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IQVIA

iqv · NYSE Healthcare
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FY2020 Annual Report · IQVIA
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

FORM 10-K 

(Mark One)
☒

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

For the fiscal year ended December 31, 2020 

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

(State or other jurisdiction of incorporation or 
organization)

27-1341991

(I.R.S. Employer Identification Number)

4820 Emperor Blvd., Durham, North Carolina 27703 
and
83 Wooster Heights Road, Danbury, Connecticut 06810 
(Address of principal executive offices and Zip Code)
(919) 998-2000 and (203) 448-4600 
(Registrant’s telephone number, including area code)

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

Title of each class

Trading Symbol(s)

Name of each exchange on which registered

Common Stock, par value $0.01 per share

IQV

New York Stock Exchange

Securities registered pursuant to Section 12(g) of the Act: None

Indicate by check mark if the registrant is a well-known seasoned issuer, as defined in Rule 405 of the Securities Act. Yes ☒ No ☐
Indicate by check mark if the registrant is not required to file reports pursuant to Section 13 or section 15(d) of the Exchange Act. Yes ☐ No ☒
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 twelve 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 ☒ 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 ☒ 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 
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

Non-accelerated filer
Emerging growth company

☒

☐

☐

Accelerated filer

Smaller reporting 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 has filed a report on and attestation to its management’s assessment of the effectiveness of its internal 

control over financial reporting under Section 404(b) of the Sarbanes-Oxley Act (15 U.S.C. 7262(b)) by the registered public accounting firm that prepared or 
issued its audit report.   ☒

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

The aggregate market value of the voting and non-voting common stock held by non-affiliates of the registrant, based upon the closing sale price as 

reported on the New York Stock Exchange on June 30, 2020, the last business day of the registrant’s most recently completed second quarter, was approximately 
$26.3 billion.

As of February 1, 2021, there were approximately 191,281,286 shares of the registrant’s common stock outstanding.

Portions  of  the  registrant’s  Proxy  Statement  for  the  2021  Annual  Meeting  of  Stockholders  are  incorporated  herein  by  reference  in  Part  III  of  this 
Annual Report on Form 10-K to the extent stated herein. Such proxy statement will be filed with the Securities and Exchange Commission within 120 days of 
the registrant’s fiscal year ended December 31, 2020. 

IQVIA HOLDINGS INC.
FORM 10-K

TABLE OF CONTENTS

PART I

PART II

Business

Risk Factors

Unresolved Staff Comments

Properties

Legal Proceedings

Mine Safety Disclosures

Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity Securities

Selected Financial Data

Management’s Discussion and Analysis of Financial Condition and Results of Operations

Item

1.

1A.

1B.

2.

3.

4.

5.

6.

7.

7A.

Quantitative and Qualitative Disclosures About Market Risk

8.

9.

9A.

9B.

10.

11.

12.

13.

14.

Financial Statements and Supplementary Data

Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

Controls and Procedures

Other Information

Directors, Executive Officers and Corporate Governance

Executive Compensation

PART III

Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

Certain Relationships and Related Transactions and Director Independence

Principal Accountant Fees and Services

PART IV

15.

Exhibits and Financial Statement Schedules

Exhibit Index

16.

Form 10-K Summary

Signatures

Page

5

13

34

35

35

35

36

36

39

41

54

55

104

104

104

105

105

106

107

107

107

108

108

109

113

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FORWARD-LOOKING STATEMENTS

Except  for  any  historical  information  contained  herein,  the  matters  discussed  or  incorporated  by  reference  in  this  Annual 
Report on Form 10-K contains 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”).  Such  forward-looking  statements  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  “anticipates,”  “believes,” 
“estimates,” “expects,” “intends,” “may,” “plans,” “projects,” “should,” “targets,” “will” and the negative thereof and similar words 
and expressions are intended to identify forward-looking statements.

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, that business 
disruptions  caused  by  natural  disasters,  pandemics  such  as  the  COVID-19  (coronavirus)  outbreak  or  international  conflict  or  other 
disruptions  outside  of  our  control;  our  ability  to  accurately  model  or  forecast  the  impact  of  the  spread  and/or  containment  of 
COVID-19,  among  other  sources  of  business  interruption,  on  our  operations  and  financial  results;  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 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  revenue;  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 
scope of prescription 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 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.

These forward-looking statements are subject to a number of risks, uncertainties and assumptions, including those described 
in  Part  I,  Item  1A,  “Risk  Factors.”  If  one  or  more  of  these  risks  or  uncertainties  materialize,  or  if  underlying  assumptions  prove 
incorrect, our actual results may vary materially from those expected, estimated or projected or as otherwise suggested by the forward-
looking statements that we make for a number of reasons. Given these uncertainties, users of the information included or incorporated 
by  reference  in  this  Form  10-K,  including  investors  and  prospective  investors,  are  cautioned  not  to  place  undue  reliance  on  such 
forward-looking statements. All forward-looking statements are made only as of the date hereof. We assume no obligation to update 
any such forward-looking information to reflect actual results or changes in the factors affecting such forward-looking information.

GENERAL

When we use the terms “IQVIA,” the “Company,” “we,” “us” or “our” in this Annual Report on Form 10-K, we mean IQVIA 

Holdings Inc. and its subsidiaries on a consolidated basis, unless we state or the context implies otherwise.

INDUSTRY AND MARKET DATA

This annual report on Form 10-K includes market data and forecasts with respect to the healthcare industry. In some cases, 
we  rely  on  and  refer  to  market  data  and  certain  industry  forecasts  that  were  obtained  from  third  party  surveys,  market  research, 
consultant surveys, publicly available information and industry publications and surveys that we believe to be reliable. However, we 

3

 
 
 
 
 
have not independently verified data from industry analyses and cannot guarantee their accuracy or completeness. We believe that data 
regarding  the  industry,  market  size  and  its  market  position  and  market  share  within  such  industry  provide  general  guidance  but  are 
inherently imprecise. Other industry and market data included in this annual report are from IQVIA analyses and have been identified 
accordingly,  including,  for  example,  IQVIA  Market  Prognosis,  which  is  a  subscription-based  service  that  provides  five-year 
pharmaceutical  market  forecasts  at  the  national,  regional  and  global  levels.  We  are  a  leading  global  information  provider  for  the 
healthcare industry and we maintain databases, produce market analyses and deliver information to clients in the ordinary course of our 
business. Our information is widely referenced in the industry and used by governments, payers, academia, the life sciences industry, 
the financial community and others. Most of this information is available on a subscription basis. Other reports and information are 
available publicly through our IQVIA Institute for Human Data Science (the “IQVIA Institute”). All such information is based upon 
our own market research, internal databases and published reports and has not been verified by any independent sources. Our estimates 
and assumptions involve risks and uncertainties and are subject to change based on various factors, including those discussed in Part I, 
Item  IA,  “Risk  Factors”.  These  and  other  factors  could  cause  results  to  differ  materially  from  those  expressed  in  the  estimates  and 
assumptions.

TRADEMARKS AND SERVICE MARKS

All  trademarks,  trade  names,  product  names,  graphics  and  logos  of  IQVIA  contained  herein  are  trademarks  or  registered 
trademarks  of  IQVIA  Holdings  Inc.  or  its  subsidiaries,  as  applicable,  in  the  United  States  and/or  other  countries.  All  other  party 
trademarks, trade names, product names, graphics and logos contained herein are the property of their respective owners. The use or 
display  of  other  parties’  trademarks,  trade  names,  product  names,  graphics  or  logos  is  not  intended  to  imply,  and  should  not  be 
construed to imply, a relationship with, or endorsement or sponsorship of IQVIA Inc. or its subsidiaries by such other party.

Solely for convenience, the trademarks, service marks and trade names referred to in this annual report are listed without the 
®,  (sm)  and  (TM)  symbols,  but  we  will  assert,  to  the  fullest  extent  under  applicable  law,  our  rights  or  the  rights  of  the  applicable 
licensors to these trademarks, service marks and trade names.

4

 
 
Item 1. Business

Our Company

PART I

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 70,000 employees, we conduct operations in more than 100 countries.

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 have one of the largest and most comprehensive collections of healthcare information in the world, which includes more 
than one billion comprehensive, longitudinal, non-identified patient records spanning sales, prescription and promotional data, medical 
claims,  electronic  medical  records,  genomics,  and  social  media.  Our  scaled  and  growing  information  set  contains  approximately  45 
petabytes of proprietary data sourced from approximately 150,000 data suppliers and covering over one million data feeds globally. 
Based on this data, we deliver information and insights on over 85% of the world’s pharmaceuticals, as measured by 2019 sales. We 
standardize,  curate,  structure  and  integrate  this  information  by  applying  our  sophisticated  analytics  and  leveraging  our  global 
technology  infrastructure.  This  helps  our  clients  run  their  organizations  more  efficiently  and  make  better  decisions  to  improve  their 
clinical,  commercial  and  financial  performance.  The  breadth  of  the  intelligent,  actionable  information  we  provide  is  not 
comprehensively  available  from  any  other  source  and  our  scope  of  information  would  be  difficult  and  costly  for  another  party  to 
replicate.

We combine our proprietary information assets with advanced analytics, transformative technology and domain expertise to 
develop clinical and commercial capabilities that enable us to grow our relationships with healthcare stakeholders throughout the life 
science’s value chain. This set of capabilities includes:

•

•

•

•

•

A leading healthcare-specific global IT infrastructure, representing what we believe is one of the largest and most 
sophisticated  information  technology  (“IT”)  infrastructures  in  healthcare.  We  receive  approximately  100  billion 
healthcare  records  annually,  and  our  infrastructure  then  connects  complex  healthcare  data  while  applying  a  wide 
range of privacy, security, operational, legal and contractual protections for data in response to local law, supplier 
requirements and industry leading practices;

Analytics-driven  clinical  development,  which  improves  clinical  trial  design,  site  identification  and  patient 
recruitment  by  empowering  therapeutic,  scientific,  and  domain  experts  with  expansive  levels  of  information, 
including product level tracking in 90 markets, and information about treatments and outcomes on more than one 
billion  non-identified patients globally;

Robust real world solutions ecosystem, with sophisticated retrospective database analytics, prospective real world 
data collection technology platforms and scientific expertise, which enables us to address critical healthcare issues 
of cost, value and patient outcomes;

A growing set of proprietary clinical and commercial applications, which helps our clients increase their clinical 
operations  performance,  supports  their  regulatory  and  compliance  needs  and  orchestrates  their  sales  operations, 
sales management, multi- channel marketing and performance management; and

A  staff  of  approximately  70,000  employees  across  the  globe,  including  over  24,000  Technology  &  Analytics 
Solutions  employees,  approximately  38,000  Research  &  Development  Solutions  employees  and  approximately 
6,000 Contract Sales & Medical Solutions employees.

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•

Integration of information, analytics, technology, and domain expertise through Connected Intelligence, which 
enables us to provide our clients with more effective options to address their needs from Research and Development 
through  commercialization  as  well  as  truly  innovative  breakthroughs  such  as  virtual  trials  and  global  real-world 
evidence networks.

Our Market Opportunity

We compete in a market of greater than $260 billion consisting of outsourced research and development, real-world evidence 
and connected health and technology enabled clinical and commercial operations markets for life sciences companies and the broader 
healthcare industry. The following sets forth our estimates for the size of our principal markets:

•

•

•

Outsourced research and development: Biopharmaceutical spending on drug development totaled approximately 
$130 billion in 2020. Of that amount, we estimate that our addressable opportunity (clinical development spending 
excluding preclinical spending) was approximately $75 billion. The portion of this addressable opportunity that was 
outsourced in 2020, based on our estimates, was approximately $36 billion;

Real-World Evidence and connected health: Total addressable market of approximately $80 billion based on 2020 
sales that consists of two relatively equal parts. First, the market for Real-World Evidence of approximately $40 
billion  includes  traditionally  defined  analytic  platforms  and  implementation,  medical  and  scientific  analytic 
services, observation studies and market access. Second, the market for connected healthcare of approximately $40 
billion  includes  areas  such  as  revenue  cycle  management,  payer  analytics  and  clinical  decision  support  services; 
and

Technology enabled commercial operations: Total addressable market of approximately $50 billion based on 2020 
sales that includes information, data warehousing, IT outsourcing, software applications and other services in the 
broader  market  for  IT  services.  This  addressable  market  also  includes  commercial  services  such  as  recruiting, 
training,  deploying  and  managing  global  sales  forces,  channel  management,  patient  engagement  services,  market 
access  consulting,  brand  communication,  advisory  services,  and  health  information  analytics  and  technology 
consulting.

In  deriving  estimates  of  the  size  of  the  various  markets  described  above,  we  review  third-party  sources,  which  include 
estimates and forecasts of spending in various segments, in combination with internal IQVIA research and analysis informed by our 
experience  serving  these  segments,  as  well  as  projected  growth  rates  for  each  of  these  segments.  See  “Industry  and  Market  Data” 
above.

We believe there are six key trends affecting our end markets that will create increasing demand for research and 

development services, technology & analytics solutions and contract sales and medical solutions:

Growth  and  innovation  in  the  life  sciences  industry.  The  life  sciences  industry  is  a  large  and  critical  part  of  the  global 
healthcare system, and, according to the latest information available from the IQVIA Market Prognosis service, is estimated to have 
generated  approximately  $1.27  trillion  in  revenue  in  2020.  According  to  our  research,  revenue  growth  in  the  life  sciences  industry 
globally is expected to range from 3% to 6% between 2021 and 2025. According to the IQVIA Institute, it is estimated that spending 
on  pharmaceuticals  in  emerging  markets  will  expand  at  a  6%  to  9%  compound  annual  growth  rate  (“CAGR”)  through  2025.  The 
growth  of  emerging  markets  is  making  these  geographies  strategically  important  to  life  sciences  organizations  and,  consistent  with 
their approach in the developed markets, we expect these organizations to apply a high degree of sophistication to their commercial 
operations in these countries. For global companies, this requires highly localized knowledge and information assets, the development 
of  market  access  strategies  and  performance  benchmarking.  In  addition,  local  players  are  learning  that  they  need  to  compete  on  the 
basis of improved information and analytics.

Growth  in  Research  and  Development.  Spending  trends  in  research  and  development  are  impacted  as  a  result  of  several 
factors,  including  major  biopharmaceutical  companies’  efforts  to  replenish  revenues  lost  from  the  so-called  “patent  cliff,”  increased 
access  to  capital  by  the  small  and  midcap  biotechnology  industry,  and  recent  increases  in  pharmaceutical  approvals  by  regulatory 
authorities. The IQVIA Institute also estimates that approximately 270 new molecular entities (“NMEs”) are expected to be approved 
between 2021 and 2025, compared to 234 between 2016 and 2020, and 220 between 2011 and 2015. We believe that further research 

6

 
 
 
 
 
and  development  spending,  combined  with  the  continued  need  for  cost  efficiency  across  the  healthcare  landscape,  will  continue  to 
create opportunities for biopharmaceutical services companies, particularly those with a global reach and broad service offerings, to 
help biopharmaceutical companies with their pre- and post-launch solutions development and commercialization needs.

Increased  Complexity  in  Research  and  Development.  Biopharmaceutical  companies  face  environments  in  which  it  has 
become  increasingly  difficult  to  operate.  Improved  standards  of  care  in  many  therapeutic  areas  and  the  emergence  of  new  types  of 
therapies,  such  as  biologics,  genetically  targeted  therapies,  gene  and  stem  cell  therapies,  and  other  treatment  modalities  have  led  to 
more  complex  development  and  regulatory  pathways.  We  believe  that  our  global  clinical  development  capabilities,  including  our 
expertise  in  biomarkers  and  genomics  and  our  global  laboratory  network,  position  us  well  to  help  biopharmaceutical  companies 
manage the complexities inherent in an environment where this type of expertise is important. For example, Connected Intelligence 
helps us validate protocols to ensure studies in new disease areas have greater accuracy and also enables us, through innovations such 
as predictive analytics, to find patients who may not have been diagnosed.

Regulators  require  clinical  trials  involving  local  populations  as  part  of  the  process  for  approving  new  pharmaceutical 
products,  especially  in  certain  Asian  and  emerging  markets.  Understanding  the  epidemiological  and  physiological  differences  in 
different ethnic populations and being able to conduct clinical trials locally in certain geographies will be important to pharmaceutical 
product growth strategies, both for multinational and local/regional biopharmaceutical companies. We believe that our global clinical 
development capabilities and unmatched presence in Asia and other emerging markets make us a strong partner for biopharmaceutical 
companies managing the complexities of international drug development.

Financial  pressures  driving  the  need  for  increased  efficiency.  Despite  expected  accelerating  growth  in  the  global  life 
sciences market, we believe our clients will face increased operating margin pressure due to their changing product mix, pricing and 
reimbursement challenges, and rising costs of compliance. Product portfolios for life sciences companies have shifted toward specialty 
products  with  lower  peak  market  sales  potential  than  traditional  primary  care  medicines.  We  believe  that  the  need  for 
biopharmaceutical companies to maximize productivity and lower costs across their processes from research and development through 
commercial operations will cause them to look to partners as they enter into outsourcing arrangements to improve efficiency. Further, 
our  clients  are  looking  for  new  ways  to  simplify  processes  and  drive  operational  efficiencies  by  using  automation,  consolidating 
vendors and adopting new technology options such as hosted and cloud-based applications. This provides opportunities for technology 
services  vendors  to  capture  and  consolidate  internal  spending  by  providing  lower-cost  and  variable-cost  options  that  lower  clients’ 
research and development, selling, marketing and administrative costs.

Evolving need to integrate and structure expanding sources of data. Over the past decade, many health systems around the 
world  have  focused  on  digitizing  medical  records.  While  such  records  theoretically  enhance  access  to  data,  relevant  information  is 
often unintegrated, unstructured, siloed in disparate software systems, or entered inconsistently. In addition, new sources of data from 
the  internet,  such  as  social  media  and  information  on  limited  patient  pools,  and  information  resulting  from  enhanced  diagnostic 
technologies are creating new sources of healthcare data.

In order to derive valuable insights from existing and expanding sources of information, clients need access to statistically 
significant data sets organized into databases that can be queried and analyzed. For example, real-world evidence studies demonstrate 
practical  and  clinical  efficacies,  which  we  believe  require  the  aggregation  and  integration  of  large  clinical  data  sets  across  all  care 
settings, types of therapies and patient cohorts. Longitudinal studies require analysis of non-identified patient diagnoses, treatments, 
procedures  and  laboratory  test  results  to  identify  types  of  patients  that  will  likely  best  respond  to  particular  therapies.  Finally, 
manufacturers  also  require  the  ability  to  analyze  social  media  activity  to  identify  unmet  patient  needs  and  support  for  new  orphan 
drugs.  This  information  is  highly  relevant  to  all  healthcare  stakeholders  and  we  believe  the  opportunity  to  more  broadly  apply 
healthcare data can only be realized through structuring, organizing and integrating new and existing forms of data in conjunction with 
sophisticated analytics.

Need  for  demonstrated  value  in  healthcare.  Participants  in  the  healthcare  industry  are  focused  on  improving  quality  and 
reducing  costs,  both  of  which  require  assessment  of  quality  and  value  of  therapies  and  providers.  As  a  result,  physicians  no  longer 
make prescribing decisions in isolation, but rather in the context of guidance and rules from payers, integrated delivery networks and 
governments. We believe life sciences companies are working to bring alignment across constituents on the value of their treatments in 
order to successfully develop and commercialize new therapies.

7

 
 
 
 
 
 
There is increasing pressure on life sciences companies to support and justify the value of their therapies. Many new drugs 
that are being approved are more expensive than existing therapies and will likely receive heightened scrutiny by regulators and payers 
to determine whether the existing treatment options would be sufficient. Additionally, many new specialty drugs are molecular-based 
therapies and require a more detailed understanding of clinical factors and influencers that demonstrate therapeutic value. As a result, 
leading life sciences companies are utilizing more sophisticated outcome research and data analytics services.

We believe we are well positioned to take advantage of these global trends in healthcare. Beyond our proprietary information 
assets,  we  have  developed  key  capabilities  to  assess  opportunities  to  develop  and  commercialize  therapies,  support  and  defend  the 
value of medicines and help our clients operate more efficiently through the application of insight-driven decision-making and cost-
efficient technology solutions.

Our Growth Strategy

We believe we are well positioned for continued growth across the markets we serve. Our strategy for achieving growth 

includes:

Continue  to  innovate  through  our  Connected  Intelligence  by  leveraging  our  information,  advanced  analytics, 
transformative  technology  and  significant  domain  expertise.  As  a  leader  in  the  development  and  commercialization  of  new 
pharmaceutical  therapies,  we  can  empower  our  therapeutic,  scientific  and  domain  experts  with  expansive  levels  of  information 
including product level tracking in 90 markets and information about treatments and outcomes on more than one billion non-identified 
patients. By connecting this intelligence, we have the ability to optimize the clinical trial process and enable our clients to reduce costs 
and  get  their  products  to  market  more  quickly  through  more  informed  site  selection,  faster  patient  recruitment  practices  and  virtual 
trials.  We  transform  Real  World  Evidence  by  linking  prospective  and  retrospective  approaches  and  introduce  innovation  such  as 
secondary control arms, which eliminate the need for a placebo group. We bring best in class SaaS platforms, purpose built for life 
sciences, to our clients to help them run their clinical and commercial operations more efficiently.

Build upon our extensive client relationships and leverage our global presence. We have a diversified base of over 10,000 
clients in over 100 countries and have expanded our client value proposition to address a broader market for research and development 
and commercial operations which we estimate to be more than $260 billion in 2020. Through the combined offerings of research and 
development and commercial services we built a platform that allows us to be a more complete partner to our clients.

Expand  the  penetration  of  our  offerings  to  the  broader  healthcare  marketplace.  We  believe  that  substantial  opportunities 
exist  to  use  our  existing  technology  and  domain  expertise  to  serve  additional  healthcare  stakeholders  (payers,  providers,  healthcare 
professionals)  to  quantify  and  optimize  cost  of  care  delivery;  provide  registry  technology  to  professional  association  and  patient 
communities and support healthcare providers with system implementation and platform migration.

Expand  portfolio  through  strategic  acquisitions.  We  have  and  expect  to  continue  to  acquire  assets  and  businesses  that 
strengthen our value proposition to clients. We have developed an internal capability to source, evaluate and integrate acquisitions that 
have  created  value  for  stockholders.  As  the  global  healthcare  landscape  evolves,  we  expect  that  there  will  be  a  growing  number  of 
acquisition  opportunities  across  the  life  sciences,  payer  and  provider  sectors.  We  expect  to  continue  to  invest  in  or  explore 
opportunities for strategic acquisitions to grow our platform and enhance our ability to provide more services to our clients.

Our Offerings

We  offer  hundreds  of  distinct  services,  applications,  technology  platforms  and  solutions  to  help  our  clients  make  critical 
decisions  and  perform  better.  We  have  three  operating  segments:  Technology  &  Analytics  Solutions,  Research  &  Development 
Solutions  and  Contract  Sales  &  Medical  Solutions.  Their  offerings  complement  each  other  and  can  provide  enhanced  value  to  our 
clients when delivered together, with each driving demand for the other.

Our Technology & Analytics Solutions offerings include:

Technology platforms. We provide an extensive range of cloud-based applications and associated implementation services. 
Software as a Service (“SaaS”) solutions that support a wide range of clinical and commercial processes, including clinical trial design 
and  planning,  site  start-up,  patient  consent,  site  payments,  content  management,  multi-channel  marketing,  real-world  evidence 

8

 
 
 
 
 
 
 
 
generation,  customer  relationship  management  (“CRM”),  performance  management,  incentive  compensation,  territory  alignment, 
roster  management,  call  planning,  compliance  and  safety  reporting  and  master  data  management.  These  solutions  are  used  by 
healthcare  companies  to  manage,  optimize  and  execute  their  clinical  and  commercial  strategies  in  an  orchestrated  manner  while 
addressing  their  regulatory  obligations.  Using  proprietary  algorithms,  we  combine  our  country-level  data,  healthcare  expertise  and 
therapeutic knowledge in over 100 countries to create our Global Market Insight family of offerings such as MIDAS, Analytics Link 
and  Disease  Insights,  which  provides  a  leading  source  of  insight  into  international  market  dynamics  and  are  used  by  most  large 
pharmaceutical companies.

Real  World  Solutions.  We  enable  life  sciences  and  provider  customers  to  generate  and  disseminate  evidence  in  a  cost-
efficient manner which informs health care decision making and ultimately improves patients’ outcomes. Our use of a wide range of 
privacy  and  security  safeguards  protect  non-identified  patient-level  medical  claims,  prescriptions,  electronic  medical  records, 
genomics,  patient  reported  outcome  and  social  media  data.  Our  scaled  information  networks  include  more  than  one  billion  non-
identified patients globally. We technology-enable these data flows by harmonizing them to common data models and loading them 
onto our proprietary evidence platforms for secure access by our customers. We provide access to deep clinical data in Oncology, Rare 
Disease,  and  other  specialty  areas.  Our  Natural  Language  Processing  capabilities  help  us  create  structured  data  from  unstructured 
clinical  notes.  We  help  our  global  customers  across  payers,  providers,  governments,  and  biopharmaceutical  companies  to  answer 
critical questions about healthcare interventions related to safety, effectiveness, and value. We also bring together stakeholders across 
healthcare  to  collaborate  in  efforts  to  develop  new  information  sources,  more  effective  reimbursement  models,  and  better  patient 
outcomes.

Analytics  and  consulting  services.  We  provide  a  broad  set  of  strategic  and  implementation  consulting  services,  including 
advanced  analytics  and  commercial  processes  outsourcing  services  to  help  the  commercial  operations  of  life  sciences  companies 
successfully transform their commercial models, engage more effectively with the healthcare stakeholders and reduce their operating 
costs.  We  also  help  our  client’s  R&D  function  to  address  strategic  challenges  in  the  drug  development  process.  Our  global  teams 
leverage  local  market  knowledge,  deep  scientific  and  therapeutic  area  expertise  and  our  global  information  resources  to  assist  our 
clients with R&D strategy, portfolio, brand and commercial strategy, as well as pricing and market access and launch excellence.

Information offerings. Our national offerings comprise unique services in over 100 countries that provide consistent country 
level  performance  metrics  related  to  sales  of  pharmaceutical  products,  prescribing  trends,  medical  treatment  and  promotional  activity 
across  multiple  channels  including  retail,  hospital  and  mail  order.  Our  sub-national  offerings  comprise  unique  services  in  over  70 
countries that provide a consistent measurement of sales or prescribing activity at the regional, zip code and individual prescriber level 
(depending  on  regulation  in  the  relevant  country).  Our  widely  used  reference  database  that  tracks  over  22  million  healthcare 
professionals  in  over  100  countries,  providing  a  comprehensive  view  of  health  care  practitioners  that  is  critical  for  the  commercial 
success of our clients’ marketing and sales initiatives.

Our Research & Development Solutions offerings include:

Project  Management  and  Clinical  Monitoring.  Drawing  upon  our  years  of  experience,  our  site  databases,  our  site 
relationships and our highly trained staff, our solutions and services enables the efficient conduct and coordination of multi-site clinical 
trials (generally Phase II-IV). Our service offerings include protocol design, feasibility and operational planning, site start up, patient 
recruitment and clinical site monitoring. By infusing technology into field-based monitoring, we are able to reduce data collection steps 
and time.

Clinical  Trial  Support  Services.  Each  clinical  trial  requires  a  number  of  concurrent  services  and  data  streams.  We  offer  a 
broad range of functional services and consultation to support clinical trials through specialized expertise that help clients efficiently 
collect, analyze and report the quality data and evidence they need to gain regulatory approval.

Clinical Laboratory Services. We provide our clients globally scaled end-to-end clinical trial laboratory and research services 
through our majority-owned joint venture with Quest Diagnostics Incorporated (“Quest”), which was formed on July 1, 2015. We offer 
the full range of central laboratory, genomic, bioanalytical, ADME, discovery, vaccine and biomarker laboratory services along with 
sample and consent tracking services supporting clinical trials offerings within the joint venture, which is referred to as Q2 Solutions.

Strategic Planning and Design. By bringing our data science capabilities to our strategic planning and design services, we 
offer    consultation  services  to  improve  decisions  and  performance  including  portfolio,  program  and  protocol  planning  and  design, 
biomarker consultation, benefit-risk management, regulatory affairs, biostatistics, modeling and simulation, and personalized medicine.

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Virtual Trials. Utilizing our proprietary information assets and transformative technology, we bring trials directly to patients, 
with the objective of increasing participation and improving cycle times. Combining this with purpose-built processes and industry-
leading clinical capabilities, we help clients reach diverse and difficult to recruit patient populations.

Our principal Contract Sales & Medical Solutions offerings include:

Health Care Provider Engagement Services. We partner with biopharmaceutical companies and other life sciences providers 
(e.g., medical device companies) to develop and deploy tailored stakeholder engagement solutions, including contract sales and market 
access professionals, which are focused on product sales and improving brand value at all stages of the product lifecycle from initial 
market entry to brands nearing patent expiry.

Patient  Engagement  Services.  Our  nurse-based  programs  directly  engage  with  patients  to  help  improve  their  disease  and 
medication understanding through interventional and non-interventional support, while also providing assistance in navigating complex 
reimbursement coverage issues. Our patient engagement services combine insight from clinical trials and social listening, behavioral 
design, personal and innovative eHealth multichannel interactions across multiple sites (e.g., the physician’s office, hospital, pharmacy, 
home), that act as an extension of the Health Care Provider prescribed treatment course which can lead to improved adherence and 
better overall outcomes.

Medical Affairs Services. We provide  a  range of  scientific strategy  and medical affairs services  to  help biopharmaceutical 
companies plan and transition from the clinical trial setting to commercialization. Beginning in the clinical trial stage, our services can 
deploy educators to clinical trial sites to accelerate patient recruitment and improve retention, assist in translation of complex clinical 
trial  data  into  a  compelling  scientific  platform  and  publication  strategy,  and,  provide  field  medical  teams  to  facilitate  scientific 
engagement with key opinion leaders and healthcare decision makers, before and after product approval.

Our Clients

Sales  to  companies  in  life  sciences,  including  pharmaceutical  companies,  biotechnology  companies,  device  and  diagnostic 
companies, and consumer health companies, account for the majority of our revenues. Nearly all of the top 100 global pharmaceutical 
and  biotechnology  companies,  measured  by  revenue,  are  clients,  and  many  of  these  companies  subscribe  to  reports  and  services  in 
many  countries.  Other  clients  include  payers,  government  and  regulatory  agencies,  providers,  pharmaceutical  distributors,  and 
pharmacies. Our client base is broad in scope and enables us to avoid dependence on any single client. No single client accounted for 
10% or more of our total company revenues in 2020, 2019, or 2018. As of December 31, 2020 the largest client based on its percentage 
of total company revenue contributed approximately 5%.

Our Competition

Our  Technology  &  Analytics  Solutions  business  competes  with  a  broad  and  diverse  set  of  businesses.  While  we  believe  no 
competitor provides the combination of geographical reach and breadth of its services, we generally compete in the countries in which 
we operate with other information, analytics, technology, services and consulting companies, as well as with the in-house capabilities of 
our clients. Also, we compete with certain government agencies, private payers and other healthcare stakeholders that provide their data 
directly  to  others.  In  addition  to  country-  by-country  competition,  we  have  a  number  of  regional  and  global  competitors  in  the 
marketplace as well. Our offerings compete with various firms, including Accenture, Aetion, Panalgo, Cognizant Technology Solutions, 
Covance Inc., Deloitte, Evidera (now part of PPD), GfK, LexisNexis Risk Solutions, IBM, Infosys, Kantar Health (now part of Cerner 
Corporation), McKinsey, Nielsen, OptumInsight, PAREXEL International Corporation, Press Ganey, RTI Health Solutions, PRA Health 
Sciences, Tempus, Veeva, and ZS Associates. We also compete with a broad range of new entrants and start-ups that are looking to bring 
new technologies and business models to healthcare information services and technology services.

The  markets  for  Research  &  Development  Solutions  offerings  are  highly  competitive,  and  we  compete  against  traditional 
clinical  research  organizations  (“CROs”),  the  in-house  research  and  development  departments  of  biopharmaceutical  companies, 
universities, and teaching hospitals. Among the traditional CROs, there are several-hundred small, limited-service providers, several 
medium-sized  firms  and  only  a  few  full-service  companies  with  global  capabilities.  Our  primary  competitors  include  Covance  Inc., 
ICON  plc,  PAREXEL  International  Corporation,  Pharmaceutical  Product  Development,  Inc.,  PRA  Health  Sciences,  and  Syneos 
Health, among others.

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Our  Contract  Sales  &  Medical  Solutions  business  competes  against  the  in-house  sales  and  marketing  departments  of 
biopharmaceutical  companies,  other  contract  pharmaceutical  sales  and  service  organizations  and  consulting  firms.  Contract  Sales  & 
Medical Solutions’ primary competitor in the United States is Syneos Health, Eversana and UDG Healthcare plc. Outside of the United 
States, Contract Sales & Medical Solutions typically competes against single country or more regionally focused service providers, such 
as UDG Healthcare plc, Syneos Health, EPS Corporation and CMIC HOLDINGS Co., Ltd.

Government Regulation

Many  aspects  of  our  businesses  are  regulated  by  federal  and  state  laws,  rules  and  regulations.  Accordingly,  we  maintain  a 
robust compliance program aimed at ensuring we operate our business in compliance with all existing legal requirements material to 
the operation of our businesses. There are, however, occasionally uncertainties involving the application of various legal requirements, 
the violation of which could result in, among other things, fines or other sanctions. See Part I, Item 1A, "Risk Factors” for additional 
detail.

Good Clinical Practice

Good  Clinical  Practice  (“GCP”)  regulations  and  guidelines  are  the  industry  standard  for  the  conduct  of  clinical  trials  with 
respect to maintaining the integrity of the data and safety of the research subjects. The United States Food and Drug Administration 
(“FDA”), the European Medicines Agency (“EMA”), Japan’s Ministry of Health, Labour and Welfare and most other global regulatory 
authorities expect that study results and data submitted to such authorities be based on clinical trials conducted in accordance with GCP 
provisions. Records for clinical trials must be maintained for specified periods for inspection by the FDA and other regulators.

Regulation of Drugs, Biologics and Medical Devices

In the United States, pharmaceutical, biological and medical device products are subject to extensive regulation by the FDA. 
The  Federal  Food,  Drug,  and  Cosmetic  Act  (“FDC  Act”),  the  Public  Health  Service  Act  (“PHS  Act”),  and  other  federal  and  state 
statutes  and  regulations,  govern,  among  other  things,  the  research,  development,  testing,  manufacture,  storage,  recordkeeping, 
approval, labeling, promotion and marketing, distribution, post-approval monitoring and reporting, sampling, and import and export of 
pharmaceutical, biological and medical device products. Failure to comply with applicable United States requirements may subject a 
company to a variety of administrative or judicial sanctions, such as FDA refusal to approve a pending new drug application (“NDA”) 
for a new drug, a biologics license application (“BLA”) for a new biological product pre-market approval (“PMA”) or clearance for a 
new  medical  device,  warning  or  untitled  letters,  clinical  holds,  product  recalls,  product  seizures,  total  or  partial  suspension  of 
production or distribution, injunctions, fines, civil penalties, and criminal prosecution.

Regulation of Patient Information

Our  information  management  services  relate  to  the  processing  of  information  regarding  patient  diagnosis  and  treatment  of 
disease and are, therefore, subject to substantial governmental regulation. In addition, the confidentiality of patient-specific information 
and the circumstances under which such patient-specific records may be released for inclusion in our databases or used in other aspects 
of our business is heavily regulated. Federal, state and foreign governments are contemplating or have proposed or adopted additional 
legislation governing the possession, use and dissemination of personal data, such as personal health information and personal financial 
data, as well as security breach notification rules for loss or theft of such data. Additional legislation or regulation of this type might, 
among other things, require us to implement additional security measures and processes or bring within the legislation or regulation de-
identified health or other data, each of which may require substantial expenditures or limit our ability to offer some of our services.

In particular, personal health information is recognized in many countries such as the United States, the European Union, or 
EU, and several countries in Asia, as a special, sensitive category of personal information, subject to additional mandatory protections. 
Violations  of  data  protection  regulations  are  subject  to  administrative  penalties,  civil  money  penalties  and  criminal  prosecution, 
including corporate fines and personal liability.

Regulation of Promotion, Marketing and Distribution of Pharmaceutical Products and Medical Devices

Certain of our services are subject to detailed and comprehensive regulation in each geographic market in which we operate. 
Such regulation relates, among other things, to the distribution of drug samples, the marketing and promotion of approved products, the 
qualifications of sales representatives and the use of healthcare professionals in sales functions.

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In the United States, certain of our services are subject to numerous federal and state laws pertaining to promotional activities 
involving pharmaceutical products and medical devices. Certain of our services are subject to the FDA’s regulations against “off-label 
promotion,”  which  require  sales  representatives  to  restrict  promotion  of  the  approved  product  they  are  detailing  to  the  approved 
labeling  for  the  product.  The  Prescription  Drug  Marketing  Act  imposes  licensing,  personnel  record  keeping,  packaging,  labeling, 
product  handling  and  facility  storage  and  security  requirements.  Other  federal  and  state  laws  prohibit  manufacturers,  suppliers  and 
providers  from  offering,  giving  or  receiving  kickbacks  or  other  remuneration  in  connection  with  ordering  or  recommending  the 
purchase or rental of healthcare items and services. The sale or distribution of pharmaceutical products and devices is also governed by 
the United States Federal Trade Commission Act and state consumer protection laws. We are subject to similar regulations currently in 
effect in the other countries where we offer Contract Sales & Medical Solutions.

We  are  also  subject  to  various  laws  and  regulations  that  may  apply  to  certain  drug  and  device  promotional  practices, 
including, among others, various aspects of Medicare and federal healthcare programs. Violations of these laws and regulations may 
result in criminal and/or civil penalties, including possibly as an “aider and abettor.”

Regulation of Laboratories

Our United States laboratories are subject to licensing  and regulation under federal, state and local laws relating to hazard 
communication and employee right-to-know regulations, and the safety and health of laboratory employees. Additionally, our United 
States laboratories are subject to applicable federal and state laws and regulations and licensing requirements relating to the handling, 
storage  and  disposal  of  hazardous  waste,  radioactive  materials  and  laboratory  specimens,  including  the  regulations  of  the 
Environmental  Protection  Agency,  the  Nuclear  Regulatory  Commission,  the  Department  of  Transportation,  the  National  Fire 
Protection Agency and the United States Drug Enforcement Administration (“DEA”). The use of controlled substances in testing for 
drugs with a potential for abuse is regulated in the United States by the DEA and by similar regulatory bodies in other parts of the 
world. Our United States laboratories using controlled substances for testing purposes are licensed by the DEA. The regulations of the 
United  States  Department  of  Transportation,  Public  Health  Service  and  Postal  Service  apply  to  the  surface  and  air  transportation  of 
laboratory  specimens.  Our  laboratories  also  are  subject  to    International  Air  Transport  Association  regulations,  which  govern 
international shipments of laboratory specimens. Furthermore, when the materials are sent to a foreign country, the transportation of 
such materials becomes subject to the laws, rules and regulations of such foreign country. Our laboratories outside the United States 
are subject to applicable national laws governing matters such as licensing, the handling and disposal of medical specimens, genetic 
material, hazardous waste and radioactive materials, as well as the health and safety of laboratory employees.

In  addition  to  its  comprehensive  regulation  of  safety  in  the  workplace,  the  United  States  Occupational  Safety  and  Health 
Administration has established extensive requirements relating to workplace safety for healthcare employers whose workers may be 
exposed to blood-borne pathogens such as HIV and the hepatitis B virus. Although we believe that we are currently in compliance in 
all material respects with such federal, state and local laws, failure to comply with such laws could subject us to denial of the right to 
conduct business, fines, criminal penalties and other  enforcement actions.

Further, laboratories that analyze human blood or other biological samples for the diagnosis and treatment of clinical trial 
subjects must comply with Clinical Laboratory Improvement Amendments (“CLIA”), as well as requirements established by various 
states. The failure to meet these requirements may result in civil penalties and suspension or revocation of the CLIA certification.

Our Intellectual Property

In  addition  to  our  proprietary  data  sets  described  above,  we  develop  and  use  a  number  of  proprietary  methodologies, 
analytics, systems, technologies and other intellectual property in the conduct of our business. We rely upon a combination of legal, 
technical, and administrative safeguards to protect our proprietary and confidential information and trade secrets, and patent, copyright 
and trademark laws to protect other intellectual property rights. We consider our trademark and related names, marks and logos to be of 
material importance to our business, and we have registered or applied for registration for certain of these trademarks including IQVIA, 
in  the  United  States  and  other  jurisdictions  and  aggressively  seek  to  protect  them.  Trademarks  and  service  marks  generally  may  be 
renewed indefinitely so long as they are in use and/or their registrations are properly maintained, and so long as they have not been 
found to have become generic. The technology and other intellectual property rights owned and licensed by us are of importance to our 
business, although our management believes that our business, as a whole, is not dependent upon any one intellectual property or group 
of such properties.

12

 
 
 
 
 
 
Human Capital

Overview.  Our  approximately  70,000  employees  help  us  drive  our  business  success  and  achieve  our  ambition  to  advance 
human  health.  We  are  a  diverse  global  team  that  shares  a  passion  for  collaboration  and  solving  complex  problems.  Our  workforce  is 
comprised of a wide variety of professionals, including clinicians, data scientists, epidemiologists, and more.

Our  culture  is  one  in  which  employees  are  encouraged  to  apply  their  insight,  curiosity,  and  intellectual  courage  across 
everything they do. The way we manage our people and the programs we offer our employees reflect our commitment to fostering this 
culture of empowerment and engagement. 

Each one of our employees provide value, no matter where they sit within the organization. We are committed to creating an 
environment where all employees are respected and heard, where people from all backgrounds can contribute to and share in our growth, 
and where opportunity and advancement is available to everyone. 

Employee Engagement. In 2020, we completed our second company-wide employee survey since the Merger between 

Quintiles and IMS Health in 2016. The survey provided a valuable opportunity to hear the perspectives of our workforce around the 
world.

In 2020, responses increased for this survey, and 81% of respondents indicated a favorable view of the Company's employee 
engagement, which was a 13 percentage point increase from our last company-wide employee survey in 2018, 4 points  higher than the 
Fortune 500 benchmark and 5 points higher than the broader survey benchmark. The survey results indicate the actions we have taken 
over  the  past  two  years  have  had  a  positive  impact.  Other  areas  where  we  saw  favorable  scores  were:  Employees  acquiring  the 
knowledge  and  skills  needed  to  be  effective  in  their  jobs  (84%);  employees  feeling  part  of  a  team  (84%);  and  employees  who  would 
recommend IQVIA as a great place to work (81%). 

Protection and Support of our Employees During the COVID-19 Pandemic.  As a company, we did our best to support our 
employees,  preserve  employment  and  maintain  base  compensation  throughout  the  year.  We  accepted  that  our  financial  performance 
would be affected by the pandemic, but declined to make dramatic cuts that would impact the lives of our employees. We also launched 
the IQVIA Cares program to provide over $1 million of financial assistance to approximately 2,200 employees facing financial hardship 
resulting from the crisis. This program was entirely funded by our directors, senior leaders and other employees from around the world 
voluntarily  forgoing  a  portion  of  their  pay  for  a  period  of  time.  We  continued  to  build  a  strong  supportive  culture  around  values  of 
mutual respect and pride in the important work we do. This will endure far beyond the crisis.

The safety of employees, patients, healthcare professionals, customers and suppliers with whom we frequently interact was our 
highest priority as COVID-19 spread across the globe.  To limit exposure, we substantially restricted travel, supplied personal protective 
equipment to field-based employees, closed facilities and asked most of our staff to work remotely. On short notice, we added bandwidth 
and VPN capacity to our advanced infrastructure to enable 95% of our employees at the peak of the pandemic to work remotely and 
avoid  service  disruptions.    At  the  same  time,  we  continued  to  maintain  and  enhance  our  cybersecurity  protections,  which  included 
completing the global roll-out of our core Endpoint Detection & Response solution to all workstations, thus protecting them from cyber 
threats  regardless  of  location  and  network  status  (on  or  off  VPN),  and  accelerating  the  deployment  of  an  Advance  Response  tool  to 
enable bulk remediation of vulnerabilities on remote workstations.

Diversity and Inclusion.  Our commitment to diversity and inclusion is reflected in the various policies, programs, training and 
support  we  offer,  including  our  Employee  Resource  Groups,  manager  diversity  and  inclusion  training  and  our  highly  diverse  global 
workforce.

Our global workforce operates in over 100 countries and represents approximately 80 different ethnicities. In the United States, 
approximately 63% of our employees identify as white and approximately 37% and 11% identify as non-White and Black or African 
American, respectively.  Approximately 59% of our employees globally are female and approximately 51% of employees worldwide at a 
manager level are female. 

Our growing network of Employee Resource Groups (ERGs) provides a framework for employees to connect and collaborate 
with colleagues with similar interests. These groups support our values and business goals and foster the diverse thinking required for 
innovation. They provide a forum for the exchange of ideas and opportunities for mentoring and professional development.

13

There are five global ERGs—all are employee-led, voluntary, and open to every employee. Each ERG has a mission that is 

aligned to our vision, values, and core operating principles.

•

•

•

•

Black,  Asian,  and  Minority  Ethnic  Network  Group  (BAME):  connects  employees  to  provide  a  sense  of  community  to 
support  in  the  professional  and  personal  development  of  Black,  Asian  and  minority  ethnic  group  employees  across  the 
organization.

Emerging Professionals Group (EPG): fosters ambition and builds community among our leadership and talent pipeline for 
emerging professionals through networking, personal development, and volunteerism.

Lesbian, Gay, Bisexual and Transgender (LGBT+) Group: supports the ability for all people at IQVIA to be their authentic 
selves by fostering an inclusive, equal, and inspiring culture for LGBT+ employees.

Veterans Employee Resource Group (VERG): offers opportunities and support through the IQVIA community to its veteran 
and active service members and family.

• Women  Inspired  Network  (WIN):  fosters  a  corporate  culture  that  inspires  women  to  excel  in  their  careers  at  IQVIA  and 

within the biopharma industry.

In 2020, we grew our ERG membership to more than 2,500 participants worldwide, with multiple chapters being established 
across  the  globe.  In  response  to  COVID-19,  the  ERGs  quickly  pivoted  and  moved  much  of  their  engagement  efforts  online,  hosting 
multiple virtual events and meet-ups to ensure the sense of community they provide to was not lost amid the pandemic. 

Employee Well-being.  Investing in resources and incentives to promote the personal well-being of our employees and their 
families  is  an  important  way  we  take  care  of  our  people.  As  a  digital  healthcare  company,  we  also  use  our  own  in-house  technical 
expertise to develop online tools to enable our employees to access resources quickly and seamlessly.  

We provide a variety of health and welfare benefit plans that are available to employees and their family members, based on 

their location and specific country regulations. Plans may include medical, dental, and vision coverage; telemedicine and on-site medical 
care; critical illness coverage; disability, accidental death and dismemberment, pet and life insurance; tuition reimbursement; identity 
theft protection; commuter benefits; matching gift programs; and locally relevant savings and retirement plans such as pensions and 
401(k) plans.

We  provide  parental  leave  for  all  full-time  employees  for  the  birth  or  adoption  of  a  child,  with  variability  in  leave  time 
dependent on location. We also provide paid leave for other life matters including sick time, bereavement, jury duty, military service, 
and time off for voting, depending on country specific policies.  

Beyond health and welfare benefits, many regions also offer employee wellness programs.  In the United States, our “Healthy 
You” wellness program offers employees a range of wellness benefits, including free flu shots, teledoc services, nutrition counseling, 
tobacco cessation support and reimbursement for wellness-related expenses. 

Our Employee Assistance Program (EAP) is available to approximately 70% of our workforce worldwide. Our EAP is a free 
and voluntary program that offers confidential mental and emotional well-being support, including assessments, counseling, and follow-
up services. In 2020, employees were faced with new and difficult burdens as the COVID-19 pandemic upended nearly everyone’s life. 
As  the  year  unfolded,  we  saw  an  urgent  need  to  address  and  assist  all  employees  in  helping  them  build  resilience  in  response  to  the 
ongoing pandemic. As a result, we accelerated our plans to roll out our EAP to the remainder of our workforce. This acceleration will 
make  support  available  to  our  entire  global  workforce  in  the  second  quarter  of  2021  through  a  network  of  existing  and  new  EAP 
programs and programs included in local benefit packages. In addition, we are exploring a training program for all managers on how to 
support team members who may be affected by the pandemic. 

Compensation and Benefits.   IQVIA compensation programs support our overall strategy by linking employee compensation 
with both business and personal performance.  This approach to compensation demonstrates our “pay for performance” philosophy, as 
well as our focus on providing compensation program that attract, retain and motivate and reward employees.  In addition to the benefits 
described above, our compensation programs include base salaries, annual bonuses, and long-term incentive awards.

14

Talent and Learning.  Helping our people grow, develop, and reach their full potential is a key component of our management 

approach. Nurturing talent is critical in a highly competitive industry, and it also keeps our employees motivated and engaged. 

We invest in our employees’ development throughout their careers at IQVIA through our various talent and learning initiatives. 
Our strategy is focused on supporting business growth, optimizing our offerings through enhanced digital tools, and building the future 
leaders of IQVIA. At the same time, we are working to transform the employee experience and evolve our performance management 
approach  to  be  more  responsive  to  our  employees’  experiences.  Mirroring  our  overall  culture,  our  approach  to  talent  and  learning  is 
underpinned by the philosophy of empowerment, and we encourage all employees to take ownership of their careers. 

We offer a suite of formal and informal learning opportunities, many which focus on business specific topics such as regulatory 

compliance, technology, analytics, clinical and therapy areas, and more. 

We want our employees to have meaningful careers, and we are committed to the idea that career development is a result of 
growth  through  new  experiences.  To  foster  this  growth,  we  engage  employees  on  their  purpose,  strengths,  and  agility.  We  encourage 
employees  to  remain  curious  and  flexible  towards  their  career,  exploring  opportunities  across  the  organization.  Employees  take 
ownership for their development in partnership with managers, mentors, and others. Similarly, performance management is driven by 
ongoing conversations about priorities, contributions and development. 

In 2020, we also introduced our Future Leaders Program, a robust training aimed to develop the next generation of leadership at 
IQVIA.  More  than  60  attendees  from  18  countries  were  chosen  to  take  part  in  this  four-month  program.  In  light  of  COVID-19,  we 
rapidly adapted the program design to make it a fully virtual experience. Sessions consisted of live webinars co-led by senior executives, 
peer coaching, projects, and skills assessments. Feedback was positive, and we will bring together two more cohorts in 2021, targeting 
nearly 100 more participants from around the world. 

Health and Safety.  Ensuring the health and safety of our employees is essential, whether they work in our corporate offices or 

labs. We strive to create a culture of safety so our employees can remain healthy and productive. 

We  incorporate  environmental  laws  and  regulations  into  our  policies  and  procedures  throughout  our  organization.  At  the 
corporate level, we have group certifications to ISO 14001:2015 and ISO45001: 2018. In accordance with both certifications, we have a 
robust, integrated Environmental, Health and Safety Management System (EHSMS) with supporting standard operating procedures in 
place, which demonstrates our commitment to continuous improvement. Under our EHSMS, all employees must actively participate in 
helping  to  maintain  a  safe,  healthy,  and  secure  work  environment.  Our  Code  of  Conduct  describes  the  obligations  of  employees  to 
maintain such an environment, follow all applicable safety and security rules and complete required training. 

Q2 Solutions, our joint venture with Quest Diagnostics, operates laboratories in the United States, United Kingdom, Singapore, 

India, Japan, and China. Q2 facilities are certified to ISO 14001:2015 and ISO45001: 2018. Depending on the location and services 
provided accreditation also will include ISO 14001, CAP ISO 15189, ISO 9001, NGSP Level 1, ANVISA, ISO45001, CDC Lipids, 
CLIA, MOH Certified Laboratory.   

Available Information

Our website address is www.iqvia.com, and our investor relations website is located at http://ir.iqvia.com. Information on our 
website is not incorporated by reference herein. Copies of our annual reports on Form 10-K, quarterly reports on Form 10-Q, current 
reports on Form 8-K and our Proxy Statements for our annual meetings of stockholders, and any amendments to those reports, as well 
as Section 16 reports filed by our insiders, are available free of charge on our website as soon as reasonably practicable after we file the 
reports with, or furnish the reports to, the Securities and Exchange Commission (“SEC”). In addition, the SEC maintains an Internet 
site  (http://www.sec.gov)  containing  reports,  proxy  and  information  statements,  and  other  information  regarding  issuers  that  file 
electronically with the SEC. Information on the SEC’s website does not constitute part of this report. Also posted on our website are 
our  certificate  of  incorporation  and  by-laws,  the  charters  for  our  Audit  Committee,  Leadership  Development  and  Compensation 
Committee and Nominating and Governance Committee, our Corporate Governance Guidelines, and our Code of Conduct governing 
our directors, officers and employees. Copies of our SEC reports and corporate governance information are available in print upon the 
request of any stockholder to our Investor Relations Department. Within the time period required by the SEC and the New York Stock 
Exchange (“NYSE”), we will post on our website any amendment to the Code of Conduct or any waiver of such policy applicable to 
any of our senior financial officers, executive officers or directors.

15

 
Item 1A. Risk Factors

RISK FACTORS

We operate in a rapidly changing environment that involves a number of risks, some of which are beyond our control. You 
should  consider  carefully  the  risks  and  uncertainties  described  below  together  with  the  other  information  included  in  this  Annual 
Report on Form 10-K, including our consolidated financial statements and related notes included elsewhere in this Annual Report on 
Form 10-K, in evaluating our Company. The occurrence of any of the following risks may materially and adversely affect our business, 
financial condition, results of operations and future prospects.

Summary of Risk Factors

Below is a summary of some of the principal risks that could adversely affect our business, operations and financial results:

Risks Relating to Our Business

•
•
•

•

•

•

•

•

Our business and operations may be adversely affected by the COVID-19 pandemic.
The potential loss or delay of contracts could adversely affect our results.
Our financial results may be adversely affected if we underprice our contracts, overrun our cost estimates or fail to receive 
approval for or experience delays in documenting change orders.
Failure to meet productivity objectives under our internal business transformation initiatives could adversely impact our 
competitiveness and harm our operating results.
If we are unsuccessful at investing in growth opportunities and are unable to develop and market new services or enter new 
markets, our growth, results of operations or financial condition could be adversely affected.
If we are unable to successfully identify, acquire and integrate existing businesses, services and technologies, our business, 
results of operations and financial condition could be adversely impacted.
If we are unable to attract suitable investigators and patients for our clinical trials, our clinical development business might 
suffer.
If we lose the services of key personnel or are unable to recruit additional qualified personnel, our business could be adversely 
affected.

Intellectual Property

• We depend on third parties for data and support services. Our suppliers or providers might restrict our use of or refuse to 

license data or provide services, which could lead to our inability to access certain data or provide certain services and, as a 
result, materially and adversely affect our operating results and financial condition.
Our success depends on our ability to protect our intellectual property rights.

•
• We may be subject to claims by others that we are infringing on their intellectual property rights.
• We rely on licenses from third parties to certain technology and intellectual property rights for some of our services and the 

licenses we currently have could terminate or expire.

IT systems and Information

•

Security breaches and unauthorized use of our IT systems and information could expose us, our clients, our data suppliers or 
others to risk of loss.

• We may experience challenges with the acquisition, development, enhancement or deployment of technology necessary for our 

•

•

business.
Our business depends on the continued effectiveness and availability of our information systems, including the information 
systems we use to provide our services to our clients.
Data protection, privacy and similar laws restrict access, use and disclosure of personal information, and failure to comply with 
these laws could materially harm our business.

Client Risks
•

Consolidation in the industries in which our clients operate may reduce the volume of services purchased by consolidated 
clients following an acquisition or merger.

• We may be adversely affected by client or therapeutic concentration.
•

Our relationships with existing or potential clients who are in competition with each other may adversely impact the degree to 
which other clients or potential clients use our services.

16

 
•

There is a risk that we may initiate a clinical trial for a client, and then the client becomes unwilling or unable to fund the 
completion of the clinical trial, and we may be ethically bound to complete or wind down the clinical trial at our own expense.

Market Forces

•

•
•

•

Disruptions in the credit and capital markets and unfavorable general economic conditions could negatively affect our business, 
results of operations and financial condition.
Our effective income tax rate may fluctuate for a variety of reasons.
Changes in accounting standards issued by the Financial Accounting Standards Board (“FASB”) or other standard-setting 
bodies may adversely affect our financial statements.
Due to the global nature of our business we are subject to international economic, political and other risks that could negatively 
affect our results of operations and financial condition.

Liability Exposure

•
Our Research & Development Solutions business could subject us to potential liability.
•
Our Contract Sales & Medical Solutions business could result in liability to us if a drug causes harm to a patient.
Our insurance may not cover all of our indemnification obligations and other liabilities associated with our operations.
•
• We may make mistakes in conducting a clinical trial that could negatively impact the usefulness of the clinical trial which 

•

could subject us to significant costs or liability.
If we fail to perform our services in accordance with contractual requirements, regulatory standards and ethical considerations, 
we could be subject to significant costs or liability.

Risks Relating to Our Industry

•
•

The biopharmaceutical services industry is highly competitive.
Outsourcing trends in the biopharmaceutical industry and changes in aggregate spending and research and development 
budgets could adversely affect our operating results and growth rate.
• We may be affected by healthcare reform and potential additional reforms.
•

Actions by government regulators or clients to limit a prescription’s scope or withdraw an approved drug from the market 
could affect our business and result in a loss of revenues.
If we do not keep pace with rapid technological changes, our services may become less competitive or obsolete.
Laws restricting biopharmaceutical sales and marketing practices may adversely impact demand for our services.

•
•

Risks Relating to Our Indebtedness

•

Restrictions imposed in the Senior Secured Credit Facilities (as defined below) and other outstanding indebtedness, including 
the indentures governing outstanding notes issued by our wholly owned subsidiary IQVIA Inc., may limit our ability to operate 
our business and to finance our future operations or capital needs or to engage in other business activities.
Restrictive covenants in our other indebtedness may limit our flexibility in our current and future operations.
•
•
Interest rate fluctuations and our ability to deduct interest expense may affect our results of operations and financial condition.
• We may be adversely affected by changes in the method of determining the London Interbank Offered Rate (“LIBOR”), or the 

replacement of LIBOR with an alternative reference rate.

Risks Related to Ownership of Our Common Stock

•

•
•

Provisions of the corporate governance documents of IQVIA could make an acquisition of IQVIA difficult and may prevent 
attempts by its stockholders to replace or remove its management, even if beneficial to its stockholders.
Our operating results and share price may be volatile, which could cause the value of our stockholders’ investments to decline.
Our certificate of incorporation contains a provision renouncing any interest and expectancy in certain corporate opportunities 
identified by certain parties.

For a more complete discussion of the material risk facing our business, see below.

17

Risks Relating to Our Business

Our business and operations has been and may in the future be adversely affected by the novel coronavirus (COVID-19) pandemic.

The outbreak of the novel coronavirus, or COVID-19, and the various governmental, industry and consumer actions related 
thereto, could have a material and adverse effect on our business, financial condition and results of operations. These effects, which 
largely depend on future developments that cannot be accurately predicted and are uncertain, could include a negative impact on the 
availability of our key personnel, temporary closures of our facilities or the facilities of our business partners, customers, suppliers, 
third party service providers or other vendors, an increased risk of customer defaults or delays in payments or purchasing decisions, 
and the interruption of domestic and global supply chains, distribution channels, liquidity and capital or financial markets.

As  COVID-19  continues  to  spread,  we  have  and  may  in  the  future  experience  disruptions  that  could  severely  impact  our 

business, including:

•

•

•

•

•

•

closure or inaccessibility of clinical site locations;

delays or difficulties in enrolling patients in our clinical trials and starting new clinical trials;

delays or difficulties in clinical site initiation, including difficulties in recruiting clinical site investigators and clinical 
site staff;

interruption of key clinical trial activities, such as clinical trial site monitoring, due to limitations on travel imposed or 
recommended by federal or state governments, employers and others;

delays in receiving approval from local regulatory authorities to initiate our planned clinical trials; and

significant disruption in our businesses that rely on face-to-face interactions or are dependent on in-person gatherings, 
events or conferences.

In addition, we have directed a substantial portion of our workforce to work from home while the outbreak persists in order 
to help minimize the risk of COVID-19 to our employees. Having a significant portion of our workforce working from home could 
cause an increased risk of loss of productivity, greater cybersecurity risk, and increased risk to our system of internal controls over 
financial reporting.

Further,  the  effects  of  the  pandemic  may  also  increase  our  cost  of  capital  or  make  additional  capital  more  difficult  or 

available only on terms less favorable to us.

The potential loss or delay of our large contracts or of multiple contracts could adversely affect our results.

Most of our Research & Development Solutions clients can terminate our contracts upon 30 to 90 days notice. Our clients 

may delay, terminate or reduce the scope of our contracts for a variety of reasons beyond our control, including but not limited to:

•

•

•

•

•

•

•

•

•

decisions to forego or terminate a particular clinical trial;

lack of available financing, budgetary limits or changing priorities;

actions by regulatory authorities;

production problems resulting in shortages of the drug being tested;

failure of products being tested to satisfy safety requirements or efficacy criteria;

unexpected or undesired clinical results for products;

insufficient patient enrollment in a clinical trial;

insufficient investigator recruitment;

shift of business to a competitor or internal resources;

18

 
•

•

product withdrawal following market launch; or

shut down of manufacturing facilities.

The COVID-19 pandemic, or a similar global event, could also exacerbate many of the above situations and cause delays, 
changes  in  scope  or  cancellation  of  our  contracts.  As  a  result,  contract  terminations,  delays  and  alterations  are  a  regular  part  of  our 
Research & Development Solutions business. In the event of termination, our contracts often provide for fees for winding down the 
project, but these fees may not be sufficient for us to realize the full amount of revenues or profits anticipated under the related services 
contracts, and termination may result in lower resource utilization rates. In addition, we will not realize the full benefits of our backlog 
of contractually committed services if our clients cancel, delay or reduce their commitments under our contracts with them, which may 
occur if, among other things, a client decides to shift its business to a competitor or revoke our status as a preferred provider. Thus, the 
loss  or  delay  of  a  large  contract  or  the  loss  or  delay  of  multiple  contracts  could  adversely  affect  our  revenues  and  profitability.  We 
believe  the  risk  of  loss  or  delay  of  multiple  contracts  potentially  has  greater  effect  where  we  are  party  to  broader  partnering 
arrangements with global biopharmaceutical companies.

We depend on third parties for data and support services. Our suppliers or providers might restrict our use of or refuse to 
license data or provide services, which could lead to our inability to access certain data or provide certain services and, as a result, 
materially and adversely affect our operating results and financial condition.

Each of our Technology & Analytics Solutions information services is derived from data we collect from third parties. These 

data suppliers are numerous and diverse, reflecting the broad scope of information that we collect and use in our business.

Although we typically enter into long-term contractual arrangements with many of these suppliers of data, at the time of entry 
into a new contract or renewal of an existing contract, suppliers may increase restrictions on our use of such data, increase the price 
they charge us for data or refuse altogether to license the data to us. In addition, during the term of any data supply contract, suppliers 
may fail to adhere to our data quality control standards or fail to deliver data. Further, although no single individual data supplier is 
material to our business, if a number of suppliers collectively representing a significant amount of data that we use for one or more of 
our  services  were  to  impose  additional  contractual  restrictions  on  our  use  of  or  access  to  data,  fail  to  adhere  to  our  quality-control 
standards,  repeatedly  fail  to  deliver  data  or  refuse  to  provide  data,  now  or  in  the  future,  our  ability  to  provide  those  services  to  our 
clients could be materially adversely impacted, which may harm our operating results and financial condition.

Additionally,  we  depend  on  third  parties  for  support  services  to  our  business.  Such  support  services  include,  but  are  not 
limited to, third- party transportation providers, suppliers of drugs for patients participating in clinical trials, suppliers of kits for use in 
our clinical trial laboratories business, suppliers of reagents for use in our testing equipment and providers of maintenance contracts for 
our equipment. The failure of any of these third parties to adequately provide the critical support services could have a material adverse 
effect on our business.

If  we  fail  to  perform  our  services  in  accordance  with  contractual  requirements,  regulatory  standards  and  ethical 

considerations, we could be subject to significant costs or liability and our reputation could be harmed.

We contract with biopharmaceutical companies to perform a wide range of services to assist them in bringing new drugs to 
market.  Our  services  include  monitoring  clinical  trials,  data  and  laboratory  analysis,  electronic  data  capture,  patient  recruitment  and 
other related services, and we perform these services in a number of ways, including through physical and technology-enabled efforts. 
Such services are complex and subject to contractual requirements, regulatory standards and ethical considerations. For example, we 
must adhere to regulatory requirements such as the FDA and current GCP and Good Laboratory Practice requirements. If we fail to 
perform our services in accordance with these requirements, regulatory agencies may take action against us for failure to comply with 
applicable  regulations  governing  clinical  trials  or  sales  and  marketing  practices.  Such  actions  may  include  sanctions,  such  as 
injunctions  or  failure  of  such  regulatory  authorities  to  grant  marketing  approval  of  products,  delay,  suspension  or  withdrawal  of 
approvals, license revocation, product seizures or recalls, operational restrictions, civil or criminal penalties or prosecutions, damages 
or fines. Clients may also bring claims against us for breach of our contractual obligations and patients in the clinical trials and patients 
taking drugs approved on the basis of those clinical trials may bring personal injury claims against us for negligence. Any such action 
could have a material adverse effect on our results of operations, financial condition and reputation.

Such consequences could arise if, among other things, the following occur:

19

 
 
 
 
 
 
 
 
Improper performance of our services. The performance of clinical development services is complex and time-consuming. 
For example, we may make mistakes in conducting a clinical trial that could negatively impact or obviate the usefulness of the clinical 
trial or cause the results of the clinical trial to be reported improperly. If the clinical trial results are compromised, we could be subject 
to significant costs or liability, which could have an adverse impact on our ability to perform our services. As examples:

•

•

•

non-compliance generally could result in the termination of ongoing clinical trials or sales and marketing projects 
or the disqualification of data for submission to regulatory authorities;

compromise  of  data  from  a  particular  clinical  trial,  such  as  failure  to  verify  that  informed  consent  was  obtained 
from patients, could require us to repeat the clinical trial under the terms of our contract at no further cost to our 
client, but at a substantial cost to us; and

breach of a contractual term could result in liability for damages or termination of the contract.

Large clinical trials can cost up to hundreds of millions of dollars, and while we endeavor to contractually limit our exposure 
to such risks, improper performance of our services could have an adverse effect on our financial condition, damage our reputation and 
result in the cancellation of current contracts by or failure to obtain future contracts from the affected client or other clients.

Investigation of clients. From time to time, one or more of our clients are audited or investigated by regulatory authorities or 
enforcement agencies with respect to regulatory compliance of their clinical trials, programs or the marketing and sale of their drugs. In 
these situations, we have often provided services to our clients with respect to the clinical trials, programs or activities being audited or 
investigated, and we are called upon to respond to requests for information by the authorities and agencies. There is a risk that either 
our clients or regulatory authorities could claim that we performed our services improperly or that we are responsible for clinical trial 
or program compliance. If our clients or regulatory authorities make such claims against us and prove them, we could be subject to 
damages, fines or penalties. In addition, negative publicity regarding regulatory compliance of our clients’ clinical trials, programs or 
drugs could have an adverse effect on our business and reputation.

Insufficient  client  funding  to  complete  a  clinical  trial.  As  noted  above,  clinical  trials  can  cost  hundreds  of  millions  of 
dollars.  There  is  a  risk  that  we  may  initiate  a  clinical  trial  for  a  client,  and  then  the  client  becomes  unwilling  or  unable  to  fund  the 
completion of the clinical trial. In such a situation, notwithstanding the client’s ability or willingness to pay for or otherwise facilitate 
the completion of the clinical trial, we may be ethically bound to complete or wind down the clinical trial at our own expense.

Security  breaches  and  unauthorized  use  of  our  IT  systems  and  information,  or  the  IT  systems  or  information  in  the 

possession of our vendors, could expose us, our clients, our data suppliers or others to risk of loss.

We rely upon the security of our computer and communications systems infrastructure to protect us from cyberattacks and 
unauthorized  access.  Cyberattacks  can  include  malware,  computer  viruses,  hacking  or  other  significant  disruption  of  our  computer, 
communications  and  related  systems.  Cyber  threats  are  rapidly  evolving  and  are  becoming  increasingly  sophisticated.  Despite  our 
efforts  to  ensure  the  integrity  of  our  systems,  as  cyber  threats  evolve  and  become  more  difficult  to  detect  and  successfully  defend 
against, one or more cyber threats might defeat the measures that we or our vendors take to anticipate, detect, avoid or mitigate such 
threats. Certain techniques used to obtain unauthorized access, introduce malicious software, disable or degrade service, or sabotage 
systems may be designed to remain dormant until a triggering event and we may be unable to anticipate these techniques or implement 
adequate preventative measures since techniques change frequently or are not recognized until launched, and because cyberattacks can 
originate from a wide variety of sources. Although we take steps to manage and avoid these risks and to prevent their recurrence, our 
preventive and remedial actions may not be successful. Such attacks, whether successful or unsuccessful, could result in our incurring 
costs  related  to,  for  example,  rebuilding  internal  systems,  defending  against  litigation,  responding  to  regulatory  inquiries  or  actions, 
paying damages or fines, or taking other remedial steps with respect to third parties. Publicity about vulnerabilities and attempted or 
successful incursions could damage our reputation with clients and data suppliers and reduce demand for our services.

We  also  store  proprietary  and  sensitive  information  in  connection  with  our  business,  which  could  be  compromised  by  a 
cyberattack. To the extent that any disruption or security breach results in a loss or damage to our data, an inappropriate disclosure of 
proprietary or sensitive  information, an inability to access data sources, or an inability to process data or provide our offerings to our 
clients, it could cause significant damage to our reputation, affect our relationships with our data suppliers and clients (including loss of 
suppliers  and  clients),  lead  to  claims  against  us  and  ultimately  harm  our  business.  We  may  be  required  to  incur  significant  costs  to 
alleviate, remedy or protect against damage caused by these disruptions or security breaches in the future. We may also face inquiry or 

20

 
 
 
 
 
 
 
increased  scrutiny  from  government  agencies  as  a  result  of  any  such  disruption  or  breach.  While  we  have  insurance  coverage  for 
certain instances of a cyber security breach, our coverage may not be sufficient if we suffer a significant attack or multiple attacks. Any 
such breach or disruption could have a material adverse effect on our operating results and our reputation as a service provider.

Some of our vendors have significant responsibility for the security of certain of our data centers and computer-based 
platforms  or  software-as-a-service  (SaaS)  applications  upon  which  our  businesses  rely  to  host  or  process  data  or  to  perform 
various  functions.  Also,  our  data  suppliers  have  responsibility  for  security  of  their  own  computer  and  communications 
environments. These third parties face risks relating to cyber security similar to ours, which could disrupt their businesses and 
therefore materially impact ours. Accordingly, we are subject to any flaw in or breaches to their computer and communications 
systems  or  those  that  they  operate  for  us,  which  could  result  in  a  material  adverse  effect  on  our  business,  operations  and 
financial results.

Failure to meet productivity objectives under our internal business transformation initiatives could adversely impact our 

competitiveness and harm our operating results.

We  are  pursuing  business  transformation  initiatives  to  update  technology,  increase  innovation  and  obtain  operating 
efficiencies.  As  part  of  these  initiatives,  which  include  accelerating  site  start-up  timelines  and  improving  our  customer  buying 
experience, we seek to improve our productivity, flexibility, quality, functionality and cost savings by investing in the development and 
implementation  of  global  platforms  and  integration  of  our  business  processes  and  functions  to  achieve  economies  of  scale.  These 
various initiatives may not yield their intended gains, or be completed in timely manner, which may impact our competitiveness and 
our ability to meet our growth objectives and, as a result, materially and adversely affect our business, operating results and financial 
condition.

If we are unsuccessful at investing in growth opportunities, our business could be materially and adversely affected.

We  continue  to  invest  significantly  in  growth  opportunities,  including  the  development  and  acquisition  of  new  data, 
technologies and services to meet our clients’ needs. For example, we are expanding our services and technology offerings, such as the 
development of a cloud-based platform with a growing number of applications to support commercial and clinical operations for life 
sciences  companies  (e.g.,  multi-channel  marketing,  marketing  campaign  management,  customer  relationship  management,  incentive 
compensation  management,  targeting  and  segmentation,  performance  management,  site  engagement  payments,  trial  master  file,  risk 
based monitoring, clinical trial management and decentralized trials and other applications). We also continue to invest significantly in 
growth  opportunities  in  emerging  markets,  such  as  the  development,  launch  and  enhancement  of  services  in  China,  India,  Russia, 
Turkey, and other countries. We consider our presence in these markets to be an important component of our growth strategy.

There is no assurance that our investment plans or growth strategy will be successful or will produce a sufficient or any return 
on our investments. Further, if we are unable to develop new technologies and services, clients do not purchase our new technologies 
and services, our new technologies and services do not work as intended or there are delays in the availability or adoption of our new 
technologies and services, then we may not be able to grow our business or growth may occur slower than anticipated. Additionally, 
although we expect continued growth in healthcare spending in emerging markets, such spending may occur more slowly or not at all, 
and we may not benefit from our investments in these markets.

We plan to fund growth opportunities with cash from operations or from future financings. There can be no assurance that 

those sources will be available in sufficient amounts to fund future growth opportunities when needed.

Any of the foregoing could have a material and adverse effect on our operating results and financial condition.

Data protection, privacy and similar laws in the United States and around the world restrict access, use and disclosure of 
personal  information,  and  failure  to  comply  with  or  adapt  to  changes  in  these  laws  could  materially  and  adversely  harm  our 
business.

The  confidentiality,  collection,  use,  retention,  security,  transfer  and  disclosure  of  personal  data,  including  individually 
identifiable  health  information  and  clinical  trial  patient-specific  information,  are  subject  to  governmental  regulation  generally  in  the 
country  that  the  personal  data  were  collected  or  used  (collectively,  "Privacy  Laws").  For  example,  United  States  federal  regulations 
under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) create specific requirements for the protection of the 
privacy  and  security  of  individual  health  information.  These  provisions  apply  to  both  “covered  entities”  (primarily  health  care 

21

 
 
 
 
 
 
 
 
 
 
providers and health insurers) and their “business associates” or service providers. As there are some instances where we are a HIPAA 
“business  associate”  of  a  “covered  entity,”  we  can  be  directly  liable  for  mishandling  protected  health  information.  Under  HIPAA’s 
enforcement  scheme,  we  can  be  subject  to  significant  penalties  in  connection  with  HIPAA  violations,  along  with  the  potential  for 
significant other expenditures related to these activities. These rules require individuals’ written authorization in many situations, in 
addition  to  any  required  informed  consent,  before  protected  health  information  may  be  used  for  research.  We  are  both  directly  and 
indirectly  affected  by  the  privacy  provisions  surrounding  individual  authorizations  because  many  investigators  with  whom  we  are 
involved  in  clinical  trials  are  directly  subject  to  them  as  a  HIPAA  “covered  entity”  and  because  we  obtain  identifiable  health 
information from third parties that are subject to such regulations. 

In general, patient health information is among the most sensitive (and highly regulated) of personal information. Privacy Laws 
in the United States and around the world are designed to ensure that information about an individual’s healthcare is properly protected 
from  inappropriate  access,  use  and  disclosure.  Privacy  Laws  also  include  the  European  Union’s  (“EU”)  General  Data  Protection 
Regulation, Canada’s Personal Information Protection and Electronic Documents Act and other data protection, privacy, data security, 
data localization and similar national, state/provincial and local laws. In the EU, personal data includes any information that relates to an 
identifiable  natural  person.    Health  information  about  an  identifiable  person  carries  additional  obligations  under  EU  law,  including 
obtaining the explicit consent from the individual for collection, use or disclosure of the information. In addition, we are subject to EU 
rules with respect to cross-border transfers of such data out of the EU (along with similar data transfer requirements or data localization 
requirements in other countries). 

We have established frameworks, models, processes and technologies to manage privacy and security for many data types, 
from a variety of sources, and under a myriad of Privacy Laws. In addition, we rely on our data suppliers to deliver information to us in 
a  form  and  in  a  manner  that  complies  with  applicable  Privacy  Laws.  These  laws  are  complex  and  there  is  no  assurance  that  the 
safeguards and controls employed by us or our data suppliers will be sufficient to prevent a breach of these laws, or that claims will not 
be filed against us or our data suppliers despite such safeguards and controls. Failure to comply with such laws, certain certification/
registration and annual re-certification/registration provisions associated with these data protection and privacy regulations, and similar 
rules  in  various  jurisdictions,  or  to  resolve  any  serious  privacy  complaints,  may  result  in,  among  other  things,  regulatory  sanctions, 
criminal  prosecution,  civil  liability,  negative  publicity,  damage  to  our  reputation,  or  data  being  blocked  from  use  or  liability  under 
contractual provisions. For example, in July 2015, indictments were issued by the Seoul Central District Prosecutors’ Office in South 
Korea  against  IMS  Korea  and  two  of  its  employees,  among  others,  alleging  improper  handling  of  sensitive  health  information  in 
violation of applicable privacy laws. See Item 3 “Legal Proceedings” for additional information.

Laws and expectations relating to privacy continue to evolve, and we continue to adapt to changing needs. For example, the 
definition  of  “personally  identifiable  information”  and  “personal  data”  continues  to  evolve  and  broaden  and  many  new  laws  and 
regulations are being enacted. In addition, certain established programs have been (or are at risk of being) declared invalid (such as the 
EU-U.S.  Privacy  Shield  framework  that  operated  for  several  years  but  was  struck  down  by  the  European  Court  of  Justice  in  July, 
2020), so that this area remains in a state of flux. Changes to these programs may adversely impact our ability to provide services to 
our clients or develop new products or services. Federal, state and foreign governments are contemplating or have proposed or adopted 
new Privacy Laws or modifications to existing Privacy Laws, including by amendment, replacement or interpretation through judicial 
or  administrative  decisions.      New  or  modified  Privacy  Laws  might,  among  other  things,  require  us  to  implement  new  security 
measures and processes or bring within the scope of the Privacy Law other data not currently regulated, each of which may require 
substantial expenditures or limit our ability to offer some of our services. Additionally, changes in Privacy Laws may limit our data 
access, use and disclosure, and may require increased expenditures by us or may dictate that we not offer certain types of services. Any 
of the foregoing may have a material adverse impact on our ability to provide services to our clients or maintain our profitability.

There is ongoing concern from privacy advocates, regulators and others regarding data protection and privacy issues, and the 
number of jurisdictions with Privacy Laws has been increasing. Also, there are ongoing public policy discussions regarding whether 
the  standards  for  de-identified,  anonymous  or  pseudonymized  health  information  are  sufficient,  and  the  risk  of  re-identification 
sufficiently  small,  to  adequately  protect  patient  privacy.  These  discussions  may  lead  to  further  restrictions  on  the  use  of  such 
information. There can be no assurance that these initiatives or future initiatives will not adversely affect our ability to access and use 
data or to develop or market current or future services.

Many Privacy Laws protect more than patient information, and although they vary by jurisdiction, these laws can extend to 
employee  information,  business  contact  information,  provider  information  and  other  information  relating  to  identifiable  individuals. 
Failure  to  comply  with  these  laws  may  result  in,  among  other  things,  civil  and  criminal  liability,  negative  publicity,  damage  to  our 

22

 
 
 
 
reputation and liability under contractual provisions. In addition, compliance with such laws may require increased costs to us or may 
dictate that we not offer certain types of services.

The occurrence of any of the foregoing could impact our ability to provide the same level of service to our clients, require us 
to modify our offerings or increase our costs, which could materially and adversely affect our operating results and financial condition.

Our success depends on our ability to protect our intellectual property rights.

Our success depends, in part, upon our ability to develop, use and protect our proprietary methodologies, analytics, systems, 
technologies  and  other  intellectual  property.  We  rely  upon  a  combination  of  trade  secrets,  confidentiality  policies,  nondisclosure, 
invention assignment and other contractual arrangements, and patent, copyright and trademark laws, to protect our intellectual property 
rights. These laws are subject to change at any time and certain agreements may not be fully enforceable, which could further restrict 
our ability to protect our innovations. Further, these laws may not provide adequate protection for our intellectual property, particularly 
in countries in which the legal system provides less protection for intellectual property rights. Our intellectual property rights may not 
prevent competitors from independently developing services similar to or duplicative of ours. Further, the steps we take in this regard 
might not be adequate to prevent or deter infringement or other misappropriation of our intellectual property by competitors, former 
employees  or  other  third  parties,  and  we  might  not  be  able  to  detect  unauthorized  use  of,  or  take  appropriate  and  timely  steps  to 
enforce, our intellectual property rights.

Our  ability  to  obtain,  protect  and  enforce  our  intellectual  property  rights  is  subject  to  general  litigation  or  third-party 
opposition risks, as well as the uncertainty as to the scope of protection, registrability, patentability, validity and enforceability of our 
intellectual property rights in each applicable country. Governments may adopt regulations, and government agencies or courts may 
render  decisions,  requiring  compulsory  licensing  of  intellectual  property  rights.  When  we  seek  to  enforce  our  intellectual  property 
rights, we may be subject to claims that the intellectual property rights are invalid or unenforceable. Litigation may be necessary in the 
future  to  enforce  our  intellectual  property  rights  and  to  protect  our  confidential  and  proprietary  information.  Litigation  brought  to 
protect and enforce our intellectual property rights could be costly, time consuming and distracting to management and could result in 
the impairment or loss of portions of our intellectual property rights. Furthermore, our efforts to enforce our intellectual property rights 
may be met with defenses, counterclaims and countersuits attacking the validity and enforceability of our intellectual property rights. 
Our inability to protect our proprietary technology against unauthorized copying or use, as well as any costly litigation or diversion of 
our management’s attention and resources, could delay further sales or the implementation of our solutions, impair the functionality of 
our solutions, delay introductions of new solutions, result in our substituting inferior or more costly technologies into our solutions, or 
injure our reputation and harm our operating results and financial condition.

The theft or unauthorized use or publication of our trade secrets and other confidential business information could reduce the 
differentiation of our services and harm our business; the value of our investment in development or business acquisitions could be 
reduced; and third parties might make claims against us related to losses of their confidential or proprietary information. In addition, 
we may not be able to discover or determine the extent of any unauthorized use of our proprietary rights. Third parties that license our 
proprietary rights also may take actions that diminish the value of our proprietary rights or reputation. The protection of our intellectual 
property  may  require  the  expenditure  of  significant  financial  and  managerial  resources.  Moreover,  the  steps  we  take  to  protect  our 
intellectual property may not adequately protect our rights or prevent third parties from infringing or misappropriating our proprietary 
rights. These incidents and claims could harm our business, reduce revenue, increase expenses and harm our reputation.

We may be subject to claims by others that we are infringing on their intellectual property rights.

Third  parties  may  assert  claims  that  we  or  our  clients  infringe  their  intellectual  property  rights  and  these  claims,  with  or 
without  merit,  could  be  expensive  to  litigate,  cause  us  to  incur  substantial  costs  and  divert  management  resources  and  attention  in 
defending  the  claim.  In  some  jurisdictions,  plaintiffs  can  also  seek  injunctive  relief  that  may  limit  the  operation  of  our  business  or 
prevent the marketing and selling of our services that infringe on the plaintiff’s intellectual property rights. To resolve these claims, we 
may enter into licensing agreements with restrictive terms or significant fees, stop selling, be required to implement costly redesigns to 
the affected services, or pay damages to satisfy contractual obligations to others. If we do not resolve these claims in advance of a trial, 
there  is  no  guarantee  that  we  will  be  successful  in  court.  These  outcomes  may  have  a  material  adverse  impact  on  our  business, 
operating results and financial condition.

23

 
 
 
 
 
 
 
In  addition,  certain  contracts  with  our  suppliers  or  clients  contain  provisions  whereby  we  indemnify,  subject  to  certain 
limitations, the counterparty for damages suffered as a result of claims related to intellectual property infringement and the use of data. 
Claims made under these provisions could be expensive to litigate and could result in significant payments.

We rely on licenses from third parties to certain technology and intellectual property rights for some of our services and 

the licenses we currently have could terminate or expire.

Some of our business services rely on technology or intellectual property rights owned and controlled by others. Our licenses 
to this technology or these intellectual property rights could be terminated or could expire. We may be unable to replace these licenses 
in a timely manner. Failure to renew these licenses, or renewals of these licenses on less advantageous terms, could harm our operating 
results and financial condition.

Our  financial  results  may  be  adversely  affected  if  we  underprice  our  contracts,  overrun  our  cost  estimates  or  fail  to 

receive approval for or experience delays in documenting change orders.

Most of our Research & Development Solutions contracts are either fee for service contracts or fixed-fee contracts. Our past 
financial  results  have  been,  and  our  future  financial  results  may  be,  adversely  impacted  if  we  initially  underprice  our  contracts  or 
otherwise overrun our cost estimates and are unable to successfully negotiate a change order. Change orders typically occur when the 
scope of work we perform needs to be modified from that originally contemplated by our contract with the client. Modifications can 
occur, for example, when there is a change in a key clinical trial assumption or parameter or a significant change in timing. Where we 
are not successful in converting out-of-scope work into change orders under our current contracts, we bear the cost of the additional 
work. Such underpricing, significant cost overruns or delay in documentation of change orders could have a material adverse effect on 
our business, results of operations, financial condition or cash flows.

The relationship of backlog to revenues varies over time.

Backlog  represents  future  revenues  for  our  Research  &  Development  Solutions  business  from  work  not  yet  completed  or 
performed  under  signed  binding  commitments  and  signed  contracts.  Once  work  begins  on  a  project,  revenue  is  recognized  over  the 
duration of the project. Projects may be terminated or delayed by the client or delayed by regulatory authorities for reasons beyond our 
control. To the extent projects are delayed, the timing of our revenue could be affected. In the event that a client cancels a contract, we 
typically would be entitled to receive payment for all services performed up to the cancellation date and subsequent client-authorized 
services related to terminating the canceled project. Typically, however, we have no contractual right to the full amount of the revenue 
reflected in our backlog in the event of a contract cancellation. The duration of the projects included in our backlog, and the related 
revenue  recognition,  range  from  a  few  weeks  to  many  years.  Our  backlog  may  not  be  indicative  of  our  future  revenues  from  our 
Research  &  Development  Solutions  business,  and  we  may  not  realize  all  the  anticipated  future  revenue  reflected  in  our  backlog.  A 
number of factors may affect backlog, including:

•

•

•

•

the size, complexity and duration of the projects;

the percentage of full services versus functional services;

the cancellation or delay of projects; and

change in the scope of work during the course of a project.

Although an increase in backlog will generally result in an increase in revenues to be recognized over time (depending on the 
level of cancellations), an increase in backlog at a particular point in time does not necessarily correspond directly to an increase in 
revenues during a particular period. The extent to which contracts in backlog will result in revenue depends on many factors, including 
but  not  limited  to  delivery  against  projected  schedules,  the  need  for  scope  changes  (change  orders),  contract  cancellations  and  the 
nature, duration, size, complexity and phase of the contracts, each of which factors can vary significantly from time to time.

The rate at which our backlog converts to revenue may vary over time for a variety of reasons. The revenue recognition on 
larger, more global projects could be slower than on smaller, less global projects for a variety of reasons, including but not limited to 
an extended period of negotiation between the time the project is awarded to us and the actual execution of the contract, as well as an 

24

 
 
 
 
 
 
 
 
 
increased timeframe for obtaining the necessary regulatory approvals. Additionally, the increased complexity of the drug development 
pipeline and the need to enroll precise patient populations could extend the length of clinical trials causing revenue to be recognized 
over a longer period of time. Further, delayed projects will remain in backlog, unless otherwise canceled by the client, and will not 
generate revenue at the rate originally expected. Thus, the relationship of backlog to realized revenues may vary over time.

Our  business  depends  on  the  continued  effectiveness  and  availability  of  our  information  systems,  including  the 

information systems we use to provide our services to our clients, and failures of these systems may materially limit our operations.

Due  to  the  global  nature  of  our  business  and  our  reliance  on  information  systems  to  provide  our  services,  we  intend  to 
increase our use of web-enabled and other integrated information systems in delivering our services. We also provide access to similar 
information systems to certain of our clients in connection with the services we provide them. As the breadth and complexity of our 
information  systems  continue  to  grow,  we  will  increasingly  be  exposed  to  the  risks  inherent  in  the  development,  integration  and 
ongoing operation of evolving information systems, including:

•

•

•

disruption, impairment or failure of data centers, telecommunications facilities or other key infrastructure platforms;

security breaches of, cyberattacks on and other failures or malfunctions in our critical application systems or their 
associated hardware; and

excessive costs, excessive delays or other deficiencies in systems development and deployment.

The materialization of any of these risks may impede the processing of data, the delivery of databases and services, and the 
day-to-day management of our business and could result in the corruption, loss or unauthorized disclosure of proprietary, confidential 
or other data. While we have disaster recovery plans in place, they might not adequately protect us in the event of a system failure. 
While many of our operations have disaster recovery plans in place, we currently do not have excess or standby computer processing 
or network capacity everywhere in the world to avoid disruption in the receipt, processing and delivery of data in the event of a system 
failure.  Despite  any  precautions  we  take,  damage  from  fire,  floods,  hurricanes,  power  loss,  telecommunications  failures,  computer 
viruses, break-ins and similar events at our various computer facilities could result in interruptions in the flow of data to our servers 
and from our servers to our clients. Corruption or loss of data may result in the need to repeat a clinical trial at no cost to the client, but 
at significant cost to us, the termination of a contract or damage to our reputation.

In  addition,  any  failure  by  our  computer  environment  to  provide  sufficient  processing  or  network  capacity  to  transfer  data 
could result in interruptions in our service. In the event of a delay in the delivery of data, we could be required to transfer our data 
collection operations to an alternative provider of server hosting services. Such a transfer could result in significant delays in our ability 
to  deliver  services  to  our  clients  and  increase  our  costs.  Additionally,  significant  delays  in  system  enhancements  or  inadequate 
performance  of  new  or  upgraded  systems  once  completed  could  damage  our  reputation  and  harm  our  business.  Finally,  long-term 
disruptions in the infrastructure caused by events such as natural disasters, the outbreak of war, the escalation of hostilities and acts of 
terrorism, particularly involving cities in which we have offices, could adversely affect our businesses. Although we carry property and 
business interruption insurance, our coverage might not be adequate to compensate us for all losses that may occur.

We  have  continued  to  undertake  significant  programs  to  optimize  business  processes  with  respect  to  our  services.  Our 
inability to effectively manage the implementation and adapt to new processes designed into new or upgraded systems in a timely and 
cost-effective manner may result in disruption to our business and negatively affect our operations.

We have entered into agreements with certain vendors to provide systems development and integration services that develop 
or license to us the IT platform for programs to optimize our business processes. If such vendors fail to perform as required or if there 
are  substantial  delays  in  developing,  implementing  and  updating  the  IT  platform,  our  client  delivery  may  be  impaired,  and  we  may 
have to make substantial further investments, internally or with third parties, to achieve our objectives. Additionally, our progress may 
be limited by parties with existing or claimed patents who seek to enjoin us from using preferred technology or seek license payments 
from us. Meeting our objectives is dependent on a number of factors which may not take place as we anticipate, including obtaining 
adequate technology-enabled services, creating IT-enabled services that our clients will find desirable and implementing our business 
model with respect to these services. Also, increased IT-related expenditures may negatively impact our profitability.

We  may  experience  challenges  with  the  acquisition,  development,  enhancement  or  deployment  of  technology  necessary 

for our business.

25

 
 
 
 
 
 
 
We operate in businesses that require sophisticated computer systems and software for data collection, data processing, cloud-
based  platforms,  analytics,  cryptography,  statistical  projections  and  forecasting,  mobile  computing,  social  media  analytics  and  other 
applications  and  technologies,  particularly  in  our  Technology  &  Analytics  Solutions  and  Research  &  Development  Solutions 
businesses. We seek to address our technology risks by increasing our reliance on the use of innovations by cross-industry technology 
leaders and adapt these for our biopharmaceutical and healthcare industry clients. Some of these technologies supporting the industries 
we serve are changing rapidly and we must continue to adapt to these changes in a timely and effective manner at an acceptable cost. 
We  also  must  continue  to  deliver  data  to  our  clients  in  forms  that  are  easy  to  use  while  simultaneously  providing  clear  answers  to 
complex questions. There can be no guarantee that we will be able to develop, acquire or integrate new technologies, that these new 
technologies will meet our needs or those of our clients’ needs or achieve expected investment goals, or that we will be able to do so as 
quickly  or  cost-effectively  as  our  competitors.  Significant  technological  change  could  render  certain  of  our  services  obsolete. 
Moreover, the introduction of new services embodying new technologies could render certain of our existing services obsolete. Our 
continued success will depend on our ability to adapt to changing technologies, manage and process ever-increasing amounts of data 
and  information  and  improve  the  performance,  features  and  reliability  of  our  services  in  response  to  changing  client  and  industry 
demands.  We  may  experience  difficulties  that  could  delay  or  prevent  the  successful  design,  development,  testing,  introduction  or 
marketing of our services. New services, or enhancements to existing services, may not adequately meet our own requirements or those 
of current and prospective clients or achieve any degree of significant market acceptance. These types of failures could have a material 
adverse effect on our operating results, financial condition and reputation.

Consolidation in the industries in which our clients operate may reduce the volume of services purchased by consolidated 

clients following an acquisition or merger, which could materially harm our operating results and financial condition.

Mergers or consolidations among our clients have in the past and could in the future reduce the number of our clients and 
potential clients. When companies consolidate, overlapping services previously purchased separately are usually purchased only once 
by the combined entity, leading to loss of revenue. Other services that were previously purchased by one of the merged or consolidated 
entities may be deemed unnecessary or cancelled. If our clients merge with or are acquired by other entities that are not our clients, or 
that use fewer of our services, they may  discontinue or reduce their use of our services. There can be no assurance as to the degree to 
which  we  may  be  able  to  address  the  revenue  impact  of  such  consolidation.  Any  of  these  developments  could  materially  harm  our 
operating results and financial condition.

We may be adversely affected by client or therapeutic concentration.

Although we did not have any client that represented 10% or more of our revenues in 2020, 2019 and 2018, we derive the 
majority  of  our  revenues  from  a  number  of  large  clients.  If  any  large  client  decreases  or  terminates  its  relationship  with  us,  our 
business, results of operations or financial condition could be materially adversely affected.

Additionally,  conducting  multiple  clinical  trials  for  different  clients  in  a  single  therapeutic  class  involving  drugs  with  the 
same or similar chemical action has in the past and may in the future adversely affect our business if some or all of the clinical trials are 
canceled  because  of  new  scientific  information  or  regulatory  judgments  that  affect  the  drugs  as  a  class  or  if  industry  consolidation 
results  in  the  rationalization  of  drug  development  pipelines.  Similarly,  marketing  and  selling  drugs  for  different  biopharmaceutical 
companies with similar chemical actions subjects us to risk if new scientific information or regulatory judgment prejudices the drugs as 
a class, which may lead to compelled or voluntary prescription limitations or withdrawal of some or all of such drugs from the market.

Our  business  is  subject  to  international  economic,  political  and  other  risks  that  could  negatively  affect  our  results  of 

operations and financial condition.

We have significant operations in countries that may require complex arrangements to deliver services throughout the world 
for our clients. Additionally, we have established operations in locations remote from our most developed business centers. As a result, 
we are subject to  heightened risks inherent in conducting business internationally, including the following:

•

required compliance with a variety of local laws and regulations which may be materially different than those to 
which  we  are  subject  in  the  United  States  or  which  may  change  unexpectedly;  for  example,  conducting  a  single 
clinical trial across multiple countries is complex, and issues in one country, such as a failure to comply with local 
regulations  or  restrictions,  may  affect  the  progress  of  the  clinical  trial  in  the  other  countries,  for  example,  by 

26

 
 
 
 
 
 
 
 
•

•

•

•

•

•

•

•

•

limiting the amount of data necessary for a clinical trial to proceed, resulting in delays or potential cancellation of 
contracts, which in turn may result in loss of revenue;

the United States or foreign countries could enact legislation or impose regulations or other restrictions, including 
unfavorable labor regulations, tax policies or economic sanctions, which could have an adverse effect on our ability 
to conduct business in or expatriate profits from the countries in which we operate, including hiring, retaining and 
overseeing qualified management personnel for managing operations in multiple countries, differing employment 
practices and labor issues, and tax-related risks, including the imposition of taxes and the lack of beneficial treaties, 
that result in a higher effective tax rate for us;

foreign  countries  are  expanding  or  may  expand  their  regulatory  framework  with  respect  to  patient  informed 
consent, protection and compensation in clinical trials, which could delay or inhibit our ability to conduct clinical 
trials in such jurisdictions;

the  regulatory  or  judicial  authorities  of  foreign  countries  may  not  enforce  legal  rights  and  recognize  business 
procedures in a manner in which we are accustomed or would reasonably expect;

local,  economic,  political  and  social  conditions,  including  potential  hyperinflationary  conditions,  political 
instability, and potential nationalization, repatriation, expropriation, price controls or other restrictive government 
actions, including changes in political and economic conditions may lead to changes in the business environment in 
which we operate, as well as changes in foreign currency exchange rates;

immigration  laws  are  subject  to  legislative  change  and  varying  standards  of  application  and  enforcement  due  to 
political  forces,  economic  conditions  or  other  events  (including  proposals  in  the  U.S.  to  change  limitations  on 
temporary  and  permanent  workers),  and  local  immigration  laws  may  require  us  to  meet  certain  other  legal 
requirements  as  a  condition  to  obtaining  or  maintaining  entry  visas,  which  may  impact  our  ability  to  provide 
services to our clients;

potential  violations  of  local  laws  or  anti-bribery  laws,  such  as  the  United  States  Foreign  Corrupt  Practices  Act 
(“FCPA”),  and  the  UK  Bribery  Act,  may  cause  difficulty  in  managing  foreign  operations,  as  well  as  significant 
consequences to us if those laws are violated;

regulatory  changes  and  economic  conditions  following  the  UK’s  exit  from  the  EU  (“Brexit”),  including 
uncertainties  as  to  its  effect  on  trade  laws,  tariffs,  instability  and  volatility  in  the  global  financial  and  currency 
markets, conflicting or redundant regulatory regimes in Europe and political stability;

clients in foreign jurisdictions may have longer payment cycles, and it may be more difficult to collect receivables 
in foreign jurisdictions; and

natural disasters, pandemics such as the COVID-19 (coronavirus), or international conflict, including terrorist acts, 
could interrupt our services, endanger our personnel, lower patient visits and increase patient drop-out rates, cause 
delays  in  recruitment  of  new  patients,  decrease  the  productivity  of  our  clinical  research  associates,  cause  other 
project delays or loss of clinical trial materials or results.

These risks and uncertainties could negatively impact our ability to, among other things, perform large, global projects for our 
clients. Furthermore, our ability to deal with these issues could be affected by applicable United States laws and the need to protect our 
assets. Any such risks could have an adverse impact on our financial condition and results of operations.

Exchange rate fluctuations may affect our results of operations and financial condition.

Because a large portion of our revenues and expenses are denominated in currencies other than the United States dollar and 
our financial statements are reported in United States dollars, changes in foreign currency exchange rates could significantly affect our 
results of operations and financial condition. Exchange rate fluctuations between local currencies and the United States dollar create 
risk in several ways, including:

27

 
 
 
•

•

Foreign  Currency  Translation  Risk.  The  revenue  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 consolidated results.

Foreign  Currency  Transaction  Risk.  We  are  subject  to  foreign  currency  transaction  risk  for  fluctuations  in 
exchange rates during the period of time between the consummation and cash settlement of a transaction. We earn 
revenue  from  our  service  contracts  over  a  period  of  several  months  and,  in  some  cases,  over  several  years. 
Accordingly,  exchange  rate  fluctuations  during  this  period  may  affect  our  profitability  with  respect  to  such 
contracts.

We may limit these risks through exchange rate fluctuation provisions stated in our service contracts, or we may hedge our 
transaction  risk  with  foreign  currency  exchange  contracts  or  options.  We  have  not,  however,  hedged  all  of  our  foreign  currency 
transaction  risk,  and  we  may  experience  fluctuations  in  financial  results  from  our  operations  outside  the  United  States  and  foreign 
currency transaction risk associated with our service contracts.

Due  to  the  global  nature  of  our  business,  we  may  be  exposed  to  liabilities  under  anti-corruption  laws,  including  the 
United States Foreign Corrupt Practices Act, the United Kingdom Bribery Act and various international anti-corruption laws, and 
any allegation or determination that we violated these laws could have a material adverse effect on our business.

We are required to comply with the FCPA, the UK Bribery Act and other international anti-corruption laws, which prohibit 
companies  from  engaging  in  bribery  including  corruptly  or  improperly  offering,  promising,  or  providing  money  or  anything  else  of 
value to non-United States officials and certain other recipients. In addition, the FCPA imposes certain books, records, and accounting 
control obligations on public companies and other issuers. We operate in parts of the world in which corruption can be common and 
compliance with anti-bribery laws may conflict with local customs and practices. Our global operations face the risk of unauthorized 
payments or offers being made by employees, consultants, sales agents, and other business partners outside of our control or without 
our  authorization.  It  is  our  policy  to  implement  safeguards  to  prohibit  these  practices  by  our  employees  and  business  partners  with 
respect to our operations. However, irrespective of these safeguards, or as a result of monitoring compliance with such safeguards, it is 
possible that we or certain other parties may discover or receive information at some point that certain employees, consultants, sales 
agents,  or  other  business  partners  may  have  engaged  in  corrupt  conduct  for  which  we  might  be  held  responsible.  Violations  of  the 
FCPA, the UK Bribery Act or other international anti-corruption laws may result in restatements of, or irregularities in, our financial 
statements as well as severe criminal or civil sanctions, and we may be subject to other liabilities, which could negatively affect our 
business, operating results  and  financial condition. In some cases, companies that violate the FCPA may be debarred by the United 
States government and/or lose their United States export privileges. Changes in anti-corruption laws or enforcement priorities could 
also result in increased compliance requirements and related costs which could adversely affect our business, financial condition and 
results  of  operations.  In  addition,  the  United  States  or  other  governments  may  seek  to  hold  us  liable  for  successor  liability  FCPA 
violations or violations of other anti-corruption laws committed by companies in which we invest or that we acquired or will acquire.

We face risks related to sales to government entities.

We  derive  a  portion  of  our  revenue  from  sales  to  government  entities  in  the  United  States.  In  general,  our  contracts  with 
United States government entities are terminable at will by the government entity at any time. Government demand and payment for 
our  services  may  be  affected  by  public-sector  budgetary  cycles  and  funding  authorizations,  including  government  shutdowns. 
Government contracts are subject to oversight, including special rules on accounting, expenses, reviews and security. Failure to comply 
with these rules could result in civil and criminal penalties and sanctions, including termination of contracts, fines and suspensions, or 
debarment  from  future  business  with  the  United  States  government.  As  a  result,  failure  to  comply  with  these  rules  could  have  an 
adverse effect on our future business, reputation, operating results and financial condition.

If we are unable to successfully develop and market new services or enter new markets, our growth, results of operations 

or financial condition could be adversely affected.

A key element of our growth strategy is the successful development and marketing of new services or entering new markets 
that  complement  or  expand  our  existing  business.  As  we  develop  new  services  or  enter  new  markets,  including  services  targeted  at 
participants  in  the  broader  healthcare  industry,  we  may  not  have  or  adequately  build  the  competencies  necessary  to  perform  such 
services  satisfactorily,  may  not  receive  market  acceptance  for  such  services  or  may  face  increased  competition.  If  we  are  unable  to 

28

 
 
 
 
 
 
 
succeed in developing new services, entering new markets or attracting a client base for our new services or in new markets, we will be 
unable  to  implement  this  element  of  our  growth  strategy,  and  our  future  business,  reputation,  results  of  operations  and  financial 
condition could be adversely affected.

Our  Research  &  Development  Solutions  business  could  subject  us  to  potential  liability  that  may  adversely  affect  our 

results of operations and financial condition.

Our  Research  &  Development  Solutions  business  involves  the  testing  of  new  drugs  on  patients  in  clinical  trials  and,  if 
marketing  approval  is  granted,  the  availability  of  these  drugs  to  be  prescribed  to  patients.  Our  involvement  in  the  clinical  trials  and 
development  process  creates  a  risk  of  liability  for  personal  injury  to  or  death  of  patients,  particularly  those  with  life-threatening 
illnesses, resulting from adverse reactions to the drugs administered during testing or after product launch, respectively. For example, 
we have from time to time been sued and may be sued in the future by individuals alleging personal injury due to their participation in 
clinical trials and seeking damages from us under a variety of legal theories. Although we maintain the types and amounts of insurance 
we view as customary in the industries and countries in which we operate, if we are required to pay damages or incur defense costs in 
connection  with  any  personal  injury  claim  that  is  outside  the  scope  of  indemnification  agreements  we  have  with  our  clients,  if  any 
indemnification  agreement  is  not  performed  in  accordance  with  its  terms  or  if  our  liability  exceeds  the  amount  of  any  applicable 
indemnification limits or available insurance coverage, our financial condition, results of operations and reputation could be materially 
and  adversely  affected.  We  maintain  professional  liability  insurance,  including  liability  for  completed  operations  coverage.  In  the 
future, we may not be able to get adequate insurance for these types of risks at reasonable rates.

We also contract with physicians to serve as investigators in conducting clinical trials. If the investigators commit errors or 
make omissions during a clinical trial that result in harm to clinical trial patients or after a clinical trial to a patient using the drug after 
it has received regulatory approval, claims for personal injury or liability damages may result. Additionally, if the investigators engage 
in fraudulent behavior, clinical trial data may be compromised, which may require us to repeat the clinical trial or subject us to liability. 
We do not believe we are legally responsible for the medical care rendered by such third-party investigators, and we would vigorously 
defend any claims brought against us. However, it is possible we could be found liable for claims with respect to the actions of third-
party investigators, which may adversely affect our financial condition, results of operations and reputation.

Some of our services involve direct interaction with clinical trial subjects or volunteers and subcontracting into a network 
of  Phase  I  clinical  facilities,  which  could  create  potential  liability  that  may  adversely  affect  our  results  of  operations,  financial 
condition and reputation.

We subcontract into  a  network of facilities where Phase I clinical trials are conducted, which ordinarily involve testing an 
investigational  drug  on  a  limited  number  of  healthy  individuals,  typically  20  to  80  persons,  to  determine  such  drug’s  basic  safety. 
Failure to operate such a facility in accordance with applicable regulations could result in that facility being shut down, which could 
disrupt our operations. Additionally, we face risks associated with adverse events resulting from the administration of such drugs to 
healthy  volunteers  and  the  professional  malpractice  of  medical  care  providers.  Any  professional  malpractice  or  negligence  by  such 
investigators, nurses or other subcontracted employees could  potentially result in liability to us in the event of personal injury to or 
death of a healthy volunteer in clinical trials, and could also cause us reputational harm. This liability, particularly if it were to exceed 
the  limits  of  any  indemnification  agreements  and  insurance  coverage  we  may  have,  may  adversely  affect  our  financial  condition, 
results of operations and reputation.

Our Contract Sales & Medical Solutions business could result in liability to us if a drug causes harm to a patient. While 

we are generally indemnified and insured against such risks, we may still suffer financial losses.

When we market drugs under contract for a biopharmaceutical company, we could suffer liability for harm allegedly caused 
by those drugs, either as a result of a lawsuit against the biopharmaceutical company to which we are joined, a lawsuit naming us or 
any  of  our  subsidiaries  or  an  action  launched  by  a  regulatory  body.  While  we  are  generally  indemnified  by  the  biopharmaceutical 
company  for  the  action  of  the  drugs  we  market  on  its  behalf,  and  we  carry  insurance  to  cover  harm  caused  by  our  negligence  in 
performing services, it is possible that we could nonetheless incur financial losses, regulatory penalties or both. In particular, any claim 
could  result  in  potential  liability  for  us  if  the  claim  is  outside  the  scope  of  the  indemnification  agreement  we  have  with  the 
biopharmaceutical  company,  the  biopharmaceutical  company  does  not  abide  by  the  indemnification  agreement  as  required  or  the 
liability exceeds the amount of any applicable indemnification limits or available insurance coverage. Such a finding could have an 
adverse impact on our financial condition, results of operations and reputation. Furthermore, negative publicity associated with harm 
caused by drugs we helped to market could have an adverse effect on our business and reputation.

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Our insurance may not cover all of our indemnification obligations and other liabilities associated with our operations.

We  maintain  insurance  designed  to  provide  coverage  for  ordinary  risks  associated  with  our  operations  and  our  ordinary 
indemnification  obligations.  The  coverage  provided  by  such  insurance  may  not  be  adequate  for  all  claims  we  may  make  or  may  be 
contested by our insurance carriers. If our insurance is not adequate or available to pay liabilities associated with our operations, or if 
we are unable to purchase adequate insurance at reasonable rates in the future, our profitability may be adversely impacted.

If we are unable to attract suitable investigators and patients for our clinical trials, our clinical development business might 

suffer.

The timely recruitment of investigators and patients for clinical trials is essential to our Research & Development Solutions 
business. Investigators are typically located at hospitals, clinics or other sites and supervise the administration of the investigational 
drug to patients during the course of a clinical trial. Patients generally include people from the communities in which the clinical trials 
are  conducted.  Our  clinical  development  business  could  be  adversely  affected  if  we  are  unable  to  attract  suitable  and  willing 
investigators  or  patients  for  clinical  trials  on  a  consistent  basis.  For  example,  if  we  are  unable  to  engage  investigators  to  conduct 
clinical  trials  as  planned  or  enroll  sufficient  patients  in  clinical  trials,  we  might  need  to  expend  additional  funds  to  obtain  access  to 
resources or else be compelled to delay or modify the clinical trial plans, which may result in additional costs to us.

If we lose the services of key personnel or are unable to recruit additional qualified personnel, our business could be 

adversely affected.

Our  success  substantially  depends  on  the  collective  performance,  contributions  and  expertise  of  our  personnel  including 
senior management and key personnel, qualified professional, scientific and technical operating staff and qualified sales representatives 
for our contract sales services. There is significant and increasing competition for qualified personnel, particularly those with higher 
educational  degrees,  such  as  a  medical  degree,  a  Ph.D.  or  an  equivalent  degree,  or  relevant  experience  in  the  industry  and  in  the 
locations in which we operate. In addition, the departure of our key employees, or our inability to continue to identify, attract and retain 
qualified personnel or replace any departed personnel in a timely fashion, may impact our ability to grow our business and compete 
effectively in our industry and may negatively affect our ability to meet financial and operational goals.

Disruptions  in  the  credit and capital markets and unfavorable general economic conditions could negatively affect our 

business, results of operations and financial condition.

Disruptions in the credit and capital markets could have negative effects on our business that may be difficult to predict or 
anticipate,  including  the  ability  of  our  clients,  vendors,  contractors  and  financing  sources  to  meet  their  contractual  obligations. 
Although  we  are  unable  to  quantify  the  impact  it  has  had  on  us,  we  are  aware  of  a  limited  number  of  instances  in  our  Research  & 
Development  Solutions  business  during  the  past  several  years  where  cancellations,  changes  in  scope  and  failure  to  pay  timely  were 
attributable, at least in part, to difficulty in our clients’ ability to obtain financing. In the future such actions by our clients could, if they 
involve a significant amount of business with us, have a material adverse effect on our results of operations.

Our effective income tax rate may fluctuate for a variety of reasons, which may adversely affect our operations, earnings 

and earnings per share.

Our  effective  income  tax  rate  is  influenced  by  our  projected  profitability  in  the  various  taxing  jurisdictions  in  which  we 
operate. Changes in a jurisdiction’s income tax rates and the distribution of our profits and losses among such jurisdictions may have a 
significant  impact  on  our  effective  income  tax  rate,  which  in  turn  could  have  an  adverse  effect  on  our  net  income  and  earnings  per 
share. Other factors that may affect our effective income tax rate include, but are not limited to:

•

•

•

changes in the value of deferred tax assets and liabilities;

changes in tax laws in various jurisdictions;

audits by taxing authorities; and

30

 
 
 
 
 
 
 
 
 
 
•

the establishment of valuation allowances against deferred income tax assets if we determined that it is more likely 
than not that future income tax benefits will not be realized.

                 In addition, our effective income tax rate is influenced by U.S. tax law which has been substantially modified by the Tax 
Cuts and Jobs Act enacted in 2017 (“Tax Act”). Currently, regulations regarding Global Intangible Low-Taxed Income (“GILTI”) and 
the use of Foreign Tax Credits have been issued in proposed form, and if the application of these provisions are modified to change the 
interpretation  to  us  it  could  have  an  adverse  impact  on  our  effective  income  tax  rate.  In  the  course  of  our  business,  there  are  many 
transactions and calculations where the ultimate tax determination is uncertain which may require the use of estimates and significant 
judgement to account for their impact on the effective income tax rate in our consolidated financial statements. As the regulations and 
guidance evolve with respect to the Tax Act, our results may differ from previous estimates and may materially affect our consolidated 
financial statements.

All of these items described above may cause fluctuations in our effective income tax rate through increased U.S. tax liability 
and/or  the  loss  of  tax  attributes  in  any  given  year  that  could  adversely  affect  our  results  of  operations  and  impact  our  earnings  and 
earnings per share. Additional information regarding our income taxes is presented in Note 16 to our audited consolidated financial 
statements included in this Annual Report on Form 10-K.

Changes  in  accounting  standards  issued  by  the  Financial  Accounting  Standards  Board  (“FASB”)  or  other  standard-

setting bodies may adversely affect our financial statements.

We are required to prepare our financial statements in accordance with generally accepted accounting principles in the United 
States  of  America  (“GAAP”),  which  is  periodically  revised  and/or  expanded.  From  time  to  time,  we  are  required  to  adopt  new  or 
revised  accounting  standards  issued  by  recognized  authoritative  bodies,  including  the  FASB  and  the  SEC.  It  is  possible  that  future 
accounting  standards  we  are  required  to  adopt,  such  as  amended  guidance  for  income  taxes,  may  require  additional  changes  to  the 
current accounting treatment that we apply to our financial statements and may require us to make significant changes to our reporting 
systems. Such changes could result in a material adverse impact on our results of operations and financial condition.

Our  relationships  with  existing  or  potential  clients  who  are  in  competition  with  each  other  may  adversely  impact  the 

degree to which other clients or potential clients use our services, which may adversely affect our results of operations.

The  biopharmaceutical  industry  is  highly  competitive,  with  biopharmaceutical  companies  each  seeking  to  persuade  payers, 
providers  and  patients  that  their  drug  therapies  are  better  and  more  cost-effective  than  competing  therapies  marketed  or  being 
developed by competing firms. In addition to the adverse competitive interests that biopharmaceutical companies have with each other, 
biopharmaceutical companies also have adverse interests with respect to drug selection and reimbursement with other participants in 
the healthcare industry, including payers and providers. Biopharmaceutical companies also compete to be first to market with new drug 
therapies.  We  regularly  provide  services  to  biopharmaceutical  companies  who  compete  with  each  other,  and  we  sometimes  provide 
services  or  funding  to  such  clients  regarding  competing  drugs  in  development.  Our  existing  or  future  relationships  with  our 
biopharmaceutical  clients  may  therefore  deter  other  biopharmaceutical  clients  from  using  our  services  or  may  result  in  our  clients 
seeking  to  place  limits  on  our  ability  to  serve  other  biopharmaceutical  industry  participants  in  connection  with  drug  development 
activities.  In  addition,  our  further  expansion  into  the  broader  healthcare  market  may  adversely  impact  our  relationships  with  
biopharmaceutical clients, and such clients may elect not to use our services, reduce the scope of services that we provide to them or 
seek to place restrictions on our ability to serve clients in the broader healthcare market with interests that are adverse to theirs. A loss 
of clients or reductions in the level of revenues from a client could have a material adverse effect on our results of operations, business 
and prospects.

If  we  are  unable  to  successfully  identify,  acquire  and  integrate  existing  businesses,  services  and  technologies,  our 

business, results of operations and financial condition could be adversely impacted.

We anticipate that a portion of our future growth may come from acquiring existing businesses, services or technologies. The 
success  of  any  acquisition  will  depend  upon,  among  other  things,  our  ability  to  effectively  integrate  acquired  personnel,  operations, 
services and technologies into our business and to retain the key personnel and clients of our acquired businesses. In addition, we may 
be unable to identify suitable acquisition opportunities or obtain any necessary financing on commercially acceptable terms. We may 
also spend time and money investigating and negotiating with potential acquisition targets but not complete the transaction. Any future 
acquisition  could  involve  other  risks,  including,  among  others,  the  assumption  of  additional  liabilities  and  expenses,  difficulties  and 

31

 
 
 
 
 
 
 
expenses in connection with integrating the acquired companies and achieving the expected benefits, issuances of potentially dilutive 
securities  or  interest-bearing  debt,  loss  of  key  employees  of  the  acquired  companies,  transaction  costs,  diversion  of  management’s 
attention from other business concerns and, with respect to the acquisition of foreign companies, the inability to overcome differences 
in foreign business practices, language and customs. Our failure to identify potential acquisitions, complete targeted acquisitions and 
integrate completed acquisitions could have a material adverse effect on our business, financial condition and results of operations.

Our results of operations may be adversely affected if we fail to realize the full value of our goodwill and intangible assets.

We assess the realizability of our indefinite-lived intangible assets and goodwill annually and conduct an interim evaluation 
whenever events or changes in circumstances, such as operating losses or a significant decline in earnings associated with the acquired 
business  or  asset,  indicate  that  these  assets  may  be  impaired.  Our  ability  to  realize  the  value  of  the  goodwill  and  indefinite-lived 
intangible assets will depend on the future cash flows of the businesses we have acquired, which in turn could depend in part on how 
well we have integrated these businesses into our own business. If we are not able to realize the value of the goodwill and indefinite-
lived  intangible  assets,  we  may  be  required  to  incur  material  charges  relating  to  the  impairment  of  those  assets.  Such  impairment 
charges could materially and adversely affect our operating results and financial condition.

We face risks arising from the restructuring of our operations.

From time to time, we have adopted restructuring plans to improve our operating efficiency through various means such as 
reduction  of  overcapacity,  elimination  of  non-billable  support  roles  or  other  realignment  of  resources.  Restructuring  presents 
significant potential risks of events occurring that could adversely affect us, including:

•

•

•

•

•

actual or perceived disruption of service or reduction in service standards to clients;

the failure to preserve supplier relationships and distribution, sales and other important relationships and to resolve 
conflicts that may arise;

loss of sales as we reduce or eliminate staffing on non-core services;

diversion of management attention from ongoing business activities; and

the failure to maintain employee morale and retain key employees.

Further, any such restructuring would result in charges that, if material, could harm our results of operations and significantly 
reduce  our  cash  position  or  increase  debt.  In  addition,  we  may  incur  certain  unforeseen  costs  once  any  restructuring  activities  are 
implemented. Further, if we determine to effect any restructuring, we can give no assurance that any projected cost reductions resulting 
from such restructuring activities will be achieved within the expected timeframe, or at all.

Because of these and other factors, we cannot predict whether we will realize the purpose and anticipated benefits of these 

measures and, if we do not, our business and results of operations may be adversely affected.

Additionally, there may be delays in implementing the restructuring activities or a failure to achieve the anticipated levels of 
cost savings and efficiency as a result of the restructuring activities, each of which could materially and adversely impact our business 
and results of operations. Further restructuring or reorganization activities may also be required in the future beyond what is currently 
planned, which could further enhance the risks associated with these activities.

Risks Relating to Our Industry

The biopharmaceutical services industry is highly competitive.

The  biopharmaceutical  services  industry  is  highly  competitive.  Our  business  often  competes  with  other  biopharmaceutical 
services  companies,  internal  discovery  departments,  development  departments,  sales  and  marketing  departments,  information 
technology departments and other departments within our clients, some of which could be considered large biopharmaceutical services 
companies  in  their  own  right  with  greater  resources  than  ours.  We  also  compete  with  universities,  teaching  hospitals,  governments 
agencies  and  others.  If  we  do  not  compete  successfully,  our  business  will  suffer.  The  biopharmaceutical  services  industry  is  highly 

32

 
 
 
 
 
 
 
 
 
fragmented, with numerous smaller specialized companies and a handful of companies with global capabilities similar to certain of our 
own capabilities. Increased competition has led to price and other forms of competition, such as acceptance of less favorable contract 
terms, that could adversely affect our operating results. There are few barriers to entry for companies considering offering any one or 
more of the services we offer. Because of their size and focus, these companies might compete effectively against us, which could have 
a material adverse impact on our business.

Our future growth and success will depend on our ability to successfully compete with other companies that provide similar 
services  in  the  same  markets,  some  of  which  may  have  financial,  marketing,  technical  and  other  advantages.  We  also  expect  that 
competition will continue to increase as a result of consolidation among these various companies. Large technology companies with 
substantial resources, technical expertise and greater brand power could also decide to enter or further expand in the markets where our 
business  operates  and  compete  with  us.  If  one  or  more  of  our  competitors  or  potential  competitors  were  to  merge  or  partner  with 
another  of  our  competitors,  or  if  a  new  entrant  emerged  with  substantial  resources,  the  change  in  the  competitive  landscape  could 
adversely affect our ability to compete effectively. We compete on the basis of various factors, including breadth and depth of services, 
reputation, reliability, quality, geographic coverage, innovation, security, price and industry expertise and experience. In addition, our 
ability  to  compete  successfully  may  be  impacted  by  the  growing  availability  of  health  information  from  social  media,  government 
health information systems and other free or low-cost sources. Consolidation or integration of wholesalers, retail pharmacies, health 
networks, payers or other healthcare stakeholders may lead any of them to provide information services directly to clients or indirectly 
through a designated service provider, resulting in increased competition from firms that may have lower costs to market (e.g., no data 
supply costs). Any of the above may result in lower demand for our services, which could result in a material adverse impact on our 
operating results and financial condition.

Outsourcing trends in the biopharmaceutical industry and changes in aggregate spending and research and development 

budgets could adversely affect our operating results and growth rate.

Economic factors and industry trends that affect biopharmaceutical companies affect our Research & Development Solutions 
business. Biopharmaceutical companies continue to seek long-term strategic collaborations with global clinical research organizations 
with favorable pricing terms. Competition for these collaborations is intense and we may decide to forego an opportunity or we may 
not be selected, in which case a competitor may enter into the collaboration and our business with the client, if any, may be limited. In 
addition,  if  the  biopharmaceutical  industry  reduces  its  Research  &  Development  Solutions  activities  or  reduces  its  outsourcing  of 
clinical  trials  and  sales  and  marketing  projects  or  such  outsourcing  fails  to  grow  at  projected  rates,  our  operations  and  financial 
condition could be materially and adversely affected. We may also be negatively impacted by consolidation and other factors in the 
biopharmaceutical industry, which may slow decision making by our clients or result in the delay or cancellation of clinical trials. Our 
commercial services may be affected by reductions in new drug launches and increases in the number of drugs losing patent protection. 
All of these events could adversely affect our business, results of operations or financial condition.

Our business may be materially and adversely impacted by factors affecting the biopharmaceutical and healthcare 

industries.

The vast majority of our revenue is generated from sales to the biopharmaceutical and healthcare industries. The clients we 
serve in these industries are commonly subject to financial pressures, including, but not limited to, increased costs, reduced demand for 
their  products,  reductions  in  pricing  and  reimbursement  for  products  and  services,  formulary  approval  and  placement,  government 
approval to market their products and limits on the manner by which they market their products, loss of patent exclusivity (whether due 
to patent expiration or as a result of a successful legal challenge) and the proliferation of or changes to regulations applicable to these 
industries. To the extent our clients face such pressures, or they change how they utilize our offerings, the demand for our services, or 
the prices our clients are willing to pay for those services, may decline. Any such decline could have a material adverse effect on our 
business, operating results and financial condition.

We may be affected by healthcare reform and potential additional reforms.

The United States Congress continues to consider healthcare reform legislation and impose health industry cost containment 
measures, which may significantly impact the biopharmaceutical industry. In addition, numerous government bodies are considering or 
have adopted various healthcare reforms and may undertake, or are in the process of undertaking, efforts to control growing healthcare 
costs through legislation, regulation and voluntary agreements with medical care providers and biopharmaceutical companies. We are 
uncertain as to the effects of these recent reforms on our business and are unable to predict what legislative proposals, if any, will be 
adopted in the future. If regulatory cost containment efforts limit the profitability of new drugs, our clients may reduce their research 

33

 
 
 
 
 
 
 
and development spending or promotional, marketing and sales expenditures, which could reduce the business they outsource to us. 
Similarly, if regulatory requirements are relaxed or simplified drug approval procedures are adopted, the demand for our services could 
decrease.

Foreign and domestic government bodies may also adopt healthcare legislation or regulations that are more burdensome than 
existing regulations. For example, product safety concerns and recommendations by the Drug Safety Oversight Board could change the 
regulatory environment for drug products, and new or heightened regulatory and licensing requirements may increase our expenses or 
limit or delay our ability to offer some of our services. Additionally, new or heightened regulatory requirements may have a negative 
impact on the ability of our clients to conduct industry-sponsored clinical trials, which could reduce the need for our services.

Actions by government regulators or clients to limit a prescription’s scope or withdraw an approved drug from the market 

could adversely affect our business and result in a loss of revenues.

Government regulators have the authority, after approving a drug, to regulate or limit its scope of prescription or withdraw it 
from the market completely based on safety concerns. Similarly, clients may act to voluntarily limit the scope of prescription of drugs 
or  withdraw  them  from  the  market.  In  the  past,  we  have  provided  services  with  respect  to  drugs  that  have  been  limited  and/or 
withdrawn. If we are providing services to clients for drugs that are limited or withdrawn, we may be required to narrow the scope of 
or terminate our services with respect to such drugs, which would prevent earning the full amount of revenues anticipated under the 
related service contracts with negative impacts to our financial results.

If we do not keep pace with rapid technological changes, our services may become less competitive or obsolete.

The biopharmaceutical industry is subject to rapid technological changes. Our current competitors or other businesses might 
develop  technologies  or  services  that  are  more  effective  or  commercially  attractive  than,  or  render  obsolete,  our  current  or  future 
technologies and services. If our competitors introduce superior technologies or services, including in the provision of clinical services, 
and if we cannot make enhancements to remain competitive, our competitive position would be harmed. If we are unable to compete 
successfully,  we  may  lose  clients  or  be  unable  to  attract  new  clients,  which  could  lead  to  a  decrease  in  our  revenue  and  financial 
condition.

Laws restricting biopharmaceutical sales and marketing practices may adversely impact demand for our services.

There have been a significant number of laws, legislative initiatives and regulatory actions over the years that seek to limit 
biopharmaceutical  sales  and  marketing  practices.  For  example,  three  states  in  2006  and  2007  passed  laws  restricting  the  use  of 
prescriber  identifiable  information  for  the  purpose  of  promoting  branded  prescription  medicines.  Although  these  laws  were 
subsequently declared to be unconstitutional based on a decision of the U.S. Supreme Court in Sorrell v. IMS Health in 2011, we are 
unable to predict whether, and in what form, other initiatives may be introduced or actions taken at the state or Federal levels to limit 
biopharmaceutical sales and marketing practices. In addition, while we will continue to seek to adapt our services to comply with the 
requirements of these laws (to the extent applicable to our services), if enacted, there can be no assurance that our efforts to adapt our 
offerings will be successful and provide the same financial contribution to us. There can also be no assurance that future legislative 
initiatives will not adversely affect our ability to develop or market current or future offerings, or that any future laws will not diminish 
the demand for our services, all of which could, over time, result in a material adverse impact on our operating results and financial 
condition.

Our  Research  &  Development  Solutions  clients  face  intense  competition  from  lower  cost  generic  products,  which  may 

lower the amount that they spend on our services.

Our Research & Development Solutions clients face increasing competition from lower cost generic products, which in turn 
may affect their ability to pursue research and development activities with us. In the United States, EU and Japan, political pressure to 
reduce  spending  on  prescription  drugs  has  led  to  legislation  and  other  measures  which  encourages  the  use  of  generic  products.  In 
addition, proposals emerge from time to time in the United States and other countries for legislation to further encourage the early and 
rapid approval of generic drugs. Loss of patent protection for a product typically is followed promptly by generic substitutes, reducing 
our clients’ sales of that product and their overall profitability. Availability of generic substitutes for our clients’ drugs may adversely 
affect their results of operations and cash flow, which in turn may mean that they would not have surplus capital to invest in research 
and  development  and  drug  commercialization,  including  in  our  services.  If  competition  from  generic  products  impacts  our  clients’ 

34

 
 
 
 
 
 
 
 
 
finances such that they decide to curtail our services, our revenues may decline and this could have a material adverse effect on our 
business.

Risks Relating to Our Indebtedness

Restrictions  imposed  in  the  Senior  Secured  Credit  Facilities  (as  defined  below)  and  other  outstanding  indebtedness, 
including the indentures governing outstanding notes issued by our wholly owned subsidiary IQVIA Inc., may limit our ability to 
operate our business and to finance our future operations or capital needs or to engage in other business activities.

The  terms  of  the  Senior  Secured  Credit  Facilities  restrict  IQVIA  and  its  restricted  subsidiaries  from  engaging  in  specified 

types of transactions. These covenants restrict the ability of IQVIA and its restricted subsidiaries, among other things, to:

•

•

•

•

•

•

•

•

•

•

•

•

incur liens;

make investments and loans;

incur indebtedness or guarantees;

issue preferred stock of a restricted subsidiary;

issue disqualified equity;

engage in mergers, acquisitions and asset sales;

declare dividends, make payments or redeem or repurchase equity interests;

alter the business IQVIA and its restricted subsidiaries conduct;

make restricted payments;

enter into agreements limiting restricted subsidiary distributions;

prepay, redeem or purchase certain indebtedness; and

engage in certain transactions with affiliates.

In addition, the revolving credit facility and the term A and B loans under the Credit Agreement (as defined below) require 
IQVIA to comply with a quarterly maximum senior secured net leverage ratio test and minimum interest coverage ratio test. IQVIA’s 
ability to comply with these financial covenants can be affected by events beyond our control, and IQVIA may not be able to satisfy 
them. Additionally, the restrictions contained in the indentures governing the outstanding notes could also limit our ability to plan for 
or react to market conditions, meet capital needs or make acquisitions or otherwise restrict our activities or business plans.

A  breach  of  any  of  these  covenants  could  result  in  a  default  under  the  Senior  Secured  Credit  Facilities  or  the  indentures 
governing the outstanding notes, which could trigger acceleration of our indebtedness and may result in the acceleration of or default 
under any other debt to which a cross-acceleration or cross-default provision applies, which could have a material adverse effect on our 
business, operations and financial results. In the event of any default under the Senior Secured Credit Facilities, the applicable lenders 
could elect to terminate borrowing commitments and declare all borrowings and loans outstanding, together with accrued and unpaid 
interest  and  any  fees  and  other  obligations,  to  be  due  and  payable.  In  addition,  or  in  the  alternative,  the  applicable  lenders  could 
exercise their rights under the security documents entered into in connection with the Senior Secured Credit Facilities. IQVIA and the 
other subsidiary guarantors have pledged substantially all of their tangible and intangible assets (subject to customary exceptions) as 
collateral  under  the  Senior  Secured  Credit  Facilities,  including  the  stock  and  the  assets  of  certain  of  our  current  and  future  wholly 
owned United States subsidiaries and a portion of the stock of certain of our non-United States subsidiaries.

If we were unable to repay or otherwise refinance these borrowings and loans when due, the applicable lenders could proceed 
against the collateral granted to them to secure that indebtedness, which could force us into bankruptcy or liquidation. In the event the 

35

 
 
 
 
applicable  lenders  accelerate  the  repayment  of  our  borrowings,  we  and  our  subsidiaries  may  not  have  sufficient  assets  to  repay  that 
indebtedness.  Any  acceleration  of  amounts  due  under  the  Credit  Agreement  governing  the  Senior  Secured  Credit  Facilities  or  the 
exercise by the applicable lenders of their rights under the security documents would likely have a material adverse effect on us.

Despite our level of indebtedness, we are able to incur more debt and undertake additional obligations. Incurring such 

debt or undertaking such additional obligations could further exacerbate the risks to our financial condition.

Although the Credit Agreement, which governs the Senior Secured Credit Facilities of our wholly owned subsidiary through 
which we conduct our operations, IQVIA Inc., contains restrictions on the incurrence of additional indebtedness, these restrictions are 
subject to a number of qualifications and exceptions and the indebtedness incurred in compliance with these restrictions could increase. 
In addition, the receivables financing facility for one of our consolidated subsidiaries, a bankruptcy-remote special purpose entity (the 
“SPE”) limits borrowing based on the amount of receivables purchased by the SPE from certain of our other subsidiaries, but when 
supported by the value of such purchased receivables, the debt under our receivables financing facility can increase.

While  the  Credit  Agreement  also  contains  restrictions  on  our  and  our  restricted  subsidiaries’  ability  to  make  loans  and 
investments,  these  restrictions  are  subject  to  a  number  of  qualifications  and  exceptions,  and  the  investments  incurred  in  compliance 
with these restrictions could be substantial.

Restrictive covenants in our other indebtedness may limit our flexibility in our current and future operations, particularly 

our ability to respond to changes in our business or to pursue our business strategies.

The  terms  contained  in  certain  of  our  indebtedness,  including  credit  facilities  and  any  future  indebtedness  of  ours,  may 
include a number of restrictive covenants that impose significant operating and financial restrictions, including restrictions on our and 
our restricted subsidiaries’ ability to take actions that we believe may be in our interest. These agreements, among other things, limit 
our ability to:

•

•

•

•

•

•

•

•

•

•

•

•

incur additional debt;

provide guarantees in respect of obligations of other persons;

issue redeemable stock and preferred stock;

pay dividends or distributions or redeem or repurchase capital stock;

prepay, redeem or repurchase debt;

make loans, investments and capital expenditures;

enter into transactions with affiliates;

create or incur liens;

make distributions from our subsidiaries;

sell assets and capital stock of our subsidiaries;

make acquisitions; and

consolidate or merge with or into, or sell substantially all of our assets to, another person.

A  breach  of  the  covenants  or  restrictions  under  the  agreements  governing  our  other  indebtedness  could  result  in  a  default 
under the applicable indebtedness. Such default may allow the creditors to accelerate the related debt and may result in the acceleration 
of any other debt to which a cross-acceleration or cross-default provision applies. In the event our lenders and noteholders accelerate 
the  repayment  of  our  borrowings,  we  cannot  assure  that  we  and  our  subsidiaries  would  have  sufficient  assets  to  repay  such 
indebtedness.

36

 
 
 
 
 
 
Our financial results, our substantial indebtedness and our credit ratings could adversely affect the availability and terms of 

future financing.

Interest rate fluctuations and our ability to deduct interest expense may affect our results of operations and financial 

condition.

Because we have variable rate debt, fluctuations in interest rates affect our business. We attempt to minimize interest rate risk 
and lower our overall borrowing costs through the utilization of derivative financial instruments, primarily interest rate caps and swaps. 
We have entered into interest rate caps and swaps with financial institutions that have reset dates and critical terms that match those of 
our senior secured term loan credit facility. Accordingly, any change in market value associated with the interest rate caps and swaps is 
offset by the opposite market impact on the related debt. Because we do not attempt to hedge all of our variable rate debt, we may incur 
higher interest costs for the portion of our variable rate debt which is not hedged.

In addition, the deduction for our interest expense may be limited, which could have an adverse impact on our taxes and net 

income.

We may be adversely affected by changes in the method of determining the London Interbank Offered Rate (“LIBOR”), or 
the replacement of LIBOR with an alternative reference rate, for our variable rate loans, derivative contracts and other financial 
assets and liabilities.

The interest rates under our credit facilities and related interest rate swaps may be impacted by the expected discontinuation 
of  LIBOR.  LIBOR  is  used  as  a  reference  rate  to  calculate  interest  rates  under  our  credit  facilities.  In  2017,  the  United  Kingdom's 
Financial Conduct Authority, which regulates LIBOR, announced that it intends to phase out LIBOR by the end of 2021. It is unclear if 
LIBOR will cease to exist at that time or if new methods of calculating LIBOR will be established such that it continues to exist after 
2021. The banking industry alongside regulators have taken steps to introduce alternative reference rates to LIBOR particularly in the 
US, the UK and Switzerland. Whether or not alternative reference rates attain market traction as a LIBOR replacement tool remains in 
question. If LIBOR ceases to exist or another indexed rate gains wide market acceptance as the successor to LIBOR, our lenders will 
select a replacement index that will be applied under our credit facilities and related interest rate swaps, and certain of the interest rates 
under our credit facilities may change. The new rates may not be as favorable to us as those in effect prior to any LIBOR phase-out.

Risks Relating to Ownership of Our Common Stock

Provisions  of  the  corporate  governance  documents  of  IQVIA  could  make  an  acquisition  of  IQVIA  difficult  and  may 

prevent attempts by its stockholders to replace or remove its management, even if beneficial to its stockholders.

Our certificate of incorporation and Delaware bylaws and the General Corporation Law of Delaware (the “DGCL”) contain 
provisions  that  could  make  it  difficult  for  a  third  party  to  acquire  IQVIA  even  if  doing  so  might  be  beneficial  to  its  stockholders, 
including:

•

•

•

•

•

•

the division of the board of directors into three classes and the election of each class for three-year terms;

the sole ability of the board of directors to fill a vacancy created by the death or resignation of a director or the 
expansion of the board of directors;

advance notice requirements for stockholder proposals and director nominations;

limitations on the ability of stockholders to call special meetings and to take action by written consent;

the approval of holders of at least seventy-five percent (75%) of the outstanding shares of IQVIA entitled to vote on 
any amendment, alteration, change, addition or repeal of the Delaware bylaws is required to amend, alter, change, 
add to or repeal the Delaware bylaws;

the  required  approval  of  holders  of  at  least  seventy-five  percent  (75%)  of  the  outstanding  shares  of  IQVIA  to 
remove directors, which removal may only be for cause; and

37

 
 
 
 
 
 
 
 
•

the  ability  of  the  board  of  directors  to  issue  new  series  of,  and  designate  the  terms  of,  preferred  stock,  without 
stockholder approval, which could be used to, among other things, institute a rights plan that would have the effect 
of significantly diluting the stock ownership of a potential hostile acquirer, likely preventing acquisitions that have 
not been approved by the board of directors.

In  addition,  IQVIA  is  subject  to  Section  203  of  the  DGCL  regulating  corporate  takeovers.  Section  203,  subject  to  certain 
exceptions,  prohibits  a  Delaware  corporation  from  engaging  in  any  “business  combination”  with  any  “interested  stockholder”  for  a 
period of three years following the date that such stockholder became an interested stockholder unless:

•

•

•

prior  to  such  date,  the  board  of  directors  of  the  corporation  approved  either  the  business  combination  or  the 
transaction that resulted in the stockholder becoming an interested stockholder;

upon  consummation  of  the  transaction  that  resulted  in  the  stockholder  becoming  an  interested  stockholder,  the 
interested    stockholder  owned  at  least  85%  of  the  voting  stock  of  the  corporation  outstanding  at  the  time  the 
transaction  commenced,  excluding  those  shares  owned  by  persons  who  are  directors  and  also  officers,  and 
employee  stock  plans  in  which  employee  participants  do  not  have  the  right  to  determine  confidentially  whether 
shares held subject to the plan will be tendered in a tender or exchange offer; or

on or subsequent to such date, the business combination is approved by the board of directors and authorized at an 
annual or special meeting of stockholders, and not by written consent, by the affirmative vote of at least two-thirds 
of the outstanding voting stock that is not owned by the interested stockholder.

In general, Section 203 defines “business combination” to include mergers or consolidations between a Delaware corporation 
and  an  interested  stockholder,  transactions  with  an  interested  stockholder  involving  the  assets  or  stock  of  the  corporation  or  its 
majority-owned  subsidiaries  and  transactions  which  increase  an  interested  stockholder’s  percentage  ownership  of  stock.  In  general, 
Section 203 defines an “interested  stockholder” as any entity or person beneficially owning 15% or more of the outstanding voting 
stock of the corporation and any entity or person affiliated with or controlling or controlled by such entity or person. These provisions 
may  frustrate  or  prevent  any  attempts  by  stockholders  to  replace  members  of  the  board  of  directors.  Because  IQVIA’s  board  is 
responsible for appointing the members of management, these provisions could in turn affect any attempt to replace current members 
of  management.  As  a  result,  stockholders  of  IQVIA  may  lose  their  ability  to  sell  their  stock  for  a  price  in  excess  of  the  prevailing 
market price due to these protective measures, and efforts by stockholders to change the direction or management of IQVIA may be 
unsuccessful.

Our operating results and share price may be volatile, which could cause the value of our stockholders’ investments to 

decline.

Our quarterly and annual operating results may fluctuate in the future, and such fluctuations may be significant. In addition, 
securities  markets  worldwide  have  experienced,  and  are  likely  to  continue  to  experience,  significant  price  and  volume  fluctuations. 
This market volatility, as well as general economic, market or political conditions, could subject the market price of our shares to wide 
price fluctuations regardless of our operating performance. Our operating results and the trading price of our shares may fluctuate in 
response to various factors, including:

•

•

•

•

•

•

market conditions in the broader stock market;

actual or anticipated fluctuations in our quarterly and annual financial and operating results;

introduction of new services by us or our competitors;

issuance of new or changed securities analysts’ reports or recommendations;

sales, or anticipated sales, of large blocks of our stock;

additions or departures of key personnel;

38

 
 
 
 
•

•

•

•

regulatory or political developments;

litigation and governmental investigations;

changing economic conditions; and

exchange rate fluctuations.

These and other factors, many of which are beyond our control, may cause our operating results and the market price for our 
shares  to  fluctuate  substantially.  While  we  believe  that  operating  results  for  any  particular  quarter  are  not  necessarily  a  meaningful 
indication  of  future  results,  fluctuations  in  our  quarterly  operating  results  could  limit  or  prevent  investors  from  readily  selling  their 
shares and may otherwise negatively affect the market price and liquidity of our shares. In addition, in the past, when the market price 
of a stock has been volatile, holders of that stock have sometimes instituted securities class action litigation against the company that 
issued the stock. If any of our stockholders brought a lawsuit against us, we could incur substantial costs defending the lawsuit. Such a 
lawsuit could also divert the time and attention of our management from our business, which could significantly harm our profitability 
and reputation.

Since  we  have  no  current  plans  to  pay  regular  cash  dividends  on  our  common  stock,  stockholders  may  not  receive  any 

return on investment unless they sell their common stock for a price greater than that which they paid for it.

Although we have previously declared dividends to our stockholders prior to our initial public offering in May 2013, we do 
not  currently  anticipate  paying  any  regular  cash  dividends  on  our  common  stock.  Any  decision  to  declare  and  pay  dividends  in  the 
future  will  be  made  at  the  discretion  of  our  Board  and  will  depend  on,  among  other  things,  our  results  of  operations,  financial 
condition, cash requirements, contractual restrictions and other factors that our Board may deem relevant. In addition, our ability to pay 
dividends  is,  and  may  be,  limited  by  covenants  of  existing  and  any  future  outstanding  indebtedness  we  or  our  subsidiaries  incur, 
including under our existing credit facilities. Therefore, any return on investment in our common stock is solely dependent upon the 
appreciation of the price of our common stock on the open market, which may not occur.

Our  certificate  of  incorporation  contains  a  provision  renouncing  any  interest  and  expectancy  in  certain  corporate 
opportunities  identified  by  certain  parties,  even  if  such  corporate  opportunities  are  ones  that  we  might  reasonably  be  deemed  to 
have pursued or had the ability or desire to pursue.

Our certificate of incorporation provides that IQVIA renounces any interest or expectancy in the business opportunities of the 
TPG Global, LLC, the Bain Capital, LLC, CPP Investment Board Private Holdings Inc., and Leonard Green & Partners, L.P., and their 
affiliates (other than our Company and our subsidiaries) and all of their respective partners, principals, directors, officers, members, 
managers,  managing  directors  and/or  employees,  and  each  such  person  will  have  no  obligation  to  offer  us  such  opportunities.  This 
provision applies to each of these current or former stockholders (and associated parties) only for so long as a nominee designated by 
such stockholder under the Shareholders Agreement continues to serve on our board of directors and no individual serving our board of 
directors  has  at  any  time  been  designated  as  a  nominee  by  such  stockholder  under  the  Shareholders  Agreement.  Stockholders  are 
deemed to have notice of and have consented to this provision of our certificate of incorporation.

Therefore, a director or officer of our Company who also serves as a director, officer, member, manager, or employee of such 
stockholders may pursue certain business opportunities, including acquisitions, that may be complementary to its business and, as a 
result, such opportunities may not be available to us. These potential conflicts of interest could have a material adverse effect on the 
business, financial condition, results of operations, or prospects of our company if attractive corporate opportunities are allocated by 
such stockholders to themselves or their other affiliates instead of to us.

Item 1B. Unresolved Staff Comments

None.

39

 
 
 
 
 
 
 
Item 2. Properties

As  of  December  31,  2020,  we  had  approximately  262  offices  located  in  approximately  82  countries.  Our  executive 
headquarters are located adjacent to Research Triangle Park, North Carolina and in Danbury, Connecticut. We own facilities in Buenos 
Aires, Argentina; Caracas, Venezuela; Los Ruices, Venezuela; and Bangalore, India. All of our other offices are leased. Our properties 
are geographically distributed to meet our worldwide operating requirements, and none of our properties are individually material to our 
business operations. We believe that collectively our facilities are suitable and adequate for our present purposes. We continue to assess 
the impacts of COVID-19 on the suitability, adequacy, productive capacity and utilization of our existing principal physical properties, 
and we are in the process of evaluating the future state of our workforce practices, which may result in changes to our physical property 
needs. 

Item 3. Legal Proceedings

Information  pertaining  to  legal  proceedings  can  be  found  in  Note  12  to  our  audited  consolidated  financial  statements 

included elsewhere in this Annual Report on Form 10-K and is incorporated by reference herein.

Item 4. Mine Safety Disclosures

Not applicable.

40

 
 
Item 5. Market for Registrant’s Common Equity, Related Stockholder Matters and Issuer Purchases of Equity 

PART II

Securities Market Information for Common Stock

Our common stock trades on the NYSE under the symbol “IQV.”

Holders of Record

On February 1, 2021, we had approximately 25 stockholders of record as reported by our transfer agent. Holders of record 
are defined as those stockholders whose shares are registered in their names in our stock records and do not include beneficial owners 
of common stock whose shares are held in the names of brokers, dealers or clearing agencies.

Dividend Policy

We do not currently intend to pay dividends on our common stock, and no dividends were declared or paid in 2020 or 2019. 
However, we expect to reevaluate our dividend policy on a regular basis and may, subject to compliance with the covenants contained 
in our Senior Secured Credit Facilities and long-term debt arrangements and other considerations, determine to pay dividends in the 
future. The declaration, amount and payment of any future dividends on shares of our common stock will be at the sole discretion of 
our  Board,  which  may  take  into  account  general  and  economic  conditions,  our  financial  condition  and  results  of  operations,  our 
available  cash  and  current  and  anticipated  cash  needs,  capital  requirements,  contractual,  legal,  tax  and  regulatory  restrictions,  the 
implications of the payment of dividends by us to our stockholders or by our subsidiaries to us, and any other factors that our Board 
may deem relevant. Our long-term debt arrangements contain usual and customary restrictive covenants that, among other things, place 
limitations  on  our  ability  to  declare  dividends.  For  additional  information  regarding  these  restrictive  covenants,  see  Part  II,  Item  7 
“Management’s  Discussion  and  Analysis  of  Financial  Condition  and  Results  of  Operations—Liquidity  and  Capital  Resources”  and 
Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report on Form 10-K.

Recent Sales of Unregistered Securities

We did not sell any unregistered equity securities in 2020.

Purchases of Equity Securities by the Issuer

On  October  30,  2013,  our  Board  of  Directors  (the  “Board”)  approved  an  equity  repurchase  program  (the  “Repurchase 
Program”)    authorizing  the  repurchase  of  up  to  $125.0  million  of  either  our  common  stock  or  vested  in-the-money  employee  stock 
options, or a combination thereof. Our Board increased the stock repurchase authorization under the Repurchase Program with respect 
to the repurchase of our common stock by $600 million, $1.5 billion, $2 billion, $1.5 billion, and $2.0 billion in 2015, 2016, 2017, 
2018,  and  2019,  respectively,  which  increased  the  total  amount  that  has  been  authorized  under  the  Repurchase  Program  to  $7.725 
billion. The Repurchase Program does not obligate us to repurchase any particular amount of common stock or vested in-the-money 
employee  stock  options,  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 December 31, 2020, we have repurchased a total of $6.4 billion of our 

securities under the Repurchase Program.

During the year ended December 31, 2020, we repurchased 2,718,447 shares of our common stock for approximately $423.1 
million  under  the  Repurchase  Program.  These  amounts  include  1,000,000  shares  of  our  common  stock  repurchased  from  certain 
Selling  Stockholders  in  a  private  transaction  for  an  aggregate  purchase  price  of  approximately  $164.3  million.  For  additional 
information regarding our equity repurchases, see Part II, Item 7 “Management’s Discussion and Analysis of Financial Condition and 

41

 
 
 
 
 
 
 
Results  of  Operations—Liquidity  and  Capital  Resources”  and  Note  13  to  our  audited  consolidated  financial  statements  included 
elsewhere in this Annual Report on Form 10-K.

As of December 31, 2020, we had remaining authorization to repurchase up to $0.9 billion of our common stock under the 

Repurchase Program.

Since  the  Merger  between  Quintiles  and  IMS  health,  we  have  repurchased  65.6  million  shares  of  our  common  stock  at  an 
average  market  price  per  share  of  $97.29  for  an  aggregate  purchase  price  of  $6.4  billion  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 activity for the three months ended December 31, 2020 and 

the approximate dollar value of shares that may yet be purchased pursuant to the Repurchase Program.

Period

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

October 1, 2020 – October 31, 2020
November 1, 2020 – November 30, 
2020
December 1, 2020 – December 31, 
2020

Stock Performance Graph

(in millions, except per share data)

0.1 $ 

0.0 $ 

0.5 $ 
0.6

156.83 

— 

168.49 

0.1 $ 

0.0 $ 

0.5 $ 
0.6

999 

999 

918 

This  performance  graph  shall  not  be  deemed  “filed”  for  purposes  of  Section  18  of  the  Exchange  Act  or  incorporated  by 
reference into any filing of IQVIA Holdings Inc. under the Exchange Act or under the Securities Act, except as shall be expressly set 
forth by specific reference in such filing.

The following graph shows a comparison from December 31, 2015 through December 31, 2020 of the cumulative total return 
for our common stock, the Standard & Poor’s 500 Stock Index (“S&P 500”) and a select peer group. The peer group consists of Cerner 
Corporation, Charles River Laboratories, Inc., Equifax Inc., ICON plc, IHS Markit Ltd., Laboratory Corporation of America Holdings, 
Nielsen N.V., PRA Health Sciences, Inc., Syneos Health (formerly INC Research Holdings), Thomson Reuters Corporation and Verisk 
Analytics, Inc. The companies in our peer group are publicly traded information services, information technology or clinical research 
companies, and thus share similar business model characteristics to IQVIA, or provide services to similar customers as IQVIA. Many 
of these companies are also used by our compensation committee for purposes of compensation benchmarking.

The graph assumes that $100 was invested in IQVIA, the S&P 500 and the peer group as of the close of market on December 
31, 2015, assumes the reinvestments of dividends, if any. The S&P 500 and our peer group are included for comparative purposes only. 
They do not necessarily reflect management’s opinion that the S&P 500 and our peer group are an appropriate measure of the relative 
performance of the stock involved, and they are not intended to forecast or be indicative of possible future performance of our common 
stock.

42

 
 
 
 
 
 
12/31/2015

12/31/2016

12/31/2017

12/31/2018

12/31/2019

12/31/2020

IQVIA

Peer Group

S&P 500

$ 

$ 

$ 

100  $ 

100  $ 

100  $ 

111  $ 

103  $ 

112  $ 

143  $ 

119  $ 

136  $ 

169  $ 

114  $ 

130  $ 

225  $ 

160  $ 

171  $ 

261 

197 

203 

Item 6. Selected Financial Data

We  have  derived  the  following  consolidated  statements  of  income  data  and  cash  flows  for  2020,  2019  and  2018  and 
consolidated  balance  sheet  data  as  of  December  31,  2020  and  2019  from  our  audited  consolidated  financial  statements  included 
elsewhere in this Annual Report on Form 10-K. We have derived the following consolidated statements of income data for 2017 and 
2016 and consolidated balance sheet data as of December 31, 2018, 2017 and 2016 from our audited consolidated financial statements 
not included in this Annual Report on Form 10-K. You should read the consolidated financial data set forth below in conjunction with 
our consolidated financial statements and related notes included elsewhere in this Annual Report on Form 10-K and the information 
under Part II, Item 7, “Management’s Discussion and Analysis of Financial Condition and Results of Operations.” Effective January 1, 
2018,  we  adopted  the  requirements  of  Accounting  Standards  Update  (“ASU”)  2014-09,  Revenue  from  Contracts  with  Customers 
(Topic 606) (“ASU 2014-09”) and ASU 2017-07, “Compensation—Retirement Benefits (Topic 715): Improving the Presentation of 
Net Periodic Pension Cost and Net Periodic Postretirement Benefit Cost” (“ASU 2017-07”) using the full retrospective method. As a 
result  of  the  adoption  of  ASU  2014-09  and  ASU  2017-07,  the  Company  retrospectively  adjusted  related  presentations.  We  have 
included the results of operations of acquired businesses from the respective date of acquisition. As a result, our period to period results 
of  operations  vary  depending  on  the  dates  and  sizes  of  the  acquisitions.  Effective  January  1,  2019,  we  adopted  the  requirements  of 
ASU 2016-02, Leases (Topic 842): Amendments to the FASB Accounting Standards Codification and elected the transition method 
which  allows  for  disclosures  to  be  updated  prospectively  and  prior  periods  to  be  presented  in  accordance  with  previous  guidance. 

43

Comparison of 5 Years Cumulative Total ReturnAssumes Initial Investment of $100December 2020IQVIA Holdings Inc.S&P 500 - Total ReturnPeer Group12/31/201512/31/201612/31/201712/31/201812/31/201912/31/2020050100150200250300 
Accordingly, this selected financial data is not necessarily comparable or indicative of our future results. You should read this selected 
consolidated financial data in conjunction with our audited consolidated financial statements and related footnotes included elsewhere 
in this Annual Report on Form 10-K.

(in millions, except per share data)
Statement of Income Data:

Revenues
Costs of revenue, exclusive of depreciation and

amortization

Selling, general and administrative expenses
Depreciation and amortization

Impairment charges(1)
Restructuring costs

Merger related costs(2)
Income from operations

Interest expense, net
Loss on extinguishment of debt

Other expense (income), net

Income before income taxes and equity in earnings
(losses) of unconsolidated affiliates

Income tax expense (benefit)(3)

Income before equity in earnings (losses) of
unconsolidated affiliates

Equity in earnings (losses) of unconsolidated affiliates

Net income

Net income attributable to non-controlling interests
Net income attributable to IQVIA Holdings Inc.

(in millions, except per share data)
Earnings per share attributable to common stockholders:

Basic
Diluted

Weighted average common shares outstanding:
Basic

Diluted

(in millions)
Statement of Cash Flow Data:

Net cash provided by (used in):

Operating activities

Investing activities

Financing activities

Other Financial Data:

Capital expenditures

2020

2019

2018

2017(4)

2016(4)(5)

Year Ended December 31, 

$ 

11,359  $ 

11,088  $ 

10,412  $ 

9,702  $ 

6,815 

7,500   

1,789   

1,287   

7,300 

1,734 

1,202 

6,746 

1,716 

1,141 

—   

52   

—   

731   

410   

13   

(65)  

373   

72   

301   

7   

308   

(29)  

279   

— 

75 

— 

777 

438 

24 

(37) 

352 

116 

236 

(9) 

227 

(36) 

191 

— 

68 

— 

741 

406 

2 

5 

328 

59 

269 

15 

284 

(25) 

259 

6,301 

1,622 

1,011 

40 

63 

— 

665 

339 

19 

13 

294 

(992) 

1,286 

10 

1,296 

(19) 

1,277 

4,748 

1,016 

289 

28 

71 

87 

576 

140 

31 

(11) 

416 

325 

91 

(4) 

87 

(15) 

72 

2020

2019

2018

2017(4)

2016(4)(5)

As of December 31,

$ 

$ 

1.46  $ 

1.43  $ 

0.98  $ 

0.96  $ 

1.27  $ 

1.24  $ 

5.86  $ 

5.74  $ 

0.48 

0.47 

191.3 
195.0 

195.1 
199.6 

203.7 
208.2 

217.8 
222.6 

149.1 
152.0 

2020

2019

2018

2017(4)

2016(4)(5)

Year Ended December 31, 

$ 

1,959  $ 

1,417  $ 

1,254  $ 

970  $ 

(796)   

(217)   

(1,190) 

(276) 

(810) 

(452) 

(1,190) 

(72) 

860 

1,731 

(2,284) 

$ 

(616)  $ 

(582)  $ 

(459)  $ 

(369)  $ 

(164) 

44

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(in millions)
Balance Sheet Data:

Cash and cash equivalents

Investments in debt, equity and other securities

Trade accounts receivable and unbilled services, net

Property and equipment, net

Total assets

Total long-term liabilities

Total debt(6)

Total stockholders’ equity (deficit)

2020

2019

2018

2017(4)

2016(4)(5)

As of December 31,

$ 

1,814  $ 

166 

2,410 

482 

24,564 

13,726 

12,600 

6,280 

837  $ 
127 

891  $ 
88 

2,582 

458 

23,251 

13,043 

11,705 

6,263 

2,394 

434 

22,549 

12,061 

11,056 

6,954 

959  $ 

1,198 

54 

2,097 

440 

22,857 

11,457 

10,269 

8,244 

53 

1,816 

406 

21,312 

9,609 

7,219 

8,781 

(1) 

 (2) 
(3)

(4) 
(5) 

(6) 

In  2017,  we  recognized  $40  million  of  impairment  losses  for  declines  in  fair  value  of  goodwill  and  identifiable  intangible  assets  in 
Encore, which we sold in the third quarter of 2017. In 2016, we recognized $28 million of impairment losses for declines in fair value of 
goodwill ($23 million) and identifiable intangible assets ($5 million) in Encore. In 2015, we wrote down $2 million related to long-lived 
assets.
Merger related costs include the direct and incremental costs associated with the Merger.
Income Tax expense in 2020 includes a tax benefit of $26 million related to our election for the GILTI high tax exception.  Income tax 
expense in 2019 includes a reversal of $25 million related to a reversal of an FDII benefit in 2018 due to proposed regulations being 
issued in 2019. Income tax expense in 2018 includes $(35) million related to finalization of SAB 118 and the impacts of GILTI and FDII. 
Income  tax  expense  in  2017  includes  $(966)  million  related  to  the  enactment  of  the  Tax  Act  and  $(261)  million  related  to  purchase 
accounting  amortization  as  a  result  of  the  Merger.  Income  tax  expense  in  2016  includes  $252  million  related  to  a  change  in  our 
indefinitely reinvested assertion on our cumulative foreign earnings as a result of the Merger.
As a result of the adoption of ASU 2014-09, we retrospectively adjusted 2017 and 2016 related presentations.
Includes the acquisition of IMS Health effective October 3, 2016.
Excludes $67 million, $60 million, $49 million, $44 million, $19 million, $33 million and $22 million of unamortized discounts and debt 
issuance costs as of December 31, 2020, 2019, 2018, 2017, and 2016.

Item 7. Management’s Discussion and Analysis of Financial Condition and Results of Operations

You should read the following discussion and analysis of our financial condition and results of operations together with our 
consolidated  financial  statements  and  the  related  notes  included  elsewhere  in  this  Annual  Report  on  Form  10-K.  Some  of  the 
information contained in this discussion and analysis or set forth elsewhere in this Annual Report, including information with respect 
to our plans and strategy for our business, includes forward-looking statements that involve risks and uncertainties. You should read 
the  “Risk  Factors”  section  of  this  Annual  Report  for  a  discussion  of  important  factors  that  could  cause  actual  results  to  differ 
materially  from  the  results  described  in  or  implied  by  the  forward-looking  statements  contained  in  the  following  discussion  and 
analysis.

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 70,000 employees, we conduct operations in more than 100 countries.

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  critical  information,  technology  solutions  and 
real  world  insights  and  services  to  our  life  science  clients.  Research  &  Development  Solutions,  which  primarily  serves 

45

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
biopharmaceutical clients, is engaged in research and development and provides clinical research and clinical trial services. Contract 
Sales & Medical Solutions provides contract sales to both biopharmaceutical clients and the broader healthcare market.

For a description of our service offerings within our segments, refer to Part I, Item 1, “Business”.

Industry Outlook

For information about the industry outlook and markets that we operate in, refer to Part I, Item I, “Our Market Outlook”.

Overview of the Impact of COVID-19

As a result of the global spread of COVID-19 beginning in early March, we began to experience general business disruptions 
that impeded normal business activity including our ability to perform on-site monitoring and deliver offerings that rely on face-to-face 
interaction or in-person gatherings.

These  disruptions  have  impacted  all  three  of  our  reportable  segments.  The  Research  &  Development  Solutions  business 
responded  quickly  to  support  our  clients  with  the  development  of  vaccines  and  therapies  for  COVID-19.    We  have  been  involved  in 
clinical trials and studies for the virus, as well as patient recruitment for COVID-19 trials. The pandemic has accelerated the need for 
remote  and  risk-based  monitoring  in  clinical  research,  which  in  turn  has  accelerated  the  adoption  of  our  virtual  trial  technology.  This 
technology  was  deployed  to  speed  vaccine  development  and  helped  secure  full-service  COVID  trials  and  new  studies  with  top 
pharmaceutical  clients.  We  continue  to  see  gradual  improvement  in  the  accessibility  of  clinical  research  sites  in  the  Research  & 
Development Solutions business. We are seeing a return to on-site monitoring visits which exceeded the number of remote visits during 
the second half of the year. In instances where sites remain physically inaccessible for clinical monitoring, remote monitoring and virtual 
solutions continue to be effective alternatives. Site start-up activities continued to increase along with patient recruitment trends. In our 
Technology & Analytics Solutions segment, our Real-World business has been relatively well insulated from the impacts of the virus 
and it had strong growth for the year. The Real-World business is advanced in the use of secondary data, remote monitoring and virtual 
research  approaches,  which  helped  us  pivot  quickly  to  working  in  the  new  remote  world  at  the  onset  of  the  pandemic.  However,  the 
portion of our Real-World business that requires site monitoring activity also experienced limitations on site accessibility, which led to a 
reduction in the associated revenue. Within our Technology & Analytics Solutions segment, we have had very little interruption in data 
supply and demand. Our analytics and consulting businesses have performed well despite business development being hampered by lack 
of in-person interactions. Our Technology & Analytics solutions offerings that rely on face-to-face interactions or are dependent on in-
person gatherings, events or conferences continue to experience disruption, and where we were unable to execute on our commitments 
due to COVID-19, we were not able to recognize the associated revenue in the period. Activity within the Contract Sales and Medical 
Solutions  business  continues  to  be  more  challenging  due  to  a  decline  in  sales  rep  visits,  and  physician  attention  diverted  to  the 
COVID-19 crisis.

We  have  accelerated  and  expanded  a  variety  of  cost  containment  actions  to  reduce  the  impact  to  profitability.  We  have 
activated  business  continuity  plans,  including  remote  delivery  capabilities  in  technology  and  analytics,  remote  monitoring  and  virtual 
trials  in  Research  &  Development  Solutions  and  virtual  commercial  activity  with  clients  wherever  possible.  We  anticipate  an 
acceleration of business momentum when the crisis subsides as delayed trial activities will still need to be performed.

The Company continues to maintain strong liquidity. As of December 31, 2020, cash and cash equivalents were $1,814 million 
and the Company had no amounts drawn under its $1.5 billion revolving credit facility. At December 31, 2020, the Company was in 
compliance with the financial covenants under its debt agreements in all material respects and does not have material uncertainty about 
ongoing ability to meet the covenants of our credit arrangements.

To help ensure the safety and well-being of our employees, customers, partners and the broader community and continuity of 
our business operations, we continue to monitor health authority guidance on mitigating the spread of COVID-19 and managing positive 
cases.  We  manage  our  response  to  the  pandemic  through  a  combination  of  enterprise-wide  and  regional  governance  teams,  with 
particular  focus  on  the  medical  and  scientific,  information  technology,  human  capital  and  financial  impacts  of  the  pandemic  on  our 
business. These teams met, and continue to meet, regularly as necessary based on the status of the pandemic. We closely monitor the 
impact of COVID-19 on our operations and report to our Board regularly on the progress of our response to the COVID-19 outbreak. We 
have established global workplace protocols that govern the return of our employees to our offices.

46

 
 
Business Combinations

We have completed and will continue to consider strategic business combinations to enhance our capabilities and offerings in 
certain  areas,  including  various  individually  immaterial  acquisitions  during  the  years  ended  December  31,  2020  and  2019.  These 
transactions  were  accounted  for  as  business  combinations  and  the  acquired  results  of  operations  are  included  in  our  consolidated 
financial information since the acquisition date. See Note 14 to our audited consolidated financial statements included elsewhere in this 
Annual Report on Form 10-K for additional information with respect to these business combinations.

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  costs  of  revenue,  reimbursed  expenses  and  selling,  general  and 
administrative  expenses.  Costs  of  revenue  include  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. As noted above, reimbursed 
expenses  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, facilities and depreciation 
and amortization.

Foreign Currency Translation

In  2020,  approximately  35%  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  revenue  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.

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.

For a discussion of our results of operations comparison for 2019 and 2018, refer to our Annual Report on Form 10-K for the 
fiscal year ended December 31, 2019 filed on February 18, 2020. Our reportable segment results of operations comparison for 2018 
included  below  within  this  Annual  Report  on  Form  10-K  reflects  the  change  in  segment  presentation  that  occurred  during  the  first 
quarter of 2019.

Revenues

Year Ended December 31,

2020 vs. 2019

2019 vs. 2018

Change

(dollars in millions)
Revenues

2020
11,359  $ 

2019
11,088  $ 

2018
10,412  $ 

$ 

$

%

$

%

271 

 2.4 % $ 

676 

 6.5 %

47

 
 
 
 
 
 
 
2020 compared to 2019

In  2020,  our  revenues  increased  $271  million,  or  2.4%,  as  compared  to  2019.  This  increase  was  comprised  of  constant 
currency  revenue  growth  of  approximately  $252  million,  or  2.3%,  reflecting  a  $365  million  increase  in  Technology  &  Analytics 
Solutions,  offset  by  a  $38  million  decrease  in  Research  &  Development  Solutions  and  a  $75  million  decrease  in  Contract  Sales  & 
Medical Solutions.

Costs of Revenue, exclusive of Depreciation and Amortization

(dollars in millions)
Costs of revenue, exclusive of depreciation and amortization

% of revenues

2020 compared to 2019

Year Ended December 31,

2020
7,500 

$ 

$ 

 66.0 %

2019

2018

7,300 
 65.8 %

$ 

6,746 

 64.8 %

When  compared  to  2019,  costs  of  revenue,  exclusive  of  depreciation  and  amortization,  in  2020 increased  $200  million,  or 
2.7%.  This  increase  included  a  constant  currency  increase  of  approximately  $223  million,  or  3.1%,  comprised  of  a  $232  million 
increase in Technology & Analytics Solutions, a $67 million increase in Research & Development Solutions, offset by a $76 million 
decrease in Contract Sales & Medical Solutions.

As a percent of revenues, costs of revenue remained flat compared to 2019.

Selling, General and Administrative Expenses

(dollars in millions)
Selling, general and administrative expenses

% of revenues

2020 compared to 2019

Year Ended December 31,

2020
1,789 

$ 

$ 

 15.7 %

2019

2018

1,734 
 15.6 %

$ 

1,716 

 16.5 %

The $55 million  increase in selling, general and administrative expenses in  2020 as  compared  to  2019 included a constant 
currency increase of approximately $62 million, or 3.6%, comprised of a $23 million increase in Technology & Analytics Solutions, a 
$31 million increase in Research & Development Solutions, and a $12 million increase in general corporate and unallocated expenses. 
These increases were partially offset by a $4 million decrease in Contract Sales & Medical Solutions.

Depreciation and Amortization

(dollars in millions)
Depreciation and amortization

% of revenues

Year Ended December 31,

2020
1,287 

$ 

$ 

 11.3 %

2019

2018

1,202 
 10.8 %

$ 

1,141 

 11.0 %

The  $85  million  increase  in  depreciation  and  amortization  in  2020  as  compared  to  2019  was  primarily  due  to  higher 
intangible  asset  balances  as  a  result  of  acquisitions  occurring  in  2019,  increased  amortization  due  to  higher  capitalized  software 
balances, and accelerated depreciation on an internal-use software asset in the first quarter of 2020.

Restructuring Costs

(in millions)
Restructuring costs

Year Ended December 31,

2020

2019

2018

$ 

52  $ 

75  $ 

68 

48

 
 
 
 
 
 
 
 
 
The restructuring costs incurred were due to ongoing efforts to streamline our global operations. The remaining actions under 
these  plans  are  expected  to  occur  throughout  2021  and  are  expected  to  consist  of  consolidating  functional  activities,  eliminating 
redundant positions, and aligning resources with customer requirements.

Interest Income and Interest Expense

(in millions)
Interest income

Interest expense

Year Ended December 31,

2020

2019

2018

$ 

$ 

(6)  $ 

416  $ 

(9)  $ 

447  $ 

(8) 

414 

Interest income included interest received primarily from bank balances and investments.

Interest  expense  during  2020  was  lower  than  2019  due  to  lower  interest  rates  attributed  to  lower  LIBOR  rates  and  the 

redemption of the $800 million of 4.875% senior notes due 2023, partially offset by an increase in the average debt outstanding.

Loss on Extinguishment of Debt

(in millions)
Loss on extinguishment of debt

Year Ended December 31,

2020

2019

2018

$ 

13  $ 

24  $ 

2 

During 2020, we recognized loss on extinguishment of debt of $13 million for fees and expenses related to the refinancing of 
our 3.500% senior notes due 2024 as discussed further in Note 10 to our audited consolidated financial statements included elsewhere 
in this Annual Report on Form 10-K.

During 2019, we recognized loss on extinguishment of debt of $24 million for fees and expenses related to the redemption of 
our  4.875%  senior  notes  due  2023  in  aggregate  principal  amount  of  $800  million  as  discussed  further  in  Note  10  to  our  audited 
consolidated financial statements included elsewhere in this Annual Report on Form 10-K.

See “—Liquidity and Capital Resources” for more information on these transactions.

Other Expense (Income), Net

(in millions)
Other (income) expense, net

Year Ended December 31,

2020

2019

2018

$ 

(65)  $ 

(37)  $ 

5 

Other  income,  net  for  2020  primarily  consisted  of  a  decrease  in  fair  value  of  acquisition-related  contingent  consideration, 

mark-to-market gains on equity securities, a decrease in foreign currency losses, and a gain on investments in mutual funds.

Other income, net for 2019 primarily consisted of a gain related to the remeasurement of a previously held equity interest of 

an equity method investment upon acquiring the remaining interest as a result of a business combination.

Income Tax Expense (Benefit)

(dollars in millions)
Income tax expense (benefit)

Effective income tax rate

Year Ended December 31,

2020

2019

2018

$ 

72 

$ 

116 

$ 

 19.3 %

 33.0 %

59 

 18.0 %

In 2020, the U.S. Treasury Department issued final regulations regarding Foreign Derived Intangible Income (“FDII”) and 
Global Intangible Low-Taxed Income (“GILTI”). We have determined we will elect the GILTI high tax exception as allowed by the 
final regulations and we will amend our 2018 and 2019 US Federal consolidated income tax returns resulting in a favorable impact of 
$26 million, which we recorded in 2020.

49

 
 
 
 
 
 
 
 
 
 
 
 
 
In  2019  the  U.S.  Treasury  Department  issued  final  regulations  on  the  transition  tax  and  proposed  regulations  on  Foreign 
Derived Intangible Income (“FDII") which we analyzed. While the final regulations related to the transition tax did not have a material 
impact on us, the proposed guidance for FDII had an unfavorable impact. Although the proposed guidance for FDII is not authoritative 
and subject to change in the regulatory review process, we reversed the tax benefit recorded in 2018 by recording a tax expense of $25 
million for this impact. 

Equity in Earnings (Losses) of Unconsolidated Affiliates

(in millions)
Equity in (losses) earnings of unconsolidated affiliates

Year Ended December 31,

2020

2019

2018

$ 

7  $ 

(9)  $ 

15 

Equity in earnings (losses) of unconsolidated affiliates increased in 2020 compared to 2019 primarily due to higher earnings 

from our investment in NovaQuest Pharma Opportunities Fund III.

Net Income Attributable to Non-controlling Interests

(in millions)
Net income attributable to non-controlling interests

Year Ended December 31,

2020

2019

2018

$ 

(29)  $ 

(36)  $ 

(25) 

Net income attributable to non-controlling interests primarily consists of Quest’s interest in Q2 Solutions.

Segment Results of Operations

Revenues and profit by segment are as follows:

(in millions)
Technology & Analytics Solutions

Research & Development Solutions

Contract Sales & Medical Solutions

Total

General corporate and unallocated

Depreciation and amortization

Restructuring costs

Consolidated

Segment Revenues

Segment Profit

2020

2019

2018

2020

2019

2018

$ 

4,858  $ 
5,760 

741 

11,359 

4,486  $ 

5,788 

814 

11,088 

4,137  $ 
5,465 

810 

10,412 

$ 

11,359  $ 

11,088  $ 

10,412  $ 

1,216  $ 
1,048 

57 

2,321 
(251)   

1,101  $ 

1,141 

52 

2,294 

(240)   

1,041 

1,055 

61 

2,157 

(207) 

(1,287)   

(1,202)   

(1,141) 

(52)   

731  $ 

(75)   

777  $ 

(68) 

741 

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  to  integration  activities  and  acquisitions.  We  also  do  not  allocate 
depreciation  and  amortization  or  impairment  charges  to  our  segments.  Prior  period  segment  results  have  been  recast  to  conform  to 
changes to management reporting in 2019. The recast impacts the allocation of selling, general and administrative expenses for 2018.

50

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Technology & Analytics Solutions

(dollars in millions)
Revenues

2020

2019

2018

$ 

4,858  $ 

4,486  $ 

4,137  $ 

2020 vs. 2019
372 

 8.3 % $ 

2019 vs. 2018
349 

 8.4 %

Year Ended December 31,

Change

Cost of revenue, exclusive 
of depreciation and 
amortization 

Selling, general and 
administrative expenses

Segment profit

2,900 

2,663 

2,343 

742 
1,216  $ 

722 
1,101  $ 

$ 

753 
1,041  $ 

237

20
115 

8.9

2.8

 10.4 % $ 

320

(31)
60 

13.7

-4.1
 5.8 %

Revenues

2020 compared to 2019

Technology & Analytics Solutions’ revenues were $4,858 million in 2020, an increase of $372 million, or 8.3%, over 2019. 
This increase was comprised of constant currency revenue growth of approximately $365 million, or 8.1%, reflecting revenue growth 
in the Europe and Africa region as well as the Americas region. The revenue growth in these regions was driven by higher real-world 
and analytical services. See Part II—Item 7—“Overview of the Impact of COVID-19" included elsewhere in this Annual Report on 
Form 10-K for a discussion of the impact from COVID-19 on Technology & Analytics Solutions business activity.

Costs of Revenue, exclusive of Depreciation and Amortization

2020 compared to 2019

Technology  &  Analytics  Solutions’  costs  of  revenue,  exclusive  of  depreciation  and  amortization,  were  $2,900  million  in 
2020,  an  increase  of  $237  million  over  2019.  This  increase  was  comprised  of  constant  currency  increase  of  approximately 
$232 million, or 8.7%, reflecting an increase in compensation and related expenses to support revenue growth.

Selling, General and Administrative Expenses

2020  compared to 2019

Technology & Analytics Solutions’ selling, general and administrative expenses increased $20 million in 2020 as compared 
to 2019. This increase was comprised of a constant currency increase of approximately $23 million, or 3.2%, reflecting an increase in 
compensation and related expenses.

Research & Development Solutions

(dollars in millions)
Revenues

Cost of revenue, exclusive of 
depreciation and amortization
Selling, general and administrative 
expenses
Segment profit

Backlog

Year Ended December 31,

2020

2019

2018

$ 

5,760  $ 

5,788  $ 

5,465  $ 

Change

2020 vs. 2019
(28) 

 (0.5) % $ 

2019 vs. 2018
323 

 5.9 %

3,974 

3,936

3,721

38

 1.0 

738 
1,048  $ 

711
1,141  $ 

689
1,055  $ 

$ 

27
(93) 

 3.8 
 (8.2) % $ 

215

22
86 

5.8

3.2
 8.2 %

Research & Development Solutions contracted backlog increased from $19.0 billion at December 31, 2019 to $22.6 billion at 
December 31, 2020 and we expect approximately $5.9 billion of this backlog to convert to revenue in the next 12 months. Contracted 
backlog was $17.1 billion at December 31, 2018. 

51

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Backlog represents, at a particular point in time, future revenues from work not yet completed or performed under signed 

contracts. Once work begins on a project, revenues are recognized over the duration of the project. 

We believe that backlog is an indicator of future revenues but the timing of revenue will be affected by a number of factors, 
including the variable size and duration of projects, many of which are performed over several years, cancellations, and changes to the 
scope of work during the course of projects. Projects that have been delayed remain in backlog, but the timing of the revenue generated 
may  differ  from  the  timing  originally  expected.  Additionally,  projects  may  be  terminated  or  delayed  by  the  customer  or  delayed  by 
regulatory authorities. In the event that a client cancels a contract, we typically would be entitled to receive payment for all services 
performed up to the cancellation date and subsequent client-authorized services related to winding down the canceled project. For more 
details regarding risks related to our backlog, see Part I, Item IA, “Risk Factors—Risks Related to our Business—The relationship of 
backlog to revenues varies over time.”

Revenues

2020 compared to 2019

Research & Development Solutions’ revenues were $5,760 million in 2020, a decrease of $28 million, or 0.5%, over 2019. 
This decrease was comprised of constant currency revenue decline of approximately $38 million, or 0.7%, reflecting volume-related 
decreases in clinical services and lab testing impacted by COVID-19, largely offset by the incremental revenue from the clinical trials 
and studies to support the development of vaccines and therapies for COVID-19. See Part II—Item 7—“Overview of the Impact of 
COVID-19" included elsewhere in this Annual Report on Form 10-K for a discussion of the impact from COVID-19 on Research & 
Development Solutions business activity.

Costs of Revenue, exclusive of Depreciation and Amortization

2020 compared to 2019

Research & Development Solutions’ costs of revenue, exclusive of depreciation and amortization, increased $38 million, or 
1.0%,  in  2020  as  compared  to  2019.  This  increase  included  a  constant  currency  increase  of  approximately  $67  million,  or  1.7%, 
reflecting an increase in compensation and related expenses.

Selling, General and Administrative Expenses

2020 compared to 2019

Research & Development Solutions’ selling, general and administrative expenses increased $27 million, or 3.8%, in 2020 as 
compared  to  2019,  which  included  a  constant  currency  increase  of  approximately  $31  million,  or  4.4%,  reflecting  an  increase  in 
compensation and related expenses.

Contract Sales & Medical Solutions

(dollars in millions)
Revenues

Cost of revenue, exclusive of depreciation and 
amortization

Selling, general and administrative expenses

Segment profit

Year Ended December 31,

2020

2019

2018

$ 

$ 

741  $ 
626 

58 
57  $ 

814  $ 

701 

61 

810  $ 
682 

67 

52  $ 

61  $ 

52

2020 vs. 2019
(73) 

(75) 

(3) 

5 

Change

 (9.0) % $ 
 (10.7) 

 (4.9) 
 9.6 % $ 

2019 vs. 2018

4 

19 

(6) 

(9) 

 0.5 %
2.8

(9.0)
 (14.8) %

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Revenues

2020 compared to 2019

Contract Sales & Medical Solutions’ revenues were $741 million in 2020, a decrease of $73 million, or 9.0%, over 2019. This 
decrease was comprised of a constant currency revenue decline of approximately $75 million, or 9.2%, reflecting a volume decrease in 
the  Americas  region.    See  Part  II—Item  7—“Overview  of  the  Impact  of  COVID-19"  included  elsewhere  in  this  Annual  Report  on 
Form 10-K for a discussion of the impact from COVID-19 on Contract Sales & Medical Solutions business activity.

Costs of Revenue, exclusive of Depreciation and Amortization

2020 compared to 2019

Contract Sales & Medical Solutions’ costs of revenue, exclusive of depreciation and amortization, decreased $75 million, or 
10.7%, in 2020 as compared to 2019. This decrease included a constant currency decrease of approximately $76 million, or 10.8%, 
reflecting a decrease in compensation and related expenses as a result of reduced volume in the Americas region.

Selling, General and Administrative Expenses

2020 compared to 2019

Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $3 million, or 4.9%, in 2020 as 
compared to 2019. This decrease included a constant currency decrease of approximately $4 million, or 6.6%, reflecting a decrease in 
compensation and related expenses.

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,  dividends,  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  $1,814  million  at  December  31,  2020  ($1,065  million  of  which  was  in  the  United  States),  an 

increase from $837 million at December 31, 2019.

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 

53

 
 
 
 
 
 
 
 
 
 
 
 
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  February  13,  2019,  the  Board  increased  the  stock  repurchase  authorization  under  the  “Repurchase  Program  by  $2.0 
billion,  which  increased  the  total  amount  that  has  been  authorized  under  the  Repurchase  Program  to  $7.725  billion  since  the  plan’s 
inception in October 2013. 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.

As of December 31, 2020, the Company has remaining authorization to repurchase up to $0.9 billion 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.

Additional information regarding the Repurchase Program is presented in Part II, Item 5 “Market for Registrant’s Common 
Equity,  Related  Stockholder  Matters  and  Issuer  Purchases  of  Equity  Securities”  and  Note  13  to  our  audited  consolidated  financial 
statements included elsewhere in this Annual Report on Form 10-K.

Debt

As of December 31, 2020, we had $12.6 billion of total indebtedness, excluding $1.5 billion of available borrowings under 
our revolving credit facilities. See Note 10 to our audited consolidated financial statements included elsewhere in this Annual Report 
on Form 10-K for additional details regarding our credit arrangements.

Our long-term debt arrangements contain customary restrictive covenants and, as of December 31, 2020, we believe we were 

in compliance with our restrictive covenants in all material respects.

Senior Secured Credit Facilities and Senior Notes

At  December  31,  2020,  our  Fourth  Amended  and  Restated  Credit  Agreement,  as  amended  (the  “Credit  Agreement”) 
provided  financing  through  several  senior  secured  credit  facilities  (collectively,  the  “senior  secured  credit  facilities”)  of  up  to 
approximately  $7,692  million,  which  consisted  of  $6,192  million  principal  amounts  of  debt  outstanding  (as  detailed  in  the  table 
above),  $4  million  of  issued  standby  letters  of  credit  and  $1,496  million  of  available  borrowing  capacity  on  the  revolving  credit 
facility. The revolving credit facility is comprised of a $675 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. The term A loans and revolving credit facility under the 
Credit  Agreement  mature  in  June  2023,  while  the  term  B  loans  under  the  Credit  Agreement  mature  in  2024  and  2025.  We  are 
required  to  make  scheduled  quarterly  payments  on  the  term  A  loans  equal  to  1.25%  of  the  original  principal  amount,  with  the 
remaining  balance  paid  at  maturity.  We  are  required  to  make  scheduled  quarterly  payments  on  the  term  B  loans  equal  to 
approximately 0.25% of the original principal amount, with the remaining balance paid at maturity. In addition, beginning with fiscal 
year ending December 31, 2017, we were required to apply 50% of excess cash flow (as defined in the Credit Agreement), subject to 
a reduction to 25% or 0% depending upon our senior secured first lien net leverage ratio, for prepayment of the term loans, with any 
such  prepayment  to  be  applied  toward  principal  payments  due  in  subsequent  quarters.  We  are  also  required  to  pay  an  annual 
commitment  fee that ranges from 0.20% to 0.35% in  respect of any unused commitments under the revolving credit facility. The 
Senior  Secured  Credit  Facilities  are  collateralized  by  substantially  all  of  our  assets  and  the  assets  of  our  material  domestic 
subsidiaries including 100% of the equity interests of substantially all of our material domestic subsidiaries and 66% of the equity 
interests of substantially all of our first-tier material foreign subsidiaries and their domestic subsidiaries.

For  information  regarding  the  Senior  Secured  Credit  Facilities  and  senior  notes,  see  Note  10  to  our  audited  consolidated 

financial statements included elsewhere in this Annual Report on Form 10-K.

54

 
 
 
 
 
 
 
 
Receivables Financing Facility

For  information  regarding  receivables  financing  facility,  see  Note  10  to  our  audited  consolidated  financial  statements 
included  elsewhere  in  this  Annual  Report  on  Form  10-K.  As  of  December  31,  2020,  there  were  $60  million  of  revolving  loans 
available under the receivables financing facility.

Years ended December 31, 2020, 2019 and 2018

Cash Flow from Operating Activities

(in millions)
Net cash provided by operating activities

2020 compared to 2019

Year Ended December 31,

2020

2019

2018

$ 

1,959  $ 

1,417  $ 

1,254 

Cash provided by operating activities increased $542 million in 2020 as compared to 2019. The increase is primarily due to 

improved collections from clients resulting in a decrease in accounts receivable and unbilled services ($377 million), an increase in 
advanced billings ($182 million), an increase in cash-related net income ($102 million), and the timing of income tax and other payables 
($78 million), partially offset by a decrease in customer prepayments ($54 million).

Cash Flow from Investing Activities

(in millions)
Net cash used in investing activities

2020 compared to 2019

Year Ended December 31,

2020

2019

2018

$ 

(796)  $ 

(1,190)  $ 

(810) 

Cash used in investing activities decreased $394 million in 2020 as compared to 2019. The decrease was primarily driven by 

lower cash used for the acquisition of businesses, net of cash acquired ($411 million).

Cash Flow from Financing Activities

(in millions)
Net cash used in financing activities

2020 compared to 2019

Year Ended December 31,
2019

2018

2020

$ 

(217)  $ 

(276)  $ 

(452) 

Cash used in financing activities decreased $59 million in 2020 as compared to 2019. The decrease in cash used in financing 
activities was primarily due to less cash used to repurchase common stock ($502 million), offset by a decrease in cash provided by 
proceeds  from  debt  issuances  ($309  million)  and  a  decrease  in  cash  proceeds  from  revolving  credit  facilities,  net  of  repayments 
($131 million).

Contingencies

We are exposed to certain known contingencies that are material to our investors. The facts and circumstances surrounding 
these  contingencies  and  a  discussion  of  their  effect  on  us  are  in  Note  12  to  our  audited  consolidated  financial  statements  included 
elsewhere in this Annual Report on Form 10-K. These contingencies may have a material effect on our liquidity, capital resources or 
results of operations. In addition, even where our reserves are adequate, the incurrence of any of these liabilities may have a material 
effect on our liquidity and the amount of cash available to us for other purposes.

We believe that we have made appropriate arrangements in respect of the future effect on us of these known contingencies. 
We also believe that the amount of cash available to us from our operations, together with cash from financing, will be sufficient for us 

55

 
 
 
 
 
 
 
 
 
 
 
 
to pay any known  contingencies as they become due without materially affecting our ability to conduct our operations and invest in 
the growth of our business.

Off-Balance Sheet Arrangements

We do not have any off-balance sheet arrangements except for operating leases entered into in the normal course of business.

Contractual Obligations and Commitments

Below is a summary of our future payment commitments by year under contractual obligations as of December 31, 2020:

(in millions)
Long-term debt, including interest(1)

2021

2022 - 2023

2024 - 2025

Thereafter

Total

$ 

498  $ 

2,758  $ 

6,875  $ 

4,088  $ 

14,219 

Operating leases

Finance leases

Data acquisition

Purchase obligations(2)

Commitments to unconsolidated affiliates(3)
Benefit obligations(4)

Uncertain income tax positions(5)

Total

159

—

344

10

— 

32

21

236

12

339

7

— 

33

37

131

12

82

2

— 

34

9

52

159

2

2

— 

90

4

578

183

767

21

— 

191

71

$ 

1,064  $ 

3,422  $ 

7,145  $ 

4,397  $ 

16,030 

(1) 
(2) 

(3) 

(4) 

(5) 

Interest payments on our debt are based on the interest rates in effect on December 31, 2020.
Purchase obligations are defined as agreements to purchase goods or services that are enforceable and legally binding and that specify all 
significant terms, including fixed or minimum quantities to be purchased, fixed, minimum or variable pricing provisions and the 
approximate timing of the transactions.
We are currently committed to invest $130 million in private equity funds. As of December 31, 2020, we have funded approximately $80.2 
million of these commitments and we have approximately $49.8 million remaining to be funded which has not been included in the above 
table as we are unable to predict when these commitments will be paid.
Amounts represent expected future benefit payments for our pension and postretirement benefit plans, as well as expected contributions for 
2021 for our funded pension benefit plans. We made cash contributions totaling approximately $30 million to our defined benefit plans in 
2020, and we estimate that we will make contributions totaling approximately $32 million to our defined benefit plans in 2021. Due to the 
potential impact of future plan investment performance, changes in interest rates, changes in other economic and demographic assumptions 
and changes in legislation in foreign jurisdictions, we are not able to reasonably estimate the timing and amount of contributions that may 
be required to fund our defined benefit plans for periods beyond 2021.
As of December 31, 2020, our liability related to uncertain income tax positions was approximately $129 million, $58 million of which has 
not been included in the above table as we are unable to predict when these liabilities will be paid due to the uncertainties in the timing of 
the settlement of the income tax positions.

Application of Critical Accounting Policies

Note 1 to the audited consolidated financial statements provided elsewhere in this Annual Report on Form 10-K describes the 
significant  accounting  policies  used  in  the  preparation  of  the  consolidated  financial  statements.  The  preparation  of  our  consolidated 
financial statements requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, 
and the disclosure of contingent assets and liabilities at the date of the financial statements, as well as the reported amounts of revenues 
and  expenses  during  the  period.  Our  estimates  are  based  on  historical  experience  and  various  other  assumptions  we  believe  are 
reasonable  under  the  circumstances.  We  evaluate  our  estimates  on  an  ongoing  basis  and  make  changes  to  the  estimates  and  related 
disclosures as experience develops or new information becomes known. Actual results may differ from those estimates.

We  believe  the  following  critical  accounting  policies  affect  our  more  significant  judgments  and  estimates  used  in  the 

preparation of our consolidated financial statements.

Revenue Recognition

The  majority  of  the  Company’s  contracts  within  the  Research  &  Development  Solutions  segment  are  service  contracts  for 
clinical research that represent a single performance obligation. The Company provides a significant integration service resulting in a 

56

 
 
 
 
 
 
 
 
 
 
 
combined output, which is clinical trial data that meets the relevant regulatory standards and can be used by the customer to progress to 
the  next  phase  of  a  clinical  trial  or  solicit  approval  of  a  treatment  by  the  applicable  regulatory  body.  The  performance  obligation  is 
satisfied over time as the output is captured in data and documentation that is available for the customer to consume over the course of 
the arrangement and furthers progress of the clinical trial. The Company recognizes revenue over time using a cost-based input method 
since  there  is  no  single  output  measure  that  would  fairly  depict  the  transfer  of  control  over  the  life  of  the  performance  obligation. 
Progress on the performance obligation is measured by the proportion of actual costs incurred to the total costs expected to complete 
the contract. Costs included in the measure of progress include direct labor and third-party costs (such as payments to investigators and 
other  pass  through  expenses  for  the  Company’s  clinical  monitors).  This  cost-based  method  of  revenue  recognition  requires  the 
Company  to  make  estimates  of  costs  to  complete  its  projects  on  an  ongoing  basis.  Significant  judgment  is  required  to  evaluate 
assumptions related to these estimates. The effect of revisions to estimates related to the transaction price or costs to complete a project 
are  recorded  in  the  period  in  which  the  estimate  is  revised.  Most  contracts  may  be  terminated  upon  30  to  90  days  notice  by  the 
customer; however, in the event of termination, most contracts require payment for services rendered through the date of termination, 
as well as for subsequent services rendered to close out the contract.

Income Taxes

Certain items of income and expense are not recognized on our income tax returns and financial statements in the same year, 
which creates timing differences. The income tax effect of these timing differences results in (1) deferred income tax assets that create 
a reduction in future income taxes and (2) deferred income tax liabilities that create an increase in future income taxes. Recognition of 
deferred income tax assets is based on management’s belief that it is more likely than not that the income tax benefit associated with 
certain temporary differences, income tax operating loss and capital loss carryforwards and income tax credits, would be realized. We 
recorded a valuation allowance to reduce our deferred income tax assets for those deferred income tax items for which it was more 
likely  than  not  that  realization  would  not  occur.  We  determined  the  amount  of  the  valuation  allowance  based,  in  part,  on  our 
assessment of future taxable income and in light of our ongoing income tax strategies. If our estimate of future taxable income or tax 
strategies changes at any time in the future, we would record an adjustment to our valuation allowance. Recording such an adjustment 
could have a material effect on our financial condition or results of operations.

Income tax expense is based on the distribution of profit before income tax among the various taxing jurisdictions in which 
we operate, adjusted as required by the income tax laws of each taxing jurisdiction. Changes in the distribution of profits and losses 
among  taxing  jurisdictions  may  have  a  significant  impact  on  our  effective  income  tax  rate.  We  do  not  consider  the  undistributed 
earnings of our foreign subsidiaries to be indefinitely reinvested outside of the United States.

Business Combinations

We  use  the  acquisition  method  to  account  for  business  combinations,  and  accordingly,  the  identifiable  assets  acquired,  the 
liabilities  assumed  and  any  non-controlling  interest  in  the  acquiree  are  recorded  at  their  estimated  fair  values  on  the  date  of  the 
acquisition.  We  use  significant  judgments,  estimates  and  assumptions  in  determining  the  estimated  fair  value  of  assets  acquired, 
liabilities assumed and non-controlling interest including expected future cash flows, discount rates that reflect the risk associated with 
the expected future cash flows and estimated useful lives.

We have recorded and allocated to our reporting units the excess of the cost over the fair value of the net assets acquired, 
known as goodwill. The recoverability of the goodwill and indefinite-lived intangible assets are evaluated annually for impairment, or 
if  and  when  events  or  circumstances  indicate  a  possible  impairment.  We  review  the  carrying  values  of  other  identifiable  intangible 
assets if the facts and circumstances indicate a possible impairment. Any future impairment could have a material adverse effect on our 
financial condition or results of operations.

Stock-based Compensation

We  measure  compensation  cost  for  stock-based  payment  awards  (stock  options  and  stock  appreciation  rights)  granted  to 
employees and non-employee directors at fair value using the Black-Scholes-Merton option-pricing model and for performance awards 
using the Monte Carlo simulation model. Stock-based compensation expense includes stock-based awards granted to employees and 
non-employee directors and has been reported in selling, general and administrative expenses in our consolidated statements of income 
based upon the classification of the individuals who were granted stock-based awards.

57

 
 
 
 
 
 
 
 
The Black-Scholes-Merton option-pricing model requires the use of subjective assumptions, including share price volatility, 
the  expected  life  of  the  award,  risk-free  interest  rate  and  the  fair  value  of  the  underlying  common  shares  on  the  date  of  grant.  In 
developing our assumptions, we take into account the following:

•

•

•

•

•

We calculate expected volatility based on reported data for selected reasonably similar publicly traded companies 
for  which  the  historical  information  is  available.  We  plan  to  continue  to  use  the  guideline  peer  group  volatility 
information until the historical volatility of our common shares is relevant to measure expected volatility for future 
award grants;

We  determine  the  risk-free  interest  rate  by  reference  to  implied  yields  available  from  United  States  Treasury 
securities with a remaining term equal to the expected life assumed at the date of grant;

We estimate the dividend yield to be zero as we do not currently anticipate paying any future dividends;

We estimate the average expected life of the award based on our historical experience; and

We estimate forfeitures based on our historical analysis of actual forfeitures.

Pensions and Other Postretirement Benefits

We  provide  retirement  benefits  to  certain  employees,  including  defined  benefit  pension  plans  and  postretirement  medical 
plans.  The  determination  of  benefit  obligations  and  expense  is  based  on  actuarial  models.  In  order  to  measure  benefit  costs  and 
obligations  using  these  models,  critical  assumptions  are  made  with  regard  to  the  discount  rate,  expected  return  on  plan  assets,  cash 
balance crediting rate, lump sum conversion rate and the assumed rate of compensation increases. In addition, retiree medical care cost 
trend  rates  are  a  key  assumption  used  exclusively  in  determining  costs  for  our  postretirement  health  care  and  life  insurance  benefit 
plans.

Recently Issued Accounting Standards

Information  relating  to  recently  issued  accounting  standards  is  included  in  Note  1  to  our  audited  consolidated  financial 

statements included elsewhere in this Annual Report on Form 10-K.

Item 7A. Quantitative and Qualitative Disclosures About Market Risk

Market risk is the potential loss arising from adverse changes in market rates and prices. In the ordinary course of business, 
we are exposed to various market risks and we regularly evaluate our exposure to such changes. Our overall risk management strategy 
seeks  to  balance  the  magnitude  of  the  exposure  and  the  cost  and  availability  of  appropriate  financial  instruments.  The  following 
analyses present the sensitivity of our financial instruments to hypothetical changes that are reasonably possible over a one-year period.

Foreign Currency Exchange Rates

We  transact  business  in  more  than  100  countries  and  approximately 60  currencies  and  are  subject  to  risks  associated  with 
fluctuating  foreign  currency  exchange  rates.  Our  objective  is  to  reduce  earnings  and  cash  flow  volatility  associated  with  foreign 
currency exchange rate movements. Accordingly, we enter into foreign currency forward contracts to hedge certain forecasted foreign 
currency cash flows related to service contracts and to hedge non-United States dollar anticipated intercompany reseller fees. It is our 
policy to enter into foreign currency transactions only to the extent necessary to meet our objectives as stated above. We do not enter 
into  foreign  currency  transactions  for  investment  or  speculative  purposes.  The  principal  currencies  hedged  in  2020  were  the  British 
Pound and the Japanese Yen.

The contractual value of our foreign exchange derivative instruments, all of which were foreign exchange forward contracts, 
was approximately $70 million at December 31, 2020. The fair value of these contracts is subject to change as a result of potential 
changes  in  foreign  exchange  rates.  We  assess  our  market  risk  based  on  changes  in  foreign  exchange  rates  utilizing  a  sensitivity 
analysis.  The  sensitivity  analysis  measures  the  potential  gain  or  loss  in  fair  values  based  on  a  hypothetical  10%  change  in  foreign 
currency exchange rates. The potential gain in fair value for foreign exchange forward contracts based on a hypothetical 10% decrease 
in the value of the United States dollar was $7 million at December 31, 2020. However, the change in the fair value of the foreign 
exchange forward contracts would likely be offset by a change in the value of the future service contract revenue or reseller fee being 

58

 
 
 
 
 
 
 
 
hedged  caused  by  the  currency  exchange  rate  fluctuation.  The  estimated  fair  values  of  the  foreign  exchange  forward  contracts  were  
determined based on quoted market prices.

Exchange rate fluctuations affect the United States dollar value of foreign currency revenue and expenses and may have a 
significant effect on our results. Excluding the impacts from any outstanding or future hedging transactions, a hypothetical 10% change 
in  average  exchange  rates  used  to  translate  all  foreign  currencies  to  the  United  States  dollar  would  have  impacted  income  before 
income  taxes  for  2020  by  approximately  $120  million.  The  actual  impact  of  exchange  rate  movements  in  the  future  could  differ 
materially from this hypothetical analysis, based on the mix of foreign currencies and the timing and magnitude of individual exchange 
rate movements.

Additionally, commencing in 2016, we designated a portion of our foreign currency denominated debt as a hedge of our net 
investment in foreign subsidiaries to reduce the volatility in stockholders’ equity caused by changes in the Euro exchange rate with 
respect to the United States dollar. As of December 31, 2020, these borrowings (net of original issue discount) were €5,323 million 
($6,529 million). A hypothetical 10% decrease in the value of the United States dollar would lead to a potential loss in fair value of 
$653 million. However, this change in fair value would be offset by the change in value of the hedged portion of our net investment in 
foreign subsidiaries caused by the currency exchange rate fluctuation.

Interest Rates

Because we have variable rate debt, fluctuations in interest rates affect our business. We attempt to minimize interest rate risk 
and lower our overall borrowing costs through the utilization of derivative financial instruments, primarily interest rate swaps. We have 
entered  into  interest  rate  swaps  with  financial  institutions  that  have  reset  dates  and  critical  terms  that  match  the  underlying  debt. 
Accordingly, any change in market value associated with the interest rate swaps is offset by the opposite market impact on the related 
debt. As of December 31, 2020, we had approximately $6.4 billion of variable rate indebtedness and interest rate swaps with a notional 
value  of  $2.2  billion.  Because  we  do  not  attempt  to  hedge  all  of  our  variable  rate  debt,  we  may  incur  higher  interest  costs  for  the 
portion of our variable rate debt that is not hedged. Excluding debt covered by hedges, each quarter-point increase or decrease in the 
interest rate on our variable rate debt would result in our interest expense changing by approximately $3.5 million per year.

Marketable Securities

At  December  31,  2020,  we  held  investments  in  marketable  equity  securities.  These  investments  are  classified  as  either 
trading  securities  or  available-for-sale  securities  and  are  recorded  at  fair  value.  These  securities  are  subject  to  price  risk.  As  of 
December  31,  2020,  the  fair  value  of  these  investments  was  $88  million  based  on  the  quoted  market  value  of  the  securities.  The 
potential loss in fair value resulting from a hypothetical decrease of 10% in quoted market values was approximately $9 million at 
December 31, 2020.

59

 
 
 
 
 
 
Item 8. Financial Statements and Supplementary Data

MANAGEMENT’S REPORT ON INTERNAL CONTROL OVER FINANCIAL REPORTING

The management of IQVIA Holdings Inc. (the “Company”) is responsible for establishing and maintaining adequate internal 
control  over  financial  reporting.  Internal  control  over  financial  reporting  is  a  process  designed  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. A company’s internal control over financial reporting includes those policies and procedures 
that pertain to the maintenance of records that, in reasonable detail, accurately and fairly reflect the transactions and dispositions of the 
assets  of  the  company;  provide  reasonable  assurance  that  transactions  are  recorded  as  necessary  to  permit  preparation  of  financial 
statements in accordance with generally accepted accounting principles, and that receipts and expenditures of the company are being 
made only in accordance with authorizations of management and directors of the company; and provide reasonable assurance regarding 
prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect 
on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, 
projections of any evaluation of effectiveness to future periods are subject to the risk that controls may become inadequate because of 
changes in conditions, or that the degree of compliance with the policies or procedures may deteriorate.

Management assessed the effectiveness of the Company’s internal control over financial reporting as of December 31, 2020. 
In making this assessment, management used the framework established in Internal Control—Integrated Framework (2013) issued by 
the Committee of Sponsoring Organizations of the Treadway Commission (COSO). As a result of this assessment and based on the 
criteria  in  the  COSO  framework,  management  has  concluded  that,  as  of  December  31,  2020,  the  Company’s  internal  control  over 
financial reporting was effective.

The effectiveness of the Company’s internal control over financial reporting as of December 31, 2020 has been audited by 

PricewaterhouseCoopers LLP, an independent registered public accounting firm, as stated in their report which appears herein.

/s/ Ari Bousbib

Ari Bousbib

Chairman and Chief Executive Officer

(Principal Executive Officer)

February 12, 2021

/s/ Ronald E. Bruehlman 

Ronald E. Bruehlman 

Executive Vice President and Chief Financial Officer

(Principal Financial Officer)

60

 
 
 
 
          
REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

To the Board of Directors and Stockholders of IQVIA Holdings Inc.

Opinions on the Financial Statements and Internal Control over Financial Reporting

We  have  audited  the  accompanying  consolidated  balance  sheets  of  IQVIA  Holdings  Inc.  and  its  subsidiaries  (the  “Company”)  as  of 
December 31, 2020 and 2019, and the related consolidated statements of income, comprehensive income (loss), stockholders’ equity and 
cash  flows  for  each  of  the  three  years  in  the  period  ended  December  31,  2020,  including  the  related  notes  and  financial  statement 
schedules listed in the index appearing under Item 15(a)(2) (collectively referred to as the “consolidated financial statements”). We also 
have audited the Company's internal control over financial reporting as of December 31, 2020, based on criteria established in Internal 
Control - Integrated Framework (2013) issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO). 

In our opinion, the consolidated financial statements referred to above present fairly, in all material respects, the financial position of the 
Company as of December 31, 2020 and 2019, and the results of its operations and its cash flows for each of the three years in the period 
ended  December  31,  2020  in  conformity  with  accounting  principles  generally  accepted  in  the  United  States  of  America.  Also  in  our 
opinion, the Company maintained, in all material respects, effective internal control over financial reporting as of December 31, 2020, 
based on criteria established in Internal Control - Integrated Framework (2013) issued by the COSO.

Change in Accounting Principle

As  discussed  in  Note  1  to  the  consolidated  financial  statements,  the  Company  changed  the  manner  in  which  it  accounts  for  leases  in 
2019.

Basis for Opinions

The  Company's  management  is  responsible  for  these  consolidated  financial  statements,  for  maintaining  effective  internal  control  over 
financial reporting, and for its assessment of the effectiveness of internal control over financial reporting, included in the accompanying 
Management’s  Report  on  Internal  Control  over  Financial  Reporting.  Our  responsibility  is  to  express  opinions  on  the  Company’s 
consolidated financial statements and on the Company's internal control over financial reporting based on our audits. We are a public 
accounting  firm  registered  with  the  Public  Company  Accounting  Oversight  Board  (United  States)  (PCAOB)  and  are  required  to  be 
independent with respect to the Company in accordance with the U.S. federal securities laws and the applicable rules and regulations of 
the Securities and Exchange Commission and the PCAOB.

We conducted our audits in accordance with the standards of the PCAOB. Those standards require that we plan and perform the audits to 
obtain reasonable assurance about whether the consolidated financial statements are free of material misstatement, whether due to error 
or fraud, and whether effective internal control over financial reporting was maintained in all material respects. 

Our audits of the consolidated financial statements included performing procedures to assess the risks of material misstatement of the 
consolidated financial statements, whether due to error or fraud, and performing procedures that respond to those risks. Such procedures 
included examining, on a test basis, evidence regarding the amounts and disclosures in the consolidated financial statements. Our audits 
also included evaluating the accounting principles used and significant estimates made by management, as well as evaluating the overall 
presentation  of  the  consolidated  financial  statements.  Our  audit  of  internal  control  over  financial  reporting  included  obtaining  an 
understanding of internal control over financial reporting, assessing the risk that a material weakness exists, and testing and evaluating 
the  design  and  operating  effectiveness  of  internal  control  based  on  the  assessed  risk.  Our  audits  also  included  performing  such  other 
procedures as we considered necessary in the circumstances. We believe that our audits provide a reasonable basis for our opinions.

Definition and Limitations of Internal Control over Financial Reporting

A company’s internal control over financial reporting is a process designed 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.  A  company’s  internal  control  over  financial  reporting  includes  those  policies  and  procedures  that  (i)  pertain  to  the 
maintenance  of  records  that,  in  reasonable  detail,  accurately  and  fairly  reflect  the  transactions  and  dispositions  of  the  assets  of  the 
company; (ii) provide reasonable assurance that transactions are recorded as necessary to permit preparation of financial statements in 
accordance  with  generally  accepted  accounting  principles,  and  that  receipts  and  expenditures  of  the  company  are  being  made  only  in 

61

accordance  with  authorizations  of  management  and  directors  of  the  company;  and  (iii)  provide  reasonable  assurance  regarding 
prevention or timely detection of unauthorized acquisition, use, or disposition of the company’s assets that could have a material effect 
on the financial statements.

Because of its inherent limitations, internal control over financial reporting may not prevent or detect misstatements. Also, projections of 
any  evaluation  of  effectiveness  to  future  periods  are  subject  to  the  risk  that  controls  may  become  inadequate  because  of  changes  in 
conditions, or that the degree of compliance with the policies or procedures may deteriorate.

Critical Audit Matters

The critical audit matter communicated below is a matter arising from the current period audit of the consolidated financial statements 
that was communicated or required to be communicated to the audit committee and that (i) relates to accounts or disclosures that are 
material  to  the  consolidated  financial  statements  and  (ii)  involved  our  especially  challenging,  subjective,  or  complex  judgments.  The 
communication of critical audit matters does not alter in any way our opinion on the consolidated financial statements, taken as a whole, 
and  we  are  not,  by  communicating  the  critical  audit  matter  below,  providing  a  separate  opinion  on  the  critical  audit  matter  or  on  the 
accounts or disclosures to which it relates.

Revenue Recognition – Estimating Measure of Progress for Clinical Research Services

As described in Notes 1 and 20 to the consolidated financial statements, revenue of the Research & Development Solutions segment for 
the  year  ended  December  31,  2020,  is  $5,760  million,  the  majority  of  which  relates  to  service  contracts  for  clinical  research  that 
represent  a  single  performance  obligation.  The  Company  recognized  revenue  for  these  contracts  over  time  using  a  cost-based  input 
method.  Revenue  was  recognized  based  on  progress  on  the  performance  obligation,  which  was  measured  by  the  proportion  of  actual 
costs incurred to the total costs expected to complete the contract. Costs included in the measure of progress include direct labor and 
third-party costs (such as payments to investigators and other pass through expenses for the Company’s clinical monitors). This cost-
based method of revenue recognition required management to make estimates of costs to complete its projects on an ongoing basis.  

The principal considerations for our determination that performing procedures relating to revenue recognition - estimating measure of 
progress  for  clinical  research  services  is  a  critical  audit  matter  are  the  high  degree  of  auditor  judgment,  subjectivity,  and  effort  in 
performing  audit  procedures  and  evaluating  audit  evidence  related  to  the  cost  estimates  made  by  management,  due  to  significant 
judgment by management when determining the total expected costs to complete its contracts, specifically the estimation of direct labor 
and third-party costs.

Addressing the matter involved performing procedures and evaluating audit evidence in connection with forming our overall opinion on 
the consolidated financial statements. These procedures included testing the effectiveness of controls relating to the revenue recognition 
process,  including  controls  over  the  estimation  of  the  total  cost  to  complete  clinical  research  service  contracts.  These  procedures  also 
included,  among  others,  testing  management’s  process  for  determining  the  estimate  of  total  costs  to  complete  its  contracts,  which 
included  evaluating  the  reasonableness  of  significant  assumptions  made  by  management  including  direct  labor  and  third  party-costs, 
evaluating the appropriateness of changes to management’s estimate of total costs to complete throughout the duration of the contract, 
testing  actual  direct  costs  incurred,  and  evaluating  management’s  ability  to  reasonably  estimate  the  total  expected  costs  to  complete 
contracts, which included performing a comparison of management’s prior period cost estimates to final actual costs.

/s/ PricewaterhouseCoopers LLP
Raleigh, North Carolina
February 12, 2021

We have served as the Company’s auditor since 2002.

62

IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF INCOME

Year Ended December 31,

2020

2019

2018

11,088  $ 

10,412 

(in millions, except per share data) 

Revenues

Costs of revenue, exclusive of depreciation and amortization

Selling, general and administrative expenses

Depreciation and amortization

Restructuring costs

Income from operations

Interest income

Interest expense

Loss on extinguishment of debt

Other (income) expense, net

Income before income taxes and equity in earnings of unconsolidated 
affiliates

Income tax expense

Income before equity in earnings (losses) of unconsolidated affiliates

Equity in  earnings (losses) of unconsolidated affiliates

Net income

Net income attributable to non-controlling interests

Net income attributable to IQVIA Holdings Inc.

Earnings per share attributable to common stockholders:

Basic

Diluted

Weighted average common shares outstanding:

Basic

Diluted

$ 

11,359  $ 
7,500 

1,789 

1,287 

52 

731 

(6)   

416 

13 
(65)   

373 
72 

301 

7 

308 
(29)   
279 

7,300 

1,734 

1,202 

75 

777 

(9)   

447 

24 

(37)   

352 
116 

236 

(9)   

227 

(36)   

191 

$ 

$ 

1.46  $ 
1.43  $ 

0.98  $ 

0.96  $ 

191.3 

195.0 

195.1 

199.6 

6,746 

1,716 

1,141 

68 

741 

(8) 

414 

2 

5 

328 
59 

269 

15 

284 

(25) 

259 

1.27 

1.24 

203.7 

208.2 

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

63

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)

(in millions)

Net income

Comprehensive income adjustments:

Unrealized (losses) gains on derivative instruments, net of 
income tax expense (benefit) of $(10), $4 and $(5)

Defined benefit plan adjustments, net of income tax (benefit) expense of

$(15), $5 and $(4)

Foreign currency translation, net of income tax expense 
(benefit) of $(145), $(30) and $50

Reclassification adjustments:

Losses (gains) on derivative instruments included in net income, net of
income tax benefit of $3, $— and $1

Amortization of actuarial losses and prior service costs included in 

net income

Comprehensive income

Comprehensive income attributable to non-controlling interests

Comprehensive income (loss) attributable to IQVIA Holdings Inc.

$ 

Year Ended December 31,

2020

2019

2018

$ 

308  $ 

227 

$ 

284 

(30)   

(15)   

(54)   

(30)   

1 

(8) 

183 

(39)   

(258) 

10 

— 

417 
(32)   
385  $ 

(1)   

— 

142 

(38)   

104  $ 

(12) 

1 

8 

(22) 

(14) 

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

64

 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONSOLIDATED BALANCE SHEETS

(in millions, except per share data)

Cash and cash equivalents

Trade accounts receivable and unbilled services, net

ASSETS

Prepaid expenses

Income taxes receivable

Investments in debt, equity and other securities

Other current assets and receivables

Total current assets

Property and equipment, net

Operating lease right-of-use assets

Investments in debt, equity and other securities

Investments in unconsolidated affiliates

Goodwill

Other identifiable intangibles, net

Deferred income taxes

Deposits and other assets

Total assets

LIABILITIES AND STOCKHOLDERS’ EQUITY

Current liabilities:

Accounts payable and accrued expenses

Unearned income

Income taxes payable

Current portion of long-term debt

Other current liabilities

Total current liabilities

Long-term debt, less current portion

Deferred income taxes

Operating lease liabilities

Other liabilities

Total liabilities

Commitments and contingencies (Note 1 and 12)

Stockholders’ equity:

Common stock and additional paid-in capital, 400.0 shares authorized at

December 31, 2020 and 2019, $0.01 par value, 254.7 shares issued and 191.2 shares
outstanding at December 31, 2020; 253.0 shares issued and 192.3 shares outstanding
at December 31, 2019

Retained earnings

Treasury stock, at cost, 63.5 and 60.7 shares at December 31, 2020 and 2019, 

respectively

Accumulated other comprehensive loss

Equity attributable to IQVIA Holdings Inc.’s stockholders

Non-controlling interests

Total stockholders’ equity

Total liabilities and stockholders’ equity

December 31,

2020

2019

$ 

1,814  $ 
2,410 

159 

56 

88 

563 

5,090 

482 

471 

78 

84 

12,654 

5,205 

114 

386 
24,564  $ 

2,813  $ 
1,252 

102 

149 

242 

4,558 

12,384 

338 

371 

633 

$ 

$ 

837 
2,582 

138 

56 

62 

451 

4,126 

458 

496 

65 

87 

12,159 

5,514 

119 

227 

23,251 

2,512 
1,014 

108 

100 

211 

3,945 

11,545 

646 

396 

456 

18,284 

16,988 

11,095 
1,277 

(6,166) 

(205) 

6,001 

279 

6,280 
24,564  $ 

$ 

11,049 
998 

(5,733) 

(311) 

6,003 

260 

6,263 

23,251 

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

65

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF CASH FLOWS

Year Ended December 31,

2020

2019

2018

$ 

308  $ 

227  $ 

284 

(in millions)
Operating activities:

Net income
Adjustments to reconcile net income to cash provided 
by operating activities:

Depreciation and amortization
Amortization of debt issuance costs and discount
Stock-based compensation
Loss on disposals of property and equipment, net
(Earnings) loss from unconsolidated affiliates
(Gain) loss on investments, net
Benefit from deferred income taxes
Changes in operating assets and liabilities:

Accounts receivable and unbilled services
Prepaid expenses and other assets
Accounts payable and accrued expenses
Unearned income
Income taxes payable and other liabilities

Net cash provided by operating activities

Investing activities:

Acquisition of property, equipment and software
Net cash paid for acquisition of businesses
Purchases of marketable securities, net
Investments in unconsolidated affiliates, net of payments received
(Investments in) proceeds from sale of equity securities
Other

Net cash used in investing activities

Financing activities:

Proceeds from issuance of debt
Payment of debt issuance costs
Repayment of debt
Proceeds from revolving credit facility
Repayment of revolving credit facility
(Payments) proceeds related to employee stock option plans
Repurchase of common stock
Distributions to non-controlling interest, net
Contingent consideration and deferred purchase price payments

Net cash used in financing activities
Effect of foreign currency exchange rate changes on cash
Increase (decrease) in cash and cash equivalents
Cash and cash equivalents at beginning of period
Cash and cash equivalents at end of period

$ 

1,287 
18 
95 
— 
(7)   
(25)   
(176)   

255 
(146)   
253 
180 
(83)   

1,959 

(616)   
(177)   
(9)   
10 
(2)   
(2)   
(796)   

1,591 

(33)   
(864)   
1,250 
(1,635)   
(44)   
(447)   
(13)   
(22)   
(217)   
31 
977 
837 
1,814  $ 

1,202 
13 
146 
1 
9 
(43)   
(157)   

(122)   
(92)   
240 

(2)   
(5)   

1,417 

(582)   
(588)   
(3)   
— 
(22)   
5 
(1,190)   

1,900 

(47)   
(899)   
2,522 
(2,776)   
11 
(949)   
(18)   
(20)   
(276)   
(5)   
(54)   
891 
837  $ 

1,141 
11 
113 
— 
(15) 
3 
(177) 

(297) 
(66) 
368 
7 
(118) 
1,254 

(459) 
(309) 
(4) 
(17) 
(23) 
2 
(810) 

1,631 
(22) 
(732) 
2,445 
(2,329) 
15 
(1,405) 
(31) 
(24) 
(452) 
(60) 
(68) 
959 
891 

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

66

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY

Common 
Stock Shares

Treasury 
Stock Shares

Common 
Stock

(in millions)
Balance, December 31, 2017

Issuance of common stock 

Repurchase of common stock

Stock-based compensation

Distributions to non-controlling interest

Net income

Unrealized gain on derivative 
instruments, net of tax
Defined benefit plan adjustments, net of 
tax
Foreign currency translation, net of tax

Reclassification adjustments, net of tax

Other
Balance, December 31, 2018

Issuance of common stock

Repurchase of common stock

Stock-based compensation

Distributions to non-controlling interest

Net income

Unrealized losses on derivative 
instruments, net of tax
Defined benefit plan adjustments, net of 
tax
Foreign currency translation, net of tax
Reclassification adjustments, net of tax
Balance, December 31, 2019
Issuance of common stock

Repurchase of common stock

Stock-based compensation

Distributions to non-controlling interests, 
net

Net income

Unrealized losses on derivative 
instruments, net of tax

Defined benefit plan adjustments, net of 
tax

Foreign currency translation, net of tax

Reclassification adjustments, net of tax

249.5 

2.0 

— 

— 

— 

— 

— 

— 

— 

— 

— 

251.5 

1.5 

— 

— 

— 

— 

— 

— 

— 
— 
253 
1.7 

— 

— 

— 

— 

— 

— 

— 

— 

Additional 
Paid-In Capital
10,780 

10 

— 

108 

— 

— 

— 

— 

— 

— 

— 

Retained 
Earnings

Treasury 
Stock

Accumulated 
Other 
Comprehensive 
(Loss) Income

Non-
controlling 
Interests

538 

— 

— 

— 

— 

259 

— 

— 

— 

— 

10 

(3,374) 

— 

(1,396) 

— 

— 

— 

— 

— 

— 

— 

— 

49 

— 

— 

— 

— 

— 

1 

(8) 

(255) 

(11) 

— 

249 

— 

— 

— 

(31) 

25 

— 

— 

(3) 

— 

— 

Total

8,244 

11 

(1,396) 

108 

(31) 

284 

1 

(8) 

(258) 

(11) 

10 

(41.4) 

— 

(12.6) 

— 

— 

— 

— 

— 

— 

— 

— 

2 

1 

— 

— 

— 

— 

— 

— 

— 

— 

— 

(54.0)  $ 

3  $ 

10,898  $ 

807  $ 

(4,770)  $ 

(224)  $ 

240  $ 

6,954 

— 

(6.7) 

— 

— 

— 

— 

— 

— 
—  $ 
(60.7)  $ 
— 

(2.8) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

11 

— 

137 

— 

— 

— 

— 

— 
—  $ 
3  $ 
— 

— 
—  $ 
11,046  $ 
(44) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

90 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

191 

— 

— 

— 
—  $ 
998  $ 
— 

— 

— 

— 

279 

— 

— 

— 

— 

— 

(963) 

— 

— 

— 

— 

— 

— 
—  $ 
(5,733)  $ 
— 

(433) 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

(15) 

(30) 

— 

— 

— 

(18) 

36 

— 

— 

(41) 
(1)  $ 
(311)  $ 
— 

2 
—  $ 
260  $ 
— 

— 

— 

— 

— 

(30) 

(54) 

180 

10 

— 

— 

(13) 

29 

— 

— 

3 

— 

11 

(963) 

137 

(18) 

227 

(15) 

(30) 

(39) 
(1) 
6,263 
(44) 

(433) 

90 

(13) 

308 

(30) 

(54) 

183 

10 

Balance, December 31, 2020

254.7 

(63.5)  $ 

3  $ 

11,092  $ 

1,277  $ 

(6,166)  $ 

(205)  $ 

279  $ 

6,280 

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

67

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. AND SUBSIDIARIES
Notes to Consolidated Financial Statements

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. 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  70,000 
employees, the Company conducts business in more than 100 countries.

IQVIA  is  a  global  leader  in  protecting  individual  patient  privacy.  The  company  uses  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.  IQVIA’s 
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.

Principles of Consolidation

The accompanying consolidated financial statements include the accounts and operations of the Company, its subsidiaries and 
investments in which the Company has control. Amounts pertaining to the non-controlling ownership interests held by third parties in 
the  operating  results  and  financial  position  of  the  Company’s  majority-owned  subsidiaries  are  reported  as  non-controlling  interests. 
Intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

The preparation of financial statements in accordance with generally accepted accounting principles in the United States of 
America (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, 
and  the  disclosure  of  contingent  assets  and  liabilities,  at  the  date  of  the  financial  statements,  as  well  as  the  reported  amounts  of 
revenues and expenses during the period. These estimates are based on historical experience and various other assumptions believed 
reasonable under the circumstances. The Company evaluates its estimates on an ongoing basis and makes changes to the estimates and 
related disclosures as experience develops or new information becomes known. Actual results may differ from those estimates. 

Foreign Currencies

The  Company’s  financial  statements  are  reported  in  United  States  dollars  and,  accordingly,  the  Company’s  results  of 
operations  are  impacted  by  fluctuations  in  exchange  rates  that  affect  the  translation  of  its  revenues  and  expenses  denominated  in 
foreign currencies into United States dollars for purposes of reporting its consolidated financial results. Assets and liabilities recorded 
in foreign currencies on the books of foreign subsidiaries are translated at the exchange rate on the balance sheet date. Revenues, costs 
and  expenses  are  translated  at  average  rates  of  exchange  during  the  year.  Translation  adjustments  resulting  from  this  process  are 
charged  or  credited  to  the  accumulated  other  comprehensive  (loss)  income  (“AOCI”)  component  of  stockholders’  equity.  The 
Company  is  subject  to  foreign  currency  transaction  risk  for  fluctuations  in  exchange  rates  during  the  period  of  time  between  the 
consummation and cash  settlement of a transaction. The Company earns revenue from its service contracts over a period of several 
months and, in some cases, over a period of several years. Accordingly, exchange rate fluctuations during this period may affect the 
Company’s profitability with respect to such contracts.

For  operations  outside  the  United  States  that  are  considered  to  be  highly  inflationary  or  where  the  United  States  dollar  is 
designated  as  the  functional  currency,  monetary  assets  and  liabilities  are  remeasured  using  end-of-period  exchange  rates,  whereas 
nonmonetary  accounts  are  remeasured  using  historical  exchange  rates,  and  all  remeasurement  and  transaction  adjustments  are 
recognized in other expense (income), net.

68

 
 
 
 
 
Cash Equivalents

The Company considers all highly liquid investments with an initial maturity of three months or less when purchased to be 

cash equivalents.

Derivatives

The  Company  uses  derivative  instruments  to  manage  exposures  to  interest  rates  and  foreign  currencies.  Derivatives  are 

recorded on the balance sheet at fair value at each balance sheet date utilizing pricing models for non-exchange-traded contracts.

At inception, the Company designates whether or not the derivative instrument is an effective hedge of an asset, liability or 
firm commitment which is then classified as either a cash flow hedge or a fair value hedge. If determined to be an effective cash flow 
hedge,  changes  in  the  fair  value  of  the  derivative  instrument  are  recorded  as  a  component  of  AOCI  until  realized.  The  Company 
includes the impact from these hedges in the same line item as the hedged item on the consolidated statements of cash flows. Changes 
in fair value of effective fair value hedges are recorded in earnings as an offset to the changes in the fair value of the related hedged 
item. Hedge ineffectiveness, if any, is immediately recognized in earnings. Changes in the fair values of derivative instruments that are 
not an effective hedge are recognized in earnings. When it is probable that a hedged forecasted transaction will not occur, the Company 
discontinues  hedge  accounting  for  the  affected  portion  of  the  forecasted  transaction  and  reclassifies  gains  or  losses  that  were 
accumulated in AOCI to earnings in other expense (income), net for foreign exchange derivatives and interest expense for interest rate 
derivatives  on  the  consolidated  statements  of  income.  Cash  flows  are  classified  consistent  with  the  underlying  hedged  item.  The 
Company  has  entered,  and  may  in  the  future  enter,  into  derivative  contracts  (caps,  swaps,  forwards,  calls  or  puts,  warrants,  for 
example) related to its debt and forecasted foreign currency transactions.

Business Combinations

The  Company  uses  the  acquisition  method  to  account  for  business  combinations,  and  accordingly,  the  identifiable  assets 
acquired, the liabilities assumed and any non-controlling interest in the acquiree are recorded at their estimated fair values on the date 
of  the  acquisition.  The  Company  uses  significant  judgments,  estimates  and  assumptions  in  determining  the  estimated  fair  value  of 
assets acquired, liabilities assumed and non-controlling interest including expected future cash flows, discount rates that reflect the risk 
associated with the expected future cash flows and estimated useful lives.

The Company records and allocates to its reporting units the excess of the cost over the fair value of the net assets acquired, 
known as goodwill. The recoverability of the goodwill and indefinite-lived intangible assets are evaluated annually for impairment, or 
if and when events or circumstances indicate a possible impairment. The Company reviews the carrying values of other identifiable 
intangible assets if the facts and circumstances indicate a possible impairment.

Long-Lived Assets

Property and equipment are stated at cost and are depreciated using the straight-line method over the shorter of the asset’s 

estimated useful life or the lease term, if related to leased property, as follows:

Buildings and leasehold improvements

Equipment

Furniture and fixtures

Transportation equipment

3 - 40 years

3 - 10 years

5 - 10 years

3 - 20 years

Definite-lived identifiable intangible assets are amortized primarily using an accelerated method that reflects the pattern in 

which the Company expects to benefit from the use of the asset over its estimated remaining useful life as follows:

Trademarks and trade names

Contract backlog and client relationships

Software and related assets

Databases

Non-compete agreements and other

69

1 - 17 years

1 - 25 years

1 - 10 years

1 - 9 years
2 - 5 years

 
 
 
 
 
Included  in  software  and  related  assets  is  the  capitalized  cost  of  internal-use  software  used  in  supporting  the  Company’s 
business. Qualifying costs incurred during the application development stage are capitalized and amortized over their estimated useful 
lives. Costs are capitalized from completion of the preliminary project stage and when it is considered probable that the software will 
be used to perform its intended function, up until the time the software is placed into service. The Company recognized $267 million, 
$196 million and $179 million of amortization expense in 2020, 2019 and 2018, respectively, related to software and related assets.

The carrying values of property, equipment and intangible and other long-lived assets are reviewed for recoverability if the 
facts and circumstances suggest that a potential impairment may have occurred. If this review indicates that carrying values will not be 
recoverable,  as  determined  based  on  undiscounted  cash  flow  projections,  the  Company  will  record  an  impairment  charge  to  reduce 
carrying values to estimated fair value. There were no impairments recognized in 2020, 2019 and 2018.

Revenue Recognition

The Company’s arrangements are primarily service contracts that range in duration from a few months to several years. The 
Company recognizes revenue when control of these services is transferred to the customer for an amount, referred to as the transaction 
price,  that  reflects  the  consideration  to  which  the  Company  is  expected  to  be  entitled  in  exchange  for  those  goods  or  services.  The 
Company  determines  revenue  recognition  utilizing  the  following  five  steps:  (1)  identification  of  the  contract  with  a  customer,  (2) 
identification  of  the  performance  obligations  in  the  contract  (promised  goods  or  services  that  are  distinct),  (3)  determination  of  the 
transaction price, (4) allocation of the transaction price to the performance obligations, and (5) recognition of revenue when, or as, the 
Company transfers control of the product or service for each performance obligation. Cash payments made to customers as incentives 
to induce customers to enter into service agreements with the Company are amortized as a reduction of revenue over the period the 
services are performed. The Company records revenues net of any tax assessments by governmental authorities, such as value added 
taxes, that are imposed on and concurrent with specific revenue generating transactions.

The  Company  derives  the  majority  of  its  revenues  in  the  Technology  &  Analytics  Solutions  segment  from  various 
information and technology service offerings. Information offerings (primarily under fixed-price contracts) typically include multiple 
performance obligations including an ongoing subscription-based deliverable for which revenue is recognized ratably as earned over 
the contract period, and/or a one-time deliverable of data offerings for which revenue is recognized upon delivery. The customer is able 
to benefit from the provision of data as it is received. The Company’s subscription arrangements typically have terms ranging from one 
to three years and are generally non-cancelable and do not contain refund-type provisions. Technology services offerings may contain 
multiple performance obligations consisting of a mix of small and large-scale services and consulting projects, multi-year outsourcing 
contracts and Software-as-a- Service (“SaaS”) arrangements. These arrangements typically have terms ranging from several weeks to 
three  years,  with  a  majority  having  terms  of  one  year  or  less.  For  arrangements  that  include  multiple  performance  obligations,  the 
transaction  price  is  allocated  to  the  identified  performance  obligations  based  on  their  relative  standalone  selling  prices.  For  these 
contracts, the standalone selling prices are based on the Company’s normal pricing practices when sold separately with consideration 
of market conditions and other factors, including customer demographics and geographic location. Revenues for services engagements 
where  the  transfer  of  control  occurs  ratably  over  time  are  recognized  on  a  straight-line  basis  over  the  term  of  the  arrangement. 
Revenues from time and material contracts are recognized based on hours as the services are provided. Revenues from fixed price ad 
hoc  services  and  consulting  contracts  are  recognized  over  the  contract  term  based  on  the  ratio  of  the  number  of  hours  incurred  for 
services provided during the period compared to the total estimated hours to be incurred over the entire arrangement (hours-based). 
Technology  services  offerings  meet  the  over  time  criterion,  as  another  party  would  not  need  to  substantially  re-perform  the  work 
already completed to satisfy the remaining obligations if the services were migrated.

The  majority  of  the  Company’s  contracts  within  the  Research  &  Development  Solutions  segment  are  service  contracts  for 
clinical research that represent a single performance obligation. The Company provides a significant integration service resulting in a 
combined output, which is clinical trial data that meets the relevant regulatory standards and can be used by the customer to progress to 
the  next  phase  of  a  clinical  trial  or  solicit  approval  of  a  treatment  by  the  applicable  regulatory  body.  The  performance  obligation  is 
satisfied over time as the output is captured in data and documentation that is available for the customer to consume over the course of 
the arrangement and furthers progress of the clinical trial. The Company recognizes revenue over time using a cost-based input method 
since  there  is  no  single  output  measure  that  would  fairly  depict  the  transfer  of  control  over  the  life  of  the  performance  obligation. 
Progress on the performance obligation is measured by the proportion of actual costs incurred to the total costs expected to complete 
the contract. Costs included in the measure of progress include direct labor and third-party costs (such as payments to investigators and 
other  pass  through  expenses  for  the  Company’s  clinical  monitors).  This  cost-based  method  of  revenue  recognition  requires  the 
Company  to  make  estimates  of  costs  to  complete  its  projects  on  an  ongoing  basis.  Significant  judgment  is  required  to  evaluate 

70

 
 
 
 
 
assumptions related to these estimates. The effect of revisions to estimates related to the transaction price or costs to complete a project 
are  recorded  in  the  period  in  which  the  estimate  is  revised.  Most  contracts  may  be  terminated  upon  30  to  90  days  notice  by  the 
customer; however, in the event of termination, most contracts require payment for services rendered through the date of termination, 
as well as for subsequent services rendered to close out the contract. 

The majority of revenue in our Contract Sales & Medical Solutions segment is from contract sales to the biopharmaceutical 
industry and broader healthcare market and recognized over time using a single measure of progress dependent on the performance 
obligation. Some of our Contract Sales & Medical Solutions contracts contain multiple performance obligations with distinct promises 
including  recruiting,  sales  force  automation  and  deployment  of  sales  representatives.  The  Company  utilizes  a  single  measure  of 
progress for each performance obligation to recognize revenue, which includes deployment of sales representatives based on employee 
days  worked;  recruiting  based  on  candidates  recruited;  sales  force  automation  set-up  based  on  hours  worked;  and  sales  force 
automation hosting and maintenance based on usage. These services meet the over time criterion as the customer consumes the benefit 
as  activities  are  performed  and  another  party  would  not  need  to  substantially  re-perform  the  work  already  completed  to  satisfy  the 
remaining obligations if the services were migrated to another party.

Variable Consideration

In some cases, contracts provide for variable consideration that is contingent upon the occurrence of uncertain future events, 
such  as  performance  incentives  (including  royalty  payments  or  penalty  clauses  that  can  either  increase  or  decrease  the  transaction 
price). Variable consideration is estimated at the expected value or at the most likely amount depending on the type of consideration. 
Estimated amounts are included in the transaction price to the extent it is probable that a significant reversal of cumulative revenue 
recognized  will  not  occur  when  the  uncertainty  associated  with  the  variable  consideration  is  resolved.  The  estimate  of  variable 
consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of 
its  anticipated  performance  and  all  information  (historical,  current  and  forecasted)  that  is  reasonably  available  to  the  Company  and 
reevaluated each reporting period.

Reimbursed Expenses

The Company includes reimbursed expenses in revenues and costs of revenue as the Company is primarily responsible for 
fulfilling the promise to provide the specified service, including the integration of the related services into a combined output to the 
customer,  which are inseparable from the integrated service. These costs include such items as payments to investigators and travel 
expenses for the Company’s clinical monitors and sales representatives, over which the Company has discretion in establishing prices. 
The Company controls the good or service and has inventory risk on contractually reimbursable expenses, as sometimes the Company 
is unable to obtain reimbursement from the customer for costs incurred.

Change Orders

Changes  in  the  scope  of  work  are  common,  especially  under  long-term  contracts,  and  generally  result  in  a  change  in 
transaction price. Change orders are evaluated on a contract-by-contract basis to determine if they should be accounted for as a new 
contract  or  as  part  of  the  existing  contract.  Generally,  services  from  change  orders  are  not  distinct  from  the  original  performance 
obligation. As a result, the effect that the contract modification has on the contract revenue, and measure of progress, is recognized as 
an adjustment to revenue when it occurs.

Costs of Revenue

Costs  of  revenue  include  (i)  compensation  and  benefits  for  billable  employees  and  personnel  involved  in  production,  data 
management and delivery, and the costs of acquiring and processing data for the Company’s information offerings; (ii) costs of staff 
directly involved with delivering technology-related services offerings and engagements, and the costs of data purchased specifically 
for  technology  services  engagements;  (iii)  reimbursed  expenses  that  are  comprised  principally  of  payments  to  investigators  who 
oversee  clinical  trials  and  travel  expenses  for  the  Company’s  clinical  monitors  and  sales  representatives;  and  (iv)  other  expenses 
directly related to service contracts such as courier fees, laboratory supplies, professional services and travel expenses.

71

 
 
 
 
 
 
 
 
Trade Receivables, Unbilled Services and Unearned Income

In  general,  billings  and  payments  are  established  by  contractual  provisions  including  predetermined  payment  schedules, 
which may or may not correspond to the timing of the transfer of control of the Company’s services under the contract. In general, the 
Company’s intention in its invoicing (payment terms) is to maintain cash neutrality over the life of the contract. Generally, the payment 
terms are 30 to 90 days based on contracts. Upfront payments, when they occur, are intended to cover certain expenses the Company 
incurs at the beginning of the contract. Neither the Company nor its customers view such upfront payments and contracted payment 
schedules as a means of financing. Unbilled services primarily arise from long-term contracts when a cost-based or hours-based input 
method of revenue recognition is utilized and revenue recognized exceeds the amount billed to the customer.

Unearned income consists of advance payments and billings in excess of revenue recognized. As the contracted services are 
subsequently  performed  and  the  associated  revenue  is  recognized,  the  unearned  income  balance  is  reduced  by  the  amount  of  the 
revenue recognized during the period. Unearned income is classified as a current liability on the condensed consolidated balance sheet 
as the Company expects to recognize the associated revenue in less than one year.

Restructuring Costs

Restructuring costs, which primarily include termination benefits and facility closure costs, are recorded at estimated value. 
Key  assumptions  in  determining  the  restructuring  costs  include  the  terms  and  payments  that  may  be  negotiated  to  terminate  certain 
contractual obligations and the timing of employees leaving the Company.

Debt Fees

Fees incurred to issue debt are generally deferred and amortized as a component of interest expense over the estimated term 

of the related debt using the effective interest rate method.

Contingencies

The Company records accruals for claims, suits, investigations and proceedings when it is probable that a liability has been 
incurred and the amount of the loss can be reasonably estimated. The Company reviews claims, suits, investigations and proceedings at 
least quarterly and records or adjusts accruals related to such matters to reflect the impact and status of any settlements, rulings, advice 
of counsel or other information pertinent to a particular matter. Legal costs associated with contingencies are charged to expense as 
incurred.

The Company is party to legal proceedings incidental to its business. While the outcome of these matters could differ from 
management’s expectations, the Company does not believe the resolution of these matters will have a material adverse effect to the 
Company’s financial  statements.

Income Taxes

Certain items of income and expense are not recognized on the Company’s income tax returns and financial statements in the 
same year, which creates timing differences. The income tax effect of these timing differences results in (1) deferred income tax assets 
that  create  a  reduction  in  future  income  taxes  and  (2)  deferred  income  tax  liabilities  that  create  an  increase  in  future  income  taxes. 
Recognition of deferred income tax assets is based on management’s belief that it is more likely than not that the income tax benefit 
associated with certain temporary differences, income tax operating loss and capital loss carryforwards and income tax credits, would 
be realized. The Company records a valuation allowance to reduce its deferred income tax assets for those deferred income tax items 
for which it was more likely than not that realization would not occur. The Company determines the amount of the valuation allowance 
based, in part, on the Company’s assessment of future taxable income and in light of the Company’s ongoing income tax strategies. If 
the estimate of future taxable income or tax strategies changes at any time in the future, the Company would record an adjustment to 
our valuation allowance. Recording such an adjustment could have a material effect on the Company’s financial condition or results of 
operations.

Income tax expense is based on the distribution of profit before income tax among the various taxing jurisdictions in which 
we operate, adjusted as required by the income tax laws of each taxing jurisdiction. Changes in the distribution of profits and losses 

72

 
 
 
 
 
 
 
 
among  taxing  jurisdictions  may  have  a  significant  impact  on  our  effective  income  tax  rate.  The  Company  does  not  consider  the 
undistributed earnings of our foreign  subsidiaries to be indefinitely reinvested outside of the United States.

Pensions and Other Postretirement Benefits

The Company provides retirement benefits to certain employees, including defined benefit pension plans and postretirement 
medical plans. The determination of benefit obligations and expense is based on actuarial models. In order to measure benefit costs and 
obligations using these models, assumptions are made with regard to the discount rate, expected return on plan assets, cash balance 
crediting rate, lump sum conversion rate and the assumed rate of compensation increases. In addition, retiree medical care cost trend 
rates  are  a  key  assumption  used  exclusively  in  determining  costs  for  the  Company’s  postretirement  health  care  and  life  insurance 
benefit plans.

Stock-based Compensation

The  Company  accounts  for  stock-based  compensation  for  stock  options  and  stock  appreciation  rights  under  the  fair  value 
method and uses the Black-Scholes-Merton model to estimate the value of such stock-based awards granted to its employees and non-
executive directors. Expected volatility is based upon the historical volatility of a peer group for a period equal to the expected term, as 
the Company does not have adequate history to calculate its own volatility and believes the expected volatility will approximate the 
historical volatility of the peer group. The Company does not currently anticipate paying dividends. The expected term represents the 
period of time the grants are expected to be outstanding. The risk- free interest rate is based on the United States Treasury yield curve 
in effect at the time of the grant.

The Company values its stock-based compensation for restricted stock awards and restricted stock units based on the closing 
market  price  of  the  Company’s  common  stock  on  the  date  of  grant.  The  Company  accounts  for  its  stock-based  compensation  for 
performance  awards  based  on  the  closing  market  price  of  the  Company’s  common  stock  on  the  date  of  grant  and  for  performance 
awards that include market conditions based upon the Monte Carlo simulation model.

Leases

The Company determines if an arrangement is a lease at inception and reassesses if there are changes in terms and conditions 
of  the  contract.  Operating  leases  are  included  in  operating  lease  right-of-use  (“ROU”)  assets,  other  current  liabilities,  and  operating 
lease liabilities on our consolidated balance sheets. Operating lease ROU assets and operating lease liabilities are recognized based on 
the present value of the future minimum lease payments over the lease term at commencement date. As most of the Company’s leases 
do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement 
date in determining the present value of future payments. The operating lease ROU asset also includes any lease payments made before 
lease commencement and initial direct costs and excludes lease incentives. The Company’s lease terms may include options to extend 
or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is 
recognized on a straight-line basis over the lease term.

The  Company  has  lease  agreements  with  lease  and  non-lease  components  that  the  Company  has  elected  to  account  for  as 

single lease components.

On January 1, 2019, the Company adopted ASC 842 using the modified retrospective transition method as of the beginning of 

the period of adoption. Therefore, on January 1, 2019, the Company recognized and measured leases without revising the historical 
comparative period information or disclosures.

Earnings Per Share

The  calculation  of  earnings  per  share  is  based  on  the  weighted  average  number  of  common  shares  or  common  stock 
equivalents outstanding during the applicable period. The dilutive effect of common stock equivalents is excluded from basic earnings 
per  share  and  is  included  in  the  calculation  of  diluted  earnings  per  share.  Potentially  dilutive  securities  include  outstanding  stock 
options and unvested restricted stock units, restricted stock and performance awards. Employee equity share options, restricted stock 
units, restricted stock, performance awards and similar equity instruments granted by the Company are treated as potential common 
shares outstanding in computing diluted earnings per share. Diluted shares outstanding are calculated based on the average share price 
for  each  fiscal  period  using  the  treasury  stock  method.  Under  the  treasury  stock  method,  the  amount  the  employee  must  pay  for 

73

 
 
 
 
 
 
exercising stock options, the amount of compensation cost for future service that the Company has not yet recognized, and the amount 
of benefits that would be recorded in additional paid-in capital when the award becomes deductible for tax purposes are assumed to be 
used to repurchase shares.

Equity Method Investments

The  Company’s  investments  in  and  advances  to  unconsolidated  affiliates  are  accounted  for  under  the  equity  method  if  the 
Company exercises significant influence or has an investment in a limited partnership that is considered to be greater than minor. These 
investments and advances are classified as investments in and advances to unconsolidated affiliates on the accompanying consolidated 
balance sheets. The Company records its pro rata share of the earnings, adjusted for accretion of basis difference, of these investments 
in  equity  in  earnings  (losses)  of  unconsolidated  affiliates  on  the  accompanying  consolidated  statements  of  income.  The  Company 
reviews  its  investments  in  and  advances  to  unconsolidated  affiliates  for  impairment  whenever  events  or  changes  in  circumstances 
indicate that the carrying amounts may not be recoverable.

Treasury Stock

The Company records treasury stock purchases under the cost method. Upon reissuance of treasury stock, amounts in excess 
of  the  acquisition  cost  are  credited  to  additional  paid  in  capital.  If  the  Company  reissues  treasury  stock  at  an  amount  below  its 
acquisition cost and additional paid in capital associated with prior treasury stock transactions is insufficient to cover the difference 
between the acquisition cost and the reissue price, this shortfall is recorded in retained earnings.

Recently Issued Accounting Standards

Accounting pronouncements recently adopted

In August 2018, the FASB issued new accounting guidance that clarifies and aligns the accounting for implementation costs 
for  hosting  arrangements  with  the  requirements  for  capitalizing  implementation  costs  incurred  to  develop  or  obtain  internal-use 
software. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance did 
not have a material effect on the Company’s consolidated financial statements.

In August 2018, the FASB issued new accounting guidance that modifies the disclosure requirements in Topic 820, Fair Value 
Measurement,  by  removing  certain  disclosure  requirements  related  to  the  fair  value  hierarchy,  modifying  existing  disclosure 
requirements related to measurement uncertainty and adding new disclosure requirements, such as disclosing the changes in unrealized 
gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of 
the reporting period and disclosing the range and weighted average of significant unobservable inputs used to develop Level 3 fair value 
measurements.  This  new  accounting  guidance  also  modifies  the  disclosure  requirements  for  employers  that  sponsor  defined  benefit 
pension or other postretirement plans. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new 
accounting guidance did not have a material effect on the Company’s consolidated financial statements.

In January 2017, the FASB issued new accounting  guidance that simplifies the measurement of goodwill by eliminating the 
step  two  impairment  test.  Step  two  measures  a  goodwill  impairment  loss  by  comparing  the  implied  fair  value  of  goodwill  with  the 
carrying  amount  of  that  goodwill.  The  new  guidance  requires  a  comparison  of  the  Company’s  fair  value  of  a  reporting  unit  with  the 
carrying amount and the Company is required to recognize an impairment charge for the amount by which the carrying amount exceeds 
the fair value. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance 
did not have a material effect on the Company’s consolidated financial statements.

In June 2016, the FASB issued a new accounting standard intended to provide financial statement users with more decision-
useful  information  about  expected  credit  losses  and  other  commitments  to  extend  credit  held  by  the  reporting  entity.  The  standard 
replaces  the  incurred  loss  impairment  methodology  in  current  GAAP  with  one  that  reflects  expected  credit  losses  and  requires 
consideration of a broader range of reasonable and supportable information to inform credit loss estimates. The Company adopted this 
new  accounting  guidance  on  January  1,  2020.  The  adoption  of  this  guidance  did  not  have  a  material  effect  on  the  Company’s 
consolidated  financial  statements.  This  is  based  on  factors  including  the  Company's  assessment  of  historical  losses,  client's 
creditworthiness and the fact that the Company's trade receivables are short term in duration.

74

 
 
 
 
Accounting pronouncements issued but not adopted as of December 31, 2020

In March 2020, the FASB issued new accounting guidance that provides optional expedients and exceptions for applying U.S. 
GAAP to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate 
that  is  expected  to  be  discontinued.  The  new  accounting  guidance  is  effective  for  the  Company  as  of  March  12,  2020  through 
December 31, 2022. The Company is currently evaluating the impact of this new accounting guidance on its credit arrangements and 
derivatives  that  reference  LIBOR.  The  Company  does  not  expect  the  new  accounting  guidance  to  have  a  material  effect  on  the 
Company’s consolidated financial statements.

In January 2020, the FASB issued new accounting guidance that states any equity security transitioning from the alternative 
method of accounting to the equity method, or vice versa, due to an observable transaction, will be remeasured immediately before the 
transition. In addition, the new accounting guidance clarifies the accounting for certain non-derivative forward contracts or purchased 
call  options  to  acquire  equity  securities  stating  such  instruments  will  be  measured  using  the  fair  value  principles  before  settlement  or 
exercise. The new accounting guidance will be effective for the Company on January 1, 2021 on a prospective basis. Early adoption is 
permitted. The Company does not expect the new accounting guidance to have a material effect on the Company’s consolidated financial 
statements.

In December 2019, the FASB issued new accounting guidance to clarify and simplify the accounting for income taxes. Changes 
under the new guidance includes eliminating certain exceptions related to the approach for intraperiod tax allocation, the methodology 
for calculating income taxes in an interim period and the recognition of deferred tax liabilities for outside basis differences. The new 
accounting guidance will be effective for the Company on January 1, 2021. Early adoption is permitted. The Company does not expect 
the new accounting guidance to have a material effect on the Company’s consolidated financial statements.

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

The Company attributes revenues to geographical region based upon where the services are performed. The following tables 

represent revenues by geographical region and reportable segment for the years ended December 31, 2020, 2019 and 2018:

(in millions)
Revenues:

Americas   

Europe and Africa

Asia-Pacific
Total revenues

(in millions)
Revenues:

Americas   

Europe and Africa

Asia-Pacific

Total revenues

December 31, 2020

Technology & 
Analytics 
Solutions

Research & 
Development 
Solutions

Contract Sales & 
Medical 
Solutions

Total

$ 

$ 

2,413  $ 

2,680  $ 

1,844 

601 
4,858  $ 

1,667 

1,413 
5,760  $ 

326  $ 

184 

231 
741  $ 

5,419 

3,695 

2,245 
11,359 

December 31, 2019

Technology & 
Analytics 
Solutions

Research & 
Development 
Solutions

Contract Sales & 
Medical 
Solutions

Total

$ 

$ 

2,370  $ 

2,693  $ 

399  $ 

1,543 

573 

1,734 

1,361 

200 

215 

5,462 

3,477 

2,149 

4,486  $ 

5,788  $ 

814  $ 

11,088 

75

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(in millions)
Revenues:

Americas   

Europe and Africa

Asia-Pacific

Total revenues

December 31, 2018

Technology & 
Analytics 
Solutions

Research & 
Development 
Solutions

Contract Sales & 
Medical 
Solutions

Total

$ 

$ 

2,087  $ 

2,553  $ 

358  $ 

1,520 

530 

1,693 

1,219 

235 

217 

4,998 

3,448 

1,966 

4,137  $ 

5,465  $ 

810  $ 

10,412 

No individual country, except for the United States and the United Kingdom, accounted for 10% or more of total revenues for 
the  year  ended  December  31,  2020,  2019  and  2018.  For  the  year  ended  December  31,  2020,  revenues  in  the  United  States  and  the 
United Kingdom accounted for 35% and 10% of total revenue, respectively. For the year ended December 31, 2019, revenues in the 
United States and the United Kingdom accounted for 45% and 10% of total revenue, respectively. For the year ended December 31, 
2018, revenues in the United States and the United Kingdom accounted for 43% and 11% of total revenue, respectively.

No individual customer represented 10% or more of total revenues for the years ended December 31, 2020, 2019 and 2018.

Transaction Price Allocated to the Remaining Performance Obligations

As of December 31, 2020, approximately $25.3 billion of revenue is expected to be recognized in the future from remaining 
performance  obligations.  The  Company  expects  to  recognize  revenue  on  approximately  30%  of  these  remaining  performance 
obligations over the next twelve months, with the balance recognized thereafter. 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)

Trade accounts receivable

Billed

Unbilled services

Trade accounts receivable and unbilled services

Allowance for doubtful accounts

Trade accounts receivable and unbilled services, net

Unbilled services and unearned income was as follows:

(in millions)
Unbilled services

Unearned income

Net balance

December 31,

2020

2019

$ 

1,181  $ 

1,263 

2,444 

(34) 

$ 

2,410  $ 

1,312 

1,286 

2,598 

(16) 

2,582 

December 31,

2020

1,263 

(1,252) 

11 

$ 

$ 

2019

1,286 

(1,014) 

272 

Change

(23) 

(238) 

(261) 

$ 

$ 

$ 

$ 

Unbilled  services,  which  is  comprised  of  approximately  60%  of  unbilled  receivables  and  40%  of  contract  assets  as  of 
December  31,  2020,  decreased  by  $23  million  as  compared  to  December  31,  2019.  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 $238 million over the same period resulting in a decrease of $261 
million in the net balance of unbilled services and unearned income between December 31, 2020 and 2019. Decrease in the net balance 

76

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
is driven by the difference in timing of revenue recognition in accordance with ASC 606, Revenue from Contracts with Customers, 
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.

Bad  debt  expense  recognized  on  the  Company’s  receivables  and  unbilled  services  was  de  minimis  for  the  years  ended 

December 31, 2020, 2019 and 2018.

4. Investments

Debt, Equity and Other Securities

Current

The Company’s short-term investments in debt, equity and other securities consist primarily of trading investments in mutual 
funds  and  are  measured  at  fair  value  with  realized  and  unrealized  gains  and  losses  recorded  in  other  expense  (income),  net  on  the 
accompanying consolidated statements of income.

Long-term

The  Company’s  long-term  equity  investments  (except  those  accounted  for  under  the  equity  method,  those  that  result  in 
consolidation of the investee and certain other investments) are measured at fair value and any changes in fair value are recognized in 
net income at the end of each reporting period. For equity investments that do not have readily determinable fair values and do not 
qualify  for  the  existing  practical  expedient  in  Accounting  Standards  Codification  (“ASC”)  820  “Fair  Value  Measurement”  (“ASC 
820”) to estimate fair value using the net asset value per share of the investment, the Company applies a new measurement alternative 
and measure those investments at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly 
transactions for the identical or a similar investment of the same issuer at each reporting period. 

Unconsolidated Affiliates

The  Company  accounts  for  its  investments  in  and  advances  to  unconsolidated  affiliates  under  the  equity  method  of 
accounting  and  records  its  pro  rata  share  of  its  losses  or  earnings  from  these  investments  in  equity  in  earnings  (losses)  of 
unconsolidated affiliates. The following is a summary of the Company’s investments in and advances to unconsolidated affiliates:

(in millions)
NovaQuest Pharma Opportunities Fund III, L.P. (“NQ Fund III”)

NovaQuest Pharma Opportunities Fund IV, L.P. (“NQ Fund IV”)

NovaQuest Pharma Opportunities Fund V, L.P. (“NQ Fund V”)

NovaQuest Private Equity Fund I, L.P. (“NQ PE Fund I”)
NostraData Pty Ltd. (“NostraData”)

Inteliquet (“Inteliquet”)

Helparound ("Helparound")

Longwood Fund V, L.P. ("Longwood")

Other

Variable Interest Entities

December 31,

2020

2019

7  $ 
8 

17 

3 

18 

16 

3 

1 

11 
84  $ 

19 

8 

13 

4 
8 

18 

4 

— 

13 
87 

$ 

$ 

As of December 31, 2020, the Company’s investments in unconsolidated variable interest entities (“VIEs”) and its estimated 

maximum exposure to loss were as follows:

77

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(in millions)

NQ Fund III

NQ Fund IV

NQ Fund V

NQ PE Fund I

Longwood

Pappas Life Science Ventures V, L.P.

5. Derivatives

Foreign Exchange Risk Management

Investments in 
Unconsolidated 
VIEs

Maximum 
Exposure to Loss

$ 

7  $ 

8 

17 

3 

1 

1 

$ 

37  $ 

13 

11 

47 

5 

10 

2 

88 

The  Company  transacts  business  in  more  than  100  countries  and  is  subject  to  risks  associated  with  fluctuating  foreign 
exchange  rates.  Accordingly,  the  Company  enters  into  foreign  currency  forward  contracts  to  (i)  hedge  certain  forecasted  foreign 
exchange cash flows arising from service contracts (“Service Contract Hedging”) and (ii) hedge non-United States dollar anticipated 
intercompany  reseller  fees  (“Reseller  Hedging”).  It  is  the  Company’s  policy  to  enter  into  foreign  currency  transactions  only  to  the 
extent necessary to reduce earnings and cash flow volatility associated with foreign exchange rate movements. The Company does not 
enter  into  foreign  currency  transactions  for  investment  or  speculative  purposes.  The  principal  currencies  hedged  in  2020  were  the 
British Pound and the Japanese Yen.

Service Contract Hedging and Reseller Hedging contracts are designated as cash flow hedges and are carried at fair value, 
with changes in the fair value recorded to AOCI. The change in fair value is reclassified from AOCI to earnings in the period in which 
the hedged transaction occurs. These contracts have various expiration dates through September 2021.

As  of  December  31,  2020  and  2019,  the  Company  had  open  Service  Contract  Hedging  and  Reseller  Hedging  contracts  to 
hedge  certain  forecasted  foreign  currency  cash  flow  transactions  occurring  in  2021  and  2020  with  notional  amounts  totaling  $70 
million  and  $148  million,  respectively.  For  accounting  purposes  these  hedges  are  considered  highly  effective.  As  of  December  31, 
2020 and 2019, the Company had recorded gross unrealized gains (losses) of $5 million and $— million and $4 million and less than 
$(1) million, respectively, related to these contracts. Upon expiration of the hedge instruments in 2020, the Company reclassified the 
unrealized holding gains and losses on the derivative instruments included in AOCI into earnings. The unrealized gains (losses) are 
included in other current assets and liabilities on the accompanying consolidated balance sheets as of December 31, 2020 and 2019.

Interest Rate Risk Management

The  Company  has  entered  into  interest  rate  swap  agreements  for  purposes  of  managing  its  exposure  to  interest  rate 

fluctuations.

In  April  2014,  IMS  Health  entered  into  United  States  dollar  and  Euro  denominated  interest  rate  swap  agreements  (“2014 
Swaps”)  to  hedge  interest  rate  exposure  on  notional  amounts  of  approximately  $600  million  of  its  borrowings.  The  2014  Swaps 
commenced between April and June 2014 and expire at various times through March 2021. As of December 31, 2020, only one of the 
2014 Swaps remain unexpired, with a notional value of $356 million. On this agreement, the Company pays a fixed rate of 1.6% and 
receives a variable rate of interest equal to the greater of three-month Euro Interbank Offered Rate (“EURIBOR”) or the equivalent to 
LIBOR,  and  1%.  During  2017,  the  2014  Swaps  ceased  to  be  considered  highly  effective  for  accounting  purposes  and  as  such,  the 
Company discontinued hedge accounting and prospective changes in the fair value of the Swaps are recognized in earnings.

On June 3, 2015, the Company entered into seven forward starting interest rate swaps (“2015 Swaps”) in an effort to limit its 
exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (as defined below). Interest on the swaps began 
accruing on June 30, 2016, and the interest rate swaps expired at various times through March 2020. As of December 31, 2020, none 

78

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
of the 2015 Swaps were still outstanding. The Company paid a fixed rate of 2.1% and received a variable rate of interest equal to the 
three-month LIBOR on these agreements.

On July 19, 2018, the Company entered into two forward starting interest rate swaps (“2018 Swaps”) with a total notional 
value of $500 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (as 
defined below). Interest on the 2018 Swaps began accruing on June 28, 2019 and the interest rate swaps expire on June 28, 2024. The 
Company pays a fixed rate of 3.0% and receives a variable rate of interest equal to the three-month LIBOR on the 2018 Swaps.

On March 27, 2020, the Company entered into an interest rate swap with a notional value of $1 billion in an effort to limit its 
exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (as defined below).  Interest on the swap began 
accruing on March 31, 2020 and the swap expires on March 31, 2023.  The Company pays a fixed rate of .56% and receives a variable 
rate of interest equal to the one-month LIBOR on the swap.

On June 4, 2020, the Company entered into an interest rate swap with a notional value of  $300 million in an effort to limit its 
exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (as defined below).  Interest on the swap began 
accruing on June 30, 2020 and the swap expires on June 28, 2024.  The Company pays a fixed rate of .54% and receives a variable rate 
of interest equal to the three-month LIBOR on the swap.

The  critical  terms  of  the  swaps  are  substantially  the  same  as  the  underlying  borrowings.    These  interest  rate  swaps  are 
accounted for as cash flow hedges as these transactions were executed to hedge the Company's interest payments and for accounting 
purposes  are  considered  highly  effective.    As  such,  the  effective  portion  of  the  hedges  is  recorded  as  unrealized  gains  (losses)  on 
derivatives included in AOCI.

The  fair  value  of  these  interest  rate  swaps  represents  the  present  value  of  the  anticipated  net  payments  the  Company  will 
make to the counterparty, which, when they occur, are reflected as interest expense on the consolidated statements of income. These 
interest rate swaps will result in a total debt mix of approximately 66% fixed rate debt and 34% variable rate debt.

Net Investment Risk Management

The Company designates its foreign currency denominated debt as a hedge of its net investment in certain foreign subsidiaries 
to reduce the volatility in stockholders’ equity caused by changes in the Euro exchange rate with respect to the United States dollar, 
which is accounted for as a cash flow hedge. As of December 31, 2020, these borrowings (net of original issue discount) were €5,323 
million ($6,528 million). The effective portion of foreign exchange gains or losses on the remeasurement of the debt is recognized in 
the  cumulative  translation  adjustment  component  of  AOCI  with  the  related  offset  in  long-term  debt.  Those  amounts  would  be 
reclassified from AOCI to earnings upon the sale or substantial liquidation of these net investments. The amount of foreign exchange 
losses related to the net investment hedge included in the cumulative translation adjustment component of AOCI for the year ended 
December 31, 2020 was $561 million.

The fair values of the Company’s derivative instruments and the line items on the accompanying consolidated balance sheets 

to which they were recorded are summarized in the following table:

(in millions)
Derivatives designated as 
hedging instruments:

Balance Sheet Classification

Assets

Liabilities

Notional

Assets

Liabilities

Notional

December 31, 2020

December 31, 2019

Foreign exchange forward 
contracts

Other current assets and 

liabilities

$ 

Interest rate swaps

Other assets and liabilities

Derivatives not designated as 

hedging instruments:

Interest rate swaps

Total derivatives

Other liabilities

5 

— 

— 

—  $ 

70  $ 

4  $ 

—  $ 

55 

1,800 

— 

1 

56 

356 

— 

$ 

4  $ 

27 

3 

30 

148 

875 

325 

$ 

5  $ 

79

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The pre-tax effect of the Company’s cash flow hedging instruments on other comprehensive (loss) income is summarized in the 

following table:

(in millions)
Foreign exchange forward contracts

Interest rate derivatives

Total

Year Ended December 31,

2020

2019

2018

$ 

$ 

1  $ 

(28) 
(27)  $ 

2  $ 

(22) 

(20)  $ 

(9) 

(6) 

(15) 

The Company expects approximately $14 million of pre-tax unrealized losses related to its foreign exchange contracts and 
interest rate derivatives included in AOCI at December 31, 2020 to be reclassified into earnings within the next twelve months. The 
total amount of cash flow hedge effect on the income statement is immaterial for year ended December 31, 2020.

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  at 
December 31, 2020 and 2019 due to their short-term nature. At December 31, 2020 and 2019, the fair value of total debt approximated 
$12,746  million  and  $11,925  million,  respectively,  as  determined  under  Level  1  and  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 December 31, 2020:

(in millions)
Assets:

Marketable securities

Derivatives

Total  

Liabilities:

Derivatives

Contingent consideration

Total  

Level 1

Level 2

Level 3

Total

122  $ 

— 

122  $ 

—  $ 

— 

—  $ 

—  $ 

5 

5  $ 

56  $ 

— 

56  $ 

—  $ 

— 

—  $ 

—  $ 

119 

119  $ 

122 

5 

127 

56 

119 

175 

$ 

$ 

$ 

$ 

80

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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, 2019:

(in millions)
Assets:

Marketable securities

Derivatives

Total  

Liabilities:

Derivatives

Contingent consideration

Total  

Level 1

Level 2

Level 3

Total

$ 

$ 

$ 

$ 

79  $ 

— 

79  $ 

—  $ 

— 

—  $ 

—  $ 

4 

4  $ 

30  $ 

— 

30  $ 

—  $ 

— 

—  $ 

—  $ 

113 

113  $ 

79 

4 

83 

30 

113 

143 

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.

The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the 

year ended December 31,:

(in millions)
Balance as of January 1

Business combinations

Contingent consideration paid

Revaluations included in earnings and foreign currency translation adjustments

Balance as of December 31,

Contingent Consideration

2020

2019

2018

$ 

$ 

113  $ 
47 

(22) 
(19)   
119  $ 

123  $ 

40 

(46) 
(4)   
113  $ 

69 

53 

(24) 
25 
123 

The Company used the following key assumptions when estimating the fair value of contingent considerations:

Unobservable Input
Revenue target

EBITDA target

Operational target

Weighted average 
probability of target 
achievement
82%

92%

91%

Range of potential 
payment
0%-100%

0%-100%

0%-100%

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

81

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Non-recurring Fair Value Measurements

Certain assets are carried on the accompanying consolidated balance sheets at cost and are not remeasured to fair value on a 
recurring  basis.  These  assets  include  equity  investments  that  do  not  have  readily  determinable  fair  values  that  are  assessed  for 
impairment quarterly or annually and when a triggering event occurs, and goodwill and identifiable intangible assets that are tested for 
impairment annually and when a triggering event occurs. See Note 4 and 8 for additional information.

As of December 31, 2020, assets carried on the balance sheet and not remeasured to fair value on a recurring basis totaled 
approximately $17,987 million and were identified as Level 3. These assets are comprised of cost and equity method investments of 
$128 million, goodwill of $12,654 million and other identifiable intangibles, net of $5,205 million.

Cost  and  Equity  Method  Investments—The  inputs  available  for  valuing  investments  in  non-public  portfolio  companies  are 
generally  not  easily  observable.  The  valuation  of  non-public  investments  requires  judgment  by  the  Company  due  to  the  absence  of 
quoted market values, inherent lack of liquidity and the long-term nature of such assets. When a triggering event occurs, the Company 
considers a wide range of available market data when assessing the estimated fair value. Such market data includes observations of the 
trading  multiples  of  public  companies  considered  comparable  to  the  private  companies  being  valued  as  well  as  publicly  disclosed 
merger  transactions  involving  comparable  private  companies.  In  addition,  valuations  are  adjusted  to  account  for  company-specific 
issues, the lack of liquidity inherent in a non-public investment and the fact that comparable public companies are not identical to the 
companies being valued. Such valuation adjustments are necessary because in the absence of a committed buyer and completion of due 
diligence similar to that performed in an actual negotiated sale process, there may be company-specific issues that are not fully known 
that may affect value. Further, a variety of additional factors are reviewed by the Company, including, but not limited to, financing and 
sales  transactions  with  third  parties,  current  operating  performance  and  future  expectations  of  the  particular  investment,  changes  in 
market outlook and the third-party financing environment. Because of the inherent uncertainty of valuations, estimated valuations may 
differ significantly from the values that would have been used had a ready market for the securities existed, and the differences could 
be material.

Goodwill—Goodwill represents the difference between the purchase price and the fair value of the identifiable tangible and 
intangible net assets resulting from business combinations. On an annual basis and if a triggering event occurs, the Company performs 
a qualitative analysis to determine whether it is more likely than not that the estimated fair value of a reporting unit is less than its book 
value.  This  includes  a  qualitative  analysis  of  macroeconomic  conditions,  industry  and  market  considerations,  internal  cost  factors, 
financial performance, fair value history and other company specific events. If this qualitative analysis indicates that it is more likely 
than not that the estimated fair value is less than the book value for the respective reporting unit, the Company determines whether the 
estimated  fair  value  of  the  reporting  unit  is  in  excess  of  its  carrying  value.  If  the  carrying  value  of  the  net  assets  assigned  to  the 
reporting unit exceeds the estimated fair value of the reporting unit, the Company compares the fair value with the carrying amount and 
recognizes  an  impairment  charge  for  the  amount  by  which  the  carrying  amount  exceeds  the  fair  value.  See  Note  8  for  additional 
information.

Definite-lived Intangible Assets—If a triggering event occurs, the Company determines the estimated fair value of definite-

lived intangible assets by determining the present value of the expected cash flows. See Note 8 for additional information.

Indefinite-lived Intangible Asset—If a triggering event occurs and a qualitative analysis indicates that it is more likely than 
not  that  the  estimated  fair  value  is  less  than  the  carrying  value  of  an  indefinite-lived  intangible  asset,  the  Company  determines  the 
estimated  fair  value  of  the  indefinite-lived  intangible  asset  (trade  name)  by  determining  the  present  value  of  the  estimated  royalty 
payments on an after-tax basis that it would be required to pay the owner for the right to use such trade name. If the carrying amount 
exceeds the estimated fair value, an impairment loss is recognized in an amount equal to the excess.

7. Property and Equipment

The major classes of property and equipment were as follows:

82

 
 
 
 
 
 
 
(in millions)
Land, buildings and leasehold improvements

Equipment

Furniture and fixtures

Transportation equipment

Property and equipment, gross

Less accumulated depreciation

Property and equipment, net

Property and equipment depreciation expense was as follows:

(in millions)

Depreciation expense

8. Goodwill and Identifiable Intangible Assets

December 31,

2020

2019

$ 

$ 

351  $ 
657 

76 

71 

1,155 

(673) 
482  $ 

331 

570 

81 

73 

1,055 

(597) 

458 

Year Ended December 31,

2020

2019

2018

134 

128 

125 

As  of  December  31,  2020,  the  Company  has  approximately  $5,205  million  of  identifiable  intangible  assets,  of  which 
approximately  $18  million,  relating  to  a  trade  name,  is  deemed  to  be  indefinite-lived  and,  accordingly,  is  not  being  amortized. 
Amortization expense associated with identifiable definite-lived intangible assets was as follows:

(in millions)

Amortization expense

Year Ended December 31,

2020

2019

2018

$ 

1,153  $ 

1,074  $ 

1,016 

Estimated amortization expense for existing identifiable intangible assets is expected to be approximately $1,062 million, $708 
million, $605 million, $508 million and $409 million for the years ending December 31, 2021, 2022, 2023, 2024, and 2025, respectively. 
Estimated  amortization  expense  can  be  affected  by  various  factors,  including  future  acquisitions  or  divestitures  of  service  and/or 
licensing and distribution rights or impairments.

The following is a summary of identifiable intangible assets:

(in millions)
Definite-lived identifiable 
intangible assets:

Client relationships and backlog

Trademarks, trade name and other

Databases

Software and related assets

Non-compete agreements

Indefinite-lived identifiable 
intangible assets

Trade name

As of December 31, 2020

As of December 31, 2019

Gross
Amount

Accumulated
Amortization

Net
Amount

Gross
Amount

Accumulated
Amortization

Net
Amount

$ 

5,095  $ 

(1,745)  $ 

3,350  $ 

4,809  $ 

(1,303)  $ 

3,506 

544 

1,930 

2,109 

28 

(212)   

(1,629)   

(915)   

(18)   

332 

301 

1,194 

10 

528 

1,836 

1,620 

32 

(158)   

(1,185)   

(665)   

(18)   

370 

651 

955 

14 

$ 

9,706  $ 

(4,519)  $ 

5,187  $ 

8,825  $ 

(3,329)  $ 

5,496 

$ 

18  $ 

—  $ 

18  $ 

18  $ 

—  $ 

18 

The following is a summary of goodwill by segment for the years ended December 31, 2020 and 2019:

83

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(in millions)
Balance as of December 31, 2018
Business combinations

Impact of foreign currency fluctuations and other
Balance as of December 31, 2019
Business combinations

Impact of foreign currency fluctuations and other
Balance as of December 31, 2020

Technology & 
Analytics 
Solutions

Research & 
Development 
Solutions

Contract Sales & 
Medical 
Solutions

Consolidated

$ 

10,239  $ 

1,427  $ 

134  $ 

11,800 

216 

(81) 

10,374 
86 

404 

215 

4 

1,646 
29 

(29) 

5 

— 

139 
0 

5 

436 

(77) 

12,159 
115 

380 

$ 

10,864  $ 

1,646  $ 

144  $ 

12,654 

There were no goodwill impairment losses for the years ended December 31, 2020 or 2019.

9. Accrued Expenses

Accrued expenses consist of the following:

(in millions)
Compensation, including bonuses, fringe benefits and payroll taxes

Restructuring

Interest

Client contract related

Professional fees

Contingent consideration and deferred purchase price

Other

December 31,

2020

2019

$ 

852  $ 

53 

55 

849 

92 

59 

272 

$ 

2,232  $ 

687 

67 

53 

763 

80 

52 

235 

1,937 

10. Credit Arrangements

The following is a summary of the Company’s revolving credit facilities at December 31, 2020:

Facility
$1,500 million (revolving credit facility)

$25 million (receivables financing facility)
£10 million (approximately $14 million) general banking 
facility

Interest Rates

LIBOR in the relevant currency borrowed plus a margin of 1.50% at 
December 31, 2020

LIBOR Market Index Rate (0.14% at December 31, 2020) plus 0.90%
Bank’s base rate of 0.10% at December 31, 2020 plus 1%

84

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

(dollars in millions)
Senior Secured Credit Facilities:

Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 1.75%

$ 

Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 2.75%

Term A Loan due 2023—Euro LIBOR at average floating rates of 1.50%

Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 1.90%

Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00%

Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 1.90%

Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 2.00%

Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00%

Revolving Credit Facility due 2023:

U.S. Dollar denominated borrowings—U.S. Dollar LIBOR at average floating rates of 1.64%

Japanese Yen denominated borrowings—Japanese Yen LIBOR at average floating rates of 
1.50%

5.0% Senior Notes due 2027—U.S. Dollar denominated

5.0% Senior Notes due 2026—U.S. Dollar denominated

2.875% Senior Notes due 2025—Euro denominated

3.25% Senior Notes due 2025—Euro denominated

3.5% Senior Notes due 2024—Euro denominated

2.25% Senior Notes due 2028—Euro denominated
2.875% Senior Notes due 2028—U.S. Euro denominated

Receivables financing facility due 2022—U.S. Dollar LIBOR at average floating rates of 1.04%

December 31,

2020

2019

728  $ 
766 
400 

535 

1,413 

726 

926 

697 

— 

— 

1,100 

1,050 

515 

1,748 

— 

883 
872 
240 

770 
— 
387 

535 

1,306 

733 

936 

644 

154 

212 

1,100 

1,050 

471 

1,598 

701 

808 
— 
300 

Principal amount of debt

Less: unamortized discount and debt issuance costs

Less: current portion

Long-term debt

12,600 

11,705 

(67) 

(149) 

(60) 

(100) 

$ 

12,384  $ 

11,545 

Contractual maturities of long-term debt at December 31, 2020 are as follows:

(in millions)
2021
2022

2023

2024

2025
Thereafter

$ 

149 

389 

1,715 

1,927 
4,515 
3,905 

$ 

12,600 

At December 31, 2020, there were bank guarantees totaling approximately £0.9 million (approximately $1.3 million) issued 
against the availability of the general banking facility with a European headquartered bank through their operations in the United 
Kingdom.

85

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Senior Secured Credit Agreement and Senior Notes

2020 Financing Transactions

At  December  31,  2020,  the  Company’s  Fourth  Amended  and  Restated  Credit  Agreement,  as  amended  (the  “Credit 
Agreement”) provided financing through several senior secured credit facilities (collectively, the “senior secured credit facilities”) of 
up to approximately $7,692 million, which consisted of $6,192 million principal amounts of debt outstanding (as detailed in the table 
above),  $4  million  of  issued  standby  letters  of  credit  and  $1,496  million  of  available  borrowing  capacity  on  the  revolving  credit 
facility. 

On June 24, 2020, IQVIA Inc. (the “Issuer”), a wholly owned subsidiary of the Company, completed the issuance and 
sale of €711 million in gross proceeds of the Issuer’s 2.875% senior notes due 2028 (the “2.875% Notes”). The 2.875% Notes 
were issued pursuant to an Indenture, dated June 24, 2020, among the Issuer, U.S. Bank National Association, as trustee of the 
Notes,  and  certain  subsidiaries  of  the  Issuer  as  guarantors.  The  2.875%  Notes  are  unsecured  obligations  of  the  Issuer,  will 
mature on June 15, 2028 and bear interest at the rate of 2.875% per year, with interest payable semiannually on June 15 and 
December  15  of  each  year,  beginning  on  December  15,  2020.  The  Issuer  may  redeem  the  2.875%  Notes  prior  to  their  final 
stated maturity, subject to a customary make-whole premium, at any time prior to June 15, 2023 (subject to a customary “equity 
claw” redemption right) and thereafter subject to a redemption premium declining from 1.438% to 0.000%. The proceeds from 
the  2.875%  Notes  offering  were  used  to  redeem  all  of  the  Issuer’s  outstanding  3.500%  senior  notes  due  2024  (the  “3.500% 
Notes”), including the payment of premiums in respect thereof, to repay a portion of the existing borrowings under the Issuer’s 
revolving credit facility and to pay fees and expenses related to the offering. The Issuer’s obligations with respect to the 3.500% 
Notes were discharged on the same day as the Issuer completed the issuance of the 3.500% Notes, and the 3.500% Notes were 
redeemed on July 9, 2020. 

On  March  11,  2020,  the  Company  entered  into  Amendment  No.  7  to  the  Credit  Agreement  to  borrow  $900  million  in 
additional U.S. Dollar denominated term A loans due 2023 (the “TLA-2 Loans”) and, on March 30, 2020, entered into Amendment 
No. 8 to the Credit Agreement to amend certain terms of the TLA-2 Loans. The TLA-2 Loans bear interest based on the U.S. Dollar 
LIBOR plus a margin ranging from 1.50% to 2.25%, with a U.S. Dollar LIBOR floor of 1.00% per annum. The proceeds from the 
TLA-2 Loans were used to repay outstanding revolving credit loans under the Company's senior secured credit facilities. On March 
30, 2020, the Company prepaid $100 million of the TLA-2 loans.

2019 Financing Transactions

At December 31, 2019, the Company’s Credit Agreement provided financing through the several senior credit facilities of 
approximately  $6,811  million,  which  consisted  of  $5,677  million  principal  amounts  of  debt  outstanding  (as  detailed  in  the  table 
above),  $3  million  of  issued  standby  letters  of  credit  and  $1,131  million  of  available  borrowing  capacity  on  the  $1,500  million 
revolving credit facility. On December 18, 2019, the Company entered into Amendment No. 6 to the Credit Agreement; pursuant to 
the Amendment, that amended the interest rate applicable to the Issuer’s Term B Loan due 2024—U.S. Dollar LIBOR and Term B 
Loan due 2025—U.S. Dollar LIBOR was reduced to LIBOR plus 1.75% per annum and the LIBOR floor applicable to the Issuer’s 
Term B-1 Dollar Loans was reduced to —% per annum. On August 9, 2019, the Company entered into Amendment No. 5 to the 
Credit Agreement that repriced the Euro LIBOR floor applicable to the Euro-denominated Term B Loan due 2024 and Term B Loan 
due 2025 to 0% per annum.

On August 13, 2019, the Issuer completed the issuance and sale of €720 million in gross proceeds of the Issuer’s 2.25% 
Senior Notes due 2028 (the “2.25% Notes”). The 2.25% Notes were issued pursuant to an Indenture, dated August 13, 2019, among 
the Issuer, U.S. Bank National Association, as trustee of the 2.25% Notes, and certain subsidiaries of the Issuer as guarantors. The 
net proceeds from the notes offering, together with available cash, were used to redeem the Issuer’s outstanding 2023 senior notes 
due 2023 (the “4.875% Notes”), and to pay fees and expenses related to the notes offering. On July 29, 2019, the Issuer issued a 
conditional notice of redemption with respect to the 4.875% Notes, for a total redemption price equal to the sum of the principal 
amount of the 4.875% Notes, accrued and unpaid interest on the 4.875% Notes to the redemption date and the applicable redemption 
premium.  The  Issuer’s  obligations  with  respect  to  the  4.875%  Notes  were  discharged  on  August  13,  2019.  The  2.25%  Notes  are 
unsecured obligations of the Issuer, will mature on January 15, 2028 and bear interest at the rate of 2.25% per annum, with interest 
payable semi-annually on January 15 and July 15 of each year, beginning on January 15, 2020. The Issuer may redeem the 2.25% 
Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to July 15, 2022 (subject to 
a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 101.125% to 0.000%.

86

On May 10, 2019, the Issuer completed the issuance and sale of $1.1 billion in gross proceeds of the Issuer’s 5.00% Senior 
Notes due 2027 (the “5.00% Notes”). The 5.00% Notes were issued pursuant to an Indenture, dated May 10, 2019, among the Issuer, 
U.S. Bank National  Association, as trustee of the 5.00% Notes, and certain subsidiaries of the Issuer as guarantors. The net proceeds 
from this notes offering were used to repay existing borrowings under the Issuer’s revolving credit facility, to pay fees and expenses 
related to the notes offering and for other general corporate purposes. The 5.00% Notes are unsecured obligations of the Issuer, will 
mature on May 15, 2027 and bear interest at the rate of 5.00% per annum, with interest payable semi-annually on January 15 and 
July 15 of each year, beginning on January 15, 2020. The Issuer may redeem the 5.00% Notes prior to their final stated maturity, 
subject to a customary make-whole premium, at any time prior to May 15, 2022 (subject to a customary “equity claw” redemption 
right) and thereafter subject to a redemption premium declining from 2.500% to 0.000%.

Receivables Financing Facility

On November 25, 2020, the Company amended its receivables financing facility to exclude certain of its accounts receivable 

from the facility.

On December 19, 2019, the Company amended its receivables financing facility to extend the term of the facility to December 

19, 2022.

On December 5, 2014, the Company entered into a four-year arrangement to securitize certain of its accounts receivable. 
Under the receivables financing facility, certain of the Company’s accounts receivable are sold on a non-recourse basis by certain of 
its  consolidated  subsidiaries  to  another  of  its  consolidated  subsidiaries,  a  bankruptcy-remote  special  purpose  entity  (“SPE”).  The 
SPE obtained a term loan and revolving loan commitment from a third-party lender, secured by liens on the assets of the SPE, to 
finance  the  purchase  of  the  accounts  receivable,  which  includes  a  $275  million  term  loan  and  a  $25  million  revolving  loan 
commitment. The revolving loan commitment may be increased by an additional $35 million as amounts are repaid under the term 
loan. The Company has guaranteed the performance of the obligations of existing and future subsidiaries that sell and service the 
accounts receivable under the receivables financing facility. The assets of the SPE are not available to satisfy any of the Company’s 
obligations  or  any  obligations  of  its  subsidiaries.  As  of  December  31,  2020,  there  were  $60  million  of  revolving  loans  available 
under the receivables financing facility.

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  Credit  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 Credit Agreement, other actions permitted to be taken by a secured creditor. The Company’s long-term 
debt arrangements contain usual and customary restrictive covenants that, among other things, place limitations on the Company’s 
ability  to  declare  dividends.  At  December  31,  2020,  the  Company  was  in  compliance  in  all  material  respects  with  the  financial 
covenants under the Company’s financing arrangements.

11. Leases

The Company has operating leases for corporate offices, datacenters, motor vehicles and certain equipment, many of which 
contain renewal and escalation clauses. These operating leases expire at various dates through 2029 with options to cancel certain 
leases at various intervals. The Company also has finance leases for office and lab spaces that expire in 2044. Based on the timing of 
payments on the finance leases the cash flow impact is not material for the year ended December 31, 2020. In determining the lease 
term  at  lease  commencement,  the  Company  includes  the  noncancellable  term  and  the  periods  which  the  Company  deems  it  is 
reasonably certain to exercise or not to exercise a renewal or cancellation option. 

The components of lease expense were as follows:

87

 
(in millions)
Operating lease cost (1)
Financing lease cost (1)
Total lease cost

Classification

Selling, general and administrative expenses

Depreciation and amortization, and Interest expense

Year Ended 
December 31, 
2020

Year Ended 
December 31, 
2019

$ 

$ 

209  $ 

6 

215  $ 

193 

— 

193 

(1) 

Includes variable lease costs, which are immaterial.

Rental expenses under lease agreements was $197 million in 2018.

Other information related to leases was as follows:

(in millions)
Supplemental Cash Flow:

Cash paid for amounts included in the measurement of lease liabilities:

Operating cash flows from operating leases

Right-of-use assets obtained in exchange for lease obligations:

Operating leases

Financing leases

Weighted Average Remaining Lease Term:

Operating leases

Financing leases

Weighted Average Discount Rate:

Operating leases

Financing leases

Year Ended 
December 31, 
2020

Year Ended 
December 31, 
2019

$ 

$ 

$ 

211 

109 

119 

$ 

$ 

$ 

195 

96 

— 

4.58 years

24 years

5.01 years

— 

 3.78% 

3.18 %  

 4.22% 

— 

Future minimum lease payments under non-cancellable leases as of December 31, 2020 were as follows:

(in millions)
2021
2022
2023
2024
2025
Thereafter

Total future minimum lease payments

Less imputed interest

Total

Reported as of December 31, 2020:

Other current liabilities

Operating lease liabilities

Other liabilities

Total

88

Operating 
Leases

Financing  
Leases

$ 

159  $ 

132 

104 

73 

58 

52 

578 

(51)   

527  $ 

156  $ 

371 

— 

527  $ 

$ 

$ 

$ 

— 

6 

6 

6 

6 

159 

183 

(61) 

122 

— 

— 

122 

122 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
12. 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 reserves 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 our 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, 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. The matter is now on appeal.  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 

89

 
 
 
 
 
 
 
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. We believe the counterclaims are 
without merit, reject all counterclaims raised by Veeva and intend to vigorously defend IQVIA Parties’ position and pursue our 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  have  been  engaged  in  the  discovery  process  in  connection  with  the  first 
lawsuit.

13. 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 and outstanding as of December 31, 2020 or 2019.

Equity Repurchase Program

On October 30, 2013, the Board first approved the Repurchase Program, authorizing the repurchase of up to $125 million of 
either the Company’s common stock or vested in-the-money employee stock options, or a combination thereof. The Board increased 
the stock repurchase authorization under the Repurchase Program with respect to the repurchase of its common stock by $600 million, 
$1.5  billion,  $2  billion  and  $1.5  billion,  $2.0  billion  in  2015,  2016,  2017,  2018,  and  2019  respectively,  which  increased  the  total 
amount  that  has  been  authorized  under  the  Repurchase  Program  to  $7.725  billion.  The  Repurchase  Program  does  not  obligate  the 
Company  to  repurchase  any  particular  amount  of  common  stock  or  vested  in-the-  money  employee  stock  options,  and  it  may  be 
modified, extended, suspended or discontinued at any time.

As of December 31, 2020, the Company has remaining authorization to repurchase up to $0.9 billion 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.

2020 Offerings

There were no equity offerings during the year.

2019 Offerings

In March 2019, the Company completed an underwritten secondary public offering of 5,000,000 shares of its common stock 
held by certain of the Company’s remaining private equity sponsors (the “Selling Stockholders”), of which the Company repurchased 
1,000,000  shares  for  an  aggregate  purchase  price  of  approximately  $140.8  million.  The  Company  did  not  offer  any  stock  in  this 
transaction and did not receive any proceeds from the sale of the shares by the Selling Stockholders. Pursuant to an agreement with the 
underwriters, the Company’s per-share purchase price for repurchased shares was the same as the per share purchase price payable by 
the underwriters to the Selling Stockholders.

Other Equity Repurchases

On  February  13,  2020,  the  Company  agreed  to  purchase  at  market  price  an  aggregate  of  1,000,000  shares  of  its  common 
stock, par value $0.01 per share, in a private transaction from certain of its existing shareholders (the “February 2020 Repurchase”). In 
addition  to  the  February  2020  Repurchase,  certain  of  the  Company’s  remaining  private  equity  sponsors  informed  the  Company  that 
they have sold 4,000,000 shares of the Company’s common stock pursuant to Rule 144 under the Securities Act of 1933, as amended, 
for a total of 5,000,000 shares.

In August 2019, the Company agreed to purchase an aggregate of 1,000,000 shares of its common stock, par value $0.01 per 
share, in a private transaction from certain of its existing shareholders (the “Repurchase”). In addition to the Repurchase, certain of the 
Company’s remaining private equity sponsors informed the Company that they have sold 4,000,000 shares of the Company’s common 
stock pursuant to Rule 144 under the Securities Act of 1933, as amended, for a total of 5,000,000 shares.

90

 
 
 
 
 
 
 
 
Summary

Below is a summary of the share repurchases made both under and outside of the Repurchase Program:

(in millions, except per share data)
Number of shares of common stock repurchased

Aggregate purchase price

Average price per share

Non-controlling Interests

Year Ended December 31,

2020

2019

2018

2.7 
423  $ 
155.63  $ 

6.6 
945  $ 
143.02  $ 

12.6 

1,396 

111.23 

$ 

$ 

The Company contributed businesses to a joint venture with Quest Diagnostics Incorporated (“Quest”) that was recorded at 

book value (carryover basis) because the Company owns 60% of the joint venture and maintains control of these businesses. As a result, 
Quest’s non- controlling interest in the joint venture, referred to as Q2
$279 million at December 31, 2020. During the year ended December 31, 2020, Q2
Quest and received a $8 million contribution from Quest to fund ongoing operational and strategic activities.

 Solutions, is equal to 40%. Quest’s non-controlling interest was 
 Solutions distributed dividends of $21 million to 

14. Business Combinations 

The  Company  completed  several  immaterial  acquisitions  during  the  year  ended  December  31,  2020.  The  Company’s 
assessment  of  fair  value  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  accompanying  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 significantly different to the actual results of operations of the Company.

The following table provides certain financial information for these acquisitions, including the preliminary allocations of the 

purchase prices to certain intangible assets acquired and goodwill:

(in millions)
Total cost of acquisitions, net of cash acquired(1)
Amounts recorded in the Consolidated Balance Sheets:

Goodwill

Portion of goodwill deductible for income tax purposes

Intangible assets:

Customer relationships

Backlog

Non-compete agreements

Software

Trade names

Total intangible assets

Amortization Period

2020

2019

$ 

$ 

years $ 
years

10 -

18

0

3 -

3 -

2 -

3

3

3

years

years

years

224  $ 

115  $ 

99 

90  $ 

— 

2  

8  

1  

$ 

101  $ 

667 

437 

186 

216 

11 

6 

35 

3 

271 

(1) 

Total cost of acquisitions, net of cash acquired, includes contingent consideration and deferred purchase payments of $47 million and 
$79 million for the years ended December 31, 2020 and 2019, respectively.

91

 
 
 
 
 
 
 
 
 
 
 
  
15. Restructuring

The Company has continued to take restructuring actions in 2020 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 into 
2021.

The management approved plans resulted in approximately $52 million, $75 million and $68 million of restructuring expense, 

net of reversals, which consisted of severance, facility closure costs and other exit-related costs in 2020, 2019, and 2018, respectively.

The following amounts were recorded for the restructuring plans:

(in millions)
Balance at December 31, 2018

Expense, net of reversals

Payments

Foreign currency translation and other

Balance at December 31, 2019

Expense, net of reversals

Payments

Foreign currency translation and other

Balance at December 31, 2020

Severance and 
Related Costs

Exit Costs

Total

$ 

$ 

$ 

47  $ 

27  $ 

75 

(57) 

(1) 

64  $ 
52 

(67) 

2 

0 

(16) 

(8) 

3  $ 

— 
(1) 

0 

51  $ 

2  $ 

74 

75 

(73) 

(9) 

67 
52 

(68) 

2 

53 

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  the  majority  of  the  restructuring  accruals  at 
December 31, 2020 will be paid in 2021.

16. Income Taxes

The components of income before income taxes and equity in earnings (losses) of unconsolidated affiliates are as follows:

(in millions)
Domestic
Foreign

Year Ended December 31,

2020

2019

2018

$ 

$ 

(649)  $ 
1,022 

373  $ 

(504)  $ 
856 

352  $ 

(521) 
849 

328 

The components of income tax expense attributable to continuing operations are as follows:

(in millions) 
Current expense:

Federal and state

Foreign

Deferred (benefit) expense:

Federal and state

Foreign

Year Ended December 31,

2020

2019

2018

$ 

—  $ 

11  $ 

244 

244 

(161) 

(11) 

(172) 

248 

259 

(109) 

(34) 

(143) 

$ 

72  $ 

116  $ 

17 

233 

250 

(170) 

(21) 

(191) 

59 

92

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The  differences  between  the  Company’s  consolidated  income  tax  expense  attributable  to  continuing  operations  and  the 

expense computed at the United States statutory income tax rate of 21% were as follows:

(in millions)
Federal income tax expense at statutory rate

State and local income taxes, net of federal effect

Research and development

United States taxes recorded on foreign earnings(*)

Tax contingencies

Foreign Derived Intangible Income (“FDII”)

Foreign rate differential

Equity compensation

Non-taxable gain on acquisition adjustment

Non-controlling interest

Tax Act impact

Other

Year Ended December 31,

2020

2019

2018

$ 

78  $ 
19 

(14) 

2 

(5) 

(8) 

25 

(29) 

6 

(5) 

— 

$ 

3 
72  $ 

74  $ 

— 

(21) 

9 

27 

20 

26 

(14) 

(5) 

(6) 

— 

6 

116  $ 

69 

(2) 

(20) 

40 

16 

(25) 

27 

(8) 

— 

(3) 

(35) 

— 

59 

(*) Includes impact of GILTI, and other U.S. taxes on foreign earnings.

In 2020, the U.S. Treasury Department issued final regulations regarding Foreign Derived Intangible Income (“FDII”) and 

Global Intangible Low-Taxed Income (“GILTI”). The Company has determined it will elect the GILTI high tax exception as allowed by 
the final regulations and will amend its 2018 and 2019 US Federal consolidated income tax returns resulting in a favorable impact of 
$26 million, which the Company recorded in 2020.

In 2019 the U.S. Treasury Department issued final regulations on the transition tax and proposed regulations on FDII, which 
was introduced by the Tax Act enacted by the U.S. government on December 22, 2017. The Tax Act is comprehensive legislation that 
includes provisions that lower the federal corporate income tax rate from 35% to 21% beginning in 2018 and imposes a one-time 
transition tax on undistributed foreign earnings. While the final regulations related to the transition tax did not have a material impact on 
the Company, the proposed guidance for FDII had an unfavorable impact. Although the proposed guidance for FDII is not authoritative 
and subject to change in the regulatory review process, the company reversed the tax benefit recorded in 2018 by recording a tax expense 
of $25 million for this impact. 

In 2018 the Company recorded a $35 million benefit related to finalizing the accounting related to the Tax Act. Additionally, 
in 2018 the Company recorded a benefit of $25 million related to FDII, as well as a tax expense of $35 million related to GILTI, as a 
result of the new provisions of the Tax Act.

Undistributed earnings of the Company’s foreign subsidiaries amounted to approximately $4,075 million at December 31, 

2020. With the enactment of the Tax Act, the Company does not consider any of its foreign earnings as indefinitely reinvested.

The income tax effects of temporary differences from continuing operations that give rise to significant portions of deferred 

income tax assets (liabilities) are presented below:

93

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(in millions)

Deferred income tax assets:

Net operating loss and capital loss carryforwards

Tax credit carryforwards

Accrued expenses and unearned income

Employee benefits

Lease liability

Foreign exchange on debt instruments 

U.S. interest expense limitation

Other

Total deferred income tax assets

Valuation allowance for deferred income tax assets

Total deferred income tax assets (net of valuation allowance)

Deferred income tax liabilities:

Amortization and depreciation

Lease right-of-use assets

Foreign exchange on debt instruments

Other

Total deferred income tax liabilities

Net deferred income tax liabilities

December 31,

2020

2019

$ 

231  $ 
369 

54 

228 

139 

143 

75 

64 

1,303 

(306) 

997 

(1,038) 

(133) 

— 

(50) 
(1,221)  $ 
(224)  $ 

$ 

$ 

246 

332 

55 

168 

119 

— 

35 

63 

1,018 

(266) 

752 

(1,105) 

(119) 

(28) 

(27) 

(1,279) 

(527) 

During 2020 the net deferred tax liabilities decreased mainly due to foreign exchange revaluations of debt instruments and 

amortization of intangibles related to the merger between Quintiles and IMS Health.

The Company had federal, state and local, and foreign tax loss carryforwards and tax credits, the tax effect of which was $646 
million as of December 31, 2020. Of this amount, $19 million has an indefinite carryforward period, and the remaining $627 million 
expires  at  various  times  beginning  in  2020.  Some  of  the  federal  losses  are  subject  to  limitations  under  the  Internal  Revenue  Code, 
however, management expects these losses to be utilized during the carryforward periods.

In  2020,  the  Company  increased  its  valuation  allowance  by  $40  million  to  $306  million  at  December  31,  2020  from  $266 
million at December 31, 2019. The valuation allowance increased primarily due to current year state tax benefits on foreign exchange 
revaluations on debt instruments, branch basket foreign tax credits that the Company has determined are not more likely than not to be 
used before their expiration, and due to an increase in the value of the U.S. state net operating losses.

A reconciliation of the beginning and ending amount of gross unrecognized income tax benefits is presented below:

(in millions)
Balance at January 1

Additions based on tax positions related to the current year

Additions for income tax positions of prior years

Impact of changes in exchange rates

Settlements with tax authorities

Reductions for income tax positions of prior years

Reductions due to the lapse of the applicable statute of limitations

Balance at December 31,

Year Ended December 31,

2020

2019

2018

$ 

$ 

120  $ 
5 

15 

3 

(2) 

(16) 

(7) 
118  $ 

94  $ 

5 

33 

— 

(1) 

(6) 

(5) 

120  $ 

82 

4 

26 

(2) 

(2) 

— 

(14) 

94 

As of December 31, 2020, the Company had total gross unrecognized income tax benefits of $118 million associated with 
over 100 jurisdictions in which the Company conducts business that, if recognized, would reduce the Company’s effective income tax 
rate.

94

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The Company’s policy for recording interest and penalties relating to uncertain income tax positions is to record them as a 
component of income tax expense in the accompanying consolidated statements of income. In 2020, 2019 and 2018, the amount of 
interest and penalties recorded as an addition to income tax expense in the accompanying consolidated statements of income was $3 
million, $2 million and $0 million, respectively. As of December 31, 2020, and 2019, the Company had accrued approximately $21 
million and $18 million, respectively, of interest and penalties.

The Company believes that it is reasonably possible that a decrease of up to $14 million in gross unrecognized income tax 
benefits for federal, state and foreign exposure items may be necessary within the next 12 months due to lapse of statutes of limitations 
or uncertain tax positions being effectively settled. The Company believes that it is reasonably possible that a decrease of up to $21 
million in gross unrecognized income tax benefits for foreign items may be necessary within the next 12 months due to payments. For 
the remaining uncertain income tax positions, it is difficult at this time to estimate the timing of the resolution.

The Company conducts business globally and, as a result, files income tax returns in the United States federal jurisdiction and 
various state and foreign jurisdictions. In the normal course of business, the Company is subject to examination by taxing authorities 
throughout the world. The following table summarizes the tax years that remain open for examination by tax authorities in the most 
significant jurisdictions in which the Company operates:

United States

India

Japan

United Kingdom

Switzerland

2017-2019

2006-2020

2019

2019

2015-2019

In  certain  of  the  jurisdictions  noted  above,  the  Company  operates  through  more  than  one  legal  entity,  each  of  which  has 
different open years subject to examination. The table above presents the open years subject to examination for the most material of the 
legal  entities  in  each  jurisdiction.  Additionally,  it  is  important  to  note  that  tax  years  are  technically  not  closed  until  the  statute  of 
limitations in each jurisdiction expires. In the jurisdictions noted above, the statute of limitations can extend beyond the open years 
subject to examination.

Due to the geographic breadth of the Company’s operations, numerous tax audits may be ongoing throughout the world at 
any  point  in  time.  Income  tax  liabilities  are  recorded  based  on  estimates  of  additional  income  taxes  that  may  be  due  upon  the 
conclusion of these audits. Estimates of these income tax liabilities are made based upon prior experience and are updated in light of 
changes in facts and circumstances. However, due to the uncertain and complex application of income tax regulations, it is possible 
that the ultimate resolution of audits may result in liabilities that could be materially different from these estimates. In such an event, 
the Company will record additional income tax expense or income tax benefit in the period in which such resolution occurs.

17. Employee Benefit Plans

Pension and Postretirement Benefit Plans

The  Company  sponsors  both  funded  and  unfunded  defined  benefit  pension  plans.  These  plans  provide  benefits  based  on 
various  criteria,  including,  but  not  limited  to,  years  of  service  and  salary.  The  Company  also  sponsors  an  unfunded  postretirement 
benefit plan in the United States that provides health and prescription drug benefits to retirees who meet the eligibility requirements. 
The Company uses a December 31 measurement date for all pension and postretirement benefit plans.

The following table summarizes changes in the benefit obligation, the plan assets and the funded status of the pension benefit 

plans:

95

 
 
 
 
 
 
(in millions)
Obligation and funded status:

Change in benefit obligation:

Projected benefit obligation at beginning of year

$ 

Service costs

Interest cost

Actuarial losses

Business combinations

Benefits paid

Contributions

Amendments

Curtailments
Settlements

Foreign currency fluctuations and other

Projected benefit obligation at end of year

Change in plan assets:

Fair value of plan assets at beginning of year

Actual return on plan assets

Contributions

Benefits paid

Settlements

Foreign currency fluctuations and other

Fair value of plan assets at end of year

Funded status

Pension Benefits

United States Plans

Non-United States Plans

December 31,

2020

2019

2020

2019

401  $ 
13 

335  $ 
12 

591  $ 
29 

12 

65 

— 

(10) 

— 

— 

— 

— 

— 

481 

401 

61 

3 

(10) 

— 

— 

14 

50 

— 

(10) 

— 

— 

— 
— 

— 

401 

330 

77 

4 

(10) 

— 

— 

8 

60 

— 

(18) 

2 

(1) 

— 

(7) 

29 

693 

418 

38 

27 

(18) 

(7) 

17 

$ 

455 
(26)  $ 

401 
—  $ 

475 
(218)  $ 

513 

25 

9 

55 

— 

(19) 

2 

— 

(5) 
(1) 

12 

591 

366 

34 

26 

(19) 

(1) 

12 

418 

(173) 

The following table summarizes the amounts recognized in the consolidated balance sheets related to the pension benefit plans: 

(in millions)
Deposits and other assets

Accrued expenses

Other long-term liabilities

AOCI

Pension Benefits

United States Plans

Non-United States Plans

December 31,

2020

2019

2020

2019

$ 

$ 

23 

2 

47 

(21) 

$ 

45 

2 

42 

13 

7  $ 
15 

210 

(65) 

11 

13 

171 

(30) 

At December 31, 2020, the benefit obligation for other postretirement benefits was $1 million, with less than $1 million 

recorded in accrued expenses and $1 million included within other long-term liabilities; and the amount recognized in AOCI was less 
than $1 million. 

The following table summarizes the accumulated benefit obligation for all pension benefit plans:

(in millions)
Accumulated benefit obligation

Pension Benefits

United States Plans

Non-United States Plans

December 31,

2020

2019

2020

2019

$ 

474  $ 

395  $ 

654 

$ 

557 

96

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The following table provides the information for pension plans with an accumulated benefit obligation in excess of plan assets 

and projected benefit obligations in excess of plan assets:

(in millions)
Plans with accumulated benefit obligation in excess of plan 
assets:

Accumulated benefit obligation
Fair value of plan assets

Plans with projected benefit obligation in excess of plan assets:

Projected benefit obligation

Fair value of plan assets

Pension Benefits

United States Plans

Non-United States Plans

December 31

2020

2019

2020

2019

$ 

$ 

$ 

52 

5 

$ 

47 

4 

$ 

572 

384 

53  $ 
5 

49  $ 
4 

610  $ 
386 

485 

334 

519 

335 

The components of net periodic benefit cost changes in plan assets and benefit obligations recognized in other comprehensive 

loss were as follows:

(in millions)
Service cost

Interest cost

Expected return on plan assets

Amortization of actuarial losses

Curtailment gain

Settlement gain

Net periodic benefit cost

Other changes in plan assets and benefit 
obligations recognized in other comprehensive 
loss:
Actuarial loss (gain) – current years

Prior service cost - current year

Curtailment gain - current year

Settlement gain - current year

Amortization of actuarial losses

Total recognized in other comprehensive loss 
(income)

Total recognized in net periodic benefit cost and 
other comprehensive loss (income)

United States Plans

Non-United States Plans

Pension Benefits

Year Ended December 31,

2020

2019

2018

2020

2019

2018

$ 

13  $ 
12 

$ 

13  $ 
12 

(30) 

— 

— 

— 

(5) 

34 

— 

— 

— 

— 
34 

12 

14 

(25) 

— 

— 

— 

1 

(2) 

— 

— 

— 

— 
(2)   

(27) 

— 

— 

— 

(2) 

22 

— 

— 

— 

— 
22 

29  $ 
8 

(18) 

1 

— 

— 

20 

35 

— 

— 

— 

— 
35 

25  $ 

9 

(16) 

— 

(5) 

— 

13 

32 

— 

5 

— 

— 
37 

26 

9 

(15) 

1 

(3) 

(1) 

17 

(15) 

2 

3 

1 

(1) 
(10) 

$ 

29  $ 

(1)  $ 

20  $ 

55  $ 

50  $ 

7 

All  components  of  net  periodic  benefit  cost  other  than  service  cost  are  recorded  in  other  expense  (income),  net  on  the 
accompanying  consolidated  statements  of  income.  Gain  (losses)  affecting  the  benefit  obligation  for  the  period  ending  December  31, 
2020 was primarily related to the change in discount rate.

On October 26, 2018, the High Court of the United Kingdom issued a judgement relating to Guaranteed Minimum Pensions 
(“GMPs”)  in  the  Lloyds  case.  The  judgement  concluded  the  schemes  should  be  amended  to  equalize  pension  benefits  for  men  and 
women in relation to guaranteed minimum pension benefits. A preliminary assessment by the Company’s actuarial advisors estimated an 
impact of approximately $1.7 million between the two United Kingdom pension schemes, which has been recognized in AOCI as a prior 

97

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
service cost in 2018. On November 20, 2020, the High Court ruled that the schemes should revisit individual transfer payments made 
since May 17, 1990 to review for any additional amount due as a result of the guaranteed minimum pension equalization. An assessment 
by the Company’s actuarial advisors determined that the impact of this ruling to be immaterial.

Assumptions

The weighted average assumptions used to determine net periodic benefit cost were as follows for the years ended December 

31:

Discount rate

Rate of compensation increases

Expected return on plan assets

Pension Benefits

United States Plans

Non-United States Plans

2020
 3.52% 

 3% 

2019
 4.42% 

 3% 

2018
 3.69% 

 3% 

 7.42% 

 7.67% 

 7.69% 

2020
 1.45% 

 2.78% 

 3.91% 

2019
 1.99% 

 4.54% 

 4.02% 

2018
 1.91% 

 4.54% 

 4.17% 

The weighted average assumptions used to determine benefit obligations were as follows at December 31:

Discount rate

Rate of compensation increases

Pension Benefits

United States Plans

Non-United States 
Plans

2020
 2.84% 
 3.00% 

2019
 3.52% 
 3.00% 

2020
 1.02% 

 2.55% 

2019
 1.45% 

 2.78% 

The discount rate represents the interest rate used to determine the present value of the future cash flows currently expected to 
be  required  to  settle  the  Company’s  defined  benefit  plan  obligations.  The  discount  rates  are  derived  using  weighted  average  yield 
curves on AA-rated corporate bonds. The cash flows from the Company’s expected benefit obligation payments are then matched to 
the yield curve to derive the discount rates.

The Company’s assumption for the expected return on plan assets was determined by the weighted average of the long-term 
expected rate of return on each of the asset classes invested as of the balance sheet date. For plan assets invested in government bonds, 
the expected return was based on the yields on the relevant indices as of the balance sheet date. There is considerable uncertainty for 
the expected return on plan assets invested in equity and diversified growth funds. 

Under the Company’s United States qualified retirement plan, participants have a notional retirement account that increases 
with pay and investment credits. The rate used to determine the investment credit (cash balance crediting rate) varies monthly and is 
equal  to  1/12th  of  the  yield  on  30-year  U.S.  Government  Treasury  Bonds,  with  a  minimum  of 0.25%.  At  retirement,  the  account  is 
converted to a monthly retirement benefit.

At December 31, 2020, the Company’s health care cost trend rate for the next seven years was assumed to be 5.5% and the 

assumed ultimate cost trend rate was 4.5%. The Company assumed that ultimate cost trend rate is reached in 2023.

Assumed health care cost trend rates could have a significant effect on the amounts reported for the health care plans. A one-
percentage- point change in assumed health care cost trend rates at December 31, 2020 would have a de minimis effect on the total of 
service and interest cost and on the accumulated postretirement benefit obligation.

Plan Assets

The Company’s pension plan weighted average asset allocations, by asset category, were as follows:

98

 
 
 
 
 
 
 
 
Asset Category

Equity securities

Debt securities

Real estate

Other

Total

United States Plans

Plan Assets at December 31,
Non-United States Plans

Total

2020
 71.15% 
 23.88 

 4.97 

 — 

2019
 70.82% 
 24.13 

 5.05 

 — 

2020
 42.69% 

2019
 42.88% 

2020
 56.62% 

2019
 56.56% 

 20.08 

 — 

 37.23 

 19.22 

 — 

 37.00 

 21.94 

 2.43 

 19.02 

 21.62 

 2.48 

 19.33 

 100.00% 

 100.00% 

 100.00% 

 100.00% 

 100.00% 

 100.00% 

The target asset allocation for the Company’s pension plans were as follows:

Asset Category
Equity securities

Debt securities

Real estate

Other

Total

45-65%

10-30%

0-5%

10-30%

The following table summarizes United States plan assets measured at fair value:

Asset Category

Level 1

Level 2

Total

Level 1

Level 2

Total

December 31, 2020

December 31, 2019

Domestic equities

International equities

Corporate bonds

Real estate

Total assets in the fair value hierarchy

Common/collective trusts measured at 
net asset value (“NAV”)(1)

Total

$ 

29  $ 

—  $ 

29  $ 

30  $ 

—  $ 

(in millions)

9 

65 

23 

126 

— 

— 

— 

— 

— 

— 

9 

65 

23 

126 

329 

16 

58 

20 

124 

— 

— 

— 

— 

— 

— 

$ 

126  $ 

—  $ 

455  $ 

124  $ 

—  $ 

The following table summarizes non-United States plan assets measured at fair value:

Asset Category

International equities

Debt issued by national, state or local 
government

Diversified growth fund

Investments funds

Insurance contracts

Other

Total assets in the fair value hierarchy

Assets measured at NAV(1)

Total

Level 1

December 31, 2020
Level 2

Total

Level 1

(in millions)

December 31, 2019
Level 2

Total

$ 

3  $ 

66  $ 

69  $ 

2  $ 

56  $ 

3 

— 

— 

— 

— 

6 

93 

— 

10 

171 

6 

346 

96 

— 

10 

171 

6 

352 

2 

— 

— 

— 

— 

4 

78 

— 

9 

153 

5 

301 

— 
6  $ 

— 
346  $ 

123 
475  $ 

— 
4  $ 

— 
301  $ 

$ 

30 

16 

58 

20 

124 

277 

401 

58 

80 

— 

9 

153 

5 

305 

113 
418 

(1)  Certain investments that are measured at fair value using the net asset value per share (or its equivalent) practical expedient have not been classified 
in the fair value hierarchy. The fair value amounts presented in the above plan asset tables are intended to permit reconciliation of the fair value of plan 
assets in the fair value hierarchy to the plan asset amounts presented in the above funded status table as of December 31, 2020 and 2019.

99

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
     
Investments in mutual funds are valued at quoted market prices. Investments in common/collective trusts and pooled funds 
are valued at the NAV as reported by the trust. The NAV is based on the fair value of the underlying investments held by the fund less 
its  liabilities.  Insurance  contracts  are  valued  at  the  amount  of  the  benefit  liability.  The  Company  has  no  Level  3  assets  that  rely  on 
unobservable inputs to measure fair value.

Investment Policies and Strategies

The  Company  invests  primarily  in  a  diversified  portfolio  of  equity  securities  that  provide  for  long-term  growth  within 
reasonable and prudent levels of risk. The asset allocation targets established by the Company are strategic and applicable to the plan’s 
long-term investing horizon. The portfolio is constructed and maintained to provide adequate liquidity to meet associated liabilities and 
minimize  long-term  expense  and  provide  prudent  diversification  among  asset  classes  in  accordance  with  the  principles  of  modern 
portfolio  theory.  The  plan  employs  a  diversified  mix  of  actively  managed  investments  around  a  core  of  passively  managed  index 
exposures  in  each  asset  class.  Within  each  asset  class,  rapid  market  shifts,  changes  in  economic  conditions  or  an  individual  fund 
manager’s outlook may cause the asset allocation to fall outside the prescribed targets. The majority of the Company’s plan assets are 
measured  quarterly  against  benchmarks  established  by  the  Company’s  investment  advisors  and  the  Company’s  Asset  Management 
Committee,  who  review  actual  plan  performance  and  have  the  authority  to  recommend  changes  as  deemed  appropriate.  Assets  are 
rebalanced periodically to their strategic targets to maintain the plan’s strategic risk/reward characteristics. The Company periodically 
conducts asset liability modeling studies to ensure that the investment strategy is aligned with the obligations of the plans and that the 
assets will generate income and capital growth to meet the cost of current and future benefits that the plans provide. The pension plans 
do not have investments in Company stock at December 31, 2020 and 2019.

The portfolio for  the Company’s United Kingdom pension plans seek to invest in a range of suitable assets of appropriate 
liquidity that will generate in the most effective manner possible, income and capital growth to ensure that there are sufficient assets to 
meet  benefit  payments  when  they  fall  due,  while  controlling  the  long-term  costs  of  the  plans  and  avoiding  short-term  volatility  of 
investment returns. The plans seek to achieve these objectives by investing in a mixture of real (equities) and monetary (fixed interest) 
assets. It recognizes that the returns on real assets, while expected to be greater over the long-term than those on monetary assets, are 
likely to be more volatile. A mixture across asset classes should nevertheless provide the level of returns required by the plans. The 
trustee periodically conducts asset liability modeling exercises to ensure the investments are aligned with the appropriate benchmark to 
better reflect the plans’ liabilities. The trustee also undertakes to review this benchmark on a regular basis.

Cash Flows

Contributions

The  Company  expects  to  contribute  approximately  $32  million  in  required  contributions  to  its  pension  and  postretirement 
benefit plans during 2021. The Company may make additional contributions into its pension plans in 2021 depending on, among other 
factors,  how  the  funded  status  of  those  plans  change  or  in  order  to  meet  minimum  funding  requirements  as  set  forth  in  employee 
benefit and tax laws, plus additional amounts the Company may deem to be appropriate.

Estimated future benefit payments and subsidy receipts

The following benefit payments (net of expected participant contributions) for pension benefits are expected to be paid as 

follows:

(in millions)
2021
2022
2023
2024
2025
Years 2026 through 2030

Pension Benefits
42 
$ 

42

44

47

48

274

497 

$ 

100

 
 
 
 
 
 
 
 
Benefit payments (net of expected participant contributions) for other postretirement benefits are expected to be de minimis 

over the periods presented.

Defined Contribution Plans

Defined contribution or profit sharing plans are offered in Australia, Austria, Belgium, Bulgaria, Canada, the Czech Republic, 
Denmark,  Finland,  France,  Germany,  Greece,  Hong  Kong,  Hungary,  India,  Ireland,  Israel,  Japan,  Malaysia,  the  Netherlands,  New 
Zealand, Poland, Slovakia, South Africa, Sweden, Switzerland, Taiwan, Thailand, the United States and the United Kingdom. In some 
cases, these plans are required by local laws or regulations.

In  the  United  States,  the  Company  has  a  401(k)  plan  under  which  the  Company  matches  employee  deferrals  at  varying 
percentages and specified limits of the employee’s salary. In 2020, 2019, and 2018, the Company expensed $48 million, $56 million 
and $49 million, respectively, related to matching contributions.

Certain key executives of the Company participate in an unfunded defined contribution executive retirement plan, assumed in 
the Merger, which was frozen to additional accruals for future service contributions in 2012. Participants continue to receive an annual 
investment  credit  based  on  the  average  of  the  annual  yields  at  the  end  of  each  month  on  the  AA-AAA  rated  10  plus  year  maturity 
component of the Merrill Lynch  United States Corporate Bond Master Index.

Plans Accounted for as Postretirement Benefits

The Company provides certain executives with postretirement medical, dental and life insurance benefits. These benefits are 
individually negotiated arrangements in accordance with their individual employment arrangements. The above tables do not include 
the  Company’s  expense  or  obligation  associated  with  providing  these  benefits.  The  obligation  related  to  these  benefits  was 
approximately $12 million as of December 31, 2020, and the Company’s expense for the year then ended was de minimis.

Stock Incentive Plans

Stock  incentive  plans  provide  incentives  to  eligible  employees,  officers  and  directors  in  the  form  of  non-qualified  stock 
options,  incentive  stock  options,  stock  appreciation  rights  (“SARs”),  restricted  stock  awards  (“RSAs”),  restricted  stock  units 
(“RSUs”),  performance  awards,  covered  annual  incentive  awards,  cash-based  awards  and  other  stock-based  awards,  in  each  case 
subject to the terms of the stock incentive plans.

In  April  2017,  the  Company’s  2017  Incentive  and  Stock  Award  Plan  (the  “2017  Plan”)  was  approved  by  the  Company’s 
stockholders.  The  2017  Plan  consolidates  the  unused  share  pools  under  the  Company’s  2014  Incentive  and  Stock  Award  Plan  (the 
“2014  Plan”),  the  Company’s  2013  Stock  Incentive  Plan  (the  “2013  Plan”),  the  Company’s  2010  Equity  Incentive  Plan  (the  “2010 
Plan”) and the Company’s 2008 Stock Incentive Plan (the “2008 Plan”), and together with the 2010 Plan, the 2013 Plan and the 2014 
Plan  (the  “Prior  Plans”),  makes  shares  underlying  outstanding  awards  granted  under  (but  not  ultimately  delivered)  the  Prior  Plans 
eligible  for  use  in  connection  with  new  awards  under  the  2017  Plan.  The  2017  Plan  provides  for  the  grant  of  stock  options,  SARs, 
restricted and deferred stock (including RSUs), performance awards, dividend equivalents, other stock-based awards and cash-based 
awards.

The fair value of stock options and SARs is estimated using the Black-Scholes-Merton option-pricing model. The fair value 
of restricted stock and RSUs is based on the closing market price of the Company’s common stock on the date of grant. The fair value 
of the performance shares related to compound annual earnings per share (“EPS”) growth and/or other internal performance measures 
is equal to the closing market price of the Company’s common stock on the date of grant. The fair value of performance shares related 
to relative total shareholder return (“TSR”) is determined based on a Monte Carlo simulation model.

The Company recognized stock-based compensation expense of $95 million, $146 million and $113 million in 2020, 2019, 
and  2018,  respectively.  Stock-based  compensation  expense  is  included  in  selling,  general  and  administrative  expenses  on  the 
accompanying consolidated statements of income. The associated future income tax benefit recognized was $14 million, $22 million 
and  $19  million  in  2020,  2019,  and  2018,  respectively.  As  of  December  31,  2020,  there  was  approximately  $105  million  of  total 
unrecognized stock-based compensation expense related to outstanding non-vested stock-based compensation arrangements, which the 
Company expects to recognize over a weighted average period of 0.92 years.

101

 
 
 
 
 
 
 
 
 
 
 
 
As of December 31, 2020, there were 10.7 million shares available for future grants under all of the Company’s stock incentive 

plans.

The Company used the following assumptions when estimating the value of the stock-based compensation for stock options 

and SARs issued as follows:

Expected volatility

Weighted average expected volatility

Expected dividends

Expected term (in years)

Risk-free interest rate

Stock Options

Year Ended December 31,

2020
23 – 31%

23%

0.0%

2019
23 – 24%

23%

0.0%

2018
22 – 24%

22%

0.0%

3.2 – 6.2

3.7 – 6.7

1.0 – 6.7

0.17 – 1.41% 1.55 –2.56%

2.05 – 3.00%

The option price is determined by the Board at the date of grant and the options expire 10 years from the date of grant. The 
vesting schedule for options granted to employees is either (i) 25% per year beginning on the first anniversary of the date of grant; or 
(ii) 33% on the third anniversary of the date of grant and 67% on the fourth anniversary of the date of grant.

The Company’s stock option activity in 2020 is as follows:

(in millions, except number of options and exercise price)
Outstanding at December 31, 2019

Exercised

Canceled

Number of 
Options
1,458,341  $ 
(924,839) 

(875) 

Weighted 
Average Exercise 
Price

Aggregate 
Intrinsic Value

174 

34.90  $ 
27.08 

64.67 

Outstanding at December 31, 2020

532,627  $ 

48.42  $ 

70 

The total intrinsic value of options exercised was approximately $120 million, $124 million and $117 million in 2020, 2019, 
and  2018,  respectively.  The  Company  received  cash  of  approximately $25  million,  $36  million  and  $48  million  in  2020,  2019,  and 
2018, respectively, from options exercised.

Selected information regarding the Company’s stock options as of December 31, 2020 is as follows:

Number of 
Options

135,468 

111,011 

86,601 

113,272 

86,275 

Options Outstanding

Options Exercisable

Exercise Price Range
—

11.46 

29.17 

50.79 

64.67 

64.86 

—

—

—

—

28.39 

47.87 

64.52 

64.67 

64.93 

Weighted 
Average Exercise 
Price

Weighted 
Average 
Remaining Life 
(in Years)

Number of 
Options

Weighted 
Average Exercise 
Price

23.72 

42.26 

57.25 

64.67 

64.92 

1.79  

2.6  

3.84  

5.17  

4.18  

135,468 

111,011 

86,601 

113,272 

86,275 

23.72 

42.26 

57.25 

64.67 

64.92 

The weighted average remaining contractual life of the options outstanding and exercisable as of December 31, 2020 is 3.4 
years. The total aggregate intrinsic value of the exercisable stock options and the stock options expected to vest as of December 31, 
2020 was approximately $70 million.

Stock Appreciation Rights – Stock Settled

102

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
The exercise price of the stock-settled SARs (“SSRs”) is equal to the closing market price of the Company’s common stock 
as of the grant date and expire on the tenth anniversary of the date of grant. The SSRs are eligible to vest either (i) in equal increments 
of 25% on each of the first four anniversaries of the date of grant or (ii) in three equal annual installments on each of the first three 
anniversaries of the date of grant.

The Company’s SSR activity in 2020 is as follows:

(in millions, except number of SSRs and exercise price)
Outstanding at December 31, 2019

Granted

Exercised

Canceled

Number of SSRs

Weighted 
Average Exercise 
Price

Aggregate 
Intrinsic Value

4,314,872 $ 
1,130,298  

(1,012,501)

(191,327)

94.37  $ 
161.44 

86.08 

128.91 

260 

Outstanding at December 31, 2020

4,241,342 $ 

112.66  $ 

282 

The total intrinsic value of SSRs exercised was approximately $73 million in 2020.

The  weighted  average  remaining  contractual  life  of  the  SSRs  outstanding  and  exercisable  as  of December  31,  2020  is  7.2 
years  and  6.1  years,  respectively.  The  total  aggregate  intrinsic  value  of  the  exercisable  SSRs  and  the  SSRs  expected  to  vest  as  of 
December 31, 2020 was approximately $280 million.

Stock Appreciation Rights – Cash Settled

The  Company’s  cash  settled  SARs  (“CSRs”)  require  the  Company  to  settle  in  cash  an  amount  equal  to  the  difference 
between  the  fair  value  of  the  Company’s  common  stock  on  the  date  of  exercise  and  the  grant  price,  multiplied  by  the  number  of 
CSRs being exercised. These awards vest either (i) 25% per year; (ii) 33% on the third anniversary of the date of grant and 67% on 
the fourth anniversary of the date of grant; or (iii) one- third per year beginning on the first anniversary of the date of grant.

The Company’s CSR activity in 2020 is as follows:

(in millions, except number of CSRs and grant price)
Outstanding at December 31, 2019

Granted

Exercised

Canceled

Number of CSRs

Weighted 
Average Grant 
Price

Aggregate 
Intrinsic Value

171,840 $ 
14,560  

62.15  $ 
161.70 

(37,884)

(1,800)

56.37 

64.93 

16 

Outstanding at December 31, 2020

146,716 $ 

73.49  $ 

16 

As  of  December  31,  2020,  2019,  and  2018,  the  weighted  average  fair  value  per  share  of  the  CSRs  granted  was  $112.10, 
$99.27 and $66.92, respectively. The Company paid approximately $4 million, $7 million and $5 million to settle exercised CSRs in 
2020, 2019, and 2018, respectively.

The  weighted  average  remaining  contractual  life  of  the  CSRs  outstanding  and  exercisable  as  of December  31,  2020  is  4.6 
years  and  3.8  years,  respectively.  The  total  aggregate  intrinsic  value  of  the  exercisable  CSRs  and  the  CSRs  expected  to  vest  as  of 
December 31, 2020 was approximately $15 million.

Restricted Stock Units – Stock Settled

The Company’s RSUs will settle in shares of the Company’s common stock within 45 days of the applicable vesting date. In 
general, RSUs granted to employees vest either (i) 25% per year beginning on the first anniversary of the date of grant; (ii) one-third 
per year beginning on the first anniversary of the grant date; (iii) 50% on the second anniversary of the date of grant and 25% on the 
third and fourth anniversary of the date of grant or (iv) 100% at the end of the three-year period following the grant date. Members of 
the Company’s board of directors receive RSUs that are fully vested when granted.

103

 
 
 
 
 
 
 
 
 
 
 
The Company’s RSU activity in 2020 is as follows:

Outstanding at December 31, 2019

Granted (1)

Vested

Canceled

Outstanding at December 31, 2020

Number of 
RSUs

Weighted 
Average 
Grant-Date
Fair Value

420,566  $ 
347,289 

(150,131) 

(44,634) 

573,090  $ 

115.90 
159.85 

109.84 

127.34 

143.23 

(1) Pursuant to the IQVIA Holdings Inc. Non-Employee Director Deferral Plan (the “Director Deferral Plan”), non-employee directors 
may elect to defer receipt of their cash retainers. If a director elects to defer his or her retainer, he or she will instead be credited with that 
value in deferred shares under the Director Deferral Plan. Deferred shares become payable in Company common stock following a 
termination of the director’s Board service or the director’s death, or upon a change in control of the Company. The Company granted 
769 deferred RSUs in 2020.

As of December 31, 2020, there are 573,090 RSUs outstanding with an intrinsic value of approximately $103 million.

Restricted Stock Units – Cash Settled

The Company’s cash settled RSUs (“Cash RSUs”) require the Company to settle in cash an amount equal to the fair value of 
the Company’s common stock on the vest date multiplied by the number of vested Cash RSUs. These awards vest either (i) 100% at 
the end of the three-year period following the date of grant, or (ii) one-third per year beginning on the first grant date anniversary.

The Company’s Cash RSU activity in 2020 is as follows:

Outstanding at December 31, 2019

Granted

Vested

Canceled

Outstanding at December 31, 2020

Number of 
Cash RSUs

Weighted 
Average 
Grant-Date 
Fair Value

20,707  $ 

10,597 

(9,751) 

(2,198) 

19,355  $ 

117.71 

160.97 

107.58 

147.96 

143.06 

As of December 31, 2020, there are 19,355 Cash RSUs outstanding with an intrinsic value of approximately $3.5 million. 

Restricted Stock Awards

Restricted stock awards (“RSAs”) vest either (i) in equal increments of 50% on each of the second and fourth anniversaries of 
the grant date; (ii) one-third per year beginning on the first anniversary of the date of grant; or (iii) 25% on each of the second and third 
anniversaries of the grant date and 50% on the fourth anniversary of the date of grant.

The Company’s RSA activity in 2020 is as follows:

Outstanding at December 31, 2019

Vested

Outstanding at December 31, 2020

Number of RSAs

190,937  $ 
(63,645) 

Weighted 
Average Grant-
Date Fair Value
78.21 
78.21 

127,292  $ 

78.21 

104

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
As of December 31, 2020, there are 127,292 RSAs outstanding with an intrinsic value of approximately $23 million.

Performance Awards

The  Company  awarded  performance  awards  that  contain  service,  performance-based  and/or  market-based  vesting  criteria. 
Vesting occurs if the recipient remains employed and depends on the degree to which performance goals are achieved during the two-
year or three-year performance period (as defined in the award agreements).

The Company’s performance award activity in 2020 is as follows:

Outstanding at December 31, 2019

Granted

Additional goal achievement shares

Vested
Canceled

Outstanding at December 31, 2020

Number of 
Performance 
Awards

1,055,807 $ 

Weighted 
Average Grant-
Date Fair Value
107.18 

237,012  

336,264  

(757,285)
(85,633)
786,165 $ 

177.13 

85.82 
86.16 
129.34 
136.96 

As of December 31, 2020, there are 786,165 performance awards outstanding with an intrinsic value of approximately $141 

million.

Other

The Company sponsors a supplemental non-qualified deferred compensation plan, covering certain management employees, 

and maintains other statutory indemnity plans as required by local laws or regulations.

18. Related Party Transactions

The  Company  has  entered  into  other  transactions  with  related  parties  that  are  not  deemed  to  be  material,  including 

investments in and advances to unconsolidated affiliates that are discussed in Note 4.

19. Property, Equipment and Software by Geography

The following table represents the Company’s property, equipment and software, net, by geographic region, which is further 

broken down to show each country that accounts for 10% or more of the totals:

(in millions)

Property, equipment and software, net:

 Americas:

United States

Other

Americas

Europe and Africa

Asia-Pacific

Total property, equipment and software, net

20. Segments

As of December 31,
2019
2020

$ 

$ 

1,379  $ 
66 

1,445 

161 

70 
1,676  $ 

1,130 

62 

1,192 

160 

61 

1,413 

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 

105

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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 customers 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  to  integration  activities  and  acquisitions.  The  Company  also  does  not 
allocate depreciation and amortization or impairment charges 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:

(in millions)

Revenues

Technology & Analytics Solutions

Research & Development Solutions

Contract Sales & Medical Solutions

Total revenues
Costs of revenue

Technology & Analytics Solutions

Research & Development Solutions

Contract Sales & Medical Solutions

Total costs of revenue

Selling, general and administrative expenses

Technology & Analytics Solutions

Research & Development Solutions

Contract Sales & Medical Solutions

General corporate and unallocated

Year Ended December 31,

2020

2019

2018

$ 

4,858  $ 
5,760 

741 

11,359 

2,900 

3,974 

626 

7,500 

742 

738 

58 

251 

4,486  $ 

5,788 

814 

11,088 

2,663 

3,936 

701 

7,300 

722 

711 

61 

240 

4,137 

5,465 

810 

10,412 

2,343 

3,721 

682 

6,746 

753 

689 

67 

207 

Total selling, general and administrative expenses

1,789 

1,734 

1,716 

Segment profit

Technology & Analytics Solutions

Research & Development Solutions

Contract Sales & Medical Solutions

Total segment profit

General corporate and unallocated

Depreciation and amortization

Restructuring costs

Total income from operations

21. Earnings Per Share

1,216 

1,048 

57 

2,321 

(251) 

(1,287) 

$ 

(52) 
731  $ 

1,101 

1,141 

52 

2,294 

(240) 

(1,202) 

(75) 

777  $ 

1,041 

1,055 

61 

2,157 

(207) 

(1,141) 

(68) 

741 

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

(in millions)
Basic weighted average common shares outstanding

Effect of dilutive stock options and share awards
Diluted weighted average common shares outstanding

Year Ended December 31,
2019

2018

2020

191.3 

3.7 

195.0 

195.1 

4.5 
199.6 

203.7 

4.5 
208.2 

The following table presents 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 or the effect of including such stock-based awards in 
the computation would be anti-dilutive:

106

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
(in millions)
Shares subject to performance conditions

Shares subject to anti-dilutive stock-based awards

Total shares excluded from diluted earnings per share

Year Ended December 31,
2019

2018

2020

1.2 

1.2 

2.4 

1.3 

0.7 

2.0 

0.8 

0.9 

1.7 

The  vesting  of  performance  awards  is  contingent  upon  the  achievement  of  certain  performance  targets.  The  performance 
awards  are  not  included  in  diluted  earnings  per  share  until  the  performance  targets  are  probable.  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.

22. Comprehensive Income

Below is a summary of the components of AOCI:

(in millions)
Balance at December 31, 2017

Other comprehensive loss before reclassifications

Reclassification adjustments

Balance at December 31, 2018

Other comprehensive loss before reclassifications

Reclassification adjustments

Balance at December 31, 2019

Other comprehensive loss before reclassifications

Reclassification adjustments

Balance at December 31, 2020

Foreign 
Currency 
Translation

Derivative 
Instrument

Defined Benefit 
Plans

Income Taxes

Total

$ 

(214)  $ 

14  $ 

30  $ 

219  $ 

(205) 

— 

(419) 

(11) 

— 

(430)  $ 

35 

— 
(395)  $ 

$ 

$ 

(4) 

(11) 

(1) 

(19) 

(1) 

(21)  $ 

(40) 

13 
(48)  $ 

(12) 

1 

19 

(35) 

— 

(16)  $ 

(69) 

— 
(85)  $ 

(41) 

(1) 

177 

(21) 

— 

156  $ 

170 

(3) 
323  $ 

49 

(262) 

(11) 

(224) 

(86) 

(1) 

(311) 

96 

10 
(205) 

Below is a summary of the adjustments for (gains) losses reclassified from AOCI into the consolidated statements of income and the 
affected financial statement line item:

(in millions)
Derivative instruments:

Affected Financial Statement 
Line Item

2020

2019

2018

Year Ended December 31,

Interest rate swaps and caps

Interest expense

$ 

Foreign exchange forward contracts

Revenues

Foreign exchange forward contracts

Other expense (income), 
net

Total before income taxes

Income tax benefit

Total net of income taxes

Defined benefit plans:

Amortization of actuarial losses

See Note 17

Total net of income taxes

$ 

$ 

$ 

13  $ 
(1) 

1 

13 

3 
10  $ 

—  $ 
—  $ 

—  $ 

5 

(6) 

(1) 

— 

(1)  $ 

—  $ 

—  $ 

— 

1 

(12) 

(11) 

1 

(12) 

1 

1 

107

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
23. Supplemental Cash Flow Information

The following table presents the Company’s supplemental cash flow information:

(in millions)
Supplemental Cash Flow Information:

Interest paid

Income taxes paid, net of refunds

24. Quarterly Financial Data (Unaudited)

Year Ended December 31,
2019

2018

2020

$ 

$ 

399 

209 

$ 

$ 

421  $ 

215  $ 

398 

211 

The following table summarizes the Company’s unaudited quarterly results of operations:

(in millions, except per share data)
Revenues

Income from operations

Net income

Net income attributable to non-controlling interests

Net income attributable to IQVIA Holdings Inc.
Basic earnings per share(1)
Diluted earnings per share(1)

$ 

$ 

$ 

(in millions, except per share data)
Revenues

Income from operations

Net income

Net income attributable to non-controlling interests

Net income attributable to IQVIA Holdings Inc.
Basic earnings per share(1)
Diluted earnings per share(1)

$ 

$ 

$ 

First Quarter

Second Quarter

Third Quarter

2020

$ 

2,754  $ 

2,521  $ 

2,786  $ 

Fourth Quarter
3,298 

193 

91 

(9) 

82  $ 

0.43  $ 

0.42  $ 

62 

(21) 

(2) 

(23)  $ 

(0.12)  $ 

(0.12)  $ 

2019

187 

108 

(7) 

101  $ 

0.53  $ 

0.52  $ 

289 

130 

(11) 

119 

0.62 

0.61 

First Quarter

Second Quarter

Third Quarter

$ 

2,684  $ 

2,740  $ 

2,769  $ 

Fourth Quarter
2,895 

210 

67 

(9) 

58  $ 

0.29  $ 

0.29  $ 

197 

71 

(11) 

60  $ 

0.31  $ 

0.30  $ 

204 

69 

(12) 

57  $ 

0.29  $ 

0.29  $ 

166 

20 

(4) 

16 

0.09 

0.09 

(1)  

The sum of the quarterly per share amounts may not equal per share amounts reported for year-to-date periods. This is due to changes in 
the number of weighted average shares outstanding and the effects of rounding for each period.

Item 9. Changes in and Disagreements with Accountants on Accounting and Financial Disclosure

None.

Item 9A. Controls and Procedures

Evaluation of Disclosure Controls and Procedures

As required by Rule 13a-15 under the Exchange Act, as amended, we carried out an evaluation of the effectiveness of the 
design and operation of our disclosure controls and procedures under the supervision and with the participation of our management, 
including the Chief Executive Officer (“CEO”) and Chief Financial Officer (“CFO”). There are inherent limitations to the effectiveness 
of any system of disclosure controls and procedures, including the possibility of human error and the circumvention or overriding of 
the controls and procedures. Accordingly, even effective disclosure controls and procedures can only provide reasonable assurance of 
achieving  their  control  objectives.  Based  upon  our  evaluation,  our  CEO  and  CFO  concluded  that  our  disclosure  controls  and 
procedures were effective to provide reasonable assurance that information required to be disclosed by us in the reports that we file or 
submit under the Exchange Act, as amended, is recorded, processed, summarized and reported within the time periods specified in the 

108

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
applicable  rules  and  forms,  and  that  it  is  accumulated  and  communicated  to  our  management,  including  our  CEO  and  CFO,  as 
appropriate, to allow timely decisions regarding required disclosure.

Management’s Report on Internal Control over Financial Reporting

Our management’s report on internal control over financial reporting is set forth in Part II, Item 8 of this Annual Report on 

Form 10-K and is incorporated herein by reference.

Changes in Internal Control over Financial Reporting

There  were  no  changes  in  our  internal  control  over  financial  reporting  during  the  quarter  ended  December  31,  2020  that 

materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.

Item 9B. Other Information

On February 11, 2020, the Board of the Company amended the Company’s Amended and Restated Bylaws (the “Bylaws”) to 
implement  a  proxy  access  provision.  The  Bylaws  include  a  new  Section  1.3,  which  permits  a  stockholder,  or  a  group  of  up  to  20 
stockholders, owning 3% or more of the Company’s outstanding common stock continuously for at least three years to nominate and 
include in the Company’s proxy materials director candidates constituting up to the greater of 2 nominees or 20% of the Board, subject 
to the terms and conditions set forth in the Bylaws.

The foregoing description of the amendments to the Bylaws does not purport to be complete and is qualified in its entirety by 

reference to the full text of the Bylaws, a copy of which is attached hereto as Exhibit 3.2 and is incorporated herein by reference.

109

 
 
 
 
Item 10. Directors, Executive Officers and Corporate Governance

PART III

Information required by this Item, other than the information regarding the executive officers of the Company set forth below, 
is incorporated by reference to the sections of our definitive Proxy Statement for our 2021 Annual Meeting of Stockholders (the “2021 
Proxy  Statement”)  entitled  “Proposal  No.  1:  Election  of  Directors”,  “IQVIA’s  Corporate  Governance—Documents  Establishing  our 
Corporate Governance” and “IQVIA’s Corporate Governance—Committees of the Board.”

The current executive officers of the Company are as follows:

Name
Ari Bousbib

Ronald E. Bruehlman

W. Richard Staub, III

Kevin C. Knightly

Eric Sherbet

Age
59

60

58

60

56

Position

Chairman and Chief Executive Officer

Executive Vice President and Chief Financial Officer

President, Research & Development Solutions

President, Technology & Commercial Solutions

Executive Vice President, General Counsel and Secretary

Ari Bousbib, Director, Chairman and Chief Executive Officer

Mr. Bousbib is Chairman and Chief Executive Officer of the Company. He assumed this position in October 2016 following 
the Merger of Quintiles and IMS Health. From 2010 until the Merger, Mr. Bousbib served as Chairman and CEO of IMS Health. Prior 
to joining IMS Health, Mr. Bousbib spent 14 years at United Technologies Corporation (“UTC”), an aerospace, defense and building 
systems  company.  From  2008  until  2010,  he  served  as  President  of  UTC’s  Commercial  Companies,  with  executive  leadership 
responsibilities for the worldwide operations of Otis Elevator Company, Carrier Corporation, UTC Fire & Security and UTC Power 
Inc. From 2002 until 2008, Mr. Bousbib was President of Otis, and from 2000 to 2002, he served as its Chief Operating Officer. Prior 
to joining UTC, Mr. Bousbib was a partner at Booz Allen Hamilton. Mr. Bousbib currently serves on the board of directors of The 
Home Depot, Inc. and is a member of the Harvard Medical School Health Care Policy Advisory Council. Mr. Bousbib holds a Master 
of Science Degree in Mathematics and Mechanical Engineering from the Ecole Superieure des Travaux Publics, Paris, and an M.B.A. 
from Columbia University.

Ronald E. Bruehlman, Executive Vice President and Chief Financial Officer

    Mr.  Bruehlman  was  appointed  as  Executive  Vice  President  and  Chief  Financial  Officer  effective  August  1,  2020.  Mr. 
Bruehlman  previously served as Senior Vice President and Chief Financial Officer of IMS Health from July 2011 until the merger of 
IMS  Health  and  Quintiles  in  2016.  Mr.  Bruehlman  also  currently  serves  as  Chairman  of  the  Board  of  Directors  at  Q2  Solutions,  an 
IQVIA  and  Quest  Diagnostics  joint  venture.  Prior  to  joining  IMS  Health,  Mr.  Bruehlman  worked  for  23  years  at  UTC,  advancing 
through finance positions of increasing responsibility, culminating in his appointment as Vice President, Business Development, which 
he held from June 2009 to April 2011, where he led the company’s global strategy and development activities. From June 2005 until 
May 2008, he was Vice President and Chief Financial Officer of Carrier Corporation. Prior to that, Mr. Bruehlman was Vice President, 
Financial  Planning  and  Analysis  for  UTC  and  also  served  as  Director,  Investor  Relations  of  UTC.  Mr.  Bruehlman  has  served  as  a 
director of The Connecticut Forum since 2005. He also served as a director of The New England Air Museum from 2009 through 2013. 
Mr. Bruehlman has a Bachelor of Science degree in Economics from the University of Delaware, and an M.B.A. from the University of 
Chicago.  

W. Richard Staub, III, President, Research & Development Solutions

Mr. Staub has served as President, Research & Development Solutions since November 2016. Previously Mr. Staub served as 
President of Novella Clinical, a Quintiles company, since 2013. Prior to Novella’s 2013 acquisition by Quintiles, Mr. Staub served as 
both president and CEO of Novella Clinical since 2008. Before joining Novella Clinical in 2004, Mr. Staub was senior vice president 
of global business development for one of the world’s largest clinical research organizations. Mr. Staub’s career in the pharmaceutical 
industry  began  at  Zeneca  Pharmaceuticals  in  1989  where  he  had  progressive  responsibilities  as  a  medical  and  hospital  sales 
representative, cardiovascular portfolio analyst and marketing manager. Mr. Staub has a Bachelor of Arts degree in Economics from 
the University of North Carolina at Chapel Hill.

110

 
 
 
 
 
 
 
Kevin C. Knightly, President, Technology & Commercial Solutions

Mr. Knightly has served as President, Technology & Commercial Solutions since October 2016. Previously Mr. Knightly 

served as Senior Vice President, Information Offerings at IMS Health from April 2015 to October 2016. From January 2011 to March 
2015, Mr. Knightly served as Senior Vice President, Supplier Management at IMS Health. Prior to that, Mr. Knightly served in a number 
of senior financial, operations, marketing and general management roles for IMS Health, including as Senior Vice President, Pharma 
Business Management from 2007 until 2010. Mr. Knightly holds a B.S. in Economics and Accounting from the College of the Holy 
Cross, and an M.B.A. from New York University’s Stern Business School.

Eric Sherbet, Executive Vice President, General Counsel and Secretary

Mr. Sherbet has served as our Executive Vice President, General Counsel and Secretary since March 2018. Prior to joining 
the  Company,  he  served  as  General  Counsel  and  Secretary  at  Patheon  N.V.  from  November  2014  until  November  2017.  Prior  to 
joining  Patheon,  he  was  General  Counsel  and  Corporate  Secretary  at  InVentiv  Health  from  April  2011  until  October  2014.  He  also 
previously served as Vice President, Deputy General Counsel and Corporate Secretary at Foster Wheeler AG and before that, as Vice 
President, Corporate and Securities Law and Secretary with Avaya, Inc. Mr. Sherbet earned his law degree from New York University 
School of Law and received his bachelor’s degree in commerce/accounting from University of Virginia.

 Item 11. Executive Compensation

Compensation

The information required by this item is set forth under the headings “Director Compensation,” “Compensation Discussion 
and Analysis,” “Compensation Committee Report,” “Compensation of Named Executive Officers,” and “Other Relevant Information
—Compensation Committee Interlocks and Insider Participation” in the 2021 Proxy Statement and is incorporated herein by reference.

Item 12. Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters

Information in response to this Item, other than Securities Authorized for Issuance Under Equity Compensation Plans, will 
be set forth in the section entitled “Security Ownership of Certain Beneficial Owners and Management” in the Company’s 2021 Proxy 
Statement, which information is incorporated herein by reference.

Securities Authorized for Issuance Under Equity Compensation Plans

The following table provides certain information with respect to all of our equity compensation plans in effect as of 

December 31, 2020:

Equity Compensation Plan Information

Number of 
Securities
to be issued 
Upon Exercise of 
Outstanding 
Options, 
Warrants and 
Rights (a)

Weighted 
Average Exercise 
Price of 
Outstanding 
Options,Warrant
s and Rights (b)

Number of 
Securities 
Remaining 
Available for 
Future Issuance 
Under Equity 
Compensation 
Plans (excluding 
securities 
reflected in 
column (a) (c)

6,133,224 (1) $ 

105.50  (3)

 10,700,716 

(4)

26,727 (2)

—

—

6,159,951

$ 

105.50  (3) 10,700,716

Plan Category
Equity compensation plans approved by security holders

Equity compensation plans not approved by security holders

Total

111

 
 
 
 
 
 
 
 
(1) 

(2) 

(3) 

(4) 

Consists  of:  (i)  4,773,969  shares  of  common  stock  issuable  upon  the  exercise  of  outstanding  time-based  stock  options  and  underlying 
outstanding time-based SARs; (ii) 571,506 shares of common stock issuable in settlement of outstanding restricted stock units awarded;  
(iii) 786,165 shares of common stock issuable in settlement of outstanding performance units awarded; and (iv) 1,584 shares of deferred 
common stock outstanding under the Director Deferral Plan. Excludes (i) 127,292 shares of common stock subject to outstanding awards 
of restricted stock.

Consists  of  outstanding  awards  issued  to  certain  executives  with  supplemental  pension  benefits  in  accordance  with  their  individual 
employment arrangements under the IMS Health DCERP.

The  weighted-average  exercise  price  includes  all  outstanding  stock  options  and  SARs  but  does  not  include  restricted  stock  units, 
restricted  stock,  performance  units  or  performance  stock,  deferred  stock  or  IMS  Health  DCERP  awards,  all  of  which  do  not  have  an 
exercise  price.  If  restricted  stock  units,  performance  units  and  other  awards  that  constitute  “rights”  were  included  in  this  calculation, 
treating such awards as having an exercise price of $0, the weighted average exercise price of outstanding options, warrants and rights 
would be $82.12.

Consists of all securities remaining available under our equity compensation plans. All of these shares are available for delivery under 
stock options, SARs, restricted stock, restricted stock units, performance awards or other forms of equity award authorized by the plans. 
Does  not  include  2,251,704  shares  that  would  have  remained  available  under  our  Employee  Stock  Purchase  Plan  had  it  not  been 
discontinued as of December 31, 2016.

Item 13. Certain Relationships and Related Transactions and Director Independence

The  information  required  by  this  item  is  set  forth  under  the  headings  “IQVIA’s  Corporate  Governance,”  and  “Certain 

Relationships and Related Party Transactions” in the 2021 Proxy Statement and is incorporated herein by reference.

Item 14. Principal Accountant Fees and Services

The information required by this item is set forth under the headings “Audit—Fees Paid to Independent Registered Public 

Accounting Firm” in the 2021 Proxy Statement and is incorporated herein by reference.

112

 
 
PART IV

Item 15. Exhibits and Financial Statement Schedules

(a)

The following documents are filed as part of this report:

(1) Financial Statements

The following consolidated financial statements of IQVIA Holdings Inc. and its subsidiaries, and the independent registered 

public accounting firm’s report thereon, are included in Part II, Item 8 of this Annual Report:

Management’s Report on Internal Control over Financial Reporting

Report of Independent Registered Public Accounting Firm

Consolidated Statements of Income

Consolidated Statements of Comprehensive (Loss) Income

Consolidated Balance Sheets

Consolidated Statements of Cash Flows

Consolidated Statements of Stockholders’ Equity (Deficit)

Notes to Consolidated Financial Statements

(2) Financial Statement Schedules for the Years Ended December 31, 2020, 2019 and 2018

Schedule I—Condensed Financial Information of Registrant (Parent Company Only)

Schedule II—Valuation and Qualifying Accounts

Page

55 

56 

58 

59 
60 

61 
62 

63 

115 

120 

All  other  schedules  are  omitted,  since  the  required  information  is  not  applicable  or  is  not  present  in  amounts  sufficient  to 
require submission of the schedule, or because the information required is included in the consolidated financial statements and notes 
thereto.

(3) Exhibits

The exhibits in the accompanying Exhibit Index preceding the signature page are filed or furnished as a part of this report and 
are  incorporated  herein  by  reference.  The  Company  agrees  to  furnish  to  the  SEC,  upon  request,  copies  of  any  long-term  debt 
instruments  that  authorize  an  amount  of  securities  constituting  10%  or  less  of  the  total  assets  of  IQVIA  Holdings  Inc.  and  its 
subsidiaries on a consolidated basis.

113

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
EXHIBIT INDEX

Incorporated by Reference 

Filed 
Herewith

Form
8-K

File No.
001-35907

Exhibit
2.1

Filing Date
May 3, 2016

10-K

001-35907

3.1

10-K

001-35907

S-1/A

333-186708

8-K

001-35907

3.2

4.1

4.1

8-K

001-35907

4.1

8-K

001-35907

4.1

February 16, 
2018

February 18, 
2020

April 26, 2013

October 3, 2016

February 28, 
2017

September 19, 
2017

8-K

001-35907

4.1

May 10, 2019

8-K

8-K

8-K

4.1

4.1

10.9

001-35907

001-35907
001-35907

August 13, 2019

June 24, 2020
October 3, 2016

8-K

001-35907

10.1

March 8, 2017

8-K

001-35907

10.1

September 19, 
2017

10-Q

001-35907

10.1

May 4, 2018

Exhibit 
Number 

2.1*

3.1

3.2

4.1

4.5

4.8

4.9

4.10

4.11

4.12

10.1

10.2

10.3

10.4

Exhibit Description 

Agreement and Plan of Merger, dated as of May 3, 2016, by and 
between Quintiles Transnational Holdings Inc. and IMS Health 
Holdings, Inc. (which includes the Plan of Conversion dated as 
of May 3, 2016 as Exhibit A thereto).

Amended and Restated Certificate of Incorporation of IQVIA 
Holdings Inc., effective November 6, 2017 (as amended through 
November 6, 2017).

Amended and Restated Bylaws of IQVIA Holdings Inc., effective 
February 11, 2020.

Specimen Common Stock Certificate of Quintiles Transnational 
Holdings Inc.

Indenture, dated as of September 28, 2016, among Quintiles IMS 
Incorporated, the Guarantors listed therein and U.S. Bank National 
Association, as Trustee.

Indenture, dated February 28, 2017, among Quintiles IMS 
Incorporated, as Issuer, U.S. Bank National Association, as 
trustee of the Notes, and certain subsidiaries of the Issuer as 

Indenture, dated September 14, 2017, among Quintiles IMS 
Incorporated, as Issuer, U.S. Bank National Association, as 
trustee of the Notes, and certain subsidiaries of the Issuer as 

Indenture, dated May 10, 2019, among IQVIA Inc., as Issuer, 
U.S. Bank National Association, as trustee of the Notes and 
certain subsidiaries of the Issuer, as guarantors.

Indenture, dated August 13, 2019, among IQVIA Inc., as Issuer, 
U.S. Bank National Association, as trustee of the Notes and certain 
subsidiaries of the Issuer, as guarantors.
Indenture, dated June 24, 2020, among IQVIA Inc., as Issuer, U.S. 
Bank National Association, as trustee of the Notes and certain 
subsidiaries of the Issuer, as guarantors.
Fourth Amended and Restated Credit Agreement, dated as of 
October 3, 2016, by and among Quintiles IMS Incorporated, 
Quintiles IMS Holdings, Inc., the Guarantors party thereto and 
the Lenders party thereto (Annex B to Exhibit 10.9 filed October 
3, 2016).

Amendment No. 1, dated March 7, 2017, to Fourth Amended 
and Restated Credit Agreement, dated October 3, 2016, among 
Quintiles IMS Incorporated, Quintiles IMS Holdings, Inc., the 
Guarantors party thereto, Bank of America N.A., as 
administrative agent and collateral agent, the Incremental Term 
B-1 Euro Lenders party thereto and the other Lenders party 

Amendment No. 2, dated September 18, 2017, to Fourth 
Amended and Restated Credit Agreement, by and among 
Quintiles IMS Incorporated, Quintiles IMS Holdings, Inc., the 
Guarantors party thereto, Bank of America N.A., as 
administrative agent and collateral agent, the Incremental Term 
B-2 Dollar Lenders party thereto and the other Lenders party 

Amendment No. 3, dated April 6, 2018, to Fourth Amended and 
Restated Credit Agreement, dated October 3, 2016, by and 
among IQVIA Inc., IQVIA Holdings Inc., the other Borrowers 
party thereto, the other Guarantors party thereto, Bank of 
America, N.A., as administrative agent and collateral agent, and 
the Incremental Revolving Credit Lenders party thereto.

114

      
10.5

10.6

10.7

10.8

10.9

10.10

10.11

10.12

Amendment No. 4, dated June 11, 2018, to Fourth Amended and 
Restated Credit Agreement, dated October 3, 2016, among 
IQVIA Inc., IQVIA Holdings Inc., IQVIA AG, IQVIA Solutions 
Japan K.K., the other guarantors party thereto, Bank of America, 
N.A. as administrative agent and as collateral agent, the Lenders 
party thereto, the Incremental Term B-3 Dollar Lenders party 
thereto and the Incremental Term B-2 Euro Lenders party 

Amendment No. 5 to Fourth Amended and Restated Credit 
Agreement, dated August 9, 2019, among IQVIA Inc., IQVIA 
Holdings Inc., the other guarantors party thereto, Bank of 
America, N.A. as administrative agent and collateral agent, the 
Term B-1 Euro Lenders, the Term B-2 Euro Lenders and 
Goldman Sachs Bank USA, as Replacement Lender.

Amendment No. 6 to Fourth Amended and Restated Credit 
Agreement, dated December 18, 2019, among IQVIA Inc., IQVIA 
Holdings Inc., the other guarantors party thereto, Bank of America, 
N.A. as administrative agent and collateral agent, the Term B-2 
Dollar Lenders and Bank of America N.A., as Replacement Lender.

Amendment No. 7 to Fourth Amended and Restated Credit 
Agreement, dated March 11, 2020, among IQVIA Inc., IQVIA 
Holdings Inc., the other guarantors party thereto, Bank of America, 
N.A. as administrative agent and collateral agent, and the 
Incremental Term A-2 Dollar Lenders

Amendment No. 8 to Fourth Amended and Restated Credit 
Agreement, dated March 30, 2020, among IQVIA Inc., IQVIA 
Holdings Inc., the other guarantors party thereto, Bank of America, 
N.A. as administrative agent and collateral agent, and the 
Incremental Term A-2 Dollar Lenders

Amended and Restated Pledge and Security Agreement, dated as 
of March 17, 2014, among Healthcare Technology Intermediate 
Holdings, Inc., IMS Health Incorporated, each of the grantors 
party thereto, and Bank of America, N.A., as Administrative 
Agent.

U.S. Guaranty, dated as of March 17, 2014, among Healthcare 
Technology Intermediate Holdings, Inc., as Holdings, IMS Health 
Incorporated, as Parent Borrower, the other Guarantors party 
thereto from time to time, and Bank of America, N.A., as 
Administrative Agent.

Stockholders Agreement, dated May 3, 2016, among Quintiles 
Transnational Holdings Inc. and the stockholders identified 
therein.

8-K

001-35907

10.1

June 12, 2018

8-K

001-35907

10.1

August 13, 2019

8-K

001-35907

10.1

December 18, 
2019

10-Q

001-35907

10.1

April 30, 2020

10-Q

001-35907

10.2

April 30, 2020

IMS
Health 
S-1/A

IMS
Health 
S-1/A

333-193159

10.33

March 24, 2014

333-193159

10.34

March 24, 2014

8-K

001-35907

10.4

May 3, 2016

10.13†

Form of Director Indemnification Agreement.

S-1/A

333-186708

10.13

April 19, 2013

8-K

001-35907

10.8

October 3, 2016

10.14

10.15†

10.16†

10.17†

Form of Indemnification Agreement with each of the non-
management directors of Quintiles IMS Holdings Inc.

Description of Non-Employee Director Compensation, effective 
as of January 1, 2017. 

Form of Non-Competition, Non-Solicitation, Confidentiality 
and IP Agreement.

Quintiles Transnational Holdings Inc. Annual Management 
Incentive Plan.

10-K

001-35907

10.27

8-K

001-35907

10.2

S-1/A

333-186708

10.57

10.17

February 16, 
2017

October 19, 2015

April 19, 2013

February 15, 
2013

February 15, 
2013

February 15, 
2013

10.18†

Quintiles Transnational Holdings Inc. 2008 Stock Incentive Plan.

S-1

333-186708

10.19†

10.20†

Form of Stock Option Award Agreement for Senior Executives 
under the Quintiles Transnational Holdings Inc. 2008 Stock 
Incentive Plan.

Form of Stock Option Award Agreement for Non-Employee 
Directors under the Quintiles Transnational Holdings Inc. 2008 
Stock Incentive Plan.

S-1

333-186708

10.18

S-1

333-186708

10.19

10.21†

Quintiles Transnational Holdings Inc. 2013 Stock Incentive Plan.

S-1/A

333-186708

10.22

April 19, 2013

115

10.22†

10.23†

10.24†

10.25†

10.26†

10.27†

10.28†

10.29†

10.30†

10.31†

10.32†

10.33†

10.34†

10.35†

10.36†

10.37†

10.38†

10.39†

10.40†

10.41†

10.42†

Form of Award Agreement Awarding Nonqualified Stock Options 
to Employees under the Quintiles Transnational Holdings Inc. 
2013 Stock Incentive Plan.

Form of Award Agreement Awarding Incentive Stock Options to 
Employees under the Quintiles Transnational Holdings Inc. 2013 
Stock Incentive Plan.

Form of Award Agreement Awarding Nonqualified Stock Options 
to Non-Employee Directors under the Quintiles Transnational 
Holdings Inc. 2013 Stock Incentive Plan.

Form of Award Agreement Awarding Stock Appreciation Rights 
under the Quintiles Transnational Holdings Inc. 2013 Stock 
Incentive Plan.

Form of Award Agreement Awarding Stock Appreciation Rights 
under the Quintiles IMS Holdings, Inc. 2013 Stock Incentive Plan 
effective February 2017.

Form of Award Agreement Awarding Restricted Stock Units 
under the Quintiles Transnational Holdings Inc. 2013 Stock 
Incentive Plan prior to February 2015.

Form of Award Agreement Awarding Restricted Stock Units 
under the Quintiles Transnational Holdings Inc. 2013 Stock 
Incentive Plan effective February 2015.

Form of Award Agreement Awarding Performance Units under 
the Quintiles Transnational Holdings Inc. 2013 Stock Incentive 
Plan.

Form of Award Agreement Awarding Performance Shares under 
the Quintiles IMS Holdings, Inc. 2013 Stock Incentive Plan 
effective February 2017.

Form of Restricted Stock Award Agreement under the 
Quintiles Transnational Holdings Inc. 2013 Stock Incentive 
Plan.

Form of Award Agreement Awarding Restricted Stock 
Units under the Quintiles IMS Holdings, Inc. 2013 Stock 
Incentive Plan effective February 2017.

Quintiles IMS Holdings, Inc. Defined Contribution Executive 
Retirement Plan.

IMS Health Incorporated Defined Contribution Executive 
Retirement Plan, as amended and restated.

First Amendment to the IMS Health Incorporated Retirement 
Excess Plan, dated March 17, 2009.

Second Amendment to the IMS Health Incorporated Retirement 
Excess Plan, dated December 8, 2009.

Third Amendment to the IMS Health Incorporated Retirement 
Excess Plan, dated April 5, 2011.

Fourth Amendment to the IMS Health Incorporated Retirement 
Excess Plan (effective May 3, 2016).

Quintiles IMS Holdings, Inc. 2010 Equity Incentive Plan.

Healthcare Technology Holdings, Inc. 2010 Equity Incentive Plan, 
as amended and restated.

Form of IMS Time-and Performance-Based Stock Option Award 
Agreement under the 2010 Equity Incentive Plan.

Form of IMS Time-Based Stock Option Award Agreement under 
the 2010 Equity Incentive Plan.

116

S-1/A

333-186708

10.23

April 19, 2013

10-Q

001-35907

10.2

May 1, 2014

S-1/A

333-186708

10.24

April 19, 2013

S-1/A

333-186708

10.56

April 19, 2013

10-K

001-35907

10.41

8-K

001-35907

10.1

10-K

001-35907

10.34

001-35907

10.35

001-35907

10.45

001-35907

10.3

001-35907

10.47

February 16, 
2017

November 26, 
2013

February 12, 
2015

February 12, 
2015

February 16, 
2017

November 3, 
2016

February 16, 
2017

001-35907

10.7

October 3, 2016

333-193159

10.10

January 2, 2014

333-193159

10.12

January 2, 2014

333-193159

10.13

January 2, 2014

333-193159

10.14

January 2, 2014

001-36381

001-35907

10.3

10.5

July 28, 2016

October 3, 2016

333-193159

10.16

February 13, 
2014

333-193159

10.17

January 2, 2014

333-193159

10.18

January 2, 2014

10-K

10-K

10-Q

10-K

8-K

IMS 
Health 
S-1

IMS 
Health 
S-1

IMS 
Health 
S-1

IMS 
Health 
S-1

IMS 
Health 
10-Q

8-K

IMS 
Health 
S-1/A

IMS 
Health 
S-1

IMS 
Health 
S-1

10.43†

10.44†

10.45†

10.46†

10.47†

10.48†

10.49†

10.50†

Form of IMS Director Stock Option Award Agreement under the 
2010 Equity Incentive Plan.

Form of IMS Restricted Stock Unit Award Agreement under the 
2010 Equity Incentive Plan.

Form of IMS Director Restricted Stock Unit Award Agreement 
under the 2010 Equity Incentive Plan.

Form of IMS Rollover Stock Appreciation Right Award 
Agreement under the 2010 Equity Incentive Plan.

IMS Health Incorporated Savings Equalization Plan, as amended 
and restated effective as of January 1, 2011.

Quintiles IMS Holdings, Inc. 2014 Incentive and Stock Award 
Plan.

Form of IMS Stock Appreciation Rights Agreement under the 
2014 Incentive and Stock Award Plan.

Form of IMS Performance Share Award Agreement under the 
2014 Incentive and Stock Award Plan.

10.51†

2014 IMS Health Annual Incentive Plan.

10.52†
10.53†

10.54†

10.55†

10.56†

10.57†

10.58†

10.59†

10.60†

10.61†

10.62†

10.63†

10.66†

10.67†

10.68†

Quintiles IMS Holdings, Inc. 2017 Incentive and Stock Award 
Plan.
Form of Award Agreement Awarding Stock Appreciation Rights 
under the Quintiles IMS Holdings, Inc. 2017 Incentive and Stock 
Award Plan effective April 2017.

Form of Award Agreement Awarding Performance Shares under 
the Quintiles IMS Holdings, Inc. 2017 Incentive and Stock Award 
Plan effective April 2017.

Form of Award Agreement Awarding Restricted Stock Units 
under the Quintiles IMS Holdings, Inc. 2017 Incentive and Stock 
Award Plan effective April 2017.

Quintiles IMS Incorporated Employee Protection Plan, effective 
January 1, 2017.

Quintiles IMS Incorporated Savings Equalization Plan, effective 
December 31, 2016.

Quintiles Transnational Corp. Elective Deferred Compensation 
Plan, as amended and restated.

Quintiles IMS Holdings Inc. Non-Employee Director Deferral Plan, 
effective January 1, 2017.

Amended and Restated Employment Agreement between IQVIA 
Holdings Inc. and Ari Bousbib, dated February 18, 2019.

Stock Appreciation Rights Agreement between IMS Health 
Holdings, Inc. and Ari Bousbib, dated February 10, 2015.

Amendment No. 1, dated December 31, 2015, to Stock 
Appreciation Rights Agreement between IMS Health Holdings, 
Inc. and Ari Bousbib dated February 10, 2015.

Restricted Stock Award Agreement between IMS Health Holdings, 
Inc. and Ari Bousbib dated December 31, 2015.

Letter Agreement between the Company and W. Richard Staub, III, 
effective on November 30, 2016.

Letter Agreement between the Company and Eric Sherbet, effective 
on March 1, 2018.

Letter Agreement between the Company and Ronald Bruehlman, 
effective on August 1, 2020.

117

IMS 
Health 
S-1

IMS 
Health 
S-1

IMS 
Health 
S-1

IMS 
Health 
S-1

IMS 
Health 
S-1

333-193159

10.19

January 2, 2014

333-193159

10.20

January 2, 2014

333-193159

10.21

January 2, 2014

333-193159

10.22

January 2, 2014

333-193159

10.15

January 2, 2014

8-K

001-35907

10.6

October 3, 2016

IMS 
Health 8-
K

IMS 
Health 8-
K

IMS 
Health 
S-1/A

DEF 
14A
10-Q

001-36381

10.1

001-36381

10.2

February 10, 
2015

February 10, 
2015

333-193159

10.30

March 10, 2014

001-35907
001-35907

Appendi
x B
10.8

February 22, 
2017
May 8, 2017

10-Q

001-35907

10.9

May 8, 2017

10-Q

001-35907

10.10

May 8, 2017

10-K

001-35907

10.69

10-K

001-35907

10.76

February 16, 
2017

February 16, 
2017

10-Q

001-35907

10.1

October 28, 2015

10-K

001-35907

10.78

10-K

001-35907

10.60

001-36381

10.34

001-36381

10.35

001-36381

10.36

IMS 
Health 
10-K

IMS 
Health 
10-K

IMS 
Health 
10-K

10-K

001-35907

10.104

10-K

001-35907

10.72

February 16, 
2017

February 19, 
2019

February 19, 
2016

February 19, 
2016

February 19, 
2016

February 16, 
2017

February 19, 
2019

10-Q

001-35907

10.10

October 22, 2020

21.1

23.1

31.1

31.2

32.1

32.2

101

104

List of Subsidiaries of IQVIA Holdings Inc.

Consent of PricewaterhouseCoopers LLP.
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.

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.
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.
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.

Interactive  Data  Files  Pursuant  to  Rule  405  of  Regulation  S-
T:  (i)  Consolidated Statements of Income, (ii) Consolidated 
Statements of Comprehensive Income, (iii) Consolidated Balance 
Sheets, (iv) Consolidated Statements of Cash Flows, (v) Notes to 
Consolidated Financial Statements and (vi) Notes to Consolidated 
Financial Statements. The instance document does not appear in the 
Interactive Data File because its XBRL tags are embedded within 
the Inline XBRL document.

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

X

X

X

X

X

X

X

†  

Indicates management contract or compensatory plan or arrangement.

*   

The  Merger  Agreement  and  the  description  thereof  included  herein  have  been  included  to  provide  investors  and  stockholders  with  information 
regarding  the  terms  of  the  agreement.  They  are  not  intended  to  provide  any  other  factual  information  about  Quintiles  or  IMS  Health  or  their 
respective subsidiaries or affiliates or stockholders. The representations, warranties and covenants contained in the Merger Agreement were made 
only for purposes of the Merger Agreement as of the specific dates therein, were solely for the benefit of the parties to the Merger Agreement, may 
be  subject  to  limitations  agreed  upon  by  the  contracting  parties,  including  being  qualified  by  confidential  disclosures  made  for  the  purposes  of 
allocating contractual risk among the parties to the Merger Agreement instead of establishing these matters as facts, and may be subject to standards 
of  materiality  applicable  to  the  contracting  parties  that  differ  from  those  applicable  to  investors.  Investors  should  not  rely  on  the  representations, 
warranties and covenants or any descriptions thereof as characterizations of the actual state of facts or condition of the parties thereto or any of their 
respective subsidiaries or affiliates. Moreover, information concerning the subject matter of representations and warranties may change after the date 
of  the  Merger  Agreement,  which  subsequent  information  may  or  may  not  be  fully  reflected  in  public  disclosures  by  Quintiles  or  IMS  Health. 
Accordingly, investors should read the representations and warranties in the Merger Agreement not in isolation but only in conjunction with the other 
information about Quintiles or IMS Health and their respective subsidiaries that the respective companies include in reports, statements and other 
filings they make with the United States Securities and Exchange Commission.

118

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Item 16. Form 10-K Summary

None.

SIGNATURES

Pursuant to the requirements of Section 13 or 15(d) of the Securities Exchange Act of 1934, the registrant has duly caused this 

report to be signed on its behalf by the undersigned, thereunto duly authorized.

IQVIA HOLDINGS INC.

By: /s/ Ronald E. Bruehlman 

Name: Ronald E. Bruehlman 

   Title: Executive Vice President and Chief

   Financial Officer

Date: February 12, 2021

Pursuant to the requirements of the Securities Exchange Act of 1934, this report has been signed below by the following persons on 
behalf of the registrant in the capacities and on the dates indicated

119

 
Signature
/s/ Ari Bousbib
Ari Bousbib

Title
Chairman, and Chief Executive Officer; Director

(Principal Executive Officer)

Date

February 12, 2021

/s/ Ronald E. Bruehlman 
Ronald E. Bruehlman 

Executive Vice President and Chief Financial Officer

(Principal Financial Officer)

February 12, 2021

/s/ Emmanuel N. Korakis
Emmanuel N. Korakis

Senior Vice President, Corporate Controller

(Principal Accounting Officer)

February 12, 2021

/s/ Carol J. Burt
Carol J. Burt

/s/ John P. Connaughton
John P. Connaughton

/s/ John G. Danhakl
John G. Danhakl

/s/ James A. Fasano
James A. Fasano

/s/ Colleen A. Goggins
Colleen A. Goggins

/s/ John M. Leonard, M.D.
John M. Leonard, M.D.

/s/ Ronald A. Rittenmeyer
Ronald A. Rittenmeyer

/s/ Todd B. Sisitsky
Todd B. Sisitsky

Director

Director

Director

Director

Director

Director

Director

Director

February 12, 2021

February 12, 2021

February 12, 2021

February 12, 2021

February 12, 2021

February 12, 2021

February 12, 2021

February 12, 2021

120

(2) Financial Statement Schedules

Schedule I—Condensed Financial Information of Registrant

IQVIA HOLDINGS INC. (PARENT COMPANY ONLY) 
CONDENSED STATEMENTS OF INCOME

(in millions)

Selling, general and administrative expenses

Loss from operations

Interest income

Other expense, net

Loss before income taxes and equity in earnings of subsidiary

Income tax benefit

(Loss) income before equity in earnings of subsidiary

Equity in earnings of subsidiary

Net income

Year Ended December 31,

2020

2019

2018

$ 

—  $ 

—  $ 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

— 

$ 

279 

279  $ 

191 

191  $ 

2 

(2) 

— 

— 

(2) 

(1) 

(1) 

260 

259 

121

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. (PARENT COMPANY ONLY) 

CONDENSED STATEMENTS OF COMPREHENSIVE (LOSS) INCOME

(in millions)
Net income
Comprehensive income (loss) adjustments:

Unrealized (losses) gains on derivative instruments, net of 
income tax expense (benefit) of $(10), $4 and $(5)
Defined benefit plan adjustments, net of income tax (benefit) expense of

$(15), $5 and $(4)
Foreign currency translation, net of income tax (benefit) 
expense of $(145), $(30) and $50

Reclassification adjustments:

Losses (gains) on derivative instruments included in net income, net of income 
tax expense of $3, $— and $1
Amortization of actuarial losses and prior service costs included in net income

Comprehensive income (loss) 

Year Ended December 31,
2019

2018

2020

$ 

279  $ 

191  $ 

259 

(30) 

(54) 

180 

10 

(15) 

(30) 

(41) 

(1) 

$ 

— 
385  $ 

— 
104  $ 

1 

(8) 

(255) 

(12) 

1 
(14) 

122

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. (PARENT COMPANY ONLY) 

CONDENSED BALANCE SHEETS

ASSETS

December 31,

2020

2019

$ 

1  $ 

$ 

$ 

— 

— 

1 

9,666 

— 

9,667  $ 

—  $ 

— 

— 

3,664 

2 

3,666 

11,095 

1,277 

(6,166) 

(205) 

6,001 

$ 

9,667  $ 

3 

— 

— 

3 

9,667 

— 

9,670 

— 

— 

— 

3,664 

3 

3,667 

11,049 

998 

(5,733) 

(311) 

6,003 

9,670 

(in millions, except per share data)

Current assets:

Cash and cash equivalents

Income taxes receivable

Other current assets and receivables

Total current assets

Investment in subsidiary

Receivable from parent company

Total assets

LIABILITIES AND STOCKHOLDERS’ EQUITY

Current liabilities:

Accounts payable

Income taxes payable

Total current liabilities

Investment in subsidiary

Payable to subsidiary

Total liabilities

Commitments and contingencies

Stockholders’ equity:

Common stock and additional paid-in capital, 400.0 shares authorized at December 31, 2020 and 
2019, $0.01 par value, 254.7 shares issued and 191.2 shares outstanding at December 31, 2020; 
253.0 shares issued and 192.3 shares outstanding at December 31, 2019

Retained earnings

Treasury stock, at cost, 63.5 and 60.7 shares at December 31, 2020 and 2019, 

respectively

Accumulated other comprehensive (loss) income

Total stockholders’ equity

Total liabilities and stockholders’ equity

123

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. (PARENT COMPANY ONLY) 

CONDENSED STATEMENTS OF CASH FLOWS

Year Ended December 31,
2019

2018

2020

(in millions)
Operating activities:

259 

143 

2 
— 

404 

983 
983 

15 
— 
(1,405) 
3 
(1,387) 
— 
— 
1 
1 

Net Income
Adjustments to reconcile net income to cash provided by operating activities:
Subsidiary loss

$ 

279  $ 

191  $ 

(279) 

— 

Change in operating assets and liabilities:

Accounts payable and accrued expenses
Income taxes payable and other liabilities

Net cash provided by operating activities

Investing activities:
Investment in subsidiary, net of dividends received
Net cash provided by investing activities
Financing activities:

Proceeds related to employee stock purchase and option plans
Issuance of common stock
Repurchase of common stock
Intercompany with subsidiary

Net cash used in financing activities

Effect of foreign currency exchange rate changes on cash
(Decrease) increase in cash and cash equivalents
Cash and cash equivalents at beginning of period
Cash and cash equivalents at end of period

— 
— 

$ 

—  $ 

—

— 
— 
1
9

191  $ 

477 
477 

— 
(44) 
(434) 
(1) 
(479) 
— 
(2) 
3 
1  $ 

760 
760 

— 
11 
(963) 
3 
(949) 
— 
2 
1 
3  $ 

$ 

124

 
 
 
 
 
 
   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
IQVIA HOLDINGS INC. (PARENT COMPANY ONLY) 

NOTES TO CONDENSED FINANCIAL INFORMATION

The  condensed  parent  company  financial  statements  have  been  prepared  in  accordance  with  Rule  12-04,  Schedule  I  of 
Regulation S-X as the restricted net assets of IQVIA Holdings Inc.’s (the “Company”) wholly-owned subsidiary, IQVIA Incorporated 
exceed 25% of the consolidated net assets of the Company. The ability of IQVIA Incorporated to pay dividends may be limited due to 
the restrictive covenants in the agreements governing its credit arrangements.

These  condensed  parent  company  financial  statements  include  the  accounts  of  IQVIA  Holdings  Inc.  on  a  standalone  basis 
(the  “Parent”)  and  the  equity  method  of  accounting  is  used  to  reflect  ownership  interest  in  its  subsidiary.  Refer  to  the  consolidated 
financial  statements  and  notes  presented  elsewhere  herein  for  additional  information  and  disclosures  with  respect  to  these  financial 
statements.

Since the Parent is part of a group that files a consolidated income tax return, in accordance with ASC 740, a portion of the 
consolidated  amount  of  current  and  deferred  income  tax  expense  of  the  Company  has  been  allocated  to  the  Parent.  The  income  tax 
benefit of $0 million, $0 million and $1 million in 2020, 2019 and 2018, respectively, represents the income tax benefit that will be or 
were already utilized in the Company’s consolidated United States federal and state income tax returns. If the Parent was not part of 
these  consolidated  income  tax  returns,  it  would  not  be  able  to  recognize  any  income  tax  benefit,  as  it  generates  no  revenue  against 
which the losses could be used on a separate filer basis.

Below is a summary of the dividends paid to the Parent by IQVIA Incorporated in 2020, 2019 and 2018:

(in millions)

Paid in December 2020

Paid in October 2020

Paid in July 2020

Paid in March 2020

Paid in February 2020

Total paid in 2020

Paid in December 2019

Paid in November 2019

Paid in September 2019

Paid in August 2019

Paid in June 2019

Paid in May 2019

Paid in March 2019

Paid in February 2019

Total paid in 2019

Paid in December 2018

Paid in November 2018

Paid in October 2018

Paid in September 2018

Paid in June 2018

Paid in May 2018

Paid in March 2018

Paid in February 2018

Total paid in 2018

125

$ 

$ 

$ 

$ 

Amount

81 

20 

2 

44 

333 

480
13 

255 

74 

239 

94 

140 

141 

3 

959 

339 

146 

132 

118 

414 

154 

54 

37 

$ 

1,394 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Deferred Tax Asset Valuation Allowance

Schedule II—Valuation and Qualifying Accounts

(in millions)
December 31, 2020

December 31, 2019

December 31, 2018

Additions

Balance at 
Beginning of 
Year

Charged to 
Expenses

Charged to 
Other 
Accounts(a)

Additions 
(Deductions) 
(b)

Balance at End 
of Year

$ 

$ 

$ 

266 

226 

200 

$ 

$ 

$ 

40 

40 

23 

$ 

$ 

$ 

—  $ 

—  $ 

—  $ 

—  $ 

—  $ 

3  $ 

306 

266 

226 

(a)
(b)

Recorded through purchase accounting transaction.
Impact of reductions recorded to expense and translation adjustments.

126

IQVIA Holdings Inc.

Subsidiary Listing – as of 12/31/2020

Subsidiary
159 Solutions, LLC
159 Technology Solutions Private Ltd
Advanced Health Media Services Ltd.
AECIO IT Solutions India Private Ltd.
Albatross Financial Solutions Limited
ALIMED Egeszsegugyi Szolgaltato Kft.
Allcare Plus Pharmacy LLC
Aposphäre GmbH
Appature Inc.
Ardentia International Limited
Ascott Sales Integration Pty Ltd
Asesorias IQVIA Solutions  Chile Limitada
Asserta Centroamerica Medicion de Mercados, S.A.
Avacare Clinical Research Network (Shanghai) Co., Ltd.
Battaerd Mansley (Proprietary) Limited
Battaerd Mansley Pty. Ltd.
Benefit Holding, Inc.
Biofortis, LLC
Branch of IQVIA RDS GesmbH in  Novosibirsk
Branch of IQVIA RDS GesmbH in St. Petersburg
BuzzeoPDMA LLC
Cambridge Pharma Consultancy Inc.
Cambridge Pharma Consultancy Limited
CDS - Centre de Service SAS
Cegedim Venezuela C.A.
Cenduit (India) Services Private Company Limited
Cenduit GmbH
Cenduit Holdings, LLC
Cenduit Limited
Cenduit LLC
Cenduit LLC Shanghai Rep. Office
Cenduit Mauritius Holdings Company
Centrix Innovations (Pty) Ltd.
CFS Clinical UK Limited
Clinical Financial Services, LLC
Clinical Insourcing Solutions Limited

Clinical Insourcing Solutions S. de R.L. de C.V.

Clinical Lab Minority Shareholder Limited

Exhibit 21.1

Jurisdiction or
State of Organization

California
India
United Kingdom
India
United Kingdom
Hungary
Massachusetts
Germany
Washington
United Kingdom
Australia
Chile
Guatemala
China
South Africa
Australia
North Carolina
Delaware
Russian Federation
Russian Federation
Delaware
Delaware
United Kingdom
France
Venezuela
India
Switzerland
Delaware
United Kingdom
Delaware
China
Mauritius
South Africa
United Kingdom
Pennsylvania
Ireland

Mexico

United Kingdom

ClinTec Austria GmbH

ClinTec CRO Services (India) Private Limited

ClinTec Gesellschaft fur Klinische Entwicklung GmbH

ClinTec International (Pty) Ltd.

ClinTec International (Pty) Ltd. (Malawi branch)

ClinTec International (Thailand) Limited

ClinTec International AG

ClinTec International Belgium BV

ClinTec International Bulgaria OOD

ClinTec International Co., Ltd.

ClinTec International d.o.o. za trgov inuisludge

ClinTec International Denmark ApS

ClinTec International doo

ClinTec International FZ-LLC

ClinTec International Hong Kong Limited

ClinTec International Hungary Kft

Clintec International Inc.

ClinTec International Italy S.r.l.

ClinTec International Limited

ClinTec International Limited

ClinTec International Limited

ClinTec International LLC

ClinTec International Ltd (Netherlands Branch)

ClinTec International Ltd, UK, Filial Sverige

ClinTec International Ltd.

ClinTec International Norway AS

ClinTec International Off-Shore S.A.L.

Clintec International Pharmaceutical Services Ltd

ClinTec International Pte Ltd.

ClinTec International Pty Ltd

ClinTec International Romania S.R.L.

ClinTec International RUS LLC

ClinTec International S.à r.l.

ClinTec International s.r.o.

ClinTec International Services Inc.

ClinTec International SL

ClinTec International sp. z.o.o.

ClinTec Luxembourg S.A.

ClinTec Turkey Medikal ve Farmasotik Hizmetler Ticaret Limited Sirketi

ClinTech Ireland International Research Limited

Compliant Community Projects (Pty) Ltd.

Austria

India

Germany

South Africa

Malawi

Thailand

Switzerland

Belgium

Bulgaria

Republic of Korea

Croatia

Denmark

Serbia

United Arab Emirates

Hong Kong

Hungary

Massachusetts

Italy

Kenya

New Zealand

Taiwan

Ukraine

The Netherlands

Sweden

United Kingdom

Norway

Lebanon

Israel

Singapore

Australia

Romania

Russian Federation

France

Czechia

Canada

Spain

Poland

Luxembourg

Turkey

Ireland

South Africa

CoreZetta Co Ltd.

CRM Health Korea Ltd.

CSD Health Korea Ltd.

CT Clinical Portugal Unipessoal Lda

CT Clinical Services Eood

CT Consulting Inc.

Data Niche Associates, Inc.

Dataline Software Limited

Datandina Ecuador S.A.

Datec Industria e Comercio, Distribudora Grafica e Mala Direta Ltda.

Dimensions Healthcare Company Ltd

Dimensions Healthcare LLC

Dimensions Healthcare LLC (Dubai Branch)

DrugDev Inc.

DrugDev Limited

EA Institute, L.L.C.

Enterprise Associates L.L.C.

Epernicus, LLC

EPID Research Oy

EPID Research Sweden

EPS Research Limited

EPS Software Limited

Excel Life Sciences Inc.

Excel Life Sciences Pvt Ltd India

Forcea NV

Foresight IT Solutions and Consulting India Private Limited

GCE Clin Solutions Limited

GCE Global Solutions, LLC

GCE Solutions International, LLC

GCE Solutions Proprietary Limited

GCE Solutions, GmbH

GCE Solutions, S. de R.L. de C.V.

genae Germany Gmbh

genae International Ag

Global Crown Investment Limited

Grace Data Corp.

HighPoint Solutions, LLC

Highpoint Solutions, LLC (Geneva Branch)

Hospital Marketing Services Ltd.

Hotel Lot C-8B, LLC

Iasist Holdco Limited

Republic of Korea

Republic of Korea

Republic of Korea

Portugal

Bulgaria

Philippines

Illinois

United Kingdom

Ecuador

Brazil

Palestinian Territory

United Arab Emirates

United Arab Emirates

Delaware

United Kingdom

Delaware

Delaware

Delaware

Finland

Sweden

United Kingdom

United Kingdom

Delaware

India

Belgium

India

United Kingdom

Delaware

Delaware

South Africa

Switzerland

Mexico

Germany

Switzerland

Hong Kong

California

Delaware

Switzerland

United Kingdom

North Carolina

United Kingdom

Iasist Portugal, Consultadoria na Área de Saúde, Unipessoal, Lda

Iasist SAU Agencia en Chile

Iasist Sociedad Anonima Unipersonal

iGuard, Inc.

Impact RX Data Management (Pty) Ltd.

IMS (UK) Pension Plan Trustee Company Limited

IMS AB

IMS Government Solutions, Inc.

IMS Health (Australia) Partnership

IMS Health Analytics Services Private Limited

IMS Health de Venezuela C.A.

IMS Health Group Limited

IMS Health Information Solutions Australia Pty. Ltd

IMS Health Information Solutions India Private Ltd.

IMS Health Korea Ltd.

IMS Health Networks Limited

IMS Health Paraguay Srl

IMS Health Surveys Limited

IMS Health Uruguay S.A.

IMS Hospital Group Limited

IMS Information Solutions Medical Research Limited

IMS Information Solutions UK Ltd.

IMS International (Proprietary) Limited

IMS Meridian Limited

IMS Meridian Research Limited

IMS Software Services Ltd.

IMS Technology Solutions UK Limited

INCARNUS MALAYSIA SDN BHD

Infocus Health Limited

Infopharm Ltd.

Innovex Holdings I LLC

Innovex Merger Corp.

Innovex Saglik Urunleri Pazarlame ve Hizmet Danismanlik Anonim Sirketi

Intercontinental Medical Statistics International, Ltd.

Intercontinental Medical Statistics Kenya Ltd.

Interface Clinical Services Ltd.

Interstatistik AG

IPP Informacion Promocional y Publicitaria S.A. de C.V.

IQVIA  Medical Development (Dalian) Co., Ltd.

IQVIA (Thailand) Co., Ltd.

IQVIA AB

Portugal

Chile

Spain

North Carolina

South Africa

United Kingdom

Sweden

Delaware

Australia

India

Venezuela

United Kingdom

Australia

India

Republic of Korea

United Kingdom

Paraguay

United Kingdom

Uruguay

United Kingdom

United Kingdom

United Kingdom

South Africa

Hong Kong

British Virgin Islands

Delaware

United Kingdom

Malaysia

United Kingdom

United Kingdom

Delaware

North Carolina

Turkey

Delaware

Kenya

United Kingdom

Switzerland

Mexico

China

Thailand

Sweden

IQVIA Adriatic d.o.o. za Konzalting

IQVIA AG

IQVIA AG (Basal Branch)

IQVIA AG (Dubai Branch)

IQVIA AG (Mexico Branch)

IQVIA AG (Representative Office - Algeria)

IQVIA AG (Representative Office - Dubai)

IQVIA AG (Representative Office - Jordan)

IQVIA AG (Representative Office - Lebanon)

IQVIA AG (Representative Office - Serbia)

IQVIA AG (Rotkreuz Branch)

IQVIA AG (UK Branch)

IQVIA Asia Pacific Commercial Holdings LLC

IQVIA Beteiligungsgesellschaft mbH

IQVIA BioSciences Holdings, LLC

IQVIA Biotech LLC

IQVIA Biotech Ltd.

IQVIA Chinametrik Inc.

IQVIA Clinical AB

IQVIA Clinical, Filial af IQVIA Clinical AB

IQVIA Commercial Consulting Sp. z.o.o.

IQVIA Commercial Deutschland Gmbh

IQVIA Commercial Finance Inc.

IQVIA Commercial GmbH & Co. OHG

IQVIA Commercial I LLC

IQVIA Commercial India Holdings Corp.

IQVIA Commercial Services LLC

IQVIA Commercial Software Gmbh

IQVIA Commercial Sp. z.o.o.

IQVIA Commercial Trading Corp.

IQVIA Consulting and Information Services India Private Limited

IQVIA Consulting Solutions BV

IQVIA CSMS GmbH

IQVIA CSMS US Inc.

IQVIA Finance Ireland Designated Activity Company

IQVIA FZ-LLC

IQVIA Government Solutions Inc.

IQVIA Healthcare (QFC Branch)

IQVIA Hellas Technology Solutions Single Member S.A.

IQVIA Holdings (UK) Ltd.

IQVIA Holdings France Sas

Croatia

Switzerland

Switzerland

United Arab Emirates

Mexico

Algeria

United Arab Emirates

Jordan

Lebanon

Serbia

Switzerland

United Kingdom

North Carolina

Germany

Delaware

Delaware

United Kingdom

Delaware

Sweden

Denmark

Poland

Germany

Delaware

Germany

Delaware

Delaware

Delaware

Germany

Poland

Delaware

India

Belgium

Germany

Delaware

Ireland

United Arab Emirates

Delaware

Qatar

Greece

United Kingdom

France

IQVIA IES Brasil Ltda.

IQVIA IES Denmark ApS

IQVIA IES Europe Limited

IQVIA IES European Holdings

IQVIA IES Italia S.r.L.

IQVIA IES Overseas Holdings Limited

IQVIA IES Oy

IQVIA IES Portugal Unipessoal LDA

IQVIA IES Puerto Rico Inc.

IQVIA IES South Africa (Pty) Limited

IQVIA IES UK Limited

IQVIA II Technology Solutions Portugal, Unipessoal LDA

IQVIA Inc.

IQVIA Inc. (Thailand Branch)

IQVIA Information Medical Statistics (Israel) Ltd.

IQVIA Information Solutions (China) Co., Ltd.

IQVIA Information Solutions GmbH

IQVIA Information, S.A.

IQVIA Integrated Services NL

IQVIA Investment Holdings Limited

IQVIA Korea Co. Ltd.

IQVIA Lebanon S.a.r.l.

IQVIA LTD.

IQVIA Market Intelligence, LLC

IQVIA Marktforschung GmbH

IQVIA Maroc S.à r.l.

IQVIA Medical Communications & Consulting, Inc.

IQVIA Medical Education Inc.

IQVIA Medical Radar AB

IQVIA MedTech Inc.

IQVIA MedTech NV

IQVIA Operations France SAS

IQVIA Partners AS

IQVIA Pharma Inc.

IQVIA Pharma Services Corp.

IQVIA Pharmaceutical Marketing Services Ltd.

IQVIA Phase One Services LLC

IQVIA RDS (India) Private Ltd.

IQVIA RDS (Pty.) Limited

IQVIA RDS (Shanghai) Co., Ltd.

IQVIA RDS AG

Brazil

Denmark

United Kingdom

United Kingdom

Italy

United Kingdom

Finland

Portugal

Puerto Rico

South Africa

United Kingdom

Portugal

Delaware

Thailand

Israel

China

Austria

Spain

The Netherlands

United Kingdom

Republic of Korea

Lebanon

United Kingdom

North Carolina

Austria

Morocco

New Jersey

New York

Sweden

Delaware

Belgium

France

Denmark

North Carolina

North Carolina

Slovenia

Kansas

India

South Africa

China

Switzerland

IQVIA RDS and Integrated Services Belgium NV

IQVIA RDS Argentina S.R.L.

IQVIA RDS Asia Inc.

IQVIA RDS Austria GmbH

IQVIA RDS Brasil Ltda.

IQVIA RDS BT Inc.

IQVIA RDS Bulgaria EOOD

IQVIA RDS Canada ULC

IQVIA RDS Chile

IQVIA RDS Clindata (Pty.) Ltd.

IQVIA RDS Clindepharm (Pty.) Ltd.

IQVIA RDS Colombia S.A.S.

IQVIA RDS Costa Rica S.A.

IQVIA RDS Czech Republic s.r.o.

IQVIA RDS d.o.o. Beograd

IQVIA RDS East Asia Pte. Ltd.

IQVIA RDS Eastern Holdings GmbH

IQVIA RDS Egypt LLC

IQVIA RDS Estonia OU

IQVIA RDS Finland Oy

IQVIA RDS France SAS

IQVIA RDS Funding LLC

IQVIA RDS GesmbH

IQVIA RDS GmbH

IQVIA RDS Guatemala S.A.

IQVIA RDS Hellas Single Member S.A.

IQVIA RDS Holdings

IQVIA RDS Hong Kong Limited
IQVIA RDS Hungary Pharmaceutical Development and Consulting Limited 
Liability Company

IQVIA RDS Inc.

IQVIA RDS Ireland (Finance) Ltd.

IQVIA RDS Ireland Ltd.

IQVIA RDS Israel Ltd.

IQVIA RDS Italy S.r.l.

IQVIA RDS Latin America LLC

IQVIA RDS Latin America LLC (Argentina Branch)

IQVIA RDS Latvia SIA

IQVIA RDS Malaysia Sdn. Bhd.

IQVIA RDS Netherlands B.V.

IQVIA RDS Norway
IQVIA RDS Panama Inc.

Belgium

Argentina

North Carolina

Austria

Brazil

North Carolina

Bulgaria

NS, Canada

Chile

South Africa

South Africa

Colombia

Costa Rica

Czechia

Serbia

Singapore

Austria

Egypt

Estonia

Finland

France

North Carolina

Austria

Germany

Guatemala

Greece

United Kingdom

Hong Kong

Hungary

North Carolina

Ireland

Ireland

Israel

Italy

North Carolina

Argentina

Latvia

Malaysia

The Netherlands

Norway
Panama

IQVIA RDS Peru S.r.l.
IQVIA RDS Philippines Inc.
IQVIA RDS Poland Sp. Zoo
IQVIA RDS Pty. Limited
IQVIA RDS Pty. Ltd.
IQVIA RDS Slovakia, s.r.o.
IQVIA RDS South Africa (Pty.) Ltd.
IQVIA RDS Spain S.L.
IQVIA RDS Spain, S.L. - Representação Permanente em Portugal
IQVIA RDS Switzerland S.à r.l.
IQVIA RDS Taiwan Ltd.
IQVIA RDS UAB
IQVIA RDS UK Holdings Ltd.
IQVIA RDS Ukraine
IQVIA RDS Vietnam LLC
IQVIA Research and Development Solutions Saudi Arabia Limited
IQVIA Romania S.R.L.
IQVIA Services Japan K.K.
IQVIA Soluções de Tecnologia do Brasil Ltda
IQVIA Solutions (NZ) Limited
IQVIA Solutions (Pty.) Ltd.
IQVIA Solutions a.s.
IQVIA Solutions Argentina S.A.
IQVIA Solutions Asia Pte. Ltd
IQVIA Solutions Australia Holdings Pty. Ltd.
IQVIA Solutions Australia Pty. Ltd.
IQVIA Solutions B.V.
IQVIA Solutions Bangladesh Limited
IQVIA Solutions Belgium BV
IQVIA Solutions Bolivia S.R.L.
IQVIA Solutions Bulgaria Eood
IQVIA SOLUTIONS CANADA INC
IQVIA Solutions Colombia S.A.
IQVIA Solutions Consulting Myanmar Company Limited
IQVIA Solutions del Peru S.A.
IQVIA Solutions Denmark AS
IQVIA Solutions do Brasil Ltda.
IQVIA Solutions Egypt Ltd.
IQVIA Solutions Enterprise Management Consulting (Shanghai) Co., Ltd (Beijing 
Branch)
IQVIA Solutions Enterprise Management Consulting (Shanghai) Co., Ltd.
IQVIA Solutions Finance B.V.
IQVIA Solutions Finance UK I Ltd.
IQVIA Solutions Finance UK II Ltd.
IQVIA Solutions Finance UK III Ltd.

Peru
Philippines
Poland
Australia
New Zealand
Slovakia
South Africa
Spain
Portugal
Switzerland
Taiwan
Lithuania
United Kingdom
Ukraine
Vietnam
Saudi Arabia
Romania
Delaware
Brazil
New Zealand
South Africa
Czechia
Argentina
Singapore
Australia
Australia
Netherlands
Bangladesh
Belgium
Bolivia
Bulgaria
Canada
Colombia
Myanmar
Peru
Denmark
Brazil
Egypt

China
China
Netherlands
United Kingdom
United Kingdom
United Kingdom

IQVIA Solutions Finance UK V Ltd.
IQVIA Solutions Finland OY
IQVIA Solutions Global Holdings UK Ltd.
IQVIA Solutions Holdings (Pty.) Ltd.
IQVIA Solutions Hong Kong Limited
IQVIA Solutions HQ Ltd.
IQVIA Solutions Ireland Limited
IQVIA Solutions Italy S.r.l.
IQVIA Solutions Japan K.K.
IQVIA Solutions Kazakhstan LLC
IQVIA Solutions Lanka (Private) Limited
IQVIA Solutions LLC
IQVIA Solutions Malaysia Sdn. Bhd.
IQVIA Solutions Norway AS
IQVIA Solutions Operations Center Philippines Inc.
IQVIA Solutions Pakistan (Private) Limited
IQVIA Solutions Pharmaceutical Srl
IQVIA Solutions Philippines Inc.
IQVIA Solutions Portugal, Lda
IQVIA Solutions Puerto Rico Inc.
IQVIA Solutions Regional Pte. Ltd.
IQVIA Solutions Republica Dominicana, S.R.L.
IQVIA Solutions s.r.o.
IQVIA Solutions Saudi Arabia Limited
IQVIA Solutions Services Ltd.
IQVIA Solutions Sweden AB
Iqvia Solutions Taiwan Ltd.
IQVIA Solutions Tunisia S.à r.l.
IQVIA Solutions UK Investments Ltd.
IQVIA Solutions UK Limited
IQVIA Staff Services Sp.A.
IQVIA Technology Services Ltd.
IQVIA Technology Solutions (China) Co., Ltd.
IQVIA Technology Solutions Colombia Ltda.
IQVIA Technology Solutions Egypt LLC
IQVIA Technology Solutions Finland Oy
IQVIA Technology Solutions Poland SP. z.o.o

IQVIA Technology Solutions Romania Srl

IQVIA Technology Solutions s.r.o.

IQVIA Technology Solutions s.r.o.

IQVIA Technology Solutions S.R.O. (Bulgaria Branch)

IQVIA Technology Solutions Ukraine LLC

IQVIA Technology Tunisia S.à r.l.

IQVIA Tibbi Istatistik Ticaret ve Musavirlik Ltd. Sirketi

United Kingdom
Finland
United Kingdom
South Africa
Hong Kong
United Kingdom
Ireland
Italy
Delaware
Kazakhstan
Sri Lanka
Russian Federation
Malaysia
Norway
Philippines
Pakistan
Romania
Philippines
Portugal
Puerto Rico
Singapore
Dominican Republic
Slovakia
Saudi Arabia
Hungary
Sweden
Taiwan
Tunisia
United Kingdom
United Kingdom
Italy
United Kingdom
China
Colombia
Egypt
Finland
Poland

Romania

Slovakia

Czechia

Bulgaria

Ukraine

Tunisia

Turkey

IQVIA Trading Management Inc.

IQVIA Transportation Services Corp.

IQVIA World Publications Ltd.

IQVIA Zagreb d.o.o.

Jäger Health Gmbh

Kun Tai Medical Development Hong Kong Limited

Kun Tuo Medical Research & Development (Beijing) Co. Ltd.

Laboratorio Commuq Pharma SLU

Linguamatics Limited

Linguamatics Solutions Limited

M&H Informatics (BD) Ltd.

Mecurial Insights Holding Pty. Ltd.

Mecurial Insights Pty. Ltd.

Meddata Group, LLC

MedicSense Ltd.

Medineos S.r.l.

Med-Vantage, Inc.

Mercados Y Analisis, S.A.

Meridian Research Vietnam Ltd.

Novasyte, LLC

Novex Pharma Laboratorio S.L.

Novex Pharma Limited

Nuevo Health Pty Ltd

Operaciones Centralizadas Latinoamericana Limitada

Optimum Contact Limited

Outcome Sciences, LLC

Penderwood Limited

Pharma Deals Limited

Pharma Strategy Group Limited

Pharmadata s.r.o.

Pharmaforce, S.A. de C.V.

PharmARC Consulting Services Gmbh

Pharmarc Inc.

Polaris Management Partners, LLC

Polaris Solutions Ltd.

Polaris Solutions, LLC

PR Editions S.A.S.

Privacy Analytics Inc.

Professional Pharmaceutical Marketing Services (Pty.) Ltd.

Prometheus Research, LLC

PT IQVIA RDS Indonesia

Delaware

Delaware

United Kingdom

Croatia

Germany

Hong Kong

China

Spain

United Kingdom

United Kingdom

Bangladesh

Australia

Australia

Massachusetts

Israel

Italy

Delaware

Spain

Vietnam

California

Spain

United Kingdom

Australia

Chile

United Kingdom

Delaware

United Kingdom

United Kingdom

United Kingdom

Slovakia

Mexico

Switzerland

New Jersey

New Jersey

Hong Kong

New York

France

Canada

South Africa

Connecticut

Indonesia

PT IQVIA Solutions Indonesia

Public Relations Algeria

Q Squared Solutions (Beijing) Co., Ltd.

Q Squared Solutions (India) Private Limited

Q Squared Solutions (Quest) Limited

Q Squared Solutions (Quest) LLC

Q Squared Solutions (Shanghai) Co., Ltd.

Q Squared Solutions B.V.

Q Squared Solutions BioSciences LLC

Q Squared Solutions China (Quest) Limited

Q Squared Solutions China Limited

Q Squared Solutions Expression Analysis LLC

Q Squared Solutions Holdings B.V.

Q Squared Solutions Holdings Limited

Q Squared Solutions Holdings LLC

Q Squared Solutions KK

Q Squared Solutions Limited

Q Squared Solutions LLC

Q Squared Solutions Proprietary Limited

Q Squared Solutions Pte. Ltd.

Q Squared Solutions S.A.

Qcare Site Services, Inc.

QH Research Limited

QIMS Pharma Services Sa De Cv

Quality Health Limited

Quintiles Benin Ltd.

Quintiles Clinical and Commercial Nigeria Limited

Quintiles Commercial Laboratorio S.L.U.

Quintiles Commercial Rus LLC

Quintiles East Africa Limited

Quintiles Finance Uruguay S.r.L.

Quintiles IMS Japan GK

Quintiles Lanka (Private) Limited

Quintiles Mauritius Holdings

Quintiles Medical Development (Shanghai) Co., Ltd.

Quintiles Mexico, S. de R.L. de C.V.

Quintiles New Zealand

Quintiles Phase One Clinical Trials India Private Limited

Quintiles RDS Latin America LLC

Quintiles Site Services, S.A.

Quintiles West Africa Limited

Indonesia

Algeria

China

India

United Kingdom

Delaware

China

The Netherlands

Delaware

United Kingdom

United Kingdom

Delaware

The Netherlands

United Kingdom

Delaware

Japan

United Kingdom

North Carolina

South Africa

Singapore

Argentina

North Carolina

United Kingdom

Mexico

United Kingdom

Benin

Nigeria

Spain

Russian Federation

Kenya

Uruguay

Japan

Sri Lanka

Mauritius

China

Mexico

New Zealand

India

Argentina

Costa Rica

Ghana

Radar Acquisition Blocker, Inc.

Redsite Limited

Representative Office of IQVIA RDS GesmbH in Moscow

RX India, LLC

Schwarzeck Verlag Gmbh

Secureconsent, LLC

Shanghai IMS Market Research Co. Ltd.

Smart I.T. Systems BV

Source Informatics Limited

Spartan Leasing Corporation

StatFin Estonia

Statfinn Oy

STI Technologies Limited

Targeted Molecular Diagnostics, LLC

Tarius A/S

Temas Srl - Società Unipersonale

TforG Support NV

The Amundsen Group, Inc.

Themis Limited

UAB IQVIA Commercial

Valuecentric Global Services Gmbh

Valuecentric Privacy Solutions LLC

Valuemedics Research, LLC

VCG&A, Inc.

VCG-BIO, Inc.

Vivacity Health Pty. Ltd.

Delaware

United Kingdom

Russian Federation

Delaware

Germany

Delaware

China

Belgium

United Kingdom

Delaware

Estonia

Finland

Canada

Illinois

Denmark

Italy

Belgium

Massachusetts

United Kingdom

Lithuania

Switzerland

Delaware

Delaware

Massachusetts

Delaware

Australia

Exhibit 23.1

CONSENT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM

We hereby consent to the incorporation by reference in the Registration Statements on Form S-8 (Nos. 333-213927, 
333-193212, 333-188431) of IQVIA Holdings Inc. of our report dated February 12, 2021 relating to the financial 
statements and financial statement schedules and the effectiveness of internal control over financial reporting, which 
appears in this Form 10-K.

/s/ PricewaterhouseCoopers LLP
Raleigh, North Carolina
February 12, 2021

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 annual report on Form 10-K 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: February 12, 2021

/s/ Ari Bousbib
Ari Bousbib
Chairman, Chief Executive Officer and President

(Principal Executive Officer)

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 annual report on Form 10-K 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: February 12, 2021

/s/ Ronald E. Bruehlman 
Ronald E. Bruehlman 
Executive Vice President and Chief Financial Officer
(Principal Financial Officer)

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  Annual  Report  on  Form  10-K  of  the  Company  for  the  year  ended  December  31,  2020  (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: February 12, 2021

/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.  

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  Annual  Report  on  Form  10-K  of  the  Company  for  the  year  ended  December  31,  2020  (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: February 12, 2021

/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.