Oct 22, 2026 earnings call — Bookings strength and updated 2026 guidance
Updated full-year 2026 revenue guidance of $2.835 billion to $2.855 billion, plus EBITDA, net income, and EPS ranges.
Revenue $0.7B (est $0.7B) · EPS $4.84 (est $4.44) · Next-quarter revenue outlook $2.8B
Key quotes
"Net new business awards reached an all time high in the quarter and our last 12-month closing awards was 23.9%."
"EBITDA margin for the third quarter was 24% compared to 22.5% in the prior year period. EBITDA margins benefited from lower reimbursable costs."
"Effective 10/20/2026, the board terminated the company's current share repurchase authorization and approved a new share repurchase authorization of up to $1 billion."
Analyst Q&A 10
bookings growth and competition
Q (Michael Cherny · Lee Partners): Analyst asked what drove the strong net bookings. He asked about the competitive environment and pricing/differentiation with core biotech customers.
A: Management said win rate has been strong and the market environment is strong. They said the mix shifted toward traditional oncology and less metabolic. They also said cancellations were toward the higher end but within expected range.
"So I think it is a combination of the 2." — August James Troendle (CEO)
consensus and pass-through mix
Q (Jailendra Singh · Truist): Asked whether current consensus applies to both revenue and EBITDA and how direct fee revenue versus pass-through will mix. Also asked about any color on revenue expectation.
A: They said they do not comment directly on direct fee versus pass-through breakdowns. Kevin said consensus looks reasonable relative to their current model and includes assumptions on pass-throughs, and they will provide more detail in February. He also noted the Cincinnati expansion will add about $20 million of operating costs in 2027.
"I would just kind of reiterate what August said that consensus looks reasonable relative to our current modeling, and that would include some assumptions on pass throughs at the current moment." — Kevin Brady (CFO)
margins despite headcount growth
Q (Kevin Caliendo · UBS): Asked what drove the strong direct-fee gross margin and whether that level is sustainable given headcount growth. Noted utilization and asked for drivers.
A: Management said margins can be lumpy quarter-to-quarter because of timing and ASC 606 effects, but overall direct service performance is good. They said utilization is in a good spot and revenue is currently growing faster than headcount.
"And while we are growing, headcount, you know, the revenue is growing faster than that at the given moment." — Kevin Brady (CFO)
cancellations cause and impact
Q (Ann Hynes · Mizuho): Asked why implied 2027 growth is lower and whether recent cancellations or rising rates are impacting demand. Also asked what is driving recent cancellations.
A: Management said cancellations have been a primary pressure on growth over recent years. They said recent cancellations are primarily due to product failures, safety signals or programs not meeting expectations, not mainly funding, and that cancellations are often random and unexpected.
"it is products that are not living up to expectation, safety signals, other things that are causing programs to stop." — August James Troendle (CEO)
why guide in February
Q (Justin Bowers · Deutsche Bank): Asked whether the decision to wait until February to provide guidance is driven more by awards or cancellations. Also asked about the pipeline of RFPs and awards.
A: Management said their view on 2027 is still shifting and they can provide a firmer guide in February than now. They said the total pending opportunities are up and of good quality, and if they win well in Q4 and cancellations remain in range, expectations for 2027 could improve.
"We feel we can provide a much more firm guide in February than we would be able to now." — August James Troendle (CEO)
win-rate improvement steps
Q (Ryan Halsted · RBC): Asked for more color on initiatives to improve win rates and how those changes are performing. Analyst asked for details.
A: Management said they made meaningful process adjustments toward the end of 2025 to improve win rate. They said the initiatives appear to have been successful so far but declined to provide details on what the initiatives were.
"I am not going to give details on what they were." — August James Troendle (CEO)
full-service vs carved-out work
Q (David Windley · Jefferies): Asked whether clients are carving out biometrics or seeking FSP work and if client engagement preferences are changing. Also asked whether Medpace is seeing more carve-outs.
A: Management said they have not seen a meaningful change in client behavior. They prefer full-service work but will take front-end-only projects if they can add real value in recruitment, trial quality and overall execution; they are not interested in purely functional FSP work.
"As long as we are able to add real value in terms of you know, managing the recruitment you know, quality of the trial, execution overall." — August James Troendle (CEO)
pass-through share and timelines
Q (Christine Rains · William Blair): Asked if the pass-through revenue mix range for 2H is still valid and whether customer decision timelines in the quarter were healthy or slowing.
A: Kevin said pass-through mix should be around where they finished Q3, roughly 40 to 40.5%. August said customer decision timelines are moving faster than last year and projects and RFPs are moving toward award and start-up at a normal pace.
"I expect it to be somewhere around where we finished the third quarter." — Kevin Brady (CFO)
margin drivers and staffing
Q (Eric Coldwell · Baird): Asked if anything beyond pass-through mix explained the strong EBITDA margin and whether turnover, hiring, or wage pressures are a concern for 2027.
A: Kevin said there was nothing specific to call out beyond normal quarter-to-quarter volatility and that the direct service business is performing well. He noted attrition rates are in a very good spot. August said turnover looks very low and there are no abnormal pressures on salaries, wages or benefits at this time.
"Attrition rates are in a very good spot." — Kevin Brady (CFO)
large pharma wins and pricing
Q (Luke Sergott · Barclays): Asked whether the step-up in large pharma revenue reflects share gains, new logos, or assets moving through the pipeline, and asked about pricing competitiveness on RFPs.
A: August said most large pharma work comes from a few providers and often from biotech clients that were acquired, not from targeted new large pharma outreach. He said they focus on quality over aggressive pricing and that the market appears to be back to a normalized environment.
"I think we are kind of back to a normalized environment." — August James Troendle (CEO)