Medpace (MEDP) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue rose 32% year-over-year to $708.5 million; full-year revenue was $2.53 billion, up 20% from 2024.

• Net new business awards in Q4 2025 increased 39.1% to $736.6 million; full-year awards totaled $2.65 billion, up 18.7%.

• Backlog cancellations reached their highest in over a year, resulting in a net book-to-bill ratio of 1.04 in Q4.

• Business environment described as adequate and improving, with strong oncology bookings and elevated metabolic cancellations.

• Oncology was the largest therapeutic area in 2025, accounting for 31% of revenue; small biopharma contributed 79%.

Financial highlights

• Q4 2025 EBITDA was $160.2 million (22.6% margin), up 20% year-over-year; full-year EBITDA was $557.7 million (22.0% margin), up 16.1%.

• Q4 net income was $135.1 million, up 15.5%; full-year net income was $451.1 million, up 11.6%.

• Q4 EPS was $4.67 (vs. $3.67 prior year); full-year EPS was $15.28 (vs. $12.63 in 2024).

• Free cash flow for Q4 2025 was $188.1 million; year-end cash and equivalents ranged from $497 million to $669.4 million.

• Net income margin declined to 19.1% in Q4 and 17.8% for full year 2025.

Outlook and guidance

• 2026 revenue expected between $2.755 billion and $2.855 billion, representing 8.9%-12.8% growth.

• 2026 EBITDA forecasted at $605 million-$635 million, up 8.5%-13.9%.

• 2026 net income projected at $487 million-$511 million; EPS expected at $16.68-$17.50.

• Guidance assumes effective tax rate of 18.5%-19.5%, interest income of $24.3-$29.2 million, and no additional share repurchases.