ICON Public Limited (ICLR) 6-K 29 Apr 22 2022 Q1 Current report (foreign) Financial data

Cover

Cover	3 Months Ended
	Mar. 31, 2022
Cover [Abstract]
Document Type	6-K
Document Fiscal Year Focus	2022
Entity Registrant Name	ICON plc
Amendment Flag	false
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001060955
Current Fiscal Year End Date	--12-31
Document Period End Date	Mar. 31, 2022

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Current Assets:
Cash and cash equivalents	$ 559,098	$ 752,213
Available for sale investments	1,712	1,712
Accounts receivable, net of allowance for credit losses	1,371,409	1,342,770
Unbilled revenue	674,509	623,121
Other receivables	60,233	56,760
Prepayments and other current assets	151,140	114,323
Income taxes receivable	52,245	50,299
Total current assets	2,870,346	2,941,198
Non-current Assets:
Property, plant and equipment, net	322,546	336,444
Goodwill	9,027,983	9,037,931
Intangible assets	4,592,587	4,710,843
Operating right-of-use assets	187,295	198,123
Other receivables	66,310	70,557
Income taxes receivable	13,841	18,637
Deferred tax asset	54,362	48,392
Equity method investments	1,588	2,373
Investments in equity- long term	25,996	22,592
Total Assets	17,162,854	17,387,090
Current Liabilities:
Accounts payable	63,508	90,764
Unearned revenue	1,300,980	1,323,961
Other liabilities	1,081,150	949,629
Income taxes payable	40,644	59,433
Current bank credit lines and loan facilities	55,150	55,150
Total current liabilities	2,541,432	2,478,937
Non-current Liabilities:
Non-current bank credit lines and loan facilities	5,086,943	5,381,162
Lease liabilities	154,345	159,483
Non-current other liabilities	38,170	42,596
Non-current income taxes payable	214,748	172,109
Deferred tax liability	1,057,899	1,085,976
Commitments and contingencies	0	0
Total Liabilities	9,093,537	9,320,263
Shareholders' Equity:
Ordinary shares, par value 6 euro cents per share; 100,000,000 shares authorized, 81,293,012 shares issued and outstanding at March 31, 2022 and 81,554,683 shares issued and outstanding at December 31, 2021	6,622	6,640
Additional paid-in capital	6,760,238	6,733,910
Other undenominated capital	1,162	1,134
Accumulated other comprehensive loss	(126,755)	(90,937)
Retained earnings	1,428,050	1,416,080
Total Shareholders' Equity	8,069,317	8,066,827
Total Liabilities and Shareholders' Equity	$ 17,162,854	$ 17,387,090

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - € / shares	Mar. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Ordinary shares, par value (in EUR cents per share)	€ 0.06	€ 0.06
Ordinary shares, shares authorized (in shares)	100,000,000	100,000,000
Ordinary shares, shares issued (in shares)	81,293,012	81,554,683
Ordinary shares, shares outstanding (in shares)	81,293,012	81,554,683

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF OPERATIONS (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Income Statement [Abstract]
Revenue	$ 1,901,764	$ 858,198
Costs and expenses:
Direct costs (excluding depreciation and amortization)	1,378,467	626,244
Selling, general and administrative expense	195,261	86,034
Depreciation and amortization	141,405	17,405
Transaction and integration-related expenses	12,085	12,501
Restructuring	4,207	0
Total costs and expenses	1,731,425	742,184
Income from operations	170,339	116,014
Interest income	127	257
Interest expense	(44,425)	(2,727)
Income before provision for income taxes	126,041	113,544
Provision for income taxes	(13,286)	(16,148)
Income before share of earnings from equity method investments	112,755	97,396
Share of losses in equity method investments	(785)	(274)
Net income attributable to the Group	$ 111,970	$ 97,122
Net income per Ordinary Share attributable to the Group (note 14):
Basic (in USD per share)	$ 1.37	$ 1.84
Diluted (in USD per share)	$ 1.36	$ 1.82
Weighted average number of Ordinary Shares outstanding (note 14):
Basic (in shares)	81,463,303	52,811,460
Diluted (in shares)	82,613,098	53,310,453

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Comprehensive income:
Net income attributable to the group	$ 111,970	$ 97,122
Currency translation adjustment	(35,995)	(19,151)
Currency impact of long term funding (net of tax)	177	(402)
Amortization of interest rate hedge	0	56
Total comprehensive income attributable to the group	$ 76,152	$ 77,625

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF SHAREHOLDERS' EQUITY (UNAUDITED) - USD ($) $ in Thousands	Total	Ordinary shares	Additional Paid-in Capital	Other Undenominated Capital	Accumulated Other Comprehensive Loss	Retained Earnings
Beginning balance (in shares) at Dec. 31, 2020		52,788,093
Beginning balance at Dec. 31, 2020	$ 1,850,236	$ 4,580	$ 617,104	$ 1,134	$ (35,477)	$ 1,262,895
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	97,122					97,122
Issue of restricted share units / performance share units (in shares)		70,097
Issue of restricted share units / performance share units	5	$ 5
Non-cash stock compensation expense	6,310		6,310
Share issuance costs	(5)		(5)
Other comprehensive loss, net of tax	(19,497)				(19,497)
Ending balance (in shares) at Mar. 31, 2021		52,858,190
Ending balance at Mar. 31, 2021	$ 1,934,171	$ 4,585	623,409	1,134	(54,974)	1,360,017
Beginning balance (in shares) at Dec. 31, 2021	81,554,683	81,554,683
Beginning balance at Dec. 31, 2021	$ 8,066,827	$ 6,640	6,733,910	1,134	(90,937)	1,416,080
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	111,970					111,970
Exercise of share options (in shares)		84,090
Exercise of share options	7,497	$ 6	7,491
Issue of restricted share units / performance share units (in shares)		74,769
Issue of restricted share units / performance share units	4	$ 4
Non-cash stock compensation expense	18,840		18,840
Share issuance costs	(3)		(3)
Share repurchase program (in shares)		(420,530)
Share repurchase program	(99,983)	$ (28)		28		(99,983)
Share repurchase costs	(17)					(17)
Other comprehensive loss, net of tax	$ (35,818)				(35,818)
Ending balance (in shares) at Mar. 31, 2022	81,293,012	81,293,012
Ending balance at Mar. 31, 2022	$ 8,069,317	$ 6,622	$ 6,760,238	$ 1,162	$ (126,755)	$ 1,428,050

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (UNAUDITED) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows from operating activities:
Net income	$ 111,970	$ 97,122
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization expense	141,405	19,837
Impairment of long lived assets	3,574	0
Reduction in carrying value of operating right-of-use assets	13,077	4,683
Loss on equity method investments	785	274
Charge on interest rate hedge	0	56
Amortization of financing costs and debt discount	5,781	139
Stock compensation expense	18,903	6,394
Deferred tax benefit	(34,702)	(664)
Unrealized foreign exchange gain	(7,323)	(1,060)
Other non-cash items	(2,895)	(744)
Changes in operating assets and liabilities:
Accounts receivable	(35,461)	52,015
Unbilled revenue	(55,427)	11,796
Unearned revenue	(16,812)	(50,079)
Other net assets	84,041	(27,849)
Net cash provided by operating activities	226,916	111,920
Cash flows from investing activities:
Purchase of property, plant and equipment	(19,632)	(8,704)
Sale/ (purchase) of investments in equity - long term	96	(599)
Net cash used in investing activities	(19,536)	(9,303)
Cash flows from financing activities:
Proceeds from exercise of equity compensation	7,491	5
Share issue costs	(3)	(5)
Repurchase of ordinary shares	(99,983)	0
Share repurchase costs	(17)	0
Repayment of bank credit lines and loan facilities	(300,000)	0
Net cash used in financing activities	(392,512)	0
Effect of exchange rate movements on cash	(7,983)	(467)
Net (decrease)/ increase in cash and cash equivalents	(193,115)	102,150
Cash and cash equivalents at beginning of period	752,213	840,305
Cash and cash equivalents at end of period	$ 559,098	$ 942,455

Basis of presentation

Basis of presentation	3 Months Ended
	Mar. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of presentation	Basis of presentation These condensed consolidated financial statements which have been prepared in accordance with United States Generally Accepted Accounting Principles (“US GAAP”) have not been audited. The condensed consolidated financial statements reflect all adjustments, which are, in the opinion of management, necessary to present a fair statement of the operating results and financial position for the periods presented. The preparation of the condensed consolidated financial statements in conformity with US GAAP requires management to make estimates and assumptions that affect reported amounts and disclosures in the condensed consolidated financial statements. Actual results could differ from those estimates. The condensed consolidated financial statements should be read in conjunction with the accounting policies and notes to the consolidated financial statements included in ICON’s Form 20-F for the year ended December 31, 2021 (see note 2 - Significant accounting policies for impact of adoption of any new accounting standards). Operating results for the three months ended March 31, 2022 are not necessarily indicative of the results that may be expected for the fiscal period ending December 31, 2022. Certain prior period amounts in the consolidated financial statements and accompanying notes have been reclassified to conform to the current period’s presentation. Most notably, the Company has presented transaction and integration-related expenses as a separate line in the Condensed Consolidated Statement of Operations and reclassified certain costs incurred in the three months ended March 31, 2021 within this line. These costs consist of transaction related expenses incurred as part of the Merger. These costs amounted to $12.5 million and were previously presented in the selling, general and administrative expenses but have been reclassified to transaction and integration-related expenses to conform to the current period’s presentation.

Significant accounting policies

Significant accounting policies	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Significant accounting policies	Significant accounting policies Revenue recognition The Company earns revenues by providing a number of different services to its customers. These services, which are integral elements of the clinical development process, include clinical trials management, consulting, contract staffing, data services and laboratory services. Contracts range in duration from a number of months to several years. ASC 606 requires application of five steps: (1) identify the contract(s) with a customer; (2) identify the performance obligation in the contract; (3) determine the transaction price; (4) allocate the transaction price to the performance obligations in the contract; and (5) recognize revenue when (or as) the entity satisfies the performance obligation(s). Clinical trial service revenue A clinical trial service is a single performance obligation satisfied over time, i.e. the full-service obligation in respect of a clinical trial (including those services performed by investigators and other parties) is considered a single performance obligation. Promises offered to the customer are not distinct within the context of the contract. We have concluded that ICON is the contract principal in respect of both direct services and in the use of third parties (principally investigator services) that support the clinical research project. The transaction price is determined by reference to the contract or change order value (total service revenue and pass-through/ reimbursable expenses) adjusted to reflect a realizable contract value. Revenue is recognized as the single performance obligation is satisfied. The progress towards completion for clinical service contracts is measured based on an input measure being total project costs incurred (inclusive of third party costs) at each reporting period as a percentage of forecasted total project costs. Contracting services revenue The Company has availed of the practical expedient which results in recognition of revenue on a right to invoice basis. Application of the practical expedient reflects the right to consideration from the customer in an amount that corresponds directly with the value to the customer of the performance completion to date. This reflects hours performed by contract staff. Consulting services revenue We have concluded that our consulting services contracts represent a single performance obligation satisfied over time. The transaction price is determined by reference to contract or change order value. Revenue is recognized as the performance obligation is satisfied. The progress towards completion for consulting contracts is measured based on total project inputs (time) at each reporting period as a percentage of forecasted total project inputs. Laboratory services revenue Revenue is recognized when, or as, obligations under the terms of a contract are satisfied, which occurs when control of the products or services are transferred to the customer. Revenue for laboratory services is measured as the amount of consideration we expect to receive in exchange for transferring products or services. Where contracts with customers contain multiple performance obligations, the transaction price is allocated to each performance obligation based on the estimated relative selling price of the promised good or service. Service revenue is recognized over time as the services are delivered to the customer based on the extent of progress towards completion of the performance obligation. The determination of the methodology to measure progress requires judgment and is based on the nature of services provided. This requires an assessment of the transfer of value to the customer. The right to invoice measure of progress is generally related to rate per unit contracts, as the extent of progress towards completion is measured based on discrete service or time-based increments, such as samples tested or labor hours incurred. Revenue is recorded in the amount invoiced since that amounts corresponds to the value of the Company's performance and the transfer of value to the customer. Data services revenue The Company provides data reports and analytics to customers based on agreed-upon specifications, including the timing of delivery, which is typically either weekly, monthly, or quarterly. If a customer requests more than one type of data report or series of data reports within a contract, each distinct type of data report is a separate performance obligation. The contracts provide for the Company to be compensated for the value of each deliverable. The transaction price is determined using list prices, discount agreements, if any, and negotiations with the customers, and generally includes any out-of-pocket expenses. Typically, the Company bills in advance of services being provided with the amount being recorded as unearned revenue. When multiple performance obligations exist, the transaction price is allocated to performance obligations on a relative standalone selling price basis. In cases where the Company contracts to provide a series of data reports, or in some cases data, the Company recognizes revenue over time using the “units delivered” output method as the data or reports are delivered. Expense reimbursements are recorded to revenue as the expenses are incurred as they relate directly to the services performed. Commissions Incremental costs of obtaining a contract are recognized as an asset on the Condensed Consolidated Balance Sheet in respect of those contracts that exceed one year. Where commission costs relate to contracts that are less than one year, the practical expedient is applied as the amortization period of the asset which would arise on deferral would be one year or less. Business Combinations The cost of a business combination is measured as the aggregate of the fair values at the date of exchange of assets given, liabilities incurred or assumed and equity instruments issued in exchange for control. Where a business combination agreement provides for an adjustment to the cost of the acquisition which is contingent upon future events, the amount of the estimated adjustment is recognized at the acquisition date at the fair value of the contingent consideration. Any changes to this estimate outside the measurement period will depend on the classification of the contingent consideration. If the contingent consideration is classified as equity it shall not be re-measured and the settlement shall be accounted for within equity. If the contingent consideration is classified as a liability any adjustments will be accounted for through the Consolidated Statement of Operations or Other Comprehensive Income depending on whether the liability is considered a financial instrument. The assets, liabilities and contingent liabilities of businesses acquired are measured at their fair values at the date of acquisition. In the case of a business combination which is completed in stages, the fair values of the identifiable assets, liabilities and contingent liabilities are determined at the date of each exchange transaction. When the initial accounting for a business combination is determined provisionally, any subsequent adjustments to the provisional values allocated to the identifiable assets, liabilities and contingent liabilities are made within twelve months of the acquisition date and presented as adjustments to goodwill in the reporting period in which the adjustments are determined. The Company allocates a share of net income to the noncontrolling interest holders based on percentage ownership. Intangible Assets Intangible assets are amortized on a straight line basis over their estimated useful life.

Revenue

Revenue	3 Months Ended
	Mar. 31, 2022
Revenue from Contract with Customer [Abstract]
Revenue	Revenue Revenue disaggregated by customer profile is as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Clients 1-5 544,625 394,194 Clients 6-10 287,740 124,098 Clients 11-25 362,192 141,124 Other 707,207 198,782 Total $ 1,901,764 $ 858,198 Revenue from individual customers greater than 10% of consolidated revenue in the respective periods was as follows: Three Months Ended March 31, 2022 March 31, 2021 Customer: Customer A * 19.1 % Customer B * 11.1 % *Less than 10% Accounts receivables and unbilled revenue are as follows: March 31, 2022 December 31, 2021 (in thousands) Contract assets: Billed services (accounts receivable) $ 1,379,131 $ 1,349,851 Allowance for credit losses (7,722) (7,081) Accounts receivable (net) 1,371,409 1,342,770 Unbilled services (unbilled revenue) 674,509 623,121 Accounts receivable and unbilled revenue, net $ 2,045,918 $ 1,965,891 Unbilled services and unearned revenue or payments on account (contract assets and liabilities) were as follows: (in thousands, except percentages) March 31, 2022 December 31, 2021 $ Change % Change Unbilled services (unbilled revenue) $ 674,509 $ 623,121 $ 51,388 8.2 % Unearned revenue (payments on account) (1,300,980) (1,323,961) 22,981 (1.7) % Net balance $ (626,471) $ (700,840) $ 74,369 (10.6) % Timing may differ between the satisfaction of performance obligations and the invoicing and collection of amounts related to our contracts with customers. We record assets for amounts related to performance obligations that are satisfied but not yet billed and/or collected. These assets are recorded as unbilled services and therefore contract assets rather than accounts receivables when receipt of the consideration is conditional on something other than the passage of time. Liabilities are recorded for amounts that are collected in advance of the satisfaction of performance obligations or billed in advance of the revenue being earned. Unbilled services/revenue balances arise where invoicing or billing is based on the timing of agreed milestones related to service contracts for clinical research. Contractual billing arrangements in respect of certain reimbursable expenses (principally investigators) require billing by the investigator to the Company prior to billing by the Company to the customer. As there is no contractual right to set-off between unbilled services (contract assets) and unearned revenue (contract liabilities), each are separately presented gross on the Condensed Consolidated Balance Sheet. Unbilled services as at March 31, 2022 increased by $51.4 million compared to December 31, 2021. Unearned revenue decreased by $23.0 million over the same period resulting in an increase of $74.4 million in the net balance of unbilled services and unearned revenue or payments on account between December 31, 2021 and March 31, 2022. These fluctuations are primarily due to timing of payments and invoicing related to the Group's clinical trial management contracts. Billings and payments are established by contractual provisions including predetermined payment schedules which may or may not correspond to the timing of the transfer of control of the Company's services under the contract. Unbilled services arise from long-term contracts when a cost-based input method of revenue recognition is applied and revenue recognized exceeds the amount billed to the customer.

Accounts receivable, unbilled r

Accounts receivable, unbilled revenue (contract assets) and unearned revenue or payments on account (contract liabilities)	3 Months Ended
	Mar. 31, 2022
Revenue from Contract with Customer [Abstract]
Accounts receivable, unbilled revenue (contract assets) and unearned revenue or payments on account (contract liabilities)	Revenue Revenue disaggregated by customer profile is as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Clients 1-5 544,625 394,194 Clients 6-10 287,740 124,098 Clients 11-25 362,192 141,124 Other 707,207 198,782 Total $ 1,901,764 $ 858,198 Revenue from individual customers greater than 10% of consolidated revenue in the respective periods was as follows: Three Months Ended March 31, 2022 March 31, 2021 Customer: Customer A * 19.1 % Customer B * 11.1 % *Less than 10% Accounts receivables and unbilled revenue are as follows: March 31, 2022 December 31, 2021 (in thousands) Contract assets: Billed services (accounts receivable) $ 1,379,131 $ 1,349,851 Allowance for credit losses (7,722) (7,081) Accounts receivable (net) 1,371,409 1,342,770 Unbilled services (unbilled revenue) 674,509 623,121 Accounts receivable and unbilled revenue, net $ 2,045,918 $ 1,965,891 Unbilled services and unearned revenue or payments on account (contract assets and liabilities) were as follows: (in thousands, except percentages) March 31, 2022 December 31, 2021 $ Change % Change Unbilled services (unbilled revenue) $ 674,509 $ 623,121 $ 51,388 8.2 % Unearned revenue (payments on account) (1,300,980) (1,323,961) 22,981 (1.7) % Net balance $ (626,471) $ (700,840) $ 74,369 (10.6) % Timing may differ between the satisfaction of performance obligations and the invoicing and collection of amounts related to our contracts with customers. We record assets for amounts related to performance obligations that are satisfied but not yet billed and/or collected. These assets are recorded as unbilled services and therefore contract assets rather than accounts receivables when receipt of the consideration is conditional on something other than the passage of time. Liabilities are recorded for amounts that are collected in advance of the satisfaction of performance obligations or billed in advance of the revenue being earned. Unbilled services/revenue balances arise where invoicing or billing is based on the timing of agreed milestones related to service contracts for clinical research. Contractual billing arrangements in respect of certain reimbursable expenses (principally investigators) require billing by the investigator to the Company prior to billing by the Company to the customer. As there is no contractual right to set-off between unbilled services (contract assets) and unearned revenue (contract liabilities), each are separately presented gross on the Condensed Consolidated Balance Sheet. Unbilled services as at March 31, 2022 increased by $51.4 million compared to December 31, 2021. Unearned revenue decreased by $23.0 million over the same period resulting in an increase of $74.4 million in the net balance of unbilled services and unearned revenue or payments on account between December 31, 2021 and March 31, 2022. These fluctuations are primarily due to timing of payments and invoicing related to the Group's clinical trial management contracts. Billings and payments are established by contractual provisions including predetermined payment schedules which may or may not correspond to the timing of the transfer of control of the Company's services under the contract. Unbilled services arise from long-term contracts when a cost-based input method of revenue recognition is applied and revenue recognized exceeds the amount billed to the customer.

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill Three Months Ended Year Ended March 31, 2022 December 31, 2021 (in thousands) Opening balance $ 9,037,931 $ 936,257 Current period acquisitions (Note 7) — 8,120,006 Prior period acquisitions 1,462 — Foreign exchange movement (11,410) (18,332) Closing balance $ 9,027,983 $ 9,037,931

Intangible assets

Intangible assets	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Intangible assets	Intangible assets Intangible assets, net consisted of the following: Three Months Ended Year Ended March 31, 2022 December 31, 2021 Cost (in thousands) Customer relationships $ 4,055,260 $ 4,056,642 Order backlog 527,451 528,022 Trade names & brands 204,648 204,685 Patient database 170,456 170,525 Technology assets 121,211 121,507 Total cost 5,079,026 5,081,381 Accumulated amortization (486,439) (370,538) Net book value $ 4,592,587 $ 4,710,843

Business combinations

Business combinations	3 Months Ended
	Mar. 31, 2022
Business Combinations [Abstract]
Business combinations	Business combinations PRA Health Sciences, Inc. - Merger Completion On July 1, 2021 (the "Merger Date"), the Company completed the Acquisition of PRA by means of a merger whereby Indigo Merger Sub, Inc., a Delaware corporation and subsidiary of ICON, merged with and into PRA Health Sciences, Inc., the parent of the PRA Health Sciences Group. The combined Group has retained the name ICON and brought together approximately 38,000 (as at the Merger date) employees across the globe, creating one of the world’s most advanced healthcare intelligence and clinical research organizations. The Merger was accounted for as a business combination using the acquisition method of accounting in accordance with ASC Topic 805, Business Combinations. The combined Company leverages its enhanced operations to transform clinical trials and accelerate biopharma customers’ commercial success through the development of much needed medicines and medical devices. The new ICON has a renewed focus on leveraging data, applying technology and accessing diverse patient populations to speed up drug development. Upon completion of the Merger, pursuant to the terms of the merger agreement, PRA became a wholly owned subsidiary of ICON plc. Under the terms of the Merger, PRA shareholders received per share $80 in cash and 0.4125 shares of ICON stock. The trading of PRA common stock on NASDAQ was suspended prior to market open on July 1, 2021. In the three months ended March 31, 2022, the Company incurred $12.1 million of Merger-related expenses which were accounted for separately from the business combination and expensed as incurred within the “Transaction and integration related expenses” line item of the condensed consolidated statements of operations. These costs consisted primarily of integration costs including severance arrangements, retention agreements and advisory fees. In the three months ended March 31, 2021 , the Company incurred $12.5 million of Merger-related expenses. These costs consisted primarily of investment banker fees, advisory fees, legal costs, accounting fees and consulting fees. The purchase accounting associated with the PRA Merger remains ongoing and we continue to review the acquisition balance sheet. We expect to conclude the purchase accounting exercise by June 30, 2022. The preliminary Merger Date fair value of the consideration transferred consisted of the following: (in thousands) Fair value of cash consideration $ 5,308,646 Fair value of ordinary shares issued to acquiree stockholders 5,658,126 Fair value of replacement share-based awards issued to acquiree employees 209,399 Repayment of term loan obligations and accrued interest * 865,800 $ 12,041,971 * This represents the portion of PRA debt paid by ICON. PRA also paid $401.6 million from available cash to settle debt obligations that existed at the Merger Date. The following table summarizes the preliminary allocation of the consideration transferred based on management’s estimates of Merger Date fair values of assets acquired and liabilities assumed, with the excess of the purchase price over the estimated fair values of the identifiable net assets acquired recorded as goodwill: July 1, 2021 (in thousands) Cash and cash equivalents $ 259,971 Accounts receivable and unbilled revenue 934,308 Other current assets 125,156 Fixed assets 156,851 Operating lease right-of-use assets 181,708 Goodwill * 8,121,468 Intangible assets 4,886,000 Deferred tax assets 28,099 Other assets 33,928 Accounts payable (50,259) Accrued expenses and other current liabilities (380,342) Current portion of operating lease liabilities (37,355) Unearned revenue (739,278) Non-current portion of operating lease liabilities (148,037) Non-current deferred tax liabilities (1,126,950) Other non-current liabilities (203,297) Net assets acquired $ 12,041,971 * The goodwill in connection with the Merger is primarily attributable to the assembled workforce of PRA and the expected synergies of the Merger. None of the goodwill recognized is expected to be deductible for income tax purposes. The following table summarizes the preliminary estimates of the fair value of identified intangible assets and their respective useful lives as of the Merger Date (in thousands, except for estimated useful lives): Estimated Fair Value Estimated Useful Life Customer relationship 3,915,000 23 years Order backlog 490,000 3 years Trade names 202,000 3 years Patient database 168,000 7 years Technology 111,000 5 years 4,886,000 Pro forma financial information The following pro forma financial information was derived from the historical financial statements of the Company and PRA and presents the combined results of operations as if the Merger had occurred on January 1, 2021. The pro forma financial information is presented for comparative purposes only and is not necessarily indicative of the results that would have actually occurred had the Merger been completed on January 1, 2021. In addition, the pro forma financial information does not give effect to any anticipated cost savings, operating efficiencies or other synergies that may result from the Merger, or any estimated costs that have been or will be incurred by the Company to integrate the assets and operations of PRA. Consequently, actual future results of the Company will differ from the pro forma financial information presented below: Three Months Ended Three Months Ended March 31, 2022 March 31, 2021 (in thousands, except per share data) Revenue $ 1,901,764 $ 1,791,973 Net income (loss) $ 111,970 $ (204,650) The pro forma financial information presented above for the three months ended March 31, 2021 reflect certain pro forma adjustments to reflect the financial performance of the Company had the Merger date been completed on January 1, 2021. The pro forma adjustments primarily relate to the amortization of acquired intangible assets, interest expense, amortization of deferred financing costs related to the new financing arrangements, transaction costs, share-based compensation expense related to the acceleration of share-based compensation awards and replacement share-based awards, and financing fees. The pro forma adjustments were tax effected using the tax rate relevant in the appropriate jurisdiction. The results presented above for the three months ended March 31, 2022 are as reported in the Consolidated Statement of Operations.

Equity method investments

Equity method investments	3 Months Ended
	Mar. 31, 2022
Equity Method Investments and Joint Ventures [Abstract]
Equity method investments	Equity method investments The Company has invested $4.9 million to obtain a 49% interest in the voting share capital of Oncacare Limited ("Oncacare"). The Company’s investment in Oncacare is accounted for under the equity method due to the Company's ability to exercise significant influence over Oncacare that is considered to be greater than minor. The Company records its pro rata share of the earnings/losses of this investment in 'Share of equity method investments' in the Condensed Consolidated Statement of Operations. The majority investor has the right to sell the 51% majority voting share capital exclusively to the Company in a two and half year period commencing from January 1, 2023 and ICON also has the right to acquire the 51% majority voting share capital from August 1, 2025. The following table represents our equity method investments at March 31, 2022: Ownership Percentage Carrying Value Carrying Value March 31, 2022 March 31, 2022 December 31, 2021 (in thousands) Oncacare Limited 49 % $ 1,588 $ 2,373 The Company has recorded a loss of $0.8 million representing its pro rata share of the losses in Oncacare for the three month period ended March 31, 2022. During the year ended December 31, 2021, the Company provided a loan of $10 million to Oncacare in order to fund the continued development of the business operations. The loan accrues annual interest at 1.6% and the loan is repayable on June 30, 2025. Oncacare continues to perform in line with expectations.

Fair value measurements

Fair value measurements	3 Months Ended
	Mar. 31, 2022
Fair Value Disclosures [Abstract]
Fair value measurements	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 amounts of financial instruments, including cash and cash equivalents, accounts receivable, unbilled services, contract assets, accounts payable, and unearned revenue approximate fair value due to the short maturities of these instruments. Recurring Fair Value Measurements The Company classifies its interests in investments in equity-long term having considered the nature of its investment, the extent of influence over operating and financial decisions and the availability of readily determinable fair values. The Company determined that the interests in funds at March 31, 2022 and December 31, 2021 meet the definition of equity securities without readily determinable fair values. The Company concluded that the interests held at March 31, 2022 and December 31, 2021 qualify for the Net Asset Value (NAV) practical expedient in ASC 820 'Fair value measurements and disclosures'. Any increases or decreases in fair value are recognized in net income in the period. These are therefore measured at Level 3 of the fair value hierarchy. The value of these investments were $26.0 million at March 31, 2022 and $22.6 million at December 31, 2021. Non-recurring Fair Value Measurements Certain assets and liabilities are carried on the accompanying Condensed Consolidated Balance Sheet at cost and are not re-measured to fair value on a recurring basis. These assets include finite-lived intangible assets that are tested for impairment when a triggering event occurs and goodwill and identifiable indefinite-lived intangible assets that are tested for impairment annually or when a triggering event occurs. As of March 31, 2022, assets carried on the balance sheet and not re-measured to fair value on a recurring basis totaled approximately $13,620.6 million and are identified as Level 3 assets. These assets are comprised of goodwill of $9,028.0 million and identifiable intangible assets, net of $4,592.6 million. Refer to "Note 12 - Bank credit lines and loan facilities" for additional information regarding the fair value of long-term debt balances.

Restructuring

Restructuring	3 Months Ended
	Mar. 31, 2022
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring In the three months ended March 31, 2022, a restructuring charge of $4.2 million was recorded in the Condensed Consolidated Statement of Operations under a restructuring plan adopted following a review of operations. The restructuring plan reflected resource rationalization across the business to improve employee utilization and an office consolidation program to optimize the Company's office footprint. The restructuring plan resulted in an impairment of ROU assets and associated unavoidable costs totaling $4.2 million, a credit of $0.2 million relating to workforce reductions and fixed asset impairment of $0.2 million. Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Restructuring charges $ 4,207 $ — Net charge $ 4,207 $ — At March 31, 2022, a total liability of $29.2 million was recorded on the Consolidated Balance Sheet relating to restructuring activities. The total liability included $24.4 million from lease and lease related liabilities of which $10.4 million is included within other liabilities and $14.0 million is included within non-current operating lease liabilities. The remaining provision of $4.8 million relates to workforce reduction and is included within other liabilities. Three Months Ended Year ended March 31, 2022 December 31, 2021 (in thousands) Opening provision $ 28,353 $ 10,748 Additional provisions 4,153 26,674 Release provision (200) — Utilization (3,082) (9,069) Ending provision $ 29,224 $ 28,353

Operating leases

Operating leases	3 Months Ended
	Mar. 31, 2022
Leases [Abstract]
Operating leases	Operating leases Lease costs recorded under operating leases for the three months ended March 31, 2022 and March 31, 2021 were as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Operating lease costs $ 15,264 $ 7,789 Income from sub-leases (327) (211) Net operating lease costs $ 14,937 $ 7,578 Of the total cost of $14.9 million incurred in the three months ended March 31, 2022 (March 31, 2021: $7.6 million), $48.0 million (March 31, 2021: $7.0 million) is recorded within selling, general and administration costs and $0.6 million (March 31, 2021: $0.6 million) is recorded within direct costs. During the three months ended March 31, 2022 and March 31, 2021, costs incurred by the Group related to variable lease payments was de minimis. Right-of-use assets obtained during the three months ended March 31, 2022, excluding early termination options, now reasonably certain to be exercised of $Nil (March 31, 2021: $4.2 million), totaled $6.8 million (March 31, 2021: $2.9 million). The weighted average remaining lease term and weighted-average discount rate at March 31, 2022 were 6.92 years and 2.48%, respectively. Future minimum lease payments under non-cancelable leases as of March 31, 2022 were as follows: Minimum rental payments (in thousands) March 31, 2022 Year 1 $ 52,372 Year 2 45,344 Year 3 29,086 Year 4 19,925 Year 5 16,870 Thereafter 56,684 Total future minimum lease payments 220,281 Lease imputed interest (17,312) Total $ 202,969 other liabilities

Bank credit lines and loan faci

Bank credit lines and loan facilities	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Bank credit lines and loan facilities	Bank credit lines and loan facilities The Company had the following debt outstanding as of March 31, 2022 and December 31, 2021: Principal amount Interest rate as of Interest rate as of March 31, December 31, (in thousands) March 31, 2022 December 31, 2021 2022 2021 Maturity Date Credit Facilities: Senior Secured Term Loan 3.313 % 2.750 % $ 4,701,213 $ 5,001,213 July 2028 Senior Secured Notes 2.875 % 2.875 % 500,000 500,000 July 2026 Total debt 5,201,213 5,501,213 Less current portion of long-term debt (55,150) (55,150) Total long-term debt 5,146,063 5,446,063 Less debt issuance costs and debt discount (59,120) (64,901) Total long-term debt, net $ 5,086,943 $ 5,381,162 The Company paid a $27.6 million debt discount in connection with the Senior Secured Credit Facility and Senior Secured Notes. As of March 31, 2022, the contractual maturities of the Company's debt obligations were as follows: Current maturities of long-term debt: (in thousands) 2022 (remaining) $ 41,363 2023 55,150 2024 55,150 2025 55,150 2026 and thereafter 4,994,400 Total $ 5,201,213 The Company's primary financing arrangements are its senior secured credit facilities (the "Senior Secured Credit Facilities"), which consists of a senior secured term loan and a revolving credit facility, and the senior secured notes (the "Senior Secured Notes"). Senior Secured Credit Facilities In conjunction with the completion of the Merger agreement, on July 1, 2021, ICON entered into a credit agreement providing for a senior secured term loan facility of $5,515 million and a senior secured revolving loan facility in an initial aggregate principal amount of $300 million (the "Senior Secured Credit Facilities"). Borrowings under the senior secured term loan facility amortize in equal quarterly installments in an amount equal to 1.00% per annum of the principal amount, with the remaining balance due at final maturity. The interest rate margin applicable to borrowings under the senior secured term loan facility is LIBOR plus an applicable margin of 2.50%, in each case, with a step down of 0.25% if the first lien net leverage ratio is equal to or less than 4.00 to 1.00. On November 10, 2021, the Company achieved a net leverage ratio of less than 4 times and the margin applicable to the senior secured term loan was reduced by 0.25%. The senior secured term loan facility is subject to a LIBOR floor of 0.50%. The interest rate margin applicable to borrowings under the revolving loan facility will be, at the option of the borrower, either (i) the applicable base rate plus an applicable margin of 1.00%, 0.60% or 0.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively, or (ii) LIBOR (or an alternative reference rate) plus an applicable margin of 2.00%, 1.60% or 1.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively. In addition, lenders of under the revolving loan facility are entitled to commitment fees as a percentage of the applicable margin at the time of drawing and utilization fees dependent on the proportion of the facility drawn. The Borrowers’ (as defined in the credit agreement) obligations under the Senior Secured Credit Facilities are guaranteed by ICON and the subsidiary guarantors. The Senior Secured Credit Facilities are secured by a lien on substantially all of ICON’s, the Borrowers’ and each of the subsidiary guarantor’s assets (subject to certain exceptions), and the Senior Secured Credit Facilities will have a first-priority lien on such assets, which will rank pari passu with the lien securing the Senior Secured Notes (see below), subject to other permitted liens. Our long-term debt arrangements contain customary restrictive covenants and, as of March 31, 2022, we were in compliance with our restrictive covenants in all material respects. On March 31, 2022 the Company repaid $300.0 million of the senior secured term loan facility and made a quarterly interest payment of $35.1 million. These repayments resulted in an additional charge associated with previously capitalized fees of $3.2 million. On December 29, 2021, the Company repaid $500.0 million of the senior secured term loan facility. The Company is permitted to make prepayments on the senior secured term loan without penalty. Senior Secured Notes In addition to the Senior Secured Credit Facilities, on July 1, 2021, a subsidiary of the Company issued $500 million in aggregate principal amount of 2.875% senior secured notes due 2026 (the "Senior Secured Notes") in a private offering (the “Offering”). The Senior Secured Notes will mature on July 15, 2026. Fair Value of Debt The estimated fair value of the Company’s debt was $5,155.3 million at March 31, 2022. The fair values of the Senior Secured Credit Facilities and Senior Secured Notes were determined based on Level 2 inputs, which are based on rates at which the debt is traded among financial institutions.

Income taxes

Income taxes	3 Months Ended
	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Income taxes	Income taxes Income taxes recognized during the three months ended March 31, 2022 and March 31, 2021, comprise: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Provision for income taxes (excluding restructuring) $ 14,114 $ 16,148 Tax impact of restructuring (828) — Provision for income taxes $ 13,286 $ 16,148 As at March 31, 2022 the Company maintains a $220.7 million liability (December 31, 2021: $217.6 million) for unrecognized tax benefit, which is comprised of $201.7 million (December 31, 2021: $202.1 million) related to items generating unrecognized tax benefits and $19.0 million (December 31, 2021: $15.5 million) for interest and penalties related to such items. The Company recognizes interest accrued on unrecognized tax benefits as an additional income tax expense. The Company has analyzed the filing positions in all of the significant federal, state and foreign jurisdictions where it is required to file income tax returns, as well as open tax years in these jurisdictions. The only periods subject to audit by the major tax jurisdictions where the Company does business are the 2016 through 2021 tax years. During such audits, local tax authorities may challenge the positions taken by us in our tax returns.

Net income per ordinary share

Net income per ordinary share	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Net income per ordinary share	Net income per ordinary share Basic net income per ordinary share attributable to the Group has been computed by dividing net income available to ordinary shareholders by the weighted average number of ordinary shares outstanding during the period. Diluted net income per ordinary share is computed by adjusting the weighted average number of ordinary shares outstanding during the period for all potentially dilutive ordinary shares outstanding during the period and adjusting net income for any changes in income or loss that would result from the conversion of such potential ordinary shares. There is no difference in net income used for basic and diluted net income per ordinary share. The reconciliation of the number of shares used in the computation of basic and diluted net income per ordinary share is as follows: Three Months Ended March 31, 2022 March 31, 2021 Weighted average number of ordinary shares outstanding for basic net income per ordinary share 81,463,303 52,811,460 Effect of dilutive share options and other awards outstanding under share based compensation programs 1,149,795 498,993 Weighted average number of ordinary shares outstanding for diluted net income per ordinary share 82,613,098 53,310,453 Three Months Ended March 31, 2022 March 31, 2021 Net income per Ordinary Share attributable to the Group: Basic $ 1.37 $ 1.84 Diluted $ 1.36 $ 1.82

Share-based awards

Share-based awards	3 Months Ended
	Mar. 31, 2022
Share-based Payment Arrangement [Abstract]
Share-based awards	Share-based awards Share Options The following table summarizes option activity for the three months ended March 31, 2022: Options Weighted Weighted Outstanding at December 31, 2021 1,695,460 $ 104.79 5.39 Granted 96,525 $ 231.68 Exercised (84,090) $ 190.75 Canceled/expired (25,660) $ 113.04 Outstanding at March 31, 2022 1,682,235 $ 118.36 5.44 Exercisable at March 31, 2022 1,054,178 $ 97.57 4.55 The Company issues ordinary shares for all options exercised. The total amount of fully vested share options which remained outstanding at March 31, 2022 was 1,054,178. Fully vested share options at March 31, 2022 have an average remaining contractual term of 4.55 years, an average exercise price of $97.57. Fair value of Stock Options Assumptions The weighted average fair value of options granted during the three months ended March 31, 2022 and March 31, 2021 was calculated using the Black-Scholes option pricing model. The weighted average grant date fair values and assumptions used were as follows: Three Months Ended March 31, 2022 March 31, 2021 Weighted average grant date fair value $ 68.24 $ 48.36 Assumptions: Expected volatility 30 % 30 % Dividend yield — % — % Risk-free interest rate 1.74 % 0.73 % Expected life 5 years 5 years Expected volatility is based on the historical volatility of our common stock over a period equal to the expected term of the options; the expected life represents the weighted average period of time that options granted are expected to be outstanding given consideration to vesting schedules and our historical experience of past vesting and termination patterns. The risk-free rate is based on the U.S. government zero-coupon bonds yield curve in effect at time of the grant for periods corresponding with the expected life of the option. Restricted Share Units and Performance Share Units On April 30 2019, the Company approved the 2019 Consultants and Directors Restricted Share Unit Plan (the “2019 Consultants RSU Plan”), which was effective as of May 16, 2019, pursuant to which the Compensation and Organization Committee of the Company’s Board of Directors may select any consultant, adviser or non-executive Director retained by the Company, or a Subsidiary to receive an award under the plan. 250,000 ordinary shares have been reserved for issuance under the 2019 Consultants RSU Plan. The awards are at par value and vest over a service period. Awards granted to non-executive directors during 2019, 2020 and 2021 vest over twelve months. The Company has awarded RSUs and PSUs to certain key individuals of the Group. The following table summarizes RSU and PSU activity for the three months ended March 31, 2022: Outstanding at December 31, 2021 154,190 $ 160.23 572,785 $ 191.20 Granted 51,949 $ 231.68 26,000 $ 231.68 Shares vested (42,409) $ 140.38 (32,360) $ 166.85 Forfeited (285) $ 140.18 (24,599) $ 200.16 Outstanding at March 31, 2022 163,445 $ 186.77 541,826 $ 194.19 The fair value of PSUs vested for the three months ended March 31, 2022 totaled $6.0 million (full year 2021: $5.1 million). The fair value of RSUs vested for the three months ended March 31, 2022 totaled $5.4 million (full year 2021: $83.5 million). The PSUs vest based on service and specified EPS targets over the periods 2020 – 2022, 2021 - 2023 and 2022 - 2024. Depending on the amount of EPS from 2020 to 2024, up to an additional 82,594 PSUs may also be granted. Non-cash stock compensation expense Non-cash stock compensation expense for the three months ended March 31, 2022 and March 31, 2021 has been allocated as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Direct costs $ 4,999 $ 2,055 Selling, general and administrative 13,904 4,339 $ 18,903 $ 6,394

Share capital

Share capital	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Share capital	Share capital The Company can acquire up to 10% of its outstanding ordinary shares (by way of redemption), in accordance with Irish law, the United States securities laws, and the Company’s constitutional documents through open market share acquisitions. On July 1, 2021, the Company completed its Merger with PRA. In accordance with the terms of the Merger Agreement, the Company issued 27,372,427 shares of the Company’s ordinary share capital at par value in exchange for all outstanding PRA shares of common stock. On February 18, 2022, the Company commenced a share buyback program which was fully complete at March 31, 2022. Under this buyback program, 420,530 ordinary shares were redeemed by the Company for total consideration of $100.0 million. The buyback program gives a broker authority to acquire the Company’s ordinary shares from time to time on the open market in accordance with agreed terms and limitations. All ordinary shares that were redeemed under the buyback program were canceled in accordance with the Constitution of the Company and the nominal value of these shares transferred to other undenominated capital reserve as required under Irish Company Law.

Business Segment and Geographic

Business Segment and Geographical Information	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Business Segment and Geographical Information	Business Segment and Geographical Information The Company is a clinical research organization ("CRO"), providing outsourced development services on a global basis to the pharmaceutical, biotechnology and medical device industries. It specializes in the strategic development, management and analysis of programs that support all stages of the clinical development process - from compound selection to Phase I-IV clinical studies. The Company has the expertise and capability to conduct clinical trials in most major therapeutic areas on a global basis and has the operational flexibility to provide development services on a stand-alone basis or as part of an integrated "full-service" solution. The Company has expanded through internal growth, together with a number of strategic acquisitions to enhance its expertise and capabilities in certain areas of the clinical development process. The Company determines and presents operating segments based on the information that is internally provided to the chief operating decision maker, the (‘CODM’) in accordance with ASC 280 'Segment Reporting' . The Company determined that the CODM was comprised of the Chief Executive Officer and the Chief Financial Officer. The Company operates as one business segment, which is the provision of outsourced development services on a global basis to the pharmaceutical, biotechnology and medical devices industries. Revenues are allocated to individual entities based on where the work is performed in accordance with the Company's global transfer pricing model. Revenues and income from operations in Ireland are a function of our global contracting model and the Group’s transfer pricing model. ICON Ireland (Ireland Segment) acts as the Group entrepreneur under the Company’s global transfer pricing model given its role in the development and management of the Group, its ownership of key intellectual property and customer relationships, its key role in the mitigation of risks faced by the Group and its responsibility for maintaining the Company’s global network. ICON Ireland enters into the majority of the Company’s customer contracts. ICON Ireland remunerates other operating entities in the ICON Group on the basis of a guaranteed cost plus mark-up for the services they perform in each of their local territories. The cost plus mark-up for each ICON entity is established to ensure that each of ICON Ireland and the ICON entities that are involved in the conduct of services for customers, earn an appropriate arms-length return having regard to the assets owned, risks borne, and functions performed by each entity from these intercompany transactions. The cost plus mark-up policy is reviewed annually to ensure that it is market appropriate. The integration of entities acquired through the Merger into this global network and global transfer pricing model remains ongoing. The geographic split of revenue disclosed for each region outside Ireland is the cost plus revenue attributable to these entities. The residual revenues of the Group, once each ICON entity has been paid its respective intercompany service fee, generally fall to be retained by ICON Ireland. As such, revenues and income from operations in Ireland are a function of this global transfer pricing model and comprise revenues of the Group after deducting the cost plus revenues attributable to the activities performed outside Ireland. The integration of entities acquired through the Merger into the global transfer pricing model remains ongoing and these entities were not substantially part of the Group's cost plus arrangement in the period ended March 31, 2022. The Company's areas of operation outside of Ireland include th e United States, United Kingdom, Austria, Belgium, Bulgaria, Czech Republic, France, Germany, Hungary, Italy, Latvia, Poland, Portugal, Romania, Russia, Serbia, Spain, Sweden, The Netherlands, Turkey, Ukraine, Canada, Argentina, Brazil, Chile, Colombia, Mexico, Peru, China (including Hong Kong), India, Israel, Japan, Singapore, South Korea, The Philippines, Taiwan, Thailand, Australia, New Zealand, South Africa, Belarus, Bermuda, British Virgin Islands, Costa Rica, Croatia, Denmark, Egypt, Estonia, Finland, Georgia, Greece, Guatemala, Iceland, Jersey, Kenya, Lithuania, Luxembourg, Malaysia, Norway, Panama, Puerto Rico, Slovakia, Switzerland and Uruguay. The geographical distribution of the Company’s segment measures as at March 31, 2022 and December 31, 2021 and for the three months ended March 31, 2022 and March 31, 2021 is as follows: a) The distribution of revenue by geographical area was as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Ireland $ 367,359 $ 308,121 Rest of Europe 456,064 120,354 U.S. 970,629 352,496 Rest of World 107,712 77,227 Total $ 1,901,764 $ 858,198 b) The distribution of income from operations by geographical area was as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Ireland * $ 9,874 $ 88,912 Rest of Europe 59,509 7,610 U.S. 60,468 13,237 Rest of World 40,488 6,255 Total $ 170,339 $ 116,014 * Includes the full amount of the amortization charge associated with the intangible asset acquired in the Merger. These assets have been provisionally allocated to Ireland. c) The distribution of long-lived assets (property, plant and equipment and operating right-of-use assets), net, by geographical area was as follows: March 31, 2022 December 31, 2021 (in thousands) Ireland $ 116,680 $ 118,253 Rest of Europe 107,742 121,174 U.S. 236,379 239,828 Rest of World 49,040 55,312 Total $ 509,841 $ 534,567

Significant accounting polici_2

Significant accounting policies (Policies)	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Reclassifications	Certain prior period amounts in the consolidated financial statements and accompanying notes have been reclassified to conform to the current period’s presentation. Most notably, the Company has presented transaction and integration-related expenses as a separate line in the Condensed Consolidated Statement of Operations and reclassified certain costs incurred in the three months ended March 31, 2021 within this line. These costs consist of transaction related expenses incurred as part of the Merger. These costs amounted to $12.5 million and were previously presented in the selling, general and administrative expenses but have been reclassified to transaction and integration-related expenses to conform to the current period’s presentation.
Revenue recognition	Revenue recognition The Company earns revenues by providing a number of different services to its customers. These services, which are integral elements of the clinical development process, include clinical trials management, consulting, contract staffing, data services and laboratory services. Contracts range in duration from a number of months to several years. ASC 606 requires application of five steps: (1) identify the contract(s) with a customer; (2) identify the performance obligation in the contract; (3) determine the transaction price; (4) allocate the transaction price to the performance obligations in the contract; and (5) recognize revenue when (or as) the entity satisfies the performance obligation(s). Clinical trial service revenue A clinical trial service is a single performance obligation satisfied over time, i.e. the full-service obligation in respect of a clinical trial (including those services performed by investigators and other parties) is considered a single performance obligation. Promises offered to the customer are not distinct within the context of the contract. We have concluded that ICON is the contract principal in respect of both direct services and in the use of third parties (principally investigator services) that support the clinical research project. The transaction price is determined by reference to the contract or change order value (total service revenue and pass-through/ reimbursable expenses) adjusted to reflect a realizable contract value. Revenue is recognized as the single performance obligation is satisfied. The progress towards completion for clinical service contracts is measured based on an input measure being total project costs incurred (inclusive of third party costs) at each reporting period as a percentage of forecasted total project costs. Contracting services revenue The Company has availed of the practical expedient which results in recognition of revenue on a right to invoice basis. Application of the practical expedient reflects the right to consideration from the customer in an amount that corresponds directly with the value to the customer of the performance completion to date. This reflects hours performed by contract staff. Consulting services revenue We have concluded that our consulting services contracts represent a single performance obligation satisfied over time. The transaction price is determined by reference to contract or change order value. Revenue is recognized as the performance obligation is satisfied. The progress towards completion for consulting contracts is measured based on total project inputs (time) at each reporting period as a percentage of forecasted total project inputs. Laboratory services revenue Revenue is recognized when, or as, obligations under the terms of a contract are satisfied, which occurs when control of the products or services are transferred to the customer. Revenue for laboratory services is measured as the amount of consideration we expect to receive in exchange for transferring products or services. Where contracts with customers contain multiple performance obligations, the transaction price is allocated to each performance obligation based on the estimated relative selling price of the promised good or service. Service revenue is recognized over time as the services are delivered to the customer based on the extent of progress towards completion of the performance obligation. The determination of the methodology to measure progress requires judgment and is based on the nature of services provided. This requires an assessment of the transfer of value to the customer. The right to invoice measure of progress is generally related to rate per unit contracts, as the extent of progress towards completion is measured based on discrete service or time-based increments, such as samples tested or labor hours incurred. Revenue is recorded in the amount invoiced since that amounts corresponds to the value of the Company's performance and the transfer of value to the customer. Data services revenue The Company provides data reports and analytics to customers based on agreed-upon specifications, including the timing of delivery, which is typically either weekly, monthly, or quarterly. If a customer requests more than one type of data report or series of data reports within a contract, each distinct type of data report is a separate performance obligation. The contracts provide for the Company to be compensated for the value of each deliverable. The transaction price is determined using list prices, discount agreements, if any, and negotiations with the customers, and generally includes any out-of-pocket expenses. Typically, the Company bills in advance of services being provided with the amount being recorded as unearned revenue. When multiple performance obligations exist, the transaction price is allocated to performance obligations on a relative standalone selling price basis. In cases where the Company contracts to provide a series of data reports, or in some cases data, the Company recognizes revenue over time using the “units delivered” output method as the data or reports are delivered. Expense reimbursements are recorded to revenue as the expenses are incurred as they relate directly to the services performed. Commissions Incremental costs of obtaining a contract are recognized as an asset on the Condensed Consolidated Balance Sheet in respect of those contracts that exceed one year. Where commission costs relate to contracts that are less than one year, the practical expedient is applied as the amortization period of the asset which would arise on deferral would be one year or less.
Business Combinations	Business Combinations The cost of a business combination is measured as the aggregate of the fair values at the date of exchange of assets given, liabilities incurred or assumed and equity instruments issued in exchange for control. Where a business combination agreement provides for an adjustment to the cost of the acquisition which is contingent upon future events, the amount of the estimated adjustment is recognized at the acquisition date at the fair value of the contingent consideration. Any changes to this estimate outside the measurement period will depend on the classification of the contingent consideration. If the contingent consideration is classified as equity it shall not be re-measured and the settlement shall be accounted for within equity. If the contingent consideration is classified as a liability any adjustments will be accounted for through the Consolidated Statement of Operations or Other Comprehensive Income depending on whether the liability is considered a financial instrument. The assets, liabilities and contingent liabilities of businesses acquired are measured at their fair values at the date of acquisition. In the case of a business combination which is completed in stages, the fair values of the identifiable assets, liabilities and contingent liabilities are determined at the date of each exchange transaction. When the initial accounting for a business combination is determined provisionally, any subsequent adjustments to the provisional values allocated to the identifiable assets, liabilities and contingent liabilities are made within twelve months of the acquisition date and presented as adjustments to goodwill in the reporting period in which the adjustments are determined.
Intangible Assets	Intangible Assets Intangible assets are amortized on a straight line basis over their estimated useful life.

Revenue (Tables)

Revenue (Tables)	3 Months Ended
	Mar. 31, 2022
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	Revenue disaggregated by customer profile is as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Clients 1-5 544,625 394,194 Clients 6-10 287,740 124,098 Clients 11-25 362,192 141,124 Other 707,207 198,782 Total $ 1,901,764 $ 858,198 Revenue from individual customers greater than 10% of consolidated revenue in the respective periods was as follows: Three Months Ended March 31, 2022 March 31, 2021 Customer: Customer A * 19.1 % Customer B * 11.1 % *Less than 10%

Accounts receivable, unbilled_2

Accounts receivable, unbilled revenue (contract assets) and unearned revenue or payments on account (contract liabilities) (Tables)	3 Months Ended
	Mar. 31, 2022
Revenue from Contract with Customer [Abstract]
Schedule of Accounts Receivables and Unbilled Revenue, and Unbilled Services and Unearned Revenue	Accounts receivables and unbilled revenue are as follows: March 31, 2022 December 31, 2021 (in thousands) Contract assets: Billed services (accounts receivable) $ 1,379,131 $ 1,349,851 Allowance for credit losses (7,722) (7,081) Accounts receivable (net) 1,371,409 1,342,770 Unbilled services (unbilled revenue) 674,509 623,121 Accounts receivable and unbilled revenue, net $ 2,045,918 $ 1,965,891 Unbilled services and unearned revenue or payments on account (contract assets and liabilities) were as follows: (in thousands, except percentages) March 31, 2022 December 31, 2021 $ Change % Change Unbilled services (unbilled revenue) $ 674,509 $ 623,121 $ 51,388 8.2 % Unearned revenue (payments on account) (1,300,980) (1,323,961) 22,981 (1.7) % Net balance $ (626,471) $ (700,840) $ 74,369 (10.6) %

Goodwill (Tables)

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	Three Months Ended Year Ended March 31, 2022 December 31, 2021 (in thousands) Opening balance $ 9,037,931 $ 936,257 Current period acquisitions (Note 7) — 8,120,006 Prior period acquisitions 1,462 — Foreign exchange movement (11,410) (18,332) Closing balance $ 9,027,983 $ 9,037,931

Intangible assets (Tables)

Intangible assets (Tables)	3 Months Ended
	Mar. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Finite-Lived Intangible Assets	Intangible assets, net consisted of the following: Three Months Ended Year Ended March 31, 2022 December 31, 2021 Cost (in thousands) Customer relationships $ 4,055,260 $ 4,056,642 Order backlog 527,451 528,022 Trade names & brands 204,648 204,685 Patient database 170,456 170,525 Technology assets 121,211 121,507 Total cost 5,079,026 5,081,381 Accumulated amortization (486,439) (370,538) Net book value $ 4,592,587 $ 4,710,843

Business combinations (Tables)

Business combinations (Tables)	3 Months Ended
	Mar. 31, 2022
Business Combinations [Abstract]
Schedule of Fair Value of PRA Health Sciences Inc Acquisition Consideration	The preliminary Merger Date fair value of the consideration transferred consisted of the following: (in thousands) Fair value of cash consideration $ 5,308,646 Fair value of ordinary shares issued to acquiree stockholders 5,658,126 Fair value of replacement share-based awards issued to acquiree employees 209,399 Repayment of term loan obligations and accrued interest * 865,800 $ 12,041,971 * This represents the portion of PRA debt paid by ICON. PRA also paid $401.6 million from available cash to settle debt obligations that existed at the Merger Date.
Schedule of PRA Health Sciences Inc Acquisition	The following table summarizes the preliminary allocation of the consideration transferred based on management’s estimates of Merger Date fair values of assets acquired and liabilities assumed, with the excess of the purchase price over the estimated fair values of the identifiable net assets acquired recorded as goodwill: July 1, 2021 (in thousands) Cash and cash equivalents $ 259,971 Accounts receivable and unbilled revenue 934,308 Other current assets 125,156 Fixed assets 156,851 Operating lease right-of-use assets 181,708 Goodwill * 8,121,468 Intangible assets 4,886,000 Deferred tax assets 28,099 Other assets 33,928 Accounts payable (50,259) Accrued expenses and other current liabilities (380,342) Current portion of operating lease liabilities (37,355) Unearned revenue (739,278) Non-current portion of operating lease liabilities (148,037) Non-current deferred tax liabilities (1,126,950) Other non-current liabilities (203,297) Net assets acquired $ 12,041,971
Schedule of Fair Value of Intangible Assets PRA Health Sciences Inc Acquisition	The following table summarizes the preliminary estimates of the fair value of identified intangible assets and their respective useful lives as of the Merger Date (in thousands, except for estimated useful lives): Estimated Fair Value Estimated Useful Life Customer relationship 3,915,000 23 years Order backlog 490,000 3 years Trade names 202,000 3 years Patient database 168,000 7 years Technology 111,000 5 years 4,886,000
Schedule of Proforma Information of PRA Health Sciences Inc Acquisition	Consequently, actual future results of the Company will differ from the pro forma financial information presented below: Three Months Ended Three Months Ended March 31, 2022 March 31, 2021 (in thousands, except per share data) Revenue $ 1,901,764 $ 1,791,973 Net income (loss) $ 111,970 $ (204,650)

Equity method investments (Tabl

Equity method investments (Tables)	3 Months Ended
	Mar. 31, 2022
Equity Method Investments and Joint Ventures [Abstract]
Summary of Equity Method Investments	The following table represents our equity method investments at March 31, 2022: Ownership Percentage Carrying Value Carrying Value March 31, 2022 March 31, 2022 December 31, 2021 (in thousands) Oncacare Limited 49 % $ 1,588 $ 2,373

Restructuring (Tables)

Restructuring (Tables)	3 Months Ended
	Mar. 31, 2022
Restructuring and Related Activities [Abstract]
Summary of Restructuring Charges	Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Restructuring charges $ 4,207 $ — Net charge $ 4,207 $ —
Summary of Details of Movement in Restructuring Charges	Three Months Ended Year ended March 31, 2022 December 31, 2021 (in thousands) Opening provision $ 28,353 $ 10,748 Additional provisions 4,153 26,674 Release provision (200) — Utilization (3,082) (9,069) Ending provision $ 29,224 $ 28,353

Operating leases (Tables)

Operating leases (Tables)	3 Months Ended
	Mar. 31, 2022
Leases [Abstract]
Schedule of Lease Costs	Lease costs recorded under operating leases for the three months ended March 31, 2022 and March 31, 2021 were as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Operating lease costs $ 15,264 $ 7,789 Income from sub-leases (327) (211) Net operating lease costs $ 14,937 $ 7,578
Schedule of Operating Lease Maturity	Future minimum lease payments under non-cancelable leases as of March 31, 2022 were as follows: Minimum rental payments (in thousands) March 31, 2022 Year 1 $ 52,372 Year 2 45,344 Year 3 29,086 Year 4 19,925 Year 5 16,870 Thereafter 56,684 Total future minimum lease payments 220,281 Lease imputed interest (17,312) Total $ 202,969

Bank credit lines and loan fa_2

Bank credit lines and loan facilities (Tables)	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Schedule of Outstanding Debt	The Company had the following debt outstanding as of March 31, 2022 and December 31, 2021: Principal amount Interest rate as of Interest rate as of March 31, December 31, (in thousands) March 31, 2022 December 31, 2021 2022 2021 Maturity Date Credit Facilities: Senior Secured Term Loan 3.313 % 2.750 % $ 4,701,213 $ 5,001,213 July 2028 Senior Secured Notes 2.875 % 2.875 % 500,000 500,000 July 2026 Total debt 5,201,213 5,501,213 Less current portion of long-term debt (55,150) (55,150) Total long-term debt 5,146,063 5,446,063 Less debt issuance costs and debt discount (59,120) (64,901) Total long-term debt, net $ 5,086,943 $ 5,381,162
Schedule of Contractual Maturities of Debt	As of March 31, 2022, the contractual maturities of the Company's debt obligations were as follows: Current maturities of long-term debt: (in thousands) 2022 (remaining) $ 41,363 2023 55,150 2024 55,150 2025 55,150 2026 and thereafter 4,994,400 Total $ 5,201,213

Income taxes (Tables)

Income taxes (Tables)	3 Months Ended
	Mar. 31, 2022
Income Tax Disclosure [Abstract]
Schedule of Components of Income Tax Expense	Income taxes recognized during the three months ended March 31, 2022 and March 31, 2021, comprise: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Provision for income taxes (excluding restructuring) $ 14,114 $ 16,148 Tax impact of restructuring (828) — Provision for income taxes $ 13,286 $ 16,148

Net income per ordinary share (

Net income per ordinary share (Tables)	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Schedule of Reconciliation of Number of Shares Used in Computation of Basic and Diluted Net Income Per Ordinary Share	The reconciliation of the number of shares used in the computation of basic and diluted net income per ordinary share is as follows: Three Months Ended March 31, 2022 March 31, 2021 Weighted average number of ordinary shares outstanding for basic net income per ordinary share 81,463,303 52,811,460 Effect of dilutive share options and other awards outstanding under share based compensation programs 1,149,795 498,993 Weighted average number of ordinary shares outstanding for diluted net income per ordinary share 82,613,098 53,310,453 Three Months Ended March 31, 2022 March 31, 2021 Net income per Ordinary Share attributable to the Group: Basic $ 1.37 $ 1.84 Diluted $ 1.36 $ 1.82

Share-based awards (Tables)

Share-based awards (Tables)	3 Months Ended
	Mar. 31, 2022
Share-based Payment Arrangement [Abstract]
Summary of Stock Option Activity	The following table summarizes option activity for the three months ended March 31, 2022: Options Weighted Weighted Outstanding at December 31, 2021 1,695,460 $ 104.79 5.39 Granted 96,525 $ 231.68 Exercised (84,090) $ 190.75 Canceled/expired (25,660) $ 113.04 Outstanding at March 31, 2022 1,682,235 $ 118.36 5.44 Exercisable at March 31, 2022 1,054,178 $ 97.57 4.55
Schedule of Weighted Average Fair Values and Assumptions Used	The weighted average grant date fair values and assumptions used were as follows: Three Months Ended March 31, 2022 March 31, 2021 Weighted average grant date fair value $ 68.24 $ 48.36 Assumptions: Expected volatility 30 % 30 % Dividend yield — % — % Risk-free interest rate 1.74 % 0.73 % Expected life 5 years 5 years
Summary of RSU and PSU Activity	The following table summarizes RSU and PSU activity for the three months ended March 31, 2022: Outstanding at December 31, 2021 154,190 $ 160.23 572,785 $ 191.20 Granted 51,949 $ 231.68 26,000 $ 231.68 Shares vested (42,409) $ 140.38 (32,360) $ 166.85 Forfeited (285) $ 140.18 (24,599) $ 200.16 Outstanding at March 31, 2022 163,445 $ 186.77 541,826 $ 194.19
Schedule of Non-cash Stock Compensation Expense	Non-cash stock compensation expense for the three months ended March 31, 2022 and March 31, 2021 has been allocated as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Direct costs $ 4,999 $ 2,055 Selling, general and administrative 13,904 4,339 $ 18,903 $ 6,394

Business Segment and Geograph_2

Business Segment and Geographical Information (Tables)	3 Months Ended
	Mar. 31, 2022
Segment Reporting [Abstract]
Schedule of Distribution of Revenue by Geographical Area	The distribution of revenue by geographical area was as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Ireland $ 367,359 $ 308,121 Rest of Europe 456,064 120,354 U.S. 970,629 352,496 Rest of World 107,712 77,227 Total $ 1,901,764 $ 858,198
Schedule of Distribution of Income from Operations by Geographical Area	The distribution of income from operations by geographical area was as follows: Three Months Ended March 31, 2022 March 31, 2021 (in thousands) Ireland * $ 9,874 $ 88,912 Rest of Europe 59,509 7,610 U.S. 60,468 13,237 Rest of World 40,488 6,255 Total $ 170,339 $ 116,014 * Includes the full amount of the amortization charge associated with the intangible asset acquired in the Merger. These assets have been provisionally allocated to Ireland.
Schedule of Distribution of Depreciation and Amortization by Geographical Area	The distribution of long-lived assets (property, plant and equipment and operating right-of-use assets), net, by geographical area was as follows: March 31, 2022 December 31, 2021 (in thousands) Ireland $ 116,680 $ 118,253 Rest of Europe 107,742 121,174 U.S. 236,379 239,828 Rest of World 49,040 55,312 Total $ 509,841 $ 534,567

Basis of presentation (Details)

Basis of presentation (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Transaction and integration-related expenses	$ 12,085	$ 12,501

Revenue (Details)

Revenue (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Disaggregation of Revenue [Line Items]
Revenue	$ 1,901,764	$ 858,198
Clients 1-5
Disaggregation of Revenue [Line Items]
Revenue	544,625	394,194
Clients 6-10
Disaggregation of Revenue [Line Items]
Revenue	287,740	124,098
Clients 11-25
Disaggregation of Revenue [Line Items]
Revenue	362,192	141,124
Other
Disaggregation of Revenue [Line Items]
Revenue	$ 707,207	$ 198,782
Customer A | Customer concentration risk | Revenue benchmark
Disaggregation of Revenue [Line Items]
Customer concentration risk		19.10%
Customer B | Customer concentration risk | Revenue benchmark
Disaggregation of Revenue [Line Items]
Customer concentration risk		11.10%

Accounts receivable, unbilled_3

Accounts receivable, unbilled revenue (contract assets) and unearned revenue or payments on account (contract liabilities) - Schedule of Accounts Receivables and Unbilled Revenue (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Billed services (accounts receivable)	$ 1,379,131	$ 1,349,851
Allowance for credit losses	(7,722)	(7,081)
Accounts receivable (net)	1,371,409	1,342,770
Unbilled services (unbilled revenue)	674,509	623,121
Accounts receivable and unbilled revenue, net	$ 2,045,918	$ 1,965,891

Accounts receivable, unbilled_4

Accounts receivable, unbilled revenue (contract assets) and unearned revenue or payments on account (contract liabilities) - Schedule of Unbilled Services and Unearned Revenue or Payments on Account (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Revenue from Contract with Customer [Abstract]
Unbilled services (unbilled revenue)	$ 674,509	$ 623,121
Change in unbilled services (unbilled revenue)	$ 51,388
Percentage change in unbilled services (unbilled revenue)	8.20%
Unearned revenue (payments on account)	$ (1,300,980)	(1,323,961)
Change in unearned revenue (payments on account)	$ 22,981
Percentage change in unearned revenue (payments on account)	(1.70%)
Net balance	$ (626,471)	$ (700,840)
Change in net balance	$ 74,369
Percentage change in net balance	(10.60%)

Accounts receivable, unbilled_5

Accounts receivable, unbilled revenue (contract assets) and unearned revenue or payments on account (contract liabilities) - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Increase in unbilled services (unbilled revenue)	$ 51,388
Decrease in unearned revenue (payments on account)	22,981
Increase in net balance	74,369
Revenue, remaining performance obligation	$ 13,600,000	$ 6,500,000
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2022-04-01
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction [Line Items]
Revenue, remaining performance obligation percentage	49.00%
Revenue, remaining performance obligation, expected timing of satisfaction, period	12 months

Goodwill - Schedule of Goodwill

Goodwill - Schedule of Goodwill (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Goodwill [Roll Forward]
Opening balance	$ 9,037,931	$ 936,257
Current period acquisitions (Note 7)	0	8,120,006
Prior period acquisitions	1,462	0
Foreign exchange movement	(11,410)	(18,332)
Closing balance	$ 9,027,983	$ 9,037,931

Goodwill - Narrative (Details)

Goodwill - Narrative (Details) - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Accumulated impairment loss	$ 0	$ 0

Intangible assets (Details)

Intangible assets (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Finite-Lived Intangible Assets [Line Items]
Total cost	$ 5,079,026	$ 5,081,381
Accumulated amortization	(486,439)	(370,538)
Net book value	4,592,587	4,710,843
Customer relationships
Finite-Lived Intangible Assets [Line Items]
Total cost	4,055,260	4,056,642
Order backlog
Finite-Lived Intangible Assets [Line Items]
Total cost	527,451	528,022
Trade names & brands
Finite-Lived Intangible Assets [Line Items]
Total cost	204,648	204,685
Patient database
Finite-Lived Intangible Assets [Line Items]
Total cost	170,456	170,525
Technology assets
Finite-Lived Intangible Assets [Line Items]
Total cost	$ 121,211	$ 121,507

Business combinations - Narrati

Business combinations - Narrative (Details) $ / shares in Units, $ in Thousands	Jul. 01, 2021Employee$ / sharesshares	Mar. 31, 2022USD ($)	Mar. 31, 2021USD ($)
Business Acquisition [Line Items]
Entity number of employees | Employee	38,000
Acquisition-related costs		$ 12,085	$ 12,501
PRA Health Sciences, Inc
Business Acquisition [Line Items]
Business acquisition, share price (in USD per share) | $ / shares	$ 80
Business acquisition, number of shares issued (in shares) | shares	0.4125
Integration-related costs		$ 12,100
Acquisition-related costs			$ 12,500

Business combinations - Schedul

Business combinations - Schedule of Fair Value of PRA Health Sciences Inc Acquisition Consideration (Details) - PRA Health Sciences, Inc $ in Thousands	Jul. 01, 2021USD ($)
Business Acquisition [Line Items]
Fair value of cash consideration	$ 5,308,646
Fair value of ordinary shares issued to acquiree stockholders	5,658,126
Fair value of replacement share-based awards issued to acquiree employees	209,399
Repayment of term loan obligations and accrued interest	865,800
Total consideration transferred	12,041,971
Payments to settle debt obligations that existed prior to acquisition date	$ 401,600

Business combinations - Sched_2

Business combinations - Schedule of PRA Health Sciences Inc Acquisition (Details) - USD ($)	Mar. 31, 2022	Dec. 31, 2021	Jul. 01, 2021	Dec. 31, 2020
Business Acquisition [Line Items]
Goodwill	$ 9,027,983,000	$ 9,037,931,000		$ 936,257,000
PRA Health Sciences, Inc
Business Acquisition [Line Items]
Cash and cash equivalents			$ 259,971,000
Accounts receivable and unbilled revenue			934,308,000
Other current assets			125,156,000
Fixed assets			156,851,000
Operating lease right-of-use assets			181,708,000
Goodwill			8,121,468,000
Intangible assets			4,886,000,000
Deferred tax assets			28,099,000
Other assets			33,928,000
Accounts payable			(50,259,000)
Accrued expenses and other current liabilities			(380,342,000)
Current portion of operating lease liabilities			(37,355,000)
Unearned revenue			(739,278,000)
Non-current portion of operating lease liabilities			(148,037,000)
Non-current deferred tax liabilities			(1,126,950,000)
Other non-current liabilities			(203,297,000)
Net assets acquired			12,041,971,000
Goodwill expected to be tax deductible			$ 0

Business combinations - Sched_3

Business combinations - Schedule of Fair Value of Intangible Assets PRA Health Sciences Inc Acquisition (Details) - PRA Health Sciences, Inc $ in Thousands	Jul. 01, 2021USD ($)
Business Acquisition [Line Items]
Estimated Fair Value	$ 4,886,000
Customer relationships
Business Acquisition [Line Items]
Estimated Fair Value	$ 3,915,000
Estimated Useful Life	23 years
Order backlog
Business Acquisition [Line Items]
Estimated Fair Value	$ 490,000
Estimated Useful Life	3 years
Trade names
Business Acquisition [Line Items]
Estimated Fair Value	$ 202,000
Estimated Useful Life	3 years
Patient database
Business Acquisition [Line Items]
Estimated Fair Value	$ 168,000
Estimated Useful Life	7 years
Technology
Business Acquisition [Line Items]
Estimated Fair Value	$ 111,000
Estimated Useful Life	5 years

Business combinations - Sched_4

Business combinations - Schedule of Proforma Information of PRA Health Sciences Inc Acquisition (Details) - PRA Health Sciences, Inc - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Business Acquisition [Line Items]
Revenue	$ 1,901,764	$ 1,791,973
Net income (loss)	$ 111,970	$ (204,650)

Equity method investments - Nar

Equity method investments - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021	Jul. 24, 2020
Related Party Transaction [Line Items]
Equity method investments	$ 1,588		$ 2,373	$ 4,900
Equity method investment, ownership percentage	49.00%
Equity method investment, majority ownership percentage	51.00%
Equity method investment, period majority voting share capital can be sold to the company	2 years 6 months
Loss on equity method investments	$ 785	$ 274
Oncacare
Related Party Transaction [Line Items]
Loan granted to related party			$ 10,000
Related party, loan interest rate			1.60%

Equity method investments - Sum

Equity method investments - Summary of Equity Method Investments (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021	Jul. 24, 2020
Equity Method Investments and Joint Ventures [Abstract]
Ownership Percentage	49.00%
Carrying Value	$ 1,588	$ 2,373	$ 4,900

Fair value measurements (Detail

Fair value measurements (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Carrying value of long-term investments in equity	$ 26	$ 22.6
Fair value, nonrecurring | Fair value, inputs, level 3
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Assets at fair value	13,620.6
Goodwill at fair value	9,028
Net intangible assets at fair value	$ 4,592.6

Restructuring - Narrative (Deta

Restructuring - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended		12 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021	Dec. 31, 2020
Restructuring Cost and Reserve [Line Items]
Restructuring charges	$ 4,207	$ 0
Restructuring credit	200		$ 0
Impairment of long lived assets	3,574	$ 0
Provision balance	29,224		$ 28,353	$ 10,748
2021 Restructuring Plan
Restructuring Cost and Reserve [Line Items]
Restructuring charges	4,200
Impairment of ROU assets and associated costs	4,200
Impairment of long lived assets	200
Employee severance | Other liabilities
Restructuring Cost and Reserve [Line Items]
Provision balance	4,800
Employee severance | 2021 Restructuring Plan
Restructuring Cost and Reserve [Line Items]
Restructuring credit	200
Lease liability
Restructuring Cost and Reserve [Line Items]
Provision balance	24,400
Lease liability | Other liabilities
Restructuring Cost and Reserve [Line Items]
Provision balance	10,400
Lease liability | Non-current operating lease liabilities
Restructuring Cost and Reserve [Line Items]
Provision balance	$ 14,000

Restructuring - Summary of Rest

Restructuring - Summary of Restructuring Charges (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Restructuring and Related Activities [Abstract]
Restructuring charges	$ 4,207	$ 0

Restructuring - Summary of Deta

Restructuring - Summary of Details of Movement in Restructuring Charges (Details) - USD ($) $ in Thousands	3 Months Ended	12 Months Ended
	Mar. 31, 2022	Dec. 31, 2021
Restructuring Reserve [Roll Forward]
Opening provision	$ 28,353	$ 10,748
Additional provisions	4,153	26,674
Release provision	(200)	0
Utilization	(3,082)	(9,069)
Ending provision	$ 29,224	$ 28,353

Operating leases - Schedule of

Operating leases - Schedule of Lease Costs (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Leases [Abstract]
Operating lease costs	$ 15,264	$ 7,789
Income from sub-leases	(327)	(211)
Net operating lease costs	$ 14,937	$ 7,578

Operating leases - Narrative (D

Operating leases - Narrative (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Lessee, Lease, Description [Line Items]
Total lease cost	$ 14,937	$ 7,578
Early termination options reasonably certain to be exercised	0	4,200
Right-of-use assets obtained in exchange for lease obligations	$ 6,800	$ 2,900
Weighted average remaining lease term	6 years 11 months 1 day
Weighted average discount rate	2.48%
Operating Lease, Liability, Current, Statement of Financial Position [Extensible Enumeration]	Other Liabilities	Other Liabilities
Other liabilities
Lessee, Lease, Description [Line Items]
Operating lease liabilities	$ 48,600	$ 23,800
Selling, general and administration costs
Lessee, Lease, Description [Line Items]
Total lease cost	48,000	7,000
Direct costs
Lessee, Lease, Description [Line Items]
Total lease cost	$ 600	$ 600

Operating leases - Schedule o_2

Operating leases - Schedule of Operating Lease Maturity (Details) $ in Thousands	Mar. 31, 2022USD ($)
Leases [Abstract]
Year 1	$ 52,372
Year 2	45,344
Year 3	29,086
Year 4	19,925
Year 5	16,870
Thereafter	56,684
Total future minimum lease payments	220,281
Lease imputed interest	(17,312)
Total	$ 202,969

Bank credit lines and loan fa_3

Bank credit lines and loan facilities - Schedule of Outstanding Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021	Jul. 01, 2021
Debt Instrument [Line Items]
Total debt	$ 5,201,213	$ 5,501,213
Less current portion of long-term debt	(55,150)	(55,150)
Total long-term debt	5,146,063	5,446,063
Less debt issuance costs and debt discount	(59,120)	(64,901)
Total long-term debt, net	$ 5,086,943	$ 5,381,162
Senior Secured Term Loan | Senior Secured Term Loan
Debt Instrument [Line Items]
Debt instrument, interest rate	3.313%	2.75%	1.00%
Total debt	$ 4,701,213	$ 5,001,213
Senior Secured Notes | Senior Secured Notes
Debt Instrument [Line Items]
Debt instrument, interest rate	2.875%	2.875%	2.875%
Total debt	$ 500,000	$ 500,000

Bank credit lines and loan fa_4

Bank credit lines and loan facilities - Narrative (Details) $ in Millions	Mar. 31, 2022USD ($)	Dec. 29, 2021USD ($)	Nov. 10, 2021	Jul. 01, 2021USD ($)	Dec. 31, 2021
Debt Instrument [Line Items]
Long-term debt at fair value	$ 5,155.3
Senior Secured Credit Facility and Senior Secured Notes | Senior Secured Term Loan
Debt Instrument [Line Items]
Debt discount paid	$ 27.6
Senior Secured Term Loan | London Interbank Offered Rate (LIBOR)
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				2.50%
Variable rate, step down percentage (in percent)				0.25%
First lien net leverage ratio			4
Decrease in basis spread on variable rate			0.25%
Senior Secured Term Loan | London Interbank Offered Rate (LIBOR) | Maximum
Debt Instrument [Line Items]
First lien net leverage ratio				4
Senior Secured Term Loan | London Interbank Offered Rate (LIBOR) | Minimum
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				0.50%
First lien net leverage ratio				1
Senior Secured Term Loan | Senior Secured Term Loan
Debt Instrument [Line Items]
Debt instrument, principal amount				$ 5,515
Debt instrument, interest rate	3.313%			1.00%	2.75%
Repayments of senior debt	$ 300	$ 500
Interest paid	35.1
Payments of debt restructuring costs	$ 3.2
Revolving loan facility | London Interbank Offered Rate (LIBOR) | Variable rate component two
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				1.60%
Revolving loan facility | London Interbank Offered Rate (LIBOR) | Maximum | Variable rate component two
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				2.00%
Revolving loan facility | London Interbank Offered Rate (LIBOR) | Minimum | Variable rate component two
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				1.25%
Revolving loan facility | Base rate | Variable rate component one
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				0.60%
Revolving loan facility | Base rate | Maximum | Variable rate component one
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				1.00%
Revolving loan facility | Base rate | Minimum | Variable rate component one
Debt Instrument [Line Items]
Basis spread on variable rate (in percent)				0.25%
Revolving loan facility | Line of credit | Revolving loan facility
Debt Instrument [Line Items]
Debt instrument, maximum borrowing capacity				$ 300
Senior Secured Notes | Senior Secured Notes
Debt Instrument [Line Items]
Debt instrument, principal amount				$ 500
Debt instrument, interest rate	2.875%			2.875%	2.875%

Bank credit lines and loan fa_5

Bank credit lines and loan facilities - Schedule of Contractual Maturities of Debt (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
2022 (remaining)	$ 41,363
2023	55,150
2024	55,150
2025	55,150
2026 and thereafter	4,994,400
Total debt	$ 5,201,213	$ 5,501,213

Income taxes - Schedule of Comp

Income taxes - Schedule of Components of Income Tax Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Income Tax Disclosure [Abstract]
Provision for income taxes (excluding restructuring)	$ 14,114	$ 16,148
Tax impact of restructuring	(828)	0
Provision for income taxes	$ 13,286	$ 16,148

Income taxes - Narrative (Detai

Income taxes - Narrative (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Liability for unrecognized tax benefit	$ 220.7	$ 217.6
Items generating unrecognized tax benefits	201.7	202.1
Interest and related penalties	$ 19	$ 15.5

Net income per ordinary share -

Net income per ordinary share - Schedule of Reconciliation of Number of Shares Used in Computation of Basic and Diluted Net Income Per Ordinary Share (Details) - shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Earnings Per Share [Abstract]
Weighted average number of ordinary shares outstanding for basic net income per ordinary share (in shares)	81,463,303	52,811,460
Effect of dilutive share options and other awards outstanding under share based compensation programs (in shares)	1,149,795	498,993
Weighted average number of ordinary shares outstanding for diluted net income per ordinary share (in shares)	82,613,098	53,310,453

Net income per ordinary share_2

Net income per ordinary share - Schedule of Reconciliation of Net Income Attributable to the Group (Details) - $ / shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Net income per Ordinary Share attributable to the Group:
Basic (in USD per share)	$ 1.37	$ 1.84
Diluted (in USD per share)	$ 1.36	$ 1.82

Share-based awards - Summary of

Share-based awards - Summary of Stock Option Activity (Details) - Employee Stock Option - $ / shares	Mar. 31, 2022	Dec. 31, 2021	Mar. 31, 2022
Options Outstanding Number of Shares
Outstanding at beginning of period (in shares)			1,695,460
Granted (in shares)			96,525
Exercised (in shares)			(84,090)
Canceled/expired (in shares)			(25,660)
Outstanding at end of period (in shares)	1,682,235	1,695,460	1,682,235
Exercisable at end of period (in shares)	1,054,178		1,054,178
Weighted Average Exercise Price
Outstanding at beginning of period (in USD per share)			$ 104.79
Granted (in USD per share)			231.68
Exercised (in USD per share)			190.75
Canceled/expired (in USD per share)			113.04
Outstanding at end of period (in USD per share)	$ 118.36	$ 104.79	118.36
Exercisable at end of period (in USD per share)	$ 97.57		$ 97.57
Weighted Average Remaining Contractual Life
Weighted average contractual term of options outstanding	5 years 5 months 8 days	5 years 4 months 20 days
Weighted average contractual term of options exercisable	4 years 6 months 18 days

Share-based awards - Narrative

Share-based awards - Narrative (Details) - USD ($) $ / shares in Units, $ in Millions	Mar. 31, 2022	Mar. 31, 2022	Dec. 31, 2021	Mar. 31, 2022	May 16, 2019
Employee Stock Option
Compensation Related Costs Share Based Payments Disclosure [Line Items]
Number of shares exercisable (in shares)	1,054,178	1,054,178		1,054,178
Weighted average contractual term of options exercisable	4 years 6 months 18 days
Weighted average exercise price of options exercisble (USD per share)	$ 97.57	$ 97.57		$ 97.57
Consultants Restricted Stock Units 2019
Compensation Related Costs Share Based Payments Disclosure [Line Items]
Ordinary shares which have been reserved for issuance (in shares)					250,000
Consultants Restricted Stock Units 2019 | Non-executive directors
Compensation Related Costs Share Based Payments Disclosure [Line Items]
Shares vesting period				12 months
Performance Share Unit (PSUs)
Compensation Related Costs Share Based Payments Disclosure [Line Items]
Fair value of stock units vested		$ 6	$ 5.1
Restricted Stock Units (RSUs)
Compensation Related Costs Share Based Payments Disclosure [Line Items]
Fair value of stock units vested		$ 5.4	$ 83.5
PSUs based on service and EPS targets | Maximum
Compensation Related Costs Share Based Payments Disclosure [Line Items]
Stock units to be granted (in shares)	82,594	82,594		82,594

Share-based awards - Schedule o

Share-based awards - Schedule of Weighted Average Fair Values and Assumptions Used (Details) - Employee Stock Option - $ / shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Weighted average grant date fair value	$ 68.24	$ 48.36
Assumptions:
Expected volatility	30.00%	30.00%
Dividend yield	0.00%	0.00%
Risk-free interest rate	1.74%	0.73%
Expected life	5 years	5 years

Share-based awards - Summary _2

Share-based awards - Summary of RSU and PSU Activity (Details)	3 Months Ended
	Mar. 31, 2022$ / sharesshares
Performance Share Unit (PSUs)
Outstanding Number of Shares
Outstanding at beginning of period (in shares) | shares	154,190
Granted (in shares) | shares	51,949
Shares vested (in shares) | shares	(42,409)
Forfeited (in shares) | shares	(285)
Outstanding at end of period (in shares) | shares	163,445
Weighted Average Grant Date Fair Value
Outstanding at beginning of period (in USD per share) | $ / shares	$ 160.23
Granted (in USD per share) | $ / shares	231.68
Shares vested (in USD per share) | $ / shares	140.38
Forfeited (in USD per share) | $ / shares	140.18
Outstanding at end of period (in USD per share) | $ / shares	$ 186.77
Restricted Stock Units (RSUs)
Outstanding Number of Shares
Outstanding at beginning of period (in shares) | shares	572,785
Granted (in shares) | shares	26,000
Shares vested (in shares) | shares	(32,360)
Forfeited (in shares) | shares	(24,599)
Outstanding at end of period (in shares) | shares	541,826
Weighted Average Grant Date Fair Value
Outstanding at beginning of period (in USD per share) | $ / shares	$ 191.20
Granted (in USD per share) | $ / shares	231.68
Shares vested (in USD per share) | $ / shares	166.85
Forfeited (in USD per share) | $ / shares	200.16
Outstanding at end of period (in USD per share) | $ / shares	$ 194.19

Share-based awards - Schedule_2

Share-based awards - Schedule of Non-cash Stock Compensation Expense (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation expense	$ 18,903	$ 6,394
Direct costs
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation expense	4,999	2,055
Selling, general and administrative
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Stock compensation expense	$ 13,904	$ 4,339

Share capital (Details)

Share capital (Details) - USD ($) $ in Thousands	Jul. 01, 2021	Mar. 31, 2022	Mar. 31, 2022
Equity, Class of Treasury Stock [Line Items]
Share repurchase program, value of shares repurchased			$ 99,983
Ordinary shares
Equity, Class of Treasury Stock [Line Items]
Issue of shares associated with a business combination (in shares)	27,372,427
Share repurchase program, number of shares repurchased (in shares)			420,530
Share repurchase program, value of shares repurchased			$ 28
Buyback Program
Equity, Class of Treasury Stock [Line Items]
Share repurchase program, number of shares repurchased (in shares)		420,530
Share repurchase program, value of shares repurchased		$ 100,000
Buyback Program | Maximum
Equity, Class of Treasury Stock [Line Items]
Share repurchase program, authorized percentage			10.00%

Business Segment and Geograph_3

Business Segment and Geographical Information - Narrative (Details)	3 Months Ended
	Mar. 31, 2022segment
Segment Reporting [Abstract]
Number of operating segments	1

Business Segment and Geograph_4

Business Segment and Geographical Information - Schedule of Distribution of Revenue by Geographical Area (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Revenue	$ 1,901,764	$ 858,198
Ireland
Segment Reporting Information [Line Items]
Revenue	367,359	308,121
Rest of Europe
Segment Reporting Information [Line Items]
Revenue	456,064	120,354
U.S.
Segment Reporting Information [Line Items]
Revenue	970,629	352,496
Rest of World
Segment Reporting Information [Line Items]
Revenue	$ 107,712	$ 77,227

Business Segment and Geograph_5

Business Segment and Geographical Information - Schedule of Distribution of Income from Operations by Geographical Area (Details) - USD ($) $ in Thousands	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Income from operations	$ 170,339	$ 116,014
Ireland
Segment Reporting Information [Line Items]
Income from operations	9,874	88,912
Rest of Europe
Segment Reporting Information [Line Items]
Income from operations	59,509	7,610
U.S.
Segment Reporting Information [Line Items]
Income from operations	60,468	13,237
Rest of World
Segment Reporting Information [Line Items]
Income from operations	$ 40,488	$ 6,255

Business Segment and Geograph_6

Business Segment and Geographical Information - Schedule of Distribution of Depreciation and Amortization by Geographical Area (Details) - USD ($) $ in Thousands	Mar. 31, 2022	Dec. 31, 2021
Segment Reporting Information [Line Items]
Long-lived assets	$ 509,841	$ 534,567
Ireland
Segment Reporting Information [Line Items]
Long-lived assets	116,680	118,253
Rest of Europe
Segment Reporting Information [Line Items]
Long-lived assets	107,742	121,174
U.S.
Segment Reporting Information [Line Items]
Long-lived assets	236,379	239,828
Rest of World
Segment Reporting Information [Line Items]
Long-lived assets	$ 49,040	$ 55,312