IQVIA (IQV) 10-Q 30 Apr 20 2020 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2020	Apr. 17, 2020
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Mar. 31, 2020
Document Fiscal Year Focus	2020
Document Fiscal Period Focus	Q1
Trading Symbol	IQV
Entity Registrant Name	IQVIA HOLDINGS INC.
Entity Central Index Key	0001478242
Current Fiscal Year End Date	--12-31
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Shell Company	false
Entity File Number	001-35907
Entity Tax Identification Number	27-1341991
Entity Incorporation, State or Country Code	DE
Entity Filer Category	Large Accelerated Filer
Entity Address, Address Line One	4820 Emperor Blvd.
Entity Address, City or Town	Durham
Entity Address, State or Province	NC
Entity Address, Postal Zip Code	27703
City Area Code	919
Local Phone Number	998-2000
Document Quarterly Report	true
Document Transition Report	false
Entity Common Stock, Shares Outstanding		190,963,771
Title of 12(b) Security	Common Stock, par value $0.01 per share
Security Exchange Name	NYSE
Principal Executive Offices [Member]
Document Information [Line Items]
Entity Address, Address Line One	83 Wooster Heights Road
Entity Address, City or Town	Danbury
Entity Address, State or Province	CT
Entity Address, Postal Zip Code	06810
City Area Code	203
Local Phone Number	448-4600

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME (unaudited) - USD ($) shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Statement [Abstract]
Revenues	$ 2,754	$ 2,684
Costs of revenue, exclusive of depreciation and amortization	1,824	1,748
Selling, general and administrative expenses	407	419
Depreciation and amortization	316	295
Restructuring costs	14	12
Income from operations	193	210
Interest income	(2)	(2)
Interest expense	106	110
Other income, net	(13)	(7)
Income before income taxes and equity in earnings of unconsolidated affiliates	102	109
Income tax expense	17	41
Income before equity in earnings of unconsolidated affiliates	85	68
Equity in earnings (loss) of unconsolidated affiliates	6	(1)
Net income	91	67
Net income attributable to non-controlling interests	(9)	(9)
Net income attributable to IQVIA Holdings Inc.	$ 82	$ 58
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 0.43	$ 0.29
Diluted (in dollars per share)	$ 0.42	$ 0.29
Weighted average common shares outstanding:
Basic (in shares)	191.6	197
Diluted (in shares)	195.7	201.7

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Net income	$ 91	$ 67
Comprehensive income (loss) adjustments:
Unrealized losses on derivative instruments, net of income tax benefit of ($7) and ($1)	(39)	(5)
Foreign currency translation, net of income tax expense of $23 and $30	(155)	(31)
Reclassification adjustments:
Losses (gains) on derivative instruments included in net income, net of income tax expense (benefit) of $0 and ($1)	16	(1)
Comprehensive (loss) income	(87)	30
Comprehensive income attributable to non-controlling interests	(5)	(10)
Comprehensive (loss) income attributable to IQVIA Holdings Inc.	$ (92)	$ 20

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (unaudited) (Parenthetical) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Statement of Comprehensive Income [Abstract]
Unrealized (losses) gains on derivative instruments, income tax {benefit) expense	$ (7)	$ (1)
Foreign currency translation, income tax expense	23	30
Gain on derivative instruments included in net income, income tax expense (benefit)	$ 0	$ (1)

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Current assets:
Cash and cash equivalents	$ 927	$ 837
Trade accounts receivable and unbilled services, net	2,634	2,582
Prepaid expenses	173	138
Income taxes receivable	49	56
Investments in debt, equity and other securities	63	62
Other current assets and receivables	431	451
Total current assets	4,277	4,126
Property and equipment, net	445	458
Operating lease right-of-use assets	489	496
Investments in debt, equity and other securities	72	65
Investments in unconsolidated affiliates	71	87
Goodwill	11,989	12,159
Other identifiable intangibles, net	5,328	5,514
Deferred income taxes	120	119
Deposits and other assets	287	227
Total assets	23,078	23,251
Current liabilities:
Accounts payable and accrued expenses	2,384	2,512
Unearned income	1,036	1,014
Income taxes payable	94	108
Current portion of long-term debt	139	100
Other current liabilities	254	211
Total current liabilities	3,907	3,945
Long-term debt	11,894	11,545
Deferred income taxes	618	646
Operating lease liabilities	366	396
Other liabilities	491	456
Total liabilities	17,276	16,988
Commitments and contingencies
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized at March 31, 2020 and December 31, 2019, $0.01 par value, 253.8 shares issued and 191.0 shares outstanding at March 31, 2020; 253.0 shares issued and 192.3 shares outstanding at December 31, 2019	11,012	11,049
Retained earnings	1,080	998
Treasury stock, at cost, 62.8 and 60.7 shares at March 31, 2020 and December 31, 2019, respectively	(6,065)	(5,733)
Accumulated other comprehensive loss	(485)	(311)
Equity attributable to IQVIA Holdings Inc.’s stockholders	5,542	6,003
Non-controlling interests	260	260
Total stockholders’ equity	5,802	6,263
Total liabilities and stockholders’ equity	$ 23,078	$ 23,251
Common stock, shares authorized	400,000,000	400,000,000
Treasury stock, shares	62,800,000	60,700,000
Common Stock, Shares, Outstanding	191,000,000	192,300,000
Common stock, shares issued	253,800,000	253,000,000
Common stock, par value	$ 0.01	$ 0.01

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - $ / shares	Mar. 31, 2020	Dec. 31, 2019
Statement of Financial Position [Abstract]
Common stock, shares authorized	400,000,000	400,000,000
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares issued	253,800,000	253,000,000
Treasury stock, shares	62,800,000	60,700,000

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Operating activities:
Net income	$ 91	$ 67
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	316	295
Amortization of debt issuance costs and discount	3	3
Stock-based compensation	0	26
(Earnings) loss from unconsolidated affiliates	(6)	1
Loss (gain) on investments, net	8	(3)
Benefit from deferred income taxes	(40)	(12)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income	(84)	(76)
Change in other operating assets and liabilities	(125)	(188)
Net cash provided by operating activities	163	113
Investing activities:
Acquisition of property, equipment and software	(141)	(141)
Acquisition of businesses, net of cash acquired	(14)	(175)
Purchases of marketable securities, net	(7)	(2)
Investments in unconsolidated affiliates, net of payments received	17	2
Investments in equity securities	(6)	0
Other	1	1
Net cash used in investing activities	(150)	(315)
Financing activities:
Proceeds from issuance of debt	800	0
Payment of debt issuance costs	(11)	0
Repayment of debt and principal payments on capital lease obligations	(25)	(25)
Proceeds from revolving credit facility	990	790
Repayment of revolving credit facility	(1,250)	(385)
(Payments) proceeds related to employee stock option plans	(41)
(Payments) proceeds related to employee stock option plans		9
Repurchase of common stock	(345)	(145)
Distributions to non-controlling interest, net	(5)	0
Contingent consideration and deferred purchase price payments	(6)	(16)
Net cash provided by financing activities	107	228
Effect of foreign currency exchange rate changes on cash	(30)	19
Increase in cash and cash equivalents	90	45
Cash and cash equivalents at beginning of period	837	891
Cash and cash equivalents at end of period	$ 927	$ 936

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (unaudited) - USD ($) shares in Millions, $ in Millions	Total	Common Stock [Member]	Treasury Stock [Member]	Additional Paid-In Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive (Loss) Income [Member]	Non-controlling Interests [Member]
Beginning balance at Dec. 31, 2018	$ 6,954	$ 3	$ (4,770)	$ 10,898	$ 807	$ (224)	$ 240
Beginning Balance, Shares at Dec. 31, 2018		251.5
Beginning Balance, Shares at Dec. 31, 2018			(54)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock	5			5
Issuance of common stock, Shares		0.7
Repurchase of common stock	(145)		$ (145)
Repurchase of common stock, Shares			(1)
Stock-based compensation	21			21
Net income	67				58		9
Unrealized losses on derivative instruments, net of tax	(5)					(5)
Foreign currency translation, net of tax	(31)					(32)	1
Reclassification adjustments, net of tax	(1)					(1)
Ending balance at Mar. 31, 2019	6,865	$ 3	$ (4,915)	10,924	865	(262)	250
Ending Balance, Shares at Mar. 31, 2019		252.2
Ending Balance, Shares at Mar. 31, 2019			(55)
Beginning balance at Dec. 31, 2019	$ 6,263	$ 3	$ (5,733)	11,046	998	(311)	260
Beginning Balance, Shares at Dec. 31, 2019	192.3	253
Beginning Balance, Shares at Dec. 31, 2019	(60.7)		(60.7)
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Issuance of common stock	$ (44)			(44)
Issuance of common stock, Shares		0.8
Repurchase of common stock	(332)		$ (332)
Repurchase of common stock, Shares			2.1
Stock-based compensation	7			7
Distributions to non-controlling interests	(5)				0		(5)
Net income	91				82		9
Unrealized losses on derivative instruments, net of tax	(39)					(39)
Foreign currency translation, net of tax	(155)					(151)	(4)
Reclassification adjustments, net of tax	16					16
Ending balance at Mar. 31, 2020	$ 5,802	$ 3	$ (6,065)	$ 11,009	$ 1,080	$ (485)	$ 260
Ending Balance, Shares at Mar. 31, 2020	191	253.8
Ending Balance, Shares at Mar. 31, 2020	(62.8)		(62.8)

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Summary of Significant Accounting Policies The Company IQVIA Holdings Inc. (together with its subsidiaries, the “Company” or “IQVIA”) is a leading global provider of advanced analytics, technology solutions and contract research services to the life sciences industry. With approximately 67,000 employees, IQVIA conducts business in more than 100 countries. Unaudited Interim Financial Information The accompanying unaudited condensed consolidated financial statements of the Company have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. 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, 2019. The balance sheet at December 31, 2019 has been derived from the audited consolidated financial statements of the Company but does not include all the disclosures required by GAAP. Additionally, t he outbreak of the novel coronavirus, or COVID-19, and the various governmental, industry and consumer actions related thereto, could have a material and adverse effect on our business, financial condition and results of operations. These effects, which largely depend on future developments that cannot be accurately predicted and are uncertain, could include a negative impact on the availability of our key personnel, temporary closures of our facilities or the facilities of our business partners, customers, suppliers, third party service providers or other vendors, an increased risk of customer defaults or delays in payments or purchasing decisions, and the interruption of domestic and global supply chains, distribution channels, liquidity and capital or financial markets. As COVID-19 continues to spread, we have and may continue to experience disruptions that could severely impact our business. As such the results for the three months ended March 31, 2020 may not be indicative of results for the full year. Recently Issued Accounting Standards Accounting pronouncements adopted In August 2018, the FASB issued new accounting guidance that clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued new accounting guidance that modifies the disclosure requirements in Topic 820, Fair Value Measurement, by removing certain disclosure requirements related to the fair value hierarchy, modifying existing disclosure requirements related to measurement uncertainty and adding new disclosure requirements, such as disclosing the changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period and disclosing the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. This new accounting guidance also modifies the disclosure requirements for employers that sponsor defined benefit pension or other postretirement plans. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In January 2017, the FASB issued new accounting guidance that simplifies the measurement of goodwill by eliminating the step two impairment test. Step two measures a goodwill impairment loss by comparing the implied fair value of goodwill with the carrying amount of that goodwill. The new guidance requires a comparison of the Company’s fair value of a reporting unit with the carrying amount and the Company is required to recognize an impairment charge for the amount by which the carrying amount exceeds the fair value. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In June 2016, the FASB issued a new accounting standard intended to provide financial statement users with more decision-useful information about expected credit losses and other commitments to extend credit held by the reporting entity. The standard replaces the incurred loss impairment methodology in current GAAP with one that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. This is based on factors including the Company's assessment of historical losses, client's creditworthiness and the fact that the Company's trade receivables are short term in duration. Accounting pronouncements being evaluated In January 2020, the FASB issued new accounting guidance that states any equity security transitioning from the alternative method of accounting to the equity method, or vice versa, due to an observable transaction, will be remeasured immediately before the transition. In addition, the new accounting guidance clarifies the accounting for certain non-derivative forward contracts or purchased call options to acquire equity securities stating such instruments will be measured using the fair value principles before settlement or exercise. The new accounting guidance will be effective for the Company on January 1, 2021 on a prospective basis. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements. In December 2019, the FASB issued new accounting guidance to clarify and simplify the accounting for income taxes. Changes under the new guidance includes eliminating certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of deferred tax liabilities for outside basis differences. The new accounting guidance will be effective for the Company on January 1, 2021. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements.

Revenues by Geography, Concentr

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations	3 Months Ended
	Mar. 31, 2020
Revenue from Contract with Customer [Abstract]
Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations	Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations The following tables represent revenues by geographic region and reportable segment for the three months ended March 31, 2020 and 2019: Three Months Ended March 31, 2020 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 581 $ 670 $ 91 $ 1,342 Europe and Africa 396 428 50 874 Asia-Pacific 140 343 55 538 Total revenues $ 1,117 $ 1,441 $ 196 $ 2,754 Three Months Ended March 31, 2019 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 553 $ 642 $ 94 $ 1,289 Europe and Africa 383 456 51 890 Asia-Pacific 139 318 48 505 Total revenues $ 1,075 $ 1,416 $ 193 $ 2,684 No customer accounted for 10% or more of consolidated revenues for the three months ended March 31, 2020 or 2019. Transaction Price Allocated to the Remaining Performance Obligations

Trade Accounts Receivable, Unbi

Trade Accounts Receivable, Unbilled Services and Unearned Income	3 Months Ended
	Mar. 31, 2020
Receivables [Abstract]
Trade Accounts Receivable, Unbilled Services and Unearned Income	Trade Accounts Receivable, Unbilled Services and Unearned Income Trade accounts receivables and unbilled services consist of the following: (in millions) March 31, 2020 December 31, 2019 Trade accounts receivable: Billed $ 1,309 $ 1,312 Unbilled services 1,341 1,286 Trade accounts receivable and unbilled services 2,650 2,598 Allowance for doubtful accounts (16) (16) Trade accounts receivable and unbilled services, net $ 2,634 $ 2,582 Unbilled services and unearned income were as follows: (in millions) March 31, 2020 December 31, 2019 Change Unbilled services $ 1,341 $ 1,286 $ 55 Unearned income (1,036) (1,014) (22) Net balance $ 305 $ 272 $ 33 Unbilled services, which is comprised of approximately equal parts of unbilled receivables and contract assets as of March 31, 2020, increased by $55 million as compared to December 31, 2019. Contract assets are unbilled services for which invoicing is based on the timing of certain milestones related to service contracts for clinical research whereas unbilled receivables are billable upon the passage of time. Unearned income increased by $22 million over the same period resulting in an increase of $33 million in the net balance of unbilled services and unearned income between December 31, 2019 and March 31, 2020. Growth in the net balance is driven by the difference in timing of revenue recognition in accordance with ASC 606, Revenue from Contracts with Customers, related to the Company’s Research & Development Solutions contracts (which is based on the percentage of costs incurred) versus the timing of invoicing, which is based on certain milestones.

Leases

Leases	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Leases	Leases The Company has operating leases for corporate offices, datacenters, motor vehicles and certain equipment, many of which contain renewal and escalation clauses. The leases expire at various dates through 2029 with options to cancel certain leases at various intervals. The Company also has a finance lease for office and lab space that expires in 2044. Based on the timing of when the finance lease commenced, the associated income statement and cash flow impact is not material for the three months ended March 31, 2020. In determining the lease term at lease commencement, the Company includes the noncancellable term and the periods which the Company deems it is reasonably certain to exercise or not to exercise a renewal or cancellation option. The components of lease expense were as follows: (in millions) Classification Three Months Ended March 31, 2020 Three Months Ended March 31, 2019 Operating lease cost (1) Selling, general and administrative expenses $ 49 $ 48 (1) Includes variable lease costs, which are immaterial. Other information related to leases was as follows: (in millions) Three Months Ended March 31, 2020 Three Months Ended March 31, 2019 Supplemental Cash Flow: Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 46 $ 53 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 32 $ 20 Finance leases $ 58 $ — Weighted Average Remaining Lease Term: Operating leases 4.75 years 5.11 years Finance leases 24.75 years — Weighted Average Discount Rate: Operating leases 4.20 % 4.31 % Finance leases 3.41 % — Future minimum lease payments under non-cancellable leases as of March 31, 2020 were as follows: (in millions) Operating Leases Finance Leases Remainder of 2020 $ 146 $ — 2021 143 — 2022 113 3 2023 82 3 2024 53 3 2025 41 3 Thereafter 41 79 Total future minimum lease payments 619 91 Less imputed interest (79) (33) Total $ 540 $ 58 Reported as of March 31, 2020: Other current liabilities $ 174 $ — Operating lease liabilities 366 — Other liabilities — 58 Total $ 540 $ 58

Goodwill

Goodwill	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill The following is a summary of goodwill by reportable segment for the three months ended March 31, 2020: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2019 $ 10,374 $ 1,646 $ 139 $ 12,159 Business combinations 12 — — 12 Impact of foreign currency fluctuations and other (135) (48) 1 (182) Balance as of March 31, 2020 $ 10,251 $ 1,598 $ 140 $ 11,989

Derivatives

Derivatives	3 Months Ended
	Mar. 31, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Derivatives	Derivatives The fair values of the Company’s derivative instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table: (in millions) Balance Sheet Classification March 31, 2020 December 31, 2019 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Foreign exchange forward contracts Other current assets and liabilities $ 1 $ 3 $ 131 $ 4 $ — $ 148 Interest rate swaps Other assets and liabilities — 50 1,500 — 27 875 Interest rate caps Deposits and other assets — — — — — — Derivatives not designated as hedging instruments: Interest rate swaps Other liabilities — 2 319 — 3 325 Total derivatives $ 1 $ 55 $ 4 $ 30 The effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table: Three Months Ended March 31, (in millions) 2020 2019 Foreign exchange forward contracts $ (6) $ 1 Interest rate derivatives (23) (9) Total $ (29) $ (8) The amount of foreign exchange gains related to the net investment hedge included in the cumulative translation adjustment component of accumulated other comprehensive loss (“AOCI”) for the three months ended March 31, 2020 was $114 million.

Fair Value Measurements

Fair Value Measurements	3 Months Ended
	Mar. 31, 2020
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 values of cash, cash equivalents, accounts receivable and accounts payable approximated their fair values at March 31, 2020 and December 31, 2019 due to their short-term nature. At March 31, 2020 and December 31, 2019, the fair value of total debt approximated $11,751 million and $11,925 million, respectively, as determined under Level 1 and Level 2 measurements for these financial instruments. Recurring Fair Value Measurements The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured and reported at fair value on a recurring basis as of March 31, 2020: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities 80 $ — $ — $ 80 Derivatives — $ 1 — 1 Total $ 80 $ 1 $ — $ 81 Liabilities: Derivatives $ — $ 55 $ — $ 55 Contingent consideration — — 98 98 Total $ — $ 55 $ 98 $ 153 Below is a summary of the valuation techniques used in determining fair value: Marketable securities — The Company values trading and available-for-sale securities using the quoted market value of the securities held. Derivatives — Derivatives consist of foreign exchange contracts and interest rate swaps. The fair value of foreign exchange contracts is based on observable market inputs of spot and forward rates or using other observable inputs. The fair value of the interest rate swaps is the estimated amount that the Company would receive or pay to terminate such agreements, taking into account market interest rates and the remaining time to maturities or using market inputs with mid-market pricing as a practical expedient for bid-ask spread. Contingent consideration — The Company values contingent consideration related to business combinations using a weighted probability calculation of potential payment scenarios discounted at rates reflective of the risks associated with the expected future cash flows. Key assumptions used to estimate the fair value of contingent consideration include various financial metrics (revenue performance targets and operating forecasts) and the probability of achieving the specific targets. The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the three months ended March 31: Contingent Consideration (in millions) 2020 2019 Balance as of January 1 $ 113 $ 123 Business combinations 8 29 Contingent consideration paid (10) (16) Revaluations included in earnings and foreign currency translation adjustments (13) 1 Balance as of March 31 $ 98 $ 137 The Company used the following key assumptions when estimating the fair value of contingent considerations: Unobservable Input Probability of target achievement Range of potential payment Revenue target 100% 0%-100% EBITDA target 100% 0%-100% Operational target 50% 0%-100% The current portion of contingent consideration is included within accrued expenses and the long-term portion is included within other liabilities on the accompanying condensed consolidated balance sheets. Revaluations of the contingent consideration are recognized in other expense (income), net on the accompanying condensed consolidated statements of income. A change in significant unobservable inputs above could result in a significantly higher or lower fair value measurement of contingent consideration.

Credit Arrangements

Credit Arrangements	3 Months Ended
	Mar. 31, 2020
Debt Disclosure [Abstract]
Credit Arrangements	Credit Arrangements The following is a summary of the Company’s revolving credit facilities at March 31, 2020: Facility Interest Rates $1,500 million (revolving credit facility) LIBOR in the relevant currency borrowed plus a margin of 1.50% at March 31, 2020 $25 million (receivables financing facility) LIBOR Market Index Rate (1.89% at March 31, 2020) plus 0.90% £10 million (approximately $12 million) (general banking facility) Bank’s base rate of 0.10% at March 31, 2020 plus 1% The following table summarizes the Company’s debt at the dates indicated: (in millions) March 31, 2020 December 31, 2019 Senior Secured Credit Facilities: Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 2.95% $ 760 $ 770 Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 3.45% 800 — Term A Loan due 2023—Euro LIBOR at average floating rates of 1.50% 374 387 Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 2.74% 535 535 Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00% 1,277 1,306 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 2.74% 731 733 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 3.20% 933 936 Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00% 630 644 Revolving Credit Facility due 2023: U.S. Dollar denominated borrowings—U.S. Dollar LIBOR at average floating rates of 2.49% 100 154 Japanese Yen denominated borrowings—Japanese Yen LIBOR at average floating rates of 1.50% — 212 5.0% Senior Notes due 2027—U.S. Dollar denominated 1,100 1,100 5.0% Senior Notes due 2026—U.S. Dollar denominated 1,050 1,050 2.875% Senior Notes due 2025—Euro denominated 462 471 3.25% Senior Notes due 2025—Euro denominated 1,568 1,598 3.5% Senior Notes due 2024—Euro denominated 688 701 2.25% Senior Notes due 2028—Euro denominated 792 808 Receivables financing facility due 2022—U.S. Dollar LIBOR at average floating rates of 1.89% 300 300 Principal amount of debt 12,100 11,705 Less: unamortized discount and debt issuance costs (67) (60) Less: current portion (139) (100) Long-term debt $ 11,894 $ 11,545 Contractual maturities of long-term debt are as follows at March 31, 2020: (in millions) Remainder of 2020 104 2021 139 2022 439 2023 1,790 2024 2,473 Thereafter 7,155 12,100 At March 31, 2020, there were bank guarantees totaling approximately £0.8 million (approximately $1.1 million) issued against the availability of the general banking facility. Senior Secured Credit Facilities At March 31, 2020, the Company’s Fourth Amended and Restated Credit Agreement, as amended (the “Credit Agreement”) provided financing through several senior secured credit facilities (collectively, the “senior secured credit facilities”) of up to approximately $7,540 million, which consisted of $6,140 million principal amounts of debt outstanding (as detailed in the table above), $3 million of standby letters of credit and $1,397 million of available borrowing capacity on the $1,500 million revolving credit facility. On March 11, 2020, the Company entered into Amendment No. 7 to the Credit Agreement to borrow $900 million in additional U.S. Dollar denominated term A loans due 2023 (the “TLA-2 Loans”) and, on March 30, 2020, entered into Amendment No. 8 to the Credit Agreement to amend certain terms of the TLA-2 Loans. The TLA-2 Loans bear interest based on the U.S. Dollar LIBOR plus a margin ranging from 1.50% to 2.25%, with a U.S. Dollar LIBOR floor of 1.00% per annum. The proceeds from the TLA-2 Loans were used to repay outstanding revolving credit loans under the Company's senior secured credit facilities. On March 30, 2020, the Company prepaid $100 million of the TLA-2 loans. Based on our current operating plan, and after considering the likely future impacts of COVID-19, we believe that our available cash and cash equivalents, future cash flows from operations and our ability to access funds under our revolving and other credit facilities will enable us to fund our operating requirements and capital expenditures and meet debt obligations for at least the next 12 months. Restrictive Covenants

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2020
Equity [Abstract]
Stockholders' Equity	Stockholders’ Equity Preferred Stock The Company is authorized to issue 1.0 million shares of preferred stock, $0.01 per share par value. No shares of preferred stock were issued or outstanding as of March 31, 2020 or December 31, 2019. Equity Repurchase Program During the three months ended March 31, 2020, the Company repurchased 2,106,403 shares of its common stock for approximately $321.4 million under the Repurchase Program. These amounts include 1,000,000 shares of our common stock repurchased from certain of the Company’s stockholders (the “Selling Stockholders”) in a private transaction for an aggregate purchase price of approximately $164.3 million. As of March 31, 2020, the Company has remaining authorization to repurchase up to approximately $1.0 billion of its common stock under the Repurchase Program. In addition, from time to time, the Company has repurchased and may continue to repurchase common stock through private or other transactions outside of the Repurchase Program.

Restructuring

Restructuring	3 Months Ended
	Mar. 31, 2020
Restructuring and Related Activities [Abstract]
Restructuring	RestructuringThe Company has continued to take restructuring actions in 2020 to align its resources and reduce overcapacity to adapt to changing market conditions and integrate acquisitions. These actions include consolidating functional activities, eliminating redundant positions, and aligning resources with customer requirements. These restructuring actions are expected to continue into 2021. The following amounts were recorded for the restructuring plans: (in millions) Severance and Related Costs Facility Exit Costs Total Balance at December 31, 2019 $ 64 $ 3 $ 67 Expense, net of reversals 15 (1) 14 Payments (17) (1) (18) Foreign currency translation and other (1) 1 — Balance at March 31, 2020 $ 61 $ 2 $ 63 Restructuring costs are not allocated to the Company’s reportable segments as they are not part of the segment performance measures regularly reviewed by management. The Company expects that the majority of the restructuring accruals at March 31, 2020 will be paid in 2020 and 2021.

Income Taxes

Income Taxes	3 Months Ended
	Mar. 31, 2020
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The effective income tax rate was 16.7% and 37.6% in the first quarter of 2020 and 2019, respectively. The effective income tax rate in the first quarter of 2020 and 2019 was favorably impacted by $21 million and $9.4 million, respectively, as a result of excess tax benefits recognized upon settlement of shared-based compensation awards. Also, the effective income tax rate in the first quarter of 2020 was unfavorably impacted by a $10 million discrete tax expense related to change in the measurement of the U.S. tax on undistributed foreign earnings. In the first quarter of 2019 the U.S. Treasury Department issued final regulations on the transition tax and proposed regulations on Foreign Derived Intangible Income (“FDII”). While the final regulations related to the transition tax did not have a material impact on the Company, the proposed guidance on FDII had an unfavorable impact. Although the proposed guidance for FDII is not authoritative and subject to change in the regulatory review process, the Company reversed a portion of the tax benefit recorded in 2019 by recording a tax expense of $20 million for this impact. It is expected that during 2020 the U.S. Treasury Department will issue final regulations on FDII.

Comprehensive Income (Loss)

Comprehensive Income (Loss)	3 Months Ended
	Mar. 31, 2020
Equity [Abstract]
Comprehensive Income (Loss)	Comprehensive Income (Loss) Below is a summary of the components of AOCI: (in millions) Foreign Currency Translation Derivative Instruments Defined Benefit Plans Income Taxes Total Balance at December 31, 2019 $ (430) $ (21) $ (16) $ 156 $ (311) Other comprehensive income (loss) before reclassifications (128) (46) — (16) (190) Reclassification adjustments — 16 — — 16 Balance at March 31, 2020 $ (558) $ (51) $ (16) $ 140 $ (485) Below is a summary of the adjustments for (gains) losses reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item: (in millions) Affected Financial Statement Line Item Three Months Ended March 31, 2020 2019 Derivative instruments: Foreign exchange forward contracts Revenues $ 2 $ 1 Foreign exchange forward contracts Other expense (income), net 14 (3) Total before income taxes 16 (2) Income tax (benefit) expense — (1) Total net of income taxes $ 16 $ (1)

Segments

Segments	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Segments	Segments The following table presents the Company’s operations by reportable segment. The Company is managed through three reportable segments, Technology & Analytics Solutions, Research & Development Solutions and Contract Sales & Medical Solutions. Technology & Analytics Solutions provides mission-critical information, technology solutions and real-world insights and services to the Company’s life sciences customers. Research & Development Solutions, which primarily serves biopharmaceutical customers, provides outsourced clinical research and clinical trial related services. Contract Sales & Medical Solutions provides health care provider (including contract sales) and patient engagement services to both biopharmaceutical customers and the broader healthcare market. Certain costs are not allocated to the Company’s segments and are reported as general corporate and unallocated expenses. These costs primarily consist of stock-based compensation and expenses related to integration activities and acquisitions. The Company also does not allocate depreciation and amortization or impairment charges to its segments. Asset information by segment is not presented, as this measure is not used by the chief operating decision maker to assess the Company’s performance. The Company’s reportable segment information is presented below: Three Months Ended March 31, (in millions) 2020 2019 Revenues Technology & Analytics Solutions $ 1,117 $ 1,075 Research & Development Solutions 1,441 1,416 Contract Sales & Medical Solutions 196 193 Total revenues 2,754 2,684 Costs of revenue, exclusive of depreciation and amortization Technology & Analytics Solutions 666 633 Research & Development Solutions 988 946 Contract Sales & Medical Solutions 170 169 Total costs of revenue 1,824 1,748 Selling, general and administrative expenses Technology & Analytics Solutions 183 184 Research & Development Solutions 185 181 Contract Sales & Medical Solutions 15 15 General corporate and unallocated 24 39 Total selling, general and administrative expenses 407 419 Segment profit Technology & Analytics Solutions 268 258 Research & Development Solutions 268 289 Contract Sales & Medical Solutions 11 9 Total segment profit 547 556 General corporate and unallocated (24) (39) Depreciation and amortization (316) (295) Restructuring costs (14) (12) Total income from operations $ 193 $ 210

Earnings Per Share

Earnings Per Share	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The following table presents the weighted average number of outstanding stock-based awards not included in the computation of diluted earnings per share because they are subject to performance conditions or the effect of including such stock-based awards in the computation would be anti-dilutive: Three Months Ended March 31, (in millions) 2020 2019 Shares subject to performance conditions 1.4 1.3 Shares subject to anti-dilutive stock-based awards 1.0 0.6 Total shares excluded from diluted earnings per share 2.4 1.9 The vesting of performance awards is contingent upon the achievement of certain performance targets. The performance awards are not included in diluted earnings per share until the performance targets have been met. Stock-based awards will have a dilutive effect under the treasury method when the respective period’s average market value of the Company’s common stock exceeds the exercise proceeds.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2020
Accounting Policies [Abstract]
Unaudited Interim Financial Information	Unaudited Interim Financial Information The accompanying unaudited condensed consolidated financial statements of the Company have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2020. 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, 2019. The balance sheet at December 31, 2019 has been derived from the audited consolidated financial statements of the Company but does not include all the disclosures required by GAAP. Additionally, t he outbreak of the novel coronavirus, or COVID-19, and the various governmental, industry and consumer actions related thereto, could have a material and adverse effect on our business, financial condition and results of operations. These effects, which largely depend on future developments that cannot be accurately predicted and are uncertain, could include a negative impact on the availability of our key personnel, temporary closures of our facilities or the facilities of our business partners, customers, suppliers, third party service providers or other vendors, an increased risk of customer defaults or delays in payments or purchasing decisions, and the interruption of domestic and global supply chains, distribution channels, liquidity and capital or financial markets. As COVID-19 continues to spread, we have and may continue to experience disruptions that could severely impact our business. As such the results for the three months ended March 31, 2020 may not be indicative of results for the full year.
Recently Issued Accounting Standards	Recently Issued Accounting Standards Accounting pronouncements adopted In August 2018, the FASB issued new accounting guidance that clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued new accounting guidance that modifies the disclosure requirements in Topic 820, Fair Value Measurement, by removing certain disclosure requirements related to the fair value hierarchy, modifying existing disclosure requirements related to measurement uncertainty and adding new disclosure requirements, such as disclosing the changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period and disclosing the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. This new accounting guidance also modifies the disclosure requirements for employers that sponsor defined benefit pension or other postretirement plans. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In January 2017, the FASB issued new accounting guidance that simplifies the measurement of goodwill by eliminating the step two impairment test. Step two measures a goodwill impairment loss by comparing the implied fair value of goodwill with the carrying amount of that goodwill. The new guidance requires a comparison of the Company’s fair value of a reporting unit with the carrying amount and the Company is required to recognize an impairment charge for the amount by which the carrying amount exceeds the fair value. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In June 2016, the FASB issued a new accounting standard intended to provide financial statement users with more decision-useful information about expected credit losses and other commitments to extend credit held by the reporting entity. The standard replaces the incurred loss impairment methodology in current GAAP with one that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. The Company adopted this new accounting guidance on January 1, 2020. The adoption of this guidance did not have a material effect on the Company’s consolidated financial statements. This is based on factors including the Company's assessment of historical losses, client's creditworthiness and the fact that the Company's trade receivables are short term in duration. Accounting pronouncements being evaluated In January 2020, the FASB issued new accounting guidance that states any equity security transitioning from the alternative method of accounting to the equity method, or vice versa, due to an observable transaction, will be remeasured immediately before the transition. In addition, the new accounting guidance clarifies the accounting for certain non-derivative forward contracts or purchased call options to acquire equity securities stating such instruments will be measured using the fair value principles before settlement or exercise. The new accounting guidance will be effective for the Company on January 1, 2021 on a prospective basis. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements. In December 2019, the FASB issued new accounting guidance to clarify and simplify the accounting for income taxes. Changes under the new guidance includes eliminating certain exceptions related to the approach for intraperiod tax allocation, the methodology for calculating income taxes in an interim period and the recognition of deferred tax liabilities for outside basis differences. The new accounting guidance will be effective for the Company on January 1, 2021. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements.

Revenues by Geography, Concen_2

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations (Tables)	3 Months Ended
	Mar. 31, 2020
Revenue from Contract with Customer [Abstract]
Summary of Revenues by Geographic Region and Reportable Segment	The following tables represent revenues by geographic region and reportable segment for the three months ended March 31, 2020 and 2019: Three Months Ended March 31, 2020 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 581 $ 670 $ 91 $ 1,342 Europe and Africa 396 428 50 874 Asia-Pacific 140 343 55 538 Total revenues $ 1,117 $ 1,441 $ 196 $ 2,754 Three Months Ended March 31, 2019 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 553 $ 642 $ 94 $ 1,289 Europe and Africa 383 456 51 890 Asia-Pacific 139 318 48 505 Total revenues $ 1,075 $ 1,416 $ 193 $ 2,684

Trade Accounts Receivable, Un_2

Trade Accounts Receivable, Unbilled Services and Unearned Income (Tables)	3 Months Ended
	Mar. 31, 2020
Receivables [Abstract]
Trade Accounts Receivable and Unbilled Services	Trade accounts receivables and unbilled services consist of the following: (in millions) March 31, 2020 December 31, 2019 Trade accounts receivable: Billed $ 1,309 $ 1,312 Unbilled services 1,341 1,286 Trade accounts receivable and unbilled services 2,650 2,598 Allowance for doubtful accounts (16) (16) Trade accounts receivable and unbilled services, net $ 2,634 $ 2,582
Schedule of Net Contract Assets (Liabilities)	Unbilled services and unearned income were as follows: (in millions) March 31, 2020 December 31, 2019 Change Unbilled services $ 1,341 $ 1,286 $ 55 Unearned income (1,036) (1,014) (22) Net balance $ 305 $ 272 $ 33

Leases (Tables)

Leases (Tables)	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Components of Lease Expense	The components of lease expense were as follows: (in millions) Classification Three Months Ended March 31, 2020 Three Months Ended March 31, 2019 Operating lease cost (1) Selling, general and administrative expenses $ 49 $ 48 (1) Includes variable lease costs, which are immaterial.
Other Information Related to Leases	Other information related to leases was as follows: (in millions) Three Months Ended March 31, 2020 Three Months Ended March 31, 2019 Supplemental Cash Flow: Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 46 $ 53 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 32 $ 20 Finance leases $ 58 $ — Weighted Average Remaining Lease Term: Operating leases 4.75 years 5.11 years Finance leases 24.75 years — Weighted Average Discount Rate: Operating leases 4.20 % 4.31 % Finance leases 3.41 % —
Future Minimum Lease Payments Under Non-cancellable Leases	Future minimum lease payments under non-cancellable leases as of March 31, 2020 were as follows: (in millions) Operating Leases Finance Leases Remainder of 2020 $ 146 $ — 2021 143 — 2022 113 3 2023 82 3 2024 53 3 2025 41 3 Thereafter 41 79 Total future minimum lease payments 619 91 Less imputed interest (79) (33) Total $ 540 $ 58 Reported as of March 31, 2020: Other current liabilities $ 174 $ — Operating lease liabilities 366 — Other liabilities — 58 Total $ 540 $ 58

Goodwill (Tables)

Goodwill (Tables)	3 Months Ended
	Mar. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Goodwill by Reportable Segment	The following is a summary of goodwill by reportable segment for the three months ended March 31, 2020: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2019 $ 10,374 $ 1,646 $ 139 $ 12,159 Business combinations 12 — — 12 Impact of foreign currency fluctuations and other (135) (48) 1 (182) Balance as of March 31, 2020 $ 10,251 $ 1,598 $ 140 $ 11,989

Derivatives (Tables)

Derivatives (Tables)	3 Months Ended
	Mar. 31, 2020
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Summary of Fair Values of Derivative Instruments Designated as Hedges	The fair values of the Company’s derivative instruments and the line items on the accompanying condensed consolidated balance sheets to which they were recorded are summarized in the following table: (in millions) Balance Sheet Classification March 31, 2020 December 31, 2019 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Foreign exchange forward contracts Other current assets and liabilities $ 1 $ 3 $ 131 $ 4 $ — $ 148 Interest rate swaps Other assets and liabilities — 50 1,500 — 27 875 Interest rate caps Deposits and other assets — — — — — — Derivatives not designated as hedging instruments: Interest rate swaps Other liabilities — 2 319 — 3 325 Total derivatives $ 1 $ 55 $ 4 $ 30
Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income	The effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table: Three Months Ended March 31, (in millions) 2020 2019 Foreign exchange forward contracts $ (6) $ 1 Interest rate derivatives (23) (9) Total $ (29) $ (8)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	3 Months Ended
	Mar. 31, 2020
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 and reported at fair value on a recurring basis as of March 31, 2020: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities 80 $ — $ — $ 80 Derivatives — $ 1 — 1 Total $ 80 $ 1 $ — $ 81 Liabilities: Derivatives $ — $ 55 $ — $ 55 Contingent consideration — — 98 98 Total $ — $ 55 $ 98 $ 153
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: Contingent Consideration (in millions) 2020 2019 Balance as of January 1 $ 113 $ 123 Business combinations 8 29 Contingent consideration paid (10) (16) Revaluations included in earnings and foreign currency translation adjustments (13) 1 Balance as of March 31 $ 98 $ 137
Fair Value Measurement Inputs and Valuation Techniques	The Company used the following key assumptions when estimating the fair value of contingent considerations: Unobservable Input Probability of target achievement Range of potential payment Revenue target 100% 0%-100% EBITDA target 100% 0%-100% Operational target 50% 0%-100%

Credit Arrangements (Tables)

Credit Arrangements (Tables)	3 Months Ended
	Mar. 31, 2020
Debt Disclosure [Abstract]
Summary of Credit Facilities	The following is a summary of the Company’s revolving credit facilities at March 31, 2020: Facility Interest Rates $1,500 million (revolving credit facility) LIBOR in the relevant currency borrowed plus a margin of 1.50% at March 31, 2020 $25 million (receivables financing facility) LIBOR Market Index Rate (1.89% at March 31, 2020) plus 0.90% £10 million (approximately $12 million) (general banking facility) Bank’s base rate of 0.10% at March 31, 2020 plus 1%
Summary of Debt	The following table summarizes the Company’s debt at the dates indicated: (in millions) March 31, 2020 December 31, 2019 Senior Secured Credit Facilities: Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 2.95% $ 760 $ 770 Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 3.45% 800 — Term A Loan due 2023—Euro LIBOR at average floating rates of 1.50% 374 387 Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 2.74% 535 535 Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00% 1,277 1,306 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 2.74% 731 733 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 3.20% 933 936 Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00% 630 644 Revolving Credit Facility due 2023: U.S. Dollar denominated borrowings—U.S. Dollar LIBOR at average floating rates of 2.49% 100 154 Japanese Yen denominated borrowings—Japanese Yen LIBOR at average floating rates of 1.50% — 212 5.0% Senior Notes due 2027—U.S. Dollar denominated 1,100 1,100 5.0% Senior Notes due 2026—U.S. Dollar denominated 1,050 1,050 2.875% Senior Notes due 2025—Euro denominated 462 471 3.25% Senior Notes due 2025—Euro denominated 1,568 1,598 3.5% Senior Notes due 2024—Euro denominated 688 701 2.25% Senior Notes due 2028—Euro denominated 792 808 Receivables financing facility due 2022—U.S. Dollar LIBOR at average floating rates of 1.89% 300 300 Principal amount of debt 12,100 11,705 Less: unamortized discount and debt issuance costs (67) (60) Less: current portion (139) (100) Long-term debt $ 11,894 $ 11,545
Contractual Maturities of Long-term Debt	Contractual maturities of long-term debt are as follows at March 31, 2020: (in millions) Remainder of 2020 104 2021 139 2022 439 2023 1,790 2024 2,473 Thereafter 7,155 12,100

Restructuring (Tables)

Restructuring (Tables)	3 Months Ended
	Mar. 31, 2020
Restructuring and Related Activities [Abstract]
Summary of Amounts Recorded for Restructuring Plans	The following amounts were recorded for the restructuring plans: (in millions) Severance and Related Costs Facility Exit Costs Total Balance at December 31, 2019 $ 64 $ 3 $ 67 Expense, net of reversals 15 (1) 14 Payments (17) (1) (18) Foreign currency translation and other (1) 1 — Balance at March 31, 2020 $ 61 $ 2 $ 63

Comprehensive Income (Loss) (Ta

Comprehensive Income (Loss) (Tables)	3 Months Ended
	Mar. 31, 2020
Equity [Abstract]
Summary of Components of AOCI	Below is a summary of the components of AOCI: (in millions) Foreign Currency Translation Derivative Instruments Defined Benefit Plans Income Taxes Total Balance at December 31, 2019 $ (430) $ (21) $ (16) $ 156 $ (311) Other comprehensive income (loss) before reclassifications (128) (46) — (16) (190) Reclassification adjustments — 16 — — 16 Balance at March 31, 2020 $ (558) $ (51) $ (16) $ 140 $ (485)
Summary of Adjustments for (Gains) Losses Reclassified from AOCI into Condensed Consolidated Statements of Income and Affected Financial Statement Line Item	Below is a summary of the adjustments for (gains) losses reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item: (in millions) Affected Financial Statement Line Item Three Months Ended March 31, 2020 2019 Derivative instruments: Foreign exchange forward contracts Revenues $ 2 $ 1 Foreign exchange forward contracts Other expense (income), net 14 (3) Total before income taxes 16 (2) Income tax (benefit) expense — (1) Total net of income taxes $ 16 $ (1)

Segments (Tables)

Segments (Tables)	3 Months Ended
	Mar. 31, 2020
Segment Reporting [Abstract]
Reconciliation of Revenues and Income from Segments to Consolidated	Asset information by segment is not presented, as this measure is not used by the chief operating decision maker to assess the Company’s performance. The Company’s reportable segment information is presented below: Three Months Ended March 31, (in millions) 2020 2019 Revenues Technology & Analytics Solutions $ 1,117 $ 1,075 Research & Development Solutions 1,441 1,416 Contract Sales & Medical Solutions 196 193 Total revenues 2,754 2,684 Costs of revenue, exclusive of depreciation and amortization Technology & Analytics Solutions 666 633 Research & Development Solutions 988 946 Contract Sales & Medical Solutions 170 169 Total costs of revenue 1,824 1,748 Selling, general and administrative expenses Technology & Analytics Solutions 183 184 Research & Development Solutions 185 181 Contract Sales & Medical Solutions 15 15 General corporate and unallocated 24 39 Total selling, general and administrative expenses 407 419 Segment profit Technology & Analytics Solutions 268 258 Research & Development Solutions 268 289 Contract Sales & Medical Solutions 11 9 Total segment profit 547 556 General corporate and unallocated (24) (39) Depreciation and amortization (316) (295) Restructuring costs (14) (12) Total income from operations $ 193 $ 210

Earnings Per Share (Tables)

Earnings Per Share (Tables)	3 Months Ended
	Mar. 31, 2020
Earnings Per Share [Abstract]
Summary of Weighted-Average Outstanding Stock-Based Awards Excluded from Computation of Diluted Earnings Per Share	The following table presents the weighted average number of outstanding stock-based awards not included in the computation of diluted earnings per share because they are subject to performance conditions or the effect of including such stock-based awards in the computation would be anti-dilutive: Three Months Ended March 31, (in millions) 2020 2019 Shares subject to performance conditions 1.4 1.3 Shares subject to anti-dilutive stock-based awards 1.0 0.6 Total shares excluded from diluted earnings per share 2.4 1.9 The vesting of performance awards is contingent upon the achievement of certain performance targets. The performance awards are not included in diluted earnings per share until the performance targets have been met. Stock-based awards will have a dilutive effect under the treasury method when the respective period’s average market value of the Company’s common stock exceeds the exercise proceeds.

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Detail) Employee in Thousands	Mar. 31, 2020EmployeeCountry
Summary Of Significant Accounting Policies [Line Items]
Number of employees | Employee	67
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of countries (more than) | Country	100

Revenues by Geography, Concen_3

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Summary of Revenues by Geographic Region and Reportable Segment (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Disaggregation of Revenue [Line Items]
Total revenues	$ 2,754	$ 2,684
Americas [Member]
Disaggregation of Revenue [Line Items]
Total revenues	1,342	1,289
Europe and Africa [Member]
Disaggregation of Revenue [Line Items]
Total revenues	874	890
Asia-Pacific [Member]
Disaggregation of Revenue [Line Items]
Total revenues	538	505
Technology & Analytics Solutions [Member]
Disaggregation of Revenue [Line Items]
Total revenues	1,117	1,075
Technology & Analytics Solutions [Member] | Americas [Member]
Disaggregation of Revenue [Line Items]
Total revenues	581	553
Technology & Analytics Solutions [Member] | Europe and Africa [Member]
Disaggregation of Revenue [Line Items]
Total revenues	396	383
Technology & Analytics Solutions [Member] | Asia-Pacific [Member]
Disaggregation of Revenue [Line Items]
Total revenues	140	139
Research & Development Solutions [Member]
Disaggregation of Revenue [Line Items]
Total revenues	1,441	1,416
Research & Development Solutions [Member] | Americas [Member]
Disaggregation of Revenue [Line Items]
Total revenues	670	642
Research & Development Solutions [Member] | Europe and Africa [Member]
Disaggregation of Revenue [Line Items]
Total revenues	428	456
Research & Development Solutions [Member] | Asia-Pacific [Member]
Disaggregation of Revenue [Line Items]
Total revenues	343	318
Contract Sales & Medical Solutions [Member]
Disaggregation of Revenue [Line Items]
Total revenues	196	193
Contract Sales & Medical Solutions [Member] | Americas [Member]
Disaggregation of Revenue [Line Items]
Total revenues	91	94
Contract Sales & Medical Solutions [Member] | Europe and Africa [Member]
Disaggregation of Revenue [Line Items]
Total revenues	50	51
Contract Sales & Medical Solutions [Member] | Asia-Pacific [Member]
Disaggregation of Revenue [Line Items]
Total revenues	$ 55	$ 48

Revenues by Geography, Concen_4

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Additional Information (Detail) $ in Billions	Mar. 31, 2020USD ($)
Revenue from Contract with Customer [Abstract]
Revenue expected to be recognized in future from remaining performance obligations	$ 22

Revenues by Geography, Concen_5

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Additional Information 1 (Detail) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2019-10-01	Mar. 31, 2020
Disaggregation of Revenue [Line Items]
Percentage of remaining performance obligations on which revenue is expected to be recognized	35.00%
Unearned income recognition period	12 months

Trade Accounts Receivable, Un_3

Trade Accounts Receivable, Unbilled Services and Unearned Income - Trade Accounts Receivable and Unbilled Services (Detail) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Trade accounts receivable:
Billed	$ 1,309	$ 1,312
Unbilled services	1,341	1,286
Trade accounts receivable and unbilled services	2,650	2,598
Allowance for doubtful accounts	(16)	(16)
Trade accounts receivable and unbilled services, net	$ 2,634	$ 2,582

Trade Accounts Receivable, Un_4

Trade Accounts Receivable, Unbilled Services and Unearned Income - Schedule of Net Contract Assets (Liabilities) (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Contract with Customer, Asset and Liability [Abstract]
Unbilled services	$ 1,341	$ 1,286
Unearned income	(1,036)	(1,014)
Net balance	305	$ 272
Unbilled Services, Change	55
Unearned Income, Change	(22)
Net balance, Change	$ 33

Trade Accounts Receivable, Un_5

Trade Accounts Receivable, Unbilled Services and Unearned Income - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Receivables [Abstract]
Increase in unbilled services	$ 55
Unearned Income, Change	22
Increase of net balance of unbilled services and unearned income	$ 33

Leases - Additional Information

Leases - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2020
Leases [Abstract]
Operating lease year of expiry	2029

Leases - Components of Lease Ex

Leases - Components of Lease Expense (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Selling, General and Administrative Expenses [Member]
Operating lease cost	$ 49	$ 48

Leases - Other Information Rela

Leases - Other Information Related to Leases (Detail) - USD ($) $ in Millions	3 Months Ended	12 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 46	$ 53
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	32	$ 20
Finance leases	$ 58
Weighted Average Remaining Lease Term:
Operating leases	4 years 9 months	5 years 1 month 9 days
Finance leases	24 years 9 months
Weighted Average Discount Rate:
Operating leases	4.20%	4.31%
Finance leases	3.41%

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments Under Non-cancellable Leases (Detail) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Operating Leases
Remainder of 2020	$ 146
2021	143
2022	113
2023	82
2024	53
2025	41
Thereafter	41
Total future minimum lease payments	619
Less imputed interest	(79)
Total	540
Other current liabilities	174
Operating lease liabilities	366	$ 396
Total	540
Finance Lease, Liability, Payment, Due [Abstract]
Remainder of 2020	0
2021	0
2022	3
2023	3
2024	3
2025	3
Thereafter	79
Finance Lease, Liability, Payment, Due, Total	91
Less imputed interest	(33)
Total	58
Other liabilities	$ 58

Goodwill - Summary of Goodwill

Goodwill - Summary of Goodwill by Reportable Segment (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Goodwill [Roll Forward]
Beginning Balance	$ 12,159
Business combinations	12
Impact of foreign currency fluctuations and other	(182)
Ending Balance	11,989
Technology & Analytics Solutions [Member]
Goodwill [Roll Forward]
Beginning Balance	10,374
Business combinations	12
Impact of foreign currency fluctuations and other	(135)
Ending Balance	10,251
Research & Development Solutions [Member]
Goodwill [Roll Forward]
Beginning Balance	1,646
Business combinations	0
Impact of foreign currency fluctuations and other	(48)
Ending Balance	1,598
Contract Sales & Medical Solutions [Member]
Goodwill [Roll Forward]
Beginning Balance	139
Business combinations	0
Impact of foreign currency fluctuations and other	1
Ending Balance	$ 140

Derivatives - Summary of Fair V

Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) - USD ($)	Mar. 31, 2020	Dec. 31, 2019
Derivatives, Fair Value [Line Items]
Derivative asset fair value	$ 1,000,000	$ 4,000,000
Derivative liability fair value	55,000,000	30,000,000
Designated as Hedging Instrument [Member] | Other Current Assets and Liabilities [Member] | Foreign Exchange Forward Contracts [Member]
Derivatives, Fair Value [Line Items]
Derivative asset fair value	1,000,000	4,000,000
Derivative liability fair value	3,000,000	0
Derivative notional amount	131,000,000	148,000,000
Designated as Hedging Instrument [Member] | Other Assets and Liabilities [Member] | Interest Rate Swaps [Member]
Derivatives, Fair Value [Line Items]
Derivative asset fair value	0	0
Derivative liability fair value	50,000,000	27,000,000
Derivative notional amount	1,500,000,000	875,000,000
Designated as Hedging Instrument [Member] | Deposits and Other Assets [Member] | Interest Rate Cap [Member]
Derivatives, Fair Value [Line Items]
Derivative asset fair value	0	0
Derivative notional amount		0
Not Designated as Hedging Instrument [Member] | Other Liabilities [Member] | Interest Rate Swaps [Member]
Derivatives, Fair Value [Line Items]
Derivative asset fair value	0	0
Derivative liability fair value	2,000,000	3,000,000
Derivative notional amount	$ 319,000,000	$ 325,000,000

Derivatives - Effect of Cash Fl

Derivatives - Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (29)	$ (8)
Foreign Exchange Forward Contracts [Member]
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Effect of cash flow hedging instruments on other comprehensive (loss) income	(6)	1
Interest Rate Derivatives [Member]
Derivative Instruments and Hedging Activities Disclosures [Line Items]
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (23)	$ (9)

Derivatives - Additional Inform

Derivatives - Additional Information (Detail) $ in Millions	Mar. 31, 2020USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Foreign exchange gains related to net investment hedge	$ 114

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Level 1 and Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of total debt	$ 11,751	$ 11,925

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 63	$ 62
Derivative asset fair value	1	$ 4
Recurring Fair Value Measurements [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	80
Fair value of assets	81
Fair value of liabilities	153
Recurring Fair Value Measurements [Member] | Derivatives [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	55
Derivative asset fair value	1
Recurring Fair Value Measurements [Member] | Contingent Consideration [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	98
Recurring Fair Value Measurements [Member] | Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of assets	80
Recurring Fair Value Measurements [Member] | Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	55
Derivative asset fair value	1
Recurring Fair Value Measurements [Member] | Level 2 [Member] | Derivatives [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	55
Recurring Fair Value Measurements [Member] | Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	98
Recurring Fair Value Measurements [Member] | Level 3 [Member] | Contingent Consideration [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	$ 98

Fair Value Measurements - Chang

Fair Value Measurements - Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Contingent Consideration [Member] - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation [Roll Forward]
Balance as of January 1	$ 113	$ 123
Business combinations	8	29
Contingent consideration paid	(10)	(16)
Revaluations included in earnings and foreign currency translation adjustments	(13)	1
Ending Balance, Contingent Consideration	$ 98	$ 137

Fair Value Measurements - Key A

Fair Value Measurements - Key Assumptions (Details)	Mar. 31, 2020
Revenue Target [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Probability of target achievement	100.00%
Revenue Target [Member] | Minimum [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value Assumptions, Range of Potential Payment	0.00%
Revenue Target [Member] | Maximum [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value Assumptions, Range of Potential Payment	100.00%
EBITDA Target [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Probability of target achievement	100.00%
EBITDA Target [Member] | Minimum [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value Assumptions, Range of Potential Payment	0.00%
EBITDA Target [Member] | Maximum [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value Assumptions, Range of Potential Payment	100.00%
Customer Target [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Probability of target achievement	50.00%
Customer Target [Member] | Minimum [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value Assumptions, Range of Potential Payment	0.00%
Customer Target [Member] | Maximum [Member]
Fair Value Measurement Inputs and Valuation Techniques [Line Items]
Fair Value Assumptions, Range of Potential Payment	100.00%

Credit Arrangements - Summary o

Credit Arrangements - Summary of Credit Facilities (Detail)	3 Months Ended
	Mar. 31, 2020USD ($)	Mar. 31, 2020GBP (£)
Revolving credit facility [Member]
Line of Credit Facility [Line Items]
Interest Rates	LIBOR in the relevant currency borrowed plus a margin of 1.50% at March 31, 2020
Facility	$ 1,500,000,000
Revolving credit facility [Member] | LIBOR [Member]
Line of Credit Facility [Line Items]
Rate	1.50%	1.50%
Receivables Financing Facility [Member]
Line of Credit Facility [Line Items]
Interest Rates	LIBOR Market Index Rate (1.89% at March 31, 2020) plus 0.90%
Facility	$ 25,000,000
Receivables Financing Facility [Member] | LIBOR [Member]
Line of Credit Facility [Line Items]
Interest rate spread on base rate	0.90%
General Banking Facility [Member]
Line of Credit Facility [Line Items]
Interest Rates	Bank’s base rate of 0.10% at March 31, 2020 plus 1%
Facility	$ 12,000,000	£ 10,000,000
General Banking Facility [Member] | Base Rate [Member]
Line of Credit Facility [Line Items]
Interest rate spread on base rate	1.00%

Credit Arrangements - Summary_2

Credit Arrangements - Summary of Debt (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Dec. 31, 2019
Senior Secured Credit Facilities:
Principal amount of debt	$ 12,100	$ 11,705
Less: unamortized discount and debt issuance costs	(67)	(60)
Less: current portion	(139)	(100)
Long-term debt	$ 11,894	11,545
Revolving credit facility [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Rate	1.50%
Due in 2023 [Member] | Senior Secured Term A Loan [Member]
Senior Secured Credit Facilities:
Less: current portion	$ (139)	(100)
U.S Dollars [Member] | Due in 2023 [Member] | Revolving credit facility [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 100	154
Average floating rate	2.49%
U.S Dollars [Member] | Due in 2023 [Member] | Senior Secured Term A Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 760	770
Average floating rate	2.95%
U.S Dollars [Member] | Due in 2023 [Member] | Senior Secured Term Loan A at 3.45 Percent [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 800	0
Average floating rate	3.45%
U.S Dollars [Member] | Due in 2024 [Member] | Senior Secured Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 535	535
Average floating rate	2.74%
U.S Dollars [Member] | Due in 2025 [Member] | Senior Secured Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 731	733
Average floating rate	2.74%
U.S Dollars [Member] | Due in 2025 [Member] | Senior Secured Additional Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 933	936
Average floating rate	3.20%
U.S Dollars [Member] | Due in 2027 [Member] | 5.0% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,100	1,100
Rate	5.00%
U.S Dollars [Member] | Due in 2026 [Member] | 5.0% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,050	1,050
Rate	5.00%
U.S Dollars [Member] | Due in 2020 [Member] | Receivables Financing Facility [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 300	300
Rate	1.89%
EUR Dollars [Member] | Due in 2023 [Member] | Senior Secured Term A Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 374	387
Average floating rate	1.50%
EUR Dollars [Member] | Due in 2024 [Member] | Senior Secured Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,277	1,306
Average floating rate	2.00%
EUR Dollars [Member] | Due in 2024 [Member] | 3.5% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 688	701
Rate	3.50%
EUR Dollars [Member] | Due in 2025 [Member] | Senior Secured Additional Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 630	644
Average floating rate	2.00%
EUR Dollars [Member] | Due in 2025 [Member] | 2.875% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 462	471
Rate	2.875%
EUR Dollars [Member] | Due in 2025 [Member] | 3.25% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,568	1,598
Rate	3.25%
EUR Dollars [Member] | Due in 2028 [Member] | 2.25% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 792	808
Rate	2.25%
Japan, Yen [Member] | Revolving credit facility [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 0	$ 212
Average floating rate	1.50%

Credit Arrangements - Contractu

Credit Arrangements - Contractual Maturities of Long-term Debt (Detail) - USD ($) $ in Millions	Mar. 31, 2020	Dec. 31, 2019
Debt Disclosure [Abstract]
Remainder of 2020	$ 104
2021	139
2022	439
2023	1,790
2024	2,473
Thereafter	7,155
Principal amount of debt	$ 12,100	$ 11,705

Credit Arrangements - Additiona

Credit Arrangements - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2020USD ($)	Mar. 31, 2020GBP (£)	Mar. 31, 2020GBP (£)	Mar. 11, 2020USD ($)	Dec. 31, 2019USD ($)
Line of Credit Facility [Line Items]
Outstanding borrowings	$ 12,100,000,000				$ 11,705,000,000
Revolving credit facility [Member]
Line of Credit Facility [Line Items]
Aggregate maximum principal amount	1,500,000,000
Standby Letters of Credit [Member]
Line of Credit Facility [Line Items]
Available borrowing capacity	$ 3,000,000
LIBOR [Member] | Revolving credit facility [Member]
Line of Credit Facility [Line Items]
Debt instrument interest rate stated percentage	1.50%		1.50%
General Banking Facility [Member]
Line of Credit Facility [Line Items]
Bank guarantees	$ 1,100,000	£ 800,000
Aggregate maximum principal amount	12,000,000		£ 10,000,000
Senior Secured Credit Facilities [Member]
Line of Credit Facility [Line Items]
Aggregate maximum principal amount	7,540,000,000
Outstanding borrowings	6,140,000,000
Available borrowing capacity	1,397,000,000
Senior Secured Credit Facilities [Member] | Revolving credit facility [Member]
Line of Credit Facility [Line Items]
Current borrowing capacity	1,500,000,000
Senior Secured Term B Loan [Member] | LIBOR [Member] | EUR Dollars [Member] | Due in 2024 [Member]
Line of Credit Facility [Line Items]
Outstanding borrowings	$ 1,277,000,000				1,306,000,000
Average floating rate	2.00%	2.00%
2.25% Senior Notes [Member] | EUR Dollars [Member] | Due in 2028 [Member]
Line of Credit Facility [Line Items]
Outstanding borrowings	$ 792,000,000				$ 808,000,000
Debt instrument interest rate stated percentage	2.25%		2.25%
TLA - 2 Loans [Member] | Secured Debt [Member]
Line of Credit Facility [Line Items]
Current borrowing capacity				$ 900,000,000
Prepaid debt	$ 100,000,000
TLA - 2 Loans [Member] | LIBOR [Member] | Secured Debt [Member]
Line of Credit Facility [Line Items]
Basis spread floor	1.00%	1.00%
TLA - 2 Loans [Member] | LIBOR [Member] | Secured Debt [Member] | Minimum [Member]
Line of Credit Facility [Line Items]
Interest rate spread on base rate	1.50%	1.50%
TLA - 2 Loans [Member] | LIBOR [Member] | Secured Debt [Member] | Maximum [Member]
Line of Credit Facility [Line Items]
Interest rate spread on base rate	2.25%	2.25%

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019	Dec. 31, 2019
Class of Stock [Line Items]
Preferred stock, authorized	1,000,000
Preferred stock, par value	$ 0.01
Preferred stock, shares issued	0		0
Preferred stock, shares outstanding	0		0
Repurchase of stock, value	$ 332	$ 145
Equity Repurchase Under Repurchase Program [Member]
Class of Stock [Line Items]
Equity available for repurchase under the repurchase program	$ 1,000
Secondary Public Offering [Member] | Equity Repurchase Under Repurchase Program [Member]
Class of Stock [Line Items]
Repurchase of stock, shares	2,106,403
Repurchase of stock, value	$ 321.4
Repurchased From Company Stockholders [Member] | Equity Repurchase Under Repurchase Program [Member]
Class of Stock [Line Items]
Repurchase of stock, shares	1,000,000
Repurchase of stock, value	$ 164.3

Restructuring - Summary of Amou

Restructuring - Summary of Amounts Recorded for Restructuring Plans (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Restructuring Reserve [Roll Forward]
Restructuring reserves, beginning balance	$ 67
Expense, net of reversals	14
Payments	(18)
Foreign currency translation and other	0
Restructuring reserves, ending balance	63
Severance and Related Costs [Member]
Restructuring Reserve [Roll Forward]
Restructuring reserves, beginning balance	64
Expense, net of reversals	15
Payments	(17)
Foreign currency translation and other	(1)
Restructuring reserves, ending balance	61
Facility Exit Costs [Member]
Restructuring Reserve [Roll Forward]
Restructuring reserves, beginning balance	3
Expense, net of reversals	(1)
Payments	(1)
Foreign currency translation and other	1
Restructuring reserves, ending balance	$ 2

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Income Tax Disclosure [Abstract]
Effective income tax rate	16.70%	37.60%
Tax impact of share-based compensation awards	$ 21	$ 9.4
Discrete tax expense	10
Tax benefit recorded in 2019	$ 20

Comprehensive Income (Loss) - S

Comprehensive Income (Loss) - Summary of Components of AOCI (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2020USD ($)
Statement of Other Comprehensive Income [Abstract]
Beginning Balance	$ 6,003
Reclassification adjustments	16
Ending Balance	5,542
Beginning Balance	156
Other comprehensive income (loss) before reclassifications	(16)
Other comprehensive income (loss) before reclassifications	(190)
Ending Balance	140
Foreign Currency Translation [Member]
Statement of Other Comprehensive Income [Abstract]
Beginning Balance	(430)
Other comprehensive income (loss) before reclassifications	(128)
Ending Balance	(558)
Derivative Instruments [Member]
Statement of Other Comprehensive Income [Abstract]
Beginning Balance	(21)
Other comprehensive income (loss) before reclassifications	(46)
Reclassification adjustments	16
Ending Balance	(51)
Defined Benefit Plans [Member]
Statement of Other Comprehensive Income [Abstract]
Beginning Balance	(16)
Ending Balance	(16)
Accumulated Other Comprehensive (Loss) Income [Member]
Statement of Other Comprehensive Income [Abstract]
Beginning Balance	(311)
Ending Balance	$ (485)

Comprehensive Income (Loss) -_2

Comprehensive Income (Loss) - Summary of Adjustments for (Gains) Losses Reclassified from AOCI into Condensed Consolidated Statements of Income and Affected Financial Statement Line Item (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before income taxes	$ 16	$ (2)
Income tax (benefit) expense	0	1
Total net of income taxes	16	(1)
Foreign Exchange Forward Contracts [Member] | Revenues [Member]
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before income taxes	2	1
Foreign Exchange Forward Contracts [Member] | Other Expense (Income), Net [Member]
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before income taxes	$ 14	$ (3)

Segments - Additional Informati

Segments - Additional Information (Detail)	3 Months Ended
	Mar. 31, 2020Segment
Segment Reporting [Abstract]
Number of reportable segments	3

Segments - Operations by Report

Segments - Operations by Reportable Segments (Detail) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Segment Reporting Information [Line Items]
Revenues	$ 2,754	$ 2,684
Costs of revenue, exclusive of depreciation and amortization	1,824	1,748
Selling, general and administrative expenses	407	419
Depreciation and amortization	(316)	(295)
Restructuring costs	(14)	(12)
Income from operations	193	210
Technology & Analytics Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,117	1,075
Research & Development Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,441	1,416
Contract Sales & Medical Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	196	193
Operating Segments [Member]
Segment Reporting Information [Line Items]
Segment profit	547	556
Operating Segments [Member] | Technology & Analytics Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,117	1,075
Costs of revenue, exclusive of depreciation and amortization	666	633
Selling, general and administrative expenses	183	184
Segment profit	268	258
Operating Segments [Member] | Research & Development Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,441	1,416
Costs of revenue, exclusive of depreciation and amortization	988	946
Selling, general and administrative expenses	185	181
Segment profit	268	289
Operating Segments [Member] | Contract Sales & Medical Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	196	193
Costs of revenue, exclusive of depreciation and amortization	170	169
Selling, general and administrative expenses	15	15
Segment profit	11	9
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Selling, general and administrative expenses	24	39
Segment profit	$ (24)	$ (39)

Earnings Per Share - Summary of

Earnings Per Share - Summary of Weighted-Average Outstanding Stock-Based Awards Excluded from Computation of Diluted Earnings Per Share (Detail) - shares shares in Millions	3 Months Ended
	Mar. 31, 2020	Mar. 31, 2019
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total shares excluded from diluted earnings per share	2.4	1.9
Performance Shares [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total shares excluded from diluted earnings per share	1.4	1.3
Share-Based Awards [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total shares excluded from diluted earnings per share	1	0.6