1. Company Overview & Business Model

The Medpace Differentiator: A Physician-Led, Full-Service CRO

Medpace Holdings, Inc. (Medpace) is a scientifically-driven, global, full-service clinical contract research organization (CRO) that provides a comprehensive suite of services for Phase I-IV clinical development.¹ Founded in 1992, the company’s stated mission is to “accelerate the global development of safe and effective medical therapeutics”.¹ This mission is executed through a distinctive “physician-led, high-science, and disciplined operating approach” that leverages deep regulatory and therapeutic expertise across a wide range of critical areas, including oncology, cardiology, metabolic disease, and neuroscience.¹

The cornerstone of the Medpace business model is its integrated, full-service platform. Unlike competitors that may offer services on a functional or siloed basis, Medpace provides an end-to-end solution that coordinates and integrates all necessary services for a clinical trial. This model is designed to create a seamless and accountable platform for clients, with the stated goals of increasing the quality and speed of clinical research while significantly reducing the client’s need for duplicate management oversight.³ The company positions itself not merely as a set of outsourced hands but as a deeply embedded extension of its clients’ teams, integrating medical, regulatory, and operational expertise directly into the trials to proactively navigate challenges.³ This hands-on, consultative approach is a fundamental element of its value proposition.

Revenue Streams and Client Profile: The “Trusted by Biotech®” Niche

Medpace generates revenue by providing its clinical development services to a diverse client base that includes biotechnology, pharmaceutical, and medical device companies.¹ A defining feature of its corporate strategy is a deliberate and highly successful focus on small to mid-size biotechnology and pharmaceutical companies. The company states that approximately 90% of its clients fall into this category, a focus so central to its identity that it has trademarked the slogan “Trusted by Biotech®”.³

This strategic alignment is not just a marketing tool but reflects a deep understanding of its target market’s needs. Small and emerging biopharma companies are the primary engines of innovation in the drug development pipeline but often lack the extensive in-house infrastructure, broad therapeutic expertise, and regulatory experience of their large pharmaceutical counterparts. Consequently, they are more reliant on a CRO partner that can provide comprehensive, consultative support throughout the entire clinical trial process.⁶ Medpace’s full-service, physician-led model is explicitly designed to meet this need, offering a higher-touch, more integrated partnership than the often more transactional, volume-based relationships that large CROs have with large pharmaceutical sponsors.⁶ This focus is reflected in its revenue mix, with an investor presentation noting that small biopharma clients accounted for 81% of revenue year-to-date in 2025.⁷

Global Footprint and Operational Infrastructure

Headquartered in Cincinnati, Ohio, Medpace has established a significant global operational footprint to support complex, multi-site international clinical trials.¹ As of March 31, 2025, the company employed approximately 5,900 people across 44 countries, operating through 32 offices and four central laboratories.¹ This global reach allows Medpace to offer clients access to diverse patient populations and navigate varied international regulatory landscapes, which is critical for the successful execution of modern clinical development programs.

Leadership and Governance: A Founder-Led Organization

Medpace is a founder-led organization, a characteristic that often correlates with a consistent long-term vision and a strong, deeply ingrained corporate culture. Dr. August J. Troendle founded the company in July 1992 and has served as its Chief Executive Officer and Chairman of the Board continuously since its inception.¹⁰ His professional background, which includes roles as a Medical Review Officer in the Division of Metabolic and Endocrine Drug Products at the U.S. Food and Drug Administration (FDA) and a manager responsible for clinical development at Sandoz (now Novartis), directly informs the company’s physician-centric and regulatory-focused operating philosophy.¹⁰ The stability and expertise of the senior management team, many of whom have long tenures with the company, further reinforce this culture of disciplined execution.¹⁰

Corporate History: A Trajectory of Purely Organic Growth

Perhaps the most unique aspect of Medpace’s corporate history and strategy is its unwavering commitment to purely organic growth for over three decades.³ In an industry where large-scale mergers and acquisitions are common—exemplified by the Quintiles/IMS Health merger to form IQVIA and ICON’s acquisition of PRA Health Sciences—Medpace has deliberately eschewed M&A.¹¹ The company explicitly states that this strategy is core to its ability to deliver “consistency and stability while avoiding the disruptions associated with mergers and acquisitions”.³

This “organic growth only” philosophy is not a passive choice but an active strategic pillar that underpins its entire value proposition. Large-scale M&A in the CRO space frequently leads to significant integration challenges, including the difficult task of harmonizing disparate IT systems, conflicting standard operating procedures (SOPs), and divergent corporate cultures. These internal frictions can manifest as inconsistent service delivery and operational seams that are particularly problematic for small biotech clients, whose entire corporate value may hinge on the successful execution of a single clinical trial. By growing organically, Medpace has cultivated a homogenous internal culture and a single, unified operational platform, including its proprietary ClinTrak® technology suite. This internal consistency is the critical enabler of the “seamless” and “integrated” client experience it promises. This creates a powerful virtuous cycle: the consistent, high-touch service model attracts and retains the target client base, and the success with this base validates the continued focus on organic growth. This represents a durable competitive advantage that is structurally difficult for its M&A-focused peers to replicate.

2. Industry Analysis & Market Dynamics

Global CRO Market: Size, Scale, and Secular Growth Tailwinds

The Contract Research Organization industry represents a large, structurally growing segment of the global healthcare landscape. Various market research reports place the size of the global CRO market in 2024 at between $82.0 billion and $85.5 billion, underscoring the substantial scale of outsourced research and development activities.¹²

The industry is supported by powerful and durable secular tailwinds, with future projections indicating a period of sustained, robust expansion. Forecasts project the market to grow to between $129.8 billion and $175.5 billion by the 2029-2032 timeframe.¹² This growth translates to a projected compound annual growth rate (CAGR) in the range of 7.6% to 9.6%, a rate that significantly outpaces global GDP growth and signals a long-term, structural shift in how biopharmaceutical innovation is conducted.¹² North America, particularly the United States, remains the largest single market for CRO services, accounting for over 50% of the market in 2024, driven by a high concentration of biopharma companies and substantial R&D investment.¹³

Key Drivers: The Engine of Outsourced R&D

The consistent growth of the CRO market is propelled by several fundamental drivers that are reshaping the biopharmaceutical industry.

• Expanding R&D Pipeline: The primary catalyst for CRO demand is the sheer volume of new drugs in development. The global R&D pipeline has expanded dramatically, more than doubling from approximately 10,479 products in 2013 to 21,292 in 2023.¹² This explosion in research activity, particularly from small and mid-sized biotech firms, creates a corresponding surge in demand for outsourced clinical trial services.
• Rising R&D Costs and Complexity: The process of bringing a new therapeutic to market is notoriously long, complex, and expensive. On average, Phase 1, 2, and 3 clinical trials can cost approximately $4.0 million, $13.0 million, and $20.0 million, respectively.¹³ By partnering with a CRO, biopharma companies can convert the high fixed costs of maintaining in-house development infrastructure into more manageable variable costs. Furthermore, as trial designs become more complex—targeting specific patient subpopulations and utilizing novel endpoints—sponsors increasingly rely on the specialized therapeutic and operational expertise that CROs can provide.¹⁶
• Increasing Outsourcing Penetration: There is a clear and ongoing trend among pharmaceutical and biotechnology companies to outsource a greater proportion of their R&D activities. This strategic shift allows sponsors to focus on their core competencies, such as drug discovery and commercialization, while leveraging the scale, efficiency, and expertise of CRO partners to manage the operational intricacies of clinical trials.¹⁴

Transformative Trends: Technology, Decentralization, and Precision Medicine

The CRO industry is in a period of significant evolution, driven by transformative trends that are redefining how clinical research is conducted.

• Technology Adoption and Digital Transformation: The integration of advanced technology is a critical trend. The adoption of artificial intelligence (AI) for patient identification, electronic data capture (EDC) systems, wearable biosensors, and remote monitoring technologies is fundamentally improving the efficiency and quality of clinical trials. CROs that effectively invest in and deploy these technologies can offer clients faster enrollment, cleaner data, and more efficient trial execution.¹²
• Decentralized Clinical Trials (DCTs): Enabled by new technologies, the DCT model is gaining traction. By reducing the need for patients to travel to central trial sites, DCTs can make participation more convenient, thereby broadening the potential patient pool and helping to mitigate one of the industry’s most persistent challenges: patient recruitment and retention.¹²
• Precision and Personalized Medicine: The shift towards precision medicine—tailoring treatments to individuals based on their genetic makeup or other biomarkers—is a powerful driver of demand for specialized CRO services. This trend is particularly pronounced in oncology, where targeted therapies are becoming the standard of care, as well as in the growing field of rare diseases.¹² These trials require sophisticated capabilities in genomics, biomarker development, and patient stratification, creating opportunities for scientifically-advanced CROs.

The Regulatory Gauntlet: FDA and EMA Impact on Clinical Development

The regulatory landscape, governed by agencies such as the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA), is a formidable and ever-present factor in drug development. The stringent requirements for trial conduct, data integrity, and patient safety, encapsulated in frameworks like Good Clinical Practice (GCP), add significant complexity to the clinical trial process.¹⁴ This complexity serves as a major driver for outsourcing, as biopharma sponsors—especially smaller ones—rely on the deep regulatory expertise of established CROs to navigate the intricate submission and approval processes successfully.¹⁴ CROs with strong regulatory track records and relationships with these agencies provide a critical service in de-risking the development pathway for their clients.

The evolution of the drug development pipeline toward more complex and targeted therapies creates a market dynamic that disproportionately benefits specialized, high-science CROs like Medpace over larger, more commoditized competitors. The industry’s growth is increasingly fueled by precision medicine, cell and gene therapies, and complex oncology trials.¹² These are not the large-scale, standardized Phase III trials for blockbuster drugs upon which the biggest CROs built their scale. Instead, they involve smaller, genetically-defined patient populations and require a much deeper level of scientific and medical expertise to design and execute. Medpace’s entire business model, with its “physician-led” and “high-science” approach, is purpose-built to provide the consultative, expert-driven partnership required for these complex programs.¹ This strategic alignment means that the industry’s most powerful growth vectors are pointing directly toward Medpace’s core strengths, creating a favorable environment for the company to continue gaining market share in the most valuable and fastest-growing segments of the CRO market.

3. Competitive Landscape & Market Position

The CRO Hierarchy: Titans vs. Niche Specialists

The global CRO market is characterized by a distinct competitive structure, with a handful of large, publicly-traded companies commanding a significant portion of the market, followed by a fragmented landscape of mid-sized and smaller niche providers. The dominant players have largely achieved their scale through significant merger and acquisition activity.

• IQVIA (IQV): The undisputed market leader, IQVIA was formed through the 2016 merger of Quintiles, a clinical research powerhouse, and IMS Health, a healthcare data and analytics giant. This combination created a unique competitor that integrates vast data resources and advanced technology solutions with traditional clinical trial services.¹⁸ For the full year 2024, IQVIA reported revenues of $15.4 billion.¹¹
• ICON plc (ICLR): A top-tier global CRO headquartered in Ireland, ICON dramatically increased its scale and capabilities with the 2021 acquisition of PRA Health Sciences. The company offers a full spectrum of services from consulting to commercialization.¹¹ For the full year 2024, ICON reported revenues of $8.3 billion.¹¹
• Thermo Fisher Scientific (TMO) / PPD: In December 2021, Thermo Fisher Scientific, a world leader in serving science, completed its acquisition of Pharmaceutical Product Development (PPD), a leading CRO, for $17.4 billion.²² This strategic move integrated PPD’s clinical research services into Thermo Fisher’s broader Laboratory Products and Services segment, creating an end-to-end offering from discovery to manufacturing and clinical logistics.²⁰
• Other Major Competitors: Other significant players include Syneos Health (taken private in 2023), Parexel (owned by private equity), and Charles River Laboratories, which is particularly strong in early-phase development.¹²

These large competitors primarily serve the needs of large pharmaceutical companies, often through Functional Service Provider (FSP) models, where they provide specific, siloed services (e.g., clinical monitoring or data management) as part of a multi-vendor strategy.²⁵

Medpace’s Competitive Moat: Organic Growth and a Specialized Focus

Medpace has carved out a distinct and defensible position in this competitive landscape. Its market position is defined by two key differentiators: its unwavering commitment to organic growth and its specialized focus on a specific client segment.

As previously discussed, Medpace has grown exclusively through organic means, avoiding the integration challenges that plague its M&A-focused rivals.³ This has allowed it to build a cohesive culture and a unified operational platform, which is a critical component of its competitive moat.

The company’s primary competitive advantage stems from its full-service outsourcing (FSO) model, which is specifically tailored to the needs of small and mid-sized biopharmaceutical companies.²⁵ This client segment, which drives a significant portion of the industry’s innovation, requires a high-touch, consultative partner to guide them through the complexities of clinical development. Medpace’s physician-led approach provides this deep level of engagement, which is fundamentally different from the more transactional FSP models favored by large pharma.⁶ This specialized focus has translated into superior operational and financial metrics, including significantly higher revenue per employee and a vastly superior Return on Invested Capital (ROIC) when compared to FSP-heavy competitors like ICON and Fortrea.²⁵

Therapeutic Area Expertise and Market Share

Medpace has cultivated deep expertise in the most active and complex areas of drug development. Its core therapeutic strengths include oncology, cardiology, metabolic disease, endocrinology, and central nervous system (CNS) disorders.¹ The company’s revenue is heavily concentrated in these high-growth areas. For 2024, its two largest therapeutic areas were Anti-cancer (31% of revenue) and Alimentary/Metabolic (25% of revenue).⁸ This alignment with the industry’s most robust research pipelines, such as oncology which is the single largest category of drugs in development, positions the company well for sustained demand.¹³ While specific market share figures are not publicly available, Medpace is consistently listed among the key global CROs and has established itself as a leader within its chosen niche.¹²

Client Relationships and Concentration Dynamics

A key strength of Medpace’s business model is its well-diversified client base. Despite its focus on the small-to-mid-size biotech segment, the company does not have excessive reliance on any single client. For the full year 2024, its top ten customers collectively represented only 29% of total revenue, and importantly, no single customer accounted for more than 10% of revenue.⁸ This low level of customer concentration provides a significant degree of stability and mitigates the risk associated with the potential failure of any single client’s clinical program—a particularly relevant risk given the high-risk, high-reward nature of early-stage biotech development.

Peer Comparison Dashboard

To provide a quantitative context for Medpace’s market position, the following table compares key financial and valuation metrics against its largest publicly-traded competitors.

Metric	Medpace (MEDP)	IQVIA (IQV)	ICON plc (ICLR)	Thermo Fisher (TMO)
Market Cap	$8.88B	$27.79B	$11.94B	$158.29B
LTM Revenue	$2.23B	$15.41B	$8.28B	$42.90B
LTM Revenue Growth (%)	9.87%	2.80%	2.00%	0.09%
LTM EBITDA Margin (%)	22.48%	21.48%	N/A	25.24%
LTM P/E Ratio	22.95	21.54	15.95	24.33
LTM EV/EBITDA Ratio	17.69	N/A	N/A	17.08
Note: Data as of mid-July 2025. Market data is dynamic. Sources: 28

The data clearly illustrates Medpace’s unique profile. While significantly smaller than its peers in terms of market capitalization and revenue, it exhibits substantially higher revenue growth. Its profitability, as measured by EBITDA margin, is in line with or slightly better than the much larger IQVIA and only modestly below the diversified life sciences giant Thermo Fisher. This combination of high growth and strong profitability in a smaller package is a key characteristic of its investment profile.

4. Financial Performance Analysis

Historical Financial Deep Dive

Medpace has delivered a period of exceptional financial performance over the last five years, characterized by rapid top-line growth, significant margin expansion, and robust cash flow generation. This performance reflects the successful execution of its differentiated business strategy and favorable industry tailwinds.

The company’s revenue growth has been a standout feature. From a base of $925.9 million in 2020, revenue surged to $2.11 billion in 2024, representing a compound annual growth rate (CAGR) of approximately 22.9%.²⁹ This growth was remarkably consistent, with year-over-year increases of 23.4% in 2021, 27.8% in 2022, 29.2% in 2023, and a more moderate but still strong 11.8% in 2024.²⁹ This track record far surpasses the overall growth rate of the CRO market, indicating significant market share gains.

This impressive revenue growth has been accompanied by expanding profitability. Net income has more than doubled over the past three years alone, climbing from $181.8 million in 2021 to $404.4 million in 2024.⁴¹ This demonstrates the company’s ability to scale its operations efficiently, translating top-line growth directly to the bottom line. Diluted earnings per share (EPS) have grown even faster, benefiting from both rising net income and a shrinking share count due to aggressive stock repurchases. EPS grew from $4.81 in 2021 to $12.63 in 2024, a CAGR of 38.0%.⁴¹

5-Year Financial Summary (2020-2024)

Fiscal Year (Ending Dec 31)	2020	2021	2022	2023	2024
Revenue (Net, $M)	$925.9	$1,142.4	$1,460.0	$1,885.8	$2,109.1
Revenue Growth (%)	7.5%	23.4%	27.8%	29.2%	11.8%
Gross Margin (%)	32.7%	28.7%	29.6%	27.8%	31.1%
Operating Income ($M)	$153.5	$219.8	$291.4	$363.1	$476.2
Operating Margin (%)	16.6%	19.2%	19.9%	19.2%	22.6%
Net Income ($M)	$124.6	$181.8	$245.4	$282.8	$404.4
Net Margin (%)	13.5%	15.9%	16.8%	15.0%	19.2%
Diluted EPS ($)	$3.29	$4.81	$7.28	$8.88	$12.63
Cash Flow from Ops ($M)	$158.4	$259.0	$310.4	$433.4	$490.5
Note: Data compiled from company financial reports. Gross Profit and Operating Income calculated from reported figures. Sources: 29

Profitability and Margin Trajectory

The company’s profitability profile is a key strength. After a dip in 2021, operating and net margins have trended upward, reaching record levels in 2024. The operating margin expanded significantly to 22.6% in 2024, up from 19.2% in the prior year.⁴² Similarly, the net income margin reached 19.2% in 2024, a substantial increase from 15.0% in 2023.⁴² This margin expansion points to increasing operational leverage, where revenue is growing faster than the associated costs, and a favorable business mix.

The company’s non-GAAP profitability metric, EBITDA margin, tells a similar story of strength and expansion. For the full year 2024, the EBITDA margin was 22.8%, a 360-basis-point improvement over the 19.2% margin reported in 2023.⁴² More recent results from the second quarter of 2025 show a continued high EBITDA margin of 21.6%, demonstrating that this high level of profitability is being sustained.⁴⁵

This superior margin profile is a direct consequence of Medpace’s strategic choices. By focusing on higher-value, full-service contracts with smaller clients, the company likely faces less commoditized pricing pressure compared to the large-scale FSP contracts that dominate the large pharma segment. Furthermore, its organic growth strategy means it has not had to absorb the significant integration costs and operational inefficiencies that often accompany large acquisitions, which can be a drag on the margins of its acquisitive peers.

Fortress Balance Sheet: A Debt-Free Anomaly

One of the most compelling aspects of Medpace’s financial profile is its exceptionally strong and clean balance sheet. As of the first quarter of 2025, the company was effectively debt-free, a remarkable and rare characteristic for a publicly-traded company of its size.⁴⁶ This lack of financial leverage provides enormous operational flexibility, reduces financial risk, and allows the company to dedicate its entire free cash flow to reinvestment and shareholder returns.

The company maintains a healthy cash position, which stood at $669.4 million at the end of fiscal 2024.⁴² While this cash balance was lower at the end of Q2 2025 ($46.3 million), this was the direct result of an enormous and deliberate deployment of capital towards share repurchases during the quarter.⁴⁵ The ability to generate substantial operating cash flow—$148.5 million in Q2 2025 alone—ensures that the company can quickly replenish its cash reserves while continuing to fund its operations and capital allocation priorities.⁴⁵ This pristine balance sheet is a testament to the capital-light nature of the CRO business model and Medpace’s disciplined financial management.

5. Growth Analysis & Opportunities

Deconstructing Historical Growth: An Organic Success Story

Medpace’s impressive growth trajectory is a direct result of its ability to consistently win new business and efficiently execute on its existing contracts. As the company has grown exclusively through organic means, its performance is a pure reflection of market share gains and the underlying growth of the CRO market.³

The primary indicators of this growth are Net New Business Awards and the resulting Book-to-Bill ratio. This ratio, which divides new business awards by revenue recognized in a period, serves as a crucial leading indicator of future revenue growth. A ratio above 1.0x indicates that the company is winning new contracts faster than it is completing existing ones, thus growing its backlog of future work. Medpace has demonstrated a strong track record in this area. For the full fiscal year 2024, the company secured $2.23 billion in net new business awards, resulting in a healthy book-to-bill ratio of 1.06x.⁴² While this metric can fluctuate quarterly, the most recent result for Q2 2025 showed a continued positive trend with a book-to-bill of 1.03x on the back of $620.5 million in new awards.⁴⁵

Future Growth Opportunities

Looking ahead, Medpace has several well-defined avenues for continued growth, leveraging its established strengths and favorable industry trends.

• Deepening Therapeutic Area Leadership: The company is already strong in high-growth therapeutic areas like oncology and metabolic diseases. There is a significant opportunity to deepen its expertise and capture an even greater share of trials in these complex fields, as well as in adjacent areas like immunology and rare diseases, which are heavily driven by biotech innovation.
• Continued Market Share Gains in the Biotech Niche: The small and mid-sized biopharmaceutical segment remains the core of Medpace’s strategy. As this segment continues to be the primary source of novel drug development, Medpace’s differentiated, high-touch model is well-positioned to continue taking market share from both larger, less nimble competitors and smaller CROs that lack its global scale and full-service capabilities.
• Technology and Service Expansion: Further investment in technology, particularly in AI-driven tools for trial optimization and platforms for decentralized clinical trials (DCTs), can enhance operational efficiency and create new, value-added service offerings. This aligns with the broader digital transformation of the clinical research industry and can serve as a competitive differentiator.¹⁵
• International Market Penetration: While Medpace already possesses a global footprint, there are opportunities to deepen its presence in key international markets. The Asia-Pacific region, in particular, has been identified as the fastest-growing geographical market for CRO services, driven by access to large patient populations and an evolving regulatory environment.¹⁴ Expanding operational capacity in this region could unlock a significant new vector of growth.

Growth Risks & Challenges

Despite the strong outlook, Medpace faces several risks and challenges that could impact its growth trajectory.

• Biotech Funding Environment: The company’s heavy concentration in the small to mid-sized biotech sector makes it particularly sensitive to the cyclical nature of biotech funding. These smaller companies rely on access to capital markets to fund their R&D activities. A prolonged downturn in biotech financing could lead to project delays, cancellations, and a slowdown in the pace of new business awards. This risk was explicitly acknowledged by Medpace’s CEO during the Q1 2025 earnings call, where funding difficulties were described as “a bigger issue than drug failures”.⁷
• Intensifying Competition: As the biotech segment continues to be a hotbed of innovation, larger CROs are increasingly targeting these clients, potentially leading to greater competition and pressure on pricing and margins.
• Talent Acquisition and Retention: The CRO industry is fundamentally a talent-based business. The ability to attract, train, and retain skilled and experienced personnel, such as clinical research associates (CRAs) and project managers, is critical to successful execution. As noted, there is conflicting external information regarding Medpace’s employee turnover, which represents a potential operational risk if not managed effectively.⁴⁷

The company’s Q2 2025 earnings release provided a powerful signal regarding its ability to navigate these challenges. After the cautious tone in the first quarter regarding the biotech funding environment, which led to an initial full-year 2025 revenue growth guidance of a modest 1.5% to 6.2%, the company issued a dramatic upward revision just three months later.⁷ The new guidance projects full-year revenue growth of 14.7% to 19.5%.⁴⁵ Such a significant and rapid reversal suggests more than just a marginal improvement in market conditions. It strongly implies that Medpace’s competitive position may be strengthening

because of the challenging environment. In a tight funding market, biotech companies cannot afford to risk their most valuable assets with second-tier CROs. This creates a “flight-to-quality,” where well-capitalized biotechs with promising clinical programs consolidate their business with the most reliable and operationally excellent partners. Medpace’s sterling reputation, physician-led model, and fortress balance sheet make it a prime beneficiary of this trend. Therefore, the guidance revision may be an early indicator of accelerated market share gains driven by its status as a best-in-class operator.

6. Capital Allocation & Shareholder Returns

A Disciplined Approach to Capital Deployment

Medpace’s capital allocation strategy is a model of simplicity and discipline, enabled by its robust free cash flow generation and debt-free balance sheet. The company’s priorities are clear: first, to reinvest sufficiently in the business to support its strong organic growth, and second, to return all excess capital to shareholders through an aggressive and consistent share repurchase program.

Share Repurchases as the Primary Return Mechanism

Share buybacks are the central pillar of Medpace’s strategy for returning capital to shareholders. The company has a long history of utilizing board-authorized repurchase programs to systematically reduce its share count, thereby increasing earnings per share and returning value to its owners.

This commitment has been particularly evident in the most recent periods. In the fourth quarter of 2024, the company repurchased $174.2 million of its stock.⁴² This activity accelerated dramatically in 2025. During the second quarter of 2025 alone, Medpace executed a massive $518.5 million in share repurchases.⁴⁵ For the first six months of the year, total repurchases amounted to an extraordinary $908.4 million.⁴⁹

The Board of Directors has consistently refreshed the repurchase authorization, signaling a strong and ongoing commitment to this policy. The authorization was increased by $600.0 million in February 2025 and by a further $1.0 billion in April 2025.⁵⁰ As of June 30, 2025, there was still $826.3 million remaining under the current authorization, indicating that this aggressive pace of repurchases could continue.⁴⁹

The sheer scale of these buybacks is a powerful statement. Repurchasing nearly $1 billion in stock in just six months for a company with a market capitalization of around $9 billion is an exceptionally bold and confident capital allocation decision.²⁸ This action, taken concurrently with the significant upward revision to the company’s full-year guidance, strongly suggests that management believes its shares are trading at a substantial discount to their intrinsic value. For investors, this is not only a tangible driver of value—as it significantly reduces the share count and provides an accretive boost to EPS—but also one of the strongest possible signals of management’s conviction in the long-term prospects of the business.

Dividend and M&A Strategy

Consistent with its focus on growth and share repurchases, Medpace does not pay a cash dividend. The company has stated that it has no plans to initiate a dividend in the foreseeable future, preferring to retain earnings for reinvestment in the business and its buyback program.⁵⁰

Similarly, the company’s M&A strategy is highly circumscribed and aligns with its core philosophy of organic growth. While Medpace may consider “selective strategic bolt-on acquisitions,” there is no indication that it plans to pursue the kind of large, transformative M&A that characterizes its larger competitors.⁵⁰ Capital allocation is therefore not directed towards large acquisitions, freeing up cash flow for shareholder returns.

7. Operational Excellence & Quality Metrics

Assessing Execution: Backlog Conversion and Business Awards

While direct measures of clinical trial success are proprietary and rarely disclosed, several key performance indicators provide a clear window into Medpace’s operational excellence and commercial momentum.

• Net New Business Awards & Book-to-Bill Ratio: As a primary indicator of demand, Medpace’s ability to win new business remains strong. The company reported $620.5 million in net new business awards in Q2 2025, a 12.6% increase over the prior-year period, resulting in a healthy book-to-bill ratio of 1.03x.⁴⁵ This demonstrates that the company’s pipeline of future revenue continues to grow.
• Ending Backlog: This metric represents the total value of contracted, yet-to-be-earned revenue. As of June 30, 2025, Medpace’s backlog stood at a substantial $2.87 billion, providing significant visibility into future revenue streams.⁴⁵
• Backlog Conversion Rate: Perhaps the most critical indicator of operational efficiency, this metric measures the rate at which backlog is converted into recognized revenue. In Q2 2025, Medpace reported a backlog conversion rate of 21.2%, a notable increase from 18.2% in the same period of the prior year.⁷ A rising conversion rate is a powerful sign of improving execution. It indicates that projects are progressing more efficiently, timelines are being met or accelerated, and the company is leveraging its operational infrastructure more effectively. This efficiency gain is a direct driver of the margin expansion observed in the company’s financial results, as it allows Medpace to spread its fixed costs over a larger revenue base in any given period.

The Talent Equation: Analyzing Employee Retention

As a professional services organization, Medpace’s success is fundamentally dependent on the quality and experience of its employees. Assessing employee retention is therefore critical, though the available data presents a conflicting picture.

On one hand, the company itself, in its 2022 Corporate Responsibility Report, states that it benchmarks its employee turnover and is “pleased that we regularly fall below the average rate” for the CRO industry.⁵² This is supported by data from the career website Zippia, which reports “high retention rates” and an average employee tenure of 4.3 years.⁵³

On the other hand, data from the employee review platform Comparably paints a different picture, assigning Medpace a “D-” retention score and placing it in the bottom 10% of similarly sized companies.⁴⁷ Anecdotal reports on public forums also suggest a reputation for high turnover and a demanding, “trial by fire” corporate culture.⁴⁸

This discrepancy warrants careful consideration. It is possible that Medpace fosters a high-performance culture that, while demanding, also rewards and retains top performers, leading to a stable core of long-tenured experts even if overall turnover is higher. However, the risk that a challenging work environment could lead to a loss of valuable, experienced talent cannot be dismissed and remains a key factor to monitor.

Client Relationships and Service Quality

Specific metrics on client retention rates are not publicly disclosed. However, strong and enduring client relationships can be inferred from the company’s consistent growth and its strategic focus. The “Trusted by Biotech®” slogan and the high percentage of revenue from the small and mid-sized biotech sector suggest a high degree of repeat business and customer loyalty.³ This client base, with its deep reliance on its CRO partner, is more likely to form long-term, strategic partnerships rather than engaging in transactional, project-by-project relationships. Case studies published by the company, while selective, highlight successful outcomes in terms of achieving enrollment timelines and reducing screen failure rates, pointing to a focus on quality execution.⁵⁴

8. Valuation Analysis

Multiple-Based Valuation

An analysis of Medpace’s valuation multiples relative to its own history and its peer group provides critical context for assessing its current market price.

• Historical Context: Medpace currently trades at a price-to-earnings (P/E) ratio of approximately 23.0x to 24.4x based on trailing twelve-month earnings.⁵⁶ This is a significant discount to its own historical valuation. The company’s 5-year average P/E ratio is 31.0x, and its 9-year historical average is even higher at 40.5x.⁵⁶ This suggests that, relative to its own past, the stock’s valuation multiple has compressed considerably, despite its strong operational and financial performance.
• Peer Comparison: When compared to its largest competitors, Medpace’s valuation appears more nuanced. Its P/E ratio is slightly higher than that of IQVIA (~21.5x) but lower than that of the diversified giant Thermo Fisher Scientific (~25x).³⁰ On an Enterprise Value to EBITDA (EV/EBITDA) basis, Medpace trades at approximately 17.7x, which is comparable to Thermo Fisher’s multiple of ~17.1x.³⁶

The central valuation question is whether Medpace’s current multiples adequately reflect its superior business profile. The company exhibits significantly faster revenue growth, higher returns on capital, and a pristine debt-free balance sheet compared to its peers. Standard valuation theory would suggest that such a profile warrants a premium valuation multiple. While it trades at a premium to some peers like ICON, its valuation is not dramatically higher than the group average, raising the question of whether the market is fully appreciating its differentiated model and growth prospects.

Valuation Multiples: Historical and Peer Comparison

Metric	MEDP (Current)	MEDP (5-Yr Avg)	IQVIA (IQV)	Thermo Fisher (TMO)
P/E (LTM)	23.0x	31.0x	21.5x	24.9x
EV/EBITDA (LTM)	17.7x	N/A	N/A	17.1x
P/S (LTM)	4.6x	N/A	1.9x	3.7x
Note: Data as of mid-July 2025. Historical averages from third-party data providers. Sources: 28

Fundamental Valuation Considerations

Beyond relative multiples, several fundamental factors support the company’s intrinsic value.

• Sustainable Growth Rate: The company’s dramatically raised guidance for 2025, projecting 14.7% to 19.5% revenue growth, provides a strong near-term anchor for its growth potential.⁴⁵ The long-term sustainability will depend on the health of the biotech funding cycle and the company’s ability to continue gaining market share.
• Margin Potential: The business has demonstrated significant operational leverage, leading to margin expansion. There may be further room for improvement as the company continues to scale and benefit from its efficient, integrated platform.
• Capital Intensity and Free Cash Flow: The CRO business model is inherently capital-light. Medpace requires minimal capital expenditures to grow, which results in very high conversion of EBITDA to free cash flow. This strong free cash flow generation is the ultimate driver of the company’s ability to fund its aggressive share repurchase program and build intrinsic value per share.

Valuation Scenario Analysis

A qualitative scenario analysis helps frame the potential range of outcomes for the investment.

• Bull Case: The biotech funding environment stabilizes and improves, providing a strong tailwind for new business awards. Medpace’s “flight-to-quality” momentum accelerates, allowing it to take significant market share from weaker competitors. The company continues to deliver double-digit revenue growth while expanding margins through operational leverage. The market recognizes its superior profile and re-rates its valuation multiple upward, closer to its historical average in the 30x P/E range.
• Base Case: The biotech funding environment remains challenging but stable. Medpace continues to execute well, growing revenue in the high-single-digits to low-double-digits, moderately ahead of the overall CRO market. Margins remain stable at their current high levels. The company continues to use its substantial free cash flow to aggressively repurchase shares, driving high-single-digit to low-double-digit EPS growth. The valuation multiple remains in the low-20s P/E range.
• Bear Case: A severe and prolonged downturn in biotech funding leads to a significant slowdown in new business awards, with the book-to-bill ratio falling below 1.0x for multiple quarters. Increased competition from large CROs targeting the biotech space leads to pricing pressure, causing margin compression. Revenue growth decelerates to the low-single-digits, and the market de-rates the stock’s valuation multiple into the mid-teens P/E range.

9. Key Risk Factors

A comprehensive analysis of Medpace must include a thorough assessment of the key risks that could materially impact the company’s business, financial condition, and stock value.

• Client and Sector Concentration: The most significant risk factor for Medpace is its strategic concentration on the small and mid-sized biotechnology sector. While this focus is the source of its competitive advantage, it also exposes the company to the inherent volatility of this market segment. The health of the biotech industry is heavily dependent on the availability of capital from public and private markets. A contraction in the biotech funding environment, driven by macroeconomic factors like rising interest rates or investor risk aversion, could lead to a reduction in R&D spending, project delays, or cancellations by Medpace’s clients, thereby negatively impacting its revenue growth and profitability.⁷
• Economic Cycle Sensitivity: Related to the above, R&D expenditures by biopharmaceutical companies can be cyclical. During periods of economic recession or uncertainty, companies may curtail their R&D budgets, which could reduce the overall demand for CRO services.
• Competitive Pressure: The CRO industry is highly competitive. Medpace faces competition from large, global CROs with greater resources, as well as smaller, specialized niche providers. While Medpace has successfully differentiated itself, there is a risk that larger competitors could more aggressively target the biotech segment, potentially leading to increased pricing pressure and a loss of market share.
• Talent and Human Capital Risks: Medpace’s success is fundamentally dependent on its ability to attract, train, and retain highly skilled professionals, including physicians, clinical research associates, and project managers. The conflicting data regarding employee turnover suggests this is a critical area.⁴⁷ High turnover could lead to operational disruptions, loss of institutional knowledge, and increased costs associated with recruitment and training, potentially impacting the quality of service delivery.
• Regulatory and Compliance Risks: The drug development process is subject to extensive and complex regulation by the FDA, EMA, and other global regulatory bodies. Any failure to comply with these regulations, including Good Clinical Practice (GCP) standards, could result in the termination of clinical trials, the rejection of clinical data by regulatory authorities, or other sanctions, which would have a severe adverse effect on the company’s business and reputation.
• Legal and Litigation Risks: The company is subject to the risks of litigation inherent in its business. Notably, news releases from late 2024 and early 2025 indicate that The Schall Law Firm, a shareholder rights litigation firm, is investigating claims of securities fraud on behalf of Medpace investors.²⁸ While the specific allegations and merits of this investigation are not detailed in the provided materials, the existence of such a probe represents a material legal and reputational risk that must be monitored.
• Technology Disruption: The clinical trial landscape is being transformed by technology. A failure by Medpace to invest in and effectively adopt new technologies, such as artificial intelligence and decentralized trial platforms, could put it at a competitive disadvantage over time.
• International and Currency Risks: With operations in 44 countries, Medpace is exposed to risks associated with doing business internationally, including political and economic instability, challenges in enforcing contracts, and fluctuations in foreign currency exchange rates.³

10. Investment Thesis Summary

Key Investment Strengths and Competitive Advantages

Medpace represents a best-in-class operator within the Contract Research Organization industry, distinguished by a unique and durable competitive moat. Its primary strengths are rooted in a highly differentiated business model that is difficult for competitors to replicate. The company’s physician-led, full-service operational platform is specifically tailored to the complex needs of its core client base: innovative small and mid-sized biotechnology companies. This strategic focus is fortified by a disciplined, 30-year commitment to purely organic growth, which has fostered a cohesive culture and a seamless, integrated service delivery platform, avoiding the operational disruptions common at its M&A-driven peers. This operational excellence translates directly into a superior financial profile, characterized by industry-leading revenue growth, high and expanding profitability margins, and an exceptionally strong, debt-free balance sheet that provides significant financial flexibility.

Primary Growth Drivers and Sustainability

The company’s future growth is supported by both powerful secular industry tailwinds and company-specific advantages. Medpace is poised to benefit from the ongoing structural shift towards greater R&D outsourcing within the biopharmaceutical industry. Its deep expertise is concentrated in the most innovative and fastest-growing therapeutic areas, such as oncology, metabolic diseases, and rare diseases, which are predominantly driven by its core biotech client base. The company’s reputation for high-quality execution and its financial stability position it as a prime beneficiary of a “flight-to-quality” trend, particularly in uncertain funding environments, suggesting a clear path to continued market share gains within its chosen niche. The sustainability of its growth is further supported by a robust backlog of contracted work and a consistently strong record of winning new business.

Main Risk Factors and Mitigation Strategies

The primary investment risk is Medpace’s significant exposure to the cyclical biotech funding environment. A prolonged downturn in capital markets for biotechnology companies could temper new business growth. However, this risk is substantially mitigated by several factors. The company’s recent strong performance and dramatically increased financial guidance suggest a high degree of resilience and potential market share gains even in a challenging macro environment. Its fortress balance sheet, with no debt, allows it to navigate downturns from a position of strength. Furthermore, its well-diversified client base, with no single customer accounting for more than 10% of revenue, reduces the impact of any individual client’s potential failure. Other notable risks include attracting and retaining top talent in a competitive labor market and the potential for increased competition from larger CROs.

Catalyst Timeline and Key Monitoring Metrics

The investment thesis will be validated by the company’s continued execution against its strategic and financial goals. Key metrics to monitor on a quarterly basis are essential for tracking performance:

• Net New Business Awards and the Book-to-Bill Ratio: The most critical leading indicators of future revenue growth.
• Backlog Conversion Rate: A key measure of operational efficiency and the pace of revenue recognition.
• EBITDA and Net Income Margins: To confirm the sustainability of the company’s superior profitability.
• Share Repurchase Activity: To gauge management’s ongoing view of the stock’s valuation and its commitment to returning capital.
• Management Commentary: Close attention should be paid to management’s discussion of the biotech funding environment and competitive dynamics during quarterly earnings calls.

Potential catalysts include the consistent achievement of the company’s raised 2025 financial guidance, further announcements of large-scale share repurchase authorizations, and any signs of a stabilization or improvement in the broader biotech capital markets.

Overall Investment Attractiveness Assessment

Medpace Holdings, Inc. presents a compelling case as a high-quality growth company with a distinct and defensible competitive position. The company’s unique business model, disciplined organic growth strategy, and superior financial metrics set it apart from its peers. The investment question hinges on the balance between this exceptional business quality and the inherent cyclical risks of its target market. The current valuation, which sits below the company’s long-term historical averages, may not fully reflect its superior growth and profitability profile. The analysis suggests that Medpace is an attractive investment for those with a long-term horizon who are willing to look through the near-term volatility of the biotech sector to own a best-in-class operator with a clear runway for sustained, profitable growth and a proven commitment to creating shareholder value.

Works cited

1. Investors – Medpace Holdings, Inc., accessed July 22, 2025, https://investor.medpace.com/
2. Medpace Holdings, Inc. – AnnualReports.com, accessed July 22, 2025, https://www.annualreports.com/Company/medpace-holdings-inc
3. Medpace: Drug and Biologic Contract Research Organization (CRO), accessed July 22, 2025, https://www.medpace.com/
4. Medpace (MEDP) Investor Relations Material – Quartr, accessed July 22, 2025, https://quartr.com/companies/medpace-holdings-inc_5839
5. MEDP SEC Filings – Medpace Holdings 10-K, 10-Q, 8-K Forms – Stock Titan, accessed July 22, 2025, https://www.stocktitan.net/sec-filings/MEDP/
6. Medpace, IQVIA, & Benefits of Scale in Biotech CRO | In Practise – InPractise, accessed July 22, 2025, https://inpractise.com/articles/medpace-large-vs-small-biotech-cros
7. Medpace Q2 2025 slides: revenue surges 14%, company raises full-year guidance, accessed July 22, 2025, https://www.investing.com/news/company-news/medpace-q2-2025-slides-revenue-surges-14-company-raises-fullyear-guidance-93CH-4144727
8. Medpace Investor Presentation, accessed July 22, 2025, https://investor.medpace.com/static-files/b1635c97-a0e6-48ba-8df4-d8583d055558
9. Medpace Holdings, Inc. Common Stock (MEDP) – Nasdaq, accessed July 22, 2025, https://www.nasdaq.com/market-activity/stocks/medp
10. Medpace Holdings Inc. (via Public) / Proxy Statement (Form DEF 14A), accessed July 22, 2025, https://www.publicnow.com/view/FD6F6E54378F72EA515580DE798637BB43B64EE3?1743630514
11. Top 10 CROs to Watch in 2025 – Proclinical, accessed July 22, 2025, https://www.proclinical.com/blogs/2025-3/top-10-cros-to-watch-in-2025
12. Contract Research Organization Services Market Size, Share, Trends and Revenue Forecast [Latest] – MarketsandMarkets, accessed July 22, 2025, https://www.marketsandmarkets.com/Market-Reports/contract-research-organization-service-market-167410116.html
13. Contract Research Organization [CRO] Services Market, 2032 – Fortune Business Insights, accessed July 22, 2025, https://www.fortunebusinessinsights.com/industry-reports/contract-research-organization-cro-services-market-100864
14. Contract Research Organization Market Size & Share, 2032, accessed July 22, 2025, https://www.gminsights.com/industry-analysis/contract-research-organization-cro-market
15. Contract Research Organization Services Market Size to Surpass USD 149.34 bn by 2034, accessed July 22, 2025, https://www.precedenceresearch.com/contract-research-organization-services-market
16. Contract Research Organization (CRO) Market Set to Surpass $113 Billion by 2031 Amid Rising R&D Outsourcing and Biotech Expansion | The Insight Partners – GlobeNewswire, accessed July 22, 2025, https://www.globenewswire.com/news-release/2025/05/07/3076311/0/en/Contract-Research-Organization-CRO-Market-Set-to-Surpass-113-Billion-by-2031-Amid-Rising-R-D-Outsourcing-and-Biotech-Expansion-The-Insight-Partners.html
17. Pharmaceutical CRO Market Size, Share, and Trends 2025 to 2034 – Nova One Advisor, accessed July 22, 2025, https://www.novaoneadvisor.com/report/pharmaceutical-cro-market
18. Investor Relations: IQVIA Holdings Inc., accessed July 22, 2025, https://ir.iqvia.com/overview/default.aspx
19. IQVIA to Announce Second-Quarter 2025 Results on July 22, 2025 – Investor Relations, accessed July 22, 2025, https://ir.iqvia.com/press-releases/press-release-details/2025/IQVIA-to-Announce-Second-Quarter-2025-Results-on-July-22-2025/default.aspx
20. IQVIA Inc. (US) and ICON Plc (Ireland) are Leading Players in the Clinical Trial Services Market – MarketsandMarkets, accessed July 22, 2025, https://www.marketsandmarkets.com/ResearchInsight/clinical-trials-market.asp
21. Document – SEC.gov, accessed July 22, 2025, https://www.sec.gov/Archives/edgar/data/1478242/000147824225000016/iqv-q4x2024earningspressre.htm
22. Thermo Fisher Scientific Completes Acquisition of PPD, Inc. – Investors, accessed July 22, 2025, https://ir.thermofisher.com/investors/news-events/news/news-details/2021/Thermo-Fisher-Scientific-Completes-Acquisition-of-PPD-Inc/default.aspx
23. Syneos Health Closes Transaction with Private Investment Firms – GlobeNewswire, accessed July 22, 2025, https://www.globenewswire.com/news-release/2023/09/28/2751390/33420/en/Syneos-Health-Closes-Transaction-with-Private-Investment-Firms.html
24. Parexel – EQT Group, accessed July 22, 2025, https://eqtgroup.com/about/current-portfolio/parexel
25. Medpace Statistics – LVS Advisory, accessed July 22, 2025, https://lvsadvisory.com/wp-content/uploads/2025/02/LVS-Advisory-Medpace-Memo.pdf
26. Top 10 Clinical Research Organizations Powering Modern Medicine – Kent State Online, accessed July 22, 2025, https://onlinedegrees.kent.edu/college-of-public-health/community/top-clinical-research-organizations
27. Contract Research Organization Market Size, Industry Trends & Share 2030, accessed July 22, 2025, https://www.mordorintelligence.com/industry-reports/contract-research-organization-market
28. Medpace Holdings (MEDP) Stock Price & Overview, accessed July 22, 2025, https://stockanalysis.com/stocks/medp/
29. Medpace Holdings (MEDP) Revenue 2015-2025 – Stock Analysis, accessed July 22, 2025, https://stockanalysis.com/stocks/medp/revenue/
30. PE Ratio – Medpace Holdings, Inc. – Wisesheets, accessed July 22, 2025, https://www.wisesheets.io/pe-ratio/MEDP
31. IQVIA (IQV) – P/E ratio – Companies Market Cap, accessed July 22, 2025, https://companiesmarketcap.com/iqvia/pe-ratio/
32. IQVIA Holdings PE Ratio 2011-2025 | IQV – Macrotrends, accessed July 22, 2025, https://macrotrends.net/stocks/charts/IQV/iqvia-holdings/pe-ratio
33. IQVIA Holdings PE Ratio Analysis – YCharts, accessed July 22, 2025, https://ycharts.com/companies/IQV/pe_ratio
34. Thermo Fisher Scientific (TMO) – P/E ratio – Companies Market Cap, accessed July 22, 2025, https://companiesmarketcap.com/thermo-fisher-scientific/pe-ratio/
35. Medpace Holdings EBITDA 2014-2025 | MEDP – Macrotrends, accessed July 22, 2025, https://www.macrotrends.net/stocks/charts/MEDP/medpace/ebitda
36. MEDP – Medpace Holdings Inc Stock Price and Quote – FINVIZ.com, accessed July 22, 2025, https://finviz.com/quote.ashx?t=MEDP
37. IQVIA Holdings EBITDA 2011-2025 | IQV – Macrotrends, accessed July 22, 2025, https://macrotrends.net/stocks/charts/IQV/iqvia-holdings/ebitda
38. IQVIA Holdings EBITDA Margin 2011-2025 | IQV – Macrotrends, accessed July 22, 2025, https://www.macrotrends.net/stocks/charts/IQV/iqvia-holdings/ebitda-margin
39. Thermo Fisher Scientific (TMO) Statistics & Valuation – Stock Analysis, accessed July 22, 2025, https://stockanalysis.com/stocks/tmo/statistics/
40. Revenue Growth For Medpace Holdings, Inc. (01P) – Finbox, accessed July 22, 2025, https://finbox.com/DB:01P/explorer/total_rev_growth
41. Medpace Holdings, Inc. Reports Fourth Quarter and Full Year 2022 Results, accessed July 22, 2025, https://investor.medpace.com/news-releases/news-release-details/medpace-holdings-inc-reports-fourth-quarter-and-full-year-2022/
42. Document – SEC.gov, accessed July 22, 2025, https://www.sec.gov/Archives/edgar/data/1668397/000166839725000012/medp-20250210exx991.htm
43. Medpace Holdings, Inc. Reports Fourth Quarter and Full Year 2024 Results, accessed July 22, 2025, https://investor.medpace.com/news-releases/news-release-details/medpace-holdings-inc-reports-fourth-quarter-and-full-year-2024/
44. MEDP 2024 Annual Report – Investors – Medpace Holdings, Inc., accessed July 22, 2025, https://investor.medpace.com/static-files/ff2476ab-b4c4-4954-b8b6-056d07a20c6b
45. MEDP 2Q25 Earnings Release – Investors – Medpace Holdings, Inc., accessed July 22, 2025, https://investor.medpace.com/static-files/9b2315c3-607f-419e-af22-39b1f7460521
46. Medpace Holdings (MEDP) Balance Sheet & Financial Health Metrics – Simply Wall St, accessed July 22, 2025, https://simplywall.st/stocks/us/pharmaceuticals-biotech/nasdaq-medp/medpace-holdings/health
47. Medpace Retention Score – Comparably, accessed July 22, 2025, https://www.comparably.com/companies/medpace/retention
48. Medpace Cincinnati : r/cincinnati – Reddit, accessed July 22, 2025, https://www.reddit.com/r/cincinnati/comments/1gucrdu/medpace_cincinnati/
49. Medpace Holdings, Inc. Reports Second Quarter 2025 Results, accessed July 22, 2025, https://investor.medpace.com/news-releases/news-release-details/medpace-holdings-inc-reports-second-quarter-2025-results/
50. Form 10-K for Medpace Holdings INC filed 02/11/2025 – Investors …, accessed July 22, 2025, https://investor.medpace.com/static-files/cd41645f-da0e-40fb-9677-ba23376ffd6a
51. Medpace Holdings, Inc. (MEDP) Stock Price, Quote, News & Analysis | Seeking Alpha, accessed July 22, 2025, https://seekingalpha.com/symbol/MEDP
52. CORPORATE RESPONSIBILITY REPORT – Medpace, accessed July 22, 2025, https://www.medpace.com/careers/wp-content/uploads/sites/2/2023/03/Corporate-Responsibility-Report_2021-2022.pdf
53. Working At Medpace: Company Overview and Culture – Zippia, accessed July 22, 2025, https://www.zippia.com/medpace-careers-7338/
54. Case Study: Strategies to Accelerate Enrollment Timelines for Trials in Commonly Spread Diseases | Medpace, accessed July 22, 2025, https://www.medpace.com/wp-content/uploads/2023/03/Case-Study-Strategies-to-Accelerate-Enrollment-Timelines-for-Trials-in-Commonly-Spread-Diseases.pdf
55. Bringing complex, concurrent trials to a successful completion requires tremendous balance – Medpace, accessed July 22, 2025, https://www.medpace.com/wp-content/uploads/2016/12/CaseStudy_OperationalExcellence.pdf
56. MEDP – Medpace Holdings PE ratio, current and historical analysis – FullRatio, accessed July 22, 2025, https://fullratio.com/stocks/nasdaq-medp/pe-ratio
57. Medpace Holdings PE Ratio 2014-2025 | MEDP – Macrotrends, accessed July 22, 2025, https://www.macrotrends.net/stocks/charts/MEDP/medpace-holdings/pe-ratio
58. Thermo Fisher Scientific Inc (1TMO) EV/EBITDA – Investing.com IN, accessed July 22, 2025, https://in.investing.com/pro/BIT:1TMO/explorer/ev_to_ebitda_ltm
59. IQVIA Holdings P/S Ratio 2011-2025 | IQV – Macrotrends, accessed July 22, 2025, https://www.macrotrends.net/stocks/charts/IQV/iqvia-holdings/price-sales