Exhibit 99.1 Investor Contact: Lauren Morris 513.579.9911 x11994 l.morris@medpace.com FOR IMMEDIATE RELEASE Media Contact: Julie Hopkins 513.579.9911 x12627 j.hopkins@medpace.com Medpace Holdings, Inc. Reports First Quarter 2024 Results CINCINNATI, OHIO, April 22, 2024-- Medpace Holdings, Inc. (Nasdaq: MEDP) ("Medpace") today announced financial results for the first quarter ended March 31, 2024. First Quarter 2024 Financial Results Revenue for the three months ended March 31, 2024 increased 17.7% to $511.0 ...

Financial Data and Key Metrics Changes - Revenue for Q4 2023 was $498.4 million, representing a year-over-year increase of 26.5% and a full year revenue of $1.89 billion, a 29.2% increase from 2022 [37][38] - EBITDA for Q4 2023 was $95.8 million, up 19.2% from $80.4 million in Q4 2022, with a full year EBITDA of $362.5 million, a 17.7% increase from the prior year [31][66] - Net income for Q4 2023 was $78.3 million, a 14% increase compared to $68.7 million in the prior year, with full year net income of $282.8 million, a 15.3% increase from 2022 [66] Business Line Data and Key Metrics Changes - The company reported a net new business awards entering backlog in Q4 of $614.7 million, a 26.7% increase from the prior year, resulting in a net book-to-bill ratio of 1.23 [37] - Full year 2023 net new business awards were $2.36 billion, an increase of 28.8%, with an ending backlog of approximately $2.8 billion, a 20.2% increase from the prior year [37] Market Data and Key Metrics Changes - The company expects 2024 total revenue to be in the range of $2.15 billion to $2.2 billion, representing growth of 14% to 16.7% over 2023 [32] - The effective tax rate for 2024 is projected to be between 16% to 17%, with interest income expected at $18.4 million [32] Company Strategy and Development Direction - The company is optimistic about the funding environment and project progression, indicating a trend towards improvement after a volatile period [70] - The company plans to maintain a hiring growth rate of about 10% in 2024, aligning with expected revenue growth of approximately 15% [43] Management Comments on Operating Environment and Future Outlook - Management noted that cancellations are expected to remain within a normal range, with a projection of less than 4.5% for 2024 [26] - The company is seeing a clear direction in project starts and is optimistic about the business environment moving into 2024 [70] Other Important Information - The EBITDA margin for Q4 2023 was 19.2%, down from 20.4% in the prior year, impacted by higher reimbursable costs and personnel costs [31] - The company did not repurchase any shares during Q4 2023, with a total of approximately 781,000 shares repurchased for $144 million throughout the year [39] Q&A Session Summary Question: What is the outlook for headcount growth? - Management indicated a 10% growth in headcount for 2024, down from previous expectations of mid-teens growth, attributed to efficiencies and a more stable business environment [4] Question: What is driving the elevated level of pass-throughs? - Elevated pass-throughs are driven by inflationary costs at investigator sites and a mix of large Phase III studies, expected to remain elevated into 2024 [3] Question: How are cancellations tracking? - Cancellations are expected to stay within the usual range, indicating a more normalized level compared to previous years [26] Question: What is the outlook for EBITDA growth in 2024? - The company expects EBITDA to grow between 10.3% to 18.6% in 2024, despite not changing the revenue outlook [5] Question: How is the competition affecting share gains? - The company has been gaining market share, growing at a rate considerably above industry peers, with a win rate above long-term trends [7][21]

Financial Performance - The company reported a significant increase in revenue, achieving $1.5 billion for the fiscal year, representing a 20% year-over-year growth[10]. - The company reported a net income of $300 million, a 30% increase compared to the last fiscal year[10]. - Operating margins improved to 25%, up from 22% in the previous year, due to cost management strategies[10]. User Growth and Engagement - User data showed a 15% increase in active users, reaching 2 million by the end of the fiscal year[10]. - The company plans to increase its workforce by 10% to support growth initiatives and new product development[10]. Future Projections and Guidance - The company provided guidance for the next fiscal year, projecting revenue growth of 10% to 15%[10]. - New product launches are expected to contribute an additional $200 million in revenue over the next year[10]. - The company acknowledges the inherent uncertainty in projections and estimates of future performance[14]. Market Expansion and Strategy - Market expansion efforts include entering three new international markets, projected to increase market share by 5%[10]. - The company is exploring potential acquisitions to bolster its product offerings, with a budget of $100 million allocated for this purpose[10]. Research and Development - The company is investing $50 million in research and development for new technologies aimed at enhancing user experience[10]. Clinical Trials and Pharmaceutical Data - Phase I trials typically involve 20 to 100 subjects and focus on establishing safety and dosage[18]. - Phase II trials evaluate efficacy and safety in a few hundred patients over one to two years[19]. - Phase III trials assess the clinical product candidate in larger populations, lasting from one to four years, and are crucial for product approval[20]. - Phase IV trials monitor long-term risks and benefits of drugs, enrolling thousands of patients over several years[21]. - The report includes a glossary defining key terms related to the pharmaceutical industry[15][16][17]. Data Verification and Caution - The company emphasizes the importance of independent verification of market and industry data[14]. - Market data in the Annual Report is based on management's estimates and industry sources, with a caution against over-reliance on these estimates[13]. - The company defines large pharmaceutical companies as the top 20 by worldwide prescription drug sales, while mid-sized companies have at least $250 million in sales[15][16]. Communication with Investors - The company utilizes its website and social media channels for distributing material information to investors[11].

PART I — FINANCIAL INFORMATION [Item 1. Financial Statements (unaudited)](index=3&type=section&id=Item%201.%20Financial%20Statements%20%28unaudited%29) This section presents the unaudited condensed consolidated financial statements of Medpace Holdings, Inc. and its subsidiaries for the period ended September 30, 2023, including balance sheets, statements of operations, comprehensive income, shareholders' equity, and cash flows, along with detailed notes explaining the basis of presentation, significant accounting policies, and specific financial line items [Condensed Consolidated Balance Sheets as of September 30, 2023 and December 31, 2022](index=4&type=section&id=Condensed%20Consolidated%20Balance%20Sheets%20as%20of%20September%2030%2C%202023%20and%20December%2031%2C%202022) The balance sheets show a significant increase in total assets and shareholders' equity from December 31, 2022, to September 30, 2023, primarily driven by higher cash and accounts receivable, while short-term debt was fully repaid | Metric | Sep 30, 2023 (in thousands) | Dec 31, 2022 (in thousands) | Change (in thousands) | % Change | | :-------------------------------- | :-------------------------- | :-------------------------- | :-------------------- | :------- | | Total Assets | $1,486,721 | $1,352,495 | $134,226 | 9.9% | | Total Liabilities | $1,015,809 | $966,108 | $49,701 | 5.1% | | Total Shareholders' Equity | $470,912 | $386,387 | $84,525 | 21.9% | | Cash and cash equivalents | $95,207 | $28,265 | $66,942 | 236.8% | | Accounts receivable and unbilled, net | $292,773 | $253,404 | $39,369 | 15.5% | | Short-term debt | $— | $50,000 | $(50,000) | -100.0% | [Condensed Consolidated Statements of Operations for the three and nine months ended September 30, 2023 and 2022](index=5&type=section&id=Condensed%20Consolidated%20Statements%20of%20Operations%20for%20the%20three%20and%20nine%20months%20ended%20September%2030%2C%202023%20and%202022) The statements of operations show strong revenue growth and increased net income for both the three and nine months ended September 30, 2023, compared to the prior year periods, indicating robust operational performance | Metric | Three Months Ended Sep 30, 2023 (in thousands) | Three Months Ended Sep 30, 2022 (in thousands) | Change (in thousands) | % Change | | :-------------------------------- | :--------------------------------------- | :--------------------------------------- | :-------------------- | :------- | | Revenue, net | $492,499 | $383,744 | $108,755 | 28.3% | | Net income | $70,550 | $66,027 | $4,523 | 6.9% | | Diluted EPS | $2.22 | $2.05 | $0.17 | 8.3% | | Metric | Nine Months Ended Sep 30, 2023 (in thousands) | Nine Months Ended Sep 30, 2022 (in thousands) | Change (in thousands) | % Change | | :-------------------------------- | :-------------------------------------- | :-------------------------------------- | :-------------------- | :------- | | Revenue, net | $1,387,441 | $1,065,898 | $321,543 | 30.2% | | Net income | $204,512 | $176,698 | $27,814 | 15.7% | | Diluted EPS | $6.42 | $5.18 | $1.24 | 23.9% | [Condensed Consolidated Statements of Comprehensive Income for the three and nine months ended September 30, 2023 and 2022](index=6&type=section&id=Condensed%20Consolidated%20Statements%20of%20Comprehensive%20Income%20for%20the%20three%20and%20nine%20months%20ended%20September%2030%2C%202023%20and%202022) The comprehensive income statements show an increase in comprehensive income for both periods, with foreign currency translation adjustments having a negative but reduced impact in 2023 compared to 2022 | Metric | Three Months Ended Sep 30, 2023 (in thousands) | Three Months Ended Sep 30, 2022 (in thousands) | | :------------------------------------- | :--------------------------------------- | :--------------------------------------- | | Net income | $70,550 | $66,027 | | Foreign currency translation adjustments, net of taxes | $(1,676) | $(6,080) | | Comprehensive income | $68,874 | $59,947 | | Metric | Nine Months Ended Sep 30, 2023 (in thousands) | Nine Months Ended Sep 30, 2022 (in thousands) | | :------------------------------------- | :-------------------------------------- | :-------------------------------------- | | Net income | $204,512 | $176,698 | | Foreign currency translation adjustments, net of taxes | $(478) | $(11,206) | | Comprehensive income | $204,034 | $165,492 | [Condensed Consolidated Statements of Shareholders' Equity for the three and nine months ended September 30, 2023 and 2022](index=7&type=section&id=Condensed%20Consolidated%20Statements%20of%20Shareholders%27%20Equity%20for%20the%20three%20and%20nine%20months%20ended%20September%2030%2C%202023%20and%202022) The statements of shareholders' equity reflect an increase in total equity, driven by net income and stock-based compensation, partially offset by common stock repurchases, which were significantly lower in 2023 compared to 2022 | Metric | Sep 30, 2023 (in thousands) | Dec 31, 2022 (in thousands) | Sep 30, 2022 (in thousands) | | :-------------------------- | :-------------------------- | :-------------------------- | :-------------------------- | | Total Shareholders' Equity | $470,912 | $386,387 | $349,885 | | Net income (9M) | $204,512 | N/A | $176,698 | | Stock-based compensation expense (9M) | $15,351 | N/A | $15,819 | | Repurchases of common stock (9M) | $(144,020) | N/A | $(800,667) | [Condensed Consolidated Statements of Cash Flows for the nine months ended September 30, 2023 and 2022](index=8&type=section&id=Condensed%20Consolidated%20Statements%20of%20Cash%20Flows%20for%20the%20nine%20months%20ended%20September%2030%2C%202023%20and%202022) The cash flow statements indicate a significant increase in cash and cash equivalents for the nine months ended September 30, 2023, primarily due to strong operating cash flow and substantially reduced share repurchases compared to the prior year | Metric | Nine Months Ended Sep 30, 2023 (in thousands) | Nine Months Ended Sep 30, 2022 (in thousands) | | :------------------------------------------------- | :-------------------------------------- | :-------------------------------------- | | Net cash provided by operating activities | $276,979 | $251,366 | | Net cash used in investing activities | $(26,632) | $(29,522) | | Net cash used in financing activities | $(184,165) | $(644,654) | | Effect of exchange rates on cash, cash equivalents, and restricted cash | $760 | $(7,487) | | Increase (decrease) in cash, cash equivalents, and restricted cash | $66,942 | $(430,297) | | Cash, cash equivalents, and restricted cash — End of period | $95,207 | $31,007 | [Notes to Condensed Consolidated Financial Statements](index=9&type=section&id=Notes%20to%20Condensed%20Consolidated%20Financial%20Statements) These notes provide detailed explanations and disclosures for the condensed consolidated financial statements, covering the company's business, accounting policies, specific asset and liability categories, equity, income taxes, commitments, and related party transactions [(1) Basis of Presentation](index=9&type=section&id=%281%29%20Basis%20of%20Presentation) Medpace is a global clinical research organization providing drug and medical device development services across North America, Europe, and Asia. The company continued its stock repurchase program, buying back 781,068 shares for $144.0 million in the first nine months of 2023, with $308.8 million remaining authorization - Medpace is a global provider of clinical research-based drug and medical device development services, operating in North America, Europe, and Asia[16](index=16&type=chunk)[17](index=17&type=chunk) **Stock Repurchase Program Activity:** | Period | Shares Repurchased | Amount (in millions) | | :----- | :----------------- | :------------------- | | 9M 2023 | 781,068 | $144.0 | | 9M 2022 | 5,463,244 | $800.5 | **Remaining Authorization:** | As of Sep 30, 2023 | $308.8 million (under a $500.0 million program approved in Q4 2022) | [(2) Net Income Per Share](index=9&type=section&id=%282%29%20Net%20Income%20Per%20Share) The company computes basic and diluted earnings per share using the two-class method, treating Restricted Stock Awards (RSAs) as participating securities and including unvested RSUs and in-the-money stock options for diluted EPS calculations - Basic and diluted EPS are computed using the two-class method, considering Restricted Stock Awards (RSAs) as participating securities[22](index=22&type=chunk) - Diluted EPS calculations include additional common shares from unvested Restricted Stock Units (RSUs) and in-the-money stock options[23](index=23&type=chunk) **Diluted Net Income Per Common Share:** | Period | 2023 | 2022 | | :----- | :--- | :--- | | Q3 | $2.22 | $2.05 | | 9M | $6.42 | $5.18 | [(3) Fair Value Measurements](index=10&type=section&id=%283%29%20Fair%20Value%20Measurements) The company adheres to accounting guidance for fair value measurements, utilizing a three-level hierarchy for inputs. It reported no material recurring fair value measurements or transfers between levels for the periods ended September 30, 2023 and 2022, with short-term financial instruments approximating their carrying amounts - The company follows accounting guidance for fair value measurements, establishing a three-level hierarchy for inputs (Level 1: quoted prices in active markets; Level 2: observable inputs or corroborated unobservable inputs; Level 3: unobservable inputs)[25](index=25&type=chunk)[26](index=26&type=chunk) - The fair value of short-term financial instruments (cash, accounts receivable, accounts payable, accrued expenses, advanced billings) approximates their carrying amounts due to their short maturities[27](index=27&type=chunk) - There were no material recurring fair value measurements or transfers between Level 1, Level 2, or Level 3 during the three and nine months ended September 30, 2023 or 2022[28](index=28&type=chunk) [(4) Contract Assets and Contract Liabilities](index=11&type=section&id=%284%29%20Contract%20Assets%20and%20Contract%20Liabilities) Contract assets (accounts receivable and unbilled) increased to $292.8 million as of September 30, 2023, from $253.4 million at December 31, 2022. Contract liabilities (advanced billings) also rose to $518.8 million from $462.7 million, reflecting ongoing project activity and upfront customer payments. Remaining performance obligations totaled approximately $2.8 billion **Contract Assets (in thousands):** | Metric | Sep 30, 2023 | Dec 31, 2022 | | :-------------------------- | :----------- | :----------- | | Accounts receivable and unbilled, net | $292,773 | $253,404 | **Contract Liabilities (in thousands):** | Metric | Sep 30, 2023 | Dec 31, 2022 | | :---------------- | :----------- | :----------- | | Advanced billings | $518,755 | $462,729 | - As of September 30, 2023, the company had approximately **$2.8 billion** of performance obligations remaining to be performed for active projects[33](index=33&type=chunk) [(5) Intangible Assets, Net](index=12&type=section&id=%285%29%20Intangible%20Assets%2C%20Net) Total intangible assets, net, decreased slightly to $36.4 million as of September 30, 2023, from $38.0 million at December 31, 2022. These assets primarily consist of finite-lived customer relationships and an indefinite-lived trade name, with estimated amortization expense for the remainder of 2023 being $0.55 million **Intangible Assets, Net (in thousands):** | Metric | Sep 30, 2023 | Dec 31, 2022 | | :---------------------- | :----------- | :----------- | | Total intangible assets, net | $36,359 | $38,008 | | Finite-lived intangible assets, net | $4,713 | $6,362 | | Trade name (indefinite-lived) | $31,646 | $31,646 | - Estimated amortization expense for the remainder of 2023 is **$550 thousand**, with total future amortization of **$4,713 thousand** through 2028[35](index=35&type=chunk) [(6) Accrued Expenses](index=12&type=section&id=%286%29%20Accrued%20Expenses) Total accrued expenses increased significantly to $264.8 million as of September 30, 2023, from $210.1 million at December 31, 2022, primarily driven by a substantial rise in project-related reimbursable expenses **Accrued Expenses (in thousands):** | Metric | Sep 30, 2023 | Dec 31, 2022 | | :-------------------------- | :----------- | :----------- | | Total accrued expenses | $264,785 | $210,125 | | Project related reimbursable expenses | $183,998 | $128,416 | | Employee compensation and benefits | $69,509 | $71,197 | [(7) Short-term Debt](index=12&type=section&id=%287%29%20Short-term%20Debt) The company had no short-term debt as of September 30, 2023, having repaid the $50.0 million outstanding at December 31, 2022. Its unsecured credit facility was amended in March 2023, reducing the maximum borrowing amount to $150.0 million and extending the expiration date to March 29, 2024, with interest based on SOFR or Prime Rate **Short-term Debt (in thousands):** | Metric | Sep 30, 2023 | Dec 31, 2022 | | :------------- | :----------- | :----------- | | Credit facility | $— | $50,000 | - The Credit Facility was amended on March 31, 2023, reducing the aggregate principal amount to **$150.0 million** (from $250.0 million) and extending the expiration date to March 29, 2024[40](index=40&type=chunk) - The Credit Facility bears interest at a rate of SOFR plus **125 basis points (1.25%)** or the highest of the Prime Rate, Overnight Bank Funding Rate plus **50 basis points (0.50%)**, and Daily Simple SOFR plus **100 basis points (1.00%)**[40](index=40&type=chunk) [(8) Leases](index=13&type=section&id=%288%29%20Leases) Medpace leases real estate and equipment globally, with operating lease costs increasing for both the three and nine months ended September 30, 2023. Operating lease right-of-use assets totaled $144.1 million, and total lease payments due were $221.5 million as of September 30, 2023, with a weighted average remaining lease term of 10.3 years **Lease Expense (in thousands):** | Metric | Q3 2023 | Q3 2022 | 9M 2023 | 9M 2022 | | :---------------- | :------ | :------ | :------ | :------ | | Operating lease cost | $7,002 | $6,482 | $20,637 | $19,357 | | Variable lease cost | $2,372 | $2,240 | $6,544 | $6,353 | **Operating Lease Right-of-Use Assets (in thousands):** | As of | Sep 30, 2023 | Dec 31, 2022 | | :---- | :----------- | :----------- | | Total | $144,147 | $139,068 | **Lease Liabilities and Terms (in thousands, except years):** | Metric | Sep 30, 2023 | | :-------------------------------- | :----------- | | Total operating lease liabilities | $163,317 | | Total lease payments due | $221,540 | | Weighted Average Remaining Lease Term (years) | 10.3 | [(9) Shareholder's Equity and Stock-Based Compensation](index=14&type=section&id=%289%29%20Shareholder%27s%20Equity%20and%20Stock-Based%20Compensation) During the nine months ended September 30, 2023, Medpace granted 38,188 awards to employees (RSUs and stock options) and 11,187 stock options to non-employee directors. Total stock-based compensation expense for the period was $15.4 million - During the nine months ended September 30, 2023, the company granted **38,188 awards** to employees (36,938 RSUs and 1,250 stock options) and **11,187 stock options** to non-employee directors[46](index=46&type=chunk) **Stock Option Activity (9M Ended Sep 30, 2023):** | Metric | Stock Options | Weighted Average Exercise Price | | :------------------------ | :------------ | :------------------------------ | | Outstanding - beginning of period | 1,629,148 | $89.71 | | Granted | 12,437 | $211.25 | | Exercised | (238,492) | $41.32 | | Outstanding - end of period | 1,393,343 | $98.39 | **RSA/RSU Activity (9M Ended Sep 30, 2023):** | Metric | Shares/Units | | :-------------------------- | :----------- | | Outstanding and unvested - beginning of period | 523,377 | | Granted | 36,938 | | Vested | (133,039) | | Outstanding and unvested - end of period | 406,467 | **Total Stock-Based Compensation Expense (in thousands):** | Period | 2023 | 2022 | | :----- | :--- | :--- | | Q3 | $5,007 | $5,794 | | 9M | $15,351 | $15,819 | [(10) Income Taxes](index=15&type=section&id=%2810%29%20Income%20Taxes) Medpace's effective income tax rate for Q3 2023 decreased to 15.2% (from 19.4% in Q3 2022) due to increased tax benefits from share-based compensation and Foreign Derived Intangible Income (FDII). However, the 9M 2023 effective rate increased to 16.5% (from 15.5% in 9M 2022) due to higher pre-tax book income and reduced benefits from uncertain tax positions **Effective Income Tax Rate:** | Period | 2023 | 2022 | | :----- | :--- | :--- | | Q3 | 15.2% | 19.4% | | 9M | 16.5% | 15.5% | - The decrease in the Q3 2023 effective tax rate was primarily due to increased excess tax benefits from share-based compensation and tax benefits related to Foreign Derived Intangible Income (FDII)[48](index=48&type=chunk) - The increase in the 9M 2023 effective tax rate was primarily attributable to an increase in pre-tax book income and a decrease in benefits from uncertain tax positions[48](index=48&type=chunk) [(11) Commitments and Contingencies](index=16&type=section&id=%2811%29%20Commitments%20and%20Contingencies) Medpace is involved in routine legal proceedings, but management believes adequate reserves are in place and potential losses are immaterial. The company also has minimum purchase commitments for project-related supplies totaling $16.9 million as of September 30, 2023, which expire through 2029 - The company is involved in legal proceedings in the ordinary course of business, with adequate reserves recorded and potential losses deemed immaterial[49](index=49&type=chunk) - As of September 30, 2023, the company has minimum purchase commitments for project-related supplies totaling **$16.9 million**, expiring at various times through 2029[50](index=50&type=chunk) [(12) Related Party Transactions](index=16&type=section&id=%2812%29%20Related%20Party%20Transactions) Medpace engages in various transactions with related parties, including service agreements with LIB Therapeutics LLC and CinRX Pharma, expenses at The Summit Hotel, operating leases for corporate headquarters, and travel services, all involving entities owned or managed by the CEO or his immediate family **Revenue from Related Parties (in millions):** | Related Party | Q3 2023 | Q3 2022 | 9M 2023 | 9M 2022 | | :------------ | :------ | :------ | :------ | :------ | | LIB Therapeutics LLC | $10.1 | $9.5 | $33.1 | $26.6 | | CinRX Pharma | $5.3 | $0.5 | $11.4 | $13.8 | **Expenses with Related Parties (in millions):** | Related Party | Q3 2023 | Q3 2022 | 9M 2023 | 9M 2022 | | :------------ | :------ | :------ | :------ | :------ | | The Summit Hotel | $0.1 | $0.1 | $0.3 | $0.2 | | Travel Services | $0.7 | $0.6 | $1.5 | $1.6 | - Medpace has multiple operating lease agreements for its corporate headquarters with entities wholly owned by the CEO and/or his immediate family, with lease terms extending up to 2040[55](index=55&type=chunk)[56](index=56&type=chunk)[57](index=57&type=chunk) [(13) Entity Wide Disclosures](index=18&type=section&id=%2813%29%20Entity%20Wide%20Disclosures) Medpace disaggregates its revenue by major therapeutic area, showing significant growth in Oncology, Metabolic, and AVAI for both the three and nine months ended September 30, 2023, compared to the prior year **Revenue by Therapeutic Area (in thousands):** | Therapeutic Area | Q3 2023 | Q3 2022 | 9M 2023 | 9M 2022 | | :--------------- | :------ | :------ | :------ | :------ | | Oncology | $149,326 | $122,834 | $438,366 | $343,589 | | Other | $106,160 | $72,767 | $294,319 | $216,739 | | Metabolic | $103,118 | $63,478 | $277,818 | $167,194 | | Cardiology | $44,360 | $49,802 | $142,107 | $129,225 | | Central Nervous System | $43,989 | $43,418 | $120,412 | $120,811 | | AVAI | $45,546 | $31,445 | $114,419 | $88,340 | | **Total revenue** | **$492,499** | **$383,744** | **$1,387,441** | **$1,065,898** | [Item 2. Management's Discussion and Analysis of Financial Condition and Results of Operations](index=18&type=section&id=Item%202.%20Management%27s%20Discussion%20and%20Analysis%20of%20Financial%20Condition%20and%20Results%20of%20Operations) This section provides management's perspective on Medpace's financial performance, liquidity, and capital resources, highlighting strong revenue growth driven by key therapeutic areas, increased operating expenses, and a significant increase in backlog. It also discusses the company's cash flow activities and share repurchase program [Forward-Looking Statements](index=19&type=section&id=Forward-Looking%20Statements) This section advises readers that the report contains forward-looking statements, which are based on current expectations and projections but are subject to inherent uncertainties, risks, and changes in circumstances. Actual results may differ materially, and the company does not plan to publicly update these statements unless required by law - The Quarterly Report contains forward-looking statements intended to be covered by safe harbor provisions of the Securities Act of 1933 and the Securities Exchange Act of 1934[63](index=63&type=chunk) - Forward-looking statements are based on current expectations and projections, but are subject to inherent uncertainties, risks, changes in circumstances, and other important factors that are difficult to predict[63](index=63&type=chunk) - The company cautions against relying on these statements and does not plan to publicly update or revise them, except as required by applicable law[63](index=63&type=chunk)[64](index=64&type=chunk) [Business Overview](index=19&type=section&id=Business%20Overview) Medpace is a leading global clinical contract research organization (CRO) focused on providing scientifically-driven, full-service Phase I-IV clinical development services to the biotechnology, pharmaceutical, and medical device industries. The company specializes in therapeutic areas such as Oncology, Metabolic Disease, and AVAI, operating with approximately 5,800 employees across 41 countries - Medpace is a leading global clinical contract research organization (CRO) providing scientifically-driven, full-service Phase I-IV clinical development services[65](index=65&type=chunk) - The company focuses on major therapeutic areas, with particular strength in Oncology, Metabolic Disease, Cardiology, Central Nervous System (CNS), and Antiviral and Anti-infective (AVAI)[66](index=66&type=chunk) - As of September 30, 2023, Medpace has approximately **5,800 employees** across **41 countries**, providing broad access to diverse markets and patient populations[66](index=66&type=chunk) [How We Generate Revenue](index=20&type=section&id=How%20We%20Generate%20Revenue) Medpace generates revenue from customer contracts for clinical development services, typically structured as fixed-fee or unit-of-service models. Revenue is recognized over time as services are performed, primarily using the input method (cost to cost). Contracts often include upfront fees and allow for customer termination with a typical 30-day notice, with fees for services rendered still due - Revenue is earned through the performance of services detailed in customer contracts, typically based on a fixed-fee or unit-of-service model[67](index=67&type=chunk) - Revenue is recognized over time as services are performed, with the progression of contract performance obligations measured primarily using the input method of cost to cost[68](index=68&type=chunk) - Customers can terminate contracts with typically **30 days' notice**, and the company is entitled to fees for services rendered through the termination date[68](index=68&type=chunk) [Costs and Expenses](index=20&type=section&id=Costs%20and%20Expenses) Medpace's costs and expenses primarily consist of total direct costs (labor, third-party services, reimbursed expenses), selling, general and administrative costs (compensation, professional fees), depreciation (property and equipment), amortization (finite-lived intangible assets), and income tax provision [Total Direct Costs](index=20&type=section&id=Total%20Direct%20Costs) Total direct costs are primarily driven by labor and employee benefits, alongside contracted third-party services, site investigator fees, reimbursed out-of-pocket expenses, and laboratory supplies. These costs are expensed as incurred and can fluctuate based on project efficiencies, workforce changes, and service mix - Total direct costs are primarily driven by labor and related employee benefits[70](index=70&type=chunk) - They also include contracted third-party service expenses, fees paid to site investigators, reimbursed out-of-pocket expenses, and laboratory supplies[70](index=70&type=chunk) - Total direct costs are expensed as incurred and can vary as a percentage of net revenue due to project labor efficiencies, changes in workforce, compensation/bonus programs, and service mix[70](index=70&type=chunk) [Selling, General and Administrative](index=20&type=section&id=Selling%2C%20General%20and%20Administrative) Selling, general and administrative expenses are mainly composed of compensation and employee benefits, as well as rent, utilities, supplies, software licenses, professional fees (e.g., legal and accounting), bad debt, travel, and marketing expenses - Selling, general and administrative expenses are primarily driven by compensation and related employee benefits[71](index=71&type=chunk) - These expenses also include rent, utilities, supplies, software licenses, professional fees (e.g., legal and accounting expenses), bad debt expense, travel, and marketing[71](index=71&type=chunk) [Depreciation](index=20&type=section&id=Depreciation) Depreciation expense is calculated using the straight-line method to allocate the cost of property and equipment over their estimated useful lives, which range from three to five years for computer hardware to thirty to forty years for buildings - Depreciation is provided on property and equipment using the straight-line method over their estimated useful lives[72](index=72&type=chunk) - Estimated useful lives range from **three to five years** for computer hardware, software, phone, and medical imaging equipment, to **thirty to forty years** for buildings[72](index=72&type=chunk) [Amortization](index=20&type=section&id=Amortization) Amortization expense relates to finite-lived intangible assets and is recognized using either the straight-line or an accelerated method over their estimated useful lives of 15 years - Amortization relates to finite-lived intangible assets[73](index=73&type=chunk) - It is recognized as an expense using the straight-line or an accelerated method over estimated useful lives of **15 years**[73](index=73&type=chunk) [Income Tax Provision](index=21&type=section&id=Income%20Tax%20Provision) The income tax provision includes federal, state, and local taxes across multiple jurisdictions. It is influenced by pre-tax earnings in varying tax rate jurisdictions, available tax credits, certain non-deductible expenses, and other discrete items, causing it to vary from statutory rates - Income tax provision consists of federal, state, and local taxes on income in multiple jurisdictions[74](index=74&type=chunk) - The provision is impacted by pre-tax earnings in jurisdictions with varying tax rates, tax incentives, certain non-deductible expenses, and other discrete items[74](index=74&type=chunk) [Key Performance Metrics](index=21&type=section&id=Key%20Performance%20Metrics) Medpace evaluates its business performance using key metrics such as new business awards, cancellations, and backlog, which are indicators of future revenue and operational activity [New Business Awards, Cancellations and Backlog](index=21&type=section&id=New%20Business%20Awards%2C%20Cancellations%20and%20Backlog) Net new business awards significantly increased for both the three and nine months ended September 30, 2023, contributing to a 20.3% rise in backlog to $2,689.5 million. Approximately $1.45 billion to $1.47 billion of this backlog is expected to convert to net revenue over the next twelve months **Net New Business Awards (in millions):** | Period | 2023 | 2022 | | :----- | :--- | :--- | | Q3 | $611.5 | $470.9 | | 9M | $1,742.1 | $1,344.4 | - Backlog as of September 30, 2023, increased by **$453.3 million**, or **20.3%**, to **$2,689.5 million** compared to $2,236.2 million as of September 30, 2022[79](index=79&type=chunk) - Approximately **$1,450.0 million to $1,470.0 million** of the backlog as of September 30, 2023, is expected to convert to net revenue over the next twelve months[79](index=79&type=chunk) [Exchange Rate Fluctuations](index=22&type=section&id=Exchange%20Rate%20Fluctuations) The majority of Medpace's contracts and operational transactions are U.S. dollar denominated, but a portion of revenue and expenses are subject to exchange rate fluctuations, with the Euro representing the largest foreign currency exposure - The majority of Medpace's contracts and operational transactions are U.S. dollar denominated[82](index=82&type=chunk) - A portion of revenue and expenses are subject to exchange rate fluctuations, with the Euro representing the largest foreign currency denomination of contractual and operational exposure[82](index=82&type=chunk) **Average Exchange Rates (U.S. Dollars per Euro):** | Period | 2023 | 2022 | | :----- | :--- | :--- | | Q3 | 1.09 | 1.01 | | 9M | 1.08 | 1.07 | [Results of Operations](index=22&type=section&id=Results%20of%20Operations) Medpace experienced significant revenue growth for both the three and nine months ended September 30, 2023, driven by key therapeutic areas. This growth was accompanied by increased operating expenses, primarily due to higher reimbursed out-of-pocket expenses and personnel costs, leading to a rise in income from operations [Three Months Ended September 30, 2023 compared to Three Months Ended September 30, 2022](index=22&type=section&id=Three%20Months%20Ended%20September%2030%2C%202023%20compared%20to%20Three%20Months%20Ended%20September%2030%2C%202022) For Q3 2023, revenue increased by 28.3% to $492.5 million, while total operating expenses rose by 33.2% to $407.6 million. Income from operations grew by 9.1% to $84.9 million, and net income increased by 6.9% to $70.6 million **Q3 2023 vs. Q3 2022 Financial Highlights (in thousands):** | Metric | 2023 | 2022 | Change | % Change | | :-------------------------------- | :----- | :----- | :----- | :------- | | Revenue, net | $492,499 | $383,744 | $108,755 | 28.3% | | Total operating expenses | $407,591 | $305,917 | $101,674 | 33.2% | | Income from operations | $84,908 | $77,827 | $7,081 | 9.1% | | Net income | $70,550 | $66,027 | $4,523 | 6.9% | [Nine Months Ended September 30, 2023 compared to Nine Months Ended September 30, 2022](index=23&type=section&id=Nine%20Months%20Ended%20September%2030%2C%202023%20compared%20to%20Nine%20Months%20Ended%20September%2030%2C%202022) For 9M 2023, revenue increased by 30.2% to $1,387.4 million, total operating expenses rose by 31.8% to $1,137.9 million, income from operations grew by 23.3% to $249.5 million, and net income increased by 15.7% to $204.5 million **9M 2023 vs. 9M 2022 Financial Highlights (in thousands):** | Metric | 2023 | 2022 | Change | % Change | | :-------------------------------- | :------- | :------- | :------- | :------- | | Revenue, net | $1,387,441 | $1,065,898 | $321,543 | 30.2% | | Total operating expenses | $1,137,936 | $863,632 | $274,304 | 31.8% | | Income from operations | $249,505 | $202,266 | $47,239 | 23.3% | | Net income | $204,512 | $176,698 | $27,814 | 15.7% | [Total revenue](index=23&type=section&id=Total%20revenue) Total revenue increased by $108.8 million (28.3%) to $492.5 million for the three months ended September 30, 2023, and by $321.5 million (30.2%) to $1,387.4 million for the nine months ended September 30, 2023. This growth was primarily driven by strong performance in the Oncology, Metabolic, and AVAI therapeutic areas - Total revenue increased by **$108.8 million** to **$492.5 million** for Q3 2023 (**28.3%** YoY increase)[86](index=86&type=chunk) - Total revenue increased by **$321.5 million** to **$1,387.4 million** for 9M 2023 (**30.2%** YoY increase)[86](index=86&type=chunk) - The increase was primarily driven by growth within the Oncology, Metabolic, and AVAI therapeutic areas[86](index=86&type=chunk) [Total direct costs](index=23&type=section&id=Total%20direct%20costs) Total direct costs increased by $94.6 million (35.7%) to $359.3 million for Q3 2023 and by $250.6 million (33.4%) to $999.7 million for 9M 2023. This rise was mainly attributed to higher reimbursed out-of-pocket expenses and increased personnel costs to support growing service activities - Total direct costs increased by **$94.6 million** to **$359.3 million** for Q3 2023 (**35.7%** YoY increase)[87](index=87&type=chunk) - Total direct costs increased by **$250.6 million** to **$999.7 million** for 9M 2023 (**33.4%** YoY increase)[87](index=87&type=chunk) - The increase was primarily due to higher reimbursed out-of-pocket expenses (Q3: +**$66.9 million**; 9M: +**$170.8 million**) and higher personnel costs (Q3: +**$24.1 million**; 9M: +**$65.0 million**)[87](index=87&type=chunk) [Selling, general and administrative](index=23&type=section&id=Selling%2C%20General%20and%20Administrative) Selling, general and administrative expenses increased by $6.0 million (16.9%) to $41.4 million for Q3 2023 and by $20.8 million (21.3%) to $118.8 million for 9M 2023. This increase was primarily driven by higher personnel costs necessary to support the growth in service activities - Selling, general and administrative expenses increased by **$6.0 million** to **$41.4 million** for Q3 2023 (**16.9%** YoY increase)[88](index=88&type=chunk) - Selling, general and administrative expenses increased by **$20.8 million** to **$118.8 million** for 9M 2023 (**21.3%** YoY increase)[88](index=88&type=chunk) - The increase was primarily attributed to higher personnel costs to support the growth in service activities (Q3: +**$5.2 million**; 9M: +**$14.7 million**)[88](index=88&type=chunk) [Depreciation and Amortization](index=23&type=section&id=Depreciation%20and%20Amortization) Depreciation and amortization expense increased by $1.1 million to $6.9 million for Q3 2023 and by $2.9 million to $19.4 million for 9M 2023. This rise was primarily related to increased depreciation from property and equipment - Depreciation and amortization expense increased by **$1.1 million** to **$6.9 million** for Q3 2023[89](index=89&type=chunk) - Depreciation and amortization expense increased by **$2.9 million** to **$19.4 million** for 9M 2023[89](index=89&type=chunk) - The increase was primarily related to increased depreciation related to Property and equipment, net[89](index=89&type=chunk) [Miscellaneous (expense) income, net](index=24&type=section&id=Miscellaneous%20%28expense%29%20income%2C%20net) Miscellaneous (expense) income, net, shifted from income to expense for both the three and nine months ended September 30, 2023. This change was mainly attributable to foreign exchange gains and losses from intercompany balances and third-party accounts, as well as third-party investment losses - Miscellaneous (expense) income, net, changed by **$7.3 million** to **$1.6 million of expense** for Q3 2023 (from $5.6 million income in Q3 2022)[90](index=90&type=chunk) - Miscellaneous (expense) income, net, changed by **$11.2 million** to **$2.2 million of expense** for 9M 2023 (from $9.0 million income in 9M 2022)[90](index=90&type=chunk) - These changes were mainly attributable to foreign exchange gains and losses from intercompany balances and third-party accounts, and third-party investment losses[90](index=90&type=chunk) [Income tax provision](index=24&type=section&id=Income%20tax%20provision) The income tax provision decreased by $3.2 million for Q3 2023, resulting in a lower effective tax rate of 15.2%, primarily due to increased tax benefits from share-based compensation and FDII. Conversely, the provision increased by $7.9 million for 9M 2023, with an effective rate of 16.5%, mainly due to higher pre-tax book income and reduced benefits from uncertain tax positions - Income tax provision decreased by **$3.2 million** to **$12.7 million** for Q3 2023, with an effective tax rate of **15.2%** (vs. 19.4% in Q3 2022)[91](index=91&type=chunk) - Income tax provision increased by **$7.9 million** to **$40.5 million** for 9M 2023, with an effective tax rate of **16.5%** (vs. 15.5% in 9M 2022)[91](index=91&type=chunk) - The Q3 decrease was primarily due to increased excess tax benefits from share-based compensation and FDII, while the 9M increase was due to higher pre-tax book income and decreased benefits from uncertain tax positions[91](index=91&type=chunk) [Liquidity and Capital Resources](index=24&type=section&id=Liquidity%20and%20Capital%20Resources) Medpace's liquidity is strong, with cash and cash equivalents increasing to $95.2 million as of September 30, 2023. The company funds operations and growth through operating cash flows and a $150.0 million revolving credit facility, with primary cash needs for operational growth, capital expenditures, and share repurchases - As of September 30, 2023, cash and cash equivalents increased to **$95.2 million** from $28.3 million at December 31, 2022[92](index=92&type=chunk) - The company's principal sources of liquidity are operating cash flows and borrowings under its unsecured credit facility, which has **$150.0 million** available for borrowing[92](index=92&type=chunk)[93](index=93&type=chunk) - Expected primary cash needs include investment in operational growth, capital expenditures, credit facility repayments, share repurchases, selective strategic acquisitions, and other general corporate needs[93](index=93&type=chunk) [Cash Flow from Operating Activities](index=25&type=section&id=Cash%20Flow%20from%20Operating%20Activities) Net cash provided by operating activities increased to $277.0 million for the nine months ended September 30, 2023, driven by net income, non-cash adjustments (depreciation, stock-based compensation, noncash lease expense), and favorable changes in advanced billings and accrued expenses, partially offset by increased accounts receivable - Net cash provided by operating activities was **$277.0 million** for 9M 2023, up from $251.4 million for 9M 2022[95](index=95&type=chunk)[97](index=97&type=chunk)[98](index=98&type=chunk) - Key adjustments reconciling net income to operating cash flow for 9M 2023 included depreciation (**$17.7 million**), stock-based compensation expense (**$15.4 million**), and noncash lease expense (**$14.6 million**)[97](index=97&type=chunk) - Changes in operating assets and liabilities provided **$33.7 million** in 9M 2023, primarily driven by increased advanced billings (+**$56.0 million**) and accrued expenses (+**$54.9 million**), offset by increased accounts receivable (+**$39.3 million**)[97](index=97&type=chunk) [Cash Flow from Investing Activities](index=25&type=section&id=Cash%20Flow%20from%20Investing%20Activities) Net cash used in investing activities was $26.6 million for the nine months ended September 30, 2023, primarily consisting of property and equipment expenditures **Net Cash Used in Investing Activities (in thousands):** | Period | 9M 2023 | 9M 2022 | | :----- | :------ | :------ | | Total | $(26,632) | $(29,522) | | Property and equipment expenditures | $(26,662) | $(27,636) | [Cash Flow from Financing Activities](index=25&type=section&id=Cash%20Flow%20from%20Financing%20Activities) Net cash used in financing activities significantly decreased to $184.2 million for the nine months ended September 30, 2023, primarily due to substantially reduced common stock repurchases compared to the prior year, despite repayments on the credit facility - Net cash used in financing activities was **$184.2 million** for 9M 2023, a significant decrease from $644.7 million for 9M 2022[95](index=95&type=chunk)[100](index=100&type=chunk)[101](index=101&type=chunk) - Key activities for 9M 2023 included **$144.0 million** in common stock repurchases and **$155.0 million** in credit facility repayments, partially offset by **$105.0 million** in credit facility proceeds and **$9.9 million** from stock option exercises[100](index=100&type=chunk) [Share Repurchases](index=25&type=section&id=Share%20Repurchases) Medpace repurchased 781,068 shares for $144.0 million during the nine months ended September 30, 2023, under a $500.0 million program, with $308.8 million remaining authorization. This represents a substantial reduction compared to the $800.5 million in repurchases during the same period in 2022 - During the nine months ended September 30, 2023, the company repurchased **781,068 shares** for **$144.0 million**[103](index=103&type=chunk) - As of September 30, 2023, **$308.8 million** remained authorized under the new **$500.0 million** stock repurchase program approved in Q4 2022[103](index=103&type=chunk) - For the nine months ended September 30, 2022, the company repurchased **5,463,244 shares** for **$800.5 million**[102](index=102&type=chunk) [Indebtedness](index=26&type=section&id=Indebtedness) As of September 30, 2023, Medpace had no outstanding indebtedness on its credit facility and less than $0.1 million in letters of credit related to operating lease obligations, which are secured by the Credit Facility - As of September 30, 2023, Medpace had **no indebtedness**[105](index=105&type=chunk) - Less than **$0.1 million** in letters of credit outstanding related to certain operating lease obligations, secured by the Credit Facility[105](index=105&type=chunk) [Critical Accounting Policies and Estimates](index=26&type=section&id=Critical%20Accounting%20Policies%20and%20Estimates) Medpace states that there have been no significant changes in its critical accounting policies and estimates from those previously described in its Annual Report on Form 10-K for the fiscal year ended December 31, 2022 - There have been no significant changes in the critical accounting policies and estimates as previously described in the Annual Report on Form 10-K for the fiscal year ended December 31, 2022[107](index=107&type=chunk) [Item 3. Quantitative and Qualitative Disclosures About Market Risk](index=26&type=section&id=Item%203.%20Quantitative%20and%20Qualitative%20Disclosures%20About%20Market%20Risk) Medpace reports that there have been no material changes to its quantitative and qualitative disclosures about market risk compared to those presented in its Annual Report on Form 10-K for the fiscal year ended December 31, 2022 - There have been no material changes to the quantitative and qualitative disclosures about market risk as compared to the Annual Report on Form 10-K for the fiscal year ended December 31, 2022[108](index=108&type=chunk) [Item 4. Controls and Procedures](index=26&type=section&id=Item%204.%20Controls%20and%20Procedures) Management, including the CEO and CFO, evaluated the effectiveness of Medpace's disclosure controls and procedures, concluding they were effective as of September 30, 2023. No material changes in internal control over financial reporting were reported during the quarter [Limitations on Effectiveness of Controls and Procedures](index=26&type=section&id=Limitations%20on%20Effectiveness%20of%20Controls%20and%20Procedures) Management acknowledges that any controls and procedures, regardless of their design, can only provide reasonable assurance of achieving desired control objectives due to inherent limitations, resource constraints, and the necessity of management judgment - Management recognizes that controls and procedures can provide only reasonable assurance of achieving desired control objectives[109](index=109&type=chunk) - The design of controls must reflect resource constraints and management's judgment in evaluating benefits versus costs[109](index=109&type=chunk) [Evaluation of Disclosure Controls and Procedures](index=26&type=section&id=Evaluation%20of%20Disclosure%20Controls%20and%20Procedures) The company's management, with the participation of the CEO and CFO, evaluated the effectiveness of its disclosure controls and procedures as of September 30, 2023, concluding they were effective in providing reasonable assurance for timely and accurate reporting of material information - The company's management, including the CEO and CFO, evaluated the effectiveness of disclosure controls and procedures as of September 30, 2023[110](index=110&type=chunk) - Based on this evaluation, they concluded that the disclosure controls and procedures were effective in providing reasonable assurance for timely and accurate reporting of required information[110](index=110&type=chunk) [Changes in Internal Control over Financial Reporting](index=27&type=section&id=Changes%20in%20Internal%20Control%20over%20Financial%20Reporting) Medpace reported no changes in its internal control over financial reporting during the three months ended September 30, 2023, that have materially affected, or are reasonably likely to materially affect, its internal control over financial reporting - No changes in internal control over financial reporting occurred during the three months ended September 30, 2023, that have materially affected, or are reasonably likely to materially affect, the company's internal control over financial reporting[112](index=112&type=chunk) PART II — OTHER INFORMATION [Item 1. Legal Proceedings](index=27&type=section&id=Item%201.%20Legal%20Proceedings) Medpace is involved in legal proceedings that arise in the ordinary course of its business. While the outcome cannot be predicted with certainty, management believes adequate reserves have been recorded, and potential losses are immaterial to the financial statements - The company is party to legal proceedings incidental to its business, including employment claims and claims related to other business transactions[113](index=113&type=chunk) - Management believes adequate reserves have been recorded and losses already recognized are immaterial, and potential losses exceeding recognized amounts are also immaterial as of September 30, 2023[113](index=113&type=chunk) [Item 1A. Risk Factors](index=27&type=section&id=Item%201A.%20Risk%20Factors) Medpace states that there have been no significant changes to the risk factors previously disclosed in its Annual Report on Form 10-K for the fiscal year ended December 31, 2022 - There have been no significant changes from the risk factors previously disclosed in the Annual Report on Form 10-K for the fiscal year ended December 31, 2022[114](index=114&type=chunk) [Item 2. Unregistered Sales of Equity Securities and Use of Proceeds](index=27&type=section&id=Item%202.%20Unregistered%20Sales%20of%20Equity%20Securities%20and%20Use%20of%20Proceeds) This section is marked as not applicable, indicating no unregistered sales of equity securities or specific use of proceeds from registered securities to report - Not applicable[115](index=115&type=chunk) [Item 3. Defaults Upon Senior Securities](index=27&type=section&id=Item%203.%20Defaults%20Upon%20Senior%20Securities) Medpace reports that there were no defaults upon senior securities during the period - None[116](index=116&type=chunk) [Item 4. Mine Safety Disclosures](index=27&type=section&id=Item%204.%20Mine%20Safety%20Disclosures) This section is marked as not applicable, indicating no mine safety disclosures are required for Medpace - Not applicable[117](index=117&type=chunk) [Item 5. Other Information](index=27&type=section&id=Item%205.%20Other%20Information) During the three months ended September 30, 2023, the General Counsel and CFO adopted non-Rule 10b5-1 trading arrangements to sell shares from stock option exercises. Additionally, Medpace Investors, LLC, controlled by the CEO, terminated a Rule 10b5-1 trading arrangement to sell up to 500,000 shares **Trading Arrangements Adopted/Terminated (Q3 2023):** | Individual/Entity | Action | Date | Type of Arrangement | Shares to be Sold | | :---------------- | :----- | :--- | :------------------ | :---------------- | | Stephen P. Ewald (General Counsel) | Adopt | July 26, 2023 | Non-Rule 10b5-1 | Up to 21,850 | | Kevin M. Brady (CFO) | Adopt | July 31, 2023 | Non-Rule 10b5-1 | Up to 7,000 | | Medpace Investors, LLC | Terminate | September 21, 2023 | Rule 10b5-1 | Up to 500,000 | [Item 6. Exhibits](index=28&type=section&id=Item%206.%20Exhibits) This section lists all exhibits filed or furnished as part of the Form 10-Q report, including certifications from the Chief Executive Officer and Chief Financial Officer, as well as Inline XBRL documents - The exhibit index includes Rule 13a-14(a) / 15d-14(a) Certifications and Section 1350 Certifications from the Chief Executive Officer and Chief Financial Officer[126](index=126&type=chunk) - The exhibits also include Inline XBRL Instance Document and Taxonomy Extension Documents[126](index=126&type=chunk) [EXHIBIT INDEX](index=29&type=section&id=EXHIBIT%20INDEX) The Exhibit Index provides a detailed list of all documents incorporated by reference or filed/furnished with the Form 10-Q, including various certifications and XBRL-related files - The index lists certifications (Rule 13a-14(a)/15d-14(a) and Section 1350) from the CEO and CFO[126](index=126&type=chunk) - It also includes Inline XBRL documents (Instance, Schema, Calculation, Definition, Label, Presentation Linkbase Documents, and Cover Page Interactive Data File)[126](index=126&type=chunk) [SIGNATURES](index=30&type=section&id=SIGNATURES) The Form 10-Q report was duly signed on behalf of Medpace Holdings, Inc. by Kevin M. Brady, Chief Financial Officer, on October 24, 2023 - The report was signed by Kevin M. Brady, Chief Financial Officer (Principal Financial Officer)[131](index=131&type=chunk) - The signing date was October 24, 2023[131](index=131&type=chunk)

Financial Data and Key Metrics Changes - Revenue for Q3 2023 was $492.5 million, representing a year-over-year increase of 28.3% [51] - Year-to-date revenue for the nine months ended September 30, 2023, was $1.39 billion, an increase of 30.2% from the prior year [54] - EBITDA for Q3 2023 was $90.2 million, a 1% increase compared to $89.3 million in Q3 2022 [54] - Net income for Q3 2023 was $70.6 million, up 6.9% from $66 million in the prior year [55] - EBITDA margin for Q3 2023 was 18.3%, down from 23.3% in the prior year [52] Business Line Data and Key Metrics Changes - Net new business awards entering backlog in Q3 increased 29.9% year-over-year to $611.5 million, resulting in a net book-to-bill ratio of 1.24 [51] - Ending backlog as of September 30, 2023, was approximately $2.7 billion, an increase of 20.3% from the prior year [58] Market Data and Key Metrics Changes - Customer concentration: Top 5 customers represent roughly 23% and Top 10 customers represent about 29% of year-to-date total revenue [56] - Cash flow from operating activities in Q3 was $114.4 million, with net days sales outstanding at negative 42.2 days [56] Company Strategy and Development Direction - The company plans to continue investing in organic growth, with increased capital expenditures related to the expansion of its headquarters in Cincinnati [45] - The company is focusing on share repurchases opportunistically, depending on execution levels [45] Management's Comments on Operating Environment and Future Outlook - Management noted a strong business environment with record levels of RFPs and awards, despite challenges in the biotech sector [79] - The company does not expect significant margin expansion in 2024 due to ongoing wage and benefit inflation [84] Other Important Information - Full year 2023 revenue guidance is expected to be in the range of $1.87 billion to $1.89 billion, representing growth of 28.1% to 29.5% over 2022 [61] - Initial guidance for 2024 expects revenue in the range of $2.15 billion to $2.2 billion [66] Q&A Session Summary Question: Can you comment on the funding environment and its impact? - Management indicated that while there are funding challenges, they are able to find opportunities among well-funded biotech companies [71][73] Question: What is the outlook for pass-through costs? - Management noted that elevated pass-through costs are broad-based and not concentrated in any one study, with metabolic studies contributing significantly [82][86] Question: How is the company addressing the current business environment? - Management stated that they have pivoted to a different subset of small biotech with funded programs, allowing them to find opportunities despite the challenges [73] Question: What are the expectations for 2024 EBITDA margins? - Management does not expect significant margin expansion in 2024 due to ongoing inflationary pressures [84]

1.38x 1.49x 17.7% 17.6% 1.28x 1.28x 1.23x 1.23x 1.28x 1.25x 17.0% 16.7% 16.6% 16.8% 3Q21 4Q21 1Q22 2Q22 3Q22 4Q22 1Q23 2Q23 3Q21 4Q21 1Q22 2Q22 3Q22 4Q22 1Q23 2Q23 Net New Business Awards ($ in millions) MAKING THE COMPLEX SEAMLESS Q2 2023 – KEY FINANCIAL HIGHLIGHTS A. See the appendix for the non-GAAP reconciliation of the EBITDA calculations. B. Net income per diluted share for 2Q23 and 2Q22 excludes $0.041 million and $0.031 million, respectively, in undistributed earnings allocated to RSAs. Net income p ...

Table of Contents UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ___________________________________________ FORM 10-Q ___________________________________________ (Mark One) x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the quarterly period ended June 30, 2023 or o TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to . Commission file number: 001-37856 ______________ ...

Financial Data and Key Metrics Changes - Revenue for the second quarter of 2023 was $460.9 million, representing a year-over-year increase of 31.2% on a reported basis and 31% on a constant currency basis [84] - Net income for the quarter was $61.1 million, an increase of 23.7% compared to $49.4 million in the prior year period, driven by higher EBITDA and a lower effective tax rate [15][29] - EBITDA for the second quarter was $83.6 million, up 22.8% from $68.1 million in the second quarter of 2022, with an EBITDA margin of 18.1% [29][90] - Earnings per diluted share increased to $1.93 from $1.46 in the prior year period [30] Business Line Data and Key Metrics Changes - Ending backlog as of June 30, 2023, was approximately $2.57 billion, an increase of 18.6% from the prior year, with an expected conversion of approximately $1.42 billion to revenue in the next 12 months [13] - Net new business awards entering backlog in the second quarter increased 27.6% from the prior year to $574.8 million, resulting in a net book-to-bill ratio of 1.25 [27] Market Data and Key Metrics Changes - The business environment continues to improve, with RFP volume in Q2 up sequentially over a strong Q1, and award notifications rebounding strongly [27] - The company is experiencing good growth across all business lines, with a notable increase in both pass-through and direct revenue [68] Company Strategy and Development Direction - The company anticipates full-year 2023 total revenue in the range of $1.84 billion to $1.88 billion, representing growth of 26% to 28.8% over 2022 [90] - The guidance for 2023 assumes continued growth in direct service activities and higher investigator site activity and costs [90] Management's Comments on Operating Environment and Future Outlook - Management noted that staffing at sites is improving and operations are becoming more normalized, which is expected to positively impact trial performance [20] - There are expectations for elevated pass-through costs for the remainder of the year, which are incorporated into the guidance [43][65] Other Important Information - The company repurchased approximately 126,000 shares for a total of $23.9 million during the quarter, with $308.8 million remaining under the share repurchase program [2] - The net debt position at the end of the quarter was $15.9 million, composed of $55 million in debt and $39.1 million in cash [16] Q&A Session Summary Question: What is the impact of inflation on direct revenue? - Management indicated that inflationary effects are present, but staffing improvements and normalized operations are also contributing positively to revenue [20][21] Question: How do you see pass-throughs affecting margins? - Management acknowledged that pass-throughs have a dilutive effect on margins, but they expect to maintain a normalized level moving forward [37][63] Question: Are you taking market share versus peers? - Management stated that while they have outstripped growth in revenue and EBITDA compared to peers, quantifying market share is challenging [55] Question: What are the hiring targets for the year? - Management is tracking towards high-teens to 20% growth in hiring, with turnover returning to pre-pandemic levels, making staffing easier to manage [52][53]

Table of Contents UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ___________________________________________ FORM 10-Q ___________________________________________ (Mark One) x QUARTERLY REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the quarterly period ended March 31, 2023 or o TRANSITION REPORT PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 For the transition period from to . Commission file number: 001-37856 _____________ ...

Medpace Holdings, Inc. (NASDAQ:MEDP) Q1 2023 Earnings Conference Call April 25, 2023 9:00 AM ET Company Participants Lauren Morris - IR August Troendle - CEO Jesse Geiger - President Kevin Brady - CFO Conference Call Participants David Windley - Jefferies Max Smock - William Blair Sandy Draper - Guggenheim Partners John Sourbeer - UBS Operator Good day, ladies and gentlemen, and welcome to the Medpace First Quarter 2023 Earnings Conference Call. At this time, all participants are in a listen-only mode. Late ...