MEDP · Medpace 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 $630
Note written ·
Price against the kill line
3.8% 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 $630.00, on record since 10 November 2026. The shares are up 9.5% 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 $630, which would give back the post-report breakout. Fourth-quarter awards near a 1.0x ratio to revenue, or a cut to the 2026 earnings guidance range, would also show the case failing.
Research onlyNot in the portfolio.
Key figures from the filings · Health Care
Quarter to 30 September 2026, filed 22 October 2026; valuation at the 13 November 2026 close
- Revenue, latest quarter ($M)
- 716
- Revenue, change on a year (%)
- +8.5
- Operating margin (%)
- 23.1
- Free cash flow, four quarters ($M)
- 668
- Net cash, cash less debt ($M)
- 705
- Price to earnings (×)
- 35.3
- Enterprise value to sales (×)
- 6.2
- Enterprise value to operating income (×)
- 29.0
All filed numbers
What Medpace 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 ($M) | On a year (%) | Operating margin (%) |
|---|---|---|---|
| first filed | 716 | +8.5 | 23.1 |
| first filed | 707 | +17.2 | 20.8 |
| first filed | 707 | +26.5 | 20.0 |
| first filed | 709 | +32.0 | 21.6 |
| first filed | 660 | +23.7 | 21.5 |
| first filed | 603 | +14.2 | 20.9 |
| Pre-tax income ($M) | 171 |
| Net income ($M) four quarters: 518 | 138 |
| Diluted shares, change on a year (%) against the quarter to 30 September 2025 | −1.5 |
| Operating cash flow ($M) | 723 |
| Capital spending ($M) | 55.4 |
| Free cash flow ($M) | 668 |
| Cash and short-term investments ($M) | 705 |
| Debt ($M) | None reported |
| Net cash, cash less debt ($M) no debt reported | 705 |
| Deferred revenue ($M) +15.3% on a year | 962 |
| Backlog, orders not yet delivered ($M) +8.6% on a year | 3,800 |
| Receivables ($M) | 448 |
| Inventory ($M) | Not reported |
| Shareholders' equity ($M) | 585 |
| Market value ($M) | 18,292 |
| Enterprise value, market value plus net debt ($M) no debt reported | 17,587 |
| Enterprise value to sales (×) no debt reported | 6.2 |
| Enterprise value to operating income (×) no debt reported | 29.0 |
| Price to earnings (×) | 35.3 |
| Price to book value (×) | 31.3 |
| Free-cash-flow yield (%) | 3.6 |
Short interest (FINRA, settled 15 October 2026, published 26 October 2026): 5.8% of shares outstanding sold short, 6.6 days of average trading to cover, +1.0% since the previous report.
| Window | Bought | Sold |
|---|---|---|
| 90 daysfrom | $0 | $191.8M |
| 12 monthsfrom | $0 | $411.2M |
The thesis
Medpace is modestly more likely to beat the S&P 500 over the next three months. Third-quarter awards of $873.4 million and a raised 2026 earnings outlook support the case, and the fourth-quarter report with the first 2027 outlook, expected in February 2027, settles it.
The shares closed at $656.84 on 12 November 2026, up 13.5% over three months from the $578.50 close of 14 August 2026. They sit 5.4% below the quoted 52-week high of $693.97, reached intraday on 28 October 2026. Since the 21 October 2026 report, the closes have ranged from $634.98 on 5 November 2026 to $672.93 on 9 November 2026. Company news since then has been limited to a webinar announcement on 2 November 2026; no analyst action, guidance change or other filing beyond insider Form 4 reports followed the report.
Bullish and bearish views on Medpace Holdings, Inc.
The bull case on Medpace Holdings, Inc. (MEDP), in brief: awards recovered across three quarters. The bear case: revenue growth has slowed sharply.
Bull case
- Awards recovered across three quarters. Net new business awards were $618.4 million in the first quarter, $795.7 million in the second and $873.4 million in the third, according to Earnings Whispers. The same source puts awards divided by revenue, the book-to-bill ratio, at 0.88x, 1.13x and about 1.22x.
- Earnings guidance moved up on 21 October 2026. Fiscal 2026 earnings per share guidance rose to $17.97–$18.32 from $17.25–$17.95 (Medpace 8-K). Third-quarter GAAP diluted earnings per share were $4.84 against $3.86 a year earlier.
- Margin improved in the third quarter. EBITDA (earnings before interest, taxes, depreciation and amortization) rose 16% to $172.1 million, a 24% margin against 22.5% a year earlier (MarketBeat call summary, 22 October 2026).
- Most post-report targets sit above the price. UBS's target is $700, Barclays's $675, TD Cowen's $673 and BMO's $670, set from 22 October to 26 October 2026 (Benzinga). All four are above the $656.84 close of 12 November 2026. Deutsche Bank's $650 and Truist's $633 are below it.
- Peer demand points the same way. IQVIA reported research and development bookings of $3.2 billion on 27 October 2026, up 15%, with a 1.2x book-to-bill, and raised its 2026 guidance.
- Cash supports a $1 billion repurchase program. The authorization took effect 20 October 2026 and runs through 2028. Medpace held $705.3 million of cash on 30 September 2026 and generated $216.6 million of operating cash flow in the third quarter, with no shares repurchased in that quarter.
Bear case
- Revenue growth has slowed sharply. Third-quarter revenue rose 8.5% to $716.0 million, against 16.9% growth for the first nine months (MarketBeat call summary, 22 October 2026). The full-year revenue range only narrowed, to $2.835–$2.855 billion.
- Backlog is growing slower than revenue. Backlog of $3,167.2 million on 30 September 2026 was up 5.6%, below the 8.5% revenue growth (Medpace 8-K, 21 October 2026). Award growth slowed to 10.6% in the third quarter from 28.2% in the second.
- Cancellations ran high in the third quarter. Management described them as near the upper end of its expected range, tied mainly to product failures and safety signals (MarketBeat call summary, 22 October 2026).
- 2027 carries a named cost. Management flagged a roughly $20 million operating cost headwind in 2027 from the Cincinnati campus expansion (MarketBeat call summary, 22 October 2026).
- Executives sold into the rally. Susan Burwig, Executive Vice President of Operations, sold 20,000 shares at $677.00 on 26 October to 27 October 2026, and General Counsel Stephen Ewald sold 1,245 shares at $690.00 on 29 October 2026 (SEC Form 4). Chief Executive August Troendle sold 15,971, 8,770 and 21,883 shares on 15 September 2026, 16 September 2026 and 21 September 2026, the last at about $623.29.
Price setup
The last close was $656.84 on 12 November 2026. The quoted 52-week high is $693.97, reached intraday on 28 October 2026, and the shares are 5.4% below it. The 52-week closing low is $393.42, set on 23 April 2026.
The shares trade above both moving averages, using adjusted daily closes as of 12 November 2026: the 50-day average is $628.31 and the 200-day average is $531.71. The close of $634.98 on 5 November 2026 was the low of the post-report range, and it came within about 1% of the 50-day average. Closes since 9 November 2026 have slipped each session from $672.93 to $656.84.
The earnings date is about three months out, and the executive sales in September and October are the main observable supply.
Catalysts ahead
- ~February 2027 (est.): Fourth-quarter and full-year 2026 report, with the first 2027 outlook. Management said the 2027 outlook depends on fourth-quarter awards and cancellations; this report shows whether third-quarter award strength carries forward and what the Cincinnati campus costs do to 2027 margins.
What would change the view
A daily close below $630, which would give back the post-report breakout. Fourth-quarter awards near a 1.0x ratio to revenue, or a cut to the 2026 earnings guidance range, would also show the case failing.
The risks this note tracks, each with what would confirm it:
- Award growth keeps slowing after the second-quarter spike, with backlog growing slower than revenue. Confirmed by: fourth-quarter awards near 1.0x revenue, or backlog growth staying below the 8.5% revenue growth reported for the third quarter.
- Cancellations move above management's expected range after running near its upper end in the third quarter. Confirmed by: management disclosing elevated cancellations at the fourth-quarter report, or citing more client trial failures and safety signals.
- Insider selling continues after the rise to the 52-week high. Confirmed by: new Form 4 filings showing further sales by Chief Executive August Troendle or other executives near or above $650.
- The 2027 outlook disappoints, with the Cincinnati campus expansion adding about $20 million of operating cost. Confirmed by: February 2027 guidance set below analyst consensus for revenue or earnings.
- Biotech funding or drug-policy shifts reduce trial starts across the contract research group. Confirmed by: a peer such as IQVIA reporting a book-to-bill ratio below 1.0x, or Medpace cancellations rising from small and mid-sized biotech clients.
What it trades with
Medpace trades with the contract research group. IQVIA's 27 October 2026 bookings report moved in the same direction as Medpace's awards, and peer reports tend to move the group together. Medpace's client base leans toward small and mid-sized biotech companies, so the shares respond to biotech funding conditions and interest rates as well as to large-pharma budgets. Shifts in drug-pricing or regulatory policy that affect trial starts reach the whole group at once.
The evidence, claim by claim (8)
- Third-quarter net new business awards were $873.4 million, up 10.6% from $789.6 million a year earlier; backlog was $3,167.2 million on 30 September 2026, up 5.6%. Medpace Q3 2026 8-K, press release exhibit · as of
- Third-quarter revenue was $716.0 million, up 8.5% from $659.9 million; GAAP diluted earnings per share were $4.84 versus $3.86 a year earlier. Medpace Q3 2026 8-K and 10-Q · as of
- Fiscal 2026 guidance: revenue $2.835–$2.855 billion, EBITDA $638–$652 million, GAAP diluted earnings per share $17.97–$18.32. Medpace Q3 2026 8-K, press release exhibit · as of
- Management said third-quarter cancellations were near the upper end of its expected range and flagged a roughly $20 million operating cost headwind in 2027 from the Cincinnati campus expansion. MarketBeat Q3 2026 earnings call highlights · as of
- IQVIA reported research and development bookings of $3.2 billion in the third quarter, up 15%, a 1.2x book-to-bill, and raised 2026 guidance. IQVIA Q3 2026 press release · as of
- Post-report targets: UBS $700, Barclays $675, TD Cowen $673, BMO $670, Deutsche Bank $650, Truist $633. Benzinga analyst ratings · as of
- Executive Vice President of Operations Susan Burwig sold 20,000 shares at $677.00 on 26 October to 27 October 2026; General Counsel Stephen Ewald sold 1,245 shares at $690.00 on 29 October 2026. SEC Form 4 filings, 28 October 2026 and 2 November 2026 · as of
- Cash and equivalents were $705.3 million on 30 September 2026; third-quarter operating cash flow was $216.6 million; no shares were repurchased in the quarter. Medpace Q3 2026 8-K, press release exhibit · as of
Sources
- MarketBeat ·
- IQVIA Reports Third-Quarter 2026 Results · ir.iqvia.com ·
- Earnings Whispers
- MarketBeat ·