IQVIA (IQV) 10-Q 1 May 14 2014 Q1 Quarterly report Financial data

Document_and_Entity_Informatio

Document and Entity Information	3 Months Ended
	Mar. 31, 2014	Apr. 24, 2014
Document And Entity Information [Abstract]	'	'
Document Type	'10-Q	'
Amendment Flag	'false	'
Document Period End Date	31-Mar-14	'
Document Fiscal Year Focus	'2014	'
Document Fiscal Period Focus	'Q1	'
Trading Symbol	'Q	'
Entity Registrant Name	'Quintiles Transnational Holdings Inc.	'
Entity Central Index Key	'0001478242	'
Current Fiscal Year End Date	'--12-31	'
Entity Filer Category	'Non-accelerated Filer	'
Entity Common Stock, Shares Outstanding	'	130,142,016

CONDENSED_CONSOLIDATED_STATEME

CONDENSED CONSOLIDATED STATEMENTS OF INCOME (unaudited) (USD $)	3 Months Ended
In Thousands, except Per Share data, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Income Statement [Abstract]	'	'
Service revenues	$1,005,288	$927,435
Reimbursed expenses	302,558	301,406
Total revenues	1,307,846	1,228,841
Costs, expenses and other:	'	'
Costs of revenue, service costs	643,722	611,109
Costs of revenue, reimbursed expenses	302,558	301,406
Selling, general and administrative	219,242	199,302
Restructuring costs	1,008	1,859
Income from operations	141,316	115,165
Interest income	-1,255	-452
Interest expense	24,703	36,042
Other income, net	-4,844	-2,382
Income before income taxes and equity in earnings (losses) of unconsolidated affiliates	122,712	81,957
Income tax expense	37,389	32,118
Income before equity in earnings (losses) of unconsolidated affiliates	85,323	49,839
Equity in earnings (losses) of unconsolidated affiliates	4,891	-1,683
Net income	90,214	48,156
Net (income) loss attributable to noncontrolling interests	-31	153
Net income attributable to Quintiles Transnational Holdings Inc.	$90,183	$48,309
Earnings per share attributable to common shareholders:	'	'
Basic	$0.69	$0.42
Diluted	$0.68	$0.41
Weighted average common shares outstanding:	'	'
Basic	129,898	115,769
Diluted	133,040	118,740

CONDENSED_CONSOLIDATED_STATEME1

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Statement Of Income And Comprehensive Income [Abstract]	'	'
Net income	$90,214	$48,156
Unrealized gains on marketable securities, net of income taxes of $1,208 and $26	1,930	42
Unrealized gains (losses) on derivative instruments, net of income taxes of ($125) and ($1,197)	322	-3,196
Foreign currency translation, net of income taxes of $0 and ($4,635)	303	-15,638
Reclassification adjustments:	'	'
Gains on marketable securities included in net income, net of income taxes of ($1,927)	-3,077	'
Losses on derivative instruments included in net income, net of income taxes of $794 and $1,368	375	2,546
Amortization of prior service costs and losses included in net income, net of income taxes of $72 and $101	120	166
Comprehensive income	90,187	32,076
Comprehensive (income) loss attributable to noncontrolling interests	-21	151
Comprehensive income attributable to Quintiles Transnational Holdings Inc.	$90,166	$32,227

CONDENSED_CONSOLIDATED_STATEME2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (unaudited) (Parenthetical) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Statement Of Income And Comprehensive Income [Abstract]	'	'
Unrealized gains on marketable securities, income taxes	$1,208	$26
Unrealized gains (losses) on derivative instruments, income taxes	-125	-1,197
Foreign currency translation, income taxes	0	-4,635
Gains on marketable securities included in net income, income taxes	-1,927	0
Losses on derivative instruments included in net income, income taxes	794	1,368
Amortization of prior service costs and losses included in net income, income taxes	$72	$101

CONDENSED_CONSOLIDATED_BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Current assets:	'	'
Cash and cash equivalents	$741,381	$778,143
Restricted cash	3,373	2,712
Trade accounts receivable and unbilled services, net	948,453	924,205
Prepaid expenses	52,893	42,801
Deferred income taxes	92,856	92,115
Income taxes receivable	16,444	16,171
Other current assets and receivables	92,420	89,541
Total current assets	1,947,820	1,945,688
Property and equipment, net	195,852	199,578
Investments in debt, equity and other securities	37,628	40,349
Investments in and advances to unconsolidated affiliates	29,072	22,927
Goodwill	409,519	409,626
Other identifiable intangibles, net	289,094	298,054
Deferred income taxes	33,430	32,864
Deposits and other assets	119,477	117,711
Total assets	3,061,892	3,066,797
Current liabilities:	'	'
Accounts payable and accrued expenses	768,868	861,805
Unearned income	511,441	538,585
Income taxes payable	46,697	35,778
Current portion of long-term debt and obligations held under capital leases	15,572	10,433
Other current liabilities	33,898	35,646
Total current liabilities	1,376,476	1,482,247
Long-term debt and obligations held under capital leases, less current portion	2,031,247	2,035,586
Deferred income taxes	35,565	37,541
Other liabilities	178,129	178,908
Total liabilities	3,621,417	3,734,282
Commitments and contingencies	'	'
Shareholders' deficit:	'	'
Common stock and additional paid-in capital, 300,000 shares authorized, $0.01 par value, 130,049 and 129,652 shares issued and outstanding at March 31, 2014 and December 31, 2013, respectively	495,917	478,144
Accumulated deficit	-1,054,998	-1,145,181
Accumulated other comprehensive loss	-393	-376
Deficit attributable to Quintiles Transnational Holdings Inc.'s shareholders	-559,474	-667,413
Deficit attributable to noncontrolling interests	-51	-72
Total shareholders' deficit	-559,525	-667,485
Total liabilities and shareholders' deficit	$3,061,892	$3,066,797

CONDENSED_CONSOLIDATED_BALANCE1

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) (USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, except Per Share data, unless otherwise specified
Statement Of Financial Position [Abstract]	'	'
Common stock, authorized	300,000	300,000
Common stock, par value	$0.01	$0.01
Common stock, shares issued	130,049	129,652
Common stock, shares outstanding	130,049	129,652

CONDENSED_CONSOLIDATED_STATEME3

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Operating activities:	'	'
Net income	$90,214	$48,156
Adjustments to reconcile net income to cash used in operating activities:	'	'
Depreciation and amortization	29,088	24,640
Amortization of debt issuance costs and discount	1,595	2,875
Share-based compensation	7,221	4,473
Gain on disposals of property and equipment, net	-181	-296
(Earnings) loss from unconsolidated affiliates	-4,891	1,683
Gain on investments, net	-5,268	-12
(Benefit from) provision for deferred income taxes	-1,587	11,164
Excess income tax benefits on stock option exercises	-5,840	-196
Changes in operating assets and liabilities:	'	'
Change in accounts receivable, unbilled services and unearned income	-51,018	-39,654
Change in other operating assets and liabilities	-87,770	-74,291
Net cash used in operating activities	-28,437	-21,458
Investing activities:	'	'
Acquisition of property, equipment and software	-17,706	-31,459
Acquisition of business, net of cash acquired	-667	'
Proceeds from disposition of property and equipment	418	659
Proceeds from sale of equity securities	5,861	60
Investments in and advances to unconsolidated affiliates, net of payments received	-1,224	-4,377
Change in restricted cash, net	-661	-1,077
Net cash used in investing activities	-13,979	-36,194
Financing activities:	'	'
Repayment of debt and principal payments on capital lease obligations	-334	-34,304
Exercise of stock options	5,916	149
Payroll taxes remitted on repurchase of stock options	-8,415	'
Excess income tax benefits on stock option exercises	5,840	196
Net cash provided by (used in) financing activities	3,007	-33,959
Effect of foreign currency exchange rate changes on cash	2,647	-21,824
Decrease in cash and cash equivalents	-36,762	-113,435
Cash and cash equivalents at beginning of period	778,143	567,728
Cash and cash equivalents at end of period	$741,381	$454,293

Basis_of_Presentation

Basis of Presentation	3 Months Ended
	Mar. 31, 2014
Accounting Policies [Abstract]	'
Basis of Presentation	'
	1. Basis of Presentation
	The accompanying unaudited condensed consolidated financial statements of Quintiles Transnational Holdings Inc. and its subsidiaries (the “Company”) have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2014. As such, the information included in this quarterly report on Form 10-Q should be read in conjunction with the Company’s audited consolidated financial statements included in the Company’s Annual Report on Form 10-K for the fiscal year ended December 31, 2013. The balance sheet at December 31, 2013 has been derived from the audited consolidated financial statements of the Company but does not include all the disclosures required by GAAP.
	Reclassifications
	Certain prior period amounts have been reclassified to conform to current period presentation. These changes had no effect on previously reported total revenues, net income, comprehensive income, shareholders’ deficit or cash flows.

Employee_Stock_Compensation

Employee Stock Compensation	3 Months Ended
	Mar. 31, 2014
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Employee Stock Compensation	'
	2. Employee Stock Compensation
	The Company granted the following share-based awards:
		Three Months Ended March 31,
		2014			2013
	Stock options		1,024,500			75,000
	Stock appreciation rights		176,800			—
	The Company had the following share-based awards outstanding:
		March 31,			December 31,
		2014			2013
	Stock options		10,578,160			10,100,160
	Stock appreciation rights		430,450			258,025
	Restricted stock units		57,167			57,167
	The Company used the following assumptions when estimating the value of the share-based compensation for stock options and stock appreciation rights issued as follows:
		Three Months Ended March 31,
		2014		2013
	Expected volatility	32 – 43%		34 – 47%
	Weighted average expected volatility	38%		42%
	Expected dividends	0.00%		5.45%
	Expected term (in years)	3.7 – 6.7		3.4 – 6.4
	Risk-free interest rate	0.99 – 2.21%		0.48 – 1.19%
	In November 2013, the Company’s Board of Directors (the “Board”) approved an Employee Stock Purchase Plan (“ESPP”) which, subject to shareholder approval at the 2014 annual meeting, allows eligible employees to authorize payroll deductions of up to 10% of their base salary to be applied toward the purchase of full shares of the Company’s common stock on the last day of the offering period. Offering periods under the ESPP are six months in duration and will begin on each March 1 and September 1. The first offering period for the ESPP began March 1, 2014. Under the ESPP, shares will be purchased on the last day of each offering period at a discount of 15% of the closing price of the common stock on such date as reported on the New York Stock Exchange. As of March 31, 2014, there have been aggregate payroll contributions of approximately $407,000 related to the ESPP.
	The Company recognized share-based compensation expense of $7.2 million and $4.5 million during the three months ended March 31, 2014 and 2013, respectively.

Concentration_of_Credit_Risk

Concentration of Credit Risk	3 Months Ended
	Mar. 31, 2014
Risks And Uncertainties [Abstract]	'
Concentration of Credit Risk	'
	3. Concentration of Credit Risk
	No customer accounted for 10% or more of consolidated service revenues for the three months ended March 31, 2014 or 2013.

Accounts_Receivable_and_Unbill

Accounts Receivable and Unbilled Services	3 Months Ended
	Mar. 31, 2014
Receivables [Abstract]	'
Accounts Receivable and Unbilled Services	'
	4. Accounts Receivable and Unbilled Services
	Accounts receivable and unbilled services consist of the following (in thousands):
		March 31,		December 31,
		2014		2013
	Trade:
	Billed	$	435,068	$	408,959
	Unbilled services		515,131		516,942
			950,199		925,901
	Allowance for doubtful accounts		(1,746)		(1,696)
		$	948,453	$	924,205

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2014
Goodwill And Intangible Assets Disclosure [Abstract]	'
Goodwill	'
	5. Goodwill
	The following is a summary of goodwill by segment for the three months ended March 31, 2014 (in thousands):
		Product		Integrated		Consolidated
		Development		Healthcare
				Services
	Balance as of December 31, 2013	$	351,144	$	58,482	$	409,626
	Impact of foreign currency fluctuations and other		(652)		545		(107)
	Balance as of March 31, 2014	$	350,492	$	59,027	$	409,519

Derivatives

Derivatives	3 Months Ended
	Mar. 31, 2014
Derivative Instruments And Hedging Activities Disclosure [Abstract]	'
Derivatives	'
	6. Derivatives
	As of March 31, 2014, the Company held the following derivative positions: (i) freestanding warrants to purchase shares of common stock of third parties, (ii) forward exchange contracts to protect against foreign exchange movements for certain forecasted foreign currency cash flows related to service contracts and (iii) interest rate swaps to hedge the exposure to variability in interest payments on variable interest rate debt. The Company does not use derivative financial instruments for speculative or trading purposes.
	As of March 31, 2014, the Company had freestanding warrants to purchase shares of third parties’ common stock. No quoted price is available for the warrants. Accordingly, the Company uses various valuation techniques to value the warrants, including the present value of estimated expected future cash flows, option-pricing models and fundamental analysis. Factors affecting the valuation include the current price of the underlying common stock, the exercise price of the warrants, the expected time to exercise the warrants, the estimated price volatility of the underlying common stock over the life of the warrants and the restrictions on the transferability of or ability to exercise the warrants. The Company did not sell any warrants during the three months ended March 31, 2014 or 2013.
	As of March 31, 2014, the Company had 14 open foreign exchange forward contracts to hedge certain forecasted foreign currency cash flow transactions occurring in 2014 with notional amounts totaling $70.6 million. As these contracts were executed to hedge the risk of the potential volatility in the cash flows resulting from fluctuations in currency exchange rates during the last nine months of 2014, these transactions are accounted for as cash flow hedges. As such, the effective portion of the gain or loss on the contracts is recorded as unrealized gains (losses) on derivatives included in the accumulated other comprehensive loss component of shareholders’ deficit. These hedges are highly effective. Upon expiration of the hedge instruments in 2014, the Company will reclassify the unrealized holding gains and losses on the derivative instruments included in accumulated other comprehensive loss into earnings.
	On June 9, 2011, the Company entered into six interest rate swaps effective September 28, 2012 and expiring between September 30, 2013 and March 31, 2016 in an effort to limit its exposure to changes in the variable interest rate on its senior secured credit facilities. The critical terms of the interest rate swaps were substantially the same as those of the Company’s senior secured credit facilities, including quarterly interest settlements. These interest rate swaps are being accounted for as cash flow hedges as these transactions were executed to hedge the Company’s interest payments, and these hedges are deemed to be highly effective. As such, changes in the fair value of these derivative instruments are recorded as unrealized gains (losses) on derivatives included in the accumulated other comprehensive loss component of shareholders’ deficit. The fair value of these interest rate swaps represents the present value of the anticipated net payments the Company will make to the counterparty, which, when they occur, are reflected as interest expense on the condensed consolidated statements of income. These payments, together with the variable rate of interest incurred on the underlying debt, result in a fixed rate of interest of 2.55% plus the applicable margin on the affected borrowings ($945.0 million or 45.9% of the Company’s variable rate debt at March 31, 2014). The Company expects that $12.4 million of unrealized losses will be reclassified out of accumulated other comprehensive loss and will form the interest rate swap component of the 2.55% fixed rate of interest incurred over the next 12 months as the underlying net payments are settled.
	The fair values of the Company’s derivative instruments designated as hedging instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table (in thousands):
		Balance Sheet Classification		March 31,				December 31,
				2014				2013
	Foreign exchange forward contracts	Other current assets		$	3,141			$	3,950
	Interest rate swaps	Other current liabilities		$	22,630			$	24,805
	The fair values of the Company’s derivative instruments not designated as hedging instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table (in thousands):
		Balance Sheet Classification		March 31,		December 31,
				2014		2013
	Warrants	Deposits and other assets		$              474		$              211
	The effect of the Company’s cash flow hedging instruments on other comprehensive income (loss) is summarized in the following table (in thousands):
		Three Months Ended March 31,
		2014				2013
	Foreign exchange forward contracts	$	(809	)		$	(2,391	)
	Interest rate swaps		2,175				1,912
	Total	$	1,366			$	(479	)
	Gains from derivative instruments not designated as hedges impacting the Company’s condensed consolidated statements of income are summarized below (in thousands):
				Three Months Ended March 31,
		Income Statement Classification		2014				2013
	Warrants	Other income, net		$	263			$	11

Fair_Value_Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2014
Fair Value Disclosures [Abstract]	'
Fair Value Measurements	'
	7. 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.
	Recurring Fair Value Measurements
	The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured on a recurring basis as of March 31, 2014 (in thousands):
			Level 1		Level 2		Level 3		Total
	Assets:
	Marketable equity securities		$	4,946	$	—	$	—	$	4,946
	Foreign exchange forward contracts			—		3,141		—		3,141
	Warrants			—		—		474		474
	Total		$	4,946	$	3,141	$	474	$	8,561
	Liabilities:
	Interest rate swaps		$	—	$	22,630	$	—	$	22,630
	Contingent consideration			—		—		12,932		12,932
	Total		$	—	$	22,630	$	12,932	$	35,562
	Below is a summary of the valuation techniques used in determining fair value:
	Marketable equity securities — The Company values marketable equity securities utilizing quoted market prices.
	Warrants — The Company values warrants utilizing the Black-Scholes-Merton model.
	Foreign exchange forward contracts — The Company values foreign exchange forward contracts using quoted market prices for identical instruments in less active markets or using other observable inputs.
	Interest rate swaps — The Company values interest rate swaps using market inputs with mid-market pricing as a practical expedient for bid-ask spread.
	Contingent consideration — The Company values contingent consideration related to business combinations using a weighted probability calculation of potential payment scenarios discounted at rates reflective of the risks associated with the expected future cash flows. Key assumptions used to estimate the fair value of contingent consideration include revenue, net new business and operating forecasts and the probability of achieving the specific targets.
	The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the three months ended March 31 (in thousands):
			Warrants – Deposits				Contingent Consideration –
			and Other Assets				Accounts Payable and Accrued
							Expenses and Other Liabilities
			2014		2013		2014		2013
	Balance as of January 1		$	211	$	29	$	13,014	$	3,521
	Purchases and issuances			—		—		—		—
	Revaluations included in earnings			263		11		-82		-181
	Balance as of March 31		$	474	$	40	$	12,932	$	3,340
	The revaluations for the warrants and the contingent consideration are recognized in other income, net on the accompanying condensed consolidated statements of income.
	Non-recurring Fair Value Measurements
	Certain assets are carried on the accompanying condensed consolidated balance sheets at cost and are not remeasured to fair value on a recurring basis. These assets include cost and equity method investments and loans that are written down to fair value for declines which are deemed to be other-than-temporary, definite-lived intangible assets which are tested for impairment annually and when a triggering event occurs, and goodwill and identifiable indefinite-lived intangible assets which are tested for impairment annually and when a triggering event occurs.
	As of March 31, 2014, assets carried on the balance sheet and not remeasured to fair value on a recurring basis totaling approximately $760.4 million were identified as Level 3. These assets are comprised of cost and equity method investments of $61.8 million, goodwill of $409.5 million and other identifiable intangibles, net of $289.1 million.
	The Company has unfunded cash commitments totaling approximately $33.0 million related to its cost and equity method investments as of March 31, 2014.
	Other
	The estimated fair value of the Company’s long-term debt, which is primarily based on rates in which the debt is traded among banks, was approximately $2.1 billion at both March 31, 2014 and December 31, 2013.

Noncontrolling_Interests

Noncontrolling Interests	3 Months Ended
	Mar. 31, 2014
Noncontrolling Interest [Abstract]	'
Noncontrolling Interests	'
	8. Noncontrolling Interests
	Below is a summary of noncontrolling interests for the three months ended March 31 (in thousands):
		2014		2013
	Balance as of January 1	$	(72)	$	479
	Comprehensive income (loss):
	Net income (loss)		31		(153)
	Foreign currency adjustments, net of income tax		(10)		2
	Balance as of March 31	$	(51)	$	328

Restructuring

Restructuring	3 Months Ended
	Mar. 31, 2014
Restructuring And Related Activities [Abstract]	'
Restructuring	'
	9. Restructuring
	In February 2014, the Board approved a restructuring plan of up to $13.0 million to better align resources with the Company’s strategic direction. These actions are expected to occur throughout 2014 and are expected to result in severance for approximately 400 positions, primarily in the Product Development segment. Since February 2014, the Company has recognized approximately $1.5 million of restructuring costs related to this plan, all of which were for activities in the Product Development segment. All of the restructuring costs are related to severance costs. Restructuring costs are not allocated to the Company’s reportable segments as they are not part of the segment performance measures regularly reviewed by management.
	The following amounts were recorded for the February 2014 restructuring plan and the restructuring plans initiated in prior years (in thousands):
		Severance and		Exit Costs		Total
		Related Costs
	Balance at December 31, 2013	$	5,276	$	198	$	5,474
	Expense, net of reversals		1,008		—		1,008
	Payments		-2,658		(42)		-2,700
	Foreign currency translation		-14		—		-14
	Balance at March 31, 2014	$	3,612	$	156	$	3,768
	The Company expects the majority of the remaining restructuring accruals to be paid in 2014.

Employee_Benefit_Plans

Employee Benefit Plans	3 Months Ended
	Mar. 31, 2014
Postemployment Benefits [Abstract]	'
Employee Benefit Plans	'
	10. Employee Benefit Plans
	Defined Benefit Plans
	The following table summarizes the components of pension expense related to the Company’s defined benefit plans (in thousands):
		Three Months Ended March 31,
		2014		2013
	Service cost	$	3,287	$	3,153
	Interest cost		987		938
	Expected return on plan assets		-928		-692
	Amortization of prior service costs		20		89
	Amortization of actuarial losses		172		178
		$	3,538	$	3,666
	Other
	As of March 31, 2014 and December 31, 2013, the Company has a severance accrual included in accounts payable and accrued expenses on the accompanying condensed consolidated balance sheets of $10.9 million and $14.1 million, respectively. The Company recognizes obligations associated with severance related to contractual termination benefits at fair value on the date that it is probable that the affected employees will be entitled to the benefit and the amount can reasonably be estimated. The severance accrual is related to cost reduction programs that will result in severance for approximately 270 positions, which are expected to lower operating costs and improve profitability by reducing excess capacity. These actions are expected to occur and be paid during 2014 and 2015. During the first quarter of 2014, the Company has recognized approximately $2.2 million of net reversals related to these cost reduction programs, primarily as a result of affected individuals transferring into other positions within the Company. Of the $2.2 million decrease from net reversals recognized for these cost reduction programs, approximately ($2.2) million, $131,000 and ($55,000) were related to activities in the Product Development segment, Integrated Healthcare Services segment and corporate activities, respectively.
	The following amounts were recorded for the severance associated with cost reduction programs (in thousands):
	Balance at December 31, 2013	$	14,056
	Expense, net of reversals		(2,160)
	Payments		(966)
	Foreign currency translation		(1)
	Balance at March 31, 2014	$	10,929

Income_Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2014
Income Tax Disclosure [Abstract]	'
Income Taxes	'
	11. Income Taxes
	The Company’s effective income tax rate was 30.5% and 39.2% for the first quarter of 2014 and 2013 respectively. The effective income tax rate for the first quarter of 2014 was positively impacted by the Company’s change in the assertion regarding the undistributed earnings of most of its foreign subsidiaries that are considered to be indefinitely reinvested outside of the United States. Prior to June 2013, the Company had not considered the majority of the undistributed earnings of its foreign subsidiaries to be indefinitely reinvested. Accordingly, the first quarter of 2013 was negatively impacted by income taxes imposed on most of the earnings of the foreign subsidiaries, as a deferred income tax liability was recorded for the anticipated income tax costs of repatriating those earnings in the future. The Company reevaluated this assertion following its initial public offering (“IPO”) in May 2013 as a portion of the IPO proceeds were used to pay down debt held in the United States as well as the fact the Company does not anticipate paying dividends in the foreseeable future, which had been significant in the past. With this reduction of debt and related interest expense and the change in approach relating to payment of dividends, the Company expects to be able to support the cash needs of its domestic subsidiaries without repatriating cash from the affected foreign subsidiaries. The Company expects to utilize the cash generated outside of the United States to fund growth outside of the United States.

Comprehensive_Income

Comprehensive Income	3 Months Ended
	Mar. 31, 2014
Equity [Abstract]	'
Comprehensive Income	'
	12. Comprehensive Income
	Below is a summary of the components of accumulated other comprehensive (loss) income for the three months ended March 31, 2014 and 2013 (in thousands):
		Foreign		Marketable		Derivative		Defined		Income		Accumulated
		Currency		Securities		Instruments		Benefit		Taxes		Other
		Translation						Plans				Comprehensive
												(Loss) Income
	Balance at December 31, 2013	$	(5,829)	$	5,708	$	(20,855)	$	(5,044)	$	25,644	$	(376)
	Other comprehensive (loss) income before reclassifications		313		3,138		197		—		(1,083)		2,565
	Reclassification adjustments		—		(5,004)		1,169		192		1,061		(2,582)
	Balance at March 31, 2014	$	(5,516)	$	3,842	$	(19,489)	$	(4,852)	$	25,622	$	(393)
		Foreign		Marketable		Derivative		Defined		Income		Accumulated
		Currency		Securities		Instruments		Benefit		Taxes		Other
		Translation						Plans				Comprehensive
												(Loss) Income
	Balance at December 31, 2012	$	19,312	$	467	$	(33,542)	$	(8,235)	$	29,693	$	7,695
	Other comprehensive income (loss) before reclassifications		(20,275)		68		(4,393)		—		5,806		(18,794)
	Reclassification adjustments		—		—		3,914		267		(1,469)		2,712
	Balance at March 31, 2013	$	(963)	$	535	$	(34,021)	$	(7,968)	$	34,030	$	(8,387)
	Below is a summary of the reclassification adjustments from accumulated other comprehensive (loss) income into net income for the three months ended March 31, 2014 and 2013 (in thousands):
		Three Months Ended March 31,
		2014		2013
	Marketable securities:
	Marketable securities – gain included in other income, net	$	(5,004)	$	—
	Total before income taxes		(5,004)		—
	Income taxes		(1,927)		—
	Total net of income taxes	$	(3,077)	$	—
	Derivative instruments:
	Interest rate swaps – increase to interest expense	$	3,080	$	3,006
	Foreign exchange forward contracts – (increase) reduction to service revenues		(1,911)		908
	Total before income taxes		1,169		3,914
	Income taxes		794		1,368
	Total net of income taxes	$	375	$	2,546
	Defined benefit plans:
	Amortization of prior service costs	$	20	$	89
	Amortization of actuarial losses		172		178
	Total before income taxes		192		267
	Income taxes		72		101
	Total net of income taxes	$	120	$	166
	Amortization of prior service costs and actuarial losses are included in the computation of pension expense for the Company’s defined benefit plans. See Note 10 for additional information.

Segments

Segments	3 Months Ended
	Mar. 31, 2014
Segment Reporting [Abstract]	'
Segments	'
	13. Segments
	The following table presents the Company’s operations by reportable segment. The Company is managed through two reportable segments, Product Development and Integrated Healthcare Services. Product Development, which primarily serves biopharmaceutical customers engaged in research and development, provides clinical research and clinical trial services. Integrated Healthcare Services provides commercialization services to biopharmaceutical customers and research, analytics, real-world and late phase research, and other services to both biopharmaceutical customers and the broader healthcare market.
	Certain costs are not allocated to the Company’s segments and are reported as general corporate and unallocated expenses. These costs primarily consist of share-based compensation and expenses for corporate overhead functions such as finance, human resources, information technology, facilities and legal. The Company does not allocate restructuring or impairment charges to its segments. Information presented below is in thousands:
		Three Months Ended March 31,
		2014		2013
	Service revenues
	Product Development	$	770,828	$	706,307
	Integrated Healthcare Services		234,460		221,128
	Total service revenues		1,005,288		927,435
	Costs of revenue, service costs
	Product Development		450,483		429,007
	Integrated Healthcare Services		193,239		182,102
	Total costs of revenue, service costs		643,722		611,109
	Selling, general and administrative
	Product Development		159,685		144,625
	Integrated Healthcare Services		32,276		32,781
	General corporate and unallocated		27,281		21,896
	Total selling, general and administrative		219,242		199,302
	Income from operations
	Product Development		160,660		132,675
	Integrated Healthcare Services		8,945		6,245
	General corporate and unallocated		(27,281)		-21,896
	Restructuring costs		(1,008)		-1,859
	Total income from operations	$	141,316	$	115,165
		Three Months Ended March 31,
		2014		2013
	Depreciation and amortization expense
	Product Development	$	22,970	$	18,447
	Integrated Healthcare Services		4,891		5,353
	General corporate and unallocated		1,227		840
	Total depreciation and amortization expense	$	29,088	$	24,640

Earnings_Per_Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2014
Earnings Per Share [Abstract]	'
Earnings Per Share	'
	14. Earnings Per Share
	The following table shows the weighted average number of outstanding share-based awards not included in the computation of diluted earnings per share as the effect of including such share-based awards in the computation would be anti-dilutive (in thousands):
		Three Months Ended March 31,
		2014		2013
	Weighted average shares subject to anti-dilutive share-based awards		766		1,631
	Share-based awards will have a dilutive effect under the treasury method only when the respective period’s average market value of the Company’s common stock exceeds the exercise proceeds.

Basis_of_Presentation_Policies

Basis of Presentation (Policies)	3 Months Ended
	Mar. 31, 2014
Accounting Policies [Abstract]	'
Reclassifications	'
	Reclassifications
	Certain prior period amounts have been reclassified to conform to current period presentation. These changes had no effect on previously reported total revenues, net income, comprehensive income, shareholders’ deficit or cash flows.

Employee_Stock_Compensation_Ta

Employee Stock Compensation (Tables)	3 Months Ended
	Mar. 31, 2014
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'
Schedule of Share Based Awards Granted and Outstanding	'
	The Company granted the following share-based awards:
		Three Months Ended March 31,
		2014			2013
	Stock options		1,024,500			75,000
	Stock appreciation rights		176,800			—
	The Company had the following share-based awards outstanding:
		March 31,			December 31,
		2014			2013
	Stock options		10,578,160			10,100,160
	Stock appreciation rights		430,450			258,025
	Restricted stock units		57,167			57,167
Assumptions Used to Estimate Value of Share-Based Compensation for Stock Options and Stock Appreciation Rights Issued	'
	The Company used the following assumptions when estimating the value of the share-based compensation for stock options and stock appreciation rights issued as follows:
		Three Months Ended March 31,
		2014		2013
	Expected volatility	32 – 43%		34 – 47%
	Weighted average expected volatility	38%		42%
	Expected dividends	0.00%		5.45%
	Expected term (in years)	3.7 – 6.7		3.4 – 6.4
	Risk-free interest rate	0.99 – 2.21%		0.48 – 1.19%

Accounts_Receivable_and_Unbill1

Accounts Receivable and Unbilled Services (Tables)	3 Months Ended
	Mar. 31, 2014
Receivables [Abstract]	'
Accounts Receivable and Unbilled Services	'
	Accounts receivable and unbilled services consist of the following (in thousands):
		March 31,		December 31,
		2014		2013
	Trade:
	Billed	$	435,068	$	408,959
	Unbilled services		515,131		516,942
			950,199		925,901
	Allowance for doubtful accounts		(1,746)		(1,696)
		$	948,453	$	924,205

Goodwill_Tables

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2014
Goodwill And Intangible Assets Disclosure [Abstract]	'
Summary of Goodwill by Segment	'
	The following is a summary of goodwill by segment for the three months ended March 31, 2014 (in thousands):
		Product		Integrated		Consolidated
		Development		Healthcare
				Services
	Balance as of December 31, 2013	$	351,144	$	58,482	$	409,626
	Impact of foreign currency fluctuations and other		(652)		545		(107)
	Balance as of March 31, 2014	$	350,492	$	59,027	$	409,519

Derivatives_Tables

Derivatives (Tables)	3 Months Ended
	Mar. 31, 2014
Summary of Fair Values of Derivative Instruments Designated as Hedges	'
	The fair values of the Company’s derivative instruments designated as hedging instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table (in thousands):
		Balance Sheet Classification		March 31,				December 31,
				2014				2013
	Foreign exchange forward contracts	Other current assets		$	3,141			$	3,950
	Interest rate swaps	Other current liabilities		$	22,630			$	24,805
Effect of Cash Flow Hedging Instruments on Other Comprehensive Income (Loss)	'
	The effect of the Company’s cash flow hedging instruments on other comprehensive income (loss) is summarized in the following table (in thousands):
		Three Months Ended March 31,
		2014				2013
	Foreign exchange forward contracts	$	(809	)		$	(2,391	)
	Interest rate swaps		2,175				1,912
	Total	$	1,366			$	(479	)
Deposits and other assets [Member]	'
Summary of Details Relating to Fair Value / Gains (Losses) of Derivative Instruments not Designated as Hedges	'
	The fair values of the Company’s derivative instruments not designated as hedging instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table (in thousands):
		Balance Sheet Classification		March 31,		December 31,
				2014		2013
	Warrants	Deposits and other assets		$              474		$              211
Other (income) expense, net [Member]	'
Summary of Details Relating to Fair Value / Gains (Losses) of Derivative Instruments not Designated as Hedges	'
	Gains from derivative instruments not designated as hedges impacting the Company’s condensed consolidated statements of income are summarized below (in thousands):
				Three Months Ended March 31,
		Income Statement Classification		2014				2013
	Warrants	Other income, net		$	263			$	11

Fair_Value_Measurements_Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2014
Fair Value Disclosures [Abstract]	'
Fair Value of Financial Assets and Liabilities Measured on Recurring Basis	'
	The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured on a recurring basis as of March 31, 2014 (in thousands):
		Level 1		Level 2		Level 3		Total
	Assets:
	Marketable equity securities	$	4,946	$	—	$	—	$	4,946
	Foreign exchange forward contracts		—		3,141		—		3,141
	Warrants		—		—		474		474
	Total	$	4,946	$	3,141	$	474	$	8,561
	Liabilities:
	Interest rate swaps	$	—	$	22,630	$	—	$	22,630
	Contingent consideration		—		—		12,932		12,932
	Total	$	—	$	22,630	$	12,932	$	35,562
Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis	'
	The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the three months ended March 31 (in thousands):
		Warrants – Deposits				Contingent Consideration –
		and Other Assets				Accounts Payable and Accrued
						Expenses and Other Liabilities
		2014		2013		2014		2013
	Balance as of January 1	$	211	$	29	$	13,014	$	3,521
	Purchases and issuances		—		—		—		—
	Revaluations included in earnings		263		11		-82		-181
	Balance as of March 31	$	474	$	40	$	12,932	$	3,340

Noncontrolling_Interests_Table

Noncontrolling Interests (Tables)	3 Months Ended
	Mar. 31, 2014
Noncontrolling Interest [Abstract]	'
Summary of Noncontrolling Interests	'
	Below is a summary of noncontrolling interests for the three months ended March 31 (in thousands):
		2014		2013
	Balance as of January 1	$	(72)	$	479
	Comprehensive income (loss):
	Net income (loss)		31		(153)
	Foreign currency adjustments, net of income tax		(10)		2
	Balance as of March 31	$	(51)	$	328

Restructuring_Tables

Restructuring (Tables)	3 Months Ended
	Mar. 31, 2014
Restructuring And Related Activities [Abstract]	'
Summary of Amounts Recorded for Restructuring Plans	'
	The following amounts were recorded for the February 2014 restructuring plan and the restructuring plans initiated in prior years (in thousands):
		Severance and		Exit Costs		Total
		Related Costs
	Balance at December 31, 2013	$	5,276	$	198	$	5,474
	Expense, net of reversals		1,008		—		1,008
	Payments		-2,658		(42)		-2,700
	Foreign currency translation		-14		—		-14
	Balance at March 31, 2014	$	3,612	$	156	$	3,768
	The Company expects the majority of the remaining restructuring accruals to be paid in 2014.

Employee_Benefit_Plans_Tables

Employee Benefit Plans (Tables)	3 Months Ended
	Mar. 31, 2014
Postemployment Benefits [Abstract]	'
Summary of Components of Pension Expenses Related to Defined Benefit Plans	'
	The following table summarizes the components of pension expense related to the Company’s defined benefit plans (in thousands):
		Three Months Ended March 31,
		2014		2013
	Service cost	$	3,287	$	3,153
	Interest cost		987		938
	Expected return on plan assets		-928		-692
	Amortization of prior service costs		20		89
	Amortization of actuarial losses		172		178
		$	3,538	$	3,666
Summary of Severance Associated with Cost Reduction Programs	'
	The following amounts were recorded for the severance associated with cost reduction programs (in thousands):
	Balance at December 31, 2013	$	14,056
	Expense, net of reversals		(2,160)
	Payments		(966)
	Foreign currency translation		(1)
	Balance at March 31, 2014	$	10,929

Comprehensive_Income_Tables

Comprehensive Income (Tables)	3 Months Ended
	Mar. 31, 2014
Equity [Abstract]	'
Summary of Components of Accumulated Other Comprehensive (Loss) Income	'
	Below is a summary of the components of accumulated other comprehensive (loss) income for the three months ended March 31, 2014 and 2013 (in thousands):
		Foreign		Marketable		Derivative		Defined		Income		Accumulated
		Currency		Securities		Instruments		Benefit		Taxes		Other
		Translation						Plans				Comprehensive
												(Loss) Income
	Balance at December 31, 2013	$	(5,829)	$	5,708	$	(20,855)	$	(5,044)	$	25,644	$	(376)
	Other comprehensive (loss) income before reclassifications		313		3,138		197		—		(1,083)		2,565
	Reclassification adjustments		—		(5,004)		1,169		192		1,061		(2,582)
	Balance at March 31, 2014	$	(5,516)	$	3,842	$	(19,489)	$	(4,852)	$	25,622	$	(393)
		Foreign		Marketable		Derivative		Defined		Income		Accumulated
		Currency		Securities		Instruments		Benefit		Taxes		Other
		Translation						Plans				Comprehensive
												(Loss) Income
	Balance at December 31, 2012	$	19,312	$	467	$	(33,542)	$	(8,235)	$	29,693	$	7,695
	Other comprehensive income (loss) before reclassifications		(20,275)		68		(4,393)		—		5,806		(18,794)
	Reclassification adjustments		—		—		3,914		267		(1,469)		2,712
	Balance at March 31, 2013	$	(963)	$	535	$	(34,021)	$	(7,968)	$	34,030	$	(8,387)
Reclassification Adjustments from Accumulated Other Comprehensive (Loss) Income	'
	Below is a summary of the reclassification adjustments from accumulated other comprehensive (loss) income into net income for the three months ended March 31, 2014 and 2013 (in thousands):
		Three Months Ended March 31,
		2014		2013
	Marketable securities:
	Marketable securities – gain included in other income, net	$	(5,004)	$	—
	Total before income taxes		(5,004)		—
	Income taxes		(1,927)		—
	Total net of income taxes	$	(3,077)	$	—
	Derivative instruments:
	Interest rate swaps – increase to interest expense	$	3,080	$	3,006
	Foreign exchange forward contracts – (increase) reduction to service revenues		(1,911)		908
	Total before income taxes		1,169		3,914
	Income taxes		794		1,368
	Total net of income taxes	$	375	$	2,546
	Defined benefit plans:
	Amortization of prior service costs	$	20	$	89
	Amortization of actuarial losses		172		178
	Total before income taxes		192		267
	Income taxes		72		101
	Total net of income taxes	$	120	$	166
	Amortization of prior service costs and actuarial losses are included in the computation of pension expense for the Company’s defined benefit plans. See Note 10 for additional information.

Segments_Tables

Segments (Tables)	3 Months Ended
	Mar. 31, 2014
Segment Reporting [Abstract]	'
Operations by Reportable Segments	'
	Information presented below is in thousands:
		Three Months Ended March 31,
		2014		2013
	Service revenues
	Product Development	$	770,828	$	706,307
	Integrated Healthcare Services		234,460		221,128
	Total service revenues		1,005,288		927,435
	Costs of revenue, service costs
	Product Development		450,483		429,007
	Integrated Healthcare Services		193,239		182,102
	Total costs of revenue, service costs		643,722		611,109
	Selling, general and administrative
	Product Development		159,685		144,625
	Integrated Healthcare Services		32,276		32,781
	General corporate and unallocated		27,281		21,896
	Total selling, general and administrative		219,242		199,302
	Income from operations
	Product Development		160,660		132,675
	Integrated Healthcare Services		8,945		6,245
	General corporate and unallocated		(27,281)		-21,896
	Restructuring costs		(1,008)		-1,859
	Total income from operations	$	141,316	$	115,165
Depreciation and Amortization Expense	'
		Three Months Ended March 31,
		2014		2013
	Depreciation and amortization expense
	Product Development	$	22,970	$	18,447
	Integrated Healthcare Services		4,891		5,353
	General corporate and unallocated		1,227		840
	Total depreciation and amortization expense	$	29,088	$	24,640

Earnings_Per_Share_Tables

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2014
Earnings Per Share [Abstract]	'
Summary of Weighted-Average Outstanding Share-Based Awards Excluded from Computation of Diluted Earnings Per Share	'
	The following table shows the weighted average number of outstanding share-based awards not included in the computation of diluted earnings per share as the effect of including such share-based awards in the computation would be anti-dilutive (in thousands):
		Three Months Ended March 31,
		2014		2013
	Weighted average shares subject to anti-dilutive share-based awards		766		1,631

Employee_Stock_Compensation_Sc

Employee Stock Compensation - Schedule of Share Based Awards and Outstanding (Detail)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Dec. 31, 2013
Disclosure Of Compensation Related Costs Sharebased Payments [Abstract]	'	'	'
Stock options granted	1,024,500	75,000	'
Stock appreciation rights granted	176,800	'	'
Stock options outstanding	10,578,160	'	10,100,160
Stock appreciation rights outstanding	430,450	'	258,025
Restricted stock units outstanding	57,167	'	57,167

Employee_Stock_Compensation_As

Employee Stock Compensation - Assumptions Used to Estimate Value of Share-Based Compensation for Stock Options and Stock Appreciation Rights Issued (Detail)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Share based Compensation Arrangement by Share based Payment Award, Fair Value Assumptions, Method Used [Line Items]	'	'
Expected volatility, Minimum	32.00%	34.00%
Expected volatility, Maximum	43.00%	47.00%
Weighted average expected volatility	38.00%	42.00%
Expected dividends	0.00%	5.45%
Risk-free interest rate, Minimum	0.99%	0.48%
Risk-free interest rate, Maximum	2.21%	1.19%
Minimum [Member]	'	'
Share based Compensation Arrangement by Share based Payment Award, Fair Value Assumptions, Method Used [Line Items]	'	'
Expected term (in years)	'3 years 8 months 12 days	'3 years 4 months 24 days
Maximum [Member]	'	'
Share based Compensation Arrangement by Share based Payment Award, Fair Value Assumptions, Method Used [Line Items]	'	'
Expected term (in years)	'6 years 8 months 12 days	'6 years 4 months 24 days

Employee_Stock_Compensation_Ad

Employee Stock Compensation - Additional Information (Detail) (USD $)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Share based compensation expense	$7,221,000	$4,473,000
Employee Stock Purchase Plan [Member]	'	'
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]	'	'
Employee stock purchase plan payroll deductions percent	10.00%	'
Discount on closing price of share	15.00%	'
Aggregate payroll contributions	$407,000	'

Concentration_of_Credit_Risk_A

Concentration of Credit Risk - Additional Information (Detail) (Sales [Member])	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
	Customer	Customer
Sales [Member]	'	'
Concentration Risk [Line Items]	'	'
Number of customers served	0	0
Percentage of service revenue from major customers	10.00%	10.00%

Accounts_Receivable_and_Unbill2

Accounts Receivable and Unbilled Services - Accounts Receivable and Unbilled Services (Detail) (USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Trade:	'	'
Billed	$435,068	$408,959
Unbilled services	515,131	516,942
Trade accounts receivable and unbilled services, gross	950,199	925,901
Allowance for doubtful accounts	-1,746	-1,696
Trade accounts receivable and unbilled services, net	$948,453	$924,205

Goodwill_Summary_of_Goodwill_b

Goodwill - Summary of Goodwill by Segment (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014
Goodwill [Line Items]	'
Beginning balance	$409,626
Impact of foreign currency fluctuations and other	-107
Ending balance	409,519
Product Development [Member]	'
Goodwill [Line Items]	'
Beginning balance	351,144
Impact of foreign currency fluctuations and other	-652
Ending balance	350,492
Integrated Healthcare Services [Member]	'
Goodwill [Line Items]	'
Beginning balance	58,482
Impact of foreign currency fluctuations and other	545
Ending balance	$59,027

Derivatives_Additional_Informa

Derivatives - Additional Information (Detail) (USD $)	Mar. 31, 2014	Mar. 31, 2014	Mar. 31, 2014	Mar. 31, 2014	Mar. 31, 2014	Jun. 09, 2011	Mar. 31, 2014	Mar. 31, 2013
In Millions, unless otherwise specified		Minimum [Member]	Maximum [Member]	Foreign exchange forward contracts [Member]	Interest Rate Swaps [Member]	Interest Rate Swaps [Member]	Warrants [Member]	Warrants [Member]
				Derivative		Agreement	Warrants	Warrants
Derivatives And Hedging Activities [Line Items]	'	'	'	'	'	'	'	'
Warrant Sold	'	'	'	'	'	'	0	0
Number of foreign exchange forward contracts	'	'	'	14	'	6	'	'
Notional amount	'	'	'	$70.60	'	'	'	'
Expiration year of hedge instruments	'	'	'	'2014	'	'	'	'
Interest rate swaps expiry date	'	30-Sep-13	31-Mar-16	'	'	'	'	'
Interest Rate Cash Flow Hedge Loss to be Reclassified During Next 12 Months, Net	12.4	'	'	'	'	'	'	'
Derivative fixed interest rate	2.55%	'	'	'	'	'	'	'
Interest rate swaps hedged amount due to future change in interest rate swaps	'	'	'	'	$945	'	'	'
Interest rate swaps effectively converted percent	45.90%	'	'	'	'	'	'	'

Derivatives_Summary_of_Fair_Va

Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) (Designated as Hedging Instrument [Member], USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Foreign exchange forward contracts [Member] | Other current assets [Member]	'	'
Derivatives, Fair Value [Line Items]	'	'
Derivative asset fair value	$3,141	$3,950
Interest Rate Swaps [Member] | Other current liabilities [Member]	'	'
Derivatives, Fair Value [Line Items]	'	'
Derivative liability fair value	$22,630	$24,805

Derivatives_Summary_of_Details

Derivatives - Summary of Details Relating to Fair Value / Gains (Losses) of Derivative Instruments not Designated as Hedges (Detail) (Warrants [Member], Derivatives Not Designated as Hedging Instruments [Member], Deposits and Other Assets [Member], USD $)	Mar. 31, 2014	Dec. 31, 2013
In Thousands, unless otherwise specified
Warrants [Member] | Derivatives Not Designated as Hedging Instruments [Member] | Deposits and Other Assets [Member]	'	'
Derivatives, Fair Value [Line Items]	'	'
Derivative asset fair value	$474	$211

Derivatives_Effect_of_Cash_Flo

Derivatives - Effect of Cash Flow Hedging Instruments on Other Comprehensive Income (Loss) (Detail) (Derivatives Designated As Cash Flow Hedges [Member], USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Derivative Instruments and Hedging Activities Disclosures [Line Items]	'	'
Effect of cash flow hedging instruments on other comprehensive income (loss)	$1,366	($479)
Foreign exchange forward contracts [Member]	'	'
Derivative Instruments and Hedging Activities Disclosures [Line Items]	'	'
Effect of cash flow hedging instruments on other comprehensive income (loss)	-809	-2,391
Interest Rate Swaps [Member]	'	'
Derivative Instruments and Hedging Activities Disclosures [Line Items]	'	'
Effect of cash flow hedging instruments on other comprehensive income (loss)	$2,175	$1,912

Derivatives_Summary_of_Gains_F

Derivatives - Summary of Gains From Derivative Instruments not Designated as Hedges Impacting Consolidated Statements of Income (Detail) (Warrants [Member], Other income, net [Member], USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Warrants [Member] | Other income, net [Member]	'	'
Derivative Instruments, Gain (Loss) [Line Items]	'	'
Derivative instrument gain in income statement	$263	$11

Fair_Value_Measurements_Fair_V

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) (Recurring Fair Value Measurements [Member], USD $)	Mar. 31, 2014
In Thousands, unless otherwise specified
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	$8,561
Fair value of liabilities	35,562
Warrants [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	474
Foreign exchange forward contracts [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	3,141
Interest Rate Swaps [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	22,630
Contingent Consideration [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	12,932
Marketable equity securities [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	4,946
Level 1 [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	4,946
Fair value of liabilities	'
Level 1 [Member] | Warrants [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	'
Level 1 [Member] | Foreign exchange forward contracts [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	'
Level 1 [Member] | Interest Rate Swaps [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	'
Level 1 [Member] | Contingent Consideration [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	'
Level 1 [Member] | Marketable equity securities [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	4,946
Level 2 [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	3,141
Fair value of liabilities	22,630
Level 2 [Member] | Warrants [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	'
Level 2 [Member] | Foreign exchange forward contracts [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	3,141
Level 2 [Member] | Interest Rate Swaps [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	22,630
Level 2 [Member] | Contingent Consideration [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	'
Level 2 [Member] | Marketable equity securities [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	'
Level 3 [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	474
Fair value of liabilities	12,932
Level 3 [Member] | Warrants [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	474
Level 3 [Member] | Foreign exchange forward contracts [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	'
Level 3 [Member] | Interest Rate Swaps [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	'
Level 3 [Member] | Contingent Consideration [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of liabilities	12,932
Level 3 [Member] | Marketable equity securities [Member]	'
Fair Value, Assets and Liabilities Measured on Recurring Basis [Line Items]	'
Fair value of assets	'

Fair_Value_Measurements_Change

Fair Value Measurements - Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis (Detail) (Level 3 [Member], USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Accounts Payable and Accrued Expenses and Other Liabilities [Member] | Contingent Consideration [Member]	'	'
Fair Value Assets Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]	'	'
Beginning Balance, contingent Consideration	$13,014	$3,521
Purchases and issuances, contingent Consideration	'	'
Revaluations included in earnings, contingent Consideration	-82	-181
Ending Balance, contingent Consideration	12,932	3,340
Deposits and Other Assets [Member] | Warrants [Member]	'	'
Fair Value Assets Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]	'	'
Beginning Balance, Warrants	211	29
Purchases and issuances, Warrants	'	'
Revaluations included in earnings, Warrants	263	11
Ending Balance, Warrants	$474	$40

Fair_Value_Measurements_Additi

Fair Value Measurements - Additional Information (Detail) (USD $)	Mar. 31, 2014	Dec. 31, 2013
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Other identifiable intangibles, net	$289,094,000	$298,054,000
Long term debt	2,100,000,000	2,100,000,000
Non-recurring Fair Value Measurements [Member] | Level 3 [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Cost and equity method investments	61,800,000	'
Goodwill	409,500,000	'
Other identifiable intangibles, net	289,100,000	'
Fair value of assets	760,400,000	'
Non-recurring Fair Value Measurements [Member] | Level 3 [Member] | Equity method investments [Member]	'	'
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]	'	'
Unfunded cash commitments	$33,000,000	'

Noncontrolling_Interests_Summa

Noncontrolling Interests - Summary of Noncontrolling Interests (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Noncontrolling Interest [Abstract]	'	'
Noncontrolling interest, Beginning Balance	($72)	$479
Comprehensive income (loss):	'	'
Net income (loss)	31	-153
Foreign currency adjustments, net of income tax	-10	2
Noncontrolling interest, Ending Balance	($51)	$328

Restructuring_Additional_Infor

Restructuring - Additional Information (Detail) (USD $)	3 Months Ended		1 Months Ended	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013	Feb. 28, 2014	Mar. 31, 2014
			Twenty Fourteen Restructuring Plan [Member]	Twenty Fourteen Restructuring Plan [Member]
			Position	Product Development [Member]
Restructuring Cost and Reserve [Line Items]	'	'	'	'
Restructuring plan approved	'	'	$13,000,000	'
Number of positions expected to reduce	'	'	400	'
Restructuring costs	$1,008,000	$1,859,000	'	$1,500,000

Restructuring_Summary_of_Amoun

Restructuring - Summary of Amounts Recorded for Restructuring Plans (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014
Restructuring Cost and Reserve [Line Items]	'
Restructuring reserves, beginning balance	$5,474
Expense, net of reversals	1,008
Payments	-2,700
Foreign currency translation	-14
Restructuring reserves, ending balance	3,768
Severance and Related Costs [Member]	'
Restructuring Cost and Reserve [Line Items]	'
Restructuring reserves, beginning balance	5,276
Expense, net of reversals	1,008
Payments	-2,658
Foreign currency translation	-14
Restructuring reserves, ending balance	3,612
Exit Costs [Member]	'
Restructuring Cost and Reserve [Line Items]	'
Restructuring reserves, beginning balance	198
Expense, net of reversals	'
Payments	-42
Foreign currency translation	'
Restructuring reserves, ending balance	$156

Employee_Benefit_Plans_Summary

Employee Benefit Plans - Summary of Components of Pension Expenses Related to Defined Benefit Plans (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Compensation And Retirement Disclosure [Abstract]	'	'
Service cost	$3,287	$3,153
Interest cost	987	938
Expected return on plan assets	-928	-692
Amortization of prior service costs	20	89
Amortization of actuarial losses	172	178
Total pension expense related to defined benefit plans	$3,538	$3,666

Employee_Benefit_Plans_Additio

Employee Benefit Plans - Additional Information (Detail) (USD $)	3 Months Ended
	Mar. 31, 2014	Dec. 31, 2013
Cost Reduction Initiative Disclosure [Line Items]	'	'
Severance expenses payable	$10,929,000	$14,056,000
Severance expense, net of reversals	-2,160,000	'
Corporate, Non-Segment [Member]	'	'
Cost Reduction Initiative Disclosure [Line Items]	'	'
Severance expense, net of reversals	-55,000	'
Product Development [Member]	'	'
Cost Reduction Initiative Disclosure [Line Items]	'	'
Severance expense, net of reversals	-2,200,000	'
Integrated Healthcare Services [Member]	'	'
Cost Reduction Initiative Disclosure [Line Items]	'	'
Severance expense, net of reversals	131,000	'
Cost Reduction Initiative [Member]	'	'
Cost Reduction Initiative Disclosure [Line Items]	'	'
Severance expenses payable	$10,900,000	$14,100,000
Number of positions expected to be eliminated	270	'

Employee_Benefit_Plans_Summary1

Employee Benefit Plans - Summary of Severance Associated with Cost Reduction Programs (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014
Compensation And Retirement Disclosure [Abstract]	'
Severance expenses payable, opening balance	$14,056
Severance expense, net of reversals	-2,160
Severance payments	-966
Severance foreign currency translation	-1
Severance expenses payable, ending balance	$10,929

Income_Taxes_Additional_Inform

Income Taxes - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2014	Mar. 31, 2013
Income Tax Disclosure [Abstract]	'	'
Effective income tax rate	30.50%	39.20%

Comprehensive_Income_Summary_o

Comprehensive Income - Summary of Components of Accumulated Other Comprehensive (Loss) Income (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Accumulated Other Comprehensive Income (Loss) [Line Items]	'	'
Beginning Balance	($376)	$7,695
Other comprehensive (loss) income before reclassifications	2,565	-18,794
Reclassification adjustments	-2,582	2,712
Ending Balance	-393	-8,387
Foreign Currency Translation [Member]	'	'
Accumulated Other Comprehensive Income (Loss) [Line Items]	'	'
Beginning Balance	-5,829	19,312
Other comprehensive (loss) income before reclassifications	313	-20,275
Ending Balance	-5,516	-963
Marketable Securities [Member]	'	'
Accumulated Other Comprehensive Income (Loss) [Line Items]	'	'
Beginning Balance	5,708	467
Other comprehensive (loss) income before reclassifications	3,138	68
Reclassification adjustments	-5,004	'
Ending Balance	3,842	535
Derivative Instruments [Member]	'	'
Accumulated Other Comprehensive Income (Loss) [Line Items]	'	'
Beginning Balance	-20,855	-33,542
Other comprehensive (loss) income before reclassifications	197	-4,393
Reclassification adjustments	1,169	3,914
Ending Balance	-19,489	-34,021
Defined Benefit Plans [Member]	'	'
Accumulated Other Comprehensive Income (Loss) [Line Items]	'	'
Beginning Balance	-5,044	-8,235
Reclassification adjustments	192	267
Ending Balance	-4,852	-7,968
Income Taxes [Member]	'	'
Accumulated Other Comprehensive Income (Loss) [Line Items]	'	'
Beginning Balance	25,644	29,693
Other comprehensive (loss) income before reclassifications	-1,083	5,806
Reclassification adjustments	1,061	-1,469
Ending Balance	$25,622	$34,030

Comprehensive_Income_Reclassif

Comprehensive Income - Reclassification Adjustments from Accumulated Other Comprehensive (Loss) Income (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]	'	'
Marketable securities - gain included in other income, net	($4,844)	($2,382)
Income taxes	-37,389	-32,118
Foreign exchange forward contracts - (increase) reduction to service revenues	-1,307,846	-1,228,841
Marketable Securities [Member] | Reclassification Adjustments from Accumulated Other Comprehensive (Loss) Income [Member]	'	'
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]	'	'
Marketable securities - gain included in other income, net	-5,004	'
Total before income taxes	-5,004	'
Income taxes	-1,927	'
Total net of income taxes	-3,077	'
Defined Benefit Plans [Member] | Reclassification Adjustments from Accumulated Other Comprehensive (Loss) Income [Member]	'	'
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]	'	'
Amortization of prior service costs	20	89
Amortization of actuarial losses	172	178
Total before income taxes	192	267
Income taxes	72	101
Total net of income taxes	120	166
Interest Rate Swaps [Member] | Derivative Instruments [Member] | Reclassification Adjustments from Accumulated Other Comprehensive (Loss) Income [Member]	'	'
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]	'	'
Interest rate swaps - increase to interest expense	3,080	3,006
Foreign exchange forward contracts [Member] | Derivative Instruments [Member] | Reclassification Adjustments from Accumulated Other Comprehensive (Loss) Income [Member]	'	'
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]	'	'
Foreign exchange forward contracts - (increase) reduction to service revenues	-1,911	908
Derivative [Member] | Derivative Instruments [Member] | Reclassification Adjustments from Accumulated Other Comprehensive (Loss) Income [Member]	'	'
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]	'	'
Total before income taxes	1,169	3,914
Income taxes	794	1,368
Total net of income taxes	$375	$2,546

Segments_Additional_Informatio

Segments - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2014
	Segment
Segment Reporting [Abstract]	'
Number of reportable segments	2

Segments_Operations_by_Reporta

Segments - Operations by Reportable Segments (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Segment Reporting Information [Line Items]	'	'
Service revenues	$1,005,288	$927,435
Costs of revenue, service costs	643,722	611,109
Selling, general and administrative	219,242	199,302
Income from operations	141,316	115,165
Restructuring costs	-1,008	-1,859
Operating Segments [Member] | Product Development [Member]	'	'
Segment Reporting Information [Line Items]	'	'
Service revenues	770,828	706,307
Costs of revenue, service costs	450,483	429,007
Selling, general and administrative	159,685	144,625
Income from operations	160,660	132,675
Operating Segments [Member] | Integrated Healthcare Services [Member]	'	'
Segment Reporting Information [Line Items]	'	'
Service revenues	234,460	221,128
Costs of revenue, service costs	193,239	182,102
Selling, general and administrative	32,276	32,781
Income from operations	8,945	6,245
Corporate, Non-Segment [Member]	'	'
Segment Reporting Information [Line Items]	'	'
Selling, general and administrative	27,281	21,896
Income from operations	-27,281	-21,896
Segment Reconciling Items [Member]	'	'
Segment Reporting Information [Line Items]	'	'
Restructuring costs	($1,008)	($1,859)

Segments_Depreciation_and_Amor

Segments - Depreciation and Amortization Expense (Detail) (USD $)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Segment Reporting Information [Line Items]	'	'
Depreciation and amortization	$29,088	$24,640
Operating Segments [Member] | Product Development [Member]	'	'
Segment Reporting Information [Line Items]	'	'
Depreciation and amortization	22,970	18,447
Operating Segments [Member] | Integrated Healthcare Services [Member]	'	'
Segment Reporting Information [Line Items]	'	'
Depreciation and amortization	4,891	5,353
Corporate, Non-Segment [Member]	'	'
Segment Reporting Information [Line Items]	'	'
Depreciation and amortization	$1,227	$840

Earnings_Per_Share_Summary_of_

Earnings Per Share - Summary of Weighted-Average Outstanding Share-Based Awards Excluded from Computation of Diluted Earnings Per Share (Detail)	3 Months Ended
In Thousands, unless otherwise specified	Mar. 31, 2014	Mar. 31, 2013
Earnings Per Share [Abstract]	'	'
Weighted average shares subject to anti-dilutive share-based awards	766	1,631