Revenue in Line with Full-Year Guidance
Full year 2025 revenue of $2,723.4 million, up ~1% year-over-year and reported in line with management guidance; Q4 2025 revenue was $660.5 million.
Strong Cash Generation and Improved Collections
Generated positive Q4 operating cash flow of $129.1 million and Q4 free cash flow of $121.6 million. Full year operating cash flow was $113.5 million and free cash flow $88.3 million. Day Sales Outstanding (DSO) improved to 16 days (improved 17 days sequentially and 24 days year-over-year).
Exceeded Cost-Savings Targets
Delivered approximately $153 million in gross savings and $93 million in net savings for 2025, exceeding original targets and supporting margin and cash improvement.
Balance Sheet Strengthening and Liquidity
Paid down ~$75.7 million of senior secured notes in Q4 using cash on hand (since the spin, ~35% of original debt repaid). Ended the quarter with no revolver borrowings and available liquidity in excess of $600 million.
Backlog and Book-to-Bill Indicate Improving Demand
Q4 book-to-bill was 1.14x and trailing 12-month book-to-bill was 1.02x, reflecting improvement in demand in the second half of 2025. Backlog stood at $7.7 billion and cancellations remained in line with historical trends.
Adjusted EBITDA Performance
Full year adjusted EBITDA was $189.9 million (toward the higher end of guidance). Q4 adjusted EBITDA was $54 million (vs. $56 million a year ago) showing relative stability against a challenging backdrop.
Operational and Commercial Progress
Notable wins in Q4 including a long-term clinical pharmacology partnership with a top-5 pharma company, multiple FSP renewals, and a healthy mix of Phase II and Phase III global clinical development wins. Net Promoter Score and employee engagement improved year-over-year.
Technology and AI Investments Driving Productivity
Advanced deployment of the accelerate platform and AI-enabled tools (AI risk radar in production, CRA mobile app, My Day platform, feasibility intelligence pilot). Operational outcomes cited include accelerating recruitment by ~3 months in a complex respiratory study and completing enrollment in a Phase II Alzheimer's study.
Leadership Additions
Expanded leadership team with hires including Aggie Gallagher (General Counsel) and Dr. Scott Dave (clinical pharmacology lead); Dr. Oren Cohen now full-time Chief Medical Officer to deepen scientific engagement.