Ladies and gentlemen, thank you for standing by. At this time, I would like to welcome everyone to the IQVIA first quarter 2022 earnings conference call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question-and-answer session. If you would like to ask a question during this time, simply press star followed by the number one on your telephone keypad. If you would like to withdraw your question, press the pound key. As a reminder, this call is being recorded. Thank you. I would now like to turn the call over to Nick Childs, Senior Vice President, Investor Relations and Corporate Communications. Mr. Childs, please begin the conference. Thank you. Good morning, everyone. Thank you for joining our first quarter 2022 earnings call. With me today are Ari Bousbib, Chairman and Chief Executive Officer, Ron Bruehlman, Executive Vice President and Chief Financial Officer, Eric Sherbet, Executive Vice President and General Counsel, Mike Fedock, Senior Vice President, Financial Planning and Analysis, and Brian Stengel, Associate Director, Investor Relations. Today, we will be referencing a presentation that will be visible during this call for those of you on our webcast. This presentation will also be available following this call in the Events and Presentation section of our IQVIA investor relations website at ir.iqvia.com. Before we begin, I would like to caution listeners that certain information discussed by management during this conference call will include forward-looking statements. Actual results will differ materially from those stated or implied by forward-looking statements due to risks and uncertainties associated with the company's business, which are discussed in the company's filing with the Securities and Exchange Commission, including our annual report on Form 10-K and subsequent SEC filings. In addition, we will discuss certain non-GAAP financial measures on this call, which should be considered a supplement to, and not a substitute for, financial measures prepared in accordance with GAAP. A reconciliation of these non-GAAP measures to the comparable GAAP measures is included in the press release and conference call presentation. I would now like to turn the call over to our Chairman and CEO, Ari Bousbib. Thank you, Nick, and good morning, everyone. Thank you for joining today to discuss our first quarter results. IQVIA had very strong financial results in the quarter, and that is despite the broader macro environment. On this note, regarding, first, the tragic situation in the Ukraine, our thoughts and concerns from the beginning have been around the safety and well-being of our employees, the patients we support, and all those affected by the ongoing events. We've been actively supporting our employees and their families on the ground with evacuation support, relocation services, and financial assistance. For example, we accelerated bonus payments and actually we continue to pay our employees there regardless of their ability to perform any work. In addition, IQVIA capabilities are being utilized to help support the resulting refugee crisis. For example, Ukrainian refugees are entering surrounding countries with medicines and prescriptions, and medical professionals in those countries are seeking to identify and convert product information on these prescriptions into their local equivalent. To help, we've established a free online service for medical professionals to search a product name, active ingredients and strength, and the tool generates a list of matching products in whichever the local country around Ukraine is. Also, we've been working very closely with our customers, suppliers, and clinical sites across the region to ensure continuity of our in-flight clinical trials. Ensure, of course, that our clients are able to continue to support the effective delivery of medicines to vulnerable patients in the region who depend on these medicines. In Ukraine, we're providing support to ensure that trial patients who have begun receiving treatment remain on their treatment protocols. We've established direct-to-patient shipments of investigational medical products and patient call centers in order to ensure patient care can continue. In Russia, we are guided by ethical concerns to ensure the safety of patients already enrolled in clinical trials. We are utilizing our global logistics and procurement infrastructure to facilitate the movement of investigational medical products, lab kits, and samples into and out of the country to minimize potential adverse impacts to patient care. For studies that are in start-up or early phase in both countries, we are redirecting patient recruitment to other countries based on consultations with our customers. Even though a little less than 1% of our overall revenue and approximately 3% of our global patient recruitment come from Ukraine and Russia, the operational disruptions I just described will have some financial impact, which we have incorporated into our updated guidance. Now, another key focus area for investors in the quarter, as you well know, has been the emerging biopharma funding environment. We've received a number of questions on this topic since our earnings release in February, and we have addressed those in multiple forums. However, there have been some lingering questions on the same topic, and I want to take this opportunity once again to reiterate our comments with a specific focus, A, on the funding environment and B, on our own company's exposure to this EBP segment. I'll start by stating that the concern about EBP funding environment is overstated. I want to support the assertion with four key points. Number one, the industry has observed a slowdown in public funding compared to the record levels seen in 2020 and 2021. The private venture capital markets have continued to be strong, and funding in the first quarter of 2022 was the third-highest ever according to the National Venture Capital Association. I will also observe that these EBP firms are sitting on large amounts of cash from the very strong funding cycles in 2020 and 2021. Number two, when there is a reduction in EBP funding or the IPO market contracts, mid and large pharma companies often step up their acquisition activities of EBP companies. Frankly, that benefits us as we have longstanding relationships with these customers. In fact, you may have seen the recent acquisition of Checkmate Pharmaceuticals by Regeneron, which illustrates this very point. Number three, history tells us that when EBP funding slows, it does not have a significant effect on our business. For example, following the last EBP funding slowdown in 2015, 2016, our IQVIA Biotech unit saw no interruption in net new business and revenue growth, nor any unusual increase in cancellations. Finally, number four, when we look at either our pipeline or RFP activity, we have simply not seen any slowdown. No unusual cancellation activity. No unusual delays in decision-making. In fact, in the quarter, our overall R&DS RFP dollars were up 13% year-over-year, and RFP dollars from EBP were up over 16%. The broader industry continues to show strength. We are seeing clinical trial starts up 7% in the first quarter compared to last year, with a 14% increase in oncology trial starts, which is a therapeutic area, as you well know, that's predominantly sponsored by EBPs. Now, let me focus on our own exposure to this segment, specifically pre-commercial EBPs, which are those EBPs that have zero revenue and are the most vulnerable and exposed to the funding environment. Here I want to make another four points. Number one, as of March 31st, pre-commercial EBPs represented just over 10% of our total R&DS backlog. Number two, less than 7% of our overall RFP dollars in the quarter came from pre-commercial EBPs. Number three, this exposure to pre-commercial EBP for IQVIA is not only minimal, but also I want to point out and underline that our vetting process for taking on a pre-commercial EBP is extremely rigorous and thorough. The process includes, for example, a review of the client's cash balances, payment history, viability and quality of their science, and of course, progress with clinical development. Again, said differently, not every EBP who knocks at our door with a molecule that they think is interesting makes it into our backlog. Number four, I will simply remind you that this exposure primarily impacts our R&DS segment. Approximately 45% of IQVIA's total company revenue comes from our commercial businesses. As you know, there is virtually zero pre-commercial EDC exposure on the commercial side. With those comments as background, let me now delve into the first quarter results. Revenue for the first quarter grew 4.7% on a reported basis and 6.8% at constant currency. The $23 million beat above the midpoint of our guidance range was driven by strong operational performance across all three segments, and that was of course, partially offset by foreign exchange headwinds. Compared to prior year and excluding COVID-related work for both years, our core businesses grew about 13% at constant currency on an organic basis. Ron will provide additional detail in his remarks, including COVID-adjusted numbers for each of our three segments. First quarter adjusted EBITDA grew 9.1%, reflecting our revenue growth as well as ongoing productivity initiatives. First quarter adjusted diluted EPS of $2.47 grew 13.3%. That was 4% above the midpoint of our guide, which is with about 3 cents of the beat coming from operational improvements. I provide an update on the business, and let's start with the commercial and technology side. We've spoken before and you're familiar with IQVIA's Connected Intelligence framework, which leverages our advanced analytics technology and domain expertise across the entire clinical and commercial portfolio, and has been critical in supporting the emerging needs of the pharma industry. I want to give a recent example of how these capabilities are being deployed. In the quarter, we entered into a multi-year agreement with argenx for the development and commercialization of new indications for their rare disease product currently approved for treatment of a rare autoimmune disorder affecting the muscles. Our collaboration with argenx incorporates IQVIA's Connected Intelligence to support clinical development, real-world evidence, regulatory and commercial support to accelerate the development of this product for potential treatment of other severe autoimmune diseases and to expand globally. It's an exciting new product with a lot of upside potential. It's currently approved to treat six indications, has the potential for up to 15 indications, plus this drug has already been launched in the U.S. And has plans to launch in Europe and in Japan in the next year. Another example of a client selecting IQVIA's integrated capabilities to solve complex problems is Ferrer. A European pharma client recently selected IQVIA's Vigilance Platform and regulatory information management technology. This is an area that's a real headache for our clients, and our technology solutions simplify and streamline their processes. Ferrer will benefit from our technology's integrated AI ML capabilities, automation of labor-heavy activities, and easy implementation. To date, over 150 clients have adopted one or more solutions within our safety, regulatory, and quality suite of technologies. In real-world evidence, I'm sure you've seen that we were selected to support DARWIN EU, or Data Analysis and Real World Interrogation Network. DARWIN EU is a strategic initiative of the EMA. This is a major win for IQVIA as it draws on our proprietary technologies, methods, and deep scientific and operational expertise. It will help us deepen our relationship with healthcare providers and sites across Europe. Moving to clinical technology, IQVIA continues to lead the industry in decentralized clinical trials. Our end-to-end solution of integrated technology and services capabilities are being utilized on just over 1/3 of our full service trials globally. To date, we've recruited over 300,000 patients across 80 countries, covering over 30 indications. Now, whether for traditional or decentralized trials, demand for our suite of digital clinical technology offerings continued to increase in the first quarter. To date, over 400 clients have adopted one or more modules within our Orchestrated Clinical Technology Suite since launch. One of these key modules, for example, is our clinical trial payment solution. This technology ensures accurate, timely, and transparent investigator payment processing. It's a key driver of both site and sponsor satisfaction. All of the top 10 and 25 of the top 30 pharma clients have now selected IQVIA's payment technology solution for their trials. This includes a major award in the quarter with a top 10 sponsor to migrate their entire payment ecosystem across several legacy platforms to our technology. The scale of this technology migration is the largest of its kind in the industry, and it encompasses 120 clinical studies across all phases with over 6,000 sites globally. Beyond these client highlights, our overall R&DS business continued to see strong momentum in the quarter, delivering over $2.5 billion of net new business, including pass-throughs. This included a record quarter of over $1.9 billion of services bookings. Resulting in a first quarter contracted net book-to-bill ratio of 1.32, excluding pass-throughs, and 1.31 including pass-throughs. Over the last 12 months, our contracted net book-to-bill ratio was 1.33, excluding pass-through, and 1.32, including pass-through. Our contracted backlog in R&DS grew 9.1% year-over-year to a record $25.3 billion as of March 31, 2022. As a result, our next 12 months revenue from backlog increased to over $7 billion, growing 8% from a year ago. As you can see, there is a lot of strong positive momentum across the business regardless of the choppy macro environment. On a final note, IQVIA was named the top CRO in overall reputation by clinical trial sites around the world in the 2021 CenterWatch Global Site Benchmark Survey. This is a big deal for us. This is a rigorous and independent survey that is highly respected in the industry. Over 60,000 investigators, trial coordinators, research nurses, and other clinical professionals representing clinical trial sites from around the world were asked to rank and score 29 CROs across 35 performance-related attributes. We're proud to have been selected and named the top CRO in overall reputation, but specifically, we received high marks, especially high marks for our comprehensive decentralized trials, direct-to-patient recruitment, and therapeutic, clinical, regulatory, and technology expertise. I will now turn it over to Ron for more details on our financial performance. Ron? Thanks, Ari, and good morning, everyone. Let's start by reviewing revenue. First quarter revenue of $3.568 billion grew 4.7% on a reported basis and 6.8% at constant currency. In the quarter, COVID-related revenues were approximately $375 million, which was down about 35% versus the first quarter of 2021. In our base business, that is excluding all COVID-related work from both this year and last, organic growth at constant currency was about 13%. Technology & Analytics Solutions revenue for the first quarter was $1.439 billion, which was up 6.8% reported and 9.8% at constant currency. Excluding all COVID-related work, organic growth at constant currency in Technology & Analytics Solutions was just over 10%. R&DS first quarter revenue of $1.934 billion was up 3.5% at actual FX rates and 4.7% at constant currency. Again, excluding all COVID-related work, organic growth at constant currency in R&DS was approximately 17%, which was consistent with our expectations. Contract sales and medical solutions or CSMS first quarter revenue of $195 million grew 1% reported and 5.7% at constant currency. Excluding all COVID-related work, organic growth at constant currency in CSMS was mid-single digits. Okay, let's move down to P&L now. Adjusted EBITDA was $812 million for the first quarter, which represented growth of 9.1% on a reported basis. First quarter GAAP net income was $325 million. That was up 53.3% year-over-year, and GAAP diluted earnings per share was $1.68, up 54.1% year-over-year. Adjusted net income was $477 million for the quarter, up 12.2% year-over-year, and adjusted diluted earnings per share grew 13.3% to $2.47. Now, as Ari reviewed, R&D Solutions delivered yet another outstanding quarter of net new business. Our backlog at March 31 stood at a record $25.3 billion, an increase of 9.1% year-over-year. Next 12 months revenue from backlog increased 8% year-over-year to just over $7 billion. I would note that both the backlog and next twelve months revenue numbers I just quoted were affected by FX rates at quarter end. That is to say they were lower than they otherwise would have been due to the strengthening of the dollar during the quarter. Okay, moving now to the balance sheet. First quarter cash flow from operations was $508 million, and CapEx was $177 million. That resulted in free cash flow of $331 million. As a reminder, our free cash flow in the first quarter of each year is affected by the timing of annual bonus payments. At March 31, cash and cash equivalents total $1.387 billion, and gross debt was $12.637 billion, which resulted in net debt of $11.25 billion. Our net leverage ratio at March 31 was 3.64 times trailing 12 month adjusted EBITDA. In the quarter, we repurchased $403 million of our shares, which leaves us with slightly over $2.1 billion of share repurchase authorizations remaining under the current program. I'll update the guidance. For the full year 2022, our expectation remains unchanged that organic revenue growth, excluding COVID-related work, will be low- to mid-teens% at constant currency. Since February, FX fluctuations have caused an incremental full-year revenue headwind of over $200 million as of yesterday's rates. In addition, we currently estimate the revenue disruption from the Russia-Ukraine crisis to be in the $40 million-$50 million range. Accordingly, we're updating our revenue guidance range to reflect these two factors. For the full year, we now expect revenue to be between $14.45 billion and $14.75 billion, which represents year-over-year growth at 6.9%-9% at constant currency and 4.2%-6.3% reported both compared to 2021. Now, as a reminder, in the revenue guidance we provided in our Q4 call in February, we absorbed a $70 million FX headwind versus the initial guidance we provided our analyst and investor conference in November. Our projected revenue growth includes just over 150 basis points of contribution from M&A activity. Now, despite the macro factors that affected our revenue guidance, we're reaffirming our full-year 2022 adjusted EBITDA and adjusted EPS guidance ranges that we provided on our fourth quarter 2021 earnings call. This includes absorbing the earnings impact of lost revenue in Russia and Ukraine, as well as the costs that remain there, such as salaries and assistance provided to employees. Accordingly, we continue to expect adjusted EBITDA to be between $3.33 billion and $3.405 billion, representing year-over-year growth of 10.2%-12.7%. We continue to expect adjusted diluted EPS to be between $9.95 and $10.25, or year-over-year growth at 10.2%-13.5%. Now our full year 2022 guidance ranges assume that foreign currency rates as of yesterday, April 26, remain in effect for the balance of the year. Moving on to second quarter guidance, I'll remind you that the first half of last year represented our peak for COVID-related revenues, and as a result of that, the second quarter should be the toughest year-over-year compare in terms of revenues. For the second quarter, revenue is expected to be between $3.47 billion and $3.52 billion, representing growth of 4.6%-6% on a constant currency basis and 0.9%-2.4% on a reported basis. Excluding COVID-related work, we expect organic revenue growth at constant currency to be in the low to mid-teens, consistent with what we had in Q1 actuals and our projected full-year revenue growth. Adjusted EBITDA is expected to be between $790 million and $805 million, up 9.4%-11.5%. Adjusted diluted EPS is expected to be between $2.35 and $2.42, growing 10.3%-13.6%. To summarize, we delivered very strong first quarter results on both the top and bottom line against what had been a very strong first quarter of 2021. Our base business maintained low teens organic growth at constant currency, excluding COVID-related work, with double-digit growth on this basis in both CAS and R&DS. Our R&DS business recorded its largest-ever quarter of service bookings. Contracted backlog exceeded $25 billion for the first time, rising over 9% year-over-year, with over $7 billion expected to convert to revenue over the next 12 months. We maintained our net leverage ratio at 3.6x 12-month adjusted EBITDA on a trailing basis. Finally, and most importantly, despite the turmoil around us, we remain very confident in our outlook and accordingly have maintained our full-year 2022 profit guidance. With that, let me hand it back over to the operator for our Q&A session. At this time, if you would like to ask a question, press star, then the number one on your telephone keypad. We'll pause for just a moment to compile the Q&A roster. Your first question comes from the line of Eric Coldwell from Baird. Your line is open. Please ask your question. Thanks very much. Good morning. Two quick ones, both on geography. First, with Russia-Ukraine. I'm sorry if I missed it, but could you tell us the impact in Q1 and then how the $40 million-$50 million of annual impact is phased through the year? I guess I would assume the majority of that or a significant portion is in 2Q. But we'd love to get your sense on how you phase that $40 million-$50 million projected impact. Secondarily, early in the pandemic, IQVIA was the first and perhaps most vocal company to talk about the impact of China and Asia Pac when COVID first broke out. Obviously, a lot of conversation these days on the rolling lockdowns in China. I'd love to get an update on what you're seeing from the impact in that market and how you're operating across that region, given the governmental actions ongoing today. Thanks very much. Thank you. Good morning, Eric, and thanks for your questions. On the first one, Ukraine. Look, Ukraine, Russia is like what not even 1% or about 1% of our revenue. A little less. A little less. So call it $130 million-$140 million, let's say. Obviously, there's been significant displacement and work that cannot be done primarily in R&DS. I might point out some of that may come back. Some of the trial work obviously needs to continue and will be delayed. It just takes time and because of the disruption. You wanna answer specifically the question on how much per quarter? We said it's we size it at $40 million-$50 million, like. It's less than a proportionate impact in Q1, obviously, because the conflict didn't start until late February. We had $a few million of impact in Q1. Not a huge impact. You're right, Eric, that it's probably that $40 million-$50 million is probably front-end loaded in the year because we should recapture a little bit as we get late in the year and we start shifting work. That always takes longer than you think it's gonna take. You know, we're not assuming a huge recovery of work in 2022. Ultimately, as we find new patients and move the clinical trial activity outside of Russia and Ukraine, we should recover a lot of that. You know, probably by back end of the year or early next. Now with respect to China, just to situate the conversation, China is about 2.5% of our global revenues. Yes. That's about 50/50 R&DS and commercial. Now to take the commercial side first, we saw virtually no impact, even at the worst of the COVID crisis when everything was shut down in China on our commercial business. Obviously, some of the business that requires some face-to-face interactions like PMR, consulting and so on, obviously went to zero. The rest of the business, the technology, the analytics, services continued pretty much intact. We have no concerns there. On the R&DS, the obvious concern, if there were lockdowns is, our ability to access sites. Now, right now, it's a fluid situation. We're tracking closely what's happening on the ground. We're seeing some disruption to site access and patient visits, again, mostly in Shanghai 'cause that's where the lockdown has been limited to so far. It's hard to imagine that these are going to be prolonged for a very long time or expand throughout China. Again, no one can tell. That's where we are. We again, you know, we are relatively confident, you know, outside China that when these things happen now, we've learned how to deal with it with our remote capabilities and, you know, our accelerated development of decentralized trials, et cetera. We've become more adept and we are prepared, you know, to address those situations. We believe the same will be true if, God forbid, in China, the situation were to deteriorate. Frankly, at this point, we haven't seen much. Again, it's the minimum and we haven't taken any adjustments or anything like that in our forecast for China. Any other comments, guys? Okay. Okay. Thank you, Eric. Thank you very much. Your next question comes from the line of Shlomo Rosenbaum from Stifel. Your line is open. Please ask your question. Hi. Thank you very much for taking my questions. Quick question just is the year's revenue and profitability pacing the way that you expected as you entered the year? I mean, obviously, you know, a little bit of change with Russia and stuff like that. I just you know, the second quarter guidance is a little bit lower than what the Street expected. Obviously, the Street doesn't have the insight into the pacing that you guys have at that level of detail, and it could be that we just didn't get the same, you know, kind of COVID headwind roll-off year-over-year. I just want to, you know, kind of start with that question, then I have one follow-up. Well, Shlomo, thank you for your question. Good morning. Look, I think Ron mentioned in his introductory remarks that last year's first half included the highest, the peak revenues from COVID. The second quarter will be the toughest compare year-over-year with COVID in. Like, the biggest step down year-over-year of COVID revenue will be in the second quarter. That's one factor. Secondly, on a reported basis, if you look at again, assuming FX rates remain where they are for the balance of the year, the worst comparisons year-over-year in terms of FX impact are in the second quarter, okay? The underlying businesses, you know, when you take this out, COVID and FX, you guys help me out with the numbers here. Second quarter is consistent. Yeah. With the rest of the. Very consistent. Yeah. That's why we're giving you ex-COVID constant currency organic because that cleans out a lot of the items that cause the volatility that you're seeing. Really across the quarters of 2022, when you look at it on that base, it's very consistent growth rate. Right. I mean, in total, as I can tell you, what's built in our forecast and reflected in our guidance is constant currency organic growth, excluding COVID related work, will be high single digits. Very consistent again with the first quarter. R&DS constant currency organic growth excluding COVID related work will be upper teens and CSMS will be low single digits excluding COVID related work at again constant currency organic growth. You're right on a reported basis, the number and with the actual COVID work included, it looks a little choppy sequentially, but the reality is the underlying base business is pretty consistent and pretty strong. Okay, cool. Great. Yeah. The other thing I would say, Shlomo, that's, you know, pretty much in line with our guidance that we gave. I mean, you know, the linearity and how it's progressing over the quarter is exactly what we were expecting. Okay, perfect. This is another one for you, Ari, just you have a really good history of being aggressive on share repurchases when the stock dips, and the stock has pulled back a lot. It's you know, at the Analyst Day, you communicated being you know. Just you know, actually more recently of having a lower leverage target and for a longer period of time. Would you consider taking up the leverage to take advantage of the stock price, given the fact that it seems like the trends in the business really haven't changed despite the changes in the stock price? Well, look, my personal inclination would be to do that, but frankly, we're not gonna do that. We can buy. You know, thankfully. You know, there's a third factor in what you're articulating, which is our cash flow generation. As you've seen, it's been pretty strong. That allows us, you know, more flexibility and affords us the ability to do both. That is to maintain a lower leverage ratio and aggressively pursue share repurchases. You saw we bought over $400 million in the first quarter. You know, frankly, you know, there are time windows where we cannot buy. You know, we reported earnings, I think in February 15th, and then we approach the end of the quarter, so we don't have a lot of time. now we're already April 27. Yes, you can expect that we will be in the market, you know, at this level or at any level, frankly. Again, the answer to your question is, yes, we will do aggressive share repurchases, but no, we will not increase the leverage ratio. Okay, thank you. Your next question comes from the line of Jack Meehan from Nephron Research. Your line is open. Please ask your question. Thank you and good morning. You know, one of the big debates for the CRO industry has also been labor. How did your wage and turnover trends compare versus prior periods? Can you just comment on how you're managing through that? Yeah. Well, look, it's interesting. We obviously experiencing the same trend that we've talked about before, which is given the strength of the industry backdrop, there's obviously competition for talent. We are really actively recruiting and hiring to meet the incremental demand. We also saw, like the rest of the industry, attrition you know pick up towards the end. I think it has stabilized, I would say, over the past few weeks. We track this very carefully. I look at it on a weekly basis. It seems to have kind of plateaued and these attrition levels have plateaued and maybe even start to come down a little bit. Look, we have approximately 82,000 employees, and we recruit thousands of employees a year. We do have the talent acquisition capabilities to be able to meet these increased demands. You know, back to the Ukraine situation, we are actually looking now at you know repositioning individuals from these countries, Russia and also Ukraine, in different geographies and utilize them in other places. You know, it we are really literally our global footprint allows us a little bit more initiative. We are seeing some margin pressure from labor cost increases, but you know, as we have the flexibility again because of our global footprint to do some arbitrage and moving things around the world to optimize our cost structure. That's part of our DNA. You know, we are continuing. That's what we do day in, day out, productivity initiatives and cost optimization actions. Look, we've also increased rate cards on existing RFPs, and we are looking for ways to pass along some of those cost increases into pricing where we can. The combination of all of that, obviously this is easier to do. The pricing lever is easier on short cycle businesses than on the longer cycle businesses where we've already, you know, priced in some price escalations, but that they don't always reflect the wage inflation that we actually see in the market. Again, the combination of all of these levers allows us to manage that situation fairly effectively. By the way, all these cost pressures that we're talking about are already factored in our guidance. Also, what I wanna point out, I mean, maybe that's, I don't know if I should say this or not, but, you know, we paid in aggregate the highest ever dollar level of bonuses for 2021 to our employee population. In aggregate, we continued to pay, I would say at a very respectable and high level, bonuses to our employees even during the worst of the pandemic. I think we've seen in our employee surveys, which we do very frequently, higher and higher satisfaction levels and loyalty to our company. You know, my understanding is not every one of our peers has done that. In fact, we know specifically of a peer that has paid zero or very little bonuses last year. You know, that also has created some employee exodus at some other peer companies, and we're benefiting from that as well. You know, it's a complex situation. Wages are going up, there is attrition and so on and so forth, but there are a lot of moving parts here, including competitive ones, and we feel confident that we can address these issues without changing anything in our guidance. Thanks for your question. Your next question comes from the line of John Sourbeer from UBS. Your line is open. Please ask your question. Hi, thanks for taking my question. I was wondering if you could just talk a little bit on the real-world evidence business growth in the quarter. You know, is this still gonna be a double-digit grower this year, even if maybe some of the COVID work going away throughout the year? Okay. Well, look, real-world evidence, we saw strong growth. You saw that in TAS in general, organic constant currency revenue growth, excluding COVID, was just over 10% in aggregate. The high growth segments, as you point out, are real-world evidence and of course, as you all know, commercial tech, which continue to be strong drivers of growth. I gave several examples, specific class examples of how in the commercial world and technology space and real-world evidence, we are utilizing our unique capabilities. You know, real-world evidence is, you know, do we disclose the numbers here or not? I mean, I can say it continues to be a. High teens. High-teens growth driver excluding any COVID impact. You know. Yeah. You know, the numbers we've been giving for real world have excluded that from the beginning. That business has been consistently in the high to upper teen growth rates and, you know, we see that continuing. Yeah, yeah, exactly, John. We see that continuing to your last question with good outlook. Look, with respect to the COVID step down in revenue, which we've been talking about for a while now, you know, we've always said during the height of the pandemic, that and it's true for real world, it's true for commercial, and certainly it's R&DS business. COVID was essentially crowded out the rest of the business. Refocused their dollars on COVID, whether it's vaccines or therapeutics or what have you, government work to track and monitor COVID patients, et cetera. They turned to us. As you know, we had a very strong in the market appropriately. The concerns that some of you had expressed at the time is, well, when that goes away, then what happens? Well, we told that when that would go away, the base business would come back because we knew that there were a lot of projects that had been essential and that there was a lot of pent-up demand that needed to be addressed. That's exactly what is happening. It's true certainly in R&DS. Thank you. Thanks. Oh, and then just maybe one follow-up. You know, as you're approaching around that 3.5x levered, any thoughts on M&A and, you know, what areas or potential businesses would you be looking at if there were to be deals? Well, look, we always said, you know, we've done and that's been consistent, by the way. You can look at our record is between one and two points of our revenue for the long term has been supplementing our organic growth. We make acquisitions within our core businesses, strategic and add capabilities or allow us to enter adjacent markets where we think we can add value. Have walked away. We do walk away from, I wanna say 90%+ of the companies we look at in the market. I mean, I always felt that valuations were very frothy and that we did not want to. We did not want to pay for assets more than what they were worth. Unfortunately, for those who did, you know, you now find yourself taking a beating. Now, you know, you've got a lot of private equity-owned businesses that are very attractive that we would like to buy. The entry point for those current owners at the time they did the acquisition was very high. I just don't know how that. It's gonna take time. I'm not suggesting that, you know, we are gonna. If we were always cautious, we are gonna continue to be cautious. Now, we will step up to the plate when the acquisition is extremely attractive, extremely accretive to our operations and our financials. You know, we've done that in the quarter. Actually, we bought a significant lab business, which is very attractive. I believe that's the bulk of our acquisition spend. Is that Yeah, that's correct. Yeah. We like very much the lab business. As we discussed before, these are very strong and necessary capabilities, and our lab business has been doing spectacular. We obviously look at CROs when they come up, but again, the valuation premiums on those assets have been out of reach for us. On the commercial side, we've bought technology companies, and we will continue to look at the digital space. We've got, as you know, a strong interest in growing, in continuing to grow on the commercial side. The commercial side is becoming increasingly sophisticated with the go-to-market strategies of our clients becoming a lot more akin to how, you know, larger consumer-oriented businesses look at the world with much better. You know, you see what our OCE suite, our OCE ecosystem does with a lot of embedded intelligence. It's no longer. We're not talking about a simple CRM point solution, as is the case for most of the competition. Our system is an ongoing live, you know, with sophisticated AI analytics that enable the users to make decisions on a timely basis with respect to targeting the right customer at the right time with the right message. Anything that complements or advances our position in the US digital and European digital commercial spaces where it's most advanced, we will look at, and we will be aggressive enough to enter those spaces and complement our capabilities. That's what this, you know, I just gave you my overall strategic panorama here in terms of acquisitions. Thanks for taking the questions. Your next question comes from the line of Luke Sergott from Barclays. Your line is open. Please ask your question. Morning, thanks for the question here. Just a couple cleanups. On the COVID step-down in 2Q, can you remind us, I might have missed this one. Can you remind us what you guys did in 2Q last year, and by the segments, just so we have an idea how that paces out? We had a combination of projects. In the TAS segment, you recall we did a lot of government work, which is stepping down as we go through this year. In the R&DS segment, we were working on some mega COVID vaccine studies and safety monitoring work and also therapeutics. You know, we were involved in hundreds of different COVID-related projects. Are you asking what type of work were we doing? Or. No, no. Yeah, what type of work? Just the revenue. Members. I'm just trying to get a sense. I don't know if I missed it. I think that's for the numbers. Yeah. Yeah. The numbers like I told you was, we did about $375 million in. Now, you're talking in Q2 or Q1 now? Q2 last year. I'm just trying to get a sense of the step-down 'cause you have a whole $1 billion coming off, right? Well, look, Q2 was the highest last year, and you can infer from the numbers we gave you on the conference call what Q1 was last year, which was. Mm-hmm. You know, over $550 million, and Q2 was slightly larger than that last year. That's helpful. You did the math. That's exactly what I was looking for. All right. Something here a little more strategic as you think about it. I mean, when Ari, when you guys came on, after the merger, you started going after the fat tails of biotech, right? And going after all the bookings. Now when you're getting up to, you know, record booking levels, 1.9+, are you guys at capacity of what your business can handle? I guess it's more of a sense of it. I understand it's hard just to add additional bodies given the tight labor market. Give us a sense of the type of work you're now taking on, how that's changed, and if we should expect, you know, the overall bookings to continue to climb or if this is kind of peak at your capacity right now? Well, first of all, look, capacity always, you know, is people-driven in this business, as you know. I would say, you know, if anything, certainly since the merger, our ability to take on more work with the same amount of people has increased significantly. Because of our decentralized clinical trials capabilities. The increase in technology content, in data analytics, in you know, process improvements that we've done since the merger is really dramatic. Our ability to take on more work with the same amount of people is significantly enhanced. I don't see, frankly, us turning away work, because somehow we don't have the capacity. We just don't do that. Again, with the minor exception of what I described before in my introductory comments, for pre-commercial EBPs that knock at our door for assistance, you know, and that don't qualify based on our rigorous vetting process. With that minor exception, we are able, willing, eager to take on any and all work. Certainly, I hope that we continue, you know, assuming the underlying dynamics of the market continue to grow, which is, I think, a very, very valuable assumption and a completely conservative expectation. Assuming that we continue to gain market share, which is also, I think, a conservative expectation, you should expect our bookings to continue to grow over the long term, no question about it. All right, great. Thanks. Thank you. Your next question comes from the line of Patrick Donnelly from Citi. Your line is open. Please ask your question. Hey, guys. Thanks for taking the questions. Ari, you know, I just wanted to circle back on EBP, a really helpful commentary during the script. I mean, it sounds like even if you did see some softening, your business is diversified enough where the impact would be pretty negligible, but to date, you haven't seen anything. Just to clean up, I guess, why you wouldn't be seeing it versus, you know, some competitors like the one yesterday who called it out. You know, is that coming down to your vetting process, you're maybe not taking on higher risk trials that others are? Do you think it comes down to kind of that process internally? Look, I don't know. I'm not gonna speak for other competitors. Obviously, people in the industry know or have knowledge of what their peers focus on in terms of market segments. Look, from the beginning of this merger, we said we were going to be a lot more thorough in terms of what gets into our backlog. If you recall, we switched from awarded business, quote-unquote, to contracted business. We became a lot more rigorous in terms of you know, the specific booking analytics. I mean, again, I certainly hope we will never, ever hear from us, God forbid, that we are making an adjustment to our bookings because we had you know, some kind of some meteorite came from the cosmos and hit our backlog. You haven't heard that from us, quite the opposite. You know, we tell you what the numbers are, and those numbers are, you know, thoroughly and rigorously scrubbed. As I repeat, we're not gonna take. You know, there are many, believe me, there are many clients that call or companies that call or venture VC firms or, there are a lot of, there's a lot of biotech stuff all over the world, with high hopes, and they'd love to have us help them and support them. They sometimes even want to leverage the fact that they are supported by IQVIA in order to raise money. Of course, we just don't do that. That's not our business. You know, there could be. You know, it is often the case that an EBP at a very early stage with one molecule and high hopes and a nice looking management team go around raising money, and they come in with, you know, at least an assertion that there is a CRO already involved and that has vetted their scientific basis, et cetera. The more credible the CRO, the better chances they have of raising money. Now, we don't do that. Simple. Others do. There are significant differences between how we book business. Someone asked earlier about capacity, and I said there is not going to be a capacity issue for us. Look, it's not like we are desperate for business. We have business, so we're not gonna take on anybody. I think that may be one difference, and it's a market segment focus. You have, Mike, you have any other comments to make? Yeah. Yeah, thanks. I was just to build on Ari's comments. You know, in addition to the vetting on both the financial and scientific basis, the nature of work that we typically take in is in the later stage clinical timeframe, whereby there's a lot more, I think, you know, historical data versus whether you're dealing in EBPs mainly in the preclinical or first in human space. I think that's another benefit to the strategy that Ari just mentioned. Thank you. That's very important. Yeah. No, that's really helpful. Appreciate it. I think. Your first comment, frankly, was the right one, which is it's a very small part of our overall business, our overall company. Right. Understood. Just a quick one, Ari, on the pricing environment. You know, what are you seeing there? I know that's a concern as biotech falls off, maybe pricing softens. It sounds like you guys still have nice power there. And on the back of that, any delay in terms of getting reimbursed on some of the shifting trials in Russia, Ukraine? Just wondering, as you put in a change order, is there near term margin pressure that then alleviates as you go through the year and get reimbursed? Just trying to figure that piece out as well. Thank you. Yes, of course. Again, it's a small piece of the overall, and we are absorbing that cost. You know, we haven't changed our profit outlook and we're not planning to do that. For now, there's no reason to do that. We can absorb it. We have enough initiatives. We are large enough, diversified enough that we can handle the Russia-Ukraine situation and disruption on our clinical trials, you know, so long as it, you know, that it is what it is now. Okay. Thank you, Patrick. Thank you all for joining us today. We look forward to speaking to you again on our next earnings call. Myself and the team will be available for the rest of the day for any follow-up questions, so feel free to reach out. We look forward to talking to everyone again soon. Thank you. This concludes today's conference call. Thank you for participating. You may now disconnect.