IQVIA Holdings, Inc. (IQV) Q2 2022 Earnings Call Transcript

IQVIA Holdings, Inc. (IQV -1.31%)
Q2 2022 Earnings Call
Jul 21, 2022, 9:00 a.m. ET

Contents:

• Prepared Remarks
• Questions and Answers
• Call Participants

Prepared Remarks:

Operator

Ladies and gentlemen, thank you for standing by. At this time, I would like to welcome everyone to the IQVIA second 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.

[Operator instructions] As a reminder, this call is being recorded. Thank you. I'd now like to turn the call over to Nick Childs, senior vice president, investor relations and corporate communications. Mr.

Childs, you may begin your conference.

Nick Childs -- Senior Vice President, Investor Relations and Corporate Communications

Thank you. Good morning, everyone. Thank you for joining our second 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 Bryan 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 Presentations 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 could 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 filings 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.

Ari Bousbib -- Chairman and Chief Executive Officer

Thank you, Nick, and good morning, everyone. Thank you for joining us today to discuss our second quarter results. IQVIA delivered strong financial results this quarter despite the dynamics of the broader macro environment and the various global geopolitical issues. Let me address a few of the key ones.

Some of you have continued to ask about the impact of biotech funding on the CRO industry. As we have said on several occasions, the recent decline in biotech funding has not had any significant impact on our business. Our exposure to pre-commercial EDPs remains a just over 10% of our backlog. We have not seen an impact on bookings or RFP, nor any increase in cancellations or delays in clinical trial work from the slowdown in biotech funding.

Actually, RFP dollars from the overall EDP client segment continue to grow double digits in the quarter. In China, the government-imposed COVID lockdowns has a modest impact on our second quarter results, mostly from disruptions to our clinical and laboratory operations. Our commercial business was virtually unaffected. Our experience in managing through prior lockdowns during the pandemic has been helpful in minimizing the operational impacts on site closures.

Our guidance assumes that modest impacts from COVID-related lockdowns in China will continue through the end of the third quarter. In Ukraine, we continue to work with sites and sponsors to ensure the safety of our employees and patients while working to mitigate trial disruptions caused by the ongoing crisis. In Russia, we continue to conduct trials currently underway to ensure the safety of patients already enrolled in critical trials but we are moving recruitment on new trials to other countries. The financial impact of the Russian-Ukraine crisis are tracking in line with the expectations we communicated back in April.

More generally, we're, of course, are monitoring, as are you, the possibility of a recession. I would just note that over the past 20 years, IQVIA, along with the broader CRO industry, has shown resilience to economic downturns. During the recessionary times over the past two decades, annual S&P 500 revenue contracted by as much as 10%, while IQVIA's clinical business and the CRO industry as a whole never experienced a year of revenue decline. The resilience of the CRO industry likely reflects the long cycle nature of our business, as well as, of course, the mission critical importance of clinical research and more generally, the defensive nature of healthcare.

With that as background, let's review the second quarter. Revenue for the second quarter grew 3% on a reported basis and 7.1% at constant currency. The $46 million beat above the midpoint of our guidance range was primarily driven by the timing of pass-through revenues versus our expectations, as well as some operational upside. Compared to last year and excluding COVID-related work from both periods, our base businesses grew 16% at constant currency on an organic basis.

Ron will provide additional detail in his remarks, including COVID-adjusted numbers for each of our segments. Second quarter adjusted EBITDA increased 10.8%, reflecting our strong revenue growth and ongoing cost management discipline. Second quarter adjusted diluted EPS of $2.44 grew 14.6%, driven entirely by our adjusted EBITDA growth. Let me provide some more updates and color on the business in the quarter.

The continued strong performance at IQVIA is driven by our highly differentiated capabilities. As you know, the key differentiator for us in the clinical and commercial spaces is IQVIA's connected intelligence. Let me give you a few examples of how IQVIA's applications here help our client's solve their most complex problems. IQVIA's AI-driven next best action platform helps our clients integrate multiple data sources, transforming raw data into personalized recommendations to sales, marketing, and medical personnel, which of course leads to deeper relationships with healthcare providers.

In the quarter, a Top 10 pharma client chose IQVIA's solution to completely transform their omnichannel commercial engagement model and to improve their go-to-market efficiency across multiple brands in eight countries by up to 30%. Another example in the quarter, we were selected by a Top 20 pharma client to optimize the delivery of brand content directly to healthcare providers for one of their respiratory brands. Our solution here connects digital and field sales channels to deliver highly personalized content that results in high quality, seamless brand experience for healthcare providers. This will improve this client digital engagement metrics by three and a half times.

Another area where demand has been growing is pharmacovigilance. Our platform here combines the unique catalog of over 500,000 safety specific terms and patterns with natural language processing to mine vast amounts of online data and to identify potential adverse events. In the quarter, another Top 10 pharma client selected as a solution to reduce the risk of noncompliance and to increase data accuracy, ultimately improving their efficiency by up to 75%. Beyond large pharma, our commercial solutions are also resonating with EDP clients, especially when they decide to commercialize their assets on their own, following approval, for example.

In the quarter, we contracted with a leading EDP client to implement and manage their entire end to end commercial information management and to support their patient engagement and access programs. This includes data provisioning, master data management, and data modeling. Our ability to offer these services on a fully integrated platform will allow for a more streamlined implementation, generating savings of up to 20% versus multi-vendor solutions. As you know, IQVIA continues to be the global leader in real world evidence.

In the quarter, a Top 10 pharma awarded IQVIA a major project in medical affairs. The project leverages our AI and ML capabilities to provide near real time disease insights across five different therapeutic areas. These insights will help identify new diagnosis and suboptimal treatments, which will in turn improve patient outcomes. As you know, our ECOA, or Electronic Clinical Outcomes Assessment platform, has won multiple awards for its breakthrough patient engagement innovations.

The product includes a library of over 1,500 pre-built clinical outcome assessments, which enables sponsors to deploy assessments to patients up to 14 weeks sooner than competitor's offerings. This efficiency reduces risks to study start-up timelines and allows our clients to capture more feedback from patients, ultimately amplifying the patient's voice real time. The top five sponsor recently engaged IQVIA to couple these ECOA platform with our patient randomization tool so that we eliminate redundant floor workflows, improve data accuracy, and patient compliance, thereby reducing site onboarding activities by an estimated 50%. Finally, in the overall R&D as business, we continued our strong momentum delivering over $2.6 billion of total net new business in the quarter, including by pass-throughs.

The services bookings also remained at historic high we have seen recently of over $1.9 billion. This resulted in a second quarter of contracted net book to bill ratio of 1.34, including pass-throughs and 1.32, excluding pass-throughs. Over the last 12 months, our contracted net book to bill ratio was 1.32, both including and excluding bathrooms. As you can see, there continues to be strong, positive momentum across the business and an unprecedented level of engagement with our clients across our portfolio of commercial and clinical businesses despite the broader environment.

I will now turn it over to Ron for more details on our financial performance.

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

Thanks, Ari, and good morning, everyone. Let's start by reviewing revenue. Second quarter revenue of $3,541,000,000 grew 3% on a reported basis and 7.1% at constant currency. In the quarter, COVID-related revenues were approximately $250 million, which was down about $300 million versus the second 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 16%. Technology and analytics solutions revenue for the second quarter was $1,408,000,000, up 4.1% reported, and 9.4% constant currency. Now excluding all COVID-related work, organic growth at constant currency impact ii was 10%. Research and Development Solutions second quarter revenue of $1,950,000,000 was up 3.1% reported, and 6% at constant currency.

And excluding all COVID-related work, organic growth at constant currency in R&DS was 22%. Contract sales and medical solutions, or CSMS, second quarter revenue of $183 million declined 5.7% reported, but grew 2.1% at constant currency. Excluding all COVID-related work, organic growth at constant currency in CSMS was 7%. First half revenue of $7,109,000,000 grew 3.8% on a reported basis and 6.9% at constant currency.

In our base business, that is excluding all COVID-related work, organic growth at constant currency for the first half was 14%. Technology and analytics solutions revenue for the first half was $2,847,000,000, up 5.4% reported, and 9.6% at constant currency. Excluding all COVID-related work, organic growth at constant currency in TAS was 10% for the first half. R&D solutions for TAS revenue of $3,884,000,000 was up 3.3% at actual FX rates and 5.3% at constant currency.

Excluding all COVID-related work, organic growth at constant currency in R&DS was 19%. And finally, Contract Sales and Medical Solutions, or CSMS, first half revenue of $378 million declined 2.3% reported, and grew 3.9% in constant currency. Excluding all COVID-related work, organic growth in constant currency in CSMS was 6%. Now going down the P&L, our adjusted EBITDA in the quarter was $800 million, representing growth of 10.8% while first half adjusted EBITDA was $1,612,000,000, up 10% year over year.

Second quarter GAAP net income was $256 million and GAAP diluted earnings per share was $1.34. For the first half, we had GAAP net income of $581 million or $3.02 in earnings per diluted share. Adjusted net income was $466 million for the second quarter, and adjusted diluted earnings per share grew 14.6% at $2.44. For the first half, adjusted net income was $943 million or $4.91 per share.

Now as Ari highlighted, R&D Solutions deliver yet another strong quarter of new business. This graph that we're showing here shows the growth of our backlog over the past few years at actual currency rates. And it demonstrates the sustained strength of our clinical business through the COVID pandemic. Now, you'll recall that as our bookings reached record levels during the pandemic, many of you expressed concerns about a looming so-called COVID cliff.

And we told you then that our COVID-related bookings would be replaced by new programs that span the breadth of our therapeutic area expertise. And in fact, that's what happened. As of June 30th, our contracted backlog stands at a record $25.6 billion, including pass-through. That's a 50% increase over about three years.

The COVID contribution to our backlog, which peaked at 11% early in 2021, is now approximately 6%. OK, let's turn to the balance sheet. As of June 30th, cash and cash equivalents totaled $1,428,000,000 in gross debt with $12,767,000,000, resulting in net debt of $11,339,000,000. Our net leverage ratio as of June 30 was 3.58 times trailing 12-month adjusted EBITDA.

Second quarter cash flow from operations was $329 million and capex was $161 million, resulting in free cash flow of $168 million for the quarter. This was somewhat lower than prior quarters, and it mainly reflected the timing of cash collections, which we expect to normalize in the second half. You saw in the quarter that we were quite active in the market, repurchasing $590 million per share. And this puts our year-to-date share repurchase activity at just shy of $1 billion.

This leaves us with slightly over $1.5 billion of share repurchase authorization remaining under the current program. OK. Moving to guidance, our full year 2022 revenue expectation at constant currency remains unchanged. On a reported basis, the strengthening of the dollar since April has caused an incremental full year revenue headwind from foreign currency translation of approximately $125 million based on rates as of this Monday, July 18th.

We're updating our revenue guidance to reflect this. For the full year, we now expect revenue to be between $14,400,000,000 and $14,550,000,000, which represents a year over year growth of 7.4% to 8.5% at constant currency and 3.8% to 4.9% at actual FX rate. As a reminder, this equates to low to mid-teens organic growth at constant currency, excluding COVID-related work. Our projected revenue growth includes just over 150 basis points of contribution from M&A.

Since FX fluctuations has had a minimal impact on our profit, our adjusted EBITDA guidance remains unchanged. We are tightening the guidance range to be between $3,345,000,000 and $3,395,000,000, which represents a year-over-year growth of 10.7% to 12.3%. And our adjusted diluted EPS guidance also remains unchanged. We are tightening the range here to between $10 and $10.20, which translates to year-over-year growth of 10.7% to 13%.

Our full year 2022 guidance assumes that foreign currency rates as of July 18th continue for the balance of the year. Since issuing our initial guidance at our Analysts and Investor Conference in November, FX fluctuations have caused full year revenue headwind of over $400 million. Moving to our third quarter guidance, we expect revenue to be between $3,550,000,000 and $3,565,000,000 or growth of 8.4% to 9.8% on a constant currency basis and 3.7% to 5.1% on a reported basis. Excluding COVID-related work, we expect organic revenue growth at constant currency to be in the low to mid-teens in the third quarter.

Adjusted EBITDA is expected to be between $805 million and $820 million, up 10.6 to 12.6%. And adjusted diluted EPS is expected to be between $2.34 and $2.42, growing 7.8% to 11.5%. So to summarize, we delivered a very strong second quarter. Our base business delivered mid-teens organic growth at constant currency, excluding COVID-related work.

Our R&DS business had another strong bookings quarter with over $2.6 billion of net new business. Contracted backlog at the end of the quarter is at a new record of $25.6 billion, up over 7% year over year. We repurchased nearly $600 million of our shares while maintaining our net leverage ratio of approximately 3.6 times trailing 12-month adjusted EBITDA. And finally, we adjusted our revenue guidance to reflect changes in foreign exchange, but held our earnings guidance unchanged.

And with that, let me turn it back over to our operator for Q&A.

Questions & Answers:

Operator

[Operator instructions] Our first question comes from Sandy Draper from Guggenheim. Please go ahead. Your line is open.

Sandy Draper -- Guggenheim Partners -- Analyst

Thanks very much and congratulations on a solid quarter in a tough environment. I guess I'm actually going to let other people ask about R&D Solutions. I'm sure there'll be a lot of questions there, but my question, Ari and Ron, is on the TAS side as we're not out of credit, but certainly getting further past it and sort of trying to act in a more normal way. Have either buying patterns of what people are focused on changed at all? So was there sort of a certain focus during COVID of these are short-term tech solutions we need because trials are being shut down or whatever it is? We can't get salespeople into doctors offices, but as we're coming out, has that -- is the general trends persisting or are you seeing any shift in refocus on new areas on the tech side? Thanks.

Ari Bousbib -- Chairman and Chief Executive Officer

Yeah. Thank you, Sandy, and good morning to you. I'll start answering your question by simply saying there's absolutely none of those concerns. We haven't seen any of that.

We're very pleased with the continued growth of our TAS business really across the board. And you know that we like to think of our business in three buckets: the high growth ones, which is real world; and technology. And that represents, Mike, we're going to see about 40%?

Mike Fedock -- Senior Vice President, Financial Planning and Analysis

45%.

Ari Bousbib -- Chairman and Chief Executive Officer

45% of the total. And that's experiencing continued growth. Hasn't been better during COVID at all and continues to sell through at the same pace. Then we have the kind of labor base, consulting, primary market research, analytics business, which grows mid to high single digits and has been very strong through COVID and continues to be strong.

It's actually, I would say, there's a lot about --

Mike Fedock -- Senior Vice President, Financial Planning and Analysis

[Inaudible]

Ari Bousbib -- Chairman and Chief Executive Officer

25% approximately. So the last balance, the 30% is basically our historic IMS data business, and that's kind of flattish to up to 1% or 2% quarter in, quarter out. And that also has been essentially flat in terms of its growth and through the COVID crisis. So as Ron mentioned, constant -- organic constant currency revenue growth for TAS, excluding COVID, was 10% in the quarter and also 10% for the first half.

So again, really, we're not seeing anything at all that's changed versus the pandemic peak or before the pandemic, continued strong momentum. Thank you, Sandy.

Operator

Our next question comes from Eric Coldwell from Baird. Please go ahead. Your line is open.

Eric Coldwell -- Robert W. Baird and Company -- Analyst

Thank you. Good morning. Wanted to hit on capital structure. With the comments, obvious comments about looking at the potential for a recession, rising interest rates, etc., a number of companies have changed their capital allocation and capital structure strategy.

I'm curious if you could talk about what you're doing on those fronts, maybe discuss any terms, maturities or issues with the various fixation instruments you have on your variable rate debt, because I do believe that the majority of your debt is effectively fixed at this point. And then what is embedded in your interest rate assumptions for the year and how much has '22 guidance in total been impacted from your first guidance to current guidance in relation to the interest rate increases that we've seen so far? I know that's a lot but --

Ari Bousbib -- Chairman and Chief Executive Officer

No, it's -- I wouldn't expect loans from you. Eric, you ask one question and you have to pack 10 questions in one. So [Inaudible]

Eric Coldwell -- Robert W. Baird and Company -- Analyst

[Inaudible] comment, right?

Ari Bousbib -- Chairman and Chief Executive Officer

It's a difficult question, obviously. And you can imagine we are looking at the broader environment, the rate. You saw the ECB bumped off 50 basis points this morning. And we do have some euro debt, as you know.

Obviously, there is a point at which those changes cross certain thresholds and it does have an impact on our capital structure. And we are modeling all of those and making different scenarios as to how we would change or not our capital allocation strategy. For now, it remains what it was. I want to ask Ron to give you more detail and address the specifics of your question.

Ron?

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

Yeah. Yeah, Eric. To your specific question, I think you had asked about our, in essence, about whether our debt and how much of our debt is fixed rate versus variable rate. So how much is affected going forward? And I know this is of interest to the group and any of that.

About 45% of our debt is fixed rate. Just shy of 60% is fixed with swaps. We did have a euro for that fixed even more of our debt up until recently but were about at the before now with the recent ECB decision. So --

Ari Bousbib -- Chairman and Chief Executive Officer

So up to today, it was like [Inaudible]

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

75%.

Ari Bousbib -- Chairman and Chief Executive Officer

75% fixed.

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

But going forward, it will be more like just shy of 60% fixed. And you would ask about what does our guidance assume? And we pretty much followed what the market consensus is there about -- in the U.S., about assuming a couple of 75-basis-point increases in the U.S. in July and September and 25-basis-point increases in the fourth quarter two times. And for the euro we have a series of increases, smaller increases assumed out through the balance of the year totaling over -- just slightly over 100 basis points baked into our numbers.

And that's pretty much in line with the market consensus right now. Now, you asked also about how much has interest expense -- the increase in rates affected our interest expense assumptions since November, I guess, when we put our initial guidance out. I'll have to go back and look at that. It's obviously had an impact, not so much in the first half of the year, but more in the second half of the year, obviously, as the rate increases, or the pace of rate increases, it has been kind of back end loaded in the year, but we'll have to come back with an answer to that unless Nick has it handy.

Nick Childs -- Senior Vice President, Investor Relations and Corporate Communications

Yeah, I mean right now we're thinking it's somewhere between $50 million to $75 million is what are seeing an interest. Yeah. But you've seen that we've been able to hold the EPS number. So we've had some favorability in terms of our assumptions on share count and all of that below the line that it's kind of helped us manage that a little bit better.

Operator

Our next question comes from Elizabeth Anderson from Evercore. Please go ahead. Your line is open.

Elizabeth Anderson -- Evercore ISI -- Analyst

Hi, guys. Thanks so much for the question. One, sort of two, maybe, maybe take Eric have a combined combo. One, if you could talk about the assumptions regarding China specifically and your -- embedded in your 3Q guidance.

And then four, looking at the guidance that you gave for 3Q, it implies a nice EBITDA step up in the fourth quarter, and you guys obviously did a nice job managing the SG&A line in particular this quarter. So I just wanted to understand there if there was something specific to call out that was driving sort of that step up in EBITDA there or the what's the explanation there? Thanks.

Ari Bousbib -- Chairman and Chief Executive Officer

Yeah, well, thanks, Elizabeth. These are two very distinct questions. So let me just start with the second one, the fourth quarter. Look, fourth quarter, there's been some level of seasonality in our business historically has always been the case both on the commercial side and on the clinical side.

And the fourth quarter traditionally is always the strongest one. If you are specifically alluding to EBITDA, and I would point that if you go back and look in general, our margins in the fourth quarter are higher than, let's say, sequentially in the third quarter, for example, and generally somewhat of a pull with higher maybe a little less than that, maybe a little bit more than that depending on the years. And that is because on the commercial side it's the end of the year. A lot of the budget tends to be spent and a lot of purchases get done last minute.

And obviously both our clients want to be done before the close of the year and our sales force pushes us always to make the quarter and so on and so forth or more sales at the end of quarter into the end of the year. So that's the kind of momentum on the commercial side, whether it's data or analytics or just across the board on our commercial portfolio. On the -- so that's always the case year in, year out. And this year, it's truly a little bit stronger than might have been the case in prior year is really not inconsistent.

On the clinical side, it's all driven by the execution of the backlogs and when and how it converts. So that's really -- we do a roll up of project by project of when we anticipate the work will be done and cost incurred and revenue recognized. And we do that bottom up and that's where it comes out. Again, in general, fourth quarter tends to be stronger in the clinical side as well historically and that is probably because people want to try to do it before the end of the works -- the year.

So that's again, not unusual. Agree that sequentially, a bit more than five years, but again, nothing inconsistent. Ron, you want to say something?

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

Yeah, I just to answer your question on China and the impact there. Modest impact in Q2, we're assuming continued modest impact in Q3, mainly around our lab business in clinical trials as not all the sites are open in areas where there's shutdowns or restrictions. The only caution I would say there is just that none of us knows exactly what's going to happen in China, where future lockdowns might happen and so forth. But right now, we're not expecting a big impact.

Ari Bousbib -- Chairman and Chief Executive Officer

Yeah, I mean, it was a mark on China. It was very modest, less than 3% of our total revenue. We have a strong presence there relative to our competitors and we are doing very well. On the clinical side is where the impact is.

Remember on the commercial side, we have exactly zero impact from the lockdowns. That was the case during the pandemic at the peak of it and it continues to be the case today. On the clinical side, obviously, the issue is accessing sites and when it's closed, it's closed. But we have learned during the pandemic how to work with that and to do remote visits, etc.

And so far, it is the feedback from China lockdowns, which have been extensive, as you know, in Shanghai and Shenzhen and some other areas. We have been able to manage through that and whatever financial impact will essentially be absorbed in our numbers. Thank you, Elizabeth.

Operator

Our next question comes from Derik De Bruin from Bank of America. Please go ahead. Your line is open.

Derik De Bruin -- Bank of America Merrill Lynch -- Analyst

Hi. Good morning and thank you for taking my question. I've gotten a bunch of questions from investors and along the lines of I think people appreciate that R&DS business is very resilient during the past recessions, but you're absolutely right. I mean, having done the Quintiles IPO, I remember the growth rates back then.

I think the question I've gotten some on the TAS business and just the like how that goes, particularly on the consulting side of the business and any sort of potential impact from the recession there. Thank you.

Ari Bousbib -- Chairman and Chief Executive Officer

Yeah. Well, thank you for the question. Look, the resilience that I'll use on the clinical side and it's adorned by the history, a long-term history, as I mentioned in my introductory remarks. On the commercial side, you are correct.

I mean, I guess you pointed to consulting because consulting is usually the most discretionary type of spend of our clients. So far, not one -- I would say not one, nor is not one -- nothing. We are looking -- I am asking every day what is going on with the business in every aspect. I mean -- and I can tell you there is no indication whatsoever that somehow people are approaching their budgets on the commercial side.

Bear in mind the last big recession we had, along with the housing crisis in the end of like '08 -- 2008, '08, '09,'10. The commercial business was affected and really by different factors. There were very large pharma consolidations. And on the commercial side, when you have a large pharma merger, you go from two clients to one client, so that automatically affects your revenues.

Not so much on the clinical side. Generally, if you are in -- if the two pharma companies that merged are in the same therapy, the authorities won't let you merge and generally the -- when pharma merge, they have complementary therapies and the clinical trials continue. So yes, there's laws, that pharma consolidation wave that took place at that time, a lot of it driven by tax considerations, affected our commercial business. We're not seeing any of that so far.

Secondly, there was a unique phenomena then, which was that there was an unusual large number of patent expiries, and those LOEs were sort of accelerating the 2008 to 2012 time frame, and there was a so-called patent cliff. And that was coupled with an unusually low number of new product approvals. The pharma commercial business is largely driven by the net of new approvals versus patent or loss of exclusivity, and usually that's a net positive. At that time, there was unusual circumstances where we had a trough the new approvals and a peak in loss of exclusivity.

And that was a reverse trend but today, we don't see that. We know the pipeline, we know the molecules in the pipe that are supposed to be approved, and the expiries and so on, and we see none of that anytime soon. So we're not concerned and we feel that the commercial business is fairly well insulated as well. Thank you.

Operator

Our next question comes from David Windley from Jefferies. Please go ahead. Your line is open.

David Windley -- Jefferies -- Analyst

Hi. Thanks. Good morning. Thanks for taking my question.

Ari, you've you've touched on China and Ukraine very effectively. You see -- the R&DS business seems to be navigating through that really, really well. Some of the things that we've heard are that in addition to those acute issues in certain parts of the world that we have kind of general staff burnout, like we have in the broader healthcare system, that sites are overwhelmed and site-level turnover and things like that, are affecting the capacity of the site network that you might be using. I wondered if again, you guys seem to be navigating that really well.

And so I wondered if you could talk to how you are supporting the sites to be able to continue to get your trials processed in an environment where the global capacity for sites is somewhat affected.

Ari Bousbib -- Chairman and Chief Executive Officer

Yeah, and I assume you mean globally, not just Russia, Ukraine. Yeah, I mean, look, Russia. Ukraine, the first part of your question, we addressed that, as you said, quite effectively. That doesn't mean that it was easy or that it didn't consume an enormous amount of management attention and work.

But thankfully, we are able to to reallocate the resources and clinical work to other sites. Now, this itself does not add incrementally to the existing burden of the existing sites. Your second point is more -- I think is extremely valid. It is true we have a lot of work to execute.

I've mentioned many times that this is our single most important operational challenge and that is execution. And that requires people and people recruiting, retention, and development is our single most important operational challenge in the current environment. I think I mentioned before and I see the trend continuing, the high attrition levels we've seen are somewhat plateauing and diminishing. That may have something to do with perhaps a more recessionary environment and people are less likely to jump ship.

Also, they have to do the fact that we really have a strong book of business and we are -- hopefully, I want to I think we need a more exciting work environment and more exciting company to be part of. So we're doing our part to try to retain our people. The sites themselves, I do -- we are not seeing -- I mean, I'm sure if you ask specific individuals, they'd say, yes, I'm burnt out. Are we asking people to work more and to be more productive and so on? Yes, but again, that's just the nature of the type of work that we do.

We're not seeing any execution difficulties as a result of people being, "burnt out." We're not. We -- when people are burnt out, they either quit or they ask to be allocated to something else, and that's what we try to do. We've always tried to prioritize the wellbeing of our employees. And during the pandemic that has accelerated, I think I may or may not have mentioned this before, but even from my cellphone down onwards, we've got -- we've had a dramatic change in tone and how we address issues with employees, with work flexibility.

We do live in a different environment where the considerations for employees and value employees and skilled employees to remain a company involved more than just work and compensation. And so we are doing our part to address that. I mean, we will be 90,000 plus people by the end of the year and we continue to hire -- I mean we certainly will have hired by the end of the year more than 25,000 people just to replace attrition and to support the growth. We are really a hiring machine.

We've dramatically improved the level of sophistication of our human resource management functions around the world and the type of analytics and artificial intelligence tools we used to track our employee's workload, and are really, really unprecedented. So it is an issue. We're managing it. You wanted to add something, Mike?

Mike Fedock -- Senior Vice President, Financial Planning and Analysis

Yeah, I think, Dave, just on the color on the site, I think one thing that we've seen is sites engaging with our on-site support offering we have within R&DS. So they're reaching out to us to try to assist themselves. I'm not going to comment say are sites burnt out or not, but clearly they have a lot of work to do and and we're providing a service to help them execute that work, which is great.

Operator

Our next question comes from Jack Meehan from Nephron Research. Please go ahead. Your line is open.

Jack Meehan -- Nephron Research -- Analyst

Thank you. Good morning. Ari, I was hoping you could share more perspective on the R&D environment, just given your RFP commentary. Just looking back, we had two banner years of funding in 2020 and 2021.

Things have obviously slowed down here in the public markets in 2022. As you look at the things you're bidding on now, give a sense for when they were funded? I guess I'm just trying to get a sense for where you think we are kind of in this funding cycle and it's showing up for a late-stage work.

Ari Bousbib -- Chairman and Chief Executive Officer

OK. Well, thank you and good morning. This is, obviously, a good question. Again, as I mentioned before for the commercial side, I did the same on the clinical side, I am almost daily asking a number of people to monitor activities.

Again, I wouldn't be saying this if I have a certain level of government that so far and to late last night, I can assure you there simply is no sign that the pipeline, very early indicators is slowing down, the RFP volume is slowing down and it is across the board in every segment that the -- the second quarter was another quarter of record bookings. I can tell you I think the awards -- the volume was the second highest quarter ever. So we're just not seeing it. I know there are concerns and it is true that the volume of funding has gone down.

It's just not translating into a slowdown in either the strength and growth of our pipeline has never been as large, record growth and volume, both dollars and numbers, or the RFP volume or the awards or the bookings. Now, you are asking a very, very pertinent question, which is the clients, whether EDP, midsize, large pharma, who are requesting proposals or who are in the pipeline, what -- where did they get their funding? And you are absolutely correct. It takes maybe three years, I'm going to say, before the funding raised today is actually spent in -- is actually spent. So a lot of it is going to be disbursed by these companies that have booked business this quarter, this is cash that was raised in prior periods.

So you want to try to say, well, funding is low now and therefore, two years, three years from now, maybe bookings should then go down. That's just not the experience historically. Again, our business is not dependent on secondary public offerings from pre-commercial EDPs. It's just not.

And secondly, a lot of things are going to happen over the next few years, where -- that's the benefit of scale. Remember, we are all over the world. We have the largest volume of business of any CRO in the world. We're not exposed to one client, two clients, 10 clients, a segment and other segment, a geography, another geography.

At any given point in time, we are working on well over 2,500 trials. I mean, we are a big ship. And like every big ship, it's very hard. We're not going to see from us 50% growth in a quarter.

But on the other hand the converse is also never going to happen. I mean, we are a very big ship and these disturbances in a long cycle business do not affect the direction of our business. Any other comments you want to make?

Jack Meehan -- Nephron Research -- Analyst

[Inaudible] That's good.

Operator

Our next question comes from Shlomo Rosenbaum from Stifel. Please go ahead. Your line is open.

Unknown speaker

Hi, this is Adam on for Shlomo. What was the difference in FX headwind for 2022 that the company is facing today versus what it was expecting on the first quarter earnings call?

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

It was $125 million headwind on revenue on the full year versus what we guided in April.

Ari Bousbib -- Chairman and Chief Executive Officer

The guidance, you mean the second half? What is the question?

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

He asked for FX headwind. So the FX headwind on our full year guidance on revenue was $125 million, 90 basis points worse than last quarter and. Correct.

Operator

Our next question comes from Tejas Savant from Morgan Stanley. Please go ahead. Your line is open.

Tejas Savant -- Morgan Stanley -- Analyst

Hey, Ari. Good morning. Just a couple of quick follow ups here and apologies for beating the R&D backlog to death here again. But we've heard some estimates of up to a third of these pre-commercial companies possibly needing to raise capital at some point in '23.

Does that sort of at the margin change your calculus at all in terms of who you choose to work with on a go-forward basis? Or do you have perhaps higher risk adjustment figures to your backlog as some of these companies get closer to needing a funding raise? And then if you could also comment separately on the M&A landscape and how you're sort of thinking about that. I know last quarter you'd said sort of repo is being the near-term priority excuse as to your take on asset valuations.

Ari Bousbib -- Chairman and Chief Executive Officer

Well. OK. Tejas, thank you very much and good morning. Again, on your question on the pre-commercial EDPs, needing more funding and other issues, these are good theoretical question and correct one for the industry.

We're just not exposed to those folks. We have very little backlog that's in -- that's with pre-commercial EDP. Those pre-commercial EDPs had been carefully vetted because that's our process, long predating the current decline in biotech funding. We never take on a molecule that doesn't have very solid science behind it, that our scientific experts have vetted and believe in.

That in and of itself is a guarantee that the science will be developed and that the clinical trials will go on independently of the funding, because worst case scenario, that science will be purchased by large pharma. You are seeing it today. You're seeing a number of large pharma companies buy out pre-commercial EDPs because those commercial entities may be running into funding issues, but the science is good. Therefore, the trial will continue no matter what.

So that's number one. Number two, we are not going to take into a backlog a company that doesn't have funding. It just doesn't happen for us. We do a thorough financial vetting of the project before we put it into our backlog so we don't have that exposure.

Our business model is different than perhaps some other smaller CROs that essentially team up with pre-commercial EDPs and go around to raise funding. They -- and they put that into their backlog. We don't do that. So this is the reason why we're not seeing anything different to, again, neither the pipeline nor the RFP volume nor the awards nor the bookings.

Again, I mean, I've got a few slew of numbers. I'm looking at a very fine level of granularity here. Look at oncology. If we look at our qualified pipeline, which is [Inaudible], with a very, very fine comb, our oncology pipeline we have a lot of pre-commercial EDPs.

And that's -- I'm speaking about the qualified pipeline, that's really, really high probability is up in the quarter 17%, 1-7, year over year. You look at internal medicine where there's a lot of rare disease stock, 14% up, qualified pipeline. Look at the pipeline in general for EDP. The pipeline is 18% up year over year in the quarter.

I mean, I'm looking at numbers that are literally record numbers both in growth and in dollars and in volume. So I wouldn't be speaking confidently if I didn't have any numbers that could tomorrow. We could all wake up tomorrow and the world is falling apart. I don't know but that's -- if I believe that, I wouldn't cross the street.

I'm looking at numbers. The rest is noise. You have another question? [Inaudible]

Tejas Savant -- Morgan Stanley -- Analyst

[Inaudible] It was on M&A. I'm just prioritizing vis-a-vis repos. Thank you, Ari.

Ari Bousbib -- Chairman and Chief Executive Officer

Yeah, yeah, yeah, M&A. Well, as you saw, we purchased almost $1 billion in the first half of the year and -- of shares. We did very little M&A not because we didn't want to. At any given point in time, we've always had a lot.

I mean lots, hundreds of potential acquisitions, small, mid, large, and that's our job. We've got a couple of development activities. We rarely execute on those, whether it's for strategic reasons or for financial reasons, sometimes. As you said, valuations have been a little bit out of whack.

It always takes time for those valuation expectations to come down and adjust to public market valuations and the environment. I think we're seeing a little bit more of that, so perhaps we will have more opportunities to execute in the second half. I just don't know. Acquisitions are binary, but we don't have -- if the acquisition make sense, if it fits in our strategy and there's nothing big here or unlike anything that we've done in the past.

You know in what we do, we're very disciplined. And if it fits in our strategy on the commercial side or the clinical side, then we'll go ahead and do it if the valuation makes sense. Thank you for your question.

Operator

Our last question will come from John Sourbeer from UBS. Please go ahead. Your line is open. John Sourbeer from UBS, your line is open.

John Sourbeer -- UBS -- Analyst

Hi, can you hear me?

Ari Bousbib -- Chairman and Chief Executive Officer

Yes. Yes, we can hear you.

John Sourbeer -- UBS -- Analyst

Great. I know it's a little early to comment on the '23 guidance, but when you think about the headline from biotech funding and then on the other hand, the company has billion in COVID R&DS headwinds this year, potentially easing comps for next year. Do you think that the '23 R&DS growth is going to be in line with that long term, low double digit guidance that was provided last year at the Investor Day?

Ari Bousbib -- Chairman and Chief Executive Officer

OK. Let me give you '23 guidance, I was just kidding. I don't know. It's a little bit early.

And as we discussed over the course of the past hour, there are lots of macro dynamics and so on and so forth. We're not going to stop venturing. There is basically nothing different today from what we told you at the end of last year in the underlying dynamics and fundamentals of our businesses, strategically or operationally. What's changed is the financial environment and the dynamics of risk because of the Russia, Ukraine, because of the energy prices and so on, so forth.

But that doesn't affect, as we've said over and over again, the underlying dynamics and fundamentals of our business. And as I sit here today, those are the same as they were when we gave you long-term guidance back in November. Thank you for your question.

Operator

We are out of time for questions today. Mr. Childs, I turn the call back over to you.

Nick Childs -- Senior Vice President, Investor Relations and Corporate Communications

OK. Thank you everyone for joining us today. We look forward to talking to you after the call and on our next call in the -- at the end of the third quarter. If anyone has any other follow-up questions, we'll be happy to take them.

Thank you all for joining.

Operator

[Operator signoff]

Duration: 0 minutes

Call participants:

Nick Childs -- Senior Vice President, Investor Relations and Corporate Communications

Ari Bousbib -- Chairman and Chief Executive Officer

Ron Bruehlman -- Executive Vice President and Chief Financial Officer

Sandy Draper -- Guggenheim Partners -- Analyst

Mike Fedock -- Senior Vice President, Financial Planning and Analysis

Eric Coldwell -- Robert W. Baird and Company -- Analyst

Elizabeth Anderson -- Evercore ISI -- Analyst

Derik De Bruin -- Bank of America Merrill Lynch -- Analyst

David Windley -- Jefferies -- Analyst

Jack Meehan -- Nephron Research -- Analyst

Unknown speaker

Tejas Savant -- Morgan Stanley -- Analyst

John Sourbeer -- UBS -- Analyst

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