revenues Segment Profit

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

These costs primarily consist of stock-based compensation and expenses related to integration activities and acquisitions, as well as certain general corporate and unallocated expenses.

These costs primarily consist of stock-based compensation, expenses related to integration activities and acquisitions, as well as certain general corporate and unallocated expenses.

We also do not allocate restructuring costs, depreciation and amortization, or impairment charges, if any, to our segments.

Technology & Analytics Solutions

Three Months Ended June 30, Change

Three Months Ended September 30, Change

(in millions) 2025 2024 $ %

3 unchanged sentences

Segment profit $ 370 $ 405 $ (35) (8.6) %

Six Months Ended June 30, Change

Nine Months Ended September 30, Change

(in millions) 2025 2024 $ %

3 unchanged sentences

Segment profit $ 1,119 $ 1,101 $ 18 1.6 %

Technology & Analytics Solutions’ revenues were $1,628 million for the second quarter of 2025, an increase of $133 million, or 8.9%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $101 million, or 6.8%, reflecting revenue growth primarily in the Europe and Africa and Americas regions.

Technology & Analytics Solutions’ revenues were $3,174 million for the first six months of 2025, an increase of $226 million, or 7.7%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $211 million, or 7.2%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Americas region.

The constant currency revenue growth for the three and six months ended June 30, 2025 was primarily driven by an increase in real world services and to a lesser extent by information and technology services.

Technology & Analytics Solutions’ revenues were $1,631 million for the third quarter of 2025, an increase of $77 million, or 5.0%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $52 million, or 3.3%, reflecting revenue growth primarily in the Americas region and to a lesser extent in the Asia-Pacific region.

Technology & Analytics Solutions’ revenues were $4,805 million for the first nine months of 2025, an increase of $303 million, or 6.7%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $263 million, or 5.8%, reflecting revenue growth primarily in the Americas region and to a lesser extent in the Europe and Africa region.

The constant currency revenue growth for the three and nine months ended September 30, 2025 was primarily driven by an increase in information and technology services and to a lesser extent by real world services.

Cost of Revenues, exclusive of Depreciation and Amortization

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $100 million, or 11.0%, in the second quarter of 2025 over the same period in 2024.

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $92 million, or 10.0%, in the third quarter of 2025 over the same period in 2024.

This increase included a constant currency increase of approximately $77 million, or 8.4%.

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $160 million, or 8.9%, in the first six months of 2025 over the same period in 2024.

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $252 million, or 9.3%, in the first nine months of 2025 over the same period in 2024.

This increase included a constant currency increase of approximately $236 million, or 8.7%.

The constant currency increase for the three and six months ended June 30, 2025 was primarily related to an increase in reimbursed expenses and to a lesser extent in compensation and related expenses to support revenue growth.

The constant currency increase for the three and nine months ended September 30, 2025 was primarily related to an increase in compensation and related expenses and to a lesser extent in reimbursed expenses to support revenue growth.

Selling, General and Administrative Expenses

Technology & Analytics Solutions’ selling, general and administrative expenses increased $5 million, or 2.2%, in the second quarter of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $1 million, or 0.4%.

Technology & Analytics Solutions’ selling, general and administrative expenses increased $13 million, or 2.9%, in the first six months of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $13 million, or 2.9%.

The constant currency increase for the six months ended June 30, 2025 was primarily related to an increase in IT-related expenses.

Technology & Analytics Solutions’ selling, general and administrative expenses increased $20 million, or 8.8%, in the third quarter of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $14 million, or 6.2%.

Technology & Analytics Solutions’ selling, general and administrative expenses increased $33 million, or 4.8%, in the first nine months of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $27 million, or 4.0%.

The constant currency increase for the nine months ended September 30, 2025 was primarily related to an increase in IT-related expenses.

Research & Development Solutions

Three Months Ended June 30, Change

Three Months Ended September 30, Change

(in millions)

3 unchanged sentences

Segment profit $ 496 $ 498 $ (2) (0.4) %

Six Months Ended June 30, Change

Nine Months Ended September 30, Change

(in millions)

3 unchanged sentences

Segment profit $ 1,407 $ 1,470 $ (63) (4.3) %

Research & Development Solutions’ contracted backlog increased from $31.1 billion as of December 31, 2024 to $32.1 billion as of June 30, 2025, and we expect approximately $8.1 billion of this backlog to convert to revenues in the next twelve months.

Research & Development Solutions’ revenues were $2,201 million for the second quarter of 2025, an increase of $54 million, or 2.5%, over the same period in 2024.

Research & Development Solutions’ contracted backlog increased from $31.1 billion as of December 31, 2024 to $32.4 billion as of September 30, 2025, and we expect approximately $8.1 billion of this backlog to convert to revenues in the next twelve months.

Research & Development Solutions’ revenues were $2,260 million for the third quarter of 2025, an increase of $98 million, or 4.5%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $73 million, or 3.4%, reflecting revenue growth primarily in the Americas region and to a lesser extent in the Asia-Pacific region.

Research & Development Solutions’ revenues were $6,563 million for the first nine months of 2025, an increase of $159 million, or 2.5%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $123 million, or 1.9%, reflecting revenue growth primarily in the Asia-Pacific region and to a lesser extent in the Americas region.

Research & Development Solutions’ revenues were $4,303 million for the first six months of 2025, an increase of $61 million, or 1.4%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $50 million, or 1.2%, reflecting revenue growth in the Asia-Pacific region.

The constant currency revenue growth for the three and six months ended June 30, 2025 was primarily the result of volume-related increases in clinical services.

The constant currency revenue growth for the three and nine months ended September 30, 2025 was primarily the result of volume-related increases in clinical services.

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

Cost of Revenues, exclusive of Depreciation and Amortization

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $92 million, or 6.4%, in the second quarter of 2025 over the same period in 2024.

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $90 million, or 6.2%, in the third quarter of 2025 over the same period in 2024.

This increase included a constant currency increase of approximately $82 million, or 5.7%.

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $123 million, or 4.4% in the first six months of 2025 over the same period in 2024.

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $213 million, or 5.0% in the first nine months of 2025 over the same period in 2024.

This increase included a constant currency increase of approximately $223 million, or 5.2%.

The constant currency increase for the three and six months ended June 30, 2025 was primarily related to an increase in compensation and related expenses as a result of volume-related increases in clinical services.

Selling, General and Administrative Expenses

Research & Development Solutions’ selling, general and administrative expenses increased $4 million, or 1.8%, in the second quarter of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $4 million, or 1.8%.

Research & Development Solutions’ selling, general and administrative expenses decreased $1 million, or 0.2% in the first six months of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $1 million, or 0.2%.

The constant currency increase for the three and six months ended June 30, 2025 was primarily related to an increase in compensation and related expenses.

Research & Development Solutions’ selling, general and administrative expenses increased $10 million, or 4.5%, in the third quarter of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $9 million, or 4.1%.

Research & Development Solutions’ selling, general and administrative expenses increased $9 million, or 1.4% in the first nine months of 2025 as compared to the same period in 2024, which included a constant currency increase of approximately $10 million, or 1.5%.

The constant currency increase for the three and nine months ended September 30, 2025 was primarily related to an increase in compensation and related expenses.

Contract Sales & Medical Solutions

Three Months Ended June 30, Change

Three Months Ended September 30, Change

(in millions)

3 unchanged sentences

Segment profit $ 13 $ 12 $ 1 8.3 %

Six Months Ended June 30, Change

Nine Months Ended September 30, Change

(in millions)

3 unchanged sentences

Segment profit $ 36 $ 34 $ 2 5.9 %

Contract Sales & Medical Solutions’ revenues were $188 million for the second quarter of 2025, an increase of $16 million, or 9.3%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $11 million, or 6.4%, reflecting revenue growth primarily in the Europe and Africa region.

Contract Sales & Medical Solutions’ revenues were $369 million in the first six months of 2025, an increase of $8 million, or 2.2%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $7 million, or 1.9%, reflecting revenue growth primarily in the Asia-Pacific region.

The constant currency revenue growth for the three and six months ended June 30, 2025 was primarily due to volume-related increases in services performed.

Contract Sales & Medical Solutions’ revenues were $209 million for the third quarter of 2025, an increase of $29 million, or 16.1%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $25 million, or 13.9%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Asia-Pacific region.

Contract Sales & Medical Solutions’ revenues were $578 million in the first nine months of 2025, an increase of $37 million, or 6.8%, over the same period in 2024.

This increase was comprised of constant currency revenue growth of approximately $32 million, or 5.9%, reflecting revenue growth primarily in the Europe and Africa region and to a lesser extent in the Asia-Pacific region.

The constant currency revenue growth for the three and nine months ended September 30, 2025 was primarily due to volume-related increases in services performed.

Cost of Revenues, exclusive of Depreciation and Amortization

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $14 million, or 9.5%, in the second quarter of 2025 as compared to the same period in 2024.

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $27 million, or 17.5%, in the third quarter of 2025 as compared to the same period in 2024.

This increase included a constant currency increase of approximately $24 million, or 15.6%.

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $10 million, or 3.2%, in the first six months of 2025 as compared to the same period in 2024.

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $37 million, or 8.0%, in the first nine months of 2025 as compared to the same period in 2024.

This increase included a constant currency increase of approximately $32 million, or 6.9%.

The constant currency increase for the three and six months ended June 30, 2025 was primarily related to an increase in compensation and related expenses.

The constant currency increase for the three and nine months ended September 30, 2025 was primarily related to an increase in compensation and related expenses.

Selling, General and Administrative Expenses

Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $1 million, or 6.7%, in the second quarter of 2025 as compared to the same period in 2024.

This decrease included no constant currency change.

Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $3 million, or 9.7%, in the first six months of 2025 as compared to the same period in 2024.

Contract Sales & Medical Solutions’ selling, general and administrative expenses increased $1 million, or 7.1%, in the third quarter of 2025 as compared to the same period in 2024.

This increase included a constant currency increase of $1 million or 7.1%.

Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $2 million, or 4.4%, in the first nine months of 2025 as compared to the same period in 2024.

This decrease included a constant currency decrease of approximately $1 million, or 2.2%.

The constant currency decrease for the six months ended June 30, 2025 was primarily related to a decrease in compensation and related expenses.

The constant currency increase for the three months ended September 30, 2025 and the decrease for the nine months ended September 30, 2025 was primarily related to changes in compensation and related expenses.

Liquidity and Capital Resources

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We have and expect to transfer cash from those subsidiaries to the United States and to other international subsidiaries when it is cost effective to do so.

We had a cash balance of $2,039 million as of June 30, 2025 ($911 million of which was in the United States), an increase from $1,702 million as of December 31, 2024.

We had a cash balance of $1,814 million as of September 30, 2025 ($656 million of which was in the United States), an increase from $1,702 million as of December 31, 2024.

Based on our current operating plan, we believe that our available cash and cash equivalents, future cash flows from operations and our ability to access funds under our revolving credit and receivables financing facilities will enable us to fund our operating requirements, capital expenditures, contractual obligations, and meet debt obligations for at least the next 12 months.

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The Repurchase Program does not obligate us to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time.

During the six months ended June 30, 2025, we repurchased 6.4 million shares of our common stock for $1,032 million under the Repurchase Program.

As of June 30, 2025, we had remaining authorization to repurchase up to $1,981 million of our common stock under the Repurchase Program.

During the nine months ended September 30, 2025, we repurchased 6.4 million shares of our common stock for $1,032 million under the Repurchase Program.

As of September 30, 2025, we had remaining authorization to repurchase up to $1,981 million of our common stock under the Repurchase Program.

In addition, from time to time, we have repurchased and may continue to repurchase common stock through private or other transactions outside of the Repurchase Program.

As of June 30, 2025, we had $15,573 million of total indebtedness, excluding $1,995 million of additional available borrowings under our revolving credit facility.

Our long-term debt arrangements contain customary restrictive covenants and, as of June 30, 2025, we believe we were in compliance with our restrictive covenants in all material respects.

As of September 30, 2025, we had $15,034 million of total indebtedness, excluding $1,995 million of additional available borrowings under our revolving credit facility.

Our long-term debt arrangements contain customary restrictive covenants and, as of September 30, 2025, we believe we were in compliance with our restrictive covenants in all material respects.

Senior Secured Credit Facilities

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In connection with this Amendment, we recognized a $4 million loss on extinguishment of debt, which includes fees and related expenses.

As of June 30, 2025, our Fifth Amended and Restated Credit Agreement provided financing through the senior secured credit facilities of up to $6,491 million, which consisted of $4,496 million principal amounts of debt outstanding, and $1,995 million of available borrowing capacity on the revolving credit facility and standby letters of credit.

As of September 30, 2025, our Fifth Amended and Restated Credit Agreement provided financing through the senior secured credit facilities of up to $6,448 million, which consisted of $4,453 million principal amounts of debt outstanding, and $1,995 million of available borrowing capacity on the revolving credit facility and standby letters of credit.

See Note 7 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding our credit arrangements.

During the three months ended September 30, 2025, the Company's Euro denominated 2.875% Senior Notes due 2025 matured and were repaid.

On June 4, 2025, we completed the issuance and sale of $2,000 million in gross proceeds of 6.250% senior notes due 2032 (the "Senior Notes").

2 unchanged sentences

Receivables Financing Facility

As of June 30, 2025, no additional amounts of revolving loans were available under the receivables financing facility.

Six months ended June 30, 2025 and 2024

As of September 30, 2025, no additional amounts of revolving loans were available under the receivables financing facility.

Nine months ended September 30, 2025 and 2024

Cash Flow from Operating Activities

Six Months Ended June 30,

Nine Months Ended September 30,

(in millions) 2025 2024

Net cash provided by operating activities $ 1,919 $ 1,831

Cash provided by operating activities decreased $99 million during the first six months of 2025 as compared to the same period in 2024.

The decrease was primarily driven by a decrease in cash from accounts receivable and unbilled services ($119 million), cash-related net income ($97 million), and cash from other operating assets and liabilities ($84 million), which includes $42 million in cash received related to the termination of our previous cross-currency swaps during the first six months of 2025, offset by an increase in cash from unearned income ($201 million).

Cash provided by operating activities increased $88 million during the first nine months of 2025 as compared to the same period in 2024.

The increase was primarily driven by an increase in cash from unearned income ($294 million), offset by a decrease in cash from accounts receivable and unbilled services ($111 million), cash from other operating assets and liabilities ($57 million), which includes $42 million in cash received related to the termination of our previous cross-currency swaps during the first nine months of 2025, and cash-related net income ($38 million).

Cash Flow from Investing Activities

Six Months Ended June 30,

Nine Months Ended September 30,

(in millions) 2025 2024

Net cash used in investing activities $ (1,201) $ (1,134)

Cash used in investing activities increased $116 million during the first six months of 2025 as compared to the same period in 2024, primarily driven by more cash used for acquisitions of businesses ($94 million), cash used in investments in debt and equity securities ($17 million), and acquisitions of property, equipment and software ($5 million), and less proceeds from sale of property, equipment, and software ($25 million), offset by less cash used for investments in unconsolidated affiliates, net ($22 million), more cash from sales of marketable securities, net ($2 million), and cash from other ($1 million).

Cash used in investing activities increased $67 million during the first nine months of 2025 as compared to the same period in 2024, primarily driven by more cash used for acquisitions of businesses ($149 million), cash used for investments in debt and equity securities ($18 million), and cash used in other ($1 million), offset by more proceeds from sale of property, equipment, and software ($50 million), less cash used for investments in unconsolidated affiliates, net ($40 million), less cash used for acquisitions of property, equipment and software ($9 million), and more cash from sales of marketable securities, net ($2 million).

Cash Flow from Financing Activities

Six Months Ended June 30,

Nine Months Ended September 30,

(in millions) 2025 2024

Net cash used in financing activities $ (685) $ (503)

Cash used in financing activities decreased $253 million during the first six months of 2025 as compared to the same period in 2024, primarily due to more proceeds from issuance of debt, net ($3,950 million), and less cash used for payments related to employee stock incentive plans ($25 million), offset by more cash payments for debt and principal payments on finance leases ($2,054 million), repurchase of common stock ($1,032 million), revolving credit facilities, net of repayments ($615 million), other ($11 million) and contingent consideration and deferred purchase price accruals ($10 million).

Cash used in financing activities increased $182 million during the first nine months of 2025 as compared to the same period in 2024, primarily due to more cash payments for debt and principal payments on finance leases ($2,546 million), repurchase of common stock ($832 million), revolving credit facilities, net of repayments ($725 million), contingent consideration and deferred purchase price accruals ($14 million), other ($11 million), and cash used for payments related to employee stock incentive plans ($5 million), offset by more proceeds from issuance of debt, net ($3,951 million).

Information about our Guarantors and the Issuer of our Guaranteed Securities

7 unchanged sentences

Each Guarantor subsidiary is consolidated by IQVIA Holdings Inc.

as of June 30, 2025 and December 31, 2024.

Refer to Exhibit 22.1 to this Quarterly Report on Form 10-Q for the detailed list of entities included within the obligated group as of June 30, 2025.

as of September 30, 2025 and December 31, 2024.

Refer to Exhibit 22.1 to this Quarterly Report on Form 10-Q for the detailed list of entities included within the obligated group as of September 30, 2025.

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

14 unchanged sentences

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

(in millions) June 30, 2025 December 31, 2024

(in millions) September 30, 2025 December 31, 2024

Total current assets (excluding amounts due from subsidiaries that are non-Guarantors) $ 599 $ 935

5 unchanged sentences

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

Six months ended Twelve months ended

(in millions) June 30, 2025 December 31, 2024

Nine months ended Twelve months ended

(in millions) September 30, 2025 December 31, 2024

Net revenues $ 5,039 $ 6,661

12 unchanged sentences

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

What changed 10-Q

Item 2. Management’s Discussion and Analysis