$71.00
$165.00
bear $71.00
base $135.00
bull $165.00
margin of safety $78.00
market price* $266.90
IQVIA sells two things to the world's drug and medical-device makers: contract research services (running clinical trials, the Research & Development Solutions segment) and healthcare data, analytics and commercial technology. Trial work is sold under multi-year contracts, and contracted backlog stood at $32.7 billion at the end of 2025, up from $31.1 billion a year earlier and $29.7 billion at the end of 2023. About $8.3 billion of that is expected to become revenue within twelve months. Revenue was $16.3 billion in 2025, up about 6%. How we measure earnings. We use owner earnings: cash from operations, less the swings in receivables, payables and customer prepayments, less stock-based compensation (a real cost paid in shares), less the part of capital spending needed just to stand still. Large non-cash charges, mainly about $1.1 billion a year of amortization of acquired intangibles, are correctly excluded because that money was spent on past acquisitions. On this basis owner earnings were about $0.88 billion in 2017 (the first year after the 2016 Quintiles-IMS merger), $0.70 to $0.82 billion in 2018-2020, then $1.56 billion in 2021, $1.50 billion in 2022, $1.59 billion in 2023, $1.77 billion in 2024 and $1.72 billion in 2025. We anchor on the median of 2021-2025, about $1.59 billion, or roughly $9.36 per share on the roughly 170 million shares now outstanding. We start the window in 2021 because earlier years reflect merger integration, heavier restructuring and a smaller business, and 2020 was distorted by the pandemic. 2021 had an unusually large $591 million inflow from customer prepayments, which we removed as a working-capital swing. Growth: last year versus year 1. Owner earnings fell about 3% in 2025 (from $1.77 billion to $1.72 billion; per share they rose about 3% only because share count fell through buybacks). Our base case assumes no growth in the first year from the anchor level, which is at or below that trailing figure, and then 2% a year. What we credit and what we leave out. We credit growth only from what is already secured or demonstrated. Backlog has grown about 5% a year for two years and is contractual, but owner earnings themselves rose only about 2.4% a year from 2021 to 2025 even though IQVIA spent roughly $5.8 billion on acquisitions over 2021-2025 (including $1.7 billion in 2025) and revenue grew about 18% over the period. That record is the ceiling for what we credit, so base uses 2% a year for ten years. We do not credit further acquisitions on top, margin gains, new products or artificial-intelligence tailwinds, and we do not credit buybacks (about $1.2 billion in 2025) as growth, because value per share is measured on today's share count. Because the amortization of acquired intangibles is added back automatically, we carry that decay in the growth path rather than in the earnings level: this is why growth is modest and why the far years fade. After year ten, we hold the earnings level flat for ten years, reflecting the long-standing customer relationships and data assets, then fade to zero over the following ten years, because nothing we can name and evidence guarantees earnings beyond that. Base case, about $135 per share: $9.36 of owner earnings in year one, growing 2% a year through year ten, flat for a further ten years, then fading to zero. Bear case, about $71 per share: owner earnings drop about 25% to roughly $7.00 per share, near the level of the 2018-2020 period and then decline 2% a year for ten years, flat for five, then fade. The named risks are these: Research & Development Solutions segment profit already fell 3.9% in 2025 (from $1,948 million to $1,873 million); IQVIA carries about $15.9 billion of debt at fair value, 27% of it at variable rates, so interest costs are a real drag if cancellations or delays cut trial activity; and the backlog is subject to cancellation by clients. Serial acquisitions that have not visibly lifted owner earnings also belong here. Bull case, about $165 per share: owner earnings return to the 2025 level of about $10.12 per share and grow 4% a year for ten years, a bit under the roughly 5% backlog growth of the last two years, then hold flat for ten years and fade to zero. What would make these estimates wrong. To test the base case we checked its most important support, the backlog. It has grown and about a quarter of it converts within a year, which supports the level. Against that, segment profit in trial services fell in 2025 and owner earnings have not risen in line with revenue. If margins keep slipping or acquisition spending keeps rising without lifting earnings, the base case is too high. If owner earnings sustain the 2024-2025 level of about $1.7 billion, the base case is too low. First-quarter 2026 revenue rose about 8% and operating cash flow was $618 million versus $568 million a year earlier, but one quarter does not move our earnings level. We also could not reconcile every year's working-capital line item to a single tagged figure in the data; we built the working-capital swing from the line items in each annual cash flow statement, and cash flow reconciles to net income plus non-cash charges in the years we checked. Because IQVIA's cash flow is after interest and we do not deduct debt again, the $15.9 billion of debt is reflected only through the bear case. We also do not add the roughly $2.0 billion of balance-sheet cash to any case value: cash is needed to run the business and is not part of the earnings stream we value. All three values are therefore based solely on the earnings stream and none is reduced to zero. The margin-of-safety price is about $78 per share, roughly 42% below the base case and only a little above the bear case, reflecting the company's leverage and the recent softness in trial-services profit.