Earnings Call Transcript - IQV Q2 2020

Operator, Operator

Ladies and gentlemen, thank you for standing by. At this time, I would like to welcome everyone to the IQVIA Second Quarter 2020 Earnings Conference Call. As a reminder, this call is being recorded. Thank you. I would like to now turn the call over to Andrew Markwick, Senior Vice President, Investor Relations and Treasury. Mr. Markwick, please begin your conference.

Andrew Markwick, Senior Vice President, Investor Relations and Treasury

Thank you. Good morning, everyone. Thank you for joining our second quarter 2020 earnings call. With me on the call today are Ari Bousbib, Chairman and Chief Executive Officer; Michael McDonnell, Executive Vice President and Chief Financial Officer; Ron Bruehlman, who will be Mike's successor, as of August 1; Eric Sherbet, Executive Vice President and General Counsel; Nick Childs, Senior Vice President, Financial Planning and Analysis; and Jen Halchak, Senior Director, Investor Relations. Today, we will be referencing a presentation that will be visible during this call for those of you on our webcast. This presentation will also be available following this call in the Events and Presentations section of our IQVIA Investor Relations website. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements. Actual results could differ materially from those stated or implied by forward-looking statements due to risks and uncertainties associated with the company's business, including COVID-19 impacts, which are discussed in the company's filings with the Securities and Exchange Commission, including our Annual Report on Form 10-K and subsequent SEC filings. In addition, we will discuss certain non-GAAP financial measures on this call, which should be considered as a supplement to and not a substitute for financial measures prepared in accordance with GAAP. A reconciliation of these non-GAAP measures to the comparable GAAP measures is included in the press release and conference call presentation. I would now like to turn the call over to our Chairman and CEO, Ari Bousbib.

Ari Bousbib, Chairman and Chief Executive Officer

Thank you, Andrew, and good morning everyone. Thank you for joining our second quarter 2020 earnings call. Before we get to the results, I'm sure you all saw the announcement last night, and this will be Mike's last IQVIA earnings call. I wanted to take the opportunity to thank him for his service and wish him well in his new role at Biogen. I also want to thank Ron and welcome him back; he really never left, but I want to thank him for agreeing to serve as our Interim Chief Financial Officer until we decide on a permanent successor. Many of you already know Ron, and I'm sure you are delighted to welcome him back to the CFO chair. Now to our results; revenue, adjusted EBITDA, and earnings all came in above our guidance ranges. Today, we are also updating our guidance for the year and raising our full-year revenue, adjusted EBITDA, and earnings ranges. Before we review the numbers, I'd like to give you a quick operational update. During the second quarter, we saw gradual improvement in the accessibility of clinical research sites in the R&D solutions business, pretty much in line with what we told you three months ago. Global site access improved to approximately 20% in April, to 40% at the end of June. Average site accessibility for the second quarter was about 30%, again in line with the assumption that we made when we set our second quarter guidance. The progress of global site reopenings is continuing into the third quarter, and today it's at 53%. I should point out that the progress has been slowing somewhat in the past couple of weeks as a result of several localized COVID-19 flare-ups in geographies around the world, and especially in parts of the United States. As sites have become accessible, we've seen an improvement in the number of onsite monitoring visits. In fact, onsite visits are now exceeding the number of remote visits, and as a result, remote visits have reduced from the peak in the second quarter. Of course, wherever sites are still inaccessible, our ability to deliver solutions like remote monitoring and virtual trials remains critical to ensuring trial continuity. Now, patients who are already enrolled in trials have slowly begun returning for in-person treatment. As you would expect, this varies by therapeutic area. For example, oncology patients are returning at a faster rate than dermatology patients. Also, the recent outbreaks in parts of the U.S. have hampered the pace of recovery in the number of patients enrolled in trials who are willing to come in for in-person treatment. For trials that have not yet started, the pace of site startup and patient recruitment has obviously been slow. It's improving, but still slow. For example, patient recruitment for new trials, which had been virtually halted during the second quarter, has resumed over the past few weeks and is now at about 25% of normal baseline enrollment levels. We expect this to continue to improve over time. R&D Solutions business development activity has remained very strong. We still have not had any material cancellations of trials in our backlog due to COVID-19. Interactions with clients, such as Big Defenses continue, as clients adjust to working virtually. RFP volume and value continue to hold at basically similar levels to 2019. And of course, the R&D Solutions team has been awarded a wide range of COVID-19 vaccine therapeutics and related lab work. Of course, you will have seen we announced a collaboration with AstraZeneca last week to accelerate development of a potential COVID vaccine. COVID-19, more broadly, has accelerated interest in our virtual trials solution, including Study Hub. Awards for our virtual trial solutions have actually doubled, albeit from a relatively small base. We are leveraging our virtual trial technology platform, Study Hub, to deliver a seamless patient experience. As you know, the platform combines eConsent, telemedicine, electronic Clinical Outcome Assessments, and digital communication. Moving to Technology & Analytics. We continue to have very little interruption in data, supply, or demand. Our data production centers around the world remain fully operational, and our Technology & Analytics deliveries continue in the ordinary course. Selling activities have started to resume as clients have adjusted to working virtually as well. There is still some delayed decision making for ad hoc services work, but we've had strong momentum in our fastest growing businesses, such as Real World Evidence and Tech. Our Real World Evidence business continues to expand even in this environment, with strong growth in the quarter. As a reminder, the results of our Real World Evidence business are reported in our Technology & Analytics Solutions segment. So unlike our CRO peers, this growth is not included in R&D Solutions results. In the Technology space, OCE has added 35 new clients so far in 2020. OCE deployments continue to progress as scheduled, as clients look to accelerate their usage and get up and running on the platform even faster. We now have 115 customers that have chosen OCE, and they represent over 60,000 potential users of the platform. Most of these customers are still in the early stage of deployment. So far, our win rate in this segment when going head-to-head against the incumbent is approximately 70%. Finally, in our Contract Sales and Medical Solutions business, we've not experienced any material cancellations. Although, as expected, we've experienced softer demand for field reps, which of course impacts revenue. Additionally, business development has slowed considerably in this segment. Let's now review the second quarter results. Revenue for the second quarter came in at $2,521,000,000, which is $118 million above the midpoint of our guidance range. Now $41 million of this $118 million beat came from foreign exchange and pass-throughs. Second quarter adjusted EBITDA was $483 million, with a $25 million beat versus the midpoint of our guidance, and this came entirely from better operational performance. Second quarter adjusted diluted EPS was $1.18. Second quarter R&D Solutions contracted backlog, including pass-throughs, grew 13.5% year-over-year to $20.5 billion at June 30, 2020. We saw good growth in awards for our large pharma clients, as well as our EBP clients in the quarter. We had broad-based booking strength by offering, with particular strength in full-service clinical and in lab. The contracted net book-to-bill ratio, including pass-throughs, was 1.64 for the second quarter of 2020, and excluding pass-throughs, the second quarter contracted book-to-bill ratio was 1.60. The last twelve months contracted book-to-bill ratio at June 30 was 1.43, including pass-throughs and 1.42 excluding pass-throughs. As we said previously, we've continued to make every effort to preserve employment during this crisis, and to the extent possible, we have not affected base compensation for our employees. Of course, we've worked to reduce other costs and discretionary spending, and as a result of these actions, our adjusted EBITDA came in well above our expectations. You can see when you adjust for pass-throughs and foreign exchange, that the drop-through incremental margin on the revenue beat was over 30%. So far, even considering several flare-ups around the world, things seem to be moving in the right direction. Sites are reopening globally, allowing us to resume our critical work in R&D Solutions. We continue to be cautiously optimistic, and we anticipate a sharp recovery in the back end of the year. Mike will review in more detail how we see the second half playing out. Finally, a quick update on our 2021 planning process. As I've already shared with you, we started this process earlier than usual, and our plan is to provide 2021 guidance before the end of this year. Given the positive trends we've seen in operational execution and client demand, together with catch-up work and the associated change orders that we currently anticipate, as well as the COVID awards, we remain optimistic that in 2021, we will see a return to our previous growth trajectory. Now I'll turn it over to Mike for some more detail on the quarter, how we see the second half of the year play out, and the upward revisions to our guidance.

Michael McDonnell, Executive Vice President and Chief Financial Officer

Thank you, Ari, and good morning everyone. Turning first to revenue; second quarter revenue was $2.521 billion compared to $2.740 billion in the second quarter of 2019. First half revenue was $5.275 billion compared to $5.424 billion in the first half of 2019. Second quarter revenue in Technology & Analytics Solutions was $1.109 billion compared to $1.102 billion in the second quarter of 2019. First half Technology & Analytics Solutions revenue was $2.226 billion compared with $2.177 billion for the first half of 2019. R&D Solutions second quarter revenue was $1.235 billion compared with $1.435 billion in the second quarter of 2019. First half revenue in R&D Solutions was $2.676 billion compared with $2.851 billion in the first half of 2019. Second quarter Contract Sales & Medical Solutions revenue was $177 million compared with $203 million in the second quarter of 2019. First half Contract Sales & Medical Solutions revenue was $373 million compared to $396 million in the first half of 2019. Turning now to profit, adjusted EBITDA was $483 million for the second quarter and $1.045 billion for the first half. Second quarter GAAP net loss was $23 million, resulting in a $0.12 loss per diluted share. For the first half, we had GAAP net income of $59 million or $0.30 of earnings per diluted share. Adjusted net income was $229 million for the second quarter or $1.18 per share. Adjusted net income for the first half was $523 million or $2.68 per share. Let's now turn to R&D Solutions backlog; closing backlog grew 13.5% to $20.5 billion at June 30, 2020. New business wins remain strong, and to date, we have experienced no material COVID-19 related cancellations. Let's now review the balance sheet; at June 30, cash and cash equivalents totaled $1.1 billion and debt was $12.1 billion, resulting in net debt of approximately $11 billion. As of June 30, 2020, our net leverage ratio ticked up slightly to 4.8 times our trailing 12-month adjusted EBITDA, as a result of the COVID-19 related impacts on our first half adjusted EBITDA. As a reminder, we continue to be committed to bringing our leverage ratio to a range of 3.5 to 4 times as we exit 2022. Cash flow from operating activities was $472 million in the second quarter and $635 million year-to-date. CapEx for the quarter was $142 million, $283 million year-to-date, and free cash flow for the quarter was $330 million or $352 million year-to-date. As you know, when the COVID-19 outbreak became a pandemic in March, we temporarily suspended share repurchase activity. Accordingly, we did not repurchase any shares in the second quarter, and as of June 30 of 2020, we had approximately $1 billion of share repurchase authorization remaining. We will continue to evaluate the right time to reinitiate our share repurchase program. We continue to have strong liquidity. At June 30, we had $1.1 billion of cash on the balance sheet, and our $1.5 billion revolving credit facility was undrawn. We also have over $1 billion of EBITDA cushion relative to our leverage and interest coverage maintenance covenants, even as our first half adjusted EBITDA has suffered a significant and unusual impact from COVID-19. And finally, I would point out that we have a lot of flexibility with capital allocation, which includes CapEx, M&A, and share repurchases. And now, let's move to guidance; on our first quarter earnings call, we outlined our assumptions regarding the global progression of the virus, the percentage of clinical research sites accessible to us throughout 2020, and our ability to interact with clients to support business development activities. These assumptions supported our 2020 guidance provided at that time. During the second quarter, it became apparent that the global spread of the virus would become wider and more prolonged than we had assumed. However, the percentage of sites accessible to us tracked in line with our expectations, and business development activities have progressed better than our original assumptions. We also had made the assumption at the time that 100% of clinical research sites would be accessible by the beginning of the fourth quarter. However, given localized flare-ups around the world, we now see this happening more at the beginning of 2021. But in spite of this, we have been able to overcome restricted site access better than we initially thought, through workarounds, including the use of our remote capabilities. Based on our better-than-expected performance in the second quarter, the company's ability to execute in this environment, incremental COVID-19 trial work, and evaluation of current business conditions and outlook for the balance of the year, we are now forecasting better performance in our Technology & Analytics Solutions segment and better execution against our R&D Solutions backlog than previously anticipated. Together, these factors are expected to contribute to improved financial performance in 2020 versus the company's expectations in April. As a result, we are raising our full-year guidance ranges for full-year revenue. We now expect full-year revenue to be between $11 billion and $11.1 billion, which represents an increase of approximately $290 million at the midpoint, of which approximately 20% represents a favorable FX impact based on exchange rates as of the end of the second quarter. Please note that FX still represents a year-over-year headwind of 60 basis points on our average revenue guidance. At the midpoint of the new guidance range, the constant currency growth represents slight growth year-over-year. For full-year profit, we expect adjusted EBITDA to be between $2.295 billion and $2.345 billion and we expect adjusted diluted EPS to be between $6.10 and $6.30. This guidance assumes foreign currency rates at the end of the second quarter remain in effect for the rest of the year. Now turning to guidance for the third quarter of 2020. Assuming FX rates at the end of the second quarter remain constant through the end of the third quarter, we expect revenue to be between $2.725 billion and $2.775 billion. Adjusted EBITDA is expected to be between $564 million and $582 million. And adjusted diluted EPS is expected to be between $1.47 and $1.55. So in summary, we delivered second quarter revenue, adjusted EBITDA, and adjusted EPS all above the top end of our guidance ranges. We are seeing encouraging signs of a migration back to normal business conditions by the end of the year. We are utilizing our unique capabilities to help in the fight against COVID-19 globally. We have raised our guidance for the full year, and we are already planning for 2021 in anticipation of a return to our growth trajectory. Finally, as Ari mentioned at the start of the call, this is my last earnings call with IQVIA. I am very grateful for the opportunity to serve as IQVIA's Chief Financial Officer since our merger. It's been a privilege to work with Ari and the executive leadership team. I have learned a lot over the past four years, and I am incredibly proud of what we have accomplished. I firmly believe IQVIA is incredibly well positioned to achieve its Vision 2022 ambitions. I intend to remain a shareholder in the company and will be rooting for its continued success. And with that, let me hand it back to the operator for Q&A.

Operator, Operator

Your first question comes from the line of George Hill from Deutsche Bank. Your line is now open.

George Hill, Analyst

You covered a lot. I guess, the first question I would ask is, have you seen any change in the competitive environment as it relates to COVID-19? I know you haven't had any cancellations and the win rate’s been strong. But I guess just talk about how the selection process is going and whether you guys think you're taking share.

Ari Bousbib, Chairman and Chief Executive Officer

Thank you, George. Good morning. Again, when we refer to no material cancellations related to COVID-19, we are speaking about cancellations of trials that were already in the backlog and not for COVID, for other indications. It just points to the resilience of our customers and their long-term view. They haven't changed their priorities, and they are still focused on the diseases that they were focused on before the crisis emerged. With respect to COVID-19 itself, we've won a wide variety of the trials, ranging from small lab work all the way to large vaccine trials. A number of those are well publicized. There are a few large ones. Some of them are nominal fees related to product reviews for small biopharma companies. There are multimillion-dollar vaccine trials. There are currently two vaccine trials that are funded by the U.S. government. So operational work speed, which we have won, one of which I mentioned in my introductory remarks, which is the collaboration with AstraZeneca. So, in terms of competitive wins, I think the crisis has shown that our unique capabilities are highly differentiated. All I can say is, we've become a lot closer to the customer base during this crisis, with many of them we had weekly forums. We've received extraordinary feedback from our customers regarding the criticality of the information we were providing them in real-time for their own decision-making processes. And we've continued to win at a very high rate. I believe that we've continued to gain market share. Moreover, we gained a significant amount of the overall COVID-19 work out there. I want to point out that this COVID-19-related work is something we are contributing to as well in the resolution of the crisis. In many cases, because these trials are government-sponsored, we are discounting these services. Therefore, they are important, and they will continue to play a role in the foreseeable future. They were a part of our bookings in the quarter, representing somewhere in the mid-teens of our service bookings.

George Hill, Analyst

And maybe if I could ask, Mike, a quick follow-up. And Mike, you're going to be missed there at IQVIA. Remote monitoring has played a huge part of the process as we've gone through the COVID crisis. I guess can you talk a little bit about the financial implications of moving to the remote environment versus the on-site environment?

Michael McDonnell, Executive Vice President and Chief Financial Officer

You're asking about the remote environment versus on-site. Yes. I mean, look, we, as I said in my remarks, the remote monitoring obviously is where everyone went because we could simply not access the sites. I think that, as I mentioned in my remarks, onsite visits have now overtaken the number of remote visits. The peak of those remote visits was around May and June, and now we have started to accelerate the actual on-site visits. We're still not at our normal pace, but it has dramatically increased. As I said, 53% of the sites are now accessible, and we are able to visit those sites. Bear in mind, while remote is helpful and we are using it primarily to meet obligations to patients and clients and to ensure their safety, et cetera. It's important to know that in-person site visits are still required in order to meet the source data verification criteria. Each trial budget, of course, will have to be revised accordingly. So we see this as more of an opportunity as we transition back to on-site visits. Thank you, George.

Operator, Operator

Your next question comes from the line of Tycho Peterson from JPMorgan. Your line is now open.

Tycho Peterson, Analyst

Thanks. I appreciate all the color. I guess, Ari, on the reopening of sites, I’m just curious about how much risk you see in the flare-up of cases now heading into the third quarter in the back half of the year and other implications to R&D Solutions and Contract Sales & Medical Solutions for your business and other steps you can take in anticipation of this to try to mitigate the impact.

Ari Bousbib, Chairman and Chief Executive Officer

Yes. I mean, look, there are flare-ups out there, in Texas, Florida, California, South Carolina, around the world. Europe and certainly Asia are pretty much back up to not quite 100%, but not that far. The main issue here is that in some parts of the United States, but again we don't disclose exactly which sites are where, you should know that it's not going to be that material, these flare-ups in the U.S. to our operations—we have over 100,000 sites globally. We've become very adept at transitioning to remote monitoring. So, I think we have been able to adapt in the second quarter, and we have several workarounds using our remote capabilities. So, we feel that the assumptions we made for the third quarter are better educated than the ones we made three months ago when we were just learning to adapt to the crisis. I should point out that these assumptions we made in April 2020, many experts believed we were getting ahead of ourselves and maybe too optimistic about those assumptions. The fact is, the progression of site accessibility as a metric was exactly as we predicted. We based that on the course of the disease in China and other geographies that had been ahead of the rest of the world in terms of the disease progression. We also relied on our own internal data and modeling for our business projections. So, while some thought we were overly optimistic, it turns out we were precisely on target regarding site accessibility, and in fact, not overly optimistic. I'm not suggesting that because we were right three months ago, that we are necessarily correct for the next three months. But I think, if anything, we are a little bit more educated now, and our models are even more precise than they were three months ago.

Tycho Peterson, Analyst

And then Ari, one follow-up. You talked about a return to normal growth next year. 15% growth off $630 million would be $725 million and is essentially where consensus is. Is that the right way to be thinking about it for next year?

Ari Bousbib, Chairman and Chief Executive Officer

I said that we are going to give guidance for 2021 much earlier than usual, this year rather than the beginning of the year. That is because, as you correctly point out, we have visibility. We have more visibility than usual because we know of the work that should have been done this year that is still in our books that we need to progress, plus the work that we won this year. So we have greater visibility. I'm not going to provide any specific numbers, but I'll let you speculate. Hopefully, in the not-too-distant future, we will be able to do this in the third quarter, but maybe we should aim for that goal.

Operator, Operator

Your next question comes from the line of Robert Jones from Goldman Sachs. Your line is now open.

Robert Jones, Analyst

Thanks for the question. And yes Mike, definitely enjoyed working with you. Good luck in your next endeavor, and I look forward to engaging. I guess maybe Ari, just on that last line of questions, the second-half revenue guidance looks like it implies about 2% year-over-year growth in total revenue over the back half of 2019? But you updated the NTM revenue and expect it to convert at a backlog, which I think is up 10% versus the last update with Q2. Does that dynamic reflect your comment on having better visibility into the backlog and what could come out of the backlog in the first half of 2021?

Ari Bousbib, Chairman and Chief Executive Officer

Yes. Andrew, do you want to take?

Andrew Markwick, Senior Vice President, Investor Relations and Treasury

Yes, sure. Yes, the next 12 months revenue from backlog increased considerably quarter-over-quarter. It was $4.9 billion at the end of Q1 and now sits at $5.4 billion, a significant sequential move. I believe that's the ultimate forward-looking indicator for future revenue growth in the trajectory of the business. So we're very pleased with that. I think obviously, we still want to dig into our plans, and we started that process, as Ari said earlier. We're looking forward to providing 2021 guidance, but I think...

Ari Bousbib, Chairman and Chief Executive Officer

Yes, but Bob, I think you're thinking about it the right way. Part of this is the fact that we won, I believe, a disproportionate piece of the market over the past year or so. Those market share gains have translated into a significant portion of our backlog, which consists of new wins that haven't started yet. A large component, which is why you saw the revenue conversion being slower than usual, even without the COVID-19 crisis. That's because site start-up activity is typically a little slower, and patient enrollment is also a bit slower. The vast majority of our book of business is not really active, meaning trials that are ongoing. The COVID-19 crisis has added to this issue since you think about its effects on trials for patients who were already enrolled. For trials that are in the active phase, where you're really executing ongoing trials with patients, we’ve been able to adjust with remote monitoring. Now, we're returning patients to sites, et cetera. However, sites that had not yet started, the site start-up activity has been much more challenging simply because people were not on-site, and we couldn't get the site up and running. This has caused delays in execution related to patient enrollment too. We are now enrolling patients back into trials, as I noted in my introductory remarks, but we are still only at 25% of the normal baseline number of patients recruited per week. It is increasing, and we are catching up. That's part of why you see more revenue pushed back into the next 12 months. That’s the pent-up revenue that should have been executed this year but is now going to need to be executed later. That's in addition to the change orders for the work that needs to be done. I mentioned earlier that we must do onsite data verification, which means that while we can conduct remote visits, some of the work must still be performed in-person. Additionally, we are continuing to book at an impressive pace, as indicated by our high book-to-bill ratios. All of that adds up to what we anticipate will comprise the expected revenue from backlog for the next 12 months.

Robert Jones, Analyst

No, that all makes a ton of sense. Just a quick follow-up, Ari, on Technology & Analytics Solutions. You touched on some elements in the prepared remarks, but clearly, performance was better than many expected. What are clients specifically utilizing within the segment? I know there are many components there. Is it the analytics for virtual meetings? Is it more safety studies? Just trying to get a better sense of what drove the performance in Technology & Analytics Solutions?

Ari Bousbib, Chairman and Chief Executive Officer

Yes, I mean look, the usual parts are data technology and Real-World Evidence. Why don't I turn to Ron, would you like to add here?

Ron Bruehlman, Interim Chief Financial Officer

Yes, look, the strongest part of the Technology & Analytics Solutions segment has been and remains Real-World Evidence. We've also seen continued implementations in the tech sector—that's gone well. Analytics solutions have actually been strong, although there have been some delayed client decisions due to COVID. I would say that across the board there’s particular strength we see in Real-World Evidence.

Ari Bousbib, Chairman and Chief Executive Officer

Again, the weakness in Technology & Analytics Solutions, as we said before, is the part of the business where we help clients organize face-to-face meetings with physicians and healthcare professionals globally, the conference business that requires in-person connections, which has essentially dried up. Interestingly, it is beginning to show signs of revival. People are scheduling conferences over the next few quarters. So that's going to come back. But certainly, that part has been largely halted and has created a gap in our revenue, which is why Technology & Analytics Solutions hasn’t performed as strongly as some others, but everything else has performed well.

Operator, Operator

Your next question comes from the line of Patrick Donnelly from Citi. Your line is now open.

Patrick Donnelly, Analyst

Maybe just a follow-up on the Technology & Analytics Solutions question. I certainly appreciate Real-World performing well. Can you just give us a bit more color on OCE? I know you kind of noted 35 new clients so far in 2020. Can you just discuss how that’s trending relative to your expectations? And then, again, maybe some of the feedback you’re getting from customers that are either converting over to you or competitive wins, what you’re hearing about the offering there?

Ari Bousbib, Chairman and Chief Executive Officer

So again, the team has really performed very well. We've crossed the 100-customer mark, and now we're at 115 wins. We continue to see a lot of success. Generally, with a handful of exceptions, we're not seeing any slowdowns in implementation; in fact, in many cases, accelerations of implementations. We went live for several deployments, including, by the way, in the midst of the crisis. I recall seeing an email from one of our large clients congratulating the team for an outstanding job they did deploying in Spain at the peak of the COVID crisis there. So things have tended to go very well with our development process. Generally, the demand for remote detailing continues to rise. We've got a module within OCE called OCE Remote Detailing, which is the most secure compliance platform in the space. We also launched last quarter our compliance solution in the commercial space, HCP engagement management, which already has four wins. A strong pipeline is building as well. So I think it's all progressing very well, in line with expectations. And frankly, for OCE, we haven't encountered any significant slowdowns in terms of certain areas where we couldn't redeploy, but we've also seen acceleration.

Patrick Donnelly, Analyst

And then maybe just one on the margin side. You guys did a pretty good job insulating the bottom line from some of the revenue headwinds or adapting quickly to execute some cost controls. I know you talked about planning for 2021 already. I guess, how should we think about some of the costs that have come out? Are those going to come back in terms of your planning? Are you feeling good enough, to your point there, Ari, I think you talked a few times about visibility? Now that you're more comfortable there, are you kind of easing on some of the cost controls? Maybe just help us think about kind of the margin cadence and the going forward cost control measures that you have in place?

Ari Bousbib, Chairman and Chief Executive Officer

Okay, yes. Do you want to add something, Ron?

Ron Bruehlman, Interim Chief Financial Officer

Yes, sure. Of course, there is some pressure on margins in the first half due to the drop in revenue and how quickly we could reduce costs—more so early on than later on. We should see margin expansion in the second half of the year as the business comes back. We've removed a lot of costs. I don't think all of it will return. Certainly, we're going to continue to keep pressure on travel and expense costs down, which I think will naturally occur during this COVID crisis. We're always looking to enhance efficiency wherever we can. One of the things that we've also looked at carefully, besides travel expenses, which obviously have decreased significantly, is renegotiating vendor contracts, reducing third-party spending. We're also reassessing our office space needs, which many companies are currently doing now. Thus, I think the trends in costs and margins will show positive movements going forward.

Ari Bousbib, Chairman and Chief Executive Officer

Again, you can see we have a large cost base. As the situation worsens, there are many levers we can use to mitigate the impact on profit. I want to emphasize that we have not taken any action that affects employment. There are very few, low-impact pockets, affecting only a few hundred employees where there were furloughs or some restructurings, but nothing out of the ordinary. We do not plan any further measures in this area. The reason for this, again, is that we are a people-oriented business. We are a services company, and we want to protect our employees. We know they're going through difficult times. Secondly, we expect a V-shaped recovery and a strong—well, here I go, I'm talking about 2021. I didn’t plan for that. But we expect a robust 2021, and we are going to need our talented employees.

Operator, Operator

Your next question comes from the line of Eric Coldwell from Baird. Your line is now open.

Eric Coldwell, Analyst

Thanks, good morning Mike, good luck with your future endeavors. A couple of quick questions here, but first off, I heard in the Q&A a mention of particular strength in Real-World Evidence. Last quarter, I believe you highlighted that Real-World Evidence could be a tale of two cities, with prospective and retrospective work—looking more like trials and potentially some headwinds. What changed there, if anything, or what were the dynamics between the old IMS Real-World Evidence and the old Quintiles' Real-World Evidence business mix?

Ari Bousbib, Chairman and Chief Executive Officer

That's a very thoughtful question, and you're right. While we are doing well in Real-World, the ability to use patient-level data—which I'll remind you is really an unparalleled asset for our company—has been extremely useful. We now have, we did over 800 million unique patient lives, which have been incredibly beneficial. The unique E360 technology capabilities enable us to conduct a lot of retrospective studies. That part of the business has remained extremely robust. The second factor is that access to sites has also been restricted, but it is less restricted than clinical trial sites. To a degree, there are many Real-World studies where the sites are actually doctor offices, as opposed to hospitals, and those have tended to have while restricted still, better access than we expected. The experience has proven that site accessibility for Real-World is somewhat better than clinical trial sites. So as a result, Real-World has done better than we expected. Bear in mind also, when we report site accessibility metrics, we only report them for clinical trials. Meanwhile, as you know, our competitors report those numbers in total.

Eric Coldwell, Analyst

Yes, helpful, thank you. IQV is one of two companies in this space that reports authorizations on a contracted basis. I think there was some speculation that you could have strong awards, but perhaps contracts would be pushed out, given the global uncertainty, with clients putting out fires. Clearly, that was not a significant headwind, but I am curious, what is the typical lag from award to contract at IQV? My hunch would be a couple of months, but I'd love to hear your thoughts. Also, has that duration of time changed in this COVID environment? We know COVID-specific trials are being contracted very quickly, but have you seen other changes in the duration between award and contract time?

Ari Bousbib, Chairman and Chief Executive Officer

Your general assumption is correct, about a two months' lag time. We're trying to reduce that. But that kind of 60-day period is a good assumption. The lag between booking and revenue could be up to 12 months. So the lag between award and contracting could be up to 60 days, 30 to 60 days let’s say. The lag between booking and revenue could indeed stretch up to 12 months, six months to 12 months depending on the client and the study dynamics. The COVID-19 situation has caused some delays in that lag time between booking and revenue further simply because we were unable to get the sites started. However, we are getting back to that as we speak, and we expect that in Asia, we are already returning to normal. We anticipate that to happen with a three to six-month lag in the rest of the world, particularly Europe and then the U.S. So yes, there have been delays in execution; however, as you suggested, COVID-19 trials are occurring much faster.

Ron Bruehlman, Interim Chief Financial Officer

Both awards and contracted bookings were very strong in the quarter. So whichever way you look at it, it’s promising.

Ari Bousbib, Chairman and Chief Executive Officer

Ron makes a good point. If we had reported bookings using just the awards method this quarter, it would have shown a materially higher book-to-bill ratio than the 1.64 at the end of the quarter.

Eric Coldwell, Analyst

Very helpful. Last one, just for clarification. There were some phone issues in one of your earlier responses. Did I hear you say that COVID work in total across therapies and vaccines accounted for mid-teens of your contracted awards?

Ari Bousbib, Chairman and Chief Executive Officer

Yes, in services, yes.

Andrew Markwick, Senior Vice President, Investor Relations and Treasury

Okay. Operator, I think we're up to the top of the hour now. So I think we've run out of time for the call. Thank you, everyone, for taking the time to join us today, and we look forward to speaking with you again on our third quarter 2020 earnings call. Jen and I are available to take any questions that you may have for the rest of the day.

Ari Bousbib, Chairman and Chief Executive Officer

And Mike and Ron.

Andrew Markwick, Senior Vice President, Investor Relations and Treasury

Yes. Mike and Ron will join us as well.

Ari Bousbib, Chairman and Chief Executive Officer

Okay, thank you, everyone.

Operator, Operator

This concludes today's conference call. You may now disconnect.