Participants

Kerri Joseph; Senior Vice President, Investor Relations & Treasury; IQVIA Holdings Inc

Ari Bousbib; Chairman of the Board, Chief Executive Officer; IQVIA Holdings Inc

Ronald Bruehlman; Chief Financial Officer, Executive Vice President; IQVIA Holdings Inc

Justin Bowers; Analyst; Deutsche Bank

Matthew Sykes; Analyst; Goldman Sachs

Shlomo Rosenbaum; Analyst; Stifel Nicolaus and Company, Incorporated

Michael Ryskin; Analyst; BofA Global Research

Jailendra Singh; Analyst; Truist Securities

Eric Coldwell; Analyst; Robert W. Baird & Co., Inc.

David Windley; Analyst; Jefferies

Tejas Savant; Analyst; Morgan Stanley

Presentation

Operator

Thank you for standing by. At this time, I would like to welcome everyone to the IQVIA first quarter 2025 earnings conference call. (Operator Instructions) As a reminder, this call is being recorded.
 I would now like to turn the call over to Kerri Joseph, Senior Vice President of Investor Relations and Treasury. Mr. Joseph, please begin your conference.

Kerri Joseph

Thank you, operator. Good morning, everyone. Thank you for joining our first quarter of 2025 earnings call. With me today are Ari Bousbib, Chairman and Chief Executive Officer; Ron Bruehlman, Executive Vice President and Chief Financial Officer; Eric Sherbet, Executive Vice President and General Counsel; Mike Fedock, Senior Vice President, Financial Planning and Analysis; and Gustavo Perrone, Senior Director, Investor Relations.
 Today we will be referencing a presentation that will be visible during this call for those of you on our webcast. This presentation also will be available following this call in the events and presentation section of our IQVIA investor relations website at ir.iqvia.com.
 Before we begin, I'd like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements. After results could differ materially from those stated or implied by forward-looking statements risk and uncertainties associated with the company's business, which are discussed in the company's filings with the Securities and Exchange Commission, including our annual report on Form 10-K and subsequent SEC filings.
 In addition, we will discuss certain non-GAAP financial measures on this call, which should be considered a supplement to and not a substitute for financial measures prepared in accordance with GAAP.
 A reconciliation of these non-GAAP measures to the comparable GAAP measures is included in the press release and conference call presentation. I would now like to turn the call over to our Chairman and CEO, Ari Bousbib.

Story Continues

Ari Bousbib

Thank you, Ari. And good morning, everyone. Thank you for joining us today to discuss our first quarter results. I'm going to start with the usual update on financial performance for the quarter. I then provide perspectives on the market, including our understanding of the possible effects of recent US government initiatives.
 How we are well positioned to navigate these near-term challenges, and finally, why we remain confident about the industry's resilience and prospects. I'll close by highlighting a few important wins in the first quarter. So let's get started.
 We delivered strong revenue and profit results at the high end of our expectations, despite a continued challenging environment in R&DS.
 Total revenue for the first quarter came in above the high end of our guidance range, representing year on year growth of 2.5% on a reported basis and 3.5% at constant currency. And compared to last year and excluding COVID-related work from both periods, we grew the top line about 4.5% on a constant currency basis, including about a couple of points of contribution from acquisitions.
 First quarter adjusted EBITDA increased 2.4%. First quarter adjusted diluted EPS of $2.70 increased 6.3% year over year. Let me share some details on the market landscape and the demand metrics we're seeing for each segment.
 Starting with us, the business continued the strong recovery trend we saw exiting last year, as our clients are launching new drugs and are executing on their commercial road maps. It is in times like these, where there is some uncertainty in the biopharmaceutical sector that we clearly see the value of the scale, diversification, and differentiation of IQVS portfolio of offerings. It's great that TAS is contributing over 40% of our revenue.
 TAS revenue growth actually can be above our expectations at 6.4% reported and 7.6% at constant currency, led by double digit growth in real-world evidence. On the critical side, as we expected, the near-term market environment continues to be bumpy. We experience delayed decision making by customers on new programs, reflecting the heightened macroeconomic and industry sector caution.
 In fact, our average time from RSP issuance to award in the quarter increased by approximately 10% both year over year and sequentially. We believe that this is the result of the sector uncertainty caused by the pronouncements of the new administration, the precise effects of which are unknowable at this point.
 Several of our clients are slowing or re-evaluating programmatic decisions until there is better visibility. Also reflecting the same concerns, the funding environment for EVPs, especially for early stage, has deteriorated. While the R&DS business is experiencing some turbulence, our demand metrics remained positive. Our backlog reached a new record of $31.5 billion at the end of the quarter, growing 4.8% compared to the prior year.
 Our first quarter RSP flow improved mid-single digits year over year and high-single digits sequential. A qualified pipeline is that low-single digits year over year, driven mostly by good growth in large farmers. Now, obviously the demand environment is impacted by the proposed changes that have been signaled by the new US administration. The White House's initiatives relative to our industry sector can be grouped into three categories tariffs, agency actions, particularly HHS and FDA related, and drug pricing.
 Starting with tariffs, when the President announced plans to initiate the reciprocal tariff program, the pharmaceutical industry received certain exemptions. However, following the announcement, the Department of Commerce began a national security investigation of the life sciences industry, which may result in tariffs specific to the pharma sector. Now IQVIA direct exposure to tariffs is limited primarily to certain supplies in our laboratory business and is immaterial financially.
 We understand that industry specific tariffs, if implemented, may have a more direct impact on our customers. However, it is too early to assess what that impact may be. With respect to agency actions, HHS announced a number of initiatives, including NIH delays and cancellations of government contracts, along with establishing a 15% cap on indirect costs. Now, to be clear, IQVIA has no clinical trial contracts with BARDA and no COVID-19 contract sponsored by the government.
 So our exposure there is zero. That said, we have excellent relationships with these agencies, including BARDA, TAS does have a minimal amount of business with the government, and we do not expect any of this to have any impact at all.
 The NIH funding cap relates to indirect administrative and overhead costs. It aims at aligning those indirect costs to the same levels as private foundations. This has no impact on direct costs for research funding and therefore zero impact on us.
 Regarding the FDA, there have been numerous restructuring actions announced which have impacted a significant portion of the workforce. These reductions in force primarily targeted overhead and support functions such as planning, training, travel, communications, and records management. Importantly, core product review teams responsible for evaluating new drugs, vaccines and medical devices, which are primarily funded by the industry, were largely preserved to maintain the FDA's essential regulatory functions. Today, we have no evidence of any trial or approval delays. Whatever anecdotal disruptions there may be in non-approval related interactions with FDA staff, we expect this to normalize.
 FDA Commissioner, Makari has announced his intention to reduce animal testing in favor of AI-based models and enhanced usage of real-world evidence in the approval process. We applaud this and we see these actions proposed by Commissioner Makary as benefiting our industry. They will enable clients to move prospects faster into clinical trials. The increased use of real-world evidence not only in pre-clinical work but also in Phase 2 and Phase 3 trials plays to IQVIA strength. Ultimately, this is positive news for EVP companies which develop over 50% of the drugs in clinical trials.
 Finally, on drug pricing, the US administration recently issued an executive order regarding the role of PBMs, pricing transparency, and Medicare costs. These initiatives are still in their early stages, and some provisions may require congressional approval. The impact of these potential actions is difficult to ascertain at this point because the specifics have not been determined.
 But there are two aspects that could actually be very positive for the industry. First, the proposed the proposal to do away with the so-called Pill Penalty provision in the IRA which subject small molecule drugs to CMS pricing review after only 9 years versus 13 years for large molecule drugs. This is key for pharma clients as 50%, 50% of the drug's value is realized in years 9 to 13.
 Second, the focus on drug pricing, treatment value, and comparative effectiveness drives the need for earlier clinical results and more real-world evidence. So in summary, some of our customers have slowed down their decision-making processes, as you would expect. And we experienced delays in RSPs moving to contracts in the first quarter.
 An unusually high number of EDP awards that were contracted in the quarter were not included in our bookings because funding had not been secured yet. Now we are confident that our industry will successfully manage this period of uncertainty and will find ways to adapt. The life sciences industry has consistently demonstrated its resilience, overcoming macroeconomic obstacles, and thriving in changing environments, and IQVIA is particularly well positioned to navigate this marketplace.
 We believe when everything is said and done, key decision makers will recognize the industry is a strategic sector for the US that deserves to be strongly supported. US companies in the biopharmaceutical sector have maintained strong global leadership in biomedical discovery and clinical research.
 Our sector serves as an extraordinary engine of innovation. It was responsible for 46% of the 634 novel drugs approved globally over the past decade, confirming strong US leadership.
 The US is responsible for 61% of global pharmaceutical sales of branded drugs, which is up from 56% a decade ago. The sector invests almost $200 billion annually in research and development and drives economic growth, contributing $1.65 trillion of economic outputs annually.
 It supports direct and indirect employment of highly skilled, highly educated workers, and growing nearly 5 million people at an average of $157,000 annually, which is double the national average. In fact, many non-US large pharma companies have moved their primary R&D centers to the US to take advantage of the talent pool.
 And of course, the biopharmaceutical industry provides substantial societal benefits by improving health outcomes and extending life expectancy. Now, before I turn it over to run, let me give you a little bit of color on business activity in the porter, and I'll be brief here and just mention a few salient examples.
 As the revenue numbers show, TAS did quite well in the court. We won a number of partnerships with clients that are launching new products. For example, the last project for an important EDP client that's launching their first product and the first ever treatment for low grade serous ovarian carcinoma.
 We also want a launch partnership with another EDP leveraging our AI-powered patient relationship manager platform for a groundbreaking treatment for a rare condition in an underserved patient community. We were selected to support a mid-sized pharma client with an omni-channel campaign that includes KPIs designed to improve patient engagement.
 Our commercial technology suite continues to be successful in the marketplace. Our award winning SmartSolve offering, which is a proprietary quality management system, displays the incumbent at an EDP client. In the Medtech space, we secured a significant contract to deploy an integrated information solution to help our clients stream our operations and decision making.
 Let me skip a few more of these and move to R&DS. We achieved notable wins across customer segments. As you recall, last year we renewed all 22 of our strategic partnerships with large pharma clients, and we expanded the scope in half a dozen of them.
 We are being awarded significant contracts from these partnerships. For example, in the quarter, a top five pharma clients that have selected IQVIA as a preferred partner awarded us four early-stage studies under the new model.
 I was selected by a top 20 pharma client to support a Phase 3 obesity program across eight studies. Our best-in-class clinical trial technology solutions and industry leading expertise were key factors in securing this deal. The top 10 pharma clients said that pharmacovigilance offerings to achieve a significant reduction in case processing time, enable efficiency, and manage the increasing volume.
 We secured a contract with an EDP client to run a Phase 2 trial for an innovative treatment for patients with pulmonary hypertension associated with interstitial lung disease. The customers selected IQVIA due to our deep technology expertise delivery model and partnership focused approach.
 Lastly, Mike mentioned our progress with AI. You may recall we announced a collaboration with Nvidia earlier in the call. We are progressing as planned to deploy highly specialized industry AI agents. So far, we moved over 20 agents into production covering three use cases in each of the commercial, real world, and R&DS, tends we are seeing positive results and productivity gains in areas where these AI agents have been deployed. For example, one agentic system in commercial allows us to reduce delivery time by two-thirds from 12 weeks to 4 weeks with a net 30% cost reduction.
 We plan to scale up from these three use cases to 12 by the end of the second quarter and 40 use cases by the end of the year. And now to Ron for more details on our financial performance.

Ronald Bruehlman

Thanks, Ari, and good morning, everyone. Let's start by revealing revenue. First quarter revenue of $3,829 million grew 2.5% on a reported basis and 3.5% at constant currency. In the quarter, we had virtually no COVID-related revenue versus over $40 million in last year's first quarter.
 Adjusting for this COVID step-down, constant currency growth was about 4.5%. As already mentioned, acquisitions contributed approximately 2 points of this growth, the majority of this in the TAS segment. Technology and analytics solutions revenue for the first quarter was $1,546 million, that was up 6.4% reported and 7.6% constant currency.
 R&D Solutions first quarter revenue was $2,102 million up 0.3% reported and 1.1% constant currency. Excluding COVID-related work, R&DS revenue grew approximately 3% of constant currency. Finally, contract sales and medical solutions first quarter revenue of $181 million declined 4.2% reported and 2.1% in constant currency.
 Moving down the P&L, adjusted EBITDA was $883 million for the quarter. That was growth at 2.4% year over year. First quarter of GAAP net income was $249 million and GAAP diluted earnings per share was $1.40. Adjusted net income was $479 million for the first quarter, up 2.4% year every year, and adjusted diluted earnings per share grew 6.3% to $2.70.
 R&DF backlog at March 31, was $31.5 billion, an increase of 4.8% year over year and 4.6% constant currency. Next 12 months revenue from this backlog is $7.9 billion.
 Reviewing the balance sheet, as of March 31, cash in cash equivalent total $1,740 million in gross debt was $14,330 million resulting in net debt of $12,590 million. Our net leverage ratio ended the quarter at 3.40 times crown 12 month adjusted EBITDA.
 First quarter cash flow from operations was $568 million in CapEx was $142 million resulting in strong free cash flow of $426 million. In the quarter, we repurchased $425 million of our shares. This leaves us with approximately $2.6 billion remaining under the current program.
 Okay, let's turn to guidance now. You saw we're raising our full year revenue guidance by $275 million. This to reflect more favorable foreign currency exchange rates since we last guided. We now expect revenue to be between $16 billion and $16,400 million which represents year after year growth to 3.9% to 6.5% on a reported basis or 5.2% growth at the mid-point.
 This guidance now includes a year over year FS tailwind of approximately 50 basis points compared to about 150 basis points of headwind in our previous guidance. We continue to assume approximately $100 million of step down in COVID-related work, and about 150 basis points of contribution from M&A activity for the full year.
 We were -- we are reaffirming our adjusted EBITDA guidance of $3,765 million to $3,885 million as FX changes had a negligible impact on EBITDA. This represents year over year growth of 2.2% to 5.5%. We're also reaffirming our adjusted diluted EPS guidance, which continues to be $11.70 to $12.10, that's up 5.1% to 8.7% versus the prior year or 6.9% growth at the midpoint.
 Now, let's go through the 2nd quarter. For the second quarter, we expect revenue to be between $3,925 million and $0.04 billion. Adjusting EBITDA is expected to be between $895 million and $915 million and adjusted diluted EPS to be between $2.72 and $2.83. Both this guidance for the 2nd quarter and our four-year guidance assumed that foreign currency rates as of May 5, continue for the balance of the year.
 So to summarize, in Q1, we delivered strong revenue and profit results at the high end of our expectations. We had a very solid free cash flow of 89% of adjusted net income. The cash business continued to achieve above target performance with revenue growth at 7.6% in constant currency, and R&DS of bookings were affected by delayed decision making by customers on new programs and lower EDP funding, reflecting incremental macroeconomic and industry sector uncertainty.
 That set forward-looking indicators for R&DS offerings such as qualified pipeline RFP flow and backlog continue to grow. We're progressing as planned to deploy new highly specialized industry AI agents, and we've identified over 40 use cases and scaled up deployment across our portfolio in 2025.
 In the quarter, we repurchased $425 million of our shares, and lastly, we raised our full-year revenue guidance by $275 million to reflect changes in FX and of course, we reaffirmed our product guidance. For that, let me hand it back over to the operator to open the session for questions and answers. Operator?

Question and Answer Session

Operator

I apologize. I was muted. (Operator Instructions) Justin Bowers at Deutsche Bank.

Justin Bowers

Thank you and good morning, everyone. Ari, could you discuss some of the drivers behind the strength in RWE in the quarter, how the order book looks for the balance of the year and whether or not this outperformance is durable?

Ari Bousbib

Thank you, Justin. Look, it has delivered better than expected revenue growth, which is what helped the company deliver above the high end of our guidance, with 7.6% of constant currency. And as I mentioned, this was driven largely by the strong growth in real world, which was strong double digits.
 This basically, you will recall that real world had declined. The part of the real world that's discretionary had essentially shut down, and in the end of 2023, beginning of 2024 time frame, and the rest of the real-world business, which is more mission critical, had been, delayed and pushed to the right in terms of when to do it and so on.
 So both the discretionary piece and the required work that's necessary to support safety or pricing, demonstrating the effectiveness of treatments, etc. of both have returned. This pent-up demand and we expect this based on the book of business to continue. The rest of was also good, basically, low to meet the single digits for the different, other aspects of the business.
 Thank you, Justin.

Operator

Thank you. Matt Sykes at Goldman Sachs.

Matthew Sykes

Thanks for taking my question, Ron. Just maybe on the margin side, I know you guys have called out in 420 basis point potential margin expansion. Looks like as you kind of rearrange the guide, maybe not expecting that. Could you just maybe talk about the opportunities for any potential margin expansion and kind of what you could do on the cost side to help achieve that?

Ronald Bruehlman

Yeah, well, one thing I would point out, Matt, when you're looking at the margin for our previous guide is obviously the impact of FX because FX effects are top line but doesn't have much impact on the bottom line. And if you're looking at gross margins or these are top margins as the dollar is weak and revenue has gone up, profit hasn't followed. So that really explains all the change in our implied margins versus what we guided to previously.
 Now, if you're looking towards what can help drive margins going forward, it's only cost reduction where AI would be one example that we're looking at. We're always looking at taking cost out across the organization that's an ongoing effort. You'll see that in our restructuring expense, of course, against that, we do have pressures on things like not just AX, but mix has gone against us to a certain extent. You'll see that in the gross margin. And that mix includes, for instance, the shift towards FSP which hurts margins a little bit. But net-net, the margin picture really hasn't changed that much. What you're seeing is mostly just the impact of FX almost entirely.

Matthew Sykes

Got it. Thank you. And just for a follow up, Ari, could you just maybe talk a little bit about on a longer-term basis you made a comment in Q3 regarding sort of the competitiveness of RFPs going from sort of 1 of 13 to 1 of 4 if I've got the numbers correctly. And just in this environment, given sort of lower levels of demand, how do you feel about your position and do you think that vendor consolidation trend, which has already been in place will accelerate in this environment?

Ari Bousbib

Are you talking about the RDS business and RSP flow?

Matthew Sykes

RDS specifically, yes, and vendor consolidation.

Ari Bousbib

Yeah, look, the RSP flow is actually pretty good given the environment. So the underlying demand is still there. We're not seeing customers decide to no longer do certain programs. We went through a period of reviews and reprioritization of pipelines, which led to very elevated cancellations during the course of 2024. Maybe 50% higher, cancellation levels in 2024 than the historic norm.
 In the order I just might have mentioned, we had cancellations that were just in a normal historic range. So what happened in the course of sector is mostly again programs that clients decided to pause and wait to see what the actual consequences are of some of the administration's pronouncements before they decide to go ahead. And separately, as you might have noted, there was a deterioration in the funding for EVPs. So we had an unusually high number of EVP awards in the first quarter that were actually now was but they were also contrasted, but our policy is not to include those in bookings. If we're not confident in the fund, as long as we're not 100% sure that the funding has been secured.
 Despite the RFP though, it's still very good. I mean, whether in -- we've seen consistent numbers in terms of whether it's dollar value or volume when our rates and heat rates are stable. So we're not seeing any changes really in the flow of RSPs whether, the large pharma RFPs are up, stronger than EVPs at this point, but it's good. It's pretty good actually and sequentially it's high single digits are higher. So from that standpoint, I feel better at this point in the quarter than I did at the same point last month.

Yeah, and as we've mentioned previously, we did very well last year with renewing and expanding all the large pharma providerships that they went through, and we're starting to see the benefits of those new RFPs from those relationships coming through.

Operator

Shlomo Rosenbaum at Stifel.

Shlomo Rosenbaum

Hi, thank you for taking my question. Yeah, Ari. I want to ask a little bit more just probing on the operating environment. Given the uncertainty of what you saw in R&DS, I'm just surprised that you didn't see that in more of the short cycle business, in TAS like you kept the guidance and I guess, the assumption that things are going to continue. But do you think that there's a risk that that could spill over into some of the uncertainty into some of those areas in TAS like consulting or some of the analytics or some of the areas like that? And could it potentially result in further reprioritizations even in the R&DS business if you give us your thoughts on those things?

Ari Bousbib

Yeah, I mean, you got to understand what you're asking the question. There's considerable uncertainty out there, and whenever you have uncertainty, then obviously, people are hesitant to spend money. That's just, that's a general rule, and that's the concern out there. But so far, we haven't seen that in past. All of our, indicators, leading indicators, pipeline, decision timelines, and so on, continue to be strong. I believe that the reason we haven't seen that is because there were pent up demands. We had already gone through a period of holding back on spend into, starting from the middle of 2023 through the middle of 2024.
 And so at that point, drugs that had been approved needed to be launched. And that's what's happening now. So what we're doing does is support the launch of the drugs, market access, pricing of drugs, supporting commercial, commercialization efforts, etc.
 And that's the day in and day out day to day business of our clients and then I stop doing that. So we haven't seen that. I understand the question, but in the business, we are seeing continued good growth as expected.
 And again I believe that the pan had been held back. For a while, and there is pent up demand and necessary things to do. Now the discretionary stuff, the absolute discretionary stuff, consulting and so on, yeah, I mean, it's not spectacular. It's just like, flat to bit single digit kind of level. So it's not that we are looking at the spectacular things. So what is being done now is the stuff that was necessary.
 To operate, I mentioned the real world before, as well as the fact that demand on other things, and then that's what's driving that. So I don't see the environment influencing this much on the R&DS side, yeah.
 Again, because of uncertainty, so you hold back on decisions. The type of reparations we saw before, were due to the IRA and I think as we mentioned, prior calls, we see that to be largely over. The reprioritization of pipelines, which led to elevated levels of cancellations that were triggered by certain provisions of the IRA and I remind you, the IRA was, I guess, at late 22, and this process started in 2023. So we are now a couple of good two years after that process started and we believe that, that reprioritization process of R&D pipelines at large pharma due to the IRA is largely complete. Now, could there be other cancellations? We haven't seen that yet.
 Due to new developments, we don't know. Again, no one really knows the exact impact of what has been signaled by the new administration the uncertainty has caused. Delays in decision making. I mentioned in my introductory remarks that the time from receiving the RFP to the actual reward has expanded by about 10%, some cases more than that, both year over year and sequential.
 So that's an indication if you with a high level meaning, but we know this directly from clients who told as well, we were planning on making a decision this quarter, but we just going to wait a little bit to understand the implications. No one has signaled that they are not going to do the program, but it's just natural that in an environment of uncertainty, you hold off on making a decision on large capital investments.

Operator

Thank you.
 Michael Ryskin at Bank of America.

Michael Ryskin

Great, thanks for taking the question, guys. Just going to follow up on, I think Matt Syke's earlier question talked about cancellations in the quarter are being kind of normal. Maybe I could H1 in on book to build trends, I know you don't like talking about this number quarterly, but just 1.02 in the quarter last year you called out a few major cancellations that cost 3Q to be lower, this year that the score doesn't seem to be the case. It's really -- so what do you attribute that number to? Is it really the emerging bio that you talked about how some of the RFPs aren't quite in bookings yet because the funding's not there? Is that the major swing in there? And so do you expect to be closer to that, 1.15, 1.2 number for the rest of the year?

Ari Bousbib

Okay, so I love this question on the quarter on IQVIA. We -- I mentioned before that, awards that should have been contracted in the quarter, the contract wasn't signed and was delayed. So that happened at last pharma a number of times in the world and that's due to this uncertainty. General uncertainty in the biochemical sector. That's one reason for softwares. The second reason, as you mentioned, is the EDP funding. I think you notice that, there are many sources for what was the EDP funding, in a given quarter, but we follow consistently by world stats, and I think the funding in the first quarter went down to $13 billion.
 Now, $30 million is fine, but it's way lower than what we had seen before. And that's an indication, I think whatever source you look at, you'll see that even once again, it's due to the same reasons people are hesitant to commit the funds. It does happen, that the EVP signs a contract with us and we decide not to include it in the bookings. Because we're not sure about the funding.
 But that happens like once or twice in a given quarter. Here we had much larger number of such cases in the court. So again, the two reasons all deriving from the same underlying factor, which is the macro uncertainty, large from up taking down the signature of the contract to a later period.
 And EVPs, not confirming that the funding is secure for a contract they've already signed, and as a result, we do not include that in our booking. That's what caused the stop the bookings in this particular order, not the cancellations.
 Now again, I mean, I want to, if you break it up and it's my kind of it's like agitating the red flag in front of a ball. I typically react to mention of holy bookmobiles. Look, we are projecting for our company 5% growth, so there are about 5.2% for this year. If you focus on the CRO business, we -- our guide for the year was 4% to 6% for the year, but we see that we have softer bookings.
 Even if it's in at the lower end of that range, the 4% kind of range for R&DS, and that's excluding the step-down of COVID business, which is about $100 million year over year. And effects, it's still somewhere around 4%.
 Now, you look at our sector, there aren't that many benchmarks out there, but we do have a large competitor that's publicly traded and published numbers, and I looked at the numbers this morning. And it happens to be coincidentally to the exact same book to be ratios quarterly or trading 12 months.
 And yet they are projecting negative growth. On a comparable basis, I think that negative growth is 5%. So you've got the same exact book to be ratio. The same exact and we're projecting about mid-single digit growth, positive growth for that segment, and they're projecting mid-single digit decline.
 It's an 8 or 94 swing in revenue growth. So if there ever was a proof point that this quarterly book to be ratio doesn't mean anything with respect to predicting. Growth and performance, I think that's a very strong one. This it's an interesting snapshot picture of what's going on at one given point in time, given circumstances in the world. It's like, you're taking a picture of a particular horse in the Kentucky Derby in the mud running and you look at the picture and it looks like all its muscles extended and doing extremely well. But then when you see the full movie, you see that the horse lost the race.
 So it really doesn't mean very much. It's a snapshot. It's interesting, but it doesn't take go.

Michael Ryskin

Not at all. Very fair point, Ari. Thank you. Thank you for that color. I appreciate the context. If I could squeeze in a quick follow up, just any commentary on pricing environment, just wondering if there's any change in the quarter given all the macro uncertainty? And again this is more specific to R&DS.

Ari Bousbib

No change. Look, I mean, pricing is not enough lever, has not been a lever for some time. So we are the pricing negotiations always are tough.
 But again, as Mike mentioned earlier, we've secured the strategic partnerships with our large pharma clients last year. That was the time at which all the rates were negotiated and so on. And so I think we are comfortable operating in the current environment, no changes.

Michael Ryskin

Thank you so much.

Operator

Jailendra Singh at Truist Securities.

Jailendra Singh

Yeah, thank you and thanks for taking my question. So just given all the recent macro development and uncertainty you flagged, and thanks for all the color you gave, are you guys seeing any change in the RSP or new bookings make in terms of FSO versus FSB? And one another follow up quickly if I can ask, what's the latest on two mega trials that were delayed? Are they expected to resume in the second half? Sorry for the part. Those three questions, it's all.

Ari Bousbib

Thank you very much for the questions. Number one, I think you're talking about the mixed, food service versus FSE. And look, we had signaled over the course of the prior year that large pharma was sort of do doing a little bit more FSE. And I think we saw this reflected in the RSP flow and in the awards and in the bookings, okay, where RSP as a percentage of total was increasing. Okay. We said that in our bookings in the year, it was reaching in 24%, close to 20%.
 Whereas in our revenue, of course, it's lower than that since we're burning revenue related to prior period bookings, in our revenue, SSP represented in 24% more, about 15% to 16%. So obviously, we'll try and do the 20%. However, again, I said before many times that these are Canallo suits.
 We've seen it before in this industry where large pharma reverts to FSP, decides to insource more of the activity. But then they swing back. And I might, you might find it interesting to know that in the core, we actually started seeing some signs of this reversal.
 Okay, actually, in the quarter, FSP bookings represented less than 10% and we look at our qualified pipeline. It's in the mid-single digits, low-single digits, and in the RFP flow, it's about 5%. We actually have a very, very strong and exciting pipeline and RFP flow in full-service work for (inaudible). And the reason is, the reasons are the same. As the reasons that have always led our clients to do more outsourcing, which are basically that they cannot possibly have all the expertise in-house. Sometimes they buy an asset in a different therapeutic indication.
 And they need resources that they don't have in-house. And thirdly, after they've been doing the SSP work and taking more oversight in-house, they realized that it can become prohibitively, costly to do so over a large number of students and invariably, they revert back for any of these reasons to full service, and we're starting to see some signals of that. It's not just a snapshot in this case, it was through in the bookings. It's through in the RSP flow, and it's through in the qualified pipeline where we see FSC as a percentage of total decline.
 I think you have another question. Oh, the two Vegas trials, yes. So the two Vegas trials, we said, had been postponed and taken out of the end of last year and pushed back to the back of this year. We received confirmation from one of them, that's the good news that it's expected to get started in the towards the second half, towards the end of the year as planned. So that's confirmed plan.
 The second one though, for reasons that are inherent to the client itself, the same logistics reasons they were facing before was pushed out of the period and won't start this year. And again, all of that was contemplated in our guidance and so nothing's changed with respect to our numbers. Mike? Any color on that?

Yeah, just add a little bit more color on that. So you know we are reaffirming our range, with that mega trial put pushed out of the period as already said, plus let's see what happens with the booking requirement for the balancing here you can conceivably see sort of RDS probably shading more towards the lower end of our guidance range, but we'll have to see our BD teams are out there actively working to secure new business and but that's kind of the current year.

Jailendra Singh

Got it. Thanks, guys.

Operator

Eric Coldwell at Baird.

Eric Coldwell

Thanks. You, I have two if you don't mind. You might have just partially answered the first one. So I was going to ask about the impact on guidance from FX, and the question was there any other change to the guidance or directionality of the guidance excluding FX? What I'm getting to is during the prepared remarks or maybe the Q&A Ron said that the year-over-year gross margin reduction in Q1 was primarily FX, but FX has now turned from a big headwind to a moderate tailwind.
 So I'm questioning how much IQVIA EPS were protected by the FX shift, i.e., would you have needed to maybe reduce the range on IQVIA EPS if it weren't for FX and then you have no?

Ronald Bruehlman

No, I mean is, you can think of it as being largely independent from the FX ranges. The impact of FX on either is very muted. The impact on revenue obviously isn't. You saw a big increase in our guidance for the year on revenue and the combination of those two reduce our margins, our implied margin guidance, but yeah, that --

Eric Coldwell

So no notable impact on EPS then for year from back? Good. And then my -- if I can have one more quickly and apologize toggling like everyone, I toggling multiple calls today so I might have missed.
 I have received a couple of inbound questions from investors during the call about a M&A and the M&A impact overall from the firm. So if you address this, I'm sorry, but I am getting some questions on it. I thought I'd throw it out there.

Ronald Bruehlman

There's about 200 basis points for the quarter, Eric, and about 150 basis points for the year, the majority, but not entirely in.

Eric Coldwell

So if TAS -- so the question, Ron was if TAS was the majority, and I don't know if that's, 60% or 90%, but if it was the majority, then mathematically I believe you could have picked up as much as 5 basis points of growth in TAS.

Ari Bousbib

No wasn't that much organic growth in single digits.

Eric Coldwell

Okay, perfect. Thanks very much.

Operator

David Windley at Jefferies.

David Windley

Hi, good morning. Thanks for taking my question. I wanted to focus on margin and ask if you could talk about, margin performance by segment and then on the restructuring activities, the expense that you took in the quarter, the ad back was a little bigger. I wondered if you could comment, related to cost takeout, what some of the targets are, is it still kind of right sizing headcount or facility consolidation, or is it something else? And how we should think about those cost takeouts again going back to the margin by segment?

Ari Bousbib

Thanks. Yeah. Well, look, what we're doing in terms of margins and is essentially to work on our cost structure the same way we've been working on it forever that is, address overhead structure as we continue to scale up our business. Address, labor arbitrage, we offshore, we have offshore centers all over the world for different, centers of excellence for different types of activities, both on the commercial and the RNGS side, and we continue to shift, work, different places where it's optimal. And finally, we use technology, automation, and our AI agents to bring more efficiencies to our processes. Those activities result in the restructuring of headcounts literally all over the world and both in all segments.
 So that's what you see reflected in the order and the structural numbers, but that's the -- do we talk about margins by segments? I mean, we do, we have a disclosure of disclosure.

Ronald Bruehlman

We have a disclosure, segment disclosure on a GAAP basis. There's a -- look, there's a little bit more pressure on overall margins in the R&DF segment than there is in the AS segment. Both had good SGNA performance, a little bit more gross margin pressure in the R&DS segment. Some of that related, relating to FSP and also increases higher growth in the lab business that tends to be a little bit lower.

Ari Bousbib

The mix influences margins in the segments, right? So real world, for example, is somewhat lower margin than the rest of the business, than the analytics or the data or the technology. And so as a result, when real world grows faster.
 You do have a mixed impact on margins. That's on the commercial side. And then on the R&DS as Ron mentioned, FSP and lab do have lower margin profile and full service, and as I mentioned, in our revenues FSP is a little bit higher, maybe the point in the revenue side, I mentioned earlier that in my commentary on bookings and pipeline, and RFPs that it seems to be going the other way now, but on the revenue side, FSP was a little larger in the quarter, and lab was also a little bit larger, and those two have somewhat lower margin profiles than for service. So yes, we did have the quarter adverse mixed impact on margins, but again that can fluctuate quarter to quarter.

David Windley

Yes, I was going to say any pass through movement as part of that conversation that we should be aware of pass through change in the revenue composition.
 Okay, great, thank you.

Kerri Joseph

All right, we have time for one more operator.

Operator

And we'll go to Tejas Savant at Morgan Stanley.

Tejas Savant

Hey guys, thank you for the time here. So I'll ask a quick two parter. Ron, any comments on the stranded cost associated with the mega trial that you said is now pushed to 2026, and is there any risk that that the second trial. Which you just got confirmation on could slip again in that sort of four time frame into 2026 as well?
 And then one for you on real-world evidence, you called out some of the unique sort of policy driven opportunities for that business over the medium term. Is there anything you're doing either organically or perhaps from an M&A standpoint that could position you to fully capitalize on some of these opportunities that are coming up?

Ronald Bruehlman

I'll start taking this with the stranded cost a little bit of impact, but not a huge impact. Obviously, on the trial that got further delayed, we're going to free up those resources and use them for other purposes. We're not going to keep them there indefinitely, but there is for the one that's going forward, there is a little bit of impact, not terribly significant, and well, we can only react to what our customer tells us on the trial that was further. And we're assuming that it will go forward the customer still wants to do it and we'll fit. Yeah.

Ari Bousbib

And the one that's starting as planned, we got recent confirmation that, that's the plan. So there's no further news on that or notification of any changes, as of today. So that's for that. What was the other question, real world, yeah. Well, no, look, real world, I think we are the industry will tell you that we are recognized as the leader in the area.
 In this segments, and we intend to fully capitalize on the opportunities that may emerge from any new initiatives from the administration, as I mentioned in my remarks. So I think again we are very well positioned here to navigate this sort of turbulent times. I'm very confident based on our conversations with clients that the world is not coming to an end. And the industry will find ways to adapt. In fact, there are many reasons to feel very optimistic.
 As I said before, and I repeat again, I feel better at this point in order than I did at the same point last quarter when I look at the metrics, whether it's on the commercial side or on the R&DS side and based on our conversation with clients. So with that, and yeah. Okay.

Kerri Joseph

Thank you everyone for taking the time to join us today and our second quarter of 2025 earnings call. The team will be available the rest of it to take any follow-up questions that you might have. Thank you very much. Have a good day.

Operator

And this concludes today's conference call. Thank you for your participation. You may now disconnect.

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