Earnings Call Transcript - IQV Q3 2025

Operator, Operator

Ladies and gentlemen, thank you for your patience. I would like to welcome everyone to the IQVIA Third Quarter 2025 Earnings Conference Call. This call is being recorded. Thank you. I will now turn the call over to Kerri Joseph, Senior Vice President of Investor Relations and Treasury. Mr. Joseph, please start your presentation.

Kerri Joseph, Senior Vice President, Investor Relations and Treasury

Thank you, operator. Good morning, everyone. Thank you for joining our third quarter 2025 earnings call. With me today are Ari Bousbib, Chairman and Chief Executive Officer; Ron Bruehlman, Executive Vice President and Chief Financial Officer; Eric Sherbet, Executive Vice President and General Counsel; Mike Fedock, Senior Vice President, Financial Planning and Analysis; and Gustavo Perrone, Senior Director, Investor Relations. Today, we will be referencing a presentation that will be visible during this call for those of you on our webcast. This presentation will also be available following this call on the Events and Presentations section of our IQVIA Investor Relations website at ir.iqvia.com. 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, which are discussed in the company's filings with the Securities and Exchange Commission, including our annual report on Form 10-K and subsequent SEC filings. In addition, we will discuss certain non-GAAP financial measures on this call, which should be considered a supplement to and not a substitute for financial measures prepared in accordance with GAAP. A reconciliation of these non-GAAP measures to the comparable GAAP measures is included in the press release and conference call presentation. I would now like to turn the call over to our Chairman and CEO, Ari Bousbib.

Ari Bousbib, Chairman and Chief Executive Officer

Thank you, Kerri, and good morning, everyone. I appreciate you joining us today to discuss our third quarter results. We had another strong quarter, with revenue and profit reaching the high end of our guidance, demonstrating solid operational performance. This quarter's free cash flow was particularly noteworthy, marking the highest quarterly free cash flow we've ever achieved, even considering the significant advances during the COVID era for vaccine trials. The robust free cash flow reflects effective and disciplined working capital management by our team, along with an improved overall industry landscape. On the clinical side, we saw net bookings this quarter total exactly $2.6 billion, resulting in a net book-to-bill ratio of 1.15x, which highlights the improving customer demand we started to see in the second quarter, alongside solid execution from our sales teams. Our third quarter net bookings were 5% higher sequentially, 13% higher than last year, and 21% higher than the low point we experienced in the first quarter of this year. Key demand metrics were also strong in this quarter. EBP funding momentum has been building this year, with each quarter showing consistent sequential growth, reaching $18 billion in Q3 according to BioWorld. Our qualified pipeline grew by 6% year-over-year, driven by large pharma and EBP segments. You may remember that in the second quarter, we observed high single-digit sequential RFP flow growth and low teens growth year-over-year. This quarter, high single-digit RFP flow growth continued sequentially, accompanied by 20% growth year-over-year across all segments. Notably, client decision-making timelines have improved sequentially. Our backlog reached a record $32.4 billion at the end of the quarter, demonstrating a 4.1% increase compared to last year. On the commercial side, TAS performed strongly in the third quarter, yielding solid results despite tougher year-over-year comparisons. Historically, Q3 typically reflects flat to declining sequential revenue growth compared to Q2, but we saw a slight increase this quarter, driven by ongoing momentum from drug launches and the strength of our broader commercial portfolio. I want to highlight the good growth we experienced this quarter in CSMS, about one-third of which stemmed from an acquisition. We chose to enhance our capabilities in this segment as we noticed a developing trend of large pharma clients seeking to outsource commercial operations for established brands in specific markets. These engagements tend to be large, spanning multiple years and involving various therapies and geographies, and IQVIA is uniquely positioned to leverage this trend by integrating our information and analytics with a local sales force footprint. Now, let me share the results of the quarter. We achieved strong revenue and profit results. Revenue for the third quarter came in at the high end of our guidance, corresponding to a 5.2% year-over-year growth on a reported basis and just under 4% at constant currency. Third quarter adjusted EBITDA increased by 1.1%. Our adjusted diluted EPS for the third quarter was $3, reflecting a 5.6% year-over-year increase. As I usually do, let me now highlight some business activities. Starting with TAS, new drug launches remain a significant area of strength for IQVIA. For example, a biotech client awarded us a multiyear integrated partnership to expedite product launches, incorporating a full suite of information assets and analytics capabilities. A top 10 pharma client contracted IQVIA to support the launch of a novel oncology therapy. Another top 20 pharma client chose IQVIA for the launch of a dual indication metabolic therapy utilizing AI capabilities to merge advanced patient insights into product utilization and patient response. A top 10 pharma client selected IQVIA to provide launch support for a new therapy for autoimmune disorders, which includes advanced AI-enabled patient-level solutions for near real-time performance tracking and analytics, integrating specialty pharmacy data and payer insights. A significant example of the commercial outsourcing trend I mentioned earlier was a major award from a top 5 pharma client for the end-to-end management of commercialization and promotion of an established brand portfolio in a large overseas market. We are on track to deploy specialized industry AI agents, with around 90 agents currently in development to address 25 use cases across commercial, real-world applications, and R&D Solutions. We are experiencing growing demand to assist our clients in accelerating AI adoption and are increasingly helping them establish robust and AI-ready data infrastructures by utilizing IQVIA's healthcare-grade AI ecosystem, which merges advanced information management, integrated platforms, security, safety, and privacy with domain expertise. Allow me to share a few examples of key achievements in the quarter. A top 20 pharma client chose IQVIA for a next-generation information management solution that streamlines numerous sales data feeds into a centralized, AI-enabled global warehouse. Another top 10 pharma client awarded IQVIA a contract to implement a next-generation AI-enabled SaaS platform for optimizing global compliance reporting. Additionally, a biotech client selected IQVIA to deploy a new global master data management program to enhance AI-driven omnichannel marketing and analytics operations. Our real-world business continues to perform effectively. Notable examples include a top 10 pharma client choosing IQVIA to lead a post-market commitment study evaluating treatment outcomes in African-American patients with lung cancer, and a biotech client selecting IQVIA for a prospective real-world study that supports regulatory commitments for a rare oncology disease. We continue to lead various retrospective real-world studies to aid in fulfilling post-marketing commitments for newly approved drugs. Shifting to R&D Solutions, we have built upon the positive momentum from Q2 into Q3. A few standout wins come from our biotech customers; for instance, a first-time sponsor selected IQVIA to conduct a Phase I trial for a novel leukemia treatment. Another biotech client entrusted us with leading a complex Phase I and Phase II trial in hematologic-oncology targeting multiple cohorts across two indications. Furthermore, we were chosen as the exclusive CRO partner for a biotech's entire cardiovascular program, reaffirming our leadership in cell and gene therapy and cardiovascular research, as well as our global execution capabilities. Large pharma also performed well this quarter, with our selection to lead a Phase II study in stroke therapy, showcasing our expertise in neuroscience and global trial capabilities. Another top 10 large pharma client selected IQVIA for managing a global Phase III MASH program, utilizing AI-enabled pathology tools and a strong site network to expedite execution. We were also selected to supervise a Phase III ovarian cancer study, emphasizing our therapeutic expertise and the strength of our integrated delivery model developed in collaboration with our clients. Before I pass it on to Ron for details on our financial performance, I want to address the CFO transition we've previously announced. Mike Fedock will assume the CFO role on February 28, 2026, succeeding Ron Bruehlman, who will retire after a remarkable tenure. Ron will continue as a senior advisor to assist with specific projects and ensure a smooth transition. Ron has been a crucial leader for this company for many years, and he and I have collaborated for over a quarter-century. He has played a significant role in shaping IQVIA's financial strategy and guiding its transformation into a leading global organization. He was instrumental in managing the IMS Health IPO in 2014 and the Quintiles merger in 2016, and returned in 2020 to help us navigate the pandemic. His steady leadership and strategic long-term vision have been vital in building a high-performance global finance organization and ensuring IQVIA's resilience during unprecedented times in recent years. Mike possesses extensive industry experience and has held significant financial leadership roles within IQVIA, including being the CFO of our R&D Solutions business and previously the CFO of our IQVIA Laboratory business. He has worked closely with me and the senior team for several years and is well-positioned to lead our finance function into IQVIA's next phase of growth. Now, I will turn it over to Ron for further details on our financial performance.

Ronald Bruehlman, Executive Vice President and Chief Financial Officer

Thanks, Ari, and good morning to everyone. Let's start by reviewing revenue. Our third quarter revenue of $4.1 billion grew 5.2% on a reported basis and 3.9% at constant currency. Excluding COVID-related work from this year and last, revenue grew 4.5% at constant currency, which included about 1.5 points from acquisitions. Technology & Analytics Solutions revenue for the third quarter was $1.631 billion, reflecting a 5% increase reported and 3.3% at constant currency. R&D Solutions third quarter revenue was $2.26 billion, growing 4.5% reported and 3.4% at constant currency. Excluding the reduction in COVID-related revenues, R&D Solutions revenue grew 4.5% at constant currency. Lastly, our Contract Sales & Medical Solutions business had revenue of $209 million, which was up 16.1% reported and 13.9% at constant currency. Year-to-date revenue for the company was $11.946 billion, up 4.4% reported and 3.7% at constant currency. Excluding all COVID-related work, our year-to-date growth was approximately 4.5% at constant currency. Tech & Analytics Solutions revenue was $4.805 billion year-to-date, representing a 6.7% increase reported and 5.8% at constant currency. R&D Solutions year-to-date revenue of $6.563 billion increased by 2.5% at actual FX rates and 1.9% at constant currency. Excluding COVID-related work from both periods, revenue grew approximately 3.5% at constant currency. Lastly, CSMS year-to-date revenue of $578 million was up 6.8% reported and 5.9% at constant currency. Now let's move down the P&L. Adjusted EBITDA for the quarter was $949 million, representing growth of 1.1%, while year-to-date adjusted EBITDA was $2.742 billion, up an even 2% year-over-year. Our third quarter GAAP net income was $331 million, and GAAP diluted earnings per share was $1.93. Year-to-date, GAAP net income was $846 million or $4.86 of diluted earnings per share. Adjusted net income was $515 million for the third quarter, with adjusted diluted earnings per share at $3. Year-to-date adjusted net income was $1.48 billion or $8.50 per share. As noted, we had strong net new bookings this quarter, confirming the improved demand environment we began to see in the second quarter. The R&D Solutions backlog at September 30 was $32.4 billion, up 4.1% year-over-year. The next 12-month revenue from backlog was $8.1 billion, also up 4.0% year-over-year. Reviewing the balance sheet, as of September 30, cash and cash equivalents totaled $1.814 billion, while gross debt was $14.957 billion, resulting in net debt of $13.143 billion. Our net leverage ratio ended the quarter at 3.52 times trailing 12-month adjusted EBITDA. Third quarter cash flow from operations was $908 million, and capital expenditures were $136 million, leading to record free cash flow for the quarter of $772 million. Now I'll turn it over to Mike Fedock, who will share details on our guidance.

Michael Fedock, Senior Vice President, Financial Planning and Analysis

Thanks, Ron, and good morning, everyone. Let's start with our full year guidance. We are confirming our full year 2025 guidance and are narrowing the ranges for revenue, adjusted EBITDA, and adjusted diluted earnings per share and are maintaining the midpoint of our prior guide. We expect revenue to be between $16.150 billion and $16.250 billion, representing year-over-year growth of 4.8% to 5.5% or 5.2% at the midpoint. This revenue guidance includes approximately $100 million of COVID-related revenue step down entirely in R&DS, approximately 100 basis points of tailwind from foreign exchange, and approximately 150 basis points of contribution from acquisitions. These assumptions are unchanged from the prior guide. We expect adjusted EBITDA to be between $3.775 billion and $3.8 billion, growing 2.5% to 3.1% year-over-year or 2.8% at the midpoint. We expect adjusted diluted EPS to be between $11.85 and $11.95, up 6.5% to 7.4% versus prior year or about 7% at the midpoint. Now turning to the fourth quarter. We're expecting revenue to be between $4.204 billion and $4.304 billion, which represents year-over-year growth of 6.2% to 8.7%. Adjusted EBITDA is expected to be between $1.033 billion and $1.058 billion, representing growth of 3.7% to 6.2% versus prior year. And adjusted diluted EPS is expected to be between $3.35 and $3.45, which represents year-over-year growth of 7.4% to 10.6%. And this guidance assumes that foreign currency rates as of October 27 continue for the balance of the year. So to summarize, in the third quarter, we delivered strong top and bottom line results as well as record high free cash flow. R&DS net bookings were $2.6 billion, growing 13% year-over-year and resulting in a net book-to-bill ratio of 1.15x. The forward-looking demand metrics in the clinical business continue to trend in the right direction with 20% RFP flow growth year-over-year and sequential improvement in client decision-making timelines. TAS performed well and delivered solid results, driven by ongoing momentum from drug launches and the strength of our broader commercial portfolio, and we reaffirmed our full year 2025 guidance. With that, let me hand it back to the operator for Q&A.

Operator, Operator

Your first question comes from the line of David Windley from Jefferies.

David Windley, Analyst

Ari, I wanted to ask you about what I think you call your see more, win more strategy and how that has played out through the middle of the year or through this year in terms of contributing to the RFP flows improvement that you're highlighting as well as your win rate and how we should think about an amount, if any, price competitiveness you're applying in that strategy and how that plays out through the P&L as that business converts to revenue?

Ari Bousbib, Chairman and Chief Executive Officer

Okay. Well, usually, we keep the best for the last, but you started with a big strategic question. So let's start with that. Okay. Well, look, the strength in bookings momentum and RFP flow, I think we have to say, and we could see it in the industry in general, I think reflects a reduction in the level of uncertainty in the market environment and the macro political environment. I think there have been a few developments that have sort of helped tilt decision-making at large pharma on certain programs favorably. And the climate overall has improved. That's undeniable in our sector. So that certainly is a big driver of our growth. The specifics of our see more, win more strategy, which we started earlier this year, which, as you know, now has a lot of imitators, has borne fruit as well in the sense that we've been looking at markets that we previously hadn't been touching and had left some more marginal players essentially in a quasi-monopoly situation in those segments, and we've decided to go after that. The pricing conversation is a little bit overdone in my opinion. In a climate where market dynamics were unfavorable with a lot of uncertainty and less deals to be had, there was more competition on pricing, and all we did in the first part of the year was to align to those pricing discounts that were being offered as opposed to walking away in order to continue to build our book of business. We don't see that trend continuing. It hasn't been an issue at all. Certainly this past quarter, the opposite. We've walked away from deals. And we think that the sector in general is a lot healthier in terms of market dynamics. The level of uncertainty has gone down and pricing has returned to normal levels. You had a question, a follow-up on P&L implications. Look, we have a $32-plus billion backlog and only a tiny portion of that was subject to a few discounts that we did earlier in the year. The revenue associated with those things are going to bleed over our P&L over the next 5 years, and we do not expect that to have any impact whatsoever on our P&L going forward.

Operator, Operator

Your next question comes from the line of Justin Bowers from Deutsche Bank.

Justin Bowers, Analyst

So Ari, it sounds like the business environment is improving, funding is up, consumer confidence is improving. And both of the segments, TAS and R&DS are strengthening, at least on a 2-year stack basis. Is this a momentum that we should expect to continue over the next few quarters and into 2026? And maybe if you could just give us a glimpse of how you're thinking about those two?

Ari Bousbib, Chairman and Chief Executive Officer

I don’t have a crystal ball, so I won’t provide guidance for 2026. We usually offer guidance for the year when we release our fourth-quarter and full-year earnings early in the year, so we’ll do that at the end of January or early February. We are currently in our planning process, and it’s still early in October. However, I can tell you that we are projecting over 5% growth in top-line revenue this year, which is a strong performance given the challenges we've faced in the last one and a half to two years. Compared to our larger CRO peers, we are performing very well. While I can't specify what 2026 will look like in the coming quarters, I would be surprised if revenue growth in 2026 isn't at least on par with or better than this year's growth. I say that with a degree of confidence.

Operator, Operator

Your next question comes from the line of Elizabeth Anderson from Evercore ISI.

Elizabeth Anderson, Analyst

Congrats, Ron, on your retirement. I was wondering if you could talk a little bit, Ari, about some of the differences between what you're seeing on the pharma side versus the biotech side. I think you covered the biotech side nicely in the see more, win more answer, but just sort of wanted to peel back the onion a little bit on the pharma side as well.

Ari Bousbib, Chairman and Chief Executive Officer

Look, large pharma went through a lot of transformation internally in terms of their investment programs. Going back to the IRA, there was this whole phase of reprioritization of programs and reviews of their pipelines, which led to an elevated level of cancellations due to this reprioritization activity. That lasted for 1 year, 1.5 years, beginning mid of '23 and certainly continuing through '24. We see that activity as having essentially been completed. And we haven't seen any further cancellations as a result of that type of activity. So we think that the pipelines are now fully sanitized. Of course, there continue to be cancellations, but they are all like more business as usual due to futility or other reasons and nothing unusual. Large pharma, actually, the RFP flow for large pharma is very strong. I mentioned that our RFP flow growth year-over-year is 20%. And that applies to large pharma and to EBP equally. I mean, there's a strong, strong momentum. And again, that's helped by the more calming environment and perhaps more certainty around what's coming. And it's also helped by the fact that these reprioritizations have been largely completed. And the programs are now on the table are programs that our clients want to engage in and want to go forward with. Our cancellations, I always say, in recent years were about $0.5 billion a quarter, plus or minus a couple of hundred million dollars. So they could range between $300 million and $700 million in a given quarter. So a couple of billion dollars plus year in, year out. In '24, we had more than 50% higher cancellation than that, right, over $3 billion in '24, because of these reprioritizations from large pharma. That essentially is behind us. And year-to-date, our cancellations follow the regular pattern. I think somewhere between $500 million, around on average about $550 million per quarter I saw the numbers yesterday. I think nothing much to talk about. This quarter, I think we were a little bit towards the higher end of our range. But again, not because of reprioritization, it's simply normal course of business. Our gross bookings were very strong, very, very strong this year. And you could see that also in our $2.6 billion of net bookings, which were up 13% year-over-year, up sequentially mid-single digits. And the trough we experienced Q1 probably was the trough. We don't see that in the near term. So again, large pharma dynamics returning to normal business conditions, trending towards normal business conditions and biotech funding improving, which as you know, is a driver of EBP growth. And that, again, is reflected in our bookings and in our RFP flow as well.

Operator, Operator

Your next question comes from the line of Michael Cherny from Leerink Partners.

Michael Cherny, Analyst

Maybe if I can ask a little bit about TAS. Nice growth against obviously a tough comp. As you think about the pathway forward, what do you see as the contributions you're getting from some of your inorganic advancements? And where do you see the best opportunities to continue to expand that business above and beyond your own R&D, talk AI, talk anything along that vein, that would be great.

Ari Bousbib, Chairman and Chief Executive Officer

Thank you, Michael. Well, you spoke about inorganic. I think we said 1.5 points of contribution from acquisitions to the company as a whole. And as you know, as always has been the case, the bulk of that is in TAS, although I think in this past quarter, we did a large acquisition that was in R&DS and SMO. I think that we spent $485 million that we spent in total. And most of that is one acquisition called NEXT Oncology, which is an SMO specialty in oncology, very attractive business. We acquired this end of Q3. So not much contribution in Q3. And the inorganic contribution to R&DS will be a few million dollars, I guess, in the double digits, like $50 million or thereabouts of revenue to R&DS in Q4. With respect to TAS, we didn't do much in Q3. And so I guess the acquisition contribution for the year, well, we did a CSMS deal as well, right, which is small, obviously, but since CSMS is a small segment, it was a large piece of it. So not much in TAS in Q3. In general, we try to buy technology companies, companies that can add capabilities to our suite of products, analytics companies. There's a lot of innovation, as you know, in the AI space.

Michael Fedock, Senior Vice President, Financial Planning and Analysis

Medical affairs...

Ari Bousbib, Chairman and Chief Executive Officer

Medical affairs and real-world evidence performed very strongly in the quarter, and we anticipate that trend will continue in the future. For the year, I estimate that 50% to 60% of the growth will come from TAS, with the remainder coming from R&DS and a small portion from CSMS in 2025.

Operator, Operator

Your next question comes from the line of Shlomo Rosenbaum, Stifel.

Shlomo Rosenbaum, Analyst

Ari, before I ask you a question, I just want to also commend Ron. So Ron, I've seen you retire before, and I'm not fully convinced you're gone right now.

Ari Bousbib, Chairman and Chief Executive Officer

Right. It's the wrong word to describe Ron, not retiring.

Shlomo Rosenbaum, Analyst

Yes, you've dragged him out of retirement in the past, Ari. So I don't know. Ari, I want to ask you to talk a little bit about the subcomponents in TAS and how they're growing in terms of real-world evidence and consulting and analytics. And just some of the trends that you're seeing there. I know consulting often kind of leads the trend in terms of you see that picking up, that means that the environment is getting better. And maybe you could just talk a little bit about each of the components and what you're seeing and maybe what that says about the market.

Ari Bousbib, Chairman and Chief Executive Officer

The growth rate in the third quarter is difficult to assess for significant trends since this quarter is typically the weakest of the year. This year, we faced a challenging comparison with last year's growth in TAS, which was around 8.6%. We anticipated a tough comparison this quarter. However, as I noted earlier, we are seeing a slight sequential increase. Given that the third quarter is challenging due to a six-week period in Europe where activity slows significantly, the performance this quarter was quite strong, primarily driven by real-world evidence, which performed exceptionally well. Other areas typically show low single-digit growth, and the rest experienced low to mid-single-digit growth, again against tough comparisons, which is also true for consulting.

Operator, Operator

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

Eric Coldwell, Analyst

Ari, I'll stick on the TAS question here just to make sure we're all level set for the fourth quarter. Back in February, you guided to $6.3 billion to $6.5 billion. That was quite a while ago. A lot of things changed. But if I use that original range and I take out what you've done year-to-date, that would put the implied fourth quarter revenue guidance about $100 million to $300 million below the Street on TAS. That's a big range and obviously a lower number than where consensus lies today. So I'm just hoping you can give us a little specificity on what you're thinking for TAS in the fourth quarter, so we aren't ahead of our skates here.

Ari Bousbib, Chairman and Chief Executive Officer

Yes. I'm not sure, you're talking about our targets and then you talked about the Street.

Eric Coldwell, Analyst

You guided in February to $6.3 billion to $6.5 billion. And the year-to-date number through 3 quarters is $4.8 billion, a little over $4.8 billion. So that leaves less than $1.5 billion to less than $1.7 billion to get to the full year, if I've done the math right.

Ari Bousbib, Chairman and Chief Executive Officer

Yes. I was going to talk to the finance team here asking. I don't have the numbers in front of me. But what you were suggesting that TAS would be lower than our guidance, I don't see that.

Michael Fedock, Senior Vice President, Financial Planning and Analysis

Eric, we'll help you with some of the Q4 details. But on a full-year basis, there's been no change all year with TAS, that the full-year CFX growth rates were between sort of 5% and 6%. So there's no change there.

Ari Bousbib, Chairman and Chief Executive Officer

We always said 5% to 6% growth year-over-year, correct?

Michael Fedock, Senior Vice President, Financial Planning and Analysis

CFX, correct.

Eric Coldwell, Analyst

I think you said 5% to 7% constant currency and I think I believe it was 5% to 7% on February 6 was the range?

Michael Fedock, Senior Vice President, Financial Planning and Analysis

We narrowed our guide in the last call there. So we're still sticking with the 5% to 6%. There's no change from the prior guide and no change where TAS is going to land in the full year.

Ari Bousbib, Chairman and Chief Executive Officer

Yes. Well, there's no change, Eric.

Michael Fedock, Senior Vice President, Financial Planning and Analysis

Yes, we'll help you with that with the Q4, but there's been no change.

Eric Coldwell, Analyst

Just want to make sure we're not ahead of our skates. I appreciate that very much.

Ari Bousbib, Chairman and Chief Executive Officer

And anything else you had on this clarification?

Eric Coldwell, Analyst

I had 42 questions, but you told us to stick to one. Let me...

Ari Bousbib, Chairman and Chief Executive Officer

I am going to give you a special discount because that wasn't really a question.

Eric Coldwell, Analyst

Well, look, I mean...

Ari Bousbib, Chairman and Chief Executive Officer

I appreciate it. So I'll sneak 2 in. Two things just quickly. One, do get some ongoing questions on those couple of mega trials that you mentioned earlier this year. I'm just curious if you can tell us what the status is. I think one was definitely ramping back up here in the back half, and I believe the other was still pushed out until next year if happening at all. So maybe just an update on the mega trials. And then secondarily, Ari, in your prepared commentary, you highlighted some interesting wins. And you mentioned Phase 1 a couple of times. And my historic interpretation of past conversations was that you weren't really a big Phase 1 shot, maybe you partnered with some others. But I'm curious on what your involvement is these days in actually managing or even having Phase I CPU units. Maybe give us a little more color on what you're doing there. Yes. It's a very good observation, Eric. We are seeing a lot of demand for Phase I work. And we are the network partners, we don't have any significant presence in that segment, but we are expanding, and this is why I chose to highlight a couple of examples. It's also, by the way, part of our see more, win more strategy. And it happens to me that there is more demand. Things are getting sort of restarted again and the pipelines are strong. And so we are seeing more demand, and we are ourselves being more present in the segment.

Ronald Bruehlman, Executive Vice President and Chief Financial Officer

Yes. And Phase I in oncology is a little bit different because you're not dealing with healthy volunteers. So it tends to feed your later business than other Phase I trials. So there is some distinction there. And that's what NEXT Oncology was Phase I oncology.

Ari Bousbib, Chairman and Chief Executive Officer

Yes. And then the 2 trials.

Ronald Bruehlman, Executive Vice President and Chief Financial Officer

Yes, the 2 trials, no change there. We don't have anything factored into our fourth quarter guidance for revenue burn from either of them. So I suppose that's a slight change from what we said.

Ari Bousbib, Chairman and Chief Executive Officer

It's basically all pushed out of the year and it's not included in the guidance. We mentioned this about a year ago because it led us to change our guidance for R&DS. These were fast-burning trials that had already started but were interrupted, which resulted in adjusting our forecast for R&DS in the last quarter of the previous year. We mention specific trials when significant events occur, and in this case, it involved two trials that impacted our numbers. However, we are working on a couple of thousand trials at any given time and our backlog continues to grow. We are pleased with the positive momentum in our bookings, which is ongoing. This allows us to keep performing well in R&DS, even without those trials resuming this year. Thank you.

Michael Fedock, Senior Vice President, Financial Planning and Analysis

Next question, operator. This will be our last question.

Operator, Operator

Your last question comes from the line of Jeff Garro from Stephens.

Jeffrey Garro, Analyst

I want to ask more about AI and maybe I'll try and make it a 2-parter. First part being if you have any insights how AI is changing your customers' business models and specifically their appetite for outsourcing? And then the second part would be how is IQVIA using AI internally to deliver results for clients that may be a little bit more efficiently and whether you have any visibility into potential gross margin improvements from those internal use cases?

Ari Bousbib, Chairman and Chief Executive Officer

Thank you, Jeff. We've discussed this before, and currently, we have around 90 AI agents under development that address 25 different use cases, and we are making good progress. By early 2027, we aim to create 500 highly specialized agents. These agents are designed to reduce physical labor in the tasks we conduct for our clients. Internally, responding to your second question, this will definitely assist in improving our margins over the long term. However, it does take time to implement and translate that into margin enhancements. We have some excellent examples on the commercial side, such as using AI tools to compare patient cohorts and identify differences in natural language output, leading to shorter cycle times from several weeks to just a couple of weeks. We have numerous examples, although it takes time to share them all. We see significant value in being able to do more with fewer resources by integrating agents into our internal processes. For our clients, I've provided several examples in my introductory remarks. They are very keen on utilizing AI. Early in the discovery phase, clients focus on using AI to analyze molecules and identify the trials most likely to succeed for specific diseases. We contribute with some models and tools we have. However, clinical processes are highly regulated, and we must navigate through established regulatory standards to implement and utilize AI effectively. It's valuable at the sites, and our clients are using AI in various technology tools, including some of ours. They apply AI to manage marketing and promotional campaigns and gather real-world patient insights. The real-world data area is significant for us and has driven our substantial growth, leveraging our extensive information assets in real-world patient data. Using AI to assess how drugs perform in real-world conditions presents a tremendous opportunity. Regarding margins, we have faced some headwinds this year due to increased pass-throughs mainly caused by foreign exchange influences, which don't contribute to profits, along with some shifts in our service mix. For instance, in Q3, our Clinical Solutions Management Services performed better, but it's of lower margin. With such market challenges, we are relying on our usual cost reduction strategies, including offshoring. Nevertheless, in the long term, the implementation of AI will help alleviate these challenges and improve our margins. Thank you, and the team will be available for any follow-up questions. Thank you for your time today.

Kerri Joseph, Senior Vice President, Investor Relations and Treasury

Thank you. Thanks for taking the time to join us today, and we look forward to speaking with you again on the 2025 fourth quarter and full year earnings call. The team will be available the rest of the day to take any follow-up questions you might have. Thank you.

Operator, Operator

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