Earnings release
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Exhibit 99.1 ICON Reports Second Quarter 2026 Results Highlights • Quarter two revenue of $2,063.5 million, an increase of 1.4% on quarter one 2026. • Quarter two adjusted EBITDA of $327.2 million or 15.9% of revenue, an increase of 3.0% on quarter one 2026. • GAAP net income for the quarter of $72.6 million or $0.94 diluted earnings per share. • Quarter two adjusted net income of $198.4 million or $2.56 adjusted diluted earnings per share, an increase of 2.4% on quarter one 2026 adjusted diluted earnings per share. • Net business wins in the quarter of $3,120 million; a net book-to-bill of 1.51, an increase of 8.3% on quarter one 2026 net business wins. • Closing backlog of $23.4 billion, an increase of 3.0% on quarter one 2026. • Net debt of $2.5 billion at June 30, 2026 with a net debt to adjusted EBITDA ratio of 1.8x. • Reaffirming 2026 full-year financial guidance issued with revenue expected in the range of $7,850 - $8,150 million and adjusted diluted earnings per share* expected in the range of $10.00 - $11.00. Dublin, Ireland, July 29, 2026 – ICON plc (NASDAQ: ICLR), a world-leading clinical research organization, today reported its financial results for the second quarter ended June 30, 2026. CEO, Mr. Barry Balfe commented, “ICON's second quarter results reflect measured progress, as disciplined cost management offset anticipated operational headwinds. While revenue and net bookings benefited from higher pass-through activity, strong strategic wins and new customer acquisition supported a direct fee book-to-bill ratio of 1.2x, underscoring the strength of our focused commercial strategy and diversified, scaled platform. We are reaffirming our 2026 financial outlook, which reflects both opportunities and risks over the balance of the year. While second-half performance remains subject to variability in factors such as pass-through activity, the underlying fundamentals of our business remain solid, supported by our diversified portfolio, operational agility and disciplined cost management. Strong cash generation continues to support our capital allocation priorities, including investing in strategic growth opportunities and returning capital to shareholders.” Second Quarter 2026 Results In quarter two 2026, gross bookings were $3,681 million, an increase of 24.1% on quarter two 2025, with cancellations of $562 million. This resulted in net business wins of $3,120 million and a book-to-bill of 1.51. Backlog as at June 30, 2026 was $23.4 billion. Revenue for the second quarter was $2,063.5 million. This represents an increase of 1.2% on quarter two 2025, an increase of 0.4% on a constant currency basis. GAAP net income was $72.6 million, resulting in diluted earnings per share of $0.94 in quarter two 2026, compared to diluted earnings per share of $2.56 in quarter two 2025. Adjusted net income for the quarter was $198.4 million, resulting in adjusted diluted earnings per share of $2.56 compared to $3.52 per share in quarter two 2025. Adjusted EBITDA for the second quarter was $327.2 million or 15.9% of revenue, a decrease of 21.7% on quarter two 2025. The effective tax rate on adjusted net income in quarter two 2026 was 18.4%.
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Free cash flow was $238.9 million in the quarter. Cash generated from operating activities for the quarter was $281.3 million. During the quarter, $42.4 million was spent on capital expenditure. $7.4 million of Term Loan B payments were made during the quarter and there were net cash outflows on the disposal of a subsidiary undertaking of $55.5 million. At June 30, 2026, the Group had cash and cash equivalents of $928.4 million, compared to cash and cash equivalents of $765.2 million at March 31, 2026 and $390.4 million at June 30, 2025. Net debt as at June 30, 2026 was $2.5 billion. Year to date 2026 Results Gross business wins year to date were $6,944 million and cancellations were $945 million. This resulted in net business wins of $5,999 million and a book-to-bill of 1.46. Revenue year to date was $4,097.5 million. This represents a year on year increase of 1.1% or a decrease of 0.8% on a constant currencybasis. GAAP net income year to date was $177.3 million, resulting in $2.29 diluted earnings per share. Year to date adjusted net income was $391.3 million, resulting in an adjusted diluted earnings per share of $5.06 compared to $6.79 per share for the equivalent prior year period. Adjusted EBITDA year to date was $645.0 million or 15.7% of revenue, a year on year decrease of 20.9%. The effective tax rate on adjusted net income year to date was 17.8%. Conference Call Details ICON will hold a conference call on July 30, 2026 at 08:00 EDT [13:00 Ireland & UK]. This call and linked slide presentation can be accessed live from our website at http://investor.iconplc.com. A recording will also be available on the website for 90 days following the call. In addition, a calendar of company events, including upcoming conference presentations, is available on our website, under “Investors”. This calendar will be updated regularly. Other Information Cautionary Statement Regarding Forward-Looking Statements Statements included herein which are not historical facts are forward-looking statements. Such forward-looking statements are madepursuant to the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Examples of forward-looking statements include, but are not limited to, statements regarding the following: anticipated financial results for 2026; contracted revenue; the Company's expectations regarding business momentum, market opportunity, demand trends, growth, and commercial performance; and the Company's expectations with respect to its long-term value creation and competitive positioning. You can identify many forward- looking statements by words such as “aims,” “anticipates,” “believes,” “continues,” “could,” “estimates,” “expects,” “focused,” “guidance,” “intends,” “look,” “may,” “opportunities,” “plans,” “positions,” “potential,” “predicts,” “projects,” “seeks,” “should,” “will,” “would” and other similar expressions and the negatives of such expressions. However, not all forward-looking statements contain these words. These statements are based on management's current expectations and information currently available, including current economic and industry conditions. The forward-looking statements involve a number of risks and uncertainties and are subject to change at any time. In the event such risks or uncertainties materialize, our results could be materially adversely affected. The risks and uncertainties include, but are not limited to, dependence on the pharmaceutical industry and certain clients, the need to regularly win projects and then to execute them efficiently and correctly, the challenges presented by rapid growth, competition and the continuing consolidation of the industry, the impact of market conditions on demand for the Company's services, risks related to the Company's ability to execute on its commercial strategy and maintain relationships with large pharmaceutical customers, and risks relating to the Company's strategic partnerships, the dependence on certain key executives, changes in the regulatory environment, exchange rate fluctuations, inflation and rising labor costs. Please also refer to the section entitled "Risk Factors" of our Annual Report on Form 20-F for the year ended December 31, 2025 filed onMay 27, 2026 for a discussion of some of the principal risks that could adversely affect our business, operations and financial results. The Company’s forward-looking statements speak only as of the date of this report or as of the date they are made, and the Company undertakes no obligation to update its forward-looking statements. Non-GAAP Financial Measures In addition to the financial measures prepared in accordance with generally accepted accounting principles (GAAP), this press release contains certain non-GAAP financial measures, including adjusted EBITDA, adjusted net income and adjusted diluted earnings per share and free cash flow. Adjusted EBITDA excludes stock-based compensation, foreign currency gains and losses, restructuring, transaction, integration related and other adjustments, fair value movement on investments in equity, loss of disposal of subsidiary undertaking, goodwill impairment and impairment of non-financial assets. Adjusted net income and adjusted diluted earnings per share exclude amortization, stock-based compensation,
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foreign currency gains and losses, restructuring, transaction, integration related and other adjustments, transaction-related financing costs, fair value movement on investments in equity, goodwill impairment, impairment of non-financial assets, loss of disposal of subsidiary undertaking and their related taxation effect. Free cash flow reflects cash generated from operating activities less capital expenditure. While non-GAAP financial measures are not superior to or a substitute for the comparable GAAP measures, ICON believes certain non- GAAP information is useful to investors for historical comparison purposes. *Adjusted diluted earnings per share to exclude amortization, stock-based compensation, foreign currency gains and losses, restructuring, transaction, integration related and other adjustments, transaction-related financing costs, fair value movement on investments in equity, goodwill impairment, impairment of non-financial assets, loss on disposal of subsidiary undertaking and their related taxation effect. Our full-year 2026 guidance adjusted diluted earnings per share measures are provided on a non-GAAP basis without a reconciliation to the most directly comparable GAAP measure because the Company is unable to predict with a reasonable degree of certainty certain items contained in the measures without unreasonable efforts. For the same reasons, the Company is unable to address the probable significance of the unavailable information. ICON plc is a world-leading clinical research organization. Offering deep operational and medical expertise we accelerate innovation, driving emerging therapies forward to improve patient outcomes. From molecule to medicine, we deliver integrated consulting, clinical development, commercialization and post-marketing solutions to pharmaceutical, biotechnology, medical device, government and public health organizations worldwide. With headquarters in Dublin, Ireland, ICON employed approximately 40,200 employees in 99 locations in 55 countries as at June 30, 2026. For further information about ICON, visit: www.iconplc.com. Source: ICON plc Contact: Investor Relations +1 888 381 7923 Nigel Clerkin Chief Financial Officer +353 1 291 2000 Kate Haven Vice President Investor Relations +1 888 381 7923 All at ICON ICON/ICLR-F 3
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ICON plc CONSOLIDATED STATEMENTS OF OPERATIONS FOR THE THREE AND SIX MONTHS ENDED JUNE 30, 2026 AND JUNE 30, 2025 (UNAUDITED) Three Months Ended Six Months Ended June 30,2026 June 30,2025 June 30,2026 June 30,2025 (in thousands, except share and per share data) Revenue $ 2,063,486 $ 2,039,088 $ 4,097,485 $ 4,054,408 Costs and expenses: Direct costs 1,584,192 1,455,758 3,140,265 2,905,016 Selling, general and administrative 194,318 205,006 394,916 403,390 Depreciation and amortization 90,767 97,718 181,098 193,676 Transaction and integration related 2,529 6,717 5,716 12,121 Restructuring 20,904 42,950 30,980 82,296 Loss on disposal of subsidiary undertaking 32,947 — 32,947 — Total costs and expenses 1,925,657 1,808,149 3,785,922 3,596,499 Income from operations 137,829 230,939 311,563 457,909 Interest income 3,155 2,054 4,976 3,856 Interest expense (48,787) (50,151) (96,784) (97,760) Income before income tax (expense) / benefit 92,197 182,842 219,755 364,005 Income tax (expense) / benefit (19,615) 20,674 (42,422) 323 Net income $ 72,582 $ 203,516 $ 177,333 $ 364,328 Net income per ordinary share: Basic $ 0.94 $ 2.57 $ 2.31 $ 4.56 Diluted $ 0.94 $ 2.56 $ 2.29 $ 4.54 Weighted average number of ordinary shares outstanding: Basic 76,845,757 79,245,448 76,712,589 79,899,091 Diluted 77,371,396 79,547,444 77,316,605 80,235,900 4
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ICON plc CONSOLIDATED BALANCE SHEETS AS AT JUNE 30, 2026 AND DECEMBER 31, 2025 (Unaudited) (Audited) June 30,2026 December 31,2025 ASSETS (in thousands) Current assets: Cash and cash equivalents $ 928,385 $ 647,295 Accounts receivable, net of allowance for credit losses 1,458,354 1,474,898 Unbilled revenue 1,054,478 1,096,592 Other receivables 117,413 116,750 Prepayments and other current assets 114,811 105,316 Income taxes receivable 75,204 60,824 Total current assets $ 3,748,645 $ 3,501,675 Non-current assets: Property, plant and equipment, net 385,427 395,724 Goodwill 8,721,268 8,731,689 Intangible assets, net 3,146,498 3,247,118 Operating right-of-use assets 114,859 128,948 Other receivables 68,985 75,707 Deferred tax asset 107,409 106,871 Investments in equity 107,229 82,050 Total Assets $ 16,400,320 $ 16,269,782 LIABILITIES AND SHAREHOLDERS’ EQUITY Current liabilities: Accounts payable $ 118,238 $ 192,117 Unearned revenue 1,603,204 1,550,471 Other liabilities 916,522 904,826 Income taxes payable 16,939 18,999 Current bank credit lines, loan facilities and notes 1,279,762 529,762 Total current liabilities $ 3,934,665 $ 3,196,175 Non-current liabilities: Non-current bank credit lines, loan facilities and notes, net 2,110,783 2,872,616 Lease liabilities 102,790 117,122 Non-current other liabilities 77,674 72,807 Non-current income taxes payable 105,923 103,251 Deferred tax liability 690,323 714,427 Commitments and contingencies — — Total Liabilities $ 7,022,158 $ 7,076,398 Shareholders' Equity: Ordinary shares, par value 6 euro cents per share; 100,000,000 shares authorized, 77,154,209 shares issued and outstanding at June 30, 2026 and 76,567,325 shares issued and outstanding at December 31, 2025 6,346 6,305 Additional paid ‑ in capital 7,180,646 7,131,956 Other undenominated capital 1,606 1,606 Accumulated other comprehensive loss (109,820) (68,534) Retained earnings 2,299,384 2,122,051 Total Shareholders' Equity $ 9,378,162 $ 9,193,384 Total Liabilities and Shareholders' Equity $ 16,400,320 $ 16,269,782 5
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ICON plc CONSOLIDATED STATEMENTS OF CASH FLOWS FOR THE SIX MONTHS ENDED JUNE 30, 2026 AND JUNE 30, 2025 (UNAUDITED) Six Months Ended June 30,2026 June 30,2025 (in thousands) Cash flows provided by operating activities: Net income $ 177,333 $ 364,328 Adjustments to reconcile net income to net cash provided by operating activities: Depreciation and amortization expense 181,098 193,676 Impairment of operating right-of-use assets and related property, plant and equipment — 5,573 Reduction in carrying value of operating right-of-use assets 17,888 18,977 Loss on disposal of subsidiary undertaking 32,947 — Amortization of financing costs and debt discount 3,048 2,971 Stock compensation expense 46,030 27,610 Deferred tax benefit (26,142) (46,095) Unrealized foreign exchange movements (22,905) 34,777 Other non-cash items 5,048 15,266 Changes in operating assets and liabilities: Accounts receivable (46,728) 15,149 Unbilled revenue 34,981 (138,521) Unearned revenue 107,463 25,761 Other net assets (61,785) (105,031) Net cash provided by operating activities 448,276 414,441 Cash flows used in investing activities: Purchase of property, plant and equipment (73,193) (61,185) Purchase of subsidiary undertakings (net of cash acquired) — (2,537) Cash outflow on disposal of subsidiary undertaking (including cash sold) (55,513) — Proceeds from investments in equity 4,741 561 Purchase of investments in equity (23,809) (12,330) Net cash used in investing activities (147,774) (75,491) Cash flows used in financing activities: Debt issue costs (2,294) — Drawdown of credit lines and loan facilities — 50,000 Repayment of credit lines and loan facilities (14,881) (64,881) Proceeds from exercise of equity compensation 2,710 6,498 Share issue costs (9) (9) Repurchase of ordinary shares — (500,000) Share repurchase costs — (300) Net cash used in financing activities (14,474) (508,692) Effect of exchange rate movements on cash (4,938) 21,353 Net increase / (decrease) in cash and cash equivalents 281,090 (148,389) Cash and cash equivalents at beginning of period 647,295 538,785 Cash and cash equivalents at end of period $ 928,385 $ 390,396 6
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ICON plc RECONCILIATION OF NON-GAAP MEASURES FOR THE THREE MONTHS AND SIX MONTHS ENDED JUNE 30, 2026 AND JUNE 30, 2025 (UNAUDITED) Three Months Ended Six Months Ended June 30,2026 June 30,2025 June 30,2026 June 30,2025 (in thousands, except share and per share data) Adjusted EBITDA Net income $ 72,582 $ 203,516 $ 177,333 $ 364,328 Income tax expense / (benefit) 19,615 (20,674) 42,422 (323) Net interest expense 45,632 48,097 91,808 93,904 Depreciation and amortization 90,767 97,718 181,098 193,676 Stock-based compensation expense 19,436 15,433 46,418 27,727 Foreign currency losses / (gains), net 670 24,015 (7,705) 42,110 Restructuring 20,904 42,950 30,980 82,296 Transaction, integration related and other 24,693 6,717 56,060 12,121 Fair value movement on investments in equity — — (6,378) — Loss on disposal of subsidiary undertaking 32,947 — 32,947 — Adjusted EBITDA $ 327,246 $ 417,772 $ 644,983 $ 815,839 Adjusted net income and adjusted diluted net incomeper Ordinary Share Net income $ 72,582 $ 203,516 $ 177,333 $ 364,328 Income tax expense / (benefit) 19,615 (20,674) 42,422 (323) Amortization 50,108 59,057 100,387 118,003 Stock-based compensation expense 19,436 15,433 46,418 27,727 Foreign currency losses / (gains), net 670 24,015 (7,705) 42,110 Restructuring 20,904 42,950 30,980 82,296 Transaction, integration related and other 24,693 6,717 56,060 12,121 Transaction-related financing costs 2,182 1,506 3,701 2,971 Fair value movement on investments in equity — — (6,378) — Loss on disposal of subsidiary undertaking 32,947 — 32,947 — Adjusted tax expense (44,737) (52,206) (84,818) (104,147) Adjusted net income $ 198,400 $ 280,314 $ 391,347 $ 545,086 Diluted weighted average number of Ordinary Sharesoutstanding 77,371,396 79,547,444 77,316,605 80,235,900 Adjusted diluted net income per Ordinary Share $ 2.56 $ 3.52 $ 5.06 $ 6.79 (a) (b) (c) (d) (f) (g) (a) (b) (c) (d) (e) (f) (g) (h) 7
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(a) Stock-based compensation expense represents the amount of expense related to the Company’s equity compensation programs(inclusive of employer related taxes).(b) Foreign currency losses / (gains), net relates to gains or losses that arise in connection with the revaluation, or settlement, of non-US dollar denominated assets and liabilities. We exclude these gains and losses from adjusted EBITDA and adjusted net incomebecause fluctuations from period-to-period do not necessarily correspond to changes in our operating results.(c) Restructuring relates to charges incurred in connection with the Company's realignment of its workforce, with the elimination ofredundant positions as well as reviewing its global office footprint and optimizing its locations to best fit the requirements of theCompany.(d) Transaction, integration related and other costs include expenses associated with our acquisitions and any other costs incurredrelated to the integration of these acquisitions. Further, costs incurred in 2026 relating to the Investigation, including out of scopeaudit fees resulting from the impact of the investigation, and in defense of the Putative Class Action are classified within thiscategory.(e) Transaction-related financing costs includes costs incurred in connection with changes to our long-term debt and amortization offinancing fees. We exclude these costs from adjusted net income because they result from financing decisions rather than fromdecisions made related to our ongoing operations.(f) Fair value movement on investments in equity. We exclude these movements from adjusted EBITDA and adjusted net incomebecause fluctuations from period-to-period do not necessarily correspond to changes in our operating results.(g) On May 8, 2026, ICON completed the disposal of Symphony Health Solutions Corporation. The Company recognized a pre-taxloss on disposal, including transaction costs, of $32.9 million. This loss is excluded from adjusted EBITDA and adjusted netincome.(h) Represents the tax effect of adjusted pre-tax income at our estimated effective tax rate. ICON plc Contact: Investor Relations +1 888 381 7923 Nigel Clerkin Chief Financial Officer +353 1 291 2000 Kate Haven Vice President Investor Relations +1 888 381 7923 http://www.iconplc.com 8