Medpace (MEDP) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue reached $706.6 million, up 26.5% year-over-year, driven by strong performance in Metabolic, Oncology, CNS, and AVAI therapeutic areas, with a backlog conversion rate of 23.3%.

• Net new business awards totaled $618.4 million, a 23.7% increase year-over-year, but the net book-to-bill ratio was 0.88 due to elevated cancellations and weaker gross bookings.

• Backlog as of March 31, 2026, was $2.93 billion, up 2.9% year-over-year, with $1.94 billion expected to convert to revenue in the next 12 months.

• Net income increased 8.1% to $123.9 million ($4.28 per diluted share), with diluted EPS rising 16.6% from the prior year.

• President Jesse Geiger will retire after 18.5 years; CEO August Troendle to reassume president duties.

Financial highlights

• EBITDA was $149.4 million, up 25.9% year-over-year, with an EBITDA margin of 21.1%.

• Operating income for Q1 2026 was $141.5 million, up from $113.5 million in Q1 2025.

• Cash and cash equivalents stood at $652.7 million as of March 31, 2026; operating cash flow was $151.8 million.

• Free cash flow for the quarter was $145.0 million, with a conversion rate of 97.1%.

• SG&A expenses decreased 17.2% year-over-year to $47.9 million, mainly from lower stock-based compensation.

Outlook and guidance

• 2026 guidance for revenue, EBITDA, net income, and EPS remains unchanged, with revenue forecasted at $2.755–$2.855 billion, EBITDA at $605–$635 million, net income at $487–$511 million, and EPS at $16.68–$17.50, assuming a 19%–20% tax rate.

• No additional share repurchases included in current guidance.

• Management expresses confidence in meeting guidance despite cancellation headwinds, but acknowledges future cancellations could impact results.

• Backlog conversion to revenue is expected to remain robust over the next twelve months.

• Capital spending as a percentage of revenue decreased to 0.96% for the quarter.