v3.25.4

ENTITY WIDE DISCLOSURES | 12 Months Ended
--- | ---
Dec. 31, 2025
Entity Wide Disclosures [Abstract] |
ENTITY WIDE DISCLOSURES | SEGMENT DISCLOSURES Information about the reportable segment, significant segment expenses and a reconciliation to consolidated net income is as follows (in thousands):
| Year Ended December 31,
| 2025 |  | 2024 |  | 2023
Revenue, net | $ | 2,530,234 |  |  | $ | 2,109,054 |  |  | $ | 1,885,842 |
Operating expenses: |  |  |  |  |
Direct service costs, excluding depreciation and amortization - Employee compensation | 588,786 |  |  | 545,417 |  |  | 499,528 |
Direct service costs, excluding depreciation and amortization - Other segment items (a) | 143,342 |  |  | 136,678 |  |  | 138,721 |
Reimbursed out-of-pocket expenses | 1,037,488 |  |  | 770,654 |  |  | 723,088 |
Total direct costs | 1,769,616 |  |  | 1,452,749 |  |  | 1,361,337 |
Selling, general and administrative | 197,559 |  |  | 180,184 |  |  | 161,352 |
Depreciation | 27,178 |  |  | 27,808 |  |  | 24,129 |
Amortization | 946 |  |  | 1,443 |  |  | 2,199 |
Total operating expenses | 1,995,299 |  |  | 1,662,184 |  |  | 1,549,017 |
Income from operations | 534,935 |  |  | 446,870 |  |  | 336,825 |
Other income (expense), net: |  |  |  |  |
Miscellaneous (expense) income, net | (5,338) |  |  | 4,056 |  |  | (655) |
Interest income (expense), net | 12,780 |  |  | 24,996 |  |  | (488) |
Total other income (expense), net | 7,442 |  |  | 29,052 |  |  | (1,143) |
Income before income taxes | 542,377 |  |  | 475,922 |  |  | 335,682 |
Income tax provision | 91,254 |  |  | 71,536 |  |  | 52,872 |
Segment net income | $ | 451,123 |  |  | $ | 404,386 |  |  | $ | 282,810 |
Reconciliation of profit or loss |  |  |  |  |
Adjustments and reconciling items | — |  |  | — |  |  | — |
Consolidated net income | $ | 451,123 |  |  | $ | 404,386 |  |  | $ | 282,810 |
(a) Direct service costs, excluding depreciation and amortization - Other segment items includes costs related to inventory, leases, project subcontractors and other direct service costs. Operations By Geographic Location The Company conducts operations in North America, Europe, Asia, South America, Africa and Australia through wholly-owned subsidiaries and representative sales offices. The Company attributes revenue to geographical locations based upon the location of the contracting entity. For the years ended December 31, 2025, 2024 and 2023, total revenue attributable to the U.S. represented approximately 99%, 98% and 98% of total consolidated total revenue, respectively. The following table summarizes property and equipment, net by geographic region and is further broken down to show countries which account for 10% or more of total as of December 31, if any (in thousands):
| 2025 |  | 2024
Property and equipment, net: |  |  |
United States | $ | 83,898 |  |  | $ | 80,692 |
Europe |  |  |
Belgium | 22,998 |  |  | 18,557 |
Other | 6,822 |  |  | 7,456 |
Total Europe | 29,820 |  |  | 26,013 |
Asia-Pacific | 14,910 |  |  | 14,552 |
Other | 2,427 |  |  | 2,358 |
Total property and equipment, net | $ | 131,055 |  |  | $ | 123,615 |
Revenue by Category The following table disaggregates the Company’s revenue by major source (in thousands):
| Year Ended December 31,
| 2025 |  | 2024 |  | 2023
Therapeutic Area |  |  |  |  |
Oncology | $ | 747,585 |  |  | $ | 651,237 |  |  | $ | 587,097 |
Metabolic | 744,957 |  |  | 457,542 |  |  | 376,842 |
Other | 408,548 |  |  | 431,384 |  |  | 404,844 |
Central Nervous System | 254,838 |  |  | 181,977 |  |  | 160,057 |
Cardiology | 239,371 |  |  | 230,454 |  |  | 193,690 |
AVAI | 134,935 |  |  | 156,460 |  |  | 163,312 |
Total revenue | $ | 2,530,234 |  |  | $ | 2,109,054 |  |  | $ | 1,885,842 |

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