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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
_________________________________________________________
FORM 10-Q
_________________________________________________________
(Mark One)
QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the quarterly period ended March 31, 2021
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)
_________________________________________________________
Delaware27-1341991
(State or other jurisdiction of
incorporation or organization)
(I.R.S. Employer
Identification Number)
4820 Emperor Blvd., Durham, North Carolina 27703
(Address of principal executive office and Zip Code)
(919998-2000
(Registrant’s telephone number, including area code)
_________________________________________________________
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 12 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 x    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 x    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 an 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
x
Accelerated filer
Non-accelerated filer
Smaller reporting company
Emerging growth 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 is a shell company (as defined in Rule 12b-2 of the Exchange Act).    Yes     No x
Securities registered pursuant to Section 12(b) of the Act:
Title of Each Class
Trading Symbol
Name of Each Exchange on which Registered
Common Stock, par value $0.01 per share
IQV
New York Stock Exchange
Indicate the number of shares outstanding of each of the issuer’s classes of Common Stock, as of the latest practicable date.
Class
Number of Shares Outstanding
Common Stock $0.01 par value191,661,174shares outstandingas of April 16, 2021



Table of contents
IQVIA HOLDINGS INC.
FORM 10-Q
TABLE OF CONTENTS
Page

2

Table of contents
PART I—FINANCIAL INFORMATION
Item 1. Financial Statements
IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF INCOME
(unaudited)
Three Months Ended March 31,
(in millions, except per share data)
20212020
Revenues$3,409 $2,754 
Costs of revenue, exclusive of depreciation and amortization2,293 1,824 
Selling, general and administrative expenses442 407 
Depreciation and amortization323 316 
Restructuring costs9 14 
Income from operations342 193 
Interest income(1)(2)
Interest expense99 106 
Loss on extinguishment of debt24  
Other income, net(37)(13)
Income before income taxes and equity in earnings of unconsolidated affiliates257 102 
Income tax expense44 17 
Income before equity in earnings of unconsolidated affiliates213 85 
Equity in earnings of unconsolidated affiliates4 6 
Net income217 91 
Net income attributable to non-controlling interests(5)(9)
Net income attributable to IQVIA Holdings Inc.$212 $82 
Earnings per share attributable to common stockholders:
Basic$1.11 $0.43 
Diluted$1.09 $0.42 
Weighted average common shares outstanding:
Basic191.5 191.6 
Diluted194.9 195.7
The accompanying notes are an integral part of these condensed consolidated financial statements.
3

Table of contents
IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS)
(unaudited)
Three Months Ended
March 31,
(in millions)20212020
Net income$217 $91 
Comprehensive income (loss) adjustments:
Unrealized gains (losses) on derivative instruments, net of income tax expense (benefit) of $1, $(7)
6 (39)
Foreign currency translation, net of income tax expense of $62, $23
(178)(155)
Reclassification adjustments:
Losses on derivative instruments included in net income, net of income tax benefit of $1, $
1 16 
Comprehensive income (loss)
46 (87)
Comprehensive income attributable to non-controlling interests
(5)(5)
Comprehensive income (loss) attributable to IQVIA Holdings Inc.
$41 $(92)
The accompanying notes are an integral part of these condensed consolidated financial statements.
4

Table of contents
IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED BALANCE SHEETS
(unaudited)
(in millions, except per share data)March 31, 2021December 31, 2020
ASSETS
Current assets:
Cash and cash equivalents$2,305 $1,814 
Trade accounts receivable and unbilled services, net2,361 2,410 
Prepaid expenses159 159 
Income taxes receivable64 56 
Investments in debt, equity and other securities97 88 
Other current assets and receivables593 563 
Total current assets5,579 5,090 
Property and equipment, net472 482 
Operating lease right-of-use assets437 471 
Investments in debt, equity and other securities74 78 
Investments in unconsolidated affiliates88 84 
Goodwill12,415 12,654 
Other identifiable intangibles, net4,915 5,205 
Deferred income taxes107 114 
Deposits and other assets380 386 
Total assets$24,467 $24,564 
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable and accrued expenses$2,819 $2,813 
Unearned income1,554 1,252 
Income taxes payable135 102 
Current portion of long-term debt144 149 
Other current liabilities216 242 
Total current liabilities4,868 4,558 
Long-term debt12,092 12,384 
Deferred income taxes337 338 
Operating lease liabilities347 371 
Other liabilities586 633 
Total liabilities18,230 18,284 
Commitments and contingencies
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of March 31, 2021 and December 31, 2020, $0.01 par value, 255.4 shares issued and 191.6 shares outstanding as of March 31, 2021; 254.7 shares issued and 191.2 shares outstanding as of December 31, 2020
11,068 11,095 
Retained earnings1,489 1,277 
Treasury stock, at cost, 63.8 and 63.5 shares as of March 31, 2021 and December 31, 2020, respectively
(6,228)(6,166)
Accumulated other comprehensive loss(376)(205)
Equity attributable to IQVIA Holdings Inc.’s stockholders5,953 6,001 
Non-controlling interests284 279 
Total stockholders’ equity6,237 6,280 
Total liabilities and stockholders’ equity$24,467 $24,564 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS
(unaudited)
Three Months Ended March 31,
(in millions)
20212020
Operating activities:
Net income
$217 $91 
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization
323 316 
Amortization of debt issuance costs and discount
5 3 
Stock-based compensation
32  
(Earnings) from unconsolidated affiliates(4)(6)
Gain on investments, net3 8 
Benefit from deferred income taxes
(39)(40)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income
342 (84)
Change in other operating assets and liabilities
(12)(125)
Net cash provided by operating activities
867 163 
Investing activities:
Acquisition of property, equipment and software
(149)(141)
Acquisition of businesses, net of cash acquired
(19)(14)
Purchases of marketable securities, net
(7)(7)
Investments in unconsolidated affiliates, net of payments received
(1)17 
Investments in equity securities
(1)(6)
Other
1 1 
Net cash used in investing activities
(176)(150)
Financing activities:
Proceeds from issuance of debt
1,751 800 
Payment of debt issuance costs
(32)(11)
Repayment of debt and principal payments on capital lease obligations
(1,758)(25)
Proceeds from revolving credit facility
 990 
Repayment of revolving credit facility
 (1,250)
(Payments) related to employee stock option plans(56)(41)
Repurchase of common stock
(62)(345)
Distributions to non-controlling interests, net (5)
Contingent consideration and deferred purchase price payments
(11)(6)
Net cash (used in) provided by financing activities(168)107 
Effect of foreign currency exchange rate changes on cash
(32)(30)
Increase in cash and cash equivalents491 90 
Cash and cash equivalents at beginning of period
1,814 837 
Cash and cash equivalents at end of period
$2,305 $927 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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IQVIA HOLDINGS INC. AND SUBSIDIARIES
CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS’ EQUITY
(unaudited)
(in millions)Common
Stock
Shares
Treasury
Stock
Shares
Common
Stock
Additional
Paid-In
Capital
Retained EarningsTreasury
Stock
Accumulated
Other
Comprehensive
(Loss) Income
Non-
controlling
Interests
Total
Balance, December 31, 2020254.7 (63.5)$3 $11,092 $1,277 $(6,166)$(205)$279 $6,280 
Issuance of common stock0.7 — — (57)— — — — (57)
Repurchase of common stock— (0.3)— — — (62)— — (62)
Stock-based compensation— — — 30 — — — — 30 
Distributions to non-controlling interests, net— — — — — — — —  
Net income— — — — 212 — — 5 217 
Unrealized gains on derivative instruments, net of tax— — — — — — 6 — 6 
Foreign currency translation, net of tax— — — — — — (178) (178)
Reclassification adjustments, net of tax— — — — — — 1 — 1 
Balance, March 31, 2021255.4 (63.8)$3 $11,065 $1,489 $(6,228)$(376)$284 $6,237 


(in millions)
Common
Stock
Shares
Treasury
Stock
Shares
Common
Stock
Additional
Paid-In
Capital
Retained Earnings
Treasury
Stock
Accumulated
Other
Comprehensive
(Loss) Income
Non-
controlling
Interests
Total
Balance, December 31, 2019253.0 (60.7)$3 $11,046 $998 $(5,733)$(311)$260 $6,263 
Issuance of common stock0.8 — — (44)— — — — (44)
Repurchase of common stock— (2.1)— — — (332)— — (332)
Stock-based compensation— — — 7 — — — — 7 
Distributions to non-controlling interests, net— — — — — — — (5)(5)
Net income— — — — 82 — — 9 91 
Unrealized losses on derivative instruments, net of tax— — — — — — (39)— (39)
Foreign currency translation, net of tax— — — — — — (151)(4)(155)
Reclassification adjustments, net of tax— — — — — — 16 — 16 
Balance, March 31, 2020253.8 (62.8)$3 $11,009 $1,080 $(6,065)$(485)$260 $5,802 
The accompanying notes are an integral part of these condensed consolidated financial statements.
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IQVIA HOLDINGS INC. AND SUBSIDIARIES
Notes to Condensed Consolidated Financial Statements
(unaudited)
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. With approximately 72,000 employees, IQVIA conducts business in more than 100 countries.
Unaudited Interim Financial Information
The accompanying unaudited condensed consolidated financial statements of the Company have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2021. As such, the information included in this Quarterly Report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2020. The balance sheet as of December 31, 2020 has been derived from the audited consolidated financial statements of the Company but does not include all the disclosures required by GAAP.
Recently Issued Accounting Standards
Accounting pronouncements adopted
In March 2020, the Financial Accounting Standards Board ("FASB") issued new accounting guidance that provides optional expedients and exceptions for applying 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 became effective for the Company as of March 12, 2020 through December 31, 2022. The Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not 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 Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not 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 Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements.




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2. Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations
The following tables represent revenues by geographic region and reportable segment for the three months ended March 31, 2021 and 2020:
Three Months Ended March 31, 2021
(in millions)
Technology &
Analytics Solutions
Research &
Development Solutions
Contract Sales &
Medical Solutions
Total
Revenues:
Americas
$600 $1,034 $78 $1,712 
Europe and Africa
590 443 49 1,082 
Asia-Pacific
158 391 66 615 
Total revenues
$1,348 $1,868 $193 $3,409 

Three Months Ended March 31, 2020
(in millions)
Technology &
Analytics Solutions
Research &
Development Solutions
Contract Sales &
Medical Solutions
Total
Revenues:
Americas
$581 $670 $91 $1,342 
Europe and Africa
396 428 50 874 
Asia-Pacific
140 343 55 538 
Total revenues
$1,117 $1,441 $196 $2,754 

No customer accounted for 10% or more of consolidated revenues for the three months ended March 31, 2021 or 2020.
Transaction Price Allocated to the Remaining Performance Obligations
As of March 31, 2021, approximately $26.1 billion of revenue is expected to be recognized in the future from remaining performance obligations. The Company expects to recognize revenue on approximately 35% of these remaining performance obligations over the next 12 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)
March 31, 2021December 31, 2020
Trade accounts receivable:
Billed
$1,159 $1,181 
Unbilled services
1,233 1,263 
Trade accounts receivable and unbilled services
2,392 2,444 
Allowance for doubtful accounts
(31)(34)
Trade accounts receivable and unbilled services, net
$2,361 $2,410 



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Unbilled services and unearned income were as follows:
(in millions)March 31, 2021December 31, 2020
Change
Unbilled services
$1,233 $1,263 $(30)
Unearned income
(1,554)(1,252)(302)
Net balance
$(321)$11 $(332)
Unbilled services, which is comprised of approximately 60% of unbilled receivables and 40% of contract assets as of March 31, 2021, decreased by $30 million as compared to December 31, 2020. 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 $302 million over the same period resulting in a decrease of $332 million in the net balance of unbilled services and unearned income between December 31, 2020 and March 31, 2021. The change in the net balance is driven by the difference in timing of revenue recognition in accordance with Accounting Standards Codification ("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 not material for the three months ended March 31, 2021 and 2020.
4. Goodwill
The following is a summary of goodwill by reportable segment for the three months ended March 31, 2021:
(in millions)
Technology & Analytics Solutions
Research & Development Solutions
Contract Sales & Medical Solutions
Consolidated
Balance as of December 31, 2020$10,864 $1,646 $144 $12,654 
Business combinations
15   15 
Impact of foreign currency fluctuations and other
(264)(4)14 (254)
Balance as of March 31, 2021$10,615 $1,642 $158 $12,415 

5. Derivatives
The fair values of the Company’s derivative instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table:
(in millions)
Balance Sheet Classification
March 31, 2021December 31, 2020
Assets
Liabilities
Notional
Assets
Liabilities
Notional
Derivatives designated as hedging instruments:
Foreign exchange forward contracts
Other current assets and liabilities
$3 $ $64 $5 $ $70 
Interest rate swaps
Other assets and liabilities
 44 1,800  55 1,800 
Derivatives not designated as hedging instruments:
Interest rate swaps
Other liabilities
    1 356 
Total derivatives
$3 $44 $5 $56 

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The effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table:
Three Months Ended March 31,
(in millions)
20212020
Foreign exchange forward contracts
$(2)$(6)
Interest rate derivatives
11 (23)
Total
$9 $(29)
The amount of foreign exchange losses related to the net investment hedge included in the cumulative translation adjustment component of accumulated other comprehensive loss (“AOCI”) for the three months ended March 31, 2021 was $285 million.
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 as of March 31, 2021 and December 31, 2020 due to their short-term nature. As of March 31, 2021 and December 31, 2020, the fair value of total debt approximated $12,392 million and $12,746 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 March 31, 2021:
(in millions)Level 1Level 2Level 3Total
Assets:
Marketable securities$126 $ $ $126 
Derivatives 3  3 
Total$126 $3 $ $129 
Liabilities:
Derivatives$ $44 $ $44 
Contingent consideration  109 109 
Total$ $44 $109 $153 
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.
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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. Based on the assessments of the probability of achieving specific targets, the Company has accrued approximately 84% of the maximum contingent consideration payments that could potentially become payable.
The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the three months ended March 31:
Contingent Consideration
(in millions)
20212020
Balance as of January 1
$119 $113 
Business combinations
5 8 
Contingent consideration paid
(9)(10)
Revaluations included in earnings and foreign currency translation adjustments
(6)(13)
Balance as of March 31$109 $98 
The current portion of contingent consideration is included within accrued expenses and the long-term portion is included within other liabilities on the accompanying condensed consolidated balance sheets. Revaluations of the contingent consideration are recognized in other expense (income), net on the accompanying condensed consolidated statements of income. A change in significant unobservable inputs above could result in a higher or lower fair value measurement of contingent consideration.
7. Credit Arrangements
The following is a summary of the Company’s revolving credit facilities as of March 31, 2021:
Facility
Interest Rates
$1,500 million (revolving credit facility)
LIBOR in the relevant currency borrowed plus a margin of 1.50% as of March 31, 2021
$25 million (receivables financing facility)
LIBOR Market Index Rate (0.11% as of March 31, 2021) plus 0.90%
£10 million (approximately $14 million) (general banking facility)
Bank’s base rate of 0.10% as of March 31, 2021 plus 1%
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The following table summarizes the Company’s debt at the dates indicated:
(in millions)March 31, 2021December 31, 2020
Senior Secured Credit Facilities:
Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 1.70%
$718 $728 
Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 2.75%
755 766 
Term A Loan due 2023—Euro LIBOR at average floating rates of 1.50%
377 400 
Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 1.86%
535 535 
Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00%
1,347 1,413 
Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 1.86%
724 726 
Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 1.95%
924 926 
Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00%
665 697 
5.0% Senior Notes due 2027—U.S. Dollar denominated
1,100 1,100 
5.0% Senior Notes due 2026—U.S. Dollar denominated
1,050 1,050 
2.875% Senior Notes due 2025—Euro denominated
493 515 
3.25% Senior Notes due 2025—Euro denominated
 1,748 
2.25% Senior Notes due 2028—Euro denominated
844 883 
2.875% Senior Notes due 2028—Euro denominated
834 872 
1.750% Senior Notes due 2026—Euro denominated
645  
2.250% Senior Notes due 2029—Euro denominated
1,056  
Receivables financing facility due 2022—U.S. Dollar LIBOR at average floating rates of 1.01%
240 240 
Principal amount of debt12,307 12,600 
Less: unamortized discount and debt issuance costs(71)(67)
Less: current portion(144)(149)
Long-term debt$12,092 $12,384 

Contractual maturities of long-term debt are as follows as of March 31, 2021:
(in millions)
Remainder of 2021$107 
2022388 
20231,700 
20241,868 
20253,560 
Thereafter4,684 
$12,307 
As of March 31, 2021, there were bank guarantees totaling approximately £0.8 million (approximately $1.1 million) issued against the availability of the general banking facility.
Senior Secured Credit Facilities
As of March 31, 2021, 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 $7.5 billion, which consisted of $6.0 billion principal amounts of debt outstanding (as detailed in the table above), and $1.5 billion of available borrowing capacity on the revolving credit facility and standby letters of credit.

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Senior Notes
On March 3, 2021, IQVIA Inc. (the “Issuer”), a wholly owned subsidiary of the Company, completed the issuance and sale of €1,450,000,000 in gross proceeds of the Issuer's (i) €550,000,000 aggregate principal amount of its 1.750% Senior Notes due 2026 (the “2026 Notes”) and (ii) €900,000,000 aggregate principal amount of its 2.250% Senior Notes due 2029 (the “2029 Notes” and, together with the 2026 Notes, the “Notes”). The Notes were issued pursuant to an Indenture, dated March 3, 2021, among the Issuer, U.S. Bank National Association, as trustee of the Notes, and certain subsidiaries of the Issuer as guarantors. The 2026 Notes are unsecured obligations of the Issuer, will mature on March 15, 2026 and bear interest at the rate of 1.750% per year, with interest payable semi-annually on March 15 and September 15 of each year, beginning on September 15, 2021. The 2029 Notes are unsecured obligations of the Issuer, will mature on March 15, 2029 and bear interest at the rate of 2.250% per year, with interest payable semi-annually on March 15 and September 15 of each year, beginning on September 15, 2021. The Issuer may redeem (i) the 2026 Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to March 15, 2023 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 0.875% to 0.000% and (ii) the 2029 Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to March 15, 2024 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 1.125% to 0.000%. The Issuer may choose to redeem the 2026 Notes and the 2029 Notes, either together or separately, on a non-ratable basis. The proceeds from the Notes offering were used to redeem all of the Issuer’s outstanding 3.250% senior notes due 2025 (the “3.250% Notes”), including the payment of premiums in respect thereof and to pay fees and expenses related to the Notes offering. On February 16, 2021, the Issuer issued a conditional notice of redemption with respect to the 3.250% Notes, for a total redemption price equal to the sum of the principal amount of the 3.250% Notes, accrued and unpaid interest on the 3.250% Notes to the redemption date and the applicable redemption premium. The Issuer’s obligations with respect to the 3.250% Notes were discharged on the same day as the Issuer completed the issuance of the Notes.
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 senior secured credit facility 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 revolving credit facility and term loans, other actions permitted to be taken by a secured creditor. The Company’s long-term debt arrangements contain other usual and customary restrictive covenants that, among other things, place limitations on the Company’s ability to declare dividends. As of March 31, 2021, the Company was in compliance in all material respects with the financial covenants under the Company’s financing arrangements.
8. 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 or outstanding as of March 31, 2021 or December 31, 2020.
Equity Repurchase Program

During the three months ended March 31, 2021, the Company repurchased 265,809 shares of its common stock for $50.5 million under the Repurchase Program. As of March 31, 2021, the Company has remaining authorization to repurchase up to approximately $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.
9. Restructuring
The Company has continued to take restructuring actions in 2021 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 2022.
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The following amounts were recorded for the restructuring plans:
(in millions)
Severance and
Related Costs
Facility
Exit Costs
Total
Balance as of December 31, 2020$51 $2 $53 
Expense, net of reversals
9  9 
Payments
(14) (14)
Foreign currency translation and other
(2) (2)
Balance as of March 31, 2021$44 $2 $46 
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 that the majority of the restructuring accruals as of March 31, 2021 will be paid in 2021 and 2022.
10. Income Taxes

The effective income tax rate was 17.1% and 16.7% in the first quarter of 2021 and 2020, respectively. The effective income tax rate in the first quarter of 2021 and 2020 was favorably impacted by $17 million and $21 million, respectively, as a result of excess tax benefits recognized upon settlement of share-based compensation awards. Also, the effective income tax rate in the first quarter of 2020 was unfavorably impacted by a $10 million discrete tax expense related to change in the measurement of U.S. tax on undistributed foreign earnings.
11. Comprehensive Income (Loss)
Below is a summary of the components of AOCI:
(in millions)
Foreign
Currency
Translation
Derivative
Instruments
Defined
Benefit
Plans
Income
Taxes
Total
Balance as of December 31, 2020$(395)$(48)$(85)$323 $(205)
Other comprehensive income (loss) before reclassifications
(116)7  (63)(172)
Reclassification adjustments
 2  (1)1 
Balance as of March 31, 2021$(511)$(39)$(85)$259 $(376)

Below is a summary of the adjustments for (gains) losses reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item:
(in millions)
Affected Financial Statement
Line Item
Three Months Ended March 31,
20212020
Derivative instruments:
 Interest rate swaps and capsInterest expense$4 $ 
Foreign exchange forward contracts
Revenues
(2)2 
Foreign exchange forward contracts
Other income, net 14 
Total before income taxes
2 16 
Income tax benefit1  
Total net of income taxes
$1 $16 

12. Segments
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 the Company’s life sciences customers. Research & Development Solutions, which primarily serves
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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 the Company’s segments and are reported as general corporate and unallocated expenses. These costs primarily consist of stock-based compensation and expenses related 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:
Three Months Ended March 31,
(in millions)
20212020
Revenues
Technology & Analytics Solutions
$1,348 $1,117 
Research & Development Solutions
1,868 1,441 
Contract Sales & Medical Solutions
193 196 
Total revenues
3,409 2,754 
Costs of revenue, exclusive of depreciation and amortization
Technology & Analytics Solutions
812 666 
Research & Development Solutions
1,321 988 
Contract Sales & Medical Solutions
160 170 
Total costs of revenue
2,293 1,824 
Selling, general and administrative expenses
Technology & Analytics Solutions
187 183 
Research & Development Solutions
185 185 
Contract Sales & Medical Solutions
13 15 
General corporate and unallocated
57 24 
Total selling, general and administrative expenses
442 407 
Segment profit
Technology & Analytics Solutions
349 268 
Research & Development Solutions
362 268 
Contract Sales & Medical Solutions
20 11 
Total segment profit
731 547 
General corporate and unallocated
(57)(24)
Depreciation and amortization
(323)(316)
Restructuring costs
(9)(14)
Total income from operations
$342 $193 

13. Earnings Per Share
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:
Three Months Ended March 31,
(in millions)
20212020
Shares subject to performance conditions0.7 1.4 
Shares subject to anti-dilutive stock-based awards0.3 1.0 
Total shares excluded from diluted earnings per share1.0 2.4 
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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 have been met. 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.
14. Subsequent Events
On April 1, 2021 the Company acquired the 40% non-controlling interest in Q2 Solutions from Quest Diagnostics Incorporated for $760 million, financed with cash on hand. The transaction will result in the Company having 100% ownership in Q2 Solutions. The Company previously held a controlling interest in, and consolidated the financial results of the joint venture. The transaction will be recorded in the second quarter of 2021.
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Item 2. Management’s Discussion and Analysis of Financial Condition and Results of Operations
Cautionary Statement for Forward-Looking Information
You should read the following discussion and analysis of our financial condition and results of operations together with our condensed consolidated financial statements and the related notes included elsewhere in this Quarterly Report on Form 10-Q and with our audited consolidated financial statements and the notes thereto included in our Annual Report on Form 10-K for the fiscal year ended December 31, 2020 (our “2020 Form 10-K”).
In addition to historical condensed consolidated financial information, the following discussion contains or incorporates by reference forward-looking statements within the meaning of the federal securities laws that are not historical facts but reflect, among other things, our current expectations and 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,” “forecasts,” “projects,” “should,” “targets,” “will” and the negative thereof and similar words and expressions are intended to identify forward-looking statements. We assume no obligation to update any such forward-looking information to reflect actual results or changes in our outlook or the factors affecting such forward-looking information.

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, 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. For a further discussion of the risks relating to our business, see Part I—Item 1A—“Risk Factors” in our 2020 Form 10-K, as updated in this Quarterly Report on Form 10-Q.
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 72,000 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
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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 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.
Sources of Revenue
Total revenues are comprised of revenues from the provision of our services. We do not have material product revenues.
Costs and Expenses
Our costs and expenses are comprised primarily of our costs of revenue, which include reimbursed expenses, and selling, general and administrative expenses. Costs of revenue include compensation and benefits for billable employees and personnel involved in production, 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; costs related to facilities; costs related to training and expenses for information technology (“IT”), reimbursed expenses that are comprised principally of payments to investigators who oversee clinical trials and travel expenses for our clinical monitors and sales representatives; and other expenses directly related to service contracts such as courier fees, laboratory supplies, professional services and travel expenses. Selling, general and administrative expenses include costs related to sales, marketing, and administrative functions (including human resources, legal, finance and general management) for compensation and benefits, travel, professional services, facilities and training and expenses for IT.
Foreign Currency Translation
In the first three months of 2021, 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.
Revenues
Three Months Ended March 31,
Change
(in millions)
20212020
$
%
Revenues
$3,409 $2,754 $655 23.8 
For the first quarter of 2021, our revenues increased $655 million, or 23.8%, as compared to the same period in 2020. This increase was comprised of constant currency revenue growth of approximately $588 million, or 21.4%, reflecting a $405 million increase in Research & Development Solutions, an $8 million decrease in Contract Sales & Medical Solutions, and a $191 million increase in Technology & Analytics Solutions.
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Costs of Revenue, exclusive of Depreciation and Amortization
Three Months Ended March 31,
(in millions)
20212020
Costs of revenue, exclusive of depreciation and amortization
$2,293 $1,824 
% of revenues
67.3 %66.2 %
The $469 million increase in costs of revenues, exclusive of depreciation and amortization, for the three months ended March 31, 2021 as compared to the same period in 2020 included a constant currency growth of approximately $410 million, or 22.5%, reflecting a $305 million increase in Research & Development Solutions, a $14 million decrease in Contract Sales & Medical Solutions, and an $119 million increase in Technology & Analytics Solutions.
Selling, General and Administrative Expenses
Three Months Ended March 31,
(in millions)
20212020
Selling, general and administrative expenses
$442 $407 
% of revenues
13.0 %14.8 %
The $35 million increase in selling, general and administrative expenses for the three months ended March 31, 2021 as compared to the same period in 2020 included a constant currency growth of approximately $25 million, or 6.1%, reflecting a $3 million decrease in Research & Development Solutions, an $1 million decrease in Technology & Analytics Solutions, a $2 million decrease in Contract Sales & Medical Solutions, offset by a $31 million increase in general corporate and unallocated expenses.
Depreciation and Amortization
Three Months Ended March 31,
(in millions)
20212020
Depreciation and amortization323 316 
% of revenues
9.5 %11.5 %

The $7 million increase in depreciation and amortization in the three months ended March 31, 2021 as compared to the same period in 2020 was primarily due to higher intangible asset balances as a result of acquisitions occurring in 2020 and increased amortization due to higher capitalized software balances.
Restructuring Costs
Three Months Ended March 31,
(in millions)20212020
Restructuring costs$$14 
The restructuring costs incurred during 2021 were due to ongoing efforts to streamline our global operations. The remaining actions under these plans are expected to occur throughout 2021 and into 2022 and are expected to consist of consolidating functional activities, eliminating redundant positions, and aligning resources with customer requirements.
Interest Income and Interest Expense
Three Months Ended March 31,
(in millions)20212020
Interest income$(1)$(2)
Interest expense$99 $106 
Interest income includes interest received primarily from bank balances and investments.

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Interest expense during the three months ended March 31, 2021 was lower than the same period in 2020 due to lower interest rates attributed to lower LIBOR rates and the redemption of the €1,425 million of 3.250% senior notes due 2025, partially offset by an increase in the average debt outstanding. See “Liquidity and Capital Resources” for more information on this transaction.
Loss on Extinguishment of Debt

Three Months Ended March 31,
(in millions)20212020
Loss on extinguishment of debt$24 $— 
During the three months ended March 31, 2021, we recognized a loss on extinguishment of debt for fees and expenses incurred related to the refinancing of our 3.250% senior notes due 2025.
Other Income, Net
Three Months Ended March 31,
(in millions)20212020
Other income, net$(37)$(13)
Other income, net for the three months ended March 31, 2021 increased as compared to the same period in the prior year, primarily due to foreign currency gain, as well as gain on investments in mutual funds.
Income Tax Expense
Three Months Ended March 31,
(in millions)20212020
Income tax expense$44 $17 

Our effective income tax rate was 17.1% and 16.7% in the first quarter of 2021 and 2020, respectively. Our effective income tax rate in the first quarter of 2021 and 2020 was favorably impacted by $17 million and $21 million, respectively, as a result of excess tax benefits recognized upon settlement of share-based compensation awards. Also, our effective income tax rate in the first quarter of 2020 was unfavorably impacted by a $10 million discrete tax expense related to change in the measurement of U.S. tax on undistributed foreign earnings.
Equity in Earnings of Unconsolidated Affiliates
Three Months Ended March 31,
(in millions)20212020
Equity in earnings of unconsolidated affiliates$$
Equity in earnings of unconsolidated affiliates for the three months ended March 31, 2021 remained relatively consistent with the same period in the prior year.
Net Income Attributable to Non-controlling Interests
Three Months Ended March 31,
(in millions)20212020
Net income attributable to non-controlling interests$(5)$(9)
Net income attributable to non-controlling interests included Quest Diagnostics Incorporated’s interest in Q2 Solutions. On April 1, 2021 the Company acquired the 40% non-controlling interest in Q2 Solutions from Quest Diagnostics Incorporated which will result in a decrease in the net income attributable to non-controlling interests in future periods. See Note 14 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding this transaction.

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Segment Results of Operations
The Company’s revenues and profit by segment are as follows:
Three Months Ended March 31, 2021 and 2020
Segment RevenuesSegment Profit
(in millions)2021202020212020
Technology & Analytics Solutions$1,348 $1,117 $349 $268 
Research & Development Solutions1,868 1,441 362 268 
Contract Sales & Medical Solutions193 196 20 11 
Total3,409 2,754 731 547 
General corporate and unallocated(57)(24)
Depreciation and amortization(323)(316)
Restructuring costs(9)(14)
Consolidated$3,409 $2,754 $342 $193 
 
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 related to integration activities and acquisitions. We also do not allocate depreciation and amortization or impairment charges to our segments.
Technology & Analytics Solutions
Three Months Ended March 31,Change
(in millions)20212020$%
Revenues$1,348 $1,117 $231 20.7 
Costs of revenue, exclusive of depreciation and amortization812 666 146 21.9 
Selling, general and administrative expenses187 183 2.2 
Segment profit$349 $268 $81 30.2 

Revenues

Technology & Analytics Solutions’ revenues were $1,348 million for the first quarter of 2021, an increase of $231 million, or 20.7%, over the same period in 2020. This increase was comprised of constant currency revenue growth of approximately $191 million, or 17.1%, reflecting revenue growth across all regions. The revenue growth in these regions was driven by higher real-world and analytical services and COVID-19 related work.
Costs of Revenue, exclusive of Depreciation and Amortization
Technology & Analytics Solutions’ costs of revenue increased $146 million, or 21.9%, in the first quarter of 2021 over the same period in 2020. This increase included a constant currency increase of approximately $119 million, or 17.9%, reflecting an increase in compensation and related expenses to support revenue growth.
Selling, General and Administrative Expenses
Technology & Analytics Solutions’ selling, general and administrative expenses increased $4 million, or 2.2%, in the first quarter of 2021 as compared to the same period in 2020, which included a constant currency decrease of approximately $1 million, or (0.5)%, reflecting the impact of on-going cost containment actions.
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Research & Development Solutions
Three Months Ended March 31,Change
(in millions)
20212020
$
%
Revenues
$1,868 $1,441 $427 29.6 
Costs of revenue, exclusive of depreciation and amortization
1,321 988 333 33.7 
Selling, general and administrative expenses
185 185 — — 
Segment profit
$362 $268 $94 35.1 

Backlog
Research & Development Solutions’ contracted backlog increased from $22.6 billion as of December 31, 2020 to $23.2 billion as of March 31, 2021 and we expect approximately $6.5 billion of this backlog to convert to revenue in the next twelve months.
Revenues
Research & Development Solutions’ revenues were $1,868 million in the first quarter of 2021, an increase of $427 million, or 29.6%, over the same period in 2020. This increase was comprised of constant currency revenue increase of approximately $405 million, or 28.1%, reflecting volume-related increases in clinical services and lab testing, including incremental revenue from large COVID-19 vaccine clinical trials.
Costs of Revenue, exclusive of Depreciation and Amortization
Research & Development Solutions’ costs of revenue increased $333 million, or 33.7%, in the first quarter of 2021 over the same period in 2020. This increase included a constant currency increase of approximately $305 million, or 30.9%, reflecting an increase in compensation and related expenses as a result of volume-related increases in clinical services and lab testing.
Selling, General and Administrative Expenses
Research & Development Solutions’ selling, general and administrative expenses remained flat in the first quarter of 2021 as compared to the same period in 2020, and included a constant currency decrease of approximately $3 million, or (1.6)%.
Contract Sales & Medical Solutions
Three Months Ended March 31,
Change
(in millions)
20212020
$
%
Revenues
$193 $196 $(3)(1.5)
Costs of revenue, exclusive of depreciation and amortization
160 170 (10)(5.9)
Selling, general and administrative expenses
13 15 (2)(13.3)
Segment profit
$20 $11 $81.8 

Revenues

Contract Sales & Medical Solutions’ revenues were $193 million in the first quarter of 2021, a decrease of $3 million, or (1.5)%, over the same period in 2020. This decrease included a constant currency revenue decrease of approximately $8 million, or (4.1)%, reflecting a volume decrease in the Americas region, partially offset by a volume increase in the Asia-Pacific region.

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Costs of Revenue, exclusive of Depreciation and Amortization
Contract Sales & Medical Solutions’ costs of revenue decreased $10 million, or (5.9)%, in the first quarter of 2021 as compared to the same period in 2020. This decrease included a constant currency decrease of approximately $14 million, or (8.2)%, reflecting a decrease in compensation and related expenses as a result of reduced volume in the Americas region.
Selling, General and Administrative Expenses
Contract Sales & Medical Solutions’ selling, general and administrative expenses decreased $2 million, or (13.3)%, in the first quarter of 2021 as compared to the same period in 2020. This decrease included a constant currency decrease of approximately $2 million, or (13.3)%, 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 and other credit 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 $2,305 million as of March 31, 2021 ($933 million of which was in the United States), an increase from $1,814 million as of December 31, 2020.

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 and other credit facilities will enable us to fund our operating requirements and capital expenditures 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 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.
On April 1, 2021 the Company acquired the 40% non-controlling interest in Q2 Solutions from Quest Diagnostics Incorporated for $760 million, financed with cash on hand. See Note 14 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding this transaction.
Equity Repurchase Program

During the three months ended March 31, 2021, we repurchased 265,809 shares of our common stock for $50.5 million under the Repurchase Program. See Note 8 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding the Repurchase Program.
As of March 31, 2021, we have remaining authorization to repurchase up to approximately $0.9 billion of our common stock under the Repurchase Program. 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.
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Debt
Senior Notes
On March 3, 2021, we completed the issuance and sale of €1,450,000,000 in gross proceeds of the Issuer's (i) €550,000,000 aggregate principal amount of its 1.750% Senior Notes due 2026 (the “2026 Notes”) and (ii) €900,000,000 aggregate principal amount of its 2.250% Senior Notes due 2029 (the “2029 Notes” and, together with the 2026 Notes, the “Notes”). The proceeds from the Notes offering were used to redeem all of the Issuer’s outstanding 3.250% senior notes due 2025 (the “3.250% Notes”), including the payment of premiums in respect thereof and to pay fees and expenses related to the Notes offering. See Note 7 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding our credit arrangements.
As of March 31, 2021, we had $12.3 billion of total indebtedness, excluding $1.5 billion of additional available borrowings under our revolving credit facility.
Our long-term debt arrangements contain customary restrictive covenants and, as of March 31, 2021, we believe we were in compliance with our restrictive covenants in all material respects.
Three months ended March 31, 2021 and 2020
Cash Flow from Operating Activities
Three Months Ended March 31,
(in millions)20212020
Net cash provided by operating activities$867 $163 

Cash provided by operating activities increased $704 million during the first three months of 2021 as compared to the same period in 2020. The increase was primarily due to an increase in cash collections from clients resulting in a decrease in accounts receivable and unbilled services ($132 million), an increase in unearned income ($294 million), higher cash related net income ($165 million) and higher cash from other operating assets and liabilities ($113 million).
Cash Flow from Investing Activities
Three Months Ended March 31,
(in millions)20212020
Net cash used in investing activities$(176)$(150)
Cash used in investing activities increased $26 million during the first three months of 2021 as compared to the same period in 2020 primarily driven by lower payments received from unconsolidated affiliates ($18 million) and increased cash used for the purchase of property and equipment ($8 million).
Cash Flow from Financing Activities
Three Months Ended March 31,
(in millions)20212020
Net cash (used in) provided by financing activities$(168)$107 
Cash used in financing activities increased $275 million during the first three months of 2021 as compared to the same period in 2020 primarily due to a decrease in cash provided by proceeds from debt issuances, net of repayments and debt issuance costs ($803 million) and an increase in cash payments related to employee stock option plans ($15 million), offset by a decrease in cash used in repayments of revolving credit facilities, net of proceeds ($260 million), and a decrease in cash used to repurchase common stock ($283 million).
Off-Balance Sheet Arrangements
We do not have any off-balance sheet arrangements.
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Contractual Obligations and Commitments
We have various contractual obligations, which are recorded as liabilities in our consolidated financial statements.
With the exception of new senior notes disclosed in Note 7 to the condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q, there have been no material changes, outside of the ordinary course of business, to our contractual obligations as previously disclosed in our 2020 Form 10-K.
Application of Critical Accounting Policies
There have been no material changes to our critical accounting policies as previously disclosed in our 2020 Form 10-K.
Item 3. Quantitative and Qualitative Disclosures About Market Risk
There have been no material changes to our quantitative and qualitative disclosures about market risk as compared to the quantitative and qualitative disclosures about market risk described in our 2020 Form 10-K.
Item 4. Controls and Procedures
Evaluation of Disclosure Controls and Procedures
Our management, with the participation of our Chief Executive Officer (“CEO”) and Chief Financial Officer (“CFO”), has evaluated the effectiveness of our disclosure controls and procedures (as defined in Rules 13a-15(e) and 15d-15(e)) under the Securities Exchange Act of 1934, as amended (“Exchange Act”) as of the end of the period covered by this Quarterly Report on Form 10-Q. Based on such evaluation, our CEO and CFO have concluded that as of such date, our disclosure controls and procedures were effective.
Changes in Internal Control over Financial Reporting
There were no changes in our internal control over financial reporting identified in management’s evaluation pursuant to Rules 13a-15(d) or 15d-15(d) of the Exchange Act during the period covered by this Quarterly Report on Form 10-Q that materially affected, or are reasonably likely to materially affect, our internal control over financial reporting.
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PART II—OTHER INFORMATION
Item 1. Legal Proceedings
We are party to legal proceedings incidental to our business. While the outcome of these matters could differ from management’s expectations, we do not believe that the resolution of these matters is reasonably likely to have a material adverse effect to our financial statements.
Item 1A. Risk Factors

For a discussion of the risks relating to our business, see Part I—Item 1A—“Risk Factors” of our 2020 Form 10-K. There have been no material changes from the risk factors previously disclosed in our 2020 Form 10-K.
Item 2. Unregistered Sales of Equity Securities and Use of Proceeds
Recent Sales of Unregistered Securities
Not applicable.
Use of Proceeds from Registered Securities
Not applicable.
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 March 31, 2021, we have repurchased a total of $6.4 billion of our securities under the Repurchase Program.

During the three months ended March 31, 2021, we repurchased 265,809 shares of our common stock for $50.5 million under the Repurchase Program. See Note 8 to our condensed consolidated financial statements included elsewhere in this Quarterly Report on Form 10-Q for additional details regarding the Repurchase Program.
As of March 31, 2021, we have remaining authorization to repurchase up to approximately $0.9 billion of our common stock under the Repurchase Program.
Since the merger between Quintiles and IMS Health, we have repurchased 65.9 million shares of our common stock at an average market price per share of $97.66 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.
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The following table summarizes the monthly equity repurchase program activity for the three months ended March 31, 2021 and the approximate dollar value of shares that may yet be purchased pursuant to the Repurchase Program.
(in millions, except per share data)Total Number of Shares PurchasedAverage Price Paid Per ShareTotal Number of Shares Purchased as Part of Publicly Announced Plans or ProgramsApproximate Dollar Value of Shares That May Yet Be Purchased Under the Plans or Programs
January 1, 2021 — January 31, 2021— — — $918 
February 1, 2021 — February 28, 2021— — — $918 
March 1, 2021 — March 31, 20210.3 189.95 0.3 $867 
0.3 0.3 

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Item 6. Exhibits
The exhibits below are filed or furnished as a part of this report and are incorporated herein by reference.
Incorporated by Reference
Exhibit
Number
Exhibit DescriptionFiled
Herewith
FormFile No.ExhibitFiling Date
3.18-K001-359073.1April 16, 2021
4.18-K001-359074.1March 3, 2021
31.1X
31.2X
32.1X
32.2X
101Interactive Data Files Pursuant to Rule 405 of Regulation S-T: (i) Condensed Consolidated Statements of Income (unaudited), (ii) Condensed Consolidated Statements of Comprehensive Income (unaudited), (iii) Condensed Consolidated Balance Sheets (unaudited), (iv) Condensed Consolidated Statements of Cash Flows (unaudited), (v) Condensed Consolidated Statements of Stockholders’ Equity (unaudited) and (vi) Notes to Condensed Consolidated Financial Statements (unaudited). The instance document does not appear in the Interactive Data File because its XBRL tags are embedded within the Inline XBRL document.X
104Cover 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

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SIGNATURES
Pursuant to the requirements of the Securities Exchange Act of 1934, the Registrant has duly caused this Quarterly Report on Form 10-Q to be signed on its behalf by the undersigned, thereunto duly authorized on April 23, 2021.
IQVIA HOLDINGS INC.
/s/ Ronald E. Bruehlman
Ronald E. Bruehlman
Executive Vice President and Chief Financial Officer
(On behalf of the Registrant and as Principal Financial Officer)

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