IQVIA (IQV)

Underperform
We’re not sold on IQVIA. Its decelerating growth and falling cash conversion suggest it’s struggling to scale down costs as demand fades. StockStory Analyst Team
Anthony Lee, Lead Equity Analyst
Kayode Omotosho, Equity Analyst

2. Summary

Underperform

Why IQVIA Is Not Exciting

Created from the 2016 merger of Quintiles (a clinical research organization) and IMS Health (a healthcare data specialist), IQVIA (NYSE:IQV) provides clinical research services, data analytics, and technology solutions to help pharmaceutical companies develop and market medications more effectively.

  • One positive is that its earnings growth has outpaced its peers over the last five years as its EPS has compounded at 13.9% annually
IQVIA falls below our quality standards. There are better opportunities in the market.
StockStory Analyst Team

Why There Are Better Opportunities Than IQVIA

IQVIA’s stock price of $227.24 implies a valuation ratio of 17.9x forward P/E. IQVIA’s multiple may seem like a great deal among healthcare peers, but we think there are valid reasons why it’s this cheap.

We’d rather pay up for companies with elite fundamentals than get a bargain on weak ones. Cheap stocks can be value traps, and as their performance deteriorates, they will stay cheap or get even cheaper.

3. IQVIA (IQV) Research Report: Q3 CY2025 Update

Clinical research company IQVIA (NYSE: IQV) announced better-than-expected revenue in Q3 CY2025, with sales up 5.2% year on year to $4.1 billion. The company expects the full year’s revenue to be around $16.2 billion, close to analysts’ estimates. Its non-GAAP profit of $3 per share was 0.8% above analysts’ consensus estimates.

IQVIA (IQV) Q3 CY2025 Highlights:

  • Revenue: $4.1 billion vs analyst estimates of $4.08 billion (5.2% year-on-year growth, 0.5% beat)
  • Adjusted EPS: $3 vs analyst estimates of $2.98 (0.8% beat)
  • Adjusted EBITDA: $949 million vs analyst estimates of $946.5 million (23.1% margin, in line)
  • The company reconfirmed its revenue guidance for the full year of $16.2 billion at the midpoint
  • Management reiterated its full-year Adjusted EPS guidance of $11.90 at the midpoint
  • EBITDA guidance for the full year is $3.79 billion at the midpoint, in line with analyst expectations
  • Operating Margin: 13.5%, in line with the same quarter last year
  • Free Cash Flow Margin: 18.8%, up from 14.7% in the same quarter last year
  • Constant Currency Revenue rose 3.9% year on year, in line with the same quarter last year
  • Market Capitalization: $36.96 billion

Company Overview

Created from the 2016 merger of Quintiles (a clinical research organization) and IMS Health (a healthcare data specialist), IQVIA (NYSE:IQV) provides clinical research services, data analytics, and technology solutions to help pharmaceutical companies develop and market medications more effectively.

IQVIA sits at the intersection of healthcare data, technology, and clinical expertise. The company maintains one of the world's largest healthcare information repositories, containing over 1.2 billion non-identified patient records spanning medical claims, prescriptions, electronic medical records, and other healthcare data. This massive dataset—approximately 64 petabytes—covers about 90% of the world's pharmaceuticals by sales.

The company operates through three main segments. The Technology & Analytics Solutions segment provides cloud-based applications, real-world evidence platforms, and analytics services that help pharmaceutical companies optimize their commercial strategies and understand market dynamics. The Research & Development Solutions segment offers clinical trial management services, including patient recruitment, site monitoring, laboratory testing, and regulatory support. The Contract Sales & Medical Solutions segment provides healthcare provider engagement services and patient support programs.

For example, a pharmaceutical company developing a new cancer drug might engage IQVIA to design and manage clinical trials, analyze real-world data to identify potential patients, and later help launch the drug with specialized sales representatives and patient support programs.

IQVIA's business model generates revenue through long-term contracts with pharmaceutical companies, biotechnology firms, medical device manufacturers, and other healthcare organizations. The company employs approximately 88,000 people across more than 100 countries, allowing it to support global clinical trials and provide localized commercial insights.

The company places significant emphasis on privacy protection, employing various technologies and safeguards to protect patient data while still enabling valuable healthcare research. IQVIA has also invested heavily in artificial intelligence capabilities, developing healthcare-specific AI tools that help clients analyze complex datasets and improve decision-making throughout the drug development and commercialization process.

4. Drug Development Inputs & Services

Companies specializing in drug development inputs and services play a crucial role in the pharmaceutical and biotechnology value chain. Essential support for drug discovery, preclinical testing, and manufacturing means stable demand, as pharmaceutical companies often outsource non-core functions with medium to long-term contracts. However, the business model faces high capital requirements, customer concentration, and vulnerability to shifts in biopharma R&D budgets or regulatory frameworks. Looking ahead, the industry will likely enjoy tailwinds such as increasing investment in biologics, cell and gene therapies, and advancements in precision medicine, which drive demand for sophisticated tools and services. There is a growing trend of outsourcing in drug development for nimbleness and cost efficiency, which benefits the industry. On the flip side, potential headwinds include pricing pressures as efforts to contain healthcare costs are always top of mind. An evolving regulatory backdrop could also slow innovation or client activity.

IQVIA's competitors include clinical research organizations like ICON plc, Parexel International, and Pharmaceutical Product Development (part of Thermo Fisher Scientific), as well as healthcare analytics and technology providers such as Optum Insight (UnitedHealth Group), Clarivate, and Veeva Systems.

5. Economies of Scale

Larger companies benefit from economies of scale, where fixed costs like infrastructure, technology, and administration are spread over a higher volume of goods or services, reducing the cost per unit. Scale can also lead to bargaining power with suppliers, greater brand recognition, and more investment firepower. A virtuous cycle can ensue if a scaled company plays its cards right.

With $15.9 billion in revenue over the past 12 months, IQVIA has decent scale. This is important as it gives the company more leverage in a heavily regulated, competitive environment that is complex and resource-intensive.

6. Revenue Growth

Examining a company’s long-term performance can provide clues about its quality. Any business can experience short-term success, but top-performing ones enjoy sustained growth for years. Thankfully, IQVIA’s 7.7% annualized revenue growth over the last five years was decent. Its growth was slightly above the average healthcare company and shows its offerings resonate with customers.

IQVIA Quarterly Revenue

We at StockStory place the most emphasis on long-term growth, but within healthcare, a half-decade historical view may miss recent innovations or disruptive industry trends. IQVIA’s recent performance shows its demand has slowed as its annualized revenue growth of 3.5% over the last two years was below its five-year trend. IQVIA Year-On-Year Revenue Growth

We can better understand the company’s sales dynamics by analyzing its constant currency revenue, which excludes currency movements that are outside their control and not indicative of demand. Over the last two years, its constant currency sales averaged 3.4% year-on-year growth. Because this number aligns with its normal revenue growth, we can see that IQVIA has properly hedged its foreign currency exposure. IQVIA Constant Currency Revenue Growth

This quarter, IQVIA reported year-on-year revenue growth of 5.2%, and its $4.1 billion of revenue exceeded Wall Street’s estimates by 0.5%.

Looking ahead, sell-side analysts expect revenue to grow 5.4% over the next 12 months, an improvement versus the last two years. This projection is above average for the sector and implies its newer products and services will fuel better top-line performance.

7. Operating Margin

IQVIA has done a decent job managing its cost base over the last five years. The company has produced an average operating margin of 12.5%, higher than the broader healthcare sector.

Analyzing the trend in its profitability, IQVIA’s operating margin rose by 4.7 percentage points over the last five years, as its sales growth gave it operating leverage. Zooming in on its more recent performance, we can see the company’s trajectory is intact as its margin has also increased by 1.2 percentage points on a two-year basis.

IQVIA Trailing 12-Month Operating Margin (GAAP)

This quarter, IQVIA generated an operating margin profit margin of 13.5%, in line with the same quarter last year. This indicates the company’s overall cost structure has been relatively stable.

8. Earnings Per Share

Revenue trends explain a company’s historical growth, but the long-term change in earnings per share (EPS) points to the profitability of that growth – for example, a company could inflate its sales through excessive spending on advertising and promotions.

IQVIA’s EPS grew at a spectacular 13.9% compounded annual growth rate over the last five years, higher than its 7.7% annualized revenue growth. This tells us the company became more profitable on a per-share basis as it expanded.

IQVIA Trailing 12-Month EPS (Non-GAAP)

Diving into IQVIA’s quality of earnings can give us a better understanding of its performance. As we mentioned earlier, IQVIA’s operating margin was flat this quarter but expanded by 4.7 percentage points over the last five years. On top of that, its share count shrank by 11.9%. These are positive signs for shareholders because improving profitability and share buybacks turbocharge EPS growth relative to revenue growth. IQVIA Diluted Shares Outstanding

In Q3, IQVIA reported adjusted EPS of $3, up from $2.84 in the same quarter last year. This print was close to analysts’ estimates. Over the next 12 months, Wall Street expects IQVIA’s full-year EPS of $11.63 to grow 8.5%.

9. Cash Is King

Although earnings are undoubtedly valuable for assessing company performance, we believe cash is king because you can’t use accounting profits to pay the bills.

IQVIA has shown impressive cash profitability, giving it the option to reinvest or return capital to investors. The company’s free cash flow margin averaged 12.9% over the last five years, better than the broader healthcare sector.

Taking a step back, we can see that IQVIA’s margin dropped by 3.6 percentage points during that time. If its declines continue, it could signal increasing investment needs and capital intensity.

IQVIA Trailing 12-Month Free Cash Flow Margin

IQVIA’s free cash flow clocked in at $772 million in Q3, equivalent to a 18.8% margin. This result was good as its margin was 4.2 percentage points higher than in the same quarter last year, but we wouldn’t put too much weight on the short term because investment needs can be seasonal, causing temporary swings. Long-term trends are more important.

10. Return on Invested Capital (ROIC)

EPS and free cash flow tell us whether a company was profitable while growing its revenue. But was it capital-efficient? A company’s ROIC explains this by showing how much operating profit it makes compared to the money it has raised (debt and equity).

IQVIA’s management team makes decent investment decisions and generates value for shareholders. Its five-year average ROIC was 7.9%, slightly better than typical healthcare business.

IQVIA Trailing 12-Month Return On Invested Capital

We like to invest in businesses with high returns, but the trend in a company’s ROIC is what often surprises the market and moves the stock price. Over the last few years, IQVIA’s ROIC averaged 2.6 percentage point increases each year. This is a good sign, and if its returns keep rising, there’s a chance it could evolve into an investable business.

11. Balance Sheet Assessment

IQVIA reported $1.97 billion of cash and $15.19 billion of debt on its balance sheet in the most recent quarter. As investors in high-quality companies, we primarily focus on two things: 1) that a company’s debt level isn’t too high and 2) that its interest payments are not excessively burdening the business.

IQVIA Net Debt Position

With $3.74 billion of EBITDA over the last 12 months, we view IQVIA’s 3.5× net-debt-to-EBITDA ratio as safe. We also see its $310 million of annual interest expenses as appropriate. The company’s profits give it plenty of breathing room, allowing it to continue investing in growth initiatives.

12. Key Takeaways from IQVIA’s Q3 Results

It was good to see IQVIA meet analysts’ constant currency revenue expectations this quarter. We were also happy its revenue narrowly outperformed Wall Street’s estimates. Looking ahead, EBITDA guidance was in line. Zooming out, we think this was a decent quarter. The market seemed to be hoping for a more convincing quarter and outlook, and the stock traded down 1.7% to $213.75 immediately following the results.

13. Is Now The Time To Buy IQVIA?

Updated: December 4, 2025 at 11:05 PM EST

Are you wondering whether to buy IQVIA or pass? We urge investors to not only consider the latest earnings results but also longer-term business quality and valuation as well.

IQVIA doesn’t top our investment wishlist, but we understand that it’s not a bad business. To kick things off, its revenue growth was decent over the last five years. And while IQVIA’s cash profitability fell over the last five years, its spectacular EPS growth over the last five years shows its profits are trickling down to shareholders.

IQVIA’s P/E ratio based on the next 12 months is 18x. While this valuation is reasonable, we don’t really see a big opportunity at the moment. We're pretty confident there are more exciting stocks to buy at the moment.

Wall Street analysts have a consensus one-year price target of $250 on the company (compared to the current share price of $224.91).