Is the CRO industry coming out of the post-COVID contraction?

After a year marked by cautious spending, cancellations, and delayed trials across the biotech and pharma sectors, recent earnings calls from CRO leaders suggest a rebound in clinical research sector demand. Major public CRO players—IQVIA, ICON, and Medpace—are pointing to improving conditions and early signs of recovery.

IQVIA’s CEO Ari Bousbib observed that while the CRO market remained “choppy,” R&D Solutions’ bookings outpaced expectations and backlog increased by ~5% year over year. In its Q2 2025 report, IQVIA noted forward‐looking demand indicators strengthening: net bookings rose 15% sequentially, and RFP (request for proposal) activity grew in the low teens year-over-year. An interesting note is that IQVIA did stock repurchases of over $1.0B in the first half of 2025, betting on themselves and also on the industry turning more positive.

ICON also reported signs of stabilization. ICON slightly increased their full year guidance for 2025, and also emphasized growth in strategic partnerships, alongside disciplined cost management and leveraging technology. Like IQVIA, ICON also did material share repurchases, totaling $500M in Q2.

Medpace was the big winner in Q2 results, further giving hope to the industry coming out of a dip. In its Q2 2025 call, CEO August Troendle pointed out a “drop in cancellations” compared to prior periods, and said that while the macro environment remains challenging, fundamental growth is intact. Medpace’s Net New Business Awards (NBA) grew 12% year-over-year, and they are anticipating revenue growth of ~15-19% vs. 2024.

The results from the public CROs offer some optimism that we are coming out of the post-COVID industry contraction in drug development R&D. It is important to note that these are off what would be considered weak comparators in 2024 data, and with high cancellation rates over the past twelve months, we will need another quarter or two to understand in which direction our industry is truly going.