IQV · IQVIA Holdings
Conviction · Medium · more likely to lead the S&P 500 over the next three months, by a modest margin
Wrong if: a daily close below $240
Note written ·
Price against the kill line
10.5% clear of its kill line on the 13 November 2026 close.
How to read this
The red mark is the price level of the published kill line: a close through it (a weekly close, on a weekly line) would prove the research note wrong on price. The dot is where the stock closed on 13 November 2026; a dot left of the mark has closed through its line.
The scale is stretched near the line, so close calls are easy to see. More than 8% from the line, the stock reads well clear, with a hollow dot to show the figure is off the drawn scale.
The kill line is the research note's own test. The portfolio sells on business facts, not on a price. How the portfolio decides
Three months against the kill line
Daily closes, to . Red: the kill line, a daily close below $240.00, on record since 10 November 2026. The shares are up 9.9% since the close; the S&P 500 is down 2.1% over the same sessions. Figures in the note can cover a different window.
Kill line
A daily close below $240, under the $241.52 close on 13 August 2026, which would erase the three-month gain; or a 2027 framework at the 1 December 2026 investor day pointing to revenue growth below the 6.4%–7.3% guided for 2026.
Research onlyNot in the portfolio.
Catalyst
Key figures from the filings · Health Care
Quarter to 30 September 2026, filed 27 October 2026; valuation at the 13 November 2026 close
- Revenue, latest quarter ($M)
- 4,428
- Revenue, change on a year (%)
- +8.0
- Gross margin (%)
- 33.8
- Operating margin (%)
- 12.9
- Free cash flow, four quarters ($M)
- 2,079
- Net cash, cash less debt ($M)
- −13,645
- Price to earnings (×)
- 31.3
- Enterprise value to sales (×)
- 3.3
All filed numbers
What IQVIA Holdings reports to the SEC in its quarterly and annual filings. Each group states its period and filing date once; a figure dated otherwise says so. Built from the filings known on .
| Quarter to | Revenue ($M) | On a year (%) | Gross margin (%) | Operating margin (%) |
|---|---|---|---|---|
| first filed | 4,428 | +8.0 | 33.8 | 12.9 |
| first filed | 4,368 | +8.7 | 32.9 | 11.6 |
| first filed | 4,151 | +8.4 | 32.6 | 12.4 |
| first filed | 4,364 | +10.3 | 32.9 | 14.4 |
| first filed | 4,100 | +5.2 | 33.5 | 13.5 |
| first filed | 4,017 | +5.3 | 32.9 | 12.6 |
| Pre-tax income ($M) | 386 |
| Net income ($M) four quarters: 1,394 | 350 |
| Diluted shares, change on a year (%) against the quarter to 30 September 2025 | −2.7 |
| Operating cash flow ($M) | 2,736 |
| Capital spending ($M) | 657 |
| Free cash flow ($M) | 2,079 |
| Cash and short-term investments ($M) | 2,422 |
| Debt ($M) non-current long-term debt plus current maturities | 16,067 |
| Net cash, cash less debt ($M) | −13,645 |
| Deferred revenue ($M) +7.1% on a year | 2,313 |
| Backlog, orders not yet delivered ($M) −0.6% on a year | 34,200 |
| Receivables ($M) | 3,293 |
| Inventory ($M) | Not reported |
| Shareholders' equity ($M) | 6,660 |
| Market value ($M) | 43,692 |
| Enterprise value, market value plus net debt ($M) | 57,337 |
| Enterprise value to sales (×) | 3.3 |
| Enterprise value to operating income (×) | 25.8 |
| Price to earnings (×) | 31.3 |
| Price to book value (×) | 6.6 |
| Free-cash-flow yield (%) | 4.8 |
Short interest (FINRA, settled 15 October 2026, published 26 October 2026): 1.8% of shares outstanding sold short, 2.4 days of average trading to cover, −7.0% since the previous report.
| Window | Bought | Sold |
|---|---|---|
| 90 daysfrom | $0 | $1.9M |
| 12 monthsfrom | $0 | $39.3M |
The thesis
IQVIA's clinical-research bookings are growing faster than its revenue, which gives the shares modestly better-than-even odds of beating the S&P 500 over the next three months. The 1 December 2026 investor day settles the case. Management will give a broad framework for 2027 there, ahead of detailed guidance with fourth-quarter results.
Third-quarter 2026 bookings rose 15% at a 1.2x book-to-bill ratio, and IQVIA raised its 2026 guidance on 27 October 2026. No results, guidance change or broker target change has been reported since 29 October 2026, per Benzinga and fiscal.ai. The shares closed at $274.53 on 11 November 2026, above the $263.79 close on 4 November 2026.
The price already reflects a recovery. The shares closed at $274.53 on 11 November 2026, 3.5% below the intraday 52-week high of $284.50 set on 27 October 2026 and well above the 52-week closing low of $156.66 on 29 April 2026. For the shares to lead from here, the 2027 framework has to show faster growth than the 2026 guidance already implies.
Bullish and bearish views on IQVIA Holdings Inc.
The bull case on IQVIA Holdings Inc. (IQV), in brief: bookings outran revenue again. The bear case: backlog was cut by $2.1 billion.
Bull case
- Bookings outran revenue again. Third-quarter net new bookings were $3.2 billion, up 15%, for a 1.2x book-to-bill, per the company's 27 October 2026 8-K. Trailing twelve-month bookings reached $11.7 billion, up 14%.
- Guidance went up on 27 October 2026. IQVIA raised 2026 revenue guidance to $17,350–$17,500 million from $17,275–$17,475 million. It set adjusted EBITDA (earnings before interest, taxes, depreciation and amortisation) at $4,025–$4,055 million and adjusted earnings per share (EPS) at $12.90–$13.00, from $12.80–$13.00.
- The quarter beat estimates. Adjusted EPS of $3.34 beat the $3.27 consensus and revenue of $4,428 million beat the $4,366 million consensus, per Benzinga on 27 October 2026. Revenue rose 8.0% as reported and 8.6% at constant currency.
- More backlog converts next year. IQVIA expects about $9.4 billion of R&D Solutions backlog to become revenue over the next twelve months, up 10%, per the 27 October 2026 release.
- Demand indicators are rising. On the 27 October 2026 call, management said request-for-proposal flow rose by a high-single-digit percentage and clinical win rates rose 2 to 3 points. It put emerging biopharma funding at $90 billion so far in 2026, up more than 85%.
- Peers report rising awards. ICON reported a 1.56x net book-to-bill on 27 October 2026, Medpace record net new awards of $873.4 million on 21 October 2026, and Fortrea a 1.12x book-to-bill on 29 October 2026, per their releases.
- Broker targets sit above the shares. Truist moved to $346, Baird to $328, JPMorgan to $325, Evercore ISI to $310 and TD Cowen to $307, per Benzinga on 28 October 2026 and 29 October 2026. Deutsche Bank's target is $310, per MarketBeat on 28 October 2026, and Rothschild & Co Redburn's is $299, per fiscal.ai on 28 October 2026.
Bear case
- Backlog was cut by $2.1 billion. Contracted R&D Solutions backlog was $32.6 billion at 30 September 2026, after IQVIA removed about $2.1 billion of trials inactive for 18 months or more. The company says the cut does not affect guidance, bookings or next-twelve-month revenue from backlog.
- Acquisitions lift the guided growth. Updated 2026 guidance assumes acquisitions add 2 to 2.5 percentage points of growth, per the 27 October 2026 call. The 2027 framework has to show demand-driven growth on top of that.
- Peer conversion is uneven. ICON's third-quarter revenue fell 2.9% despite its 1.56x book-to-bill, per its 27 October 2026 release. Medpace's backlog grew 5.6%, slower than its 8.5% revenue growth, per its 21 October 2026 8-K.
- Commercial Solutions grows more slowly. The segment's third-quarter revenue was $1,789 million, up 6.9%, against 8.7% for R&D Solutions, per the 27 October 2026 release. R&D Solutions growth was 6.8% excluding reimbursed pass-through costs.
- Debt is high. Net leverage was 3.45x net debt to trailing adjusted EBITDA at 30 September 2026, per the company's 8-K.
- Expectations are set high. RBC Capital Markets, per Finimize, says the direction of the 2027 framework matters more than another beat-and-raise, and that lower growth or margins than bullish forecasts could pressure the shares.
Price setup
The shares closed at $274.53 on 11 November 2026, 3.5% below the intraday 52-week high of $284.50 reached on 27 October 2026. They are up 13.7% over three months, from a $241.52 close on 13 August 2026. In adjusted daily closes, the 50-day moving average stands at $267.40 and the 200-day at $210.72 as of 11 November 2026, so the shares trade above both.
After the report, the shares fell to $263.79 on 4 November 2026 and $264.88 on 5 November 2026. They then rose to $271.83 on 6 November 2026 and $278.84 on 9 November 2026, before easing to $275.15 on 10 November 2026 and $274.53 on 11 November 2026. The $284.50 high is the nearest level overhead; the 50-day average is the nearest level below.
Insider selling is limited. Executive James G. Berkshire exercised options on 5,381 shares at $131.82 on 2 September 2026, sold 2,668 shares in the open market at $261.33 and handed 2,713 shares to the company at $261.54, per his Form 4 filed 4 September 2026. IQVIA bought back $950 million of stock in the first nine months of 2026 and has reported no share issuance.
Catalysts ahead
- 1 December 2026: IQVIA investor day; senior management presentations from 9:00 a.m. to about 12:30 p.m. ET, with a broad framework for 2027. Shows whether two quarters of 1.2x book-to-bill and a rising next-twelve-month backlog become 2027 revenue growth above the 6.4%–7.3% guided for 2026.
- ~February 2027 (est.): Fourth-quarter 2026 results and detailed 2027 guidance. Tests whether bookings hold against what management called very difficult fourth-quarter comparisons, and sets the 2027 revenue and EPS targets.
What would change the view
A daily close below $240, under the $241.52 close on 13 August 2026, which would erase the three-month gain; or a 2027 framework at the 1 December 2026 investor day pointing to revenue growth below the 6.4%–7.3% guided for 2026.
The risks this note tracks, each with what would confirm it:
- Backlog quality: the ~$2.1B inactive-trial removal is followed by further write-downs or rising cancellations. Confirmed by: a second backlog adjustment, or management citing cancellations above the historical range at the 1 December 2026 investor day or the fourth-quarter report.
- Bookings gains fail to lift revenue growth in 2027. Confirmed by: a 2027 framework at the 1 December 2026 investor day pointing to revenue growth below the 6.4%–7.3% guided for 2026, or growth that leans mainly on acquisitions.
- The shares already reflect the recovery after a cluster of broker target raises in late October 2026. Confirmed by: no new target raises after the 1 December 2026 investor day, or brokers cutting 2027 estimates after the framework.
- Industry-wide bookings do not convert to revenue on schedule. Confirmed by: ICON or IQVIA reporting flat or falling revenue again in the fourth quarter despite book-to-bill above 1.0x, or Medpace citing further slowing in backlog conversion.
- Commercial Solutions slowdown persists. Confirmed by: segment growth staying below the 6.9% reported in Q3 2026 in the fourth-quarter report.
- High debt limits flexibility if demand softens. Confirmed by: net leverage rising back above the 3.45x reported at 30 September 2026.
What it trades with
IQVIA trades with the contract research group: ICON, Medpace, Fortrea and Charles River. Their shared driver is biopharma research spending, which follows emerging biotech funding; IQVIA cited $90 billion raised so far in 2026, up more than 85%. The Commercial Solutions data business ties part of IQVIA to large-pharma budgets. With net leverage at 3.45x, the shares carry more interest-rate sensitivity than less-indebted peers such as Medpace.
The evidence, claim by claim (8)
- Q3 2026 net new bookings $3.2B, up 15% year on year; book-to-bill 1.2x; trailing twelve-month bookings $11.7B, up 14% IQVIA Q3 2026 earnings release, 8-K · as of
- Q3 2026 revenue $4,428M, up 8.0% reported and 8.6% at constant currency, beating the $4,366M estimate; adjusted diluted EPS $3.34 beat the $3.27 estimate; GAAP diluted EPS $2.10 IQVIA Q3 2026 earnings release, 8-K; Benzinga 27 October 2026 · as of
- FY2026 guidance raised to revenue $17,350–$17,500M (from $17,275–$17,475M), adjusted EBITDA $4,025–$4,055M, adjusted EPS $12.90–$13.00 (from $12.80–$13.00) IQVIA Q3 2026 earnings release, 8-K · as of
- R&D Solutions contracted backlog $32.6B after a ~$2.1B removal of long-inactive trials; about $9.4B expected to convert to revenue in the next 12 months, up 10% IQVIA Q3 2026 earnings release, 8-K · as of
- Q3 2026 R&D Solutions revenue $2,639M, up 8.7% (6.8% excluding pass-throughs); Commercial Solutions $1,789M, up 6.9% IQVIA Q3 2026 earnings release, 8-K · as of
- Q3 2026 peers: ICON net book-to-bill 1.56x with revenue down 2.9%; Medpace net new awards $873.4M, revenue up 8.5%, backlog up 5.6%; Fortrea book-to-bill 1.12x ICON, Medpace and Fortrea Q3 2026 results releases · as of
- Price targets after the report: Truist $346, Baird $328, JPMorgan $325, Evercore ISI $310, Deutsche Bank $310, TD Cowen $307, Rothschild & Co Redburn $299 Benzinga, fiscal.ai and MarketBeat 28 October to 29 October 2026 · as of
- Executive James G. Berkshire exercised options on 5,381 shares at $131.82 and sold 2,668 shares in the open market at $261.33 on 2 September 2026 SEC Form 4 filed 4 September 2026 · as of
Sources
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