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Text: And as a result of this performance and an improved outlook for the rest of the year, we have once again raised our guidance.
The 2021 guidance that we provided you last quarter was already within reach of our original pre-COVID plans for 2021.
Our revised guidance today significantly exceeds those original plans.
In many ways 2020 was a reset year for our company and also for the industry.
We've been saying for a long time that the traditional timelines for the development of new drugs are too long.
The speed at which COVID vaccines were developed in 2020 has obviously raised the bar in terms of what expectation should be.
The crisis accelerated the adoption of new technologies and we believe it will force a lasting change in how innovative medicines are developed and commercialized.
All of these has made IQVIA even more relevant to our clients and has highlighted the power of our differentiated offerings.
The deep client engagements that we had during the pandemic demonstrated how uniquely positioned we are to bring new insights and expertise that can improve drug development and commercial timelines.
What is also becoming clear is that there is a lot of pent-up demand due to one, the many trials that were slowed down or temporarily pushed to the right.
And two the trials that did not get started as they were crowded out by the COVID resolution efforts on which everyone was focused.
This pent-up demand across therapy areas combined with record levels of biotech funding provide a very strong backdrop for our industry.
As a result of these favorable conditions we started the process of revisiting our vision 2022 goals.
We plan to update you later this year on our vision '22 progress and lay the groundwork for the next phase of our journey.
We may do this at an investor conference later this year, especially if we are able to hold one in person, so stay tuned for more information.
So now, let's review the quarter.
Revenue for the first quarter grew 24% on a reported basis and 21% at constant currency was $209 million above the high end of our guidance range, but about half of this beat came from strong operational performance and half was from higher pass-throughs.
First quarter adjusted EBITDA grew 32%, reflecting our revenue growth and productivity measures.
The $69 million beat above the high end of our guidance range was entirely due to the stronger organic revenue performance.
First quarter adjusted diluted earnings per share of $2.18 grew 45%.
The beat here entirely reflect the adjusted EBITDA drop-through.
A little bit more color on the business.
Our commercial technology presence continues to grow as we launch new offerings in the market.
During the quarter, a top 10 pharma client deployed our next best action solution in 14 countries.
This tool is a SaaS-based technology platform that optimizes our client's sales force effectiveness.
It increases the success of their marketing activities by providing automated sales call recommendations to the field based on advanced artificial intelligence and machine learning algorithms.
Our base OCM -- CRM win rates remain strong.
We added another 10 new clients this quarter and now have 150 clients deploying about 70,000 users.
Our eCOA technology platform or Electronic Clinical Outcomes Assessment tool, which is used by our real world as well as R&DS team is also experiencing strong demand.
This cloud-based platform utilizes a user-friendly interface to collect clinical data directly from patients.
We launched this solution during 2019 and the team is seeing strong user acceptance.
To-date, we've been awarded over 125 studies with over 300,000 patients enrolled and over 4 million surveys completed.
Moving now to R&DS.
We continue to build on our strong bookings momentum in our R&DS business.
In the first quarter, we achieved a contracted net book-to-bill ratio of 1.41, including pass-throughs and 1.41 excluding pass-throughs.
At March 31st, our LTM contracted book-to-bill ratio was 1.52 including pass-throughs and 1.45 excluding pass-throughs.
These numbers are although more impressive, obviously, given our strong revenue growth.
Our contracted backlog in R&DS including pass-throughs grew 18.3% year-over-year to $23.2 billion at March 31, 2021.
As a result, our next 12 months revenue from backlog increased by over $600 million sequentially to $6.5 billion, that's up 31.1% year-over-year.
The R&D team is building on the success we experienced in 2020 with our hybrid virtual trial offering or the term what is now decentralized trials.
In the first quarter we won decentralized trials in new therapeutic areas, including cardiovascular and metabolic disorders.
We are working with 5 of the top 10 pharma client and to-date we've recruited almost 170,000 patients using our advanced decentralized trial solutions.
Finally, you saw that on April 1, we completed the acquisition of the remaining interest in Q Squared Solutions from Quest Diagnostics.
As you know Q Squared is an industry-leading laboratory service provider for clinical trials with global capabilities across safety, bioanalytical, vaccine, genomics, and bioanalytical testing along with best-in-class technology in bio specimen and consent lifecycle management.
This transaction streamline strategic decision making for us and gives us the flexibility to build out greater bioanalytical, genomic and biomarker capability, as we see increased attractive growth opportunities in this expanding market.
As already mentioned, this was a very strong quarter.
We'd start first by giving you some more detail on revenue.
First quarter revenue of $3,409 million grew 23.8% on a reported basis.
Analytics Solutions revenue for the first quarter was $1,348 million, which was up 20.7% reported and 17.1% at constant currency.
R&D Solutions first quarter revenue of $1,868 million improved 29.6% at actual FX rates, and 28.1% at constant currency.
Pass-through revenues were a tailwind of 770 basis points to the R&DS revenue growth rate in the quarter.
CSMS revenue of $193 million was down 1.5% reported and 4.1% on a constant currency basis.
Moving down to P&L, adjusted EBITDA was $744 million for the quarter.
Margins expanded 140 basis points despite significant headwinds from higher pass-through revenue and lower margin COVID work.
GAAP net income was $212 million and GAAP diluted earnings per share were $1.09.
Adjusted net income was $425 million for the first quarter and adjusted diluted earnings per share grew 45.3% between [Technical Issues] $2.18.
R&D Solutions delivered another exceptional quarter of net new business.
Backlog was up 18.3% year-over-year to $23.2 billion at March 31.
Next 12 months revenue as Ari mentioned from backlog grew significantly and currently stands at $6.5 billion, up 31.1% year-over-year.
And of course this metric now includes the first quarter of 2022, which is a further indication that we see the momentum of the business continuing beyond this year.
Now let's review the balance sheet.
At March 31, cash and cash equivalents totaled $2.3 billion and debt was $12.2 billion, resulting in net debt of $9.9 billion.
Our net leverage ratio at March 31 improved to 3.9 times trailing 12 month adjusted EBITDA, marking the first time since just following the merger that this ratio was below 4 times.
And this is particularly noteworthy, you may recall that in 2019, when we gave you our three year guidance, we committed to delever to 4 turns or below exiting 2022.
We're pleased to have achieved this target entering 2021.
First quarter cash flow, free cash flow in particular was very strong.
Cash flow from operations was $867 million, capex was $149 million, resulting in free cash flow of $718 million.
We repurchased $50 million of our shares in the quarter, which leaves us with $867 million of share repurchase authorization remaining under the program.
Now let's turn to guidance.
You'll recall that back on April 1, when we announced the acquisition of Quest 40% interest in our Q Squared joint venture, we raised our 2021 earnings per share guidance by $0.12 to reflect the elimination of Quest minority interest in the joint venture's earnings.
We wrapped revenue and adjusted EBITDA guidance unchanged, of course because we already consolidated the -- or consolidated the financial of the joint venture prior to the transaction.
Well, today we're revising our guidance upward again as follows.
We're raising our full-year 2021 revenue guidance, both at the low and high end of that range, resulting in an increase of $625 million at the midpoint of the range.
The new revenue guidance is $13,200 million to $13,500 million, which represents year-over-year growth of 16.2% to 18.8%.
This increased guidance range reflects the first quarter strength and the continued operational momentum that we see in the business.
And also absorbed an FX headwind versus our previous guidance.
Now compared to the prior year, FX is expected to be a tailwind of about 150 basis point to full-year revenue growth.
From segment perspective, we now expect full year Technology & Analytics Solutions revenue to grow at a low to mid-teens percentage rate and R&D Solutions to grow in the low to mid-20s.
Our previous expectation that revenue in the CSMS business would be slightly down, remains unchanged.
We're also raising our full-year profit guidance as a result of stronger revenue outlook, we've increased it, increased adjusted EBITDA guidance at both the low and high end of the range, resulting in an increase of $133 million at the midpoint.
Our new full-year guidance is $2,900 million to $2,965 million, which represents year-over-year growth at 21.6% to 24.4%.
Moving to EPS, I mentioned Q Squared transaction on April 1, as a result of that, we raised our adjusted diluted earnings per share guidance by $0.12 to a new range of $7.89 to $8.20.
We're now raising both the low and the high end of that guidance range, resulting in a new adjusted diluted earnings per share guidance of $8.50 to $8.75 or year-over-year growth of 32.4% to 36.3%.
Moving to detail on P&L, interest expense is expected to be approximately $400 million for the year, operational depreciation and amortization is still expected to be somewhat over $400 million and we're continuing to assume an effective tax rate of approximately 20% for the full year.
This guidance assumes that current foreign currency exchange rates remain in effect for the rest of the year.
Now let's turn to the second quarter guidance, assuming FX rates remain constant through the end of the quarter, second quarter revenue is expected to be between $3,225 million and $3,300 million, which represents reported growth of 27.9% to 30.9%.
Adjusted EBITDA is expected to be between $690 million and $715 million, which represents reported growth of 42.9% to 48%.
And finally, adjusted diluted earnings per share is expected to be between $2 and $2.10, up 69.5% to 78%.
So to summarize, we delivered very strong first quarter results, once again reporting double-digit growth in all key financial metrics.
This included revenue growth of over 20% in both our TAS and R&DS segment.
R&DS backlog improved to $23.2 billion, up 18% year-over-year.
Next 12 months revenue from that backlog increased to $6.5 billion, up 31% year-over-year.
Free cash flow was strong again this quarter.
Net leverage improved to 3.9 times trailing 12 month adjusted EBITDA.
And finally, given the strong momentum we see in the business, we are once again raising our full year guidance for revenue, adjusted EBITDA and adjusted diluted EPS.
Before we open up the call up for Q&A, I'd like to make you aware of a couple of leadership changes within IQVIA finance organization.
Andrew Markwick, who has led Investor Relations function for the past four years very capably, I think you'll agree, is moving on to become, CFO of the R&DS unit.
Nick Childs, who currently runs our Corporate FP&A function will take-over as SVP of Investor Relations and Corporate Communications.
Nick has been in his role for over three years and has a very deep knowledge of the company and our financials.
He will be succeeded by Mike Fedock who has served as CFO of the R&DS unit for the past few years.
Finally those of you on the fixed income side know that Andrew who has also served as our Treasurer for the past couple of years and Manny Korakis who is our Corporate Controller will also assume leadership of the Treasury function going forward.
And with that, let me hand it back over to Casey, who will open the call for Q&A.

user
q1 adjusted earnings per share $2.18.
q1 gaap earnings per share $1.09.
q1 revenue rose 23.8 percent to $3.409 billion.
sees 2021 revenue $13,200 million - $13,500 million.
sees 2021 adjusted diluted earnings per share $8.50 - $8.75.
sees q2 revenue $3,225 million - $3,300 million.
sees q2 adjusted diluted earnings per share $2.00 - $2.10.

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