Good day, ladies and gentlemen, and welcome to the Medpace First Quarter 2025 earnings conference call. At this time, all participants are in the listen-only mode. After the speaker's remarks, there will be a question-and-answer session. If you would like to ask a question, please press star one one on your phone. If your question has been answered and you'd like to remove yourself from the queue, simply press star one one again. As a reminder, this call is being recorded. I would now like to introduce your host for today's conference call, Lauren Morris, Medpace's Director of Investor Relations. You may begin. Good morning, and thank you for joining Medpace's First Quarter 2025 earnings conference call. Also on the call today is our CEO, August Troendle, our President, Jesse Geiger, and our CFO, Kevin Brady. Before we begin, I would like to remind you that our remarks and responses to your questions during this teleconference may include forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These statements involve inherent assumptions with known and unknown risks and uncertainties, as well as other important factors that could cause actual results to differ materially from our current expectations. These factors are discussed in our Form 10-K and other filings with the SEC. Please note that we assume no obligation to update forward-looking statements even if estimates change. Accordingly, you should not rely on any of today's forward-looking statements as representing our views as of any date after today. During this call, we will also be referring to certain non-GAAP financial measures. These non-GAAP measures are not superior to or replacement for the comparable GAAP measures, but we believe these measures help investors gain a more complete understanding of results. A reconciliation of such non-GAAP financial measures to the most directly comparable GAAP measures is available in the earnings press release and earnings call presentation slides provided in connection with today's call. The slides are available in the Investor Relations section of our website at investor.medpace.com. With that, I would now like to turn the call over to August Troendle. Good day, everyone. Our quarter one net awards were down sequentially year-over-year with a net book-to-bill ratio of 0.90. This was primarily a reflection of high pipeline cancellations in prior quarters, as previously discussed. Backlog cancellations were modestly elevated in Q1, but pre-backlog cancellations were worse, impacting Q1 and future projected backlog net awards. RFP flow was strong in Q1, but quality has been variable and decisions are slowing. We continue to see a path to improved backlog growth reflected in book-to-bill ratios above 1.15 in Q3 and Q4. However, this will depend upon moderating cancellations and an improved business climate. Jesse will now provide comments on the quarter. Jesse. Thank you, and good morning, everyone. Revenue for the first quarter of 2025 was $558.6 million, which represents a year-over-year increase of 9.3%. Net new business awards entering backlog in the first quarter decreased 18.8% from the prior year to $500 million, resulting in a 0.9 net book-to-bill. Ending backlog as of March 31st, 2025, was approximately $2.8 billion, a decrease of 2.1% from the prior year. We project that approximately $1.61 billion of backlog will convert to revenue in the next 12 months, and backlog conversion in the first quarter was 19.2% of beginning backlog. With that, I will turn the call over to Kevin to review our financial performance in more detail and discuss our 2025 guidance. Kevin. Thank you, Jesse, and good morning to everyone listening in. As Jesse mentioned, revenue was $558.6 million in the first quarter of 2025. This represented a year-over-year increase of 9.3%. EBITDA of $118.6 million increased 2.6% compared to $115.7 million in the first quarter of 2024. EBITDA margin for the first quarter was 21.2% compared to 22.6% in the prior year period. EBITDA margin compared to the prior year period was impacted by employee-related costs and foreign exchange behind the weakening of the U.S. dollar in the quarter. In the first quarter of 2025, net income of $114.6 million increased 11.7% compared to net income of $102.6 million in the prior year period. Net income growth above EBITDA growth was primarily driven by a lower effective tax rate from option exercises in the quarter and higher interest income. Net income per diluted share for the quarter was $3.67 compared to $3.20 in the prior year period. Regarding customer concentration, our top five and top ten customers represented roughly 22% and 32%, respectively, of our first quarter 2025 revenue. In the first quarter, we generated $125.8 million in cash flow from operating activities, and our net day sales outstanding was negative 67.8 days. As of March 31, 2025, we had $441.4 million in cash. During the first quarter, we repurchased approximately 1.19 million shares for $389.8 million. At the end of the quarter, we had $344.8 million remaining under our share purchase authorization program. Moving now to our updated guidance for 2025. Full year 2025 total revenue is now expected in the range of $2.14 billion-$2.24 billion, representing growth of 1.5%-6.2% over 2024 total revenue of $2.11 billion. Our 2025 EBITDA is expected in the range of $462 million-$492 million, representing a decline of 3.8% to growth of 2.5% compared to EBITDA of $480.2 million in 2024. We forecast 2025 net income in the range of $378 million-$402 million. This guidance assumes a full year 2025 effective tax rate of 15.5%-16.5%, interest income of $15.8 million, and $30.8 million diluted weighted average shares outstanding for 2025. There are no additional share repurchases reflected in our guidance. Earnings per diluted share is now expected to be in the range of $12.26-$13.04. Guidance is based on foreign exchange rates as of March 31, 2025. With that, I will turn the call back over to the operator so we can take your questions. Thank you. As a reminder to ask a question, please press star one one on your telephone and wait for your name to be announced. To withdraw your question, please press star one one again. Our first question will come from David Windley with Jefferies. Your line is open. Hi, thanks for taking my questions. Good morning. August, your comment, and maybe August and Jesse, your comments around RFPs and quality of RFPs I wanted to explore. We've, in some of our discussions, been told that biotechs and kind of your target client audience are inviting more CROs into bid situations and, in some cases, taking a larger number of CROs, maybe by one or two, but a larger number of CROs forward into bid defense, and maybe implied fishing for lower prices. Wanted to get you to flesh out, if you would, your quality comments. Are you seeing these kinds of trends? Are you seeing more price competition? Is that a little bit of what you mean when you say the quality is a little more mixed? Thanks. Yeah, yeah, David, that is true. Anytime there's a slowdown in the industry, there tends to be more price competition, more broader look at CROs. A big factor is unfunded projects that they're looking toward funding and getting proposals so that they can bring that back to try to make a story for moving a product forward, rather than having some assets to move the product forward to start with. Yeah, they do tend to get more churn and a larger number of CROs participating in particular bids. RFP numbers can go up, but that just means they've doubled the average number of CROs they're inviting to each RFP, and everyone sees an increase in RFPs. Yeah, I do think that's a good part of it. The more concerning issue for me is the likelihood of funding and the type of assets and where they are in their funding cycle and how far out the project is, at what stage it is, that leads to a worsening in quality of the RFPs. Thanks for that. August, your comments about still depending on environment, I didn't get your exact words, but kind of depending on environment, still believe you have the potential to track still 1.15 book-to-bill in the second half. I noted your comments about backlog cancellations, but pre-backlog cancellations were worse. I guess I would love for you to flesh out what would be required, I guess, to achieve that, because in, say, middle of last year, when you talked about that intensification of pre-backlog cancellations, that was essentially what seemed to cement your view that you wouldn't be able to get to a higher book-to-bill, say, later last year and maybe early this year. How is that different now? Sure. Yeah. The pipeline cancellations, the pre-backlog cancellations, particularly, have narrowed our options quite a bit and limited the possible booking levels in the next few quarters. You realize we have pretty good visibility in the opportunities that could, most of the opportunities that could convert into backlog in the next few quarters. They're kind of already known to us as opportunities at whatever stage. They're sufficient to get us there if cancellations come back to a nice reasonable range and we do not see this across the pipeline kind of elevated level. Things continue to move forward. We've seen a slowing in decisions on RFPs. Once in a while, you also have delays in project starts due to funding or for other reasons. We need the projects to move into operational execution and recognition and backlog, and we need to avoid large cancellations. Our path there has narrowed quite a bit, but we still see the reason and it's not just a hypothetical far-off, you know what I'm saying? It's still possible, but it's highly improbable. We still have a reasonable path to get there if cancellations come back quite a bit. Thank you for that. I'll leave it at that. Thank you. Our next question will come from Max Smock with William Blair. Your line is open. Hi, good morning. Thanks for taking our question. August, you mentioned thinking to back to 1.15 book-to-bill in the back half of the year, if you get that improved climate. I guess my question would be, what do you think bookings look like if you don't get that improved climate? In that scenario where we assume even a stable environment from here, how much downside is there to the top line this year? What would that imply for top line growth in 2026? Thank you. How much risk is there to top line this year? You mean bookings, or are you talking about revenue? I guess more. In the second half. Yeah, more impact on revenue in the second half. I guess it's three parts, right? If the environment's stable from here, what does book-to-bill look like in the back half of the year? How much downside is there to how you're thinking about revenue in the back half of the year in your guide for this year? What does that all imply for top line growth in 2026? Yeah. That's kind of a difficult hypothetical. What kind of downside is there? That depends on how bad the environment gets. If cancellations continue kind of the way they have of recent past, and particularly this past quarter and some of the quarters last year, we're going to be in the same kind of place we've been, somewhere around one, I guess. I think that's kind of the downside. We still have opportunities to, again, paths toward getting to 1.15. Revenue in the second half is pretty much locked in. That's kind of a different issue because that's a different cancellation. It would mean a more later stage cancellation to knock our revenue off. Now, that's possible. Of course, we continue to have clients with funding difficulties that we have to stop work on or cancel the project because of work. There is still some risk to second half revenue, but most of that is pretty locked in. I really do not have a model for 2026, so I cannot go there yet. The environment is just too early to really talk about 2026 revenue impact of poor bookings through this year. Yeah, I understood. Maybe framing it as the downside scenario was not the right way to do it. I was thinking more if things stay the same, stay the way they are today, and you do not get that improved climate. Just to confirm, if that is the case, then we are talking book-to-bill kind of around 1.0 in the back half of the year versus if you do get that improvement, you are still thinking you can get to 1.15. Correct. Okay. That's helpful. Thank you. Maybe as a follow-up, there's been a lot of headlines recently around just out of the FDA, and there was one over the weekend from an interview where they were saying going to require less clinical trials in certain areas going forward if the mechanism of action makes sense and if there's an unmet need. Do you have any sense or can you provide us any detail around what your rare disease exposure looks like? Just how you're thinking about this kind of discussion from the FDA and the talk about doing less trials in some of these indications moving forward, is that a long-term structural headwind for Medpace and for the CRO industry as a whole? I don't know. That's pretty hypothetical. You make drugs easier to develop, and you tend to get more development. Certainly, if you took away the need for significant trials in an area, that does have an impact. I think that's very hypothetical. Rare disease, it kind of depends on how you define it, is certainly a meaningful part of our business. I really don't make much of the—I think it's great to have the trial requirements be proportional to the serious and needs of society for drugs. You have the right balance. We want effective drugs, but we want them developed at a reasonable cost. That's just kind of the trade-offs. I don't really see a risk to our industry from that. Got it. Thank you. Our next question comes from Ann Hynes with Mizuho. Your line is open. Hi, good morning. Maybe talk about cancellations a little bit more. Can you remind us what your cancellation rate is? I don't think you said what it was this quarter versus what it was last quarter and what it is versus historical. Maybe just the type of trials that you're seeing canceled. Is it widespread? Is it specific customers? Any incremental detail on cancellations would be very helpful. Thanks. Sure. Yeah. You did not hear it because we did not say it because we do not disclose it. We just do not provide cancellation rate. We do talk about broad trends in magnitude, but we do not give the rates. The cancellations have been pretty broad, but largely centered around funding issues. You can call it reprioritization and other things, and that is certainly part of it. There are certainly drugs that have had significant safety signals or other failures of trials that have impacted the development of the program. Funding has been at least a part of a good portion of the cancellations. I cannot sort out a different therapeutic area or anything like that. It is kind of across the board. Great. My next question is just on share repurchase. Obviously, your stock's down year to date. It's going to be down a little bit more today. There's no incremental share repurchase in your guidance. I guess what would trigger Medpace to get more aggressive on share repurchases? Yeah. I mean, and this is Kevin. We'll continue to take an opportunistic approach as we have the last couple of quarters. We'll continue to look for those opportunities to do that. We'll kind of see how we're able to execute. As you saw, we did increase the board authorization on share repurchases. We'll look for opportunities and continue to do that. Thank you. Our next question comes from Dan Leonard with UBS. Your line is open. Thank you. I have a question on that small biopharma exposure that you report at 80% of your revenue. Do you have any sense for how much of that is negative enterprise value of biotech? And are you concerned at all that some of these biotechs that have negative enterprise value might just start to close up shop and return the cash? Jesse, do you have any proportions on that? We continue to see companies fail. I don't know how many that have if the drugs failed and they're not doing anything and they close up shop, I guess who cares? They don't have a viable drug to go forward with. Certainly, funding difficulties is a bigger issue than drug failures and closing up shop at the current time. Jesse, do you have any kind of metrics on? Yeah. I don't have anything on negative EV quantification. The things we do quantify, we'll look at what percentage is public versus privately funded companies and kind of what percentage is partnered with large pharma. But we're not tracking and reporting EV values. Got it. It doesn't sound like that's a high level of concern of yours, independent from the broader funding environment anyway. Is that fair? Yeah. I think companies having too much money and having to return it to investors is not our problem. It's those that don't have money and have too much money. Understood. My follow-up question, which is coming up a lot in the investment community, August, do you have any sense on whether all the turnover at the FDA is impacting your client discussions at all and making them incrementally behave differently or more worried about the future? I think it makes everybody worried about the future. I'm not convinced there's any kind of evidence that there's been delays or problems to date or changing behavior. We'll have to see. I think it's too early. Okay. Thank you. Our next question will come from Eric Coldwell with Baird. Your line is open. Thanks very much. I wanted to hit on the other side of growth. You've got bookings. You also have backlog burn. Backlog burn was up pretty nicely year-over-year. It looks like the forecast must incorporate higher levels of backlog burn this year. I'm curious how much of that is a function of the lower backlog growth and the lower bookings, which naturally changes the denominator-denominator equation. Also, were there unusual timing shifts in the burn rate of your backlog or project-specific items this quarter? Are there execution improvements that you're showing and maybe think are sustainable? We'd just like to get a better sense on the magnitude of this backlog burn re-acceleration, how sustainable it is. Yeah. Eric, this is Kevin. I mean, it's more a function of you saw an acceleration in revenue in the quarter. For programs, we're progressing well, but you also saw an increase in the reimbursable cost activity, right? That was a bit higher than what we had expected. That's going to influence it as well. It's the lower bookings that August talked about. His prepared remarks is coming in a bit soft. It's not that we're changing execution or anything associated with that. I mean, programs continue to progress very nicely. It's more a reflection of the numerator and the denominator. Okay. Kevin, last quarter on the call, mid-February, you had, in response to one of my questions, you had suggested that you thought revenue would be more modest in the first quarter and then linearly progressing through the year. We got quite the opposite with over 9% revenue growth, but the rest of your targeted growth rates are lower. Other than the near 10% growth in pass-throughs, what were the other dynamics in play? Were you really thinking pass-throughs were going to be down and instead they grew 10%? Maybe we did not know what to model, but in your mind, that was the big delta here. I am just. Yeah. You told us to start low and grow revenue, and it was the opposite. Yeah. That was six weeks left in the quarter is what we heard. I am just trying to figure out what changed. Yeah. Yeah. I think the bigger influence was the reimbursable cost activity. Now, having said that, your programs progressed probably a bit better than I had anticipated in the first quarter as well. I think the bigger influence was the reimbursable. My last question for this call, just I saw a little bit of headcount growth quarter-over-quarter, a little bit more year-over-year, but maybe a bit slower than I was originally anticipating probably because of the lower bookings. What is your new outlook on turnover, hiring, timing of hiring this year? I'm curious what your plans are at this point, what you'd like to do, and what you think is actually doable in the environment. Yeah. Thanks, Eric. We did have a little bit of modest headcount growth in the first quarter. Turnover remains pretty good, and we're still targeting headcount growth this year, likely around mid-single digit. Okay. Thanks very much. Our next question comes from Charles Rhyee with TD Cowen. Your line is open. Yeah. Thanks for taking the question. August, I want to go back a little bit when you're talking about, obviously, the funding issues with clients. Are you seeing any clients? Because we've heard in some instances where companies have been committed, have gotten funding, but then either their private equity or VC backers kind of maybe pulled back on some of those commitments. Maybe some of the funding data we've seen over the last year or so may not actually materialize. Just curious if that is some of the dynamics you're seeing in some of clients potentially having some funding issues. Sure. Yeah. I definitely think that's part of it. Often clients represent to us that they've got funding arranged. They have commitments. They have whatever, how strong those commitments are. VCs and others having to choose between the winners and losers in their portfolio. But it's where we are. Yeah. Okay. I know you're not disclosing sort of the cancellation rates, but can you give us a sense sort of maybe between pre-backlog cancellations and just cancellations out of backlog, sort of maybe the relative mix between the two? As you kind of I know you guys said you kind of were looking at your pre-backlog kind of expectations for the course of the year. I know you said it was higher, but was it really outside the realm that you expected, or was it just kind of at the upper bounds of what you kind of thought could happen? Yeah. I think I'd classify our backlog cancellations kind of in that range, just outside of the range kind of. The pre-backlog cancellations were significantly worse and very high. Overall, it was a pretty high rate of pipeline cancellations. Okay. Thanks. Jesse, maybe just real quickly, you talked about headcount. Would you say you're still on track for a mid to high single-digit growth, or is that really just now dependent on what we see in terms of the environment over the next couple of months? Yeah. I would say at this moment, we're on track for mid-single-digit growth, but it will depend on how the environment unfolds. If things pick up, we'll accelerate more aggressive hiring. Great. Thank you. Our next question comes from Michael Cherny with Leerink Partners. Your line is open. Good morning. Thanks for taking the question. Maybe just to come at the cancellations question another way, both on the existing backlog and the pre-backlog, is there anything you can tell us about cadence over the course of the quarter? Clearly, we can't, knowing you can't control the dynamics going on at play across the changeover in HHS, but did you see any elevated activity maybe over the course into March, given the uncertainty that's been created from the moving pieces across FDA? Yeah. I'm not sure it had anything to do with movements at FDA. I mean, I don't have the cadence in terms of month-to-month in front of me, but it didn't strike me as all back-end or front-end loaded. It was kind of across the quarter. Okay. On the dynamics and the build-back towards an improved book-to-bill, you talked about there are conditions in place to get back to 1.15. Is there anything your clients are telling you in terms of how they feel about achieving those conditions and what would be the comfort factors you're looking for in order to get back to those levels? Curious along those lines what the feedback is from the channel specifically. Yeah. No, I have no, I don't think that's provided me any input. I don't think anybody knows. Okay. Thank you. Our next question comes from Jailendra Singh with Truist. Your line is open. Thank you. Good morning. Thanks for taking my question. I just want to go back to revenue guidance rates for the year. You report this metric of amount of backlog expected to convert in the next 12 months. It has been around a little over $1.6 billion for the last few quarters. Have you seen any cancellation in that bucket recently? It seems you are implying that even if booking trends and book-to-bill remain at the current levels for the rest of the year, you still feel good about revenue outlook for the year. I'm wondering because you don't see much concern around that $1.6 billion amount of backlog conversion. Yeah. This is Kevin. I mean, in terms of kind of reemphasizing what August said, we feel good about the 2025 guidance because we've got the programs in backlog. And barring any acceleration in cancellations, we always have cancellations in that bucket. As long as they stay relatively normal, we feel good about the revenue that's going to come out of that bucket. Now, certainly, revenue or backlog has declined a little bit, and so that next 12-month figure has come down a little bit. We feel good, again, about the guidance that we have out there on revenue. Okay. My follow-up, I want to go back to David's question around biotech CRO landscape getting more competitive. I mean, historically, your pitch to biotech companies has been giving them more personalized focus, more personalized services. If some of your peers are restructuring their approach and going after this market more aggressively, how are you guys responding to that? Are you guys making any changes to your pitch or your approach as you go after these clients? I don't think there's been a change in our competitive dynamics lately of any material. In fact, everybody tries to give their clients individual attention, and there's been no change. Okay. Thank you. As a reminder to ask a question, please press star one one on your telephone. Our next question comes from Justin Bowers with DB. Your line is open. Hi. Good Good morning, everyone. Just a few follow-ups from what's been discussed. In terms of the programs progressing faster and this got booked in 1 Q revenue, Kevin, is that more internal or external factors? Meaning, was it execution on your end, or is there a push from clients to maybe sort of get the data done faster? Just anything to call out the progression there? Yeah. I mean, I would say there's nothing unusual. It's just that the programs, the active programs that we have in backlog, just continue to progress very nicely. It's not to say that we've made any major internal changes. There's always pressure from sponsors to do things faster, and we certainly do what we can. I would say there's no change internally as it relates to how we execute. Okay. In terms of the cancellations, it sounds like most of that was concentrated or the elevation was around the pre-booking. In terms of the in-flight cancellations, was that elevated as well? What trends are you seeing there? Is it more around futility, or is it also funding-related? Yeah. I mean, the in-flight backlog cancellations tend to be a bit more related to drug performance, but funding has been a big part of even our backlog cancellations. So it's a lot of overlap. Okay. Just in terms of one of the earlier questions on pricing pressure, I think Medpace, at least compared to the bigger guys, has been pretty competitively priced. The pressure that you talked about, are you seeing that from your mid-sized peers, or are you also seeing that coming from some of the larger competitors that may be encroaching on your market space? It's both. I mean, we're seeing competitive. I think it's from clients. Yeah. I'm sorry. Go ahead, Jesse. Yeah. I was going to say it's from both peers and larger mid-size and larger competitors, but also the pricing is influenced by just scarcity of funds as well from the biotech perspective. Got it. All right. Thank you. I will jump back into queue. Our next question comes from David Windley with Jefferies. Your line is open. Hi. Thanks for taking my follow-up. I have a few, but I'm only going to ask one bigger one, which is around sites and the pass-through elements. One of the things that we've heard anecdotally a fair amount is that the NIH grant funding, what's called debate, freeze, whatever, does have academic medical centers nervous about their situations. While those funds probably fund investigator-driven studies and not the type that you would directly run, those funds probably also fund research infrastructure at these academic medical centers that could influence the throughput capabilities of the sites that you might use in studies. With that having been said, I'm wondering about general site access, recruitment rates, how much do you use academic medical centers, and to what extent how should we think about the pass-through increase in your revenue? Is that inflation-driven at the site? Is it just re-budgeting of kind of quantity of consumption? And how much of that pass-through inflation that we saw in the first quarter is also driving the revenue for the year? Thank you. I think either the threats and concern around academic funding at these large university centers is not reflected in anything to date. I mean, it's a theoretical issue for the future. I think to date, the increase in pass-throughs of investigator costs as portions of budgets relates to a number of things, including complexity of the evaluations done at sites, inflation and scarcity of patients. The pandemic, of course, had a huge impact on operations at centers and caused considerable cost increases and inflationary impact, you might say, at sites. Costs were driven up at sites and passed through to trials. That's been the driver we've seen to date, this shifting of possible overhead costs onto sponsor-driven clinical trials, commercial clinical trials. Maybe that'll happen. I don't know, but it's certainly not a factor in the current dynamic. On the revenue mix for the year, if we were to think about you raised by a little bit, is all of that raised pass-through? Is more than the raised pass-through? How should we think about the pass-through influence on revenue versus your prior expectations? In the quarter, Dave? I mean, I'm really thinking about the guidance for the year. Yeah. I mean, certainly, it was elevated in the quarter, but we kind of see that as being more timing-related. We continue to feel that the cost, the pass-through pre-fund reimbursable costs as a percentage will be at similar levels to what we saw in the back half of 2024. As you know, it bounces around from quarter to quarter, but the expectation for the year is that it is somewhere similar to what we saw in the back half of 2024. Yeah. The question is, the jump in our revenue, is that an anticipation of jump in pass-through or direct fees? Yeah. Dave, as I said before, we were not expecting pass-throughs to be this high in the quarter. A big part of the revenue increase that we saw this quarter was influenced by the reimbursable activity. Yeah. Yeah. Thank you for that. I show no further questions at this time. I would now like to turn the call back to Lauren for closing remarks. Thank you all for joining us on today's call and for your interest in Medpace. We look forward to speaking with you again on our second quarter 2025 earnings call. This concludes today's conference call. 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