Steve Cutler
Analyst · Evercore, ISI. Please ask your question
Thank you, Brendan, and good day everyone. I had a strong start to the year in Quarter 1, reflecting continued operational strength and business momentum, despite macroeconomic headwinds impacting our business. Throughout the year, ICON employees continue to exhibit their ongoing resilience and dedication to delivering customers programs as effects from the pandemic continued with the emergence of new COVID variants, and the war in Ukraine presented a new set of challenges. Ensuring the safety of our employees in the region is our first and foremost priority. We've been able to provide support to many Ukrainian families and employees that have crossed the border to neighboring regions, and assisted in relocation to other ICON offices where circumstances allow. We are working closely with our customers to ensure studies continue and patient safety is my intent to the full extent possible, deploying remote technologies for monitoring and assisting dislocated patients in finding new trial sites. Patient recruitment activity in the region has been halted and no new studies or sites are being started at this time in Russia or the Ukraine. Earlier this month, I was in our office in Poland, which has been at the forefront, hoping to provide the on-the-ground support to many of our employees leaving Ukraine. I'm incredibly proud of the extraordinary efforts exhibited by our employees in Poland and nearby countries. Our staff in the region not only have gone above and beyond for their colleagues and for our customers, [Indiscernible], and patients as well. Ensuring trial continuity and mitigating risk to the best of our abilities. They are an excellent representation of the ICON culture and we are grateful for their dedication and tireless efforts. In the quarter, the financial impact from the war in Ukraine was approximately $5 million. We anticipate a continued impact in subsequent quarters, up to an estimated 1% of revenue for the full year, assuming no further change in our ability to operate in the region for the foreseeable future. Despite challenges from the war in Ukraine and emergence of additional COVID variants, the broader environment to clinical development remains strong. Total RFP volume was solid in Quarter 1 increasing by low double-digits on a year-over-year basis. While the biotech funding market declined further in the quarter, we have seen Pharma R&D spend continue to grow, and we have not witnessed the slowdown in RFP activity in the small and mid-sized Biopharma segment, which was consistent with the strong levels we saw in Quarter 4, 2021. Additionally, I would note that we haven't seen an uptick in the level of cancellations or project delays in this segment of our business, we have continued to see private and venture capital funding supporting companies with strong signs and novel therapies in areas such as oncology, rare disease, infectious diseases, and neurology. In the last few years, Icon has worked with over 1,000 emerging biopharma companies. And our consultative partnership model strongly appeals to this customer segment. We have confident with Icon's ability to continue winning market share across the Biotech and small farmer segment giving our leading expertise and purpose-built Biotech unit, consisting of 8,000 dedicated employees. Our backlog exposure to capital market dependent companies remains low, and our strong position across all other key market segments should ensure our business wins remained robust, in the foreseeable future. Our business development performance was excellent in the quarter, resulting in another record quarter of net business wins of $2.43 billion representing a net book-to-bill of 1.2% for the quarter, and 1.27 on a trailing 12-month basis. Backlog grew 10% year-over-year to $19.6 billion on a combined company basis, an increase of 2.7% sequentially from quarter four 2021. Sales performance was particularly strong in our large farming unit that was broad-based across all business units, reflecting continued demand for our innovative and integrated solutions. Strategic discussions across several key partnerships are continuing to advance presenting opportunities for growth and expansion across our business segments. Our clinically focused, but diversified business mix and customer - centric offering, has played a key role in winning new customers and renewing existing partnerships as customers seek flexible development models along with a broad set of services and expertise. One of our key success factors in building and maintaining strong customer partnerships is our commitment to collaboration and operational excellence. In the quarter, we held our first partner of choice meeting as new ICON, bringing together several of our partners in the Strategic Solutions segment of our business to share insights and why the further is innovate in this area. ICON is leading the way with its approach to customer engagement, and events like this clearly demonstrate our commitment to our focus on creating enduring customer partnerships. Financial performance was strong in the first quarter, resulting in combined company revenue of 6%, or 8% on a constant currency basis, year-over-year. These results exceeded our initial expectations given difficult comparisons on a year-over-year basis from high pass-through revenue related to COVID studies and further headwinds due to foreign currency fluctuations, and the war in Ukraine, which will continue to challenge us in Quarter 2. Despite these macro headwinds, operational performance was impressive with adjusted EBITDA growth of 19% year-over-year on a combined accompanied basis in quarter one, as SG&A cost management was particularly strong due to achievement of initial cost synergies. I was also very pleased with our adjusted earnings per share of $2.76, which grew 27% from quarter one 2021. At a high level, our overall customer mix has stayed consistent and well-balanced in quarter one with approximately 50% of total revenue in large Biopharma and approximately 45% of total revenue in mid and small Biopharma. Within the small Biopharma segment, companies that have less than a $100 million in annual R&D spend, again represented a mid-teens percentage of our overall revenue and backlog for quarter one. Given our cash collection efforts in the quarter, we were able to make a $300 million payment on our term loan b facility, further reducing our leverage to 3.3 times adjusted EBITDA at the end of the quarter down from 3.4 times at the end of Quarter 4. We believe we are on track to hit our aspirational target of exiting 2022 with a leverage ratio of approximately 2.5 times adjusted EBITDA. Our integration progress continued throughout Quarter 1 as we passed the one year mark since we announced the transformative union with PRA Health Sciences that now completed 9 months operating as a combined organization. Our focus on enabling a unified employee experience has continued to advance, bringing more of our stuff together physically through facility integration of which we have now completed 50 across the globe. Even more importantly, our efforts to connect the organization through the implementation of common platforms and enterprise-wide technology systems are reaching critical milestones. A few of our first system implementations, including our human capital management system, will go live this quarter. And we are advancing deployment, several other Tier 1 enterprise-wide systems, which will come online in the next few months. Our successful integration efforts to-date have enabled continued progress on our synergy targets. And as we reaffirmed in March at our Analyst Day, we expect to realize approximately 50% of our cost synergy target, or $75 million in 2022. From our revenue synergy perspective, our cross-sell activity was again strong in Quarter 1, with approximately $30 million in new awards, consistent with the activity in the fourth quarter of 2021. Cross-sell awards in the first quarter were led by the laboratory services, early phase, and by our [Indiscernible]. Turning to COVID related trends, it was several notable factors impacting our business in Quarter 1. Revenue related to COVID studies was consistent with Quarter 4, representing a mid-single-digit percentage of overall revenues. Backlog related to COVID programs was approximately 5% total ending backlog, as we were successful in winning new business for additional vaccine work related to boost studies in the quarter. These additional study wins our evidence that COVID related work will be part of our business for some time and an excellent testament to ICON’s leadership in vaccine development and strong trial execution in this area. With the new awards won in Quarter 1, we expected COVID -related revenues will represent approximately 5% of our total revenue for the full year 2022. From aside excess perspective, we saw continued resilience from site and staff throughout the quarter, despite the emergence of addition COVID variant and the lockdown in China causing restricted access to site that had previously reopened. This dynamic coupled with site access impacts from the war in Ukraine holds a slight increase in the number of sites restricted in some capacity. Now totaling approximately 17%. While we have seen volatility in levels of site access across different regions, either due to COVID or more recently from the war in Ukraine. Our teams are now able to pivot faster and more seamlessly, by deploying remote based solutions, lessening trial impacts that would have been more substantial two years ago. We have seen continued adoption across customer segments of decentralized trial components, particularly hard good models of development. While we have noted that fully decentralized trials are few in number currently, we were pleased to have started a recruitment on a full phase two decentralized Clinical Trial study in Women's Health in Quarter 1, this study is a great example of the power of our broad set of integrated services with the trial is being executed utilizing multiple decentralized components. Digital patient recruitment services, our Accellacare site network, and concierge services center, with the study managed by our decentralized clinical trials operational team. We remain focused on our commitment to further invest in key technologies, tools, and platforms that will improve efficiency and delivery in our industry. One Search, our innovative site selection tool, is continuing to deliver insights to our customers on optimal site selection reducing site start-up times, decreasing the number of normal recruiting sites, and improving overall patient recruitment rates. During the quarter we invested further in the tool with interface updates to enable better user experience and data enhancements to add valuable data sources, as well as back-end mapping. We've continued to look for opportunities to integrate broader sources of data, not only to One Search but across our entire set of solutions. Our focus is on increasing our access to not necessarily ownership of unique data sources, as well as the evaluating partnerships and other opportunities that advance our health care intelligence strategy while further enhancing our analytics capability, producing more targeted results and outcomes for our customers. Another area of strong focus for our organization is automation. Through the additional capacity provided by robotic process automation, we have continued to enable our new capabilities and offerings customers with the outputs of clinical trials can be delivered in a more timely way and at a higher level of consistency and quality. A great example of this in the completion of our ETMS, which has been one of the strongest areas for RPA productivity in 2022 so far, with over 2,800 FTD business days saved in Quarter 1. In addition, we continue to leverage advancements in technology, enabling us to employ remote monitoring across a range of workflows in our clinical trials. We are unifying our sights towards a single way of working, enabling remote review of ECG's and lab reports, and combining patient recruitment and scheduling into an overall integrated capability. As clinical development continues to evolve and bio - pharma customers increasingly look to their partners to provide innovative solutions, we see an excellent opportunity to lead the market with our focus on health care intelligence. We believe our investments in talent, technologies, data, and analytics are leading to improvements in long-held industry challenges: basic recruitment, site identification, and study startup, just to name a few. We remain excited by the opportunity to create a new paradigm for bringing clinical research to patients, and the enhanced outcomes it will deliver for all of our stakeholders. With the strong performance in the first quarter, we continued positive customer demand environment, we are reiterating our 2022 financial guidance revenue in the range of $7.77 to $8.05 billion and adjusted earnings per share in the range of $11.55 to $11.95. As indicated at our Analyst Day in March, we expect an adjusted EBITDA margin of approximately 18% in the full-year 2022. Finally, earlier this month, I was honored to accept the award of Island's Company of the year 2021 business and finance awards, on behalf of ICON. This award recognizes companies based on their market position, operational and financial achievements, and is attributed to the dedication and engagement of our 39,000 employees around the world. Before moving to our Q&A session, I would like to take an opportunity to recognize our employees for their commitment and efforts in Quarter 1. We look forward to the continued success of our organization throughout the year as we remain focused on delivery for customers, sites, and patients around the world. Operator, we're now ready for questions.