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Text: Some of these factors are set forth in detail in our most recent annual report on Form 10-K and subsequent quarterly reports on Form 10-Q and in the company's other filings with the SEC.
At Labcorp, we continue to leverage innovation, science and technology to accelerate our strategy as we work to improve health and improve lives around the world.
We serve as a trusted source of health information that helps customers advance healthcare and guide medical decisions.
At the same time, we've remained focused on helping the world through the pandemic.
In the third quarter, we delivered strong results.
Revenue totaled $4.1 billion, adjusted earnings per share reached $6.82, and free cash flow was $650 million.
As a result of our strong performance and our improved outlook, we're raising full year guidance for revenue, adjusted earnings per share and free cash flow.
Glenn will cover those in more detail in a few minutes.
The Base Business for both Diagnostics and Drug Development performed well with 10% and 22% growth, respectively.
We saw consistent recovery across both businesses.
In Diagnostics, we experienced broad geographic recovery in our Base Business and across our testing portfolio.
Esoteric and routine testing demonstrated solid year-over-year growth for the quarter.
The trailing 12-month net book-to-bill for Drug Development remains strong at 1.34.
Drug Development continues to recover with nearly 85% of sites now open.
The business also saw decentralized trials increasing by more than 50% versus prior year.
Now I'd like to turn to our ongoing role in the pandemic response.
Labcorp continues to support the fight against the pandemic in every way possible through both our diagnostic and our drug development capabilities.
We experienced greater-than-anticipated COVID testing volumes in the quarter, although levels were below the same period last year.
Time to results for COVID test remains an average of one to two days, with results typically available within one day.
PCR testing volume averaged 85,000 per day in the quarter, up from 54,000 per day in the second quarter.
We averaged 114,000 tests per day in September, with volumes declining week-over-week since that time.
We will continue to break out COVID testing from Base Business revenue and volume as it remains difficult to forecast.
We will also continue to maintain high capacity levels to be prepared for potential future scenarios.
We also had another successful quarter of bringing new innovations to market.
Notably, we recently received Emergency Use Authorization for a combined COVID and flu-at-home collection kit.
With flu season upon us, the kit offers a convenient way to test for both viruses.
This new offering will be available for adults and children ages two and over and no upfront cost for those who meet clinical guidelines.
In addition, we collaborated with AstraZeneca on both a COVID prevention and treatment trial of its new long-acting antibody combination.
In the trial, the investigational antibody combination demonstrated statistically significant benefit in preventing symptomatic COVID and in reducing severe COVID or death in outpatients with mild to moderate COVID, promising milestones in the development of new treatments.
Also earlier this month, Merck filed for FDA Emergency Use Authorization for its investigational oral antiviral medicine for the treatment of mild to moderate COVID in at-risk adults, a treatment that we supported through Phase I, Phase II and Phase III clinical trials.
I'll now discuss progress on our strategy, and I'll start with oncology.
The OmniSeq integration is going as planned, and their leading pan-cancer diagnostic capabilities extend our portfolio of solutions in this area.
Additionally, we launched clonoSEQ, the first and only FDA-cleared test for monitoring residual blood cancer.
As part of our efforts to address healthy equity -- health equity issues, we recently partnered with the Community Clinical Oncology Research Network to assess social and economic impacts of cancer care disparities.
And we also recently began work with Pillar Biosciences to enhance our next-generation sequencing and plan to offer a specialty oncology assay.
During the quarter, we advanced our commitment to intensifying our customer focus and embedding technology and data throughout our business.
We acquired Ovia Health, a leading digital platform trusted by millions of women for family planning, pregnancy and parenting support.
Ovia Health extends our position as a go-to source for women's health insights through our deep expertise in diagnostic, genetic and specialty testing.
Additionally, we are working with several organizations to begin deploying Labcorp Diagnostic Assistant, which delivers comprehensive lab results and clinical insights directly to the point of care.
We're also using technology to improve health for low-income individuals and families.
We partnered with Medical Home Network to incorporate lab testing results into the records of Medicaid safety net patients.
And lastly, through a collaboration with Medidata, we are utilizing digital biomarkers with drug, vaccine and device trials to enhance our decentralized clinical trialing offers.
Pursuing opportunities with long-term, high-growth potential remains a focus.
Our recent acquisitions, including OmniSeq, Myriad's Vectra test for rheumatoid arthritis and Ovia Health advance our position in key growth markets.
Our M&A pipeline remains robust.
We expect continued activity on this front for the balance of fourth quarter and into the first quarter of 2022.
Importantly, Labcorp continues to be recognized for the significant work we do.
Just this month, we were named by Forbes as one of the world's best employers in 2021.
In addition, Informa Pharma Intelligence selected Labcorp as a finalist for Best Contract Research Organization of the Year.
Lastly, I'd like to provide a brief update on the Board and management team's ongoing assessment of the company's structure and capital allocation strategy.
We remain committed to ensuring Labcorp is best positioned to unlock shareholder value while offering patients and customers the support that they've come to expect.
Working closely with our advisors, we have made significant progress on assessing both our capital allocation and our structure.
And as previously shared, we expect to update you on our conclusions in this quarter.
To summarize, our Base Business in both Diagnostics and Drug Development had a strong third quarter and is well positioned for continued success.
We remain dedicated to the fight against COVID, all while delivering on our strategy and carrying out our mission.
I'm excited by the progress we've made and for what lies ahead.
With that, Glenn will take you through the details of our third quarter results.
I'm going to start my comments with a review of our third quarter results, followed by a discussion of our performance in each segment and conclude with an update on our full year guidance.
Revenue for the quarter was $4.1 billion, an increase of 4.3% over last year due to organic growth of 3.4%, acquisitions of 0.4% and favorable foreign currency translation of 50 basis points.
The 3.4% increase in organic revenue is driven by a 10.2% increase in the company's organic Base business partially offset by a 6.8% decrease in COVID testing.
Operating income for the quarter was $767 million or 18.9% of revenue.
During the quarter, we had $92 million of amortization and $48 million of restructuring charges and special items.
Excluding these items, adjusted operating income in the quarter was $907 million or 22.3% of revenue compared to $1.2 billion or 29.7% last year.
The decrease in adjusted operating income and margin was due to a reduction in COVID testing as well as higher personnel costs resulting from increased Base Business demand and a tight labor market as the company continues to invest in its workforce.
Partially offsetting these headwinds were the benefit from organic Base Business growth and LaunchPad savings.
The tax rate for the quarter was 23.5%.
The adjusted tax rate, excluding restructuring charges, special items and amortization, was 24.4% compared to 25.7% last year.
The lower adjusted rate was primarily due to the geographic mix of earnings.
We continue to expect our full year adjusted tax rate to be approximately 25%.
Net earnings for the quarter were $587 million or $6.05 per diluted share.
Adjusted EPS, which exclude amortization, restructuring charges and special items, were $6.82 in the quarter, down from $8.41 last year.
Operating cash flow was $767 million in the quarter compared to $786 million a year ago.
The decrease in operating cash flow was due to lower cash earnings partially offset by favorable working capital.
Capital expenditures totaled $118 million or 2.9% of revenue compared to $77 million or 2% of revenue last year.
As a result, free cash flow was $650 million in the quarter compared to $709 million last year.
During the quarter, we used $300 million of our cash flow for our share repurchase program and invested $292 million on acquisitions.
Now I'll review our segment performance, beginning with Diagnostics.
Revenue for the quarter was $2.6 billion, a decrease of 3.2% compared to last year due to organic revenue being down 3.9%, partially offset by acquisitions of 0.4% and favorable foreign currency translation of 30 basis points.
The decrease in organic revenue was due to a 9.7% reduction from COVID testing partially offset by a 5.8% increase in the Base Business.
Relative to the third quarter of 2019, the compound annual growth rate for Base Business revenue was 4.7%, primarily due to organic growth.
Total volume increased 0.2% over last year as acquisition volume contributed 0.2% and organic volume decreased by 0.1%.
The decrease in organic volume was due to a 5.9% decrease in COVID testing partially offset by a 5.9% increase in the Base Business.
As a reminder, we do not include hospital lab management agreements in our volume, which would have added approximately 1.1% to our organic Base Business volume growth.
Price/mix decreased 3.4% versus last year due to lower COVID testing of 3.8% partially offset by currency of 0.3% and acquisitions of 0.2%.
Diagnostics organic Base Business revenue growth was 9% compared to its Base Business last year, with 7.7% coming from volume and 1.3% coming from price/mix, which was primarily due to an increase in test per session.
Diagnostics adjusted operating income for the quarter was $775 million or 29.6% of revenue compared to $1 billion or 37.1% last year.
The decrease in adjusted operating income and margin was primarily due to a reduction of COVID testing and higher personnel costs partially offset by organic Base Business growth and LaunchPad savings.
Relative to the third quarter of 2019, Base Business margins were down slightly due to the negative impact from PAMA.
Diagnostics three year LaunchPad initiative remains on track to deliver approximately $200 million of net savings by the end of this year.
Now I'll review the performance of Drug Development.
Revenue for the quarter was $1.5 billion, an increase of 17.5% compared to last year due to organic Base Business growth of 19.9%, acquisitions of 0.4% and favorable foreign currency translation of 100 basis points.
This was partially offset by lower COVID testing performed through its central lab business of 3.5% and divestitures of 0.3%.
Drug Development's Base Business benefited from broad-based growth across all businesses, including COVID vaccine and therapeutic work.
Relative to the third quarter of 2019, the compound annual growth rate for Base Business revenue was 11.4% primarily driven by organic growth.
Adjusted operating income for the segment was $226 million or 15.5% of revenue compared to $210 million or 16.9% last year.
The increase in adjusted operating income was primarily due to organic Base Business growth and LaunchPad savings partially offset by lower COVID testing and higher personnel costs.
The decline in adjusted operating margin was due to lower COVID testing.
Excluding the impact from COVID testing, operating margins would have been up compared to last year.
For comparability to peers, Drug Development earnings exclude $36 million of expense related to the enterprise component of its bonus, which is included in unallocated corporate expense.
We expect full year margins to be up over 2020, which were up over 2019.
For the trailing 12 months, net orders and net book-to-bill remained strong at $7.8 billion and 1.34, respectively.
During the quarter, orders were negatively impacted by approximately $150 million due to a significant scope change, which decreased the book-to-bill.
Backlog at the end of the quarter was $14.4 billion, an increase of 15.4% compared to last year.
We expect approximately $4.9 billion of this backlog to convert into revenue over the next 12 months.
Now I'll discuss our 2021 full year guidance, which assumes foreign exchange rates effective as of September 30, 2021, for the remainder of the year.
We are raising our full year guidance to reflect the company's strong third quarter performance and improved outlook for the remainder of the year.
We expect enterprise revenue to grow 13% to 14% from prior guidance of 6.5% to 9%.
This includes the benefit from foreign currency translation of 90 basis points.
This guidance range also includes the expectation that the Base Business will grow 18.5% to 19.5%, while COVID testing is expected to be down 11% to down 6%.
We are raising our expectations for revenue to grow in Diagnostics by 8% to 10% from prior guidance of minus 1% to plus 2%.
This guidance range includes the expectation that the Base Business will grow 16% to 17%, while COVID testing revenue is expected to be down 11% to down 6%.
We're also raising our growth expectations for revenue in Drug Development to 19.5% to 20.5% from prior guidance of 17% to 19%.
Our current guidance includes the benefit from foreign currency translation of 170 basis points.
This guidance range also includes the expectation that the Base Business will grow 21.5% to 22.5%.
Given the improved top line growth expectations, we are raising our adjusted earnings per share guidance to $26 to $28, up from prior guidance of $21.5 to $25.
Free cash flow is now expected to be between $2.45 billion to $2.6 billion, up from prior guidance of $1.95 billion to $2.15 billion.
For additional comparison purposes, we've also included in the supplemental deck on our Investor Relations website a view of 2021 third quarter results and full year guidance compared to 2019 results.
In summary, the company had another quarter of strong performance.
We remain focused on performing a critical role in response to the global pandemic while also growing our Base Business.
We expect to drive continued profitable growth in our Base Business, while COVID testing volumes are expected to decline through the remainder of the year.
We expect to continue to use our free cash flow generation for acquisitions that supplement our organic growth while also returning capital to shareholders through our share repurchase programs.
Operator, we will now take questions.

user
q3 earnings per share $6.05.
q3 adjusted earnings per share $6.82.
q3 revenue $4.1 billion.
revenue: q3 of $4.1 billion, versus $3.9 billion last year.
company raises full-year guidance.
qtrly diagnostics revenue for quarter was $2.62 billion, a decrease of (3.2%).
drug development revenue for quarter was $1.46 billion, an increase of 17.5% over $1.24 billion in q3 of 2020.
qtrly drug development revenue was $1.46 billion, an increase of 17.5%.
diluted eps: q3 of $6.05, versus $7.17 last year.

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