SEGMENT DISCLOSURES
Information about the reportable segment, significant segment expenses and a reconciliation to consolidated net income is as follows (in thousands):
| | | | | | | | | | | | | | | | | |
| Year Ended December 31, |
| 2025 | | 2024 | | 2023 |
| Revenue, net | $ | 2,530,234 | | | $ | 2,109,054 | | | $ | 1,885,842 | |
| Operating expenses: | | | | | |
| Direct service costs, excluding depreciation and amortization - Employee compensation | 588,786 | | | 545,417 | | | 499,528 | |
| Direct service costs, excluding depreciation and amortization - Other segment items (a) | 143,342 | | | 136,678 | | | 138,721 | |
| Reimbursed out-of-pocket expenses | 1,037,488 | | | 770,654 | | | 723,088 | |
| Total direct costs | 1,769,616 | | | 1,452,749 | | | 1,361,337 | |
| Selling, general and administrative | 197,559 | | | 180,184 | | | 161,352 | |
| Depreciation | 27,178 | | | 27,808 | | | 24,129 | |
| Amortization | 946 | | | 1,443 | | | 2,199 | |
| Total operating expenses | 1,995,299 | | | 1,662,184 | | | 1,549,017 | |
| Income from operations | 534,935 | | | 446,870 | | | 336,825 | |
| Other income (expense), net: | | | | | |
| Miscellaneous (expense) income, net | (5,338) | | | 4,056 | | | (655) | |
| Interest income (expense), net | 12,780 | | | 24,996 | | | (488) | |
| Total other income (expense), net | 7,442 | | | 29,052 | | | (1,143) | |
| Income before income taxes | 542,377 | | | 475,922 | | | 335,682 | |
| Income tax provision | 91,254 | | | 71,536 | | | 52,872 | |
| Segment net income | $ | 451,123 | | | $ | 404,386 | | | $ | 282,810 | |
| | | | | |
| Reconciliation of profit or loss | | | | | |
| Adjustments and reconciling items | — | | | — | | | — | |
| Consolidated net income | $ | 451,123 | | | $ | 404,386 | | | $ | 282,810 | |
(a) Direct service costs, excluding depreciation and amortization - Other segment items includes costs related to inventory, leases, project subcontractors and other direct service costs.
Operations By Geographic Location
The Company conducts operations in North America, Europe, Asia, South America, Africa and Australia through wholly-owned subsidiaries and representative sales offices. The Company attributes revenue to geographical locations based upon the location of the contracting entity. For the years ended December 31, 2025, 2024 and 2023, total revenue attributable to the U.S. represented approximately 99%, 98% and 98% of total consolidated total revenue, respectively.
The following table summarizes property and equipment, net by geographic region and is further broken down to show countries which account for 10% or more of total as of December 31, if any (in thousands):
| | | | | | | | | | | |
| 2025 | | 2024 |
| Property and equipment, net: | | | |
| United States | $ | 83,898 | | | $ | 80,692 | |
| Europe | | | |
| Belgium | 22,998 | | | 18,557 | |
| Other | 6,822 | | | 7,456 | |
| Total Europe | 29,820 | | | 26,013 | |
| Asia-Pacific | 14,910 | | | 14,552 | |
| Other | 2,427 | | | 2,358 | |
| Total property and equipment, net | $ | 131,055 | | | $ | 123,615 | |
Revenue by Category
The following table disaggregates the Company’s revenue by major source (in thousands):
| | | | | | | | | | | | | | | | | |
| Year Ended December 31, |
| 2025 | | 2024 | | 2023 |
| Therapeutic Area | | | | | |
| Oncology | $ | 747,585 | | | $ | 651,237 | | | $ | 587,097 | |
| Metabolic | 744,957 | | | 457,542 | | | 376,842 | |
| Other | 408,548 | | | 431,384 | | | 404,844 | |
| Central Nervous System | 254,838 | | | 181,977 | | | 160,057 | |
| Cardiology | 239,371 | | | 230,454 | | | 193,690 | |
| AVAI | 134,935 | | | 156,460 | | | 163,312 | |
| Total revenue | $ | 2,530,234 | | | $ | 2,109,054 | | | $ | 1,885,842 | |
About Segments Disclosures
Segment disclosures break a company into its reportable operating units, revealing revenue, profit, and asset allocation that consolidated financial statements obscure. Under ASC 280, segments must match how the chief operating decision maker views the business, providing a window into internal management structure and resource allocation priorities.
Key signals: compare segment margins to identify which units drive profitability and which destroy value. Watch for changes in the number of reportable segments — segment aggregation or disaggregation often coincides with strategic shifts or attempts to obscure declining performance. Intersegment elimination patterns reveal internal pricing practices. The reconciliation between segment totals and consolidated figures exposes corporate overhead allocation and unallocated items. Geographic revenue concentration highlights regulatory and currency exposure. Compare segment-level capital expenditure against segment revenue to assess where management is investing for future growth versus harvesting existing assets.