Medpace Delivers Strong Q1 Results Amid Challenging Market Conditions
Medpace, a leading global contract research organization (CRO), has reported impressive first-quarter results for 2026, despite facing increasing cancellations and a softer RFP environment. During the earnings conference call on April 23rd, 2026, CEO August Troendle and his team highlighted several key highlights from the quarter.
One of the notable trends in Q1 was the rise in cancellations, with backlog cancels reaching their highest point in over a year. However, net bookings were still well above those in Q1 2025, with a Net Book-to-Bill Ratio of 0.88. This indicates that while cancellations are increasing, new business awards are also growing at a steady pace.
Revenue for the first quarter of 2026 was $706.6 million, representing a year-over-year increase of 26.5%. This growth was driven by a 23.7% increase in net new business awards entering backlog to $618.4 million. The ending backlog as of March 31st, 2026, stood at approximately $2.9 billion, an increase of 2.9% from the prior year.
"We're pleased with our revenue growth and continued expansion of our pipeline," said August Troendle during the conference call. "While cancellations are a concern, we remain focused on improving our win rate through targeted initiatives." He also acknowledged Jesse Geiger's 18.5 years of service as President, thanking him for his dedication and contributions to the company.
Financially, Medpace reported EBITDA of $149.4 million in Q1 2026, a 25.9% increase compared to the same period in 2025. On a constant currency basis, first-quarter EBITDA increased 28.6%. The company's net income grew by 8.1% year-over-year to $123.9 million, driven primarily by revenue growth. Net income per diluted share for the quarter was $4.28, compared to $3.67 in the prior year period.
The conference call also highlighted Medpace's customer concentration, with the top 5 and top 10 customers representing roughly 28% and 37%, respectively, of their last 12 months revenue.
Medpace continues to navigate a challenging market environment with resilience. As the company looks ahead to future quarters, it remains committed to expanding its pipeline, improving win rates, and delivering strong financial performance for its shareholders."
