ICON Reports First Quarter 2026 Results

Highlights Quarter one revenue of $2,034.0 million, an increase of 0.9% on quarter one 2025. Quarter one adjusted EBITDA of $317.7 million or 15.6% of revenue. GAAP net income for the quarter of $104.8 million or $1.36 diluted earnings per share. Quarter one adjusted net income of $192.9 million or $2.50 adjusted diluted earnings per share. Net business wins in the quarter of $2,880 million; a net book-to-bill of 1.42. Closing backlog of $22.7 billion, an increase of 4.0% on quarter four 2025. Net debt of $2.6 billion at March 31, 2026 with a net debt to adjusted EBITDA ratio of 1.8x. Reaffirming 2026 full-year financial guidance issued with revenue expected in the range of $7,850 - $8,150 million and adjusted diluted earnings per share expected in the range of $10.00 - $11.00. Adjusted diluted earnings per share to exclude amortization, stock-based compensation, foreign currency gains and losses, restructuring, transaction, integration-related and other adjustments, transaction-related financing costs, fair value movement on investments in equity, goodwill impairment, impairment of non-financial assets and their related taxation effect. DUBLIN--(BUSINESS WIRE)-- ICON plc (NASDAQ: ICLR), a world-leading clinical research organization, today reported its financial results for the first quarter ended March 31, 2026. CEO, Mr. Barry Balfe commented, “ICON maintained strong commercial momentum in quarter one, delivering net bookings of $2.9 billion, and a net book-to-bill of 1.42, driven by robust gross award activity and low levels of cancellations. The improved win rates in quarter four sustained into this quarter, supported by partnerships added in H2 2025 and the addition of two new partnerships during the quarter. While quarter one financial performance was impacted, as expected, by business mix, I am pleased with the progress in executing our strategic plan and am confident that we will see incremental progress throughout 2026 and beyond.” First Quarter 2026 Results In quarter one 2026, gross bookings were $3,263 million with cancellations of $383 million, as determined under the new policy which went into effect October 1, 2025. This resulted in net business wins of $2,880 million and a book-to-bill of 1.42. Backlog as at March 31, 2026 was $22.7 billion. Revenue for the first quarter was $2,034.0 million. This represents an increase of 0.9% on quarter one 2025 or a decrease of 1.9% on a constant currency basis. GAAP net income was $104.8 million, resulting in diluted earnings per share of $1.36 in quarter one 2026, compared to diluted earnings per share of $1.99 in quarter one 2025. Adjusted net income for the quarter was $192.9 million, resulting in adjusted diluted earnings per share of $2.50 compared to $3.27 per share for the first quarter 2025. Adjusted EBITDA for the first quarter was $317.7 million or 15.6% of revenue, a decrease of 20.2% on quarter one 2025. The effective tax rate on adjusted net income in quarter one 2026 was 17.2%. Free cash flow was $136.2 million in the quarter. Cash generated from operating activities for the quarter was $167.0 million. During the quarter, $30.8 million was spent on capital expenditure. $7.4 million of Term Loan B payments were made during the quarter. At March 31, 2026, the Group had cash and cash equivalents of $765.2 million, compared to cash and cash equivalents of $647.3 million at December 31, 2025 and $526.7 million at March 31, 2025. Net debt as at March 31, 2026 was $2.6 billion. Conference Call Details ICON will hold a conference call on June 24, 2026 at 08:00 EDT [13:00 Ireland & UK]. This call and linked slide presentation can be accessed live from our website at http://investor.iconplc.com . A recording will also be available on the website for 90 days following the call. In addition, a calendar of company events, including upcoming conference presentations, is available on our website, under “Investors”. This calendar will be updated regularly. Other Information Cautionary Statement Regarding Forward-Looking Statements Statements included herein which are not historical facts are forward-looking statements. Such forward-looking statements are made pursuant to the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Examples of forward-looking statements include, but are not limited to, statements regarding the following: anticipated financial results for 2026; contracted revenue; the Company's expectations regarding business momentum, market opportunity, demand trends, growth, and commercial performance; and the Company's expectations with respect to its long-term value creation and competitive positioning. You can identify many forward-looking statements by words such as “aims,” “anticipates,” “believes,” “continues,” “could,” “estimates,” “expects,” “focused,” “guidance,” “intends,” “look,” “may,” “opportunities,” “plans,” “positions,” “potential,” “predicts,” “projects,” “seeks,” “should,” “will,” “would” and other similar expressions and the negatives of such expressions. However, not all forward-looking statements contain these words. These statements are based on management's current expectations and information currently available, including current economic and industry conditions. The forward looking statements involve a number of risks and uncertainties and are subject to change at any time. In the event such risks or uncertainties materialize, our results could be materially adversely affected. The risks and uncertainties include, but are not limited to, dependence on the pharmaceutical industry and certain clients, the need to regularly win projects and then to execute them efficiently and correctly, the challenges presented by rapid growth, competition and the continuing consolidation of the industry, the impact of market conditions on demand for the Company's services, risks related to the Company's ability to execute on its commercial strategy and maintain relationships with large pharmaceutical customers, and risks relating to the Company's strategic partnerships, the dependence on certain key executives, changes in the regulatory environment, exchange rate fluctuations, inflation and rising labor costs. Please also refer to the section entitled "Risk Factors" of our Annual Report on Form 20-F for the year ended December 31, 2025 filed on May 27, 2026 for a discussion of some of the principal risks that could adversely affect our business, operations and financial results. The Company’s forward-looking statements speak only as of the date of this report or as of the date they are made, and the Company undertakes no obligation to update its forward-looking statements. Non-GAAP Financial Measures In addition to the financial measures prepared in accordance with generally accepted accounting principles (GAAP), this press release contains certain non-GAAP financial measures, including adjusted EBITDA, adjusted net income and adjusted diluted earnings per share and free cash flow. Adjusted EBITDA excludes stock-based compensation, foreign currency gains and losses, restructuring, transaction, integration-related and other adjustments, fair value movement on investments in equity, and goodwill impairment, impairment of non-financial assets. Adjusted net income and adjusted diluted earnings per share exclude amortization, stock-based compensation, foreign currency gains and losses, restructuring, transaction, integration-related and other adjustments, transaction-related financing costs, fair value movement on investments in equity, goodwill impairment, impairment of non-financial assets and their related taxation effect. Free cash flow reflects cash generated from operating activities less capital expenditure. While non-GAAP financial measures are not superior to or a substitute for the comparable GAAP measures, ICON believes certain non-GAAP information is useful to investors for historical comparison purposes. *Our full-year 2026 guidance adjusted diluted earnings per share measures are provided on a non-GAAP basis without a reconciliation to the most directly comparable GAAP measure because the Company is unable to predict with a reasonable degree of certainty certain items contained in the measures without unreasonable efforts. For the same reasons, the Company is unable to address the probable significance of the unavailable information. ICON plc is a world-leading clinical research organization. Offering deep operational and medical expertise we accelerate innovation, driving emerging therapies forward to improve patient outcomes. From molecule to medicine, we deliver integrated consulting, clinical development, commercialization and post-marketing solutions to pharmaceutical, biotechnology, medical device, government and public health organizations worldwide. With headquarters in Dublin, Ireland, ICON employed approximately 40,350 employees in 97 locations in 55 countries as at March 31, 2026. For further information about ICON, visit: www.iconplc.com. Source: ICON plc Contact: Investor Relations +1 888 381 7923 Nigel Clerkin Chief Financial Officer +353 1 291 2000 Kate Haven Vice President Investor Relations +1 888 381 7923 All at ICON ICON/ICLR-F ICON plc CONSOLIDATED STATEMENTS OF OPERATIONS FOR THE THREE MONTHS ENDED MARCH 31, 2026 AND MARCH 31, 2025 (UNAUDITED) Three Months Ended March 31, 2026 March 31, 2025 (in thousands, except share and per share data) Revenue $ 2,033,999 $ 2,015,320 Costs and expenses: Direct costs 1,556,073 1,449,258 Selling, general and administrative 200,598 198,384 Depreciation and amortization 90,331 95,958 Transaction and integration related 3,187 5,404 Restructuring 10,076 39,346 Total costs and expenses 1,860,265 1,788,350 Income from operations 173,734 226,970 Interest income 1,821 1,802 Interest expense (47,997 ) (47,609 ) Income before income tax expense 127,558 181,163 Income tax expense (22,807 ) (20,351 ) Net income $ 104,751 $ 160,812 Net income per ordinary share: Basic $ 1.37 $ 2.00 Diluted $ 1.36 $ 1.99 Weighted average number of ordinary shares outstanding: Basic 76,579,420 80,552,734 Diluted 77,261,813 80,924,355 ICON plc CONSOLIDATED BALANCE SHEETS AS AT MARCH 31, 2026 AND DECEMBER 31, 2025 (UNAUDITED) March 31, 2026 December 31, 2025 ASSETS (in thousands) Current assets: Cash and cash equivalents $ 765,164 $ 647,295 Accounts receivable, net of allowance for credit losses 1,471,304 1,474,898 Unbilled revenue 1,090,950 1,096,592 Other receivables 91,804 116,750 Prepayments and other current assets 144,150 105,316 Income taxes receivable 43,965 60,824 Total current assets $ 3,607,337 $ 3,501,675 Non-current assets: Property, plant and equipment, net 384,750 395,724 Goodwill 8,725,780 8,731,689 Intangible assets, net 3,196,704 3,247,118 Operating right-of-use assets 123,606 128,948 Other receivables 74,442 75,707 Deferred tax asset 109,437 106,871 Investments in equity 96,966 82,050 Total Assets $ 16,319,022 $ 16,269,782 LIABILITIES AND SHAREHOLDERS’ EQUITY Current liabilities: Accounts payable $ 99,846 $ 192,117 Unearned revenue 1,547,527 1,550,471 Other liabilities 964,790 904,826 Income taxes payable 27,611 18,999 Current bank credit lines, loan facilities and notes 529,762 529,762 Total current liabilities $ 3,169,536 $ 3,196,175 Non-current liabilities: Non-current bank credit lines, loan facilities and notes, net 2,866,695 2,872,616 Lease liabilities 111,329 117,122 Non-current other liabilities 72,337 72,807 Non-current income taxes payable 104,509 103,251 Deferred tax liability 694,320 714,427 Commitments and contingencies — — Total Liabilities $ 7,018,726 $ 7,076,398 Shareholders' Equity: Ordinary shares, par value 6 euro cents per share; 100,000,000 shares authorized, 76,601,538 shares issued and outstanding at March 31, 2026 and 76,567,325 shares issued and outstanding at December 31, 2025 6,307 6,305 Additional paid-in capital 7,160,610 7,131,956 Other undenominated capital 1,606 1,606 Accumulated other comprehensive loss (95,029 ) (68,534 ) Retained earnings 2,226,802 2,122,051 Total Shareholders' Equity $ 9,300,296 $ 9,193,384 Total Liabilities and Shareholders' Equity $ 16,319,022 $ 16,269,782 ICON plc CONSOLIDATED STATEMENTS OF CASH FLOWS FOR THE THREE MONTHS ENDED MARCH 31, 2026 AND MARCH 31, 2025 (UNAUDITED) Three Months Ended March 31, 2026 March 31, 2025 (in thousands) Cash flows provided by operating activities: Net income $ 104,751 $ 160,812 Adjustments to reconcile net income to net cash provided by operating activities: Depreciation and amortization expense 90,331 95,958 Reduction in carrying value of operating right-of-use assets 8,980 9,384 Amortization of financing costs and debt discount 1,519 1,480 Stock compensation expense 27,574 12,359 Deferred tax benefit (22,861 ) (25,014 ) Unrealized foreign exchange movements (13,076 ) 18,081 Other non-cash items 224 8,240 Changes in operating assets and liabilities: Accounts receivable (3,188 ) 481 Unbilled revenue 6,766 (66,376 ) Unearned revenue (1,967 ) 23,463 Other net assets (32,047 ) 29,372 Net cash provided by operating activities 167,006 268,240 Cash flows used in investing activities: Purchase of property, plant and equipment (30,771 ) (28,907 ) Purchase of subsidiary undertakings (net of cash acquired) — (2,537 ) Proceeds from investments in equity 263 103 Purchase of investments in equity (8,930 ) (5,941 ) Net cash used in investing activities (39,438 ) (37,282 ) Cash flows used in financing activities: Drawdown of credit lines and loan facilities — 50,000 Repayment of credit lines and loan facilities (7,440 ) (57,440 ) Proceeds from exercise of equity compensation 1,087 4,763 Share issue costs (5 ) (5 ) Repurchase of ordinary shares — (250,000 ) Share repurchase costs — (150 ) Net cash used in financing activities (6,358 ) (252,832 ) Effect of exchange rate movements on cash (3,341 ) 9,787 Net increase / (decrease) in cash and cash equivalents 117,869 (12,087 ) Cash and cash equivalents at beginning of period 647,295 538,785 Cash and cash equivalents at end of period $ 765,164 $ 526,698 ICON plc RECONCILIATION OF NON-GAAP MEASURES FOR THE THREE MONTHS ENDED MARCH 31, 2026 AND MARCH 31, 2025 (UNAUDITED) Three Months Ended March 31, 2026 March 31, 2025 (in thousands, except share and per share data) Adjusted EBITDA Net income $ 104,751 $ 160,812 Income tax expense 22,807 20,351 Net interest expense 46,176 45,807 Depreciation and amortization 90,331 95,958 Stock-based compensation expense (a) 26,982 12,294 Foreign currency (gains) / losses, net (b) (8,375 ) 18,095 Restructuring (c) 10,076 39,346 Transaction, integration related and other (d) 31,367 5,404 Fair value movement on investments in equity (f) (6,378 ) — Adjusted EBITDA $ 317,737 $ 398,067 Adjusted net income and adjusted diluted net income per Ordinary Share Net income $ 104,751 $ 160,812 Income tax expense 22,807 20,351 Amortization 50,279 58,946 Stock-based compensation expense (a) 26,982 12,294 Foreign currency (gains) / losses, net (b) (8,375 ) 18,095 Restructuring (c) 10,076 39,346 Transaction, integration related and other (d) 31,367 5,404 Transaction-related financing costs (e) 1,519 1,465 Fair value movement on investments in equity (f) (6,378 ) — Adjusted tax expense (g) (40,081 ) (51,941 ) Adjusted net income $ 192,947 $ 264,772 Diluted weighted average number of Ordinary Shares outstanding 77,261,813 80,924,355 Adjusted diluted net income per Ordinary Share $ 2.50 $ 3.27 (a) Stock-based compensation expense represents the amount of expense related to the Company’s equity compensation programs (inclusive of employer related taxes). (b) Foreign currency (gains) / losses, net relates to gains or losses that arise in connection with the revaluation, or settlement, of non-US dollar denominated assets and liabilities. We exclude these gains and losses from adjusted EBITDA and adjusted net income because fluctuations from period-to-period do not necessarily correspond to changes in our operating results. (c) Restructuring relates to charges incurred in connection with the Company's realignment of its workforce, with the elimination of redundant positions as well as reviewing its global office footprint and optimizing its locations to best fit the requirements of the Company. (d) Transaction, integration related and other costs include expenses associated with our acquisitions and any other costs incurred related to the integration of these acquisitions. Further, costs incurred in quarter one 2026 relating to the Investigation, including out of scope audit fees resulting from the impact of the investigation, and in defense of the Putative Class Action are classified within this category. For further information, please see our Annual Report on Form 20-F filed on May 27, 2026. (e) Transaction-related financing costs includes costs incurred in connection with changes to our long-term debt and amortization of financing fees. We exclude these costs from adjusted net income because they result from financing decisions rather than from decisions made related to our ongoing operations. (f) Fair value movement on investments in equity. We exclude these movements from adjusted EBITDA and adjusted net income because fluctuations from period-to-period do not necessarily correspond to changes in our operating results. (g) Represents the tax effect of adjusted pre-tax income at our estimated effective tax rate. Contacts Investor Relations +1 888 381 7923 Nigel Clerkin Chief Financial Officer +353 1 291 2000 Kate Haven Vice President Investor Relations +1 888 381 7923 http://www.iconplc.com