Tearsheet

Medpace (MEDP)


Market Price (3/9/2026): $470.5 | Market Cap: $13.3 Bil
Sector: Health Care | Industry: Life Sciences Tools & Services

Medpace (MEDP)


Market Price (3/9/2026): $470.5
Market Cap: $13.3 Bil
Sector: Health Care
Industry: Life Sciences Tools & Services

Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.

0 Attractive operating margins
Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is 21%
Weak multi-year price returns
2Y Excs Rtn is -15%
Expensive valuation multiples
P/EBITPrice/EBIT or Price/(Operating Income) ratio is 25x, P/EPrice/Earnings or Price/(Net Income) is 30x
1 Attractive cash flow generation
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 28%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 27%
  Key risks
MEDP key risks include its high concentration of small and mid-sized biopharmaceutical clients, Show more.
2 Attractive yield
FCF Yield is 5.1%
  
3 Megatrend and thematic drivers
Megatrends include Precision Medicine, and Biotechnology & Genomics. Themes include Biopharmaceutical R&D, Gene Editing & Therapy, Show more.
  
0 Attractive operating margins
Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is 21%
1 Attractive cash flow generation
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is 28%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is 27%
2 Attractive yield
FCF Yield is 5.1%
3 Megatrend and thematic drivers
Megatrends include Precision Medicine, and Biotechnology & Genomics. Themes include Biopharmaceutical R&D, Gene Editing & Therapy, Show more.
4 Weak multi-year price returns
2Y Excs Rtn is -15%
5 Expensive valuation multiples
P/EBITPrice/EBIT or Price/(Operating Income) ratio is 25x, P/EPrice/Earnings or Price/(Net Income) is 30x
6 Key risks
MEDP key risks include its high concentration of small and mid-sized biopharmaceutical clients, Show more.

Valuation, Metrics & Events

Price Chart

Why The Stock Moved

Qualitative Assessment

AI Analysis | Feedback

Medpace (MEDP) stock has lost about 20% since 11/30/2025 because of the following key factors:

1. Elevated Backlog Cancellations and Resulting Margin Pressure.

Medpace experienced a significant increase in backlog cancellations during the fourth quarter of 2025, which were described by CEO August Troendle as the highest in over a year and particularly impacted the metabolic therapeutic area. This led to a lower net book-to-bill ratio of 1.04x for Q4 2025. This uptick in cancellations and a shift in business mix contributed to a decline in operating margin to 21.6% in Q4 2025, down from 23.4% in the comparable prior-year period. Similarly, the EBITDA margin for Q4 2025 was 22.6%, compared to 24.9% in Q4 2024.

2. Moderating 2026 Revenue Growth Guidance.

Despite strong 2025 revenue growth of 20.0% to $2.53 billion, Medpace provided 2026 revenue guidance in the range of $2.755 billion to $2.855 billion. This forecast represents a growth rate of 8.9% to 12.8% over 2025 revenue. This anticipated moderation in growth from previous years was noted negatively by the market, with analysts cutting price targets and suggesting increased pessimism regarding the company's intrinsic value.

Show more

Stock Movement Drivers

Fundamental Drivers

The -20.6% change in MEDP stock from 11/30/2025 to 3/8/2026 was primarily driven by a -23.4% change in the company's P/E Multiple.
(LTM values as of)113020253082026Change
Stock Price ($)592.46470.59-20.6%
Change Contribution By: 
Total Revenues ($ Mil)2,3582,5307.3%
Net Income Margin (%)18.4%17.8%-2.9%
P/E Multiple38.529.5-23.4%
Shares Outstanding (Mil)2828-0.5%
Cumulative Contribution-20.6%

LTM = Last Twelve Months as of date shown

Market Drivers

11/30/2025 to 3/8/2026
ReturnCorrelation
MEDP-20.6% 
Market (SPY)-1.6%25.8%
Sector (XLV)-3.1%28.7%

Fundamental Drivers

The -1.0% change in MEDP stock from 8/31/2025 to 3/8/2026 was primarily driven by a -9.2% change in the company's P/E Multiple.
(LTM values as of)83120253082026Change
Stock Price ($)475.51470.59-1.0%
Change Contribution By: 
Total Revenues ($ Mil)2,2322,53013.4%
Net Income Margin (%)18.7%17.8%-4.9%
P/E Multiple32.529.5-9.2%
Shares Outstanding (Mil)29281.1%
Cumulative Contribution-1.0%

LTM = Last Twelve Months as of date shown

Market Drivers

8/31/2025 to 3/8/2026
ReturnCorrelation
MEDP-1.0% 
Market (SPY)4.5%34.9%
Sector (XLV)11.6%34.9%

Fundamental Drivers

The 43.8% change in MEDP stock from 2/28/2025 to 3/8/2026 was primarily driven by a 20.0% change in the company's Total Revenues ($ Mil).
(LTM values as of)22820253082026Change
Stock Price ($)327.32470.5943.8%
Change Contribution By: 
Total Revenues ($ Mil)2,1092,53020.0%
Net Income Margin (%)19.2%17.8%-7.0%
P/E Multiple25.129.517.8%
Shares Outstanding (Mil)31289.4%
Cumulative Contribution43.8%

LTM = Last Twelve Months as of date shown

Market Drivers

2/28/2025 to 3/8/2026
ReturnCorrelation
MEDP43.8% 
Market (SPY)14.2%28.6%
Sector (XLV)3.9%36.2%

Fundamental Drivers

The 142.7% change in MEDP stock from 2/28/2023 to 3/8/2026 was primarily driven by a 73.3% change in the company's Total Revenues ($ Mil).
(LTM values as of)22820233082026Change
Stock Price ($)193.88470.59142.7%
Change Contribution By: 
Total Revenues ($ Mil)1,4602,53073.3%
Net Income Margin (%)16.8%17.8%6.1%
P/E Multiple24.629.519.8%
Shares Outstanding (Mil)312810.2%
Cumulative Contribution142.7%

LTM = Last Twelve Months as of date shown

Market Drivers

2/28/2023 to 3/8/2026
ReturnCorrelation
MEDP142.7% 
Market (SPY)76.0%32.3%
Sector (XLV)25.7%36.0%

Return vs. Risk

Price Returns Compared

 202120222023202420252026Total [1]
Returns
MEDP Return56%-2%44%8%69%-16%237%
Peers Return54%-32%3%-20%6%-16%-22%
S&P 500 Return27%-19%24%23%16%-0%82%

Monthly Win Rates [3]
MEDP Win Rate67%58%75%33%67%67% 
Peers Win Rate81%33%42%37%54%42% 
S&P 500 Win Rate75%42%67%75%67%33% 

Max Drawdowns [4]
MEDP Max Drawdown-5%-40%-18%-7%-17%-26% 
Peers Max Drawdown-1%-42%-21%-27%-40%-23% 
S&P 500 Max Drawdown-1%-25%-1%-2%-15%-1% 


[1] Cumulative total returns since the beginning of 2021
[2] Peers: IQV, CRL, LH, FTRE.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2026 data is for the year up to 3/6/2026 (YTD)

How Low Can It Go

Unique KeyEventMEDPS&P 500
2022 Inflation Shock2022 Inflation Shock  
2022 Inflation Shock% Loss% Loss-42.9%-25.4%
2022 Inflation Shock% Gain to Breakeven% Gain to Breakeven75.0%34.1%
2022 Inflation ShockTime to BreakevenTime to Breakeven261 days464 days
2020 Covid Pandemic2020 Covid Pandemic  
2020 Covid Pandemic% Loss% Loss-39.5%-33.9%
2020 Covid Pandemic% Gain to Breakeven% Gain to Breakeven65.2%51.3%
2020 Covid PandemicTime to BreakevenTime to Breakeven119 days148 days
2018 Correction2018 Correction  
2018 Correction% Loss% Loss-39.0%-19.8%
2018 Correction% Gain to Breakeven% Gain to Breakeven64.1%24.7%
2018 CorrectionTime to BreakevenTime to Breakeven181 days120 days

Compare to IQV, CRL, LH, FTRE

In The Past

Medpace's stock fell -42.9% during the 2022 Inflation Shock from a high on 12/27/2021. A -42.9% loss requires a 75.0% gain to breakeven.

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About Medpace (MEDP)

Medpace Holdings, Inc. provides clinical research-based drug and medical device development services in North America, Europe, and Asia. It offers a suite of services supporting the clinical development process from Phase I to Phase IV in various therapeutic areas. The company also provides clinical development services to the pharmaceutical, biotechnology, and medical device industries; and development plan design, coordinated central laboratory, project management, regulatory affairs, clinical monitoring, data management and analysis, pharmacovigilance new drug application submissions, and post-marketing clinical support services. In addition, it offers bio-analytical laboratory services, clinical human pharmacology, imaging services, and electrocardiography reading support for clinical trials. The company was founded in 1992 and is based in Cincinnati, Ohio.

AI Analysis | Feedback

Medpace is a Clinical Research Organization (CRO) that provides outsourced clinical development services to the pharmaceutical, biotechnology, and medical device industries. Here are 1-2 analogies:

  • It's like **AWS for clinical trials**, providing the essential, scalable infrastructure and services that drug companies need to run their R&D.
  • It's like **Foxconn for drug development**, where Medpace handles the complex, high-volume execution of clinical studies for other companies.

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Major Services of Medpace (MEDP)

  • Clinical Trial Management: Manages and executes all phases of clinical trials (Phase I-IV) for pharmaceutical, biotechnology, and medical device companies.
  • Regulatory Affairs and Medical Writing: Provides strategic regulatory guidance and prepares essential documentation for drug and device development submissions.
  • Biometrics and Data Management: Offers comprehensive services in biostatistics, data collection, and statistical programming for clinical trial data analysis.
  • Central Laboratory Services: Delivers specialized laboratory testing and bioanalysis services required for clinical trials worldwide.
  • Pharmacovigilance: Monitors and reports adverse events and drug safety information throughout the product lifecycle.
  • Early Phase Clinical Development: Conducts complex Phase I studies, including first-in-human trials, in dedicated research units.

AI Analysis | Feedback

Medpace (MEDP) is a Contract Research Organization (CRO) that provides a full range of clinical development services, from early-stage to post-marketing trials, to bring new medical therapies to market. As such, Medpace primarily sells its services to other companies, specifically those involved in the development of pharmaceuticals, biotechnologies, and medical devices.

Due to the confidential nature of their client relationships and the extensive number of companies they serve across various clinical trials, Medpace does not publicly disclose a specific list of its "major customer companies" by name. Their customer base typically includes a diverse portfolio of organizations across the life sciences industry, which can be categorized as:

  • Pharmaceutical Companies: Large, established pharmaceutical firms developing a wide range of drugs across various therapeutic areas.
  • Biotechnology Companies: Companies focused on developing biologic drugs, gene therapies, and other advanced biotechnologies, ranging from large, established biotechs to smaller, emerging firms.
  • Medical Device Companies: Manufacturers developing new medical devices and diagnostics that require clinical validation.

These entities are the "sponsors" of clinical trials, who outsource the design, execution, and reporting of these trials to CROs like Medpace.

AI Analysis | Feedback

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August J. Troendle, M.D. Chief Executive Officer and Chairman of the Board

Dr. Troendle founded Medpace in July 1992. He previously served as a manager at Sandoz (now Novartis) from 1987 to 1992, where he was responsible for the clinical development of lipid-altering agents. From 1986 to 1987, Dr. Troendle worked as a Medical Review Officer at the FDA's Division of Metabolic and Endocrine Drug Products. He has served on the boards of several public and private healthcare companies, including Coherus BioSciences, Inc., Xenon Pharmaceuticals Inc., Symplmed Pharmaceuticals, LLC, LIB Therapeutics, LLC, and CinRx Pharma, LLC. Medpace was acquired by CCMP Capital in 2011 and subsequently by Cinven in 2014, before becoming a publicly traded company in 2017.

Jesse Geiger President

Mr. Geiger joined Medpace in October 2007 as Corporate Controller. He was appointed Chief Financial Officer in March 2011 and expanded his role to include Chief Operating Officer, Laboratory Operations in November 2014. Mr. Geiger was appointed President on August 1, 2021. Prior to Medpace, he served as Corporate Controller and Manager of Financial Planning and Analysis for SENCORP from 2004 to 2007, and as Director of Capital Markets for Cincinnati Bell from 2002 to 2004. He began his career in the audit practice at Arthur Andersen LLP. Mr. Geiger has also served as a director for private companies such as LIB Therapeutics, LLC and CinRx Pharma, LLC.

Kevin Brady Chief Financial Officer

Mr. Brady joined Medpace in 2018 and was appointed Chief Financial Officer effective August 1, 2021. He previously served as Executive Director of Finance and Treasurer for Medpace. Before joining Medpace, he was the Vice President of Finance for Myriad Genetics, Inc. from 2015 to 2018. Prior to Myriad, he spent 10 years at Procter & Gamble in various finance and accounting leadership positions (2003-2014). His experience also includes serving as Vice President & Corporate Controller of Assurex Health (2015-2016) and Corporate Controller of Champion Window Manufacturing (2014-2015). Mr. Brady began his career in the audit practice at Ernst & Young LLP.

Susan Burwig Executive Vice President, Operations

Ms. Burwig joined Medpace in August 1993 and has held various key leadership roles within the Clinical Operations department. She served as Senior Vice President, Clinical Operations from February 2003 to May 2015, where she oversaw clinical trial management, monitoring, start-up activities, and new business proposals. In June 2015, Ms. Burwig was appointed Senior Vice President, Operations, and in January 2017, she was named Executive Vice President, Operations. Before joining Medpace, she led heart failure clinical research studies at the University of Cincinnati.

Stephen P. Ewald General Counsel, Chief Compliance Officer & Corporate Secretary

Mr. Ewald joined Medpace in 2012. Previously, he served as the Managing Director and Chief Legal Officer of Brevet Capital Management.

AI Analysis | Feedback

The key risks to Medpace's business (NASDAQ: MEDP) include the company's reliance on funding within the biopharmaceutical sector, the impact of evolving healthcare regulations, and broader market volatility affecting research and development budgets.

  1. Reliance on Small and Mid-Sized Biopharmaceutical Clients and Contract Risks: Medpace primarily serves small and mid-sized biopharmaceutical companies, which may have limited access to capital. A significant risk stems from the potential for a sudden, sustained decrease in new business awards or an increase in project cancellations if these clients face funding constraints. Furthermore, the loss, delay, or non-renewal of contracts, or non-payment for services rendered, could adversely impact Medpace's financial results. The conversion rate of the company's backlog into actual revenue is also subject to fluctuations.
  2. Regulatory Changes and Healthcare Reform: The clinical research industry is subject to stringent and evolving regulatory requirements. Changes in government regulations, compliance standards, or healthcare reform policies, such as mandates for drug price reductions or cuts in healthcare expenses, could lead to increased operational costs, delays in clinical trial timelines, reduced demand for Medpace's services, or negative impacts on profitability.
  3. Market Volatility and Economic Downturns: Economic downturns or general volatility within the biotechnology and pharmaceutical sectors can significantly influence research and development budgets. Such market conditions may lead to reduced demand for Medpace's clinical development services, impacting the company's growth trajectory and financial performance.

AI Analysis | Feedback

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The addressable market for Medpace's main products and services, which primarily fall under the Contract Research Organization (CRO) sector providing comprehensive clinical trial services, is substantial both globally and within the United States.

For the **global** market, the Contract Research Organization (CRO) services market size in 2025 is estimated to be between approximately USD 77.00 billion and USD 92.27 billion. This market is projected to grow significantly, with some estimates reaching USD 149.34 billion by 2034 and USD 175.53 billion by 2032.

For the **U.S.** market, the Contract Research Organization (CRO) services market size in 2025 is estimated to be between approximately USD 15.01 billion and USD 24.1 billion. The U.S. market is also expected to grow, with projections suggesting it could reach USD 37.63 billion by 2034 and USD 49.56 billion by 2032.

AI Analysis | Feedback

Medpace (MEDP) is expected to experience future revenue growth over the next 2-3 years driven by several key factors:

  1. Continued Growth in Pharmaceutical and Biotechnology R&D Spending: The broader clinical research organization (CRO) industry, including Medpace, is poised to benefit from sustained increases in pharmaceutical and biotechnology research and development (R&D) expenditures. This trend is fueled by the escalating complexity of clinical trials and the global nature of drug development, creating a persistent demand for outsourced clinical services.
  2. Conversion of Existing Backlog and Robust Net New Business Awards: Medpace consistently reports on its substantial backlog of awarded projects, a significant portion of which is anticipated to convert into revenue within the next 12 months. The company also aims for a normalized book-to-bill ratio exceeding 1.15 in the second half of 2025, indicating strong acquisition of new business that will translate into future revenue.
  3. Strategic Expansion of Operational Capacity and Workforce: Medpace is undertaking a significant investment in expanding its Cincinnati headquarters. This includes constructing new office buildings and a Clinical Pharmacology Unit, a project valued at $327 million. This expansion is projected to nearly double the campus's total seating capacity and create 1,500 new jobs over six years, directly enhancing Medpace's ability to take on and execute more clinical trials.
  4. Deep Therapeutic Expertise and Focus on High-Growth Therapeutic Areas: Medpace's scientifically-driven approach and deep therapeutic expertise, particularly in high-growth areas such as Metabolic, Oncology, and Central Nervous System, enable the company to attract specialized and complex clinical trials. This specialized focus allows Medpace to capture a significant share of R&D spending in these critical therapeutic segments.

AI Analysis | Feedback

Share Repurchases

  • Medpace repurchased approximately $912.9 million in shares year-to-date through Q3 2025, with $821.7 million remaining under its authorized share repurchase program as of Q3 2025.
  • In 2024, the company repurchased $174.2 million in shares and announced a $600 million increase to its stock repurchase program.
  • In 2022, Medpace repurchased approximately $847.7 million in shares.

Share Issuance

  • Medpace's basic shares outstanding have shown a net decline over the last few years, indicating a focus on share repurchases rather than new issuances. For example, annual basic shares outstanding for 2023 were $0.031 billion, a 5.14% decline from 2022, and for 2022 were $0.032 billion, a 9.69% decline from 2021.

Inbound Investments

  • No significant inbound investments by third-parties were identified in the provided information for the specified period.

Outbound Investments

  • No significant outbound investments or acquisitions by Medpace were identified in the provided information for the specified period.

Capital Expenditures

  • Medpace's capital expenditures were $36.5 million (1.7% of revenue) in 2024, $36.6 million (1.9% of revenue) in 2023, and $36.9 million (2.5% of revenue) in 2022.
  • These expenditures are primarily focused on infrastructure investments in facilities, equipment, and technology.
  • Medpace generally operates with a "CapEx light business model," with capital expenditures typically around 2% of revenue.

Better Bets vs. Medpace (MEDP)

Latest Trefis Analyses

Trade Ideas

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Unique KeyDateTickerCompanyCategoryTrade Strategy6M Fwd Rtn12M Fwd Rtn12M Max DD
QDEL_2282026_Insider_Buying_45D_2Buy_200K02282026QDELQuidelOrthoInsiderInsider Buys 45DStrong Insider Buying
Companies with multiple insider buys in the last 45 days
0.0%0.0%0.0%
CHE_2272026_Dip_Buyer_FCFYield02272026CHEChemedDip BuyDB | FCFY OPMDip Buy with High FCF Yield and High Margin
Buying dips for companies with high FCF yield and meaningfully high operating margin
0.0%0.0%0.0%
LLY_2272026_Monopoly_xInd_xCD_Getting_Cheaper02272026LLYEli LillyMonopolyMY | Getting CheaperMonopoly-Like with P/S Decline
Large cap with monopoly-like margins or cash flow generation and getting cheaper based on P/S multiple
0.0%0.0%0.0%
HAE_2202026_Dip_Buyer_FCFYield02202026HAEHaemoneticsDip BuyDB | FCFY OPMDip Buy with High FCF Yield and High Margin
Buying dips for companies with high FCF yield and meaningfully high operating margin
3.5%3.5%0.0%
IQV_2132026_Dip_Buyer_ValueBuy02132026IQVIQVIADip BuyDB | P/E OPMDip Buy with Low PE and High Margin
Buying dips for companies with tame PE and meaningfully high operating margin
7.1%7.1%-3.0%
MEDP_4302025_Dip_Buyer_ValueBuy04302025MEDPMedpaceDip BuyDB | P/E OPMDip Buy with Low PE and High Margin
Buying dips for companies with tame PE and meaningfully high operating margin
89.6%46.5%-6.4%
MEDP_8312022_Dip_Buyer_FCFYield08312022MEDPMedpaceDip BuyDB | FCFY OPMDip Buy with High FCF Yield and High Margin
Buying dips for companies with high FCF yield and meaningfully high operating margin
33.0%83.1%-1.7%

Recent Active Movers

Peer Comparisons

Peers to compare with:

Financials

MEDPIQVCRLLHFTREMedian
NameMedpace IQVIA Charles .Labcorp Fortrea  
Mkt Price470.59174.49174.46269.679.61174.49
Mkt Cap13.329.68.622.30.913.3
Rev LTM2,53016,3104,01513,9522,7234,015
Op Inc LTM5352,2874011,516-31535
FCF LTM6822,0515181,20688682
FCF 3Y Avg5501,8884621,059150550
CFO LTM7132,6547381,640114738
CFO 3Y Avg5852,5067191,518182719

Growth & Margins

MEDPIQVCRLLHFTREMedian
NameMedpace IQVIA Charles .Labcorp Fortrea  
Rev Chg LTM20.0%5.9%-0.9%7.2%1.0%5.9%
Rev Chg 3Y Avg20.3%4.2%0.4%3.5%-1.3%3.5%
Rev Chg Q32.0%10.3%-0.8%5.6%-5.2%5.6%
QoQ Delta Rev Chg LTM7.3%2.6%-0.2%1.4%-1.3%1.4%
Op Mgn LTM21.1%14.0%10.0%10.9%-1.1%10.9%
Op Mgn 3Y Avg20.1%14.2%12.0%9.6%-1.1%12.0%
QoQ Delta Op Mgn LTM-0.4%-0.2%1.1%1.0%1.3%1.0%
CFO/Rev LTM28.2%16.3%18.4%11.8%4.2%16.3%
CFO/Rev 3Y Avg26.7%16.1%17.7%11.6%6.6%16.1%
FCF/Rev LTM26.9%12.6%12.9%8.6%3.2%12.6%
FCF/Rev 3Y Avg25.0%12.1%11.4%8.1%5.5%11.4%

Valuation

MEDPIQVCRLLHFTREMedian
NameMedpace IQVIA Charles .Labcorp Fortrea  
Mkt Cap13.329.68.622.30.913.3
P/S5.31.82.11.60.31.8
P/EBIT24.912.81,140.916.7-1.016.7
P/E29.521.8-59.525.4-0.921.8
P/CFO18.711.211.613.68.211.6
Total Yield3.4%4.6%-1.7%5.0%-106.2%3.4%
Dividend Yield0.0%0.0%0.0%1.1%0.0%0.0%
FCF Yield 3Y Avg4.7%5.0%4.5%5.4%7.8%5.0%
D/E0.00.50.30.31.20.3
Net D/E-0.00.50.30.31.00.3

Returns

MEDPIQVCRLLHFTREMedian
NameMedpace IQVIA Charles .Labcorp Fortrea  
1M Rtn-13.2%-6.9%-7.8%-2.5%-34.4%-7.8%
3M Rtn-14.1%-22.7%-5.3%4.6%-32.5%-14.1%
6M Rtn-3.4%-7.0%6.4%-2.7%-17.4%-3.4%
12M Rtn41.4%-8.9%-0.8%7.7%-10.0%-0.8%
3Y Rtn150.3%-14.0%-18.8%23.1%-73.9%-14.0%
1M Excs Rtn-14.1%-11.8%-11.4%-0.0%-38.1%-11.8%
3M Excs Rtn-16.8%-21.6%-3.9%3.3%-32.5%-16.8%
6M Excs Rtn-6.1%-8.9%3.8%-5.2%-12.2%-6.1%
12M Excs Rtn27.9%-21.5%-11.2%-8.2%-27.1%-11.2%
3Y Excs Rtn69.2%-87.8%-92.3%-54.5%-144.5%-87.8%

Financials

Segment Financials

Revenue by Segment
$ Mil20252024202320222021
Single Segment2,1091,886   
Antiviral and Anti-infective (AVAI)  118111103
Cardiology  17512095
Central Nervous System  15812288
Metabolic  245160126
Oncology  468363298
Other  297267215
Total2,1091,8861,4601,142926


Operating Income by Segment
$ Mil20252024202320222021
Single Segment447    
Total447    


Net Income by Segment
$ Mil20252024202320222021
Single Segment404    
Total404    


Price Behavior

Price Behavior
Market Price$470.59 
Market Cap ($ Bil)13.3 
First Trading Date08/11/2016 
Distance from 52W High-24.2% 
   50 Days200 Days
DMA Price$536.12$480.60
DMA Trendupdown
Distance from DMA-12.2%-2.1%
 3M1YR
Volatility43.5%67.9%
Downside Capture213.71133.95
Upside Capture143.14147.50
Correlation (SPY)28.9%28.6%
MEDP Betas & Captures as of 2/28/2026

 1M2M3M6M1Y3Y
Beta1.281.311.261.271.011.09
Up Beta-0.900.381.261.840.710.98
Down Beta-1.39-0.030.190.380.800.66
Up Capture102%130%88%139%195%309%
Bmk +ve Days9203170142431
Stock +ve Days9203063128398
Down Capture412%292%239%157%121%107%
Bmk -ve Days12213054109320
Stock -ve Days12213161122352

[1] Upside and downside betas calculated using positive and negative benchmark daily returns respectively
Based On 1-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with MEDP
MEDP46.7%67.6%0.79-
Sector ETF (XLV)3.4%17.5%0.0436.4%
Equity (SPY)16.4%19.2%0.6628.4%
Gold (GLD)77.1%26.1%2.175.5%
Commodities (DBC)19.6%17.1%0.899.7%
Real Estate (VNQ)3.1%16.6%0.0129.0%
Bitcoin (BTCUSD)-24.9%45.6%-0.4918.9%

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Based On 5-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with MEDP
MEDP23.6%50.9%0.59-
Sector ETF (XLV)7.6%14.5%0.3439.7%
Equity (SPY)13.0%17.0%0.6040.1%
Gold (GLD)24.2%17.2%1.146.6%
Commodities (DBC)11.9%19.0%0.516.1%
Real Estate (VNQ)5.0%18.8%0.1735.3%
Bitcoin (BTCUSD)6.5%56.8%0.3417.8%

Smart multi-asset allocation framework can stack odds in your favor. Learn How
Based On 10-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with MEDP
MEDP33.0%49.7%0.79-
Sector ETF (XLV)10.4%16.5%0.5244.5%
Equity (SPY)15.0%17.9%0.7244.6%
Gold (GLD)15.1%15.6%0.805.6%
Commodities (DBC)9.0%17.6%0.4311.9%
Real Estate (VNQ)6.1%20.7%0.2637.5%
Bitcoin (BTCUSD)65.9%66.8%1.0513.8%

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Short Interest

Short Interest: As Of Date2132026
Short Interest: Shares Quantity1.3 Mil
Short Interest: % Change Since 1312026-3.9%
Average Daily Volume0.6 Mil
Days-to-Cover Short Interest2.2 days
Basic Shares Quantity28.3 Mil
Short % of Basic Shares4.6%

Returns Analyses

Earnings Returns History

Expand for More
 Forward Returns
Earnings Date1D Returns5D Returns21D Returns
2/9/2026-15.9%-19.3% 
10/22/20259.1%6.9%7.2%
7/21/202554.7%46.7%49.6%
4/21/2025-2.3%3.2%6.1%
2/10/2025-7.5%-3.9%-8.3%
10/21/2024-7.5%-6.7%-10.8%
7/22/2024-18.3%-11.9%-10.9%
4/22/20248.2%6.4%5.4%
...
SUMMARY STATS   
# Positive101212
# Negative12109
Median Positive11.8%8.6%10.3%
Median Negative-6.8%-6.8%-9.9%
Max Positive54.7%46.7%49.6%
Max Negative-20.3%-19.6%-22.2%

SEC Filings

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Report DateFiling DateFiling
12/31/202502/10/202610-K
09/30/202510/23/202510-Q
06/30/202507/22/202510-Q
03/31/202504/22/202510-Q
12/31/202402/11/202510-K
09/30/202410/22/202410-Q
06/30/202407/23/202410-Q
03/31/202404/23/202410-Q
12/31/202302/13/202410-K
09/30/202310/24/202310-Q
06/30/202307/25/202310-Q
03/31/202304/25/202310-Q
12/31/202202/14/202310-K
09/30/202210/25/202210-Q
06/30/202207/26/202210-Q
03/31/202204/26/202210-Q

Insider Activity

Expand for More
#OwnerTitleHoldingActionFiling DatePriceSharesTransacted
Value
Value of
Held Shares
Form
1Troendle, August JCEODirectSell12042025590.69668394,581381,694,427Form
2Troendle, August JCEODirectSell12032025593.2523,17813,750,348387,125,288Form
3Troendle, August JCEODirectSell12032025590.475,6983,364,498381,946,700Form
4Troendle, August JCEODirectSell12012025606.8841,33125,082,957419,280,648Form
5Troendle, August JCEODirectSell12012025593.4615,1518,991,512401,017,539Form

MEDP Trade Sentinel


Stock Conviction

UNDERWEIGHT (Score 3-4)

CONVICTION RATIONALE

The stock is assigned a low score despite a mathematically favorable risk/reward skew. The qualitative factors are overwhelmingly negative and leading. An 'ERODING' competitive trajectory, coupled with a 'SPECULATIVE' valuation in the face of a sharp growth deceleration, creates a high risk of the downside scenario materializing. This profile fits a potential value trap where the attractive upside is unlikely to be realized due to deteriorating business fundamentals.

STOCK ARCHETYPE
Type B: 'Quality Compounder / Stalwart'

While Medpace previously exhibited the hyper-growth of a 'High-Beta Compounder' (Type A), the company's own guidance confirms a sharp deceleration. The investment thesis now hinges on the durability of its high margins, ROIC, and moat—hallmarks of a 'Quality Compounder'. The market is currently re-rating the stock from a Type A valuation to a Type B reality.

INVESTMENT THESIS
Durable Profitability and FCF Compounding in High-Science Clinical Trials

The market is over-penalizing Medpace for a growth deceleration that is now public knowledge. The core long-term value driver remains its 'high-science,' physician-led model, which commands superior margins and generates substantial free cash flow. As the market's focus shifts from top-line growth to profitability and capital return, Medpace's elite operational efficiency and accretive buybacks will drive shareholder value.

Mechanism: Medpace captures value by serving as the embedded, high-touch R&D partner for capital-constrained biotech clients with complex drug candidates. This integration creates high switching costs and allows for premium pricing, which translates into industry-leading margins and free cash flow conversion, subsequently used for significant share repurchases.
Supporting Evidence:
  • Superior Profitability: FY 2025 EBITDA margin of 22% and operating margin of 21.6% demonstrate high operational efficiency.
  • Exceptional Capital Efficiency: Asset-light model with a 122.3% conversion rate of EBITDA to free cash flow for the full year 2025.
  • Accretive Capital Allocation: Management has demonstrated a commitment to returning capital to shareholders via substantial share repurchases, totaling $912.9M in 2025.
PRIMARY RISK
Backlog Replenishment Failure Driven by Elevated Cancellations and Competitive Pressure

The primary risk is that the guided slowdown is not a temporary trough but the start of a structural decline. Forward-looking indicators are flashing red: elevated and widespread project cancellations are eroding the existing backlog, while a weak book-to-bill ratio relative to key competitors suggests new business is not being won fast enough to offset the decay. This indicates a potential loss of competitive positioning in its core markets.

Mechanism: A leaky backlog breaks the CRO business model. If cancellations continue to accelerate, the high visibility historically afforded by the backlog will disappear. This forces revenue estimates down, compresses margins as the company fights to win new business, and ultimately leads to a significant P/E multiple contraction as the market loses faith in the company's growth and predictability.
Supporting Evidence:
  • Elevated Cancellations: Management confirmed Q4 2025 saw the highest rate of project cancellations in over a year, with weakness skewed to the critical metabolic area.
  • Slowing Pipeline: The total backlog grew only 4.3% YoY, a rate that cannot structurally support a high-growth narrative.
  • Competitive Underperformance: The Q4 2025 net book-to-bill ratio of 1.04x signals anemic new business wins and lags key competitor IQVIA's stronger 1.18x in the same period.
Key KPI Watchlist
KPI Threshold Rationale
Net Book-to-Bill RatioSustainably > 1.15xThis is the primary indicator of new business momentum. A ratio below 1.1x, especially while lagging peers, confirms the company is losing its growth algorithm.
Project CancellationsNormalization to pre-2025 levelsManagement has flagged this as the key issue driving the current weakness. A failure to normalize this metric means the backlog is unreliable and future revenue is at risk.
Year-over-Year Backlog GrowthRe-acceleration to High-Single-DigitsThe 4.3% growth rate is a major red flag. This KPI must improve to support a narrative of stabilizing growth beyond the next 12 months.
Core Investment Debate

Backlog Integrity vs. Margin Durability

BULL VIEW

The market is over-penalizing a temporary growth slowdown. Superior margins (~22%), high FCF conversion (122.3%), and accretive buybacks will drive long-term value, proving operational excellence.

CORE TENSION

Bears see a leaky backlog (cancellations) and slowing new business as a structural break. Bulls believe elite margins and FCF can weather this now-public growth deceleration.


PREVAILING SENTIMENT
BEARISH

The Q4 2025 earnings report confirmed the highest rate of cancellations in a year, a book-to-bill of 1.04x lagging rival IQVIA, and guidance for a sharp growth deceleration.

BEAR VIEW

Elevated cancellations, anemic backlog growth (4.3% YoY), and a book-to-bill (1.04x) lagging peers (IQV 1.18x) signal a permanent loss of competitive advantage and future revenue.

Next 6 months: Risks and Catalysts
Timeline Event & Metric To Watch
Late April 2026
Q1 2026 Earnings Call
Watch: Net Book-to-Bill ratio. Watch for improvement from Q4's 1.04x and commentary confirming cancellations have normalized from their 'highest in a year' levels.
Late July 2026
Q2 2026 Earnings Call
Watch: FY2026 Guidance Update. The key is whether management reaffirms or revises the current 8.9%-12.8% revenue growth guidance based on H1 trends.
Quarterly (April/July 2026)
Biotech Venture Capital Funding Reports
Watch: Headline: Quarterly change in VC funding for biotech. A downturn directly pressures MEDP's small/mid-sized client base, which comprises 82% of revenue.
Ongoing / Next 6 months
Federal Reserve Interest Rate Decisions
Watch: Headline: 10-Year Treasury Yield breaks and holds above 4.5%. This macro event could trigger a de-rating for high-multiple stocks like MEDP.
Key Events in Last 6 Months
Date Event Stock Impact
8/29/2025
Insider Selling Disclosures
Details: Filings revealed significant insider selling by executives, including the CEO, over the preceding months, a trend that continued through the end of the year.
Flat (0.5%)
$472.94 -> $475.51
10/22/2025
Q3 2025 Earnings Report
Details: Medpace reported strong Q3 results with revenue up 23.7% YoY. Net new business awards surged 47.9% YoY, driving a healthy 1.20x book-to-bill ratio.
Surged +9.1%
$546.74 -> $596.61
12/4/2025
Market Downturn / Profit Taking
Details: Stock experienced a sharp one-day drop, likely due to sector-wide profit-taking or macroeconomic concerns following a strong run-up in prior months.
Plummeted -5.5%
$576.49 -> $544.77
1/15/2026
Stock Hits 52-Week High
Details: Stock reached its peak price in the provided data, rallying over 10% in the first two weeks of the year ahead of its Q4 earnings report.
Surged +10.0%
$561.65 -> $618.04
2/9/2026
Q4 2025 Earnings & FY26 Guidance
Details: Despite beating Q4 estimates (Revenue +32% YoY), stock crashed on news of elevated cancellations, a low 1.04x book-to-bill, and weak FY26 revenue growth guidance of 8.9%-12.8%.
Plummeted -15.9%
$530.35 -> $446.05
Risk Management
Position Sizing

1% - 3%

CONSERVATIVE

Stock is in an Explosive Volatility regime (3.25x S&P). The Bearish sentiment, Speculative valuation, and Eroding Moat override the high backlog visibility, mandating a Conservative sizing.

Diversification Alternatives
IQV
INDUSTRY

Unlike MEDP, IQVIA has stronger new business momentum (book-to-bill 1.18x vs 1.04x) and a data/AI-driven moat that MEDP cannot replicate, offering a more durable growth profile.

Core Thesis: IQVIA is the scaled market leader, leveraging its massive data assets and integrated technology platform to win in an industry consolidating around a few mega-platforms.
TMO
SECTOR

Thermo Fisher (via its PPD unit) offers a highly diversified life sciences tools and services platform, making it less vulnerable to the biotech funding cycle than the concentrated MEDP model.

Core Thesis: TMO is a 'picks and shovels' play on the entire life sciences sector, providing essential tools, services, and clinical research capabilities from discovery to commercialization.
How Is The Market Pricing MEDP?

Medpace is a high-growth Contract Research Organization (CRO) that monetizes a ~$3.0B project backlog by executing clinical trials primarily for small-to-mid-sized biopharma companies.

Filter all news through the lens of backlog growth and quality. The key debate is whether a recent spike in project cancellations is a one-off event or the start of a trend that threatens future revenue growth.

What will confirm the thesis

Book-to-bill ratio consistently >1.10x; net new business awards growth >+15% YoY; management commentary indicating cancellation rates have normalized; announcements of new large-scale trial wins.

What will damage the thesis

Book-to-bill ratio below 1.0x for consecutive quarters; continued commentary on elevated cancellations; news of funding difficulties for small/mid-cap biotech sector; significant customer concentration increase.

Noise: Real but irrelevant to thesis

Quarterly fluctuations in reimbursable pass-through costs; single-trial results for specific customers (the business is a portfolio of trials); general CRO market growth forecasts (Medpace's niche focus is the key driver).

Repricing Catalyst

The market is currently focused on the forward trajectory of revenue growth, repricing the stock based on the interplay between new business wins and a recent, unprecedented spike in project cancellations. The key catalyst will be the book-to-bill ratio in the upcoming quarters. A return to >1.1x would confirm the cancellation spike was temporary, supporting renewed multiple expansion. Continued sluggishness (near 1.0x) would validate the current, more cautious valuation and suggest the 2026 growth guidance (8.9%-12.8%) is at risk.

What MEDP Makes & Who Pays
TTM figures based on Q4 2025 Earnings Press Release, Feb 9, 2026
Clinical Research Services
$2.5B TTM (100% of Total) · 30.1% Margin
What It Is

End-to-end clinical trial management services, including study design, patient recruitment, data management, regulatory submissions, and specialized laboratory services (central lab, imaging core lab, bioanalytical lab).

Who Pays & How

Primarily small and mid-sized biopharmaceutical companies (~80% of revenue) pay Medpace to act as their outsourced R&D department. These clients lack the scale and broad expertise to run complex, global clinical trials in-house and rely on Medpace's integrated, full-service model and therapeutic expertise to accelerate drug development.

Fee-for-service based on time, materials, and unit-based fees for managing the multi-year duration of a clinical study.
Competition
Large CROs like IQVIA, Labcorp, and Icon plc.
Larger competitors have greater scale, broader global reach, and more extensive relationships with large pharmaceutical companies.
Medpace's moat is its specialized focus on the underserved small-to-mid-sized biopharma segment, offering a highly integrated, physician-led, full-service model that these clients prefer over the more fragmented services of larger CROs.
MEDP Evolution: Price Return by Era
1992–2010 · Foundation & Organic Expansion
Building the Physician-Led Model
Founded in 1992 by Dr. August Troendle, Medpace established its identity as a scientifically-driven CRO. This era was defined by methodical, organic growth, expanding services to include central laboratories and imaging labs, and establishing a geographic footprint in Europe, Asia Pacific, and Latin America.
2011–2016 · Private Equity Ownership
Scaling for the Public Market
The company was acquired by private equity firm CCMP Capital in 2011 and later by Cinven in 2014. This period was characterized by scaling the business and preparing for a public listing, culminating in its Initial Public Offering (IPO) in 2016.
2017–Present · Public Company Growth
High-Growth Niche Compounder +~10x (Aug 2016 IPO to Feb 2026)
As a public company, Medpace has demonstrated strong growth by deepening its focus on the small and mid-sized biopharma niche. This strategy has resulted in a multi-billion dollar backlog and significant revenue growth, though the company now faces the challenge of maintaining its high growth rate amid market concerns about project cancellations.
Market Is In Wait-and-See Mode
Price structure is in a downtrend. Multiple SMA levels broken and declining. Thesis requires reclaiming 200D before any bull case is credible. Relative to SPY: Significantly underperforming and deteriorating. Potential evidence of capital being actively rotating away. Volume and momentum are mixed. There is no clear institutional footprint in either direction. Earnings history is mildly supportive. The reaction or drift are positive but not both at full conviction.
① Structure
-4
Structural pillar score (-4 to +4). Driven by trend regime, SMA cross events, proximity to 52W high, and relative strength vs SPY.
② Volume / Momentum
0
Volume/Momentum pillar score (-4 to +4). Driven by institutional footprint score, OBV divergence, and momentum character.
③ Catalyst
+1
Catalyst pillar score (-4 to +4). Driven by earnings day reaction, 20D post-earnings drift, and post-earnings volume character.
Combined Score
-3 / 12
1 Price Structure & Trend Broken In Short Term · -
2 Momentum Deteriorating
3 Relative Strength vs. SPY Strong Underperformance
4 Institutional Footprint & Volume Neutral / Mixed
5 Volatility Normal
6 Key Price Levels Range · Vol Falling
7 Earnings Reaction History Inconsistent
8 How the Verdict Is Derived Three Pillars