10-Q

UNITED STATES

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

______________________________________________________

FORM 10-Q

_________________________________________________________

(Mark One)

☒ QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the quarterly period ended September 30, 2023

or

☐ TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934

For the transition period from            to             .

Commission File Number: 001-35907

_________________________________________________________

IQVIA HOLDINGS INC.

(Exact name of registrant as specified in its charter)

_________________________________________________________

Delaware	27-1341991
(State or other jurisdiction of incorporation or organization)	(I.R.S. Employer Identification Number)

2400 Ellis Rd., Durham, North Carolina 27703

(Address of principal executive office and Zip Code)

(919) 998-2000

(Registrant’s telephone number, including area code)

_________________________________________________________

Indicate by check mark whether the registrant (1) has filed all reports required to be filed by Section 13 or 15(d) of the Securities Exchange Act of 1934 during the preceding 12 months (or for such shorter period that the registrant was required to file such reports), and (2) has been subject to such filing requirements for the past 90 days.    Yes x    No ¨

Indicate by check mark whether the registrant has submitted electronically every Interactive Data File required to be submitted pursuant to Rule 405 of Regulation S-T (§232.405 of this chapter) during the preceding 12 months (or for such shorter period that the registrant was required to submit such files).    Yes x    No ¨

Indicate by check mark whether the registrant is a large accelerated filer, an accelerated filer, a non-accelerated filer, a smaller reporting company, or an emerging growth company. See the definitions of “large accelerated filer,” “accelerated filer,” “smaller reporting company,” and “emerging growth company” in Rule 12b-2 of the Exchange Act.

Large accelerated filer	x	Accelerated filer	☐
Non-accelerated filer	☐	Smaller reporting company	☐
		Emerging growth company	☐

If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act.    ¨

Indicate by check mark whether the registrant is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes ☐    No x

Securities registered pursuant to Section 12(b) of the Act:

Title of Each Class	Trading Symbol	Name of Each Exchange on which Registered
Common Stock, par value $0.01 per share	IQV	New York Stock Exchange

Indicate the number of shares outstanding of each of the issuer’s classes of Common Stock, as of the latest practicable date.

Class	Number of Shares Outstanding
Common Stock $0.01 par value	182.5 million shares outstanding as of October 19, 2023

IQVIA HOLDINGS INC.

FORM 10-Q

TABLE OF CONTENTS

		Page
PART I—FINANCIAL INFORMATION		3
Item 1.	Financial Statements (unaudited)	3
	Condensed Consolidated Statements of Income for the three and nine months ended September 30, 2023 and 2022	3
	Condensed Consolidated Statements of Comprehensive Income for the three and nine months ended September 30, 2023 and 2022	4
	Condensed Consolidated Balance Sheets as of September 30, 2023 and December 31, 2022	5
	Condensed Consolidated Statements of Cash Flows for the nine months ended September 30, 2023 and 2022	6
	Condensed Consolidated Statements of Stockholders’ Equity for the three and nine months ended September 30, 2023 and 2022	7
	Notes to Condensed Consolidated Financial Statements	9
Item 2.	Management’s Discussion and Analysis of Financial Condition and Results of Operations	23
Item 3.	Quantitative and Qualitative Disclosures About Market Risk	33
Item 4.	Controls and Procedures	33
PART II—OTHER INFORMATION		34
Item 1.	Legal Proceedings	34
Item 1A.	Risk Factors	34
Item 2.	Unregistered Sales of Equity Securities and Use of Proceeds	34
Item 5.	Other Information	35
Item 6.	Exhibits	36
SIGNATURES		37

2

PART I—FINANCIAL INFORMATION

Item 1. Financial Statements

IQVIA HOLDINGS INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF INCOME

(unaudited)

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions, except per share data)	2023		2022		2023		2022
Revenues	$	3,736	$	3,562	$	11,116	$	10,671
Cost of revenues, exclusive of depreciation and amortization	2,426		2,321		7,267		6,975
Selling, general and administrative expenses	502		517		1,497		1,488
Depreciation and amortization	297		248		809		773
Restructuring costs	30		4		67		15
Income from operations	481		472		1,476		1,420
Interest income	(14)		(4)		(24)		(7)
Interest expense	181		108		491		288
Other (income) expense, net	(35)		8		(77)		51
Income before income taxes and equity in earnings (losses) of unconsolidated affiliates	349		360		1,086		1,088
Income tax expense	51		70		203		212
Income before equity in earnings (losses) of unconsolidated affiliates	298		290		883		876
Equity in earnings (losses) of unconsolidated affiliates	5		(7)		6		(12)
Net income	$	303	$	283	$	889	$	864
Earnings per share attributable to common stockholders:
Basic	$	1.66	$	1.52	$	4.82	$	4.59
Diluted	$	1.63	$	1.49	$	4.76	$	4.52
Weighted average common shares outstanding:
Basic	182.9		186.5		184.4		188.3
Diluted	185.5		189.4		186.9		191.3

The accompanying notes are an integral part of these condensed consolidated financial statements.

3

IQVIA HOLDINGS INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME

(unaudited)

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Net income	$	303	$	283	$	889	$	864
Comprehensive income adjustments:
Unrealized gains on derivative instruments, net of income tax expense of $—, $2, $11, $10	2		6		34		29
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	—		10		1		4
Foreign currency translation, net of income tax expense of $44, $84, $12, $195	(136)		(218)		(170)		(539)
Reclassification adjustments:
Reclassifications on derivative instruments included in net income, net of income tax (expense) benefit of $(3), $—, $(14), $4	(9)		1		(41)		14
Comprehensive income	$	160	$	82	$	713	$	372

The accompanying notes are an integral part of these condensed consolidated financial statements.

4

IQVIA HOLDINGS INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED BALANCE SHEETS

(unaudited)

(in millions, except per share data)	September 30, 2023		December 31, 2022
ASSETS
Current assets:
Cash and cash equivalents	$	1,224	$	1,216
Trade accounts receivable and unbilled services, net	3,227		2,917
Prepaid expenses	177		151
Income taxes receivable	49		43
Investments in debt, equity and other securities	108		93
Other current assets and receivables	423		561
Total current assets	5,208		4,981
Property and equipment, net	498		532
Operating lease right-of-use assets	292		331
Investments in debt, equity and other securities	99		68
Investments in unconsolidated affiliates	115		94
Goodwill	14,288		13,921
Other identifiable intangibles, net	4,907		4,820
Deferred income taxes	111		118
Deposits and other assets, net	459		472
Total assets	$	25,977	$	25,337
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable and accrued expenses	$	3,133	$	3,316
Unearned income	1,838		1,797
Income taxes payable	172		161
Current portion of long-term debt	1,309		152
Other current liabilities	137		152
Total current liabilities	6,589		5,578
Long-term debt, less current portion	12,322		12,595
Deferred income taxes	365		464
Operating lease liabilities	217		264
Other liabilities	679		671
Total liabilities	20,172		19,572
Commitments and contingencies (Note 8)
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of September 30, 2023 and December 31, 2022, $0.01 par value, 257.1 shares issued and 182.5 shares outstanding as of September 30, 2023; 256.4 shares issued and 185.7 shares outstanding as of December 31, 2022	10,994		10,898
Retained earnings	4,223		3,334
Treasury stock, at cost, 74.6 and 70.7 shares as of September 30, 2023 and December 31, 2022, respectively	(8,509)		(7,740)
Accumulated other comprehensive loss	(903)		(727)
Total stockholders’ equity	5,805		5,765
Total liabilities and stockholders’ equity	$	25,977	$	25,337

The accompanying notes are an integral part of these condensed consolidated financial statements.

5

IQVIA HOLDINGS INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS

(unaudited)

	Nine Months Ended September 30,
(in millions)	2023		2022
Operating activities:
Net income	$	889	$	864
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	809		773
Amortization of debt issuance costs and discount	13		11
Stock-based compensation	172		136
(Earnings) losses from unconsolidated affiliates	(6)		12
(Gain) loss on investments, net	(5)		35
Benefit from deferred income taxes	(117)		(52)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income	(241)		(88)
Change in other operating assets and liabilities	(112)		9
Net cash provided by operating activities	1,402		1,700
Investing activities:
Acquisition of property, equipment and software	(470)		(503)
Acquisition of businesses, net of cash acquired	(869)		(1,012)
Purchases of marketable securities, net	(4)		(4)
Investments in unconsolidated affiliates, net of payments received	(16)		(14)
Investments in debt and equity securities	(36)		—
Other	4		4
Net cash used in investing activities	(1,391)		(1,529)
Financing activities:
Proceeds from issuance of debt	1,250		1,250
Payment of debt issuance costs	(19)		(5)
Repayment of debt and principal payments on finance leases	(118)		(86)
Proceeds from revolving credit facility	2,009		1,500
Repayment of revolving credit facility	(2,184)		(1,600)
Payments related to employee stock option plans	(58)		(70)
Repurchase of common stock	(763)		(1,103)
Contingent consideration and deferred purchase price payments	(79)		(22)
Net cash provided by (used in) financing activities	38		(136)
Effect of foreign currency exchange rate changes on cash	(41)		(127)
Increase (decrease) in cash and cash equivalents	8		(92)
Cash and cash equivalents at beginning of period	1,216		1,366
Cash and cash equivalents at end of period	$	1,224	$	1,274

The accompanying notes are an integral part of these condensed consolidated financial statements.

6

IQVIA HOLDINGS INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

(unaudited)

(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, 2022	256.4	(70.7)	$	3	$	10,895	$	3,334	$	(7,740)	$	(727)	$	5,765
Issuance of common stock	0.5	—	—		(58)		—		—		—		(58)
Repurchase of common stock	—	(0.7)	—		—		—		(129)		—		(129)
Stock-based compensation	—	—	—		69		—		—		—		69
Net income	—	—	—		—		289		—		—		289
Unrealized gains on derivative instruments, net of tax	—	—	—		—		—		—		10		10
Defined benefit plan adjustments, net of tax	—	—	—		—		—		—		1		1
Foreign currency translation, net of tax	—	—	—		—		—		—		10		10
Reclassification adjustments, net of tax	—	—	—		—		—		—		(25)		(25)
Balance, March 31, 2023	256.9	(71.4)	3		10,906		3,623		(7,869)		(731)		5,932
Issuance of common stock	0.1	—	—		—		—		—		—		—
Repurchase of common stock, net of tax	—	(2.5)	—		—		—		(495)		—		(495)
Stock-based compensation	—	—	—		43		—		—		—		43
Net income	—	—	—		—		297		—		—		297
Unrealized gains on derivative instruments, net of tax	—	—	—		—		—		—		22		22
Foreign currency translation, net of tax	—	—	—		—		—		—		(44)		(44)
Reclassification adjustments, net of tax	—	—	—		—		—		—		(7)		(7)
Balance, June 30, 2023	257.0	(73.9)	3		10,949		3,920		(8,364)		(760)		5,748
Issuance of common stock	0.1	—	—		—		—		—		—		—
Repurchase of common stock, net of tax	—	(0.7)	—		—		—		(145)		—		(145)
Stock-based compensation	—	—	—		42		—		—		—		42
Net income	—	—	—		—		303		—		—		303
Unrealized gains on derivative instruments, net of tax	—	—	—		—		—		—		2		2
Foreign currency translation, net of tax	—	—	—		—		—		—		(136)		(136)
Reclassification adjustments, net of tax	—	—	—		—		—		—		(9)		(9)
Balance, September 30, 2023	257.1	(74.6)	$	3	$	10,991	$	4,223	$	(8,509)	$	(903)	$	5,805

The accompanying notes are an integral part of these condensed consolidated financial statements.

7

IQVIA HOLDINGS INC. AND SUBSIDIARIES

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

(unaudited)

(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	0.4	—	—		(67)		—		—		—		(67)
Repurchase of common stock	—	(1.7)	—		—		—		(403)		—		(403)
Stock-based compensation	—	—	—		35		—		—		—		35
Net income	—	—	—		—		325		—		—		325
Unrealized gains on derivative instruments, net of tax	—	—	—		—		—		—		30		30
Defined benefit plan adjustments, net of tax	—	—	—		—		—		—		(2)		(2)
Foreign currency translation, net of tax	—	—	—		—		—		—		(40)		(40)
Reclassification adjustments, net of tax	—	—	—		—		—		—		(1)		(1)
Balance, March 31, 2022	256.2	(66.9)	3		10,742		2,568		(6,975)		(419)		5,919
Issuance of common stock	0.1	—	—		(2)		—		—		—		(2)
Repurchase of common stock	—	(2.8)	—		—		—		(590)		—		(590)
Stock-based compensation	—	—	—		47		—		—		—		47
Net income	—	—	—		—		256		—		—		256
Unrealized losses on derivative instruments, net of tax	—	—	—		—		—		—		(7)		(7)
Defined benefit plan adjustments, net of tax	—	—	—		—		—		—		(4)		(4)
Foreign currency translation, net of tax	—	—	—		—		—		—		(281)		(281)
Reclassification adjustments, net of tax	—	—	—		—		—		—		14		14
Balance, June 30, 2022	256.3	(69.7)	3		10,787		2,824		(7,565)		(697)		5,352
Issuance of common stock	—	—	—		(1)		—		—		—		(1)
Repurchase of common stock	—	(0.8)	—		—		—		(150)		—		(150)
Stock-based compensation	—	—	—		64		—		—		—		64
Net income	—	—	—		—		283		—		—		283
Unrealized gains on derivative instruments, net of tax	—	—	—		—		—		—		6		6
Defined benefit plan adjustments, net of tax	—	—	—		—		—		—		10		10
Foreign currency translation, net of tax	—	—	—		—		—		—		(218)		(218)
Reclassification adjustments, net of tax	—	—	—		—		—		—		1		1
Balance, September 30, 2022	256.3	(70.5)	$	3	$	10,850	$	3,107	$	(7,715)	$	(898)	$	5,347

The accompanying notes are an integral part of these condensed consolidated financial statements.

8

IQVIA HOLDINGS INC. AND SUBSIDIARIES

Notes to Condensed Consolidated Financial Statements

(unaudited)

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 advanced analytics, technology solutions and clinical research services to the life sciences industry. With approximately 87,000 employees, the Company conducts business in more than 100 countries.

Unaudited Interim Financial Information

The accompanying unaudited condensed consolidated financial statements of the Company have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022. The balance sheet as of December 31, 2022 has been derived from the audited consolidated financial statements of the Company, but does not include all the disclosures required by GAAP.

Recently Issued Accounting Standards

Accounting pronouncements adopted

In September 2022, the Financial Accounting Standards Board ("FASB") issued new accounting guidance, Accounting Standards Update ("ASU") 2022-04, Liabilities - Supplier Finance Programs, to enhance the transparency of supplier finance programs. The amendments in this ASU address investor and other financial statement user requests for additional information about the use of supplier finance programs by the buyer party to understand the effect of those programs on an entity's working capital, liquidity, and cash flows. The Company adopted this new accounting guidance effective January 1, 2023. The adoption of this new accounting guidance did not have a material effect on the Company's disclosures within the condensed consolidated financial statements.

9

2. Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations

The following tables represent revenues by geographic region and reportable segment for the three and nine months ended September 30, 2023 and 2022:

	Three Months Ended September 30, 2023
(in millions)		Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas		$	761	$	1,017	$	78	$	1,856
Europe and Africa		519		520		50		1,089
Asia-Pacific		151		585		55		791
Total revenues		$	1,431	$	2,122	$	183	$	3,736

	Three Months Ended September 30, 2022
(in millions)		Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas		$	746	$	960	$	91	$	1,797
Europe and Africa		503		488		40		1,031
Asia-Pacific		151		531		52		734
Total revenues		$	1,400	$	1,979	$	183	$	3,562

	Nine Months Ended September 30, 2023
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,268	$	2,982	$	228	$	5,478
Europe and Africa	1,606		1,547		146		3,299
Asia-Pacific	457		1,715		167		2,339
Total revenues	$	4,331	$	6,244	$	541	$	11,116

	Nine Months Ended September 30, 2022
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,143	$	2,772	$	270	$	5,185
Europe and Africa	1,639		1,527		129		3,295
Asia-Pacific	465		1,564		162		2,191
Total revenues	$	4,247	$	5,863	$	561	$	10,671

No individual customer represented 10% or more of consolidated revenues for the three and nine months ended September 30, 2023 or 2022.

10

Transaction Price Allocated to the Remaining Performance Obligations

As of September 30, 2023, approximately $31.3 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:

(in millions)	September 30, 2023		December 31, 2022
Trade accounts receivable	$	1,349	$	1,329
Unbilled services	1,905		1,624
Trade accounts receivable and unbilled services	3,254		2,953
Allowance for doubtful accounts	(27)		(36)
Trade accounts receivable and unbilled services, net	$	3,227	$	2,917

Unbilled services and unearned income were as follows:

(in millions)	September 30, 2023		December 31, 2022		Change
Unbilled services	$	1,905	$	1,624	$	281
Unearned income	(1,838)		(1,797)		(41)
Net balance	$	67	$	(173)	$	240

Unbilled services, which is comprised of approximately 66% and 61% of unbilled receivables and 34% and 39% of contract assets as of September 30, 2023 and December 31, 2022, respectively, increased by $281 million as compared to December 31, 2022. 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 increased by $41 million over the same period resulting in an increase of $240 million in the net balance of unbilled services and unearned income between September 30, 2023 and December 31, 2022. The change in the net balance is driven by the difference in timing of revenue recognition in accordance with Accounting Standards Codification ("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 based on certain milestones.

The majority of the unearned income balance as of the beginning of the year is expected to be recognized in revenues during the year ended December 31, 2023.

Bad debt expense recognized on the Company’s trade accounts receivable was immaterial for the three and nine months ended September 30, 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. During the nine months ended September 30, 2023, through its accounts receivable factoring arrangements that the Company utilizes most frequently, the Company factored approximately $545 million of customer invoices on a non-recourse basis and received approximately $534 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.

11

4. Goodwill

The following is a summary of goodwill by reportable segment for the nine months ended September 30, 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	331		181		—		512
Impact of foreign currency fluctuations and other	(139)		—		(6)		(145)
Balance as of September 30, 2023	$	11,712	$	2,428	$	148	$	14,288

5. Derivatives

The fair values of the Company’s derivative instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table:

(in millions)	Balance Sheet Classification	September 30, 2023						December 31, 2022
		Assets		Liabilities		Notional		Assets		Liabilities		Notional
Derivatives designated as hedging instruments:
Interest rate swaps	Other current assets, other assets and other current liabilities	$	36	$	—	$	1,800	$	42	$	—	$	1,800
Foreign exchange forward contracts	Other current assets and other current liabilities	—		4		124		2		2		122
Total derivatives		$	36	$	4			$	44	$	2

The pre-tax effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Interest rate swaps	$	(1)	$	14	$	(6)	$	69
Foreign exchange forward contracts	(9)		(5)		(4)		(12)
Total	$	(10)	$	9	$	(10)	$	57

The Company expects approximately $30 million of pre-tax unrealized gains related to its foreign exchange contracts and interest rate derivatives included in accumulated other comprehensive (loss) income (“AOCI”) as of September 30, 2023 to be reclassified into earnings within the next twelve months. As of September 30, 2023, the Company's foreign currency denominated debt balance (net of original issue discount) designated as a hedge of its net investment in certain foreign subsidiaries totaled €5,199 million ($5,498 million). The amount of foreign exchange gains related to the net investment hedge included in the cumulative translation adjustment component of AOCI for the nine months ended September 30, 2023 and 2022 was $69 million and $807 million, respectively.

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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 September 30, 2023 and December 31, 2022 due to their short-term nature. As of September 30, 2023 and December 31, 2022, the fair value of total debt was $13,138 million and $12,281 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 September 30, 2023:

(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	130	$	—	$	—	$	130
Derivatives	—		36		—		36
Total	$	130	$	36	$	—	$	166
Liabilities:
Derivatives	$	—	$	4	$	—	$	4
Contingent consideration	—		—		104		104
Total	$	—	$	4	$	104	$	108

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, 2022:

(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	122	$	—	$	—	$	122
Derivatives	—		44		—		44
Total	$	122	$	44	$	—	$	166
Liabilities:
Derivatives	$	—	$	2	$	—	$	2
Contingent consideration	—		—		173		173
Total	$	—	$	2	$	173	$	175

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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 and interest rate 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.

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 (revenue 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 September 30, 2023, the Company has accrued approximately 35% 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 nine months ended September 30, 2023:

(in millions)	Contingent Consideration
Balance as of December 31, 2022	$	173
Business combinations	59
Contingent consideration paid	(72)
Revaluations included in earnings and foreign currency translation adjustments	(56)
Balance as of September 30, 2023	$	104

The current portion of contingent consideration is included within accrued expenses and the long-term portion is included within other liabilities on the accompanying condensed consolidated balance sheets. Revaluations of contingent consideration are recognized in other (income) expense, net on the accompanying condensed consolidated statements of income. A change in significant unobservable inputs could result in a higher or lower fair value measurement of contingent consideration.

Non-recurring Fair Value Measurements

As of September 30, 2023, assets carried on the balance sheet and not remeasured to fair value on a recurring basis totaled $19,387 million and were identified as Level 3. These assets are comprised of debt investments and cost and equity method investments of $192 million, goodwill of $14,288 million and other identifiable intangibles, net of $4,907 million.

7. Credit Arrangements

The following is a summary of the Company’s revolving credit facilities as of September 30, 2023:

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 September 30, 2023
$110 million (receivables financing facility)	U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of September 30, 2023

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The following table summarizes the Company’s debt at the dates indicated:

(dollars in millions)	September 30, 2023		December 31, 2022
Revolving Credit Facility due 2026:
U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 6.66%	$	250	$	425
Senior Secured Credit Facilities:
Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.66%	1,288		1,343
Term A Loan due 2026—Euribor at average floating rates of 5.22%	298		314
Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.66%	1,172		1,219
Term B Loan due 2024—Euribor at average floating rates of 5.85%	1,157		1,172
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14%	670		670
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14%	861		860
Term B Loan due 2025—Euribor at average floating rates of 5.85%	552		559
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
5.700% Senior Secured Notes due 2028—U.S. Dollar denominated	750		—
6.500% Senior Notes due 2030—U.S. Dollar denominated	500		—
2.875% Senior Notes due 2025—Euro denominated	444		450
2.25% Senior Notes due 2028—Euro denominated	761		771
2.875% Senior Notes due 2028—Euro denominated	752		761
1.750% Senior Notes due 2026—Euro denominated	582		589
2.250% Senior Notes due 2029—Euro denominated	952		964
Receivables financing facility due 2024—U.S. Dollar Term SOFR at average floating rates of 6.33%:
Revolving Loan Commitment	110		110
Term Loan	440		440
Principal amount of debt	13,689		12,797
Less: unamortized discount and debt issuance costs	(58)		(50)
Less: current portion	(1,309)		(152)
Long-term debt	$	12,322	$	12,595

Contractual maturities of long-term debt as of September 30, 2023 are as follows:

(in millions)
Remainder of 2023	$	38
2024	1,859
2025	2,679
2026	3,329
2027	2,069
Thereafter	3,715
	$	13,689

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Senior Secured Credit Facilities

As of September 30, 2023, the Company’s Fifth Amended and Restated Credit Agreement provided financing through several senior secured credit facilities of up to $7,998 million, which consisted of $6,248 million principal amounts of debt outstanding (as detailed in the table above), and $1,745 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.

On April 17, 2023, the Company increased the capacity of its 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 SOFR plus a 10 basis point Credit Spread Adjustment.

Senior Notes

On May 23, 2023, IQVIA Inc. (the “Issuer”), a wholly owned subsidiary of the Company, completed the issuance and sale of $750 million in gross proceeds of the Issuer’s 5.700% senior secured notes due 2028 (the “Senior Secured Notes”) and $500 million in gross proceeds of 6.500% senior notes due 2030 (the “Senior Notes” and, together with the Senior Secured Notes, the “Notes”). The Senior Secured Notes were issued pursuant to an Indenture, dated May 23, 2023 (the “Secured Notes Indenture”), among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the Senior Secured Notes and as collateral agent, and the Company and certain subsidiaries of the Issuer as guarantors. The 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 Senior Notes, and certain subsidiaries of the Issuer as guarantors (the “Senior Notes Indenture” and, together with the Secured Notes Indenture, the “Indentures”). The net proceeds from the notes offering were used to repay existing borrowings under the Issuer’s revolving credit facility and to pay fees and expenses related to the Notes offering.

The Notes have not been registered under the Securities Act of 1933, as amended, or the securities laws of any other jurisdiction. Pursuant to a registration rights agreement entered into in connection with the Notes offering, the Issuer and the guarantors agreed, among other things, to use commercially reasonable efforts to, within certain time periods, file a registration statement with respect to a registered offer to exchange the Senior Secured Notes for new exchange notes, have the exchange offer registration statement declared effective, and complete the exchange offer promptly thereafter, unless the Senior Secured Notes are redeemed earlier.

The Senior Secured Notes are secured obligations of the Issuer, 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 Senior Notes are unsecured obligations of the Issuer, 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 Issuer may redeem (i) the 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 and (ii) the 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%.

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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 other usual and customary restrictive covenants that, among other things, place limitations on the Company’s ability to declare dividends. As of September 30, 2023, the Company was in compliance in all material respects with the financial covenants under the Company’s financing arrangements.

8. 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.

On February 13, 2014, a group of approximately 1,200 medical doctors and 900 private individuals filed a civil lawsuit with the Seoul Central District Court against IMS Korea and two other defendants, the Korean Pharmaceutical Association (“KPA”) and the Korean Pharmaceutical Information Center (“KPIC”). The civil lawsuit alleges KPA and KPIC collected their personal information in violation of applicable privacy laws without the necessary consent through a software system installed on pharmacy computer systems in Korea, and that personal information was transferred to IMS Korea and sold to pharmaceutical companies. On September 11, 2017, the District Court issued a final decision that the encryption in use by the defendants since June 2014 was adequate to meet the requirements of the Korean Personal Information Privacy Act (“PIPA”) and the sharing of non-identified information for market research purposes was allowed under PIPA. The District Court also found an earlier version of encryption was insufficient to meet PIPA requirements, but no personal data had been leaked or re-identified. The District Court did not award any damages to plaintiffs. Approximately 280 medical doctors and 200 private individuals appealed the District Court decision. On May 3, 2019, the Appellate Court issued a final decision in which it concluded all of the non-identified information transferred by KPIC to IMS Korea for market research purposes violated PIPA, but did not award any damages to plaintiffs (affirming the District Court’s decision on this latter point). On May 24, 2019, approximately 247 plaintiffs appealed the Appellate Court’s decision to the Supreme Court. The Company believes the appeal is without merit and is vigorously defending its position.

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On July 23, 2015, indictments were issued by the Seoul Central District Prosecutors’ Office in South Korea against 24 individuals and companies alleging improper handling of sensitive health information in violation of, among others, South Korea’s Personal Information Protection Act. IMS Korea and two of its employees were among the individuals and organizations indicted. Although there is no assertion that IMS Korea used patient identified health information in any of its offerings, prosecutors allege that certain of IMS Korea’s data suppliers should have obtained patient consent when they converted sensitive patient information into non-identified data and that IMS Korea had not taken adequate precautions to reduce the risk of re-identification. On February 14, 2020, the Seoul Central District Court acquitted IMS Korea and its two employees of the charges of improper handling of sensitive health information, and the Prosecutor's Office appealed. On December 23, 2021, the appellate court affirmed the judgment of the Seoul Central District Court. The Prosecutor's Office has appealed to the Supreme Court. The Company intends to vigorously defend its position on appeal.

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. The parties are engaged in the discovery process in connection with these lawsuits.

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 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 is currently appealing the Order.

9. 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 or outstanding as of September 30, 2023 or December 31, 2022.

Equity Repurchase Program

On July 31, 2023, the Company's Board of Directors (the "Board") increased the stock repurchase authorization under the Company's equity repurchase program (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 $11,725 million. The Repurchase Program does not obligate the Company to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time.

During the nine months ended September 30, 2023, the Company repurchased 3.9 million shares of its common stock for $763 million under the Repurchase Program. As of September 30, 2023, the Company had remaining authorization to repurchase up to $2,592 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.

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10. Business Combinations

The Company completed several individually immaterial acquisitions during the nine months ended September 30, 2023. The Company’s assessment of fair value, including the valuation of certain identified intangibles, and the purchase price allocation related to these acquisitions is preliminary and subject to change upon completion. Further adjustments 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 customer relationships. The condensed 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:

(in millions)	September 30, 2023
Assets acquired:
Cash and cash equivalents	$	27
Accounts receivable	42
Other assets	9
Goodwill	512
Other identifiable intangibles	416
Liabilities assumed:
Other liabilities	(38)
Deferred income taxes, long-term	(17)
Net assets acquired (1)	$	951

(1) Net assets acquired includes contingent consideration and deferred purchase price of $66 million.

The portion of goodwill deductible for income tax purposes was preliminarily assessed as $373 million.

The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired:

(in millions)	Amortization Period				September 30, 2023
Other identifiable intangibles:
Customer relationships	10	-	15	years	$	330
Backlog			2	years	51
Software and related assets	5	-	8	years	29
Databases	3	-	5	years	3
Trade names			5	years	3
Total Other identifiable intangibles					$	416

11. Restructuring

The Company has continued to take restructuring actions in 2023 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 throughout 2023 and into 2024.

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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	67
Payments	(50)
Foreign currency translation and other	(1)
Balance as of September 30, 2023	$	42

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 that the majority of the restructuring accruals as of September 30, 2023 will be paid in 2023 and 2024.

12. Income Taxes

The Company's effective income tax rate was 14.6% and 19.4% in the third quarter of 2023 and 2022, and 18.7% and 19.5% in the first nine months of 2023 and 2022, respectively. The effective income tax rate in the third quarter and first nine months of 2023 was favorably impacted by a reversal of uncertain tax positions relating to tax credit carryforwards in the amount of $21 million. Additionally, the effective income tax rate in the third quarter and in the first nine months of 2023 and 2022 was favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards. For the third quarter of 2023 and 2022 this impact was $2 million and $1 million, respectively, and for the first nine months of 2023 and 2022 this impact was $12 million and $15 million, respectively.

Historically, the Company recorded deferred tax assets related to certain foreign tax credits. 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. As a result of an anticipated internal legal entity restructuring, the Company now believes it is reasonably possible that these foreign tax credits will be utilized and expects to reverse the valuation allowance in the near term which could create a material discrete tax benefit in the period recorded.

13. 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, 2022	$	(825)	$	44	$	(8)	$	62	$	(727)
Other comprehensive (loss) income before reclassifications	(158)		45		1		(23)		(135)
Reclassification adjustments	—		(55)		—		14		(41)
Balance as of September 30, 2023	$	(983)	$	34	$	(7)	$	53	$	(903)

Below is a summary of the adjustments for amounts reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item:

(in millions)	Affected Financial Statement Line Item	Three Months Ended September 30,				Nine Months Ended September 30,
		2023		2022		2023		2022
Derivative instruments:
Interest rate swaps	Interest expense	$	17	$	(9)	$	35	$	(16)
Foreign exchange forward contracts	Revenues	(5)		8		20		(2)
Total before income taxes		12		(1)		55		(18)
Income taxes		3		—		14		(4)
Total net of income taxes		$	9	$	(1)	$	41	$	(14)

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14. 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 clients and the broader healthcare market.

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. The Company also does not allocate 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 operating decision maker to assess the Company’s performance. The Company’s reportable segment information is presented below:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Revenues
Technology & Analytics Solutions	$	1,431	$	1,400	$	4,331	$	4,247
Research & Development Solutions	2,122		1,979		6,244		5,863
Contract Sales & Medical Solutions	183		183		541		561
Total revenues	3,736		3,562		11,116		10,671
Cost of revenues, exclusive of depreciation and amortization
Technology & Analytics Solutions	859		828		2,593		2,490
Research & Development Solutions	1,410		1,335		4,213		4,005
Contract Sales & Medical Solutions	157		158		461		480
Total cost of revenues, exclusive of depreciation and amortization	2,426		2,321		7,267		6,975
Selling, general and administrative expenses
Technology & Analytics Solutions	217		213		652		628
Research & Development Solutions	217		199		640		614
Contract Sales & Medical Solutions	14		17		43		48
General corporate and unallocated	54		88		162		198
Total selling, general and administrative expenses	502		517		1,497		1,488
Segment profit
Technology & Analytics Solutions	355		359		1,086		1,129
Research & Development Solutions	495		445		1,391		1,244
Contract Sales & Medical Solutions	12		8		37		33
Total segment profit	862		812		2,514		2,406
General corporate and unallocated	(54)		(88)		(162)		(198)
Depreciation and amortization	(297)		(248)		(809)		(773)
Restructuring costs	(30)		(4)		(67)		(15)
Total income from operations	$	481	$	472	$	1,476	$	1,420

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15. Earnings Per Share

The following table reconciles the basic to diluted weighted average shares outstanding:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions, except per share data)	2023		2022		2023		2022
Numerator:
Net income	$	303	$	283	$	889	$	864
Denominator:
Basic weighted average common shares outstanding	182.9		186.5		184.4		188.3
Effect of dilutive stock options and share awards	2.6		2.9		2.5		3.0
Diluted weighted average common shares outstanding	185.5		189.4		186.9		191.3
Earnings per share attributable to common stockholders:
Basic	$	1.66	$	1.52	$	4.82	$	4.59
Diluted	$	1.63	$	1.49	$	4.76	$	4.52

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 three and nine months ended September 30, 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 0.9 million and 0.4 million, and 1.0 million and 0.5 million, respectively.

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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations

Cautionary Statement for Forward-Looking Information

You should read the following discussion and analysis of our financial condition and results of operations together with our condensed consolidated financial statements and the related notes included elsewhere in this Quarterly Report on Form 10-Q and with our audited consolidated financial statements and the notes thereto included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2022 (our “2022 Form 10-K”).

In addition to historical condensed consolidated financial information, the following discussion contains or incorporates by reference forward-looking statements within the meaning of the federal securities laws, including Section 27A of the Securities Act of 1933, as amended (“Securities Act”), and Section 21E of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), that are not historical facts but reflect, among other things, our current expectations, our forecasts and our anticipated results of operations, all of which are subject to known and unknown risks, uncertainties and other factors that may cause our actual results, performance or achievements, market trends, or industry results to differ materially from those expressed or implied by such forward-looking statements. Therefore, any statements contained herein that are not statements of historical fact may be forward-looking statements and should be evaluated as such. Without limiting the foregoing, the words “assumes,” “anticipates,” “believes,” “estimates,” “expects,” “intends,” “may,” "forecasts," “plans,” “projects,” “should,” “seeks,” “sees,” “targets,” “will,” “would” and similar words and expressions, and variations and negatives of these words are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. We assume no obligation to update any such forward-looking information to reflect actual results or changes in our outlook or the factors affecting such forward-looking information.

We caution you that any such forward-looking statements are further qualified by important factors that could cause our actual operating results to differ materially from those in the forward-looking statements, including without limitation, business disruptions caused by natural disasters, pandemics such as the COVID-19 (coronavirus) outbreak, including any variants, and the public health policy responses to the outbreak, and international conflicts or other disruptions outside of our control such as the current situation in Ukraine and Russia; most of our contracts may be terminated on short notice, and we may lose or experience delays with large client contracts or be unable to enter into new contracts; the market for our services may not grow as we expect; we may be unable to successfully develop and market new services or enter new markets; imposition of restrictions on our use of data by data suppliers or their refusal to license data to us; any failure by us to comply with contractual, regulatory or ethical requirements under our contracts, including current or future changes to data protection and privacy laws; breaches or misuse of our or our outsourcing partners’ security or communications systems; failure to meet our productivity or business transformation objectives; failure to successfully invest in growth opportunities; our ability to protect our intellectual property rights and our susceptibility to claims by others that we are infringing on their intellectual property rights; the expiration or inability to acquire third party licenses for technology or intellectual property; any failure by us to accurately and timely price and formulate cost estimates for contracts, or to document change orders; hardware and software failures, delays in the operation of our computer and communications systems or the failure to implement system enhancements; the rate at which our backlog converts to revenues; our ability to acquire, develop and implement technology necessary for our business; consolidation in the industries in which our clients operate; risks related to client or therapeutic concentration; government regulators or our customers may limit the number or scope of indications for medicines and treatments or withdraw products from the market, and government regulators may impose new regulatory requirements or may adopt new regulations affecting the biopharmaceutical industry; the risks associated with operating on a global basis, including currency or exchange rate fluctuations and legal compliance, including anti-corruption laws; risks related to changes in accounting standards; general economic conditions in the markets in which we operate, including financial market conditions, inflation and risks related to sales to government entities; the impact of changes in tax laws and regulations; and our ability to successfully integrate, and achieve expected benefits from, our acquired businesses. For a further discussion of the risks relating to our business, see Part I—Item 1A—“Risk Factors” in our 2022 Form 10-K, as updated in our subsequently filed Quarterly Reports on Form 10-Q.

Overview

IQVIA is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry. IQVIA creates intelligent connections across all aspects of healthcare through its analytics, transformative technology, big data resources and extensive domain expertise. IQVIA Connected Intelligence™ delivers powerful insights with speed and agility — enabling customers to accelerate the clinical development and commercialization of innovative medical treatments that improve healthcare outcomes for patients. With approximately 87,000 employees, we conduct operations in more than 100 countries.

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We are a global leader in protecting individual patient privacy. We use a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. Our insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors and scientific advances, in an effort to advance their path toward cures.

We are managed through three reportable segments: Technology & Analytics Solutions, Research & Development Solutions and Contract Sales & Medical Solutions. Technology & Analytics Solutions provides mission critical information, technology solutions and real world insights and services to our life science clients. Research & Development Solutions, which primarily serves biopharmaceutical customers, provides outsourced clinical research and clinical trial related services. Contract Sales & Medical Solutions provides health care provider (including contract sales) and patient engagement services to both biopharmaceutical clients and the broader healthcare market.

Sources of Revenue

Total revenues are comprised of revenues from the provision of our services. We do not have any material product revenues.

Costs and Expenses

Our costs and expenses are comprised primarily of our cost of revenues including reimbursed expenses and selling, general and administrative expenses. Cost of revenues includes compensation and benefits for billable employees and personnel involved in production, trial monitoring, data management and delivery, and the costs of acquiring and processing data for our information offerings; costs of staff directly involved with delivering technology-related services offerings and engagements, related accommodations and the costs of data purchased specifically for technology services engagements; and other expenses directly related to service contracts such as courier fees, laboratory supplies, professional services and travel expenses. Reimbursed expenses, which are included in cost of revenues, are comprised principally of payments to investigators who oversee clinical trials and travel expenses for our clinical monitors and sales representatives. Selling, general and administrative expenses include costs related to sales, marketing and administrative functions (including human resources, legal, finance, quality assurance, compliance and general management) for compensation and benefits, travel, professional services, training and expenses for information technology and facilities. We also incur costs and expenses associated with depreciation and amortization.

Foreign Currency Translation

In the first nine months of 2023, approximately 30% of our revenues were denominated in currencies other than the United States dollar, which represents approximately 60 currencies. Because a large portion of our revenues and expenses are denominated in foreign currencies and our financial statements are reported in United States dollars, changes in foreign currency exchange rates can significantly affect our results of operations. The revenues and expenses of our foreign operations are generally denominated in local currencies and translated into United States dollars for financial reporting purposes. Accordingly, exchange rate fluctuations will affect the translation of foreign results into United States dollars for purposes of reporting our condensed consolidated results. As a result, we believe that reporting results of operations that exclude the effects of foreign currency rate fluctuations on certain financial results can facilitate analysis of period to period comparisons. This constant currency information assumes the same foreign currency exchange rates that were in effect for the comparable prior-year period were used in translation of the current period results. As such, the differences noted below between reported results of operations and constant currency information is wholly attributable to the effects of foreign currency rate fluctuations.

Consolidated Results of Operations

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

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Revenues

	Three Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	3,736	$	3,562	$	174	4.9	%

For the third quarter of 2023, our revenues increased $174 million, or 4.9%, as compared to the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $147 million, or 4.1%, reflecting a $12 million increase in Technology & Analytics Solutions, a $126 million increase in Research & Development Solutions, and a $9 million increase in Contract Sales & Medical Solutions.

	Nine Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	11,116	$	10,671	$	445	4.2	%

For the first nine months of 2023, our revenues increased $445 million, or 4.2%, as compared to the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $509 million, or 4.8%, reflecting a $102 million increase in Technology & Analytics Solutions, a $400 million increase in Research & Development Solutions, and a $7 million increase in Contract Sales & Medical Solutions.

Cost of Revenues, exclusive of Depreciation and Amortization

	Three Months Ended September 30,						Nine Months Ended September 30,
(in millions)	2023			2022			2023			2022
Cost of revenues, exclusive of depreciation and amortization	$	2,426		$	2,321		$	7,267		$	6,975
% of revenues	64.9		%	65.2		%	65.4		%	65.4		%

The $105 million increase in cost of revenues, exclusive of depreciation and amortization, for the three months ended September 30, 2023 as compared to the same period in 2022 included a constant currency increase of approximately $113 million, or 4.9%, reflecting a $19 million increase in Technology & Analytics Solutions, a $93 million increase in Research & Development Solutions, and a $1 million increase in Contract Sales & Medical Solutions.

The $292 million increase in cost of revenues, exclusive of depreciation and amortization, for the nine months ended September 30, 2023 as compared to the same period in 2022 included a constant currency increase of approximately $463 million, or 6.6%, reflecting a $126 million increase in Technology & Analytics Solutions and a $340 million increase in Research & Development Solutions, offset by a $3 million decrease in Contract Sales & Medical Solutions.

Selling, General and Administrative Expenses

	Three Months Ended September 30,						Nine Months Ended September 30,
(in millions)	2023			2022			2023			2022
Selling, general and administrative expenses	$	502		$	517		$	1,497		$	1,488
% of revenues	13.4		%	14.5		%	13.5		%	13.9		%

The $15 million decrease in selling, general and administrative expenses for the three months ended September 30, 2023 as compared to the same period in 2022 included a constant currency decrease of approximately $17 million, or 3.3%, reflecting a $1 million increase in Technology & Analytics Solutions and a $19 million increase in Research & Development Solutions, offset by a $2 million decrease in Contract Sales & Medical Solutions and a $35 million decrease in general corporate and unallocated expenses.

The $9 million increase in selling, general and administrative expenses for the nine months ended September 30, 2023 as compared to the same period in 2022 included a constant currency increase of approximately $38 million, or 2.6%, reflecting a $38 million increase in Technology & Analytics Solutions and a $36 million increase in Research & Development Solutions, offset by a $4 million decrease in Contract Sales & Medical Solutions and a $32 million decrease in general corporate and unallocated expenses.

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Depreciation and Amortization

	Three Months Ended September 30,						Nine Months Ended September 30,
(in millions)	2023			2022			2023			2022
Depreciation and amortization	$	297		$	248		$	809		$	773
% of revenues	7.9		%	7.0		%	7.3		%	7.2		%

The $49 million increase in depreciation and amortization for the three months ended September 30, 2023 compared to the same period in 2022 was primarily the result of an increase in amortization of capitalized software and of intangible assets from acquisitions occurring in 2022 and 2023.

The $36 million increase in depreciation and amortization for the nine months ended September 30, 2023 compared to the same period in 2022 was primarily the result of an increase in amortization of capitalized software and of intangible assets from acquisitions occurring in 2022 and 2023, offset by less amortization from certain intangible assets from the merger between Quintiles and IMS Health and less accelerated amortization related to the abandonment of certain software assets.

Restructuring Costs

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Restructuring costs	$	30	$	4	$	67	$	15

The restructuring costs incurred during 2023 and 2022 were due to ongoing efforts to streamline our global operations and reduce overcapacity to adapt to changing market conditions and integrate acquisitions. These restructuring actions are expected to occur throughout 2023 and into 2024 and are expected to consist of consolidating functional activities, eliminating redundant positions and aligning resources with customer requirements.

Interest Income and Interest Expense

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Interest income	$	(14)	$	(4)	$	(24)	$	(7)
Interest expense	$	181	$	108	$	491	$	288

Interest income includes interest received primarily from bank balances and investments. The increase for the three and nine months ended September 30, 2023 as compared to the same periods in 2022 is primarily a result of higher deposit rates.

Interest expense during the three and nine months ended September 30, 2023 increased compared to the same periods in 2022 primarily due to higher base rate interest costs across the floating rate debt portfolio as well as from an increase in our net debt.

Other (Income) Expense, Net

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Other (income) expense, net	$	(35)	$	8	$	(77)	$	51

Other (income) expense, net for the three months ended September 30, 2023 increased compared to the same period in 2022 primarily due to revaluations of contingent consideration and less foreign currency loss on transactions.

Other (income) expense, net for the nine months ended September 30, 2023 increased compared to the same period in 2022 primarily due to foreign currency gain on transactions, revaluations of contingent consideration and gains on investments.

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Income Tax Expense

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Income tax expense	$	51	$	70	$	203	$	212

Our effective income tax rate was 14.6% and 19.4% in the third quarter of 2023 and 2022, and 18.7% and 19.5% in the first nine months of 2023 and 2022, respectively. Our effective income tax rate in the third quarter and first nine months of 2023 was favorably impacted by a reversal of uncertain tax positions relating to tax credit carryforwards in the amount of $21 million. Additionally, our effective income tax rate in the third quarter and in the first nine months of 2023 and 2022 was favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards. For the third quarter of 2023 and 2022 this impact was $2 million and $1 million, respectively, and for the first nine months of 2023 and 2022 this impact was $12 million and $15 million, respectively.

Historically, we recorded deferred tax assets related to certain foreign tax credits. 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. As a result of an anticipated internal legal entity restructuring, we now believe it is reasonably possible that these foreign tax credits will be utilized and expect to reverse the valuation allowance in the near term which could create a material discrete tax benefit in the period recorded.

Segment Results of Operations

Revenues and profit by segment are as follows:

Three Months Ended September 30, 2023 and 2022
	Segment Revenues				Segment Profit
(in millions)	2023		2022		2023		2022
Technology & Analytics Solutions	$	1,431	$	1,400	$	355	$	359
Research & Development Solutions	2,122		1,979		495		445
Contract Sales & Medical Solutions	183		183		12		8
Total	3,736		3,562		862		812
General corporate and unallocated					(54)		(88)
Depreciation and amortization					(297)		(248)
Restructuring costs					(30)		(4)
Consolidated	$	3,736	$	3,562	$	481	$	472

Nine Months Ended September 30, 2023 and 2022
	Segment Revenues				Segment Profit
(in millions)	2023		2022		2023		2022
Technology & Analytics Solutions	$	4,331	$	4,247	$	1,086	$	1,129
Research & Development Solutions	6,244		5,863		1,391		1,244
Contract Sales & Medical Solutions	541		561		37		33
Total	11,116		10,671		2,514		2,406
General corporate and unallocated					(162)		(198)
Depreciation and amortization					(809)		(773)
Restructuring costs					(67)		(15)
Consolidated	$	11,116	$	10,671	$	1,476	$	1,420

Certain costs are not allocated to our segments and are reported as general corporate and unallocated expenses. These costs primarily consist of stock-based compensation and expenses related to integration activities and acquisitions. We also do not allocate depreciation and amortization or impairment charges, if any, to our segments.

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Technology & Analytics Solutions

	Three Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	1,431	$	1,400	$	31	2.2	%
Cost of revenues, exclusive of depreciation and amortization	859		828		31		3.7
Selling, general and administrative expenses	217		213		4		1.9
Segment profit	$	355	$	359	$	(4)	(1.1)	%

	Nine Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	4,331	$	4,247	$	84	2.0	%
Cost of revenues, exclusive of depreciation and amortization	2,593		2,490		103		4.1
Selling, general and administrative expenses	652		628		24		3.8
Segment profit	$	1,086	$	1,129	$	(43)	(3.8)	%

Revenues

Technology & Analytics Solutions’ revenues were $1,431 million for the third quarter of 2023, an increase of $31 million, or 2.2%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $12 million, or 0.9%, reflecting revenue growth primarily in the Americas region and to a lesser extent in the Asia-Pacific region.

Technology & Analytics Solutions’ revenues were $4,331 million for the first nine months of 2023, an increase of $84 million, or 2.0%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $102 million, or 2.4%, reflecting revenue growth primarily in the Americas 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, 2023 was driven by an increase in real world services and information and technology services. The constant currency revenue growth was impacted by a decrease in COVID-19 related work.

Cost of Revenues, exclusive of Depreciation and Amortization

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $31 million, or 3.7%, in the third quarter of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $19 million, or 2.3%.

Technology & Analytics Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $103 million, or 4.1%, in the first nine months of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $126 million, or 5.1%.

The constant currency increase for the three and nine months ended September 30, 2023 was related to an increase in compensation and related expenses and an increase in costs of acquiring and processing data to support revenue growth.

Selling, General and Administrative Expenses

Technology & Analytics Solutions’ selling, general and administrative expenses increased $4 million, or 1.9%, in the third quarter of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $1 million, or 0.5%.

Technology & Analytics Solutions’ selling, general and administrative expenses increased $24 million, or 3.8%, in the first nine months of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $38 million, or 6.1%.

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The constant currency increase for the three and nine months ended September 30, 2023 was primarily related to an increase in compensation and related expenses.

Research & Development Solutions

	Three Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	2,122	$	1,979	$	143	7.2	%
Cost of revenues, exclusive of depreciation and amortization	1,410		1,335		75		5.6
Selling, general and administrative expenses	217		199		18		9.0
Segment profit	$	495	$	445	$	50	11.2	%

	Nine Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	6,244	$	5,863	$	381	6.5	%
Cost of revenues, exclusive of depreciation and amortization	4,213		4,005		208		5.2
Selling, general and administrative expenses	640		614		26		4.2
Segment profit	$	1,391	$	1,244	$	147	11.8	%

Backlog

Research & Development Solutions’ contracted backlog increased from $27.2 billion as of December 31, 2022 to $28.8 billion as of September 30, 2023, and we expect approximately $7.4 billion of this backlog to convert to revenue in the next twelve months.

Revenues

Research & Development Solutions’ revenues were $2,122 million for the third quarter of 2023, an increase of $143 million, or 7.2%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $126 million, or 6.4%, reflecting revenue growth primarily in the Americas and Asia-Pacific regions.

Research & Development Solutions’ revenues were $6,244 million in the first nine months of 2023, an increase of $381 million, or 6.5%, over the same period in 2022. This increase was comprised of constant currency revenue growth of approximately $400 million, or 6.8%, reflecting revenue growth primarily in the Americas and Asia-Pacific regions.

The constant currency revenue growth for the three and nine months ended September 30, 2023 was primarily the result of volume-related increases in clinical services and to a lesser extent from volume-related increases in lab testing. The constant currency revenue growth was impacted by a decrease in COVID-19 related work.

Cost of Revenues, exclusive of Depreciation and Amortization

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $75 million, or 5.6%, in the third quarter of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $93 million, or 7.0%.

Research & Development Solutions’ cost of revenues, exclusive of depreciation and amortization, increased $208 million, or 5.2%, in the first nine months of 2023 over the same period in 2022. This increase included a constant currency increase of approximately $340 million, or 8.5%.

The constant currency increase for the three and nine months ended September 30, 2023 was primarily related to an increase in compensation and related expenses as a result of volume-related increases in clinical services and lab testing.

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Selling, General and Administrative Expenses

Research & Development Solutions’ selling, general and administrative expenses increased $18 million, or 9.0%, in the third quarter of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $19 million, or 9.5%.

Research & Development Solutions’ selling, general and administrative expenses increased $26 million, or 4.2%, in the first nine months of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $36 million, or 5.9%.

The constant currency increase for the three and nine months ended September 30, 2023 was primarily related to an increase in compensation and related expenses.

Contract Sales & Medical Solutions

	Three Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	183	$	183	$	—	0.0	%
Cost of revenues, exclusive of depreciation and amortization	157		158		(1)		(0.6)
Selling, general and administrative expenses	14		17		(3)		(17.6)
Segment profit	$	12	$	8	$	4	50.0	%

	Nine Months Ended September 30,				Change
(in millions)	2023		2022		$		%
Revenues	$	541	$	561	$	(20)	(3.6)	%
Cost of revenues, exclusive of depreciation and amortization	461		480		(19)		(4.0)
Selling, general and administrative expenses	43		48		(5)		(10.4)
Segment profit	$	37	$	33	$	4	12.1	%

Revenues

Contract Sales & Medical Solutions’ revenues were $183 million for the third quarter of 2023, which is consistent with the same period in 2022 and included a constant currency revenue growth of approximately $9 million, or 4.9%.

Contract Sales & Medical Solutions’ revenues were $541 million in the first nine months of 2023, a decrease of $20 million, or 3.6%, over the same period in 2022. This decrease included a constant currency revenue growth of approximately $7 million, or 1.2%.

Cost of Revenues, exclusive of Depreciation and Amortization

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, decreased $1 million, or 0.6%, in the third quarter of 2023 as compared to the same period in 2022, which included a constant currency increase of approximately $1 million, or 0.6%.

Contract Sales & Medical Solutions’ cost of revenues, exclusive of depreciation and amortization, decreased $19 million, or 4.0%, in the first nine months of 2023 as compared to the same period in 2022. This decrease included a constant currency decrease of approximately $3 million, or 0.6%.

Selling, General and Administrative Expenses

Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $3 million, or 17.6%, in the third quarter of 2023 as compared to the same period in 2022, which included a constant currency decrease of approximately $2 million, or 11.8%.

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Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $5 million, or 10.4%, in the first nine months of 2023 as compared to the same period in 2022, which included a constant currency decrease of approximately $4 million, or 8.3%.

Liquidity and Capital Resources

Overview

We assess our liquidity in terms of our ability to generate cash to fund our operating, investing and financing activities. Our principal source of liquidity is operating cash flows. In addition to operating cash flows, other significant factors that affect our overall management of liquidity include: capital expenditures, acquisitions, investments, debt service requirements, equity repurchases, adequacy of our revolving credit and receivables financing facilities, and access to the capital markets.

We manage our worldwide cash requirements by monitoring the funds available among our subsidiaries and determining the extent to which those funds can be accessed on a cost-effective basis. The repatriation of cash balances from certain of our subsidiaries could have adverse tax consequences; however, those balances are generally available without legal restrictions to fund ordinary business operations. We have and expect to transfer cash from those subsidiaries to the United States and to other international subsidiaries when it is cost effective to do so.

We had a cash balance of $1,224 million as of September 30, 2023 ($406 million of which was in the United States), an increase from $1,216 million as of December 31, 2022.

Based on our current operating plan, we believe that our available cash and cash equivalents, future cash flows from operations and our ability to access funds under our revolving credit and receivables financing facilities will enable us to fund our operating requirements, capital expenditures, contractual obligations, and meet debt obligations for at least the next 12 months. We regularly evaluate our debt arrangements, as well as market conditions, and from time to time we may explore opportunities to modify our existing debt arrangements or pursue additional financing arrangements that could result in the issuance of new debt securities by us or our affiliates. We may use our existing cash, cash generated from operations or dispositions of assets or businesses and/or proceeds from any new financing arrangements or issuances of debt or equity securities to repay or reduce some of our outstanding obligations, to repurchase shares from our stockholders or for other purposes. As part of our ongoing business strategy, we also continually evaluate new acquisition, expansion and investment possibilities or other strategic growth opportunities, as well as potential dispositions of assets or businesses, as appropriate, including dispositions that may cause us to recognize a loss on certain assets. Should we elect to pursue any such transaction, we may seek to obtain debt or equity financing to facilitate those activities. Our ability to enter into any such potential transactions and our use of cash or proceeds is limited to varying degrees by the terms and restrictions contained in our existing debt arrangements. We cannot provide assurances that we will be able to complete any such financing arrangements or other transactions on favorable terms or at all.

Equity Repurchase Program

On July 31, 2023, our Board of Directors increased the stock repurchase authorization under our equity repurchase program (the "Repurchase Program") with respect to the repurchase of our common stock by an additional $2,000 million, which increased the total amount that has been authorized under the Repurchase Program to $11,725 million. 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 nine months ended September 30, 2023, we repurchased 3.9 million shares of our common stock for $763 million under the Repurchase Program. As of September 30, 2023, we had remaining authorization to repurchase up to $2,592 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.

Debt

As of September 30, 2023, we had $13,689 million of total indebtedness, excluding $1,745 million of additional available borrowings under our revolving credit facility. Our long-term debt arrangements contain customary restrictive covenants and, as of September 30, 2023, we believe we were in compliance with our restrictive covenants in all material respects.

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Senior Secured Credit Facilities

As of September 30, 2023, our Fifth Amended and Restated Credit Agreement provided financing through the senior secured credit facilities of up to $7,998 million, which consisted of $6,248 million principal amounts of debt outstanding, and $1,745 million of available borrowing capacity on the revolving credit facility and standby letters of credit.

On April 17, 2023, we increased the capacity of our senior secured revolving credit facility by $500 million U.S. dollars, bringing the total capacity of the revolving credit facility to $2,000 million.

Senior Notes

On May 23, 2023, we completed the issuance and sale of $750 million in gross proceeds of 5.700% senior secured notes due 2028 (the “Senior Secured Notes”) and $500 million in gross proceeds of 6.500% senior notes due 2030 (the “Senior Notes” and, together with the Senior Secured Notes, the “Notes”). The net proceeds from the notes offering were used to repay existing borrowings under our revolving credit facility and to pay fees and expenses related to the Notes offering. See Note 7 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding our credit arrangements.

Receivables Financing Facility

As of September 30, 2023, no additional amounts of revolving loan commitments were available under the receivables financing facility.

Nine months ended September 30, 2023 and 2022

Cash Flow from Operating Activities

	Nine Months Ended September 30,
(in millions)	2023		2022
Net cash provided by operating activities	$	1,402	$	1,700

Cash provided by operating activities decreased $298 million during the first nine months of 2023 as compared to the same period in 2022. The decrease was due to a decrease in cash from other operating assets and liabilities ($121 million), unearned income ($95 million), accounts receivable and unbilled services ($58 million) and from cash-related net income ($24 million).

Cash Flow from Investing Activities

	Nine Months Ended September 30,
(in millions)	2023		2022
Net cash used in investing activities	$	(1,391)	$	(1,529)

Cash used in investing activities decreased $138 million during the first nine months of 2023 as compared to the same period in 2022, primarily driven by less cash used for acquisitions of businesses ($143 million) and acquisitions of property, equipment and software ($33 million), offset by more cash used in investments in debt and equity securities ($36 million) and investments in unconsolidated affiliates, net ($2 million).

Cash Flow from Financing Activities

	Nine Months Ended September 30,
(in millions)	2023		2022
Net cash provided by (used in) financing activities	$	38	$	(136)

Cash provided by financing activities increased $174 million during the first nine months of 2023 as compared to the same period in 2022, primarily due to a decrease in cash used to repurchase common stock ($340 million) and cash payments related to employee stock option plans ($12 million), offset by an increase in cash payments on revolving credit facilities, net of proceeds ($75 million), contingent consideration and deferred purchase price accruals ($57 million), debt and principal payments on finance leases ($32 million) and debt issuance costs ($14 million).

32

Off-Balance Sheet Arrangements

We do not have any material off-balance sheet arrangements.

Contractual Obligations and Commitments

We have various contractual obligations, which are recorded as liabilities in our consolidated financial statements.

There have been no material changes, outside of the ordinary course of business, to our contractual obligations as previously disclosed in our 2022 Form 10-K.

Application of Critical Accounting Policies

There have been no material changes to our critical accounting policies as previously disclosed in our 2022 Form 10-K.

Item 3. Quantitative and Qualitative Disclosures About Market Risk

There have been no material changes to our quantitative and qualitative disclosures about market risk as compared to the quantitative and qualitative disclosures about market risk described in our 2022 Form 10-K.

Item 4. Controls and Procedures

Evaluation of Disclosure Controls and Procedures

Our management, with the participation of our Chief Executive Officer (“CEO”) and Chief Financial Officer (“CFO”), has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e)) under the Securities Exchange Act of 1934, as amended (“Exchange Act”) as of the end of the period covered by this Quarterly Report on Form 10-Q. Based on such evaluation, our CEO and CFO have concluded that as of such date, our disclosure controls and procedures were effective.

Changes in Internal Control over Financial Reporting

There were no changes in our internal control over financial reporting identified in management’s evaluation pursuant to Rules 13a-15(d) or 15d-15(d) of the Exchange Act during the period covered by this Quarterly Report on Form 10-Q that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

33

PART II—OTHER INFORMATION

Item 1. Legal Proceedings

We are party to legal proceedings incidental to our business. While the outcome of these matters could differ from management’s expectations, we do not believe that the resolution of these matters is reasonably likely to have a material adverse effect to our financial statements.

Information pertaining to legal proceedings can be found in Note 8 to the condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q and is incorporated by reference herein.

Item 1A. Risk Factors

For a discussion of the risks relating to our business, see Part I—Item 1A—“Risk Factors” of our 2022 Form 10-K. There have been no material changes from the risk factors previously disclosed in our 2022 Form 10-K.

Item 2. Unregistered Sales of Equity Securities and Use of Proceeds

Recent Sales of Unregistered Securities

Not applicable.

Use of Proceeds from Registered Securities

Not applicable.

Purchases of Equity Securities by the Issuer

On October 30, 2013, the Company's Board of Directors (the "Board") approved an equity repurchase program (the “Repurchase Program”) authorizing the repurchase of up to $125 million of our 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, and $2.0 billion in 2015, 2016, 2017, 2018, 2019, and 2022, respectively. On July 31, 2023, the Board increased the stock repurchase authorization under the Repurchase Program by an additional $2,000 million, which increased the total amount that has been authorized under the Repurchase Program to $11,725 million. The Repurchase Program does not obligate us to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time. The timing and amount of repurchases are determined by our management based on a variety of factors such as the market price of our common stock, our corporate requirements, and overall market conditions. Purchases of our common stock may be made in open market transactions effected through a broker-dealer at prevailing market prices, in block trades, or in privately negotiated transactions. The Repurchase Program for common stock does not have an expiration date. 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.

From inception of the Repurchase Program through September 30, 2023, we have repurchased a total of $9,133 million of our securities under the Repurchase Program.

During the nine months ended September 30, 2023, we repurchased 3.9 million shares of our common stock for $763 million under the Repurchase Program. See Note 9 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding the Repurchase Program.

As of September 30, 2023, we had remaining authorization to repurchase up to $2,592 million of our common stock under the Repurchase Program.

34

Since the merger between Quintiles and IMS Health, we have repurchased 77.0 million shares of our common stock at an average market price per share of $113.80 for an aggregate purchase price of $8,759 million both under and outside of the Repurchase Program. This includes shares withheld from employees to satisfy certain tax obligations due in connection with grants of stock under the Quintiles IMS Holdings, Inc. 2017 Incentive and Stock Award Plan (the “Plan”). The Plan provides for the withholding of shares to satisfy tax obligations. It does not specify a maximum number of shares that can be withheld for this purpose. The shares of common stock withheld to satisfy tax withholding obligations may be deemed to be “issuer purchases” of shares that are required to be disclosed pursuant to this Item.

The following table summarizes the monthly equity repurchase program activity for the three months ended September 30, 2023 and the approximate dollar value of shares that may yet be purchased pursuant to the Repurchase Program.

(in millions, except per share data)	Total Number of Shares Purchased	Average Price Paid Per Share		Total Number of Shares Purchased as Part of Publicly Announced Plans or Programs	Approximate Dollar Value of Shares That May Yet Be Purchased Under the Plans or Programs
July 1, 2023 — July 31, 2023	—	$	—	—	$	2,736
August 1, 2023 — August 31, 2023	0.4	$	214.65	0.4	$	2,647
September 1, 2023 — September 30, 2023	0.3	$	205.63	0.3	$	2,592
	0.7			0.7

Item 5. Other Information

In the third quarter of 2023, no director or officer (as defined in Exchange Act Rule 16a-1(f)) of IQVIA Holdings Inc. adopted or terminated a Rule 10b5-1 trading arrangement or non-Rule 10b5-1 trading arrangement for the purchase or sale of securities of IQVIA Holdings Inc., within the meaning of Item 408 of Regulation S-K.

35

Item 6. Exhibits

The exhibits below are filed or furnished as a part of this report and are incorporated herein by reference.

			Incorporated by Reference
Exhibit Number	Exhibit Description	Filed Herewith	Form	File No.	Exhibit	Filing Date
31.1	Certification of Chief Executive Officer, pursuant to Rule 13a-14(a)/15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.	X
31.2	Certification of Executive Vice President and Chief Financial Officer, pursuant to Rule 13a-14(a)/15d-14(a), as adopted pursuant to Section 302 of the Sarbanes-Oxley Act of 2002.	X
32.1	Certification of Chief Executive Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.	X
32.2	Certification of Executive Vice President and Chief Financial Officer, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002.	X
101	Interactive Data Files Pursuant to Rule 405 of Regulation S-T: (i) Condensed Consolidated Statements of Income (unaudited), (ii) Condensed Consolidated Statements of Comprehensive Income (unaudited), (iii) Condensed Consolidated Balance Sheets (unaudited), (iv) Condensed Consolidated Statements of Cash Flows (unaudited), (v) Condensed Consolidated Statements of Stockholders’ Equity (unaudited) and (vi) Notes to Condensed Consolidated Financial Statements (unaudited). The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.	X
104	Cover Page Interactive Data File. The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.	X

36

SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this Quarterly Report on Form 10-Q to be signed on its behalf by the undersigned, thereunto duly authorized on November 1, 2023.

IQVIA HOLDINGS INC.

/s/ Ronald E. Bruehlman

Ronald E. Bruehlman

Executive Vice President and Chief Financial Officer

(On behalf of the Registrant and as Principal Financial Officer)

37

EX-31.1

Exhibit 31.1

CERTIFICATION OF PERIODIC REPORT UNDER SECTION 302 OF

THE SARBANES-OXLEY ACT OF 2002

I, Ari Bousbib, certify that:

1. I have reviewed this quarterly report on Form 10-Q of IQVIA Holdings Inc. (the “registrant”);

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, 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;

(c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d)Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: November 1, 2023
	/s/ Ari Bousbib
	Ari Bousbib Chairman, Chief Executive Officer and President (Principal Executive Officer)

EX-31.2

Exhibit 31.2

CERTIFICATION OF PERIODIC REPORT UNDER SECTION 302 OF

THE SARBANES-OXLEY ACT OF 2002

I, Ronald E. Bruehlman, certify that:

1. I have reviewed this quarterly report on Form 10-Q of IQVIA Holdings Inc. (the “registrant”);

2. Based on my knowledge, this report does not contain any untrue statement of a material fact or omit to state a material fact necessary to make the statements made, in light of the circumstances under which such statements were made, not misleading with respect to the period covered by this report;

3. Based on my knowledge, the financial statements, and other financial information included in this report, fairly present in all material respects the financial condition, results of operations and cash flows of the registrant as of, and for, the periods presented in this report;

4. The registrant’s other certifying officer and I are responsible for establishing and maintaining disclosure controls and procedures (as defined in Exchange Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the registrant and have:

(a)Designed such disclosure controls and procedures, or caused such disclosure controls and procedures to be designed under our supervision, to ensure that material information relating to the registrant, including its consolidated subsidiaries, is made known to us by others within those entities, particularly during the period in which this report is being prepared;

(b)Designed such internal control over financial reporting, or caused such internal control over financial reporting to be designed under our supervision, 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;

(c)Evaluated the effectiveness of the registrant’s disclosure controls and procedures and presented in this report our conclusions about the effectiveness of the disclosure controls and procedures, as of the end of the period covered by this report based on such evaluation; and

(d)Disclosed in this report any change in the registrant’s internal control over financial reporting that occurred during the registrant’s most recent fiscal quarter (the registrant’s fourth fiscal quarter in the case of an annual report) that has materially affected, or is reasonably likely to materially affect, the registrant’s internal control over financial reporting; and

5. The registrant’s other certifying officer and I have disclosed, based on our most recent evaluation of internal control over financial reporting, to the registrant’s auditors and the audit committee of the registrant’s board of directors (or persons performing the equivalent functions):

(a)All significant deficiencies and material weaknesses in the design or operation of internal control over financial reporting which are reasonably likely to adversely affect the registrant’s ability to record, process, summarize and report financial information; and

(b)Any fraud, whether or not material, that involves management or other employees who have a significant role in the registrant’s internal control over financial reporting.

Date: November 1, 2023
	/s/ Ronald E. Bruehlman
	Ronald E. Bruehlman Executive Vice President and Chief Financial Officer (Principal Financial Officer)

EX-32.1

Exhibit 32.1

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350

AS ADOPTED PURSUANT TO SECTION 906

OF THE SARBANES-OXLEY ACT OF 2002

I, Ari Bousbib, Chairman, Chief Executive Officer and President of IQVIA Holdings Inc. (the “Company”), do hereby certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that to the best of my knowledge:

(1)the Quarterly Report on Form 10-Q of the Company for the quarter ended September 30, 2023 (the “Report”) fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2)the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods presented therein.

Date: November 1, 2023
	/s/ Ari Bousbib
	Ari Bousbib Chairman, Chief Executive Officer and President (Principal Executive Officer)

This certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. § 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, and shall not be deemed “filed” by the Company for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and shall not be incorporated by reference into any filing of the Company under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, whether made before or after the date of this Report, irrespective of any general incorporation language contained in such filing.

A signed original of this written statement required by Section 906 of the Sarbanes-Oxley Act of 2002 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.

EX-32.2

Exhibit 32.2

CERTIFICATION PURSUANT TO

18 U.S.C. SECTION 1350

AS ADOPTED PURSUANT TO SECTION 906

OF THE SARBANES-OXLEY ACT OF 2002

I, Ronald E. Bruehlman, Executive Vice President and Chief Financial Officer of IQVIA Holdings Inc. (the “Company”), do hereby certify, pursuant to 18 U.S.C. Section 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, that to the best of my knowledge:

(1)the Quarterly Report on Form 10-Q of the Company for the quarter ended September 30, 2023 (the “Report”) fully complies with the requirements of Section 13(a) or 15(d) of the Securities Exchange Act of 1934; and

(2)the information contained in the Report fairly presents, in all material respects, the financial condition and results of operations of the Company for the periods presented therein.

Date: November 1, 2023
	/s/ Ronald E. Bruehlman
	Ronald E. Bruehlman Executive Vice President and Chief Financial Officer (Principal Financial Officer)

This certification is being furnished solely to accompany the Report pursuant to 18 U.S.C. § 1350, as adopted pursuant to Section 906 of the Sarbanes-Oxley Act of 2002, and shall not be deemed “filed” by the Company for purposes of Section 18 of the Securities Exchange Act of 1934, as amended, and shall not be incorporated by reference into any filing of the Company under the Securities Act of 1933, as amended, or the Securities Exchange Act of 1934, as amended, whether made before or after the date of this Report, irrespective of any general incorporation language contained in such filing.

A signed original of this written statement required by Section 906 of the Sarbanes-Oxley Act of 2002 has been provided to the Company and will be retained by the Company and furnished to the Securities and Exchange Commission or its staff upon request.

XML

Cover Page - shares	9 Months Ended
	Sep. 30, 2023	Oct. 19, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
Document Transition Report	false
Entity File Number	001-35907
Entity Registrant Name	IQVIA HOLDINGS INC.
Entity Incorporation, State	DE
Entity Tax Identification Number	27-1341991
Entity Address, Street	2400 Ellis Rd.
Entity Address, City	Durham
Entity Address, State	NC
Entity Address, Postal Zip Code	27703
City Area Code	919
Local Phone Number	998-2000
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of Each Class	Common Stock, par value $0.01 per share
Trading Symbol	IQV
Name of Each Exchange on which Registered	NYSE
Entity Common Stock, Shares Outstanding		182,500,000
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001478242
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q3

XML

CONDENSED CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Millions, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Revenues	$ 3,736	$ 3,562	$ 11,116	$ 10,671
Cost of revenues, exclusive of depreciation and amortization	2,426	2,321	7,267	6,975
Selling, general and administrative expenses	502	517	1,497	1,488
Depreciation and amortization	297	248	809	773
Restructuring costs	30	4	67	15
Income from operations	481	472	1,476	1,420
Interest income	(14)	(4)	(24)	(7)
Interest expense	181	108	491	288
Other (income) expense, net	(35)	8	(77)	51
Income before income taxes and equity in earnings (losses) of unconsolidated affiliates	349	360	1,086	1,088
Income tax expense	51	70	203	212
Income before equity in earnings (losses) of unconsolidated affiliates	298	290	883	876
Equity in earnings (losses) of unconsolidated affiliates	5	(7)	6	(12)
Net income	303	283	889	864
Net Income (Loss) Attributable to Parent, Total	$ 303	$ 283	$ 889	$ 864
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 1.66	$ 1.52	$ 4.82	$ 4.59
Diluted (in dollars per share)	$ 1.63	$ 1.49	$ 4.76	$ 4.52
Weighted average common shares outstanding:
Basic (in shares)	182.9	186.5	184.4	188.3
Diluted (in shares)	185.5	189.4	186.9	191.3

XML

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 303	$ 283	$ 889	$ 864
Comprehensive income adjustments:
Unrealized gains on derivative instruments, net of income tax expense of $—, $2, $11, $10	2	6	34	29
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	0	10	1	4
Foreign currency translation, net of income tax expense of $44, $84, $12, $195	(136)	(218)	(170)	(539)
Reclassification adjustments:
Reclassifications on derivative instruments included in net income, net of income tax (expense) benefit of $(3), $—, $(14), $4	(9)	1	(41)	14
Comprehensive income	$ 160	$ 82	$ 713	$ 372

XML

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Unrealized (losses) gains on derivative instruments, income tax (benefit) expense	$ 0	$ 2	$ 11	$ 10
Defined benefit plan adjustments, income tax (benefit) expense	0	2	0	2
Foreign currency translation, income tax expense (benefit)	44	84	12	195
(Gain) losses on derivative instruments included in net income, income tax expense	$ (3)	$ 0	$ (14)	$ 4

XML

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 1,224	$ 1,216
Trade accounts receivable and unbilled services, net	3,227	2,917
Prepaid expenses	177	151
Income taxes receivable	49	43
Investments in debt, equity and other securities	108	93
Other current assets and receivables	423	561
Total current assets	5,208	4,981
Property and equipment, net	498	532
Operating lease right-of-use assets	292	331
Investments in debt, equity and other securities	99	68
Investments in unconsolidated affiliates	115	94
Goodwill	14,288	13,921
Other identifiable intangibles, net	4,907	4,820
Deferred income taxes	111	118
Deposits and other assets, net	459	472
Total assets	25,977	25,337
Current liabilities:
Accounts payable and accrued expenses	3,133	3,316
Unearned income	1,838	1,797
Income taxes payable	172	161
Current portion of long-term debt	1,309	152
Other current liabilities	137	152
Total current liabilities	6,589	5,578
Long-term debt, less current portion	12,322	12,595
Deferred income taxes	365	464
Operating lease liabilities	217	264
Other liabilities	679	671
Total liabilities	20,172	19,572
Commitments and contingencies (Note 8)
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of September 30, 2023 and December 31, 2022, $0.01 par value, 257.1 shares issued and 182.5 shares outstanding as of September 30, 2023; 256.4 shares issued and 185.7 shares outstanding as of December 31, 2022	10,994	10,898
Retained earnings	4,223	3,334
Treasury stock, at cost, 74.6 and 70.7 shares as of September 30, 2023 and December 31, 2022, respectively	(8,509)	(7,740)
Accumulated other comprehensive loss	(903)	(727)
Total stockholders’ equity	5,805	5,765
Total liabilities and stockholders’ equity	$ 25,977	$ 25,337

XML

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares shares in Millions	Sep. 30, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Common stock, shares authorized (in shares)	400.0	400.0
Common stock, par value, ( in usd per share)	$ 0.01	$ 0.01
Common stock, shares issued (in shares)	257.1	256.4
Common stock, shares outstanding (in shares)	182.5	185.7
Treasury stock, shares (in shares)	74.6	70.7

XML

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Operating activities:
Net income	$ 889	$ 864
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	809	773
Amortization of debt issuance costs and discount	13	11
Stock-based compensation	172	136
(Earnings) losses from unconsolidated affiliates	(6)	12
(Gain) loss on investments, net	(5)	35
Benefit from deferred income taxes	(117)	(52)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income	(241)	(88)
Change in other operating assets and liabilities	(112)	9
Net cash provided by operating activities	1,402	1,700
Investing activities:
Acquisition of property, equipment and software	(470)	(503)
Acquisition of businesses, net of cash acquired	(869)	(1,012)
Purchases of marketable securities, net	(4)	(4)
Investments in unconsolidated affiliates, net of payments received	(16)	(14)
Investments in debt and equity securities	(36)	0
Other	4	4
Net cash used in investing activities	(1,391)	(1,529)
Financing activities:
Proceeds from issuance of debt	1,250	1,250
Payment of debt issuance costs	(19)	(5)
Repayment of debt and principal payments on finance leases	(118)	(86)
Proceeds from revolving credit facility	2,009	1,500
Repayment of revolving credit facility	(2,184)	(1,600)
Payments related to employee stock option plans	(58)	(70)
Repurchase of common stock	(763)	(1,103)
Contingent consideration and deferred purchase price payments	(79)	(22)
Net cash provided by (used in) financing activities	38	(136)
Effect of foreign currency exchange rate changes on cash	(41)	(127)
Increase (decrease) in cash and cash equivalents	8	(92)
Cash and cash equivalents at beginning of period	1,216	1,366
Cash and cash equivalents at end of period	$ 1,224	$ 1,274

XML

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Treasury Stock, Common	Additional Paid-In Capital	Retained Earnings	Accumulated Other Comprehensive (Loss) Income
Beginning balance (in shares) at Dec. 31, 2021		255.8	65.2
Beginning balance at Dec. 31, 2021	$ 6,042	$ 3	$ (6,572)	$ 10,774	$ 2,243	$ (406)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.4
Issuance of common stock	(67)			(67)
Repurchase of common stock (in shares)			(1.7)
Repurchase of common stock	(403)		$ (403)
Stock-based compensation	35			35
Net income	325				325
Unrealized gains on derivative instruments, net of tax	30					30
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	(2)					(2)
Foreign currency translation, net of tax	(40)					(40)
Reclassification adjustments, net of tax	(1)					(1)
Ending balance (in shares) at Mar. 31, 2022		256.2	66.9
Ending balance at Mar. 31, 2022	5,919	$ 3	$ (6,975)	10,742	2,568	(419)
Beginning balance (in shares) at Dec. 31, 2021		255.8	65.2
Beginning balance at Dec. 31, 2021	6,042	$ 3	$ (6,572)	10,774	2,243	(406)
Increase (Decrease) in Stockholders' Equity
Net income	864
Unrealized gains on derivative instruments, net of tax	29
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	4
Foreign currency translation, net of tax	(539)
Ending balance (in shares) at Sep. 30, 2022		256.3	70.5
Ending balance at Sep. 30, 2022	5,347	$ 3	$ (7,715)	10,850	3,107	(898)
Beginning balance (in shares) at Mar. 31, 2022		256.2	66.9
Beginning balance at Mar. 31, 2022	5,919	$ 3	$ (6,975)	10,742	2,568	(419)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	(2)			(2)
Repurchase of common stock (in shares)			(2.8)
Repurchase of common stock	(590)		$ (590)
Stock-based compensation	47			47
Net income	256				256
Unrealized gains on derivative instruments, net of tax	(7)					(7)
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	(4)					(4)
Foreign currency translation, net of tax	(281)					(281)
Reclassification adjustments, net of tax	14					14
Ending balance (in shares) at Jun. 30, 2022		256.3	69.7
Ending balance at Jun. 30, 2022	5,352	$ 3	$ (7,565)	10,787	2,824	(697)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.0
Issuance of common stock	(1)			(1)
Repurchase of common stock (in shares)			(0.8)
Repurchase of common stock	(150)		$ (150)
Stock-based compensation	64			64
Net income	283				283
Unrealized gains on derivative instruments, net of tax	6					6
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	10					10
Foreign currency translation, net of tax	(218)					(218)
Reclassification adjustments, net of tax	1					1
Ending balance (in shares) at Sep. 30, 2022		256.3	70.5
Ending balance at Sep. 30, 2022	$ 5,347	$ 3	$ (7,715)	10,850	3,107	(898)
Beginning balance (in shares) at Dec. 31, 2022	185.7	256.4	70.7
Beginning balance at Dec. 31, 2022	$ 5,765	$ 3	$ (7,740)	10,895	3,334	(727)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.5
Issuance of common stock	(58)			(58)
Repurchase of common stock (in shares)			(0.7)
Repurchase of common stock	(129)		$ (129)
Stock-based compensation	69			69
Net income	289				289
Unrealized gains on derivative instruments, net of tax	10					10
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	1					1
Foreign currency translation, net of tax	10					10
Reclassification adjustments, net of tax	(25)					(25)
Ending balance (in shares) at Mar. 31, 2023		256.9	71.4
Ending balance at Mar. 31, 2023	$ 5,932	$ 3	$ (7,869)	10,906	3,623	(731)
Beginning balance (in shares) at Dec. 31, 2022	185.7	256.4	70.7
Beginning balance at Dec. 31, 2022	$ 5,765	$ 3	$ (7,740)	10,895	3,334	(727)
Increase (Decrease) in Stockholders' Equity
Net income	889
Unrealized gains on derivative instruments, net of tax	34
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	1
Foreign currency translation, net of tax	$ (170)
Ending balance (in shares) at Sep. 30, 2023	182.5	257.1	74.6
Ending balance at Sep. 30, 2023	$ 5,805	$ 3	$ (8,509)	10,991	4,223	(903)
Beginning balance (in shares) at Mar. 31, 2023		256.9	71.4
Beginning balance at Mar. 31, 2023	5,932	$ 3	$ (7,869)	10,906	3,623	(731)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	0			0
Repurchase of common stock (in shares)			(2.5)
Repurchase of common stock	(495)		$ (495)
Stock-based compensation	43			43
Net income	297				297
Unrealized gains on derivative instruments, net of tax	22					22
Foreign currency translation, net of tax	(44)					(44)
Reclassification adjustments, net of tax	(7)					(7)
Ending balance (in shares) at Jun. 30, 2023		257.0	73.9
Ending balance at Jun. 30, 2023	5,748	$ 3	$ (8,364)	10,949	3,920	(760)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	0			0
Repurchase of common stock (in shares)			(0.7)
Repurchase of common stock	(145)		$ (145)
Stock-based compensation	42			42
Net income	303				303
Unrealized gains on derivative instruments, net of tax	2					2
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	0
Foreign currency translation, net of tax	(136)					(136)
Reclassification adjustments, net of tax	$ (9)					(9)
Ending balance (in shares) at Sep. 30, 2023	182.5	257.1	74.6
Ending balance at Sep. 30, 2023	$ 5,805	$ 3	$ (8,509)	$ 10,991	$ 4,223	$ (903)

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Summary of Significant Accounting Policies

9 Months Ended

Sep. 30, 2023

Accounting Policies [Abstract]

Summary of Significant Accounting Policies

Summary of Significant Accounting Policies

The Company

IQVIA Holdings Inc. (together with its subsidiaries, the “Company” or “IQVIA”) is a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry. With approximately 87,000 employees, the Company conducts business in more than 100 countries.

Unaudited Interim Financial Information

The accompanying unaudited condensed consolidated financial statements of the Company have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022. The balance sheet as of December 31, 2022 has been derived from the audited consolidated financial statements of the Company, but does not include all the disclosures required by GAAP.

Recently Issued Accounting Standards

Accounting pronouncements adopted

In September 2022, the Financial Accounting Standards Board ("FASB") issued new accounting guidance, Accounting Standards Update ("ASU") 2022-04, Liabilities - Supplier Finance Programs, to enhance the transparency of supplier finance programs. The amendments in this ASU address investor and other financial statement user requests for additional information about the use of supplier finance programs by the buyer party to understand the effect of those programs on an entity's working capital, liquidity, and cash flows. The Company adopted this new accounting guidance effective January 1, 2023. The adoption of this new accounting guidance did not have a material effect on the Company's disclosures within the condensed consolidated financial statements.

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Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations

9 Months Ended

Sep. 30, 2023

Revenue from Contract with Customer [Abstract]

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations

The following tables represent revenues by geographic region and reportable segment for the three and nine months ended September 30, 2023 and 2022:

	Three Months Ended September 30, 2023
(in millions)		Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas		$	761	$	1,017	$	78	$	1,856
Europe and Africa		519		520		50		1,089
Asia-Pacific		151		585		55		791
Total revenues		$	1,431	$	2,122	$	183	$	3,736

	Three Months Ended September 30, 2022
(in millions)		Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas		$	746	$	960	$	91	$	1,797
Europe and Africa		503		488		40		1,031
Asia-Pacific		151		531		52		734
Total revenues		$	1,400	$	1,979	$	183	$	3,562

	Nine Months Ended September 30, 2023
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,268	$	2,982	$	228	$	5,478
Europe and Africa	1,606		1,547		146		3,299
Asia-Pacific	457		1,715		167		2,339
Total revenues	$	4,331	$	6,244	$	541	$	11,116

	Nine Months Ended September 30, 2022
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,143	$	2,772	$	270	$	5,185
Europe and Africa	1,639		1,527		129		3,295
Asia-Pacific	465		1,564		162		2,191
Total revenues	$	4,247	$	5,863	$	561	$	10,671

No individual customer represented 10% or more of consolidated revenues for the three and nine months ended September 30, 2023 or 2022.

Transaction Price Allocated to the Remaining Performance Obligations As of September 30, 2023, approximately $31.3 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

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Trade Accounts Receivable, Unbilled Services and Unearned Income

9 Months Ended

Sep. 30, 2023

Receivables [Abstract]

Trade Accounts Receivable, Unbilled Services and Unearned Income

Trade Accounts Receivable, Unbilled Services and Unearned Income

Trade accounts receivables and unbilled services consist of the following:

(in millions)	September 30, 2023		December 31, 2022
Trade accounts receivable	$	1,349	$	1,329
Unbilled services	1,905		1,624
Trade accounts receivable and unbilled services	3,254		2,953
Allowance for doubtful accounts	(27)		(36)
Trade accounts receivable and unbilled services, net	$	3,227	$	2,917

Unbilled services and unearned income were as follows:

(in millions)	September 30, 2023		December 31, 2022		Change
Unbilled services	$	1,905	$	1,624	$	281
Unearned income	(1,838)		(1,797)		(41)
Net balance	$	67	$	(173)	$	240

Unbilled services, which is comprised of approximately 66% and 61% of unbilled receivables and 34% and 39% of contract assets as of September 30, 2023 and December 31, 2022, respectively, increased by $281 million as compared to December 31, 2022. 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 increased by $41 million over the same period resulting in an increase of $240 million in the net balance of unbilled services and unearned income between September 30, 2023 and December 31, 2022. The change in the net balance is driven by the difference in timing of revenue recognition in accordance with Accounting Standards Codification ("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 based on certain milestones.

The majority of the unearned income balance as of the beginning of the year is expected to be recognized in revenues during the year ended December 31, 2023.

Bad debt expense recognized on the Company’s trade accounts receivable was immaterial for the three and nine months ended September 30, 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. During the nine months ended September 30, 2023, through its accounts receivable factoring arrangements that the Company utilizes most frequently, the Company factored approximately $545 million of customer invoices on a non-recourse basis and received approximately $534 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.

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Goodwill

9 Months Ended

Sep. 30, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill

Goodwill

The following is a summary of goodwill by reportable segment for the nine months ended September 30, 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	331		181		—		512
Impact of foreign currency fluctuations and other	(139)		—		(6)		(145)
Balance as of September 30, 2023	$	11,712	$	2,428	$	148	$	14,288

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Derivatives

9 Months Ended

Sep. 30, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivatives

Derivatives

The fair values of the Company’s derivative instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table:

(in millions)	Balance Sheet Classification	September 30, 2023						December 31, 2022
		Assets		Liabilities		Notional		Assets		Liabilities		Notional
Derivatives designated as hedging instruments:
Interest rate swaps	Other current assets, other assets and other current liabilities	$	36	$	—	$	1,800	$	42	$	—	$	1,800
Foreign exchange forward contracts	Other current assets and other current liabilities	—		4		124		2		2		122
Total derivatives		$	36	$	4			$	44	$	2

The pre-tax effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Interest rate swaps	$	(1)	$	14	$	(6)	$	69
Foreign exchange forward contracts	(9)		(5)		(4)		(12)
Total	$	(10)	$	9	$	(10)	$	57

The Company expects approximately $30 million of pre-tax unrealized gains related to its foreign exchange contracts and interest rate derivatives included in accumulated other comprehensive (loss) income (“AOCI”) as of September 30, 2023 to be reclassified into earnings within the next twelve months. As of September 30, 2023, the Company's foreign currency denominated debt balance (net of original issue discount) designated as a hedge of its net investment in certain foreign subsidiaries totaled €5,199 million ($5,498 million). The amount of foreign exchange gains related to the net investment hedge included in the cumulative translation adjustment component of AOCI for the nine months ended September 30, 2023 and 2022 was $69 million and $807 million, respectively.

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Fair Value Measurements

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

Fair Value Measurements

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 September 30, 2023 and December 31, 2022 due to their short-term nature. As of September 30, 2023 and December 31, 2022, the fair value of total debt was $13,138 million and $12,281 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 September 30, 2023:

(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	130	$	—	$	—	$	130
Derivatives	—		36		—		36
Total	$	130	$	36	$	—	$	166
Liabilities:
Derivatives	$	—	$	4	$	—	$	4
Contingent consideration	—		—		104		104
Total	$	—	$	4	$	104	$	108

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, 2022:

(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	122	$	—	$	—	$	122
Derivatives	—		44		—		44
Total	$	122	$	44	$	—	$	166
Liabilities:
Derivatives	$	—	$	2	$	—	$	2
Contingent consideration	—		—		173		173
Total	$	—	$	2	$	173	$	175

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 and interest rate 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.

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 (revenue 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 September 30, 2023, the Company has accrued approximately 35% 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 nine months ended September 30, 2023:

(in millions)	Contingent Consideration
Balance as of December 31, 2022	$	173
Business combinations	59
Contingent consideration paid	(72)
Revaluations included in earnings and foreign currency translation adjustments	(56)
Balance as of September 30, 2023	$	104

The current portion of contingent consideration is included within accrued expenses and the long-term portion is included within other liabilities on the accompanying condensed consolidated balance sheets. Revaluations of contingent consideration are recognized in other (income) expense, net on the accompanying condensed consolidated statements of income. A change in significant unobservable inputs could result in a higher or lower fair value measurement of contingent consideration.

Non-recurring Fair Value Measurements

As of September 30, 2023, assets carried on the balance sheet and not remeasured to fair value on a recurring basis totaled $19,387 million and were identified as Level 3. These assets are comprised of debt investments and cost and equity method investments of $192 million, goodwill of $14,288 million and other identifiable intangibles, net of $4,907 million.

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Credit Arrangements

9 Months Ended

Sep. 30, 2023

Debt Disclosure [Abstract]

Credit Arrangements

Credit ArrangementsThe following is a summary of the Company’s revolving credit facilities as of September 30, 2023:

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 September 30, 2023
$110 million (receivables financing facility)	U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of September 30, 2023

The following table summarizes the Company’s debt at the dates indicated:

(dollars in millions)	September 30, 2023		December 31, 2022
Revolving Credit Facility due 2026:
U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 6.66%	$	250	$	425
Senior Secured Credit Facilities:
Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.66%	1,288		1,343
Term A Loan due 2026—Euribor at average floating rates of 5.22%	298		314
Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.66%	1,172		1,219
Term B Loan due 2024—Euribor at average floating rates of 5.85%	1,157		1,172
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14%	670		670
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14%	861		860
Term B Loan due 2025—Euribor at average floating rates of 5.85%	552		559
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
5.700% Senior Secured Notes due 2028—U.S. Dollar denominated	750		—
6.500% Senior Notes due 2030—U.S. Dollar denominated	500		—
2.875% Senior Notes due 2025—Euro denominated	444		450
2.25% Senior Notes due 2028—Euro denominated	761		771
2.875% Senior Notes due 2028—Euro denominated	752		761
1.750% Senior Notes due 2026—Euro denominated	582		589
2.250% Senior Notes due 2029—Euro denominated	952		964
Receivables financing facility due 2024—U.S. Dollar Term SOFR at average floating rates of 6.33%:
Revolving Loan Commitment	110		110
Term Loan	440		440
Principal amount of debt	13,689		12,797
Less: unamortized discount and debt issuance costs	(58)		(50)
Less: current portion	(1,309)		(152)
Long-term debt	$	12,322	$	12,595

Contractual maturities of long-term debt as of September 30, 2023 are as follows:

(in millions)
Remainder of 2023	$	38
2024	1,859
2025	2,679
2026	3,329
2027	2,069
Thereafter	3,715
	$	13,689

Senior Secured Credit Facilities

As of September 30, 2023, the Company’s Fifth Amended and Restated Credit Agreement provided financing through several senior secured credit facilities of up to $7,998 million, which consisted of $6,248 million principal amounts of debt outstanding (as detailed in the table above), and $1,745 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.

On April 17, 2023, the Company increased the capacity of its 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 SOFR plus a 10 basis point Credit Spread Adjustment.

Senior Notes

On May 23, 2023, IQVIA Inc. (the “Issuer”), a wholly owned subsidiary of the Company, completed the issuance and sale of $750 million in gross proceeds of the Issuer’s 5.700% senior secured notes due 2028 (the “Senior Secured Notes”) and $500 million in gross proceeds of 6.500% senior notes due 2030 (the “Senior Notes” and, together with the Senior Secured Notes, the “Notes”). The Senior Secured Notes were issued pursuant to an Indenture, dated May 23, 2023 (the “Secured Notes Indenture”), among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the Senior Secured Notes and as collateral agent, and the Company and certain subsidiaries of the Issuer as guarantors. The 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 Senior Notes, and certain subsidiaries of the Issuer as guarantors (the “Senior Notes Indenture” and, together with the Secured Notes Indenture, the “Indentures”). The net proceeds from the notes offering were used to repay existing borrowings under the Issuer’s revolving credit facility and to pay fees and expenses related to the Notes offering.

The Notes have not been registered under the Securities Act of 1933, as amended, or the securities laws of any other jurisdiction. Pursuant to a registration rights agreement entered into in connection with the Notes offering, the Issuer and the guarantors agreed, among other things, to use commercially reasonable efforts to, within certain time periods, file a registration statement with respect to a registered offer to exchange the Senior Secured Notes for new exchange notes, have the exchange offer registration statement declared effective, and complete the exchange offer promptly thereafter, unless the Senior Secured Notes are redeemed earlier.

The Senior Secured Notes are secured obligations of the Issuer, 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 Senior Notes are unsecured obligations of the Issuer, 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 Issuer may redeem (i) the 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 and (ii) the 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%.

Restrictive CovenantsThe 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 other usual and customary restrictive covenants that, among other things, place limitations on the Company’s ability to declare dividends. As of September 30, 2023, the Company was in compliance in all material respects with the financial covenants under the Company’s financing arrangements

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Contingencies

9 Months Ended

Sep. 30, 2023

Commitments and Contingencies Disclosure [Abstract]

Contingencies

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.

On February 13, 2014, a group of approximately 1,200 medical doctors and 900 private individuals filed a civil lawsuit with the Seoul Central District Court against IMS Korea and two other defendants, the Korean Pharmaceutical Association (“KPA”) and the Korean Pharmaceutical Information Center (“KPIC”). The civil lawsuit alleges KPA and KPIC collected their personal information in violation of applicable privacy laws without the necessary consent through a software system installed on pharmacy computer systems in Korea, and that personal information was transferred to IMS Korea and sold to pharmaceutical companies. On September 11, 2017, the District Court issued a final decision that the encryption in use by the defendants since June 2014 was adequate to meet the requirements of the Korean Personal Information Privacy Act (“PIPA”) and the sharing of non-identified information for market research purposes was allowed under PIPA. The District Court also found an earlier version of encryption was insufficient to meet PIPA requirements, but no personal data had been leaked or re-identified. The District Court did not award any damages to plaintiffs. Approximately 280 medical doctors and 200 private individuals appealed the District Court decision. On May 3, 2019, the Appellate Court issued a final decision in which it concluded all of the non-identified information transferred by KPIC to IMS Korea for market research purposes violated PIPA, but did not award any damages to plaintiffs (affirming the District Court’s decision on this latter point). On May 24, 2019, approximately 247 plaintiffs appealed the Appellate Court’s decision to the Supreme Court. The Company believes the appeal is without merit and is vigorously defending its position.

On July 23, 2015, indictments were issued by the Seoul Central District Prosecutors’ Office in South Korea against 24 individuals and companies alleging improper handling of sensitive health information in violation of, among others, South Korea’s Personal Information Protection Act. IMS Korea and two of its employees were among the individuals and organizations indicted. Although there is no assertion that IMS Korea used patient identified health information in any of its offerings, prosecutors allege that certain of IMS Korea’s data suppliers should have obtained patient consent when they converted sensitive patient information into non-identified data and that IMS Korea had not taken adequate precautions to reduce the risk of re-identification. On February 14, 2020, the Seoul Central District Court acquitted IMS Korea and its two employees of the charges of improper handling of sensitive health information, and the Prosecutor's Office appealed. On December 23, 2021, the appellate court affirmed the judgment of the Seoul Central District Court. The Prosecutor's Office has appealed to the Supreme Court. The Company intends to vigorously defend its position on appeal.

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. The parties are engaged in the discovery process in connection with these lawsuits.

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 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 is currently appealing the Order.

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Stockholders' Equity

9 Months Ended

Sep. 30, 2023

Equity [Abstract]

Stockholders' Equity

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 or outstanding as of September 30, 2023 or December 31, 2022.

Equity Repurchase Program

On July 31, 2023, the Company's Board of Directors (the "Board") increased the stock repurchase authorization under the Company's equity repurchase program (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 $11,725 million. The Repurchase Program does not obligate the Company to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time.

During the nine months ended September 30, 2023, the Company repurchased 3.9 million shares of its common stock for $763 million under the Repurchase Program. As of September 30, 2023, the Company had remaining authorization to repurchase up to $2,592 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.

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Business Combinations

9 Months Ended

Sep. 30, 2023

Business Combination and Asset Acquisition [Abstract]

Business Combinations

Business Combinations

The Company completed several individually immaterial acquisitions during the nine months ended September 30, 2023. The Company’s assessment of fair value, including the valuation of certain identified intangibles, and the purchase price allocation related to these acquisitions is preliminary and subject to change upon completion. Further adjustments 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 customer relationships. The condensed 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:

(in millions)	September 30, 2023
Assets acquired:
Cash and cash equivalents	$	27
Accounts receivable	42
Other assets	9
Goodwill	512
Other identifiable intangibles	416
Liabilities assumed:
Other liabilities	(38)
Deferred income taxes, long-term	(17)
Net assets acquired (1)	$	951

(1) Net assets acquired includes contingent consideration and deferred purchase price of $66 million.

The portion of goodwill deductible for income tax purposes was preliminarily assessed as $373 million.

The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired:

(in millions)	Amortization Period				September 30, 2023
Other identifiable intangibles:
Customer relationships	10	-	15	years	$	330
Backlog			2	years	51
Software and related assets	5	-	8	years	29
Databases	3	-	5	years	3
Trade names			5	years	3
Total Other identifiable intangibles					$	416

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Restructuring

9 Months Ended

Sep. 30, 2023

Restructuring and Related Activities [Abstract]

Restructuring

RestructuringThe Company has continued to take restructuring actions in 2023 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 throughout 2023 and into 2024.

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	67
Payments	(50)
Foreign currency translation and other	(1)
Balance as of September 30, 2023	$	42

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 that the majority of the restructuring accruals as of September 30, 2023 will be paid in 2023 and 2024.

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Income Taxes

9 Months Ended

Sep. 30, 2023

Income Tax Disclosure [Abstract]

Income Taxes

Income Taxes

The Company's effective income tax rate was 14.6% and 19.4% in the third quarter of 2023 and 2022, and 18.7% and 19.5% in the first nine months of 2023 and 2022, respectively. The effective income tax rate in the third quarter and first nine months of 2023 was favorably impacted by a reversal of uncertain tax positions relating to tax credit carryforwards in the amount of $21 million. Additionally, the effective income tax rate in the third quarter and in the first nine months of 2023 and 2022 was favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards. For the third quarter of 2023 and 2022 this impact was $2 million and $1 million, respectively, and for the first nine months of 2023 and 2022 this impact was $12 million and $15 million, respectively.

Historically, the Company recorded deferred tax assets related to certain foreign tax credits. 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. As a result of an anticipated internal legal entity restructuring, the Company now believes it is reasonably possible that these foreign tax credits will be utilized and expects to reverse the valuation allowance in the near term which could create a material discrete tax benefit in the period recorded.

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Accumulated Other Comprehensive (Loss) Income

9 Months Ended

Sep. 30, 2023

Equity [Abstract]

Accumulated Other Comprehensive (Loss) Income

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, 2022	$	(825)	$	44	$	(8)	$	62	$	(727)
Other comprehensive (loss) income before reclassifications	(158)		45		1		(23)		(135)
Reclassification adjustments	—		(55)		—		14		(41)
Balance as of September 30, 2023	$	(983)	$	34	$	(7)	$	53	$	(903)

Below is a summary of the adjustments for amounts reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item:

(in millions)	Affected Financial Statement Line Item	Three Months Ended September 30,				Nine Months Ended September 30,
		2023		2022		2023		2022
Derivative instruments:
Interest rate swaps	Interest expense	$	17	$	(9)	$	35	$	(16)
Foreign exchange forward contracts	Revenues	(5)		8		20		(2)
Total before income taxes		12		(1)		55		(18)
Income taxes		3		—		14		(4)
Total net of income taxes		$	9	$	(1)	$	41	$	(14)

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Segments

9 Months Ended

Sep. 30, 2023

Segment Reporting [Abstract]

Segments

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 clients and the broader healthcare market.

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. The Company also does not allocate 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 operating decision maker to assess the Company’s performance. The Company’s reportable segment information is presented below:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Revenues
Technology & Analytics Solutions	$	1,431	$	1,400	$	4,331	$	4,247
Research & Development Solutions	2,122		1,979		6,244		5,863
Contract Sales & Medical Solutions	183		183		541		561
Total revenues	3,736		3,562		11,116		10,671
Cost of revenues, exclusive of depreciation and amortization
Technology & Analytics Solutions	859		828		2,593		2,490
Research & Development Solutions	1,410		1,335		4,213		4,005
Contract Sales & Medical Solutions	157		158		461		480
Total cost of revenues, exclusive of depreciation and amortization	2,426		2,321		7,267		6,975
Selling, general and administrative expenses
Technology & Analytics Solutions	217		213		652		628
Research & Development Solutions	217		199		640		614
Contract Sales & Medical Solutions	14		17		43		48
General corporate and unallocated	54		88		162		198
Total selling, general and administrative expenses	502		517		1,497		1,488
Segment profit
Technology & Analytics Solutions	355		359		1,086		1,129
Research & Development Solutions	495		445		1,391		1,244
Contract Sales & Medical Solutions	12		8		37		33
Total segment profit	862		812		2,514		2,406
General corporate and unallocated	(54)		(88)		(162)		(198)
Depreciation and amortization	(297)		(248)		(809)		(773)
Restructuring costs	(30)		(4)		(67)		(15)
Total income from operations	$	481	$	472	$	1,476	$	1,420

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Earnings Per Share

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Earnings Per Share

Earnings Per Share

The following table reconciles the basic to diluted weighted average shares outstanding:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions, except per share data)	2023		2022		2023		2022
Numerator:
Net income	$	303	$	283	$	889	$	864
Denominator:
Basic weighted average common shares outstanding	182.9		186.5		184.4		188.3
Effect of dilutive stock options and share awards	2.6		2.9		2.5		3.0
Diluted weighted average common shares outstanding	185.5		189.4		186.9		191.3
Earnings per share attributable to common stockholders:
Basic	$	1.66	$	1.52	$	4.82	$	4.59
Diluted	$	1.63	$	1.49	$	4.76	$	4.52

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 three and nine months ended September 30, 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 0.9 million and 0.4 million, and 1.0 million and 0.5 million, respectively.

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Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net income	$ 303	$ 283	$ 889	$ 864

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Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

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Summary of Significant Accounting Policies (Policies)

9 Months Ended

Sep. 30, 2023

Accounting Policies [Abstract]

Unaudited Interim Financial Information

Unaudited Interim Financial Information

The accompanying unaudited condensed consolidated financial statements of the Company have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2023. As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2022. The balance sheet as of December 31, 2022 has been derived from the audited consolidated financial statements of the Company, but does not include all the disclosures required by GAAP.

Recently Issued Accounting Standards

Recently Issued Accounting Standards

Accounting pronouncements adopted

In September 2022, the Financial Accounting Standards Board ("FASB") issued new accounting guidance, Accounting Standards Update ("ASU") 2022-04, Liabilities - Supplier Finance Programs, to enhance the transparency of supplier finance programs. The amendments in this ASU address investor and other financial statement user requests for additional information about the use of supplier finance programs by the buyer party to understand the effect of those programs on an entity's working capital, liquidity, and cash flows. The Company adopted this new accounting guidance effective January 1, 2023. The adoption of this new accounting guidance did not have a material effect on the Company's disclosures within the condensed consolidated financial statements.

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Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations (Tables)

9 Months Ended

Sep. 30, 2023

Revenue from Contract with Customer [Abstract]

Summary of Revenues by Geographic Region and Reportable Segment

The following tables represent revenues by geographic region and reportable segment for the three and nine months ended September 30, 2023 and 2022:

	Three Months Ended September 30, 2023
(in millions)		Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas		$	761	$	1,017	$	78	$	1,856
Europe and Africa		519		520		50		1,089
Asia-Pacific		151		585		55		791
Total revenues		$	1,431	$	2,122	$	183	$	3,736

	Three Months Ended September 30, 2022
(in millions)		Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas		$	746	$	960	$	91	$	1,797
Europe and Africa		503		488		40		1,031
Asia-Pacific		151		531		52		734
Total revenues		$	1,400	$	1,979	$	183	$	3,562

	Nine Months Ended September 30, 2023
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,268	$	2,982	$	228	$	5,478
Europe and Africa	1,606		1,547		146		3,299
Asia-Pacific	457		1,715		167		2,339
Total revenues	$	4,331	$	6,244	$	541	$	11,116

	Nine Months Ended September 30, 2022
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,143	$	2,772	$	270	$	5,185
Europe and Africa	1,639		1,527		129		3,295
Asia-Pacific	465		1,564		162		2,191
Total revenues	$	4,247	$	5,863	$	561	$	10,671

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Trade Accounts Receivable, Unbilled Services and Unearned Income (Tables)

9 Months Ended

Sep. 30, 2023

Receivables [Abstract]

Schedule of Trade Accounts Receivable and Unbilled Services

Trade accounts receivables and unbilled services consist of the following:

(in millions)	September 30, 2023		December 31, 2022
Trade accounts receivable	$	1,349	$	1,329
Unbilled services	1,905		1,624
Trade accounts receivable and unbilled services	3,254		2,953
Allowance for doubtful accounts	(27)		(36)
Trade accounts receivable and unbilled services, net	$	3,227	$	2,917

Schedule of Net Contract Assets (Liabilities)

Unbilled services and unearned income were as follows:

(in millions)	September 30, 2023		December 31, 2022		Change
Unbilled services	$	1,905	$	1,624	$	281
Unearned income	(1,838)		(1,797)		(41)
Net balance	$	67	$	(173)	$	240

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Goodwill (Tables)

9 Months Ended

Sep. 30, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of Goodwill by Reportable Segment

The following is a summary of goodwill by reportable segment for the nine months ended September 30, 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	331		181		—		512
Impact of foreign currency fluctuations and other	(139)		—		(6)		(145)
Balance as of September 30, 2023	$	11,712	$	2,428	$	148	$	14,288

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Derivatives (Tables)

9 Months Ended

Sep. 30, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Summary of Fair Values of Derivative Instruments Designated as Hedges

The fair values of the Company’s derivative instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table:

(in millions)	Balance Sheet Classification	September 30, 2023						December 31, 2022
		Assets		Liabilities		Notional		Assets		Liabilities		Notional
Derivatives designated as hedging instruments:
Interest rate swaps	Other current assets, other assets and other current liabilities	$	36	$	—	$	1,800	$	42	$	—	$	1,800
Foreign exchange forward contracts	Other current assets and other current liabilities	—		4		124		2		2		122
Total derivatives		$	36	$	4			$	44	$	2

Schedule of Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income

The pre-tax effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Interest rate swaps	$	(1)	$	14	$	(6)	$	69
Foreign exchange forward contracts	(9)		(5)		(4)		(12)
Total	$	(10)	$	9	$	(10)	$	57

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Fair Value Measurements (Tables)

9 Months Ended

Sep. 30, 2023

Fair Value Disclosures [Abstract]

Summary of Fair Value of Financial Assets and Liabilities Measured on Recurring Basis

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 September 30, 2023:

(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	130	$	—	$	—	$	130
Derivatives	—		36		—		36
Total	$	130	$	36	$	—	$	166
Liabilities:
Derivatives	$	—	$	4	$	—	$	4
Contingent consideration	—		—		104		104
Total	$	—	$	4	$	104	$	108

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, 2022:

(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	122	$	—	$	—	$	122
Derivatives	—		44		—		44
Total	$	122	$	44	$	—	$	166
Liabilities:
Derivatives	$	—	$	2	$	—	$	2
Contingent consideration	—		—		173		173
Total	$	—	$	2	$	173	$	175

Schedule of Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis

The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the nine months ended September 30, 2023:

(in millions)	Contingent Consideration
Balance as of December 31, 2022	$	173
Business combinations	59
Contingent consideration paid	(72)
Revaluations included in earnings and foreign currency translation adjustments	(56)
Balance as of September 30, 2023	$	104

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Credit Arrangements (Tables)

9 Months Ended

Sep. 30, 2023

Debt Disclosure [Abstract]

Summary of Credit Facilities

The following is a summary of the Company’s revolving credit facilities as of September 30, 2023:

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 September 30, 2023
$110 million (receivables financing facility)	U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of September 30, 2023

Summary of Debt

The following table summarizes the Company’s debt at the dates indicated:

(dollars in millions)	September 30, 2023		December 31, 2022
Revolving Credit Facility due 2026:
U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 6.66%	$	250	$	425
Senior Secured Credit Facilities:
Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.66%	1,288		1,343
Term A Loan due 2026—Euribor at average floating rates of 5.22%	298		314
Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.66%	1,172		1,219
Term B Loan due 2024—Euribor at average floating rates of 5.85%	1,157		1,172
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14%	670		670
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14%	861		860
Term B Loan due 2025—Euribor at average floating rates of 5.85%	552		559
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
5.700% Senior Secured Notes due 2028—U.S. Dollar denominated	750		—
6.500% Senior Notes due 2030—U.S. Dollar denominated	500		—
2.875% Senior Notes due 2025—Euro denominated	444		450
2.25% Senior Notes due 2028—Euro denominated	761		771
2.875% Senior Notes due 2028—Euro denominated	752		761
1.750% Senior Notes due 2026—Euro denominated	582		589
2.250% Senior Notes due 2029—Euro denominated	952		964
Receivables financing facility due 2024—U.S. Dollar Term SOFR at average floating rates of 6.33%:
Revolving Loan Commitment	110		110
Term Loan	440		440
Principal amount of debt	13,689		12,797
Less: unamortized discount and debt issuance costs	(58)		(50)
Less: current portion	(1,309)		(152)
Long-term debt	$	12,322	$	12,595

Schedule of Contractual Maturities of Long-term Debt

Contractual maturities of long-term debt as of September 30, 2023 are as follows:

(in millions)
Remainder of 2023	$	38
2024	1,859
2025	2,679
2026	3,329
2027	2,069
Thereafter	3,715
	$	13,689

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Business Combinations (Tables)

9 Months Ended

Sep. 30, 2023

Business Combination and Asset Acquisition [Abstract]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

The following table provides certain preliminary financial information for these acquisitions:

(in millions)	September 30, 2023
Assets acquired:
Cash and cash equivalents	$	27
Accounts receivable	42
Other assets	9
Goodwill	512
Other identifiable intangibles	416
Liabilities assumed:
Other liabilities	(38)
Deferred income taxes, long-term	(17)
Net assets acquired (1)	$	951

(1) Net assets acquired includes contingent consideration and deferred purchase price of $66 million.

Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination

The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired:

(in millions)	Amortization Period				September 30, 2023
Other identifiable intangibles:
Customer relationships	10	-	15	years	$	330
Backlog			2	years	51
Software and related assets	5	-	8	years	29
Databases	3	-	5	years	3
Trade names			5	years	3
Total Other identifiable intangibles					$	416

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Restructuring (Tables)

9 Months Ended

Sep. 30, 2023

Restructuring and Related Activities [Abstract]

Summary of Amounts Recorded for Restructuring Plans

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	67
Payments	(50)
Foreign currency translation and other	(1)
Balance as of September 30, 2023	$	42

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Accumulated Other Comprehensive (Loss) Income (Tables)

9 Months Ended

Sep. 30, 2023

Equity [Abstract]

Summary of Components of AOCI

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, 2022	$	(825)	$	44	$	(8)	$	62	$	(727)
Other comprehensive (loss) income before reclassifications	(158)		45		1		(23)		(135)
Reclassification adjustments	—		(55)		—		14		(41)
Balance as of September 30, 2023	$	(983)	$	34	$	(7)	$	53	$	(903)

Summary of Adjustments for (Gains) Losses Reclassified from AOCI into Condensed Consolidated Statements of Income and Affected Financial Statement Line Item

Below is a summary of the adjustments for amounts reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item:

(in millions)	Affected Financial Statement Line Item	Three Months Ended September 30,				Nine Months Ended September 30,
		2023		2022		2023		2022
Derivative instruments:
Interest rate swaps	Interest expense	$	17	$	(9)	$	35	$	(16)
Foreign exchange forward contracts	Revenues	(5)		8		20		(2)
Total before income taxes		12		(1)		55		(18)
Income taxes		3		—		14		(4)
Total net of income taxes		$	9	$	(1)	$	41	$	(14)

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Segments (Tables)

9 Months Ended

Sep. 30, 2023

Segment Reporting [Abstract]

Reconciliation of Revenues and Income from Segments to Consolidated

Asset information by segment is not presented, as this measure is not used by the chief operating decision maker to assess the Company’s performance. The Company’s reportable segment information is presented below:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions)	2023		2022		2023		2022
Revenues
Technology & Analytics Solutions	$	1,431	$	1,400	$	4,331	$	4,247
Research & Development Solutions	2,122		1,979		6,244		5,863
Contract Sales & Medical Solutions	183		183		541		561
Total revenues	3,736		3,562		11,116		10,671
Cost of revenues, exclusive of depreciation and amortization
Technology & Analytics Solutions	859		828		2,593		2,490
Research & Development Solutions	1,410		1,335		4,213		4,005
Contract Sales & Medical Solutions	157		158		461		480
Total cost of revenues, exclusive of depreciation and amortization	2,426		2,321		7,267		6,975
Selling, general and administrative expenses
Technology & Analytics Solutions	217		213		652		628
Research & Development Solutions	217		199		640		614
Contract Sales & Medical Solutions	14		17		43		48
General corporate and unallocated	54		88		162		198
Total selling, general and administrative expenses	502		517		1,497		1,488
Segment profit
Technology & Analytics Solutions	355		359		1,086		1,129
Research & Development Solutions	495		445		1,391		1,244
Contract Sales & Medical Solutions	12		8		37		33
Total segment profit	862		812		2,514		2,406
General corporate and unallocated	(54)		(88)		(162)		(198)
Depreciation and amortization	(297)		(248)		(809)		(773)
Restructuring costs	(30)		(4)		(67)		(15)
Total income from operations	$	481	$	472	$	1,476	$	1,420

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Earnings Per Share (Tables)

9 Months Ended

Sep. 30, 2023

Earnings Per Share [Abstract]

Schedule of Earnings Per Share, Basic and Diluted

The following table reconciles the basic to diluted weighted average shares outstanding:

	Three Months Ended September 30,				Nine Months Ended September 30,
(in millions, except per share data)	2023		2022		2023		2022
Numerator:
Net income	$	303	$	283	$	889	$	864
Denominator:
Basic weighted average common shares outstanding	182.9		186.5		184.4		188.3
Effect of dilutive stock options and share awards	2.6		2.9		2.5		3.0
Diluted weighted average common shares outstanding	185.5		189.4		186.9		191.3
Earnings per share attributable to common stockholders:
Basic	$	1.66	$	1.52	$	4.82	$	4.59
Diluted	$	1.63	$	1.49	$	4.76	$	4.52

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Summary of Significant Accounting Policies - Additional Information (Detail) Employee in Thousands	Sep. 30, 2023 Employee Country
Summary Of Significant Accounting Policies [Line Items]
Number of employees | Employee	87
Minimum
Summary Of Significant Accounting Policies [Line Items]
Number of countries (more than) | Country	100

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Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Summary of Revenues by Geographic Region and Reportable Segment (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation of Revenue
Total revenues	$ 3,736	$ 3,562	$ 11,116	$ 10,671
Americas
Disaggregation of Revenue
Total revenues	1,856	1,797	5,478	5,185
Europe and Africa
Disaggregation of Revenue
Total revenues	1,089	1,031	3,299	3,295
Asia-Pacific
Disaggregation of Revenue
Total revenues	791	734	2,339	2,191
Technology & Analytics Solutions
Disaggregation of Revenue
Total revenues	1,431	1,400	4,331	4,247
Technology & Analytics Solutions | Americas
Disaggregation of Revenue
Total revenues	761	746	2,268	2,143
Technology & Analytics Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	519	503	1,606	1,639
Technology & Analytics Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	151	151	457	465
Research & Development Solutions
Disaggregation of Revenue
Total revenues	2,122	1,979	6,244	5,863
Research & Development Solutions | Americas
Disaggregation of Revenue
Total revenues	1,017	960	2,982	2,772
Research & Development Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	520	488	1,547	1,527
Research & Development Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	585	531	1,715	1,564
Contract Sales & Medical Solutions
Disaggregation of Revenue
Total revenues	183	183	541	561
Contract Sales & Medical Solutions | Americas
Disaggregation of Revenue
Total revenues	78	91	228	270
Contract Sales & Medical Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	50	40	146	129
Contract Sales & Medical Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	$ 55	$ 52	$ 167	$ 162

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Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Additional Information (Detail) - Customer	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Revenue from Contract with Customer [Abstract]
Number of customer accounting for ten percent or more of revenue	0	0	0	0

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Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Future Obligation Terms (Detail) $ in Billions	Sep. 30, 2023 USD ($)
Revenue from Contract with Customer [Abstract]
Revenue expected to be recognized in future from remaining performance obligations	$ 31.3
Percentage of remaining performance obligations on which revenue is expected to be recognized in next twelve months (in percent)	30.00%
Unearned income recognition period	12 months
Percentage of remaining performance obligations on which revenue is expected to be recognized in next five years (in percent)	85.00%
Unearned income recognition period	5 years

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Trade Accounts Receivable, Unbilled Services and Unearned Income - Trade Accounts Receivable and Unbilled Services (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Receivables, Net, Current [Abstract]
Trade accounts receivable	$ 1,349	$ 1,329
Unbilled services	1,905	1,624
Trade accounts receivable and unbilled services	3,254	2,953
Allowance for doubtful accounts	(27)	(36)
Trade accounts receivable and unbilled services, net	$ 3,227	$ 2,917

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Trade Accounts Receivable, Unbilled Services and Unearned Income - Schedule of Net Contract Assets (Liabilities) (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Unbilled Contracts Receivables
Unbilled services, beginning balance	$ 1,624
Change	281
Unbilled services, ending balance	1,905
Unearned Income
Unearned income, beginning balance	(1,797)
Change	(41)
Unearned income, ending balance	(1,838)
Net change in balance	240
Net balance, beginning balance	$ 67	$ (173)

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Trade Accounts Receivable, Unbilled Services and Unearned Income - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2023	Dec. 31, 2022
Receivables [Abstract]
Unbilled receivables (percentage)	66.00%	66.00%	61.00%
Contract assets (percentage)	34.00%	34.00%	39.00%
Increase in unbilled services		$ 281
Decrease in unearned income		41
Net change in balance		240
Trade accounts receivable	$ 545	$ 545
Cash proceeds from trade accounts	$ 534

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Goodwill - Summary of Goodwill by Reportable Segment (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Goodwill
Beginning balance	$ 13,921
Business combinations	512
Impact of foreign currency fluctuations and other	(145)
Ending balance	14,288
Technology & Analytics Solutions
Goodwill
Beginning balance	11,520
Business combinations	331
Impact of foreign currency fluctuations and other	(139)
Ending balance	11,712
Research & Development Solutions
Goodwill
Beginning balance	2,247
Business combinations	181
Impact of foreign currency fluctuations and other	0
Ending balance	2,428
Contract Sales & Medical Solutions
Goodwill
Beginning balance	154
Business combinations	0
Impact of foreign currency fluctuations and other	(6)
Ending balance	$ 148

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Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) - USD ($)	Sep. 30, 2023	Dec. 31, 2022
Derivatives, Fair Value
Assets	$ 36,000,000	$ 44,000,000
Liabilities	4,000,000	2,000,000
Derivatives designated as hedging instruments: | Other current assets and other current liabilities | Foreign exchange forward contracts
Derivatives, Fair Value
Assets	0	2,000,000
Liabilities	4,000,000	2,000,000
Notional	124,000,000	122,000,000
Derivatives designated as hedging instruments: | Other current assets, other assets and other current liabilities | Interest rate swaps
Derivatives, Fair Value
Assets	36,000,000	42,000,000
Liabilities	0	0
Notional	$ 1,800,000,000	$ 1,800,000,000

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Derivatives - Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (10)	$ 9	$ (10)	$ 57
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	30		30
Foreign exchange forward contracts
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	(9)	(5)	(4)	(12)
Interest rate swaps
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (1)	$ 14	$ (6)	$ 69

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Derivatives - Additional Information (Detail) € in Millions, $ in Millions	Sep. 30, 2023 EUR (€)	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)
Derivative Instruments and Hedging Activities Disclosures
Foreign exchange loss related to net investment hedge		$ 69	$ 807
Net Investment Hedging
Derivative Instruments and Hedging Activities Disclosures
Long-term debt	€ 5,199	$ 5,498

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Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Percentage accrued of maximum consideration payments to become payable	35.00%
Other identifiable intangibles, net	$ 4,907	$ 4,820
Level 1 and Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value of total debt	13,138	$ 12,281
Level 3 | Fair Value, Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Assets, Fair Value Disclosure	19,387
Cost and equity method investments	192
Goodwill	14,288
Other identifiable intangibles, net	$ 4,907

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Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Assets:
Marketable securities	$ 108	$ 93
Derivatives	36	44
Recurring Fair Value Measurements
Assets:
Marketable securities	130	122
Derivatives	36	44
Total	166	166
Liabilities:
Derivatives	4	2
Contingent consideration	104	173
Total	108	175
Recurring Fair Value Measurements | Level 1
Assets:
Marketable securities	130	122
Derivatives	0	0
Total	130	122
Liabilities:
Derivatives	0	0
Contingent consideration	0	0
Total	0	0
Recurring Fair Value Measurements | Level 2
Assets:
Marketable securities	0	0
Derivatives	36	44
Total	36	44
Liabilities:
Derivatives	4	2
Contingent consideration	0	0
Total	4	2
Recurring Fair Value Measurements | Level 3
Assets:
Marketable securities	0	0
Derivatives	0	0
Total	0	0
Liabilities:
Derivatives	0	0
Contingent consideration	104	173
Total	$ 104	$ 173

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Fair Value Measurements - Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Contingent consideration $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation
Beginning balance	$ 173
Business combinations	59
Contingent consideration paid	(72)
Revaluations included in earnings and foreign currency translation adjustments	(56)
Ending balance	$ 104

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Credit Arrangements - Summary of Credit Facilities (Detail)	9 Months Ended
	Sep. 30, 2023 USD ($)
Revolving Credit Facility | USD Revolving Credit Facility
Line of Credit Facility
Interest rate description	U.S. Dollar Term SOFR plus a margin of 1.25% plus a 10 basis credit spread adjustment as of September 30, 2023
Facility	$ 2,000,000,000
Interest rate spread on base rate	0.10%
Revolving Credit Facility | USD Revolving Credit Facility | SOFR
Line of Credit Facility
Rate	1.25%
Interest rate spread on base rate	0.10%
Facility | Receivables Financing Facility
Line of Credit Facility
Facility	$ 110,000,000
Facility | Receivables Financing Facility | SOFR
Line of Credit Facility
Interest rate description	U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of September 30, 2023
Rate	0.90%
Interest rate spread on base rate	0.11%

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Credit Arrangements - Summary of Debt (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Apr. 17, 2023	Dec. 31, 2022
Senior Secured Credit Facilities:
Principal amount of debt	$ 13,689		$ 12,797
Less: unamortized discount and debt issuance costs	(58)		(50)
Less: current portion	(1,309)		(152)
Long-term debt	12,322		12,595
U.S Dollars | Senior Secured Term A Loan, 3.03% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,172		1,219
Average floating rate	6.66%
U.S Dollars | Senior Secured Notes Due 2028, 5.700% | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 750		0
Rate	5.70%
U.S Dollars | Senior Notes Due 2030, 6.500% | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 500		0
Rate	6.50%
U.S Dollars | Term Loan | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 440		440
U.S Dollars | Due in 2024 | Senior Secured Term B Loan, 1.85% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt		$ 500
U.S Dollars | Due in 2024 | Receivable Financing Facilities | SOFR
Senior Secured Credit Facilities:
Average floating rate	6.33%
U.S Dollars | Due in 2025 | Senior Secured Term B Loan, 1.85% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 670		670
Average floating rate	7.14%
U.S Dollars | Due in 2025 | Senior Secured Term B Loan 1.97% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 861		860
Average floating rate	7.14%
U.S Dollars | Due in 2026 | Senior Secured Term A Loan, 1.47% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,288		1,343
Average floating rate	6.66%
U.S Dollars | Due in 2026 | 5.0% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,050		1,050
Rate	5.00%
U.S Dollars | Due in 2027 | 5.0% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,100		1,100
Rate	5.00%
EUR Dollars | Due in 2024 | Senior Secured Term B Loan, 2.00% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,157		1,172
Average floating rate	5.85%
EUR Dollars | Due in 2025 | Senior Secured Term B Loan, 2.00% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 552		559
Average floating rate	5.85%
EUR Dollars | Due in 2025 | 2.875% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 444		450
Rate	2.875%
EUR Dollars | Due in 2026 | Senior Secured Term A Loan, 1.25% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 298		314
Average floating rate	5.22%
EUR Dollars | Due in 2026 | 1.75% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 582		589
Rate	1.75%
EUR Dollars | Due in 2028 | 2.875% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 752		761
Rate	2.875%
EUR Dollars | Due in 2028 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 761		771
Rate	2.25%
EUR Dollars | Due in 2029 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 952		964
Rate	2.25%
Revolving Credit Facility | U.S Dollars | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 250		425
Average floating rate	6.66%
Revolving Credit Facility | U.S Dollars | Revolving Loan Commitment | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 110		$ 110

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Credit Arrangements - Contractual Maturities of Long-term Debt (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
Remainder of 2022	$ 38
2024	1,859
2025	2,679
2026	3,329
2027	2,069
Thereafter	3,715
Principal amount of debt	$ 13,689	$ 12,797

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Credit Arrangements - Senior Secured Credit Facilities (Detail) - USD ($) $ in Millions	May 23, 2023	Sep. 30, 2023	Apr. 17, 2023	Dec. 31, 2022
Line of Credit Facility
Principal amount of debt		$ 13,689		$ 12,797
SOFR | Revolving Credit Facility | U.S Dollars
Line of Credit Facility
Principal amount of debt		250		425
Senior Secured Term A Loan, 3.03% | SOFR | U.S Dollars
Line of Credit Facility
Principal amount of debt		1,172		1,219
Senior Secured Credit Facilities, Fifth Amended and Restated Credit Agreement
Line of Credit Facility
Aggregate maximum principal amount		7,998
Principal amount		6,248
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit
Line of Credit Facility
Aggregate maximum principal amount		2,000	$ 2,000
Available borrowing capacity		1,745
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit | U.S Dollars
Line of Credit Facility
Principal amount		1,175
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit | U.S. dollars, Euros, Swiss Francs And Other Foreign Currencies
Line of Credit Facility
Principal amount		600
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit | US Dollars And Yen
Line of Credit Facility
Principal amount		225
Senior Secured Term B Loan, 1.85% | SOFR | Due in 2024 | U.S Dollars
Line of Credit Facility
Principal amount of debt			$ 500
Senior Notes Due 2030, 6.500% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt		$ 500		0
Rate		6.50%
Senior Notes Due 2030, 6.500% | Minimum
Line of Credit Facility
Redemption price percentage	0.00%
Senior Notes Due 2030, 6.500% | Maximum
Line of Credit Facility
Redemption price percentage	3.25%
Senior Notes Due 2030, 6.500% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt	$ 500
Rate	6.50%
Senior Secured Notes Due 2028, 5.700% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt		$ 750		$ 0
Rate		5.70%
Senior Secured Notes Due 2028, 5.700% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt	$ 750
Rate	5.70%

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Contingencies - Additional Information (Detail) $ in Millions	Jul. 14, 2020 private_individual	May 24, 2019 medical_doctor	Sep. 11, 2017 medical_doctor	Sep. 11, 2017 private_individual	May 13, 2017 USD ($)	Jul. 23, 2015 private_individual	Feb. 13, 2014 medical_doctor	Feb. 13, 2014 private_individual	Feb. 13, 2014 Defendant
KPIC
Loss Contingencies
Number of plaintiffs		247	280	200			1,200	900
Number of defendants | Defendant									2
Seoul Central District Prosecutors
Loss Contingencies
Number of defendants						24
Seoul Central District Prosecutors | Employee
Loss Contingencies
Number of defendants	2					2
Veeva | Minimum
Loss Contingencies
Amount of damages claimed | $					$ 200

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Stockholders' Equity (Detail) - USD ($) $ / shares in Units, $ in Millions		3 Months Ended						9 Months Ended
	Jul. 31, 2023	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Dec. 31, 2022
Class of Stock
Preferred stock, authorized (shares)		1,000,000						1,000,000
Preferred stock, par value (usd per share)		$ 0.01						$ 0.01
Preferred stock, shares issued (shares)		0						0	0
Preferred stock, shares outstanding (shares)		0						0	0
Repurchase of stock, value		$ 145	$ 495	$ 129	$ 150	$ 590	$ 403
Equity Repurchase Under Repurchase Program
Class of Stock
Equity repurchase program authorized amount	$ 11,725
Repurchase of stock (in shares)								3,900,000
Repurchase of stock, value								$ 763
Equity available for repurchase under the repurchase program		$ 2,592						$ 2,592
Equity repurchase program additional authorized amount	$ 2,000

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Business Combinations - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Assets acquired:
Goodwill	$ 14,288	$ 13,921
Several Individually Immaterial Acquisitions
Assets acquired:
Cash and cash equivalents	27
Accounts receivable	42
Other assets	9
Goodwill	512
Other identifiable intangibles	416
Liabilities assumed:
Other liabilities	(38)
Deferred income taxes, long-term	(17)
Net assets acquired	951
Contingent consideration and deferred payments	$ 66

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Business Combinations - Narrative (Details) $ in Millions	Sep. 30, 2023 USD ($)
Several Individually Immaterial Acquisitions
Business Acquisition [Line Items]
Portion of goodwill deductible for income tax purposes	$ 373

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Business Combinations - Indefinite-Lived Intangible Assets Acquired as Part of Business Combination (Details) - Several Individually Immaterial Acquisitions $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 416
Customer relationships
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 330
Backlog
Business Acquisition [Line Items]
Amortization Period	2 years
Total Other identifiable intangibles	$ 51
Software and related assets
Business Acquisition [Line Items]
Total Other identifiable intangibles	29
Databases
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 3
Trade names
Business Acquisition [Line Items]
Amortization Period	5 years
Total Other identifiable intangibles	$ 3
Minimum | Customer relationships
Business Acquisition [Line Items]
Amortization Period	10 years
Minimum | Software and related assets
Business Acquisition [Line Items]
Amortization Period	5 years
Minimum | Databases
Business Acquisition [Line Items]
Amortization Period	3 years
Maximum | Customer relationships
Business Acquisition [Line Items]
Amortization Period	15 years
Maximum | Software and related assets
Business Acquisition [Line Items]
Amortization Period	8 years
Maximum | Databases
Business Acquisition [Line Items]
Amortization Period	5 years

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Restructuring - Summary of Amounts Recorded for Restructuring Plans (Detail) - Severance and Related Costs $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Restructuring Reserve
Restructuring reserves, beginning balance	$ 26
Expense, net of reversals	67
Payments	(50)
Foreign currency translation and other	(1)
Restructuring reserves, ending balance	$ 42

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Income Taxes - Narratives (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Effective income tax rate (percent)	14.60%	19.40%	18.70%	19.50%
Tax impact of share-based compensation awards	$ 2	$ 1	$ 12	$ 15

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Accumulated Other Comprehensive (Loss) Income - Summary of Components of AOCI (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Statement of Other Comprehensive Income
Beginning balance	$ 5,765
Ending balance	5,805
Income Taxes
Beginning balance	62
Other comprehensive (loss) income before reclassifications	(23)
Reclassification adjustments	14
Ending balance	53
Other comprehensive (loss) income before reclassifications	(135)
Reclassification adjustments	(41)
Foreign Currency Translation
Statement of Other Comprehensive Income
Beginning balance	(825)
Other comprehensive (loss) income before reclassifications	(158)
Reclassification adjustments	0
Ending balance	(983)
Derivative Instruments
Statement of Other Comprehensive Income
Beginning balance	44
Other comprehensive (loss) income before reclassifications	45
Reclassification adjustments	(55)
Ending balance	34
Defined Benefit Plans
Statement of Other Comprehensive Income
Beginning balance	(8)
Other comprehensive (loss) income before reclassifications	1
Reclassification adjustments	0
Ending balance	(7)
Total
Statement of Other Comprehensive Income
Beginning balance	(727)
Ending balance	$ (903)

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Accumulated Other Comprehensive (Loss) Income - Summary of Adjustments for (Gains) Losses Reclassified from AOCI into Condensed Consolidated Statements of Income and Affected Financial Statement Line Item (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 12	$ (1)	$ 55	$ (18)
Income taxes	3	0	14	(4)
Total net of income taxes	9	(1)	41	(14)
Interest rate swaps | Interest expense
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	17	(9)	35	(16)
Foreign exchange forward contracts | Revenues
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ (5)	$ 8	$ 20	$ (2)

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Segments - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2023 Segment
Segment Reporting [Abstract]
Number of reportable segments	3

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Segments - Operations by Reportable Segments (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting Information
Revenues	$ 3,736	$ 3,562	$ 11,116	$ 10,671
Cost of revenues, exclusive of depreciation and amortization	2,426	2,321	7,267	6,975
Selling, general and administrative expenses	502	517	1,497	1,488
Segment profit	862	812	2,514	2,406
Depreciation and amortization	(297)	(248)	(809)	(773)
Restructuring costs	(30)	(4)	(67)	(15)
Income from operations	481	472	1,476	1,420
Technology & Analytics Solutions
Segment Reporting Information
Revenues	1,431	1,400	4,331	4,247
Cost of revenues, exclusive of depreciation and amortization	859	828	2,593	2,490
Research & Development Solutions
Segment Reporting Information
Revenues	2,122	1,979	6,244	5,863
Cost of revenues, exclusive of depreciation and amortization	1,410	1,335	4,213	4,005
Contract Sales & Medical Solutions
Segment Reporting Information
Revenues	183	183	541	561
Cost of revenues, exclusive of depreciation and amortization	157	158	461	480
Operating Segments | Technology & Analytics Solutions
Segment Reporting Information
Selling, general and administrative expenses	217	213	652	628
Segment profit	355	359	1,086	1,129
Operating Segments | Research & Development Solutions
Segment Reporting Information
Selling, general and administrative expenses	217	199	640	614
Segment profit	495	445	1,391	1,244
Operating Segments | Contract Sales & Medical Solutions
Segment Reporting Information
Selling, general and administrative expenses	14	17	43	48
Segment profit	12	8	37	33
General corporate and unallocated
Segment Reporting Information
Selling, general and administrative expenses	54	88	162	198
Segment profit	$ (54)	$ (88)	$ (162)	$ (198)

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Earnings Per Share - Reconciles the Basic to Diluted Weighted Average Shares Outstanding (Detail) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Net income	$ 303	$ 283	$ 889	$ 864
Denominator:
Basic weighted average common shares outstanding (in shares)	182.9	186.5	184.4	188.3
Effect of dilutive stock options and share awards (in shares)	2.6	2.9	2.5	3.0
Diluted weighted average common shares outstanding (in shares)	185.5	189.4	186.9	191.3
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 1.66	$ 1.52	$ 4.82	$ 4.59
Diluted (in dollars per share)	$ 1.63	$ 1.49	$ 4.76	$ 4.52

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Earnings Per Share - Narrative (Details) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	0.9	0.4	1.0	0.5