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美国

证券交易委员会

华盛顿特区 20549

6-K 表

外国私人发行人报告

根据第 13a-16 条或第 15d-16 条

《1934 年证券交易法》

2026 年 10 月

委员会档案编号：333-08704

ICON plc

（注册人名称的英文译名）

爱尔兰都柏林 18 区 Leopardstown，South County Business Park，D18 X5R3

（主要行政办公室地址）


请勾选注册人是否根据 20-F 表或 40-F 表提交或将提交年度报告。
	20-F 表 ☒	40-F 表 ☐

ICON plc

本 6-K 表报告通过引用纳入 ICON plc 的 S-8 表注册声明（注册号 333-152802、333-204153、333-231527、333-254891、333-257578 和 333-282826）以及 F-3 表注册声明（注册号 333-278943）；自本报告提交之日起，本 6-K 表报告应视为上述各注册声明的一部分，但以 ICON plc 根据《1933 年证券法》或《1934 年证券交易法》随后提交或提供的文件或报告未予取代为限。

一般信息

本文所称“ICON plc”、“ICON”、“ICON Group”、“本公司”以及“我们”或“我们的”，除非上下文另有要求，均指 ICON public limited company 及其合并子公司。

业务

ICON 是一家合同研究组织（“CRO”），为制药、生物技术、医疗器械、政府及公共卫生机构提供全球外包服务。我们专注于临床开发流程各阶段项目的战略开发、管理和分析，从化合物筛选到 I-IV 期临床研究。我们的愿景是通过提供行业领先的解决方案和一流的临床开发表现，成为首选的医疗保健情报合作伙伴。

我们认为，我们是少数几家 CRO 之一，具备专业知识和能力，能够在全球范围内开展大多数主要治疗领域的临床试验，并拥有运营灵活性，可单独提供开发服务，也可作为集成式“全方位服务”或“混合服务”解决方案的一部分。截至 2026 年 9 月 30 日，我们在 55 个国家的 98 个地点约有 40,250 名员工。在截至 2026 年 9 月 30 日的九个月内，我们分别有 27.6%、60.3% 和 12.1% 的收入来自美国、欧洲和世界其他地区（截至 2025 年 9 月 30 日的九个月内分别为 30.9%、58.2% 和 10.9%）。

我们于 1990 年开始运营，并通过内生增长以及一系列战略收购拓展业务，以增强我们在临床开发流程某些领域的能力和专业知识。我们在爱尔兰注册成立，主要行政办公室位于：爱尔兰共和国都柏林 18 区 Leopardstown，South County Business Park，D18 X5R3。该办公室的联系电话为 +353-1-291-2000。

近期进展

本节中使用但未定义的大写术语，其含义见本文所含简明合并财务报表附注10 银行信贷额度、贷款融资及票据。

桥接担保信贷额度

2026年7月15日，公司全额提取了桥接担保信贷额度，并将所得款项$500.0 million 用于全额偿还 $500.0 million 本金总额的2.875% 优先担保票据（“2026年票据”）。该票据由公司的一家子公司于2021年7月发行，并于2026年7月15日到期。桥接担保信贷额度已于2026年8月17日全额偿还。

2026年8月发行票据

2026年8月13日，ICON Investments Six Designated Activity Company（“发行人”）作为ICON plc的全资子公司，出售并发行了$2.15 billion 优先无担保票据（统称“2026年8月发行票据”），包括本金总额$500.0 million的5.064% 2029年到期票据、本金总额$1.0 billion的5.421% 2031年到期票据，以及$650.0 million 本金总额的5.995% 2036年到期票据。2026年8月发行票据的利息每年于2月13日和8月13日支付，首次支付日为2027年2月13日。ICON plc为2026年8月发行票据提供优先无担保担保。

公司就2026年8月发行票据支付了承销费$7.7 million。

公司将发行所得款项净额用于：(i) 于2026年8月13日偿还全部未偿还的优先担保定期贷款$900.0 million；(ii) 于2026年8月14日全额赎回未偿还的2027年5月票据$750.0 million；以及(iii) 于2026年8月17日偿还桥接担保信贷额度项下全部未偿还借款$500.0 million。

偿还桥接担保信贷额度和优先担保定期贷款后，为ICON集团循环信贷额度、2029年5月票据和2034年5月票据提供担保的抵押品自动解除，2029年5月票据和2034年5月票据项下的子公司担保也自动解除。简明合并经营报表中的利息费用包括债务清偿损失$12.2 million，其中包括2027年5月票据的提前偿还费用$7.8 million。

股份回购计划

截至2026年9月30日的三个月内，公司根据股份回购计划赎回了2,359,703股，总代价为$400.0 million。2026年10月20日，公司董事会（“董事会”）批准提高股份回购授权额度，使该计划下可用于回购的总金额增至$750.0 million。截至2026年10月27日，公司根据股份回购计划仍获授权回购最多$750.0 million的普通股。

根据公司的章程，回购计划下回购的所有普通股均已注销，这些股份的面值已按爱尔兰公司法要求转入其他无面值资本。

期权计划延期

2026年10月20日，董事会批准修订 ICON Employee Share Option Plan 2008 和 ICON Consultants Share Option Plan 2008（合称“2008 年期权计划”）。修订将 2008 年期权计划下可授予奖励的期限延长十年。因此，修订后，2008 年期权计划下不得在 2037 年 2 月 14 日之后授予期权，而非原定的 2027 年 2 月 14 日。修订不会增加 2008 年期权计划预留发行的普通股数量，也不会影响任何未结奖励的条款。

外汇折算

公司以美元（“美元”）编制财务报表，而若干子公司的本地业绩以美元以外的货币编制，其中包括英镑和欧元等。此外，公司与客户签订的合同有时以美元以外的货币计价。最后，由于全球运营所在地的大多数费用均以当地货币发生，公司在费用项目上面临多种货币的风险。因此，美元与这些其他货币之间汇率的变动可能影响公司的财务业绩。

ICON plc

简明合并资产负债表

截至 2026 年 9 月 30 日和 2025 年 12 月 31 日


	（未经审计）		（经审计）
	2026 年 9 月 30 日		2025 年 12 月 31 日
资产	（单位：千）
流动资产：
现金及现金等价物	$	808,984			$	647,295

应收账款，扣除信贷损失准备	1,510,045			1,474,898
未开票收入	1,023,170			1,096,592
其他应收款	100,669			116,750

预付款及其他流动资产	116,521			105,316
应收所得税	81,990			60,824
流动资产总额	$	3,641,379			$	3,501,675

非流动资产：
不动产、厂房及设备净额	375,265			395,724
商誉	8,721,911			8,731,689
无形资产净额	3,100,266			3,247,118
经营性使用权资产	103,064			128,948
其他应收款	73,658			75,707

递延所得税资产	105,538			106,871
权益投资	121,251			82,050

资产总额	$	16,242,332			$	16,269,782

负债及股东权益
流动负债：
应付账款	$	86,003			$	192,117
预收收入	1,727,355			1,550,471
其他负债	936,745			904,826

应付所得税	18,553			18,999
流动银行信贷额度、贷款融资及票据	—			529,762
流动负债总额	$	2,768,656			$	3,196,175

非流动负债：
非流动银行信贷额度、贷款融资及票据净额	3,379,107			2,872,616
租赁负债	97,144			117,122
非流动其他负债	79,362			72,807
非流动应付所得税	109,800			103,251
递延所得税负债	680,944			714,427
承诺及或有事项	—			—
负债总额	$	7,115,013			$	7,076,398

股东权益：
普通股，每股面值 6 欧分；授权发行 100,000,000 股，
截至 2026 年 9 月 30 日已发行并流通 74,916,724 股，
截至 2025 年 12 月 31 日已发行并流通 76,567,325 股	6,189			6,305
额外实缴资本	7,208,291			7,131,956
其他未指定资本	1,771			1,606
累计其他综合亏损	(110,352)			(68,534)
留存收益	2,021,420			2,122,051
股东权益总额	$	9,127,319			$	9,193,384


负债和股东权益总额	$	16,242,332			$	16,269,782

随附附注是这些未经审计的简明合并财务报表不可分割的组成部分。

ICON plc

简明合并经营报表

截至 2026 年 9 月 30 日和 2025 年 9 月 30 日止三个月和九个月

（未经审计）


		截至三个月		截至九个月
		9 月 30 日， 2026		9 月 30 日， 2025		9 月 30 日， 2026		9 月 30 日， 2025
	（单位：千，股份和每股数据除外）

收入		$	2,024,757			$	2,084,415		$	6,122,242	$	6,138,823

成本和费用：
直接成本		1,532,925			1,538,951			4,673,190		4,443,967
销售、一般及行政费用		196,850			197,049			591,766		600,439
折旧及无形资产摊销		94,422			99,030			275,520		292,706
交易及整合相关费用		233			7,020			5,949		19,141
重组费用		1,486			—			32,466		82,296
处置子公司损失		—			—			32,947		—
商誉减值		—			364,248			—		364,248
非金融资产减值		—			101,027			—		101,027
成本和费用总额		1,825,916			2,307,325			5,611,838		5,903,824

经营收入／（亏损）		198,841			(222,910)			510,404		234,999
利息收入		5,612			1,761			10,588		5,617
利息费用		(66,175)			(50,243)			(162,959)		(148,003)


所得税费用前收入／（亏损）		138,278			(271,392)			358,033		92,613
所得税费用		(32,446)			(12,791)			(74,868)		(12,468)

权益法投资净收益份额前收入／（亏损）		105,832			(284,183)			283,165		80,145
权益法投资净收益份额		16,298			—			16,298		—
净收入／（亏损）		$	122,130			$	(284,183)		$	299,463	$	80,145

每股普通股净收入／（亏损）：

基本		$	1.59			$	(3.67)		$	3.90	$	1.01
稀释		$	1.58			$	(3.67)		$	3.87	$	1.01

加权平均流通普通股数：

基本		76,932,640			77,373,534			76,785,939		79,057,239
稀释		77,404,061			77,373,534			77,345,757		79,518,086

随附附注是这些未经审计的简明合并财务报表不可分割的组成部分。

ICON plc

简明合并综合收益表

截至 2026 年 9 月 30 日和 2025 年 9 月 30 日止三个月和九个月

（未经审计）


	截至三个月		截至九个月
	9 月 30 日， 2026		9 月 30 日， 2025	9 月 30 日， 2026		9 月 30 日， 2025
	（单位：千）

净收入／（亏损）	$	122,130		$	(284,183)		$	299,463	$	80,145
其他综合收益，税后净额：
货币折算调整	293		(18,181)	(40,993)		145,405
现金流量套期净变动	(825)		—	(825)		(2,420)
综合收益／（亏损）总额	$	121,598		$	(302,364)		$	257,645	$	223,130

随附附注是这些未经审计的简明合并财务报表不可分割的组成部分。

ICON plc

简明合并股东权益变动表

（未经审计）


	普通股股数	普通股	额外实缴资本	其他未指定资本	累计其他综合亏损	留存收益	总计
	（单位：千，股份数据除外）
2025年12月31日余额	76,567,325		$	6,305		$	7,131,956	$	1,606		$	(68,534)	$	2,122,051	$	9,193,384
综合收益（扣除税项后）：
净收益	—		—		—		—	—		104,751		104,751
货币折算调整	—		—		—		—	(26,495)		—		(26,495)


综合收益总额							78,256
行使股票期权	10,174		1		1,085		—	—		—		1,086
发行限制性股票单位	24,039		1		—		—	—		—		1
股份支付费用	—		—		27,574		—	—		—		27,574
股份发行成本	—		—		(5)		—	—		—		(5)


2026年3月31日余额	76,601,538		$	6,307		$	7,160,610	$	1,606		$	(95,029)	$	2,226,802	$	9,300,296
综合收益（扣除税项后）：
净收益	—		—		—		—	—		72,582		72,582
货币折算调整	—		—		—		—	(14,791)		—		(14,791)


综合收益总额							57,791
行使股票期权	12,519		1		1,584		—	—		—		1,585
发行限制性股票单位	540,152		38		—		—	—		—		38
股份支付费用	—		—		18,456		—	—		—		18,456
股份发行成本	—		—		(4)		—	—		—		(4)


2026年6月30日余额	77,154,209		$	6,346		$	7,180,646	$	1,606		$	(109,820)	$	2,299,384	$	9,378,162
综合收益（扣除税项后）：
净收益	—		—		—		—	—		122,130		122,130
货币折算调整	—		—		—		—	293		—		293

现金流量套期变动净额	—		—		—		—	(825)		—		(825)
综合收益总额							121,598
行使股票期权	84,252		5		10,362		—	—		—		10,367
发行限制性股票单位	37,966		3		—		—	—		—		3
股份支付费用	—		—		17,289		—	—		—		17,289
股份发行成本	—		—		(6)		—	—		—		(6)
回购普通股	(2,359,703)		(165)		—		165	—		(400,000)		(400,000)
股份回购成本	—		—		—		—	—		(94)		(94)
2026年9月30日余额	74,916,724		$	6,189		$	7,208,291	$	1,771		$	(110,352)	$	2,021,420	$	9,127,319

ICON plc

简明合并股东权益报表（续）

（未经审计）


	普通股股数	普通股	额外实收资本	其他未指定资本	累计其他综合亏损	留存收益	总计
	（千元，股份数据除外）
2024年12月31日余额	80,756,860		$	6,586		$	7,020,231	$	1,304		$	(229,929)	$	2,643,162	$	9,441,354
综合收益（扣除税项后）：
净收益	—		—		—		—	—		160,812		160,812
货币折算调整	—		—		—		—	59,158		—		59,158

现金流量套期变动	—		—		—		—	(2,420)		—		(2,420)
综合收益总额							217,550
行使股票期权	40,883		3		4,759		—	—		—		4,762
发行限制性股票单位/绩效股票单位	27,046		1		—		—	—		—		1
股份支付费用	—		—		12,359		—	—		—		12,359
股份发行成本	—		—		(5)		—	—		—		(5)
回购普通股	(1,360,537)		(85)		—		85	—		(250,000)		(250,000)
股份回购成本	—		—		—		—	—		(150)		(150)
2025年3月31日余额	79,464,252		$	6,505		$	7,037,344	$	1,389		$	(173,191)	$	2,553,824	$	9,425,871
综合收益（扣除税项后）：
净收益	—		—		—		—	—		203,516		203,516
货币折算调整	—		—		—		—	104,428		—		104,428


综合收益总额							307,944
行使股票期权	17,901		1		1,733		—	—		—		1,734
发行限制性股票单位	7,158		1		—		—	—		—		1
股份支付费用	—		—		15,251		—	—		—		15,251
股份发行成本	—		—		(4)		—	—		—		(4)
回购普通股	(1,717,181)		(117)		—		117	—		(250,000)		(250,000)
股份回购成本	—		—		—		—	—		(150)		(150)
2025年6月30日余额	77,772,130		$	6,390		$	7,054,324	$	1,506		$	(68,763)	$	2,507,190	$	9,500,647
综合亏损（扣除税项后）：
净亏损	—		—		—		—	—		(284,183)		(284,183)
货币折算调整	—		—		—		—	(18,181)		—		(18,181)


综合亏损总额							(302,364)
行使股票期权	7,110		—		821		—	—		—		821
发行限制性股票单位	7,304		—		—		—	—		—		—
股份支付费用	—		—		44,919		—	—		—		44,919
股份发行成本	—		—		(5)		—	—		—		(5)
回购普通股	(1,426,612)		(100)		—		100	—		(250,000)		(250,000)
股份回购成本	—		—		—		—	—		(150)		(150)
2025年9月30日余额	76,359,932		$	6,290		$	7,100,059	$	1,606		$	(86,944)	$	1,972,857	$	8,993,868

随附附注是这些未经审计的简明合并财务报表不可分割的一部分。

ICON plc

简明合并现金流量表

截至2026年9月30日和2025年9月30日的九个月

（未经审计）


	截至九个月
	9月30日， 2026		9月30日， 2025
	（千元）
经营活动提供的现金流：
净利润	$	299,463			$	80,145

将净利润调节为经营活动提供的净现金的调整项：
折旧及无形资产摊销	275,520			292,706
商誉减值	—			364,248
非金融资产减值	—			101,027
经营性使用权资产及相关不动产、厂房和设备减值	—			5,573
经营性使用权资产账面价值减少	34,596			29,473
权益法投资净收益份额	(16,298)			—
处置子公司损失	32,947			—
融资成本摊销	8,108			4,470
债务清偿损失	12,233			—
股份支付费用	63,319			72,529
递延税项收益	(32,986)			(114,257)
未实现汇兑变动	(24,963)			24,661
其他非现金项目	4,195			20,561
经营性资产和负债变动：
应收账款	(99,754)			(8,212)
未开票收入	64,474			(157,162)
递延收入	235,605			64,542
其他净资产	(63,045)			21,739
经营活动提供的净现金	793,414			802,043
投资活动使用的现金流：
购置不动产、厂房和设备	(111,183)			(114,885)
收购子公司（扣除取得的现金）	—			(2,537)
处置子公司现金流出（包括出售的现金）	(57,142)			—
股权投资所得款项	2,908			2,114
购入股权投资	(32,939)			(16,286)
投资活动使用的净现金	(198,356)			(131,594)
融资活动使用的现金流：
债务发行成本	(16,679)			—
提前还款费用	(7,841)			—
提取信贷额度及贷款融资	2,650,000			50,000
偿还信贷额度及贷款融资	(2,666,688)			(72,321)
根据股权激励计划发行股票所得款项	13,080			7,319
股票发行成本	(15)			(14)
回购普通股	(400,000)			(750,000)
股票回购成本	(94)			(450)
融资活动使用的净现金	(428,237)			(765,466)
汇率变动对现金的影响	(5,132)			25,120
现金及现金等价物净增加／（减少）	161,689			(69,897)
期初现金及现金等价物	647,295			538,785
期末现金及现金等价物	$	808,984			$	468,888

随附附注是这些未经审计的简明合并财务报表不可分割的一部分。

ICON plc

简明合并财务报表附注

（未经审计）

2026年9月30日

1. 编制基础

这些简明合并财务报表按美国公认会计原则（“U.S. GAAP”）编制，未经审计。简明合并财务报表反映了所有调整；管理层认为，这些调整对于公允列报所列期间的经营业绩和财务状况是必要的。按照美国公认会计原则编制简明合并财务报表，要求管理层作出估计和假设，这些估计和假设会影响简明合并财务报表中列报的金额和披露。实际结果可能与这些估计不同。

简明合并财务报表应与 ICON 截至 2025 年 12 月 31 日止年度的 20-F 表格年度报告中所载的合并财务报表会计政策及附注一并阅读（见附注 2 重要会计政策摘要）。截至 2026 年 9 月 30 日止九个月的经营业绩不一定能代表截至 2026 年 12 月 31 日止财年的预期业绩。

2. 重要会计政策摘要

收入确认

公司通过向客户提供多种不同服务取得收入。这些服务是临床开发流程不可或缺的组成部分，包括临床试验管理、咨询、合同人员配置、数据服务和实验室服务。下文所述的这些服务可作为临床试验合同的一部分合并购买，也可单独购买。经济因素对这些服务的影响不存在显著差异。合同期限从数月到数年不等。

ASC 第 606 主题，客户合同收入（“ASC 606”）要求应用以下五个步骤：(1) 识别与客户签订的合同；(2) 识别合同中的履约义务；(3) 确定交易价格；(4) 将交易价格分摊至合同中的履约义务；以及 (5) 在（或随着）主体履行履约义务时确认收入。上述步骤已应用于下文所述各项服务确认的收入。

临床试验服务收入

临床试验服务是一项随时间履行的单一履约义务。它代表与临床试验相关的全方位服务义务（包括由研究者及其他方提供的服务），并被视为一项单一履约义务。向客户作出的承诺在合同背景下并非可明确区分。对于直接服务以及使用支持临床研究项目的第三方（主要为研究者服务），ICON 均为合同主要责任人。交易价格根据合同或变更订单金额（服务收入总额以及转付费用／可报销费用）确定，并调整以反映可实现的合同金额。随着单一履约义务的履行，收入随时间确认。临床服务合同的履约进度以投入法计量，即在每个报告期发生的项目总成本（包括转付费用／可报销费用）占预计项目总成本的比例。

实验室服务收入

当合同条款下的履约义务已履行时或履行过程中确认收入；履约义务在产品或服务的控制权转移给客户时履行。实验室服务收入按预期因转让产品或服务而收取的对价金额计量。如果与客户签订的合同包含多项履约义务，则根据承诺商品或服务的估计相对单独售价，将交易价格分摊至各项履约义务。服务收入随着服务交付给客户，按照履约义务完成进度随时间确认。确定进度计量方法需要作出判断，并依据所提供服务的性质。这需要评估价值向客户的转移情况。开票权进度计量法通常适用于按单位计费的合同，因为履约义务完成进度是根据离散的服务或基于时间的增量（例如已检测的样本或已投入的工时）计量的。收入按开票金额入账，因为该金额对应于公司的履约价值以及向客户转移的价值。

合同人员服务收入

公司采用了实务简便方法，因此按开票权确认收入。采用该实务简便方法，反映了公司有权从客户处获得与截至当日已完成履约向客户提供的价值直接对应的对价。该价值体现了合同人员已提供的工时。

咨询服务收入

我们的咨询服务合同代表一项随时间履行的单项履约义务。交易价格根据合同或变更订单金额确定。随着履约义务的履行，收入随时间确认。咨询合同的完成进度按各报告期的项目总投入（时间）占预计项目总投入的比例计量。

佣金

对于期限超过一年的合同，获取合同的增量成本在简明合并资产负债表中确认为资产。对于佣金成本涉及期限不足一年的合同，适用实务简便方法，因为递延后形成的资产的摊销期为一年或更短。

无形资产

无形资产在收购日按公允价值计量，并在各自估计使用寿命内按直线法摊销。公司没有使用寿命不确定的无形资产。当存在减值迹象时，公司会评估其无形资产是否减值。

无形资产在其估计使用寿命内按直线法摊销，具体如下表所示：


	估计使用寿命
客户关系	8 - 23 年
订单积压	3 - 5 年


技术资产	5 年

公司会定期评估无形资产的预计使用年限，以判断收购时确定的使用年限是否仍然适当。

股权投资

公司在考虑投资性质、对经营和财务决策的影响程度以及公允价值是否易于确定后，对其持有的股权证券进行会计处理。

对于未纳入合并范围的投资，若公司具有重大影响，则采用权益法进行会计处理。公司在简明合并经营报表的“权益法投资收益/（亏损）份额”项目中记录其应占这些投资的收益/亏损。每当发生事件或情况变化表明账面金额可能无法收回时，公司都会对权益法投资进行减值评估。

公司认定，其在某些基金中的权益符合公允价值不易确定的股权证券定义，并符合 ASC Topic 820《公允价值计量》（“ASC 820”）中的净资产价值（“NAV”）实务简便方法。NAV 的任何增加或减少均在当期确认为收益。

其他股权投资按成本计量，并扣除减值。

这些投资在简明合并资产负债表中归类为股权投资。

所得税

公司采用资产负债法核算所得税。根据资产负债法，针对现有资产和负债的财务报表账面金额与其各自计税基础之间的差异，以及经营亏损和税收抵免结转所产生的未来税务影响，确认递延所得税资产和负债。递延所得税资产和负债按已颁布的税率计量，该税率为预计在这些暂时性差异预期转回或结算年度适用于应纳税所得额的税率。税率变动对递延所得税资产和负债的影响，在包含颁布日期的期间确认为所得税拨备的一部分。递延所得税资产通过计提估值备抵，减记至很可能实现的金额。公司仅在所得税税务立场很可能得以维持时，才确认其影响。已确认的所得税税务立场按结算时实现概率超过 50% 的最大税收利益金额计量。与所得税相关的利息和罚款计入所得税费用，并在合并资产负债表中与相关负债归类列示。公司在全球无形低税收入（“GILTI”）产生的期间核算其影响，因此未就该项目计提递延所得税。

处置子公司

如果失去对某家子公司的控制权，公司将在不再拥有该实体控股性财务权益之日对其进行出表。公司通过在简明合并经营报表中确认收益或损失来核算子公司出表，金额按收到对价的公允价值总额与前子公司资产和负债账面金额之间的差额计量。

3. 收入

按客户集中度拆分的收入如下：


	截至三个月		截至九个月
	2026年 9月30日	2025年 9月30日		2026年 9月30日	2025年 9月30日
	（千美元）


客户1-5	$	480,214		$	501,343		$	1,483,064	$	1,499,847
客户6-10	306,817		308,045			927,675	890,203
客户11-25	490,378		541,879			1,466,245	1,546,626
其他	747,348		733,148			2,245,258	2,202,147
总计	$	2,024,757		$	2,084,415		$	6,122,242	$	6,138,823

各期间均无单一客户的收入超过合并收入的10%。各期间列示的客户仅适用于所指期间。

4. 应收账款、未开票收入（合同资产）及未赚取收入或账户付款（合同负债）

应收账款和未开票收入如下：


	2026年 9月30日	2025年 12月31日
	（千美元）
应收账款（已开票服务）	$	1,550,525		$	1,517,217
信用损失准备	(40,480)		(42,319)
应收账款净额	1,510,045		1,474,898
未开票收入（未开票服务）	1,023,170		1,096,592
应收账款和未开票收入净额	$	2,533,215		$	2,571,490

未开票服务和未赚取收入或账户付款（合同资产和负债）如下：


	2026年 9月30日	2025年 12月31日	变动额	变动百分比
	（千美元，百分比除外）
未开票收入（未开票服务）	$	1,023,170		$	1,096,592	$	(73,422)	(6.7)	%
未赚取收入（账户付款）	(1,727,355)		(1,550,471)		(176,884)	11.4	%

履行履约义务的时间可能与相关客户合同金额的开票和收款时间不同。对于已履行但尚未开票和/或收款的履约义务相关金额，我们确认为资产。当收取对价的条件并非仅取决于时间经过时，这些资产确认为未开票收入，因此属于合同资产而非应收账款。对于在履约义务履行前已收取，或在收入赚取前已开票的金额，则确认为负债。

在临床研究服务合同中，若开票依据是约定里程碑的时间，便会产生未开票服务/收入余额。对于某些可报销费用（主要是研究者费用），合同约定要求研究者先向公司开票，然后公司才能向客户开票。由于未开票服务（合同资产）与未赚取收入（合同负债）之间不存在合同抵销权，因此两者均在简明合并资产负债表中分别按总额列示。

截至2026年9月 30日，未开票服务较2025年12月 31日减少7,340万美元。未赚取收入较2025年12月 31日增加1.769亿美元。这些波动主要是由于本公司的临床试验管理合同相关付款和开票时间不同所致。开票和付款依据合同条款确定，取决于单位/里程碑的交付，包括预先确定的付款计划；这些计划可能与合同项下本公司服务控制权转移的时间相对应，也可能不对应。未开票服务产生于长期合同，在采用基于成本投入法确认收入时，已确认收入超过向客户开票的金额。

截至2026年9月 30日，未履行履约义务预计未来确认的收入约为164亿美元（2025年12月 31日：149亿美元）。本公司预计未来12个月内确认约47%的未履行履约义务收入（2025年12月 31日：48%），其余部分预计在此后客户合同期限内确认。我们认为，任何日期的未履行履约义务不一定能有意义地预测未来业绩，因为其中所含项目可能被取消或延期；对于我们能够将这项未履行履约义务实现为收入的程度，无法作出保证。

5. 商誉

2025年12月 31日至2026年9月 30日之间商誉账面金额的变动如下：


	截至九个月	截至年度
	2026年9月30日	2025年12月31日
	（单位：千）
期初余额	$	8,731,689		$	9,051,410

前期收购	—		5,109
减值	—		(364,248)
汇兑变动	(9,778)		39,418
期末余额	$	8,721,911		$	8,731,689

截至2026年9月 30日的九个月内未计提减值费用（截至2025年12月 31日的年度内：3.642亿美元，与本公司原数据解决方案报告单位有关）。该数据解决方案报告单位由Symphony构成，已于2026年5月8日处置。有关处置详情，请参阅附注17处置子公司。

6. 无形资产

截至2026年9月 30日和2025年12月 31日的无形资产账面金额如下：



	2026年9月30日	2025年12月31日
	（单位：千）
成本
客户关系	$	4,114,252		$	4,134,478
订单积压	544,514		546,054
商号及品牌	189,686		204,721
患者数据库	2,463		170,511
技术资产	116,466		151,754



成本总额	4,967,381		5,207,518
累计摊销	(1,867,115)		(1,873,663)
减值	—		(86,737)
账面净值	$	3,100,266		$	3,247,118

截至2026年9月 30日的三个月内，本公司确认的摊销费用为4,620万美元（截至2025年9月 30日的三个月：5,870万美元）。

截至2026年9月30日止九个月，公司确认的摊销费用为1.466亿美元（截至2025年9月30日止九个月：1.767亿美元，以及年截至2025年12月31日止年度：2.272亿美元）。

截至2026年9月30日止九个月，未增加无形资产。

7. 公允价值计量

公司没有任何经常性按公允价值计量的资产或负债。包括现金及现金等价物、应收账款和应付账款在内的金融工具账面金额，由于这些工具期限较短，接近其公允价值。

非经常性公允价值计量

某些资产和负债列于随附的简明合并资产负债表中，且并非按经常性基础重新计量至公允价值。这些资产包括权益投资（见附注2重要会计政策摘要）、在发生触发事件时进行减值测试的有限使用寿命无形资产，以及每年或在发生触发事件时进行减值测试的商誉。截至2026年9月30日，简明合并资产负债表中列示且未按经常性基础重新计量至公允价值的资产总额为119.435亿美元（2025年12月31日：120.609亿美元）。这些资产包括商誉87.219亿美元（2025年12月31日：87.317亿美元）、无形资产31.003亿美元（2025年12月31日：32.471亿美元）以及权益投资1.213亿美元（2025年12月31日：0.821亿美元）。

截至2026年9月30日，公司债务的估计公允价值为33.281亿美元（2025年12月31日：35.001亿美元）。公司债务的公允价值根据金融机构之间交易这些债务工具的利率确定。

8. 重组

截至九个月 2026年9月30日，简明合并经营报表中记录了4,910万美元的重组及相关成本，其中包括：(1) 计入重组费用的员工裁减成本3,250万美元；(2) 为优化公司办公场所而对使用权资产及相关合同成本加速摊销的920万美元，计入销售、一般及行政费用；此外，相关加速折旧740万美元计入无形资产折旧及摊销费用。

在截至9个月 2025年9月30日的期间内，记录了8,230万美元的重组费用，反映了7,560万美元的人员缩减，以及一项旨在优化公司办公场所布局的办公室整合计划产生的670万美元，其中包括使用权资产及相关不动产、厂房和设备减值560万美元，以及亏损合同成本110万美元。


	截至三个月		截至九个月
	2026年9月30日	2025年9月30日		2026年9月30日	2025年9月30日
	（千美元）
重组	$	1,486		$	—	$	32,466	$	82,296
重组相关成本*	$	16,650		$	—	$	16,650	$	—
重组及相关成本总额	$	18,136		$	—	$	49,116	$	82,296

*截至2026年9月30日的三个月和九个月期间的成本包括一笔820万美元的费用，涉及使用权资产加速摊销，以及一笔100万美元的相关合同成本费用，计入销售、一般及行政费用；此外，相关不动产、厂房和设备的加速折旧费用为740万美元，计入简明合并经营报表中的无形资产折旧及摊销。

截至2026年9月30日，简明合并资产负债表中记录的与重组活动相关的负债总额为1,380万美元（2025年12月31日：1,250万美元）。


	截至九个月	截至年度
	2026年9月30日	2025年12月31日
	（千美元）
期初准备金	$	12,525		$	31,474
本期计提费用，净额**	33,458		75,386
使用额	(32,232)		(94,335)
期末准备金	$	13,751		$	12,525

**截至9个月 2026年9月30日期间的计提费用净额反映了3,250万美元的人员缩减（2025年12月31日：7,460万美元）以及重组相关合同成本100万美元（2025年12月31日：80万美元）。

截至的期末准备金2026年9月30日为1,380万美元（2025年12月31日：1,250万美元），反映了：

(1) 1,100万美元（2025年12月31日：910万美元）的人员缩减相关负债；全部归类为其他负债中的流动负债，以及

(2) 280万美元（2025年12月31日：340万美元）的设施相关负债，其中90万美元（2025年12月31日：130万美元）计入其他负债，1,900万美元（2025年12月31日：210万美元）计入非流动其他负债。

9. 经营租赁

截至2026年9月30日和2025年9月30日止三个月和九个月的经营租赁成本如下：


	截至三个月		截至九个月
	2026年 9月30日	2025年 9月30日		2026年 9月30日	2025年 9月30日
	（单位：千）
经营租赁成本	$	18,442		$	12,378		$	39,856	$	35,046
转租收入	(412)		(905)			(1,297)	(2,524)
经营租赁成本净额	$	18,030		$	11,473		$	38,559	$	32,522

截至2026年9月30日止三个月发生的总成本为$18.0 million（其中包括$8.2 million的加速摊销费用（2025年9月30日：$nil））（2025年9月30日：$11.5 million）；其中$15.7 million（2025年9月30日：$9.8 million）计入销售、一般及行政费用，$2.3 million（2025年9月30日：$1.7 million）计入直接成本。

截至九个月的总成本为$38.6 million （其中包括$8.2 million的加速摊销费用（2025年9月30日：$nil）），截至2026年9月30日止九个月发生的成本（2025年9月30日：$32.5 million）中，$33.3 million（2025年9月30日：$27.9 million）计入销售、一般及行政费用，$5.3 million（2025年9月30日：$4.6 million）计入直接成本。

截至2026年9月30日和2025年9月30日止三个月和九个月，本集团发生的可变租赁付款相关成本微不足道。

截至2026年9月30日止三个月，以承担租赁义务为对价取得的使用权资产总额为$5.7 million（2025年9月30日：$4.1 million）。截至2026年9月30日止九个月，以承担租赁义务为对价取得的使用权资产总额为$12.6 million（2025年9月30日：$13.9 million）。

截至2026年9月30日，剩余租赁期限加权平均值和加权平均折现率分别为 5.53 年和3.79%。截至2025年12月31日，剩余租赁期限加权平均值和加权平均折现率分别为5.96年和4.04%。

截至2026年9月30日，不可取消租赁项下未来最低租赁付款如下：



	（单位：千）
第1年		$	37,144
第2年		32,514
第3年		23,972
第4年		14,518
第5年		8,444
此后		26,808
未来最低租赁付款总额		143,400
租赁隐含利息		(13,361)
总计		$	130,039

经营租赁负债列为流动负债和非流动负债。截至2026年9月30日，经营租赁负债中的$32.9 million已计入其他负债（2025年12月31日： $36.3 million），另有$97.1 million已归类为非流动租赁负债（2025年12月31日：$117.1 million）。

10. 银行信贷额度、贷款安排及票据

截至2026年9月30日和2025年12月31日，公司有以下未偿债务：


	截至以下日期的本金金额
	2026年 9月30日	2025年 12月31日
	（单位：千）
高级定期贷款，利率 5.672%，2028年7月到期	$	—		$	916,688
优先票据，利率 2.875%，2026年7月到期（“2026年票据”）	—		500,000

优先票据，利率 5.809%，2027年5月到期 (1) （“2027年5月票据”）	—		750,000
优先票据，利率 5.849%，2029年5月到期 (1) （“2029年5月票据”）	750,000		750,000
优先票据，利率 5.064%，2029年8月到期 (2)（“2029年8月票据”）	500,000		—
优先票据，利率 5.421%，2031年8月到期 (2) （“2031年8月票据”）	1,000,000		—
优先票据，利率 6.000%，2034年5月到期 (1)（“2034年5月票据”）	500,000		500,000
优先票据，利率 5.995%，2036年8月到期 (2) （“2036年8月票据”）	650,000		—

债务总额	3,400,000		3,416,688
减：债务流动部分	—		(529,762)
长期债务总额	3,400,000		2,886,926
减：债务发行成本及债务折价	(20,893)		(14,310)
长期债务总额，净额	$	3,379,107		$	2,872,616

(1)于2024年5月8日发行；(2)于2026年8月13日发行。

公司在截至2026年9月30日和2025年9月30日的三个月和九个月期间，因各种融资安排产生了利息成本，具体如下表所示。这些成本已计入简明合并经营报表中的利息费用项目。


	截至三个月		截至九个月
	2026年 9月30日	2025年 9月30日		2026年 9月30日	2025年 9月30日
	（千元）
已提款融资的利息费用	$	48,137		$	47,931		$	140,139	$	140,992
融资成本摊销	5,059		1,499			8,108	4,470
债务清偿损失	12,233		—			12,233	—
其他融资成本*	746		813			2,479	2,541
融资成本总额	$	66,175		$	50,243		$	162,959	$	148,003

*包括与循环贷款安排相关的成本以及与债务协议豁免相关的成本。

在截至2026年9月30日的三个月内，公司将1,730万美元的交易相关融资成本计入费用（截至2025年9月30日的三个月：150万美元），其中包括此前已资本化的融资费用摊销以及与债务协议豁免相关的成本。

在截至2026年9月30日的九个月内，公司将2,100万美元的交易相关融资成本计入费用（截至2025年9月30日的九个月：450万美元），其中包括此前已资本化的融资费用摊销以及与债务协议豁免相关的成本。

截至2026年9月30日，公司的债务合同到期情况如下：


债务合同到期情况	（千元）
2026年（剩余期间）	$	—
2027	—
2028	—
2029	1,250,000
2030年及以后	2,150,000
总计	$	3,400,000

截至2026年9月30日，公司的主要融资安排包括2026年8月发行票据（定义见本附注后文）、2024年5月发行票据（定义见本附注后文）以及循环信贷额度（定义见本附注后文）。

2026年8月发行票据

2026年8月13日，ICON Investments Six Designated Activity Company（“发行人”），一家由 ICON plc 全资拥有的子公司，出售并发行了总额为 21.5 亿美元的优先无担保票据（统称“2026年8月已发行票据”），包括本金总额为 5 亿美元、利率为 5.064%、于 2029 年到期的票据，本金总额为 10 亿美元、利率为 5.421%、于 2031 年到期的票据，以及本金总额为 6.5 亿美元、利率为 5.995%、于 2036 年到期的票据。2026年8月已发行票据的利息每年于 2 月 13 日和 8 月 13 日支付，自 2027 年 2 月 13 日起支付。ICON plc 为 2026年8月已发行票据提供优先无担保担保。

公司就 2026年8月已发行票据支付了 770 万美元的承销费。

公司将发行所得款项净额用于：(i) 于 2026 年 8 月 13 日偿还所有未偿还的 9 亿美元优先担保定期贷款（定义见本附注后文）；(ii) 于 2026 年 8 月 14 日全额赎回未偿还的 7.5 亿美元 2027 年 5 月票据（定义见本附注后文）；以及 (iii) 于 2026 年 8 月 17 日偿还桥接担保信贷额度（定义见本附注后文）项下所有未偿还借款，金额为 5 亿美元。

偿还桥接担保信贷额度和优先担保定期贷款后，为 ICON 集团循环信贷额度（定义见本附注后文）、2029 年 5 月票据和 2034 年 5 月票据提供担保的抵押品自动解除，2029 年 5 月票据和 2034 年 5 月票据项下的子公司担保也自动解除。简明合并经营报表中的利息费用包含 1,220 万美元的债务清偿损失，其中包括 2027 年 5 月票据的 780 万美元提前还款费。

与本次发行同时，发行人、ICON 和初始购买方签订了注册权协议（“注册权协议”），根据该协议，ICON 同意尽商业上合理的努力，于 2027 年 11 月 11 日或之前为 2026年8月已发行票据办理注册。如果未在规定期限内完成交换要约，或未在注册权协议规定的期限内满足某些其他注册要求，则在注册违约持续期间的首个 90 天内，2026年8月已发行票据的利率将每年上调 0.25%；此后每年再上调 0.25%，但其年利率累计上调幅度最高为 0.50%。如果触发条件仍未解决，该安排下未来未折现付款的最高潜在金额约为每年 1,080 万美元（不包括首个 90 天期间）。截至 2026 年 9 月 30 日，未发生注册违约，也未确认任何负债。

2024年5月已发行票据

2024年5月8日，发行人发行了20亿美元的优先担保票据（“2024年5月发行票据”）。2024年5月发行票据的本金总额包括：7.5亿美元、利率为5.809%、2027年到期的优先担保票据（“2027年5月票据”）；7.5亿美元、利率为5.849%、2029年到期的优先担保票据（“2029年5月票据”）；以及5亿美元、利率为6.000%、2034年到期的优先担保票据（“2034年5月票据”）。2024年5月发行票据的利息每年于5月8日和11月8日支付。

公司就2024年5月发行票据支付了680万美元的承销费。

2027年5月票据已于2026年8月14日全部赎回。2026年8月偿还过桥担保信贷安排和优先担保定期贷款后，为2029年5月票据和2034年5月票据提供担保的抵押品以及这两类票据项下的子公司担保均自动解除。截至2026年8月17日，2029年5月票据和2034年5月票据为优先无担保票据，由ICON plc提供担保。

母公司担保

所有未偿票据均由ICON plc（“母公司”）提供优先无担保担保。票据（统称“2024年5月发行票据”和“2026年8月发行票据”）是发行人和母公司的优先无担保债务，在偿付顺序上与发行人或母公司所有现有及未来优先债务同等，包括其各自在循环信贷安排项下的义务。票据的偿付顺序优先于发行人或母公司未来的任何次级债务；在有效偿付顺序上，则次于母公司、发行人或母公司子公司的所有现有及未来由留置权担保的债务（以担保该等债务的抵押品价值为限）；在结构性偿付顺序上，则次于母公司子公司（发行人除外）的所有负债，包括其各自在循环信贷安排项下的义务。

优先担保信贷安排

公司的优先担保信贷安排包括一项本金为5,515 百万美元、原定于2028年7月到期的优先担保定期贷款安排（“优先担保定期贷款”），以及一项本金总额为500.0 百万美元的优先担保循环信贷安排（“循环信贷安排”）（优先担保定期贷款和循环信贷安排合称“优先担保信贷安排”）。2026年8月13日，优先担保定期贷款已偿还。截至2026年9月30日，循环信贷安排项下未提款（截至2025年12月31日止年度：未提款）。

循环信贷额度项下任何借款适用的利率差额，由借款人选择，采用以下任一方式：(i) 适用基准利率加适用利差；根据标普对公司当前企业家族评级为 BB（或更低）或 BB+（或更高），利差分别为 0.35% 或 0.00%；或 (ii) 定期 SOFR（对于非美元借款人，则为适用参考利率）加适用利差；根据标普对公司当前企业家族评级为 BB（或更低）、BB+、BBB-、BBB 或 BBB+（或更高），利差分别为 1.35%、1.00%、0.75%、0.55% 或 0.40%。此外，循环信贷额度的贷款人有权收取承诺费，费率以提款时适用的利差为基准；还可根据已提取额度占比收取使用费。

在 2026年8月13日偿还之前，优先担保信贷额度项下的借款由母公司和子公司担保人提供担保，并以 ICON、借款人（定义见优先担保信贷额度）及各子公司担保人的几乎全部资产（某些例外情况除外）上的留置权作为担保；优先担保信贷额度对这些资产享有第一顺位留置权，该留置权与担保 2024年5月发行票据的留置权享有同等顺位，但须受其他允许留置权的约束。

截至2026年9月30日止九个月及截至2025年12月31日止年度，优先担保定期贷款的本金偿还（包括强制性和自愿性偿还）如下：


本金偿还	（千元）
2025年第1季度	$	(7,440)
2025年第2季度	(7,441)
2025年第3季度	(7,440)
2025年第4季度	(7,441)
2025年偿还总额	$	(29,762)
2026年第1季度	(7,440)
2026年第2季度	(7,441)
2026年第3季度	(901,807)
2026年偿还总额	$	(916,688)

截至2026年9月30日的季度内，公司提取了$nil （截至2025年12月31日止年度： $50.0 million）循环信贷额度，并偿还了 $nil （截至 2025年12月31日止年度： $50.0 million）。


	提取	偿还	期末余额
	（千元）
2025年1月1日余额			$	—
2025年第1季度	$	50,000		$	(50,000)	—
2025年第2季度	—		—		—
2025年第3季度	—		—		—
2025年第4季度	—		—		—
2025年提取/（偿还）总额	50,000		(50,000)
2026年第1季度	—		—		—
2026年第2季度	—		—		—
2026年第3季度	—		—		—
2026年提取/（偿还）总额	$	—		$	—

过桥担保信贷额度

2026年4月27日，ICON Global Treasury Unlimited Company（“过桥融资借款人”）作为公司的子公司，签订了一项过桥融资信贷协议，本金总额为$500 million（“过桥担保信贷额度”）。

过桥担保信贷额度项下的借款不分期摊还，并于最终到期日到期。过桥担保信贷额度项下借款适用的利率差额为美元定期 SOFR 加固定的日历化适用利差，范围为1.00%至2.25%。

2026年7月15日，公司全额提用了过桥担保信贷额度，并使用所得款项中的$500.0 million 全额偿还本金总额为$500.0 million 、利率为2.875%的优先担保票据（“2026年票据”）。该票据由公司一家子公司于2021年7月发行，并于2026年7月15日到期。过桥担保信贷额度已于2026年8月17日全额偿还。

11. 所得税

截至2026年和2025年9月30日止三个月和九个月确认的所得税包括：


	截至三个月		截至九个月
	2026年9月30日	2025年9月30日		2026年9月30日	2025年9月30日
	（千美元）
所得税费用	$	32,446		$	12,791	$	74,868	$	12,468
合计	$	32,446		$	12,791	$	74,868	$	12,468

The Income tax expense for the three months ended September 30, 2026 was $32.4 million, compared to $12.8 million for the three months ended September 30, 2025. The change in the charge primarily relates to the $25.6 million net decrease in tax benefit associated with the impact of the release of deferred tax on intangible assets in the three months ended September 30, 2026 compared with the three months ended September 30, 2025.

The Income tax expense for the nine months ended September 30, 2026 increased to $74.9 million compared to a $12.5 million expense for the nine months ended September 30, 2025. The change in the tax charge for the nine months ended September 30, 2026 was primarily due to the net build of provisions for uncertain tax positions in the period of $6.4 million (nine months ended September 30, 2025: $23.4 million net release), no release of a deferred tax liability related to investments in foreign subsidiaries associated with unremitted earnings (nine months ended September 30, 2025: $29.8 million release), and reduced benefit associated with the release of deferred tax on intangible assets in the nine months ended September 30, 2026.

In the normal course of business, the Company provides for uncertain tax positions and the related interest and adjusts its unrecognized tax benefits and accrued interest accordingly. As at September 30, 2026, the Company maintains a $109.8 million liability (December 31, 2025: $103.3 million) for unrecognized tax benefits, which is comprised of $83.1 million (December 31, 2025: $81.0 million) and $26.7 million (December 31, 2025: $22.3 million) for interest and penalties related to such items. The Company recognizes interest accrued on unrecognized tax benefits as an additional income tax expense.

The Company has analyzed the filing positions in all of the significant jurisdictions where it is required to file income tax returns, as well as open tax years in these jurisdictions. The periods subject to audit by the major tax jurisdictions where the Company does business are the 2015 through 2025 tax years. During such audits, local tax authorities may challenge the positions taken by us in our tax returns.

12. Net income / (loss) per ordinary share

Basic net income / (loss) per ordinary share has been computed by dividing net income / (loss) available to ordinary shareholders by the weighted average number of ordinary shares outstanding during the period.

Diluted net income / (loss) per ordinary share is computed by adjusting the weighted average number of ordinary shares outstanding during the period for all potentially dilutive ordinary shares outstanding during the period and adjusting net income / (loss) for any changes in income or loss that would result from the conversion of such potential ordinary shares.

There is no difference in net income / (loss) used for basic and diluted net income per ordinary share.

The reconciliation of the number of shares used in the computation of basic and diluted net income / (loss) per ordinary share is as follows:


	Three Months Ended		Nine Months Ended
	September 30, 2026	September 30, 2025		September 30, 2026	September 30, 2025
Weighted average number of ordinary shares outstanding for basic net income / (loss) per ordinary share	76,932,640		77,373,534			76,785,939	79,057,239
Effect of dilutive share options and other awards outstanding under share-based compensation programs	471,421		—			559,818	460,847
Weighted average number of ordinary shares outstanding for diluted net income / (loss) per ordinary share	77,404,061		77,373,534			77,345,757	79,518,086

Due to the Net loss for the three months ended September 30, 2025, the effect of share options and other awards outstanding under share-based compensation programs is anti-dilutive.


	Three Months Ended		Nine Months Ended
	September 30, 2026	September 30, 2025		September 30, 2026	September 30, 2025
Net income / (loss) per Ordinary Share:
Basic	$	1.59		$	(3.67)	$	3.90	$	1.01
Diluted	$	1.58		$	(3.67)	$	3.87	$	1.01

13. Share-based awards

Share Options

The following table summarizes option activity for the nine months ended September 30, 2026:


	Options Outstanding Number of Shares	Weighted Average Exercise Price		Weighted Average Remaining Contractual Life
Outstanding at December 31, 2025	639,184		$	179.12	3.90
Granted	65,202		$	166.05
Exercised	(106,945)		$	121.92
Expired	(31,560)		$	116.06
Outstanding at September 30, 2026	565,881		$	191.94	4.27
Exercisable at September 30, 2026	424,543		$	191.13	3.47

The Company issues ordinary shares for all options exercised.

Fair value of Stock Options Assumptions

The weighted average fair value of options granted during the nine months ended September 30, 2026 and September 30, 2025 was calculated using the Black-Scholes option pricing model. The weighted average grant date fair values and assumptions used were as follows:


	Nine Months Ended
	September 30, 2026		September 30, 2025
Weighted average grant date fair value	$	75.50			$	64.42
Assumptions:
Expected volatility	49	%		35	%
Dividend yield	—	%		—	%
Risk-free interest rate	4.33	%		4.00	%
Expected life	4.4 years		4.4 years

Expected volatility is based on the historical volatility of our common stock over a period equal to the expected term of the options; the expected life represents the weighted average period of time that options granted are expected to be outstanding given consideration to vesting schedules and our historical experience of past vesting and termination patterns. The risk-free rate is based on the U.S. government zero-coupon bonds yield curve in effect at time of the grant for periods corresponding with the expected life of the option.

Restricted Share Units (\"RSU\") and Performance Share Units (\"PSU\")

The following table summarizes RSU and PSU activity for the nine months ended September 30, 2026:


	PSU Outstanding Number of Shares	PSU Weighted Average Grant Date Fair Value		RSU Outstanding Number of Shares	RSU Weighted Average Grant Date Fair Value
Outstanding at December 31, 2025	16,474		$	185.18		1,476,169	$	162.53
Awarded*	98,400		$	162.85		652,246	$	166.05
Shares vested	—		$	—		(602,157)	$	133.96
Cash settled	—		$	—		(18,470)	$	127.17

Forfeited	—		$	—		(92,795)	$	181.60
Outstanding at September 30, 2026	114,874		$	166.05		1,414,993	$	175.53

*We issue PSUs for which the number of shares awarded are based on pre-established targets. For PSUs awarded, the number of units reflects the estimated number of shares to be issued based on performance as of the current reporting period. Awarded units are presented net of performance adjustments.

The fair value of RSUs vested during the nine months ended September 30, 2026 totaled $80.7 million (September 30, 2025: $9.1 million). The fair value of RSUs granted during the nine months ended September 30, 2026 totaled $108.3 million (September 30, 2025: $151.9 million).

The fair value of PSUs vested during the nine months ended September 30, 2026 were $nil (September 30, 2025: $1.9 million). The PSUs vest based on service and specified performance targets over the periods of 2024 - 2026, 2025 - 2027 and 2026 - 2028. If the Company achieves the specified performance targets during those periods, up to an additional 91,434 PSUs may also be awarded and issued.

Share-based compensation expense

Share-based compensation expense (inclusive of employer related taxes) for the three and nine months ended September 30, 2026 and September 30, 2025 has been allocated as follows:


	Three Months Ended		Nine Months Ended
	September 30, 2026	September 30, 2025		September 30, 2026	September 30, 2025
	(in thousands)
Direct costs	$	8,231		$	21,479		$	38,949	$	36,150
Selling, general and administrative	9,775		24,712			25,475	37,768
Total	$	18,006		$	46,191		$	64,424	$	73,918

14. Share capital

During the three months ended September 30, 2026, 2,359,703 shares were redeemed by the Company under the share buyback program for a total consideration of $400.0 million. On September 30, 2026, the Company had remaining authorization to repurchase up to $350.0 million of ordinary shares under the share repurchase program.

Share redemption activity for the nine months ended September 30, 2026 is set out below:


	Total number of shares purchased	Average price paid per share	Total number of shares purchased as part of publicly announced program	Approximate dollar value of shares that may yet be purchased under the program (in millions)
September 9/9/2026 - 9/29/2026	2,359,703		$169.51	2,359,703	$350.0



	2,359,703		$169.51	2,359,703

On October 20, 2026, the Board of Directors of the Company (\"Board\") approved an increase in the share buyback authorization, bringing the total amount available for repurchases under the program up to $750.0 million. As of October 27, 2026, the Company has remaining authorization to repurchase up to $750.0 million of ordinary shares under the share repurchase program.

During the year ended December 31, 2025, 4,504,330 ordinary shares were redeemed by the Company under this repurchase program for a total consideration of $750.0 million.

Share redemption activity for the year ended December 31, 2025 is set out below:


	Total number of shares purchased	Average price paid per share	Total number of shares purchased as part of publicly announced program	Approximate dollar value of shares that may yet be purchased under the program (in millions)
March 3/12/2025 - 3/19/2025	1,360,537		$183.75	1,360,537	$750.0
June 6/13/2025 - 6/23/2025	1,717,181		$145.59	1,717,181	$500.0
August 8/15/2025 - 8/20/2025	560,100		$178.20	560,100	$900.2
September 9/10/2025 - 9/19/2025	866,512		$173.33	866,512	$750.0
	4,504,330		$166.51	4,504,330

Under the repurchase program, a broker purchased or may purchase the Company's shares from time to time on the open market or in privately negotiated transactions in accordance with agreed terms and limitations. The program was and may be in the future designed to allow share repurchases during periods when the Company would ordinarily not be permitted to do so because it may be in possession of material non-public or price-sensitive information or due to applicable insider trading laws or self-imposed trading blackout periods. The Company's instructions to the broker in such cases were or may in the future be irrevocable and the trading decisions in respect of the repurchase program were made or will be made independently of and uninfluenced by the Company. The Company confirms that on entering the share repurchase plans it had no material non-public, price-sensitive or inside information regarding the Company or its securities. Furthermore, the Company will not enter into additional plans whilst in possession of such information. The timing and actual number of shares acquired by way of the redemption will be dependent on market conditions, legal and regulatory requirements and the other terms and limitations contained in the program. In addition, acquisitions under the program may be suspended or discontinued in certain circumstances in accordance with the agreed terms. Therefore, there can be no assurance as to the timing or number of shares that may be acquired under the program.

15. Business Segment and Geographical Information

The Company is a CRO providing outsourced services on a global basis to pharmaceutical, biotechnology, medical device and government and public health organizations. It specializes in the strategic development, management and analysis of programs that support all stages of the clinical development process, from compound selection to Phase I-IV clinical studies. We believe that we are one of a select group of CROs with the expertise and capability to conduct clinical trials in most major therapeutic areas on a global basis and have the operational flexibility to provide development services on a stand-alone basis or as part of an integrated \"full-service\" or a “blended-service” solution. The Company has expanded through organic growth, together with a number of strategic acquisitions to enhance its capabilities and expertise in certain areas of the clinical development process.

The Company operates as one reportable segment, which is the provision of outsourced development services on a global basis to the pharmaceutical, biotechnology and medical devices industries. During the nine months ended September 30, 2026, the Company determined that the Chief Operating Decision Maker (\"CODM\") was comprised of the Chief Executive Officer and the Chief Financial Officer. As the Company is managed on a consolidated basis, the CODM evaluates performance and allocates resources based on consolidated net income. The CODM uses consolidated net income, as reported on the Condensed Consolidated Statements of Operations, to evaluate income generated from segment assets and for decisions related to the deployment of operating and capital resources. The measure of segment assets is reported on the Condensed Consolidated Balance Sheets as total consolidated assets.

The accounting policies of the reportable segment are the same as those described in ICON’s Form 20-F for the year ended December 31, 2025 (see Note 2 Summary of significant accounting policies). In the context of considerations around significant segment expenses, as the expense information that is regularly provided to the CODM is aligned with the respective consolidated expenses for direct costs and selling, general, and administrative expenses, as presented on the Condensed Consolidated Statements of Operations, such expense disclosures are not replicated here. Furthermore, as the Company consists of a single reportable segment, other quantitative disclosures, as required by ASC 280 Segment Reporting, are as presented on the Condensed Consolidated Statements of Operations.

Revenues are allocated to individual entities based on where the work is performed in accordance with the Company's global transfer pricing model. Revenues and income from operations in Ireland are a function of the Company's global contracting model and the ICON Group’s transfer pricing model.

ICON Clinical Research Limited and Accellacare Limited (collectively “ICON Ireland”) acts as the Group entrepreneur under the Company’s global transfer pricing model given its role in the development and management of the Group, its ownership of key intellectual property and customer relationships, its key role in the mitigation of risks faced by the Group and its responsibility for maintaining the Company’s global network. ICON Ireland enters into the majority of the Company’s customer contracts.

ICON Ireland remunerates other operating entities in the ICON Group on the basis of an arm’s length return, in accordance with the 2022 OECD transfer pricing guidelines, for the services they perform in each of their local territories. The arm’s length return for each ICON entity is established to ensure that each of ICON Ireland and the ICON entities that are involved in the conduct of services for customers, earn an appropriate return having regard to their respective functions performed, assets owned, and risks assumed in these intercompany transactions. The arm’s length return is reviewed annually to ensure that it is market appropriate.

The geographic split of revenue disclosed for each region outside Ireland is the arm’s length revenue attributable to these entities. The residual revenues of the ICON Group, once each ICON entity has been paid its respective intercompany service fee, generally fall to be retained by ICON Ireland. As such, revenues and income from operations in Ireland are a function of this global transfer pricing model and comprise revenues of the ICON Group after deducting the arm’s length revenues attributable to the activities performed outside Ireland.

There have been no changes to the overall basis of segmentation or the measurement basis for the segment results since the prior year.

The geographical distribution of the Company’s segment measures for the three and nine months ended September 30, 2026 and September 30, 2025 and as at September 30, 2026 and December 31, 2025 is as follows:

a) The distribution of revenue by geographical area was as follows:


	Three Months Ended		Nine Months Ended
	September 30, 2026		September 30, 2025		September 30, 2026	September 30, 2025
	(in thousands)
Ireland	$	895,686			$	801,771		$	2,535,435	$	2,438,137
Rest of Europe	379,935			399,035			1,155,809	1,134,970
U.S.	497,421			649,040			1,686,696	1,894,859
Rest of World	251,715			234,569			744,302	670,857
Total	$	2,024,757			$	2,084,415		$	6,122,242	$	6,138,823

b) The distribution of income / (loss) from operations by geographical area was as follows:


	Three Months Ended		Nine Months Ended
	September 30, 2026	September 30, 2025		September 30, 2026	September 30, 2025
	(in thousands)
Ireland	$	137,431		$	164,983		$	386,311	$	527,967
Rest of Europe	29,156		51,040			95,855	95,861
U.S.	63,087		68,182			151,199	208,903
Rest of World	15,411		16,848			56,617	44,234
Sub-total	$	245,085		$	301,053		$	689,982	$	876,965
Amortization of intangible assets	(46,244)		(58,688)			(146,631)	(176,691)
Goodwill impairment	—		(364,248)			—	(364,248)
Impairment of non-financial assets	—		(101,027)			—	(101,027)
Loss on disposal of subsidiary undertaking	—		—			(32,947)	—
Total	$	198,841		$	(222,910)		$	510,404	$	234,999

c) The distribution of long-lived assets (property, plant and equipment and operating right-of-use assets), net, by geographical area was as follows:



	September 30, 2026		December 31, 2025
	(in thousands)
Ireland	$	248,263			$	250,566
Rest of Europe	78,880			94,920
U.S.	96,925			122,896
Rest of World	54,261			56,290
Total	$	478,329			$	524,672

16. Commitments and contingencies

Other than as described below, we do not expect any current litigation to have a materially adverse effect on our financial condition or results of operations. However, from time to time, we may become involved in various lawsuits and legal proceedings which arise in the ordinary course of business. Litigation is subject to inherent uncertainties, and an adverse result in these or other matters may arise from time to time that may harm our business, and one or more unfavorable outcomes could adversely affect us for the period in which they are resolved. In addition, regardless of their merits or their ultimate outcomes, lawsuits and legal proceedings are costly, divert management attention, and may adversely affect our reputation, even if they are resolved in our favor.

The Company, its former Chief Executive Officer, and its former Chief Financial Officer were named as defendants in two class action lawsuits involving similar claims, filed in the United States District Court for the Eastern District of New York on February 10, 2025 (Shing v. ICON plc, et al.) and April 2, 2025 (Police and Fire Retirement System of the City of Detroit v. ICON plc, et al.), respectively, alleging that defendants made misleading statements regarding the Company’s financial performance and future business prospects in violation of Sections 10(b) and 20(a) of the Securities Exchange Act of 1934. The two cases have been consolidated and are proceeding under the caption In re ICON plc Securities Litigation, No. 2:25-cv-00763 (the \"Putative Class Action\"). Lead plaintiffs and lead counsel for the putative class were appointed on June 10, 2025. On September 12, 2025, the lead plaintiffs filed an amended complaint that names the Company’s current Chief Executive Officer in addition to the original defendants.

The lead plaintiffs filed a further amended complaint on June 26, 2026 (the “Second Amended Complaint”). The Second Amended Complaint adds two new named plaintiffs (Macomb County Retiree Health Care Fund and The Trustees of the Plumbers Local Union No. 690 Pension Fund), as well as the Company's current Chief Financial Officer and a former employee as additional defendants. The Second Amended Complaint asserts additional alleged misstatements regarding the company’s financial performance, as well as a “scheme liability” claim under Section 10(b). On September 1, 2026, ICON and certain named defendants filed a motion to dismiss the Second Amended Complaint. The motion is scheduled to be fully briefed by November 24, 2026.

Given the preliminary stage of the litigation, we are unable at this time to form a view as to whether an adverse outcome is either probable or remote or to estimate the amount or range of potential loss in the event of an adverse outcome.

17. Disposal of subsidiary undertaking

Disposal of Symphony Health Solutions Corporation

On May 8, 2026, ICON completed the disposal of Symphony Health Solutions Corporation (\"Symphony\") pursuant to a merger agreement, by and among HealthVerity, Inc. (\"HealthVerity\"), Symphony, Pharmaceutical Research Associates, Inc. and HealthVerity Merger Sub, Inc. (\"HV Merger Sub\"), a wholly owned subsidiary of HealthVerity. Pursuant to the merger agreement, HV Merger Sub merged with and into Symphony, with Symphony surviving the merger as a wholly owned subsidiary of HealthVerity.

The consideration payable by HealthVerity in connection with the merger consisted of shares of stock in HealthVerity, subject to customary adjustments as set forth in the merger agreement. In connection with the merger, ICON also purchased additional shares of stock in HealthVerity for an aggregate purchase price of $37.5 million. As a result, ICON holds a minority equity interest in HealthVerity.

The Company's purchase of additional HealthVerity shares occurred in conjunction with the overall disposal transaction. The Company therefore concluded that the disposal of Symphony and the subscription for additional HealthVerity shares were economically linked. Accordingly, the Company accounted for the arrangements together in determining the gain or loss on disposal.

In determining the fair value of the consideration received, the Company considered, among other factors, the rights associated with the shares, HealthVerity's capital structure and other relevant valuation metrics. Based on the specific facts and circumstances of the transaction and the characteristics of the HealthVerity shares received, the Company determined that the fair value of the consideration received was nominal.

The Company recognized a pre-tax loss on disposal, including transaction costs, of $32.9 million in the Condensed Consolidated Statements of Operations for the nine months ended September 30, 2026 related to this disposal. The pre-tax loss on disposal was determined with reference to (i) the fair value of consideration received, (ii) the net carrying amount of Symphony immediately prior to disposal, (iii) the Company's $37.5 million payment made as part of the overall transaction, and (iv) the fair value of certain tax indemnifications. A capital tax loss was generated on disposal of this investment, and no net tax benefit was recorded as a result in the period. As at September 30, 2026 the carrying value of the Company's investment in HealthVerity was $nil.

18. Subsequent events

The Company has evaluated subsequent events from the Balance Sheet date through to the date at which the financial statements were available to be issued.

Share repurchase program

All ordinary shares redeemed under the repurchase program are canceled in accordance with the constitutional documents of the Company and the nominal value of these shares transferred to an undenominated capital fund as required under Irish Company law. Repurchases under the repurchase program may be effected from time to time in open market or privately negotiated transactions in accordance with agreed terms and limitations. The timing and amount of the repurchase transactions under this program will depend on a variety of factors, including market conditions and corporate and regulatory considerations. Depending upon results of operations, market conditions and the development of the economy, as well as other factors, generally we will consider share repurchases on an opportunistic basis from time to time.

Extension of Option Plans

On October 20, 2026, the Board approved amendments to the ICON Employee Share Option Plan 2008 and the ICON Consultants Share Option Plan 2008 (together, the \"2008 Option Plans\"). The amendments extend the period during which awards may be granted under the 2008 Option Plans for an additional ten years. As a result of the amendments, no options may be granted under the 2008 Option Plans after 14 February 2037, rather than 14 February 2027. The amendments do not increase the number of ordinary shares reserved for issuance under the 2008 Option Plans and do not affect the terms of any outstanding awards.

The Company has determined that there are no further items to disclose.

ICON plc

Management’s discussion and analysis of financial condition and results of operations

The following discussion and analysis should be read in conjunction with the unaudited condensed consolidated financial statements and accompanying notes included elsewhere herein and the consolidated financial statements and related notes thereto included in our Annual Report on Form 20-F for the year ended December 31, 2025. The condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States.

Overview

We are a CRO providing outsourced services on a global basis to pharmaceutical, biotechnology, medical device and government and public health organizations. We specialize in the strategic development, management and analysis of programs that support all stages of the clinical development process, from compound selection to Phase I-IV clinical studies. Our vision is to be the healthcare intelligence partner of choice by delivering industry leading solutions and best in class performance in clinical development.

We believe that we are one of a select group of CROs with the expertise and capability to conduct clinical trials in most major therapeutic areas on a global basis and have the operational flexibility to provide development services on a stand-alone basis or as part of an integrated \"full-service\" or a “blended-service” solution. At September 30, 2026 we had approximately 40,250 employees in 98 locations in 55 countries. During the three months ended September 30, 2026 we derived 24.6%, 63.0% and 12.4% of our revenue in the United States, Europe and Rest of World respectively (during the three months ended September 30, 2025: 31.1%, 57.6% and 11.3% respectively).

Revenue consists of fees earned under contracts with third-party clients. In most cases, a portion of the contract fee is paid at the time the study or trial is started, with the balance of the contract fee generally payable in installments over the study or trial duration, based on the delivery of certain performance targets or milestones. Revenue from long term contracts is recognized on a proportional performance method based on the relationship between cost incurred and the total estimated costs of the trial or on a fee-for-service basis according to the particular circumstances of the contract. As is customary in the CRO industry, we contract with third party investigators in connection with clinical trials. Investigator costs and certain other third party costs are included in our assessment of progress towards completion and costs incurred in measuring revenue. Where these costs are reimbursed by clients, they are included in the total contract value recognized over time, based on our assessment of progress towards completion.

As the nature of our business involves the management of projects, the majority of which have a duration of one to four years, the commencement or completion of projects in a fiscal year can have a material impact on revenues earned with the relevant clients in such years. In addition, as we typically work with some, but not all divisions of a client, fluctuations in the number and status of available projects within such divisions can also have a material impact on revenues earned from such clients from year to year.

Termination or delay in the performance of an individual contract may occur for various reasons, including, but not limited to, unexpected or undesired results, production problems resulting in shortages of the drug being studied, adverse patient reactions to the drug, the client’s decision to de-emphasize a particular trial or inadequate patient enrollment or investigator recruitment. In the event of termination, the Company is usually entitled to all sums owed for work performed through the notice of termination and certain costs associated with the termination of the study. In addition, contracts generally contain provisions for renegotiation in the event of changes in the scope, nature, duration, or volume of services of the contract.

Our unsatisfied performance obligation comprises our assessment of contracted revenue yet to be earned from projects awarded by clients. At September 30, 2026 we had unsatisfied performance obligations of approximately $16.4 billion (see Note 4 Accounts receivable, unbilled revenue (contract assets) and unearned revenue or payments on account (contract liabilities) for further details). We believe that our unsatisfied performance obligation as of any date is not necessarily a meaningful predictor of future results, due to the potential for cancellation or delay of the projects included in the unsatisfied performance obligation, and no assurances can be given on the extent to which we will be able to realize the unsatisfied performance obligation.

Although we are domiciled in Ireland, we report our results in U.S. dollars. As a consequence, the results of our non-U.S. based operations, when translated into U.S. dollars, could be materially affected by fluctuations in exchange rates between the U.S. dollar and the currencies of those operations.

In addition to translation exposures, we are also subject to transaction exposures where the currency in which contracts are priced can be different from the currencies in which costs relating to those contracts are incurred. Our operations in the United States are not materially exposed to such currency differences as the majority of our revenues and costs are in U.S. dollars. However, outside of the United States the multinational nature of our activities means that contracts are usually priced in a single currency, most often U.S. dollars or euro, while costs arise in a number of currencies, depending, among other things, on which of our offices provide staff for the contract and the location of investigator sites. Although many such contracts benefit from some degree of natural hedging, due to the matching of contract revenues and costs in the same currency, where costs are incurred in currencies other than those in which contracts are priced, fluctuations in the relative value of those currencies could have a material effect on our results of operations. We regularly review our currency exposures.

As we conduct operations on a global basis, our effective tax rate has depended, and will depend, on the geographic distribution of our revenue and earnings among locations with varying tax rates. Our results therefore may be affected by changes in the tax rates of the various jurisdictions. In particular, as the geographic mix of our results of operations among various tax jurisdictions changes, our effective tax rate may vary significantly from period to period.

Operating Results

The following tables set forth for the periods indicated certain financial data as a percentage of revenue and the percentage change in these items compared to the prior comparable period. The trends illustrated in the following table may not be indicative of future results.

Three Months Ended September 30, 2026


	Three Months Ended September 30,
	2026	2025	2025 to 2026

	Percentage of Revenue	Percentage Increase/(Decrease)
Revenue	100.0	%	100.0	%	(2.9)	%
Costs and expenses:
Direct costs	75.7	%	73.8	%	(0.4)	%
Selling, general and administrative	9.7	%	9.5	%	(0.1)	%
Depreciation	2.4	%	2.0	%	19.4	%
Amortization of intangible assets	2.3	%	2.8	%	(21.2)	%
Transaction and integration related	—	%	0.3	%	(96.7)	%
Restructuring	0.1	%	—		NM
Goodwill impairment	—		17.5	%	NM
Impairment of non-financial assets	—		4.8	%	NM
Income from operations	9.8	%	(10.7)	%	NM

*NM – Not Meaningful

Nine Months Ended September 30, 2026


	Nine Months Ended September 30,
	2026	2025	2025 to 2026

	Percentage of Revenue	Percentage Increase/(Decrease)
Revenue	100.0	%	100.0	%	(0.3)	%
Costs and expenses:
Direct costs	76.4	%	72.5	%	5.2	%
Selling, general and administrative	9.7	%	9.8	%	(1.4)	%
Depreciation	2.1	%	1.9	%	11.1	%
Amortization of intangible assets	2.4	%	2.9	%	(17.0)	%
Transaction and integration related	0.1	%	0.3	%	(68.9)	%
Restructuring	0.5	%	1.3	%	(60.5)	%
Loss on disposal of subsidiary undertaking	0.5	%	—		NM
Goodwill impairment	—		5.9	%	NM
Impairment of non-financial assets	—		1.6	%	NM
Income from operations	8.3	%	3.8	%	117.2	%

*NM – Not Meaningful

Revenue


	Three Months Ended September 30,	Change
(in thousands)	2026	2025	$	%
Revenue	$	2,024,757		$	2,084,415	$	(59,658)	(2.9)	%

Revenue for the three months ended September 30, 2026 decreased by $59.7 million, or 2.9%, to $2,024.8 million, compared to $2,084.4 million for the three months ended September 30, 2025. Revenue decreased by 2.5% in constant currency terms. The decrease in revenue for the three months ended September 30, 2026 was partially a result of the disposal of Symphony and changes in business mix.

During the three months ended September 30, 2026, we derived 24.6%, 63.0% and 12.4% of our revenue in the United States, Europe and Rest of World respectively. Revenues from our top five customers amounted to $480.2 million in the three months ended September 30, 2026, compared to $501.3 million for the three months ended September 30, 2025 or 23.7% and 24.1% of total revenue respectively. New customer accounts are continually added across the full portfolio of large pharma customers, mid-tier pharma customers and biotech customers.

Revenue in Ireland increased by $93.9 million for the three months ended September 30, 2026, to $895.7 million, compared to $801.8 million for the three months ended September 30, 2025. Revenue in Ireland during the three months ended September 30, 2026 increased by 11.7% compared to an overall decrease in ICON Group revenue of 2.9%. Revenue in Ireland is principally a function of our global contracting model (see Note 15 Business Segment and Geographical Information for further details).

Revenue in our Rest of Europe region for the three months ended September 30, 2026 decreased by $19.1 million or 4.8%, to $379.9 million, compared to $399.0 million for the three months ended September 30, 2025. Revenue in the U.S. region decreased by $151.6 million or 23.4%, to $497.4 million, compared to $649.0 million for the three months ended September 30, 2025. Revenue in the Rest of World ('Other') region increased by $17.1 million or 7.3%, to $251.7 million, compared to $234.6 million for the three months ended September 30, 2025.


	Nine months ended September 30,	Change
(in thousands)	2026	2025	$	%
Revenue	$	6,122,242		$	6,138,823	$	(16,581)	(0.3)	%

Revenue for the nine months ended September 30, 2026 decreased by $16.6 million, or 0.3%, to $6,122.2 million, compared to $6,138.8 million for the nine months ended September 30, 2025. Revenue decreased by 1.4% in constant currency terms. The decrease in revenue for the nine months ended September 30, 2026 was partially a result of the disposal of Symphony and changes in business mix.

During the nine months ended September 30, 2026, we derived 27.6%, 60.3% and 12.1% of our revenue in the United States, Europe and Rest of World respectively. Revenues from our top five customers amounted to $1,483.1 million in the nine months ended September 30, 2026, compared to $1,499.8 million for the nine months ended September 30, 2025 or 24.2% and 24.4% of total revenue respectively. New customer accounts are continually added across the full portfolio of large pharma customers, mid-tier pharma customers and biotech customers.

Revenue in Ireland increased by $97.3 million for the nine months ended September 30, 2026, to $2,535.4 million, compared to $2,438.1 million for the nine months ended September 30, 2025. Revenue in Ireland during the nine months ended September 30, 2026 increased by 4.0% compared to an overall decrease in ICON Group revenue of 0.3%. Revenue in Ireland is principally a function of our global contracting model (see Note 15 Business Segment and Geographical Information for further details).

Revenue in our Rest of Europe region for the nine months ended September 30, 2026 increased by $20.8 million or 1.8%, to $1,155.8 million, compared to $1,135.0 million for the nine months ended September 30, 2025. Revenue in the U.S. region for the nine months ended September 30, 2026 decreased by $208.2 million or 11.0%, to $1,686.7 million, compared to $1,894.9 million for the nine months ended September 30, 2025. Revenue in the Rest of World ('Other') region for the nine months ended September 30, 2026 increased by $73.4 million or 10.9%, to $744.3 million, compared to $670.9 million for the nine months ended September 30, 2025.

Direct costs


	Three Months Ended September 30,		Nine Months Ended September 30,
(in thousands)	2026	2025	Change	2026	2025	Change
Direct costs	$	1,532,925		$	1,538,951		$	(6,026)		$	4,673,190		$	4,443,967	$	229,223
% of revenue	75.7	%	73.8	%	(0.4)	%	76.4	%	72.5	%	5.2	%

Direct costs for the three months ended September 30, 2026 decreased by $6.0 million, or 0.4%, to $1,532.9 million compared to $1,539.0 million for the three months ended September 30, 2025. Direct costs consist primarily of investigator and other reimbursable costs, compensation, associated fringe benefits and share-based compensation expense for project-related employees and other direct project driven costs. The decrease in costs for the three months ended September 30, 2026 is primarily due to decreases in data costs driven by the disposal of the Symphony business and decreases in personnel costs exceeding increases in reimbursable expenses. As a percentage of revenue, direct costs have increased to 75.7% of revenue during the three months ended September 30, 2026 compared to 73.8% for the three months ended September 30, 2025.

Direct costs for the nine months ended September 30, 2026 increased by $229.2 million, or 5.2%, to $4,673.2 million compared to $4,444.0 million for the nine months ended September 30, 2025. The increase in costs for the nine months ended September 30, 2026 is primarily due to increases in reimbursable expenses and personnel expenses for the period exceeding the reductions in data costs driven by the disposal of the Symphony business. As a percentage of revenue, direct costs have increased to 76.4% of revenue during the nine months ended September 30, 2026 compared to 72.5% for the nine months ended September 30, 2025.

Selling, general and administrative


	Three Months Ended September 30,		Nine Months Ended September 30,
(in thousands)	2026	2025	Change	2026	2025	Change
Selling, general and administrative	$	196,850		$	197,049		$	(199)		$	591,766		$	600,439	$	(8,673)
% of revenue	9.7	%	9.5	%	(0.1)	%	9.7	%	9.8	%	(1.4)	%

Selling, general and administrative expenses for the three months ended September 30, 2026 were relatively consistent with selling, general and administrative expenses for the three months ended September 30, 2025, with a modest decrease of $0.2 million, or 0.1%. Selling, general and administrative expenses comprise primarily of compensation, related fringe benefits and share-based compensation expense for non-project-related employees, recruitment expenditure, professional service costs, advertising costs and costs related to facilities and information systems. Further, costs incurred relating to the investigation initiated by the Audit Committee in October 2025 and concluded in April 2026 (the \"Investigation\"), including out of scope audit fees resulting from the impact of the Investigation, and legal fees in defense of the putative class action (as referred to in Note 16 Commitments and Contingencies) are classified within this category.

The decrease of $0.2 million for the three months ended September 30, 2026 primarily results from an increase of $8.2 million due to a restructuring related accelerated amortization charge on right-of-use assets, $9.6 million due to professional fees, and foreign exchange movements offset by decreases in various other costs including general and personnel costs.

Selling, general and administrative expenses for the nine months ended September 30, 2026 decreased by $8.7 million, or 1.4%, to $591.8 million, compared to $600.4 million for the nine months ended September 30, 2025. The decrease for the nine months ended September 30, 2026 primarily relates to decreases in general costs of $32.4 million, positive foreign exchange movements of $36.4 million and personnel costs, partially offset by an increase in professional fees of $59.2 million (primarily related to increased costs resulting from the impact of the Investigation) and an increase of $8.2 million due to a restructuring related accelerated amortization charge on right-of-use assets.

Depreciation and amortization of intangible assets


	Three Months Ended September 30,		Nine Months Ended September 30,
(in thousands)	2026	2025	Change	2026	2025	Change
Depreciation	$	48,178		$	40,342		$	7,836		$	128,889		$	116,015	$	12,874
% of revenue	2.4	%	2.0	%	19.4	%	2.1	%	1.9	%	11.1	%
Amortization of intangible assets	$	46,244		$	58,688		$	(12,444)		$	146,631		$	176,691	$	(30,060)
% of revenue	2.3	%	2.8	%	(21.2)	%	2.4	%	2.9	%	(17.0)	%

The depreciation expense for the three months ended September 30, 2026 increased by $7.8 million, or 19.4%, to $48.2 million compared to $40.3 million for the three months ended September 30, 2025. The depreciation charge reflects investments in facilities, information systems and equipment. As a percentage of revenue, the depreciation expense increased to 2.4% of revenues, for the three months ended September 30, 2026 compared to 2.0% for the three months ended September 30, 2025. The depreciation expense for the nine months ended September 30, 2026 increased by $12.9 million, or 11.1%, to $128.9 million compared to $116.0 million for the nine months ended September 30, 2025. As a percentage of revenue, the depreciation expense increased to 2.1% of revenues, for the nine months ended September 30, 2026 compared to 1.9% for the nine months ended September 30, 2025. The depreciation charge has increased primarily due to accelerated charges of $7.4 million as part of the restructuring related office consolidation program.

The amortization of intangible asset expense for the three months ended September 30, 2026 decreased by $12.4 million, or 21.2%, to $46.2 million compared to $58.7 million for the three months ended September 30, 2025. The amortization expense represents the amortization of intangible assets acquired in business combinations. As a percentage of revenue, the amortization expense was 2.3% for the three months ended September 30, 2026, compared to 2.8% for the three months ended September 30, 2025. Amortization expense for the nine months ended September 30, 2026 decreased by $30.1 million, or 17.0%, to $146.6 million compared to $176.7 million for the nine months ended September 30, 2025. The decrease in amortization for the three and nine months ended September 30, 2026 primarily reflects the impact of the impairment of the intangible assets related to the former Data Solutions reporting unit which occurred in the three months ended September 30, 2025 resulting in reduced amortization in subsequent periods.

Restructuring, transaction and integration related expenses


	Three Months Ended September 30,		Nine Months Ended September 30,
(in thousands)	2026	2025	Change	2026	2025	Change
Transaction and integration related	$	233		$	7,020		$	(6,787)		$	5,949		$	19,141	$	(13,192)
% of revenue	—	%	0.3	%	(96.7)	%	0.1	%	0.3	%	(68.9)	%
Restructuring	$	1,486		$	—		$	1,486		$	32,466		$	82,296	$	(49,830)
% of revenue	0.1	%	—		NM	0.5	%	1.3	%	(60.5)	%

*NM – Not Meaningful

During the three and nine months ended September 30, 2026, the Company incurred $0.2 million and $5.9 million, respectively, for transaction and integration-related expenses. The charge includes costs associated with ongoing integration activities related to our recent acquisitions. Such costs include professional fees, legal costs and related integration costs.

During the nine months ended September 30, 2026 the Company has undertaken a restructuring program aimed at realigning its workforce reflecting a charge of $32.5 million (nine months ended September 30, 2025: $75.6 million). During the nine months ended September 30, 2025 an impairment charge of $6.7 million was also included related to an office consolidation program to optimize the Company's office footprint. Included within selling, general and administrative expenses as noted previously, is $8.2 million due to a restructuring related accelerated amortization charge on right-of-use assets; in addition, as included within depreciation and amortization of intangible assets, an accelerated depreciation charge of $7.4 million as part of the restructuring related office consolidation program.

Goodwill impairment and impairment of non-financial assets


	Three Months Ended September 30,		Nine Months Ended September 30,
(in thousands)	2026	2025	Change	2026	2025	Change
Goodwill impairment	—		$	364,248		$	(364,248)		—		$	364,248	$	(364,248)
% of revenue	—		17.5	%	NM	—		5.9	%	NM
Impairment of non-financial assets	—		$	101,027		$	(101,027)		—		$	101,027	$	(101,027)
% of revenue	—		4.8	%	NM	—		1.6	%	NM

*NM – Not Meaningful

No goodwill impairment or impairment of non-financial assets was recorded for the three or nine months ended September 30, 2026. For the three months ended September 30, 2025 the Company recorded a goodwill impairment charge of $364.2 million in the Condensed Consolidated Statements of Operations related to the former Data Solutions reporting unit. This represented the entire balance of goodwill attributed to the Data Solutions reporting unit. This charge represents 17.5% of revenue for the three months ended September 30, 2025 (5.9% for the nine months ended September 30, 2025). Impairment of non-financial assets of $101.0 million was recorded related to property, plant and equipment and intangible assets in the Data Solutions reporting unit. This charge represented 4.8% of revenue for the three months ended September 30, 2025. (1.6% for the nine months ended September 30, 2025). The Data Solutions reporting unit was comprised of Symphony Health Solutions Corporation (\"Symphony\"), which was disposed of on May 8, 2026.

Loss on disposal of subsidiary undertaking


	Three Months Ended September 30,	Nine Months Ended September 30,
(in thousands)	2026	2025	Change	2026	2025	Change
Loss on disposal of subsidiary undertaking	—		—		—		$	32,947		—		$	32,947
% of revenue	—		—		—		0.5	%	—		NM

*NM – Not Meaningful

On May 8, 2026, ICON completed the disposal of Symphony and recognized a pre-tax loss on disposal, including transaction costs, of $32.9 million in the Condensed Consolidated Statements of Operations for the nine months ended September 30, 2026 related to this disposal.

Income / (loss) from operations


	Three Months Ended September 30,
(in thousands)	2026	2025	Change
Income / (loss) from operations	$	198,841		$	(222,910)	$	421,751
% of revenue	9.8	%	(10.7)	%	NM

*NM – Not Meaningful

Income from operations for the three months ended September 30, 2026 moved by $421.8 million to $198.8 million compared to a loss from operations of $222.9 million for the three months ended September 30, 2025. As a percentage of revenue, income / loss from operations increased to 9.8% compared to (10.7)% of revenue for the three months ended September 30, 2025.

Excluding amortization of intangible assets, income from operations in Ireland for the three months ended September 30, 2026 decreased to $137.4 million compared to $165.0 million (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for three months ended September 30, 2025.

In the Rest of Europe region, excluding amortization of intangible assets, income from operations for the three months ended September 30, 2026 decreased to $29.2 million compared to $51.0 million (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the three months ended September 30, 2025. As a percentage of revenues, excluding amortization of intangible assets, income from operations in the Rest of Europe region decreased to 7.7% for the three months ended September 30, 2026 compared to 12.8% (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the three months ended September 30, 2025.

In the U.S. region, income from operations, excluding amortization of intangible assets, decreased to $63.1 million compared to $68.2 million (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the three months ended September 30, 2025. As a percentage of revenues, excluding amortization of intangible assets, income from operations in the U.S. region increased to 12.7% for the three months ended September 30, 2026 compared to 10.5% (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the three months ended September 30, 2025.

In Rest of World, income from operations, excluding amortization of intangible assets for the three months ended September 30, 2026, decreased to $15.4 million compared to $16.8 million (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the three months ended September 30, 2025. As percentage of revenue, excluding amortization of intangible assets, income from operations in the Rest of World decreased to 6.1% compared to 7.2% (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the three months ended September 30, 2025.


	Nine Months Ended September 30,
(in thousands)	2026	2025	Change
Income from operations	$	510,404		$	234,999		$	275,405
% of revenue	8.3	%	3.8	%	117.2	%

Income from operations for the nine months ended September 30, 2026 increased by $275.4 million or 117.2% to $510.4 million compared to $235.0 million for the nine months ended September 30, 2025. As a percentage of revenue, income from operations increased to 8.3% compared to 3.8% of revenue for the nine months ended September 30, 2025.

Excluding amortization of intangible assets and loss on disposal of subsidiary undertaking, income from operations for the nine months ended September 30, 2026 in Ireland decreased to $386.3 million compared to $528.0 million (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the nine months ended September 30, 2025.

In the Rest of Europe region, excluding amortization of intangible assets and loss on disposal of subsidiary undertaking, income from operations for the nine months ended September 30, 2026 remained consistent at $95.9 million for both nine month periods. The nine months ended September 30, 2025 excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets. As a percentage of revenues, excluding amortization of intangible assets and loss on disposal of subsidiary undertaking, income from operations in the Rest of Europe region for the nine months ended September 30, 2026 decreased to 8.3% compared to 8.4% (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the nine months ended September 30, 2025.

In the U.S. region, excluding amortization of intangible assets and loss on disposal of subsidiary undertaking, income from operations for the nine months ended September 30, 2026 decreased to $151.2 million compared to $208.9 million (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the nine months ended September 30, 2025. As a percentage of revenues, excluding amortization of intangible assets and loss on disposal of subsidiary undertaking, income from operations in the U.S. region decreased to 9.0% compared to 11.0% (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the nine months ended September 30, 2025.

In Rest of World, income from operations, excluding amortization of intangible assets and loss on disposal of subsidiary undertaking, for the nine months ended September 30, 2026 increased to $56.6 million compared to $44.2 million (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the nine months ended September 30, 2025. As a percentage of revenue, excluding amortization of intangible assets and loss on disposal of subsidiary undertaking, income from operations in Rest of World increased to 7.6% compared to 6.6% (which excluded amortization of intangible assets, the non-cash goodwill impairment charge and impairment of non financial assets) for the nine months ended September 30, 2025.

Interest income and expense


	Three Months Ended September 30,	Change	Nine Months Ended September 30,	Change
(in thousands)	2026	2025	$	%	2026	2025	$	%
Interest income	$	5,612		$	1,761		$	3,851	218.7	%	$	10,588	$	5,617	$	4,971	88.5	%
Interest expense	$	(66,175)		$	(50,243)		$	(15,932)	31.7	%	$	(162,959)	$	(148,003)	$	(14,956)	10.1	%

Interest expense for the three months ended September 30, 2026 increased to $66.2 million, compared to $50.2 million for the three months ended September 30, 2025. The increase in the period primarily reflects a loss on extinguishment of $12.2 million incurred related to the repayment of debt facilities following the August 2026 debt issuance in addition to fees associated with the drawdown of the Bridge Secured Credit Facility.

Interest income for the three months ended September 30, 2026 increased to $5.6 million compared to $1.8 million for the three months ended September 30, 2025 reflecting increased cash balances on deposit during the period and increases in interest rates in the United States.

Interest expense for the nine months ended September 30, 2026 increased to $163.0 million, compared to $148.0 million for the nine months ended September 30, 2025. The increase in the period primarily reflects a loss on extinguishment of $12.2 million incurred related to the repayment of debt facilities following the August 2026 debt issuance in addition to fees associated with the drawdown of the Bridge Secured Credit Facility.

Interest income for the nine months ended September 30, 2026 was $10.6 million compared to $5.6 million for the nine months ended September 30, 2025 reflecting increased cash balances on deposit during the period and increases in interest rates in the United States.

Share of net gains from equity method investments


	Three Months Ended September 30,	Change	Nine Months Ended September 30,	Change
(in thousands)	2026	2025		2026	2025
Share of net gains from equity method investments	$	16,298		—		$	16,298	$	16,298	—	$	16,298

Share of net gains from equity method investments for the three and nine months ended September 30, 2026 were $16.3 million, reflecting the Company's pro rata share of net gains in certain investments in equities accounted for under the equity method.

Income tax expense


	Three Months Ended September 30,	Change	Nine Months Ended September 30,	Change
(in thousands)	2026	2025		2026	2025
Income tax expense	$	32,446		$	12,791		$	19,655		$	74,868	$	12,468	$	62,400
Effective income tax rate	23.5	%	(4.7)	%		20.9	%	13.5	%

Income tax expense increased to $32.4 million for the three months ended September 30, 2026 compared to $12.8 million for the three months ended September 30, 2025. The Company’s effective tax rate for the three months ended September 30, 2026 was 23.5% compared with (4.7)% for the three months ended September 30, 2025. This is primarily due to the $25.6 million net decrease in tax benefit associated with the impact of the release of deferred tax on intangible assets in the three months ended September 30, 2026 compared with the three months ended September 30, 2025 and the effect of the impairment of goodwill and non-financial assets on the loss before income tax expense in the three months ended September 30, 2025.

The Income tax expense increased to $74.9 million for the nine months ended September 30, 2026 compared to a $12.5 million expense for the nine months ended September 30, 2025. The Company's effective tax rate for the nine months ended September 30, 2026 was 20.9% compared with 13.5% for the nine months ended September 30, 2025. This is primarily due to the net build of provisions for uncertain tax positions in the period of $6.4 million (nine months ended September 30, 2025: $23.4 million net release), no release of a deferred tax liability related to investments in foreign subsidiaries associated with unremitted earnings (nine months ended September 30, 2025: $29.8 million release), and the effect of the impairment of goodwill and non-financial assets on the income before income tax expense in the nine months ended September 30, 2025.

With the exception of the foregoing, the Company’s effective tax rate remains principally a function of the distribution of pre-tax profits amongst the territories in which it operates.

Liquidity and capital resources

The CRO industry is generally not capital intensive. The Company’s principal operating cash needs are payment of salaries, office rents, travel expenditures and payments to investigators. Investing activities primarily reflect capital expenditures for facilities and information systems enhancements, the purchase and sale of short term investments, disposals and acquisitions. Financing activities primarily reflect the servicing of the Company's external debt and transactions pertaining to its ordinary shares.

The Company’s principal sources of cash are its existing cash and cash equivalents as well as cash generated from operations. In addition, the Company may from time to time supplement its liquidity through additional issuances of debt, the refinancing of existing indebtedness, borrowings under its revolving credit facility, or proceeds from the sale of assets or short-term investments, subject to prevailing market conditions.

Bridge Secured Credit Facility

On July 15, 2026, the Company drew down on its Bridge Secured Credit Facility in full and used the proceeds of $500.0 million to repay in full the $500.0 million aggregate principal amount of the 2.875% Senior Secured Notes (the “2026 Notes”) issued by a subsidiary of the Company in July 2021 that matured on July 15, 2026. The Bridge Secured Credit Facility was repaid in full on August 17, 2026.

August 2026 Issued Notes

On August 13, 2026, ICON Investments Six Designated Activity Company (the “Issuer”), a wholly-owned subsidiary of ICON plc, sold and issued $2.15 billion of senior unsecured notes (collectively, the “August 2026 Issued Notes”), consisting of $500.0 million aggregate principal amount of 5.064% Notes due 2029, $1.0 billion aggregate principal amount of 5.421% Notes due 2031 and $650.0 million aggregate principal amount of 5.995% Notes due 2036. Interest on the August 2026 Issued Notes is payable on February 13 and August 13 of each year, commencing on February 13, 2027. The August 2026 Issued Notes are guaranteed on a senior unsecured basis by ICON plc.

The Company applied the net proceeds from the issuance to, (i) on August 13, 2026, repay all the outstanding Senior Secured Term Loan of $900.0 million, (ii) on August 14, 2026, redeem, in full, the outstanding May 2027 Notes of $750.0 million, and (iii) on August 17, 2026, repay all outstanding borrowings under the Bridge Secured Credit Facility of $500.0 million.

Our clinical research and development contracts are generally fixed price with some variable components and range in duration from a few weeks to several years. Revenue from contracts is generally recognized as income on the basis of the relationship between costs incurred and the total estimated contract costs. The cash flow from contracts typically consists of a down payment at the time the contract is entered into, with the balance paid in installments over the contract duration, in some cases on the achievement of certain milestones. Therefore, cash receipts do not correspond to costs incurred and revenue recognized on contracts. In the Company's opinion, working capital, together with the Company's available financing arrangements, is sufficient to meet the Company's present requirements.

Cash and cash equivalents and net borrowings


	Balance December 31, 2025	Net (drawn down)/repaid	Net cash flow	Other non- cash adjustments	Effect of exchange rates	Balance September 30, 2026
	(in thousands)
Cash and cash equivalents	$	647,295		$	—		$	166,821		$	—	$	(5,132)	$	808,984

Bank credit lines loan facilities and notes, net	(3,402,378)		16,688		24,520		(17,937)		—		(3,379,107)
Net cash and cash equivalents and borrowings	$	(2,755,083)		$	16,688		$	191,341		$	(17,937)	$	(5,132)	$	(2,570,123)

Net cash and cash equivalents and borrowings is a useful measure that assists understanding of the Company’s liquidity and capital resources, which is relevant to the Company’s strategy. The Company’s cash and cash equivalents at September 30, 2026 amounted to $809.0 million compared with $647.3 million at December 31, 2025.

Refer to Note 10 Bank credit lines, loan facilities and notes for details on the Company's outstanding debt. Refer to Note 9 Operating Leases for further details on the Company's contractual liabilities for lease arrangements.

Cash flows

Net cash from operating activities

Net cash provided by operating activities decreased by $8.6 million to $793.4 million for the nine months ended September 30, 2026 as compared to net cash provided by operating activities of $802.0 million for the nine months ended September 30, 2025. The decrease in net cash provided by operating activities of $8.6 million is primarily due to a change of mix in revenue, pricing pressures and underlying cost increases.

The change in working capital is primarily attributable to an increase in unbilled revenue related cash inflows of $221.6 million (as unbilled revenue balances decreased during the nine months ended September 30, 2026 compared to an increase during the nine months ended September 30, 2025), an increase in unearned revenue related cash inflows of $171.1 million (as unearned revenue balances increased to a greater extent during the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025) offset by a decrease in accounts receivable related cash flows of $91.5 million (as accounts receivable balances (excluding the impact of the disposal of Symphony) increased to a greater extent during the nine months ended September 30, 2026 compared to the nine months ended September 30, 2025), and a decrease in other net assets related cash flows of $84.8 million.

Cash generated from working capital may be positively or negatively impacted by, amongst others, the scheduling of contractual milestones over a study or trial duration, the achievement of a particular milestone during the period, the timing of receipt of invoices from third parties for reimbursable costs and the timing of cash receipts from customers. Contract fees are generally payable in installments based on the achievement of certain performance targets or “milestones” (e.g. target patient enrollment rates, clinical testing sites initiated or case report forms completed), such milestones being specific to the terms of each individual contract, while revenues on contracts are recognized as contractual obligations are performed. Further, credit terms negotiated between the Company and its customers, and movement in exchange rates also impact cash inflows.

Net cash used in investing activities

Net cash used in investing activities was $198.4 million for the nine months ended September 30, 2026 compared to net cash used in investing activities of $131.6 million for the nine months ended September 30, 2025. Net cash used in investing activities during the nine months ended September 30, 2026 was primarily related to cash outflows of $111.2 million for capital expenditures made mainly relating to investment in facilities and IT infrastructure and $30.0 million of net cash outflows in relation to investments in equity and a cash outflow of $57.1 million related to the disposal of Symphony Health Solutions Corporation. Net cash used in investing activities during the nine months ended September 30, 2025 was primarily related to cash outflows of $114.9 million for capital expenditures made mainly relating to investment in facilities and IT infrastructure and $14.2 million in relation to investments in equity.

Net cash used in financing activities

Net cash used in financing activities during the nine months ended September 30, 2026 amounted to $428.2 million compared to net cash used in financing activities of $765.5 million for the nine months ended September 30, 2025. During the nine months ended September 30, 2026, the Company refinanced a certain amount of its existing debt facilities (See the Condensed Consolidated Statements of Cash Flows and Note 10 Bank credit lines, loan facilities and notes for further details).

Further, the Company repurchased 2,359,703 ordinary shares for a total consideration of $400.0 million. These outflows were offset by $13.1 million received by the Company from the exercise of equity compensation.

During the nine months ended September 30, 2025, the Company made a net repayment of $22.3 million on external financing (See the Condensed Consolidated Statements of Cash Flows for further details). Further, the Company repurchased 4,504,330 ordinary shares for a total consideration of $750.0 million. These outflows were offset by $7.3 million received by the Company from the exercise of equity compensation.

Net cash inflow

As a result of these cash flows, cash and cash equivalents increased by $161.7 million for the nine months ended September 30, 2026 compared to a decrease of $69.9 million for the nine months ended September 30, 2025.

Legal proceedings

Forward-Looking Statements

Statements included herein which are not historical facts are forward-looking statements. Such forward-looking statements are made pursuant to the safe harbor provisions of the U.S. Private Securities Litigation Reform Act of 1995. Examples of forward-looking statements include, but are not limited to, statements regarding the following: contracted revenue; the repayment of indebtedness; share repurchases; ongoing litigation; the Company's expectations regarding business momentum, market opportunity, demand trends, growth, and commercial performance; and the Company's expectations with respect to its long-term value creation and competitive positioning. You can identify many forward-looking statements by words such as “aims,” “anticipates,” “believes,” “continues,” “could,” “estimates,” “expects,” “focused,” “guidance,” “intends,” “look,” “may,” “opportunities,” “plans,” “positions,” “potential,” “predicts,” “projects,” “seeks,” “should,” “will,” “would” and other similar expressions and the negatives of such expressions. However, not all forward-looking statements contain these words. These statements are based on management's current expectations and information currently available, including current economic and industry conditions. The forward looking statements involve a number of risks and uncertainties and are subject to change at any time. In the event such risks or uncertainties materialize, our results could be materially adversely affected. The risks and uncertainties include, but are not limited to, dependence on the pharmaceutical industry and certain clients, the need to regularly win projects and then to execute them efficiently and correctly, the challenges presented by rapid growth, competition and the continuing consolidation of the industry, the impact of market conditions on demand for the Company's services, risks related to the Company's ability to execute on its commercial strategy and maintain relationships with large pharmaceutical customers, and risks relating to the Company's strategic partnerships, the dependence on certain key executives, changes in the regulatory environment, exchange rate fluctuations, inflation and rising labor costs. Please also refer to the section entitled \"Risk Factors\" of our Annual Report on Form 20-F for the year ended December 31, 2025 filed on May 27, 2026 for a discussion of some of the principal risks that could adversely affect our business, operations and financial results. The Company’s forward-looking statements speak only as of the date of this report or as of the date they are made, and the Company undertakes no obligation to update its forward-looking statements.

Exhibits of ICON plc and subsidiaries


Exhibit Number		Title

99.1*		ICON plc Consultants Share Option Plan 2008 (as amended and restated effective as of 14 February 2017 and further updated 14 May 2026 and 20 October 2026).

99.2*		ICON plc Employee Share Option Plan 2008 As updated 16 December 2008 for Bonus Share Issue and further updated on 29 August 2012, 14 February 2017 and 20 October 2026.

101.1*		Interactive Data Files (Inline XBRL – Related Documents).

104		Cover Page Interactive Data File (embedded within the Inline XBRL document and included in Exhibit 101).
* Filed herewith

SIGNATURE

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized.

ICON plc

Date:

October 27, 2026

By:

/s/ Nigel Clerkin

Name:

Nigel Clerkin

Title:

Chief Financial Officer

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