IQVIA Q3 2026 Results delivered revenue of $4,428 million for the quarter ended September 30, 2026, up 8.0% year-over-year and 8.6% at constant currency, according to a report dated October 27, 2026 from IQVIA Holdings Inc. (NYSE:IQV). The company provides clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. It also raised its full-year 2026 guidance for revenue, Adjusted EBITDA and Adjusted Diluted Earnings per Share.
GAAP net income was $350 million and GAAP diluted earnings per share were $2.10. Adjusted EBITDA reached $1,032 million, up 8.7% year-over-year. Adjusted Diluted Earnings per Share came in at $3.34, up 11.3%. Chairman and CEO Ari Bousbib described the period as “another record quarter,” saying revenue, Adjusted EBITDA and Adjusted Diluted EPS all exceeded the high end of the company’s expectations.
Operating cash flow was $825 million and free cash flow was $667 million, representing 120% of Adjusted Net Income. IQVIA also announced it will host an Investor Day on December 1, 2026. The sections below break down segment performance, bookings, backlog, cash flow, leverage and guidance, with every figure taken from the company’s third-quarter release.
IQVIA Q3 2026 Results by Segment: Commercial Solutions and R&D Solutions
Effective January 1, 2026, IQVIA adopted a simplified organizational model and now reports two segments: Commercial Solutions and Research & Development Solutions (R&DS). Prior-period segment amounts were recast to match. In the IQVIA Q3 2026 Results, Commercial Solutions revenue was $1,789 million, up 6.9% on a reported basis and 7.9% at constant currency.
R&D Solutions revenue was $2,639 million, up 8.7% reported and 9.1% at constant currency. Excluding reimbursed expenses, R&DS revenue grew 6.8% on a reported basis. R&DS is the larger of the two segments by revenue, and it also posted the faster growth rate in the quarter.
The table below summarizes the third-quarter headline figures against the same quarter of 2025, as reported in the company’s condensed financial statements. All values are in millions of U.S. dollars except per-share data.
IQVIA Third-Quarter 2026 Headline Metrics vs. Third-Quarter 2025
| Metric | Q3 2026 | Q3 2025 | Reported Change |
|---|---|---|---|
| Revenue | $4,428M | $4,100M | Up 8.0% (8.6% constant currency) |
| Net income attributable to IQVIA Holdings | $350M | $331M | Not stated in release |
| Adjusted EBITDA | $1,032M | $949M | Up 8.7% |
| Adjusted Net Income | $557M | $515M | Not stated in release |
| GAAP diluted EPS | $2.10 | $1.93 | Not stated in release |
| Adjusted diluted EPS | $3.34 | $3.00 | Up 11.3% |
| Operating cash flow | $825M | $908M | Not stated in release |
| Free cash flow | $667M | $772M | Not stated in release |
Segment Revenue, Third Quarter and First Nine Months of 2026
| Segment | Q3 2026 Revenue | Q3 Reported Growth | Q3 Constant-Currency Growth | 9M 2026 Revenue | 9M Reported Growth | 9M Constant-Currency Growth |
|---|---|---|---|---|---|---|
| Commercial Solutions | $1,789M | 6.9% | 7.9% | $5,336M | 9.0% | 8.3% |
| R&D Solutions | $2,639M | 8.7% | 9.1% | $7,611M | 8.0% | 7.4% |
| Total IQVIA | $4,428M | 8.0% | 8.6% | $12,947M | 8.4% | 7.7% |
Bookings and Backlog in IQVIA Q3 2026 Results Signal Demand Strength
R&D Solutions net new bookings were $3.2 billion in the third quarter, up 15% year-over-year, for a book-to-bill ratio of 1.2x. Last-twelve-month net new bookings were $11.7 billion, up 14% year-over-year. Bousbib said higher win rates produced the company’s strongest clinical quarterly bookings since 2022.
In the release, Bousbib pointed to several demand indicators that he characterized as favorable: EBP funding, RFP flow, clinical trial starts, FDA approvals, outsourcing trends, and pipeline growth across clinical and commercial. He also said more than 400 AI agents have been deployed to date. Organic growth accelerated year-over-year to double the rate for commercial and nearly triple the rate for clinical, according to his statement.
The company also disclosed a backlog adjustment. After a detailed review of inactive trials, IQVIA reduced its backlog estimates by approximately $2.1 billion. IQVIA states the adjustment has no impact on historical financial results, 2026 guidance, book-to-bill, or next-twelve-month revenue from backlog. R&DS contracted backlog stood at $32.6 billion as of September 30, 2026, and the company expects about $9.4 billion of it to convert to revenue over the next twelve months, representing 10% year-over-year growth. These bookings and backlog figures are central to the IQVIA Q3 2026 Results.
R&D Solutions Bookings and Backlog (as of September 30, 2026)
| Metric | Value |
|---|---|
| Q3 2026 net new bookings | $3.2 billion (up 15% year-over-year) |
| Q3 2026 book-to-bill ratio | 1.2x |
| Last-twelve-month net new bookings | $11.7 billion (up 14% year-over-year) |
| Backlog adjustment for inactive trials | Approximately $2.1 billion |
| R&DS contracted backlog | $32.6 billion |
| Backlog expected to convert to revenue in next 12 months | Approximately $9.4 billion (10% year-over-year growth) |
| AI agents deployed to date | Over 400 |
IQVIA Q3 2026 Results: Cash Flow, Debt and Balance Sheet Position
As of September 30, 2026, IQVIA held cash and cash equivalents of $2,249 million against debt of $16,067 million, for net debt of $13,818 million. The Net Leverage Ratio was 3.45x trailing twelve-month Adjusted EBITDA of $4,004 million, and the Gross Leverage Ratio was 4.01x. Investors tracking credit quality will want to watch these ratios alongside the company’s growth outlook.
For the first nine months of 2026, revenue was $12,947 million, up 8.4% reported and 7.7% at constant currency. GAAP net income was $880 million with diluted EPS of $5.24. Adjusted EBITDA was $2,958 million, up 7.9%, while Adjusted Net Income was $1,576 million and Adjusted Diluted EPS was $9.38, up 10.4%. Nine-month operating cash flow was $2,001 million, compared with $1,919 million a year earlier, and free cash flow was $1,518 million versus $1,490 million.
A closer reading of the IQVIA Q3 2026 Results shows that third-quarter operating cash flow of $825 million and free cash flow of $667 million were lower than the $908 million and $772 million reported for the third quarter of 2025. Third-quarter interest expense was $203 million versus $189 million, and restructuring costs were $36 million versus $20 million. The company repurchased $950 million of common stock over the nine months, compared with $1,032 million in the prior-year period. The release does not provide an explanation for the quarterly cash flow comparison beyond the figures themselves.
Balance Sheet, Leverage and Nine-Month Cash Flow
| Item | Value |
|---|---|
| Cash and cash equivalents (Sept. 30, 2026) | $2,249M |
| Total debt (Sept. 30, 2026) | $16,067M |
| Net debt | $13,818M |
| LTM Adjusted EBITDA | $4,004M |
| Gross Leverage Ratio | 4.01x |
| Net Leverage Ratio | 3.45x |
| Nine-month operating cash flow (2026 / 2025) | $2,001M / $1,919M |
| Nine-month free cash flow (2026 / 2025) | $1,518M / $1,490M |
| Nine-month share repurchases (2026 / 2025) | $950M / $1,032M |
| Nine-month acquisitions, net of cash acquired (2026 / 2025) | $589M / $798M |
What IQVIA Q3 2026 Results Mean for 2026 Guidance and the Investor Day
IQVIA is raising its full-year 2026 guidance. The company now expects revenue between $17,350 million and $17,500 million, Adjusted EBITDA between $4,025 million and $4,055 million, and Adjusted Diluted EPS between $12.90 and $13.00. These are forward-looking statements and may differ materially from actual results.
The revenue guidance anticipates 250 basis points of contribution from acquisitions, including deals the company expects to complete by year-end, and roughly 20 basis points of foreign exchange tailwind. All guidance assumes exchange rates as of October 26, 2026 remain in effect. The company noted that guidance measures other than revenue are provided on a non-GAAP basis without a GAAP reconciliation, because certain items cannot be predicted with reasonable certainty.
