Cover Page - USD ($) $ in Billions	12 Months Ended
Cover Page - USD ($) $ in Billions	Dec. 31, 2023	Feb. 05, 2024	Jun. 30, 2023
Cover [Abstract]
Document Type	10-K
Document Annual Report	true
Document Period End Date	Dec. 31, 2023
Current Fiscal Year End Date	--12-31
Document Transition Report	false
Entity File Number	001-35907
Entity Registrant Name	IQVIA HOLDINGS INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	27-1341991
Entity Address, Address Line One	2400 Ellis Rd.
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
Title of 12(b) Security	Common Stock, par value $0.01 per share
Trading Symbol	IQV
Security Exchange Name	NYSE
Entity Well-known Seasoned Issuer	Yes
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
ICFR Auditor Attestation Flag	true
Entity Shell Company	false
Entity Public Float			$ 40.8
Entity Common Stock, Shares Outstanding		181,500,000
Documents Incorporated by Reference	Portions of the registrant’s Proxy Statement for the 2024 Annual Meeting of Stockholders are incorporated herein by reference in Part III of this Annual Report on Form 10-K to the extent stated herein. Such proxy statement will be filed with the Securities and Exchange Commission within 120 days of the registrant’s fiscal year ended December 31, 2023.
Amendment Flag	false
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	FY
Entity Central Index Key	0001478242
Document Financial Statement Error Correction [Flag]	false

Audit Information	12 Months Ended
Audit Information	Dec. 31, 2023
Auditor Information [Abstract]
Auditor Name	PricewaterhouseCoopers LLP
Auditor Location	Raleigh, North Carolina
Auditor Firm ID	238

CONSOLIDATED STATEMENTS OF INCOME - USD ($) shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Statement [Abstract]
Revenues	$ 14,984	$ 14,410	$ 13,874
Cost of revenues, exclusive of depreciation and amortization	9,745	9,382	9,233
Selling, general and administrative expenses	2,053	2,071	1,964
Depreciation and amortization	1,125	1,130	1,264
Restructuring costs	84	28	20
Income from operations	1,977	1,799	1,393
Interest income	(36)	(13)	(6)
Interest expense	672	416	375
Loss on extinguishment of debt	6	0	26
Other (income) expense, net	(124)	33	(130)
Income before income taxes and equity in (losses) earnings of unconsolidated affiliates	1,459	1,363	1,128
Income tax expense	101	260	163
Income before equity in (losses) earnings of unconsolidated affiliates	1,358	1,103	965
Equity in (losses) earnings of unconsolidated affiliates	0	(12)	6
Net income	1,358	1,091	971
Net income attributable to non-controlling interests	0	0	(5)
Net income attributable to IQVIA Holdings Inc.	$ 1,358	$ 1,091	$ 966
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 7.39	$ 5.82	$ 5.05
Diluted (in dollars per share)	$ 7.29	$ 5.72	$ 4.95
Weighted average common shares outstanding:
Basic (in shares)	183.8	187.6	191.4
Diluted (in shares)	186.3	190.6	195.0

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 1,358	$ 1,091	$ 971
Comprehensive income adjustments:
Unrealized (losses) gains on derivative instruments, net of income tax (benefit) expense of $(3), $13 and $2	(7)	40	9
Defined benefit plan adjustments, net of income tax expense (benefit) of $4, $(3) and $21	7	(10)	69
Foreign currency translation, net of income tax (benefit) expense of $(55), $106 and $116	(89)	(361)	(281)
Reclassification adjustments:
Reclassifications on derivative instruments included in net income, net of income tax (expense) benefit of $(17), $2 and $4	(51)	10	12
Comprehensive income	1,218	770	780
Comprehensive income attributable to non-controlling interests	0	0	(5)
Comprehensive income attributable to IQVIA Holdings Inc.	$ 1,218	$ 770	$ 775

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME (LOSS) (Parenthetical) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Statement of Comprehensive Income [Abstract]
Unrealized (losses) gains on derivative instruments, income tax expense {benefit)	$ (3)	$ 13	$ 2
Defined benefit plan adjustments, income tax (benefit) expense	4	(3)	21
Foreign currency translation, income tax (benefit) expense	(55)	106	116
(Gain) losses on derivative instruments included in net income, income tax expense	$ (17)	$ 2	$ 4

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
ASSETS
Cash and cash equivalents	$ 1,376	$ 1,216
Trade accounts receivable and unbilled services, net	3,381	2,917
Prepaid expenses	141	151
Income taxes receivable	32	43
Investments in debt, equity and other securities	120	93
Other current assets and receivables	546	561
Total current assets	5,596	4,981
Property and equipment, net	523	532
Operating lease right-of-use assets	296	331
Investments in debt, equity and other securities	105	68
Investments in unconsolidated affiliates	134	94
Goodwill	14,567	13,921
Other identifiable intangibles, net	4,839	4,820
Deferred income taxes	166	118
Deposits and other assets, net	455	472
Total assets	26,681	25,337
Current liabilities:
Accounts payable and accrued expenses	3,564	3,316
Unearned income	1,799	1,797
Income taxes payable	116	161
Current portion of long-term debt	718	152
Other current liabilities	294	152
Total current liabilities	6,491	5,578
Long-term debt, less current portion	12,955	12,595
Deferred income taxes	202	464
Operating lease liabilities	223	264
Other liabilities	698	671
Total liabilities	20,569	19,572
Commitments and contingencies (Note 1 and 12)
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of December 31, 2023 and 2022, $0.01 par value, 257.2 shares issued and 181.5 shares outstanding as of December 31, 2023; 256.4 shares issued and 185.7 shares outstanding as of December 31, 2022	11,028	10,898
Retained earnings	4,692	3,334
Treasury stock, at cost, 75.7 and 70.7 shares as of December 31, 2023 and 2022, respectively	(8,741)	(7,740)
Accumulated other comprehensive loss	(867)	(727)
Total stockholders’ equity	6,112	5,765
Total liabilities and stockholders’ equity	$ 26,681	$ 25,337

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Statement of Financial Position [Abstract]
Common stock authorized (in shares)	400,000,000.0	400,000,000.0
Common stock, par value (usd per share)	$ 0.01	$ 0.01
Common stock, shares issued (shares)	257,200,000	256,400,000
Common stock, shares outstanding (in shares)	181,500,000	185,700,000
Treasury stock (in shares)	75,700,000	70,700,000

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities:
Net income	$ 1,358	$ 1,091	$ 971
Adjustments to reconcile net income to cash provided by operating activities:
Depreciation and amortization	1,125	1,130	1,264
Amortization of debt issuance costs and discount	18	15	17
Stock-based compensation	217	194	170
Gain on disposals of property and equipment, net	0	(10)	0
Losses (earnings) from unconsolidated affiliates	0	12	(6)
(Gain) loss on investments, net	(20)	27	(16)
Benefit from deferred income taxes	(269)	(115)	(138)
Changes in operating assets and liabilities:
Accounts receivable and unbilled services	(388)	(421)	(138)
Prepaid expenses and other assets	34	7	(15)
Accounts payable and accrued expenses	267	427	244
Unearned income	(29)	31	591
Income taxes payable and other liabilities	(164)	(128)	(2)
Net cash provided by operating activities	2,149	2,260	2,942
Investing activities:
Acquisition of property, equipment and software	(649)	(674)	(640)
Acquisition of businesses, net of cash acquired	(876)	(1,315)	(1,458)
Purchases of marketable securities, net	(6)	(5)	(10)
Investments in unconsolidated affiliates, net of payments received	(39)	(20)	(5)
(Investments in) proceeds from sale of debt and equity securities	(38)	0	5
Other	5	8	5
Net cash used in investing activities	(1,603)	(2,006)	(2,103)
Financing activities:
Proceeds from issuance of debt	4,000	1,250	1,951
Payment of debt issuance costs	(50)	(5)	(40)
Repayment of debt and principal payments on finance leases	(2,873)	(634)	(2,091)
Proceeds from revolving credit facility	2,384	2,350	810
Repayment of revolving credit facility	(2,709)	(2,025)	(600)
Payments related to employee stock option plans	(61)	(71)	(59)
Repurchase of common stock	(992)	(1,168)	(406)
Payments to Noncontrolling Interests	0	0	(758)
Contingent consideration and deferred purchase price payments	(81)	(26)	(42)
Net cash used in financing activities	(382)	(329)	(1,235)
Effect of foreign currency exchange rate changes on cash	(4)	(75)	(52)
Increase (decrease) in cash and cash equivalents	160	(150)	(448)
Cash and cash equivalents at beginning of period	1,216	1,366	1,814
Cash and cash equivalents at end of period	$ 1,376	$ 1,216	$ 1,366

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Treasury Stock	Additional Paid-In Capital	Retained Earnings	Accumulated Other Comprehensive (Loss) Income	Non-controlling Interests
Beginning balance (in shares) at Dec. 31, 2020		254.7	63.5
Beginning balance at Dec. 31, 2020	$ 6,280	$ 3	$ (6,166)	$ 11,092	$ 1,277	$ (205)	$ 279
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		1.1
Issuance of common stock	(59)	$ 0		(59)
Repurchase of common stock (in shares)			(1.7)
Repurchase of common stock	(406)		$ (406)
Stock-based compensation	157			157
Acquisition of Quest's non-controlling interest, net of tax	(710)			416		10	(284)
Net income	971				966	0	5
Unrealized gains on derivative instruments, net of tax	9					9
Defined benefit plan adjustments, net of tax	(69)					(69)
Foreign currency translation, net of tax	(281)					(281)
Reclassification adjustments, net of tax	(12)					(12)
Ending balance (in shares) at Dec. 31, 2021		255.8	65.2
Ending balance at Dec. 31, 2021	6,042	$ 3	$ (6,572)	10,774	2,243	(406)	0
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.6
Issuance of common stock	(71)			(71)
Repurchase of common stock (in shares)			(5.5)
Repurchase of common stock	(1,168)		$ (1,168)
Stock-based compensation	192			192
Net income	1,091				1,091
Unrealized gains on derivative instruments, net of tax	40					40
Defined benefit plan adjustments, net of tax	(10)					(10)
Foreign currency translation, net of tax	(361)					(361)
Reclassification adjustments, net of tax	$ 10					10
Ending balance (in shares) at Dec. 31, 2022	185.7	256.4	70.7
Ending balance at Dec. 31, 2022	$ 5,765	$ 3	$ (7,740)	10,895	3,334	(727)	0
Increase (Decrease) in Stockholders' Equity
Issuance of common stock (in shares)		0.8
Issuance of common stock	(61)			(61)
Repurchase of common stock (in shares)			(5.0)
Repurchase of common stock	(1,001)		$ (1,001)
Stock-based compensation	191			191
Net income	1,358				1,358
Unrealized gains on derivative instruments, net of tax	(7)					(7)
Defined benefit plan adjustments, net of tax	7					7
Foreign currency translation, net of tax	(89)					(89)
Reclassification adjustments, net of tax	$ (51)					(51)
Ending balance (in shares) at Dec. 31, 2023	181.5	257.2	(75.7)
Ending balance at Dec. 31, 2023	$ 6,112	$ 3	$ (8,741)	$ 11,025	$ 4,692	$ (867)	$ 0

Summary of Significant Accounting Policies

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

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 clinical research services to the life sciences industry. IQVIA creates intelligent connections across all aspects of healthcare through its analytics, transformative technology, big data resources, extensive domain expertise and network of partners. IQVIA Connected Intelligence delivers actionable insights and powerful solutions with speed and agility — enabling customers to accelerate the clinical development and commercialization of innovative medical treatments that improve healthcare outcomes for patients. With approximately 87,000 employees, the Company conducts business in more than 100 countries.

IQVIA is a global leader in protecting individual patient privacy. The Company uses a wide variety of privacy-enhancing technologies and safeguards to protect individual privacy while generating and analyzing information on a scale that helps healthcare stakeholders identify disease patterns and correlate with the precise treatment path and therapy needed for better outcomes. IQVIA’s insights and execution capabilities help biotech, medical device and pharmaceutical companies, medical researchers, government agencies, payers and other healthcare stakeholders tap into a deeper understanding of diseases, human behaviors and scientific advances, in an effort to advance their path toward cures.

Principles of Consolidation

The accompanying consolidated financial statements include the accounts and operations of the Company, its subsidiaries and investments in which the Company has control. Amounts pertaining to the non-controlling ownership interests held by third parties in the operating results and financial position of the Company’s majority-owned subsidiaries are reported as non-controlling interests. Intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

The preparation of financial statements in accordance with generally accepted accounting principles in the United States of America (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and the disclosure of contingent assets and liabilities, at the date of the financial statements, as well as the reported amounts of revenues and expenses during the period. These estimates are based on historical experience and various other assumptions believed reasonable under the circumstances. The Company evaluates its estimates on an ongoing basis and makes changes to the estimates and related disclosures as experience develops or new information becomes known. Actual results may differ from those estimates.

Foreign Currencies

The Company’s consolidated financial statements are reported in United States dollars and, accordingly, the Company’s results of operations are impacted by fluctuations in exchange rates that affect the translation of its revenues and expenses denominated in foreign currencies into United States dollars for purposes of reporting its consolidated financial results. Assets and liabilities recorded in foreign currencies on the books of foreign subsidiaries are translated at the exchange rate on the balance sheet date. Revenues, costs and expenses are translated at average rates of exchange during the year. Translation adjustments resulting from this process are charged or credited to the accumulated other comprehensive (loss) income (“AOCI”) component of stockholders’ equity. The Company is subject to foreign currency transaction risk for fluctuations in exchange rates during the period of time between the consummation and cash settlement of a transaction. The Company earns revenues from its service contracts over a period of several months and, in some cases, over a period of several years. Accordingly, exchange rate fluctuations during this period may affect the Company’s profitability with respect to such contracts.

For operations outside the United States that are considered to be highly inflationary or where the United States dollar is designated as the functional currency, monetary assets and liabilities are remeasured using end-of-period exchange rates, whereas nonmonetary accounts are remeasured using historical exchange rates, and all remeasurement and transaction adjustments are recognized in other (income) expense, net.

Cash Equivalents

The Company considers all highly liquid investments with an initial maturity of three months or less when purchased to be cash equivalents.

Derivatives

The Company uses derivative instruments to manage exposures to interest rates and foreign currencies. Derivatives are recorded on the balance sheet at fair value at each balance sheet date utilizing pricing models for non-exchange-traded contracts.

At inception, the Company designates whether or not the derivative instrument is an effective hedge of an asset, liability or firm commitment which is then classified as either a cash flow hedge or a fair value hedge. If determined to be an effective cash flow hedge, changes in the fair value of the derivative instrument are recorded as a component of AOCI until realized. The Company includes the impact from these hedges in the same line item as the hedged item on the consolidated statements of cash flows. Changes in fair value of effective fair value hedges are recorded in earnings as an offset to the changes in the fair value of the related hedged item. Hedge ineffectiveness, if any, is immediately recognized in earnings. Changes in the fair values of derivative instruments that are not an effective hedge are recognized in earnings. When it is probable that a hedged forecasted transaction will not occur, the Company discontinues hedge accounting for the affected portion of the forecasted transaction and reclassifies gains or losses that were accumulated in AOCI to earnings for foreign exchange derivatives and interest expense for interest rate derivatives on the consolidated statements of income. Cash flows are classified consistent with the underlying hedged item. The Company has entered, and may in the future enter, into derivative contracts (caps, swaps, forwards, calls or puts, warrants, for example) related to its debt and forecasted foreign currency transactions. The Company does not enter into derivative instruments for investment or speculative purposes.

The Company designates its cross-currency swaps and a portion of its foreign currency denominated debt as a hedge of its net investment in certain foreign subsidiaries to reduce the volatility in stockholders’ equity caused by changes in the Euro exchange rate with respect to the United States dollar. Foreign exchange gains or losses on the remeasurement of the debt designated as part of a hedge of net investments is recognized in the cumulative translation adjustment component of AOCI with the related offset in long-term debt. Those amounts would be reclassified from AOCI to earnings upon the sale or substantial liquidation of the net investments. The change in fair value of the cross-currency swaps are also recognized in the cumulative translation adjustment component of AOCI and would be reclassified from AOCI to earnings upon the sale or substantial liquidation of the net investments. The interest rate component of the cross-currency swaps is excluded from the assessment of hedge effectiveness and, thus, is recognized as a reduction to interest expense over the life of the cross-currency swaps.

Business Combinations and Goodwill

The Company uses the acquisition method to account for business combinations, and accordingly, the identifiable assets acquired, the liabilities assumed and any non-controlling interest in the acquiree are recorded at their estimated fair values on the date of the acquisition. The Company uses significant judgments, estimates and assumptions in determining the estimated fair value of assets acquired, liabilities assumed and non-controlling interests including expected future cash flows, and discount rates that reflect the risk associated with the expected future cash flows and estimated useful lives.

The Company records and allocates to its reporting units the excess of the cost over the fair value of the net assets acquired, known as goodwill. On an annual basis, and if a triggering event occurs, the Company performs a qualitative analysis to determine whether it is more likely than not that the estimated fair value of a reporting unit is less than its carrying amount. This includes a qualitative analysis of macroeconomic conditions, industry and market considerations, cost factors, financial performance, fair value history and other company specific events. If this qualitative analysis indicates that it is more likely than not that the estimated fair value is less than the carrying value for the respective reporting unit, the Company would then need to calculate the fair value of the reporting unit. The Company may also choose to bypass the qualitative assessment for any or all reporting units and proceed directly to a quantitative assessment, which involves estimating the fair value of the Company's reporting units and comparing to the carrying value of the reporting units. If the reporting unit calculated fair value is less than the carrying amount, the Company would record an impairment charge for the difference, with the impairment charge not to exceed the carrying amount of goodwill.

The Company reviews the carrying values of other identifiable definite-lived intangible assets if the facts and circumstances indicate a possible impairment.

Long-Lived Assets

Property and equipment are stated at cost and are depreciated using the straight-line method over the shorter of the asset’s estimated useful life or the lease term, if related to leased property, as follows:


Buildings and leasehold improvements	3	-	40 years
Equipment	3	-	10 years
Furniture and fixtures	5	-	10 years
Transportation equipment	3	-	20 years

Definite-lived other identifiable intangible assets are amortized primarily using an accelerated method that reflects the pattern in which the Company expects to benefit from the use of the asset over its estimated remaining useful life as follows:


Client relationships and backlog	1	-	25 years
Software and related assets	1	-	10 years
Trademarks, trade names and other	1	-	17 years
Databases	1	-	9 years
Non-compete agreements	2	-	5 years

Included in software and related assets is the capitalized cost of internal-use software used in supporting the Company’s business. Qualifying costs incurred during the application development stage are capitalized and amortized over their estimated useful lives. Costs are capitalized from completion of the preliminary project stage and when it is considered probable that the software will be used to perform its intended function, up until the time the software is placed into service. The Company recognized $475 million, $419 million and $211 million of amortization expense for the years ended December 31, 2023, 2022 and 2021, respectively, related to software and related assets.

The carrying values of property, equipment and intangible and other long-lived assets are reviewed for recoverability at the asset grouping level to determine if the facts and circumstances suggest that a potential impairment may have occurred. If this review indicates that carrying values will not be recoverable, as determined based on undiscounted cash flow projections, the Company will record an impairment charge to reduce carrying values to estimated fair value. There were no impairments recognized in the years ended December 31, 2023, 2022 and 2021.

Revenue Recognition

The Company’s arrangements are primarily service contracts that range in duration from a few months to several years. The Company recognizes revenues when control of these services is transferred to the customer for an amount, referred to as the transaction price, that reflects the consideration to which the Company is expected to be entitled in exchange for those goods or services. The Company determines revenue recognition utilizing the following five steps: (1) identification of the contract with a customer, (2) identification of the performance obligations in the contract (promised goods or services that are distinct), (3) determination of the transaction price, (4) allocation of the transaction price to the performance obligations, and (5) recognition of revenues when, or as, the Company transfers control of the product or service for each performance obligation. Cash payments made to customers as incentives to induce customers to enter into service agreements with the Company are amortized as a reduction of revenues over the period the services are performed. The Company records revenues net of any tax assessments by governmental authorities, such as value added taxes, that are imposed on and concurrent with specific revenues generating transactions.

The Company derives the majority of its revenues in the Technology & Analytics Solutions segment from various information and technology service offerings. Information offerings (primarily under fixed-price contracts) typically include multiple performance obligations including an ongoing subscription-based deliverable for which revenues are recognized ratably as earned over the contract period, and/or a one-time deliverable of data offerings for which revenues are recognized upon delivery. The customer is able to benefit from the provision of data as it is received. The Company’s subscription arrangements typically have terms ranging from one to three years and are generally non-cancelable and do not contain refund-type provisions. Technology services offerings may contain multiple performance obligations consisting of a mix of small and large-scale services and consulting projects, multi-year outsourcing contracts and Software-as-a-Service (“SaaS”) arrangements. These arrangements typically have terms ranging from several weeks to three years, with a majority having terms of one year or less. For arrangements that include multiple performance obligations, the transaction price is allocated to the identified performance obligations based on their relative standalone selling prices. For these contracts, the standalone selling prices are based on the Company’s normal pricing practices when sold separately with consideration of market conditions and other factors, including customer demographics and geographic location. Revenues for services engagements where the transfer of control occurs ratably over time are recognized on a straight-line basis over the term of the arrangement. Revenues from time and material contracts are recognized based on hours as the services are provided. Revenues from fixed price ad hoc services and consulting contracts are recognized over the contract term based on the ratio of the number of hours incurred for services provided during the period compared to the total estimated hours to be incurred over the entire arrangement (hours-based). Technology services offerings meet the over time criterion, as another party would not need to substantially re-perform the work already completed to satisfy the remaining obligations if the services were migrated.

The majority of the Company’s contracts within the Research & Development Solutions segment are service contracts for clinical research that represent a single performance obligation. The Company provides a significant integration service resulting in a combined output, which is clinical trial data that meets the relevant regulatory standards and can be used by the customer to progress to the next phase of a clinical trial or solicit approval of a treatment by the applicable regulatory body. The performance obligation is satisfied over time as the output is captured in data and documentation that is available for the customer to consume over the course of the arrangement and furthers progress of the clinical trial. The Company recognizes revenues over time using a cost-based input method since there is no single output measure that would fairly depict the transfer of control over the life of the performance obligation. Progress on the performance obligation is measured by the proportion of actual costs incurred to the total costs expected to complete the contract. Costs included in the measure of progress include direct labor and third-party costs (such as payments to investigators and other reimbursed expenses for the Company’s clinical monitors). This cost-based method of revenue recognition requires the Company to make estimates of costs to complete its projects on an ongoing basis. Significant judgment is required to evaluate assumptions related to these estimates. The effect of revisions to estimates related to the transaction price or costs to complete a project are recorded in the period in which the estimate is revised. Most contracts may be terminated upon 30 to 90 days' notice by the customer; however, in the event of termination, most contracts require payment for services rendered through the date of termination, as well as for subsequent services rendered to close out the contract.

The majority of revenues in the Company's Contract Sales & Medical Solutions segment is from contract salesforce to the biopharmaceutical industry and broader healthcare market and recognized over time using a single measure of progress dependent on the performance obligation. Some of the Company's Contract Sales & Medical Solutions contracts contain multiple performance obligations with distinct promises including recruiting, sales force automation and deployment of sales representatives. The Company utilizes a single measure of progress for each performance obligation to recognize revenues, which includes deployment of sales representatives based on employee days worked; recruiting based on candidates recruited; sales force automation set-up based on hours worked; and sales force automation hosting and maintenance based on usage. These services meet the over time criterion as the customer consumes the benefit as activities are performed and another party would not need to substantially re-perform the work already completed to satisfy the remaining obligations if the services were migrated to another party.

Variable Consideration

In some cases, contracts provide for variable consideration that is contingent upon the occurrence of uncertain future events, such as performance incentives (including royalty payments, bonuses, or penalty clauses that can either increase or decrease the transaction price). Variable consideration is estimated at the expected value or at the most likely amount depending on the type of consideration. Estimated amounts are included in the transaction price to the extent it is probable that a significant reversal of cumulative revenues recognized will not occur when the uncertainty associated with the variable consideration is resolved. The estimate of variable consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of the Company's anticipated performance and all information (historical, current and forecasted) that is reasonably available to the Company and reevaluated each reporting period.

Reimbursed Expenses

The Company includes reimbursed expenses in revenues and cost of revenues as the Company is primarily responsible for fulfilling the promise to provide the specified service, including the integration of the related services into a combined output to the customer, which are inseparable from the integrated service. These costs include such items as payments to investigators and travel expenses for the Company’s clinical monitors and sales representatives, over which the Company has discretion in establishing prices. The Company controls the good or service and has inventory risk on contractually reimbursable expenses, as sometimes the Company is unable to obtain reimbursement from the customer for costs incurred.

Change Orders

Changes in the scope of work are common, especially under long-term contracts, and generally result in a change in transaction price. Change orders are evaluated on a contract-by-contract basis to determine if they should be accounted for as a new contract or as part of the existing contract. Generally, services from change orders are not distinct from the original performance obligation. As a result, the effect that the contract modification has on the contract revenues, and measure of progress, is recognized as an adjustment to revenues when it occurs.

Cost of Revenues

Cost of revenues include (i) compensation and benefits for billable employees and personnel involved in production, data management and delivery, and the costs of acquiring and processing data for the Company’s information offerings; (ii) costs of staff directly involved with delivering technology-related services offerings and engagements, and the costs of data purchased specifically for technology services engagements; (iii) reimbursed expenses that are comprised principally of payments to investigators who oversee clinical trials and travel expenses for the Company’s clinical monitors and sales representatives; and (iv) other expenses directly related to service contracts such as courier fees, laboratory supplies, professional services and travel expenses.

Trade Receivables, Unbilled Services and Unearned Income

In general, billings and payments are established by contractual provisions including predetermined payment schedules, which may or may not correspond to the timing of the transfer of control of the Company’s services under the contract. In general, the Company’s intention in its invoicing (payment terms) is to maintain cash neutrality over the life of the contract. Generally, the payment terms are 30 to 90 days based on contracts. Upfront payments, when they occur, are intended to cover certain expenses the Company incurs at the beginning of the contract. Neither the Company nor its customers view such upfront payments and contracted payment schedules as a means of financing. Unbilled services primarily arise from long-term contracts when a cost-based or hours-based input method of revenue recognition is utilized and revenues recognized exceeds the amount billed to the customer.

Unearned income consists of advance payments and billings in excess of revenues recognized. As the contracted services are subsequently performed and the associated revenues are recognized, the unearned income balance is reduced by the amount of the revenue recognized during the period. Unearned income is classified as a current liability on our consolidated balance sheets as the Company expects to recognize the associated revenues in less than one year.

Restructuring Costs

Restructuring costs, which primarily include termination benefits, are recorded at estimated value. Key assumptions in determining the restructuring costs include the terms and payments that may be negotiated to terminate certain contractual obligations and the timing of employees leaving the Company.

Debt Fees

Fees incurred to issue debt are generally deferred and amortized as a component of interest expense over the estimated term of the related debt using the effective interest rate method.

Contingencies

The Company records accruals for claims, suits, investigations and proceedings when it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. The Company reviews claims, suits, investigations and proceedings at least quarterly and records or adjusts accruals related to such matters to reflect the impact and status of any settlements, rulings, advice of counsel or other information pertinent to a particular matter. Legal costs associated with contingencies are charged to expense as incurred.

The Company is party to legal proceedings incidental to its business. While the outcome of these matters could differ from management’s expectations, the Company does not believe the resolution of these matters will have a material adverse effect to the Company’s financial statements. See Note 12 for additional information.

Income Taxes

The provision for income taxes includes federal, state, local and foreign taxes. Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the estimated future tax consequences of temporary differences between the financial statement carrying amounts and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the year in which the temporary differences are expected to be recovered or settled. The Company records U.S. deferred taxes based on the Federal corporate income tax rate of 21%. The Company accounts for tax related to Global Intangible Low-Taxed Income (“GILTI”) as a period cost when incurred. Recognition of deferred income tax assets is based on management’s belief that it is more likely than not that the income tax benefit associated with certain temporary differences, income tax operating loss, capital loss carryforwards, and income tax credits, will be realized. The Company records a valuation allowance to reduce its deferred income tax assets for those deferred income tax items for which it was more likely than not that realization would not occur. The Company determines the amount of the valuation allowance based, in part, on the Company’s assessment of future taxable income and in light of the Company’s ongoing income tax strategies. If the estimate of future taxable income or tax strategies changes at any time in the future, the Company would record an adjustment to its valuation allowance. Recording such an adjustment could have a material effect on the Company’s financial condition or results of operations.

Income tax expense is based on the distribution of profit before income tax among the various taxing jurisdictions in which the Company operates, adjusted as required by the income tax laws of each taxing jurisdiction. Changes in the distribution of profits and losses among taxing jurisdictions may have a significant impact on the Company's effective income tax rate. The Company does not consider the undistributed earnings of our foreign subsidiaries to be indefinitely reinvested outside of the United States.

Pensions and Other Postretirement Benefits

The Company provides retirement benefits to certain employees, including defined benefit pension plans. The determination of benefit obligations and expense is based on actuarial models. In order to measure benefit costs and obligations using these models, assumptions are made with regard to the discount rate, expected return on plan assets, cash balance crediting rate, lump sum conversion rate and the assumed rate of compensation increases.

Stock-based Compensation

The Company accounts for stock-based compensation for stock options and stock appreciation rights under the fair value method and uses the Black-Scholes-Merton model to estimate the value of such stock-based awards granted to its employees and non-executive directors. Expected volatility is based on an analysis that incorporates the historical volatility of the Company's stock since the Merger in October 2016 and reported data for selected reasonably similar publicly traded companies for which the historical information is available. The Company does not currently anticipate paying dividends. The expected term represents the period of time the grants are expected to be outstanding. The risk-free interest rate is based on the United States Treasury yield curve in effect at the time of the grant.

The Company values its stock-based compensation for restricted stock awards and restricted stock units based on the closing market price of the Company’s common stock on the date of grant. The Company accounts for its stock-based compensation for performance awards related to compound annual earnings per share (“EPS”) growth based on the closing market price of the Company’s common stock on the date of grant, and for performance awards related to relative total shareholder return (“TSR”) based on a Monte Carlo simulation model.

Leases

The Company determines if an arrangement is a lease at inception and reassesses if there are changes in terms and conditions of the contract. Operating leases are included in operating lease right-of-use (“ROU”) assets, other current liabilities, and operating lease liabilities on our consolidated balance sheets. Finance leases are included in deposits and other assets, net, other current liabilities, and other liabilities on the Company's consolidated balance sheets. Lease assets and 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. Lease assets also include any lease payments made before lease commencement and initial direct costs and excludes lease incentives. 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. Operating lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. Finance lease expense is recognized as a combination of depreciation expense for the leased asset and interest expense for the outstanding lease liabilities using the discount rate discussed above.

The Company has lease agreements with lease and non-lease components that the Company has elected to account for as single lease components.

Earnings Per Share

The calculation of earnings per share is based on the weighted average number of common shares or common stock equivalents outstanding during the applicable period. The dilutive effect of common stock equivalents is excluded from basic earnings per share and is included in the calculation of diluted earnings per share. Potentially dilutive securities include outstanding stock options and unvested restricted stock units, restricted stock, performance awards and other stock-based awards. Diluted shares outstanding are calculated based on the average share price for each fiscal period using the treasury stock method. Under the treasury stock method, the amount the employee must pay for exercising stock options, and the amount of compensation cost for future service that the Company has not yet recognized are assumed to be used to repurchase shares.

Investments in Unconsolidated Affiliates

The Company’s investments in unconsolidated affiliates are accounted for under the equity method if the Company exercises significant influence or has an investment in a limited partnership that is considered to be greater than minor. These investments are classified as investments in unconsolidated affiliates on the accompanying consolidated balance sheets. The Company records its pro rata share of the earnings, adjusted for accretion of basis difference, of these investments in equity in (losses) earnings of unconsolidated affiliates on the accompanying consolidated statements of income. The Company reviews its investments in unconsolidated affiliates for impairment whenever events or changes in circumstances indicate that the carrying amounts may not be recoverable.

Treasury Stock

The Company records treasury stock purchases under the cost method. Upon reissuance of treasury stock, amounts in excess of the acquisition cost are credited to additional paid-in capital. If the Company reissues treasury stock at an amount below its acquisition cost and additional paid-in capital associated with prior treasury stock transactions is insufficient to cover the difference between the acquisition cost and the reissue price, this shortfall is recorded in retained earnings.

Recently Issued Accounting Standards

Accounting pronouncements recently adopted

In September 2022, the Financial Accounting Standards Board ("FASB") issued new accounting guidance, Accounting Standards Update ("ASU") 2022-04, Liabilities - Supplier Finance Programs, to enhance the transparency of supplier finance programs. The amendments in this ASU address investor and other financial statement user requests for additional information about the use of supplier finance programs by the buyer party to understand the effect of those programs on a Company's working capital, liquidity, and cash flows. The Company adopted this new accounting guidance effective January 1, 2023. The adoption of this new accounting guidance did not have a material effect on the Company's disclosures within the consolidated financial statements.

Accounting pronouncements issued but not adopted as of December 31, 2023

In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, to improve reportable segment disclosure requirements. The new guidance requires disclosure of significant segment expenses that are regularly provided to the chief operating decision maker and included in the reported measure of segment profit or loss. It does not change the definition of a segment or the guidance for determining reportable segments. The new guidance will be effective for the Company in the annual period beginning January 1, 2024 and in 2025 for interim periods. The Company is assessing the impacts of this ASU on its disclosures within the consolidated financial statements.

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, to enhance the transparency and decision usefulness of income tax disclosures. The amendments in this ASU require additional disclosures about income taxes, primarily focused on the disclosure of income taxes paid and the rate reconciliation table. The new guidance will be effective for the Company in the annual period beginning January 1, 2025. The Company is assessing the impacts of this ASU on its disclosures within the consolidated financial statements.

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations

The Company attributes revenues to geographical region based upon where the services are performed. The following tables represent revenues by geographical region and reportable segment for the years ended December 31, 2023, 2022 and 2021:


	December 31, 2023
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	3,091	$	4,157	$	304	$	7,552
Europe and Africa	2,156		2,103		200		4,459
Asia-Pacific	615		2,135		223		2,973
Total revenues	$	5,862	$	8,395	$	727	$	14,984


	December 31, 2022
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,947	$	3,747	$	354	$	7,048
Europe and Africa	2,175		2,016		175		4,366
Asia-Pacific	624		2,158		214		2,996
Total revenues	$	5,746	$	7,921	$	743	$	14,410


	December 31, 2021
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,610	$	3,887	$	351	$	6,848
Europe and Africa	2,282		1,899		176		4,357
Asia-Pacific	642		1,770		257		2,669
Total revenues	$	5,534	$	7,556	$	784	$	13,874

When attributing revenues to individual countries based upon where the services are performed, no individual country, except for the United States, accounted for 10% or more of total revenues for the years ended December 31, 2023 and 2022. For the year ended December 31, 2023, revenues in the United States accounted for approximately 45% of total revenues using this revenue attribution approach. For the year ended December 31, 2022, revenues in the United States accounted for approximately 42% of total revenues using this revenue attribution approach. For the year ended December 31, 2021, revenues in the United States and the United Kingdom accounted for approximately 42% and 11% of total revenues, respectively, using this revenue attribution approach.

No individual customer represented 10% or more of total revenues for the years ended December 31, 2023, 2022 and 2021.

Transaction Price Allocated to the Remaining Performance Obligations

As of December 31, 2023, approximately $31.7 billion of revenues are expected to be recognized in the future from remaining performance obligations. The Company expects to recognize revenues on approximately 30% of these remaining performance obligations over the next twelve months, on approximately 85% over the next five years, with the balance recognized thereafter. Most of the Company's remaining performance obligations where revenues are expected to be recognized beyond the next twelve months are for service contracts for clinical research in the Company's Research & Development Solutions segment. 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.

- Definition

The entire disclosure of revenue from contract with customer to transfer good or service and to transfer nonfinancial asset. Includes, but is not limited to, disaggregation of revenue, credit loss recognized from contract with customer, judgment and change in judgment related to contract with customer, and asset recognized from cost incurred to obtain or fulfill contract with customer. Excludes insurance and lease contracts.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 9
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-9

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 10
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-10

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-15

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 12
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-12

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)(2)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-13

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Name Accounting Standards Codification
-Topic 606
-Publisher FASB
-URI https://asc.fasb.org//606/tableOfContent

+ Details

Trade Accounts Receivable, Unbilled Services and Unearned Income

12 Months Ended

Dec. 31, 2023

Receivables [Abstract]

Trade Accounts Receivable, Unbilled Services and Unearned Income

Trade accounts receivables and unbilled services consist of the following:


	December 31,
(in millions)	2023		2022
Trade accounts receivable	$	1,473	$	1,329
Unbilled services	1,942		1,624
Trade accounts receivable and unbilled services	3,415		2,953
Allowance for doubtful accounts	(34)		(36)
Trade accounts receivable and unbilled services, net	$	3,381	$	2,917

Unbilled services and unearned income were as follows:


	December 31,
(in millions)	2023		2022		Change
Unbilled services	$	1,942	$	1,624	$	318
Unearned income	(1,799)		(1,797)		(2)
Net balance	$	143	$	(173)	$	316

Unbilled services, which is comprised of approximately 68% and 61% of unbilled receivables and 32% and 39% of contract assets as of December 31, 2023 and December 31, 2022, respectively, increased by $318 million as compared to December 31, 2022. 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 increased by $2 million over the same period resulting in an increase of $316 million in the net balance of unbilled services and unearned income between December 31, 2023 and 2022. The change in the net balance is driven by the difference in timing of revenue recognition in accordance with ASC 606, Revenue from Contracts with Customers, primarily 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.

The majority of the unearned income balance as of the beginning of the year was recognized in revenues during the year ended December 31, 2023.

Bad debt expense recognized on the Company’s receivables and unbilled services was immaterial for the years ended December 31, 2023, 2022 and 2021.

Accounts Receivable Factoring Arrangements

The Company has accounts receivable factoring agreements to sell certain eligible unsecured trade accounts receivable, either based on automatic arrangements or at its option, without recourse, to unrelated third-party financial institutions for cash. For the year ended December 31, 2023, through its accounts receivable factoring arrangements that the Company utilizes most frequently, the Company factored approximately $699 million of customer invoices on a non-recourse basis and received approximately $686 million in cash proceeds from the sales. For the year ended December 31, 2022, through these same accounts receivable factoring arrangements, the Company factored approximately $608 million of customer invoices on a non-recourse basis and received approximately $600 million in cash proceeds from the sales. The fees associated with these transactions were immaterial. The Company has other accounts receivable arrangements for which the activity associated with them is immaterial.

Investments

12 Months Ended

Dec. 31, 2023

Investments, Debt and Equity Securities [Abstract]

Investments

Debt, Equity and Other Securities

Current

The Company’s short-term investments in debt, equity and other securities consist primarily of trading investments in mutual funds and are measured at fair value with realized and unrealized gains and losses recorded in other (income) expense, net on the accompanying consolidated statements of income.

Long-term

The Company’s long-term debt and equity investments (except those accounted for under the equity method, those that result in consolidation of the investee and certain other investments) are measured at fair value and any changes in fair value are recognized in net income at the end of each reporting period. For debt and equity investments that do not have readily determinable fair values and do not qualify for the existing practical expedient in ASC 820, Fair Value Measurement, to estimate fair value using the net asset value per share of the investment, the Company applies the measurement alternative and measures those investments at cost, less any impairment, plus or minus changes resulting from observable price changes in orderly transactions for the identical or a similar investment of the same issuer at each reporting period.

Unconsolidated Affiliates

The Company accounts for its investments in unconsolidated affiliates under the equity method of accounting and records its pro rata share of its losses or earnings from these investments in equity in (losses) earnings of unconsolidated affiliates. The following is a summary of the Company’s investments in unconsolidated affiliates:


	December 31,
(in millions)	2023		2022
NovaQuest Pharma Opportunities Fund V, L.P. (“NQ Fund V”)	$	35	$	29
NostraData Pty Ltd. (“NostraData”)	18		18
NovaQuest Pharma Opportunities Fund IV, L.P. (“NQ Fund IV”)	6		8
NovaQuest Private Equity Fund I, L.P. (“NQ PE Fund I”)	10		8
Longwood Fund V, L.P. ("Longwood")	7		6
RxWare (formerly "Helparound")	2		2
NovaQuest Pharma Opportunities Fund III, L.P. (“NQ Fund III”)	1		1
Other	55		22
	$	134	$	94

Variable Interest Entities

As of December 31, 2023, the Company’s investments in unconsolidated variable interest entities (“VIEs”) and its estimated maximum exposure to loss were as follows:


(in millions)	Investments in Unconsolidated VIEs		Maximum Exposure to Loss
NQ Fund V	$	35	$	44
Longwood	7		10
NQ PE Fund I	10		11
NQ Fund IV	6		7
NQ Fund III	1		6
Other	48		293
	$	107	$	371

Derivatives

12 Months Ended

Dec. 31, 2023

Derivative Instruments and Hedging Activities Disclosure [Abstract]

Derivatives

Interest Rate Risk Management

The Company has entered into interest rate swaps for purposes of managing its exposure to interest rate fluctuations. The Company does not enter into interest rate swaps for investment or speculative purposes.

On July 19, 2018, the Company entered into forward starting interest rate swaps with a total notional value of $500 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swaps began accruing on June 28, 2019 and the swaps expire on June 28, 2024. The Company pays an average fixed rate of 2.75% and receives a variable rate of interest equal to the three-month Term SOFR on these swaps.

On March 27, 2020, the Company entered into an interest rate swap with a notional value of $1,000 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swap began accruing on March 31, 2020 and the swap expired on March 31, 2023. The Company paid a fixed rate of 0.56% and received a variable rate of interest equal to the one-month LIBOR on the swap.

On June 4, 2020, the Company entered into an interest rate swap with a notional value of $300 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swap began accruing on June 30, 2020 and the swap expires on June 28, 2024. The Company pays a fixed rate of 0.32% and receives a variable rate of interest equal to the three-month Term SOFR on the swap.

On January 3, 2023, the Company entered into interest rate swaps with a combined notional value of $1,000 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swaps began accruing on December 30, 2022 and the swaps expire on December 31, 2025. The Company pays a fixed rate of 4.10% and receives a variable rate of interest equal to one-month Term SOFR on the swaps.

On November 17, 2023, the Company entered into interest rate swaps with a combined notional value of $1,500 million in an effort to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities (see Note 10 for additional information). Interest on the swaps began accruing on November 28, 2023 and the swaps expire on January 2, 2031. The Company pays a fixed rate of 6.11% and receives a variable rate of interest equal to three-month Term SOFR plus 2.00% on the swaps.

The critical terms of the interest rate swaps noted above are substantially the same as the underlying borrowings. These interest rate swaps are accounted for as cash flow hedges as these transactions were executed to hedge the Company's interest payments and for accounting purposes are considered highly effective. As such, changes in the fair value of the interest rate swaps are recorded as unrealized gains (losses) on derivatives included in AOCI.

The fair value of these interest rate swaps represents the present value of the anticipated net payments the Company will make to the counterparty, which, when they occur, are reflected as interest expense on the consolidated statements of income. These interest rate swaps result in a total debt mix of approximately 84% fixed rate debt and 16% variable rate debt.

Foreign Exchange Risk Management

The Company transacts business in more than 100 countries and is subject to risks associated with fluctuating foreign exchange rates. Accordingly, the Company enters into foreign currency forward contracts to hedge certain forecasted foreign exchange cash flows arising from service contracts (“Service Contract Hedging”). It is the Company’s policy to enter into foreign currency forward contracts only to the extent necessary to reduce earnings and cash flow volatility associated with foreign exchange rate movements. The Company does not enter into foreign currency forward contracts for investment or speculative purposes. The principal currency hedged in 2023 was the British Pound.

Service Contract Hedging contracts are designated as cash flow hedges and are carried at fair value, with changes in the fair value recorded to AOCI. The change in fair value is reclassified from AOCI to earnings in the period in which the hedged transaction occurs. These contracts have various expiration dates through September 2024.

As of December 31, 2023 and 2022, the Company had open Service Contract Hedging contracts to hedge certain forecasted foreign currency cash flow transactions occurring in 2024 and 2023 with notional amounts totaling $121 million and $122 million, respectively. For accounting purposes these hedges are considered highly effective. As of December 31, 2023 and 2022, the Company had recorded gross unrealized gains (losses) of $2 million and $— million, and $2 million and $(2) million, respectively, related to these contracts. Upon expiration of the hedge instruments in 2023, the Company reclassified the unrealized holding gains and losses on the derivative instruments included in AOCI into earnings. The unrealized gains (losses) are included in other current assets and other current liabilities on the accompanying consolidated balance sheets as of December 31, 2023 and 2022.

Net Investment Risk Management, Euro Denominated Notes

As of December 31, 2023, the portion of the Company's foreign currency denominated debt balance that was designated as a hedge of its net investment in certain foreign subsidiaries totaled approximately €2,449 million ($2,703 million). The amount of foreign exchange (losses) gains related to this net investment hedge included in the cumulative translation adjustment component of AOCI was $(102) million, $332 million, and $475 million for the years ended December 31, 2023, 2022 and 2021, respectively.

Net Investment Risk Management, Cross-Currency Swaps

On November 15, 2023, in connection with the issuance of the 2029 Senior Secured Notes (see Note 10 for additional information), the Company entered into cross-currency swaps with a combined notional value of $1,250 million to effectively convert $1,250 million of the 2029 Senior Secured Notes into euro-denominated borrowings at prevailing euro interest rates through February 2029. The Company designated these agreements as a hedge of its net investment in certain foreign subsidiaries. These cross-currency swaps expire in February 2029. The Company will receive semiannual interest payments on February 1 and August 1 from the counterparties based on a fixed interest rate until maturity of these agreements. The effective net borrowing rate to the Company is approximately 4.8555%, inclusive of the yield on the notes and the beneficial impact of the cross-currency swaps.

On November 17, 2023, in connection with the allocation of the Term B-4 Dollar Loans (see Note 10 for additional information), the Company entered into cross-currency swaps with a combined notional value of $1,500 million to effectively convert $1,500 million of the Term B-4 Dollar Loans into euro-denominated borrowings at prevailing euro interest rates through January 2031. These cross-currency swaps expire in January 2031. The Company will receive quarterly interest payments from the counterparties based on a fixed interest rate until maturity of these agreements. The effective net borrowing rate to the Company is approximately 4.9015%, inclusive of the yield on the loans, the beneficial impact of the cross-currency swaps and of the interest rate swaps entered on November 17, 2023 as noted above.

The Company does not enter into cross-currency swaps for investment or speculative purposes. For the year ended December 31, 2023, the Company recorded a loss of $108 million within AOCI as a result of these cross-currency swaps. The Company recognized approximately $3 million related to the excluded component as a reduction of interest expense for the year ended December 31, 2023.

The fair values of the Company’s derivative instruments, on a gross basis, and the line items on the accompanying consolidated balance sheets to which they were recorded are summarized in the following table:


		December 31, 2023						December 31, 2022
(in millions)	Balance Sheet Classification	Assets		Liabilities		Notional		Assets		Liabilities		Notional
Derivatives designated as hedging instruments:
Interest rate swaps	Other current assets, other assets and other current liabilities	$	13	$	51	$	3,300	$	42	$	—	$	1,800
Cross-currency swaps	Other current liabilities	—		108		2,750		—		—		—
Foreign exchange forward contracts	Other current assets and other current liabilities	2		—		121		2		2		122

Total derivatives		$	15	$	159			$	44	$	2

The pre-tax effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table:


	Year Ended December 31,
(in millions)	2023		2022		2021
Interest rate swaps	$	(80)	$	62	$	35
Foreign exchange forward contracts	2		3		(8)
Total	$	(78)	$	65	$	27

The Company expects $48 million of pre-tax unrealized gains related to its foreign exchange contracts and interest rate derivatives included in AOCI as of December 31, 2023 to be reclassified into earnings within the next twelve months. The total amount, net of income taxes, of the cash flow hedge effect on the accompanying consolidated statements of income was $51 million, $(10) million, and $(12) million for the years ended December 31, 2023, 2022 and 2021, respectively.

Fair Value Measurements

12 Months Ended

Dec. 31, 2023

Fair Value Disclosures [Abstract]

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 as of December 31, 2023 and 2022 due to their short-term nature. As of December 31, 2023 and 2022, the fair value of total debt was $13,597 million and $12,281 million, respectively, as determined under 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 December 31, 2023:


(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	146	$	—	$	—	$	146
Derivatives	—		15		—		15
Total	$	146	$	15	$	—	$	161
Liabilities:
Derivatives	$	—	$	159	$	—	$	159
Contingent consideration	—		—		106		106
Total	$	—	$	159	$	106	$	265

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 December 31, 2022:


(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	122	$	—	$	—	$	122
Derivatives	—		44		—		44
Total	$	122	$	44	$	—	$	166
Liabilities:
Derivatives	$	—	$	2	$	—	$	2
Contingent consideration	—		—		173		173
Total	$	—	$	2	$	173	$	175

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, interest rate swaps, and cross-currency 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. The fair value of the cross-currency swaps is the estimated amount that the Company would receive or pay to terminate such agreements, taking into account the effective interest rates, foreign exchange rates and the remaining time to maturities.

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. Assumptions used to estimate the fair value of contingent consideration include various financial metrics (revenues performance targets and operating forecasts) and the probability of achieving the specific targets. Based on the assessments of the probability of achieving specific targets, as of December 31, 2023 the Company has accrued approximately 40% of the maximum contingent consideration payments that could potentially become payable.

The following table summarizes the changes in Level 3 financial assets and liabilities measured on a recurring basis for the year ended December 31:


	Contingent Consideration
(in millions)	2023		2022		2021
Balance as of January 1	$	173	$	76	$	119
Business combinations	64		134		39
Contingent consideration paid	(73)		(22)		(39)
Revaluations included in earnings and foreign currency translation adjustments	(58)		(15)		(43)
Balance as of December 31	$	106	$	173	$	76

The current portion of contingent consideration is included within accrued expenses and the long-term portion is included within other liabilities on the accompanying consolidated balance sheets. Revaluations of contingent consideration are recognized in other (income) expense, net on the accompanying consolidated statements of income. A change in significant unobservable inputs could result in a higher or lower fair value measurement of contingent consideration.

Non-recurring Fair Value Measurements

Certain assets are carried on the accompanying consolidated balance sheets at cost and are not remeasured to fair value on a recurring basis. As of December 31, 2023, assets carried on the balance sheet and not remeasured to fair value on a recurring basis totaled $19,619 million and were identified as Level 3. These assets are comprised of debt investments and cost and equity method investments of $213 million, goodwill of $14,567 million and other identifiable intangibles, net of $4,839 million.

Cost and Equity Method Investments and Debt Investments—The inputs available for valuing investments in non-public portfolio companies are generally not easily observable. The valuation of non-public investments requires judgment by the Company due to the absence of quoted market values, inherent lack of liquidity and the long-term nature of such assets. When a triggering event occurs, the Company considers a wide range of available market data when assessing the estimated fair value. Such market data includes observations of the trading multiples of public companies considered comparable to the private companies being valued as well as publicly disclosed merger transactions involving comparable private companies. In addition, valuations are adjusted to account for company-specific issues, the lack of liquidity inherent in a non-public investment, and the fact that comparable public companies are not identical to the companies being valued. Such valuation adjustments are necessary because in the absence of a committed buyer and completion of due diligence similar to that performed in an actual negotiated sale process, there may be company-specific issues that are not fully known that may affect value. Further, a variety of additional factors are reviewed by the Company, including, but not limited to, financing and sales transactions with third parties, current operating performance and future expectations of the particular investment, changes in market outlook, and the third-party financing environment. Because of the inherent uncertainty of valuations, estimated valuations may differ significantly from the values that would have been used had a ready market for the securities existed, and the differences could be material.

Goodwill—Goodwill represents the difference between the purchase price and the fair value of the identifiable tangible and intangible net assets resulting from business combinations. The recoverability of goodwill is evaluated annually for impairment, or if and when events or circumstances indicate a possible impairment. For the year ended December 31, 2023, the Company elected to perform a quantitative impairment assessment for each of the Company's reporting units. As part of the quantitative impairment assessment, the Company compared the fair value of each reporting unit to its carrying value. The quantitative test requires significant judgments, estimates, and assumptions. The Company estimated the fair value of each reporting by weighting results of the income and market approaches, with greater weight given to the income approach. Significant estimates used in the income approach include estimates of future revenues, EBITDA, cash flows, long-term growth rates, tax rates, and discount rates. The selected discount rates consider the risk and nature of the respective reporting unit’s cash flows, and the rates of return a market participant would expect to earn by investing in the Company's reporting units. The market approach uses information about the Company as well as other publicly traded guideline companies, including revenue and EBITDA-related multiples and estimates of control premiums. See Note 8 for additional information.

Other Identifiable Intangibles, Net—If a triggering event occurs, the Company determines the estimated fair value of definite-lived intangible assets by determining the present value of the expected cash flows. See Note 8 for additional information.

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Property and Equipment

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Property and Equipment

The major classes of property and equipment were as follows:


	December 31,
(in millions)	2023		2022
Land, buildings and leasehold improvements	$	376	$	363
Equipment	803		852
Transportation equipment	81		83
Furniture and fixtures	66		74
Property and equipment, gross	1,326		1,372
Less accumulated depreciation	(803)		(840)
Property and equipment, net	$	523	$	532

Property and equipment depreciation expense was as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Depreciation expense	$	151	$	160	$	147

Goodwill and Identifiable Intangible Assets

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Identifiable Intangible Assets

Goodwill and Other Identifiable Intangible Assets

As of December 31, 2023, the Company has approximately $4,839 million of other identifiable intangible assets. Amortization expense associated with other identifiable definite-lived intangible assets was as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Amortization expense	$	974	$	970	$	1,117

Estimated amortization expense for existing other identifiable intangible assets is expected to be approximately $911 million, $803 million, $665 million, $519 million and $201 million for the years ending December 31, 2024, 2025, 2026, 2027 and 2028, respectively. Estimated amortization expense can be affected by various factors such as future acquisitions, divestitures, abandonments or impairments.

The following is a summary of other identifiable intangible assets:


	December 31, 2023						December 31, 2022

(in millions)	Gross Amount		Accumulated Amortization		Net Amount		Gross Amount		Accumulated Amortization		Net Amount
Definite-lived identifiable intangible assets:
Client relationships and backlog	$	5,688	$	(2,724)	$	2,964	$	5,339	$	(2,332)	$	3,007
Software and related assets	3,629		(2,005)		1,624		3,106		(1,591)		1,515
Trademarks, trade names and other	548		(320)		228		545		(278)		267
Databases	1,837		(1,819)		18		1,817		(1,794)		23
Non-compete agreements	16		(11)		5		23		(15)		8
	$	11,718	$	(6,879)	$	4,839	$	10,830	$	(6,010)	$	4,820

The following is a summary of goodwill by reportable segment for the years ended December 31, 2023 and 2022:


(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Consolidated
Balance as of December 31, 2021	$	11,337	$	1,802	$	162	$	13,301
Business combinations	554		472		—		1,026
Impact of foreign currency fluctuations and other	(371)		(27)		(8)		(406)
Balance as of December 31, 2022	11,520		2,247		154		13,921
Business combinations	352		181		—		533
Impact of foreign currency fluctuations and other	104		11		(2)		113
Balance as of December 31, 2023	$	11,976	$	2,439	$	152	$	14,567

There were no goodwill impairment losses for the years ended December 31, 2023, 2022 and 2021.

Accrued Expenses

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Accrued Expenses

Accrued expenses consist of the following:


	December 31,
(in millions)	2023		2022
Client contract related	$	1,315	$	1,065
Compensation, including bonuses, fringe benefits and payroll taxes	968		980
Professional fees	112		99
Contingent consideration and deferred purchase price	27		90
Interest	66		43
Restructuring	36		26
Other	331		368
	$	2,855	$	2,671

Credit Arrangements

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Credit Arrangements

The following is a summary of the Company’s revolving credit facilities as of December 31, 2023:


Facility						Interest Rates
$2,000 million (revolving credit facility)						U.S. Dollar Term SOFR plus a margin of 1.25% plus a 10 basis credit spread adjustment as of December 31, 2023
$110 million (receivables financing facility)						U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of December 31, 2023

The following table summarizes the Company’s debt at the dates indicated:


	December 31,
(dollars in millions)	2023		2022
Revolving Credit Facility due 2026:
U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 6.71%	$	100	$	425
Senior Secured Credit Facilities:
Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.71%	1,270		1,343
Term A Loan due 2026—Euribor at average floating rates of 5.18%	306		314
Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.74%	1,156		1,219
Term B Loan due 2024—Euribor at average floating rates of —%	—		1,172
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of —%	—		670
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of —%	—		860
Term B Loan due 2025—Euribor at average floating rates of 5.93%	576		559
Term B Loan due 2031—U.S Dollar Term SOFR at average floating rates of 7.35%	1,500		—
5.700% Senior Secured Notes due 2028—U.S. Dollar denominated	750		—
6.250% Senior Secured Notes due 2029—U.S. Dollar denominated	1,250		—
5.0% Senior Notes due 2027—U.S. Dollar denominated	1,100		1,100
5.0% Senior Notes due 2026—U.S. Dollar denominated	1,050		1,050
6.500% Senior Notes due 2030—U.S. Dollar denominated	500		—
2.875% Senior Notes due 2025—Euro denominated	464		450
2.25% Senior Notes due 2028—Euro denominated	795		771
2.875% Senior Notes due 2028—Euro denominated	785		761
1.750% Senior Notes due 2026—Euro denominated	607		589
2.250% Senior Notes due 2029—Euro denominated	993		964
Receivables financing facility due 2024—U.S. Dollar Term SOFR at average floating rates of 6.36%
Revolving Loan Commitment	110		110
Term Loan	440		440
Principal amount of debt	13,752		12,797
Less: unamortized discount and debt issuance costs	(79)		(50)
Less: current portion	(718)		(152)
Long-term debt	$	12,955	$	12,595

Contractual maturities of long-term debt as of December 31, 2023 are as follows:


(in millions)
2024	$	718
2025	1,207
2026	3,231
2027	2,084
2028	2,345
Thereafter	4,167
	$	13,752

Senior Secured Credit Facilities

2023 Financing Transactions

On November 28, 2023, the Company entered into an amendment (the “Amendment”) to its Fifth Amended and Restated Credit Agreement (the “Credit Agreement”), among IQVIA Inc., a wholly owned subsidiary of the Company, the Company, IQVIA RDS Inc., a wholly owned subsidiary of the Company, the other guarantors party thereto, Bank of America, N.A. as administrative agent and as collateral agent, and the Lenders (as defined therein) party thereto. Pursuant to the Amendment, the Company borrowed $1,500 million in incremental Term B-4 Dollar Loans (as defined in the Credit Agreement) due January 2, 2031. The net proceeds from the Term B-4 Dollar Loans were used to repay certain of the outstanding term loans due in 2024 and in 2025 under the Company’s senior secured credit facilities, and to pay fees and expenses related to the Amendment and the offering of 2029 Senior Secured Notes (as defined below). In connection with this Amendment, the Company recognized a $6 million loss on extinguishment of debt, which includes fees and expenses.

On April 17, 2023, the Company increased the capacity of the senior secured revolving credit facility by $500 million U.S. dollars, bringing the total capacity of the revolving credit facility to $2,000 million. At the same time, the Company also amended the benchmark rate of the U.S dollar revolving credit facility and the U.S dollar Term A Loans from U.S dollar LIBOR to U.S. dollar Secured Overnight Financing Rate term rates ("Term SOFR"), plus a 10 basis point Credit Spread Adjustment.

As of December 31, 2023, the Credit Agreement provided financing through several senior secured credit facilities of up to $6,808 million, which consisted of $4,908 million principal amounts of debt outstanding (as detailed in the table above), and $1,900 million of available borrowing capacity on the $2,000 million revolving credit facility and standby letters of credit. The revolving credit facility is comprised of a $1,175 million senior secured revolving facility available in U.S. dollars, a $600 million senior secured revolving facility available in U.S. dollars, Euros, Swiss Francs and other foreign currencies, and a $225 million senior secured revolving facility available in U.S. dollars and Yen.

2022 Financing Transactions

On June 16, 2022, the Company entered into Amendment No. 1 to the Credit Agreement to borrow $1,250 million in additional U.S. Dollar denominated term A loans due 2027 (the “Additional Term A Loans”). The Additional Term A Loans bear interest based at Term SOFR, plus a credit spread adjustment of 0.10% plus a margin ranging from 1.125% to 2.00%, with a Term SOFR floor of 0.00% per annum. The proceeds from the Additional Term A Loans were used to repay approximately $950 million of outstanding revolving credit loans under the Credit Agreement and for general corporate purposes.

On October 13, 2022, the Company elected to prepay $510 million, the entire outstanding balance, of its U.S. Dollar Term B Loan due 2024.

Senior Secured Notes

2023 Financing Transactions

On November 28, 2023, IQVIA Inc. (the “Issuer”), completed the issuance and sale of $1,250 million in gross proceeds of 6.250% senior secured notes due 2029 (the “2029 Senior Secured Notes”). The 2029 Senior Secured Notes were issued pursuant to an Indenture, dated November 28, 2023, among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the 2029 Senior Secured Notes and as collateral agent, and the Company and certain subsidiaries of the Issuer as guarantors. The net proceeds from the 2029 Senior Secured Notes offering were used to repay certain of the outstanding term loans under the Company’s senior secured credit facilities due in 2024 and in 2025, and to pay fees and expenses related to the 2029 Senior Secured Notes offering and the Amendment.

The 2029 Senior Secured Notes are secured obligations of the Company, will mature on February 1, 2029, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 6.250% per year, with interest payable semi-annually on February 1 and August 1 of each year, beginning on February 1, 2024. The Company may redeem the 2029 Senior Secured Notes prior to January 1, 2029 subject to a customary make-whole premium, and thereafter subject to a redemption price equal to 100% of the principal amount thereof plus accrued and unpaid interest.

On May 23, 2023, IQVIA Inc. (the “Issuer”) completed the issuance and sale of $750 million in gross proceeds of 5.700% senior secured notes due 2028 (the “2028 Senior Secured Notes”). The 2028 Senior Secured Notes were issued pursuant to an Indenture, dated May 23, 2023, among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the 2028 Senior Secured Notes and as collateral agent, and the Company and certain subsidiaries of the Issuer as guarantors. The net proceeds from the 2028 Senior Secured Notes offering were used to repay existing borrowings under the Company’s revolving credit facility and to pay fees and expenses related to the 2028 Senior Secured Notes offering and offering of 2030 Senior Notes (as defined below).

The 2028 Senior Secured Notes are secured obligations of the Company, will mature on May 15, 2028, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 5.700% per year, with interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2023. The Company may redeem the 2028 Senior Secured Notes prior to April 15, 2028 subject to a customary make-whole premium, and thereafter subject to a redemption price equal to 100% of the principal amount thereof plus accrued and unpaid interest.

Each of the Company's current direct and indirect material U.S. wholly owned restricted subsidiaries (excluding IQVIA Solutions Japan LLC and IQVIA Services Japan LLC) and IQVIA Holdings Inc., have jointly and severally, irrevocably and unconditionally, on a senior secured basis, guaranteed the obligations under the 2028 Senior Secured Notes and the 2029 Senior Secured Notes.

The 2028 Senior Secured Notes and 2029 Senior Secured Notes have not been registered under the Securities Act of 1933, as amended (the “Securities Act”), or the securities laws of any other jurisdiction. In January 2024, the Company filed a registration statement with respect to an offer (the “Exchange Offer”) to exchange the 2028 Senior Secured Notes for an equal amount of $750 million aggregate principal amount of 5.700% Senior Secured Notes due 2028 registered under the Securities Act (the “2028 Registered Notes”) and the 2029 Senior Secured Notes for an equal amount of $1,250 million aggregate principal amount of 6.250% Senior Secured Notes due 2029 registered under the Securities Act (the “2029 Registered Notes”). The Exchange Offer commenced on January 26, 2024 and will expire on February 23, 2024, unless the Company extends the offer. The terms of the 2028 Registered Notes and the 2029 Registered Notes to be issued in the Exchange Offer are substantially identical in all material respects to the terms of the 2028 Senior Secured Notes and 2029 Senior Secured Notes, respectively, except that the registered notes will not be subject to restrictions on transfer or to any increase in the annual interest rate for failure to comply with the applicable registration rights agreement.

2022 Financing Transactions

None

Senior Notes

2023 Financing Transactions

On May 23, 2023, IQVIA Inc. (the “Issuer”) completed the issuance and sale of $500 million in gross proceeds of 6.500% senior notes due 2030 (the “2030 Senior Notes”). The 2030 Senior Notes were issued pursuant to an Indenture, dated May 23, 2023, among the Issuer, U.S. Bank Trust Company, National Association, as trustee of the 2030 Senior Notes, and certain subsidiaries of the Issuer as guarantors. The net proceeds from the 2030 Senior Notes offering were used to repay existing borrowings under the Company’s revolving credit facility, and to pay fees and expenses related to the 2030 Senior Notes offering and 2028 Senior Secured Notes offering.

The 2030 Senior Notes are unsecured obligations of the Company, will mature on May 15, 2030, unless earlier repurchased or redeemed in accordance with their terms, and bear interest at the rate of 6.500% per year, with interest payable semi-annually on May 15 and November 15 of each year, beginning on November 15, 2023. The Company may redeem the 2030 Senior Notes prior to their final stated maturity, subject to a customary make-whole premium, at any time prior to May 15, 2026 (subject to a customary “equity claw” redemption right) and thereafter subject to a redemption premium declining from 3.250% to 0.000%.

2022 Financing Transactions

None

Receivables Financing Facility

Under the receivables financing facility, certain of the Company's accounts receivable are sold on a non-recourse basis by certain of the Company's consolidated subsidiaries (each, an “Originator”) to another of the Company's consolidated subsidiaries, a bankruptcy-remote special purpose entity (the “SPE”). The SPE obtained a term loan and revolving loan commitment from a third-party lender, secured by liens on the assets of the SPE, to finance the purchase of the accounts receivable, which includes a $440 million term loan and a $110 million revolving loan commitment. As of December 31, 2023, no additional amounts of revolving loans were available under the receivables financing facility. The Company has guaranteed the performance of the obligations of existing and future subsidiaries that sell and service the accounts receivable under the receivables financing facility. The assets of the SPE are not available to satisfy any of the Company’s obligations or any obligations of its subsidiaries. As of December 31, 2023, approximately $1,566 million of the Company's trade accounts receivable and unbilled services were pledged as collateral to secure the facility.

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 usual and customary restrictive covenants that, among other things, place limitations on the Company’s ability to declare dividends. As of December 31, 2023, the Company was in compliance in all material respects with the financial covenants under the Company’s financing arrangements.

- Definition

The entire disclosure for information about short-term and long-term debt arrangements, which includes amounts of borrowings under each line of credit, note payable, commercial paper issue, bonds indenture, debenture issue, own-share lending arrangements and any other contractual agreement to repay funds, and about the underlying arrangements, rationale for a classification as long-term, including repayment terms, interest rates, collateral provided, restrictions on use of assets and activities, whether or not in compliance with debt covenants, and other matters important to users of the financial statements, such as the effects of refinancing and noncompliance with debt covenants.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 470
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//470/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1C
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1C

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1E
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1E

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1I
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

Leases

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Leases

The Company has operating leases for corporate offices, data centers, motor vehicles and certain equipment, many of which contain renewal and escalation clauses. These operating leases expire at various dates through 2037 with options to cancel certain leases at various intervals. The Company also has finance leases for offices and lab spaces that expire at various dates through 2048.

The components of lease expense were as follows:


		Year Ended December 31,
(in millions)	Classification	2023		2022		2021
Operating lease cost (1)	Selling, general and administrative expenses	$	160	$	171	$	184
Finance lease cost (1)	Depreciation and amortization, and Interest expense	18		12		10
Total lease cost		$	178	$	183	$	194

(1) Includes variable lease costs, which are immaterial.

Other information related to leases was as follows:


	Year Ended December 31,
(in millions)	2023			2022			2021
Supplemental Cash Flow:
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	175		$	173		$	175
Operating cash flows for finance leases	$	8		$	5		$	—
Financing cash flows for finance leases	$	3		$	4		$	—
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	59		$	79		$	81
Finance leases	$	—		$	54		$	44
Weighted Average Remaining Lease Term:
Operating leases	4.61 years			4.72 years			4.53 years
Finance leases	20.67 years			21.64 years			21.28 years
Weighted Average Discount Rate:
Operating leases	3.81		%	3.12		%	3.36		%
Finance leases	3.88		%	3.87		%	2.70		%

Future minimum lease payments under non-cancellable leases as of December 31, 2023 were as follows:


(in millions)	Operating Leases		Finance Leases
2024	$	117	$	13
2025	96		13
2026	55		13
2027	36		14
2028	24		14
Thereafter	31		283
Total future minimum lease payments	359		350
Less imputed interest	(29)		(122)
Total	$	330	$	228
Reported as of December 31, 2023:
Other current liabilities	$	107	$	—
Operating lease liabilities	223		—
Other liabilities	—		228
Total	$	330	$	228

Leases

The Company has operating leases for corporate offices, data centers, motor vehicles and certain equipment, many of which contain renewal and escalation clauses. These operating leases expire at various dates through 2037 with options to cancel certain leases at various intervals. The Company also has finance leases for offices and lab spaces that expire at various dates through 2048.

The components of lease expense were as follows:


		Year Ended December 31,
(in millions)	Classification	2023		2022		2021
Operating lease cost (1)	Selling, general and administrative expenses	$	160	$	171	$	184
Finance lease cost (1)	Depreciation and amortization, and Interest expense	18		12		10
Total lease cost		$	178	$	183	$	194

(1) Includes variable lease costs, which are immaterial.

Other information related to leases was as follows:


	Year Ended December 31,
(in millions)	2023			2022			2021
Supplemental Cash Flow:
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	175		$	173		$	175
Operating cash flows for finance leases	$	8		$	5		$	—
Financing cash flows for finance leases	$	3		$	4		$	—
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	59		$	79		$	81
Finance leases	$	—		$	54		$	44
Weighted Average Remaining Lease Term:
Operating leases	4.61 years			4.72 years			4.53 years
Finance leases	20.67 years			21.64 years			21.28 years
Weighted Average Discount Rate:
Operating leases	3.81		%	3.12		%	3.36		%
Finance leases	3.88		%	3.87		%	2.70		%

Future minimum lease payments under non-cancellable leases as of December 31, 2023 were as follows:


(in millions)	Operating Leases		Finance Leases
2024	$	117	$	13
2025	96		13
2026	55		13
2027	36		14
2028	24		14
Thereafter	31		283
Total future minimum lease payments	359		350
Less imputed interest	(29)		(122)
Total	$	330	$	228
Reported as of December 31, 2023:
Other current liabilities	$	107	$	—
Operating lease liabilities	223		—
Other liabilities	—		228
Total	$	330	$	228

Contingencies	12 Months Ended
Contingencies	Dec. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies The Company and its subsidiaries are involved in legal and tax proceedings, claims and litigation arising in the ordinary course of business. Management periodically assesses the Company’s liabilities and contingencies in connection with these matters based upon the latest information available. For those matters where management currently believes it is probable that the Company will incur a loss and that the probable loss or range of loss can be reasonably estimated, the Company has recorded an accrual in the consolidated financial statements based on its best estimates of such loss. In other instances, because of the uncertainties related to either the probable outcome or the amount or range of loss, management is unable to make a reasonable estimate of a liability, if any. However, even in many instances where the Company has recorded an estimated liability, the Company is unable to predict with certainty the final outcome of the matter or whether resolution of the matter will materially affect the Company’s results of operations, financial position or cash flows. As additional information becomes available, the Company adjusts its assessments and estimates of such liabilities accordingly. The Company routinely enters into agreements with third parties, including its clients and suppliers, all in the normal course of business. In these agreements, the Company sometimes agrees to indemnify and hold harmless the other party for any damages such other party may suffer as a result of potential intellectual property infringement and other claims. The Company has not accrued a liability with respect to these matters generally, as the exposure is considered remote. Based on its review of the latest information available, management does not expect the impact of pending legal and tax proceedings, claims and litigation, either individually or in the aggregate, to have a material adverse effect on the Company’s results of operations, cash flows or financial position. However, one or more unfavorable outcomes in any claim or litigation against the Company could have a material adverse effect for the period in which it is resolved. The following is a summary of certain legal matters involving the Company. On February 13, 2014, a group of approximately 1,200 medical doctors and 900 private individuals filed a civil lawsuit with the Seoul Central District Court against IMS Korea and two other defendants, the Korean Pharmaceutical Association (“KPA”) and the Korean Pharmaceutical Information Center (“KPIC”). The civil lawsuit alleges KPA and KPIC collected their personal information in violation of applicable privacy laws without the necessary consent through a software system installed on pharmacy computer systems in Korea, and that personal information was transferred to IMS Korea and sold to pharmaceutical companies. On September 11, 2017, the District Court issued a final decision that the encryption in use by the defendants since June 2014 was adequate to meet the requirements of the Korean Personal Information Privacy Act (“PIPA”) and the sharing of non-identified information for market research purposes was allowed under PIPA. The District Court also found an earlier version of encryption was insufficient to meet PIPA requirements, but no personal data had been leaked or re-identified. The District Court did not award any damages to plaintiffs. Approximately 280 medical doctors and 200 private individuals appealed the District Court decision. On May 3, 2019, the Appellate Court issued a final decision in which it concluded all of the non-identified information transferred by KPIC to IMS Korea for market research purposes violated PIPA, but did not award any damages to plaintiffs (affirming the District Court’s decision on this latter point). On May 24, 2019, approximately 247 plaintiffs appealed the Appellate Court’s decision to the Supreme Court. The Company believes the appeal is without merit and is vigorously defending its position. On July 23, 2015, indictments were issued by the Seoul Central District Prosecutors’ Office in South Korea against 24 individuals and companies alleging improper handling of sensitive health information in violation of, among others, South Korea’s Personal Information Protection Act. IMS Korea and two of its employees were among the individuals and organizations indicted. Although there is no assertion that IMS Korea used patient identified health information in any of its offerings, prosecutors allege that certain of IMS Korea’s data suppliers should have obtained patient consent when they converted sensitive patient information into non-identified data and that IMS Korea had not taken adequate precautions to reduce the risk of re-identification. On February 14, 2020, the Seoul Central District Court acquitted IMS Korea and its two employees of the charges of improper handling of sensitive health information, and the Prosecutor's Office appealed. On December 23, 2021, the appellate court affirmed the judgment of the Seoul Central District Court. The Prosecutor's Office has appealed to the Supreme Court. The Company intends to vigorously defend its position on appeal. On January 10, 2017, Quintiles IMS Health Incorporated and IMS Software Services Ltd. (collectively “IQVIA Parties”), filed a lawsuit in the U.S. District Court for the District of New Jersey against Veeva Systems, Inc. (“Veeva”) alleging Veeva unlawfully used IQVIA Parties intellectual property to improve Veeva data offerings, to promote and market Veeva data offerings and to improve Veeva technology offerings. IQVIA Parties seek injunctive relief, appointment of a monitor, the award of compensatory and punitive damages and reimbursement of all litigation expenses, including reasonable attorneys’ fees and costs. On March 13, 2017, Veeva filed counterclaims alleging anticompetitive business practices in violation of the Sherman Act and state laws. Veeva claims damages in excess of $200 million, and is seeking punitive damages and litigation costs, including attorneys’ fees. The Company believes the counterclaims are without merit, rejects all counterclaims raised by Veeva and intends to vigorously defend IQVIA Parties’ position and pursue its claims against Veeva. Since the initial filings, the parties have filed additional litigations against each other, primarily concerning the use of IQVIA data with various other Veeva products. Trial has been scheduled for early 2025. On May 7, 2021, the Court issued an order and opinion (the “Order”) in which it found significant evidence that Veeva had (1) misappropriated IQVIA data and unlawfully used it to improve Veeva data offerings, (2) engaged in a cover-up by deleting significant evidence of its theft of IQVIA’s trade secrets, and (3) improperly withheld certain evidence in furtherance of a crime and/or fraud against IQVIA. The Court imposed five sanctions against Veeva, including ordering three separate adverse inference instructions be issued to the jury and that IQVIA be permitted to present evidence to the jury of Veeva’s destruction efforts. Veeva is currently appealing the Order.

Stockholders' Equity

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Stockholders' Equity

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 and outstanding as of December 31, 2023 or 2022.

Equity Repurchase Program

On October 30, 2013, the Company’s Board of Directors (the “Board”) first approved the Company's equity repurchase program (the “Repurchase Program”), authorizing the repurchase of up to $125 million of the Company’s common stock. The Board increased the stock repurchase authorization under the Repurchase Program with respect to the repurchase of the Company's common stock by $600 million, $1.5 billion, $2.0 billion, $1.5 billion, $2.0 billion, and $2.0 billion in 2015, 2016, 2017, 2018, 2019, and 2022, respectively. On July 31, 2023, the Board increased the stock repurchase authorization under the Repurchase Program with respect to the repurchase of the Company's common stock by an additional $2,000 million, which increased the total amount that has been authorized under the Repurchase Program to $11,725 million. 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.

As of December 31, 2023, the Company had remaining authorization to repurchase up to $2,363 million 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.

There were no equity offerings during the years ended December 31, 2023, 2022 and 2021.

Summary

Below is a summary of the share repurchases made under the Repurchase Program:


	Year Ended December 31,
(in millions, except per share data)	2023		2022		2021
Number of shares of common stock repurchased	5.0		5.5		1.7
Aggregate purchase price	$	992	$	1,168	$	395
Average price per share	$	196.89	$	213.06	$	238.22

Non-controlling Interests

On April 1, 2021, the Company acquired the 40% non-controlling interest in Q2 Solutions, a fully consolidated subsidiary, from Quest Diagnostics Incorporated ("Quest") for approximately $758 million, financed with cash on hand. The transaction resulted in the Company having 100% ownership in Q2 Solutions. As of December 31, 2023 and 2022, the Company had no other material non-controlling interests.

- Definition

The entire disclosure for equity.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 505
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481004/946-505-50-6

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480237/815-40-50-6

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.3-04)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480008/505-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(e)(1))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Topic 505
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//505/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (i)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
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-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 16
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-16

Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-18

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-18

Reference 19: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-18

+ Details

Business Combinations

12 Months Ended

Dec. 31, 2023

Business Combination and Asset Acquisition [Abstract]

Business Combinations

The Company completed several individually immaterial acquisitions during the years ended December 31, 2023 and 2022. The Company’s assessment of fair value, including the valuation of certain acquired intangibles and the purchase price allocation related to the acquisitions that occurred during the year ended December 31, 2023 is preliminary and subject to change upon completion. Further adjustments, largely related to acquired intangible assets and related deferred taxes, 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 Company recorded goodwill from these acquisitions, primarily attributable to assembled workforce, expected synergies and new client relationships. The consolidated financial statements include the results of the acquisitions subsequent to their respective closing dates. Pro forma information is not presented as pro forma results of operations would not be materially different to the actual results of operations of the Company.

The following table provides certain preliminary financial information for these acquisitions:


	Year Ended December 31,
(in millions)	2023		2022
Assets acquired:
Cash and cash equivalents	$	28	$	33
Accounts receivable	44		—
Other assets	9		115
Goodwill	533		1,026
Other identifiable intangibles	425		509
Liabilities assumed:
Other liabilities	(44)		(103)
Deferred income taxes, long-term	(18)		(93)
Net assets acquired (1)	$	977	$	1,487

(1) Net assets acquired include contingent consideration and deferred purchase price of $73 million and $139 million, respectively.

The portion of goodwill deductible for income tax purposes was preliminarily assessed as $379 million and $275 million for the years ended December 31, 2023 and 2022, respectively.

The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired:


				Year Ended December 31,
(in millions)	Amortization Period			2023		2022
Other identifiable intangibles:
Client relationships	1	-	17 years	$	324	$	382
Software and related assets	3	-	8 years	44		79
Backlog	1	-	4 years	51		24
Databases	3	-	7 years	4		11
Trade names	2	-	5 years	2		7
Non-compete agreements	3	-	5 years	—		6
Total Other identifiable intangibles				$	425	$	509

Restructuring

12 Months Ended

Dec. 31, 2023

Restructuring and Related Activities [Abstract]

Restructuring

The Company has continued to take restructuring actions in the year ended December 31, 2023 to align its resources and reduce overcapacity to adapt to changing market conditions and integrate acquisitions. These actions include consolidating functional activities, eliminating redundant positions, and aligning resources with customer requirements. These restructuring actions are expected to continue into 2024.

The management approved plans resulted in approximately $84 million, $28 million and $20 million of restructuring expense, net of reversals, which consisted primarily of severance and other exit-related costs in the years ended December 31, 2023, 2022 and 2021, respectively.

The following amounts were recorded for the restructuring plans:


(in millions)	Severance and Related Costs
Balance as of December 31, 2021	$	30
Expense, net of reversals	28
Payments	(31)
Foreign currency translation and other	(1)
Balance as of December 31, 2022	$	26
Expense, net of reversals	84
Payments	(74)

Balance as of December 31, 2023	$	36

The reversals were due to changes in estimates primarily resulting from the redeployment of staff and higher than expected voluntary terminations. 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 the majority of the restructuring accruals as of December 31, 2023 will be paid in 2024.

Income Taxes

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Income Taxes

The components of income before income taxes and equity in (losses) earnings of unconsolidated affiliates are as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Domestic	$	108	$	(45)	$	(73)
Foreign	1,351		1,408		1,201
	$	1,459	$	1,363	$	1,128

The components of income tax expense attributable to continuing operations are as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Current expense:
Federal and state	$	21	$	24	$	16
Foreign	349		358		293
	370		382		309
Deferred (benefit) expense:
Federal and state	(236)		(94)		(106)
Foreign	(33)		(28)		(40)
	(269)		(122)		(146)
	$	101	$	260	$	163

The differences between the Company’s consolidated income tax expense attributable to continuing operations and the expense computed at the United States statutory income tax rate of 21% were as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Federal income tax expense at statutory rate	$	306	$	286	$	237
State and local income taxes, net of federal effect	16		(15)		2
Research and development	(25)		(19)		(14)
United States taxes recorded on foreign earnings(*)	(41)		(4)		(29)
Tax contingencies	17		14		3
Foreign Derived Intangible Income (“FDII”)	(53)		(41)		(34)
Foreign rate differential	45		38		17
Equity compensation	—		2		(23)
Valuation Allowance Release	(102)		—		—
Basis Difference Reversal	(61)		—		—
Other	(1)		(1)		4
	$	101	$	260	$	163

(*) Includes impact of GILTI, and other U.S. taxes on foreign earnings.

In the year ended December 31, 2023, the Company completed an internal legal entity restructuring that resulted in a benefit of $125 million. Historically, the Company recorded deferred tax assets related to certain foreign tax credits, and a full valuation allowance in relation to these foreign tax credits was established as it was not expected the credits would be utilized prior to expiration. The Company now believes it is reasonably possible that these foreign tax credits will be utilized and therefore recorded a tax benefit of $64 million related to the valuation allowance release and establishing related uncertain tax positions. Additionally, due to the restructuring the Company also reversed a deferred tax liability of $61 million due to a basis difference that was recovered in a tax-free manner. The effective tax rate was also favorably impacted by a reversal of uncertain tax positions relating to tax credit carryforwards in the amount of $21 million due to an audit settlement. Lastly, the effective tax rate was also impacted by changes in the geographical mix of earnings amongst foreign tax jurisdictions as well as state and local tax rates.

In the year ended December 31, 2022, the Company recorded a benefit of $6 million related to a 2021 U.S. Federal tax return position associated with FDII and GILTI tax credits. In addition, the effective tax rate was impacted by changes in the geographical mix of earnings amongst foreign tax jurisdictions as well as state and local tax rates.

On August 16, 2022, the U.S. government enacted the Inflation Reduction Act of 2022, which, among other things, implements a 15% minimum tax on book income of certain large corporations, a 1% excise tax on net stock repurchases and several tax incentives to promote clean energy. Many of the provisions took effect beginning in 2023. The Company assessed the impacts and determined it was not subject to the minimum tax and there were no other material income tax impacts during 2023. The Company will continue to monitor future impacts to its consolidated financial statements.

On December 12, 2022 the European Union member states agreed to implement the Organization for Economic Co-operation and Development’s (“OECD”) Pillar 2 global corporate minimum tax rate of 15% on companies with revenues of at least $790 million, which would go into effect in 2024. The Company is assessing the impact of this proposal as countries are actively considering changes to their tax laws to adopt certain parts of the OECD’s proposal.

In the year ended December 31, 2021, the Company recorded a benefit of $29 million related to a 2020 U.S. Federal tax return position associated with FDII and GILTI tax credits. Also in 2021, the Company recorded a $9 million tax expense as a result of the U.S. Treasury Department issuing final regulations on foreign tax credits.

Undistributed earnings of the Company’s foreign subsidiaries amounted to approximately $3,575 million as of December 31, 2023. The Company does not consider any of its foreign earnings as indefinitely reinvested.

The income tax effects of temporary differences from continuing operations that give rise to significant portions of deferred income tax assets (liabilities) are presented below:


	December 31,
(in millions)	2023		2022
Deferred income tax assets:
Net operating loss and capital loss carryforwards	$	132	$	145
Tax credit carryforwards	254		295
Accrued expenses and unearned income	103		90
Employee benefits	202		202
Lease liability	65		73
U.S. interest expense limitation	59		30
Other	81		52
Total deferred income tax assets	896		887
Valuation allowance for deferred income tax assets	(166)		(257)
Total deferred income tax assets (net of valuation allowance)	730		630
Deferred income tax liabilities:
Amortization and depreciation	(590)		(727)
Lease right-of-use assets	(56)		(61)
Foreign exchange on debt instruments	(48)		(125)
Other	(72)		(63)
Total deferred income tax liabilities	(766)		(976)
Net deferred income tax assets (liabilities)	$	(36)	$	(346)

During the year ended December 31, 2023, the net deferred tax liabilities decreased due to foreign exchange revaluations of debt instruments, reversal of a previously established valuation allowance for Foreign Tax Credits, and amortization of intangibles related to the merger between Quintiles and IMS Health.

The Company had federal, state and local, and foreign tax loss carryforwards and tax credits, the tax effect of which was $462 million as of December 31, 2023. Of this amount, $8 million has an indefinite carryforward period, and the remaining $454 million expires at various times beginning in 2024. Some of the federal losses are subject to limitations under the Internal Revenue Code, however, management expects these losses to be utilized during the carryforward periods.

In the year ended December 31, 2023, the Company decreased its valuation allowance by $91 million to $166 million as of December 31, 2023 from $257 million as of December 31, 2022. The valuation allowance decreased primarily due to the release of the valuation allowance on branch basket foreign tax credits as the Company has determined they are more likely than not to be used prior to expiration.

A reconciliation of the beginning and ending amount of gross unrecognized income tax benefits is presented below:


	Year Ended December 31,
(in millions)	2023		2022		2021
Balance as of January 1	$	122	$	116	$	118
Additions based on tax positions related to the current year	53		13		7
Additions for income tax positions of prior years	8		20		16
Impact of changes in exchange rates	1		(2)		(3)
Settlements with tax authorities	(6)		(4)		(2)
Reductions for income tax positions of prior years	(25)		(11)		(11)
Reductions due to the lapse of the applicable statute of limitations	(13)		(10)		(9)
Balance as of December 31	$	140	$	122	$	116

As of December 31, 2023, the Company had total gross unrecognized income tax benefits of $131 million associated with over 100 jurisdictions in which the Company conducts business that, if recognized, would reduce the Company’s effective income tax rate.

The Company’s policy for recording interest and penalties relating to uncertain income tax positions is to record them as a component of income tax expense in the accompanying consolidated statements of income. In the years ended December 31, 2023, 2022 and 2021, the amount of interest and penalties recorded as an addition to income tax expense in the accompanying consolidated statements of income was $— million, $2 million and $— million, respectively. As of December 31, 2023, and 2022, the Company had accrued approximately $20 million and $21 million, respectively, of interest and penalties.

The Company believes that it is reasonably possible that a decrease of up to $16 million in gross unrecognized income tax benefits for federal, state and foreign exposure items may be necessary within the next 12 months due to lapse of statutes of limitations or uncertain tax positions being effectively settled. The Company believes that it is reasonably possible that a decrease of up to $16 million in gross unrecognized income tax benefits for foreign items may be necessary within the next 12 months due to payments. For the remaining uncertain income tax positions, it is difficult at this time to estimate the timing of the resolution.

The Company conducts business globally and, as a result, files income tax returns in the United States federal jurisdiction and various state and foreign jurisdictions. In the normal course of business, the Company is subject to examination by taxing authorities throughout the world. The following table summarizes the tax years that remain open for examination by tax authorities in the most significant jurisdictions in which the Company operates:


United States			2020-2022
India			2006-2023
Japan			2017-2022
United Kingdom			2021-2022
Switzerland			2019-2022

In certain of the jurisdictions noted above, the Company operates through more than one legal entity, each of which has different open years subject to examination. The table above presents the open years subject to examination for the most material of the legal entities in each jurisdiction. Additionally, it is important to note that tax years are technically not closed until the statute of limitations in each jurisdiction expires. In the jurisdictions noted above, the statute of limitations can extend beyond the open years subject to examination.

Due to the geographic breadth of the Company’s operations, numerous tax audits may be ongoing throughout the world at any point in time. Income tax liabilities are recorded based on estimates of additional income taxes that may be due upon the conclusion of these audits. Estimates of these income tax liabilities are made based upon prior experience and are updated in light of changes in facts and circumstances. However, due to the uncertain and complex application of income tax regulations, it is possible that the ultimate resolution of audits may result in liabilities that could be materially different from these estimates. In such an event, the Company will record additional income tax expense or income tax benefit in the period in which such resolution occurs.

- Definition

The entire disclosure for income taxes. Disclosures may include net deferred tax liability or asset recognized in an enterprise's statement of financial position, net change during the year in the total valuation allowance, approximate tax effect of each type of temporary difference and carryforward that gives rise to a significant portion of deferred tax liabilities and deferred tax assets, utilization of a tax carryback, and tax uncertainties information.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-13

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(h)(2))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//740/tableOfContent

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-14

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-21

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 270
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482526/740-270-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 17
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482685/740-10-50-17

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB TOPIC 6.I.5.Q1)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 2
-Subparagraph (SAB Topic 11.C)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479360/740-10-S99-2

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 740
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482603/740-30-50-2

+ Details

Employee Benefit Plans

12 Months Ended

Dec. 31, 2023

Retirement Benefits [Abstract]

Employee Benefit Plans

Pension and Postretirement Benefit Plans

The Company sponsors both funded and unfunded defined benefit pension plans. These plans provide benefits based on various criteria, including, but not limited to, years of service and salary. The Company also sponsors an unfunded postretirement benefit plan in the United States that provides health and prescription drug benefits to retirees who meet the eligibility requirements. The Company uses a December 31 measurement date for all pension and postretirement benefit plans.

The following table summarizes changes in the benefit obligation, the plan assets and the funded status of the pension benefit plans:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Obligation and funded status:
Change in benefit obligation:
Projected benefit obligation at beginning of year	$	400	$	488	$	461	$	652
Service costs	10		13		35		29
Interest cost	22		13		17		8
Actuarial losses	15		(101)		5		(144)
Business combinations	—		—		—		3
Benefits paid	(13)		(11)		(20)		(24)
Contributions	—		—		3		2


Settlements	—		(2)		(3)		(4)
Foreign currency fluctuations and other	—		—		27		(61)
Projected benefit obligation at end of year	434		400		525		461
Change in plan assets:
Fair value of plan assets at beginning of year	419		524		355		494
Actual return on plan assets	75		(97)		2		(97)
Contributions	5		5		27		32
Benefits paid	(13)		(11)		(20)		(24)
Settlements	—		(2)		(3)		(4)
Business combinations	—		—		—		1
Foreign currency fluctuations and other	—		—		18		(47)
Fair value of plan assets at end of year	486		419		379		355
Funded status	$	52	$	19	$	(146)	$	(106)

The following table summarizes the amounts recognized in the consolidated balance sheets related to the pension benefit plans:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Deposits and other assets, net	$	87	$	56	$	49	$	50
Accounts payable and accrued expenses	$	4	$	4	$	12	$	10
Other liabilities	$	31	$	33	$	183	$	146
Accumulated other comprehensive loss	$	28	$	(2)	$	(25)	$	(6)

As of December 31, 2023, the benefit obligation and amount recognized in AOCI for other postretirement benefits were immaterial.

The following table summarizes the accumulated benefit obligation for all pension benefit plans:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Accumulated benefit obligation	$	430	$	397	$	480	$	426

The following table provides the information for pension plans with an accumulated benefit obligation in excess of plan assets and projected benefit obligations in excess of plan assets:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Plans with accumulated benefit obligation in excess of plan assets:
Accumulated benefit obligation	$	41	$	42	$	251	$	189
Fair value of plan assets	$	7	$	6	$	101	$	64
Plans with projected benefit obligation in excess of plan assets:
Projected benefit obligation	$	41	$	43	$	295	$	243
Fair value of plan assets	$	7	$	6	$	101	$	87

The components of net periodic benefit cost changes in plan assets and benefit obligations recognized in comprehensive income were as follows:


	Pension Benefits
	United States Plans						Non-United States Plans
	Year Ended December 31,
(in millions)	2023		2022		2021		2023		2022		2021
Service cost	$	10	$	13	$	14	$	35	$	29	$	29
Interest cost	22		13		11		17		8		6
Expected return on plan assets	(30)		(38)		(32)		(17)		(18)		(20)
Amortization of actuarial losses	—		1		—		(2)		1		1

Settlement gain	—		1		—		—		(1)		1
Net periodic benefit cost	2		(10)		(7)		33		19		17
Other changes in plan assets and benefit obligations recognized in other comprehensive loss:
Actuarial (gain) loss – current year	(30)		31		(50)		19		(18)		(39)
Prior service cost – current year	—		—		—		—		—		(2)

Total recognized in other comprehensive income	(30)		31		(50)		19		(18)		(41)
Total recognized in net periodic benefit cost and other comprehensive income	$	(28)	$	21	$	(57)	$	52	$	1	$	(24)

All components of net periodic benefit cost other than service cost are recorded in other (income) expense, net on the accompanying consolidated statements of income. Gains (losses) affecting the benefit obligation for the year ending December 31, 2023 were primarily related to the changes in discount rates, as well as changes in other actuarial assumptions which are driven by changing market conditions.

Assumptions

The weighted average assumptions used to determine net periodic benefit cost were as follows for the years ended December 31:


	Pension Benefits
	United States Plans						Non-United States Plans
	2023		2022		2021		2023		2022		2021
Discount rate	5.65	%	3.08	%	2.84	%	3.59	%	1.46	%	1.00	%
Rate of compensation increases	3.00	%	3.00	%	3.00	%	2.93	%	2.57	%	2.55	%
Expected return on plan assets	7.20	%	7.23	%	7.23	%	4.53	%	4.22	%	3.92	%

The weighted average assumptions used to determine benefit obligations were as follows as of December 31:


	Pension Benefits
	United States Plans				Non-United States Plans
	2023		2022		2023		2022
Discount rate	5.35	%	5.65	%	3.52	%	3.59	%
Rate of compensation increases	3.00	%	3.00	%	2.78	%	2.93	%

The discount rate represents the interest rate used to determine the present value of the future cash flows currently expected to be required to settle the Company’s defined benefit plan obligations. The discount rates are derived using weighted average yield curves on AA-rated corporate bonds. The cash flows from the Company’s expected benefit obligation payments are then matched to the yield curve to derive the discount rates.

The Company’s assumption for the expected return on plan assets was determined by the weighted average of the long-term expected rate of return on each of the asset classes invested as of the balance sheet date. For plan assets invested in government bonds, the expected return was based on the yields on the relevant indices as of the balance sheet date. There is considerable uncertainty for the expected return on plan assets invested in equity and diversified growth funds.

Under the Company’s United States qualified retirement plan, participants have a notional retirement account that increases with pay and investment credits. The rate used to determine the investment credit (cash balance crediting rate) varies monthly and is equal to 1/12th of the yield on 30-year U.S. Government Treasury Bonds, with a minimum of 0.25%. At retirement, the account is converted to a monthly retirement benefit.

Plan Assets

The Company’s pension plan target asset allocations and weighted average asset allocations, by asset category, were as follows:


		Plan Assets as of December 31,
	Target	United States Plans				Non-United States Plans				Total
Asset Category	Allocation	2023		2022		2023		2022		2023		2022
Equity securities	40-65%	73	%	71	%	—	%	27	%	42	%	51	%
Debt securities	10-40%	21		24		56		30		36		26
Real estate	0-5%	4		5		—		—		2		3
Other	10-30%	2		—		44		43		20		20
Total		100	%	100	%	100	%	100	%	100	%	100	%

The following table summarizes United States plan assets measured at fair value:


	December 31, 2023						December 31, 2022
Asset Category	Level 1		Level 2		Total		Level 1		Level 2		Total
	(in millions)
Domestic equities	$	33	$	—	$	33	$	29	$	—	$	29
International equities	11		—		11		9		—		9
Corporate bonds	65		—		65		64		—		64
Real estate	21		—		21		19		—		19
Total assets in the fair value hierarchy	130		—		130		121		—		121
Assets measured at net asset value (“NAV”)(1)	—		—		356		—		—		298
Total	$	130	$	—	$	486	$	121	$	—	$	419

The following table summarizes non-United States plan assets measured at fair value:


	December 31, 2023						December 31, 2022
Asset Category	Level 1		Level 2		Total		Level 1		Level 2		Total
	(in millions)
International equities	$	1	$	1	$	2	$	—	$	4	$	4
Debt issued by national, state or local government	2		210		212		3		103		106
Investments funds	—		10		10		—		10		10
Insurance contracts	—		145		145		—		133		133
Other	3		7		10		3		6		9
Total assets in the fair value hierarchy	6		373		379		6		256		262
Assets measured at NAV(1)	—		—		—		—		—		93
Total	$	6	$	373	$	379	$	6	$	256	$	355

(1) Certain investments that are measured at fair value using the net asset value ("NAV") per share (or its equivalent) practical expedient have not been classified in the fair value hierarchy. The fair value amounts presented in the above plan asset tables are intended to permit reconciliation of the fair value of plan assets in the fair value hierarchy to the plan asset amounts presented in the above funded status table as of December 31, 2023 and 2022.

Investments in mutual funds are valued at quoted market prices. Investments in common/collective trusts and pooled funds are valued at the NAV as reported by the trust. The NAV is based on the fair value of the underlying investments held by the fund less its liabilities. Insurance contracts are valued at the amount of the benefit liability. The Company has no Level 3 assets that rely on unobservable inputs to measure fair value.

Investment Policies and Strategies

The Company invests primarily in a diversified portfolio of debt and equity securities that provide for long-term growth within reasonable and prudent levels of risk. The asset allocation targets established by the Company are strategic and applicable to the plan’s long-term investing horizon. The portfolio is constructed and maintained to provide adequate liquidity to meet associated liabilities and minimize long-term expense and provide prudent diversification among asset classes in accordance with the principles of modern portfolio theory. The plan employs a diversified mix of actively managed investments around a core of passively managed index exposures in each asset class. Within each asset class, rapid market shifts, changes in economic conditions or an individual fund manager’s outlook may cause the asset allocation to fall outside the prescribed targets. The majority of the Company’s plan assets are measured quarterly against benchmarks established by the Company’s investment advisors and the Company’s Asset Management Committee, who review actual plan performance and have the authority to recommend changes as deemed appropriate. Assets are rebalanced periodically to their strategic targets to maintain the plan’s strategic risk/reward characteristics. The Company periodically conducts asset liability modeling studies to ensure that the investment strategy is aligned with the obligations of the plans and that the assets will generate income and capital growth to meet the cost of current and future benefits that the plans provide. The pension plans do not have investments in Company stock as of December 31, 2023 and 2022.

The portfolio for the Company’s United Kingdom pension plans seek to invest in a range of suitable assets of appropriate liquidity that will generate in the most effective manner possible, income and capital growth to ensure that there are sufficient assets to meet benefit payments when they fall due, while controlling the long-term costs of the plans, avoiding short-term volatility of investment returns, and managing risks in accordance with plan investment strategies. The plans seek to achieve these objectives by investing in a mixture of real (equities) and monetary (fixed interest) assets, which is expected to provide the level of returns required by the plans. The trustee periodically conducts asset liability modeling exercises to ensure the investments are aligned with the appropriate benchmark to better reflect the plans’ liabilities. The trustee also undertakes to review this benchmark on a regular basis.

Cash Flows

Contributions

The Company expects to contribute approximately $31 million in required contributions to its pension and postretirement benefit plans during 2024. The Company may make additional contributions into its pension plans in 2024 depending on, among other factors, how the funded status of those plans change or in order to meet minimum funding requirements as set forth in employee benefit and tax laws, plus additional amounts the Company may deem to be appropriate.

Estimated future benefit payments and subsidy receipts

The following benefit payments (net of expected participant contributions) for pension benefits are expected to be paid as follows:


(in millions)
2024	$	48
2025	50
2026	53
2027	56
2028	58
Years 2029 through 2033	325
	$	590

Benefit payments (net of expected participant contributions) for other postretirement benefits are expected to be immaterial over the years presented.

Defined Contribution Plans

Defined contribution or profit sharing plans are offered in various countries in which the Company operates. In some cases, these plans are required by local laws or regulations.

In the United States, the Company has a 401(k) plan under which the Company matches employee deferrals at varying percentages and specified limits of the employee’s salary. For the years ended December 31, 2023, 2022 and 2021, the Company expensed $81 million, $74 million and $60 million, respectively, related to matching contributions.

Certain key executives of the Company participate in an unfunded defined contribution executive retirement plan, assumed in the merger between Quintiles and IMS Health, which was frozen to additional accruals for future service contributions in 2012. Participants continue to receive an annual investment credit based on the average of the annual yields at the end of each month on the AA-AAA rated 10 plus year maturity component of the Merrill Lynch United States Corporate Bond Master Index.

Plans Accounted for as Postretirement Benefits

The Company provides certain executives with postretirement medical, dental and life insurance benefits. These benefits are individually negotiated arrangements in accordance with their individual employment arrangements. The above tables do not include the Company’s expense or obligation associated with providing these benefits. The obligation related to these benefits as of December 31, 2023 and 2022, and the Company’s expense for the years then ended, were not material.

Stock Incentive Plans

Stock incentive plans provide incentives to eligible employees, officers and directors in the form of non-qualified stock options, incentive stock options, stock appreciation rights (“SARs”), restricted stock awards, restricted stock units (“RSUs”), performance awards, covered annual incentive awards, cash-based awards and other stock-based awards, in each case subject to the terms of the stock incentive plans.

In April 2017, the Company’s 2017 Incentive and Stock Award Plan (the “2017 Plan”) was approved by the Company’s stockholders. The 2017 Plan provides for the grant of stock options, SARs, restricted and deferred stock (including RSUs), performance awards, dividend equivalents, other stock-based awards and cash-based awards.

The Company recognized stock-based compensation expense of $217 million, $194 million and $170 million in the years ended December 31, 2023, 2022 and 2021, respectively. Stock-based compensation expense is included in selling, general and administrative expenses on the accompanying consolidated statements of income. The associated future income tax benefit recognized was $34 million, $28 million and $26 million in the years ended December 31, 2023, 2022 and 2021, respectively. As of December 31, 2023, there was approximately $194 million of total unrecognized stock-based compensation expense related to outstanding non-vested stock-based compensation arrangements, which the Company expects to recognize over a weighted average period of 1.30 years.

As of December 31, 2023, there were 8.5 million shares available for future grants under all of the Company’s stock incentive plans.

The Company used the following assumptions when estimating the value of the stock-based compensation for Stock Settled SARs granted as follows:

Year Ended December 31,

2023

2022

2021

Expected volatility

29 – 35%

28 – 34%

27 – 31%

Weighted average expected volatility

32%

30%

29%

Expected dividends

0.0%

Expected term (in years)

2.4 – 5.4

3.3 – 6.3

3.6 – 6.6

Risk-free interest rate

3.38 – 4.75%

1.84 –4.22%

0.28 – 1.40%

Stock Appreciation Rights – Stock Settled

The exercise price of the stock-settled SARs (“SSRs”) is equal to the closing market price of the Company’s common stock as of the grant date and expire on the tenth anniversary of the date of grant. The SSRs are eligible to vest in three equal annual installments on each of the first three anniversaries of the date of grant.

The Company’s SSR activity in the year ended December 31, 2023 is as follows:


(in millions, except number of SSRs and exercise price)	Number of SSRs	Weighted Average Exercise Price		Aggregate Intrinsic Value
Outstanding as of December 31, 2022	4,055,769	$	134.36	$	304
Granted	399,427	231.86
Exercised	(535,982)	122.94
Canceled	(56,504)	218.68
Outstanding as of December 31, 2023	3,862,710	$	144.79	$	342

The total intrinsic value of SSRs exercised was approximately $51 million, $25 million and $81 million in the years ended December 31, 2023, 2022 and 2021 respectively.

The weighted average remaining contractual life of the SSRs outstanding and exercisable as of December 31, 2023 is 5.4 years and 4.6 years, respectively. The total aggregate intrinsic value of the exercisable SSRs and the SSRs expected to vest as of December 31, 2023 was approximately $342 million.

Stock Options

The option price is determined by the Board at the date of grant and the options expire 10 years from the date of grant. All outstanding stock options are fully vested.

The Company’s stock option activity in the year ended December 31, 2023 is as follows:


(in millions, except number of options and exercise price)	Number of Options	Weighted Average Exercise Price		Aggregate Intrinsic Value
Outstanding as of December 31, 2022	320,353	$	54.99	$	48
Exercised	(145,382)	46.13
Outstanding as of December 31, 2023	174,971	$	62.35	$	30

The total intrinsic value of options exercised was approximately $23 million, $9 million and $29 million in the years ended December 31, 2023, 2022 and 2021, respectively. The Company received cash of approximately $7 million, $2 million and $7 million in 2023, 2022, and 2021, respectively, from options exercised.

The weighted average remaining contractual life of the options outstanding and exercisable as of December 31, 2023 is 1.5 years. The total aggregate intrinsic value of the exercisable stock options as of December 31, 2023 was approximately $30 million.

Performance Awards

The Company awarded performance awards that contain service, performance-based and/or market-based vesting criteria. Vesting occurs if the recipient remains employed and depends on the degree to which performance goals are achieved during the three-year performance period (as defined in the award agreements).

The Company’s performance award activity in the year ended December 31, 2023 is as follows:


	Number of Performance Awards	Weighted Average Grant-Date Fair Value
Outstanding as of December 31, 2022	642,701	$	216.00
Granted	359,588	229.88
Additional goal achievement shares	176,329	169.76
Vested	(380,386)	173.74
Canceled	(52,162)	232.93
Outstanding as of December 31, 2023	746,070	$	232.13

As of December 31, 2023, there are 746,070 performance awards outstanding with an intrinsic value of approximately $173 million.

Restricted Stock Units – Stock Settled

The Company’s RSUs will settle in shares of the Company’s common stock within 45 days of the applicable vesting date. In general, RSUs granted to employees vest either (i) one-third per year beginning on the first anniversary of the grant date or (ii) 100% at the end of the three-year period following the grant date. Members of the Company’s Board receive RSUs that are fully vested when granted.

The Company’s RSU activity in the year ended December 31, 2023 is as follows:


	Number of RSUs	Weighted Average Grant-Date Fair Value
Outstanding as of December 31, 2022	896,733	$	215.16
Granted (1)	443,009	227.84
Vested	(379,871)	197.56
Canceled	(71,015)	220.79
Outstanding as of December 31, 2023	888,856	$	228.55

(1) Pursuant to the IQVIA Holdings Inc. Non-Employee Director Deferral Plan (the “Director Deferral Plan”), non-employee directors may elect to defer receipt of their cash retainers. If a director elects to defer his or her retainer, he or she will instead be credited with that value in deferred shares under the Director Deferral Plan. Deferred shares become payable in Company common stock following a termination of the director’s Board service or the director’s death, or upon a change in control of the Company. The Company granted 1,782 deferred RSUs in 2023.

As of December 31, 2023, there are 888,856 RSUs outstanding with an intrinsic value of approximately $206 million.

Stock Appreciation Rights – Cash Settled

The Company’s cash settled SARs (“CSRs”) require the Company to settle in cash an amount equal to the difference between the fair value of the Company’s common stock on the date of exercise and the grant price, multiplied by the number of CSRs being exercised. All outstanding CSRs are fully vested.

As of December 31, 2023, 2022 and 2021, the weighted average fair value per share of the CSRs outstanding was $152.17, $147.41 and $216.87, respectively. The Company paid approximately $11 million, $1 million and $1 million to settle exercised CSRs in the years ended December 31, 2023, 2022 and 2021 respectively.

The weighted average remaining contractual life of the CSRs outstanding and exercisable as of December 31, 2023 is 3.1 years. The total aggregate intrinsic value of the exercisable CSRs as of December 31, 2023 was approximately $8 million.

Restricted Stock Units – Cash Settled

The Company’s cash settled RSUs (“Cash RSUs”) require the Company to settle in cash an amount equal to the fair value of the Company’s common stock on the vest date multiplied by the number of vested Cash RSUs. These awards vest either (i) 100% at the end of the three-year period following the date of grant, or (ii) one-third per year beginning on the first grant date anniversary. As of December 31, 2023, there are 5,326 Cash RSUs outstanding with an intrinsic value of approximately $1 million.

Long Term Incentive Awards - Stock Settled

During the year ended December 31, 2022, the Company entered into long term incentive award agreements with certain employees totaling a fixed monetary amount of $80 million to issue a variable number of common shares based on the fair market value when the awards vest on the third anniversary of the grant date. The Company accounts for the awards as liability-classified awards with the liability recorded in other liabilities in the consolidated balance sheets. The Company recorded approximately $22 million and $9 million of stock-based compensation expense for these awards during the years ended December 31, 2023 and December 31, 2022, respectively.

Other

The Company sponsors a supplemental non-qualified deferred compensation plan, covering certain management employees, and maintains other statutory indemnity plans as required by local laws or regulations.

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2023
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions The Company has entered into transactions with related parties that are not deemed to be material, including investments in unconsolidated affiliates that are discussed in Note 4.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-2

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480990/946-20-50-6

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 235
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481062/946-235-50-2

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(g)(3))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(c))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 220
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.6-07(2)(e))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483575/946-220-S99-1

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-Name Accounting Standards Codification
-Publisher FASB
-URI https://asc.fasb.org//850/tableOfContent

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 6
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-6

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 850
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483326/850-10-50-1

+ Details

Property, Equipment and Software by Geography

12 Months Ended

Dec. 31, 2023

Property Equipment And Software By Geography [Abstract]

Property, Equipment and Software by Geography

The following table represents the Company’s property, equipment and software, net, by geographic region, which is further broken down to show each country that accounts for 10% or more of the totals:


	December 31,
(in millions)	2023		2022
Property, equipment and software, net:
Americas:
United States	$	1,820	$	1,699
Other	97		99
Americas	1,917		1,798
Europe and Africa	193		196
Asia-Pacific	36		53
Total property, equipment and software, net	$	2,146	$	2,047

Segments

12 Months Ended

Dec. 31, 2023

Segment Reporting [Abstract]

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. Technology & Analytics Solutions provides mission critical information, technology solutions and real world insights and services to the Company’s life science clients. Research & Development Solutions, which primarily serves biopharmaceutical customers, provides outsourced clinical research and clinical trial related services. Contract Sales & Medical Solutions provides health care provider (including contract sales) and patient engagement services to both biopharmaceutical customers and the broader healthcare market.

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 restructuring costs, depreciation and amortization or impairment charges, if any, to its segments. 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:


	Year Ended December 31,
(in millions)	2023		2022		2021
Revenues
Technology & Analytics Solutions	$	5,862	$	5,746	$	5,534
Research & Development Solutions	8,395		7,921		7,556
Contract Sales & Medical Solutions	727		743		784
Total revenues	14,984		14,410		13,874
Cost of revenues, exclusive of depreciation and amortization
Technology & Analytics Solutions	3,496		3,348		3,278
Research & Development Solutions	5,629		5,395		5,303
Contract Sales & Medical Solutions	620		639		652
Total cost of revenues, exclusive of depreciation and amortization	9,745		9,382		9,233
Selling, general and administrative expenses
Technology & Analytics Solutions	876		848		798
Research & Development Solutions	851		831		777
Contract Sales & Medical Solutions	58		62		57
General corporate and unallocated	268		330		332
Total selling, general and administrative expenses	2,053		2,071		1,964
Segment profit
Technology & Analytics Solutions	1,490		1,550		1,458
Research & Development Solutions	1,915		1,695		1,476
Contract Sales & Medical Solutions	49		42		75
Total segment profit	3,454		3,287		3,009
General corporate and unallocated	(268)		(330)		(332)
Depreciation and amortization	(1,125)		(1,130)		(1,264)

Restructuring costs	(84)		(28)		(20)
Total income from operations	$	1,977	$	1,799	$	1,393

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-15

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 31
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-31

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-42

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-40

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-URI https://asc.fasb.org//280/tableOfContent

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 26
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-26

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 34
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-34

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
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-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-21

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 21
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-21

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

+ Details

Earnings Per Share

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Earnings Per Share

The following table presents the computation of basic and diluted earnings per share:


	Year Ended December 31,
(in millions, except per share data)	2023		2022		2021
Numerator:
Net income attributable to IQVIA Holdings Inc.	$	1,358	$	1,091	$	966
Denominator:
Basic weighted average common shares outstanding	183.8		187.6		191.4
Effect of dilutive stock options and share awards	2.5		3.0		3.6
Diluted weighted average common shares outstanding	186.3		190.6		195.0
Earnings per share attributable to common stockholders:
Basic	$	7.39	$	5.82	$	5.05
Diluted	$	7.29	$	5.72	$	4.95

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. Performance awards are included in diluted earnings per share based on if the performance targets have been met at the end of the reporting period.

For the years ended December 31, 2023, 2022 and 2021 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 that have not been met at the end of the reporting period or the effect of including such stock-based awards in the computation would be anti-dilutive was 1.0 million, 0.5 million, and 0.1 million, million, respectively.

Accumulated Other Comprehensive (Loss) Income

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Accumulated Other Comprehensive (Loss) Income

Below is a summary of the components of AOCI:


(in millions)	Foreign Currency Translation		Derivative Instruments		Defined Benefit Plans		Income Taxes		Total
Balance as of December 31, 2020	$	(395)	$	(48)	$	(85)	$	323	$	(205)
Other comprehensive (loss) income before reclassifications	(165)		11		90		(139)		(203)
Reclassification adjustments	—		16		—		(4)		12
Acquisition of Quest's non-controlling interest	(10)		—		—		—		(10)
Balance as of December 31, 2021	(570)		(21)		5		180		(406)
Other comprehensive (loss) income before reclassifications	(255)		53		(13)		(116)		(331)
Reclassification adjustments	—		12		—		(2)		10
Balance as of December 31, 2022	(825)		44		(8)		62		(727)
Other comprehensive (loss) income before reclassifications	(144)		(10)		11		54		(89)
Reclassification adjustments	—		(68)		—		17		(51)
Balance as of December 31, 2023	$	(969)	$	(34)	$	3	$	133	$	(867)

Below is a summary of the adjustments for amounts reclassified from AOCI into the consolidated statements of income and the affected financial statement line item:


		Year Ended December 31,
(in millions)	Affected Financial Statement Line Item	2023		2022		2021
Derivative instruments:
Interest rate swaps	Interest expense	$	47	$	(22)	$	(21)
Foreign exchange forward contracts	Revenues	21		10		5

Total before income taxes		68		(12)		(16)
Income taxes		17		(2)		(4)
Total net of income taxes		$	51	$	(10)	$	(12)

Supplemental Cash Flow Information

12 Months Ended

Dec. 31, 2023

Supplemental Cash Flow Elements [Abstract]

Supplemental Cash Flow Information

The following table presents the Company’s supplemental cash flow information:


	Year Ended December 31,
(in millions)	2023		2022		2021
Supplemental Cash Flow Information:
Interest paid, net	$	556	$	379	$	343
Income taxes paid, net of refunds	$	340	$	255	$	222

Schedule I - Condensed Financial Information of Registrant

12 Months Ended

Dec. 31, 2023

Condensed Financial Information Disclosure [Abstract]

Schedule I-Condensed Financial Information of Registrant

(2) Financial Statement Schedules

Schedule I—Condensed Financial Information of Registrant

IQVIA HOLDINGS INC. (PARENT COMPANY ONLY)

CONDENSED STATEMENTS OF INCOME AND COMPREHENSIVE INCOME


	Year Ended December 31,
(in millions)	2023		2022		2021
Equity in earnings of subsidiary, net of tax	$	1,358	$	1,091	$	966
Net income	1,358		1,091		966
Equity in other comprehensive (loss) income of subsidiary, net of tax	(140)		(321)		(191)
Comprehensive income	$	1,218	$	770	$	775

IQVIA HOLDINGS INC. (PARENT COMPANY ONLY)

CONDENSED BALANCE SHEETS


	December 31,
(in millions, except per share data)	2023		2022
ASSETS
Current assets:
Cash and cash equivalents	$	2	$	2
Total current assets	2		2
Investment in subsidiary	9,667		9,667
Total assets	$	9,669	$	9,669
LIABILITIES AND STOCKHOLDERS’ EQUITY
Current liabilities:
Accounts payable	$	8	$	—
Total current liabilities	8		—
Investment in subsidiary	3,546		3,902
Payable to subsidiary	3		2
Total liabilities	3,557		3,904
Commitments and contingencies
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of December 31, 2023 and 2022, $0.01 par value, 257.2 shares issued and 181.5 shares outstanding as of December 31, 2023; 256.4 shares issued and 185.7 shares outstanding as of December 31, 2022	11,028		10,898
Retained earnings	4,692		3,334
Treasury stock, at cost, 75.7 and 70.7 shares as of December 31, 2023 and 2022, respectively	(8,741)		(7,740)
Accumulated other comprehensive loss	(867)		(727)
Total stockholders’ equity	6,112		5,765
Total liabilities and stockholders’ equity	$	9,669	$	9,669

IQVIA HOLDINGS INC. (PARENT COMPANY ONLY)

CONDENSED STATEMENTS OF CASH FLOWS


	Year Ended December 31,
(in millions)	2023		2022		2021
Operating activities:
Net Income	$	1,358	$	1,091	$	966
Adjustments to reconcile net income to cash provided by operating activities:
Equity in earnings of subsidiary	(1,358)		(1,091)		(966)
Change in operating assets and liabilities:
Other operating assets and liabilities	—		1		(1)
Net cash provided by (used in) operating activities	—		1		(1)
Investing activities:
Investment in subsidiary, net of dividends received	1,052		1,238		467
Net cash provided by investing activities	1,052		1,238		467
Financing activities:
Payments related to employee stock option plans	(61)		(71)		(59)
Repurchase of common stock	(992)		(1,168)		(406)
Intercompany with subsidiary	1		—		—
Net cash used in financing activities	(1,052)		(1,239)		(465)
Increase in cash and cash equivalents	—		—		1
Cash and cash equivalents at beginning of period	2		2		1
Cash and cash equivalents at end of period	$	2	$	2	$	2

IQVIA HOLDINGS INC. (PARENT COMPANY ONLY)

NOTES TO CONDENSED FINANCIAL INFORMATION

The condensed parent company financial statements have been prepared in accordance with Rule 12-04, Schedule I of Regulation S-X as the restricted net assets of IQVIA Holdings Inc.’s (the “Company”) wholly owned subsidiary, IQVIA Incorporated exceed 25% of the consolidated net assets of the Company. These condensed parent company financial statements are not the general-purpose financial statements of the reporting entity. The ability of IQVIA Incorporated to pay dividends may be limited due to the restrictive covenants in the agreements governing its credit arrangements.

These condensed parent company financial statements include the accounts of IQVIA Holdings Inc. on a standalone basis (the “Parent”) and the equity method of accounting is used to reflect ownership interest in its subsidiary. Refer to the consolidated financial statements and notes presented elsewhere herein for additional information and disclosures with respect to these financial statements.

Below is a summary of the dividends paid to the Parent by IQVIA Incorporated in the years ended December 31, 2023, 2022 and 2021:


(in millions)	Amount
Paid in November 2023	$	232
Paid in September 2023	55
Paid in August 2023	89
Paid in May 2023	490
Paid in March 2023	130
Paid in February 2023	56
Total paid in 2023	$	1,052
Paid in December 2022	$	25
Paid in November 2022	3
Paid in October 2022	40
Paid in September 2022	110
Paid in August 2022	1
Paid in July 2022	100
Paid in June 2022	188
Paid in May 2022	303
Paid in April 2022	2
Paid in March 2022	125
Paid in February 2022	322
Paid in January 2022	20
Total paid in 2022	$	1,239
Paid in December 2021	$	57
Paid in November 2021	89
Paid in October 2021	60
Paid in September 2021	36
Paid in August 2021	35
Paid in July 2021	25
Paid in June 2021	20
Paid in May 2021	23
Paid in April 2021	4
Paid in March 2021	51
Paid in February 2021	70
Total paid in 2021	$	470

Schedule II - Valuation and Qualifying Accounts

12 Months Ended

Dec. 31, 2023

SEC Schedule, 12-09, Valuation and Qualifying Accounts [Abstract]

Schedule II-Valuation and Qualifying Accounts

Schedule II—Valuation and Qualifying Accounts

Deferred Tax Asset Valuation Allowance


			Additions
(in millions)	Balance at Beginning of Year		Charged to Expenses		Charged to Other Accounts(a)		Additions (Deductions) (b)		Balance at End of Year
December 31, 2023	$	257	$	(99)	$	—	$	8	$	166
December 31, 2022	$	294	$	(27)	$	—	$	(10)	$	257
December 31, 2021	$	306	$	1	$	—	$	(13)	$	294

(a)Recorded through purchase accounting transaction.

(b)Impact of reductions recorded to expense and translation adjustments.

Pay vs Performance Disclosure - USD ($) $ in Millions	12 Months Ended
Pay vs Performance Disclosure - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Pay vs Performance Disclosure
Net income attributable to IQVIA Holdings Inc.	$ 1,358	$ 1,091	$ 966

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(g)(1)(ii))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 323
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481687/323-10-50-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 825
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 28
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482907/825-10-50-28

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
-Paragraph 6
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Reference 5: http://www.xbrl.org/2003/role/disclosureRef
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-SubTopic 10
-Name Accounting Standards Codification
-Section 50
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-URI https://asc.fasb.org//1943274/2147483443/250-10-50-3

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
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-Publisher FASB
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 65
-Paragraph 1
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
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+ Details

Insider Trading Arrangements	3 Months Ended
Insider Trading Arrangements	Dec. 31, 2023
Trading Arrangements, by Individual
Rule 10b5-1 Arrangement Adopted	false
Non-Rule 10b5-1 Arrangement Adopted	false
Rule 10b5-1 Arrangement Terminated	false
Non-Rule 10b5-1 Arrangement Terminated	false

Summary of Significant Accounting Policies (Policies)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Principles of Consolidation

The accompanying consolidated financial statements include the accounts and operations of the Company, its subsidiaries and investments in which the Company has control. Amounts pertaining to the non-controlling ownership interests held by third parties in the operating results and financial position of the Company’s majority-owned subsidiaries are reported as non-controlling interests. Intercompany accounts and transactions have been eliminated in consolidation.

Use of Estimates

The preparation of financial statements in accordance with generally accepted accounting principles in the United States of America (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities, and the disclosure of contingent assets and liabilities, at the date of the financial statements, as well as the reported amounts of revenues and expenses during the period. These estimates are based on historical experience and various other assumptions believed reasonable under the circumstances. The Company evaluates its estimates on an ongoing basis and makes changes to the estimates and related disclosures as experience develops or new information becomes known. Actual results may differ from those estimates.

Foreign Currencies

The Company’s consolidated financial statements are reported in United States dollars and, accordingly, the Company’s results of operations are impacted by fluctuations in exchange rates that affect the translation of its revenues and expenses denominated in foreign currencies into United States dollars for purposes of reporting its consolidated financial results. Assets and liabilities recorded in foreign currencies on the books of foreign subsidiaries are translated at the exchange rate on the balance sheet date. Revenues, costs and expenses are translated at average rates of exchange during the year. Translation adjustments resulting from this process are charged or credited to the accumulated other comprehensive (loss) income (“AOCI”) component of stockholders’ equity. The Company is subject to foreign currency transaction risk for fluctuations in exchange rates during the period of time between the consummation and cash settlement of a transaction. The Company earns revenues from its service contracts over a period of several months and, in some cases, over a period of several years. Accordingly, exchange rate fluctuations during this period may affect the Company’s profitability with respect to such contracts.

For operations outside the United States that are considered to be highly inflationary or where the United States dollar is designated as the functional currency, monetary assets and liabilities are remeasured using end-of-period exchange rates, whereas nonmonetary accounts are remeasured using historical exchange rates, and all remeasurement and transaction adjustments are recognized in other (income) expense, net.

Cash Equivalents

The Company considers all highly liquid investments with an initial maturity of three months or less when purchased to be cash equivalents.

Derivatives

The Company uses derivative instruments to manage exposures to interest rates and foreign currencies. Derivatives are recorded on the balance sheet at fair value at each balance sheet date utilizing pricing models for non-exchange-traded contracts.

At inception, the Company designates whether or not the derivative instrument is an effective hedge of an asset, liability or firm commitment which is then classified as either a cash flow hedge or a fair value hedge. If determined to be an effective cash flow hedge, changes in the fair value of the derivative instrument are recorded as a component of AOCI until realized. The Company includes the impact from these hedges in the same line item as the hedged item on the consolidated statements of cash flows. Changes in fair value of effective fair value hedges are recorded in earnings as an offset to the changes in the fair value of the related hedged item. Hedge ineffectiveness, if any, is immediately recognized in earnings. Changes in the fair values of derivative instruments that are not an effective hedge are recognized in earnings. When it is probable that a hedged forecasted transaction will not occur, the Company discontinues hedge accounting for the affected portion of the forecasted transaction and reclassifies gains or losses that were accumulated in AOCI to earnings for foreign exchange derivatives and interest expense for interest rate derivatives on the consolidated statements of income. Cash flows are classified consistent with the underlying hedged item. The Company has entered, and may in the future enter, into derivative contracts (caps, swaps, forwards, calls or puts, warrants, for example) related to its debt and forecasted foreign currency transactions. The Company does not enter into derivative instruments for investment or speculative purposes.

The Company designates its cross-currency swaps and a portion of its foreign currency denominated debt as a hedge of its net investment in certain foreign subsidiaries to reduce the volatility in stockholders’ equity caused by changes in the Euro exchange rate with respect to the United States dollar. Foreign exchange gains or losses on the remeasurement of the debt designated as part of a hedge of net investments is recognized in the cumulative translation adjustment component of AOCI with the related offset in long-term debt. Those amounts would be reclassified from AOCI to earnings upon the sale or substantial liquidation of the net investments. The change in fair value of the cross-currency swaps are also recognized in the cumulative translation adjustment component of AOCI and would be reclassified from AOCI to earnings upon the sale or substantial liquidation of the net investments. The interest rate component of the cross-currency swaps is excluded from the assessment of hedge effectiveness and, thus, is recognized as a reduction to interest expense over the life of the cross-currency swaps.

Business Combinations

Business Combinations and Goodwill

The Company uses the acquisition method to account for business combinations, and accordingly, the identifiable assets acquired, the liabilities assumed and any non-controlling interest in the acquiree are recorded at their estimated fair values on the date of the acquisition. The Company uses significant judgments, estimates and assumptions in determining the estimated fair value of assets acquired, liabilities assumed and non-controlling interests including expected future cash flows, and discount rates that reflect the risk associated with the expected future cash flows and estimated useful lives.

The Company records and allocates to its reporting units the excess of the cost over the fair value of the net assets acquired, known as goodwill. On an annual basis, and if a triggering event occurs, the Company performs a qualitative analysis to determine whether it is more likely than not that the estimated fair value of a reporting unit is less than its carrying amount. This includes a qualitative analysis of macroeconomic conditions, industry and market considerations, cost factors, financial performance, fair value history and other company specific events. If this qualitative analysis indicates that it is more likely than not that the estimated fair value is less than the carrying value for the respective reporting unit, the Company would then need to calculate the fair value of the reporting unit. The Company may also choose to bypass the qualitative assessment for any or all reporting units and proceed directly to a quantitative assessment, which involves estimating the fair value of the Company's reporting units and comparing to the carrying value of the reporting units. If the reporting unit calculated fair value is less than the carrying amount, the Company would record an impairment charge for the difference, with the impairment charge not to exceed the carrying amount of goodwill.

Property and Equipment

Property and equipment are stated at cost and are depreciated using the straight-line method over the shorter of the asset’s estimated useful life or the lease term, if related to leased property, as follows:


Buildings and leasehold improvements	3	-	40 years
Equipment	3	-	10 years
Furniture and fixtures	5	-	10 years
Transportation equipment	3	-	20 years

Definite-lived Identifiable Intangible Assets

Definite-lived other identifiable intangible assets are amortized primarily using an accelerated method that reflects the pattern in which the Company expects to benefit from the use of the asset over its estimated remaining useful life as follows:


Client relationships and backlog	1	-	25 years
Software and related assets	1	-	10 years
Trademarks, trade names and other	1	-	17 years
Databases	1	-	9 years
Non-compete agreements	2	-	5 years

Included in software and related assets is the capitalized cost of internal-use software used in supporting the Company’s business. Qualifying costs incurred during the application development stage are capitalized and amortized over their estimated useful lives. Costs are capitalized from completion of the preliminary project stage and when it is considered probable that the software will be used to perform its intended function, up until the time the software is placed into service. The Company recognized $475 million, $419 million and $211 million of amortization expense for the years ended December 31, 2023, 2022 and 2021, respectively, related to software and related assets.

The carrying values of property, equipment and intangible and other long-lived assets are reviewed for recoverability at the asset grouping level to determine if the facts and circumstances suggest that a potential impairment may have occurred. If this review indicates that carrying values will not be recoverable, as determined based on undiscounted cash flow projections, the Company will record an impairment charge to reduce carrying values to estimated fair value. There were no impairments recognized in the years ended December 31, 2023, 2022 and 2021.

Revenue Recognition

The Company’s arrangements are primarily service contracts that range in duration from a few months to several years. The Company recognizes revenues when control of these services is transferred to the customer for an amount, referred to as the transaction price, that reflects the consideration to which the Company is expected to be entitled in exchange for those goods or services. The Company determines revenue recognition utilizing the following five steps: (1) identification of the contract with a customer, (2) identification of the performance obligations in the contract (promised goods or services that are distinct), (3) determination of the transaction price, (4) allocation of the transaction price to the performance obligations, and (5) recognition of revenues when, or as, the Company transfers control of the product or service for each performance obligation. Cash payments made to customers as incentives to induce customers to enter into service agreements with the Company are amortized as a reduction of revenues over the period the services are performed. The Company records revenues net of any tax assessments by governmental authorities, such as value added taxes, that are imposed on and concurrent with specific revenues generating transactions.

The Company derives the majority of its revenues in the Technology & Analytics Solutions segment from various information and technology service offerings. Information offerings (primarily under fixed-price contracts) typically include multiple performance obligations including an ongoing subscription-based deliverable for which revenues are recognized ratably as earned over the contract period, and/or a one-time deliverable of data offerings for which revenues are recognized upon delivery. The customer is able to benefit from the provision of data as it is received. The Company’s subscription arrangements typically have terms ranging from one to three years and are generally non-cancelable and do not contain refund-type provisions. Technology services offerings may contain multiple performance obligations consisting of a mix of small and large-scale services and consulting projects, multi-year outsourcing contracts and Software-as-a-Service (“SaaS”) arrangements. These arrangements typically have terms ranging from several weeks to three years, with a majority having terms of one year or less. For arrangements that include multiple performance obligations, the transaction price is allocated to the identified performance obligations based on their relative standalone selling prices. For these contracts, the standalone selling prices are based on the Company’s normal pricing practices when sold separately with consideration of market conditions and other factors, including customer demographics and geographic location. Revenues for services engagements where the transfer of control occurs ratably over time are recognized on a straight-line basis over the term of the arrangement. Revenues from time and material contracts are recognized based on hours as the services are provided. Revenues from fixed price ad hoc services and consulting contracts are recognized over the contract term based on the ratio of the number of hours incurred for services provided during the period compared to the total estimated hours to be incurred over the entire arrangement (hours-based). Technology services offerings meet the over time criterion, as another party would not need to substantially re-perform the work already completed to satisfy the remaining obligations if the services were migrated.

The majority of the Company’s contracts within the Research & Development Solutions segment are service contracts for clinical research that represent a single performance obligation. The Company provides a significant integration service resulting in a combined output, which is clinical trial data that meets the relevant regulatory standards and can be used by the customer to progress to the next phase of a clinical trial or solicit approval of a treatment by the applicable regulatory body. The performance obligation is satisfied over time as the output is captured in data and documentation that is available for the customer to consume over the course of the arrangement and furthers progress of the clinical trial. The Company recognizes revenues over time using a cost-based input method since there is no single output measure that would fairly depict the transfer of control over the life of the performance obligation. Progress on the performance obligation is measured by the proportion of actual costs incurred to the total costs expected to complete the contract. Costs included in the measure of progress include direct labor and third-party costs (such as payments to investigators and other reimbursed expenses for the Company’s clinical monitors). This cost-based method of revenue recognition requires the Company to make estimates of costs to complete its projects on an ongoing basis. Significant judgment is required to evaluate assumptions related to these estimates. The effect of revisions to estimates related to the transaction price or costs to complete a project are recorded in the period in which the estimate is revised. Most contracts may be terminated upon 30 to 90 days' notice by the customer; however, in the event of termination, most contracts require payment for services rendered through the date of termination, as well as for subsequent services rendered to close out the contract.

The majority of revenues in the Company's Contract Sales & Medical Solutions segment is from contract salesforce to the biopharmaceutical industry and broader healthcare market and recognized over time using a single measure of progress dependent on the performance obligation. Some of the Company's Contract Sales & Medical Solutions contracts contain multiple performance obligations with distinct promises including recruiting, sales force automation and deployment of sales representatives. The Company utilizes a single measure of progress for each performance obligation to recognize revenues, which includes deployment of sales representatives based on employee days worked; recruiting based on candidates recruited; sales force automation set-up based on hours worked; and sales force automation hosting and maintenance based on usage. These services meet the over time criterion as the customer consumes the benefit as activities are performed and another party would not need to substantially re-perform the work already completed to satisfy the remaining obligations if the services were migrated to another party.

Variable Consideration

In some cases, contracts provide for variable consideration that is contingent upon the occurrence of uncertain future events, such as performance incentives (including royalty payments, bonuses, or penalty clauses that can either increase or decrease the transaction price). Variable consideration is estimated at the expected value or at the most likely amount depending on the type of consideration. Estimated amounts are included in the transaction price to the extent it is probable that a significant reversal of cumulative revenues recognized will not occur when the uncertainty associated with the variable consideration is resolved. The estimate of variable consideration and determination of whether to include estimated amounts in the transaction price are based largely on an assessment of the Company's anticipated performance and all information (historical, current and forecasted) that is reasonably available to the Company and reevaluated each reporting period.

Reimbursed Expenses

The Company includes reimbursed expenses in revenues and cost of revenues as the Company is primarily responsible for fulfilling the promise to provide the specified service, including the integration of the related services into a combined output to the customer, which are inseparable from the integrated service. These costs include such items as payments to investigators and travel expenses for the Company’s clinical monitors and sales representatives, over which the Company has discretion in establishing prices. The Company controls the good or service and has inventory risk on contractually reimbursable expenses, as sometimes the Company is unable to obtain reimbursement from the customer for costs incurred.

Change Orders

Changes in the scope of work are common, especially under long-term contracts, and generally result in a change in transaction price. Change orders are evaluated on a contract-by-contract basis to determine if they should be accounted for as a new contract or as part of the existing contract. Generally, services from change orders are not distinct from the original performance obligation. As a result, the effect that the contract modification has on the contract revenues, and measure of progress, is recognized as an adjustment to revenues when it occurs.

Cost of Revenues

Cost of revenues include (i) compensation and benefits for billable employees and personnel involved in production, data management and delivery, and the costs of acquiring and processing data for the Company’s information offerings; (ii) costs of staff directly involved with delivering technology-related services offerings and engagements, and the costs of data purchased specifically for technology services engagements; (iii) reimbursed expenses that are comprised principally of payments to investigators who oversee clinical trials and travel expenses for the Company’s clinical monitors and sales representatives; and (iv) other expenses directly related to service contracts such as courier fees, laboratory supplies, professional services and travel expenses.

Trade Receivables, Unbilled Services and Unearned Income

In general, billings and payments are established by contractual provisions including predetermined payment schedules, which may or may not correspond to the timing of the transfer of control of the Company’s services under the contract. In general, the Company’s intention in its invoicing (payment terms) is to maintain cash neutrality over the life of the contract. Generally, the payment terms are 30 to 90 days based on contracts. Upfront payments, when they occur, are intended to cover certain expenses the Company incurs at the beginning of the contract. Neither the Company nor its customers view such upfront payments and contracted payment schedules as a means of financing. Unbilled services primarily arise from long-term contracts when a cost-based or hours-based input method of revenue recognition is utilized and revenues recognized exceeds the amount billed to the customer.

Unearned income consists of advance payments and billings in excess of revenues recognized. As the contracted services are subsequently performed and the associated revenues are recognized, the unearned income balance is reduced by the amount of the revenue recognized during the period. Unearned income is classified as a current liability on our consolidated balance sheets as the Company expects to recognize the associated revenues in less than one year.

Restructuring Costs

Restructuring costs, which primarily include termination benefits, are recorded at estimated value. Key assumptions in determining the restructuring costs include the terms and payments that may be negotiated to terminate certain contractual obligations and the timing of employees leaving the Company.

Debt Fees

Fees incurred to issue debt are generally deferred and amortized as a component of interest expense over the estimated term of the related debt using the effective interest rate method.

Contingencies

The Company records accruals for claims, suits, investigations and proceedings when it is probable that a liability has been incurred and the amount of the loss can be reasonably estimated. The Company reviews claims, suits, investigations and proceedings at least quarterly and records or adjusts accruals related to such matters to reflect the impact and status of any settlements, rulings, advice of counsel or other information pertinent to a particular matter. Legal costs associated with contingencies are charged to expense as incurred.

The Company is party to legal proceedings incidental to its business. While the outcome of these matters could differ from management’s expectations, the Company does not believe the resolution of these matters will have a material adverse effect to the Company’s financial statements. See Note 12 for additional information.

Income Taxes

The provision for income taxes includes federal, state, local and foreign taxes. Income taxes are accounted for under the asset and liability method. Deferred tax assets and liabilities are recognized for the estimated future tax consequences of temporary differences between the financial statement carrying amounts and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the year in which the temporary differences are expected to be recovered or settled. The Company records U.S. deferred taxes based on the Federal corporate income tax rate of 21%. The Company accounts for tax related to Global Intangible Low-Taxed Income (“GILTI”) as a period cost when incurred. Recognition of deferred income tax assets is based on management’s belief that it is more likely than not that the income tax benefit associated with certain temporary differences, income tax operating loss, capital loss carryforwards, and income tax credits, will be realized. The Company records a valuation allowance to reduce its deferred income tax assets for those deferred income tax items for which it was more likely than not that realization would not occur. The Company determines the amount of the valuation allowance based, in part, on the Company’s assessment of future taxable income and in light of the Company’s ongoing income tax strategies. If the estimate of future taxable income or tax strategies changes at any time in the future, the Company would record an adjustment to its valuation allowance. Recording such an adjustment could have a material effect on the Company’s financial condition or results of operations.

Income tax expense is based on the distribution of profit before income tax among the various taxing jurisdictions in which the Company operates, adjusted as required by the income tax laws of each taxing jurisdiction. Changes in the distribution of profits and losses among taxing jurisdictions may have a significant impact on the Company's effective income tax rate. The Company does not consider the undistributed earnings of our foreign subsidiaries to be indefinitely reinvested outside of the United States.

Pensions and Other Postretirement Benefits

The Company provides retirement benefits to certain employees, including defined benefit pension plans. The determination of benefit obligations and expense is based on actuarial models. In order to measure benefit costs and obligations using these models, assumptions are made with regard to the discount rate, expected return on plan assets, cash balance crediting rate, lump sum conversion rate and the assumed rate of compensation increases.

Stock-based Compensation

The Company accounts for stock-based compensation for stock options and stock appreciation rights under the fair value method and uses the Black-Scholes-Merton model to estimate the value of such stock-based awards granted to its employees and non-executive directors. Expected volatility is based on an analysis that incorporates the historical volatility of the Company's stock since the Merger in October 2016 and reported data for selected reasonably similar publicly traded companies for which the historical information is available. The Company does not currently anticipate paying dividends. The expected term represents the period of time the grants are expected to be outstanding. The risk-free interest rate is based on the United States Treasury yield curve in effect at the time of the grant.

The Company values its stock-based compensation for restricted stock awards and restricted stock units based on the closing market price of the Company’s common stock on the date of grant. The Company accounts for its stock-based compensation for performance awards related to compound annual earnings per share (“EPS”) growth based on the closing market price of the Company’s common stock on the date of grant, and for performance awards related to relative total shareholder return (“TSR”) based on a Monte Carlo simulation model.

Leases

The Company determines if an arrangement is a lease at inception and reassesses if there are changes in terms and conditions of the contract. Operating leases are included in operating lease right-of-use (“ROU”) assets, other current liabilities, and operating lease liabilities on our consolidated balance sheets. Finance leases are included in deposits and other assets, net, other current liabilities, and other liabilities on the Company's consolidated balance sheets. Lease assets and 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. Lease assets also include any lease payments made before lease commencement and initial direct costs and excludes lease incentives. 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. Operating lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. Finance lease expense is recognized as a combination of depreciation expense for the leased asset and interest expense for the outstanding lease liabilities using the discount rate discussed above.

The Company has lease agreements with lease and non-lease components that the Company has elected to account for as single lease components.

Earnings Per Share

The calculation of earnings per share is based on the weighted average number of common shares or common stock equivalents outstanding during the applicable period. The dilutive effect of common stock equivalents is excluded from basic earnings per share and is included in the calculation of diluted earnings per share. Potentially dilutive securities include outstanding stock options and unvested restricted stock units, restricted stock, performance awards and other stock-based awards. Diluted shares outstanding are calculated based on the average share price for each fiscal period using the treasury stock method. Under the treasury stock method, the amount the employee must pay for exercising stock options, and the amount of compensation cost for future service that the Company has not yet recognized are assumed to be used to repurchase shares.

Investments in Unconsolidated Affiliates

The Company’s investments in unconsolidated affiliates are accounted for under the equity method if the Company exercises significant influence or has an investment in a limited partnership that is considered to be greater than minor. These investments are classified as investments in unconsolidated affiliates on the accompanying consolidated balance sheets. The Company records its pro rata share of the earnings, adjusted for accretion of basis difference, of these investments in equity in (losses) earnings of unconsolidated affiliates on the accompanying consolidated statements of income. The Company reviews its investments in unconsolidated affiliates for impairment whenever events or changes in circumstances indicate that the carrying amounts may not be recoverable.

Treasury Stock

The Company records treasury stock purchases under the cost method. Upon reissuance of treasury stock, amounts in excess of the acquisition cost are credited to additional paid-in capital. If the Company reissues treasury stock at an amount below its acquisition cost and additional paid-in capital associated with prior treasury stock transactions is insufficient to cover the difference between the acquisition cost and the reissue price, this shortfall is recorded in retained earnings.

Recently Issued Accounting Standards

Accounting pronouncements recently adopted

In September 2022, the Financial Accounting Standards Board ("FASB") issued new accounting guidance, Accounting Standards Update ("ASU") 2022-04, Liabilities - Supplier Finance Programs, to enhance the transparency of supplier finance programs. The amendments in this ASU address investor and other financial statement user requests for additional information about the use of supplier finance programs by the buyer party to understand the effect of those programs on a Company's working capital, liquidity, and cash flows. The Company adopted this new accounting guidance effective January 1, 2023. The adoption of this new accounting guidance did not have a material effect on the Company's disclosures within the consolidated financial statements.

Accounting pronouncements issued but not adopted as of December 31, 2023

In November 2023, the FASB issued ASU 2023-07, Segment Reporting (Topic 280): Improvements to Reportable Segment Disclosures, to improve reportable segment disclosure requirements. The new guidance requires disclosure of significant segment expenses that are regularly provided to the chief operating decision maker and included in the reported measure of segment profit or loss. It does not change the definition of a segment or the guidance for determining reportable segments. The new guidance will be effective for the Company in the annual period beginning January 1, 2024 and in 2025 for interim periods. The Company is assessing the impacts of this ASU on its disclosures within the consolidated financial statements.

In December 2023, the FASB issued ASU 2023-09, Income Taxes (Topic 740): Improvements to Income Tax Disclosures, to enhance the transparency and decision usefulness of income tax disclosures. The amendments in this ASU require additional disclosures about income taxes, primarily focused on the disclosure of income taxes paid and the rate reconciliation table. The new guidance will be effective for the Company in the annual period beginning January 1, 2025. The Company is assessing the impacts of this ASU on its disclosures within the consolidated financial statements.

Summary of Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2023

Accounting Policies [Abstract]

Summary of Major Classes of Property and Equipment

Property and equipment are stated at cost and are depreciated using the straight-line method over the shorter of the asset’s estimated useful life or the lease term, if related to leased property, as follows:


Buildings and leasehold improvements	3	-	40 years
Equipment	3	-	10 years
Furniture and fixtures	5	-	10 years
Transportation equipment	3	-	20 years

The major classes of property and equipment were as follows:


	December 31,
(in millions)	2023		2022
Land, buildings and leasehold improvements	$	376	$	363
Equipment	803		852
Transportation equipment	81		83
Furniture and fixtures	66		74
Property and equipment, gross	1,326		1,372
Less accumulated depreciation	(803)		(840)
Property and equipment, net	$	523	$	532

Definite-Lived Identifiable Intangible Assets Amortized

Definite-lived other identifiable intangible assets are amortized primarily using an accelerated method that reflects the pattern in which the Company expects to benefit from the use of the asset over its estimated remaining useful life as follows:


Client relationships and backlog	1	-	25 years
Software and related assets	1	-	10 years
Trademarks, trade names and other	1	-	17 years
Databases	1	-	9 years
Non-compete agreements	2	-	5 years

The following is a summary of other identifiable intangible assets:


	December 31, 2023						December 31, 2022

(in millions)	Gross Amount		Accumulated Amortization		Net Amount		Gross Amount		Accumulated Amortization		Net Amount
Definite-lived identifiable intangible assets:
Client relationships and backlog	$	5,688	$	(2,724)	$	2,964	$	5,339	$	(2,332)	$	3,007
Software and related assets	3,629		(2,005)		1,624		3,106		(1,591)		1,515
Trademarks, trade names and other	548		(320)		228		545		(278)		267
Databases	1,837		(1,819)		18		1,817		(1,794)		23
Non-compete agreements	16		(11)		5		23		(15)		8
	$	11,718	$	(6,879)	$	4,839	$	10,830	$	(6,010)	$	4,820

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations (Tables)

12 Months Ended

Dec. 31, 2023

Revenue from Contract with Customer [Abstract]

Summary of Revenues by Geographical Region and Reportable Segment

The Company attributes revenues to geographical region based upon where the services are performed. The following tables represent revenues by geographical region and reportable segment for the years ended December 31, 2023, 2022 and 2021:


	December 31, 2023
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	3,091	$	4,157	$	304	$	7,552
Europe and Africa	2,156		2,103		200		4,459
Asia-Pacific	615		2,135		223		2,973
Total revenues	$	5,862	$	8,395	$	727	$	14,984


	December 31, 2022
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,947	$	3,747	$	354	$	7,048
Europe and Africa	2,175		2,016		175		4,366
Asia-Pacific	624		2,158		214		2,996
Total revenues	$	5,746	$	7,921	$	743	$	14,410


	December 31, 2021
(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Total
Revenues:
Americas	$	2,610	$	3,887	$	351	$	6,848
Europe and Africa	2,282		1,899		176		4,357
Asia-Pacific	642		1,770		257		2,669
Total revenues	$	5,534	$	7,556	$	784	$	13,874

Trade Accounts Receivable, Unbilled Services and Unearned Income (Tables)

12 Months Ended

Dec. 31, 2023

Receivables [Abstract]

Trade Accounts Receivable and Unbilled Services

Trade accounts receivables and unbilled services consist of the following:


	December 31,
(in millions)	2023		2022
Trade accounts receivable	$	1,473	$	1,329
Unbilled services	1,942		1,624
Trade accounts receivable and unbilled services	3,415		2,953
Allowance for doubtful accounts	(34)		(36)
Trade accounts receivable and unbilled services, net	$	3,381	$	2,917

Schedule of Net Contract Assets (Liabilities)

Unbilled services and unearned income were as follows:


	December 31,
(in millions)	2023		2022		Change
Unbilled services	$	1,942	$	1,624	$	318
Unearned income	(1,799)		(1,797)		(2)
Net balance	$	143	$	(173)	$	316

Investments (Tables)

12 Months Ended

Dec. 31, 2023

Investments, Debt and Equity Securities [Abstract]

Investments in and Advances to Unconsolidated Affiliates

The following is a summary of the Company’s investments in unconsolidated affiliates:


	December 31,
(in millions)	2023		2022
NovaQuest Pharma Opportunities Fund V, L.P. (“NQ Fund V”)	$	35	$	29
NostraData Pty Ltd. (“NostraData”)	18		18
NovaQuest Pharma Opportunities Fund IV, L.P. (“NQ Fund IV”)	6		8
NovaQuest Private Equity Fund I, L.P. (“NQ PE Fund I”)	10		8
Longwood Fund V, L.P. ("Longwood")	7		6
RxWare (formerly "Helparound")	2		2
NovaQuest Pharma Opportunities Fund III, L.P. (“NQ Fund III”)	1		1
Other	55		22
	$	134	$	94

Summary of Investments in Unconsolidated Variable Interest Entities and Estimated Maximum Exposure to Loss

As of December 31, 2023, the Company’s investments in unconsolidated variable interest entities (“VIEs”) and its estimated maximum exposure to loss were as follows:


(in millions)	Investments in Unconsolidated VIEs		Maximum Exposure to Loss
NQ Fund V	$	35	$	44
Longwood	7		10
NQ PE Fund I	10		11
NQ Fund IV	6		7
NQ Fund III	1		6
Other	48		293
	$	107	$	371

- Definition

Tabular disclosure of the significant judgments and assumptions made in determining whether a variable interest (as defined) held by the entity requires the variable interest entity (VIE) (as defined) to be consolidated and (or) disclose information about its involvement with the VIE, individually or in aggregate (as applicable); the nature of restrictions, if any, on the consolidated VIE's assets and on the settlement of its liabilities reported by an entity in its statement of financial position, including the carrying amounts of such assets and liabilities; the nature of, and changes in, the risks associated with involvement in the VIE; how involvement with the VIE affects the entity's financial position, financial performance, and cash flows; the lack of recourse if creditors (or beneficial interest holders) of the consolidated VIE have no recourse to the general credit of the primary beneficiary (if applicable); the terms of arrangements, giving consideration to both explicit arrangements and implicit variable interests, if any, that could require the entity to provide financial support to the VIE, including events or circumstances that could expose the entity to a loss; the methodology used by the entity for determining whether or not it is the primary beneficiary of the variable interest entity; the significant factors considered and judgments made in determining that the power to direct the activities of a VIE that most significantly impact the VIE's economic performance are shared (as defined); the carrying amounts and classification of assets and liabilities of the VIE included in the statement of financial position; the entity's maximum exposure to loss, if any, as a result of its involvement with the VIE, including how the maximum exposure is determined and significant sources of the entity's exposure to the VIE; a comparison of the carrying amounts of the assets and liabilities and the entity's maximum exposure to loss; information about any liquidity arrangements, guarantees, and (or) other commitments by third parties that may affect the fair value or risk of the entity's variable interest in the VIE; whether or not the entity has provided financial support or other support (explicitly or implicitly) to the VIE that it was not previously contractually required to provide or whether the entity intends to provide that support, including the type and amount of the support and the primary reasons for providing the support; and supplemental information the entity determines necessary to provide.

+ References + Details

Derivatives (Tables)

12 Months Ended

Dec. 31, 2023

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, on a gross basis, and the line items on the accompanying consolidated balance sheets to which they were recorded are summarized in the following table:


		December 31, 2023						December 31, 2022
(in millions)	Balance Sheet Classification	Assets		Liabilities		Notional		Assets		Liabilities		Notional
Derivatives designated as hedging instruments:
Interest rate swaps	Other current assets, other assets and other current liabilities	$	13	$	51	$	3,300	$	42	$	—	$	1,800
Cross-currency swaps	Other current liabilities	—		108		2,750		—		—		—
Foreign exchange forward contracts	Other current assets and other current liabilities	2		—		121		2		2		122

Total derivatives		$	15	$	159			$	44	$	2

Pre-tax Effect of Cash Flow Hedging Instruments on Other Comprehensive Income (Loss)

The pre-tax effect of the Company’s cash flow hedging instruments on other comprehensive income is summarized in the following table:


	Year Ended December 31,
(in millions)	2023		2022		2021
Interest rate swaps	$	(80)	$	62	$	35
Foreign exchange forward contracts	2		3		(8)
Total	$	(78)	$	65	$	27

Fair Value Measurements (Tables)

12 Months Ended

Dec. 31, 2023

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 December 31, 2023:


(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	146	$	—	$	—	$	146
Derivatives	—		15		—		15
Total	$	146	$	15	$	—	$	161
Liabilities:
Derivatives	$	—	$	159	$	—	$	159
Contingent consideration	—		—		106		106
Total	$	—	$	159	$	106	$	265

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 December 31, 2022:


(in millions)	Level 1		Level 2		Level 3		Total
Assets:
Marketable securities	$	122	$	—	$	—	$	122
Derivatives	—		44		—		44
Total	$	122	$	44	$	—	$	166
Liabilities:
Derivatives	$	—	$	2	$	—	$	2
Contingent consideration	—		—		173		173
Total	$	—	$	2	$	173	$	175

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 year ended December 31:


	Contingent Consideration
(in millions)	2023		2022		2021
Balance as of January 1	$	173	$	76	$	119
Business combinations	64		134		39
Contingent consideration paid	(73)		(22)		(39)
Revaluations included in earnings and foreign currency translation adjustments	(58)		(15)		(43)
Balance as of December 31	$	106	$	173	$	76

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2023

Property, Plant and Equipment [Abstract]

Summary of Major Classes of Property and Equipment

Property and equipment are stated at cost and are depreciated using the straight-line method over the shorter of the asset’s estimated useful life or the lease term, if related to leased property, as follows:


Buildings and leasehold improvements	3	-	40 years
Equipment	3	-	10 years
Furniture and fixtures	5	-	10 years
Transportation equipment	3	-	20 years

The major classes of property and equipment were as follows:


	December 31,
(in millions)	2023		2022
Land, buildings and leasehold improvements	$	376	$	363
Equipment	803		852
Transportation equipment	81		83
Furniture and fixtures	66		74
Property and equipment, gross	1,326		1,372
Less accumulated depreciation	(803)		(840)
Property and equipment, net	$	523	$	532

Schedule of Property and Equipment Depreciation Expense

Property and equipment depreciation expense was as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Depreciation expense	$	151	$	160	$	147

Goodwill and Identifiable Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2023

Goodwill and Intangible Assets Disclosure [Abstract]

Amortization Expense Associated with Identifiable Definite-Lived Intangible Assets

Amortization expense associated with other identifiable definite-lived intangible assets was as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Amortization expense	$	974	$	970	$	1,117

Definite-Lived Identifiable Intangible Assets Amortized

Definite-lived other identifiable intangible assets are amortized primarily using an accelerated method that reflects the pattern in which the Company expects to benefit from the use of the asset over its estimated remaining useful life as follows:


Client relationships and backlog	1	-	25 years
Software and related assets	1	-	10 years
Trademarks, trade names and other	1	-	17 years
Databases	1	-	9 years
Non-compete agreements	2	-	5 years

The following is a summary of other identifiable intangible assets:


	December 31, 2023						December 31, 2022

(in millions)	Gross Amount		Accumulated Amortization		Net Amount		Gross Amount		Accumulated Amortization		Net Amount
Definite-lived identifiable intangible assets:
Client relationships and backlog	$	5,688	$	(2,724)	$	2,964	$	5,339	$	(2,332)	$	3,007
Software and related assets	3,629		(2,005)		1,624		3,106		(1,591)		1,515
Trademarks, trade names and other	548		(320)		228		545		(278)		267
Databases	1,837		(1,819)		18		1,817		(1,794)		23
Non-compete agreements	16		(11)		5		23		(15)		8
	$	11,718	$	(6,879)	$	4,839	$	10,830	$	(6,010)	$	4,820

Schedule of Indefinite-Lived Intangible Assets

The following is a summary of other identifiable intangible assets:


	December 31, 2023						December 31, 2022

(in millions)	Gross Amount		Accumulated Amortization		Net Amount		Gross Amount		Accumulated Amortization		Net Amount
Definite-lived identifiable intangible assets:
Client relationships and backlog	$	5,688	$	(2,724)	$	2,964	$	5,339	$	(2,332)	$	3,007
Software and related assets	3,629		(2,005)		1,624		3,106		(1,591)		1,515
Trademarks, trade names and other	548		(320)		228		545		(278)		267
Databases	1,837		(1,819)		18		1,817		(1,794)		23
Non-compete agreements	16		(11)		5		23		(15)		8
	$	11,718	$	(6,879)	$	4,839	$	10,830	$	(6,010)	$	4,820

Summary of Goodwill by Segment

The following is a summary of goodwill by reportable segment for the years ended December 31, 2023 and 2022:


(in millions)	Technology & Analytics Solutions		Research & Development Solutions		Contract Sales & Medical Solutions		Consolidated
Balance as of December 31, 2021	$	11,337	$	1,802	$	162	$	13,301
Business combinations	554		472		—		1,026
Impact of foreign currency fluctuations and other	(371)		(27)		(8)		(406)
Balance as of December 31, 2022	11,520		2,247		154		13,921
Business combinations	352		181		—		533
Impact of foreign currency fluctuations and other	104		11		(2)		113
Balance as of December 31, 2023	$	11,976	$	2,439	$	152	$	14,567

- Definition

Tabular disclosure of goodwill by reportable segment and in total which includes a rollforward schedule.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 24
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482548/350-20-55-24

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 5: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 6: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 7: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 8: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (e)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 9: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 10: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Subparagraph (g)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1

Reference 11: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1A
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-1A

Reference 12: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 350
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482573/350-20-50-2

+ Details

Accrued Expenses (Tables)

12 Months Ended

Dec. 31, 2023

Payables and Accruals [Abstract]

Accrued Expenses

Accrued expenses consist of the following:


	December 31,
(in millions)	2023		2022
Client contract related	$	1,315	$	1,065
Compensation, including bonuses, fringe benefits and payroll taxes	968		980
Professional fees	112		99
Contingent consideration and deferred purchase price	27		90
Interest	66		43
Restructuring	36		26
Other	331		368
	$	2,855	$	2,671

Credit Arrangements (Tables)

12 Months Ended

Dec. 31, 2023

Debt Disclosure [Abstract]

Summary of Credit Facilities

The following is a summary of the Company’s revolving credit facilities as of December 31, 2023:


Facility						Interest Rates
$2,000 million (revolving credit facility)						U.S. Dollar Term SOFR plus a margin of 1.25% plus a 10 basis credit spread adjustment as of December 31, 2023
$110 million (receivables financing facility)						U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of December 31, 2023

Summary of Debt

The following table summarizes the Company’s debt at the dates indicated:


	December 31,
(dollars in millions)	2023		2022
Revolving Credit Facility due 2026:
U.S. Dollar denominated borrowings—U.S. Dollar Term SOFR at average floating rates of 6.71%	$	100	$	425
Senior Secured Credit Facilities:
Term A Loan due 2026—U.S. Dollar Term SOFR at average floating rates of 6.71%	1,270		1,343
Term A Loan due 2026—Euribor at average floating rates of 5.18%	306		314
Term A Loan due 2027—U.S. Dollar Term SOFR at average floating rates of 6.74%	1,156		1,219
Term B Loan due 2024—Euribor at average floating rates of —%	—		1,172
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of —%	—		670
Term B Loan due 2025—U.S. Dollar Term SOFR at average floating rates of —%	—		860
Term B Loan due 2025—Euribor at average floating rates of 5.93%	576		559
Term B Loan due 2031—U.S Dollar Term SOFR at average floating rates of 7.35%	1,500		—
5.700% Senior Secured Notes due 2028—U.S. Dollar denominated	750		—
6.250% Senior Secured Notes due 2029—U.S. Dollar denominated	1,250		—
5.0% Senior Notes due 2027—U.S. Dollar denominated	1,100		1,100
5.0% Senior Notes due 2026—U.S. Dollar denominated	1,050		1,050
6.500% Senior Notes due 2030—U.S. Dollar denominated	500		—
2.875% Senior Notes due 2025—Euro denominated	464		450
2.25% Senior Notes due 2028—Euro denominated	795		771
2.875% Senior Notes due 2028—Euro denominated	785		761
1.750% Senior Notes due 2026—Euro denominated	607		589
2.250% Senior Notes due 2029—Euro denominated	993		964
Receivables financing facility due 2024—U.S. Dollar Term SOFR at average floating rates of 6.36%
Revolving Loan Commitment	110		110
Term Loan	440		440
Principal amount of debt	13,752		12,797
Less: unamortized discount and debt issuance costs	(79)		(50)
Less: current portion	(718)		(152)
Long-term debt	$	12,955	$	12,595

Contractual Maturities of Long-term Debt

Contractual maturities of long-term debt as of December 31, 2023 are as follows:


(in millions)
2024	$	718
2025	1,207
2026	3,231
2027	2,084
2028	2,345
Thereafter	4,167
	$	13,752

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 55
-Paragraph 69B
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481568/470-20-55-69B

Reference 2: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
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-Name Accounting Standards Codification
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-URI https://asc.fasb.org//1943274/2147481568/470-20-55-69E

Reference 3: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-3

Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org//1943274/2147482925/835-30-45-2

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Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 7: http://fasb.org/us-gaap/role/ref/legacyRef
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Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
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-URI https://asc.fasb.org//1943274/2147481112/505-10-50-7

+ Details

Leases (Tables)

12 Months Ended

Dec. 31, 2023

Leases [Abstract]

Components of Lease Expense

The components of lease expense were as follows:


		Year Ended December 31,
(in millions)	Classification	2023		2022		2021
Operating lease cost (1)	Selling, general and administrative expenses	$	160	$	171	$	184
Finance lease cost (1)	Depreciation and amortization, and Interest expense	18		12		10
Total lease cost		$	178	$	183	$	194

(1) Includes variable lease costs, which are immaterial.

Other Information Related to Leases

Other information related to leases was as follows:


	Year Ended December 31,
(in millions)	2023			2022			2021
Supplemental Cash Flow:
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows for operating leases	$	175		$	173		$	175
Operating cash flows for finance leases	$	8		$	5		$	—
Financing cash flows for finance leases	$	3		$	4		$	—
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	$	59		$	79		$	81
Finance leases	$	—		$	54		$	44
Weighted Average Remaining Lease Term:
Operating leases	4.61 years			4.72 years			4.53 years
Finance leases	20.67 years			21.64 years			21.28 years
Weighted Average Discount Rate:
Operating leases	3.81		%	3.12		%	3.36		%
Finance leases	3.88		%	3.87		%	2.70		%

Future Minimum Lease Payments Under Non-cancellable Leases

Future minimum lease payments under non-cancellable leases as of December 31, 2023 were as follows:


(in millions)	Operating Leases		Finance Leases
2024	$	117	$	13
2025	96		13
2026	55		13
2027	36		14
2028	24		14
Thereafter	31		283
Total future minimum lease payments	359		350
Less imputed interest	(29)		(122)
Total	$	330	$	228
Reported as of December 31, 2023:
Other current liabilities	$	107	$	—
Operating lease liabilities	223		—
Other liabilities	—		228
Total	$	330	$	228

Stockholders' Equity (Tables)

12 Months Ended

Dec. 31, 2023

Equity [Abstract]

Schedule of Share Repurchases Made Both Under and Outside of Repurchase Program

Below is a summary of the share repurchases made under the Repurchase Program:


	Year Ended December 31,
(in millions, except per share data)	2023		2022		2021
Number of shares of common stock repurchased	5.0		5.5		1.7
Aggregate purchase price	$	992	$	1,168	$	395
Average price per share	$	196.89	$	213.06	$	238.22

Business Combinations (Tables)

12 Months Ended

Dec. 31, 2023

Business Combination and Asset Acquisition [Abstract]

Schedule of Recognized Identified Assets Acquired and Liabilities Assumed

The following table provides certain preliminary financial information for these acquisitions:


	Year Ended December 31,
(in millions)	2023		2022
Assets acquired:
Cash and cash equivalents	$	28	$	33
Accounts receivable	44		—
Other assets	9		115
Goodwill	533		1,026
Other identifiable intangibles	425		509
Liabilities assumed:
Other liabilities	(44)		(103)
Deferred income taxes, long-term	(18)		(93)
Net assets acquired (1)	$	977	$	1,487

(1) Net assets acquired include contingent consideration and deferred purchase price of $73 million and $139 million, respectively.

Indefinite-Lived Intangible Assets Acquired as Part of Business Combination

The following table provides a summary of the preliminary estimated fair value of certain intangible assets acquired:


				Year Ended December 31,
(in millions)	Amortization Period			2023		2022
Other identifiable intangibles:
Client relationships	1	-	17 years	$	324	$	382
Software and related assets	3	-	8 years	44		79
Backlog	1	-	4 years	51		24
Databases	3	-	7 years	4		11
Trade names	2	-	5 years	2		7
Non-compete agreements	3	-	5 years	—		6
Total Other identifiable intangibles				$	425	$	509

Restructuring (Tables)

12 Months Ended

Dec. 31, 2023

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
Balance as of December 31, 2021	$	30
Expense, net of reversals	28
Payments	(31)
Foreign currency translation and other	(1)
Balance as of December 31, 2022	$	26
Expense, net of reversals	84
Payments	(74)

Balance as of December 31, 2023	$	36

Income Taxes (Tables)

12 Months Ended

Dec. 31, 2023

Income Tax Disclosure [Abstract]

Components of Income Before Income Taxes and Equity in Earnings (Losses) of Unconsolidated Affiliates

The components of income before income taxes and equity in (losses) earnings of unconsolidated affiliates are as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Domestic	$	108	$	(45)	$	(73)
Foreign	1,351		1,408		1,201
	$	1,459	$	1,363	$	1,128

Components of Income Tax Expense Attributable to Continuing Operations

The components of income tax expense attributable to continuing operations are as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Current expense:
Federal and state	$	21	$	24	$	16
Foreign	349		358		293
	370		382		309
Deferred (benefit) expense:
Federal and state	(236)		(94)		(106)
Foreign	(33)		(28)		(40)
	(269)		(122)		(146)
	$	101	$	260	$	163

Effective Income Tax Rate Reconciliation

The differences between the Company’s consolidated income tax expense attributable to continuing operations and the expense computed at the United States statutory income tax rate of 21% were as follows:


	Year Ended December 31,
(in millions)	2023		2022		2021
Federal income tax expense at statutory rate	$	306	$	286	$	237
State and local income taxes, net of federal effect	16		(15)		2
Research and development	(25)		(19)		(14)
United States taxes recorded on foreign earnings(*)	(41)		(4)		(29)
Tax contingencies	17		14		3
Foreign Derived Intangible Income (“FDII”)	(53)		(41)		(34)
Foreign rate differential	45		38		17
Equity compensation	—		2		(23)
Valuation Allowance Release	(102)		—		—
Basis Difference Reversal	(61)		—		—
Other	(1)		(1)		4
	$	101	$	260	$	163

(*) Includes impact of GILTI, and other U.S. taxes on foreign earnings.

Income Tax Effects of Temporary Differences from Continuing Operations that Give Rise to Significant Portions of Deferred Income Tax Assets (Liabilities)

The income tax effects of temporary differences from continuing operations that give rise to significant portions of deferred income tax assets (liabilities) are presented below:


	December 31,
(in millions)	2023		2022
Deferred income tax assets:
Net operating loss and capital loss carryforwards	$	132	$	145
Tax credit carryforwards	254		295
Accrued expenses and unearned income	103		90
Employee benefits	202		202
Lease liability	65		73
U.S. interest expense limitation	59		30
Other	81		52
Total deferred income tax assets	896		887
Valuation allowance for deferred income tax assets	(166)		(257)
Total deferred income tax assets (net of valuation allowance)	730		630
Deferred income tax liabilities:
Amortization and depreciation	(590)		(727)
Lease right-of-use assets	(56)		(61)
Foreign exchange on debt instruments	(48)		(125)
Other	(72)		(63)
Total deferred income tax liabilities	(766)		(976)
Net deferred income tax assets (liabilities)	$	(36)	$	(346)

Reconciliation of Beginning and Ending Amount of Gross Unrecognized Income Tax Benefits

A reconciliation of the beginning and ending amount of gross unrecognized income tax benefits is presented below:


	Year Ended December 31,
(in millions)	2023		2022		2021
Balance as of January 1	$	122	$	116	$	118
Additions based on tax positions related to the current year	53		13		7
Additions for income tax positions of prior years	8		20		16
Impact of changes in exchange rates	1		(2)		(3)
Settlements with tax authorities	(6)		(4)		(2)
Reductions for income tax positions of prior years	(25)		(11)		(11)
Reductions due to the lapse of the applicable statute of limitations	(13)		(10)		(9)
Balance as of December 31	$	140	$	122	$	116

Summary of Tax Years Open for Examination

The Company conducts business globally and, as a result, files income tax returns in the United States federal jurisdiction and various state and foreign jurisdictions. In the normal course of business, the Company is subject to examination by taxing authorities throughout the world. The following table summarizes the tax years that remain open for examination by tax authorities in the most significant jurisdictions in which the Company operates:


United States			2020-2022
India			2006-2023
Japan			2017-2022
United Kingdom			2021-2022
Switzerland			2019-2022

Employee Benefit Plans (Tables)

12 Months Ended

Dec. 31, 2023

Retirement Benefits [Abstract]

Summary of Changes in Benefit Obligation, Plan Assets and Funded Status of Pension Benefit Plans

The following table summarizes changes in the benefit obligation, the plan assets and the funded status of the pension benefit plans:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Obligation and funded status:
Change in benefit obligation:
Projected benefit obligation at beginning of year	$	400	$	488	$	461	$	652
Service costs	10		13		35		29
Interest cost	22		13		17		8
Actuarial losses	15		(101)		5		(144)
Business combinations	—		—		—		3
Benefits paid	(13)		(11)		(20)		(24)
Contributions	—		—		3		2


Settlements	—		(2)		(3)		(4)
Foreign currency fluctuations and other	—		—		27		(61)
Projected benefit obligation at end of year	434		400		525		461
Change in plan assets:
Fair value of plan assets at beginning of year	419		524		355		494
Actual return on plan assets	75		(97)		2		(97)
Contributions	5		5		27		32
Benefits paid	(13)		(11)		(20)		(24)
Settlements	—		(2)		(3)		(4)
Business combinations	—		—		—		1
Foreign currency fluctuations and other	—		—		18		(47)
Fair value of plan assets at end of year	486		419		379		355
Funded status	$	52	$	19	$	(146)	$	(106)

Summary of Amounts Recognized in Consolidated Balance Sheets

The following table summarizes the amounts recognized in the consolidated balance sheets related to the pension benefit plans:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Deposits and other assets, net	$	87	$	56	$	49	$	50
Accounts payable and accrued expenses	$	4	$	4	$	12	$	10
Other liabilities	$	31	$	33	$	183	$	146
Accumulated other comprehensive loss	$	28	$	(2)	$	(25)	$	(6)

Summary of Accumulated Benefit Obligation for Pension Benefit Plans

The following table summarizes the accumulated benefit obligation for all pension benefit plans:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Accumulated benefit obligation	$	430	$	397	$	480	$	426

Summary of Pension Plans with Accumulated Benefit Obligation in Excess of Plan Assets and Projected Benefit Obligations in Excess of Plan Assets

The following table provides the information for pension plans with an accumulated benefit obligation in excess of plan assets and projected benefit obligations in excess of plan assets:


	Pension Benefits
	United States Plans				Non-United States Plans
	December 31,
(in millions)	2023		2022		2023		2022
Plans with accumulated benefit obligation in excess of plan assets:
Accumulated benefit obligation	$	41	$	42	$	251	$	189
Fair value of plan assets	$	7	$	6	$	101	$	64
Plans with projected benefit obligation in excess of plan assets:
Projected benefit obligation	$	41	$	43	$	295	$	243
Fair value of plan assets	$	7	$	6	$	101	$	87

Components of Net Periodic Benefit Cost and Other Changes in Plan Assets and Benefit Obligations Recognized in Other Comprehensive Income (Loss)

The components of net periodic benefit cost changes in plan assets and benefit obligations recognized in comprehensive income were as follows:


	Pension Benefits
	United States Plans						Non-United States Plans
	Year Ended December 31,
(in millions)	2023		2022		2021		2023		2022		2021
Service cost	$	10	$	13	$	14	$	35	$	29	$	29
Interest cost	22		13		11		17		8		6
Expected return on plan assets	(30)		(38)		(32)		(17)		(18)		(20)
Amortization of actuarial losses	—		1		—		(2)		1		1

Settlement gain	—		1		—		—		(1)		1
Net periodic benefit cost	2		(10)		(7)		33		19		17
Other changes in plan assets and benefit obligations recognized in other comprehensive loss:
Actuarial (gain) loss – current year	(30)		31		(50)		19		(18)		(39)
Prior service cost – current year	—		—		—		—		—		(2)

Total recognized in other comprehensive income	(30)		31		(50)		19		(18)		(41)
Total recognized in net periodic benefit cost and other comprehensive income	$	(28)	$	21	$	(57)	$	52	$	1	$	(24)

Schedule of Weighted Average Assumptions Used to Determine Net Periodic Benefit Cost and Benefit Obligations

The weighted average assumptions used to determine net periodic benefit cost were as follows for the years ended December 31:


	Pension Benefits
	United States Plans						Non-United States Plans
	2023		2022		2021		2023		2022		2021
Discount rate	5.65	%	3.08	%	2.84	%	3.59	%	1.46	%	1.00	%
Rate of compensation increases	3.00	%	3.00	%	3.00	%	2.93	%	2.57	%	2.55	%
Expected return on plan assets	7.20	%	7.23	%	7.23	%	4.53	%	4.22	%	3.92	%

The weighted average assumptions used to determine benefit obligations were as follows as of December 31:


	Pension Benefits
	United States Plans				Non-United States Plans
	2023		2022		2023		2022
Discount rate	5.35	%	5.65	%	3.52	%	3.59	%
Rate of compensation increases	3.00	%	3.00	%	2.78	%	2.93	%

Schedule of Allocation of Pension Plan Assets

The Company’s pension plan target asset allocations and weighted average asset allocations, by asset category, were as follows:


		Plan Assets as of December 31,
	Target	United States Plans				Non-United States Plans				Total
Asset Category	Allocation	2023		2022		2023		2022		2023		2022
Equity securities	40-65%	73	%	71	%	—	%	27	%	42	%	51	%
Debt securities	10-40%	21		24		56		30		36		26
Real estate	0-5%	4		5		—		—		2		3
Other	10-30%	2		—		44		43		20		20
Total		100	%	100	%	100	%	100	%	100	%	100	%

Summary of Plan Assets Measured at Fair Value

The following table summarizes United States plan assets measured at fair value:


	December 31, 2023						December 31, 2022
Asset Category	Level 1		Level 2		Total		Level 1		Level 2		Total
	(in millions)
Domestic equities	$	33	$	—	$	33	$	29	$	—	$	29
International equities	11		—		11		9		—		9
Corporate bonds	65		—		65		64		—		64
Real estate	21		—		21		19		—		19
Total assets in the fair value hierarchy	130		—		130		121		—		121
Assets measured at net asset value (“NAV”)(1)	—		—		356		—		—		298
Total	$	130	$	—	$	486	$	121	$	—	$	419

The following table summarizes non-United States plan assets measured at fair value:


	December 31, 2023						December 31, 2022
Asset Category	Level 1		Level 2		Total		Level 1		Level 2		Total
	(in millions)
International equities	$	1	$	1	$	2	$	—	$	4	$	4
Debt issued by national, state or local government	2		210		212		3		103		106
Investments funds	—		10		10		—		10		10
Insurance contracts	—		145		145		—		133		133
Other	3		7		10		3		6		9
Total assets in the fair value hierarchy	6		373		379		6		256		262
Assets measured at NAV(1)	—		—		—		—		—		93
Total	$	6	$	373	$	379	$	6	$	256	$	355

(1) Certain investments that are measured at fair value using the net asset value ("NAV") per share (or its equivalent) practical expedient have not been classified in the fair value hierarchy. The fair value amounts presented in the above plan asset tables are intended to permit reconciliation of the fair value of plan assets in the fair value hierarchy to the plan asset amounts presented in the above funded status table as of December 31, 2023 and 2022.

Schedule of Expected Benefit Payments, Net of Expected Participants Contributions for Pension Benefits

The following benefit payments (net of expected participant contributions) for pension benefits are expected to be paid as follows:


(in millions)
2024	$	48
2025	50
2026	53
2027	56
2028	58
Years 2029 through 2033	325
	$	590

Estimated Fair Value of Stock Options and SARs

The Company used the following assumptions when estimating the value of the stock-based compensation for Stock Settled SARs granted as follows:

Year Ended December 31,

2023

2022

2021

Expected volatility

29 – 35%

28 – 34%

27 – 31%

Weighted average expected volatility

32%

30%

29%

Expected dividends

0.0%

Expected term (in years)

2.4 – 5.4

3.3 – 6.3

3.6 – 6.6

Risk-free interest rate

3.38 – 4.75%

1.84 –4.22%

0.28 – 1.40%

Summary of Stock Option Activity

The Company’s stock option activity in the year ended December 31, 2023 is as follows:


(in millions, except number of options and exercise price)	Number of Options	Weighted Average Exercise Price		Aggregate Intrinsic Value
Outstanding as of December 31, 2022	320,353	$	54.99	$	48
Exercised	(145,382)	46.13
Outstanding as of December 31, 2023	174,971	$	62.35	$	30

Schedule of Stock Appreciation Rights Activity

The Company’s SSR activity in the year ended December 31, 2023 is as follows:


(in millions, except number of SSRs and exercise price)	Number of SSRs	Weighted Average Exercise Price		Aggregate Intrinsic Value
Outstanding as of December 31, 2022	4,055,769	$	134.36	$	304
Granted	399,427	231.86
Exercised	(535,982)	122.94
Canceled	(56,504)	218.68
Outstanding as of December 31, 2023	3,862,710	$	144.79	$	342

Summary of Performance Award Activity

The Company’s performance award activity in the year ended December 31, 2023 is as follows:


	Number of Performance Awards	Weighted Average Grant-Date Fair Value
Outstanding as of December 31, 2022	642,701	$	216.00
Granted	359,588	229.88
Additional goal achievement shares	176,329	169.76
Vested	(380,386)	173.74
Canceled	(52,162)	232.93
Outstanding as of December 31, 2023	746,070	$	232.13

Schedule of Restricted Stock Units Activity

The Company’s RSU activity in the year ended December 31, 2023 is as follows:


	Number of RSUs	Weighted Average Grant-Date Fair Value
Outstanding as of December 31, 2022	896,733	$	215.16
Granted (1)	443,009	227.84
Vested	(379,871)	197.56
Canceled	(71,015)	220.79
Outstanding as of December 31, 2023	888,856	$	228.55

(1) Pursuant to the IQVIA Holdings Inc. Non-Employee Director Deferral Plan (the “Director Deferral Plan”), non-employee directors may elect to defer receipt of their cash retainers. If a director elects to defer his or her retainer, he or she will instead be credited with that value in deferred shares under the Director Deferral Plan. Deferred shares become payable in Company common stock following a termination of the director’s Board service or the director’s death, or upon a change in control of the Company. The Company granted 1,782 deferred RSUs in 2023.

Property, Equipment and Software by Geography (Tables)

12 Months Ended

Dec. 31, 2023

Property Equipment And Software By Geography [Abstract]

Property, Equipment and Software, Net, by Geographic Region

The following table represents the Company’s property, equipment and software, net, by geographic region, which is further broken down to show each country that accounts for 10% or more of the totals:


	December 31,
(in millions)	2023		2022
Property, equipment and software, net:
Americas:
United States	$	1,820	$	1,699
Other	97		99
Americas	1,917		1,798
Europe and Africa	193		196
Asia-Pacific	36		53
Total property, equipment and software, net	$	2,146	$	2,047

Segments (Tables)

12 Months Ended

Dec. 31, 2023

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:


	Year Ended December 31,
(in millions)	2023		2022		2021
Revenues
Technology & Analytics Solutions	$	5,862	$	5,746	$	5,534
Research & Development Solutions	8,395		7,921		7,556
Contract Sales & Medical Solutions	727		743		784
Total revenues	14,984		14,410		13,874
Cost of revenues, exclusive of depreciation and amortization
Technology & Analytics Solutions	3,496		3,348		3,278
Research & Development Solutions	5,629		5,395		5,303
Contract Sales & Medical Solutions	620		639		652
Total cost of revenues, exclusive of depreciation and amortization	9,745		9,382		9,233
Selling, general and administrative expenses
Technology & Analytics Solutions	876		848		798
Research & Development Solutions	851		831		777
Contract Sales & Medical Solutions	58		62		57
General corporate and unallocated	268		330		332
Total selling, general and administrative expenses	2,053		2,071		1,964
Segment profit
Technology & Analytics Solutions	1,490		1,550		1,458
Research & Development Solutions	1,915		1,695		1,476
Contract Sales & Medical Solutions	49		42		75
Total segment profit	3,454		3,287		3,009
General corporate and unallocated	(268)		(330)		(332)
Depreciation and amortization	(1,125)		(1,130)		(1,264)

Restructuring costs	(84)		(28)		(20)
Total income from operations	$	1,977	$	1,799	$	1,393

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2023

Earnings Per Share [Abstract]

Reconciles the Basic to Diluted Weighted Average Shares Outstanding

The following table presents the computation of basic and diluted earnings per share:


	Year Ended December 31,
(in millions, except per share data)	2023		2022		2021
Numerator:
Net income attributable to IQVIA Holdings Inc.	$	1,358	$	1,091	$	966
Denominator:
Basic weighted average common shares outstanding	183.8		187.6		191.4
Effect of dilutive stock options and share awards	2.5		3.0		3.6
Diluted weighted average common shares outstanding	186.3		190.6		195.0
Earnings per share attributable to common stockholders:
Basic	$	7.39	$	5.82	$	5.05
Diluted	$	7.29	$	5.72	$	4.95

Accumulated Other Comprehensive (Loss) Income (Tables)

12 Months Ended

Dec. 31, 2023

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 as of December 31, 2020	$	(395)	$	(48)	$	(85)	$	323	$	(205)
Other comprehensive (loss) income before reclassifications	(165)		11		90		(139)		(203)
Reclassification adjustments	—		16		—		(4)		12
Acquisition of Quest's non-controlling interest	(10)		—		—		—		(10)
Balance as of December 31, 2021	(570)		(21)		5		180		(406)
Other comprehensive (loss) income before reclassifications	(255)		53		(13)		(116)		(331)
Reclassification adjustments	—		12		—		(2)		10
Balance as of December 31, 2022	(825)		44		(8)		62		(727)
Other comprehensive (loss) income before reclassifications	(144)		(10)		11		54		(89)
Reclassification adjustments	—		(68)		—		17		(51)
Balance as of December 31, 2023	$	(969)	$	(34)	$	3	$	133	$	(867)

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 amounts reclassified from AOCI into the consolidated statements of income and the affected financial statement line item:


		Year Ended December 31,
(in millions)	Affected Financial Statement Line Item	2023		2022		2021
Derivative instruments:
Interest rate swaps	Interest expense	$	47	$	(22)	$	(21)
Foreign exchange forward contracts	Revenues	21		10		5

Total before income taxes		68		(12)		(16)
Income taxes		17		(2)		(4)
Total net of income taxes		$	51	$	(10)	$	(12)

Supplemental Cash Flow Information (Tables)

12 Months Ended

Dec. 31, 2023

Supplemental Cash Flow Elements [Abstract]

Supplemental Cash Flow Information

The following table presents the Company’s supplemental cash flow information:


	Year Ended December 31,
(in millions)	2023		2022		2021
Supplemental Cash Flow Information:
Interest paid, net	$	556	$	379	$	343
Income taxes paid, net of refunds	$	340	$	255	$	222

Summary of Significant Accounting Policies - Additional Information (Detail) Employee in Thousands	12 Months Ended
	Dec. 31, 2023 USD ($) Employee Country	Dec. 31, 2022 USD ($)	Dec. 31, 2021 USD ($)
Summary Of Significant Accounting Policies
Number of employees \| Employee	87
Capitalized and amortized expense related to software and related assets	$ 475,000,000	$ 419,000,000	$ 211,000,000
Impairment charges recognized	$ 0	$ 0	$ 0
Minimum
Summary Of Significant Accounting Policies
Number of countries \| Country	100
Subscription arrangements terms	1 year
Maximum
Summary Of Significant Accounting Policies
Subscription arrangements terms	3 years

Summary of Significant Accounting Policies - Property and Equipment at Cost Using Straight-Line Method (Detail)	Dec. 31, 2023
Buildings and leasehold improvements \| Minimum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	3 years
Buildings and leasehold improvements \| Maximum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	40 years
Equipment \| Minimum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	3 years
Equipment \| Maximum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	10 years
Furniture and fixtures \| Minimum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	5 years
Furniture and fixtures \| Maximum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	10 years
Transportation equipment \| Minimum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	3 years
Transportation equipment \| Maximum
Property, Plant and Equipment
Property and equipment, Estimated useful life, Years	20 years

Summary of Significant Accounting Policies - Definite-lived identifiable intangible assets amortized (Detail)	Dec. 31, 2023
Client relationships and backlog \| Minimum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	1 year
Client relationships and backlog \| Maximum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	25 years
Software and related assets \| Minimum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	1 year
Software and related assets \| Maximum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	10 years
Trademarks, trade names and other \| Minimum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	1 year
Trademarks, trade names and other \| Maximum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	17 years
Databases \| Minimum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	1 year
Databases \| Maximum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	9 years
Non-compete agreements \| Minimum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	2 years
Non-compete agreements \| Maximum
Finite-Lived Intangible Assets
Definite-lived intangible assets, Estimated useful life, Years	5 years

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Summary of Revenues by Geographical Region and Reportable Segment (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Disaggregation of Revenue
Total revenues	$ 14,984	$ 14,410	$ 13,874
Americas
Disaggregation of Revenue
Total revenues	7,552	7,048	6,848
Europe and Africa
Disaggregation of Revenue
Total revenues	4,459	4,366	4,357
Asia-Pacific
Disaggregation of Revenue
Total revenues	2,973	2,996	2,669
Technology & Analytics Solutions
Disaggregation of Revenue
Total revenues	5,862	5,746	5,534
Technology & Analytics Solutions \| Americas
Disaggregation of Revenue
Total revenues	3,091	2,947	2,610
Technology & Analytics Solutions \| Europe and Africa
Disaggregation of Revenue
Total revenues	2,156	2,175	2,282
Technology & Analytics Solutions \| Asia-Pacific
Disaggregation of Revenue
Total revenues	615	624	642
Research & Development Solutions
Disaggregation of Revenue
Total revenues	8,395	7,921	7,556
Research & Development Solutions \| Americas
Disaggregation of Revenue
Total revenues	4,157	3,747	3,887
Research & Development Solutions \| Europe and Africa
Disaggregation of Revenue
Total revenues	2,103	2,016	1,899
Research & Development Solutions \| Asia-Pacific
Disaggregation of Revenue
Total revenues	2,135	2,158	1,770
Contract Sales & Medical Solutions
Disaggregation of Revenue
Total revenues	727	743	784
Contract Sales & Medical Solutions \| Americas
Disaggregation of Revenue
Total revenues	304	354	351
Contract Sales & Medical Solutions \| Europe and Africa
Disaggregation of Revenue
Total revenues	200	175	176
Contract Sales & Medical Solutions \| Asia-Pacific
Disaggregation of Revenue
Total revenues	$ 223	$ 214	$ 257

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

- Definition

Amount, excluding tax collected from customer, of revenue from satisfaction of performance obligation by transferring promised good or service to customer. Tax collected from customer is tax assessed by governmental authority that is both imposed on and concurrent with specific revenue-producing transaction, including, but not limited to, sales, use, value added and excise.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 924
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SAB Topic 11.L)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479941/924-10-S99-1

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 5
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-5

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 30
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-30

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 42
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-42

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 40
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-40

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 22
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-22

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 32
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-32

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 280
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 41
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482810/280-10-50-41

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 606
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 4
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479806/606-10-50-4

+ Details

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Credit Risk (Detail) - Geographic Concentration Risk - Revenue	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
United States
Disaggregation of Revenue
Concentration risk	45.00%	42.00%	42.00%
United Kingdom
Disaggregation of Revenue
Concentration risk			11.00%

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Revenues by Geography, Concentration of Credit Risk and Remaining Performance Obligations - Future Obligations (Detail) $ in Billions	Dec. 31, 2023 USD ($)
Disaggregation of Revenue
Revenue expected to be recognized in future from remaining performance obligations	$ 31.7
Revenue, Remaining Performance Obligation, Expected Timing of Satisfaction, Start Date: 2022-01-01
Disaggregation of Revenue
Percentage of remaining performance obligations on which revenue is expected to be recognized	30.00%
Unearned income recognition period	12 months

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References + Details

Trade Accounts Receivable, Unbilled Services and Unearned Income - Trade Accounts Receivable and Unbilled Services (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Trade accounts receivable	$ 1,473	$ 1,329
Unbilled services	1,942	1,624
Trade accounts receivable and unbilled services	3,415	2,953
Allowance for doubtful accounts	(34)	(36)
Trade accounts receivable and unbilled services, net	$ 3,381	$ 2,917

Trade Accounts Receivable, Unbilled Services and Unearned Income - Schedule of Net Contract Assets (Liabilities) (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Unbilled services
Unbilled services, beginning balance	$ 1,624
Change	318
Unbilled services, ending balance	1,942
Unearned income
Unearned income, beginning balance	(1,797)
Change	(2)
Unearned income, ending balance	(1,799)
Net balance	143	$ (173)
Decrease of net balance of unbilled services and unearned income	$ 316

Trade Accounts Receivable, Unbilled Services and Unearned Income - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Receivables [Abstract]
Unbilled receivables (percentage)	68.00%	61.00%
Contract assets (percentage)	32.00%	39.00%
Increase in unbilled services	$ 318
Increase in unearned income	2
Decrease of net balance of unbilled services and unearned income	316
Trade accounts receivable	699	$ 608
Cash proceeds from trade accounts	$ 686	$ 600

Investments - Investments in and Advances to Unconsolidated Affiliates (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	$ 134	$ 94
NQ Fund V
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	35	29
NostraData Pty Ltd. (“NostraData”)
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	18	18
NQ Fund IV
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	6	8
NQ PE Fund I
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	10	8
Longwood Fund V, L.P. ("Longwood")
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	7	6
RxWare (formerly "Helparound")
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	2	2
NQ Fund III
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	1	1
Other
Investments in and Advances to Affiliates
Investments in unconsolidated affiliates	$ 55	$ 22

Investments - Summary of Investments in Unconsolidated Variable Interest Entities and Estimated Maximum Exposure to Loss (Detail) - USD ($)	Dec. 31, 2023	Dec. 31, 2022
Variable Interest Entity
Investments in Unconsolidated VIEs	$ 26,681,000,000	$ 25,337,000,000
Variable Interest Entity, Not Primary Beneficiary
Variable Interest Entity
Investments in Unconsolidated VIEs	107,000,000
Maximum Exposure to Loss	371,000,000
Variable Interest Entity, Not Primary Beneficiary \| NQ Fund III
Variable Interest Entity
Investments in Unconsolidated VIEs	1,000,000
Maximum Exposure to Loss	6,000,000
Variable Interest Entity, Not Primary Beneficiary \| NQ Fund IV
Variable Interest Entity
Investments in Unconsolidated VIEs	6,000,000
Maximum Exposure to Loss	7,000,000
Variable Interest Entity, Not Primary Beneficiary \| NQ Fund V
Variable Interest Entity
Investments in Unconsolidated VIEs	35,000,000
Maximum Exposure to Loss	44,000,000
Variable Interest Entity, Not Primary Beneficiary \| NQ PE Fund I
Variable Interest Entity
Investments in Unconsolidated VIEs	10,000,000
Maximum Exposure to Loss	11,000,000
Variable Interest Entity, Not Primary Beneficiary \| Longwood
Variable Interest Entity
Investments in Unconsolidated VIEs	7,000,000
Maximum Exposure to Loss	10,000,000
Variable Interest Entity, Not Primary Beneficiary \| Other
Variable Interest Entity
Investments in Unconsolidated VIEs	48,000,000
Maximum Exposure to Loss	$ 293,000,000

Derivatives - Additional Information (Detail) € in Millions	12 Months Ended
Derivatives - Additional Information (Detail) € in Millions	Dec. 31, 2023 USD ($) Country	Dec. 31, 2022 USD ($)	Dec. 31, 2023 EUR (€) Country	Nov. 17, 2023 USD ($)	Nov. 15, 2023	Jan. 03, 2023 USD ($)	Dec. 31, 2021 USD ($)	Jun. 04, 2020 USD ($)	Mar. 27, 2020 USD ($)	Jul. 19, 2018 USD ($)
Derivative Instruments and Hedging Activities Disclosures
Gains related to contracts	$ 2,000,000	$ 2,000,000
Losses related to contracts	0	2,000,000
Foreign exchange losses related to net investment hedge	(102,000,000)	332,000,000					$ 475,000,000
Foreign currency unrealized loss expected to be reclassified in the next 12 months	48,000,000
Foreign currency denominated debt
Derivative Instruments and Hedging Activities Disclosures
Borrowings, net of original issue discount	$ 2,703,000,000		€ 2,449
Senior Secured Notes Due 2029, 6.250% \| USD \| Senior Notes
Derivative Instruments and Hedging Activities Disclosures
Derivative variable interest rates					4.8555%
Senior Secured Facilities, Term B-4 Dollar Loans \| USD \| Secured Overnight Financing Rate (SOFR)
Derivative Instruments and Hedging Activities Disclosures
Derivative variable interest rates				4.9015%
Minimum
Derivative Instruments and Hedging Activities Disclosures
Number of countries \| Country	100		100
Foreign Exchange Risk
Derivative Instruments and Hedging Activities Disclosures
Notional amount	$ 122,000,000
2018 Swaps
Derivative Instruments and Hedging Activities Disclosures
Notional amount										$ 500,000,000
Derivative fixed interest rate										2.75%
Interest rate swaps
Derivative Instruments and Hedging Activities Disclosures
Notional amount				$ 1,500,000,000		$ 1,000,000,000		$ 300,000,000	$ 1,000,000,000
Derivative fixed interest rate				6.11%		4.10%		0.32%	0.56%
Variable rate				2.00%
Interest rate swap, fixed interest rate debt percent	84.00%		84.00%
Interest rate swaps, variable rate debt percent	16.00%		16.00%
Cross Currency Interest Rate Contract
Derivative Instruments and Hedging Activities Disclosures
Losses related to contracts	$ 108,000,000
Interest rate reduction	3,000,000
Cross Currency Interest Rate Contract \| Derivatives designated as hedging instruments: \| Other Current Liabilities
Derivative Instruments and Hedging Activities Disclosures
Notional amount	$ 2,750,000,000	$ 0

Derivatives - Summary of Fair Values of Derivative Instruments Designated as Hedges (Detail) - USD ($)	Dec. 31, 2023	Nov. 17, 2023	Jan. 03, 2023	Dec. 31, 2022	Jun. 04, 2020	Mar. 27, 2020
Derivatives, Fair Value
Assets	$ 15,000,000			$ 44,000,000
Liabilities	159,000,000			2,000,000
Interest rate swaps
Derivatives, Fair Value
Notional		$ 1,500,000,000	$ 1,000,000,000		$ 300,000,000	$ 1,000,000,000
Derivatives designated as hedging instruments: \| Other current assets, other assets and other current liabilities \| Interest rate swaps
Derivatives, Fair Value
Assets	13,000,000			42,000,000
Liabilities	51,000,000			0
Notional	3,300,000,000			1,800,000,000
Derivatives designated as hedging instruments: \| Other Current Liabilities \| Cross Currency Interest Rate Contract
Derivatives, Fair Value
Assets	0			0
Liabilities	108,000,000			0
Notional	2,750,000,000			0
Derivatives designated as hedging instruments: \| Other current assets and other current liabilities \| Foreign exchange forward contracts
Derivatives, Fair Value
Assets	2,000,000			2,000,000
Liabilities	0			2,000,000
Notional	$ 121,000,000			$ 122,000,000

Derivatives - Pre-tax Effect of Cash Flow Hedging Instruments on Other Comprehensive (Loss) Income (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive income (loss)	$ (78)	$ 65	$ 27
Foreign exchange forward contracts
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive income (loss)	2	3	(8)
Interest rate swaps
Derivative Instruments and Hedging Activities Disclosures
Effect of cash flow hedging instruments on other comprehensive income (loss)	$ (80)	$ 62	$ 35

Fair Value Measurements - Additional Information (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Percentage accrued of maximum consideration payments to become payable	40.00%
Identifiable intangible assets	$ 4,839	$ 4,820
Level 1 and Level 2
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Fair value of total debt	13,597	$ 12,281
Level 3 \| Non-recurring Fair Value Measurements
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis
Total	19,619
Cost and equity method investments	213
Goodwill	14,567
Identifiable intangible assets	$ 4,839

Fair Value Measurements - Fair Value of Financial Assets and Liabilities Measured on Recurring Basis (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Assets:
Marketable securities	$ 120	$ 93
Derivatives	$ 15	44
Liabilities:
Derivative Liability, Statement of Financial Position [Extensible Enumeration]	Other current liabilities
Recurring
Assets:
Marketable securities	$ 146	122
Derivatives	15	44
Total	161	166
Liabilities:
Derivatives	159	2
Contingent consideration	106	173
Total	265	175
Level 1 \| Recurring
Assets:
Marketable securities	146	122
Derivatives	0	0
Total	146	122
Liabilities:
Derivatives	0	0
Contingent consideration	0	0
Total	0	0
Level 2 \| Recurring
Assets:
Marketable securities	0	0
Derivatives	15	44
Total	15	44
Liabilities:
Derivatives	159	2
Contingent consideration	0	0
Total	159	2
Level 3 \| Recurring
Assets:
Marketable securities	0	0
Derivatives	0	0
Total	0	0
Liabilities:
Derivatives	0	0
Contingent consideration	106	173
Total	$ 106	$ 173

Fair Value Measurements - Changes in Level 3 Financial Assets and Liabilities Measured on Recurring Basis (Detail) - Contingent Consideration - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Fair Value, Assets Measured on Recurring Basis, Unobservable Input Reconciliation, Calculation
Balance as of January 1	$ 173	$ 76	$ 119
Business combinations	64	134	39
Contingent consideration paid	(73)	(22)	(39)
Revaluations included in earnings and foreign currency translation adjustments	(58)	(15)	(43)
Balance as of December 31	$ 106	$ 173	$ 76

Property and Equipment - Summary of Major Classes of Property and Equipment (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Property, Plant and Equipment
Property and equipment, gross	$ 1,326	$ 1,372
Less accumulated depreciation	(803)	(840)
Property and equipment, net	523	532
Land, buildings and leasehold improvements
Property, Plant and Equipment
Property and equipment, gross	376	363
Equipment
Property, Plant and Equipment
Property and equipment, gross	803	852
Furniture and fixtures
Property, Plant and Equipment
Property and equipment, gross	66	74
Transportation equipment
Property, Plant and Equipment
Property and equipment, gross	$ 81	$ 83

Property and Equipment -Schedule of Property and Equipment Depreciation Expense (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 151	$ 160	$ 147

Goodwill and Identifiable Intangible Assets - Additional Information (Detail) - USD ($)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Identifiable intangible assets	$ 4,839,000,000	$ 4,820,000,000
Estimated amortization expense, 2022	911,000,000
Estimated amortization expense, 2023	803,000,000
Estimated amortization expense, 2024	665,000,000
Estimated amortization expense, 2025	519,000,000
Estimated amortization expense, 2026	201,000,000
Goodwill impairment losses	$ 0	$ 0	$ 0

Goodwill and Identifiable Intangible Assets - Summary of Amortization Expense Associated with Identifiable Definite-Lived Intangible Assets (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expense	$ 974	$ 970	$ 1,117

Goodwill and Identifiable Intangible Assets - Summary of Identifiable Intangible Assets (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Definite-lived identifiable intangible assets:
Gross Amount	$ 11,718	$ 10,830
Accumulated Amortization	(6,879)	(6,010)
Net Amount	4,839	4,820
Client relationships and backlog
Definite-lived identifiable intangible assets:
Gross Amount	5,688	5,339
Accumulated Amortization	(2,724)	(2,332)
Net Amount	2,964	3,007
Databases
Definite-lived identifiable intangible assets:
Gross Amount	1,837	1,817
Accumulated Amortization	(1,819)	(1,794)
Net Amount	18	23
Trademarks, trade names and other
Definite-lived identifiable intangible assets:
Gross Amount	548	545
Accumulated Amortization	(320)	(278)
Net Amount	228	267
Software and related assets
Definite-lived identifiable intangible assets:
Gross Amount	3,629	3,106
Accumulated Amortization	(2,005)	(1,591)
Net Amount	1,624	1,515
Non-compete agreements
Definite-lived identifiable intangible assets:
Gross Amount	16	23
Accumulated Amortization	(11)	(15)
Net Amount	$ 5	$ 8

Goodwill and Identifiable Intangible Assets - Summary of Goodwill by Segment (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Goodwill
Beginning Balance	$ 13,921	$ 13,301
Business combinations	533	1,026
Impact of foreign currency fluctuations and other	113	(406)
Ending Balance	14,567	13,921
Technology & Analytics Solutions
Goodwill
Beginning Balance	11,520	11,337
Business combinations	352	554
Impact of foreign currency fluctuations and other	104	(371)
Ending Balance	11,976	11,520
Research & Development Solutions
Goodwill
Beginning Balance	2,247	1,802
Business combinations	181	472
Impact of foreign currency fluctuations and other	11	(27)
Ending Balance	2,439	2,247
Contract Sales & Medical Solutions
Goodwill
Beginning Balance	154	162
Business combinations	0	0
Impact of foreign currency fluctuations and other	(2)	(8)
Ending Balance	$ 152	$ 154

- Definition

Amount after accumulated impairment loss of an asset representing future economic benefits arising from other assets acquired in a business combination that are not individually identified and separately recognized.

+ References + Details

Accrued Expenses - Accrued Expenses (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Payables and Accruals [Abstract]
Compensation, including bonuses, fringe benefits and payroll taxes	$ 968	$ 980
Restructuring	36	26
Interest	66	43
Client contract related	1,315	1,065
Professional fees	112	99
Contingent consideration and deferred purchase price	27	90
Other	331	368
Total	$ 2,855	$ 2,671

Credit Arrangements - Summary of Credit Facilities (Detail) $ in Millions	12 Months Ended
	Dec. 31, 2023 USD ($)
Revolving credit facility
Line of Credit Facility
Interest Rate Description	U.S. Dollar Term SOFR plus a margin of 1.25% plus a 10 basis credit spread adjustment as of December 31, 2023
USD Revolving Credit Facility \| Revolving credit facility
Line of Credit Facility
Facility	$ 2,000
Interest rate spread on base rate	0.10%
USD Revolving Credit Facility \| Revolving credit facility \| SOFR
Line of Credit Facility
Rate	1.25%
Interest rate spread on base rate	0.10%
Term Loan
Line of Credit Facility
Interest Rate Description	U.S. Dollar Term SOFR plus a margin of 0.90% plus a 11 basis credit spread adjustment as of December 31, 2023
Term Loan \| Line of Credit
Line of Credit Facility
Facility	$ 110
Term Loan \| Line of Credit \| SOFR
Line of Credit Facility
Rate	0.90%
Interest rate spread on base rate	0.11%

Credit Arrangements - Summary of Debt (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Nov. 28, 2023	May 23, 2023	Dec. 31, 2022	Jun. 16, 2022
Senior Secured Credit Facilities:
Principal amount of debt	$ 13,752			$ 12,797
Less: unamortized discount and debt issuance costs	(79)			(50)
Less: current portion	(718)			(152)
Long-term debt, less current portion	$ 12,955			12,595
Senior Notes Due 2030, 6.500% \| Senior Notes \| USD
Senior Secured Credit Facilities:
Principal amount of debt			$ 500	0
Rate			6.50%
Senior Secured Notes Due 2028, 5.700% \| Senior Notes \| USD
Senior Secured Credit Facilities:
Principal amount of debt			$ 750	0
Rate			5.70%
Senior Secured Notes Due 2029, 6.250% \| Senior Notes \| USD
Senior Secured Credit Facilities:
Principal amount of debt		$ 1,250		0
Rate		6.25%
USD
Senior Secured Credit Facilities:
Average floating rate	6.36%
USD \| Senior Secured Facilities, Term A Loan \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Principal amount of debt					$ 1,250
USD \| 5.0% Senior Notes \| Senior Notes
Senior Secured Credit Facilities:
Rate	5.00%
USD \| Senior Secured Facilities, Term B-4 Dollar Loans \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Principal amount of debt		$ 1,500		0
USD \| Revolving credit facility \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Principal amount of debt	$ 100			425
Average floating rate	6.71%
USD \| Due in 2024 \| Receivables Financing Facility \| LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 440			440
USD \| Due in 2024 \| Revolving credit facility \| Receivables Financing Facility \| LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	110			110
USD \| Due in 2025 \| Senior Secured Facilities, Term B Loan \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Principal amount of debt	$ 0			670
Average floating rate	0.00%
USD \| Due in 2025 \| Senior Secured Additional Term B Loan \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Principal amount of debt	$ 0			860
Average floating rate	0.00%
USD \| Due in 2025 \| Senior Secured Facilities, Term B-4 Dollar Loans \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Average floating rate	7.35%
USD \| Due in 2026 \| Senior Secured Term A Loan At One Point Thirty Three Percent \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,270			1,343
Average floating rate	6.71%
USD \| Due in 2026 \| Senior Secured Term A Loan At One Point Twenty Five Pecent \| EURO LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 306			314
USD \| Due in 2026 \| 5.0% Senior Notes \| Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,050			1,050
Rate	5.00%
USD \| Due in 2027 \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Average floating rate	6.74%
USD \| Due in 2027 \| 5.0% Senior Notes \| Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 1,100			1,100
USD \| Due in 2027 \| Senior Secured Term A Loan At Five Point Six Seven Percent \| Secured Overnight Financing Rate (SOFR)
Senior Secured Credit Facilities:
Principal amount of debt	1,156			1,219
EUR \| Due in 2024 \| Senior Secured Facilities, Term B Loan \| EURO LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 0			1,172
Average floating rate	0.00%
EUR \| Due in 2025 \| EURO LIBOR
Senior Secured Credit Facilities:
Average floating rate	5.93%
EUR \| Due in 2025 \| Senior Secured Additional Term B Loan \| EURO LIBOR
Senior Secured Credit Facilities:
Principal amount of debt	$ 576			559
EUR \| Due in 2025 \| 2.875% Senior Notes \| Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 464			450
Rate	2.875%
EUR \| Due in 2026 \| Senior Secured Term A Loan At One Point Twenty Five Pecent \| EURO LIBOR
Senior Secured Credit Facilities:
Average floating rate	5.18%
EUR \| Due in 2026 \| 1.75% Senior Notes due 2026 \| Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 607			589
Rate	1.75%
EUR \| Due in 2028 \| 2.875% Senior Notes \| Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 785			761
Rate	2.875%
EUR \| Due in 2028 \| Three Point Five Percentage Senior Notes \| Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 795			771
Rate	2.25%
EUR \| Due in 2029 \| 2.250% Senior Notes due 2029—Euro denominated \| Senior Notes
Senior Secured Credit Facilities:
Principal amount of debt	$ 993			$ 964
Rate	2.25%

Credit Arrangements - Contractual Maturities of Long-term Debt (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Contractual Maturities
2024	$ 718
2025	1,207
2026	3,231
2027	2,084
2028	2,345
Thereafter	4,167
Principal amount of debt	$ 13,752	$ 12,797

Credit Arrangements - Senior Credit Facilities (Details) - USD ($) $ in Millions				12 Months Ended
	May 23, 2023	Oct. 13, 2022	Jun. 16, 2022	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Nov. 28, 2023	Apr. 17, 2023
Debt Instrument [Line Items]
Principal amount of debt				$ 13,752	$ 12,797
Loss on extinguishment of debt				6	0	$ 26
Revolving credit facility
Debt Instrument [Line Items]
Repayments of debt			$ 950
Revolving credit facility \| USD \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Principal amount of debt				100	425
Senior Secured Facilities, Term A Loan \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Debt Instrument, Credit Spread Adjustment			0.10%
Debt Instrument, Term Floor, Percent			0.00%
Senior Secured Facilities, Term A Loan \| Minimum \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Interest rate spread on base rate			1.125%
Senior Secured Facilities, Term A Loan \| Maximum \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Interest rate spread on base rate			2.00%
Senior Secured Facilities, Term A Loan \| USD \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Principal amount of debt			$ 1,250
Senior Secured Facilities, Term B Loan
Debt Instrument [Line Items]
Repayments of debt		$ 510
Senior Secured Credit Facilities
Debt Instrument [Line Items]
Principal amount of debt				4,908
Facility				6,808
Available borrowing capacity				1,900
Current borrowing capacity				2,000
Senior Secured Credit Facilities, Available in US Dollars, Euro, Swiss Francs, And Other Foreign Currencies
Debt Instrument [Line Items]
Facility								$ 2,000
Current borrowing capacity				600
Senior Secured Credit Facilities, Available in US Dollars, Euro, Swiss Francs, And Other Foreign Currencies \| USD
Debt Instrument [Line Items]
Current borrowing capacity				1,175
Senior Secured Credit Facilities, Available In US Dollars And Yen
Debt Instrument [Line Items]
Current borrowing capacity				225
Senior Secured Term B Loan 1.85% \| USD \| Secured Overnight Financing Rate (SOFR) \| Due in 2024
Debt Instrument [Line Items]
Principal amount of debt								$ 500
USD Revolving Credit Facility \| Revolving credit facility
Debt Instrument [Line Items]
Facility				$ 2,000
Interest rate spread on base rate				0.10%
Senior Secured Notes Due 2028, 5.700% \| USD \| Senior Notes
Debt Instrument [Line Items]
Principal amount of debt	$ 750				0
Rate	5.70%
Senior Notes Due 2030, 6.500% \| USD \| Senior Notes
Debt Instrument [Line Items]
Principal amount of debt	$ 500				0
Rate	6.50%
Senior Notes Due 2030, 6.500% \| Minimum
Debt Instrument [Line Items]
Redemption price (as a percent)	0.00%
Senior Notes Due 2030, 6.500% \| Maximum
Debt Instrument [Line Items]
Redemption price (as a percent)	3.25%
Senior Secured Notes Due 2029, 6.250% \| USD \| Senior Notes
Debt Instrument [Line Items]
Principal amount of debt					0		$ 1,250
Rate							6.25%
Senior Secured Facilities, Term B-4 Dollar Loans \| USD \| Secured Overnight Financing Rate (SOFR)
Debt Instrument [Line Items]
Principal amount of debt					$ 0		$ 1,500

Credit Arrangements - Senior Notes (Details) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Principal amount of debt	$ 13,752	$ 12,797
Loss on extinguishment of debt	6	0	$ 26
EUR \| Senior Notes \| 1.75% Senior Notes due 2026 \| Due in 2026
Debt Instrument [Line Items]
Principal amount of debt	$ 607	589
Rate	1.75%
EUR \| Senior Notes \| 2.250% Senior Notes due 2029—Euro denominated \| Due in 2029
Debt Instrument [Line Items]
Principal amount of debt	$ 993	964
Rate	2.25%
EUR \| Senior Notes \| 2.875% Senior Notes \| Due in 2025
Debt Instrument [Line Items]
Principal amount of debt	$ 464	450
Rate	2.875%
EUR \| Senior Notes \| 2.875% Senior Notes \| Due in 2028
Debt Instrument [Line Items]
Principal amount of debt	$ 785	761
Rate	2.875%
EUR \| Senior Notes \| Three Point Five Percentage Senior Notes \| Due in 2028
Debt Instrument [Line Items]
Principal amount of debt	$ 795	$ 771
Rate	2.25%

Credit Arrangements - Receivables Financing Facility (Details) - Bankruptcy-remote Special Purpose Entity ("SPE") - USD ($) $ in Millions	Dec. 31, 2023	Aug. 13, 2021
Accounts Receivable Financing Facility, Term Loan
Debt Instrument [Line Items]
Long-term line of credit		$ 440
Accounts Receivable Financing Facility, Revolving Loan Commitment
Debt Instrument [Line Items]
Long-term line of credit		$ 110
Pledged receivables to secure credit facility	$ 1,566

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 835
-SubTopic 30
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482900/835-30-50-1

Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(f))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-3

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
-SubTopic 20
-Name Accounting Standards Codification
-Section 50
-Paragraph 1B
-Subparagraph (a)
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Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Topic 470
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-Name Accounting Standards Codification
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-Paragraph 69B
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Reference 6: http://www.xbrl.org/2003/role/exampleRef
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Reference 7: http://www.xbrl.org/2003/role/exampleRef
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Reference 8: http://www.xbrl.org/2003/role/exampleRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 470
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-Paragraph 1B
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-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1B

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/exampleRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-Paragraph 1B
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 25: http://www.xbrl.org/2003/role/disclosureRef
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-Section 50
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-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481139/470-20-50-1I

+ Details

- Definition

The carrying value as of the balance sheet date of the current and noncurrent portions of long-term obligations drawn from a line of credit, which is a bank's commitment to make loans up to a specific amount. Examples of items that might be included in the application of this element may consist of letters of credit, standby letters of credit, and revolving credit arrangements, under which borrowings can be made up to a maximum amount as of any point in time conditional on satisfaction of specified terms before, as of and after the date of drawdowns on the line. Includes short-term obligations that would normally be classified as current liabilities but for which (a) postbalance sheet date issuance of a long term obligation to refinance the short term obligation on a long term basis, or (b) the enterprise has entered into a financing agreement that clearly permits the enterprise to refinance the short-term obligation on a long term basis and the following conditions are met (1) the agreement does not expire within 1 year and is not cancelable by the lender except for violation of an objectively determinable provision, (2) no violation exists at the BS date, and (3) the lender has entered into the financing agreement is expected to be financially capable of honoring the agreement.

+ References + Details

Leases - Components of Lease Expense (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Lessee, Lease, Description
Total lease cost	$ 178	$ 183	$ 194
Selling, general and administrative expenses
Lessee, Lease, Description
Operating lease cost	160	171	184
Depreciation and amortization, and Interest expense
Lessee, Lease, Description
Finance Lease Costs	$ 18	$ 12	$ 10

Leases - Other Information Related to Leases (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Cash paid for amounts included in the measurement of lease liabilities:
Operating cash flows from operating leases	$ 175	$ 173	$ 175
Operating cash flows for finance leases	8	5	0
Financing cash flows for finance leases	3	4	0
Right-of-use assets obtained in exchange for lease obligations:
Operating leases	59	79	81
Finance leases	$ 0	$ 54	$ 44
Weighted Average Remaining Lease Term:
Operating leases	4 years 7 months 9 days	4 years 8 months 19 days	4 years 6 months 10 days
Finance leases	20 years 8 months 1 day	21 years 7 months 20 days	21 years 3 months 10 days
Weighted Average Discount Rate:
Operating leases	3.81%	3.12%	3.36%
Finance leases	3.88%	3.87%	2.70%

Leases - Future Minimum Lease Payments Under Non-cancellable Leases (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Operating Leases
2024	$ 117
2025	96
2026	55
2027	36
2028	24
Thereafter	31
Total future minimum lease payments	359
Less imputed interest	(29)
Total	330
Other current liabilities	$ 107
Operating Lease, Liability, Current, Statement of Financial Position	Other current liabilities
Operating lease liabilities	$ 223	$ 264
Total	330
Finance Leases
2024	13
2025	13
2026	13
2027	14
2028	14
Thereafter	283
Total future minimum lease payments	350
Less imputed interest	(122)
Total	228
Other current liabilities	$ 0
Finance Lease, Liability, Current, Statement of Financial Position	Other current liabilities
Other liabilities	$ 228
Finance Lease, Liability, Noncurrent, Statement of Financial Position	Other liabilities
Total	$ 228

Contingencies - Additional Information (Detail)	May 24, 2019 medical_doctor	Sep. 11, 2017 medical_doctor	Sep. 11, 2017 private_individual	Mar. 13, 2017 USD ($)	Feb. 23, 2015 employees private_individual	Feb. 13, 2014 medical_doctor	Feb. 13, 2014 private_individual	Feb. 13, 2014 Defendant
KPIC
Loss Contingencies
Number of plaintiffs	247	280	200			1,200	900
Number of defendants \| Defendant								2
Seoul Central District Prosecutors
Loss Contingencies
Number of plaintiffs \| private_individual					24
Number of defendants \| employees					2
Minimum \| Veeva
Loss Contingencies
Amount of damages claimed \| $				$ 200,000,000

Stockholders' Equity - Additional Information (Detail) - USD ($)				12 Months Ended
	Jul. 31, 2023	Feb. 10, 2022	Apr. 01, 2021	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2023	Dec. 31, 2022	Oct. 30, 2013
Class of Stock
Preferred stock, authorized (shares)									1,000,000
Preferred stock, par value (usd per share)									$ 0.01
Preferred stock, shares issued (shares)									0	0
Preferred stock, shares outstanding (shares)									0	0
Quest \| Q2 Solutions
Class of Stock
Percentage of voting interest acquired			40.00%
Voting interest acquired, consideration			$ 758,000,000
Q2 Solutions \| Quest
Class of Stock
Percentage of Quest's non-controlling interest in Q2 Solutions			100.00%
Equity Repurchase Program
Class of Stock
Equity repurchase program authorized amount		$ 11,725,000,000									$ 125,000,000
Equity repurchase program increase in authorized amount	$ 2,000,000,000	2,000,000,000		$ 2,000,000,000.0	$ 1,500,000,000	$ 2,000,000,000.0	$ 1,500,000,000	$ 600,000,000
Equity available for repurchase under the repurchase program		$ 2,363,000,000

Stockholders' Equity - Schedule of Share Repurchases Made Both Under and Outside of Repurchase Program (Detail) - Equity Repurchase Under and Outside of Repurchase Program - USD ($) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Class of Stock
Number of shares of common stock repurchased (in shares)	5.0	5.5	1.7
Aggregate purchase price	$ 992	$ 1,168	$ 395
Average price per share (in usd per share)	$ 196.89	$ 213.06	$ 238.22

- Definition

Line items represent financial concepts included in a table. These concepts are used to disclose reportable information associated with domain members defined in one or many axes to the table.

+ References

Reference 1: http://www.xbrl.org/2003/role/exampleRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (d)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 2: http://www.xbrl.org/2003/role/recommendedDisclosureRef
-Topic 272
-SubTopic 10
-Name Accounting Standards Codification
-Section 45
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483014/272-10-45-3

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 272
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 1
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482987/272-10-50-1

Reference 4: http://www.xbrl.org/2009/role/commonPracticeRef
-Topic 235
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.4-08(d))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480678/235-10-S99-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (a)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (e)
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-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 8: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 13
-Subparagraph (h)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-13

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 14
-Subparagraph (b)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-14

Reference 10: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 18
-Subparagraph (c)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-18

Reference 11: http://www.xbrl.org/2003/role/disclosureRef
-Topic 210
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(27)(b))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480566/210-10-S99-1

Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Topic 210
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(28))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480566/210-10-S99-1

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Topic 505
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 2
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147481112/505-10-50-2

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
-Topic 210
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02(29))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480566/210-10-S99-1

Reference 15: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
-Section S99
-Paragraph 3
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-Publisher FASB
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
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-Name Accounting Standards Codification
-Section S99
-Paragraph 3
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.6-03(i)(2)(i))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479886/946-10-S99-3

Reference 18: http://www.xbrl.org/2003/role/disclosureRef
-Topic 946
-SubTopic 10
-Name Accounting Standards Codification
-Section S99
-Paragraph 3
-Subparagraph (SX 210.6-03(i)(2)(ii))
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147479886/946-10-S99-3

+ Details

- Definition

Number of shares that have been repurchased during the period and have not been retired and are not held in treasury. Some state laws may govern the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.

+ References + Details

- Definition

Equity impact of the value of stock that has been repurchased during the period and has not been retired and is not held in treasury. Some state laws may mandate the circumstances under which an entity may acquire its own stock and prescribe the accounting treatment therefore. This element is used when state law does not recognize treasury stock.

+ References + Details

Business Combinations - Schedule of Recognized Identified Assets Acquired and Liabilities Assumed (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Assets acquired:
Goodwill	$ 14,567	$ 13,921	$ 13,301
Several Individually Immaterial Acquisitions
Assets acquired:
Cash and cash equivalents	28	33
Accounts receivable	44	0
Other assets	9	115
Goodwill	533	1,026
Other identifiable intangibles	425	509
Liabilities assumed:
Other liabilities	(44)	(103)
Deferred income taxes, long-term	(18)	(93)
Net assets acquired	977	1,487
Contingent consideration and deferred payments	$ 73	$ 139

Business Combinations - Narrative (Details) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Several Individually Immaterial Acquisitions
Business Acquisition
Business Acquisition, Goodwill, Expected Tax Deductible Amount	$ 379	$ 275

Business Combinations - Indefinite-Lived Intangible Assets Acquired as Part of Business Combination (Details) - Several Individually Immaterial Acquisitions - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Business Acquisition
Total Other identifiable intangibles	$ 425	$ 509
Client relationships
Business Acquisition
Total Other identifiable intangibles	324	382
Non-compete agreements
Business Acquisition
Total Other identifiable intangibles	0	6
Software and related assets
Business Acquisition
Total Other identifiable intangibles	44	79
Trademarks, trade names and other
Business Acquisition
Total Other identifiable intangibles	$ 2	7
Backlog
Business Acquisition
Amortization Period	4 years
Total Other identifiable intangibles	$ 51	24
Databases
Business Acquisition
Total Other identifiable intangibles	$ 4	$ 11
Minimum \| Client relationships
Business Acquisition
Amortization Period	1 year
Minimum \| Non-compete agreements
Business Acquisition
Amortization Period	3 years
Minimum \| Software and related assets
Business Acquisition
Amortization Period	3 years
Minimum \| Trademarks, trade names and other
Business Acquisition
Amortization Period	2 years
Minimum \| Backlog
Business Acquisition
Amortization Period	1 year
Minimum \| Databases
Business Acquisition
Amortization Period	3 years
Maximum \| Client relationships
Business Acquisition
Amortization Period	17 years
Maximum \| Non-compete agreements
Business Acquisition
Amortization Period	5 years
Maximum \| Software and related assets
Business Acquisition
Amortization Period	8 years
Maximum \| Trademarks, trade names and other
Business Acquisition
Amortization Period	5 years
Maximum \| Databases
Business Acquisition
Amortization Period	7 years

Restructuring - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Restructuring and Related Activities [Abstract]
Restructuring costs	$ 84	$ 28	$ 20

Restructuring - Summary of Amounts Recorded for Restructuring Plans (Detail) - Severance and Related Costs - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Restructuring Reserve
Restructuring reserves, beginning balance	$ 26	$ 30
Expense, net of reversals	84	28
Payments	(74)	(31)
Foreign currency translation and other		(1)
Restructuring reserves, ending balance	$ 36	$ 26

Income Taxes - Components of Income Before Income Taxes and Equity in Earnings (Losses) of Unconsolidated Affiliates (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Examination
Total before income taxes	$ 1,459	$ 1,363	$ 1,128
Domestic
Income Tax Examination
Total before income taxes	108	(45)	(73)
Foreign
Income Tax Examination
Total before income taxes	$ 1,351	$ 1,408	$ 1,201

Income Taxes - Components of Income Tax Expense Attributable to Continuing Operations (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Current expense:
Federal and state	$ 21	$ 24	$ 16
Foreign	349	358	293
Total	370	382	309
Deferred (benefit) expense:
Federal and state	(236)	(94)	(106)
Foreign	(33)	(28)	(40)
Total	(269)	(122)	(146)
Income tax expense (benefit)	$ 101	$ 260	$ 163

- Definition

Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

+ References + Details

Income Taxes - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021	Dec. 31, 2020
Income Tax Examination
Tax benefit related to FDII and GILTI tax credits	$ 125	$ 6
Tax expense (benefit) related to FDII	64
Tax liability related to FDII	61
Tax expense related to final regulation on foreign tax credits		9
Favorable tax impact			$ 29
Undistributed earnings of foreign subsidiaries	3,575
Increase (decrease) in valuation allowances	(91)
Valuation allowance	166	257
Gross unrecognized income tax benefits	140	122	116	$ 118
Addition/(Reduction) of interest and penalties recorded	0	2	$ 0
Accrued interest and penalties	20	$ 21
Federal, State And Foreign
Income Tax Examination
Tax credit and tax loss carryforwards, tax effect	462
Gross unrecognized income tax benefits	16
Foreign Tax
Income Tax Examination
Gross unrecognized income tax benefits	16
Indefinite Carryforward Period \| Federal, State And Foreign
Income Tax Examination
Tax credit and tax loss carryforwards, tax effect	8
Earliest Tax Year \| Federal, State And Foreign
Income Tax Examination
Tax credit and tax loss carryforwards, tax effect	$ 454

Income Taxes - Effective Income Tax Rate Reconciliation (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Tax Disclosure [Abstract]
Federal income tax expense at statutory rate	$ 306	$ 286	$ 237
State and local income taxes, net of federal effect	16	(15)	2
Research and development	(25)	(19)	(14)
United States taxes recorded on foreign earnings	(41)	(4)	(29)
Tax contingencies	17	14	3
Foreign Derived Intangible Income (“FDII”)	(53)	(41)	(34)
Foreign rate differential	45	38	17
Equity compensation	0	2	(23)
Valuation Allowance Release	(102)	0	0
Basis Difference Reversal	(61)	0	0
Other	(1)	(1)	4
Income tax expense (benefit)	$ 101	$ 260	$ 163

Income Taxes - Income Tax Effects of Temporary Differences from Continuing Operations that Give Rise to Significant Portions of Deferred Income Tax Assets (Liabilities) (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Deferred income tax assets:
Net operating loss and capital loss carryforwards	$ 132	$ 145
Tax credit carryforwards	254	295
Accrued expenses and unearned income	103	90
Employee benefits	202	202
Lease liability	65	73
U.S. interest expense limitation	59	30
Other	81	52
Total deferred income tax assets	896	887
Valuation allowance for deferred income tax assets	(166)	(257)
Total deferred income tax assets (net of valuation allowance)	730	630
Deferred income tax liabilities:
Amortization and depreciation	(590)	(727)
Lease right-of-use assets	(56)	(61)
Foreign exchange on debt instruments	(48)	(125)
Other	(72)	(63)
Total deferred income tax liabilities	(766)	(976)
Net deferred income tax assets (liabilities)	$ (36)	$ (346)

Income Taxes - Reconciliation of Beginning and Ending Amount of Gross Unrecognized Income Tax Benefits (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reconciliation of Unrecognized Tax Benefits
Beginning balance	$ 122	$ 116	$ 118
Additions based on tax positions related to the current year	53	13	7
Additions for income tax positions of prior years	8	20	16
Impact of changes in exchange rates	1	(2)	(3)
Settlements with tax authorities	(6)	(4)	(2)
Reductions for income tax positions of prior years	(25)	(11)	(11)
Reductions due to the lapse of the applicable statute of limitations	(13)	(10)	(9)
Ending balance	$ 140	$ 122	$ 116

Income Taxes - Summary of Tax Years Open for Examination (Detail)	12 Months Ended
	Dec. 31, 2023
United States \| Earliest Tax Year
Schedule Of Income Taxes
Open tax year	2020
United States \| Latest Tax Year
Schedule Of Income Taxes
Open tax year	2022
India \| Earliest Tax Year
Schedule Of Income Taxes
Open tax year	2006
India \| Latest Tax Year
Schedule Of Income Taxes
Open tax year	2023
Japan \| Earliest Tax Year
Schedule Of Income Taxes
Open tax year	2017
Japan \| Latest Tax Year
Schedule Of Income Taxes
Open tax year	2022
United Kingdom \| Earliest Tax Year
Schedule Of Income Taxes
Open tax year	2021
Switzerland \| Earliest Tax Year
Schedule Of Income Taxes
Open tax year	2019
Switzerland \| Latest Tax Year
Schedule Of Income Taxes
Open tax year	2022

Employee Benefit Plans - Summary of Changes in Benefit Obligation, Plan Assets and Funded Status of Pension Benefit Plans (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
United States
Change in plan assets:
Fair value of plan assets at beginning of year	$ 419
Business combinations	0	$ 0
Fair value of plan assets at end of year	486	419
Non-United States Plans
Change in plan assets:
Fair value of plan assets at beginning of year	355
Business combinations	0	1
Fair value of plan assets at end of year	379	355
Pension Benefits \| United States
Change in benefit obligation:
Projected benefit obligation at beginning of year	400	488
Service costs	10	13	$ 14
Interest cost	22	13	11
Actuarial losses	15	(101)
Business combinations	0	0
Benefits paid	(13)	(11)
Contributions	0	0
Settlements	0	(2)
Foreign currency fluctuations and other	0	0
Projected benefit obligation at end of year	434	400	488
Change in plan assets:
Fair value of plan assets at beginning of year	419	524
Actual return on plan assets	75	(97)
Contributions	5	5
Benefits paid	(13)	(11)
Settlements	0	(2)
Foreign currency fluctuations and other	0	0
Fair value of plan assets at end of year	486	419	524
Funded status	52	19
Pension Benefits \| Non-United States Plans
Change in benefit obligation:
Projected benefit obligation at beginning of year	461	652
Service costs	35	29	29
Interest cost	17	8	6
Actuarial losses	5	(144)
Business combinations	0	3
Benefits paid	(20)	(24)
Contributions	3	2
Settlements	(3)	(4)
Foreign currency fluctuations and other	27	(61)
Projected benefit obligation at end of year	525	461	652
Change in plan assets:
Fair value of plan assets at beginning of year	355	494
Actual return on plan assets	2	(97)
Contributions	27	32
Benefits paid	(20)	(24)
Settlements	(3)	(4)
Foreign currency fluctuations and other	18	(47)
Fair value of plan assets at end of year	379	355	$ 494
Funded status	$ (146)	$ (106)

Employee Benefit Plans - Summary of Amounts Recognized in Consolidated Balance Sheets Related to the Pension Benefit Plans (Detail) - Pension Benefits - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
United States
Defined Benefit Plan Disclosure
Deposits and other assets	$ 87	$ 56
Accrued expenses	4	4
Other liabilities	31	33
United States \| Actuarial Net (Gain) Loss
Defined Benefit Plan Disclosure
AOCI	28	(2)
Non-United States Plans
Defined Benefit Plan Disclosure
Deposits and other assets	49	50
Accrued expenses	12	10
Other liabilities	183	146
Non-United States Plans \| Actuarial Net (Gain) Loss
Defined Benefit Plan Disclosure
AOCI	$ (25)	$ (6)

- Definition

Amount of asset, recognized in statement of financial position, for overfunded defined benefit pension and other postretirement plans.

+ References + Details

Employee Benefit Plans - Accumulated Benefit Obligation For Pension Benefit Plans (Detail) - Pension Benefits - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
United States
Defined Contribution And Defined Benefit Plans
Accumulated benefit obligation	$ 430	$ 397
Defined Benefit Plan, Benefit Obligation	434	400	$ 488
Service costs	10	13	14
Interest cost	22	13	11
Non-United States Plans
Defined Contribution And Defined Benefit Plans
Accumulated benefit obligation	480	426
Defined Benefit Plan, Benefit Obligation	525	461	652
Service costs	35	29	29
Interest cost	$ 17	$ 8	$ 6

Employee Benefit Plans - Summary of Pension Plans with Accumulated Benefit Obligation in Excess of Plan Assets and Projected Benefit Obligations in Excess of Plan Assets (Detail) - Pension Benefits - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
United States
Defined Benefit Plan Disclosure
Accumulated benefit obligation	$ 41	$ 42
Fair value of plan assets	7	6
Projected benefit obligation	41	43
Fair value of plan assets	7	6
Non-United States Plans
Defined Benefit Plan Disclosure
Accumulated benefit obligation	251	189
Fair value of plan assets	101	64
Projected benefit obligation	295	243
Fair value of plan assets	$ 101	$ 87

Employee Benefit Plans - Components of Net Periodic Benefit Cost and Other Changes in Plan Assets and Benefit Obligations Recognized in Other Comprehensive Income (Loss) (Detail) - Pension Benefits - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
United States
Defined Benefit Plan Disclosure
Service cost	$ 10	$ 13	$ 14
Interest cost	22	13	11
Expected return on plan assets	(30)	(38)	(32)
Amortization of actuarial losses	0	1	0
Settlement gain	0	1	0
Net periodic benefit cost	2	(10)	(7)
Other changes in plan assets and benefit obligations recognized in other comprehensive loss:
Actuarial (gain) loss – current year	(30)	31	(50)
Prior service cost – current year	0	0	0
Total recognized in other comprehensive income	(30)	31	(50)
Total recognized in net periodic benefit cost and other comprehensive income	(28)	21	(57)
Non-United States Plans
Defined Benefit Plan Disclosure
Service cost	35	29	29
Interest cost	17	8	6
Expected return on plan assets	(17)	(18)	(20)
Amortization of actuarial losses	(2)	1	1
Settlement gain	0	(1)	1
Net periodic benefit cost	33	19	17
Other changes in plan assets and benefit obligations recognized in other comprehensive loss:
Actuarial (gain) loss – current year	19	(18)	(39)
Prior service cost – current year	0	0	(2)
Total recognized in other comprehensive income	19	(18)	(41)
Total recognized in net periodic benefit cost and other comprehensive income	$ 52	$ 1	$ (24)

Employee Benefit Plans - Schedule of Weighted Average Assumptions Used to Determine Net Periodic Benefit Cost and Benefit Obligations (Detail) - Pension Benefits	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
United States
Defined Benefit Plan, Weighted Average Assumptions Used in Calculating Net Periodic Benefit Cost
Discount rate	5.65%	3.08%	2.84%
Rate of compensation increases	3.00%	3.00%	3.00%
Expected return on plan assets	7.20%	7.23%	7.23%
Defined Benefit Plan, Weighted Average Assumptions Used in Calculating Benefit Obligation
Discount rate	5.35%	5.65%
Rate of compensation increases	3.00%	3.00%
Non-United States Plans
Defined Benefit Plan, Weighted Average Assumptions Used in Calculating Net Periodic Benefit Cost
Discount rate	3.59%	1.46%	1.00%
Rate of compensation increases	2.93%	2.57%	2.55%
Expected return on plan assets	4.53%	4.22%	3.92%
Defined Benefit Plan, Weighted Average Assumptions Used in Calculating Benefit Obligation
Discount rate	3.52%	3.59%
Rate of compensation increases	2.78%	2.93%

Employee Benefit Plans - Defined Contribution Plans And Defined Benefit Plans - Additional Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Defined Benefit Plan Disclosure
Expected future employer contributions, next fiscal year	$ 31
Expenses related to matching contributions	$ 81	$ 74	$ 60
U.S. Government Treasury Bonds
Defined Benefit Plan Disclosure
Investment credit term	30 years
Cash balance crediting rate as a portion of yield	8.3333%
Cash balance credit rate percentage	0.25%

Employee Benefit Plans - Schedule of Pension Plan Weighted Average Asset Allocations (Detail) - Pension Benefits	Dec. 31, 2023	Dec. 31, 2022
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	100.00%	100.00%
United States
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	100.00%	100.00%
Non-United States Plans
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	100.00%	100.00%
Equity securities
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	42.00%	51.00%
Equity securities \| Minimum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	40.00%
Equity securities \| Maximum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	65.00%
Equity securities \| United States
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	73.00%	71.00%
Equity securities \| Non-United States Plans
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	0.00%	27.00%
Debt securities
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	36.00%	26.00%
Debt securities \| Minimum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	10.00%
Debt securities \| Maximum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	40.00%
Debt securities \| United States
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	21.00%	24.00%
Debt securities \| Non-United States Plans
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	56.00%	30.00%
Real estate
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	2.00%	3.00%
Real estate \| Minimum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	0.00%
Real estate \| Maximum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	5.00%
Real estate \| United States
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	4.00%	5.00%
Real estate \| Non-United States Plans
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	0.00%	0.00%
Other
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	20.00%	20.00%
Other \| Minimum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	10.00%
Other \| Maximum
Defined Benefit Plan Disclosure
Defined benefit plan, percentage of expected rate of return on plan assets	30.00%
Other \| United States
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	2.00%	0.00%
Other \| Non-United States Plans
Defined Benefit Plan Disclosure
Defined pension plan weighted average asset allocations	44.00%	43.00%

Employee Benefit Plans - Schedule of Plan Assets Measured at Fair Value (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
United States
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	$ 130	$ 121
Common/collective trusts measured at net asset value ("NAV")	356	298
Total	486	419
United States \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	130	121
Common/collective trusts measured at net asset value ("NAV")	0	0
Total	130	121
United States \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	0	0
Common/collective trusts measured at net asset value ("NAV")	0	0
Total	0	0
United States \| Domestic equities
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	33	29
United States \| Domestic equities \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	33	29
United States \| Domestic equities \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	0	0
United States \| International equities
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	11	9
United States \| International equities \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	11	9
United States \| International equities \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	0	0
United States \| Corporate bonds
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	65	64
United States \| Corporate bonds \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	65	64
United States \| Corporate bonds \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	0	0
United States \| Real estate
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	21	19
United States \| Real estate \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	21	19
United States \| Real estate \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	0	0
Non-United States Plans
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	379	262
Common/collective trusts measured at net asset value ("NAV")	0	93
Total	379	355
Non-United States Plans \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	6	6
Common/collective trusts measured at net asset value ("NAV")	0	0
Total	6	6
Non-United States Plans \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	373	256
Common/collective trusts measured at net asset value ("NAV")	0	0
Total	373	256
Non-United States Plans \| International equities
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	2	4
Non-United States Plans \| International equities \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	1	0
Non-United States Plans \| International equities \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	1	4
Non-United States Plans \| Debt issued by national, state or local government
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	212	106
Non-United States Plans \| Debt issued by national, state or local government \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	2	3
Non-United States Plans \| Debt issued by national, state or local government \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	210	103
Non-United States Plans \| Investments funds
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	10	10
Non-United States Plans \| Investments funds \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	0	0
Non-United States Plans \| Investments funds \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	10	10
Non-United States Plans \| Insurance contracts
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	145	133
Non-United States Plans \| Insurance contracts \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	0	0
Non-United States Plans \| Insurance contracts \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	145	133
Non-United States Plans \| Other
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	10	9
Non-United States Plans \| Other \| Level 1
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	3	3
Non-United States Plans \| Other \| Level 2
Defined Benefit Plan Disclosure
Total assets in the fair value hierarchy	$ 7	$ 6

Employee Benefit Plans - Schedule of Expected Benefit Payments, Net of Expected Participants Contributions for Pension Benefits (Detail) - Pension Benefits $ in Millions	Dec. 31, 2023 USD ($)
Defined Benefit Plan Disclosure
2024	$ 48
2025	50
2026	53
2027	56
2028	58
Years 2029 through 2033	325
Defined Benefit Plan Expected Future Benefit Payments, Total	$ 590

Employee Benefit Plans - Stock Incentive Plans - Additional Information (Detail) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award
Stock-based compensation	$ 217.0	$ 194.0	$ 170.0
Recognized future income tax benefit	34.0	28.0	26.0
Unrecognized non-vested stock-based compensation	$ 194.0
Weighted average period of stock-based compensation	1 year 3 months 18 days
Expiry period of options from grant date	10 years
Weighted average remaining contractual life of the options outstanding	1 year 6 months
Aggregate intrinsic value of the exercisable stock options and the stock options expected to vest	$ 30.0
Stock Options
Share-based Compensation Arrangement by Share-based Payment Award
Total intrinsic value of options exercised	23.0	9.0	29.0
Proceeds from options exercised	$ 7.0	2.0	7.0
At End Of Three Year Period
Share-based Compensation Arrangement by Share-based Payment Award
Percentage of options granted per annum	100.00%
Stock Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award
Number of shares available for future grant	8,500,000
Stock Appreciation Rights - Stock Settled
Share-based Compensation Arrangement by Share-based Payment Award
Intrinsic value of shares exercised	$ 51.0	25.0	$ 81.0
Weighted average remaining contractual life of equity instruments other than options outstanding	5 years 4 months 24 days
Aggregate intrinsic value of exercisable expected to vest	$ 342.0
Aggregate Intrinsic Value	$ 342.0	$ 304.0
Number of stock units outstanding (shares)	3,862,710	4,055,769
Stock Appreciation Rights - Stock Settled \| First Anniversary of Grant Date
Share-based Compensation Arrangement by Share-based Payment Award
Percentage of options granted per annum	33.33%
Stock Appreciation Rights - Stock Settled \| Second Anniversary of Grant Date
Share-based Compensation Arrangement by Share-based Payment Award
Percentage of options granted per annum	33.33%
Stock Appreciation Rights - Stock Settled \| Third Anniversary Of Grant Date
Share-based Compensation Arrangement by Share-based Payment Award
Percentage of options granted per annum	33.33%
Performance Awards
Share-based Compensation Arrangement by Share-based Payment Award
Number of stock units outstanding	746,070	642,701
Aggregate Intrinsic Value	$ 173.0
Fair value of Stock Appreciation Rights granted	$ 229.88
Restricted Stock Units - Stock Settled
Share-based Compensation Arrangement by Share-based Payment Award
Number of stock units outstanding	888,856	896,733
Aggregate Intrinsic Value	$ 206.0
Number of days for stock units to settle in common stock from vesting date	45 days
Fair value of Stock Appreciation Rights granted	$ 227.84
Stock Appreciation Rights - Cash Settled
Share-based Compensation Arrangement by Share-based Payment Award
Weighted average remaining contractual life of equity instruments other than options outstanding	3 years 1 month 6 days
Aggregate intrinsic value of exercisable expected to vest	$ 8.0
Fair value of Stock Appreciation Rights granted	$ 152.17	$ 147.41	$ 216.87
Cash paid to settle exercised SARs	$ 11.0	$ 1.0	$ 1.0
Restricted Stock Units - Cash Settled
Share-based Compensation Arrangement by Share-based Payment Award
Aggregate Intrinsic Value	$ 1.0
Number of stock units outstanding (shares)	5,326
Restricted Stock Units - Cash Settled \| Third Anniversary Of Grant Date
Share-based Compensation Arrangement by Share-based Payment Award
Percentage of options granted per annum	100.00%
Long Term Incentive Awards
Share-based Compensation Arrangement by Share-based Payment Award
Stock-based compensation	$ 22.0	9.0
Fixed monetary amount		$ 80.0

Employee Benefit Plans - Assumptions Used to Estimate Value of Stock-Based Compensation for Stock Options and Stock Appreciation Rights Issued (Detail)	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Share based Compensation Arrangement by Share based Payment Award, Fair Value Assumptions, Method Used
Expected volatility, Minimum	29.00%	28.00%	27.00%
Expected volatility, Maximum	35.00%	34.00%	31.00%
Weighted average expected volatility	32.00%	30.00%	29.00%
Expected dividends	0.00%	0.00%	0.00%
Risk-free interest rate, Minimum	3.38%	1.84%	0.28%
Risk-free interest rate, Maximum	4.75%	4.22%	1.40%
Minimum
Share based Compensation Arrangement by Share based Payment Award, Fair Value Assumptions, Method Used
Expected term (in years)	2 years 4 months 24 days	3 years 3 months 18 days	3 years 7 months 6 days
Maximum
Share based Compensation Arrangement by Share based Payment Award, Fair Value Assumptions, Method Used
Expected term (in years)	5 years 4 months 24 days	6 years 3 months 18 days	6 years 7 months 6 days

Employee Benefit Plans - Summary of Stock Option Activity (Detail) - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding [Roll Forward]
Beginning balance (shares)	320,353
Exercised (shares)	(145,382)
Ending balance (shares)	174,971
Share-Based Compensation Arrangement by Share-Based Payment Award, Options, Outstanding, Weighted Average Exercise Price [Abstract]
Beginning balance (usd per share)	$ 54.99
Exercised (usd per share)	46.13
Ending balance (usd per share)	$ 62.35
Aggregate Intrinsic Value	$ 30	$ 48

Employee Benefit Plans - Schedule of Stock Appreciation Rights - Stock Settled And Cash Settled Activity (Detail) - Stock Appreciation Rights - Stock Settled - USD ($) $ / shares in Units, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022
Number of Stock Appreciation Rights
Shares outstanding, beginning (shares)	4,055,769
Granted (shares)	399,427
Exercised (shares)	(535,982)
Canceled (shares)	(56,504)
Shares outstanding, ending (shares)	3,862,710
Share Based Compensation Arrangement By Share Based Payment Award Non Option Equity Instruments Weighted Average Grant Price [Abstract]
Outstanding, beginning balance (usd per share)	$ 134.36
Granted (usd per share)	231.86
Exercised (usd per share)	122.94
Canceled (usd per share)	218.68
Outstanding, ending balance (usd per share)	$ 144.79
Aggregate Intrinsic Value	$ 342	$ 304

Employee Benefit Plans - Summary of Performance Award Activity (Detail) - Performance Awards	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Nonvested Other than Options
Beginning balance (shares) \| shares	642,701
Granted (shares) \| shares	359,588
Additional goal achievement shares (shares) \| shares	176,329
Vested (shares) \| shares	(380,386)
Canceled (shares) \| shares	(52,162)
Ending balance (shares) \| shares	746,070
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Beginning Balance (usd per share) \| $ / shares	$ 216.00
Granted (usd per share) \| $ / shares	229.88
Additional goal achievement shares (usd per share) \| $ / shares	169.76
Vested (usd per share) \| $ / shares	173.74
Canceled (usd per share) \| $ / shares	232.93
Ending balance (usd per share) \| $ / shares	$ 232.13

Employee Benefit Plans - Summary of Restricted Stock Units - Stock Settled And Cash Settled Activity (Detail) - Restricted Stock Units - Stock Settled	12 Months Ended
	Dec. 31, 2023 $ / shares shares
Nonvested Other than Options
Beginning balance (shares)	896,733
Granted (shares)	443,009
Vested (shares)	(379,871)
Canceled (shares)	(71,015)
Ending balance (shares)	888,856
Share-based Compensation Arrangement by Share-based Payment Award, Equity Instruments Other than Options, Nonvested, Weighted Average Grant Date Fair Value [Abstract]
Beginning Balance (usd per share) \| $ / shares	$ 215.16
Granted (usd per share) \| $ / shares	227.84
Vested (usd per share) \| $ / shares	197.56
Canceled (usd per share) \| $ / shares	220.79
Ending balance (usd per share) \| $ / shares	$ 228.55
Director Deferral Plan
Nonvested Other than Options
Granted (shares)	1,782

Property, Equipment and Software by Geography - Property, Equipment and Software, Net, by Geographic Region (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Long Lived Assets Geographic
Total property, equipment and software, net	$ 2,146	$ 2,047
Americas
Long Lived Assets Geographic
Total property, equipment and software, net	1,917	1,798
United States
Long Lived Assets Geographic
Total property, equipment and software, net	1,820	1,699
Other
Long Lived Assets Geographic
Total property, equipment and software, net	97	99
Europe and Africa
Long Lived Assets Geographic
Total property, equipment and software, net	193	196
Asia-Pacific
Long Lived Assets Geographic
Total property, equipment and software, net	$ 36	$ 53

Segments - Additional Information (Detail)	12 Months Ended
Segments - Additional Information (Detail)	Dec. 31, 2023 Segment
Segment Reporting [Abstract]
Number of reportable segments	3

Segments - Operations by Reportable Segments (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Segment Reporting Information
Revenues	$ 14,984	$ 14,410	$ 13,874
Cost of revenues, exclusive of depreciation and amortization	9,745	9,382	9,233
Selling, general and administrative expenses	2,053	2,071	1,964
Depreciation and amortization	(1,125)	(1,130)	(1,264)
Restructuring costs	(84)	(28)	(20)
Total income from operations	1,977	1,799	1,393
Technology & Analytics Solutions
Segment Reporting Information
Revenues	5,862	5,746	5,534
Research & Development Solutions
Segment Reporting Information
Revenues	8,395	7,921	7,556
Contract Sales & Medical Solutions
Segment Reporting Information
Revenues	727	743	784
Operating Segments
Segment Reporting Information
Segment profit	3,454	3,287	3,009
Operating Segments \| Technology & Analytics Solutions
Segment Reporting Information
Revenues	5,862	5,746	5,534
Cost of revenues, exclusive of depreciation and amortization	3,496	3,348	3,278
Selling, general and administrative expenses	876	848	798
Segment profit	1,490	1,550	1,458
Operating Segments \| Research & Development Solutions
Segment Reporting Information
Revenues	8,395	7,921	7,556
Cost of revenues, exclusive of depreciation and amortization	5,629	5,395	5,303
Selling, general and administrative expenses	851	831	777
Segment profit	1,915	1,695	1,476
Operating Segments \| Contract Sales & Medical Solutions
Segment Reporting Information
Revenues	727	743	784
Cost of revenues, exclusive of depreciation and amortization	620	639	652
Selling, general and administrative expenses	58	62	57
Segment profit	49	42	75
General corporate and unallocated
Segment Reporting Information
Selling, general and administrative expenses	268	330	332
Segment profit	$ (268)	$ (330)	$ (332)

Earnings Per Share - Reconciles the Basic to Diluted Weighted Average Shares Outstanding (Detail) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Earnings Per Share [Abstract]
Net income attributable to IQVIA Holdings Inc.	$ 1,358	$ 1,091	$ 966
Denominator:
Basic weighted average common shares outstanding (in shares)	183.8	187.6	191.4
Effect of dilutive stock options and share awards (in shares)	2.5	3.0	3.6
Diluted weighted average common shares outstanding (in shares)	186.3	190.6	195.0
Earnings per share attributable to common stockholders:
Basic (in dollars per share)	$ 7.39	$ 5.82	$ 5.05
Diluted (in dollars per share)	$ 7.29	$ 5.72	$ 4.95

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-3

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 260
-SubTopic 10
-Name Accounting Standards Codification
-Section 55
-Paragraph 15
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482635/260-10-55-15

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
-Name Accounting Standards Codification
-Section 65
-Paragraph 1
-Subparagraph (e)(4)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480175/815-40-65-1

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Topic 815
-SubTopic 40
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-Section 65
-Paragraph 1
-Subparagraph (f)
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147480175/815-40-65-1

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
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-Name Accounting Standards Codification
-Section 50
-Paragraph 11
-Subparagraph (a)
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-URI https://asc.fasb.org//1943274/2147483443/250-10-50-11

Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
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Reference 7: http://www.xbrl.org/2003/role/disclosureRef
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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-Section 45
-Paragraph 7
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147482689/260-10-45-7

+ Details

- Definition

The amount of net income (loss) for the period available to each share of common stock or common unit outstanding during the reporting period and to each share or unit that would have been outstanding assuming the issuance of common shares or units for all dilutive potential common shares or units outstanding during the reporting period.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Topic 250
-SubTopic 10
-Name Accounting Standards Codification
-Section 50
-Paragraph 3
-Publisher FASB
-URI https://asc.fasb.org//1943274/2147483443/250-10-50-3

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Topic 260
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Reference 3: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Earnings Per Share - Narrative (Detail) - shares shares in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Earnings Per Share [Abstract]
Antidilutive securities excluded from computation of earnings per share, amount (in shares)	1.0	0.5	0.1

Accumulated Other Comprehensive (Loss) Income - Summary of Components of AOCI (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Income Taxes
Beginning Balance	$ 62	$ 180	$ 323
Other comprehensive (loss) income before reclassifications	54	(116)	(139)
Reclassification adjustments	17	(2)	(4)
Acquisition of Quest's non-controlling interest			0
Ending Balance	133	62	180
Other comprehensive loss before reclassifications, Total	(89)	(331)	(203)
Reclassification adjustments, Total	(51)	10	12
Accumulated Other Comprehensive (Loss) Income
Increase (Decrease) in Stockholders' Equity
Beginning Balance	(727)	(406)	(205)
Ending Balance	(867)	(727)	(406)
Foreign Currency Translation
Increase (Decrease) in Stockholders' Equity
Beginning Balance	(825)	(570)	(395)
Other comprehensive (loss) income before reclassifications	(144)	(255)	(165)
Reclassification adjustments	0	0	0
Acquisition of Quest's non-controlling interest			10
Ending Balance	(969)	(825)	(570)
Derivative Instruments
Increase (Decrease) in Stockholders' Equity
Beginning Balance	44	(21)	(48)
Other comprehensive (loss) income before reclassifications	(10)	53	11
Reclassification adjustments	(68)	12	16
Acquisition of Quest's non-controlling interest			0
Ending Balance	(34)	44	(21)
Defined Benefit Plans
Increase (Decrease) in Stockholders' Equity
Beginning Balance	(8)	5	(85)
Other comprehensive (loss) income before reclassifications	11	(13)	90
Reclassification adjustments	0	0	0
Acquisition of Quest's non-controlling interest			0
Ending Balance	$ 3	$ (8)	$ 5

Accumulated Other Comprehensive (Loss) Income - 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	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 68	$ (12)	$ (16)
Income taxes	17	(2)	(4)
Total net of income taxes	51	(10)	(12)
Interest rate swaps \| Interest expense
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	47	(22)	(21)
Foreign exchange forward contracts \| Revenues
Reclassification Adjustment out of Accumulated Other Comprehensive Income
Total before income taxes	$ 21	$ 10	$ 5

Supplemental Cash Flow Information - Supplemental Cash Flow Information (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Supplemental Cash Flow Information:
Interest paid, net	$ 556	$ 379	$ 343
Income taxes paid, net of refunds	$ 340	$ 255	$ 222

Schedule I - Condensed Statements of Income And Comprehensive Income (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Condensed Financial Statements, Captions
Net income attributable to IQVIA Holdings Inc.	$ 1,358	$ 1,091	$ 966
Comprehensive income attributable to IQVIA Holdings Inc.	1,218	770	775
Parent Company
Condensed Financial Statements, Captions
Equity in earnings of subsidiary	1,358	1,091	966
Net income attributable to IQVIA Holdings Inc.	1,358	1,091	966
Equity in other comprehensive (loss) income of subsidiary, net of tax	(140)	(321)	(191)
Comprehensive income attributable to IQVIA Holdings Inc.	$ 1,218	$ 770	$ 775

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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+ Details

Schedule I - Condensed Balance Sheets (Detail) - USD ($) $ in Millions	Dec. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 1,376	$ 1,216
Total current assets	5,596	4,981
Investments in Unconsolidated VIEs	26,681	25,337
LIABILITIES AND STOCKHOLDERS’ EQUITY
Liabilities, Current	6,491	5,578
Total liabilities	20,569	19,572
Commitments and contingencies
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of December 31, 2023 and 2022, $0.01 par value, 257.2 shares issued and 181.5 shares outstanding as of December 31, 2023; 256.4 shares issued and 185.7 shares outstanding as of December 31, 2022	11,028	10,898
Retained earnings	4,692	3,334
Treasury stock, at cost, 75.7 and 70.7 shares as of December 31, 2023 and 2022, respectively	(8,741)	(7,740)
Accumulated other comprehensive loss	(867)	(727)
Total liabilities and stockholders’ equity	26,681	25,337
Parent Company
Current assets:
Cash and cash equivalents	2	2
Total current assets	2	2
Investment in subsidiary	9,667	9,667
Investments in Unconsolidated VIEs	9,669	9,669
LIABILITIES AND STOCKHOLDERS’ EQUITY
Accounts Payable	8	0
Liabilities, Current	8	0
Investment in subsidiary	3,546	3,902
Payable to subsidiary	3	2
Total liabilities	3,557	3,904
Commitments and contingencies
Stockholders’ equity:
Common stock and additional paid-in capital, 400.0 shares authorized as of December 31, 2023 and 2022, $0.01 par value, 257.2 shares issued and 181.5 shares outstanding as of December 31, 2023; 256.4 shares issued and 185.7 shares outstanding as of December 31, 2022	11,028	10,898
Retained earnings	4,692	3,334
Treasury stock, at cost, 75.7 and 70.7 shares as of December 31, 2023 and 2022, respectively	(8,741)	(7,740)
Accumulated other comprehensive loss	(867)	(727)
Equity attributable to IQVIA Holdings Inc.’s stockholders	6,112	5,765
Total liabilities and stockholders’ equity	$ 9,669	$ 9,669

Schedule I - Condensed Balance Sheets -Narrative (Detail) - $ / shares	Dec. 31, 2023	Dec. 31, 2022
Condensed Financial Statements, Captions
Common stock authorized (in shares)	400,000,000.0	400,000,000.0
Common stock, par value (usd per share)	$ 0.01	$ 0.01
Common stock, shares issued (shares)	257,200,000	256,400,000
Common stock, shares outstanding (in shares)	181,500,000	185,700,000
Treasury stock (in shares)	75,700,000	70,700,000
Parent Company
Condensed Financial Statements, Captions
Common stock authorized (in shares)	400,000,000.0	400,000,000.0
Common stock, par value (usd per share)	$ 0.01	$ 0.01
Common stock, shares issued (shares)	257,200,000	256,400,000
Common stock, shares outstanding (in shares)	181,500,000	185,700,000
Treasury stock (in shares)	75,700,000	70,700,000

Schedule I - Condensed Statements of Cash Flows (Detail) - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Operating activities:
Net income	$ 1,358	$ 1,091	$ 971
Changes in operating assets and liabilities:
Net cash provided by operating activities	2,149	2,260	2,942
Investing activities:
Net cash used in investing activities	(1,603)	(2,006)	(2,103)
Financing activities:
Payments related to employee stock option plans	(61)	(71)	(59)
Repurchase of common stock	(992)	(1,168)	(406)
Net cash used in financing activities	(382)	(329)	(1,235)
Increase in cash and cash equivalents	160	(150)	(448)
Cash and cash equivalents at beginning of period	1,216	1,366	1,814
Cash and cash equivalents at end of period	1,376	1,216	1,366
Parent Company
Operating activities:
Net income	1,358	1,091	966
Adjustments to reconcile net income to cash provided by operating activities:
Equity in earnings of subsidiary	(1,358)	(1,091)	(966)
Changes in operating assets and liabilities:
Other operating assets and liabilities	0	1	(1)
Net cash provided by operating activities	0	1	(1)
Investing activities:
Investment in subsidiary, net of dividends received	1,052	1,238	467
Net cash used in investing activities	1,052	1,238	467
Financing activities:
Payments related to employee stock option plans	(61)	(71)	(59)
Repurchase of common stock	(992)	(1,168)	(406)
Intercompany with subsidiary	1	0	0
Net cash used in financing activities	(1,052)	(1,239)	(465)
Increase in cash and cash equivalents	0	0	1
Cash and cash equivalents at beginning of period	2	2	1
Cash and cash equivalents at end of period	$ 2	$ 2	$ 2

Schedule I - Additional Information (Detail)	12 Months Ended
Schedule I - Additional Information (Detail)	Dec. 31, 2023
Parent Company
Condensed Financial Statements, Captions
Minimum percentage of restricted net assets of consolidated subsidiaries of consolidated net assets	25.00%

Schedule I - Dividends Paid (Detail) - USD ($) $ in Millions	1 Months Ended																													12 Months Ended
	Nov. 30, 2023	Sep. 30, 2023	Aug. 31, 2023	May 31, 2023	Mar. 31, 2023	Feb. 28, 2023	Dec. 31, 2022	Nov. 30, 2022	Oct. 31, 2022	Sep. 30, 2022	Aug. 31, 2022	Jul. 31, 2022	Jun. 30, 2022	May 31, 2022	Apr. 30, 2022	Mar. 31, 2022	Feb. 28, 2022	Jan. 31, 2022	Dec. 31, 2021	Nov. 30, 2021	Oct. 31, 2021	Sep. 30, 2021	Aug. 31, 2021	Jul. 31, 2021	Jun. 30, 2021	May 31, 2021	Apr. 30, 2021	Mar. 31, 2021	Feb. 28, 2021	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
Parent
Dividends Payable
Cash dividend paid to parent company	$ 232	$ 55	$ 89	$ 490	$ 130	$ 56	$ 25	$ 3	$ 40	$ 110	$ 1	$ 100	$ 188	$ 303	$ 2	$ 125	$ 322	$ 20	$ 57	$ 89	$ 60	$ 36	$ 35	$ 25	$ 20	$ 23	$ 4	$ 51	$ 70	$ 1,052	$ 1,239	$ 470

Schedule II - Valuation and Qualifying Accounts (Detail) - Valuation Allowance of Deferred Tax Assets - USD ($) $ in Millions	12 Months Ended
	Dec. 31, 2023	Dec. 31, 2022	Dec. 31, 2021
SEC Schedule, 12-09, Movement in Valuation Allowances and Reserves
Balance at Beginning of Year	$ 257	$ 294	$ 306
Additions Charged to Expenses	(99)	(27)	1
Additions Charged to Other Accounts	0	0	0
Additions (Deductions)	8	(10)	(13)
Balance at End of Year	$ 166	$ 257	$ 294