IQVIA (IQV) 10-Q 31 Oct 24 2024 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares shares in Millions	9 Months Ended
	Sep. 30, 2024	Oct. 24, 2024
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2024
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		181.5
Current Fiscal Year End Date	--12-31
Entity Central Index Key	0001478242
Amendment Flag	false
Document Fiscal Year Focus	2024
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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Statement [Abstract]
Revenues	$ 3,896	$ 3,736	$ 11,447	$ 11,116
Cost of revenues, exclusive of depreciation and amortization	2,518	2,426	7,450	7,267
Selling, general and administrative expenses	522	502	1,539	1,497
Depreciation and amortization	278	297	811	809
Restructuring costs	28	30	71	67
Income from operations	550	481	1,576	1,476
Interest income	(13)	(14)	(36)	(24)
Interest expense	170	181	499	491
Other expense (income), net	44	(35)	(12)	(77)
Income before income taxes and equity in earnings of unconsolidated affiliates	349	349	1,125	1,086
Income tax expense	65	51	189	203
Income before equity in earnings of unconsolidated affiliates	284	298	936	883
Equity in earnings of unconsolidated affiliates	1	5	0	6
Net income	285	303	936	889
Net Income (Loss) Attributable to Parent, Total	$ 285	$ 303	$ 936	$ 889
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 1.57	$ 1.66	$ 5.14	$ 4.82
Diluted (in dollars per share)	$ 1.55	$ 1.63	$ 5.08	$ 4.76
Weighted average common shares outstanding:
Basic (in shares)	182.1	182.9	182.1	184.4
Diluted (in shares)	184.2	185.5	184.3	186.9

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Comprehensive Income [Abstract]
Net income	$ 285	$ 303	$ 936	$ 889
Comprehensive income adjustments:
Unrealized (losses) gains on derivative instruments, net of income tax (benefit) expense of $(14),$—,$2,$11	(41)	2	8	34
Defined benefit plan adjustments, net of income tax expense of $—, $—,$—,$—	(1)	0	(1)	1
Foreign currency translation, net of income tax (benefit) expense of $(37),$44,$13,$12	173	(136)	62	(170)
Reclassification adjustments:
Reclassifications on derivative instruments included in net income, net of income tax (expense) of $(3),$(3),$(10),$(14)	(8)	(9)	(28)	(41)
Comprehensive income	$ 408	$ 160	$ 977	$ 713

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Statement of Comprehensive Income [Abstract]
Unrealized (losses) gains on derivative instruments, income tax (benefit) expense	$ (14)	$ 0	$ 2	$ 11
Defined benefit plan adjustments, income tax (benefit) expense	0	0	0	0
Foreign currency translation, income tax expense (benefit)	(37)	44	13	12
Income taxes	$ (3)	$ (3)	$ (10)	$ (14)

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Current assets:
Cash and cash equivalents	$ 1,572	$ 1,376
Trade accounts receivable and unbilled services, net	3,196	3,381
Prepaid expenses	195	141
Income taxes receivable	54	32
Investments in debt, equity and other securities	140	120
Other current assets and receivables	475	546
Total current assets	5,632	5,596
Property and equipment, net	513	523
Operating lease right-of-use assets	259	296
Investments in debt, equity and other securities	117	105
Investments in unconsolidated affiliates	203	134
Goodwill	15,091	14,567
Other identifiable intangibles, net	4,734	4,839
Deferred income taxes	164	166
Deposits and other assets, net	467	455
Total assets	27,180	26,681
Current liabilities:
Accounts payable and accrued expenses	3,434	3,564
Unearned income	1,824	1,799
Income taxes payable	161	116
Current portion of long-term debt	1,219	718
Other current liabilities	354	294
Total current liabilities	6,992	6,491
Long-term debt, less current portion	12,293	12,955
Deferred income taxes	128	202
Operating lease liabilities	188	223
Other liabilities	612	698
Total liabilities	20,213	20,569
Commitments and contingencies (Note 8)
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of September 30, 2024 and December 31, 2023, $0.01 par value, 258.1 shares issued and 181.6 shares outstanding as of September 30, 2024; 257.2 shares issued and 181.5 shares outstanding as of December 31, 2023	11,106	11,028
Retained earnings	5,628	4,692
Treasury stock, at cost, 76.5 and 75.7 shares as of September 30, 2024 and December 31, 2023, respectively	(8,941)	(8,741)
Accumulated other comprehensive loss	(826)	(867)
Total stockholders’ equity	6,967	6,112
Total liabilities and stockholders’ equity	$ 27,180	$ 26,681

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares shares in Millions	Sep. 30, 2024	Dec. 31, 2023
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)	258.1	257.2
Common stock, shares outstanding (in shares)	181.6	181.5
Treasury stock, shares (in shares)	76.5	75.7

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Operating activities:
Net income	$ 936	$ 889
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	811	809
Amortization of debt issuance costs and discount	16	13
Stock-based compensation	158	172
Earnings from unconsolidated affiliates	0	(6)
Gain on investments, net	(29)	(5)
Benefit from deferred income taxes	(114)	(117)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income	259	(241)
Change in other operating assets and liabilities	(206)	(112)
Net cash provided by operating activities	1,831	1,402
Investing activities:
Acquisition of property, equipment and software	(438)	(470)
Acquisition of businesses, net of cash acquired	(649)	(869)
Purchases of marketable securities, net	0	(4)
Investments in unconsolidated affiliates, net of payments received	(68)	(16)
Investments in debt and equity securities	(2)	(36)
Proceeds from sale of property, equipment and software	25	0
Other	(2)	4
Net cash used in investing activities	(1,134)	(1,391)
Financing activities:
Proceeds from issuance of debt	0	1,250
Payment of debt issuance costs	0	(19)
Repayment of debt and principal payments on finance leases	(130)	(118)
Proceeds from revolving credit facility	685	2,009
Repayment of revolving credit facility	(785)	(2,184)
Payments related to employee stock incentive plans	(61)	(58)
Repurchase of common stock	(200)	(763)
Contingent consideration and deferred purchase price payments	(12)	(79)
Net cash (used in) provided by financing activities	(503)	38
Effect of foreign currency exchange rate changes on cash	2	(41)
Increase in cash and cash equivalents	196	8
Cash and cash equivalents at beginning of period	1,376	1,216
Cash and cash equivalents at end of period	$ 1,572	$ 1,224

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, 2022		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 $—, $—,$—,$—	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		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 $—, $—,$—,$—	1
Foreign currency translation, net of tax	(170)
Ending balance (in shares) at Sep. 30, 2023		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 $—, $—,$—,$—	0
Foreign currency translation, net of tax	(136)					(136)
Reclassification adjustments, net of tax	(9)					(9)
Ending balance (in shares) at Sep. 30, 2023		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 Dec. 31, 2023	181.5	257.2	75.7
Beginning balance at Dec. 31, 2023	$ 6,112	$ 3	$ (8,741)	11,025	4,692	(867)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.7
Issuance of common stock	(61)			(61)
Stock-based compensation	49			49
Net income	288				288
Unrealized gains on derivative instruments, net of tax	34					34
Foreign currency translation, net of tax	(69)					(69)
Reclassification adjustments, net of tax	(9)					(9)
Ending balance (in shares) at Mar. 31, 2024		257.9	75.7
Ending balance at Mar. 31, 2024	$ 6,344	$ 3	$ (8,741)	11,013	4,980	(911)
Beginning balance (in shares) at Dec. 31, 2023	181.5	257.2	75.7
Beginning balance at Dec. 31, 2023	$ 6,112	$ 3	$ (8,741)	11,025	4,692	(867)
Increase (Decrease) in Stockholders' Equity
Net income	936
Unrealized gains on derivative instruments, net of tax	8
Defined benefit plan adjustments, net of income tax expense of $—, $—,$—,$—	(1)
Foreign currency translation, net of tax	$ 62
Ending balance (in shares) at Sep. 30, 2024	181.6	258.1	76.5
Ending balance at Sep. 30, 2024	$ 6,967	$ 3	$ (8,941)	11,103	5,628	(826)
Beginning balance (in shares) at Mar. 31, 2024		257.9	75.7
Beginning balance at Mar. 31, 2024	6,344	$ 3	$ (8,741)	11,013	4,980	(911)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	(1)			(1)
Stock-based compensation	44			44
Net income	363				363
Unrealized gains on derivative instruments, net of tax	15					15
Foreign currency translation, net of tax	(42)					(42)
Reclassification adjustments, net of tax	(11)					(11)
Ending balance (in shares) at Jun. 30, 2024		258	75.7
Ending balance at Jun. 30, 2024	6,714	$ 3	$ (8,741)	11,058	5,343	(949)
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.1
Issuance of common stock	1			1
Repurchase of common stock (in shares)			(0.8)
Repurchase of common stock	(200)		$ (200)
Stock-based compensation	46			46
Net income	285				285
Unrealized gains on derivative instruments, net of tax	(41)					(41)
Defined benefit plan adjustments, net of income tax expense of $—, $—,$—,$—	(1)					(1)
Foreign currency translation, net of tax	173					173
Reclassification adjustments, net of tax	$ (8)					(8)
Ending balance (in shares) at Sep. 30, 2024	181.6	258.1	76.5
Ending balance at Sep. 30, 2024	$ 6,967	$ 3	$ (8,941)	$ 11,103	$ 5,628	$ (826)

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2024
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 clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. With approximately 88,000 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, 2024. 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, 2023. The balance sheet as of December 31, 2023 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 issued but not adopted as of September 30, 2024 In November 2023, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures , to improve reportable segment disclosure requirements. The new guidance requires disclosure of significant segment expenses that are regularly provided to the chief operating decision maker and included in the reported measure of segment profit or loss. It does not change the definition of a segment or the guidance for determining reportable segments. The new guidance is effective for the Company in the annual period beginning January 1, 2024 and in 2025 for interim periods. Adoption of this ASU will result in additional disclosure, but it will not impact the Company’s consolidated financial position, results of operations or cash flows. In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures , to enhance the transparency and decision usefulness of income tax disclosures. The amendments in this ASU require additional disclosures about income taxes, primarily focused on the disclosure of income taxes paid and the rate reconciliation table. The new guidance will be effective for the Company in the annual period beginning January 1, 2025. The Company is assessing the impacts of this ASU on its disclosures within the consolidated financial statements.

Revenues by Geography, Concentr

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations	9 Months Ended
	Sep. 30, 2024
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, 2024 and 2023: Three Months Ended September 30, 2024 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 797 $ 969 $ 72 $ 1,838 Europe and Africa 626 607 54 1,287 Asia-Pacific 131 586 54 771 Total revenues $ 1,554 $ 2,162 $ 180 $ 3,896 Three Months Ended September 30, 2023 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions 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 Nine Months Ended September 30, 2024 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 2,323 $ 2,969 $ 211 $ 5,503 Europe and Africa 1,757 1,699 166 3,622 Asia-Pacific 422 1,736 164 2,322 Total revenues $ 4,502 $ 6,404 $ 541 $ 11,447 Nine Months Ended September 30, 2023 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions 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 No individual customer represented 10% or more of consolidated revenues for the three and nine months ended September 30, 2024 or 2023. Transaction Price Allocated to the Remaining Performance Obligations

Trade Accounts Receivable, Unbi

Trade Accounts Receivable, Unbilled Services and Unearned Income	9 Months Ended
	Sep. 30, 2024
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, 2024 December 31, 2023 Trade accounts receivable $ 1,176 $ 1,473 Unbilled services 2,061 1,942 Trade accounts receivable and unbilled services 3,237 3,415 Allowance for doubtful accounts (41) (34) Trade accounts receivable and unbilled services, net $ 3,196 $ 3,381 Unbilled services and unearned income were as follows: (in millions) September 30, 2024 December 31, 2023 Change Unbilled services $ 2,061 $ 1,942 $ 119 Unearned income (1,824) (1,799) (25) Net balance $ 237 $ 143 $ 94 Unbilled services, which is comprised of approximately 67% and 68% of unbilled receivables and 33% and 32% of contract assets as of September 30, 2024 and December 31, 2023, respectively, increased by $119 million as compared to December 31, 2023. 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 $25 million over the same period resulting in an increase of $94 million in the net balance of unbilled services and unearned income between September 30, 2024 and December 31, 2023. 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, 2024. Bad debt expense recognized on the Company’s trade accounts receivable was immaterial for the three and nine months ended September 30, 2024 and 2023. 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, 2024, through its accounts receivable factoring arrangements that the Company utilizes most frequently, the Company factored approximately $531 million of customer invoices on a non-recourse basis and received approximately $520 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, 2024
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, 2024: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2023 $ 11,976 $ 2,439 $ 152 $ 14,567 Business combinations 289 181 — 470 Impact of foreign currency fluctuations and other 49 5 — 54 Balance as of September 30, 2024 $ 12,314 $ 2,625 $ 152 $ 15,091

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2024
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, 2024 December 31, 2023 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Interest rate swaps Other current assets, other assets and other current liabilities $ — $ 70 $ 2,489 $ 13 $ 51 $ 3,300 Cross-currency swaps Other current liabilities — 102 2,739 — 108 2,750 Foreign exchange forward contracts Other current assets and other current liabilities 6 — 118 2 — 121 Total derivatives $ 6 $ 172 $ 15 $ 159 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) 2024 2023 2024 2023 Interest rate swaps $ (70) $ (1) $ (32) $ (6) Foreign exchange forward contracts 4 (9) 4 (4) Total $ (66) $ (10) $ (28) $ (10) The Company expects approximately $21 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, 2024 to be reclassified into earnings within the next twelve months. For the three and nine months ended September 30, 2024 and 2023, the total amount, net of income taxes, of the cash flow hedge effect on the accompanying condensed consolidated statements of income was $8 million and $9 million, and $28 million and $41 million, respectively. As of September 30, 2024, the Company's cross-currency swaps were designated as a hedge of its net investment in certain foreign subsidiaries. For the three and nine months ended September 30, 2024, the Company recorded a $(101) million loss and $6 million gain, respectively, within AOCI as a result of these cross-currency swaps. The Company recognized approximately $8 million and $26 million related to the excluded component as a reduction of interest expense for the three and nine months ended September 30, 2024, respectively. As of September 30, 2024, the portion of 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 €2,564 million ($2,862 million). The amount of foreign exchange (losses) gains related to the net investment hedge included in the cumulative translation adjustment component of AOCI for the three and nine months ended September 30, 2024 and 2023 was $(114) million, $(26) million, $161 million, and $69 million, respectively.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2024
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, 2024 and December 31, 2023 due to their short-term nature. As of September 30, 2024 and December 31, 2023, the fair value of total debt was $13,547 million and $13,597 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, 2024: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 173 $ — $ — $ 173 Derivatives — 6 — 6 Total $ 173 $ 6 $ — $ 179 Liabilities: Derivatives $ — $ 172 $ — $ 172 Contingent consideration — — 94 94 Total $ — $ 172 $ 94 $ 266 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, 2023: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 146 $ — $ — $ 146 Derivatives — 15 — 15 Total $ 146 $ 15 $ — $ 161 Liabilities: Derivatives $ — $ 159 $ — $ 159 Contingent consideration — — 106 106 Total $ — $ 159 $ 106 $ 265 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, interest rate swaps, and cross-currency 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. The fair value of the cross-currency swaps is the estimated amount that the Company would receive or pay to terminate such agreements, taking into account the effective interest rates, foreign exchange rates and the remaining time to maturities. 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 (revenues 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, 2024, the Company has accrued approximately 29% 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, 2024: (in millions) Contingent Consideration Balance as of December 31, 2023 $ 106 Business combinations 55 Contingent consideration paid (10) Revaluations included in earnings and foreign currency translation adjustments (57) Balance as of September 30, 2024 $ 94 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 expense (income), 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, 2024
Debt Disclosure [Abstract]
Credit Arrangements	Credit Arrangements The following is a summary of the Company’s revolving credit facilities as of September 30, 2024: 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, 2024 $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, 2024 The following table summarizes the Company’s debt at the dates indicated: (dollars in millions) September 30, 2024 December 31, 2023 Revolving Credit Facility due 2026: U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of —% $ — $ 100 Senior Secured Credit Facilities: Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.20% 1,216 1,270 Term A Loan due 2026—Euribor at average floating rates of 4.60% 296 306 Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.41% 1,109 1,156 Term B Loan due 2025—Euribor at average floating rates of 5.35% 583 576 Term B Loan due 2031—U.S. Dollar Term SOFR at average floating rates of 6.60% 1,489 1,500 5.700% Senior Secured Notes due 2028—U.S. Dollar denominated 750 750 6.250% Senior Secured Notes due 2029—U.S. Dollar denominated 1,250 1,250 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 6.500% Senior Notes due 2030—U.S. Dollar denominated 500 500 2.875% Senior Notes due 2025—Euro denominated 469 464 2.25% Senior Notes due 2028—Euro denominated 804 795 2.875% Senior Notes due 2028—Euro denominated 793 785 1.750% Senior Notes due 2026—Euro denominated 614 607 2.250% Senior Notes due 2029—Euro denominated 1,005 993 Receivables financing facility due 2027—U.S. Dollar Term SOFR at average floating rates of 6.22%: Revolving Loan Commitment 110 110 Term Loan 440 440 Principal amount of debt 13,578 13,752 Less: unamortized discount and debt issuance costs (66) (79) Less: current portion (1,219) (718) Long-term debt $ 12,293 $ 12,955 Contractual maturities of long-term debt as of September 30, 2024 are as follows: (in millions) Remainder of 2024 $ 42 2025 1,219 2026 3,141 2027 2,634 2028 2,362 Thereafter 4,180 $ 13,578 Senior Secured Credit Facilities As of September 30, 2024, the Company’s Fifth Amended and Restated Credit Agreement provided financing through several senior secured credit facilities of up to $6,688 million, which consisted of $4,693 million principal amounts of debt outstanding (as detailed in the table above), and $1,995 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. Receivables Financing Facility On October 1, 2024, the Company amended its receivables financing facility to extend the term of the $550 million facility to October 1, 2027. Under the receivables financing facility, certain of the Company's accounts receivable are sold on a non-recourse basis by certain of its consolidated subsidiaries (each, an “Originator”) to another of its consolidated subsidiaries, a bankruptcy-remote special purpose entity (the “SPE”). The SPE obtained a term loan and revolving loan commitment from third-party lenders, secured by liens on the assets of the SPE, to finance the purchase of the accounts receivable, which includes a $440 million term loan and a $110 million revolving loan commitment. As of September 30, 2024, no additional amounts of revolving loans were available under the receivables financing facility. Restrictive Covenants

Contingencies

Contingencies	9 Months Ended
	Sep. 30, 2024
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 Protection 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. On July 11, 2024, the Supreme Court dismissed plaintiffs’ appeal. The Supreme Court's decision in favor of IMS Korea is final and conclusive. 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 PIPA. 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 appealed to the Supreme Court. On July 11, 2024, the Supreme Court dismissed the appeal by the Prosecutor’s Office. The Supreme Court's decision in favor of IMS Korea is final and conclusive. 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. Trial has been scheduled for early 2025. 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 under privilege 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 appealed the Order. On March 30, 2024, the Court denied Veeva’s appeal with regard to its rejected privilege claims, while reserving ruling on the appropriate sanctions to be imposed for a later time.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2024
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, 2024 or December 31, 2023. Equity Repurchase Program

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [Abstract]
Business Combinations	Business Combinations The Company completed several individually immaterial acquisitions during the nine months ended September 30, 2024. 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, largely related to acquired intangible assets and related deferred taxes, 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, 2024 Assets acquired: Cash and cash equivalents $ 23 Accounts receivable 49 Other assets 51 Goodwill 470 Other identifiable intangibles 266 Liabilities assumed: Other liabilities (88) Deferred income taxes, long-term (37) Net assets acquired (1) $ 734 (1) Net assets acquired includes contingent consideration and deferred purchase price of $62 million. The portion of goodwill deductible for income tax purposes was preliminarily assessed as $297 million. The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired: (in millions) Amortization Period September 30, 2024 Other identifiable intangibles: Customer relationships 10 - 16 years $ 222 Backlog 1 - 4 years 27 Trade names 5 years 6 Software and related assets 3 - 5 years 6 Non-compete agreements 3 - 5 years 3 Databases 5 years 2 Total Other identifiable intangibles $ 266

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2024
Restructuring and Related Activities [Abstract]
Restructuring	Restructuring The Company has continued to take restructuring actions in 2024 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 2024 and into 2025. The following amounts were recorded for the restructuring plans: (in millions) Severance and Related Costs Balance as of December 31, 2023 $ 36 Expense, net of reversals 71 Payments (62) Foreign currency translation and other 1 Balance as of September 30, 2024 $ 46 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, 2024 will be paid in 2024 and 2025.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2024
Income Tax Disclosure [Abstract]
Income Taxes	Income Taxes The Company's effective income tax rate was 18.6% and 14.6% in the third quarter of 2024 and 2023, and 16.8% and 18.7% in the first nine months of 2024 and 2023, respectively. The effective income tax rate in the third quarter and in the first nine months of 2024 was favorably impacted due to changes in the geographical mix of earnings amongst the United States and foreign tax jurisdictions. 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. The effective income tax rate in the third quarter and in the first nine months of 2024 and 2023 was also favorably impacted as a result of excess tax benefits recognized upon settlement of share-based compensation awards. For both the third quarter of 2024 and 2023 this impact was $2 million, and for the first nine months of 2024 and 2023 this impact was $14 million and $12 million, respectively.

Accumulated Other Comprehensive

Accumulated Other Comprehensive (Loss) Income	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Accumulated Other Comprehensive (Loss) Income	Accumulated Other Comprehensive (Loss) Income Below is a summary of the components of AOCI: (in millions) Foreign Currency Translation Derivative Instruments Defined Benefit Plans Income Taxes Total Balance as of December 31, 2023 $ (969) $ (34) $ 3 $ 133 $ (867) Other comprehensive income (loss) before reclassifications 75 10 (1) (15) 69 Reclassification adjustments — (38) — 10 (28) Balance as of September 30, 2024 $ (894) $ (62) $ 2 $ 128 $ (826) 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 Line Item Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Derivative instruments: Interest rate swaps Interest expense $ 8 $ 17 $ 38 $ 35 Foreign exchange forward contracts Revenues 3 (5) — 20 Total before income taxes 11 12 38 55 Income taxes 3 3 10 14 Total net of income taxes $ 8 $ 9 $ 28 $ 41

Segments

Segments	9 Months Ended
	Sep. 30, 2024
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 restructuring costs, 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 September 30, Nine Months Ended September 30, (in millions) 2024 2023 2024 2023 Revenues Technology & Analytics Solutions $ 1,554 $ 1,431 $ 4,502 $ 4,331 Research & Development Solutions 2,162 2,122 6,404 6,244 Contract Sales & Medical Solutions 180 183 541 541 Total revenues 3,896 3,736 11,447 11,116 Cost of revenues, exclusive of depreciation and amortization Technology & Analytics Solutions 922 859 2,720 2,593 Research & Development Solutions 1,442 1,410 4,268 4,213 Contract Sales & Medical Solutions 154 157 462 461 Total cost of revenues, exclusive of depreciation and amortization 2,518 2,426 7,450 7,267 Selling, general and administrative expenses Technology & Analytics Solutions 227 217 681 652 Research & Development Solutions 222 217 666 640 Contract Sales & Medical Solutions 14 14 45 43 General corporate and unallocated 59 54 147 162 Total selling, general and administrative expenses 522 502 1,539 1,497 Segment profit Technology & Analytics Solutions 405 355 1,101 1,086 Research & Development Solutions 498 495 1,470 1,391 Contract Sales & Medical Solutions 12 12 34 37 Total segment profit 915 862 2,605 2,514 General corporate and unallocated (59) (54) (147) (162) Depreciation and amortization (278) (297) (811) (809) Restructuring costs (28) (30) (71) (67) Total income from operations $ 550 $ 481 $ 1,576 $ 1,476

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The following table presents the computation of basic and diluted earnings per share: Three Months Ended September 30, Nine Months Ended September 30, (in millions, except per share data) 2024 2023 2024 2023 Numerator: Net income $ 285 $ 303 $ 936 $ 889 Denominator: Basic weighted average common shares outstanding 182.1 182.9 182.1 184.4 Effect of dilutive stock options and share awards 2.1 2.6 2.2 2.5 Diluted weighted average common shares outstanding 184.2 185.5 184.3 186.9 Earnings per share attributable to common stockholders: Basic $ 1.57 $ 1.66 $ 5.14 $ 4.82 Diluted $ 1.55 $ 1.63 $ 5.08 $ 4.76 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, 2024 and 2023, 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 1.0 million and 0.9 million, and 1.0 million and 1.0 million, respectively.

Pay vs Performance Disclosure

Pay vs Performance Disclosure - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Pay vs Performance Disclosure
Net income	$ 285	$ 303	$ 936	$ 889

Insider Trading Arrangements

Insider Trading Arrangements	3 Months Ended
	Sep. 30, 2024
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, 2024
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, 2024. 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, 2023. The balance sheet as of December 31, 2023 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

Revenues by Geography, Concen_2

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024 and 2023: Three Months Ended September 30, 2024 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 797 $ 969 $ 72 $ 1,838 Europe and Africa 626 607 54 1,287 Asia-Pacific 131 586 54 771 Total revenues $ 1,554 $ 2,162 $ 180 $ 3,896 Three Months Ended September 30, 2023 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions 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 Nine Months Ended September 30, 2024 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 2,323 $ 2,969 $ 211 $ 5,503 Europe and Africa 1,757 1,699 166 3,622 Asia-Pacific 422 1,736 164 2,322 Total revenues $ 4,502 $ 6,404 $ 541 $ 11,447 Nine Months Ended September 30, 2023 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions 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

Trade Accounts Receivable, Un_2

Trade Accounts Receivable, Unbilled Services and Unearned Income (Tables)	9 Months Ended
	Sep. 30, 2024
Receivables [Abstract]
Schedule of Trade Accounts Receivable and Unbilled Services	Trade accounts receivables and unbilled services consist of the following: (in millions) September 30, 2024 December 31, 2023 Trade accounts receivable $ 1,176 $ 1,473 Unbilled services 2,061 1,942 Trade accounts receivable and unbilled services 3,237 3,415 Allowance for doubtful accounts (41) (34) Trade accounts receivable and unbilled services, net $ 3,196 $ 3,381
Schedule of Net Contract Assets (Liabilities)	Unbilled services and unearned income were as follows: (in millions) September 30, 2024 December 31, 2023 Change Unbilled services $ 2,061 $ 1,942 $ 119 Unearned income (1,824) (1,799) (25) Net balance $ 237 $ 143 $ 94

Goodwill (Tables)

Goodwill (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2023 $ 11,976 $ 2,439 $ 152 $ 14,567 Business combinations 289 181 — 470 Impact of foreign currency fluctuations and other 49 5 — 54 Balance as of September 30, 2024 $ 12,314 $ 2,625 $ 152 $ 15,091

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024 December 31, 2023 Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Interest rate swaps Other current assets, other assets and other current liabilities $ — $ 70 $ 2,489 $ 13 $ 51 $ 3,300 Cross-currency swaps Other current liabilities — 102 2,739 — 108 2,750 Foreign exchange forward contracts Other current assets and other current liabilities 6 — 118 2 — 121 Total derivatives $ 6 $ 172 $ 15 $ 159
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) 2024 2023 2024 2023 Interest rate swaps $ (70) $ (1) $ (32) $ (6) Foreign exchange forward contracts 4 (9) 4 (4) Total $ (66) $ (10) $ (28) $ (10)

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2024
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, 2024: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 173 $ — $ — $ 173 Derivatives — 6 — 6 Total $ 173 $ 6 $ — $ 179 Liabilities: Derivatives $ — $ 172 $ — $ 172 Contingent consideration — — 94 94 Total $ — $ 172 $ 94 $ 266 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, 2023: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 146 $ — $ — $ 146 Derivatives — 15 — 15 Total $ 146 $ 15 $ — $ 161 Liabilities: Derivatives $ — $ 159 $ — $ 159 Contingent consideration — — 106 106 Total $ — $ 159 $ 106 $ 265
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, 2024: (in millions) Contingent Consideration Balance as of December 31, 2023 $ 106 Business combinations 55 Contingent consideration paid (10) Revaluations included in earnings and foreign currency translation adjustments (57) Balance as of September 30, 2024 $ 94

Credit Arrangements (Tables)

Credit Arrangements (Tables)	9 Months Ended
	Sep. 30, 2024
Debt Disclosure [Abstract]
Summary of Credit Facilities	The following is a summary of the Company’s revolving credit facilities as of September 30, 2024: 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, 2024 $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, 2024
Summary of Debt	The following table summarizes the Company’s debt at the dates indicated: (dollars in millions) September 30, 2024 December 31, 2023 Revolving Credit Facility due 2026: U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of —% $ — $ 100 Senior Secured Credit Facilities: Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.20% 1,216 1,270 Term A Loan due 2026—Euribor at average floating rates of 4.60% 296 306 Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.41% 1,109 1,156 Term B Loan due 2025—Euribor at average floating rates of 5.35% 583 576 Term B Loan due 2031—U.S. Dollar Term SOFR at average floating rates of 6.60% 1,489 1,500 5.700% Senior Secured Notes due 2028—U.S. Dollar denominated 750 750 6.250% Senior Secured Notes due 2029—U.S. Dollar denominated 1,250 1,250 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 6.500% Senior Notes due 2030—U.S. Dollar denominated 500 500 2.875% Senior Notes due 2025—Euro denominated 469 464 2.25% Senior Notes due 2028—Euro denominated 804 795 2.875% Senior Notes due 2028—Euro denominated 793 785 1.750% Senior Notes due 2026—Euro denominated 614 607 2.250% Senior Notes due 2029—Euro denominated 1,005 993 Receivables financing facility due 2027—U.S. Dollar Term SOFR at average floating rates of 6.22%: Revolving Loan Commitment 110 110 Term Loan 440 440 Principal amount of debt 13,578 13,752 Less: unamortized discount and debt issuance costs (66) (79) Less: current portion (1,219) (718) Long-term debt $ 12,293 $ 12,955
Schedule of Contractual Maturities of Long-term Debt	Contractual maturities of long-term debt as of September 30, 2024 are as follows: (in millions) Remainder of 2024 $ 42 2025 1,219 2026 3,141 2027 2,634 2028 2,362 Thereafter 4,180 $ 13,578

Business Combinations (Tables)

Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2024
Business Combination, Asset Acquisition, and Joint Venture Formation [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, 2024 Assets acquired: Cash and cash equivalents $ 23 Accounts receivable 49 Other assets 51 Goodwill 470 Other identifiable intangibles 266 Liabilities assumed: Other liabilities (88) Deferred income taxes, long-term (37) Net assets acquired (1) $ 734 (1) Net assets acquired includes contingent consideration and deferred purchase price of $62 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, 2024 Other identifiable intangibles: Customer relationships 10 - 16 years $ 222 Backlog 1 - 4 years 27 Trade names 5 years 6 Software and related assets 3 - 5 years 6 Non-compete agreements 3 - 5 years 3 Databases 5 years 2 Total Other identifiable intangibles $ 266

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2024
Restructuring and Related Activities [Abstract]
Summary of Amounts Recorded for Restructuring Plans	The following amounts were recorded for the restructuring plans: (in millions) Severance and Related Costs Balance as of December 31, 2023 $ 36 Expense, net of reversals 71 Payments (62) Foreign currency translation and other 1 Balance as of September 30, 2024 $ 46

Accumulated Other Comprehensi_2

Accumulated Other Comprehensive (Loss) Income (Tables)	9 Months Ended
	Sep. 30, 2024
Equity [Abstract]
Summary of Components of AOCI	Below is a summary of the components of AOCI: (in millions) Foreign Currency Translation Derivative Instruments Defined Benefit Plans Income Taxes Total Balance as of December 31, 2023 $ (969) $ (34) $ 3 $ 133 $ (867) Other comprehensive income (loss) before reclassifications 75 10 (1) (15) 69 Reclassification adjustments — (38) — 10 (28) Balance as of September 30, 2024 $ (894) $ (62) $ 2 $ 128 $ (826)
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 Line Item Three Months Ended September 30, Nine Months Ended September 30, 2024 2023 2024 2023 Derivative instruments: Interest rate swaps Interest expense $ 8 $ 17 $ 38 $ 35 Foreign exchange forward contracts Revenues 3 (5) — 20 Total before income taxes 11 12 38 55 Income taxes 3 3 10 14 Total net of income taxes $ 8 $ 9 $ 28 $ 41

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2024
Segment Reporting [Abstract]
Reconciliation of Revenues and Income from Segments to Consolidated	Asset information by segment is not presented, as this measure is not used by the chief operating decision maker to assess the Company’s performance. The Company’s reportable segment information is presented below: Three Months Ended September 30, Nine Months Ended September 30, (in millions) 2024 2023 2024 2023 Revenues Technology & Analytics Solutions $ 1,554 $ 1,431 $ 4,502 $ 4,331 Research & Development Solutions 2,162 2,122 6,404 6,244 Contract Sales & Medical Solutions 180 183 541 541 Total revenues 3,896 3,736 11,447 11,116 Cost of revenues, exclusive of depreciation and amortization Technology & Analytics Solutions 922 859 2,720 2,593 Research & Development Solutions 1,442 1,410 4,268 4,213 Contract Sales & Medical Solutions 154 157 462 461 Total cost of revenues, exclusive of depreciation and amortization 2,518 2,426 7,450 7,267 Selling, general and administrative expenses Technology & Analytics Solutions 227 217 681 652 Research & Development Solutions 222 217 666 640 Contract Sales & Medical Solutions 14 14 45 43 General corporate and unallocated 59 54 147 162 Total selling, general and administrative expenses 522 502 1,539 1,497 Segment profit Technology & Analytics Solutions 405 355 1,101 1,086 Research & Development Solutions 498 495 1,470 1,391 Contract Sales & Medical Solutions 12 12 34 37 Total segment profit 915 862 2,605 2,514 General corporate and unallocated (59) (54) (147) (162) Depreciation and amortization (278) (297) (811) (809) Restructuring costs (28) (30) (71) (67) Total income from operations $ 550 $ 481 $ 1,576 $ 1,476

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2024
Earnings Per Share [Abstract]
Schedule of Earnings Per Share, Basic and Diluted	The following table presents the computation of basic and diluted earnings per share: Three Months Ended September 30, Nine Months Ended September 30, (in millions, except per share data) 2024 2023 2024 2023 Numerator: Net income $ 285 $ 303 $ 936 $ 889 Denominator: Basic weighted average common shares outstanding 182.1 182.9 182.1 184.4 Effect of dilutive stock options and share awards 2.1 2.6 2.2 2.5 Diluted weighted average common shares outstanding 184.2 185.5 184.3 186.9 Earnings per share attributable to common stockholders: Basic $ 1.57 $ 1.66 $ 5.14 $ 4.82 Diluted $ 1.55 $ 1.63 $ 5.08 $ 4.76

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Detail) Employee in Thousands	Sep. 30, 2024 Employee Country
Summary Of Significant Accounting Policies [Line Items]
Number of employees | Employee	88
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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Disaggregation of Revenue
Total revenues	$ 3,896	$ 3,736	$ 11,447	$ 11,116
Americas
Disaggregation of Revenue
Total revenues	1,838	1,856	5,503	5,478
Europe and Africa
Disaggregation of Revenue
Total revenues	1,287	1,089	3,622	3,299
Asia-Pacific
Disaggregation of Revenue
Total revenues	771	791	2,322	2,339
Technology & Analytics Solutions
Disaggregation of Revenue
Total revenues	1,554	1,431	4,502	4,331
Technology & Analytics Solutions | Americas
Disaggregation of Revenue
Total revenues	797	761	2,323	2,268
Technology & Analytics Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	626	519	1,757	1,606
Technology & Analytics Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	131	151	422	457
Research & Development Solutions
Disaggregation of Revenue
Total revenues	2,162	2,122	6,404	6,244
Research & Development Solutions | Americas
Disaggregation of Revenue
Total revenues	969	1,017	2,969	2,982
Research & Development Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	607	520	1,699	1,547
Research & Development Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	586	585	1,736	1,715
Contract Sales & Medical Solutions
Disaggregation of Revenue
Total revenues	180	183	541	541
Contract Sales & Medical Solutions | Americas
Disaggregation of Revenue
Total revenues	72	78	211	228
Contract Sales & Medical Solutions | Europe and Africa
Disaggregation of Revenue
Total revenues	54	50	166	146
Contract Sales & Medical Solutions | Asia-Pacific
Disaggregation of Revenue
Total revenues	$ 54	$ 55	$ 164	$ 167

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
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, 2024 USD ($)
Revenue from Contract with Customer [Abstract]
Revenue expected to be recognized in future from remaining performance obligations	$ 33.3
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%

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, 2024	Dec. 31, 2023
Receivables, Net, Current [Abstract]
Trade accounts receivable	$ 1,176	$ 1,473
Unbilled services	2,061	1,942
Trade accounts receivable and unbilled services	3,237	3,415
Allowance for doubtful accounts	(41)	(34)
Trade accounts receivable and unbilled services, net	$ 3,196	$ 3,381

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, 2024	Dec. 31, 2023
Unbilled Contracts Receivables
Unbilled services, beginning balance	$ 1,942
Change	119
Unbilled services, ending balance	2,061
Unearned Income
Unearned income, beginning balance	(1,799)
Change	(25)
Unearned income, ending balance	(1,824)
Net change in balance	94
Net balance, beginning balance	$ 237	$ 143

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, 2024	Sep. 30, 2024	Dec. 31, 2023
Receivables [Abstract]
Unbilled receivables (percentage)	67%	67%	68%
Contract assets (percentage)	33%	33%	32%
Increase in unbilled services		$ 119
Decrease in unearned income		25
Net change in balance		94
Trade accounts receivable	$ 531	$ 531
Cash proceeds from trade accounts	$ 520

Goodwill - Summary of Goodwill

Goodwill - Summary of Goodwill by Reportable Segment (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2024 USD ($)
Goodwill
Beginning balance	$ 14,567
Business combinations	470
Impact of foreign currency fluctuations and other	54
Ending balance	15,091
Technology & Analytics Solutions
Goodwill
Beginning balance	11,976
Business combinations	289
Impact of foreign currency fluctuations and other	49
Ending balance	12,314
Research & Development Solutions
Goodwill
Beginning balance	2,439
Business combinations	181
Impact of foreign currency fluctuations and other	5
Ending balance	2,625
Contract Sales & Medical Solutions
Goodwill
Beginning balance	152
Business combinations	0
Impact of foreign currency fluctuations and other	0
Ending balance	$ 152

Derivatives - Summary of Fair V

Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) - USD ($)	Sep. 30, 2024	Dec. 31, 2023
Derivatives, Fair Value
Assets	$ 6,000,000	$ 15,000,000
Liabilities	172,000,000	159,000,000
Derivatives designated as hedging instruments: | Other current assets and other current liabilities | Foreign exchange forward contracts
Derivatives, Fair Value
Assets	6,000,000	2,000,000
Liabilities	0	0
Notional	118,000,000	121,000,000
Derivatives designated as hedging instruments: | Other current assets, other assets and other current liabilities | Interest rate swaps
Derivatives, Fair Value
Assets	0	13,000,000
Liabilities	70,000,000	51,000,000
Notional	2,489,000,000	3,300,000,000
Derivatives designated as hedging instruments: | Other current assets, other assets and other current liabilities | Cross-currency swaps
Derivatives, Fair Value
Assets	0	0
Liabilities	102,000,000	108,000,000
Notional	$ 2,739,000,000	$ 2,750,000,000

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (66)	$ (10)	$ (28)	$ (10)
Interest rate swaps
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	(70)	(1)	(32)	(6)
Foreign exchange forward contracts
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ 4	$ (9)	$ 4	$ (4)

Derivatives - Additional Inform

Derivatives - Additional Information (Detail) € in Millions, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2024 USD ($)	Sep. 30, 2023 USD ($)	Sep. 30, 2022 USD ($)	Sep. 30, 2024 EUR (€)
Derivative Instruments and Hedging Activities Disclosures
Foreign Currency Cash Flow Hedge Gain (Loss) to be Reclassified During Next 12 Months	$ 21		$ 21
Other Comprehensive Income (Loss), Cash Flow Hedge, Gain (Loss), Reclassification, after Tax	8	$ 9	28	$ 41
Cross-currency swaps | Derivatives designated as hedging instruments:
Derivative Instruments and Hedging Activities Disclosures
Net investment hedge, gain (loss), before Tax	(101)		6
Foreign currency transaction loss, before tax, interest rate reduction	8		26
Net Investment Hedging | Derivatives designated as hedging instruments:
Derivative Instruments and Hedging Activities Disclosures
Net investment hedge, gain (loss), before Tax	(114)	$ (26)		$ 161	$ 69
Long-term debt	$ 2,862		$ 2,862			€ 2,564

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Percentage accrued of maximum consideration payments to become payable	29%
Other identifiable intangibles, net	$ 4,734	$ 4,839
Level 1 and Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value of total debt	13,547	$ 13,597
Level 3 | Fair Value, Nonrecurring
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Assets, Fair Value Disclosure	20,112
Cost and equity method investments	287
Goodwill	15,091
Other identifiable intangibles, net	$ 4,734

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Assets:
Marketable securities	$ 140	$ 120
Derivatives	6	15
Recurring Fair Value Measurements
Assets:
Marketable securities	173	146
Derivatives	6	15
Total	179	161
Liabilities:
Derivatives	172	159
Contingent consideration	94	106
Total	266	265
Recurring Fair Value Measurements | Level 1
Assets:
Marketable securities	173	146
Derivatives	0	0
Total	173	146
Liabilities:
Derivatives	0	0
Contingent consideration	0	0
Total	0	0
Recurring Fair Value Measurements | Level 2
Assets:
Marketable securities	0	0
Derivatives	6	15
Total	6	15
Liabilities:
Derivatives	172	159
Contingent consideration	0	0
Total	172	159
Recurring Fair Value Measurements | Level 3
Assets:
Marketable securities	0	0
Derivatives	0	0
Total	0	0
Liabilities:
Derivatives	0	0
Contingent consideration	94	106
Total	$ 94	$ 106

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, 2024 USD ($)
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation
Beginning balance	$ 106
Business combinations	55
Contingent consideration paid	(10)
Revaluations included in earnings and foreign currency translation adjustments	(57)
Ending balance	$ 94

Credit Arrangements - Summary o

Credit Arrangements - Summary of Credit Facilities (Detail)	9 Months Ended
	Sep. 30, 2024 USD ($)
Revolving Credit Facility | USD Revolving Credit Facility
Line of Credit Facility
Facility	$ 2,000,000,000
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, 2024
Rate	1.25%
Interest rate spread on base rate	0.10%
Facility | Receivables Financing Facility
Line of Credit Facility
Facility	$ 110,000,000
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, 2024
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, 2024	Dec. 31, 2023
Senior Secured Credit Facilities:
Principal amount of debt	$ 13,578	$ 13,752
Less: unamortized discount and debt issuance costs	(66)	(79)
Less: current portion	(1,219)	(718)
Long-term debt	12,293	12,955
U.S Dollars | Senior Secured Term A Loan, 6.69%
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,109	1,156
U.S Dollars | Senior Secured Term A Loan, 6.69% | SOFR
Senior Secured Credit Facilities:
Average floating rate	6.41%
U.S Dollars | Senior Notes Due 2030, 6.500% | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 500	500
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 | Receivable Financing Facilities | SOFR
Senior Secured Credit Facilities:
Average floating rate	6.22%
U.S Dollars | Due in 2026 | Senior Secured Facilities Term A Loan At 6.68% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,216	1,270
Average floating rate	6.20%
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%
U.S Dollars | Due in 2028 | Senior Secured Notes Due 2028, 5.700% | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 750	750
Rate	5.70%
U.S Dollars | Due in 2029 | Senior Secured Notes Due 2029, 5.625% | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,250	1,250
Rate	6.25%
U.S Dollars | Due in 2031 | Senior Secured Term B Loan, 7.31% | SOFR
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,489	1,500
Average floating rate	6.60%
EUR Dollars | Due in 2025 | Senior Secured Term B Loan, 5.90% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 583	576
Average floating rate	5.35%
EUR Dollars | Due in 2025 | 2.875% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 469	464
Rate	2.875%
EUR Dollars | Due in 2026 | Senior Secured Term A Loan, 5.15% | Euribor Rate
Senior Secured Credit Facilities:
Principal amount of debt	$ 296	306
Average floating rate	4.60%
EUR Dollars | Due in 2026 | 1.75% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 614	607
Rate	1.75%
EUR Dollars | Due in 2028 | 2.875% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 793	785
Rate	2.875%
EUR Dollars | Due in 2028 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 804	795
Rate	2.25%
EUR Dollars | Due in 2029 | 2.25% Senior Notes | Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,005	993
Rate	2.25%
Revolving Credit Facility | U.S Dollars
Senior Secured Credit Facilities:
Principal amount of debt	$ 0	100
Revolving Credit Facility | U.S Dollars | SOFR
Senior Secured Credit Facilities:
Average floating rate	0%
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, 2024	Dec. 31, 2023
Debt Disclosure [Abstract]
Remainder of 2022	$ 42
2025	1,219
2026	3,141
2027	2,634
2028	2,362
Thereafter	4,180
Principal amount of debt	$ 13,578	$ 13,752

Credit Arrangements - Senior Se

Credit Arrangements - Senior Secured Credit Facilities (Detail) - USD ($) $ in Millions	Sep. 30, 2024	Dec. 31, 2023
Line of Credit Facility
Principal amount of debt	$ 13,578	$ 13,752
Revolving Credit Facility | U.S Dollars
Line of Credit Facility
Principal amount of debt	0	100
Senior Secured Term A Loan, 6.69% | U.S Dollars
Line of Credit Facility
Principal amount of debt	1,109	1,156
Senior Secured Credit Facilities, Fifth Amended and Restated Credit Agreement
Line of Credit Facility
Aggregate maximum principal amount	6,688
Principal amount	4,693
Senior Secured Credit Facilities, Revolving Credit Facility And Standby Letters Of Credit
Line of Credit Facility
Aggregate maximum principal amount	2,000
Available borrowing capacity	1,995
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 Notes Due 2030, 6.500% | U.S Dollars | Senior Notes
Line of Credit Facility
Principal amount of debt	$ 500	$ 500
Rate	6.50%

Contingencies - Additional Info

Contingencies - Additional Information (Detail) $ in Millions	May 13, 2017 USD ($)
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
	Sep. 30, 2024	Sep. 30, 2023	Jun. 30, 2023	Mar. 31, 2023	Sep. 30, 2024	Dec. 31, 2023	Jul. 31, 2023
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	$ 200	$ 145	$ 495	$ 129
Equity Repurchase Under Repurchase Program
Class of Stock
Equity repurchase program authorized amount							$ 11,725
Repurchase of stock (in shares)					800,000
Repurchase of stock, value					$ 200
Equity available for repurchase under the repurchase program	$ 2,163				$ 2,163

Business Combinations - Schedul

Business Combinations - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Dec. 31, 2023
Assets acquired:
Goodwill	$ 15,091	$ 14,567
Several Individually Immaterial Acquisitions
Assets acquired:
Cash and cash equivalents	23
Accounts receivable	49
Other assets	51
Goodwill	470
Other identifiable intangibles	266
Liabilities assumed:
Other liabilities	(88)
Deferred income taxes, long-term	(37)
Net assets acquired	734
Contingent consideration and deferred payments	$ 62

Business Combinations - Narrati

Business Combinations - Narrative (Details) $ in Millions	Sep. 30, 2024 USD ($)
Several Individually Immaterial Acquisitions
Business Acquisition [Line Items]
Portion of goodwill deductible for income tax purposes	$ 297

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, 2024 USD ($)
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 266
Customer relationships
Business Acquisition [Line Items]
Total Other identifiable intangibles	222
Software and related assets
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 6
Trade names
Business Acquisition [Line Items]
Amortization Period	5 years
Total Other identifiable intangibles	$ 6
Backlog
Business Acquisition [Line Items]
Amortization Period	4 years
Total Other identifiable intangibles	$ 27
Non-compete agreements
Business Acquisition [Line Items]
Total Other identifiable intangibles	3
Databases
Business Acquisition [Line Items]
Total Other identifiable intangibles	$ 2
Minimum | Customer relationships
Business Acquisition [Line Items]
Amortization Period	10 years
Minimum | Software and related assets
Business Acquisition [Line Items]
Amortization Period	3 years
Minimum | Non-compete agreements
Business Acquisition [Line Items]
Amortization Period	3 years
Minimum | Databases
Business Acquisition [Line Items]
Amortization Period
Maximum | Customer relationships
Business Acquisition [Line Items]
Amortization Period	16 years
Maximum | Software and related assets
Business Acquisition [Line Items]
Amortization Period	5 years
Maximum | Non-compete agreements
Business Acquisition [Line Items]
Amortization Period	5 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, 2024 USD ($)
Restructuring Reserve
Restructuring reserves, beginning balance	$ 36
Expense, net of reversals	71
Payments	(62)
Foreign currency translation and other	1
Restructuring reserves, ending balance	$ 46

Income Taxes - Narratives (Deta

Income Taxes - Narratives (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Income Tax Disclosure [Abstract]
Effective income tax rate (percent)	18.60%	14.60%
Tax impact of share-based compensation awards	$ 2		$ 14	$ 12

Accumulated Other Comprehensi_3

Accumulated Other Comprehensive (Loss) Income - Summary of Components of AOCI (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2024 USD ($)
Statement of Other Comprehensive Income
Beginning balance	$ 6,112
Ending balance	6,967
Income Taxes
Beginning balance	133
Other comprehensive income (loss) before reclassifications	(15)
Reclassification adjustments	10
Ending balance	128
Other comprehensive income (loss) before reclassifications	69
Reclassification adjustments	(28)
Foreign Currency Translation
Statement of Other Comprehensive Income
Beginning balance	(969)
Other comprehensive income (loss) before reclassifications	75
Reclassification adjustments	0
Ending balance	(894)
Derivative Instruments
Statement of Other Comprehensive Income
Beginning balance	(34)
Other comprehensive income (loss) before reclassifications	10
Reclassification adjustments	(38)
Ending balance	(62)
Defined Benefit Plans
Statement of Other Comprehensive Income
Beginning balance	3
Other comprehensive income (loss) before reclassifications	(1)
Reclassification adjustments	0
Ending balance	2
Total
Statement of Other Comprehensive Income
Beginning balance	(867)
Ending balance	$ (826)

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 11	$ 12	$ 38	$ 55
Income taxes	3	3	10	14
Total net of income taxes	8	9	28	41
Interest rate swaps | Interest expense
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	8	17	38	35
Foreign exchange forward contracts | Revenues
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 3	$ (5)	$ 0	$ 20

Segments - Additional Informati

Segments - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2024 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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Segment Reporting Information
Revenues	$ 3,896	$ 3,736	$ 11,447	$ 11,116
Cost of revenues, exclusive of depreciation and amortization	2,518	2,426	7,450	7,267
Selling, general and administrative expenses	522	502	1,539	1,497
Segment profit	915	862	2,605	2,514
Depreciation and amortization	(278)	(297)	(811)	(809)
Restructuring costs	(28)	(30)	(71)	(67)
Income from operations	550	481	1,576	1,476
Technology & Analytics Solutions
Segment Reporting Information
Revenues	1,554	1,431	4,502	4,331
Cost of revenues, exclusive of depreciation and amortization	922	859	2,720	2,593
Research & Development Solutions
Segment Reporting Information
Revenues	2,162	2,122	6,404	6,244
Cost of revenues, exclusive of depreciation and amortization	1,442	1,410	4,268	4,213
Contract Sales & Medical Solutions
Segment Reporting Information
Revenues	180	183	541	541
Cost of revenues, exclusive of depreciation and amortization	154	157	462	461
Operating Segments | Technology & Analytics Solutions
Segment Reporting Information
Selling, general and administrative expenses	227	217	681	652
Segment profit	405	355	1,101	1,086
Operating Segments | Research & Development Solutions
Segment Reporting Information
Selling, general and administrative expenses	222	217	666	640
Segment profit	498	495	1,470	1,391
Operating Segments | Contract Sales & Medical Solutions
Segment Reporting Information
Selling, general and administrative expenses	14	14	45	43
Segment profit	12	12	34	37
General corporate and unallocated
Segment Reporting Information
Selling, general and administrative expenses	59	54	147	162
Segment profit	$ (59)	$ (54)	$ (147)	$ (162)

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, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Net income	$ 285	$ 303	$ 936	$ 889
Denominator:
Basic weighted average common shares outstanding (in shares)	182.1	182.9	182.1	184.4
Effect of dilutive stock options and share awards (in shares)	2.1	2.6	2.2	2.5
Diluted weighted average common shares outstanding (in shares)	184.2	185.5	184.3	186.9
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 1.57	$ 1.66	$ 5.14	$ 4.82
Diluted (in dollars per share)	$ 1.55	$ 1.63	$ 5.08	$ 4.76

Earnings Per Share - Narrative

Earnings Per Share - Narrative (Details) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023	Sep. 30, 2024	Sep. 30, 2023
Earnings Per Share [Abstract]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	1	0.9	1	1