Tearsheet

Medpace (MEDP)


Market Price (4/24/2026): $410.72 | Market Cap: $11.6 Bil
Sector: Health Care | Industry: Life Sciences Tools & Services

Medpace (MEDP)


Market Price (4/24/2026): $410.72
Market Cap: $11.6 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%

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%

Stock buyback support
Stock Buyback 3Y Total is 1.2 Bil

Megatrend and thematic drivers
Megatrends include Precision Medicine, and Biotechnology & Genomics. Themes include Biopharmaceutical R&D, Gene Editing & Therapy, Show more.

Weak multi-year price returns
2Y Excs Rtn is -9.2%

Expensive valuation multiples
P/EBITPrice/EBIT or Price/(Operating Income) ratio is 27x, P/EPrice/Earnings or Price/(Net Income) is 32x

Key risks
MEDP key risks include its high concentration of small and mid-sized biopharmaceutical clients, 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 Stock buyback support
Stock Buyback 3Y Total is 1.2 Bil
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 -9.2%
5 Expensive valuation multiples
P/EBITPrice/EBIT or Price/(Operating Income) ratio is 27x, P/EPrice/Earnings or Price/(Net Income) is 32x
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 30% since 12/31/2025 because of the following key factors:

1. Weaker-than-expected Book-to-Bill Ratios and Increased Backlog Cancellations.Medpace's stock decline was primarily driven by lower new business awards relative to revenue, signaling weakening market demand. The book-to-bill ratio for Q4 2025 was 1.04, falling below the company's guidance of 1.15 and leading to a 15.9% stock drop on February 10, 2026. This trend continued into Q1 2026, with the net book-to-bill ratio further dipping to 0.88x, indicating a rise in cancellations and impacting future revenue visibility. The company noted Q4 2025 backlog cancellations were "the highest they've been in over a year".

2. Declining Net Income Margins.Despite strong revenue growth, Medpace experienced a contraction in its net income margin. The net income margin decreased to 17.5% in Q1 2026, down from 20.5% in the comparable prior-year period (Q1 2025). This indicates pressure on profitability, which likely contributed to investor concern despite beating earnings per share estimates for both Q4 2025 and Q1 2026.

Show more
Holding a concentrated position? Know your true downside before the momentum shifts.
Protect Your Wealth →

Stock Movement Drivers

Fundamental Drivers

The -30.0% change in MEDP stock from 12/31/2025 to 4/23/2026 was primarily driven by a -32.4% change in the company's P/E Multiple.
(LTM values as of)123120254232026Change
Stock Price ($)561.65393.42-30.0%
Change Contribution By: 
Total Revenues ($ Mil)2,3582,5307.3%
Net Income Margin (%)18.4%17.8%-2.9%
P/E Multiple36.524.7-32.4%
Shares Outstanding (Mil)2828-0.5%
Cumulative Contribution-30.0%

LTM = Last Twelve Months as of date shown

Market Drivers

12/31/2025 to 4/23/2026
ReturnCorrelation
MEDP-30.0% 
Market (SPY)4.2%31.2%
Sector (XLV)-5.5%28.5%

Fundamental Drivers

The -23.5% change in MEDP stock from 9/30/2025 to 4/23/2026 was primarily driven by a -29.8% change in the company's P/E Multiple.
(LTM values as of)93020254232026Change
Stock Price ($)514.16393.42-23.5%
Change Contribution By: 
Total Revenues ($ Mil)2,2322,53013.4%
Net Income Margin (%)18.7%17.8%-4.9%
P/E Multiple35.224.7-29.8%
Shares Outstanding (Mil)29281.1%
Cumulative Contribution-23.5%

LTM = Last Twelve Months as of date shown

Market Drivers

9/30/2025 to 4/23/2026
ReturnCorrelation
MEDP-23.5% 
Market (SPY)7.0%33.9%
Sector (XLV)5.5%31.0%

Fundamental Drivers

The 29.1% change in MEDP stock from 3/31/2025 to 4/23/2026 was primarily driven by a 20.0% change in the company's Total Revenues ($ Mil).
(LTM values as of)33120254232026Change
Stock Price ($)304.69393.4229.1%
Change Contribution By: 
Total Revenues ($ Mil)2,1092,53020.0%
Net Income Margin (%)19.2%17.8%-7.0%
P/E Multiple23.324.75.8%
Shares Outstanding (Mil)31289.4%
Cumulative Contribution29.1%

LTM = Last Twelve Months as of date shown

Market Drivers

3/31/2025 to 4/23/2026
ReturnCorrelation
MEDP29.1% 
Market (SPY)28.1%29.0%
Sector (XLV)1.5%36.2%

Fundamental Drivers

The 109.2% change in MEDP stock from 3/31/2023 to 4/23/2026 was primarily driven by a 73.3% change in the company's Total Revenues ($ Mil).
(LTM values as of)33120234232026Change
Stock Price ($)188.05393.42109.2%
Change Contribution By: 
Total Revenues ($ Mil)1,4602,53073.3%
Net Income Margin (%)16.8%17.8%6.1%
P/E Multiple23.924.73.2%
Shares Outstanding (Mil)312810.2%
Cumulative Contribution109.2%

LTM = Last Twelve Months as of date shown

Market Drivers

3/31/2023 to 4/23/2026
ReturnCorrelation
MEDP109.2% 
Market (SPY)79.8%31.1%
Sector (XLV)18.3%35.0%

Return vs. Risk

Price Returns Compared

 202120222023202420252026Total [1]
Returns
MEDP Return56%-2%44%8%69%-9%265%
Peers Return54%-32%3%-20%6%-15%-22%
S&P 500 Return27%-19%24%23%16%4%90%

Monthly Win Rates [3]
MEDP Win Rate67%58%75%33%67%75% 
Peers Win Rate81%33%42%37%54%50% 
S&P 500 Win Rate75%42%67%75%67%50% 

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


[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 4/23/2026 (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.

Preserve Wealth

Limiting losses and compounding gains is essential to preserving wealth.

Asset Allocation

Actively managed asset allocation strategies protect wealth. Learn more.

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

Here are 1-3 brief analogies for Medpace (MEDP):

  • The AWS for drug and medical device clinical trials.
  • Accenture for pharmaceutical and medical device R&D.

AI Analysis | Feedback

  • Clinical Development & Monitoring: Comprehensive management and oversight of clinical trials for drugs and medical devices from Phase I through Phase IV.
  • Regulatory Affairs: Expert guidance and support for navigating global regulatory processes and preparing submissions for market authorization.
  • Data Management & Biostatistics: Collection, processing, analysis, and reporting of clinical trial data to derive meaningful insights.
  • Pharmacovigilance: Systematic monitoring and reporting of adverse drug reactions to ensure patient safety throughout the product lifecycle.
  • Central Laboratory Services: Standardized and coordinated laboratory testing, sample management, and bio-analytical services for clinical studies.
  • Specialized Imaging & ECG: Provision of advanced medical imaging and electrocardiography reading support for clinical trials.

AI Analysis | Feedback

Medpace (MEDP) provides clinical research and development services primarily to other companies in the life sciences sector. Medpace serves a broad and diversified client base, and as such, no single customer typically accounts for a significant portion of its revenue (e.g., 10% or more) that would require individual disclosure in its public filings. Therefore, specific names of major customer companies are not publicly available.

Instead, Medpace's customer base can be categorized into the following industries:

  • Pharmaceutical Companies: This includes a range of clients from large, established global pharmaceutical corporations to emerging small and mid-sized drug developers that require clinical trial services for their drug candidates.
  • Biotechnology Companies: Often innovative and rapidly growing firms focused on developing biological products and therapies, these companies frequently outsource their clinical development needs to Contract Research Organizations (CROs) like Medpace.
  • Medical Device Companies: Organizations engaged in the development, manufacturing, and marketing of medical devices also utilize Medpace's services for clinical trials, regulatory support, and post-market studies.

AI Analysis | Feedback

null

AI Analysis | Feedback

August J. Troendle, MD, Chief Executive Officer & Chairman of the Board of Directors
Dr. Troendle founded Medpace in July 1992 and has served as its Chief Executive Officer and Chairman of the Board since its inception. Prior to founding Medpace, he served as Assistant, Associate, and Senior Associate Director at Sandoz (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 in the Division of Metabolic and Endocrine Drug Products at the FDA. He has extensive experience as a director for various public and private companies, including Coherus BioSciences, Inc., Xenon Pharmaceuticals Inc., LIB Therapeutics, LLC, CinCor Pharma, Inc., and CinRx Pharma, LLC. Medpace transitioned from a founder-led private firm to a public CRO after a 2014 recapitalization by CCMP Capital and an August 2016 Nasdaq IPO.

Kevin Brady, Chief Financial Officer and Treasurer
Mr. Brady joined Medpace in November 2018 as Executive Director, Finance, became Treasurer in February 2019, and was appointed Chief Financial Officer on August 1, 2021. Before joining Medpace, he served as Vice President of Finance for Myriad Genetics, Inc. from 2015 to 2018. Prior to Myriad, he spent ten years at Procter & Gamble in various finance and accounting leadership roles and started his career in the audit practice at Ernst & Young LLP. He also served as Vice President & Corporate Controller of Assurex Health from May 2015 through August 2016, which was subsequently acquired by Myriad Genetics, Inc.

Jesse Geiger, President
Mr. Geiger joined Medpace in October 2007 as Corporate Controller, became Chief Financial Officer in March 2011, and expanded his role to include Chief Operating Officer of Laboratory Operations in November 2014. He was appointed President on August 1, 2021. Mr. Geiger was instrumental in leading Medpace through two equity recapitalizations, including with Cinven in early 2014. Prior to Medpace, he worked for SENCORP from 2004 to 2007 as Corporate Controller and Manager of Financial Planning and Analysis, and before that, he was the 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 several private companies, including LIB Therapeutics, LLC and CinRx Pharma, LLC since 2015.

Stephen P. Ewald, General Counsel, Chief Compliance Officer & Corporate Secretary
Mr. Ewald joined Medpace in 2012.

Susan Burwig, Executive Vice President, Operations
Ms. Burwig joined Medpace in 1993.

AI Analysis | Feedback

The key risks to Medpace's business are primarily tied to the cyclical nature and funding environment of the biopharmaceutical industry, stringent regulatory landscapes, and intense market competition. Here are the key risks:
  1. Dependence on Biopharmaceutical R&D Spending, Funding, and Project Cancellations: Medpace's revenue is heavily reliant on the research and development (R&D) expenditures of pharmaceutical, biotechnology, and medical device companies, particularly smaller biopharmaceutical firms which accounted for 79% of its net revenue in 2024. These companies may have limited access to capital, making Medpace susceptible to a slowdown in biotech funding or reduced R&D budgets. A soft biotech funding environment, as observed since 2022, and higher interest rates affecting industry funding, can lead to decreased demand for Medpace's services. Furthermore, cancellations and delays in clinical trials negatively impact Medpace's operating results, with the company reporting a higher level of cancellations and a historically low net book-to-bill ratio in the third quarter of 2024 and Q4 2025.
  2. Regulatory Changes and Compliance Risks: Medpace operates in a highly regulated industry, making it vulnerable to healthcare reform and potential additional regulatory changes that could impact the biopharmaceutical industry. Such reforms might reduce the need for Medpace's services or negatively affect its profitability. Recent legislation mandating medicine price cuts in the U.S. and reductions in U.S. government healthcare expenses pose a considerable risk, as they could lead customers to reduce R&D expenditures. Any failure to comply with stringent regulatory requirements, such as Good Clinical Practice (GCP) regulations, could result in significant liabilities, including the need to repeat clinical trials, thereby affecting the company's financial performance and reputation.
  3. Intense Industry Competition and Pricing Pressure: The clinical research organization (CRO) industry is highly competitive and characterized by rapid consolidation and the emergence of new competitors. Medpace must continuously innovate and differentiate its services to maintain its market position against larger or more specialized CROs. This competitive landscape can lead to increased pricing pressure or other pressures, which could result in a decrease in Medpace's operating margins if the company is unable to achieve efficiencies or grow revenues at a rate faster than expenses.

AI Analysis | Feedback

The increasing adoption of artificial intelligence (AI) and machine learning (ML) by pharmaceutical and biotechnology companies for drug discovery, clinical trial design, patient recruitment, and data analysis represents a clear emerging threat. This technology can enable sponsors to perform more tasks in-house or rely on specialized AI-driven platforms, potentially reducing the scope or volume of traditional outsourced services provided by Contract Research Organizations (CROs) like Medpace. It also opens the door for new, tech-first competitors that leverage AI more effectively in clinical development.

The acceleration and mainstream adoption of decentralized clinical trials (DCTs) and virtual trial models also represent a clear emerging threat. These models shift away from traditional site-centric operations towards remote patient monitoring, telemedicine, wearables, and direct-to-patient services. If Medpace does not rapidly and effectively integrate and scale these technology-driven operational models, it risks losing market share to competitors (both established and new tech-focused players) that are more agile in implementing DCTs, potentially diminishing the demand for Medpace's traditional labor-intensive monitoring and site management services.

AI Analysis | Feedback

Medpace Holdings, Inc. (MEDP) operates within the Contract Research Organization (CRO) industry, providing a comprehensive suite of clinical research-based drug and medical device development services across various therapeutic areas globally, including North America, Europe, and Asia. These services span the entire clinical development process from Phase I to Phase IV.

According to Medpace's corporate presentation from May 2025, their core addressable market for the services they provide is estimated to be $71 billion globally. With a specific emphasis on serving small to mid-sized biotechnology, pharmaceutical, and medical device companies, this addressable market is clarified to be $29 billion globally. Medpace's strategic focus is on these smaller biopharma clients, with 81% of their year-to-date 2025 revenue coming from this segment.

For broader context, the global contract research organization (CRO) services market, which encompasses Medpace's main products and services, was valued at approximately USD 77.00 billion in 2025 and is projected to grow to around USD 149.34 billion by 2034, exhibiting a compound annual growth rate (CAGR) of 7.61% from 2025 to 2034. Other estimates for the global CRO market in 2025 range from USD 84.61 billion to USD 92.27 billion.

Regionally, North America is a significant market for CRO services, holding the largest share of the global market. In 2024, North America accounted for 35% of the global market. Its market size was valued at USD 49.88 billion in 2026. The European CRO market is projected to grow from USD 23.6 billion in 2024 to USD 44.81 billion by 2035. The Asia-Pacific CRO market is estimated at USD 18.94 billion in 2025 and is expected to reach USD 31.10 billion by 2030.

AI Analysis | Feedback

Expected Drivers of Future Revenue Growth for Medpace (MEDP)

Over the next two to three years, Medpace Holdings, Inc. (MEDP) is expected to drive revenue growth through several key factors:
  1. Conversion of Robust Backlog into Revenue: Medpace consistently highlights its significant backlog of awarded projects. For instance, as of December 31, 2025, approximately $1.9 billion of the company's nearly $3 billion backlog was projected to convert into revenue within the subsequent 12 months. This strong existing pipeline provides a predictable base for future revenue generation.
  2. Continued Growth in Net New Business Awards: The company's ability to secure new contracts, evidenced by its net new business awards and book-to-bill ratio, is a crucial indicator of future revenue. Medpace reported $736.6 million in net new business awards in Q4 2025, resulting in a healthy net book-to-bill ratio of 1.04x for the quarter and 1.05x for the full year 2025. A sustained book-to-bill ratio above 1.0 indicates continued expansion of its project pipeline.
  3. Enhanced Operational Efficiency and Productivity: Medpace emphasizes ongoing improvements in operational efficiency and productivity. These efforts are expected to optimize resource utilization, allowing the company to execute projects more efficiently and handle increasing demand, thereby contributing to revenue growth without a proportional increase in costs. The company also noted a modest headcount growth alongside substantial revenue growth, suggesting productivity improvements.
  4. Sustained Demand for Outsourced, Complex Clinical Trials: Medpace's business model is centered on providing services for complex clinical trials across various therapeutic areas, including cutting-edge cell therapy work. The broader long-term need for outsourced clinical research, particularly for specialized and faster-burning studies, underpins the company's revenue acceleration. While there have been some shifts and elevated cancellations in metabolic trials, management expects a normalization of these trends, supporting overall demand for their services.
  5. Stable Funding Environment and Request for Proposal (RFP) Flow: Management commentary suggests a stable funding environment for clinical research and anticipates stable to improved RFP flow. A consistent and robust flow of new project requests is essential for replenishing the backlog and driving future revenue growth.

AI Analysis | Feedback

Share Repurchases

  • Medpace authorized an additional $1 billion share repurchase program in May 2025.
  • For the full year 2025, the company repurchased 2,961,924 shares for a total of $912.9 million.
  • As of December 31, 2025, Medpace had $821.7 million remaining under its authorized share repurchase program.

Share Issuance

  • Medpace Holdings' shares outstanding declined by 7.77% in 2025 to 0.03 billion, indicating that share repurchases outpaced any issuances.
  • In 2024, shares outstanding increased by 0.54% from 2023 to 0.032 billion.
  • Stock-based compensation expense, a source of potential dilution, was $34.786 million in 2025 and $25.514 million in 2024.

Capital Expenditures

  • Property and equipment expenditures were $31.356 million in 2025 and $36.548 million in 2024.
  • Capital expenditures were $36.65 million in 2023 and $36.88 million in 2022.
  • The primary focus of capital expenditures is on infrastructure investments in facilities, equipment, and technology.

Better Bets vs. Medpace (MEDP)

Latest Trefis Analyses

Trade Ideas

Select ideas related to MEDP.

Unique KeyDateTickerCompanyCategoryTrade Strategy6M Fwd Rtn12M Fwd Rtn12M Max DD
PGNY_3312026_Dip_Buyer_High_FCF_Yield_ExInd_DE_RevG03312026PGNYProgynyDip BuyDB | FCF Yield | Low D/EDip Buy with High Free Cash Flow Yield
Buying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap
0.0%0.0%0.0%
CNC_3272026_Dip_Buyer_High_FCF_Yield_ExInd_DE_RevG03272026CNCCenteneDip BuyDB | FCF Yield | Low D/EDip Buy with High Free Cash Flow Yield
Buying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap
2.3%2.3%-0.6%
OSCR_3272026_Dip_Buyer_High_FCF_Yield_ExInd_DE_RevG03272026OSCROscar HealthDip BuyDB | FCF Yield | Low D/EDip Buy with High Free Cash Flow Yield
Buying dips for companies with significant free cash flow yield (FCF / Market Cap) and reasonable debt / market cap
3.0%3.0%-2.6%
WAT_3202026_Monopoly_xInd_xCD_Getting_Cheaper03202026WATWatersMonopolyMY | 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
-0.4%-0.4%-3.3%
GILD_3202026_Quality_Momentum_RoomToRun_10%03202026GILDGilead SciencesQualityQ | Momentum | UpsideQuality Stocks with Momentum and Upside
Buying quality stocks with strong momentum but still having room to run
1.6%1.6%-2.2%
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%55.7%-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 Price393.42160.68167.74264.929.63167.74
Mkt Cap11.127.38.321.90.911.1
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 Inc Chg LTM19.7%0.8%-9.3%33.2%72.6%19.7%
Op Inc Chg 3Y Avg24.4%7.9%-14.3%-1.5%-104.5%-1.5%
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 Cap11.127.38.321.90.911.1
P/S4.41.72.11.60.31.7
P/Op Inc20.811.920.614.4-30.414.4
P/EBIT20.811.81,096.916.4-1.016.4
P/E24.720.1-57.225.0-0.920.1
P/CFO15.610.311.213.38.211.2
Total Yield4.1%5.0%-1.7%5.1%-106.0%4.1%
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/E0.00.60.30.31.20.3
Net D/E-0.00.50.30.31.00.3

Returns

MEDPIQVCRLLHFTREMedian
NameMedpace IQVIA Charles .Labcorp Fortrea  
1M Rtn-14.6%-3.3%5.4%-0.5%0.5%-0.5%
3M Rtn-35.1%-32.8%-25.1%-1.6%-44.5%-32.8%
6M Rtn-34.1%-26.9%-12.2%-6.2%-10.8%-12.2%
12M Rtn35.4%9.3%53.9%19.5%81.0%35.4%
3Y Rtn110.1%-20.8%-17.7%16.6%-73.9%-17.7%
1M Excs Rtn-23.0%-11.7%-3.0%-8.9%-7.9%-8.9%
3M Excs Rtn-37.9%-35.6%-27.9%-4.4%-47.3%-35.6%
6M Excs Rtn-33.4%-32.1%-16.4%-11.8%-12.9%-16.4%
12M Excs Rtn4.9%-22.5%22.5%-12.9%40.7%4.9%
3Y Excs Rtn34.2%-91.8%-89.7%-53.3%-144.9%-89.7%

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$393.42 
Market Cap ($ Bil)11.1 
First Trading Date08/11/2016 
Distance from 52W High-36.6% 
   50 Days200 Days
DMA Price$469.23$509.62
DMA Trendupdown
Distance from DMA-16.2%-22.8%
 3M1YR
Volatility65.0%66.5%
Downside Capture319.13181.43
Upside Capture101.10156.47
Correlation (SPY)36.1%23.2%
MEDP Betas & Captures as of 3/31/2026

 1M2M3M6M1Y3Y
Beta1.041.011.081.151.031.05
Up Beta0.07-0.640.331.570.710.96
Down Beta1.840.030.350.510.930.62
Up Capture142%120%136%138%204%297%
Bmk +ve Days7162765139424
Stock +ve Days16253668134402
Down Capture30%188%169%130%118%106%
Bmk -ve Days12233358110323
Stock -ve Days6172758117347

[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
MEDP42.7%70.3%0.75-
Sector ETF (XLV)9.8%15.8%0.4031.6%
Equity (SPY)36.1%12.7%2.1522.9%
Gold (GLD)38.7%27.3%1.187.7%
Commodities (DBC)45.3%18.0%1.93-4.4%
Real Estate (VNQ)14.6%13.3%0.7720.4%
Bitcoin (BTCUSD)-16.3%42.1%-0.3116.7%

Smart multi-asset allocation framework can stack odds in your favor. Learn How
Based On 5-Year Data
Annualized
Return
Annualized
Volatility
Sharpe
Ratio
Correlation
with MEDP
MEDP17.5%51.9%0.49-
Sector ETF (XLV)5.4%14.6%0.1939.2%
Equity (SPY)12.6%17.1%0.5839.4%
Gold (GLD)21.0%17.8%0.966.5%
Commodities (DBC)14.5%19.1%0.623.4%
Real Estate (VNQ)3.7%18.8%0.1034.3%
Bitcoin (BTCUSD)4.9%56.4%0.3117.1%

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
MEDP30.6%50.0%0.74-
Sector ETF (XLV)9.5%16.5%0.4644.2%
Equity (SPY)14.9%17.9%0.7144.3%
Gold (GLD)13.9%15.9%0.736.0%
Commodities (DBC)10.0%17.8%0.4710.6%
Real Estate (VNQ)5.5%20.7%0.2336.9%
Bitcoin (BTCUSD)68.5%66.9%1.0813.6%

Smart multi-asset allocation framework can stack odds in your favor. Learn How

Short Interest

Short Interest: As Of Date3312026
Short Interest: Shares Quantity1.2 Mil
Short Interest: % Change Since 3152026-12.9%
Average Daily Volume0.3 Mil
Days-to-Cover Short Interest4.1 days
Basic Shares Quantity28.3 Mil
Short % of Basic Shares4.3%

Returns Analyses

Earnings Returns History

Expand for More
 Forward Returns
Earnings Date1D Returns5D Returns21D Returns
4/22/2026-22.6%  
2/9/2026-15.9%-19.3%-9.9%
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%
...
SUMMARY STATS   
# Positive101212
# Negative131010
Median Positive11.8%8.6%10.3%
Median Negative-7.5%-6.8%-9.9%
Max Positive54.7%46.7%49.6%
Max Negative-22.6%-19.6%-22.2%

SEC Filings

Expand for More
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

Recent Forward Guidance [BETA]

Latest: Q1 2026 Earnings Reported 4/22/2026

Forward GuidanceGuidance Change
MetricLowMidHigh% Chg% DeltaChangePrior
2026 Revenue2.75 Bil2.81 Bil2.85 Bil0 AffirmedGuidance: 2.81 Bil for 2026
2026 Revenue Growth8.9%10.85%12.8%00AffirmedGuidance: 10.85% for 2026
2026 Net Income487.00 Mil499.00 Mil511.00 Mil0 AffirmedGuidance: 499.00 Mil for 2026
2026 EBITDA605.00 Mil620.00 Mil635.00 Mil0 AffirmedGuidance: 620.00 Mil for 2026
2026 EPS16.717.117.50 AffirmedGuidance: 17.1 for 2026

Prior: Q4 2025 Earnings Reported 2/9/2026

Forward GuidanceGuidance Change
MetricLowMidHigh% Chg% DeltaChangePrior
2026 Revenue2.75 Bil2.81 Bil2.85 Bil10.9% Higher NewActual: 2.53 Bil for 2025
2026 Revenue Growth8.9%10.85%12.8%-42.3%-8.0%LoweredGuidance: 18.8% for 2025
2026 Net Income487.00 Mil499.00 Mil511.00 Mil14.7% RaisedGuidance: 435.00 Mil for 2025
2026 EPS16.717.117.516.0% RaisedGuidance: 14.7 for 2025

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.

Looking for high-conviction positions with a better risk/reward profile? See what's currently in the Trefis High Quality Portfolio.
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 Appears To Be Skeptical Of Core Thesis
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 deeply bearish. The sustained distribution is evident across multiple volume metrics. 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
-3
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
-6 / 12
1 Price Structure & Trend Downtrend · Death Cross
2 Momentum Deteriorating
3 Relative Strength vs. SPY Strong Underperformance
4 Institutional Footprint & Volume Mild Distribution
5 Volatility Expanded
6 Key Price Levels Range · Vol Rising
7 Earnings Reaction History Emerging Resilience
8 How the Verdict Is Derived Three Pillars