IQVIA (IQV) 10-Q 1 Nov 23 2023 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares	9 Months Ended
	Sep. 30, 2023	Oct. 19, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2023
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	2400 Ellis Rd.
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		182,500,000
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001478242
Amendment Flag	false
Document Fiscal Year Focus	2023
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, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Statement [Abstract]
Revenues	$ 3,736	$ 3,562	$ 11,116	$ 10,671
Cost of revenues, exclusive of depreciation and amortization	2,426	2,321	7,267	6,975
Selling, general and administrative expenses	502	517	1,497	1,488
Depreciation and amortization	297	248	809	773
Restructuring costs	30	4	67	15
Income from operations	481	472	1,476	1,420
Interest income	(14)	(4)	(24)	(7)
Interest expense	181	108	491	288
Other (income) expense, net	(35)	8	(77)	51
Income before income taxes and equity in earnings (losses) of unconsolidated affiliates	349	360	1,086	1,088
Income tax expense	51	70	203	212
Income before equity in earnings (losses) of unconsolidated affiliates	298	290	883	876
Equity in earnings (losses) of unconsolidated affiliates	5	(7)	6	(12)
Net income	303	283	889	864
Net Income (Loss) Attributable to Parent, Total	$ 303	$ 283	$ 889	$ 864
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 1.66	$ 1.52	$ 4.82	$ 4.59
Diluted (in dollars per share)	$ 1.63	$ 1.49	$ 4.76	$ 4.52
Weighted average common shares outstanding:
Basic (in shares)	182.9	186.5	184.4	188.3
Diluted (in shares)	185.5	189.4	186.9	191.3

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 303	$ 283	$ 889	$ 864
Comprehensive income adjustments:
Unrealized gains on derivative instruments, net of income tax expense of $—, $2, $11, $10	2	6	34	29
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	0	10	1	4
Foreign currency translation, net of income tax expense of $44, $84, $12, $195	(136)	(218)	(170)	(539)
Reclassification adjustments:
Reclassifications on derivative instruments included in net income, net of income tax (expense) benefit of $(3), $—, $(14), $4	(9)	1	(41)	14
Comprehensive income	$ 160	$ 82	$ 713	$ 372

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Statement of Comprehensive Income [Abstract]
Unrealized (losses) gains on derivative instruments, income tax (benefit) expense	$ 0	$ 2	$ 11	$ 10
Defined benefit plan adjustments, income tax (benefit) expense	0	2	0	2
Foreign currency translation, income tax expense (benefit)	44	84	12	195
(Gain) losses on derivative instruments included in net income, income tax expense	$ (3)	$ 0	$ (14)	$ 4

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 1,224	$ 1,216
Trade accounts receivable and unbilled services, net	3,227	2,917
Prepaid expenses	177	151
Income taxes receivable	49	43
Investments in debt, equity and other securities	108	93
Other current assets and receivables	423	561
Total current assets	5,208	4,981
Property and equipment, net	498	532
Operating lease right-of-use assets	292	331
Investments in debt, equity and other securities	99	68
Investments in unconsolidated affiliates	115	94
Goodwill	14,288	13,921
Other identifiable intangibles, net	4,907	4,820
Deferred income taxes	111	118
Deposits and other assets, net	459	472
Total assets	25,977	25,337
Current liabilities:
Accounts payable and accrued expenses	3,133	3,316
Unearned income	1,838	1,797
Income taxes payable	172	161
Current portion of long-term debt	1,309	152
Other current liabilities	137	152
Total current liabilities	6,589	5,578
Long-term debt, less current portion	12,322	12,595
Deferred income taxes	365	464
Operating lease liabilities	217	264
Other liabilities	679	671
Total liabilities	20,172	19,572
Commitments and contingencies (Note 8)
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of September 30, 2023 and December 31, 2022, $0.01 par value, 257.1 shares issued and 182.5 shares outstanding as of September 30, 2023; 256.4 shares issued and 185.7 shares outstanding as of December 31, 2022	10,994	10,898
Retained earnings	4,223	3,334
Treasury stock, at cost, 74.6 and 70.7 shares as of September 30, 2023 and December 31, 2022, respectively	(8,509)	(7,740)
Accumulated other comprehensive loss	(903)	(727)
Total stockholders’ equity	5,805	5,765
Total liabilities and stockholders’ equity	$ 25,977	$ 25,337

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares shares in Millions	Sep. 30, 2023	Dec. 31, 2022
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)	257.1	256.4
Common stock, shares outstanding (in shares)	182.5	185.7
Treasury stock, shares (in shares)	74.6	70.7

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022
Operating activities:
Net income	$ 889	$ 864
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	809	773
Amortization of debt issuance costs and discount	13	11
Stock-based compensation	172	136
(Earnings) losses from unconsolidated affiliates	(6)	12
(Gain) loss on investments, net	(5)	35
Benefit from deferred income taxes	(117)	(52)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income	(241)	(88)
Change in other operating assets and liabilities	(112)	9
Net cash provided by operating activities	1,402	1,700
Investing activities:
Acquisition of property, equipment and software	(470)	(503)
Acquisition of businesses, net of cash acquired	(869)	(1,012)
Purchases of marketable securities, net	(4)	(4)
Investments in unconsolidated affiliates, net of payments received	(16)	(14)
Investments in debt and equity securities	(36)	0
Other	4	4
Net cash used in investing activities	(1,391)	(1,529)
Financing activities:
Proceeds from issuance of debt	1,250	1,250
Payment of debt issuance costs	(19)	(5)
Repayment of debt and principal payments on finance leases	(118)	(86)
Proceeds from revolving credit facility	2,009	1,500
Repayment of revolving credit facility	(2,184)	(1,600)
Payments related to employee stock option plans	(58)	(70)
Repurchase of common stock	(763)	(1,103)
Contingent consideration and deferred purchase price payments	(79)	(22)
Net cash provided by (used in) financing activities	38	(136)
Effect of foreign currency exchange rate changes on cash	(41)	(127)
Increase (decrease) in cash and cash equivalents	8	(92)
Cash and cash equivalents at beginning of period	1,216	1,366
Cash and cash equivalents at end of period	$ 1,224	$ 1,274

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Treasury Stock, Common	Additional Paid-In Capital	Retained Earnings	Accumulated Other Comprehensive (Loss) Income
Beginning balance (in shares) at Dec. 31, 2021		255.8	65.2
Beginning balance at Dec. 31, 2021	$ 6,042	$ 3	$ (6,572)	$ 10,774	$ 2,243	$ (406)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.4
Issuance of common stock	(67)			(67)
Repurchase of common stock (in shares)			(1.7)
Repurchase of common stock	(403)		$ (403)
Stock-based compensation	35			35
Net income	325				325
Unrealized gains on derivative instruments, net of tax	30					30
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	(2)					(2)
Foreign currency translation, net of tax	(40)					(40)
Reclassification adjustments, net of tax	(1)					(1)
Ending balance (in shares) at Mar. 31, 2022		256.2	66.9
Ending balance at Mar. 31, 2022	5,919	$ 3	$ (6,975)	10,742	2,568	(419)
Beginning balance (in shares) at Dec. 31, 2021		255.8	65.2
Beginning balance at Dec. 31, 2021	6,042	$ 3	$ (6,572)	10,774	2,243	(406)
Increase (Decrease) in Stockholders' Equity
Net income	864
Unrealized gains on derivative instruments, net of tax	29
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	4
Foreign currency translation, net of tax	(539)
Ending balance (in shares) at Sep. 30, 2022		256.3	70.5
Ending balance at Sep. 30, 2022	5,347	$ 3	$ (7,715)	10,850	3,107	(898)
Beginning balance (in shares) at Mar. 31, 2022		256.2	66.9
Beginning balance at Mar. 31, 2022	5,919	$ 3	$ (6,975)	10,742	2,568	(419)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	(2)			(2)
Repurchase of common stock (in shares)			(2.8)
Repurchase of common stock	(590)		$ (590)
Stock-based compensation	47			47
Net income	256				256
Unrealized gains on derivative instruments, net of tax	(7)					(7)
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	(4)					(4)
Foreign currency translation, net of tax	(281)					(281)
Reclassification adjustments, net of tax	14					14
Ending balance (in shares) at Jun. 30, 2022		256.3	69.7
Ending balance at Jun. 30, 2022	5,352	$ 3	$ (7,565)	10,787	2,824	(697)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0
Issuance of common stock	(1)			(1)
Repurchase of common stock (in shares)			(0.8)
Repurchase of common stock	(150)		$ (150)
Stock-based compensation	64			64
Net income	283				283
Unrealized gains on derivative instruments, net of tax	6					6
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	10					10
Foreign currency translation, net of tax	(218)					(218)
Reclassification adjustments, net of tax	1					1
Ending balance (in shares) at Sep. 30, 2022		256.3	70.5
Ending balance at Sep. 30, 2022	$ 5,347	$ 3	$ (7,715)	10,850	3,107	(898)
Beginning balance (in shares) at Dec. 31, 2022	185.7	256.4	70.7
Beginning balance at Dec. 31, 2022	$ 5,765	$ 3	$ (7,740)	10,895	3,334	(727)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.5
Issuance of common stock	(58)			(58)
Repurchase of common stock (in shares)			(0.7)
Repurchase of common stock	(129)		$ (129)
Stock-based compensation	69			69
Net income	289				289
Unrealized gains on derivative instruments, net of tax	10					10
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	1					1
Foreign currency translation, net of tax	10					10
Reclassification adjustments, net of tax	(25)					(25)
Ending balance (in shares) at Mar. 31, 2023		256.9	71.4
Ending balance at Mar. 31, 2023	$ 5,932	$ 3	$ (7,869)	10,906	3,623	(731)
Beginning balance (in shares) at Dec. 31, 2022	185.7	256.4	70.7
Beginning balance at Dec. 31, 2022	$ 5,765	$ 3	$ (7,740)	10,895	3,334	(727)
Increase (Decrease) in Stockholders' Equity
Net income	889
Unrealized gains on derivative instruments, net of tax	34
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	1
Foreign currency translation, net of tax	$ (170)
Ending balance (in shares) at Sep. 30, 2023	182.5	257.1	74.6
Ending balance at Sep. 30, 2023	$ 5,805	$ 3	$ (8,509)	10,991	4,223	(903)
Beginning balance (in shares) at Mar. 31, 2023		256.9	71.4
Beginning balance at Mar. 31, 2023	5,932	$ 3	$ (7,869)	10,906	3,623	(731)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	0			0
Repurchase of common stock (in shares)			(2.5)
Repurchase of common stock	(495)		$ (495)
Stock-based compensation	43			43
Net income	297				297
Unrealized gains on derivative instruments, net of tax	22					22
Foreign currency translation, net of tax	(44)					(44)
Reclassification adjustments, net of tax	(7)					(7)
Ending balance (in shares) at Jun. 30, 2023		257	73.9
Ending balance at Jun. 30, 2023	5,748	$ 3	$ (8,364)	10,949	3,920	(760)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	0			0
Repurchase of common stock (in shares)			(0.7)
Repurchase of common stock	(145)		$ (145)
Stock-based compensation	42			42
Net income	303				303
Unrealized gains on derivative instruments, net of tax	2					2
Defined benefit plan adjustments, net of income tax expense of $—, $2, $—, $2	0
Foreign currency translation, net of tax	(136)					(136)
Reclassification adjustments, net of tax	$ (9)					(9)
Ending balance (in shares) at Sep. 30, 2023	182.5	257.1	74.6
Ending balance at Sep. 30, 2023	$ 5,805	$ 3	$ (8,509)	$ 10,991	$ 4,223	$ (903)

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2023
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 87,000 employees, the Company 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, 2023. 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, 2022. The balance sheet as of December 31, 2022 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 September 2022, the Financial Accounting Standards Board ("FASB") issued new accounting guidance, Accounting Standards Update ("ASU") 2022-04, Liabilities - Supplier Finance Programs

Revenues by Geography, Concentr

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations	9 Months Ended
	Sep. 30, 2023
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, 2023 and 2022: Three Months Ended September 30, 2023 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 761 $ 1,017 $ 78 $ 1,856 Europe and Africa 519 520 50 1,089 Asia-Pacific 151 585 55 791 Total revenues $ 1,431 $ 2,122 $ 183 $ 3,736 Three Months Ended September 30, 2022 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 746 $ 960 $ 91 $ 1,797 Europe and Africa 503 488 40 1,031 Asia-Pacific 151 531 52 734 Total revenues $ 1,400 $ 1,979 $ 183 $ 3,562 Nine Months Ended September 30, 2023 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 2,268 $ 2,982 $ 228 $ 5,478 Europe and Africa 1,606 1,547 146 3,299 Asia-Pacific 457 1,715 167 2,339 Total revenues $ 4,331 $ 6,244 $ 541 $ 11,116 Nine Months Ended September 30, 2022 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 2,143 $ 2,772 $ 270 $ 5,185 Europe and Africa 1,639 1,527 129 3,295 Asia-Pacific 465 1,564 162 2,191 Total revenues $ 4,247 $ 5,863 $ 561 $ 10,671 No individual customer represented 10% or more of consolidated revenues for the three and nine months ended September 30, 2023 or 2022.

Trade Accounts Receivable, Unbi

Trade Accounts Receivable, Unbilled Services and Unearned Income	9 Months Ended
	Sep. 30, 2023
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, 2023 December 31, 2022 Trade accounts receivable $ 1,349 $ 1,329 Unbilled services 1,905 1,624 Trade accounts receivable and unbilled services 3,254 2,953 Allowance for doubtful accounts (27) (36) Trade accounts receivable and unbilled services, net $ 3,227 $ 2,917 Unbilled services and unearned income were as follows: (in millions) September 30, 2023 December 31, 2022 Change Unbilled services $ 1,905 $ 1,624 $ 281 Unearned income (1,838) (1,797) (41) Net balance $ 67 $ (173) $ 240 Unbilled services, which is comprised of approximately 66% and 61% of unbilled receivables and 34% and 39% of contract assets as of September 30, 2023 and December 31, 2022, respectively, increased by $281 million as compared to December 31, 2022. 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 $41 million over the same period resulting in an increase of $240 million in the net balance of unbilled services and unearned income between September 30, 2023 and December 31, 2022. 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 , primarily 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. The majority of the unearned income balance as of the beginning of the year is expected to be recognized in revenues during the year ended December 31, 2023. Bad debt expense recognized on the Company’s trade accounts receivable was immaterial for the three and nine months ended September 30, 2023 and 2022. Accounts Receivable Factoring Arrangements The Company has accounts receivable factoring agreements to sell certain eligible unsecured trade accounts receivable, either based on automatic arrangements or at its option, without recourse, to unrelated third-party financial institutions for cash. During the nine months ended September 30, 2023, through its accounts receivable factoring arrangements that the Company utilizes most frequently, the Company factored approximately $545 million of customer invoices on a non-recourse basis and received approximately $534 million in cash proceeds from the sales. The fees associated with these transactions were immaterial. The Company has other accounts receivable arrangements for which the activity associated with them is immaterial.

Goodwill

Goodwill	9 Months Ended
	Sep. 30, 2023
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, 2023: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2022 $ 11,520 $ 2,247 $ 154 $ 13,921 Business combinations 331 181 — 512 Impact of foreign currency fluctuations and other (139) — (6) (145) Balance as of September 30, 2023 $ 11,712 $ 2,428 $ 148 $ 14,288

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2023
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, 2023 December 31, 2022 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Interest rate swaps Other current assets, other assets and other current liabilities $ 36 $ — $ 1,800 $ 42 $ — $ 1,800 Foreign exchange forward contracts Other current assets and other current liabilities — 4 124 2 2 122 Total derivatives $ 36 $ 4 $ 44 $ 2 The pre-tax 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) 2023 2022 2023 2022 Interest rate swaps $ (1) $ 14 $ (6) $ 69 Foreign exchange forward contracts (9) (5) (4) (12) Total $ (10) $ 9 $ (10) $ 57 The Company expects approximately $30 million of pre-tax unrealized gains related to its foreign exchange contracts and interest rate derivatives included in accumulated other comprehensive (loss) income (“AOCI”) as of September 30, 2023 to be reclassified into earnings within the next twelve months. As of September 30, 2023, the Company's foreign currency denominated debt balance (net of original issue discount) designated as a hedge of its net investment in certain foreign subsidiaries totaled €5,199 million ($5,498 million). The amount of foreign exchange gains related to the net investment hedge included in the cumulative translation adjustment component of AOCI for the nine months ended September 30, 2023 and 2022 was $69 million and $807 million, respectively.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2023
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, 2023 and December 31, 2022 due to their short-term nature. As of September 30, 2023 and December 31, 2022, the fair value of total debt was $13,138 million and $12,281 million, respectively, as determined under 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, 2023: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 130 $ — $ — $ 130 Derivatives — 36 — 36 Total $ 130 $ 36 $ — $ 166 Liabilities: Derivatives $ — $ 4 $ — $ 4 Contingent consideration — — 104 104 Total $ — $ 4 $ 104 $ 108 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 December 31, 2022: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 122 $ — $ — $ 122 Derivatives — 44 — 44 Total $ 122 $ 44 $ — $ 166 Liabilities: Derivatives $ — $ 2 $ — $ 2 Contingent consideration — — 173 173 Total $ — $ 2 $ 173 $ 175 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, 2023, the Company has accrued approximately 35% 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, 2023: (in millions) Contingent Consideration Balance as of December 31, 2022 $ 173 Business combinations 59 Contingent consideration paid (72) Revaluations included in earnings and foreign currency translation adjustments (56) Balance as of September 30, 2023 $ 104 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 contingent consideration are recognized in other (income) expense, net on the accompanying condensed consolidated statements of income. A change in significant unobservable inputs could result in a higher or lower fair value measurement of contingent consideration. Non-recurring Fair Value Measurements

Credit Arrangements

Credit Arrangements	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Credit Arrangements	Credit Arrangements The following is a summary of the Company’s revolving credit facilities as of September 30, 2023: Facility Interest Rates $2,000 million (revolving credit facility) U.S. Dollar Term SOFR plus a margin of 1.25% plus a 10 basis credit spread adjustment as of September 30, 2023 $110 million (receivables financing facility) U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of September 30, 2023 The following table summarizes the Company’s debt at the dates indicated: (dollars in millions) September 30, 2023 December 31, 2022 Revolving Credit Facility due 2026: U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 6.66% $ 250 $ 425 Senior Secured Credit Facilities: Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.66% 1,288 1,343 Term A Loan due 2026—Euribor at average floating rates of 5.22% 298 314 Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.66% 1,172 1,219 Term B Loan due 2024—Euribor at average floating rates of 5.85% 1,157 1,172 Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14% 670 670 Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14% 861 860 Term B Loan due 2025—Euribor at average floating rates of 5.85% 552 559 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 5.700% Senior Secured Notes due 2028—U.S. Dollar denominated 750 — 6.500% Senior Notes due 2030—U.S. Dollar denominated 500 — 2.875% Senior Notes due 2025—Euro denominated 444 450 2.25% Senior Notes due 2028—Euro denominated 761 771 2.875% Senior Notes due 2028—Euro denominated 752 761 1.750% Senior Notes due 2026—Euro denominated 582 589 2.250% Senior Notes due 2029—Euro denominated 952 964 Receivables financing facility due 2024—U.S. Dollar Term SOFR at average floating rates of 6.33%: Revolving Loan Commitment 110 110 Term Loan 440 440 Principal amount of debt 13,689 12,797 Less: unamortized discount and debt issuance costs (58) (50) Less: current portion (1,309) (152) Long-term debt $ 12,322 $ 12,595 Contractual maturities of long-term debt as of September 30, 2023 are as follows: (in millions) Remainder of 2023 $ 38 2024 1,859 2025 2,679 2026 3,329 2027 2,069 Thereafter 3,715 $ 13,689 Senior Secured Credit Facilities As of September 30, 2023, the Company’s Fifth Amended and Restated Credit Agreement provided financing through several senior secured credit facilities of up to $7,998 million, which consisted of $6,248 million principal amounts of debt outstanding (as detailed in the table above), and $1,745 million of available borrowing capacity on the $2,000 million revolving credit facility and standby letters of credit. The revolving credit facility is comprised of a $1,175 million senior secured revolving facility available in U.S. dollars, a $600 million senior secured revolving facility available in U.S. dollars, Euros, Swiss Francs and other foreign currencies, and a $225 million senior secured revolving facility available in U.S. dollars and Yen. On April 17, 2023, the Company increased the capacity of its senior secured revolving credit facility by $500 million U.S. dollars, bringing the total capacity of the revolving credit facility to $2,000 million. At the same time, the Company also amended the benchmark rate of the U.S. dollar revolving credit facility and the U.S. dollar Term A Loans from U.S. dollar LIBOR to U.S. dollar SOFR plus a 10 basis point Credit Spread Adjustment. Senior Notes On May 23, 2023, IQVIA Inc. (the “Issuer”), a wholly owned subsidiary of the Company, completed the issuance and sale of $750 million in gross proceeds of the Issuer’s 5.700% senior secured notes due 2028 (the “Senior Secured Notes”) and $500 million in gross proceeds of 6.500% senior notes due 2030 (the “Senior Notes” and, together with the Senior Secured Notes, the “Notes”). The Senior Secured Notes were issued pursuant to an Indenture, dated May 23, 2023 (the “Secured Notes Indenture”), among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the Senior Secured Notes and as collateral agent, and the Company and certain subsidiaries of the Issuer as guarantors. The Senior Notes were issued pursuant to an Indenture, dated May 23, 2023, among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the Senior Notes, and certain subsidiaries of the Issuer as guarantors (the “Senior Notes Indenture” and, together with the Secured Notes Indenture, the “Indentures”). The net proceeds from the notes offering were used to repay existing borrowings under the Issuer’s revolving credit facility and to pay fees and expenses related to the Notes offering. The Notes have not been registered under the Securities Act of 1933, as amended, or the securities laws of any other jurisdiction. Pursuant to a registration rights agreement entered into in connection with the Notes offering, the Issuer and the guarantors agreed, among other things, to use commercially reasonable efforts to, within certain time periods, file a registration statement with respect to a registered offer to exchange the Senior Secured Notes for new exchange notes, have the exchange offer registration statement declared effective, and complete the exchange offer promptly thereafter, unless the Senior Secured Notes are redeemed earlier. The Senior Secured Notes are secured obligations of the Issuer, will mature on May 15, 2028, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 5.700% per year, with interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2023. The Senior Notes are unsecured obligations of the Issuer, will mature on May 15, 2030, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 6.500% per year, with interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2023. The Issuer may redeem (i) the Senior Secured Notes prior to April 15, 2028 subject to a customary make-whole premium, and thereafter subject to a redemption price equal to 100% of the principal amount thereof plus accrued and unpaid interest and (ii) the Senior Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to May 15, 2026 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 3.250% to 0.000%.

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2023
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 an accrual 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 its 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, the Korean Pharmaceutical Association (“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, and the Prosecutor's Office appealed. On December 23, 2021, the appellate court affirmed the judgment of the Seoul Central District Court. The Prosecutor's Office has appealed to the Supreme Court. 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. The Company believes the counterclaims are without merit, rejects all counterclaims raised by Veeva and intends to vigorously defend IQVIA Parties’ position and pursue its 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 an 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 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, 2023
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, 2023 or December 31, 2022. Equity Repurchase Program On July 31, 2023, the Company's Board of Directors (the "Board") increased the stock repurchase authorization under the Company's equity repurchase program (the "Repurchase Program") with respect to the repurchase of the Company's common stock by an additional $2,000 million, which increased the total amount that has been authorized under the Repurchase Program to $11,725 million. The Repurchase Program does not obligate the Company to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time.

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Business Combinations The Company completed several individually immaterial acquisitions during the nine months ended September 30, 2023. The Company’s assessment of fair value, including the valuation of certain identified intangibles, 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, expected synergies and new customer relationships. 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 preliminary financial information for these acquisitions: (in millions) September 30, 2023 Assets acquired: Cash and cash equivalents $ 27 Accounts receivable 42 Other assets 9 Goodwill 512 Other identifiable intangibles 416 Liabilities assumed: Other liabilities (38) Deferred income taxes, long-term (17) Net assets acquired (1) $ 951 (1) Net assets acquired includes contingent consideration and deferred purchase price of $66 million. The portion of goodwill deductible for income tax purposes was preliminarily assessed as $373 million. The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired: (in millions) Amortization Period September 30, 2023 Other identifiable intangibles: Customer relationships 10 - 15 years $ 330 Backlog 2 years 51 Software and related assets 5 - 8 years 29 Databases 3 - 5 years 3 Trade names 5 years 3 Total Other identifiable intangibles $ 416

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2023
Restructuring and Related Activities [Abstract]
Restructuring	RestructuringThe Company has continued to take restructuring actions in 2023 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 throughout 2023 and into 2024. The following amounts were recorded for the restructuring plans: (in millions) Severance and Balance as of December 31, 2022 $ 26 Expense, net of reversals 67 Payments (50) Foreign currency translation and other (1) Balance as of September 30, 2023 $ 42 The reversals were due to changes in estimates primarily resulting from the redeployment of staff and higher than expected voluntary terminations. 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, 2023 will be paid in 2023 and 2024.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company's effective income tax rate was 14.6% and 19.4% in the third quarter of 2023 and 2022, and 18.7% and 19.5% in the first nine months of 2023 and 2022, respectively. The effective income tax rate in the third quarter and first nine months of 2023 was favorably impacted by a reversal of uncertain tax positions relating to tax credit carryforwards in the amount of $21 million. Additionally, the effective income tax rate in the third quarter and in the first nine months of 2023 and 2022 was favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards. For the third quarter of 2023 and 2022 this impact was $2 million and $1 million, respectively, and for the first nine months of 2023 and 2022 this impact was $12 million and $15 million, respectively. Historically, the Company recorded deferred tax assets related to certain foreign tax credits. A full valuation allowance in relation to these foreign tax credits was established as it was not expected the credits would be utilized prior to expiration. As a result of an anticipated internal legal entity restructuring, the Company now believes it is reasonably possible that these foreign tax credits will be utilized and expects to reverse the valuation allowance in the near term which could create a material discrete tax benefit in the period recorded.

Accumulated Other Comprehensive

Accumulated Other Comprehensive (Loss) Income	9 Months Ended
	Sep. 30, 2023
Equity [Abstract]
Accumulated Other Comprehensive (Loss) Income	Accumulated Other Comprehensive (Loss) Income Below is a summary of the components of AOCI: (in millions) Foreign Derivative Defined Income Total Balance as of December 31, 2022 $ (825) $ 44 $ (8) $ 62 $ (727) Other comprehensive (loss) income before reclassifications (158) 45 1 (23) (135) Reclassification adjustments — (55) — 14 (41) Balance as of September 30, 2023 $ (983) $ 34 $ (7) $ 53 $ (903) Below is a summary of the adjustments for amounts 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, 2023 2022 2023 2022 Derivative instruments: Interest rate swaps Interest expense $ 17 $ (9) $ 35 $ (16) Foreign exchange forward contracts Revenues (5) 8 20 (2) Total before income taxes 12 (1) 55 (18) Income taxes 3 — 14 (4) Total net of income taxes $ 9 $ (1) $ 41 $ (14)

Segments

Segments	9 Months Ended
	Sep. 30, 2023
Segment Reporting [Abstract]
Segments	Segments The following table presents the Company’s operations by reportable segment. The Company is managed through three reportable segments, Technology & Analytics Solutions, Research & Development Solutions and Contract Sales & Medical Solutions. Technology & Analytics Solutions provides mission critical information, technology solutions and real world insights and services to the Company's life science clients. Research & Development Solutions, which primarily serves biopharmaceutical customers, provides outsourced clinical research and clinical trial related services. Contract Sales & Medical Solutions provides health care provider (including contract sales) and patient engagement services to both biopharmaceutical clients and the broader healthcare market. Certain costs are not allocated to our 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, if any, 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 Nine Months Ended (in millions) 2023 2022 2023 2022 Revenues Technology & Analytics Solutions $ 1,431 $ 1,400 $ 4,331 $ 4,247 Research & Development Solutions 2,122 1,979 6,244 5,863 Contract Sales & Medical Solutions 183 183 541 561 Total revenues 3,736 3,562 11,116 10,671 Cost of revenues, exclusive of depreciation and amortization Technology & Analytics Solutions 859 828 2,593 2,490 Research & Development Solutions 1,410 1,335 4,213 4,005 Contract Sales & Medical Solutions 157 158 461 480 Total cost of revenues, exclusive of depreciation and amortization 2,426 2,321 7,267 6,975 Selling, general and administrative expenses Technology & Analytics Solutions 217 213 652 628 Research & Development Solutions 217 199 640 614 Contract Sales & Medical Solutions 14 17 43 48 General corporate and unallocated 54 88 162 198 Total selling, general and administrative expenses 502 517 1,497 1,488 Segment profit Technology & Analytics Solutions 355 359 1,086 1,129 Research & Development Solutions 495 445 1,391 1,244 Contract Sales & Medical Solutions 12 8 37 33 Total segment profit 862 812 2,514 2,406 General corporate and unallocated (54) (88) (162) (198) Depreciation and amortization (297) (248) (809) (773) Restructuring costs (30) (4) (67) (15) Total income from operations $ 481 $ 472 $ 1,476 $ 1,420

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The following table reconciles the basic to diluted weighted average shares outstanding: Three Months Ended September 30, Nine Months Ended September 30, (in millions, except per share data) 2023 2022 2023 2022 Numerator: Net income $ 303 $ 283 $ 889 $ 864 Denominator: Basic weighted average common shares outstanding 182.9 186.5 184.4 188.3 Effect of dilutive stock options and share awards 2.6 2.9 2.5 3.0 Diluted weighted average common shares outstanding 185.5 189.4 186.9 191.3 Earnings per share attributable to common stockholders: Basic $ 1.66 $ 1.52 $ 4.82 $ 4.59 Diluted $ 1.63 $ 1.49 $ 4.76 $ 4.52 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. Performance awards are included in diluted earnings per share based on if the performance targets have been met at the end of the reporting period. For the three and nine months ended September 30, 2023 and 2022, 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 that have not been met at the end of the reporting period or the effect of including such stock-based awards in the computation would be anti-dilutive was 0.9 million and 0.4 million, and 1.0 million and 0.5 million, respectively.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Pay vs Performance Disclosure
Net income	$ 303	$ 283	$ 889	$ 864

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2023
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, 2023. 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, 2022. The balance sheet as of December 31, 2022 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 September 2022, the Financial Accounting Standards Board ("FASB") issued new accounting guidance, Accounting Standards Update ("ASU") 2022-04, Liabilities - Supplier Finance Programs

Revenues by Geography, Concen_2

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations (Tables)	9 Months Ended
	Sep. 30, 2023
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, 2023 and 2022: Three Months Ended September 30, 2023 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 761 $ 1,017 $ 78 $ 1,856 Europe and Africa 519 520 50 1,089 Asia-Pacific 151 585 55 791 Total revenues $ 1,431 $ 2,122 $ 183 $ 3,736 Three Months Ended September 30, 2022 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 746 $ 960 $ 91 $ 1,797 Europe and Africa 503 488 40 1,031 Asia-Pacific 151 531 52 734 Total revenues $ 1,400 $ 1,979 $ 183 $ 3,562 Nine Months Ended September 30, 2023 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 2,268 $ 2,982 $ 228 $ 5,478 Europe and Africa 1,606 1,547 146 3,299 Asia-Pacific 457 1,715 167 2,339 Total revenues $ 4,331 $ 6,244 $ 541 $ 11,116 Nine Months Ended September 30, 2022 (in millions) Technology & Research & Contract Sales & Total Revenues: Americas $ 2,143 $ 2,772 $ 270 $ 5,185 Europe and Africa 1,639 1,527 129 3,295 Asia-Pacific 465 1,564 162 2,191 Total revenues $ 4,247 $ 5,863 $ 561 $ 10,671

Trade Accounts Receivable, Un_2

Trade Accounts Receivable, Unbilled Services and Unearned Income (Tables)	9 Months Ended
	Sep. 30, 2023
Receivables [Abstract]
Schedule of Trade Accounts Receivable and Unbilled Services	Trade accounts receivables and unbilled services consist of the following: (in millions) September 30, 2023 December 31, 2022 Trade accounts receivable $ 1,349 $ 1,329 Unbilled services 1,905 1,624 Trade accounts receivable and unbilled services 3,254 2,953 Allowance for doubtful accounts (27) (36) Trade accounts receivable and unbilled services, net $ 3,227 $ 2,917
Schedule of Net Contract Assets (Liabilities)	Unbilled services and unearned income were as follows: (in millions) September 30, 2023 December 31, 2022 Change Unbilled services $ 1,905 $ 1,624 $ 281 Unearned income (1,838) (1,797) (41) Net balance $ 67 $ (173) $ 240

Goodwill (Tables)

Goodwill (Tables)	9 Months Ended
	Sep. 30, 2023
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, 2023: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2022 $ 11,520 $ 2,247 $ 154 $ 13,921 Business combinations 331 181 — 512 Impact of foreign currency fluctuations and other (139) — (6) (145) Balance as of September 30, 2023 $ 11,712 $ 2,428 $ 148 $ 14,288

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2023
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, 2023 December 31, 2022 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Interest rate swaps Other current assets, other assets and other current liabilities $ 36 $ — $ 1,800 $ 42 $ — $ 1,800 Foreign exchange forward contracts Other current assets and other current liabilities — 4 124 2 2 122 Total derivatives $ 36 $ 4 $ 44 $ 2
Schedule of Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income	The pre-tax 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) 2023 2022 2023 2022 Interest rate swaps $ (1) $ 14 $ (6) $ 69 Foreign exchange forward contracts (9) (5) (4) (12) Total $ (10) $ 9 $ (10) $ 57

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2023
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, 2023: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 130 $ — $ — $ 130 Derivatives — 36 — 36 Total $ 130 $ 36 $ — $ 166 Liabilities: Derivatives $ — $ 4 $ — $ 4 Contingent consideration — — 104 104 Total $ — $ 4 $ 104 $ 108 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 December 31, 2022: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 122 $ — $ — $ 122 Derivatives — 44 — 44 Total $ 122 $ 44 $ — $ 166 Liabilities: Derivatives $ — $ 2 $ — $ 2 Contingent consideration — — 173 173 Total $ — $ 2 $ 173 $ 175
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, 2023: (in millions) Contingent Consideration Balance as of December 31, 2022 $ 173 Business combinations 59 Contingent consideration paid (72) Revaluations included in earnings and foreign currency translation adjustments (56) Balance as of September 30, 2023 $ 104

Credit Arrangements (Tables)

Credit Arrangements (Tables)	9 Months Ended
	Sep. 30, 2023
Debt Disclosure [Abstract]
Summary of Credit Facilities	The following is a summary of the Company’s revolving credit facilities as of September 30, 2023: Facility Interest Rates $2,000 million (revolving credit facility) U.S. Dollar Term SOFR plus a margin of 1.25% plus a 10 basis credit spread adjustment as of September 30, 2023 $110 million (receivables financing facility) U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of September 30, 2023
Summary of Debt	The following table summarizes the Company’s debt at the dates indicated: (dollars in millions) September 30, 2023 December 31, 2022 Revolving Credit Facility due 2026: U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 6.66% $ 250 $ 425 Senior Secured Credit Facilities: Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.66% 1,288 1,343 Term A Loan due 2026—Euribor at average floating rates of 5.22% 298 314 Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.66% 1,172 1,219 Term B Loan due 2024—Euribor at average floating rates of 5.85% 1,157 1,172 Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14% 670 670 Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of 7.14% 861 860 Term B Loan due 2025—Euribor at average floating rates of 5.85% 552 559 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 5.700% Senior Secured Notes due 2028—U.S. Dollar denominated 750 — 6.500% Senior Notes due 2030—U.S. Dollar denominated 500 — 2.875% Senior Notes due 2025—Euro denominated 444 450 2.25% Senior Notes due 2028—Euro denominated 761 771 2.875% Senior Notes due 2028—Euro denominated 752 761 1.750% Senior Notes due 2026—Euro denominated 582 589 2.250% Senior Notes due 2029—Euro denominated 952 964 Receivables financing facility due 2024—U.S. Dollar Term SOFR at average floating rates of 6.33%: Revolving Loan Commitment 110 110 Term Loan 440 440 Principal amount of debt 13,689 12,797 Less: unamortized discount and debt issuance costs (58) (50) Less: current portion (1,309) (152) Long-term debt $ 12,322 $ 12,595
Schedule of Contractual Maturities of Long-term Debt	Contractual maturities of long-term debt as of September 30, 2023 are as follows: (in millions) Remainder of 2023 $ 38 2024 1,859 2025 2,679 2026 3,329 2027 2,069 Thereafter 3,715 $ 13,689

Business Combinations (Tables)

Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Schedule of Recognized Identified Assets Acquired and Liabilities Assumed	The following table provides certain preliminary financial information for these acquisitions: (in millions) September 30, 2023 Assets acquired: Cash and cash equivalents $ 27 Accounts receivable 42 Other assets 9 Goodwill 512 Other identifiable intangibles 416 Liabilities assumed: Other liabilities (38) Deferred income taxes, long-term (17) Net assets acquired (1) $ 951 (1) Net assets acquired includes contingent consideration and deferred purchase price of $66 million.
Finite-Lived and Indefinite-Lived Intangible Assets Acquired as Part of Business Combination	The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired: (in millions) Amortization Period September 30, 2023 Other identifiable intangibles: Customer relationships 10 - 15 years $ 330 Backlog 2 years 51 Software and related assets 5 - 8 years 29 Databases 3 - 5 years 3 Trade names 5 years 3 Total Other identifiable intangibles $ 416

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2023
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 Balance as of December 31, 2022 $ 26 Expense, net of reversals 67 Payments (50) Foreign currency translation and other (1) Balance as of September 30, 2023 $ 42

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive (Loss) Income (Tables)	9 Months Ended
	Sep. 30, 2023
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, 2022 $ (825) $ 44 $ (8) $ 62 $ (727) Other comprehensive (loss) income before reclassifications (158) 45 1 (23) (135) Reclassification adjustments — (55) — 14 (41) Balance as of September 30, 2023 $ (983) $ 34 $ (7) $ 53 $ (903)
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 amounts 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, 2023 2022 2023 2022 Derivative instruments: Interest rate swaps Interest expense $ 17 $ (9) $ 35 $ (16) Foreign exchange forward contracts Revenues (5) 8 20 (2) Total before income taxes 12 (1) 55 (18) Income taxes 3 — 14 (4) Total net of income taxes $ 9 $ (1) $ 41 $ (14)

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2023
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 Nine Months Ended (in millions) 2023 2022 2023 2022 Revenues Technology & Analytics Solutions $ 1,431 $ 1,400 $ 4,331 $ 4,247 Research & Development Solutions 2,122 1,979 6,244 5,863 Contract Sales & Medical Solutions 183 183 541 561 Total revenues 3,736 3,562 11,116 10,671 Cost of revenues, exclusive of depreciation and amortization Technology & Analytics Solutions 859 828 2,593 2,490 Research & Development Solutions 1,410 1,335 4,213 4,005 Contract Sales & Medical Solutions 157 158 461 480 Total cost of revenues, exclusive of depreciation and amortization 2,426 2,321 7,267 6,975 Selling, general and administrative expenses Technology & Analytics Solutions 217 213 652 628 Research & Development Solutions 217 199 640 614 Contract Sales & Medical Solutions 14 17 43 48 General corporate and unallocated 54 88 162 198 Total selling, general and administrative expenses 502 517 1,497 1,488 Segment profit Technology & Analytics Solutions 355 359 1,086 1,129 Research & Development Solutions 495 445 1,391 1,244 Contract Sales & Medical Solutions 12 8 37 33 Total segment profit 862 812 2,514 2,406 General corporate and unallocated (54) (88) (162) (198) Depreciation and amortization (297) (248) (809) (773) Restructuring costs (30) (4) (67) (15) Total income from operations $ 481 $ 472 $ 1,476 $ 1,420

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2023
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table reconciles the basic to diluted weighted average shares outstanding: Three Months Ended September 30, Nine Months Ended September 30, (in millions, except per share data) 2023 2022 2023 2022 Numerator: Net income $ 303 $ 283 $ 889 $ 864 Denominator: Basic weighted average common shares outstanding 182.9 186.5 184.4 188.3 Effect of dilutive stock options and share awards 2.6 2.9 2.5 3.0 Diluted weighted average common shares outstanding 185.5 189.4 186.9 191.3 Earnings per share attributable to common stockholders: Basic $ 1.66 $ 1.52 $ 4.82 $ 4.59 Diluted $ 1.63 $ 1.49 $ 4.76 $ 4.52

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Detail) Employee in Thousands	Sep. 30, 2023 Employee Country
Summary Of Significant Accounting Policies [Line Items]
Number of employees | Employee	87
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, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Disaggregation of Revenue
Total revenues	$ 3,736	$ 3,562	$ 11,116	$ 10,671
Americas
Disaggregation of Revenue
Total revenues	1,856	1,797	5,478	5,185
Europe and Africa
Disaggregation of Revenue
Total revenues	1,089	1,031	3,299	3,295
Asia-Pacific
Disaggregation of Revenue
Total revenues	791	734	2,339	2,191
Technology & Analytics Solutions
Disaggregation of Revenue
Total revenues	1,431	1,400	4,331	4,247
Technology & Analytics Solutions | Americas
Disaggregation of Revenue
Total revenues	761	746	2,268	2,143
Technology & Analytics Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	519	503	1,606	1,639
Technology & Analytics Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	151	151	457	465
Research & Development Solutions
Disaggregation of Revenue
Total revenues	2,122	1,979	6,244	5,863
Research & Development Solutions | Americas
Disaggregation of Revenue
Total revenues	1,017	960	2,982	2,772
Research & Development Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	520	488	1,547	1,527
Research & Development Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	585	531	1,715	1,564
Contract Sales & Medical Solutions
Disaggregation of Revenue
Total revenues	183	183	541	561
Contract Sales & Medical Solutions | Americas
Disaggregation of Revenue
Total revenues	78	91	228	270
Contract Sales & Medical Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	50	40	146	129
Contract Sales & Medical Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	$ 55	$ 52	$ 167	$ 162

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, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
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, 2023 USD ($)
Revenue from Contract with Customer [Abstract]
Revenue expected to be recognized in future from remaining performance obligations	$ 31.3
Percentage of remaining performance obligations on which revenue is expected to be recognized in next twelve months (in percent)	30%
Unearned income recognition period	12 months
Percentage of remaining performance obligations on which revenue is expected to be recognized in next five years (in percent)	85%
Unearned income recognition period	5 years

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, 2023	Dec. 31, 2022
Receivables, Net, Current [Abstract]
Trade accounts receivable	$ 1,349	$ 1,329
Unbilled services	1,905	1,624
Trade accounts receivable and unbilled services	3,254	2,953
Allowance for doubtful accounts	(27)	(36)
Trade accounts receivable and unbilled services, net	$ 3,227	$ 2,917

Trade Accounts Receivable, Un_4

Trade Accounts Receivable, Unbilled Services and Unearned Income - Schedule of Net Contract Assets (Liabilities) (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Unbilled Contracts Receivables
Unbilled services, beginning balance	$ 1,624
Change	281
Unbilled services, ending balance	1,905
Unearned Income
Unearned income, beginning balance	(1,797)
Change	(41)
Unearned income, ending balance	(1,838)
Net change in balance	240
Net balance, beginning balance	$ 67	$ (173)

Trade Accounts Receivable, Un_5

Trade Accounts Receivable, Unbilled Services and Unearned Income - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2023	Sep. 30, 2023	Dec. 31, 2022
Receivables [Abstract]
Unbilled receivables (percentage)	66%	66%	61%
Contract assets (percentage)	34%	34%	39%
Increase in unbilled services		$ 281
Decrease in unearned income		41
Net change in balance		240
Trade accounts receivable	$ 545	$ 545
Cash proceeds from trade accounts	$ 534

Goodwill - Summary of Goodwill

Goodwill - Summary of Goodwill by Reportable Segment (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Goodwill
Beginning balance	$ 13,921
Business combinations	512
Impact of foreign currency fluctuations and other	(145)
Ending balance	14,288
Technology & Analytics Solutions
Goodwill
Beginning balance	11,520
Business combinations	331
Impact of foreign currency fluctuations and other	(139)
Ending balance	11,712
Research & Development Solutions
Goodwill
Beginning balance	2,247
Business combinations	181
Impact of foreign currency fluctuations and other	0
Ending balance	2,428
Contract Sales & Medical Solutions
Goodwill
Beginning balance	154
Business combinations	0
Impact of foreign currency fluctuations and other	(6)
Ending balance	$ 148

Derivatives - Summary of Fair V

Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) - USD ($)	Sep. 30, 2023	Dec. 31, 2022
Derivatives, Fair Value
Assets	$ 36,000,000	$ 44,000,000
Liabilities	4,000,000	2,000,000
Derivatives designated as hedging instruments: | Other current assets and other current liabilities | Foreign exchange forward contracts
Derivatives, Fair Value
Assets	0	2,000,000
Liabilities	4,000,000	2,000,000
Notional	124,000,000	122,000,000
Derivatives designated as hedging instruments: | Other current assets, other assets and other current liabilities | Interest rate swaps
Derivatives, Fair Value
Assets	36,000,000	42,000,000
Liabilities	0	0
Notional	$ 1,800,000,000	$ 1,800,000,000

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, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (10)	$ 9	$ (10)	$ 57
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	30		30
Foreign exchange forward contracts
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	(9)	(5)	(4)	(12)
Interest rate swaps
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (1)	$ 14	$ (6)	$ 69

Derivatives - Additional Inform

Derivatives - Additional Information (Detail) € in Millions, $ in Millions	Sep. 30, 2023 EUR (€)	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)
Derivative Instruments and Hedging Activities Disclosures
Foreign exchange loss related to net investment hedge		$ 69	$ 807
Net Investment Hedging
Derivative Instruments and Hedging Activities Disclosures
Long-term debt	€ 5,199	$ 5,498

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Percentage accrued of maximum consideration payments to become payable	35%
Other identifiable intangibles, net	$ 4,907	$ 4,820
Level 1 and Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value of total debt	13,138	$ 12,281
Level 3 | Fair Value, Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Assets, Fair Value Disclosure	19,387
Cost and equity method investments	192
Goodwill	14,288
Other identifiable intangibles, net	$ 4,907

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Assets:
Marketable securities	$ 108	$ 93
Derivatives	36	44
Recurring Fair Value Measurements
Assets:
Marketable securities	130	122
Derivatives	36	44
Total	166	166
Liabilities:
Derivatives	4	2
Contingent consideration	104	173
Total	108	175
Recurring Fair Value Measurements | Level 1
Assets:
Marketable securities	130	122
Derivatives	0	0
Total	130	122
Liabilities:
Derivatives	0	0
Contingent consideration	0	0
Total	0	0
Recurring Fair Value Measurements | Level 2
Assets:
Marketable securities	0	0
Derivatives	36	44
Total	36	44
Liabilities:
Derivatives	4	2
Contingent consideration	0	0
Total	4	2
Recurring Fair Value Measurements | Level 3
Assets:
Marketable securities	0	0
Derivatives	0	0
Total	0	0
Liabilities:
Derivatives	0	0
Contingent consideration	104	173
Total	$ 104	$ 173

Fair Value Measurements - Chang

Fair Value Measurements - Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Contingent consideration $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation
Beginning balance	$ 173
Business combinations	59
Contingent consideration paid	(72)
Revaluations included in earnings and foreign currency translation adjustments	(56)
Ending balance	$ 104

Credit Arrangements - Summary o

Credit Arrangements - Summary of Credit Facilities (Detail)	9 Months Ended
	Sep. 30, 2023 USD ($)
Revolving Credit Facility | USD Revolving Credit Facility
Line of Credit Facility
Interest rate description	U.S. Dollar Term SOFR plus a margin of 1.25% plus a 10 basis credit spread adjustment as of September 30, 2023
Facility	$ 2,000,000,000
Interest rate spread on base rate	0.10%
Revolving Credit Facility | USD Revolving Credit Facility | SOFR
Line of Credit Facility
Rate	1.25%
Interest rate spread on base rate	0.10%
Facility | Receivables Financing Facility
Line of Credit Facility
Facility	$ 110,000,000
Facility | Receivables Financing Facility | SOFR
Line of Credit Facility
Interest rate description	U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of September 30, 2023
Rate	0.90%
Interest rate spread on base rate	0.11%

Credit Arrangements - Summary_2

Credit Arrangements - Summary of Debt (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Apr. 17, 2023	Dec. 31, 2022
Senior Secured Credit Facilities:
Principal amount of debt	$ 13,689		$ 12,797
Less: unamortized discount and debt issuance costs	(58)		(50)
Less: current portion	(1,309)		(152)
Long-term debt	12,322		12,595
U.S Dollars | Senior Secured Term A Loan, 3.03% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,172		1,219
Average floating rate	6.66%
U.S Dollars | Senior Secured Notes Due 2028, 5.700% | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 750		0
Rate	5.70%
U.S Dollars | Senior Notes Due 2030, 6.500% | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 500		0
Rate	6.50%
U.S Dollars | Term Loan | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 440		440
U.S Dollars | Due in 2024 | Senior Secured Term B Loan, 1.85% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt		$ 500
U.S Dollars | Due in 2024 | Receivable Financing Facilities | SOFR
Senior Secured Credit Facilities:
Average floating rate	6.33%
U.S Dollars | Due in 2025 | Senior Secured Term B Loan, 1.85% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 670		670
Average floating rate	7.14%
U.S Dollars | Due in 2025 | Senior Secured Term B Loan 1.97% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 861		860
Average floating rate	7.14%
U.S Dollars | Due in 2026 | Senior Secured Term A Loan, 1.47% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,288		1,343
Average floating rate	6.66%
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	5%
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	5%
EUR Dollars | Due in 2024 | Senior Secured Term B Loan, 2.00% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,157		1,172
Average floating rate	5.85%
EUR Dollars | Due in 2025 | Senior Secured Term B Loan, 2.00% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 552		559
Average floating rate	5.85%
EUR Dollars | Due in 2025 | 2.875% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 444		450
Rate	2.875%
EUR Dollars | Due in 2026 | Senior Secured Term A Loan, 1.25% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 298		314
Average floating rate	5.22%
EUR Dollars | Due in 2026 | 1.75% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 582		589
Rate	1.75%
EUR Dollars | Due in 2028 | 2.875% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 752		761
Rate	2.875%
EUR Dollars | Due in 2028 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 761		771
Rate	2.25%
EUR Dollars | Due in 2029 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 952		964
Rate	2.25%
Revolving Credit Facility | U.S Dollars | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 250		425
Average floating rate	6.66%
Revolving Credit Facility | U.S Dollars | Revolving Loan Commitment | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 110		$ 110

Credit Arrangements - Contractu

Credit Arrangements - Contractual Maturities of Long-term Debt (Detail) - USD ($) $ in Millions	Sep. 30, 2023	Dec. 31, 2022
Debt Disclosure [Abstract]
Remainder of 2022	$ 38
2024	1,859
2025	2,679
2026	3,329
2027	2,069
Thereafter	3,715
Principal amount of debt	$ 13,689	$ 12,797

Credit Arrangements - Senior Se

Credit Arrangements - Senior Secured Credit Facilities (Detail) - USD ($) $ in Millions	May 23, 2023	Sep. 30, 2023	Apr. 17, 2023	Dec. 31, 2022
Line of Credit Facility
Principal amount of debt		$ 13,689		$ 12,797
SOFR | Revolving Credit Facility | U.S Dollars
Line of Credit Facility
Principal amount of debt		250		425
Senior Secured Term A Loan, 3.03% | SOFR | U.S Dollars
Line of Credit Facility
Principal amount of debt		1,172		1,219
Senior Secured Credit Facilities, Fifth Amended and Restated Credit Agreement
Line of Credit Facility
Aggregate maximum principal amount		7,998
Principal amount		6,248
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit
Line of Credit Facility
Aggregate maximum principal amount		2,000	$ 2,000
Available borrowing capacity		1,745
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit | U.S Dollars
Line of Credit Facility
Principal amount		1,175
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit | U.S. dollars, Euros, Swiss Francs And Other Foreign Currencies
Line of Credit Facility
Principal amount		600
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit | US Dollars And Yen
Line of Credit Facility
Principal amount		225
Senior Secured Term B Loan, 1.85% | SOFR | Due in 2024 | U.S Dollars
Line of Credit Facility
Principal amount of debt			$ 500
Senior Notes Due 2030, 6.500% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt		$ 500		0
Rate		6.50%
Senior Notes Due 2030, 6.500% | Minimum
Line of Credit Facility
Redemption price percentage	0%
Senior Notes Due 2030, 6.500% | Maximum
Line of Credit Facility
Redemption price percentage	3.25%
Senior Notes Due 2030, 6.500% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt	$ 500
Rate	6.50%
Senior Secured Notes Due 2028, 5.700% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt		$ 750		$ 0
Rate		5.70%
Senior Secured Notes Due 2028, 5.700% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt	$ 750
Rate	5.70%

Contingencies - Additional Info

Contingencies - Additional Information (Detail) $ in Millions	Jul. 14, 2020 private_individual	May 24, 2019 medical_doctor	Sep. 11, 2017 medical_doctor	Sep. 11, 2017 private_individual	May 13, 2017 USD ($)	Jul. 23, 2015 private_individual	Feb. 13, 2014 medical_doctor	Feb. 13, 2014 private_individual	Feb. 13, 2014 Defendant
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
Veeva | Minimum
Loss Contingencies
Amount of damages claimed | $					$ 200

Stockholders' Equity (Detail)

Stockholders' Equity (Detail) - USD ($) $ / shares in Units, $ in Millions		3 Months Ended						9 Months Ended
	Jul. 31, 2023	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2023	Dec. 31, 2022
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		$ 145	$ 495	$ 129	$ 150	$ 590	$ 403
Equity Repurchase Under Repurchase Program
Class of Stock
Equity repurchase program authorized amount	$ 11,725
Repurchase of stock (in shares)								3,900,000
Repurchase of stock, value								$ 763
Equity available for repurchase under the repurchase program		$ 2,592						$ 2,592
Equity repurchase program additional authorized amount	$ 2,000

Business Combinations - Schedul

Business Combinations - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2023	Dec. 31, 2022
Assets acquired:
Goodwill	$ 14,288	$ 13,921
Several Individually Immaterial Acquisitions
Assets acquired:
Cash and cash equivalents	27
Accounts receivable	42
Other assets	9
Goodwill	512
Other identifiable intangibles	416
Liabilities assumed:
Other liabilities	(38)
Deferred income taxes, long-term	(17)
Net assets acquired	951
Contingent consideration and deferred payments	$ 66

Business Combinations - Narrati

Business Combinations - Narrative (Details) $ in Millions	Sep. 30, 2023 USD ($)
Several Individually Immaterial Acquisitions
Business Acquisition [Line Items]
Portion of goodwill deductible for income tax purposes	$ 373

Business Combinations - Indefin

Business Combinations - Indefinite-Lived Intangible Assets Acquired as Part of Business Combination (Details) - Several Individually Immaterial Acquisitions $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 416
Customer relationships
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 330
Backlog
Business Acquisition [Line Items]
Amortization Period	2 years
Total Other identifiable intangibles	$ 51
Software and related assets
Business Acquisition [Line Items]
Total Other identifiable intangibles	29
Databases
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 3
Trade names
Business Acquisition [Line Items]
Amortization Period	5 years
Total Other identifiable intangibles	$ 3
Minimum | Customer relationships
Business Acquisition [Line Items]
Amortization Period	10 years
Minimum | Software and related assets
Business Acquisition [Line Items]
Amortization Period	5 years
Minimum | Databases
Business Acquisition [Line Items]
Amortization Period	3 years
Maximum | Customer relationships
Business Acquisition [Line Items]
Amortization Period	15 years
Maximum | Software and related assets
Business Acquisition [Line Items]
Amortization Period	8 years
Maximum | Databases
Business Acquisition [Line Items]
Amortization Period	5 years

Restructuring - Summary of Amou

Restructuring - Summary of Amounts Recorded for Restructuring Plans (Detail) - Severance and Related Costs $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Restructuring Reserve
Restructuring reserves, beginning balance	$ 26
Expense, net of reversals	67
Payments	(50)
Foreign currency translation and other	(1)
Restructuring reserves, ending balance	$ 42

Income Taxes - Narratives (Deta

Income Taxes - Narratives (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Income Tax Disclosure [Abstract]
Effective income tax rate (percent)	14.60%	19.40%	18.70%	19.50%
Tax impact of share-based compensation awards	$ 2	$ 1	$ 12	$ 15

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive (Loss) Income - Summary of Components of AOCI (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2023 USD ($)
Statement of Other Comprehensive Income
Beginning balance	$ 5,765
Ending balance	5,805
Income Taxes
Beginning balance	62
Other comprehensive (loss) income before reclassifications	(23)
Reclassification adjustments	14
Ending balance	53
Other comprehensive (loss) income before reclassifications	(135)
Reclassification adjustments	(41)
Foreign Currency Translation
Statement of Other Comprehensive Income
Beginning balance	(825)
Other comprehensive (loss) income before reclassifications	(158)
Reclassification adjustments	0
Ending balance	(983)
Derivative Instruments
Statement of Other Comprehensive Income
Beginning balance	44
Other comprehensive (loss) income before reclassifications	45
Reclassification adjustments	(55)
Ending balance	34
Defined Benefit Plans
Statement of Other Comprehensive Income
Beginning balance	(8)
Other comprehensive (loss) income before reclassifications	1
Reclassification adjustments	0
Ending balance	(7)
Total
Statement of Other Comprehensive Income
Beginning balance	(727)
Ending balance	$ (903)

Accumulated Other Comprehensi_4

Accumulated Other Comprehensive (Loss) 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, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 12	$ (1)	$ 55	$ (18)
Income taxes	3	0	14	(4)
Total net of income taxes	9	(1)	41	(14)
Interest rate swaps | Interest expense
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	17	(9)	35	(16)
Foreign exchange forward contracts | Revenues
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ (5)	$ 8	$ 20	$ (2)

Segments - Additional Informati

Segments - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2023 Segment
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, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting Information
Revenues	$ 3,736	$ 3,562	$ 11,116	$ 10,671
Cost of revenues, exclusive of depreciation and amortization	2,426	2,321	7,267	6,975
Selling, general and administrative expenses	502	517	1,497	1,488
Segment profit	862	812	2,514	2,406
Depreciation and amortization	(297)	(248)	(809)	(773)
Restructuring costs	(30)	(4)	(67)	(15)
Income from operations	481	472	1,476	1,420
Technology & Analytics Solutions
Segment Reporting Information
Revenues	1,431	1,400	4,331	4,247
Cost of revenues, exclusive of depreciation and amortization	859	828	2,593	2,490
Research & Development Solutions
Segment Reporting Information
Revenues	2,122	1,979	6,244	5,863
Cost of revenues, exclusive of depreciation and amortization	1,410	1,335	4,213	4,005
Contract Sales & Medical Solutions
Segment Reporting Information
Revenues	183	183	541	561
Cost of revenues, exclusive of depreciation and amortization	157	158	461	480
Operating Segments | Technology & Analytics Solutions
Segment Reporting Information
Selling, general and administrative expenses	217	213	652	628
Segment profit	355	359	1,086	1,129
Operating Segments | Research & Development Solutions
Segment Reporting Information
Selling, general and administrative expenses	217	199	640	614
Segment profit	495	445	1,391	1,244
Operating Segments | Contract Sales & Medical Solutions
Segment Reporting Information
Selling, general and administrative expenses	14	17	43	48
Segment profit	12	8	37	33
General corporate and unallocated
Segment Reporting Information
Selling, general and administrative expenses	54	88	162	198
Segment profit	$ (54)	$ (88)	$ (162)	$ (198)

Earnings Per Share - Reconciles

Earnings Per Share - Reconciles the Basic to Diluted Weighted Average Shares Outstanding (Detail) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Net income	$ 303	$ 283	$ 889	$ 864
Denominator:
Basic weighted average common shares outstanding (in shares)	182.9	186.5	184.4	188.3
Effect of dilutive stock options and share awards (in shares)	2.6	2.9	2.5	3
Diluted weighted average common shares outstanding (in shares)	185.5	189.4	186.9	191.3
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 1.66	$ 1.52	$ 4.82	$ 4.59
Diluted (in dollars per share)	$ 1.63	$ 1.49	$ 4.76	$ 4.52

Earnings Per Share - Narrative

Earnings Per Share - Narrative (Details) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Earnings Per Share [Abstract]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	0.9	0.4	1	0.5