IQVIA (IQV) 10-Q 1 Nov 19 2019 Q3 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	9 Months Ended
	Sep. 30, 2019	Oct. 21, 2019
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Period End Date	Sep. 30, 2019
Document Fiscal Year Focus	2019
Document Fiscal Period Focus	Q3
Trading Symbol	IQV
Entity Registrant Name	IQVIA HOLDINGS INC.
Entity Central Index Key	0001478242
Current Fiscal Year End Date	--12-31
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Shell Company	false
Entity File Number	001-35907
Entity Tax Identification Number	27-1341991
Entity Incorporation, State or Country Code	DE
Entity Filer Category	Large Accelerated Filer
Entity Address, Address Line One	4820 Emperor Blvd.
Entity Address, City or Town	Durham
Entity Address, State or Province	NC
Entity Address, Postal Zip Code	27703
City Area Code	919
Local Phone Number	998-2000
Document Quarterly Report	true
Document Transition Report	false
Entity Common Stock, Shares Outstanding		194,037,571
Title of 12(b) Security	Common Stock, par value $0.01 per share
Security Exchange Name	NYSE
Principal Executive Offices [Member]
Document Information [Line Items]
Entity Address, Address Line One	83 Wooster Heights Road
Entity Address, City or Town	Danbury
Entity Address, State or Province	CT
Entity Address, Postal Zip Code	06810
City Area Code	203
Local Phone Number	448-4600

CONDENSED CONSOLIDATED STATEMEN

CONDENSED CONSOLIDATED STATEMENTS OF INCOME (unaudited) - USD ($) shares in Millions, $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Statement [Abstract]
Revenues	$ 2,769	$ 2,594	$ 8,193	$ 7,724
Type of Revenue [Extensible List]	us-gaap:ServiceMember	us-gaap:ServiceMember	us-gaap:ServiceMember	us-gaap:ServiceMember
Costs of revenue, exclusive of depreciation and amortization	$ 1,852	$ 1,678	$ 5,399	$ 5,004
Type of Cost, Good or Service [Extensible List]	us-gaap:ServiceMember	us-gaap:ServiceMember	us-gaap:ServiceMember	us-gaap:ServiceMember
Selling, general and administrative expenses	$ 395	$ 429	$ 1,250	$ 1,273
Depreciation and amortization	299	283	888	847
Restructuring costs	19	23	45	66
Income from operations	204	181	611	534
Interest income	(3)	(2)	(7)	(5)
Interest expense	114	105	338	308
Loss on extinguishment of debt	24		24	2
Other expense (income), net		27		5
Income before income taxes and equity in earnings of unconsolidated affiliates	69	51	256	224
Income tax (benefit) expense	(1)	(14)	48	29
Income before equity in earnings of unconsolidated affiliates	70	65	208	195
Equity in (loss) earnings of unconsolidated affiliates	(1)	2	(1)	13
Net income	69	67	207	208
Net income attributable to non-controlling interests	(12)	(7)	(32)	(18)
Net income attributable to IQVIA Holdings Inc.	$ 57	$ 60	$ 175	$ 190
Earnings per share attributable to common stockholders:
Basic	$ 0.29	$ 0.30	$ 0.89	$ 0.93
Diluted	$ 0.29	$ 0.29	$ 0.87	$ 0.91
Weighted average common shares outstanding:
Basic	194.5	202.3	195.9	205.2
Diluted	199	206.8	200.5	209.6

CONDENSED CONSOLIDATED STATEM_2

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (unaudited) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement Of Income And Comprehensive Income [Abstract]
Net income	$ 69	$ 67	$ 207	$ 208
Comprehensive income (loss) adjustments:
Unrealized (losses) gains on derivative instruments, net of income tax (benefit) expense of ($2), $1, ($7) and $3	(5)	4	(23)	8
Foreign currency translation, net of income tax expense of $57, $12, $65 and $40	(162)	(122)	(131)	(280)
Reclassification adjustments:
Gains on derivative instruments included in net income, net of income tax expense (benefit) of $0, ($1), ($1) and $0	2		(2)
Comprehensive (loss) income	(96)	(51)	51	(64)
Comprehensive income attributable to non-controlling interests	(9)	(5)	(29)	(15)
Comprehensive (loss) income attributable to IQVIA Holdings Inc.	$ (105)	$ (56)	$ 22	$ (79)

CONDENSED CONSOLIDATED STATEM_3

CONDENSED CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (unaudited) (Parenthetical) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Statement Of Income And Comprehensive Income [Abstract]
Unrealized (losses) gains on derivative instruments, income tax {benefit) expense	$ (2)	$ 1	$ (7)	$ 3
Foreign currency translation, income tax expense	57	12	65	40
Gain on derivative instruments included in net income, income tax expense (benefit)	$ 0	$ (1)	$ (1)	$ 0

CONDENSED CONSOLIDATED BALANCE

CONDENSED CONSOLIDATED BALANCE SHEETS (unaudited) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Current assets:
Cash and cash equivalents	$ 863	$ 891
Trade accounts receivable and unbilled services, net	2,514	2,394
Prepaid expenses	150	151
Income taxes receivable	65	69
Investments in debt, equity and other securities	57	47
Other current assets and receivables	346	322
Total current assets	3,995	3,874
Property and equipment, net	451	434
Operating lease right-of-use assets	490
Investments in debt, equity and other securities	47	41
Investments in unconsolidated affiliates	96	101
Goodwill	11,919	11,800
Other identifiable intangibles, net	5,546	5,951
Deferred income taxes	108	109
Deposits and other assets	240	239
Total assets	22,892	22,549
Current liabilities:
Accounts payable and accrued expenses	2,190	2,295
Unearned income	954	1,007
Income taxes payable	123	100
Current portion of long-term debt	98	100
Other current liabilities	211	32
Total current liabilities	3,576	3,534
Long-term debt	11,444	10,907
Deferred income taxes	654	736
Operating lease liabilities	393
Other liabilities	431	418
Total liabilities	16,498	15,595
Commitments and contingencies
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized at September 30, 2019 and December 31, 2018, $0.01 par value, 252.8 and 251.5 shares issued at September 30, 2019 and December 31, 2018, respectively	10,990	10,901
Retained earnings	982	807
Treasury stock, at cost, 58.8 and 54.0 shares at September 30, 2019 and December 31, 2018, respectively	(5,464)	(4,770)
Accumulated other comprehensive loss	(377)	(224)
Equity attributable to IQVIA Holdings Inc.’s stockholders	6,131	6,714
Non-controlling interests	263	240
Total stockholders’ equity	6,394	6,954
Total liabilities and stockholders’ equity	$ 22,892	$ 22,549

CONDENSED CONSOLIDATED BALANC_2

CONDENSED CONSOLIDATED BALANCE SHEETS (unaudited) (Parenthetical) - $ / shares	Sep. 30, 2019	Dec. 31, 2018
Statement Of Financial Position [Abstract]
Common stock, shares authorized	400,000,000	400,000,000
Common stock, par value	$ 0.01	$ 0.01
Common stock, shares issued	252,800,000	251,500,000
Treasury stock, shares	58,800,000	54,000,000

CONDENSED CONSOLIDATED STATEM_4

CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Operating activities:
Net income	$ 207	$ 208
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	888	847
Amortization of debt issuance costs and discount	10	8
Stock-based compensation	87	78
Loss (earnings) from unconsolidated affiliates	1	(13)
Gain on investments, net		(3)
Benefit from deferred income taxes	(154)	(183)
Changes in operating assets and liabilities:
Change in accounts receivable, unbilled services and unearned income	(167)	(219)
Change in other operating assets and liabilities	(38)	114
Net cash provided by operating activities	834	837
Investing activities:
Acquisition of property, equipment and software	(445)	(321)
Acquisition of businesses, net of cash acquired	(461)	(255)
Purchases of marketable securities, net	(2)	(3)
Investments in unconsolidated affiliates, net of payments received	3	(24)
Investments in equity securities	(10)	(23)
Other	5	(6)
Net cash used in investing activities	(910)	(632)
Financing activities:
Proceeds from issuance of debt	1,900	1,631
Payment of debt issuance costs	(47)	(23)
Repayment of debt and principal payments on capital lease obligations	(875)	(707)
Proceeds from revolving credit facility	1,710	1,800
Repayment of revolving credit facility	(1,930)	(2,169)
Proceeds related to employee stock option plans	15	18
Repurchase of common stock	(679)	(801)
Distributions to non-controlling interest, net	(6)	(19)
Contingent consideration and deferred purchase price payments	(21)	(24)
Net cash provided by (used in) financing activities	67	(294)
Effect of foreign currency exchange rate changes on cash	(19)	(43)
Decrease in cash and cash equivalents	(28)	(132)
Cash and cash equivalents at beginning of period	891	959
Cash and cash equivalents at end of period	$ 863	$ 827

CONDENSED CONSOLIDATED STATEM_5

CONDENSED CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (unaudited) - USD ($) shares in Millions, $ in Millions	Total	Common Stock [Member]	Treasury Stock [Member]	Additional Paid-In Capital [Member]	Retained Earnings [Member]	Accumulated Other Comprehensive (Loss) Income [Member]	Non-controlling Interests [Member]
Beginning balance at Dec. 31, 2017	$ 8,244	$ 2	$ (3,374)	$ 10,780	$ 538	$ 49	$ 249
Beginning Balance, Shares at Dec. 31, 2017		249.5
Beginning Balance, Shares at Dec. 31, 2017			(41.4)
Issuance of common stock	(5)			(5)
Issuance of common stock, Shares		0.5
Repurchase of common stock	(86)		$ (86)
Repurchase of common stock, Shares			(0.9)
Stock-based compensation	20			20
Net income	73				69		4
Unrealized losses on derivative instruments, net of tax	1					1
Foreign currency translation, net of tax	207					203	4
Reclassification adjustments, net of tax	1					1
Other	(2)				(2)
Ending balance at Mar. 31, 2018	8,453	$ 2	$ (3,460)	10,795	605	254	257
Ending Balance, Shares at Mar. 31, 2018		250
Ending Balance, Shares at Mar. 31, 2018			(42.3)
Beginning balance at Dec. 31, 2017	8,244	$ 2	$ (3,374)	10,780	538	49	249
Beginning Balance, Shares at Dec. 31, 2017		249.5
Beginning Balance, Shares at Dec. 31, 2017			(41.4)
Net income	208
Unrealized losses on derivative instruments, net of tax	8
Foreign currency translation, net of tax	(280)
Ending balance at Sep. 30, 2018	7,460	$ 3	$ (4,167)	10,873	726	(220)	245
Ending Balance, Shares at Sep. 30, 2018		251.2
Ending Balance, Shares at Sep. 30, 2018			(48.9)
Beginning balance at Mar. 31, 2018	8,453	$ 2	$ (3,460)	10,795	605	254	257
Beginning Balance, Shares at Mar. 31, 2018		250
Beginning Balance, Shares at Mar. 31, 2018			(42.3)
Issuance of common stock	14	$ 1		13
Issuance of common stock, Shares		0.4
Repurchase of common stock	(573)		$ (573)
Repurchase of common stock, Shares			(5.6)
Stock-based compensation	25			25
Distribution to non-controlling interest	(19)						(19)
Contribution from non-controlling interest	10						10
Net income	68				61		7
Unrealized losses on derivative instruments, net of tax	3					3
Foreign currency translation, net of tax	(365)					(360)	(5)
Reclassification adjustments, net of tax	(1)					(1)
Other	(1)				(1)
Ending balance at Jun. 30, 2018	7,614	$ 3	$ (4,033)	10,833	665	(104)	250
Ending Balance, Shares at Jun. 30, 2018		250.4
Ending Balance, Shares at Jun. 30, 2018			(47.9)
Issuance of common stock	15			15
Issuance of common stock, Shares		0.8
Repurchase of common stock	(134)		$ (134)
Repurchase of common stock, Shares			(1)
Stock-based compensation	25			25
Distribution to non-controlling interest	(10)						(10)
Contribution from non-controlling interest	0
Net income	67				60		7
Unrealized losses on derivative instruments, net of tax	4					4
Foreign currency translation, net of tax	(122)					(120)	(2)
Other	1				1
Ending balance at Sep. 30, 2018	7,460	$ 3	$ (4,167)	10,873	726	(220)	245
Ending Balance, Shares at Sep. 30, 2018		251.2
Ending Balance, Shares at Sep. 30, 2018			(48.9)
Beginning balance at Dec. 31, 2018	$ 6,954	$ 3	$ (4,770)	10,898	807	(224)	240
Beginning Balance, Shares at Dec. 31, 2018		251.5
Beginning Balance, Shares at Dec. 31, 2018	(54)		(54)
Issuance of common stock	$ 5			5
Issuance of common stock, Shares		0.7
Repurchase of common stock	(145)		$ (145)
Repurchase of common stock, Shares			(1)
Stock-based compensation	21			21
Net income	67				58		9
Unrealized losses on derivative instruments, net of tax	(5)					(5)
Foreign currency translation, net of tax	(31)					(32)	1
Reclassification adjustments, net of tax	(1)					(1)
Ending balance at Mar. 31, 2019	6,865	$ 3	$ (4,915)	10,924	865	(262)	250
Ending Balance, Shares at Mar. 31, 2019		252.2
Ending Balance, Shares at Mar. 31, 2019			(55)
Beginning balance at Dec. 31, 2018	$ 6,954	$ 3	$ (4,770)	10,898	807	(224)	240
Beginning Balance, Shares at Dec. 31, 2018		251.5
Beginning Balance, Shares at Dec. 31, 2018	(54)		(54)
Net income	$ 207
Unrealized losses on derivative instruments, net of tax	(23)
Foreign currency translation, net of tax	(131)
Ending balance at Sep. 30, 2019	$ 6,394	$ 3	$ (5,464)	10,987	982	(377)	263
Ending Balance, Shares at Sep. 30, 2019		252.8
Ending Balance, Shares at Sep. 30, 2019	(58.8)		(58.8)
Beginning balance at Mar. 31, 2019	$ 6,865	$ 3	$ (4,915)	10,924	865	(262)	250
Beginning Balance, Shares at Mar. 31, 2019		252.2
Beginning Balance, Shares at Mar. 31, 2019			(55)
Issuance of common stock	8			8
Issuance of common stock, Shares		0.4
Repurchase of common stock	(236)		$ (236)
Repurchase of common stock, Shares			(1.8)
Stock-based compensation	29			29
Distribution to non-controlling interest	(2)						(2)
Net income	71				60		11
Unrealized losses on derivative instruments, net of tax	(13)					(13)
Foreign currency translation, net of tax	62					63	(1)
Reclassification adjustments, net of tax	(3)					(3)
Ending balance at Jun. 30, 2019	6,781	$ 3	$ (5,151)	10,961	925	(215)	258
Ending Balance, Shares at Jun. 30, 2019		252.6
Ending Balance, Shares at Jun. 30, 2019			(56.8)
Issuance of common stock	(4)			(4)
Issuance of common stock, Shares		0.2
Repurchase of common stock	(313)		$ (313)
Repurchase of common stock, Shares			(2)
Stock-based compensation	30			30
Distribution to non-controlling interest	(4)						(4)
Net income	69				57		12
Unrealized losses on derivative instruments, net of tax	(5)					(5)
Foreign currency translation, net of tax	(162)					(159)	(3)
Reclassification adjustments, net of tax	2					2
Ending balance at Sep. 30, 2019	$ 6,394	$ 3	$ (5,464)	$ 10,987	$ 982	$ (377)	$ 263
Ending Balance, Shares at Sep. 30, 2019		252.8
Ending Balance, Shares at Sep. 30, 2019	(58.8)		(58.8)

Summary of Significant Accounti

Summary of Significant Accounting Policies	9 Months Ended
	Sep. 30, 2019
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	1. Summary of Significant Accounting Policies The Company IQVIA Holdings Inc. (together with its subsidiaries, the “Company” or “IQVIA”) is a leading global provider of advanced analytics, technology solutions and contract research services to the life sciences industry. With approximately 65,000 employees, IQVIA conducts business in more than 100 countries. Unaudited Interim Financial Information The accompanying unaudited condensed consolidated financial statements of the Company have been prepared in accordance with generally accepted accounting principles in the United States of America (“GAAP”) for interim financial information. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of management, all adjustments (consisting of normal recurring adjustments) considered necessary for a fair statement of the Company’s financial condition and results of operations have been included. Operating results for the periods presented are not necessarily indicative of the results that may be expected for the year ending December 31, 2019. 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, 2018. The balance sheet at December 31, 2018 has been derived from the audited consolidated financial statements of the Company but does not include all the disclosures required by GAAP. Leases The Company determines if an arrangement is a lease at inception. Operating leases are included in operating lease right-of-use (“ROU”) assets, other current liabilities, and operating lease liabilities on our condensed consolidated balance sheets. Operating lease ROU assets and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of future payments. The operating lease ROU asset also includes any lease payments made before lease commencement and initial direct costs and excludes lease incentives. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. The Company has lease agreements with lease and non-lease components that the Company has elected to account for as single lease components. Recently Issued Accounting Standards Accounting pronouncements adopted In February 2018, the FASB issued new accounting guidance that will allow a reclassification from accumulated other comprehensive income to retained earnings for “stranded income tax effects” resulting from the Tax Act. Because the income statement impact related to the reduction of the historical corporate income tax rate under the Tax Act is required to be included in income tax expense, the guidance acknowledges that the income tax effects of items within accumulated other comprehensive income (“stranded income tax effects”) do not reflect the appropriate income tax rate. The Company adopted this new accounting guidance on January 1, 2019 using the aggregate portfolio approach. The Company elected the option to not reclassify accumulated other comprehensive income to retained earnings for “stranded income tax effects” resulting from the Tax Act. In August 2017, the FASB issued new accounting guidance that will allow more financial and nonfinancial hedging strategies to be eligible for hedge accounting. It also amends the presentation and disclosure requirements and changes how companies assess hedge effectiveness. It is intended to more closely align hedge accounting with risk management strategies, simplify the application of hedge accounting, and increase transparency as to the scope and results of hedging programs. The Company adopted this new accounting guidance on January 1, 2019. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In February 2016, the FASB issued new accounting guidance that requires lessees to recognize almost all leases on their balance sheet as a right-of-use asset and a lease liability. The income statement will reflect lease expense for operating leases, and amortization and interest expense for financing leases. The Company adopted this new accounting guidance on January 1, 2019 and elect ed the practical expedients upon transition that retain ed the lease classification , initial direct costs and determination of whether contracts are or contain a lease, for any leases that exist ed prior to adoption of the new guidance . The Company also elected the transition method which allows for disclosures to be updated prospectively and prior periods to be presented in acco rdance with previous guidance. The adoption of this standard had a material impact on the Company’s condensed consolidated balance sheets but did not have a material impact on the Company’s condensed consolidated results of operations or cash flows. Accounting pronouncements being evaluated In August 2018, the FASB issued new accounting guidance that clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The new accounting guidance will be effective for the Company on January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements. In August 2018, the FASB issued new accounting guidance that modifies the disclosure requirements for employers that sponsor defined benefit pension or other postretirement plans. The new accounting guidance will be effective for the Company on January 1, 2021. Early adoption is permitted. The adoption of this new accounting guidance is not expected to have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued new accounting guidance that modifies the disclosure requirements in Topic 820, Fair Value Measurement, by removing certain disclosure requirements related to the fair value hierarchy, modifying existing disclosure requirements related to measurement uncertainty and adding new disclosure requirements, such as disclosing the changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period and disclosing the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. The new accounting guidance will be effective for the Company on January 1, 2020. Early adoption is permitted. The adoption of this new accounting guidance is not expected to have a material effect on the Company’s consolidated financial statements. In January 2017, the FASB issued new accounting guidance that simplifies the measurement of goodwill by eliminating the step two impairment test. Step two measures a goodwill impairment loss by comparing the implied fair value of goodwill with the carrying amount of that goodwill. The new guidance requires a comparison of the Company’s fair value of a reporting unit with the carrying amount and the Company is required to recognize an impairment charge for the amount by which the carrying amount exceeds the fair value. The new accounting guidance will be effective for the Company on January 1, 2020. Early adoption is permitted. The adoption of this new accounting guidance is not expected to have a material effect on the Company’s consolidated financial statements. In June 2016, the FASB issued a new accounting standard intended to provide financial statement users with more decision-useful information about expected credit losses and other commitments to extend credit held by the reporting entity. The standard replaces the incurred loss impairment methodology in current GAAP with one that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. The standard will be effective for the Company on January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements.

Revenues by Geography, Concentr

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations	9 Months Ended
	Sep. 30, 2019
Revenue From Contract With Customer [Abstract]
Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations	2. 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, 2019 and 2018: Three Months Ended September 30, 2019 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 580 $ 726 $ 104 $ 1,410 Europe and Africa 369 394 48 811 Asia-Pacific 146 346 56 548 Total revenues $ 1,095 $ 1,466 $ 208 $ 2,769 Three Months Ended September 30, 2018 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 527 $ 670 $ 87 $ 1,284 Europe and Africa 359 418 56 833 Asia-Pacific 128 294 55 477 Total revenues $ 1,014 $ 1,382 $ 198 $ 2,594 Nine Months Ended September 30, 2019 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 1,722 $ 2,009 $ 298 $ 4,029 Europe and Africa 1,128 1,298 148 2,574 Asia-Pacific 422 1,010 158 1,590 Total revenues $ 3,272 $ 4,317 $ 604 $ 8,193 Nine Months Ended September 30, 2018 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 1,506 $ 1,909 $ 272 $ 3,687 Europe and Africa 1,111 1,279 180 2,570 Asia-Pacific 393 909 165 1,467 Total revenues $ 3,010 $ 4,097 $ 617 $ 7,724 No customer accounted for 10% or more of consolidated revenues for the three and nine months ended September 30, 2019 or 2018. Transaction Price Allocated to the Remaining Performance Obligations As of September 30, 2019, approximately $20.0 billion of revenue is expected to be recognized in the future from remaining performance obligations. The Company expects to recognize revenue on approximately 35% of these remaining performance obligations over the next 12 months, with the balance recognized thereafter. The customer contract transaction price allocated to the remaining performance obligations differs from backlog in that it does not include wholly unperformed contracts under which the customer has a unilateral right to cancel the arrangement.

Trade Accounts Receivable, Unbi

Trade Accounts Receivable, Unbilled Services and Unearned Income	9 Months Ended
	Sep. 30, 2019
Receivables [Abstract]
Trade Accounts Receivable, Unbilled Services and Unearned Income	3. Trade Accounts Receivable, Unbilled Services and Unearned Income Trade accounts receivables and unbilled services consist of the following: (in millions) September 30, 2019 December 31, 2018 Trade accounts receivable: Billed $ 1,176 $ 1,279 Unbilled services 1,351 1,130 Trade accounts receivable and unbilled services 2,527 2,409 Allowance for doubtful accounts (13 ) (15 ) Trade accounts receivable and unbilled services, net $ 2,514 $ 2,394 Unbilled services and unearned income were as follows: (in millions, except percentages) September 30, 2019 December 31, 2018 Change Unbilled services $ 1,351 $ 1,130 $ 221 Unearned income (954 ) (1,007 ) 53 Net balance $ 397 $ 123 $ 274 Unbilled services, which is comprised of approximately equal parts of unbilled receivables and contract assets as of September 30, 2019, increased by $221 million as compared to December 31, 2018. 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 decreased by $53 million over the same period resulting in an increase of $274 million in the net balance of unbilled services and unearned income between December 31, 2018 and September 30, 2019. Growth in the net balance is driven by the difference in timing of revenue recognition in accordance with ASC 606, Revenue from Contracts with Customers, related to the Company’s Research & Development Solutions contracts (which is based on the percentage of costs incurred) versus the timing of invoicing, which is based on certain milestones. Bad debt expense recognized on the Company’s receivables and unbilled services was de minimis for the three and nine months ended September 30, 2019 and 2018.

Leases

Leases	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Leases	4. Leases The Company has operating leases for corporate offices, datacenters, motor vehicles and certain equipment, many of which contain renewal and escalation clauses. The leases expire at various dates through 2029 with options to cancel certain leases at various intervals. In determining the lease term at lease commencement, the Company includes the noncancellable term and the periods which the Company deems it is reasonably certain to exercise or not to exercise a renewal or cancellation option. As of September 30, 2019, the Company has additional operating leases, primarily for corporate offices, that have not yet commenced of $15 million. These operating leases will commence in the third quarter of 2019 with lease terms through 2026. The components of lease expense were as follows: (in millions) Classification Three Months Ended September 30, 2019 Nine Months Ended September 30, 2019 Operating lease cost (1) Selling, general and administrative expenses $ 48 $ 143 Total lease cost $ 48 $ 143 (1) Includes variable lease costs, which are immaterial. Other information related to leases was as follows: (in millions) Nine Months Ended September 30, 2019 Supplemental Cash Flow: Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 147 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 62 Weighted Average Remaining Lease Term: Operating leases 4.90 years Weighted Average Discount Rate: Operating leases 4.26 % Future minimum lease payments under non-cancellable leases as of September 30, 2019 were as follows: (in millions) Operating Leases Remainder of 2019 $ 44 2020 151 2021 120 2022 97 2023 74 2024 49 Thereafter 80 Total future minimum lease payments 615 Less imputed interest (69 ) Total $ 546 Reported as of September 30, 2019: Other current liabilities $ 153 Operating lease liabilities 393 Total $ 546 The Company elected the alternative modified transition method and as such, included the following prior period information as previously disclosed in accordance with Accounting Standards Codification (“ASC”) 840. The following is a summary of future minimum payments under operating leases that have initial or remaining non-cancelable lease terms in excess of one year at December 31, 2018: (in millions) Operating Leases 2019 $ 167 2020 136 2021 108 2022 90 2023 69 Thereafter 119 Total minimum lease payments $ 689

Goodwill

Goodwill	9 Months Ended
	Sep. 30, 2019
Goodwill And Intangible Assets Disclosure [Abstract]
Goodwill	5. Goodwill The following is a summary of goodwill by reportable segment for the nine months ended September 30, 2019: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2018 $ 10,239 $ 1,427 $ 134 $ 11,800 Business combinations 157 171 5 333 Impact of foreign currency fluctuations and other (210 ) (4 ) — (214 ) Balance as of September 30, 2019 $ 10,186 $ 1,594 $ 139 $ 11,919

Derivatives

Derivatives	9 Months Ended
	Sep. 30, 2019
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Derivatives	6. 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: September 30, 2019 December 31, 2018 (in millions) Balance Sheet Classification Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Foreign exchange forward contracts Other current assets and liabilities $ — $ 4 $ 132 $ 5 $ 3 $ 202 Interest rate swaps Other assets and liabilities — 33 875 3 9 890 Interest rate caps Deposits and other assets — — — 1 — 700 Derivatives not designated as hedging instruments: Interest rate swaps Other liabilities — 3 317 — 5 432 Total derivatives $ — $ 40 $ 9 $ 17 The effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table: Three Months Ended September 30, Nine Months Ended September 30, (in millions) 2019 2018 2019 2018 Foreign exchange forward contracts $ (1 ) $ 1 $ (5 ) $ 2 Interest rate derivatives (3 ) 3 (27 ) 9 Total $ (4 ) $ 4 $ (32 ) $ 11 The amount of foreign exchange gains related to the net investment hedge included in the cumulative translation adjustment component of accumulated other comprehensive loss (“AOCI”)

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2019
Fair Value Disclosures [Abstract]
Fair Value Measurements	7. Fair Value Measurements The Company records certain assets and liabilities at fair value. Fair value is defined as the price that would be received to sell an asset or paid to transfer a liability in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. A three-level fair value hierarchy that prioritizes the inputs used to measure fair value is described below. This hierarchy requires entities to maximize the use of observable inputs and minimize the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: • Level 1 — Quoted prices in active markets for identical assets or liabilities. • Level 2 — Observable inputs other than quoted prices included in Level 1, such as quoted prices for similar assets and liabilities in active markets; quoted prices for identical or similar assets and liabilities in markets that are not active; or other inputs that are observable or can be corroborated by observable market data. • Level 3 — Unobservable inputs that are supported by little or no market activity. This includes certain pricing models, discounted cash flow methodologies and similar techniques that use significant unobservable inputs. The carrying values of cash, cash equivalents, accounts receivable and accounts payable approximated their fair values at September 30, 2019 and December 31, 2018 due to their short-term nature. At September 30, 2019 and December 31, 2018, the fair value of total debt approximated $11,792 million and $10,850 million, respectively, as determined under Level 1 and Level 2 measurements for these financial instruments. Recurring Fair Value Measurements The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured and reported at fair value on a recurring basis as of September 30, 2019: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 69 $ — $ — $ 69 Derivatives — — — — Total $ 69 $ — $ — $ 69 Liabilities: Derivatives $ — $ 40 $ — $ 40 Contingent consideration — — 113 113 Total $ — $ 40 $ 113 $ 153 Below is a summary of the valuation techniques used in determining fair value: Marketable securities — The Company values trading and available-for-sale securities using the quoted market value of the securities held. Derivatives — Derivatives consist of foreign exchange contracts and interest rate swaps. The fair value of foreign exchange contracts is based on observable market inputs of spot and forward rates or using other observable inputs. The fair value of the interest rate swaps is the estimated amount that the Company would receive or pay to terminate such agreements, taking into account market interest rates and the remaining time to maturities or using market inputs with mid-market pricing as a practical expedient for bid-ask spread. Contingent consideration — The Company values contingent consideration related to business combinations using a weighted probability calculation of potential payment scenarios discounted at rates reflective of the risks associated with the expected future cash flows. Key assumptions used to estimate the fair value of contingent consideration include various financial metrics (revenue performance targets and operating forecasts) and the probability of achieving the specific targets. The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the nine months ended September 30: Contingent Consideration (in millions) 2019 2018 Balance as of January 1 $ 123 $ 69 Business combinations 41 22 Contingent consideration paid (44 ) (24 ) Revaluations included in earnings and foreign currency translation adjustments (7 ) 35 Balance as of September 30 $ 113 $ 102 The current portion of contingent consideration is included within accrued expenses and the long-term portion is included within other liabilities on the accompanying condensed consolidated balance sheets. Revaluations of the contingent consideration are recognized in other expense (income), net on the accompanying condensed consolidated statements of income.

Credit Arrangements

Credit Arrangements	9 Months Ended
	Sep. 30, 2019
Debt Disclosure [Abstract]
Credit Arrangements	8. Credit Arrangements The following is a summary of the Company’s revolving credit facilities at September 30, 2019: Facility Interest Rates $1,500 million (revolving credit facility) LIBOR in the relevant currency borrowed plus a margin of 1.50% at September 30, 2019 $25 million (receivables financing facility) LIBOR Market Index Rate (2.02% at September 30, 2019) plus 0.90% £10 million (approximately $12 million) (general banking facility) Bank’s base rate of 0.75% at September 30, 2019 plus 1% The following table summarizes the Company’s debt at the dates indicated: (in millions) September 30, 2019 December 31, 2018 Senior Secured Credit Facilities: Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 3.60% $ 780 $ 812 Term A Loan due 2023—Euro LIBOR at average floating rates of 1.50% 382 416 Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 4.10% 535 535 Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00% 1,274 1,346 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 4.10% 735 741 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 3.85% 938 945 Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00% 628 664 Revolving Credit Facility due 2023: U.S. Dollar denominated borrowings — floating rates of 3.54% 400 620 5.0% Senior Notes due 2027 — 1,100 — 5.0% Senior Notes due 2026 — 1,050 1,050 2.875% Senior Notes due 2025—Euro denominated 459 481 3.25% Senior Notes due 2025 — 1,556 1,631 3.5% Senior Notes due 2024 — 682 715 4.875% Senior Notes due 2023—U.S. Dollar denominated — 800 2.25% Senior Notes due 2028—Euro denominated 786 — Receivables financing facility due 2020—U.S. Dollar LIBOR at average floating rates of 2.92% 300 300 Principal amount of debt 11,605 11,056 Less: unamortized discount and debt issuance costs (63 ) (49 ) Less: current portion (98 ) (100 ) Long-term debt $ 11,444 $ 10,907 Contractual maturities of long-term debt are as follows at September 30, 2019: (in millions) Remainder of 2019 $ 25 2020 398 2021 98 2022 98 2023 1,398 Thereafter 9,588 $ 11,605 At September 30, 2019, there were bank guarantees totaling approximately £0.8 million (approximately $1.0 million) issued against the availability of the general banking facility. Senior Secured Credit Facilities At September 30, 2019, the Company’s senior credit facilities provided financing of approximately $6,772 million, which consisted of $5,672 million principal amounts of debt outstanding (as detailed in the table above) and $1,100 million of available borrowing capacity on the $1,500 million revolving credit facility. On August 9, 2019, the Company repriced the Euro LIBOR floor applicable to the Euro-denominated Term B Loan due 2024 and Term B Loan due 2025 to 0% Senior Notes On August 13, 2019, IQVIA Inc. (the “Issuer”), a wholly owned subsidiary of the Company, completed the issuance and sale of €720 million in gross proceeds of the Issuer’s 2.25% Senior Notes due 2028 (the “2.25% Notes”). The 2.25% Notes were issued pursuant to an Indenture, dated August 13, 2019, among the Issuer, U.S. Bank National Association, as trustee of the 2.25% Notes, and certain subsidiaries of the Issuer as guarantors. The net proceeds from the notes offering, together with available cash, were used to redeem the Issuer’s outstanding 4.875% senior notes due 2023 (the “4.875% Notes”), and to pay fees and expenses related to the notes offering. On July 29, 2019, the Issuer issued a conditional notice of redemption with respect to the 4.875% Notes, for a total redemption price equal to the sum of the principal amount of the 4.875% Notes, accrued and unpaid interest on the 4.875% Notes to the redemption date and the applicable redemption premium. The Issuer’s obligations with respect to the 4.875% Notes were discharged on August 13, 2019. The 2.25 % Notes are unsecured obligations of the Issuer, will mature on January 15, 2028 and bear interest at the rate of 2.25% per annum, with interest payable semi-annually on January 15 and July 15 of each year, beginning on January 15, 2020. The Issuer may redeem the Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to July 15, 2022 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premi um declining from 101.125 % to 0.000 %. On May 10, 2019, the “Issuer completed the issuance and sale of $1.1 billion in gross proceeds of the Issuer’s 5.00% Senior Notes due 2027 (the “5.00% Notes”). The 5.00% Notes were issued pursuant to an Indenture, dated May 10, 2019, among the Issuer, U.S. Bank National Association, as trustee of the 5.00% Notes, and certain subsidiaries of the Issuer as guarantors. The net proceeds from the notes offering were used to repay existing borrowings under the Issuer’s revolving credit facility, to pay fees and expenses related to the notes offering and for other general corporate purposes. The 5.00% Notes are unsecured obligations of the Issuer, will mature on May 15, 2027 and bear interest at the rate of 5.00% per annum, with interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2019. The Issuer may redeem the 5.00% Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to May 15, 2022 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 2.500% to 0.000%. Restrictive Covenants The Company’s debt agreements provide for certain covenants and events of default customary for similar instruments, including a covenant not to exceed a specified ratio of consolidated senior secured net indebtedness to Consolidated EBITDA, as defined in the senior secured credit facility agreement and a covenant to maintain a specified minimum interest coverage ratio. If an event of default occurs under any of the Company’s or the Company’s subsidiaries’ financing arrangements, the creditors under such financing arrangements will be entitled to take various actions, including the acceleration of amounts due under such arrangements, and in the case of the lenders under the revolving credit facility and term loans, other actions permitted to be taken by a secured creditor. The Company’s long-term debt arrangements contain other usual and customary restrictive covenants that, among other things, place limitations on the Company’s ability to declare dividends. At September 30, 2019, the Company was in compliance with the financial covenants under its debt agreements in all material respects.

Stockholders' Equity

Stockholders' Equity	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Stockholders' Equity	9. 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, 2019 or December 31, 2018. Equity Repurchase Program and Secondary Public Offering In March 2019, the Company completed an underwritten secondary public offering of 5,000,000 shares of its common stock held by certain of the Company’s remaining private equity sponsors (the “Selling Stockholders”), of which the Company repurchased 1,000,000 shares for an aggregate purchase price of approximately $140.8 million. The Company did not offer any stock in this transaction and did not receive any proceeds from the sale of the shares by the Selling Stockholders. Pursuant to an agreement with the underwriters, the Company’s per-share purchase price for repurchased shares was the same as the per-share purchase price payable by the underwriters to the Selling Stockholders. On February 13, 2019, the Company’s Board of Directors (the “Board”) increased the stock repurchase authorization under a previously approved equity repurchase program (the “Repurchase Program”) by $2.0 billion, which increased the total amount that has been authorized under the Repurchase Program to $7.725 billion since the plan’s inception in October 2013. The Repurchase Program does not obligate the Company to repurchase any particular amount of common stock, and it may be modified, extended, suspended or discontinued at any time. During the nine months ended September 30, 2019, the Company repurchased 4,785,803 shares of its common stock for approximately $690.3 million under the Repurchase Program. These amounts include shares of the Company’s common stock that it repurchased directly from underwriters in connection with the underwritten secondary public offering described above and 1,000,000 shares of the Company’s common stock repurchased from certain Selling Stockholders in a private transaction for an aggregate purchase price of approximately $156.9 million. As of September 30, 2019, the Company has remaining authorization to repurchase up to approximately $1.6 billion of its common stock under the Repurchase Program. In addition, from time to time, the Company has repurchased and may continue to repurchase common stock through private or other transactions outside of the Repurchase Program.

Business Combinations

Business Combinations	9 Months Ended
	Sep. 30, 2019
Business Combinations [Abstract]
Business Combinations	10. Business Combinations The Company completed several immaterial acquisitions during the nine months ended September 30, 2019. The Company’s assessment of fair value and the purchase price allocation related to these acquisitions is preliminary and subject to change upon completion. Further adjustments may be necessary as additional information related to the fair values of assets acquired and liabilities assumed is assessed during the measurement period (up to one year from the acquisition date). The condensed consolidated financial statements include the results of the acquisitions subsequent to their respective closing dates. Pro forma information is not presented for these acquisitions as the aggregate operations of the acquired businesses were not significant to the overall operations of the Company. The following table provides certain financial information for these acquisitions, including the preliminary allocation of the purchase price to certain intangible assets acquired and goodwill: Amortization (in millions) Period 2019 Total cost of acquisitions, net of cash acquired (1) $ 525 Amounts recorded in the condensed consolidated balance sheets: Goodwill 333 Portion of goodwill deductible for income tax purposes 106 Intangible assets: Customer relationships 6-18 years 167 Non-compete agreements 3-5 years 4 Software 3-8 years 27 Trade names 1-8 years 3 Backlog 2 years 11 Total intangible assets 212 (1) Total cost of acquisitions, net of cash acquired, includes contingent consideration and deferred purchase payments of $64 million.

Restructuring

Restructuring	9 Months Ended
	Sep. 30, 2019
Restructuring And Related Activities [Abstract]
Restructuring	11. Restructuring The Company has continued to take restructuring actions in 2019 to align its resources and reduce overcapacity to adapt to changing market conditions and integrate acquisitions. These actions include closing facilities, consolidating functional activities, eliminating redundant positions, and aligning resources with customer requirements. These restructuring actions are expected to continue into 2020. During the first quarter of 2019, there was also a decrease of $9 million in facility exit costs due to the reclassification of restructuring into a long-term operating lease liability related to the implementation of ASC 842, Leases. The following amounts were recorded for the restructuring plans: (in millions) Severance and Related Costs Facility Exit Costs Total Balance at December 31, 2018 $ 47 $ 27 $ 74 Expense, net of reversals 45 — 45 Payments (40 ) (15 ) (55 ) Foreign currency translation and other (2 ) (9 ) (11 ) Balance at September 30, 2019 $ 50 $ 3 $ 53 Restructuring costs are not allocated to the Company’s reportable segments as they are not part of the segment performance measures regularly reviewed by management. The Company expects that the majority of the restructuring accruals at September 30, 2019 will be paid in 2019 and 2020.

Income Taxes

Income Taxes	9 Months Ended
	Sep. 30, 2019
Income Tax Disclosure [Abstract]
Income Taxes	12. Income Taxes The effective income tax rate was (1.4%) and (27.5%) in the third quarter of 2019 and 2018, respectively, and 18.8% and 12.9% in the first nine months of 2019 and 2018, respectively. The effective income tax rate several individually immaterial discrete benefits. a $27 million provisional benefit related to the transition tax.

Comprehensive Income (Loss)

Comprehensive Income (Loss)	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Comprehensive Income (Loss)	1 3 . Comprehensive Income (Loss) Below is a summary of the components of AOCI: (in millions) Foreign Currency Translation Derivative Instruments Defined Benefit Plans Income Taxes Total Balance at December 31, 2018 $ (419 ) $ (1 ) $ 19 $ 177 $ (224 ) Other comprehensive income (loss) before reclassifications (63 ) (30 ) — (58 ) (151 ) Reclassification adjustments — (2 ) — — (2 ) Balance at September 30, 2019 $ (482 ) $ (33 ) $ 19 $ 119 $ (377 ) Below is a summary of the adjustments for (gains) losses reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item: Affected Financial Statement Three Months Ended September 30, Nine Months Ended September 30, (in millions) Line Item 2019 2018 2019 2018 Derivative instruments: Foreign exchange forward contracts Revenues $ 2 $ 1 $ 3 $ (2 ) Foreign exchange forward contracts Other expense (income), net — (2 ) (6 ) 2 Total before income taxes 2 (1 ) (3 ) — Income tax (benefit) expense — (1 ) (1 ) — Total net of income taxes $ 2 $ — $ (2 ) $ —

Segments

Segments	9 Months Ended
	Sep. 30, 2019
Segment Reporting [Abstract]
Segments	14. 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 Contract Sales & Medical Solutions Certain costs are not allocated to the Company’s segments and are reported as general corporate and unallocated expenses. These costs primarily consist of stock-based compensation and expenses related to integration activities and acquisitions. The Company also does not allocate depreciation and amortization or impairment charges to its segments. Prior period segment results have been recast to conform to changes to management reporting in 2019. The recast impacts the allocation of selling, general and administrative expenses for 2018. 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) 2019 2018 2019 2018 Revenues Technology & Analytics Solutions $ 1,095 $ 1,014 $ 3,272 $ 3,010 Research & Development Solutions 1,466 1,382 4,317 4,097 Contract Sales & Medical Solutions 208 198 604 617 Total revenues 2,769 2,594 8,193 7,724 Costs of revenue, exclusive of depreciation and amortization Technology & Analytics Solutions 667 589 1,956 1,718 Research & Development Solutions 1,007 921 2,924 2,765 Contract Sales & Medical Solutions 178 168 519 521 Total costs of revenue 1,852 1,678 5,399 5,004 Selling, general and administrative expenses Technology & Analytics Solutions 167 190 539 558 Research & Development Solutions 172 171 529 519 Contract Sales & Medical Solutions 15 16 45 51 General corporate and unallocated 41 52 137 145 Total selling, general and administrative expenses 395 429 1,250 1,273 Segment profit Technology & Analytics Solutions 261 235 777 734 Research & Development Solutions 287 290 864 813 Contract Sales & Medical Solutions 15 14 40 45 Total segment profit 563 539 1,681 1,592 General corporate and unallocated (41 ) (52 ) (137 ) (145 ) Depreciation and amortization (299 ) (283 ) (888 ) (847 ) Restructuring costs (19 ) (23 ) (45 ) (66 ) Total income from operations $ 204 $ 181 $ 611 $ 534

Earnings Per Share

Earnings Per Share	9 Months Ended
	Sep. 30, 2019
Earnings Per Share [Abstract]
Earnings Per Share	15. Earnings Per Share The following table presents the weighted average number of outstanding stock-based awards not included in the computation of diluted earnings per share because they are subject to performance conditions or the effect of including such stock-based awards in the computation would be anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, (in millions) 2019 2018 2019 2018 Shares subject to performance conditions 1.3 0.8 1.3 0.8 Shares subject to anti-dilutive stock-based awards 0.4 0.6 0.7 1.1 Total shares excluded from diluted earnings per share 1.7 1.4 2.0 1.9 The vesting of performance awards is contingent upon the achievement of certain performance targets. The performance awards are not included in diluted earnings per share until the performance targets have been met. Stock-based awards will have a dilutive effect under the treasury method when the respective period’s average market value of the Company’s common stock exceeds the exercise proceeds.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2019
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, 2019. 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, 2018. The balance sheet at December 31, 2018 has been derived from the audited consolidated financial statements of the Company but does not include all the disclosures required by GAAP.
Leases	Leases The Company determines if an arrangement is a lease at inception. Operating leases are included in operating lease right-of-use (“ROU”) assets, other current liabilities, and operating lease liabilities on our condensed consolidated balance sheets. Operating lease ROU assets and operating lease liabilities are recognized based on the present value of the future minimum lease payments over the lease term at commencement date. As most of the Company’s leases do not provide an implicit rate, the Company uses its incremental borrowing rate based on the information available at commencement date in determining the present value of future payments. The operating lease ROU asset also includes any lease payments made before lease commencement and initial direct costs and excludes lease incentives. The Company’s lease terms may include options to extend or terminate the lease when it is reasonably certain that we will exercise that option. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. The Company has lease agreements with lease and non-lease components that the Company has elected to account for as single lease components.
Recently Issued Accounting Standards	Recently Issued Accounting Standards Accounting pronouncements adopted In February 2018, the FASB issued new accounting guidance that will allow a reclassification from accumulated other comprehensive income to retained earnings for “stranded income tax effects” resulting from the Tax Act. Because the income statement impact related to the reduction of the historical corporate income tax rate under the Tax Act is required to be included in income tax expense, the guidance acknowledges that the income tax effects of items within accumulated other comprehensive income (“stranded income tax effects”) do not reflect the appropriate income tax rate. The Company adopted this new accounting guidance on January 1, 2019 using the aggregate portfolio approach. The Company elected the option to not reclassify accumulated other comprehensive income to retained earnings for “stranded income tax effects” resulting from the Tax Act. In August 2017, the FASB issued new accounting guidance that will allow more financial and nonfinancial hedging strategies to be eligible for hedge accounting. It also amends the presentation and disclosure requirements and changes how companies assess hedge effectiveness. It is intended to more closely align hedge accounting with risk management strategies, simplify the application of hedge accounting, and increase transparency as to the scope and results of hedging programs. The Company adopted this new accounting guidance on January 1, 2019. The adoption of this new accounting guidance did not have a material effect on the Company’s consolidated financial statements. In February 2016, the FASB issued new accounting guidance that requires lessees to recognize almost all leases on their balance sheet as a right-of-use asset and a lease liability. The income statement will reflect lease expense for operating leases, and amortization and interest expense for financing leases. The Company adopted this new accounting guidance on January 1, 2019 and elect ed the practical expedients upon transition that retain ed the lease classification , initial direct costs and determination of whether contracts are or contain a lease, for any leases that exist ed prior to adoption of the new guidance . The Company also elected the transition method which allows for disclosures to be updated prospectively and prior periods to be presented in acco rdance with previous guidance. The adoption of this standard had a material impact on the Company’s condensed consolidated balance sheets but did not have a material impact on the Company’s condensed consolidated results of operations or cash flows. Accounting pronouncements being evaluated In August 2018, the FASB issued new accounting guidance that clarifies and aligns the accounting for implementation costs for hosting arrangements with the requirements for capitalizing implementation costs incurred to develop or obtain internal-use software. The new accounting guidance will be effective for the Company on January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements. In August 2018, the FASB issued new accounting guidance that modifies the disclosure requirements for employers that sponsor defined benefit pension or other postretirement plans. The new accounting guidance will be effective for the Company on January 1, 2021. Early adoption is permitted. The adoption of this new accounting guidance is not expected to have a material effect on the Company’s consolidated financial statements. In August 2018, the FASB issued new accounting guidance that modifies the disclosure requirements in Topic 820, Fair Value Measurement, by removing certain disclosure requirements related to the fair value hierarchy, modifying existing disclosure requirements related to measurement uncertainty and adding new disclosure requirements, such as disclosing the changes in unrealized gains and losses for the period included in other comprehensive income for recurring Level 3 fair value measurements held at the end of the reporting period and disclosing the range and weighted average of significant unobservable inputs used to develop Level 3 fair value measurements. The new accounting guidance will be effective for the Company on January 1, 2020. Early adoption is permitted. The adoption of this new accounting guidance is not expected to have a material effect on the Company’s consolidated financial statements. In January 2017, the FASB issued new accounting guidance that simplifies the measurement of goodwill by eliminating the step two impairment test. Step two measures a goodwill impairment loss by comparing the implied fair value of goodwill with the carrying amount of that goodwill. The new guidance requires a comparison of the Company’s fair value of a reporting unit with the carrying amount and the Company is required to recognize an impairment charge for the amount by which the carrying amount exceeds the fair value. The new accounting guidance will be effective for the Company on January 1, 2020. Early adoption is permitted. The adoption of this new accounting guidance is not expected to have a material effect on the Company’s consolidated financial statements. In June 2016, the FASB issued a new accounting standard intended to provide financial statement users with more decision-useful information about expected credit losses and other commitments to extend credit held by the reporting entity. The standard replaces the incurred loss impairment methodology in current GAAP with one that reflects expected credit losses and requires consideration of a broader range of reasonable and supportable information to inform credit loss estimates. The standard will be effective for the Company on January 1, 2020. Early adoption is permitted. The Company is currently evaluating the impact of this new accounting guidance on its consolidated financial statements.

Revenues by Geography, Concen_2

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations (Tables)	9 Months Ended
	Sep. 30, 2019
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, 2019 and 2018: Three Months Ended September 30, 2019 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 580 $ 726 $ 104 $ 1,410 Europe and Africa 369 394 48 811 Asia-Pacific 146 346 56 548 Total revenues $ 1,095 $ 1,466 $ 208 $ 2,769 Three Months Ended September 30, 2018 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 527 $ 670 $ 87 $ 1,284 Europe and Africa 359 418 56 833 Asia-Pacific 128 294 55 477 Total revenues $ 1,014 $ 1,382 $ 198 $ 2,594 Nine Months Ended September 30, 2019 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 1,722 $ 2,009 $ 298 $ 4,029 Europe and Africa 1,128 1,298 148 2,574 Asia-Pacific 422 1,010 158 1,590 Total revenues $ 3,272 $ 4,317 $ 604 $ 8,193 Nine Months Ended September 30, 2018 (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Total Revenues: Americas $ 1,506 $ 1,909 $ 272 $ 3,687 Europe and Africa 1,111 1,279 180 2,570 Asia-Pacific 393 909 165 1,467 Total revenues $ 3,010 $ 4,097 $ 617 $ 7,724

Trade Accounts Receivable, Un_2

Trade Accounts Receivable, Unbilled Services and Unearned Income (Tables)	9 Months Ended
	Sep. 30, 2019
Receivables [Abstract]
Trade Accounts Receivable and Unbilled Services	Trade accounts receivables and unbilled services consist of the following: (in millions) September 30, 2019 December 31, 2018 Trade accounts receivable: Billed $ 1,176 $ 1,279 Unbilled services 1,351 1,130 Trade accounts receivable and unbilled services 2,527 2,409 Allowance for doubtful accounts (13 ) (15 ) Trade accounts receivable and unbilled services, net $ 2,514 $ 2,394
Schedule of Net Contract Assets (Liabilities)	Unbilled services and unearned income were as follows: (in millions, except percentages) September 30, 2019 December 31, 2018 Change Unbilled services $ 1,351 $ 1,130 $ 221 Unearned income (954 ) (1,007 ) 53 Net balance $ 397 $ 123 $ 274

Leases (Tables)

Leases (Tables)	9 Months Ended
	Sep. 30, 2019
Leases [Abstract]
Components of Lease Expense	The components of lease expense were as follows: (in millions) Classification Three Months Ended September 30, 2019 Nine Months Ended September 30, 2019 Operating lease cost (1) Selling, general and administrative expenses $ 48 $ 143 Total lease cost $ 48 $ 143 (1) Includes variable lease costs, which are immaterial.
Other Information Related to Leases	Other information related to leases was as follows: (in millions) Nine Months Ended September 30, 2019 Supplemental Cash Flow: Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 147 Right-of-use assets obtained in exchange for lease obligations: Operating leases $ 62 Weighted Average Remaining Lease Term: Operating leases 4.90 years Weighted Average Discount Rate: Operating leases 4.26 %
Future Minimum Lease Payments Under Non-cancellable Leases	Future minimum lease payments under non-cancellable leases as of September 30, 2019 were as follows: (in millions) Operating Leases Remainder of 2019 $ 44 2020 151 2021 120 2022 97 2023 74 2024 49 Thereafter 80 Total future minimum lease payments 615 Less imputed interest (69 ) Total $ 546 Reported as of September 30, 2019: Other current liabilities $ 153 Operating lease liabilities 393 Total $ 546
Summary of Future Minimum Lease Payments Under Operating Leases	The following is a summary of future minimum payments under operating leases that have initial or remaining non-cancelable lease terms in excess of one year at December 31, 2018: (in millions) Operating Leases 2019 $ 167 2020 136 2021 108 2022 90 2023 69 Thereafter 119 Total minimum lease payments $ 689

Goodwill (Tables)

Goodwill (Tables)	9 Months Ended
	Sep. 30, 2019
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, 2019: (in millions) Technology & Analytics Solutions Research & Development Solutions Contract Sales & Medical Solutions Consolidated Balance as of December 31, 2018 $ 10,239 $ 1,427 $ 134 $ 11,800 Business combinations 157 171 5 333 Impact of foreign currency fluctuations and other (210 ) (4 ) — (214 ) Balance as of September 30, 2019 $ 10,186 $ 1,594 $ 139 $ 11,919

Derivatives (Tables)

Derivatives (Tables)	9 Months Ended
	Sep. 30, 2019
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: September 30, 2019 December 31, 2018 (in millions) Balance Sheet Classification Assets Liabilities Notional Assets Liabilities Notional Derivatives designated as hedging instruments: Foreign exchange forward contracts Other current assets and liabilities $ — $ 4 $ 132 $ 5 $ 3 $ 202 Interest rate swaps Other assets and liabilities — 33 875 3 9 890 Interest rate caps Deposits and other assets — — — 1 — 700 Derivatives not designated as hedging instruments: Interest rate swaps Other liabilities — 3 317 — 5 432 Total derivatives $ — $ 40 $ 9 $ 17
Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income	The effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table: Three Months Ended September 30, Nine Months Ended September 30, (in millions) 2019 2018 2019 2018 Foreign exchange forward contracts $ (1 ) $ 1 $ (5 ) $ 2 Interest rate derivatives (3 ) 3 (27 ) 9 Total $ (4 ) $ 4 $ (32 ) $ 11

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	9 Months Ended
	Sep. 30, 2019
Fair Value Disclosures [Abstract]
Fair Value of Financial Assets and Liabilities Measured on Recurring Basis	The following table summarizes the fair value of the Company’s financial assets and liabilities that are measured and reported at fair value on a recurring basis as of September 30, 2019: (in millions) Level 1 Level 2 Level 3 Total Assets: Marketable securities $ 69 $ — $ — $ 69 Derivatives — — — — Total $ 69 $ — $ — $ 69 Liabilities: Derivatives $ — $ 40 $ — $ 40 Contingent consideration — — 113 113 Total $ — $ 40 $ 113 $ 153
Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis	The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the nine months ended September 30: Contingent Consideration (in millions) 2019 2018 Balance as of January 1 $ 123 $ 69 Business combinations 41 22 Contingent consideration paid (44 ) (24 ) Revaluations included in earnings and foreign currency translation adjustments (7 ) 35 Balance as of September 30 $ 113 $ 102

Credit Arrangements (Tables)

Credit Arrangements (Tables)	9 Months Ended
	Sep. 30, 2019
Debt Disclosure [Abstract]
Summary of Credit Facilities	The following is a summary of the Company’s revolving credit facilities at September 30, 2019: Facility Interest Rates $1,500 million (revolving credit facility) LIBOR in the relevant currency borrowed plus a margin of 1.50% at September 30, 2019 $25 million (receivables financing facility) LIBOR Market Index Rate (2.02% at September 30, 2019) plus 0.90% £10 million (approximately $12 million) (general banking facility) Bank’s base rate of 0.75% at September 30, 2019 plus 1%
Summary of Debt	The following table summarizes the Company’s debt at the dates indicated: (in millions) September 30, 2019 December 31, 2018 Senior Secured Credit Facilities: Term A Loan due 2023—U.S. Dollar LIBOR at average floating rates of 3.60% $ 780 $ 812 Term A Loan due 2023—Euro LIBOR at average floating rates of 1.50% 382 416 Term B Loan due 2024—U.S. Dollar LIBOR at average floating rates of 4.10% 535 535 Term B Loan due 2024—Euro LIBOR at average floating rates of 2.00% 1,274 1,346 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 4.10% 735 741 Term B Loan due 2025—U.S. Dollar LIBOR at average floating rates of 3.85% 938 945 Term B Loan due 2025—Euro LIBOR at average floating rates of 2.00% 628 664 Revolving Credit Facility due 2023: U.S. Dollar denominated borrowings — floating rates of 3.54% 400 620 5.0% Senior Notes due 2027 — 1,100 — 5.0% Senior Notes due 2026 — 1,050 1,050 2.875% Senior Notes due 2025—Euro denominated 459 481 3.25% Senior Notes due 2025 — 1,556 1,631 3.5% Senior Notes due 2024 — 682 715 4.875% Senior Notes due 2023—U.S. Dollar denominated — 800 2.25% Senior Notes due 2028—Euro denominated 786 — Receivables financing facility due 2020—U.S. Dollar LIBOR at average floating rates of 2.92% 300 300 Principal amount of debt 11,605 11,056 Less: unamortized discount and debt issuance costs (63 ) (49 ) Less: current portion (98 ) (100 ) Long-term debt $ 11,444 $ 10,907
Contractual Maturities of Long-term Debt	Contractual maturities of long-term debt are as follows at September 30, 2019: (in millions) Remainder of 2019 $ 25 2020 398 2021 98 2022 98 2023 1,398 Thereafter 9,588 $ 11,605

Business Combinations (Tables)

Business Combinations (Tables)	9 Months Ended
	Sep. 30, 2019
Business Combinations [Abstract]
Schedule of Preliminary Allocation of Purchase to Certain Intangible Assets Acquired and Goodwill	The following table provides certain financial information for these acquisitions, including the preliminary allocation of the purchase price to certain intangible assets acquired and goodwill: Amortization (in millions) Period 2019 Total cost of acquisitions, net of cash acquired (1) $ 525 Amounts recorded in the condensed consolidated balance sheets: Goodwill 333 Portion of goodwill deductible for income tax purposes 106 Intangible assets: Customer relationships 6-18 years 167 Non-compete agreements 3-5 years 4 Software 3-8 years 27 Trade names 1-8 years 3 Backlog 2 years 11 Total intangible assets 212 (1) Total cost of acquisitions, net of cash acquired, includes contingent consideration and deferred purchase payments of $64 million.

Restructuring (Tables)

Restructuring (Tables)	9 Months Ended
	Sep. 30, 2019
Restructuring And Related Activities [Abstract]
Summary of Amounts Recorded for Restructuring Plans	The following amounts were recorded for the restructuring plans: (in millions) Severance and Related Costs Facility Exit Costs Total Balance at December 31, 2018 $ 47 $ 27 $ 74 Expense, net of reversals 45 — 45 Payments (40 ) (15 ) (55 ) Foreign currency translation and other (2 ) (9 ) (11 ) Balance at September 30, 2019 $ 50 $ 3 $ 53

Comprehensive Income (Loss) (Ta

Comprehensive Income (Loss) (Tables)	9 Months Ended
	Sep. 30, 2019
Equity [Abstract]
Summary of Components of AOCI	Below is a summary of the components of AOCI: (in millions) Foreign Currency Translation Derivative Instruments Defined Benefit Plans Income Taxes Total Balance at December 31, 2018 $ (419 ) $ (1 ) $ 19 $ 177 $ (224 ) Other comprehensive income (loss) before reclassifications (63 ) (30 ) — (58 ) (151 ) Reclassification adjustments — (2 ) — — (2 ) Balance at September 30, 2019 $ (482 ) $ (33 ) $ 19 $ 119 $ (377 )
Summary of Adjustments for (Gains) Losses Reclassified from AOCI into Condensed Consolidated Statements of Income and Affected Financial Statement Line Item	Below is a summary of the adjustments for (gains) losses reclassified from AOCI into the condensed consolidated statements of income and the affected financial statement line item: Affected Financial Statement Three Months Ended September 30, Nine Months Ended September 30, (in millions) Line Item 2019 2018 2019 2018 Derivative instruments: Foreign exchange forward contracts Revenues $ 2 $ 1 $ 3 $ (2 ) Foreign exchange forward contracts Other expense (income), net — (2 ) (6 ) 2 Total before income taxes 2 (1 ) (3 ) — Income tax (benefit) expense — (1 ) (1 ) — Total net of income taxes $ 2 $ — $ (2 ) $ —

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2019
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) 2019 2018 2019 2018 Revenues Technology & Analytics Solutions $ 1,095 $ 1,014 $ 3,272 $ 3,010 Research & Development Solutions 1,466 1,382 4,317 4,097 Contract Sales & Medical Solutions 208 198 604 617 Total revenues 2,769 2,594 8,193 7,724 Costs of revenue, exclusive of depreciation and amortization Technology & Analytics Solutions 667 589 1,956 1,718 Research & Development Solutions 1,007 921 2,924 2,765 Contract Sales & Medical Solutions 178 168 519 521 Total costs of revenue 1,852 1,678 5,399 5,004 Selling, general and administrative expenses Technology & Analytics Solutions 167 190 539 558 Research & Development Solutions 172 171 529 519 Contract Sales & Medical Solutions 15 16 45 51 General corporate and unallocated 41 52 137 145 Total selling, general and administrative expenses 395 429 1,250 1,273 Segment profit Technology & Analytics Solutions 261 235 777 734 Research & Development Solutions 287 290 864 813 Contract Sales & Medical Solutions 15 14 40 45 Total segment profit 563 539 1,681 1,592 General corporate and unallocated (41 ) (52 ) (137 ) (145 ) Depreciation and amortization (299 ) (283 ) (888 ) (847 ) Restructuring costs (19 ) (23 ) (45 ) (66 ) Total income from operations $ 204 $ 181 $ 611 $ 534

Earnings Per Share (Tables)

Earnings Per Share (Tables)	9 Months Ended
	Sep. 30, 2019
Earnings Per Share [Abstract]
Summary of Weighted-Average Outstanding Stock-Based Awards Excluded from Computation of Diluted Earnings Per Share	The following table presents the weighted average number of outstanding stock-based awards not included in the computation of diluted earnings per share because they are subject to performance conditions or the effect of including such stock-based awards in the computation would be anti-dilutive: Three Months Ended September 30, Nine Months Ended September 30, (in millions) 2019 2018 2019 2018 Shares subject to performance conditions 1.3 0.8 1.3 0.8 Shares subject to anti-dilutive stock-based awards 0.4 0.6 0.7 1.1 Total shares excluded from diluted earnings per share 1.7 1.4 2.0 1.9

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Detail)	Sep. 30, 2019EmployeeCountry
Summary Of Significant Accounting Policies [Line Items]
Number of employees | Employee	65,000
Minimum [Member]
Summary Of Significant Accounting Policies [Line Items]
Number of countries | 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, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Disaggregation Of Revenue [Line Items]
Total revenues	$ 2,769	$ 2,594	$ 8,193	$ 7,724
Americas [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	1,410	1,284	4,029	3,687
Europe and Africa [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	811	833	2,574	2,570
Asia-Pacific [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	548	477	1,590	1,467
Technology & Analytics Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	1,095	1,014	3,272	3,010
Technology & Analytics Solutions [Member] | Americas [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	580	527	1,722	1,506
Technology & Analytics Solutions [Member] | Europe and Africa [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	369	359	1,128	1,111
Technology & Analytics Solutions [Member] | Asia-Pacific [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	146	128	422	393
Research & Development Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	1,466	1,382	4,317	4,097
Research & Development Solutions [Member] | Americas [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	726	670	2,009	1,909
Research & Development Solutions [Member] | Europe and Africa [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	394	418	1,298	1,279
Research & Development Solutions [Member] | Asia-Pacific [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	346	294	1,010	909
Contract Sales & Medical Solutions [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	208	198	604	617
Contract Sales & Medical Solutions [Member] | Americas [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	104	87	298	272
Contract Sales & Medical Solutions [Member] | Europe and Africa [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	48	56	148	180
Contract Sales & Medical Solutions [Member] | Asia-Pacific [Member]
Disaggregation Of Revenue [Line Items]
Total revenues	$ 56	$ 55	$ 158	$ 165

Revenues by Geography, Concen_4

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Additional Information (Detail) $ in Billions	3 Months Ended		9 Months Ended
	Sep. 30, 2019USD ($)Customer	Sep. 30, 2018Customer	Sep. 30, 2019USD ($)Customer	Sep. 30, 2018Customer
Revenue From Contract With Customer [Abstract]
Number of major customer | Customer	0	0	0	0
Revenue expected to be recognized in future from remaining performance obligations | $	$ 20		$ 20

Revenues by Geography, Concen_5

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Additional Information 1 (Detail) - Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2019-10-01	Sep. 30, 2019
Disaggregation Of Revenue [Line Items]
Percentage of remaining performance obligations on which revenue is expected to be recognized	35.00%
Unearned income recognition period	12 months

Trade Accounts Receivable, Un_3

Trade Accounts Receivable, Unbilled Services and Unearned Income - Trade Accounts Receivable and Unbilled Services (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Trade accounts receivable:
Billed	$ 1,176	$ 1,279
Unbilled services	1,351	1,130
Trade accounts receivable and unbilled services	2,527	2,409
Allowance for doubtful accounts	(13)	(15)
Trade accounts receivable and unbilled services, net	$ 2,514	$ 2,394

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, 2019	Dec. 31, 2018
Contract With Customer Asset And Liability [Abstract]
Unbilled services	$ 1,351	$ 1,130
Unearned income	(954)	(1,007)
Net balance	397	$ 123
Unbilled Services, Change	221
Unearned Income, Change	53
Net balance, Change	$ 274

Trade Accounts Receivable, Un_5

Trade Accounts Receivable, Unbilled Services and Unearned Income - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Receivables [Abstract]
Increase in unbilled services	$ 221
Unearned Income, Change	53
Increase of net balance of unbilled services and unearned income	$ 274

Leases - Additional Information

Leases - Additional Information (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Leases [Abstract]
Operating lease year of expiry	2029
Term of operating lease not yet commenced	through 2026
Operating expenses not yet commenced	$ 15

Leases - Components of Lease Ex

Leases - Components of Lease Expense (Detail) - USD ($) $ in Millions	3 Months Ended	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2019
Total lease cost	$ 48	$ 143
Selling General And Administrative Expenses [Member]
Operating lease cost	$ 48	$ 143

Leases - Other Information Rela

Leases - Other Information Related to Leases (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 147
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$ 62
Weighted Average Remaining Lease Term:
Operating leases	4 years 10 months 24 days
Weighted Average Discount Rate:
Operating leases	4.26%

Leases - Future Minimum Lease P

Leases - Future Minimum Lease Payments Under Non-cancellable Leases (Detail) $ in Millions	Sep. 30, 2019USD ($)
Operating Leases
Remainder of 2019	$ 44
2020	151
2021	120
2022	97
2023	74
2024	49
Thereafter	80
Total future minimum lease payments	615
Less imputed interest	(69)
Total	546
Other current liabilities	$ 153
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	us-gaap:OtherLiabilitiesCurrent
Operating lease liabilities	$ 393
Total	$ 546

Leases - Summary of Future Mini

Leases - Summary of Future Minimum Lease Payments Under Operating Leases (Detail) $ in Millions	Dec. 31, 2018USD ($)
Leases [Abstract]
Operating leases, future minimum payments due, 2019	$ 167
Operating leases, future minimum payments due, 2020	136
Operating leases, future minimum payments due, 2021	108
Operating leases, future minimum payments due, 2022	90
Operating leases, future minimum payments due, 2023	69
Operating leases, future minimum payments due, Thereafter	119
Operating leases, total minimum lease payments	$ 689

Goodwill - Summary of Goodwill

Goodwill - Summary of Goodwill by Reportable Segment (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Goodwill [Line Items]
Beginning Balance	$ 11,800
Business combinations	333
Impact of foreign currency fluctuations and other	(214)
Ending Balance	11,919
Technology & Analytics Solutions [Member]
Goodwill [Line Items]
Beginning Balance	10,239
Business combinations	157
Impact of foreign currency fluctuations and other	(210)
Ending Balance	10,186
Research & Development Solutions [Member]
Goodwill [Line Items]
Beginning Balance	1,427
Business combinations	171
Impact of foreign currency fluctuations and other	(4)
Ending Balance	1,594
Contract Sales & Medical Solutions [Member]
Goodwill [Line Items]
Beginning Balance	134
Business combinations	5
Ending Balance	$ 139

Derivatives - Summary of Fair V

Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) - USD ($)	Sep. 30, 2019	Dec. 31, 2018
Derivatives Fair Value [Line Items]
Derivative asset fair value		$ 9,000,000
Derivative liability fair value	$ 40,000,000	17,000,000
Designated as Hedging Instrument [Member] | Other Current Assets and Liabilities [Member] | Foreign Exchange Forward Contracts [Member]
Derivatives Fair Value [Line Items]
Derivative asset fair value		5,000,000
Derivative liability fair value	4,000,000	3,000,000
Derivative notional amount	132,000,000	202,000,000
Designated as Hedging Instrument [Member] | Other Assets and Liabilities [Member] | Interest Rate Swaps [Member]
Derivatives Fair Value [Line Items]
Derivative asset fair value		3,000,000
Derivative liability fair value	33,000,000	9,000,000
Derivative notional amount	875,000,000	890,000,000
Designated as Hedging Instrument [Member] | Deposits and Other Assets [Member] | Interest Rate Cap [Member]
Derivatives Fair Value [Line Items]
Derivative asset fair value		1,000,000
Derivative notional amount		700,000,000
Not Designated as Hedging Instrument [Member] | Other Liabilities [Member] | Interest Rate Swaps [Member]
Derivatives Fair Value [Line Items]
Derivative liability fair value	3,000,000	5,000,000
Derivative notional amount	$ 317,000,000	$ 432,000,000

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, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (4)	$ 4	$ (32)	$ 11
Foreign Exchange Forward Contracts [Member]
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Effect of cash flow hedging instruments on other comprehensive (loss) income	(1)	1	(5)	2
Interest Rate Derivatives [Member]
Derivative Instruments And Hedging Activities Disclosures [Line Items]
Effect of cash flow hedging instruments on other comprehensive (loss) income	$ (3)	$ 3	$ (27)	$ 9

Derivatives - Additional Inform

Derivatives - Additional Information (Detail) $ in Millions	Sep. 30, 2019USD ($)
Derivative Instruments And Hedging Activities Disclosure [Abstract]
Foreign exchange gains related to net investment hedge	$ 255

Fair Value Measurements - Addit

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Level 1 and Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of total debt	$ 11,792	$ 10,850

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	$ 57	$ 47
Recurring Fair Value Measurements [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	69
Fair value of assets	69
Fair value of liabilities	153
Recurring Fair Value Measurements [Member] | Derivatives [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	40
Recurring Fair Value Measurements [Member] | Contingent Consideration [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	113
Recurring Fair Value Measurements [Member] | Level 2 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	40
Recurring Fair Value Measurements [Member] | Level 2 [Member] | Derivatives [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	40
Recurring Fair Value Measurements [Member] | Level 1 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Marketable securities	69
Fair value of assets	69
Recurring Fair Value Measurements [Member] | Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	113
Recurring Fair Value Measurements [Member] | Level 3 [Member] | Contingent Consideration [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Fair value of liabilities	$ 113

Fair Value Measurements - Chang

Fair Value Measurements - Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Contingent Consideration [Member] - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018
Fair Value Liabilities Measured On Recurring Basis Unobservable Input Reconciliation [Line Items]
Beginning Balance, Contingent Consideration	$ 123	$ 69
Business combinations	41	22
Contingent consideration paid	(44)	(24)
Revaluations included in earnings and foreign currency translation adjustments	(7)	35
Ending Balance, Contingent Consideration	$ 113	$ 102

Credit Arrangements - Summary o

Credit Arrangements - Summary of Credit Facilities (Detail)	9 Months Ended
	Sep. 30, 2019USD ($)	Sep. 30, 2019GBP (£)
Revolving credit facility [Member]
Line Of Credit Facility [Line Items]
Facility	$ 1,500,000,000
Interest Rate Description	LIBOR in the relevant currency borrowed plus a margin of 1.50%    at September 30, 2019
Revolving credit facility [Member] | LIBOR [Member]
Line Of Credit Facility [Line Items]
Rate	1.50%	1.50%
Receivables Financing Facility [Member]
Line Of Credit Facility [Line Items]
Facility	$ 25,000,000
Interest Rate Description	LIBOR Market Index Rate (2.02% at September 30, 2019) plus 0.90%
Receivables Financing Facility [Member] | LIBOR [Member]
Line Of Credit Facility [Line Items]
Rate	2.02%	2.02%
Interest Rate spread on base rate	0.90%
General Banking Facility [Member]
Line Of Credit Facility [Line Items]
Facility	$ 12,000,000	£ 10,000,000
Interest Rate Description	Bank’s base rate of 0.75% at September 30, 2019 plus 1%
General Banking Facility [Member] | Base Rate [Member]
Line Of Credit Facility [Line Items]
Rate	0.75%	0.75%
Interest Rate spread on base rate	1.00%

Credit Arrangements - Summary_2

Credit Arrangements - Summary of Debt (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Aug. 13, 2019	May 10, 2019	Dec. 31, 2018
Senior Secured Credit Facilities:
Principal amount of debt	$ 11,605			$ 11,056
Less: unamortized discount and debt issuance costs	(63)			(49)
Less: current portion	(98)			(100)
Long-term debt	11,444			10,907
Due in 2027 [Member] | 5.0% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt			$ 1,100
Due in 2028 [Member] | 2.25% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt		$ 720
U.S Dollars [Member] | Due in 2023 [Member] | Revolving credit facility [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	400			620
U.S Dollars [Member] | Due in 2023 [Member] | Senior Secured Term A Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	780			812
U.S Dollars [Member] | Due in 2023 [Member] | 4.875% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt				800
U.S Dollars [Member] | Due in 2024 [Member] | Senior Secured Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	535			535
U.S Dollars [Member] | Due in 2025 [Member] | Senior Secured Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	735			741
U.S Dollars [Member] | Due in 2025 [Member] | Senior Secured Additional Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	938			945
U.S Dollars [Member] | Due in 2027 [Member] | 5.0% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	1,100
U.S Dollars [Member] | Due in 2026 [Member] | 5.0% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	1,050			1,050
U.S Dollars [Member] | Due in 2020 [Member] | Receivables Financing Facility [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	300			300
EUR Dollars [Member] | Due in 2023 [Member] | Senior Secured Term A Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	382			416
EUR Dollars [Member] | Due in 2024 [Member] | Senior Secured Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	1,274			1,346
EUR Dollars [Member] | Due in 2024 [Member] | 3.5% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	682			715
EUR Dollars [Member] | Due in 2025 [Member] | Senior Secured Additional Term B Loan [Member] | LIBOR [Member]
Senior Secured Credit Facilities:
Principal amount of debt	628			664
EUR Dollars [Member] | Due in 2025 [Member] | 2.875% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	459			481
EUR Dollars [Member] | Due in 2025 [Member] | 3.25% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	1,556			$ 1,631
EUR Dollars [Member] | Due in 2028 [Member] | 2.25% Senior Notes [Member]
Senior Secured Credit Facilities:
Principal amount of debt	$ 786

Credit Arrangements - Summary_3

Credit Arrangements - Summary of Debt (Parenthetical) (Detail)	Aug. 13, 2019	Aug. 09, 2019	May 10, 2019	Sep. 30, 2019
Senior Secured Term A Loan [Member] | Due in 2023 [Member]
Debt Instrument [Line Items]
Debt maturity year				2023
Senior Secured Term B Loan [Member] | Due in 2024 [Member]
Debt Instrument [Line Items]
Debt maturity year		2024		2024
Senior Secured Term B Loan [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Debt maturity year		2025		2025
Senior Secured Additional Term B Loan [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Debt maturity year				2025
5.0% Senior Notes [Member] | Due in 2026 [Member]
Debt Instrument [Line Items]
Debt maturity year				2026
5.0% Senior Notes [Member] | Due in 2027 [Member]
Debt Instrument [Line Items]
Debt maturity year			2027	2027
Debt instrument interest rate stated percentage			5.00%
5.0% Senior Notes [Member] | U.S Dollars [Member] | Due in 2026 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				5.00%
5.0% Senior Notes [Member] | U.S Dollars [Member] | Due in 2027 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				5.00%
3.25% Senior Notes [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Debt maturity year				2025
3.25% Senior Notes [Member] | EUR Dollars [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				3.25%
3.5% Senior Notes [Member] | Due in 2024 [Member]
Debt Instrument [Line Items]
Debt maturity year				2024
3.5% Senior Notes [Member] | EUR Dollars [Member] | Due in 2024 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				3.50%
2.875% Senior Notes [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Debt maturity year				2025
2.875% Senior Notes [Member] | EUR Dollars [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				2.875%
4.875% Senior Notes [Member] | Due in 2023 [Member]
Debt Instrument [Line Items]
Debt maturity year	2023			2023
Debt instrument interest rate stated percentage	4.875%
4.875% Senior Notes [Member] | U.S Dollars [Member] | Due in 2023 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				4.875%
Receivables Financing Facility [Member] | Due in 2020 [Member]
Debt Instrument [Line Items]
Debt maturity year				2020
Debt instrument interest rate terms, Description				LIBOR at average floating rates of 2.00%
2.25% Senior Notes [Member] | Due in 2028 [Member]
Debt Instrument [Line Items]
Debt maturity year	2028			2028
Debt instrument interest rate stated percentage	2.25%
2.25% Senior Notes [Member] | EUR Dollars [Member] | Due in 2028 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				2.25%
Revolving credit facility [Member] | Due in 2023 [Member]
Debt Instrument [Line Items]
Debt maturity year				2023
LIBOR [Member] | Senior Secured Term A Loan [Member] | U.S Dollars [Member] | Due in 2023 [Member]
Debt Instrument [Line Items]
Average floating rate				3.60%
LIBOR [Member] | Senior Secured Term A Loan [Member] | EUR Dollars [Member] | Due in 2023 [Member]
Debt Instrument [Line Items]
Average floating rate				1.50%
LIBOR [Member] | Senior Secured Term B Loan [Member] | U.S Dollars [Member] | Due in 2024 [Member]
Debt Instrument [Line Items]
Average floating rate				4.10%
LIBOR [Member] | Senior Secured Term B Loan [Member] | U.S Dollars [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Average floating rate				4.10%
LIBOR [Member] | Senior Secured Term B Loan [Member] | EUR Dollars [Member] | Due in 2024 [Member]
Debt Instrument [Line Items]
Average floating rate		0.00%		2.00%
LIBOR [Member] | Senior Secured Term B Loan [Member] | EUR Dollars [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Average floating rate		0.00%
LIBOR [Member] | Senior Secured Additional Term B Loan [Member] | U.S Dollars [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Average floating rate				3.85%
LIBOR [Member] | Senior Secured Additional Term B Loan [Member] | EUR Dollars [Member] | Due in 2025 [Member]
Debt Instrument [Line Items]
Average floating rate				2.00%
LIBOR [Member] | Receivables Financing Facility [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				2.02%
LIBOR [Member] | Receivables Financing Facility [Member] | Due in 2020 [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				2.92%
LIBOR [Member] | Revolving credit facility [Member]
Debt Instrument [Line Items]
Debt instrument interest rate stated percentage				1.50%
LIBOR [Member] | Revolving credit facility [Member] | U.S Dollars [Member] | Due in 2023 [Member]
Debt Instrument [Line Items]
Average floating rate				3.54%

Credit Arrangements - Contractu

Credit Arrangements - Contractual Maturities of Long-term Debt (Detail) - USD ($) $ in Millions	Sep. 30, 2019	Dec. 31, 2018
Debt Disclosure [Abstract]
Remainder of 2019	$ 25
2020	398
2021	98
2022	98
2023	1,398
Thereafter	9,588
Principal amount of debt	$ 11,605	$ 11,056

Credit Arrangements - Additiona

Credit Arrangements - Additional Information (Detail)	Aug. 13, 2019USD ($)	Aug. 09, 2019	May 10, 2019USD ($)	Sep. 30, 2019USD ($)	Sep. 30, 2019GBP (£)	Sep. 30, 2019GBP (£)	Dec. 31, 2018USD ($)
Line Of Credit Facility [Line Items]
Outstanding borrowings				$ 11,605,000,000			$ 11,056,000,000
Revolving credit facility [Member]
Line Of Credit Facility [Line Items]
Aggregate maximum principal amount				$ 1,500,000,000
Revolving credit facility [Member] | Due in 2023 [Member]
Line Of Credit Facility [Line Items]
Debt maturity year				2023	2023
LIBOR [Member] | Revolving credit facility [Member]
Line Of Credit Facility [Line Items]
Debt instrument interest rate stated percentage				1.50%		1.50%
General Banking Facility [Member]
Line Of Credit Facility [Line Items]
Bank guarantees				$ 1,000,000	£ 800,000
Aggregate maximum principal amount				12,000,000		£ 10,000,000
Senior Secured Credit Facilities [Member]
Line Of Credit Facility [Line Items]
Aggregate maximum principal amount				6,772,000,000
Outstanding borrowings				5,672,000,000
Available borrowing capacity				1,100,000,000
Senior Secured Credit Facilities [Member] | Revolving credit facility [Member]
Line Of Credit Facility [Line Items]
Current borrowing capacity				$ 1,500,000,000
Senior Secured Term B Loan [Member] | Due in 2024 [Member]
Line Of Credit Facility [Line Items]
Debt maturity year		2024		2024	2024
Senior Secured Term B Loan [Member] | Due in 2025 [Member]
Line Of Credit Facility [Line Items]
Debt maturity year		2025		2025	2025
Senior Secured Term B Loan [Member] | LIBOR [Member] | EUR Dollars [Member] | Due in 2024 [Member]
Line Of Credit Facility [Line Items]
Outstanding borrowings				$ 1,274,000,000			$ 1,346,000,000
Average floating rate		0.00%		2.00%	2.00%
Senior Secured Term B Loan [Member] | LIBOR [Member] | EUR Dollars [Member] | Due in 2025 [Member]
Line Of Credit Facility [Line Items]
Average floating rate		0.00%
2.25% Senior Notes [Member] | Due in 2028 [Member]
Line Of Credit Facility [Line Items]
Outstanding borrowings	$ 720,000,000
Debt maturity year	2028			2028	2028
Debt instrument interest rate stated percentage	2.25%
Debt instrument maturity date	Jan. 15, 2028
Debt instrument, frequency of periodic payment				semi-annually	semi-annually
Debt instrument, payment terms				interest payable semi-annually on January 15 and July 15 of each year, beginning on January 15, 2020.	interest payable semi-annually on January 15 and July 15 of each year, beginning on January 15, 2020.
2.25% Senior Notes [Member] | Due in 2028 [Member] | Maximum [Member]
Line Of Credit Facility [Line Items]
Redemption premium percentage	101.125%
2.25% Senior Notes [Member] | Due in 2028 [Member] | Minimum [Member]
Line Of Credit Facility [Line Items]
Redemption premium percentage	0.00%
2.25% Senior Notes [Member] | EUR Dollars [Member] | Due in 2028 [Member]
Line Of Credit Facility [Line Items]
Outstanding borrowings				$ 786,000,000
Debt instrument interest rate stated percentage				2.25%		2.25%
4.875% Senior Notes [Member] | Due in 2023 [Member]
Line Of Credit Facility [Line Items]
Debt maturity year	2023			2023	2023
Debt instrument interest rate stated percentage	4.875%
5.0% Senior Notes [Member] | Due in 2027 [Member]
Line Of Credit Facility [Line Items]
Outstanding borrowings			$ 1,100,000,000
Debt maturity year			2027	2027	2027
Debt instrument interest rate stated percentage			5.00%
Debt instrument maturity date			May 15, 2027
Debt instrument, frequency of periodic payment				semi-annually	semi-annually
Debt instrument, payment terms				interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2019	interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2019
5.0% Senior Notes [Member] | Due in 2027 [Member] | Maximum [Member]
Line Of Credit Facility [Line Items]
Redemption premium percentage			2.50%
5.0% Senior Notes [Member] | Due in 2027 [Member] | Minimum [Member]
Line Of Credit Facility [Line Items]
Redemption premium percentage			0.00%

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Detail) - USD ($)	Feb. 13, 2019	Mar. 31, 2019	Sep. 30, 2019	Jun. 30, 2019	Mar. 31, 2019	Sep. 30, 2018	Jun. 30, 2018	Mar. 31, 2018	Sep. 30, 2019	Dec. 31, 2018
Class Of Stock [Line Items]
Preferred stock, authorized			1,000,000						1,000,000
Preferred stock, par value			$ 0.01						$ 0.01
Preferred stock, shares issued			0						0	0
Preferred stock, shares outstanding			0						0	0
Repurchase of stock, value			$ 313,000,000	$ 236,000,000	$ 145,000,000	$ 134,000,000	$ 573,000,000	$ 86,000,000
Equity Repurchase Under Repurchase Program [Member]
Class Of Stock [Line Items]
Repurchase of stock, shares									1,000,000
Repurchase of stock, value									$ 156,900,000
Equity repurchase program increase in authorized amount	$ 2,000,000,000
Equity repurchase program authorized amount	$ 7,725,000,000
Equity available for repurchase under the repurchase program			$ 1,600,000,000						$ 1,600,000,000
Secondary Public Offering [Member]
Class Of Stock [Line Items]
Common stock held by Selling Stockholders underwritten		5,000,000			5,000,000
Repurchase of stock, shares		1,000,000
Repurchase of stock, value		$ 140,800,000
Secondary Public Offering [Member] | Equity Repurchase Under Repurchase Program [Member]
Class Of Stock [Line Items]
Repurchase of stock, shares									4,785,803
Repurchase of stock, value									$ 690,300,000

Business Combinations - Schedul

Business Combinations - Schedule of Preliminary Allocation of Purchase to Certain Intangible Assets Acquired and Goodwill (Detail) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Dec. 31, 2018
Business Acquisition [Line Items]
Total cost of acquisitions, net of cash acquired	$ 461	$ 255
Goodwill	11,919		$ 11,800
Several Individually Immaterial Acquisitions [Member]
Business Acquisition [Line Items]
Total cost of acquisitions, net of cash acquired	525
Goodwill	333
Portion of goodwill deductible for income tax purposes	106
Total intangible assets	212
Several Individually Immaterial Acquisitions [Member] | Customer Relationships [Member]
Business Acquisition [Line Items]
Total intangible assets	$ 167
Several Individually Immaterial Acquisitions [Member] | Customer Relationships [Member] | Minimum [Member]
Business Acquisition [Line Items]
Amortization Period	6 years
Several Individually Immaterial Acquisitions [Member] | Customer Relationships [Member] | Maximum [Member]
Business Acquisition [Line Items]
Amortization Period	18 years
Several Individually Immaterial Acquisitions [Member] | Non-compete Agreements [Member]
Business Acquisition [Line Items]
Total intangible assets	$ 4
Several Individually Immaterial Acquisitions [Member] | Non-compete Agreements [Member] | Minimum [Member]
Business Acquisition [Line Items]
Amortization Period	3 years
Several Individually Immaterial Acquisitions [Member] | Non-compete Agreements [Member] | Maximum [Member]
Business Acquisition [Line Items]
Amortization Period	5 years
Several Individually Immaterial Acquisitions [Member] | Software [Member]
Business Acquisition [Line Items]
Total intangible assets	$ 27
Several Individually Immaterial Acquisitions [Member] | Software [Member] | Minimum [Member]
Business Acquisition [Line Items]
Amortization Period	3 years
Several Individually Immaterial Acquisitions [Member] | Software [Member] | Maximum [Member]
Business Acquisition [Line Items]
Amortization Period	8 years
Several Individually Immaterial Acquisitions [Member] | Trade Names [Member]
Business Acquisition [Line Items]
Total intangible assets	$ 3
Several Individually Immaterial Acquisitions [Member] | Trade Names [Member] | Minimum [Member]
Business Acquisition [Line Items]
Amortization Period	1 year
Several Individually Immaterial Acquisitions [Member] | Trade Names [Member] | Maximum [Member]
Business Acquisition [Line Items]
Amortization Period	8 years
Several Individually Immaterial Acquisitions [Member] | Backlog [Member]
Business Acquisition [Line Items]
Amortization Period	2 years
Total intangible assets	$ 11

Business Combinations - Sched_2

Business Combinations - Schedule of Preliminary Allocation of Purchase to Certain Intangible Assets Acquired and Goodwill (Parenthetical) (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Business Combination Increase Decrease To Reflect Liabilities Acquired At Fair Value [Abstract]
Contingent consideration and deferred purchase payments	$ 64

Restructuring - Additional Info

Restructuring - Additional Information (Detail) $ in Millions	3 Months Ended
	Mar. 31, 2019USD ($)
Accounting Standards Update 2016-02 [Member]
Restructuring Cost and Reserve [Line Items]
Decrease in facility exit costs	$ 9

Restructuring - Summary of Amou

Restructuring - Summary of Amounts Recorded for Restructuring Plans (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Restructuring Cost and Reserve [Line Items]
Restructuring reserves, beginning balance	$ 74
Expense, net of reversals	45
Payments	(55)
Foreign currency translation and other	(11)
Restructuring reserves, ending balance	53
Severance and Related Costs [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring reserves, beginning balance	47
Expense, net of reversals	45
Payments	(40)
Foreign currency translation and other	(2)
Restructuring reserves, ending balance	50
Facility Exit Costs [Member]
Restructuring Cost and Reserve [Line Items]
Restructuring reserves, beginning balance	27
Payments	(15)
Foreign currency translation and other	(9)
Restructuring reserves, ending balance	$ 3

Income Taxes - Additional Infor

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Income Tax Disclosure [Abstract]
Effective income tax rate	(1.40%)	(27.50%)	18.80%	12.90%
Provisional benefit related to the transition tax		$ 27		$ 27

Comprehensive Income (Loss) - S

Comprehensive Income (Loss) - Summary of Components of AOCI (Detail) $ in Millions	9 Months Ended
	Sep. 30, 2019USD ($)
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	$ 6,714
Ending Balance	6,131
Beginning Balance	177
Other comprehensive income (loss) before reclassifications	(58)
Ending Balance	119
Other comprehensive income (loss) before reclassifications	(151)
Reclassification adjustments, net of tax	(2)
Foreign Currency Translation [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	(419)
Other comprehensive income (loss) before reclassifications	(63)
Ending Balance	(482)
Derivative Instruments [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	(1)
Other comprehensive income (loss) before reclassifications	(30)
Reclassification adjustments, before tax	(2)
Ending Balance	(33)
Defined Benefit Plans [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	19
Ending Balance	19
Accumulated Other Comprehensive (Loss) Income [Member]
Accumulated Other Comprehensive Income (Loss) [Line Items]
Beginning Balance	(224)
Ending Balance	$ (377)

Comprehensive Income (Loss) -_2

Comprehensive Income (Loss) - Summary of Adjustments for (Gains) Losses Reclassified from AOCI into Condensed Consolidated Statements of Income and Affected Financial Statement Line Item (Detail) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before income taxes	$ 2	$ (1)	$ (3)
Income tax (benefit) expense	0	(1)	(1)	$ 0
Total net of income taxes	2		(2)
Foreign Exchange Forward Contracts [Member] | Revenues [Member]
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before income taxes	$ 2	1	3	(2)
Foreign Exchange Forward Contracts [Member] | Other Expense (Income), Net [Member]
Reclassification Adjustment out of Accumulated Other Comprehensive Income [Line Items]
Total before income taxes		$ (2)	$ (6)	$ 2

Segments - Additional Informati

Segments - Additional Information (Detail)	9 Months Ended
	Sep. 30, 2019Segment
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, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Segment Reporting Information [Line Items]
Revenues	$ 2,769	$ 2,594	$ 8,193	$ 7,724
Costs of revenue, exclusive of depreciation and amortization	1,852	1,678	5,399	5,004
Selling, general and administrative expenses	395	429	1,250	1,273
Depreciation and amortization	(299)	(283)	(888)	(847)
Restructuring costs	(19)	(23)	(45)	(66)
Income from operations	204	181	611	534
Technology & Analytics Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,095	1,014	3,272	3,010
Research & Development Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,466	1,382	4,317	4,097
Contract Sales & Medical Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	208	198	604	617
Operating Segments [Member]
Segment Reporting Information [Line Items]
Segment profit	563	539	1,681	1,592
Operating Segments [Member] | Technology & Analytics Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,095	1,014	3,272	3,010
Costs of revenue, exclusive of depreciation and amortization	667	589	1,956	1,718
Selling, general and administrative expenses	167	190	539	558
Segment profit	261	235	777	734
Operating Segments [Member] | Research & Development Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	1,466	1,382	4,317	4,097
Costs of revenue, exclusive of depreciation and amortization	1,007	921	2,924	2,765
Selling, general and administrative expenses	172	171	529	519
Segment profit	287	290	864	813
Operating Segments [Member] | Contract Sales & Medical Solutions [Member]
Segment Reporting Information [Line Items]
Revenues	208	198	604	617
Costs of revenue, exclusive of depreciation and amortization	178	168	519	521
Selling, general and administrative expenses	15	16	45	51
Segment profit	15	14	40	45
Corporate, Non-Segment [Member]
Segment Reporting Information [Line Items]
Selling, general and administrative expenses	41	52	137	145
Segment profit	$ (41)	$ (52)	$ (137)	$ (145)

Earnings Per Share - Summary of

Earnings Per Share - Summary of Weighted-Average Outstanding Stock-Based Awards Excluded from Computation of Diluted Earnings Per Share (Detail) - shares shares in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2019	Sep. 30, 2018	Sep. 30, 2019	Sep. 30, 2018
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total shares excluded from diluted earnings per share	1.7	1.4	2	1.9
Performance Shares [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total shares excluded from diluted earnings per share	1.3	0.8	1.3	0.8
Share-Based Awards [Member]
Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]
Total shares excluded from diluted earnings per share	0.4	0.6	0.7	1.1