Medpace Holdings, Inc.

What they do

Medpace earns fees by running full-service Phase I-IV clinical trials for customers, primarily small and mid-sized biopharmaceutical companies. It employs approximately 6,500 people across 46 countries as of June 30, 2026, and operates through therapeutic expertise concentrated in Oncology, Metabolic Disease, Cardiology, CNS and Antiviral/Anti-infective. Contracts are priced on a fixed-fee or unit-of-service basis and are typically a single performance obligation recognized over time using a cost-to-cost input method.

Revenue drivers

• Full-service Phase I-IV clinical development — The company generates substantially all revenue from a single service line: outsourced clinical trial execution from Phase I through Phase IV across all major therapeutic areas, billed to customers under individually negotiated contracts.
• Therapeutic-area concentration — Medpace states particular strength in Oncology, Metabolic Disease, Cardiology, CNS and AVAI, so revenue mix shifts with the therapeutic composition and life-cycle stage of active studies.
• Net new business awards — Awards drive future revenue; second-quarter 2026 net new business awards were $795.7 million, up 28.2% year over year, producing a net book-to-bill ratio of 1.13x.
• Backlog — Backlog was $3,014.2 million as of June 30, 2026, up 4.9% from $2,873.6 million a year earlier; second-quarter 2026 backlog conversion was 24.1%.

Recent performance

Second-quarter 2026 revenue was $707.3 million, up 17.2% from $603.3 million a year earlier, and backlog conversion was 24.1%. Net new business awards of $795.7 million rose 28.2% year over year, a net book-to-bill of 1.13x. GAAP net income was $121.4 million, or $4.25 per diluted share, versus $90.3 million, or $3.10 per diluted share, a year earlier, with net income margin of 17.2% versus 15.0%. EBITDA was $153.4 million, a 21.7% margin. Year-to-date 2026 revenue was $1,413.9 million, up 21.7%, with GAAP net income of $245.2 million and EBITDA of $302.8 million.

Strategy

Medpace describes a disciplined operating model centered on full-service Phase I-IV delivery and therapeutic expertise, targeting share gains in the Phase I-IV CRO market. It positions itself as a partner of choice for small and mid-sized biopharmaceutical companies and runs a global platform of about 6,500 employees in 46 countries. The company continues to return capital: it repurchased 705,616 shares for $294.7 million in the second quarter of 2026, leaving $527.0 million authorized. It carries no long-term debt on its latest reported balance sheet and held $502.7 million in cash and equivalents at June 30, 2026.

Risks

• Contract loss, delay or non-payment — Medpace cites potential loss, delay or non-renewal of contracts, or non-payment by customers, as a risk; contracts can typically be terminated on about 30 days' notice.
• Backlog conversion — The company states its backlog may not convert to net revenue at historical conversion rates, making reported backlog an uncertain indicator of future revenue.
• Fixed-fee pricing and cost overruns — Medpace bears financial risk if it underprices fixed-fee contracts or overruns cost estimates, and results can suffer from unapproved or delayed change orders.
• Customer and therapeutic-area concentration — Customer or therapeutic-area concentration is disclosed as a risk that could materially affect business, financial condition, results of operations or cash flows.

Outlook

Management forecasts 2026 revenue of $2.805 billion to $2.885 billion, representing growth of 10.9% to 14.0% over 2025 revenue of $2.530 billion. Full-year 2026 GAAP net income is guided to $494.0 million to $514.0 million and EBITDA to $618.0 million to $642.0 million, with diluted GAAP EPS of $17.25 to $17.95. Guidance assumes a full-year 2026 tax rate of 19.0% to 19.5%, interest income of $21.1 million, foreign exchange rates as of June 30, 2026, and 28.6 million diluted weighted average shares outstanding.