ICON plc ICLR posted first-quarter 2025  adjusted earnings per share of $3.19, down 8.1% from the year-ago period’s reported figure. However, the metric surpassed the Zacks Consensus Estimate by 3.5%. (Find the latest EPS estimates and surprises on Zacks Earnings Calendar).

The company reported GAAP EPS of $1.90, down 15.6% from the year-earlier level.

ICLR’s Q1 Revenues

Total revenues decreased 4.3% year over year to $2.00 billion. The figure was down 3.2% on a constant-currency (CER) basis. The metric fell short of the Zacks Consensus Estimate by 0.5%.

Gross business wins in the quarter amounted to $2.68 billion, and cancellations totaled $659 million. This resulted in net business wins of $2.02 billion and a book-to-bill of 1.01.

Following the earnings announcement, ICLR stock plunged 3.6% in the after-market trading yesterday. 

ICLR’s Q1 Margins

The gross profit decreased 9.8% year over year to $558.7 million. The gross margin contracted 170 basis points (bps) to 27.9%.

Selling, general and administrative expenses increased 11.9% to $198.4 million.

The adjusted operating income was $360.3 million, reflecting a decrease of 18.4% year over year. The adjusted operating margin contracted 313 bps to 18%.

ICLR’s Cash Position

ICON exited the first quarter with cash and cash equivalents of $526.7 million compared with $538.8 million at the end of the fourth quarter of 2024. It had a net debt balance of $2.9 billion at the end of the reported quarter. 

Cumulative cash flow provided by operating activities was $268.2 million compared with $327.1 million in the prior-year period.

ICLR’s 2025 Guidance

The company updated its full-year 2025 guidance, now expecting revenues between $7.75 and $8.15 million (earlier $8.05-$8.65 million). The revised range represents a year-over-year decrease of 6.4% to 1.6%. The Zacks Consensus Estimate for the metric currently stands at $8.21 billion.

Adjusted EPS for the year is anticipated between $12.75 and $14.25, representing a year-over-year movement of (8.9%) to 1.8%. The earlier forecast for the metric was $13.00-$15.00. Meanwhile, the Zacks Consensus Estimate for ICON’s earnings is pegged at $13.48 per share.

Our Take on ICLR

ICON ended the first quarter of 2025 with earnings beat and revenue miss. Both metrics were down on a year-over-year basis. The company’s performance reflected the ongoing volatility and cautiousness in the broader clinical development market. Bookings came in below expectations due to delays in customer decision-making, careful capital allocation and continued high levels of cancellations. Additionally, the contraction of both margins in the quarter was discouraging. ICON updated its 2025 financial outlook, mainly to exclude the two large next-generation COVID-19 vaccine trials.

Meanwhile, the bottom line aligned with the company’s expectations, supported by focused resource utilization and strong cost control across the business.

ICLR’s Zacks Rank and Key Picks

ICON currently carries a Zacks Rank #4 (Sell).

Some better-ranked stocks from the broader medical space are AngioDynamics ANGO, Integer Holdings Corporation ITGR and Boston Scientific BSX.

AngioDynamics, currently sporting a Zacks Rank #1 (Strong Buy), reported a third-quarter fiscal 2025 adjusted EPS of 3 cents against the Zacks Consensus Estimate of a 13-cent loss. Revenues of $72 million beat the Zacks Consensus Estimate by 2%. You can see the complete list of today’s Zacks #1 Rank stocks here.

ANGO has an estimated fiscal 2026 earnings growth rate of 27.8% compared with the S&P 500 composite’s 10.5% growth. The company surpassed earnings estimates in each of the trailing four quarters, with the average surprise being 70.9%.

Integer Holdings, sporting a Zacks Rank #1 at present, posted a first-quarter 2025 adjusted EPS of $1.31, exceeding the Zacks Consensus Estimate by 3.1%. Revenues of $437.4 million surpassed the Zacks Consensus Estimate by 1.3%.

ITGR has an estimated long-term earnings growth rate of 20.8% compared with the industry’s 14.3% growth. The company’s earnings surpassed estimates in three of the trailing four quarters and missed on one occasion, with the average surprise being 2.8%.

Boston Scientific, carrying a Zacks Rank #2 (Buy), reported a first-quarter 2025 adjusted EPS of 75 cents, which surpassed the Zacks Consensus Estimate by 11.9%. Revenues of $4.66 billion topped the Zacks Consensus Estimate by 2.3%.

BSX has an estimated 2025 earnings growth rate of 15.9% compared with the S&P 500 composite’s 11.9% growth. The company’s earnings surpassed estimates in each of the trailing four quarters, with the average surprise being 8.8%.

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