Start here if you're new
what it is
Medpace runs clinical trials for drug and device companies that would rather outsource the regulatory pain.
how it gets paid
Last year Medpace made $2.5B in revenue. clinical trial management was the main engine at $0.88B, or 35% of sales.
why it's growing
Revenue grew 20.0% last year. Fourth-quarter earnings were strong enough that the 2026 outlook moved higher.
what just happened
Medpace posted Q4 EPS of $4.67, beating the $4.22 consensus by 10.66%.
At a glance
B++ balance sheet — above average — nothing keeping you up at night
95/100 earnings predictability — you can trust these numbers
28.0x trailing p/e — priced about right
51.5% return on capital — a money-printing machine
xvary composite: 70/100 — average
What they do
Medpace runs clinical trials for drug and device companies that would rather outsource the regulatory pain.
Drug studies are slow, regulated, and expensive. Clients hire one firm to run the mess from Phase I through Phase IV, and Medpace turns that into a 24.7% operating margin and 51.5% return on capital. Contract research organization → outsourced trial manager → so what: once your trial is in motion, switching vendors can blow up timelines and budgets.
How they make money
$2.5B
annual revenue · their business grew +20.0% last year
clinical trial management
$0.88B
study start-up and feasibility
$0.38B
clinical monitoring
$0.50B
medical affairs and data services
$0.40B
phase i-iv support services
$0.34B
The products that matter
outsourced trial management
Clinical Research Services
$2.5B revenue
It is the whole reported business today. When you see $2.5B in annual revenue here, you are looking at the single engine that drives the stock.
100% of revenue
demand signal
Program starts and client budgets
38.9% growth
The page does not give you detailed backlog data, so the cleanest read is the top line: revenue grew 38.9% last year. If that slows meaningfully, it usually means client demand is changing before the market says it out loud.
growth driver
profit filter
Operating margin
23.8%
This is the number that separates a good CRO from a great stock. Medpace keeps about 24 cents of every revenue dollar after operating costs, and that is why investors tolerate a premium multiple.
quality check
Key numbers
51.5%
return on capital
Return on capital → profit earned on each dollar invested → so what: Medpace turns capital into earnings far better than a typical service business.
24.7%
operating margin
Operating margin → profit after running the business → so what: this is a research contractor with software-style discipline.
28.0x
trailing p/e
Trailing P/E → price versus last 12 months of earnings → so what: you are paying up for execution, not getting a bargain bin multiple.
$495
18-month target
That target is 15.6% above $428.03, which says the upside case exists but is not huge relative to the stock's volatility.
Financial health
B++
strength
- balance sheet grade B++ — above average financial health
- risk rank 3 — safer than 50% of stocks
- price stability 25 / 100
- net profit margin 14.8% — keeps 15 cents of every dollar in revenue
- return on equity 52% — $0.52 profit for every $1 investors have put in
B++ — functional but not a standout on the balance sheet.
Total return vs. market
You invested $10,000 in MEDP 3 years ago → it's now worth $18,700.
The index would have given you $13,880.
source: institutional data · total return
What just happened
beat estimates
Medpace posted Q4 EPS of $4.67, beating the $4.22 consensus by 10.66%.
Fourth-quarter earnings were strong enough that the 2026 outlook moved higher. The market still fixated on backlog concerns, which is why the stock fell even after the beat.
$625M
revenue
$4.67
eps
24.7%
gross margin
the number that mattered
The key number was the $4.67 EPS print, because it beat estimates by 10.66% and still failed to calm investors about future demand.
-
medpace shares remain up nearly 30% over the trailing 12-month window, but the last month has not been pretty.
-
the stock is down 30% in the last 30 days, even though the fourth-quarter earnings report was a strong one (more color below).
-
still, the investment community zeroed in on a negative.digging deeper, medpace’s book-to-bill ratio clocked in at 1.04x, versus the consensus expectation of 1.15x (earlier year 1.20x). the fourth-quarter reading depicts a situation where the company booked only slightly more business than it sold. the quotation had flirted with the $630 level late in 2025 and profit-taking was rampant at the first sight of any slippage.
-
our 2026 earnings outlook is up by a noticeable margin.
-
medpace closed out 2025 with a top-line beat of more than $20 million, while share earnings were $0.45 ahead of the midpoint of the set target range.
source: company earnings report, 2026
Get this snapshot in your inbox
This page, delivered free — plus weekly updates when the numbers change. plain english, no spam.
weekly updates
earnings alerts
plain english
no spam
What could go wrong
Medpace is a one-engine business, so the top risk is clinical trial demand slowing at biotech and pharma clients.
med
client budgets tighten
When biotech funding or pharma development budgets cool, trial starts can slow fast. Because reported revenue is $2.5B from clinical research services, there is no second segment waiting to absorb the hit.
If demand slows, both growth and sentiment take the hit first.
med
utilization slips and margins follow
This model depends on keeping people and trial infrastructure productive. A 23.8% operating margin looks great until staffing runs ahead of project volume. Then the math gets rude.
A margin slide from current levels would pressure the premium multiple.
med
the stock stops getting paid for steadiness
At 28.0x trailing earnings, you are not buying a neglected asset. You are buying a business the market already respects. Respect can fade even if operations stay decent.
That means limited upside if execution merely stays good instead of exceptional.
All three risks point to the same place: if growth cools from 38.9% and the 23.8% operating margin starts slipping, this stops being a precision story and becomes just another service stock.
source: institutional data · regulatory filings · risk analysis
Pay attention to
metric
operating margin
23.8% is doing a lot of work here. If that starts moving the wrong way, the market will stop treating MEDP like a premium operator.
calendar
next earnings update
Use the next report to check whether management still sounds precise on demand and execution. Last full review: updated feb 27, 2026.
risk
client spending
A CRO rarely breaks all at once. You want to catch softer client budgets before they show up as a pattern in reported revenue.
trend
predictability versus volatility
95/100 earnings predictability and a $250–$629 trading range do not usually live in the same sentence. That tension is worth tracking every quarter.
Analyst rankings
short-term outlook
top 20%
Momentum score 2. In human-speak, analysts expect above-average price performance over the next year.
risk profile
average
Stability score 3. You are not in bunker-stock territory, but this is not chaos either.
chart momentum
top 5%
Technical score 1. The chart has been stronger than almost everything else, even with the stock's wide range.
earnings predictability
95 / 100
That is elite consistency. In plain English: these results usually do not surprise you.
source: institutional data
Institutional activity
institutions have been net buying for 3 consecutive quarters — 319 buyers vs. 316 sellers in 3q2025. total institutional holdings: 24.0M shares. net buying for 3 quarters.
source: institutional data
Price targets
3-5 year target range
$275
$714
$428
current price
$495
target midpoint · +16% from current · 3-5yr high: $705 (+65% · 10% ann'l return)
Want the deeper analysis?
The full deep dive: dcf model, scenario analysis, competitive moat breakdown, and quarterly tracking — everything on this page, taken further.
see plans from $5/moThe deep dive