IQVIA (IQV) 10-Q 22 Oct 21 2021 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2021	Oct. 20, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2021
Document Transition Report	false
Entity File Number	001-35907
Entity Registrant Name	IQVIA HOLDINGS INC.
Entity Incorporation, State	DE
Entity Tax Identification Number	27-1341991
Entity Address, Street	4820 Emperor Blvd.
Entity Address, City	Durham
Entity Address, State	NC
Entity Address, Postal Zip Code	27703
City Area Code	919
Local Phone Number	998-2000
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Title of Each Class	Common Stock, par value $0.01 per share
Trading Symbol	IQV
Name of Each Exchange on which Registered	NYSE
Entity Common Stock, Shares Outstanding		191,039,501
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001478242
Amendment Flag	false
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q3

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Millions, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
Revenues	$ 3,391	$ 2,786	$ 10,238	$ 8,061
Costs of revenue, exclusive of depreciation and amortization	2,253	1,800	6,869	5,328
Selling, general and administrative expenses	498	460	1,422	1,298
Depreciation and amortization	336	319	1,002	943
Restructuring costs	2	20	15	50
Income from operations	302	187	930	442
Interest income	(2)	(1)	(4)	(4)
Interest expense	92	100	285	314
Loss on extinguishment of debt	1	0	25	12
Other income, net	(62)	(14)	(128)	(59)
Income before income taxes and equity in earnings of unconsolidated affiliates	273	102	752	179
Income tax expense (benefit)	12	(3)	104	9
Income before equity in earnings of unconsolidated affiliates	261	105	648	170
Equity in earnings of unconsolidated affiliates	0	3	5	8
Net income	261	108	653	178
Net income attributable to non-controlling interests	0	(7)	(5)	(18)
Net income attributable to IQVIA Holdings Inc.	$ 261	$ 101	$ 648	$ 160
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 1.36	$ 0.53	$ 3.38	$ 0.84
Diluted (in dollars per share)	$ 1.34	$ 0.52	$ 3.32	$ 0.82
Weighted average common shares outstanding:
Basic (in shares)	191.5	191.3	191.5	191.3
Diluted (in shares)	195.3	194.9	195	194.9

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 261	$ 108	$ 653	$ 178
Comprehensive income adjustments:
Unrealized (losses) gains on derivative instruments, net of income tax expense (benefit) of $—, $(8), $—, $(11)	(4)	(1)	0	(33)
Foreign currency translation, net of income tax (benefit) expense of $28, $(54), $66, $(83)	(117)	130	(237)	20
Reclassification adjustments:
Losses on derivative instruments included in net income, net of income tax benefit of $1, $1, $2, $2	3	2	7	6
Comprehensive income	143	239	423	171
Comprehensive income attributable to non-controlling interests	0	(11)	(5)	(17)
Comprehensive income attributable to IQVIA Holdings Inc.	$ 143	$ 228	$ 418	$ 154

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Statement of Comprehensive Income [Abstract]
Unrealized (losses) gains on derivative instruments, income tax (benefit) expense	$ 0	$ (8)	$ 0	$ (11)
Foreign currency translation, income tax expense (benefit)	28	(54)	66	(83)
Income tax benefit	$ (1)	$ (1)	$ (2)	$ (2)

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 1,470	$ 1,814
Trade accounts receivable and unbilled services, net	2,330	2,410
Prepaid expenses	164	159
Income taxes receivable	56	56
Investments in debt, equity and other securities	104	88
Other current assets and receivables	410	563
Total current assets	4,534	5,090
Property and equipment, net	485	482
Operating lease right-of-use assets	404	471
Investments in debt, equity and other securities	74	78
Investments in unconsolidated affiliates	84	84
Goodwill	13,124	12,654
Other identifiable intangibles, net	4,812	5,205
Deferred income taxes	105	114
Deposits and other assets	411	386
Total assets	24,033	24,564
Current liabilities:
Accounts payable and accrued expenses	2,663	2,813
Unearned income	1,826	1,252
Income taxes payable	53	102
Current portion of long-term debt	91	149
Other current liabilities	214	242
Total current liabilities	4,847	4,558
Long-term debt, less current portion	12,081	12,384
Deferred income taxes	297	338
Operating lease liabilities	323	371
Other liabilities	656	633
Total liabilities	18,204	18,284
Commitments and contingencies (Note 8)
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of September 30, 2021 and December 31, 2020, $0.01 par value, 255.6 shares issued and 191.1 shares outstanding as of September 30, 2021; 254.7 shares issued and 191.2 shares outstanding as of December 31, 2020	10,747	11,095
Retained earnings	1,925	1,277
Treasury stock, at cost, 64.5 and 63.5 shares as of September 30, 2021 and December 31, 2020, respectively	(6,398)	(6,166)
Accumulated other comprehensive loss	(445)	(205)
Equity attributable to IQVIA Holdings Inc.’s stockholders	5,829	6,001
Non-controlling interests	0	279
Total stockholders’ equity	5,829	6,280
Total liabilities and stockholders’ equity	$ 24,033	$ 24,564

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares shares in Millions	Sep. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Common stock, shares authorized (in shares)	400	400
Common stock, par value, ( in usd per share)	$ 0.01	$ 0.01
Common stock, shares issued (in shares)	255.6	254.7
Common stock, shares outstanding (in shares)	191.1	191.2
Treasury stock, shares (in shares)	64.5	63.5

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Operating activities:
Net income	$ 653	$ 178
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	1,002	943
Amortization of debt issuance costs and discount	14	13
Stock-based compensation	128	69
Earnings from unconsolidated affiliates	(5)	(8)
Gain on investments, net	(9)	(17)
Benefit from deferred income taxes	(83)	(160)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income	663	328
Change in other operating assets and liabilities	(113)	(137)
Net cash provided by operating activities	2,250	1,209
Investing activities:
Acquisition of property, equipment and software	(456)	(440)
Acquisition of businesses, net of cash acquired	(994)	(118)
Purchases of marketable securities, net	(9)	(8)
Investments in unconsolidated affiliates, net of payments received	(3)	8
Proceeds from sale of (investments in) equity securities	5	(2)
Other	1	0
Net cash used in investing activities	(1,456)	(560)
Financing activities:
Proceeds from issuance of debt	1,951	1,591
Payment of debt issuance costs	(40)	(33)
Repayment of debt and principal payments on finance leases	(2,068)	(792)
Proceeds from revolving credit facility	410	1,250
Repayment of revolving credit facility	(300)	(1,610)
(Payments) related to employee stock option plans	(51)	(43)
Repurchase of common stock	(202)	(346)
Distributions to non-controlling interest, net	0	(16)
Acquisition of Quest's non-controlling interest	758	0
Contingent consideration and deferred purchase price payments	(39)	(20)
Net cash used in financing activities	(1,097)	(19)
Effect of foreign currency exchange rate changes on cash	(41)	(3)
(Decrease) increase in cash and cash equivalents	(344)	627
Cash and cash equivalents at beginning of period	1,814	837
Cash and cash equivalents at end of period	$ 1,470	$ 1,464

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	Retained Earnings	Accumulated Other Comprehensive (Loss) Income	Non- controlling Interests
Beginning balance (in shares) at Dec. 31, 2019		253	60.7
Beginning balance at Dec. 31, 2019	$ 6,263	$ 3	$ (5,733)	$ 11,046	$ 998	$ (311)	$ 260
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.8
Issuance of common stock	(44)			(44)
Repurchase of common stock (in shares)			(2.1)
Repurchase of common stock	(332)		$ (332)
Stock-based compensation	7			7
Distributions to non-controlling interests, net	(5)						(5)
Net income	91				82		9
Unrealized gains 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 (in shares) at Mar. 31, 2020		253.8	62.8
Ending balance at Mar. 31, 2020	5,802	$ 3	$ (6,065)	11,009	1,080	(485)	260
Beginning balance (in shares) at Dec. 31, 2019		253	60.7
Beginning balance at Dec. 31, 2019	6,263	$ 3	$ (5,733)	11,046	998	(311)	260
Increase (Decrease) in Stockholders' Equity
Net income	178
Unrealized gains on derivative instruments, net of tax	(33)
Foreign currency translation, net of tax	20
Ending balance (in shares) at Sep. 30, 2020		254.5	62.8
Ending balance at Sep. 30, 2020	6,107	$ 3	$ (6,065)	11,067	1,158	(317)	261
Beginning balance (in shares) at Mar. 31, 2020		253.8	62.8
Beginning balance at Mar. 31, 2020	5,802	$ 3	$ (6,065)	11,009	1,080	(485)	260
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.3
Issuance of common stock	1			1
Stock-based compensation	30			30
Net income	(21)				(23)		2
Unrealized gains on derivative instruments, net of tax	7					7
Foreign currency translation, net of tax	45					46	(1)
Reclassification adjustments, net of tax	(12)					(12)
Ending balance (in shares) at Jun. 30, 2020		254.1	62.8
Ending balance at Jun. 30, 2020	5,852	$ 3	$ (6,065)	11,040	1,057	(444)	261
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.4
Issuance of common stock	(3)			(3)
Stock-based compensation	30			30
Distributions to non-controlling interests, net	(11)						(11)
Net income	108				101		7
Unrealized gains on derivative instruments, net of tax	(1)					(1)
Foreign currency translation, net of tax	130					126	4
Reclassification adjustments, net of tax	2					2
Ending balance (in shares) at Sep. 30, 2020		254.5	62.8
Ending balance at Sep. 30, 2020	$ 6,107	$ 3	$ (6,065)	11,067	1,158	(317)	261
Beginning balance (in shares) at Dec. 31, 2020	191.2	254.7	63.5
Beginning balance at Dec. 31, 2020	$ 6,280	$ 3	$ (6,166)	11,092	1,277	(205)	279
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.7
Issuance of common stock	(57)			(57)
Repurchase of common stock (in shares)			(0.3)
Repurchase of common stock	(62)		$ (62)
Stock-based compensation	30			30
Net income	217				212		5
Unrealized gains on derivative instruments, net of tax	6					6
Foreign currency translation, net of tax	(178)					(178)	0
Reclassification adjustments, net of tax	1					1
Ending balance (in shares) at Mar. 31, 2021		255.4	63.8
Ending balance at Mar. 31, 2021	$ 6,237	$ 3	$ (6,228)	11,065	1,489	(376)	284
Beginning balance (in shares) at Dec. 31, 2020	191.2	254.7	63.5
Beginning balance at Dec. 31, 2020	$ 6,280	$ 3	$ (6,166)	11,092	1,277	(205)	279
Increase (Decrease) in Stockholders' Equity
Acquisition of Quest's non-controlling interest, net of tax	(10)
Net income	653
Unrealized gains on derivative instruments, net of tax	0
Foreign currency translation, net of tax	$ (237)
Ending balance (in shares) at Sep. 30, 2021	191.1	255.6	64.5
Ending balance at Sep. 30, 2021	$ 5,829	$ 3	$ (6,398)	10,744	1,925	(445)	0
Beginning balance (in shares) at Mar. 31, 2021		255.4	63.8
Beginning balance at Mar. 31, 2021	6,237	$ 3	$ (6,228)	11,065	1,489	(376)	284
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.2
Issuance of common stock	1			1
Repurchase of common stock (in shares)			(0.2)
Repurchase of common stock	(45)		$ (45)
Stock-based compensation	42			42
Acquisition of Quest's non-controlling interest, net of tax	709			415		10	284
Net income	175				175		0
Unrealized gains on derivative instruments, net of tax	(2)					(2)
Foreign currency translation, net of tax	58					58	0
Reclassification adjustments, net of tax	3					3
Ending balance (in shares) at Jun. 30, 2021		255.6	64
Ending balance at Jun. 30, 2021	5,760	$ 3	$ (6,273)	10,693	1,664	(327)	0
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0
Issuance of common stock	4			4
Repurchase of common stock (in shares)			(0.5)
Repurchase of common stock	(125)		$ (125)
Stock-based compensation	48			48
Acquisition of Quest's non-controlling interest, net of tax	(1)			(1)
Net income	261				261		0
Unrealized gains on derivative instruments, net of tax	(4)					(4)
Foreign currency translation, net of tax	(117)					(117)	0
Reclassification adjustments, net of tax	$ 3					3
Ending balance (in shares) at Sep. 30, 2021	191.1	255.6	64.5
Ending balance at Sep. 30, 2021	$ 5,829	$ 3	$ (6,398)	$ 10,744	$ 1,925	$ (445)	$ 0

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2021
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 clinical research services to the life sciences industry. With approximately 77,000 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, 2021. 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, 2020. The balance sheet as of December 31, 2020 has been derived from the audited consolidated financial statements of the Company, but does not include all the disclosures required by GAAP. Recently Issued Accounting Standards Accounting pronouncements adopted In March 2020, the Financial Accounting Standards Board ("FASB") issued new accounting guidance that provides optional expedients and exceptions for applying GAAP to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The new accounting guidance became effective for the Company as of March 12, 2020 through December 31, 2022. The Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. 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 Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not have a material effect on the Company’s 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 Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements.

Revenues by Geography, Concentr

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations	9 Months Ended
	Sep. 30, 2021
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 and nine months ended September 30, 2021 and 2020: Three Months Ended September 30, 2021 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 647 $ 942 $ 94 $ 1,683 Europe and Africa 529 448 42 1,019 Asia-Pacific 161 463 65 689 Total revenues $ 1,337 $ 1,853 $ 201 $ 3,391 Three Months Ended September 30, 2020 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 599 $ 628 $ 76 $ 1,303 Europe and Africa 457 411 44 912 Asia-Pacific 151 361 59 571 Total revenues $ 1,207 $ 1,400 $ 179 $ 2,786 Nine Months Ended September 30, 2021 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 1,882 $ 2,911 $ 258 $ 5,051 Europe and Africa 1,684 1,398 133 3,215 Asia-Pacific 472 1,303 197 1,972 Total revenues $ 4,038 $ 5,612 $ 588 $ 10,238 Nine Months Ended September 30, 2020 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 1,747 $ 1,826 $ 247 $ 3,820 Europe and Africa 1,254 1,214 134 2,602 Asia-Pacific 432 1,036 171 1,639 Total revenues $ 3,433 $ 4,076 $ 552 $ 8,061 No customer accounted for 10% or more of consolidated revenues for the three and nine months ended September 30, 2021 or 2020. Transaction Price Allocated to the Remaining Performance Obligations

Trade Accounts Receivable, Unbi

Trade Accounts Receivable, Unbilled Services and Unearned Income	9 Months Ended
	Sep. 30, 2021
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) September 30, 2021 December 31, 2020 Trade accounts receivable: Billed $ 1,141 $ 1,181 Unbilled services 1,219 1,263 Trade accounts receivable and unbilled services 2,360 2,444 Allowance for doubtful accounts (30) (34) Trade accounts receivable and unbilled services, net $ 2,330 $ 2,410 Unbilled services and unearned income were as follows: (in millions, except percentages) September 30, 2021 December 31, 2020 Change Unbilled services $ 1,219 $ 1,263 $ (44) Unearned income (1,826) (1,252) (574) Net balance $ (607) $ 11 $ (618) Unbilled services, which is comprised of approximately 63% of unbilled receivables and 37% of contract assets as of September 30, 2021, decreased by $44 million as compared to December 31, 2020. 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 $574 million over the same period resulting in a decrease of $618 million in the net balance of unbilled services and unearned income between December 31, 2020 and September 30, 2021. The change in the net balance is driven by the difference in timing of revenue recognition in accordance with Accounting Standards Codification ("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.

Goodwill

Goodwill	9 Months Ended
	Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill	Goodwill The following is a summary of goodwill by reportable segment for the nine months ended September 30, 2021: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2020 $ 10,864 $ 1,646 $ 144 $ 12,654 Business combinations 587 160 25 772 Impact of foreign currency fluctuations and other (293) (4) (5) (302) Balance as of September 30, 2021 $ 11,158 $ 1,802 $ 164 $ 13,124

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2021
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 September 30, 2021 December 31, 2020 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Foreign exchange forward contracts Other current assets and liabilities $ — $ 4 $ 109 $ 5 $ — $ 70 Interest rate swaps Other assets and liabilities — 38 1,800 — 55 1,800 Derivatives not designated as hedging instruments: Interest rate swaps Other liabilities — — — — 1 356 Total derivatives $ — $ 42 $ 5 $ 56 The effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table: Three Months Ended September 30, Nine Months Ended September 30, (in millions) 2021 2020 2021 2020 Foreign exchange forward contracts $ (5) $ 2 $ (9) $ (4) Interest rate derivatives 4 1 17 (32) Total $ (1) $ 3 $ 8 $ (36) The amount of foreign exchange losses related to the net investment hedge included in the cumulative translation adjustment component of accumulated other comprehensive loss (“AOCI”) for the nine months ended September 30, 2021 was $332 million.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2021
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 as of September 30, 2021 and December 31, 2020 due to their short-term nature. As of September 30, 2021 and December 31, 2020, the fair value of total debt approximated $12,333 million and $12,746 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 September 30, 2021: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 137 $ — $ — $ 137 Total $ 137 $ — $ — $ 137 Liabilities: Derivatives $ — $ 42 $ — $ 42 Contingent consideration — — 96 96 Total $ — $ 42 $ 96 $ 138 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. 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. Based on the assessments of the probability of achieving specific targets, as of September 30, 2021 the Company has accrued approximately 66% of the maximum contingent consideration payments that could potentially become payable. The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the nine months ended September 30: Contingent Consideration (in millions) 2021 2020 Balance as of January 1 $ 119 $ 113 Business combinations 39 32 Contingent consideration paid (37) (22) Revaluations included in earnings and foreign currency translation adjustments (25) (15) Balance as of September 30 $ 96 $ 108 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 income, net on the accompanying condensed consolidated statements of income. A change in significant unobservable inputs above could result in a higher or lower fair value measurement of contingent consideration.

Credit Arrangements

Credit Arrangements	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Credit Arrangements	Credit Arrangements The following is a summary of the Company’s revolving credit facilities as of September 30, 2021: Facility Interest Rates $1,500 million (revolving credit facility) LIBOR in the relevant currency borrowed plus a margin of 1.25% as of September 30, 2021 $110 million (receivables financing facility) LIBOR Market Index Rate (0.08% as of September 30, 2021) plus 0.90% £10 million (approximately $14 million) (general banking facility) Bank’s base rate of 0.10% as of September 30, 2021 plus 1% The following table summarizes the Company’s debt at the dates indicated: (in millions) September 30, 2021 December 31, 2020 Senior Secured Credit Facilities: Term A Loan due 2023—U.S. Dollar $ — $ 728 Term A Loan due 2023—U.S. Dollar — 766 Term A Loan due 2026—U.S. Dollar LIBOR at average floating rates of 1.33% 1,433 — Term A Loan due 2023—Euro — 400 Term A Loan due 2026—Euro LIBOR at average floating rates of 1.25% 363 — Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 1.85% 510 535 Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00% 1,269 1,413 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 1.85% 670 726 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 1.90% 860 926 Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00% 605 697 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 487 515 3.25% Senior Notes due 2025—Euro denominated — 1,748 2.25% Senior Notes due 2028—Euro denominated 834 883 2.875% Senior Notes due 2028—Euro denominated 824 872 1.750% Senior Notes due 2026—Euro denominated 637 — 2.250% Senior Notes due 2029—Euro denominated 1,043 — Receivables financing facility due 2022—U.S. Dollar — 240 Receivables financing facility due 2024—U.S. Dollar LIBOR at average floating rates of 0.98% 550 — Principal amount of debt 12,236 12,600 Less: unamortized discount and debt issuance costs (64) (67) Less: current portion (91) (149) Long-term debt $ 12,081 $ 12,384 Contractual maturities of long-term debt are as follows as of September 30, 2021: (in millions) Remainder of 2021 $ 23 2022 91 2023 91 2024 2,419 2025 2,714 Thereafter 6,898 $ 12,236 As of September 30, 2021, there were bank guarantees totaling approximately £0.8 million (approximately $1.0 million) issued against the availability of the general banking facility. Senior Secured Credit Facilities On August 25, 2021, we entered into Amendment No. 9 (the “Amendment”) to the Company’s Fourth Amended and Restated Credit Agreement (the “Prior Credit Agreement,” and together with the Amendment, the "Fifth Amended and Restated Credit Agreement") to (i) extend the maturity of our revolving credit facility to 2026, (ii) refinance our existing term A loans with a new class of term A loans that mature in 2026 and (iii) add IQVIA RDS Inc. as a borrower under the senior secured credit facilities. In connection with this Amendment, we recognized a $1 million loss on extinguishment of debt, which includes fees and related expenses. As of September 30, 2021, the Fifth Amended and Restated Credit Agreement provided financing through several senior secured credit facilities (collectively, the “senior secured credit facilities”) of up to approximately $7.2 billion, which consisted of $5.7 billion principal amounts of debt outstanding (as detailed in the table above), and $1.5 billion of available borrowing capacity on the revolving credit facility and standby letters of credit. On September 14, 2021, we repaid $250 million of our term B loans under the senior secured credit facilities using the proceeds from the increased loans under our receivables financing facility. Receivables Financing Facility On August 13, 2021, the Company amended its receivables financing facility (the “Receivables Amendment”) to extend the term of the facility to October 1, 2024 and to increase the size of the facility to $550 million from $300 million. Under the receivables financing facility, certain of our accounts receivable are sold on a non-recourse basis by certain of our consolidated subsidiaries (each, an “Originator”) to another of our consolidated subsidiaries, a bankruptcy-remote special purpose entity (the “SPE”). The SPE obtained a term loan and revolving loan commitment from a third-party lender, secured by liens on the assets of the SPE, to finance the purchase of the accounts receivable, which includes a $440 million term loan and a $110 million revolving loan commitment. Pursuant to the Receivables Amendment, we also added three additional subsidiaries as Originators. As of September 30, 2021, no additional amounts of revolving loans were available under the receivables financing facility. Senior Notes On March 3, 2021, IQVIA Inc. (the “Issuer”), a wholly owned subsidiary of the Company, completed the issuance and sale of €1,450,000,000 in gross proceeds of the Issuer's (i) €550,000,000 aggregate principal amount of its 1.750% Senior Notes due 2026 (the “2026 Notes”) and (ii) €900,000,000 aggregate principal amount of its 2.250% Senior Notes due 2029 (the “2029 Notes” and, together with the 2026 Notes, the “Notes”). The Notes were issued pursuant to an Indenture, dated March 3, 2021, among the Issuer, U.S. Bank National Association, as trustee of the Notes, and certain subsidiaries of the Issuer as guarantors. The 2026 Notes are unsecured obligations of the Issuer, will mature on March 15, 2026 and bear interest at the rate of 1.750% per year, with interest payable semi-annually on March 15 and September 15 of each year, beginning on September 15, 2021. The 2029 Notes are unsecured obligations of the Issuer, will mature on March 15, 2029 and bear interest at the rate of 2.250% per year, with interest payable semi-annually on March 15 and September 15 of each year, beginning on September 15, 2021. The Issuer may redeem (i) the 2026 Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to March 15, 2023 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 0.875% to 0.000% and (ii) the 2029 Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to March 15, 2024 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 1.125% to 0.000%. The Issuer may choose to redeem the 2026 Notes and the 2029 Notes, either together or separately, on a non-ratable basis. The proceeds from the Notes offering were used to redeem all of the Issuer’s outstanding 3.250% senior notes due 2025 (the “3.250% Notes”), including the payment of premiums in respect thereof and to pay fees and expenses related to the Notes offering. On February 16, 2021, the Issuer issued a conditional notice of redemption with respect to the 3.250% Notes, for a total redemption price equal to the sum of the principal amount of the 3.250% Notes, accrued and unpaid interest on the 3.250% Notes to the redemption date and the applicable redemption premium. The Issuer’s obligations with respect to the 3.250% Notes were discharged on the same day as the Issuer completed the issuance of the Notes. Restrictive Covenants

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies The Company and its subsidiaries are involved in legal and tax proceedings, claims and litigation arising in the ordinary course of business. Management periodically assesses the Company’s liabilities and contingencies in connection with these matters based upon the latest information available. For those matters where management currently believes it is probable that the Company will incur a loss and that the probable loss or range of loss can be reasonably estimated, the Company has recorded reserves in the consolidated financial statements based on its best estimates of such loss. In other instances, because of the uncertainties related to either the probable outcome or the amount or range of loss, management is unable to make a reasonable estimate of a liability, if any. However, even in many instances where the Company has recorded an estimated liability, the Company is unable to predict with certainty the final outcome of the matter or whether resolution of the matter will materially affect the Company’s results of operations, financial position or cash flows. As additional information becomes available, the Company adjusts its assessments and estimates of such liabilities accordingly. The Company routinely enters into agreements with third parties, including our clients and suppliers, all in the normal course of business. In these agreements, the Company sometimes agrees to indemnify and hold harmless the other party for any damages such other party may suffer as a result of potential intellectual property infringement and other claims. The Company has not accrued a liability with respect to these matters generally, as the exposure is considered remote. Based on its review of the latest information available, management does not expect the impact of pending legal and tax proceedings, claims and litigation, either individually or in the aggregate, to have a material adverse effect on the Company’s results of operations, cash flows or financial position. However, one or more unfavorable outcomes in any claim or litigation against the Company could have a material adverse effect for the period in which it is resolved. The following is a summary of certain legal matters involving the Company. On February 13, 2014, a group of approximately 1,200 medical doctors and 900 private individuals filed a civil lawsuit with the Seoul Central District Court against IMS Korea and two other defendants, KPA and the Korean Pharmaceutical Information Center (“KPIC”). The civil lawsuit alleges KPA and KPIC collected their personal information in violation of applicable privacy laws without the necessary consent through a software system installed on pharmacy computer systems in Korea, and that personal information was transferred to IMS Korea and sold to pharmaceutical companies. On September 11, 2017, the District Court issued a final decision that the encryption in use by the defendants since June 2014 was adequate to meet the requirements of the Korean Personal Information Privacy Act (“PIPA”) and the sharing of non-identified information for market research purposes was allowed under PIPA. The District Court also found an earlier version of encryption was insufficient to meet PIPA requirements, but no personal data had been leaked or re-identified. The District Court did not award any damages to plaintiffs. Approximately 280 medical doctors and 200 private individuals appealed the District Court decision. On May 3, 2019, the Appellate Court issued a final decision in which it concluded all of the non-identified information transferred by KPIC to IMS Korea for market research purposes violated PIPA, but did not award any damages to plaintiffs (affirming the District Court’s decision on this latter point). On May 24, 2019, approximately 247 plaintiffs appealed the Appellate Court’s decision to the Supreme Court. The Company believes the appeal is without merit and is vigorously defending its position. On July 23, 2015, indictments were issued by the Seoul Central District Prosecutors’ Office in South Korea against 24 individuals and companies alleging improper handling of sensitive health information in violation of, among others, South Korea’s Personal Information Protection Act. IMS Korea and two of its employees were among the individuals and organizations indicted. Although there is no assertion that IMS Korea used patient identified health information in any of its offerings, prosecutors allege that certain of IMS Korea’s data suppliers should have obtained patient consent when they converted sensitive patient information into non-identified data and that IMS Korea had not taken adequate precautions to reduce the risk of re-identification. On February 14, 2020, the Seoul Central District Court acquitted IMS Korea and its two employees of the charges of improper handling of sensitive health information. The matter is now on appeal. The Company intends to vigorously defend its position on appeal. On January 10, 2017, Quintiles IMS Health Incorporated and IMS Software Services Ltd. (collectively “IQVIA Parties”), filed a lawsuit in the U.S. District Court for the District of New Jersey against Veeva Systems, Inc. (“Veeva”) alleging Veeva unlawfully used IQVIA Parties intellectual property to improve Veeva data offerings, to promote and market Veeva data offerings and to improve Veeva technology offerings. IQVIA Parties seek injunctive relief, appointment of a monitor, the award of compensatory and punitive damages and reimbursement of all litigation expenses, including reasonable attorneys’ fees and costs. On March 13, 2017, Veeva filed counterclaims alleging anticompetitive business practices in violation of the Sherman Act and state laws. Veeva claims damages in excess of $200 million, and is seeking punitive damages and litigation costs, including attorneys’ fees. We believe the counterclaims are without merit, reject all counterclaims raised by Veeva and intend to vigorously defend IQVIA Parties’ position and pursue our claims against Veeva. Since the initial filings, the parties have filed additional litigations against each other, primarily concerning the use of IQVIA data with various other Veeva products. The parties are engaged in the discovery process in connection with these lawsuits. On May 7, 2021, the Court issued a 115-page order and opinion (the “Order”) in which it found significant evidence that Veeva had (1) misappropriated IQVIA data and unlawfully used it to improve Veeva data offerings, (2) engaged in a cover-up by deleting significant evidence of its theft of IQVIA’s trade secrets, and (3) improperly withheld certain evidence in furtherance of a crime and/or fraud against IQVIA. The Court imposed five serious sanctions against Veeva, including ordering three separate adverse inference instructions be issued to the jury and that IQVIA be permitted to present evidence to the jury of Veeva’s destruction efforts. Veeva is currently appealing the Order.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2021
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 September 30, 2021 or December 31, 2020. Equity Repurchase Program During the nine months ended September 30, 2021, the Company repurchased 973,313 shares of its common stock for $221 million under its equity repurchase program (the “Repurchase Program”). As of September 30, 2021, the Company has remaining authorization to repurchase up to approximately $0.7 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. Non-controlling Interests On April 1, 2021 the Company acquired the 40% non-controlling interest in Q 2 Solutions from Quest Diagnostics Incorporated ("Quest") for approximately $758 million, financed with cash on hand. The $758 million reflects post-closing adjustments to date. The transaction resulted in the Company having 100% ownership in Q 2

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2021
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring The Company has continued to take restructuring actions in 2021 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 2022. The following amounts were recorded for the restructuring plans: (in millions) Severance and Facility Total Balance as of December 31, 2020 $ 51 $ 2 $ 53 Expense, net of reversals 15 — 15 Payments (35) (1) (36) Foreign currency translation and other (2) — (2) Balance as of September 30, 2021 $ 29 $ 1 $ 30 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 as of September 30, 2021 will be paid in 2021 and 2022.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
Income Taxes	Income TaxesThe effective income tax rate was 4.4% and (2.9)% in the third quarter of 2021 and 2020, respectively, and 13.8% and 5.0% in the first nine months of 2021 and 2020, respectively. In the third quarter of 2021 the Company recorded a benefit related to a 2020 U.S. Federal tax return position associated with Foreign Derived Intangible Income (“FDII”) and Global Intangible Low-Taxed Income (“GILTI”) tax credits of $29 million. In the third quarter of 2020, the U.S. Treasury Department issued final regulations regarding FDII and GILTI and the Company had determined it would elect the GILTI high tax exception as allowed by the final regulations. As a result, the Company amended its 2018 U.S. Federal consolidated income tax return and plans to amend its 2019 U.S. Federal consolidated income tax return. This resulted in a favorable impact of $24 million, which the Company recorded in the third quarter of 2020. Additionally, the effective income tax rate in the third quarter and first nine months of 2021 and 2020 was favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards. For the third quarter of 2021 and 2020 this impact was $3 million and $9 million, respectively, and for the first nine months of 2021 and 2020 this impact was $26 million and $35 million, respectively. Also, the effective income tax rate in the first nine months of 2020 was unfavorably impacted by a $10 million discrete tax expense related to change in the measurement of U.S. tax on undistributed foreign earnings.

Comprehensive Income

Comprehensive Income	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Comprehensive Income (Loss)	Comprehensive Income Below is a summary of the components of AOCI: (in millions) Foreign Derivative Defined Income Total Balance as of December 31, 2020 $ (395) $ (48) $ (85) $ 323 $ (205) Other comprehensive income (loss) before reclassifications (170) (1) — (66) (237) Reclassification adjustments — 9 — (2) 7 Acquisition of Quest's non-controlling interest (10) — — — (10) Balance as of September 30, 2021 $ (575) $ (40) $ (85) $ 255 $ (445) 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 Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Derivative instruments: Interest rate swaps and caps Interest expense $ 5 $ — $ 14 $ — Foreign exchange forward contracts Revenues (1) 4 (5) 9 Foreign exchange forward contracts Other income, net — (1) — (1) Total before income taxes 4 3 9 8 Income tax benefit 1 1 2 2 Total net of income taxes $ 3 $ 2 $ 7 $ 6

Segments

Segments	9 Months Ended
	Sep. 30, 2021
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 critical information, technology solutions and real world insights and services to our life science clients. Research & Development Solutions, which primarily serves biopharmaceutical clients, is engaged in research and development and provides clinical research and clinical trial services. Contract Sales & Medical Solutions provides contract sales to both biopharmaceutical clients 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 September 30, Nine Months Ended September 30, (in millions) 2021 2020 2021 2020 Revenues Technology & Analytics Solutions $ 1,337 $ 1,207 $ 4,038 $ 3,433 Research & Development Solutions 1,853 1,400 5,612 4,076 Contract Sales & Medical Solutions 201 179 588 552 Total revenues 3,391 2,786 10,238 8,061 Costs of revenue, exclusive of depreciation and amortization Technology & Analytics Solutions 795 727 2,415 2,048 Research & Development Solutions 1,291 925 3,967 2,811 Contract Sales & Medical Solutions 167 148 487 469 Total costs of revenue 2,253 1,800 6,869 5,328 Selling, general and administrative expenses Technology & Analytics Solutions 199 188 579 549 Research & Development Solutions 198 184 576 544 Contract Sales & Medical Solutions 14 14 41 44 General corporate and unallocated 87 74 226 161 Total selling, general and administrative expenses 498 460 1,422 1,298 Segment profit Technology & Analytics Solutions 343 292 1,044 836 Research & Development Solutions 364 291 1,069 721 Contract Sales & Medical Solutions 20 17 60 39 Total segment profit 727 600 2,173 1,596 General corporate and unallocated (87) (74) (226) (161) Depreciation and amortization (336) (319) (1,002) (943) Restructuring costs (2) (20) (15) (50) Total income from operations $ 302 $ 187 $ 930 $ 442

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2021
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 September 30, Nine Months Ended September 30, (in millions) 2021 2020 2021 2020 Shares subject to performance conditions 0.9 1.1 0.8 1.2 Shares subject to anti-dilutive stock-based awards — 1.1 0.1 1.3 Total shares excluded from diluted earnings per share 0.9 2.2 0.9 2.5 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.

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Business Combinations The Company completed several individually immaterial acquisitions during the nine months ended September 30, 2021. The Company’s assessment of fair value and the purchase price allocation related to these acquisitions is preliminary and subject to change upon completion. Further adjustments may be necessary as additional information related to the fair values of assets acquired and liabilities assumed is assessed during the measurement period (up to one year from the acquisition date). The Company recorded goodwill from these acquisitions, primarily attributable to assembled workforce and expected synergies. The condensed consolidated financial statements include the results of the acquisitions subsequent to their respective closing dates. Pro forma information is not presented as pro forma results of operations would not be materially different to the actual results of operations of the Company. The following table provides certain financial information for these acquisitions, including the preliminary allocation of the purchase price to certain intangible assets acquired and goodwill: (in millions) 2021 Amortization Period Assets acquired: Cash and cash equivalents $ 7 Other assets 40 Goodwill 772 Other identifiable intangibles, net Customer relationships 208 16 years Non-compete agreements 2 5 years Software and related assets 72 8 years Trade names 7 10 years Backlog 17 2 years Liabilities assumed: Other liabilities (21) Deferred income taxes, long-term (60) Net assets acquired $ 1,044 The portion of goodwill deductible for income tax purposes was preliminarily assessed as $503 million.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2021
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, 2021. 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, 2020. The balance sheet as of December 31, 2020 has been derived from the audited consolidated financial statements of the Company, but does not include all the disclosures required by GAAP.
Recently Issued Accounting Standards	Recently Issued Accounting Standards Accounting pronouncements adopted In March 2020, the Financial Accounting Standards Board ("FASB") issued new accounting guidance that provides optional expedients and exceptions for applying GAAP to contract modifications and hedging relationships, subject to meeting certain criteria, that reference LIBOR or another rate that is expected to be discontinued. The new accounting guidance became effective for the Company as of March 12, 2020 through December 31, 2022. The Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. 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 Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not have a material effect on the Company’s 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 Company adopted this new accounting guidance on January 1, 2021. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements.

Revenues by Geography, Concen_2

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations (Tables)	9 Months Ended
	Sep. 30, 2021
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 and nine months ended September 30, 2021 and 2020: Three Months Ended September 30, 2021 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 647 $ 942 $ 94 $ 1,683 Europe and Africa 529 448 42 1,019 Asia-Pacific 161 463 65 689 Total revenues $ 1,337 $ 1,853 $ 201 $ 3,391 Three Months Ended September 30, 2020 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 599 $ 628 $ 76 $ 1,303 Europe and Africa 457 411 44 912 Asia-Pacific 151 361 59 571 Total revenues $ 1,207 $ 1,400 $ 179 $ 2,786 Nine Months Ended September 30, 2021 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 1,882 $ 2,911 $ 258 $ 5,051 Europe and Africa 1,684 1,398 133 3,215 Asia-Pacific 472 1,303 197 1,972 Total revenues $ 4,038 $ 5,612 $ 588 $ 10,238 Nine Months Ended September 30, 2020 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 1,747 $ 1,826 $ 247 $ 3,820 Europe and Africa 1,254 1,214 134 2,602 Asia-Pacific 432 1,036 171 1,639 Total revenues $ 3,433 $ 4,076 $ 552 $ 8,061

Trade Accounts Receivable, Un_2

Trade Accounts Receivable, Unbilled Services and Unearned Income (Tables)	9 Months Ended
	Sep. 30, 2021
Receivables [Abstract]
Schedule of Trade Accounts Receivable and Unbilled Services	Trade accounts receivables and unbilled services consist of the following: (in millions) September 30, 2021 December 31, 2020 Trade accounts receivable: Billed $ 1,141 $ 1,181 Unbilled services 1,219 1,263 Trade accounts receivable and unbilled services 2,360 2,444 Allowance for doubtful accounts (30) (34) Trade accounts receivable and unbilled services, net $ 2,330 $ 2,410
Schedule of Net Contract Assets (Liabilities)	Unbilled services and unearned income were as follows: (in millions, except percentages) September 30, 2021 December 31, 2020 Change Unbilled services $ 1,219 $ 1,263 $ (44) Unearned income (1,826) (1,252) (574) Net balance $ (607) $ 11 $ (618)

Goodwill (Tables)

Goodwill (Tables)	9 Months Ended
	Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Summary of Goodwill by Reportable Segment	The following is a summary of goodwill by reportable segment for the nine months ended September 30, 2021: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2020 $ 10,864 $ 1,646 $ 144 $ 12,654 Business combinations 587 160 25 772 Impact of foreign currency fluctuations and other (293) (4) (5) (302) Balance as of September 30, 2021 $ 11,158 $ 1,802 $ 164 $ 13,124

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2021
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 September 30, 2021 December 31, 2020 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Foreign exchange forward contracts Other current assets and liabilities $ — $ 4 $ 109 $ 5 $ — $ 70 Interest rate swaps Other assets and liabilities — 38 1,800 — 55 1,800 Derivatives not designated as hedging instruments: Interest rate swaps Other liabilities — — — — 1 356 Total derivatives $ — $ 42 $ 5 $ 56
Schedule of 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 September 30, Nine Months Ended September 30, (in millions) 2021 2020 2021 2020 Foreign exchange forward contracts $ (5) $ 2 $ (9) $ (4) Interest rate derivatives 4 1 17 (32) Total $ (1) $ 3 $ 8 $ (36)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
Summary of 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 September 30, 2021: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 137 $ — $ — $ 137 Total $ 137 $ — $ — $ 137 Liabilities: Derivatives $ — $ 42 $ — $ 42 Contingent consideration — — 96 96 Total $ — $ 42 $ 96 $ 138
Schedule of 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 nine months ended September 30: Contingent Consideration (in millions) 2021 2020 Balance as of January 1 $ 119 $ 113 Business combinations 39 32 Contingent consideration paid (37) (22) Revaluations included in earnings and foreign currency translation adjustments (25) (15) Balance as of September 30 $ 96 $ 108

Credit Arrangements (Tables)

Credit Arrangements (Tables)	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
Summary of Credit Facilities	The following is a summary of the Company’s revolving credit facilities as of September 30, 2021: Facility Interest Rates $1,500 million (revolving credit facility) LIBOR in the relevant currency borrowed plus a margin of 1.25% as of September 30, 2021 $110 million (receivables financing facility) LIBOR Market Index Rate (0.08% as of September 30, 2021) plus 0.90% £10 million (approximately $14 million) (general banking facility) Bank’s base rate of 0.10% as of September 30, 2021 plus 1%
Summary of Debt	The following table summarizes the Company’s debt at the dates indicated: (in millions) September 30, 2021 December 31, 2020 Senior Secured Credit Facilities: Term A Loan due 2023—U.S. Dollar $ — $ 728 Term A Loan due 2023—U.S. Dollar — 766 Term A Loan due 2026—U.S. Dollar LIBOR at average floating rates of 1.33% 1,433 — Term A Loan due 2023—Euro — 400 Term A Loan due 2026—Euro LIBOR at average floating rates of 1.25% 363 — Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 1.85% 510 535 Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00% 1,269 1,413 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 1.85% 670 726 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 1.90% 860 926 Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00% 605 697 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 487 515 3.25% Senior Notes due 2025—Euro denominated — 1,748 2.25% Senior Notes due 2028—Euro denominated 834 883 2.875% Senior Notes due 2028—Euro denominated 824 872 1.750% Senior Notes due 2026—Euro denominated 637 — 2.250% Senior Notes due 2029—Euro denominated 1,043 — Receivables financing facility due 2022—U.S. Dollar — 240 Receivables financing facility due 2024—U.S. Dollar LIBOR at average floating rates of 0.98% 550 — Principal amount of debt 12,236 12,600 Less: unamortized discount and debt issuance costs (64) (67) Less: current portion (91) (149) Long-term debt $ 12,081 $ 12,384
Schedule of Contractual Maturities of Long-term Debt	Contractual maturities of long-term debt are as follows as of September 30, 2021: (in millions) Remainder of 2021 $ 23 2022 91 2023 91 2024 2,419 2025 2,714 Thereafter 6,898 $ 12,236

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2021
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 Facility Total Balance as of December 31, 2020 $ 51 $ 2 $ 53 Expense, net of reversals 15 — 15 Payments (35) (1) (36) Foreign currency translation and other (2) — (2) Balance as of September 30, 2021 $ 29 $ 1 $ 30

Comprehensive Income (Loss) (Ta

Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
Summary of Components of AOCI	Below is a summary of the components of AOCI: (in millions) Foreign Derivative Defined Income Total Balance as of December 31, 2020 $ (395) $ (48) $ (85) $ 323 $ (205) Other comprehensive income (loss) before reclassifications (170) (1) — (66) (237) Reclassification adjustments — 9 — (2) 7 Acquisition of Quest's non-controlling interest (10) — — — (10) Balance as of September 30, 2021 $ (575) $ (40) $ (85) $ 255 $ (445)
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 Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 Derivative instruments: Interest rate swaps and caps Interest expense $ 5 $ — $ 14 $ — Foreign exchange forward contracts Revenues (1) 4 (5) 9 Foreign exchange forward contracts Other income, net — (1) — (1) Total before income taxes 4 3 9 8 Income tax benefit 1 1 2 2 Total net of income taxes $ 3 $ 2 $ 7 $ 6

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2021
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 September 30, Nine Months Ended September 30, (in millions) 2021 2020 2021 2020 Revenues Technology & Analytics Solutions $ 1,337 $ 1,207 $ 4,038 $ 3,433 Research & Development Solutions 1,853 1,400 5,612 4,076 Contract Sales & Medical Solutions 201 179 588 552 Total revenues 3,391 2,786 10,238 8,061 Costs of revenue, exclusive of depreciation and amortization Technology & Analytics Solutions 795 727 2,415 2,048 Research & Development Solutions 1,291 925 3,967 2,811 Contract Sales & Medical Solutions 167 148 487 469 Total costs of revenue 2,253 1,800 6,869 5,328 Selling, general and administrative expenses Technology & Analytics Solutions 199 188 579 549 Research & Development Solutions 198 184 576 544 Contract Sales & Medical Solutions 14 14 41 44 General corporate and unallocated 87 74 226 161 Total selling, general and administrative expenses 498 460 1,422 1,298 Segment profit Technology & Analytics Solutions 343 292 1,044 836 Research & Development Solutions 364 291 1,069 721 Contract Sales & Medical Solutions 20 17 60 39 Total segment profit 727 600 2,173 1,596 General corporate and unallocated (87) (74) (226) (161) Depreciation and amortization (336) (319) (1,002) (943) Restructuring costs (2) (20) (15) (50) Total income from operations $ 302 $ 187 $ 930 $ 442

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2021
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 September 30, Nine Months Ended September 30, (in millions) 2021 2020 2021 2020 Shares subject to performance conditions 0.9 1.1 0.8 1.2 Shares subject to anti-dilutive stock-based awards — 1.1 0.1 1.3 Total shares excluded from diluted earnings per share 0.9 2.2 0.9 2.5

Business Combinations (Tables)

Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table provides certain financial information for these acquisitions, including the preliminary allocation of the purchase price to certain intangible assets acquired and goodwill: (in millions) 2021 Amortization Period Assets acquired: Cash and cash equivalents $ 7 Other assets 40 Goodwill 772 Other identifiable intangibles, net Customer relationships 208 16 years Non-compete agreements 2 5 years Software and related assets 72 8 years Trade names 7 10 years Backlog 17 2 years Liabilities assumed: Other liabilities (21) Deferred income taxes, long-term (60) Net assets acquired $ 1,044

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Detail) Employee in Thousands	Sep. 30, 2021EmployeeCountry
Summary Of Significant Accounting Policies [Line Items]
Number of employees | Employee	77
Minimum
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		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue
Total revenues	$ 3,391	$ 2,786	$ 10,238	$ 8,061
Americas
Disaggregation of Revenue
Total revenues	1,683	1,303	5,051	3,820
Europe and Africa
Disaggregation of Revenue
Total revenues	1,019	912	3,215	2,602
Asia-Pacific
Disaggregation of Revenue
Total revenues	689	571	1,972	1,639
Technology & Analytics Solutions
Disaggregation of Revenue
Total revenues	1,337	1,207	4,038	3,433
Technology & Analytics Solutions | Americas
Disaggregation of Revenue
Total revenues	647	599	1,882	1,747
Technology & Analytics Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	529	457	1,684	1,254
Technology & Analytics Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	161	151	472	432
Research & Development Solutions
Disaggregation of Revenue
Total revenues	1,853	1,400	5,612	4,076
Research & Development Solutions | Americas
Disaggregation of Revenue
Total revenues	942	628	2,911	1,826
Research & Development Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	448	411	1,398	1,214
Research & Development Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	463	361	1,303	1,036
Contract Sales & Medical Solutions
Disaggregation of Revenue
Total revenues	201	179	588	552
Contract Sales & Medical Solutions | Americas
Disaggregation of Revenue
Total revenues	94	76	258	247
Contract Sales & Medical Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	42	44	133	134
Contract Sales & Medical Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	$ 65	$ 59	$ 197	$ 171

Revenues by Geography, Concen_4

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Additional Information (Detail) - Customer	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Revenue from Contract with Customer [Abstract]
Number of customer accounting for ten percent or more of revenue	0	0	0	0

Revenues by Geography, Concen_5

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Future Obligation Terms (Detail) $ in Billions	Sep. 30, 2021USD ($)
Disaggregation of Revenue
Revenue expected to be recognized in future from remaining performance obligations	$ 25.5
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date [Axis]: 2020-10-01
Disaggregation of Revenue
Percentage of remaining performance obligations on which revenue is expected to be recognized (in percent)	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	Sep. 30, 2021	Dec. 31, 2020
Trade accounts receivable:
Billed	$ 1,141	$ 1,181
Unbilled services	1,219	1,263
Trade accounts receivable and unbilled services	2,360	2,444
Allowance for doubtful accounts	(30)	(34)
Trade accounts receivable and unbilled services, net	$ 2,330	$ 2,410

Trade Accounts Receivable, Un_4

Trade Accounts Receivable, Unbilled Services and Unearned Income - Schedule of Net Contract Assets (Liabilities) (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)
Unbilled Contracts Receivables
Unbilled services, beginning balance	$ 1,263
Change	(44)
Unbilled services, ending balance	1,219
Unearned Income
Unearned income, beginning balance	(1,252)
Change	(574)
Unearned income, ending balance	(1,826)
Net balance, beginning balance	11
Change	(618)
Net, balance ending balance	$ (607)

Trade Accounts Receivable, Un_5

Trade Accounts Receivable, Unbilled Services and Unearned Income - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)
Receivables [Abstract]
Unbilled receivables (percentage)	63.00%
Contract assets (percentage)	37.00%
Increase in unbilled services	$ (44)
Increase in unearned income	574
Net change in balance	$ (618)

Goodwill - Summary of Goodwill

Goodwill - Summary of Goodwill by Reportable Segment (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)
Goodwill
Beginning balance	$ 12,654
Business combinations	772
Impact of foreign currency fluctuations and other	(302)
Ending balance	13,124
Technology & Analytics Solutions
Goodwill
Beginning balance	10,864
Business combinations	587
Impact of foreign currency fluctuations and other	(293)
Ending balance	11,158
Research & Development Solutions
Goodwill
Beginning balance	1,646
Business combinations	160
Impact of foreign currency fluctuations and other	(4)
Ending balance	1,802
Contract Sales & Medical Solutions
Goodwill
Beginning balance	144
Business combinations	25
Impact of foreign currency fluctuations and other	(5)
Ending balance	$ 164

Derivatives - Summary of Fair V

Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) - USD ($)	Sep. 30, 2021	Dec. 31, 2020
Derivatives, Fair Value
Assets	$ 0	$ 5,000,000
Liabilities	42,000,000	56,000,000
Derivatives designated as hedging instruments: | Other current assets and liabilities | Foreign exchange forward contracts
Derivatives, Fair Value
Assets	0	5,000,000
Liabilities	4,000,000	0
Notional	109,000,000	70,000,000
Derivatives designated as hedging instruments: | Other assets and liabilities | Interest rate swaps
Derivatives, Fair Value
Assets	0	0
Liabilities	38,000,000	55,000,000
Notional	1,800,000,000	1,800,000,000
Derivatives not designated as hedging instruments: | Other liabilities | Interest rate swaps
Derivatives, Fair Value
Assets	0	0
Liabilities	0	1,000,000
Notional	$ 0	$ 356,000,000

Derivatives - Effect of Cash Fl

Derivatives - Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (1)	$ 3	$ 8	$ (36)
Foreign exchange forward contracts
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	(5)	2	(9)	(4)
Interest rate derivatives
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ 4	$ 1	$ 17	$ (32)

Derivatives - Additional Inform

Derivatives - Additional Information (Detail) $ in Millions	Sep. 30, 2021USD ($)
Derivative Instruments and Hedging Activities Disclosure [Abstract]
Foreign exchange loss related to net investment hedge	$ 332

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Percentage accrued of maximum consideration payments to become payable	66.00%
Level 1 and Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value of total debt	$ 12,333	$ 12,746

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Assets:
Marketable securities	$ 104	$ 88
Recurring Fair Value Measurements
Assets:
Marketable securities	137
Total	137
Liabilities:
Derivatives	42
Contingent consideration	96
Total	138
Recurring Fair Value Measurements | Level 1
Assets:
Marketable securities	137
Total	137
Liabilities:
Derivatives	0
Contingent consideration	0
Total	0
Recurring Fair Value Measurements | Level 2
Assets:
Marketable securities	0
Total	0
Liabilities:
Derivatives	42
Contingent consideration	0
Total	42
Recurring Fair Value Measurements | Level 3
Assets:
Marketable securities	0
Total	0
Liabilities:
Derivatives	0
Contingent consideration	96
Total	$ 96

Fair Value Measurements - Chang

Fair Value Measurements - Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Contingent consideration - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation
Beginning balance	$ 119	$ 113
Business combinations	39	32
Contingent consideration paid	(37)	(22)
Revaluations included in earnings and foreign currency translation adjustments	(25)	(15)
Ending balance	$ 96	$ 108

Credit Arrangements - Summary o

Credit Arrangements - Summary of Credit Facilities (Detail)	9 Months Ended
	Sep. 30, 2021USD ($)	Sep. 30, 2021GBP (£)	Aug. 13, 2021USD ($)	Aug. 12, 2021USD ($)
Receivables Financing Facility
Line of Credit Facility
Facility			$ 550,000,000	$ 300,000,000
Revolving Credit Facility | USD Revolving Credit Facility
Line of Credit Facility
Interest Rates	LIBOR in the relevant currency borrowed plus a margin of 1.25% as of September 30, 2021
Facility	$ 1,500,000,000
Revolving Credit Facility | USD Revolving Credit Facility | LIBOR
Line of Credit Facility
Rate (percent)	1.25%	1.25%
Facility | Receivables Financing Facility
Line of Credit Facility
Interest Rates	LIBOR Market Index Rate (0.08% as of September 30, 2021) plus 0.90%
Rate (percent)	0.08%	0.08%
Facility	$ 110,000,000
Facility | Receivables Financing Facility | LIBOR
Line of Credit Facility
Interest rate spread on base rate (percent)	0.90%
Facility | General Banking Facility
Line of Credit Facility
Interest Rates	Bank’s base rate of 0.10% as of September 30, 2021 plus 1%
Rate (percent)	0.10%	0.10%
Facility	$ 14,000,000	£ 10,000,000
Facility | General Banking Facility | Base Rate
Line of Credit Facility
Interest rate spread on base rate (percent)	1.00%

Credit Arrangements - Summary_2

Credit Arrangements - Summary of Debt (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)	Mar. 03, 2021EUR (€)	Dec. 31, 2020USD ($)
Senior Secured Credit Facilities:
Principal amount of debt	$ 12,236		$ 12,600
Less: unamortized discount and debt issuance costs	(64)		(67)
Less: current portion	(91)		(149)
Long-term debt, less current portion	12,081		12,384
U.S Dollars | Due in 2022 | Receivables Financing Facility | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	0		240
U.S Dollars | Due in 2023 | Senior Secured Term A Loan | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	0		728
U.S Dollars | Due in 2023 | Senior Secured Facilities, Term A Loan 2 | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	0		766
U.S Dollars | Due in 2024 | Senior Secured Term B Loan | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 510		535
Average floating rate	1.85%
U.S Dollars | Due in 2024 | Senior Secured Additional Term B Loan | LIBOR
Senior Secured Credit Facilities:
Average floating rate	0.98%
U.S Dollars | Due in 2024 | Receivables Financing Facility | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 550		0
U.S Dollars | Due in 2025 | Senior Secured Term B Loan | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 670		726
Average floating rate	1.85%
U.S Dollars | Due in 2025 | Senior Secured Additional Term B Loan | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 860		926
Average floating rate	1.90%
U.S Dollars | Due in 2026 | Senior Secured Term A Loan At 1.33% | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,433		0
Average floating rate	1.33%
U.S Dollars | Due in 2026 | Senior Secured Term A Loan At 1.25% | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 363		0
U.S Dollars | Due in 2026 | 5.0% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,050		1,050
Rate (percent)	5.00%
U.S Dollars | Due in 2027 | 5.0% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,100		1,100
Rate (percent)	5.00%
EUR Dollars | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt | €		€ 1,450,000,000
EUR Dollars | Due in 2023 | Senior Secured Term A Loan | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 0		400
EUR Dollars | Due in 2024 | Senior Secured Term B Loan | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,269		1,413
Average floating rate	2.00%
EUR Dollars | Due in 2025 | Senior Secured Additional Term B Loan | LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 605		697
Average floating rate	2.00%
EUR Dollars | Due in 2025 | 2.875 Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 487		515
Rate (percent)	2.875%
EUR Dollars | Due in 2025 | 3.25% Senior Notes due 2025—Euro denominated | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 0		1,748
Rate (percent)	3.25%
EUR Dollars | Due in 2026 | Senior Secured Term A Loan At 1.25% | LIBOR
Senior Secured Credit Facilities:
Average floating rate	1.25%
EUR Dollars | Due in 2026 | 1.750% Senior Notes due 2026—Euro denominated | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 637	550,000,000	0
Rate (percent)	1.75%
EUR Dollars | Due in 2028 | 2.875 Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 824		872
Rate (percent)	2.875%
EUR Dollars | Due in 2028 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 834		883
Rate (percent)	2.25%
EUR Dollars | Due in 2029 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,043	€ 900,000,000	$ 0
Rate (percent)	2.25%

Credit Arrangements - Contractu

Credit Arrangements - Contractual Maturities of Long-term Debt (Detail) - USD ($) $ in Millions	Sep. 30, 2021	Dec. 31, 2020
Debt Disclosure [Abstract]
Remainder of 2020	$ 23
2022	91
2023	91
2024	2,419
2025	2,714
Thereafter	6,898
Principal amount of debt	$ 12,236	$ 12,600

Credit Arrangements - Additiona

Credit Arrangements - Additional Information (Detail) £ in Millions, $ in Millions	Sep. 14, 2021USD ($)	Aug. 25, 2021USD ($)	Mar. 03, 2021EUR (€)	Sep. 30, 2021USD ($)	Sep. 30, 2020USD ($)	Sep. 30, 2021USD ($)	Sep. 30, 2021GBP (£)	Sep. 30, 2020USD ($)	Aug. 13, 2021USD ($)	Aug. 12, 2021USD ($)	Dec. 31, 2020USD ($)
Line of Credit Facility
Loss on extinguishment of debt				$ 1	$ 0	$ 25		$ 12
Outstanding borrowings				12,236		12,236					$ 12,600
Senior Notes | EUR Dollars
Line of Credit Facility
Outstanding borrowings | €			€ 1,450,000,000
Standby Letters of Credit
Line of Credit Facility
Available borrowing capacity				1,500		1,500
General Banking Facility
Line of Credit Facility
Bank guarantees						1	£ 0.8
Senior Secured Credit Facilities
Line of Credit Facility
Aggregate maximum principal amount				7,200		7,200
Outstanding borrowings				5,700		5,700
Available borrowing capacity				1,500		1,500
Senior Secured Term A Loan
Line of Credit Facility
Loss on extinguishment of debt		$ 1
Senior Secured Term B Loan
Line of Credit Facility
Repayments of debt	$ 250
1.750% Senior Notes due 2026—Euro denominated | Senior Notes | Due in 2026
Line of Credit Facility
Redemption premium percentage			0.875%
Redemption premium percentage, early redemption rate			0.00%
1.750% Senior Notes due 2026—Euro denominated | Senior Notes | Due in 2026 | EUR Dollars
Line of Credit Facility
Outstanding borrowings			€ 550,000,000	$ 637		$ 637					0
Debt instrument interest rate stated percentage				1.75%		1.75%
Receivables Financing Facility
Line of Credit Facility
Aggregate maximum principal amount									$ 550	$ 300
2.25% Senior Notes | Senior Notes | Due in 2029
Line of Credit Facility
Redemption premium percentage			1.125%
Redemption premium percentage, early redemption rate			0.00%
2.25% Senior Notes | Senior Notes | Due in 2029 | EUR Dollars
Line of Credit Facility
Outstanding borrowings			€ 900,000,000	$ 1,043		$ 1,043					$ 0
Debt instrument interest rate stated percentage				2.25%		2.25%
Accounts Receivable Financing Facility, Term Loan | Special Purpose Entity ("SPE")
Line of Credit Facility
Debt related to financing the purchase of accounts receivable									440
Accounts Receivable Financing Facility, Revolving Loan Commitment | Special Purpose Entity ("SPE")
Line of Credit Facility
Debt related to financing the purchase of accounts receivable									$ 110

Contingencies - Additional Info

Contingencies - Additional Information (Detail) $ in Millions	Jul. 14, 2020private_individual	May 24, 2019medical_doctor	Sep. 11, 2017medical_doctor	Sep. 11, 2017private_individual	May 13, 2017USD ($)	Jul. 23, 2015private_individual	Feb. 13, 2014medical_doctor	Feb. 13, 2014private_individual	Feb. 13, 2014Defendant
KPIC
Loss Contingencies
Number of plaintiffs		247	280	200			1,200	900
Number of defendants | Defendant									2
Seoul Central District Prosecutors
Loss Contingencies
Number of defendants						24
Seoul Central District Prosecutors | Employee
Loss Contingencies
Number of defendants	2					2
Minimum | Veeva
Loss Contingencies
Amount of damages claimed | $					$ 200

Stockholders' Equity - Narrativ

Stockholders' Equity - Narratives (Detail) - USD ($)	Apr. 01, 2021	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Mar. 31, 2020	Sep. 30, 2021	Dec. 31, 2020
Class of Stock
Preferred stock, authorized (shares)		1,000,000				1,000,000
Preferred stock, par value (usd per share)		$ 0.01				$ 0.01
Preferred stock, shares issued (shares)		0				0	0
Preferred stock, shares outstanding (shares)		0				0	0
Repurchase of stock, value		$ 125,000,000	$ 45,000,000	$ 62,000,000	$ 332,000,000
Q2 Solutions
Class of Stock
Percentage acquired	40.00%
Consideration transferred	$ 758,000,000
Ownership percentage as result of transaction	100.00%
Equity Repurchase Under Repurchase Program
Class of Stock
Equity available for repurchase under the repurchase program		$ 700,000,000				$ 700,000,000
Secondary Public Offering | Equity Repurchase Under Repurchase Program
Class of Stock
Repurchase of stock (in shares)						973,313
Repurchase of stock, value						$ 221,000,000

Restructuring - Summary of Amou

Restructuring - Summary of Amounts Recorded for Restructuring Plans (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2021USD ($)
Restructuring Reserve
Restructuring reserves, beginning balance	$ 53
Expense, net of reversals	15
Payments	(36)
Foreign currency translation and other	(2)
Restructuring reserves, ending balance	30
Severance and Related Costs
Restructuring Reserve
Restructuring reserves, beginning balance	51
Expense, net of reversals	15
Payments	(35)
Foreign currency translation and other	(2)
Restructuring reserves, ending balance	29
Facility Exit Costs
Restructuring Reserve
Restructuring reserves, beginning balance	2
Expense, net of reversals	0
Payments	(1)
Foreign currency translation and other	0
Restructuring reserves, ending balance	$ 1

Income Taxes - Narratives (Deta

Income Taxes - Narratives (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Tax Disclosure [Abstract]
Effective income tax rate (percent)	4.40%	(2.90%)	13.80%	5.00%
Tax cuts and jobs act, tax credit	$ 29
Federal consolidated income tax returns		$ 24		$ 10
Tax impact of share-based compensation awards	$ 3	$ 9	$ 26	$ 35

Comprehensive Income - Summary

Comprehensive Income - Summary of Components of AOCI (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Sep. 30, 2021
Statement of Other Comprehensive Income
Beginning balance			$ 6,001
Other comprehensive income (loss) before reclassifications			(237)
Reclassification adjustments			7
Acquisition of Quest's non-controlling interest, net of tax	$ (1)	$ 709	(10)
Ending balance	5,829		5,829
Income Taxes
Beginning balance			323
Other comprehensive income (loss) before reclassifications			(66)
Reclassification adjustments			(2)
Acquisition of Quest's non-controlling interest			0
Ending balance	255		255
Foreign Currency Translation
Statement of Other Comprehensive Income
Beginning balance			(395)
Other comprehensive income (loss) before reclassifications			(170)
Reclassification adjustments			0
Acquisition of Quest's non-controlling interest, net of tax			(10)
Ending balance	(575)		(575)
Derivative Instruments
Statement of Other Comprehensive Income
Beginning balance			(48)
Other comprehensive income (loss) before reclassifications			(1)
Reclassification adjustments			9
Acquisition of Quest's non-controlling interest, net of tax			0
Ending balance	(40)		(40)
Defined Benefit Plans
Statement of Other Comprehensive Income
Beginning balance			(85)
Other comprehensive income (loss) before reclassifications			0
Reclassification adjustments			0
Acquisition of Quest's non-controlling interest, net of tax			0
Ending balance	(85)		(85)
Total
Statement of Other Comprehensive Income
Beginning balance			(205)
Acquisition of Quest's non-controlling interest, net of tax		$ 10
Ending balance	$ (445)		$ (445)

Comprehensive Income - Summar_2

Comprehensive Income - 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		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 4	$ 3	$ 9	$ 8
Income tax benefit	1	1	2	2
Total net of income taxes	3	2	7	6
Interest rate swaps | Interest expense
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	5	0	14	0
Foreign exchange forward contracts | Revenues
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	(1)	4	(5)	9
Foreign exchange forward contracts | Other income, net
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 0	$ (1)	$ 0	$ (1)

Segments - Additional Informati

Segments - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2021Segment
Segment Reporting [Abstract]
Number of reportable segments	3

Segments - Operations by Report

Segments - Operations by Reportable Segments (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Segment Reporting Information
Revenues	$ 3,391	$ 2,786	$ 10,238	$ 8,061
Costs of revenue, exclusive of depreciation and amortization	2,253	1,800	6,869	5,328
Selling, general and administrative expenses	498	460	1,422	1,298
Segment profit	727	600	2,173	1,596
Depreciation and amortization	(336)	(319)	(1,002)	(943)
Restructuring costs	(2)	(20)	(15)	(50)
Income from operations	302	187	930	442
Technology & Analytics Solutions
Segment Reporting Information
Revenues	1,337	1,207	4,038	3,433
Costs of revenue, exclusive of depreciation and amortization	795	727	2,415	2,048
Segment profit	343	292	1,044	836
Research & Development Solutions
Segment Reporting Information
Revenues	1,853	1,400	5,612	4,076
Costs of revenue, exclusive of depreciation and amortization	1,291	925	3,967	2,811
Segment profit	364	291	1,069	721
Contract Sales & Medical Solutions
Segment Reporting Information
Revenues	201	179	588	552
Costs of revenue, exclusive of depreciation and amortization	167	148	487	469
Segment profit	20	17	60	39
Operating Segments | Technology & Analytics Solutions
Segment Reporting Information
Selling, general and administrative expenses	199	188	579	549
Operating Segments | Research & Development Solutions
Segment Reporting Information
Selling, general and administrative expenses	198	184	576	544
Operating Segments | Contract Sales & Medical Solutions
Segment Reporting Information
Selling, general and administrative expenses	14	14	41	44
General corporate and unallocated
Segment Reporting Information
Selling, general and administrative expenses	87	74	226	161
Segment profit	$ (87)	$ (74)	$ (226)	$ (161)

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		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Antidilutive Securities Excluded from Computation of Earnings Per Share
Total shares excluded from diluted earnings per share	0.9	2.2	0.9	2.5
Shares subject to performance conditions
Antidilutive Securities Excluded from Computation of Earnings Per Share
Total shares excluded from diluted earnings per share	0.9	1.1	0.8	1.2
Shares subject to anti-dilutive stock-based awards
Antidilutive Securities Excluded from Computation of Earnings Per Share
Total shares excluded from diluted earnings per share	0	1.1	0.1	1.3

Business Combinations - Schedul

Business Combinations - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Assets acquired:
Goodwill	$ 13,124	$ 12,654
Several Individually Immaterial Acquisitions
Assets acquired:
Cash and cash equivalents	7
Other assets	40
Goodwill	772
Liabilities assumed:
Other liabilities	(21)
Deferred income taxes, long-term	(60)
Net assets acquired	1,044
Several Individually Immaterial Acquisitions | Customer relationships
Assets acquired:
Other identifiable intangibles, net	$ 208
Liabilities assumed:
Amortization Period	16 years
Several Individually Immaterial Acquisitions | Non-compete agreements
Assets acquired:
Other identifiable intangibles, net	$ 2
Liabilities assumed:
Amortization Period	5 years
Several Individually Immaterial Acquisitions | Software and related assets
Assets acquired:
Other identifiable intangibles, net	$ 72
Liabilities assumed:
Amortization Period	8 years
Several Individually Immaterial Acquisitions | Trade names
Assets acquired:
Other identifiable intangibles, net	$ 7
Liabilities assumed:
Amortization Period	10 years
Several Individually Immaterial Acquisitions | Backlog
Assets acquired:
Other identifiable intangibles, net	$ 17
Liabilities assumed:
Amortization Period	2 years

Business Combinations - Narrati

Business Combinations - Narrative (Details) $ in Millions	Sep. 30, 2021USD ($)
Several Individually Immaterial Acquisitions
Business Acquisition [Line Items]
Portion of goodwill deductible for income tax purposes	$ 503