Document

FORM 6-K

SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

Report of Foreign Private Issuer
Pursuant to Rule 13a-16 under
the Securities Exchange Act of 1934


For the month of June 2024

ICON plc
(Translation of Registrant's name into English)


333-08704
(Commission file number)


South County Business Park, Leopardstown, Dublin 18, Ireland
(Address of principal executive offices)




Indicate by check mark whether the registrant files or will file annual reports under cover Form 20-F or Form 40-F.
Form 20-F___X___
Form 40-F______
Indicate by check mark whether the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(1):
Yes______
No___X___
Indicate by check mark whether the registrant is submitting the Form 6-K in paper as permitted by Regulation S-T Rule 101(b)(7):
Yes______
No___X___




EXHIBIT LIST
ExhibitDescription



SIGNATURES

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
/s/Brendan Brennan 
Date:June 10, 2024Brendan Brennan
Chief Financial Officer



Document
Exhibit 99.1

Notice of Annual General Meeting
to be held on 23 July 2024






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ICON plc
(the “Company” or “ICON”)













THIS DOCUMENT IS IMPORTANT AND REQUIRES YOUR IMMEDIATE ATTENTION.

If you are in any doubt as to the action to be taken, you should consult with your independent financial adviser who, if you are taking advice in Ireland, is authorised or exempted under the European Communities (Markets in Financial Instruments) Regulations 2017 (as amended) or the Investment Intermediaries Act, 1995 (as amended).

If you have sold or transferred your entire holding of ordinary shares in ICON, please pass this document, together with the attached proxy form, to the purchaser or transferee, or to the stockbroker, bank or other agent through whom the sale was effected, for transmission to the purchaser or transferee as soon as possible.






10 June 2024
To: All ICON Shareholders

NOTICE OF ANNUAL GENERAL MEETING

Dear Shareholder

The Annual General Meeting of ICON plc will be held at 9.00am (Dublin time) on 23 July 2024 at ICON’s global headquarters in South County Business Park, Leopardstown, Dublin 18, Ireland (the AGM).

The purpose of this letter is to outline the background to and summarise the resolutions to be proposed at the AGM. Please refer to the form of proxy for the AGM (which is separately enclosed) and the notes on pages 9 to 11 for details on how to vote your shares and return your form of proxy. Your attention is also drawn to the notice of the AGM on pages 6 to 8 which sets out the matters to be considered at the AGM.

Re-election of Directors (ordinary resolutions 1.1 to 1.7)
In accordance with our Constitution (by-laws), one third of the members of the Board who are subject to retirement by rotation are required to retire from office and may stand for re-election at the AGM. In July 2022, in response to stakeholder feedback and current corporate governance best practice, the Board of Directors unanimously agreed that all Directors will retire and stand for re-election annually at each AGM. Ms. Joan Garahy, an independent non-executive director, has decided not to stand for re-election and will instead retire from the Board at the AGM. Accordingly, the following Directors (being all of the Directors with the exception of Ms. Joan Garahy) will stand for re-election:

-Mr. Ciaran Murray – non-executive Director and Chair

-Dr. Steve Cutler – Chief Executive Officer and Director
-Mr. Rónán Murphy – Lead Independent Director and non-executive Director

-Dr. John Climax – founder & non-executive Director

-Ms. Julie O’Neill – non-executive Director

-Mr. Eugene McCague – non-executive Director

-Dr. Linda Grais – non-executive Director

Mr. Ciaran Murray, Mr. Rónán Murphy, Dr. John Climax, Ms. Julie O’Neill, Mr. Eugene McCague, and Dr. Linda Grais are “independent” non-executive Directors (as that term is defined under the published listing requirements of NASDAQ). Dr. Steve Cutler, ICON’s Chief Executive Officer, is an executive officer.

Each of the Directors standing for re-election demonstrates the necessary commitment to the role and provides valuable skills, knowledge and experience and makes important contributions to the working of the Board. Further information on the experience, qualifications and industry knowledge of the current Directors is available from the Annual Report and/or Form 20-F at https://investor.iconplc.com/financials-filings/annual-reports and the details of current committee composition is set out on our website at https://investor.iconplc.com/corporate-governance/committee-composition. The following table provides additional information regarding the directors:
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ICON plc – Notice of Annual General Meeting 2024




 Ciaran Murray Dr. Steve CutlerRónán Murphy Dr. John ClimaxJulie O'Neill Eugene McCague Dr. Linda Grais Joan Garahy
Independent*YesNo YesYesYesYesYesYes
Gender MaleMaleMaleMaleFemaleMaleFemaleFemale
NationalityIrishAustralianIrishIrishIrishIrishAmericanIrish
EthnicityWhiteWhiteWhiteAsianWhiteWhiteWhiteWhite
Age** 6163667158656861
No. of years on ICON Board**1287345636

* Independent in accordance with NASDAQ Rules
** As at 23 July 2024

With Ms. Garahy’s upcoming retirement at the AGM, the Board intends to appoint a new female independent non-executive director to the Board during Quarter 3 2024. As with all Board appointments, the Board, through the Nominating, Sustainability and Governance Committee, will evaluate the balance of skills, knowledge, experience and diversity on the Board and then, based on this evaluation, seek to identify and recommend individual(s) as appropriate to join the Board of the Company.

Ms. Joan Garahy has served as a non-executive director of ICON since November 2017. On behalf of everyone at ICON and, in particular, my fellow Board members, I would like to thank Ms. Garahy for her significant contribution to the ICON Board and we wish her all the best for the future.

ICON’s 2023 Accounts (ordinary resolution 2)
This resolution is to review the Company's affairs and consider ICON’s 2023 accounts which have been audited by KPMG, ICON’s independent auditors.

Remuneration of Auditors (ordinary resolution 3)
This resolution authorises the Directors to fix the remuneration of the auditors.

While KPMG currently remains in place as our independent auditor, after our AGM in 2023 the Audit Committee of the Company engaged in a competitive audit tender process for the position of independent auditor. Based on the results of this process, Ernst & Young (EY) have been appointed as independent auditor to the Company in respect of the financial year ending December 31, 2025. EY's appointment will be subject to the passing of an ordinary resolution confirming the appointment at the Company's 2025 Annual General Meeting.

KPMG will audit the financial statements for the year ending December 31, 2024 and are then expected to resign shortly after completion of the audit of the Company's financial statements for the year ending December 31, 2024.

For more information on the change of our of independent auditor see the auditor section set out in the Directors’ Report in the 2023 IFRS Annual Report at https://investor.iconplc.com/financials-filings/annual-reports.





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ICON plc – Notice of Annual General Meeting 2024



Authority to issue shares up to 20% of share capital (ordinary resolution 4)
This resolution authorises the Directors to issue shares until the earlier of the next Annual General Meeting of the Company or 22 January 2026 up to an aggregate of 20% of the share capital of the Company without further shareholder approval.

This resolution is required under Irish law as the Company is an Irish incorporated company. The 20% cap on this resolution aligns the resolution with the NASDAQ rules which provide that up to 20% of share capital can be issued without shareholder approval.

Authority to issue shares up to 10% of share capital without offering to existing shareholders, with an additional 10% for funding capital investment or acquisitions (special resolution 5 and special resolution 6)
Resolution 5 authorises the Directors to issue shares for cash, subject to resolution 4, until the earlier of the next Annual General Meeting of the Company or 22 January 2026 up to an aggregate of 10% of the share capital of the Company without having to offer the shares to existing shareholders on a pro rata basis. Resolution 6 authorises the Directors to issue an additional 10% of the share capital for cash, again subject to Resolution 4, on a non pre-emptive basis provided that the proceeds of any such share issuance are to be used only for the purposes of financing (or refinancing, if the authority is to be used within six months after the original transaction) an acquisition or other capital investment.

A resolution authorising the issuance of shares for cash without such offer round is a requirement of Irish law and there is no such requirement under the applicable U.S. Securities and Exchange Commission (the SEC) rules and NASDAQ rules. As above, this year the authorities under these resolutions expire on the earlier of the next Annual General Meeting of the Company or 22 January 2026.

The caps on resolutions 4, 5 and 6 provide our shareholders with anti-dilution protection equivalent to protections provided to the shareholders of many other NASDAQ-listed companies. Every year since the Company was listed (apart from 2014 as resolutions with 5 year authority were passed in 2013), the Directors have put resolutions to authorise the issuance of shares and to disapply offer round to the shareholders and each such resolution has been passed.

Authority to buy back shares up to 10% of share capital (special resolution 7)
This resolution authorises the Company to purchase in the market (buy-back) up to 10% of the outstanding share capital of the Company. It is important both for the Company and shareholders that the Company has this flexibility to implement a buy-back (without having to seek further shareholder approval) if the market conditions favour a buy-back. It should also be noted that while the applicable SEC rules and NASDAQ rules do not require shareholder approval prior to a share buy-back, this resolution is required as the Company is an Irish incorporated company and Irish law requires shareholders to pass such a resolution to give Directors the authority to put a buy-back in place. The authority under this resolution expires on the earlier of the next Annual General Meeting and 22 January 2026.

Authority to reissue shares held as treasury shares (special resolution 8)
This resolution authorises the price range at which the Company can reissue shares that it holds as treasury shares. Any share buy-back activity by the Company will result in ordinary shares either being cancelled or reissued as treasury shares. We may reissue treasury shares that we acquire through our proposed share buy-back activities including in connection with our executive compensation programme, our employee restricted share unit programme and our other compensation programmes. As a result of using this authority in this way, ICON would avoid the need to issue new shares (and the resulting shareholder dilution) when the vesting of equity awards triggers the requirement to issue shares.

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ICON plc – Notice of Annual General Meeting 2024



The authority being sought from shareholders provides that the minimum and maximum prices at which an ordinary share held in treasury may be reissued are 95% and 120%, respectively, of the average closing price per ordinary share of the Company, as reported by NASDAQ, for the thirty (30) trading days immediately preceding the proposed date of reissuance. Any reissuance of treasury shares will be at price levels that the Board considers in the best interests of our shareholders.
There is no resolution dealing with executive compensation as ICON, being a foreign private issuer, is not obliged to provide a “say on pay” shareholder resolution on executive compensation. Details of ICON’s executive officers' compensation for 2023 are available in the Annual Report and Form 20-F for 2023 which are available at https://investor.iconplc.com/financials-filings/annual-reports.
Approval of Resolutions
Resolutions 1.1 to 1.7, 2, 3 and 4 are ordinary resolutions which require approval of a simple majority of the votes cast in person or by proxy and resolutions 5 to 8 are special resolutions which require approval of 75% of the votes cast in person or by proxy.

Recommendation of Directors
Your Board believes that the resolutions to be proposed at the AGM are in the best interests of the Company and its shareholders. Accordingly, your Directors unanimously recommend that you vote in favour of all resolutions as they intend to do in respect of the shares held by them. On 3 June 2024, the Directors held 514,373 ordinary shares representing approximately 0.62% of the issued ordinary share capital of the Company.





Yours sincerely,
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Ciaran Murray
Chair




















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ICON plc – Notice of Annual General Meeting 2024




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ICON plc
South County Business Park,
Leopardstown,
Dublin 18, Ireland
+353-1-291-2000

NOTICE OF ANNUAL GENERAL MEETING OF SHAREHOLDERS
TO BE HELD ON 23
JULY 2024

To the Shareholders of ICON plc:
NOTICE is hereby given that the Annual General Meeting of the Company will be held at ICON’s global headquarters in South County Business Park, Leopardstown, Dublin 18, Ireland on 23 July 2024 at 9.00am (Dublin time) (the AGM).

ORDINARY BUSINESS

To consider and, if thought fit, pass the following ordinary resolutions:

1.To re-elect, by separate resolutions, the following individuals who retire as Directors and, being eligible, offer themselves for re-election:

1.1 Mr. Ciaran Murray
1.2 Dr. Steve Cutler
1.3 Mr. Rónán Murphy
1.4 Dr. John Climax
1.5 Ms. Julie O’Neill
1.6 Mr. Eugene McCague
1.7Dr. Linda Grais

2.To review the Company's affairs and consider the accounts for the year ended 31st December 2023 and the reports of the Directors and auditors thereon.

3.To authorise the Directors to fix the remuneration of the auditors.

SPECIAL BUSINESS

To consider and, if thought fit, pass the following ordinary resolution:

4.“That the Directors be and are hereby generally and unconditionally authorised, pursuant to Section 1021 of the Companies Act 2014, to exercise all the powers of the Company to allot relevant securities (within the meaning of Section 1021 of the Companies Act 2014) up to an aggregate nominal amount of €993,699.82 representing approximately 20% of the aggregate
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ICON plc – Notice of Annual General Meeting 2024



nominal value of the issued ordinary share capital of the Company as at 7 June 2024 and the authority conferred by this resolution shall expire on the earlier of the date of the next Annual General Meeting of the Company or 22 January 2026, unless previously renewed, varied or revoked; provided that the Company may make an offer or agreement before the expiry of the authority conferred by this resolution, which would or might require any such securities to be allotted after the authority conferred by this resolution has expired and, in that case, the Directors may allot relevant securities in pursuance of any such offer or agreement as if the authority conferred hereby had not expired.

To consider and, if thought fit, pass the following special resolutions:

5.“That, subject to the passing of Resolution 4, the Directors be and are hereby empowered pursuant to Section 1022 and Section 1023(3) of the Companies Act 2014, to allot equity securities (as defined in Section 1023 of the Companies Act 2014) for cash as if the provisions of sub-section (1) of the said Section 1022 did not apply to any such allotment up to an aggregate nominal amount of €496,849.91 representing approximately 10% of the aggregate nominal value of the issued ordinary share capital of the Company as at 7 June 2024 and the authority conferred by this resolution shall expire on the earlier of the date of the next Annual General Meeting of the Company or 22 January 2026, unless previously renewed, varied or revoked; provided that the Company may make an offer or agreement before the expiry of the authority conferred by this resolution, which would or might require any such securities to be allotted after the authority conferred by this resolution has expired and, in that case, the Directors may allot relevant securities in pursuance of any such offer or agreement as if the authority conferred hereby had not expired.”

6.“That subject to the passing of Resolution 4, the Directors be and they are hereby authorised in addition to any authority granted under Resolution 5, to allot equity securities (as defined in Section 1023 of the Companies Act 2014) for cash as if the provisions of sub-section (1) of the said Section 1022 did not apply to any such allotment provided that:

(i)The proceeds of any such allotment are to be used for the purposes of financing (or refinancing, if the authority is to be used within six months after the original transaction) an acquisition or other capital investment; and

(ii)The nominal value of all equity securities allotted pursuant to this authority together with the nominal value of all treasury shares (as defined in Section 106 of the Companies Act 2014) reissued pursuant to Resolution 8 not exceed €496,849.91 representing approximately 10% of the nominal value of the issued share capital as at 7 June 2024.

The authority conferred by this resolution shall expire on the earlier of the date of the next Annual General Meeting of the Company or 22 January 2026, unless previously renewed, varied or revoked; provided that the Company may make an offer or agreement before the expiry of the authority conferred by this resolution, which would or might require any such securities to be allotted after the authority conferred by this resolution has expired and, in that case, the Directors may allot relevant securities in pursuance of any such offer or agreement as if the authority conferred hereby had not expired.”

7.“That the Company and/or any subsidiary (as such expression is defined by Section 7 of the Companies Act 2014) of the Company be and they are hereby generally authorised to make overseas market purchases (as defined by Section 1072(2) of the Companies Act 2014) of shares of any class of the Company on such terms and conditions and in such manner as the
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ICON plc – Notice of Annual General Meeting 2024



Directors or, as the case may be, the Directors of such subsidiary, may from time to time determine in accordance with and subject to the provisions of the Companies Act 2014 and the following restrictions and provisions:

(i)The maximum aggregate number of shares authorised to be acquired pursuant to this resolution shall not exceed 10% of the aggregate number of shares issued by the Company at close of business on the date of passing of this resolution;

(ii)The minimum price (exclusive of expenses) which may be paid for any such share shall be an amount equal to the nominal value thereof; and

(iii)The maximum price (exclusive of expenses) to be paid for any ordinary share shall be an amount equal to 115% of the NASDAQ Official Closing Price (the “NOCP”) (as reported by NASDAQ) of the Company’s ordinary shares on the trading day preceding the day on which the relevant shares are purchased by the Company.

The authority hereby conferred shall expire on the earlier of the date of the next Annual General Meeting of the Company or 22 January 2026 or (if earlier) unless previously varied, revoked or renewed in accordance with the provisions of Section 1074 of the Companies Act 2014. The Company or any subsidiary may before such expiry make a contract for the purchase of shares which would or might be wholly or partly executed after such expiry and may make a purchase of shares pursuant to any such contract as if the authority hereby conferred had not expired.”

8.    “That the reissue price range at which any treasury shares held by the Company may be reissued off-market shall be as follows:

(i)    the maximum price at which such treasury share may be reissued off-market shall be an amount equal to 120% of the “market price”;

(ii)    the minimum price at which a treasury share may be reissued off-market shall be the nominal value of the share where such a share is required to satisfy an obligation under an employee share plan operated by the Company or, in all other cases, an amount equal to 95% of the “market price”; and

(iii)    for the purposes of this resolution, the “market price” shall mean the average closing price per ordinary share of the Company, as reported by NASDAQ, for the thirty (30) trading days immediately preceding the proposed date of reissuance.

The authority hereby conferred to reissue treasury shares shall expire eighteen months from the date of the passing of this resolution unless previously varied or renewed in accordance with the provisions of Section 1078 of the Companies Act 2014.”

By Order of the Board of Directors,
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Diarmaid Cunningham
Company Secretary

Dublin, Ireland
Dated: 10 June 2024
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ICON plc – Notice of Annual General Meeting 2024



NOTES:

1.     Information and Documentation
Information regarding the Annual General Meeting is available on the Company’s website www.iconplc.com and from www.proxyvote.com. If you require a paper copy of the Form 20-F or IFRS Annual Report, please contact Investor Relations at 1-888-381-7923 or IR@iconplc.com.

2.     Who is eligible to vote and how?
The record date for the Annual General Meeting is 3 June 2024.

If your shares are registered in your name, you are a shareholder of record. Shareholders of record who are entered in the Register of Members of the Company on 3 June 2024 shall be entitled to attend, speak, ask questions, vote, demand a poll, and/or join in the demand for a poll at the Annual General Meeting, or if relevant, any adjournment thereof. Changes in the Register of Members of the Company after that time will be disregarded in determining the right of any person to attend and/or vote at the Annual General Meeting.

For those shareholders whose shares are not held in their name, but rather in an account at a brokerage firm, bank, dealer or other similar organisation, who in turn hold through The Depository Trust Company (DTC), then their entitlement to vote is determined as at 3 June 2024.

Depending on whether your shares are registered in your name or whether your shares are held in a “street name” the arrangements are as follows:
Shareholder of Record: Shares Registered in Your Name
As a shareholder of record, you may vote in person at the Annual General Meeting or vote by proxy. In the case of joint holders, the vote of the senior member who tenders a vote, whether in person or by proxy, shall be accepted to the exclusion of the votes of the other shareholder of record and, for this purpose, seniority shall be determined by the order in which the names stand in the Register of Members of the Company in respect of the joint holding. The appointment of a proxy will not preclude a shareholder of record from attending, speaking, asking questions and voting at the Annual General Meeting should the shareholder subsequently wish to do so. A proxy need not be a member of the Company. If you wish to appoint more than one proxy or a person not listed on the form of proxy, please contact Investor Relations at 1-888-381-7923 or IR@iconplc.com.

A Form of Proxy is enclosed with this notice of Annual General Meeting for shareholders of record. To be effective, the Form of Proxy duly completed and executed, together with any authority under which it is executed, or a copy thereof certified, must be deposited at the registered office of the Company, so as to be received by 11.59pm ET on 22 July 2024 or if the Annual General Meeting is adjourned, on the day that falls before the day appointed for the adjourned meeting or (in the case of a poll taken otherwise than at or on the same day as the Annual General Meeting or adjourned meeting) the day before the taking of the poll at which it is to be used. Any alteration to the Form of Proxy must be initialled by the person who signs it.
Alternatively, provided it is received by 11.59pm ET on 21 July 2024 or if the Annual General Meeting is adjourned, by 11.59pm ET on the day that falls 48 hours before the time appointed for the adjourned meeting or (in the case of a poll taken otherwise than at or on the same day as the Annual General Meeting or adjourned meeting) by 11.59pm ET on the day
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ICON plc – Notice of Annual General Meeting 2024



that falls 48 hours before the taking of the poll at which it is to be used, the appointment of a proxy may be submitted by telephone or electronically, subject to the applicable terms and conditions, using the phone number on the Form of Proxy and following the instructions provided or via the Internet by accessing Broadridge’s website www.proxyvote.com and following the instructions on the website. The information you need to appoint your proxy by telephone or electronically is included at the top of your Form of Proxy.

You need only vote in one way (so that, if you vote by Internet or by telephone, you need not return the Form of Proxy). In the case of a corporation, the Form of Proxy must be either executed under seal or signed on its behalf by a duly authorised officer or attorney.
Beneficial Owner: Shares Registered in the Name of a Broker, Bank or Other Agent
If, as at 3 June 2024, your shares were not held in your name, but rather in an account at a brokerage firm, bank, dealer or other similar organisation, who in turn hold through DTC, then you are the beneficial owner of shares held in “street name” and these proxy materials are being forwarded to you by that organisation, together with instructions as to voting. You will need to carefully follow the instructions from your broker, bank or other agent or contact your broker, bank or other agent if you have any queries.
As a beneficial owner, you have the right to direct your broker or other agent on how to vote the shares in your account as per the instructions enclosed by your broker. You are also invited to attend the Annual General Meeting. However, since you are not the shareholder of record, you may not vote your shares in person at the Annual General Meeting unless you contact your broker and obtain a valid proxy card from your broker or other agent.
Therefore as a beneficial owner of shares registered in the name of your broker, bank or other agent, who in turn hold the shares through DTC, you should have received a voting instruction card and voting instructions with these proxy materials from that organisation rather than from us. Simply follow the instructions on the voting instruction card provided by your broker, bank or other agent to ensure that your vote is counted.

3.     How many votes do you have?
The total number of issued ordinary shares on the record date, 3 June 2024, was 82,777,280. On a vote on a show of hands, every shareholder present in person and every proxy has one vote (but no individual shall have more than one vote). On a poll, every shareholder present in person and every proxy shall have one vote for every share carrying rights of which he is the holder or proxy. Ordinary resolutions are required to be passed by a simple majority of shareholders voting in person or by proxy. Special resolutions are required to be passed by a majority of 75 per cent of shareholders voting in person or by proxy.

4.    Broker Voting
If your shares are held by a broker on your behalf (that is, in “street name”), and you do not instruct the broker as to how to vote these shares, the broker may not exercise discretion to vote for or against any of the proposals. This would be a “broker non-vote” and these shares will not be counted as having been voted on the proposals. Please instruct your bank or broker so your vote can be counted.

5.    Can I change my vote after submitting my proxy?
Shareholder of Record: Shares Registered in Your Name
Yes. You can revoke your proxy at any time before the commencement of the Annual General Meeting. If you are the record holder of your shares, you may revoke your proxy in any one of three ways: 
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ICON plc – Notice of Annual General Meeting 2024



You may submit another properly completed proxy with a later date. Your revised proxy must be received before the commencement of the Annual General Meeting at 09.00am Dublin time on 23 July 2024 or if the Annual General Meeting is adjourned, before the commencement of the adjourned meeting;

You may send a written notice that you are revoking your proxy to Erina Fox, Deputy Company Secretary, ICON plc at the registered office of the Company (being South County Business Park, Leopardstown, Dublin 18, Ireland) or by email to IR@iconplc.com. Your notice must be received before the commencement of the Annual General Meeting at 09.00am Dublin time on 23 July 2024 or if the Annual General Meeting is adjourned, before the commencement of the adjourned meeting; or

You may attend the Annual General Meeting and vote in person.

Beneficial Owner: Shares Registered in the Name of a Broker, Bank or Other Agent
If your shares are held by your broker, bank or other agent, you should follow the instructions provided by them. Please contact your broker, bank or other agent if you have any queries.

6.    What does it mean if I receive more than one set of materials?
If you receive more than one set of materials, your shares are registered in more than one name or are registered in different accounts. In order to vote all the shares you own, you must sign and return all of the proxy cards or follow the instructions for any alternative voting procedure on each of the proxy cards you receive.
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ICON plc – Notice of Annual General Meeting 2024

iconplc_prxyxgt20xp14245
Signature [PLEASE SIGN WITHIN BOX] Date Signature (Joint Owners) Date TO VOTE, MARK BLOCKS BELOW IN BLUE OR BLACK INK AS FOLLOWS: KEEP THIS PORTION FOR YOUR RECORDS DETACH AND RETURN THIS PORTION ONLYTHIS PROXY CARD IS VALID ONLY WHEN SIGNED AND DATED. V52607-P14245 For Against Abstain For Against Abstain ! !! ! !! ! !! ! !! ! !! ! !! ! !! ! !! ! !! ! !! ! !! ! !! ! !! ! !! ICON PLC 1.1 Mr. Ciaran Murray 1.2 Dr. Steve Cutler 1.3 Mr. Rónán Murphy 1.4 Dr. John Climax 1.5 Ms. Julie O'Neill 1.6 Mr. Eugene McCague 1.7 Dr. Linda Grais 1. Election of Directors 4. To authorise the Company to allot shares 7. To authorise the Company to make market purchases of shares 6. To disapply the statutory pre-emption rights for funding capital investment or acquisitions 5. To disapply the statutory pre-emption rights 8. To authorise the price range at which the Company can reissue shares that it holds as treasury shares The Board of Directors recommends you vote FOR the following: Nominees: Please sign exactly as your name(s) appear(s) hereon. When signing as attorney, executor, administrator, or other fiduciary, please give full title as such. If a corporation or partnership, please sign in full corporate or partnership name by authorised officer. The Board of Directors recommends you vote FOR proposals 2 through 8: 2. To review the Company's affairs and consider the Accounts and Reports 3. To authorise the fixing of the Auditors' Remuneration SCAN TO VIEW MATERIALS & VOTEw ICON PLC SOUTH COUNTY BUSINESS PARK LEOPARDSTOWN DUBLIN 18 IRELAND VOTE BY INTERNET - www.proxyvote.com or scan the QR Barcode above Use the Internet to transmit your voting instructions and for electronic delivery of information up until 11:59 P.M. Eastern Time on Sunday 21st July 2024. Have your proxy card in hand when you access the web site and follow the instructions to obtain your records and to create an electronic voting instruction form. ELECTRONIC DELIVERY OF FUTURE PROXY MATERIALS If you would like to reduce the costs incurred by our company in mailing proxy materials, you can consent to receiving all future proxy statements, proxy cards and annual reports electronically via e-mail or the Internet. To sign up for electronic delivery, please follow the instructions above to vote using the Internet and, when prompted, indicate that you agree to receive or access proxy materials electronically in future years. VOTE BY PHONE - 1-800-690-6903 Use any touch-tone telephone to transmit your voting instructions up until 11:59 P.M. Eastern Time on Sunday 21st July 2024. Have your proxy card in hand when you call and then follow the instructions. VOTE BY MAIL Mark, sign and date your proxy card and return it to the registered office address of the company (Erina Fox, Deputy Company Secretary, ICON plc, South County Business Park, Leopardstown, Dublin 18, Ireland) so as to be received by 11:59 P.M. Eastern Time on Monday 22nd July 2024. Exhibit 99.2 V52608-P14245 ICON plc Annual General Meeting of Shareholders Tuesday, July 23, 2024 9:00 AM, Dublin Time ICON plc South County Business Park Leopardstown Dublin 18 Ireland If voting by mail, please date, sign and mail this proxy card as soon as possible. Important Notice Regarding the Availability of Proxy Materials for the Annual General Meeting: The Notice & Proxy Statement, Annual Report and 20F are available at www.proxyvote.com. ICON PLC Annual General Meeting of Shareholders July 23, 2024 9:00 AM This proxy is solicited by the Board of Directors The shareholder(s) of the Company hereby appoint(s) the Chairman of the Annual General Meeting, as the proxy of the shareholder(s) to attend, speak, vote, demand a poll and/or join in the demand for a poll for the shareholder(s) on behalf of the shareholder(s) as designated on the reverse side of this ballot, all of the Ordinary Shares of ICON plc that the shareholder(s) is/are entitled to vote at the Annual General Meeting to be held at 9:00 AM, Dublin Time on July 23, 2024, at the ICON plc Headquarters, South County Business Park, Leopardstown, Dublin 18, Ireland, and any adjournment or postponement thereof. This proxy, when properly executed, will be voted in the manner directed herein. If no such direction is made, this proxy will be voted in accordance with the Board of Directors' recommendations. Note: This proxy may also be voted in accordance with the Board of Directors' recommendations with respect to such other business as may properly come before the Annual General Meeting or any adjournment, postponement or continuation thereof. Continued and to be signed on reverse side


 
Document

Exhibit 99.3














ICON plc and Subsidiaries


Consolidated Financial Statements


Year ended 31 December 2023



Registered number: 145835







Directors’ Report and Consolidated Financial Statements


ContentsPage
Directors’ and Other Information
Directors’ Report
Statement of Directors’ Responsibilities in respect of the Directors’ report and the financial statements
Independent Auditor’s Report to the members of ICON plc
Consolidated Statement of Profit and Loss
Consolidated Statement of Comprehensive Income
Consolidated Statement of Financial Position
Consolidated Statement of Changes in Equity
Consolidated Statement of Cash Flows
Notes to Consolidated Financial Statements
Company Statement of Financial Position
Company Statement of Changes in Equity
Notes to Company Financial Statements
Reconciliation from IFRS to US Accounting Polices
Appendix A: Risk Factors
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Directors’ and Other Information
DirectorsCiaran Murray (Irish – Chair)
Dr. Steve Cutler (Australian – Chief Executive Officer)
Rónán Murphy (Irish – Non-Executive)
Dr. John Climax (Irish – Non-Executive)
Joan Garahy (Irish – Non-Executive)
Eugene McCague (Irish – Non-Executive)
Julie O'Neill (Irish – Non-Executive)
Dr. Linda Grais (American - Non-Executive)
Company secretaryDiarmaid Cunningham
Registered officeSouth County Business Park
Leopardstown
Dublin 18
Auditor    
KPMG
1 Stokes Place
St. Stephen’s Green
Dublin 2
SolicitorsA & L Goodbody
International Financial Services Centre
North Wall Quay
Dublin 1
Cahill Gordon & Reindel LLP
32 Old Slip
New York
NY 10005
USA
RegistrarsComputershare Investor Services (Ireland) Limited
3100 Lake Drive
Citywest Business Campus
Dublin 24
Bankers    
Citibank
Canada Square
Canary Wharf
London E14 5LB
United Kingdom
JP Morgan Chase Bank N.A.
4 New York Plaza
New York
NY 10004
USA
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Directors’ Report
The Directors present their report and audited Consolidated and Company Financial Statements of ICON plc (“the Company”, “ICON”, "we", "our" or "us"), a public limited company incorporated in the Republic of Ireland, and its subsidiary undertakings (“the Subsidiaries”), with the Company and the Subsidiaries being together (“the Group”) for the year ended 31 December 2023.

The Company’s ordinary shares are traded on the NASDAQ market. The Company is considered a foreign private issuer in the U.S. and accordingly it is not subject to the same ongoing regulatory requirements as a U.S. registered company with a primary listing on the NASDAQ market.

These Consolidated and Company Financial Statements (together “the financial statements”) for the year ended 31 December 2023 are prepared in accordance with IFRS as adopted by the EU and meet the reporting requirements pursuant to Irish Company Law. In addition to the Consolidated Financial Statements contained in this annual report, we also prepare separate consolidated financial statements on Form 20-F pursuant to the rules and regulations of the U.S. Securities and Exchange Commission ("SEC") and in accordance with accounting principles generally accepted in the United States (U.S. GAAP). The Form 20-F (under U.S. GAAP) is a separate document, a copy of which may be obtained from the Company’s website www.iconplc.com. IFRS differs in certain respects from U.S. GAAP, details of which are set out on pages 145 to 148 of this annual report.

Principal activities, business review and future developments

ICON public limited company (“ICON plc”) is a contract research organisation (“CRO”), founded in Dublin, Ireland in 1990. For over thirty years we have grown significantly to become a leading global provider of outsourced development and services to pharmaceutical, biotechnology, medical device and government and public health organisations. Our mission is to improve the lives of patients by accelerating the development of our customers’ drugs and devices through innovative solutions.

We are a public limited company in Ireland and operate under the Irish Companies Acts. Our principal executive office is located at: South County Business Park, Leopardstown, Dublin 18, Republic of Ireland. The contact telephone number of this office is +353 1 2912000. Our website is www.iconplc.com.

ICON is a leading global provider of outsourced development and commercialisation services to pharmaceutical, biotechnology, medical device, and government and public health organisations. We offer a full range of clinical, consulting and commercial services that range from clinical development strategy, planning and trial design, to full study execution, and post-market commercialisation. ICON provides its services across a range of clinical outsourcing operating models including strategic partnerships, preferred provider, full-service delivery to functional service provision and stand-alone services.

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Directors’ Report (continued)
We specialise 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 earn revenue by providing a number of different services to our customers. Those services are integral components of the clinical development process and include clinical trial management, consulting, contract staffing, data solutions and laboratory services.

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 the 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 solution. In order to achieve this vision, we are capitalising on the enhanced scale, technology and data analytics capabilities that the recent acquisition of PRA Health Sciences delivered.

ICON maintains a sustained focus on research and development. We continue to enhance our portfolio of data solutions and decentralised clinical trial technology through the development of industry-leading technologies and processes to support our clients. ICON is leading the industry transformation through four key levers: transforming clinical trials, site and patient centricity, healthcare intelligence and applied innovation, and seamless, integrated service delivery.

At 31 December 2023, we employed approximately 41,100 employees in 106 locations in 53 countries. During the year ended 31 December 2023, we derived approximately 40.4%, 48.7% and 10.9% of our revenue in the United States, Europe and Rest of World, respectively.

We have achieved strong growth since our foundation in 1990, as a global provider of outsourced development and commercialisation services to pharmaceutical, biotechnology, medical device and government and public health organisations. We focus our innovation on those factors that are critical to our clients - reducing time to market, reducing cost and increasing quality. Our global team has extensive experience in a broad range of therapeutic areas. ICON has been recognised as one of the world's leading Contract Research Organisations (''CROs") through a number of high-profile industry awards (see www.iconplc.com/awards).

As our market has evolved, biopharmaceutical companies are tackling productivity challenges, budget constraints and greater demands to demonstrate product value; all of which are placing increased pressure on their revenues and levels of profitability. However, these trends have generally been positive for CROs, as increased outsourcing has been adopted by these companies as they seek to create greater efficiencies in their development processes, convert previously fixed costs to variable, and accelerate time to market for new treatments.

Regulatory and reimbursement pressures will increase the emphasis on late stage (post marketing) research, while increasing requirements to demonstrate the economic value of new treatments. As a result, outcomes and comparative effectiveness research will most likely be required in order to secure on-going product reimbursement. Furthermore, we believe advances in molecular biology and genetics will drive further growth in innovation in the long term which in turn should create further growth opportunities for both biopharma companies and their outsource development partners.

We expect that continued outsourcing will be a core strategy of clients in the near term as they respond to the increased pressures on their revenues and profitability. Larger clients were the first to form strategic partnerships with global CROs in an effort to reduce the number of outsource partners with whom they engage and to reduce inefficiencies in their current drug development models. More recently we have seen the increasing adoption of this partner model with mid-tier pharmaceutical and biotechnology firms as they also seek to drive development efficiencies. As outsourcing penetration increases, we believe clients may seek a greater level of integration of service offerings from CROs, although some will continue to purchase services on a stand-alone basis. Creating greater connectivity and “seamlessness” between our services and the sharing of “real-time” clinical, operational and “real world” data with clients will therefore become increasingly important for CROs. ICON will seek to benefit from this increased outsourcing by clients to grow our business by increasing market share with our existing client base and adding new clients within the Phase I-IV outsourced development services market; the aim being to ensure we will be considered for all major Phase I-IV projects.

Delivery of our mission and strategy is focused on our four strategic pillars, being (i) Patient Access & Engagement (ii) Career Development & Employer of choice (iii) Enduring Customer Partnerships and (iv) Healthcare Intelligence & Applied Innovation.
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Directors’ Report (continued)
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Patient Access & Engagement

ICON has a focused patient, site and data strategy, which is helping us to improve site identification, study placement and patient recruitment and retention.

Accellacare is ICON's global clinical research network offering customers a wide range of stand-alone and integrated solutions at site or in patients' homes as part of decentralised trials. Our patient centric approach accelerates study start-up and increases patient recruitment and retention for the pharmaceutical, biotechnology and medical device industries.

Accellacare In-Home Services takes study visits directly to patients where they live, work, study or play in all phases and therapeutic areas of clinical trials. By bringing trial visits directly to patients, we ease the burden of participating in clinical research to increase patient recruitment, retention and diversity. Accellacare In-Home Services has experience in more than 450 clinical trials, tailoring our services to fit each study's specific requirements across more than 50 countries. This cohesive approach is leading to higher patient recruitment and retention rates. Accellacare is also achieving faster study start-up for its customers through efficiencies gained in central process management including budget and contracting, which can otherwise be a source of delay. This combined with a finely tuned feasibility approach allows the network to identify and recruit more patients to studies, in a wide range of therapeutic areas, in a shorter time frame. Accellacare is an important part of the integrated patient, site and data strategy, helping us to improve patient recruitment and retention. Through Accellacare, we are committed to delivering on the promise of patient centricity in clinical research whilst also providing investigators with innovative treatments for their patients with a quality-focused clinical research infrastructure supported by experienced professionals globally.

The Accellacare Site Network encompasses more than 50 sites across 6 countries covering the United States, Europe and South Africa. Accellacare offers a quality focused clinical research infrastructure delivering value and benefits to sponsors. Accellacare supports customers with faster start-up and the time from site selection to site initiation visit is on average 30% faster when compared to other sites. Furthermore, Accellacare achieves an average of 40% more patients per site when compared to other sites.

In 2023, Accellacare Site Network optimised its site partnerships and focused on enhancing capabilities within its US locations with a continued focus on Central nervous system (CNS) capabilities. ICON fully acquired the Oncacare site network in April 2023.

Finding and engaging suitable patients to conduct clinical trials is one of the biggest issues facing the drug development industry today. Less than 1% of the US population participates in clinical trials and the performance of investigative sites that do take part in research is uneven, hard to predict and many trials do not meet the initial recruitment goals. The current market challenge in patient enrolment creates an opportunity for ICON to differentiate its service offering and we are working to reduce patient recruitment times through enhanced site and investigator selection based on key performance metrics and
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Directors’ Report (continued)
through use of our proprietary FIRECREST technology which is used to train and support sites during the development process.

ICON's site networks enhance our ability to enrol patients onto the clinical studies we perform. We have also developed strategic alliances with investigator site groups and healthcare systems in all major global research markets. In partnership with others, we are pioneering patient recruitment solutions that leverage cognitive computing to transform clinical trial matching and allow a data-driven approach to deliver the right patients for trials. One Search is our intuitive, integrated workflow and interrogation tool that enables access to multiple data sources and provides the visualisation and tools necessary for optimum site identification based on ICON and industry data of capability, experience and performance. Scoring on enrolment performance, speed of start-up and quality supports better site selection.

Career development and employer of choice

People have long been central to our mission to improve the lives of patients by accelerating the development of our customers’ drugs and devices through innovative solutions. We encourage our people to bring flexibility, innovation, and determination to every situation. By doing so, our people can build exciting and rewarding careers, and deliver results to bring life-changing medicines to market and to maintain our success as an industry leader.

Our leadership and talent programs contribute to the enhanced retention of our employees, better project deliverables for our customers and the enhanced financial performance of the business.

We aim to be an industry leader: a company where talented people come to do important work, a place where our employees can shape the future of healthcare, grow their careers, and reach their full potential. We have long held a deep commitment to cultivating strong people practices. This includes competitive total rewards packages along with a focus on continuous learning. We nurture a culture of development and aim to boost engagement by supporting our people’s growth, both personally and professionally. We are dedicated to finding opportunities for our employees to grow and develop.

Our success depends on the knowledge, capabilities, and quality of our people. To improve their skills, we are committed to providing continuous learning. This commitment is underpinned by clearly defined competencies, which offer employees a clear path along which to develop skills and advance their careers.

To support employees at every stage of their career journeys, training and development programs are aimed at advancing scientific, technical, and business knowledge. Programs include tailored CRA academies and a range of project management curricula, therapeutic-focused programs, and people leader development programs.

Enduring customer partnerships

We continue to focus on expanding and deepening our partnerships with existing customers, while also developing new customer relationships.

Strategic client relationships will increasingly manifest themselves in many different forms. Many of these relationships will require innovative forms of collaboration across ICON service areas and departments and will therefore require increased flexibility to offer services on both a standalone functional basis and as part of a fully integrated service solution. To support this objective, we continue to evolve our collaboration and delivery models, invest in technology that will enable closer data integration across our service areas and enhance our project and program management capabilities.

To meet the evolving needs of both our existing and new clients we continue to enhance our capabilities through both organic service development and targeted acquisitions. In addition, we continue to enhance our scientific and therapeutic expertise to support our customers in specific areas including oncology, orphan and rare diseases, CNS, dermatology, infectious disease and women's health.

ICON has extensive experience in vaccine clinical development for commercial businesses, governments and NGOs. This experience enabled us to play a significant role in the search for vaccines and treatments for COVID-19.

Of particular note was our work in partnering with Pfizer and BioNTech on their investigational COVID-19 vaccine program - the first to announce positive efficacy results from a Phase 3, late-stage study of a COVID-19 vaccine and to receive Emergency Use Authorisation in individuals 16 years of age or older from the U.S. Food and Drug Administration.

ICON mobilised a large global team of therapeutic and operational specialists to partner on the implementation of Pfizer‘s and BioNTech’s strategic plan and framework for the monitoring of the trial, which included a high level of remote clinical monitoring and source data verification in addition to on-site monitoring, safeguarding data quality and integrity in the evolving pandemic environment. The team combined the benefits of full service and functional service provider clinical operating models to increase efficiency and ensure rapid study start-up.
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Directors’ Report (continued)
ICON worked with 153 sites in the US, Europe, South Africa and Latin America to ensure the recruitment of more than 44,000 trial participants over a four-month period in late 2020. ICON provided site training, document management and operational support for patient Informed Consent Form review, coordinated eConsent in most countries, and assisted with clinical supply management services. Achieving the unprecedented trial timelines, while maintaining high standards of quality, undertaken in response to the pandemic required collaboration and strong communication between the ICON and sponsor project teams.

We continue to target growth in under-penetrated CRO market segments. Penetration within medical device companies has lagged that of bio-pharma firms but is beginning to accelerate. EU regulatory reform enacted in 2017 is a further catalyst to growth in this segment as it included stricter requirements to perform clinical evaluations and post-sale surveillance. In early 2020, ICON acquired MedPass which has further enhanced our value offering in this area.

We also invested significantly in our site and patient network (Accellacare), and consider our expertise and offering in this area as one of our strategic pillars.

Healthcare intelligence and applied innovation
Innovation at ICON is focused on the factors that are critical to our clients. We develop integrated technologies to significantly enhance the efficiency and productivity of clients’ drug and device development programs, providing true transparency across all areas of a study.

ICON is focused on applying innovation that can help our customers improve their development outcomes. We are focusing this innovation in three critical areas: improving clinical trial design and execution; faster and more predictable patient recruitment; and evolving clinical trials to be more patient centric which includes data collection and analysis directly from patient’s digital devices. Our approach to developing solutions to these challenges incorporates partnering with best-in-class technology providers but is also supported by a suite of differentiated ICON proprietary technologies.

Through an informatics strategy built around key platforms including ICONIK and Health Cloud, we have continued to invest in building our capabilities in the gathering, analysis and application of real world patient data within both the clinical trial and post-trial observational study environments. ICONIK and Health Cloud enable ICON to deliver services such as Risk Based Monitoring (RBM) which uses near-real time clinical data to drive monitoring visit schedules, enabling better decision making and the successful implementation of clinical trial strategies that significantly improve efficiency in clinical trials thereby reducing overall cost and time to market whilst better protecting patient safety.

ICON’s proprietary One Search tool helps to efficiently and effectively identify optimum trial sites. It synthesizes multiple data sources, applying AI machine learning and rich data visualisation for optimum site identification, resulting in improved study start-up and site cycle times, significant reductions in the percentage of low performing sites and increasing the percentage of studies meeting planned First Patient In (FPI).

FIRECREST is ICON’s proprietary comprehensive site performance management system. It is a web-based solution which enables accurate study information, including protocol information, training manuals and case report forms, to be rolled out quickly and simultaneously to investigative sites. It allows site behaviour to be tracked to ensure training is understood, procedures are being followed and that timelines and study parameters are met. It can significantly reduce the number of data queries originated from investigator sites. FIRECREST is now integrated into the ICON Safety Reporting Solution and provides a Site Question Management Tool.

The ICON Patient Engagement Platform was developed to support improved patient experience and enrolment in clinical trials. The web-based patient engagement platform, provides patients with study specific information and connectivity with the nearest investigative site. The solution supplements patient recruitment outreach by sites and increases visibility of potential study participants for sponsors and sites. An easy to navigate, user friendly interface guides the patient to new and ongoing studies in their particular indication and a pre-qualification questionnaire helps to determine if the study is a right fit for them. If the patient decides to register interest, they are given the option to select their nearest investigative site. This establishes connection with the site and the patient can then choose to contact the site or ask to be contacted for pre-screening.

We positively impact patients’ lives by understanding their journeys and how they can benefit from drugs currently in development and on the market. We do this by developing a holistic, global data environment across pharmaceutical and biotech companies (development to commercial) that gives insights into patients, and how best to serve them. Alongside the application of these technology solutions we are also focused on innovation through the redesign and where appropriate the automation of current clinical trial processes.

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Directors’ Report (continued)
Operational excellence, quality and delivery

Quality is the foundation of our success. The quality of our work is vital to our mission of bringing better medications to patients around the world. We are committed to maintaining, supporting, checking and improving our quality systems to meet or exceed the quality standards demanded by our clients, patients and regulatory authorities. We focus our innovation on the factors that are critical to our clients – reducing time to market, reducing cost and increasing quality – and our global team of experts has extensive experience in a broad range of therapeutic areas.

Quality project execution underpins all that we do and we have an ongoing focus on developing our people and processes to continue to enhance our service delivery. We also deploy supporting technologies which we believe will enable faster and deeper insights into the quality of trial data.

We are focused on operational excellence across our support functions, and we operate a global business support infrastructure across functions including finance, information technology, facilities, human resources, legal and quality assurance. This enables us to enhance the service levels across these support areas whilst driving down the costs of the service provision

Principal activities of the Company

The principal activity of the Company is to act as a holding Company. The Company also operates branch offices: ICON Poland in Warsaw, ICON Latvia in Riga and ICON Lithuania in Vilnius. These branches provide contract research services to the pharmaceutical industry.

Acquisition activity

Since ICON was founded, the Company has expanded through organic growth, together with a number of strategic acquisitions to enhance its expertise and capabilities in certain areas of the clinical development process and to broaden the service portfolio and add scale to existing services.

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Recent investments, which continue to strengthen our service offerings to meet the needs of our customers include:

On 2 October 2023, the Company acquired 100% of the equity of BioTel Research, LLC which comprised the business formerly known as Philips Pharma Solutions, a leading provider of medical imaging and cardiac safety monitoring services.

On 20 April 2023, the Company completed the purchase of the majority investor's 51% voting share capital of Oncacare Limited (such that Oncacare and its subsidiaries became wholly-owned subsidiaries of the ICON Group), a global network of oncology research sites that provide a unique patient recruitment and delivery solution for the clinical research industry.

On 1 July 2021, the Company completed the acquisition of PRA Health Sciences, Inc. ("PRA") by means of a merger whereby Indigo Merger Sub, Inc., a Delaware corporation and subsidiary of ICON, merged with and into PRA, the parent of the PRA Health Sciences ("the Merger").
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Directors’ Report (continued)

With approximately 41,100 employees across the globe, ICON has established relationships with a majority of the world’s top pharmaceutical and biotech companies. We believe the Company now has the expertise, technology, and data assets to lead the industry into a new paradigm for bringing clinical research to more patients and enabling expanded capabilities for customers. We believe the Merger will deliver a transformational effect on ICON through:

Scale: With a deeper clinical, commercialisation and consulting services portfolio, a broader geographic footprint, depth in therapeutic expertise, and data-driven healthcare technology, the Company can deliver enhanced globally scaled expertise & solutions for all customers and patients.

Focus: The Company will have a singular focus on clinical research and commercialisation, leveraging transformational technology and innovation to execute clinical trials from Phase 1 to post-approval studies with the highest quality, expertise and speed.

Speed to market: Our extensive services portfolio, digital and data technology capabilities, and enhanced access to more diverse patient populations, have been combined with flexible delivery approaches and partnership models – all with the aim of reducing development time and costs.

Flexible partnership models: ICON has partnerships with a majority of world’s top biopharma and biotech companies worldwide. ICON is a global leader in Functional Service Provision and a top global provider of full service clinical research.

Differentiated DCT platform, healthcare intelligence & technology: ICON can deliver differentiated decentralised and hybrid trial solutions through a suite of capabilities, including mobile health, commercial connected health platforms, real world data and information solutions, a global site network, home health services and wearables expertise.

Access to patients: ICON offers customers enhanced access to a larger global pool of more diverse patients through its global site network (Accellacare), specialised oncology network (Oncacare), a paediatric site network, in-home clinical services and a network of six Phase I clinical research units across the United States and Europe.

Future developments

Please see note 31 Subsequent events for details of events in the period from year-end to the approval of the financial statements.

The Group looks forward to continuing to expand through organic growth in 2024 and beyond, together with strategic acquisitions to enhance its expertise and capabilities in certain areas of the clinical development process and to continue to deliver on the Company’s mission to accelerate the development of drugs and devices that save lives and improve the quality of life.


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Directors’ Report (continued)
Results and dividends

The results for the financial year and state of affairs of the Group are set out in the Consolidated Statement of Profit and Loss, the Consolidated Statement of Comprehensive Income, the Consolidated Statement of Financial Position, the Consolidated Statement of Changes in Equity and the Consolidated Statement of Cash Flows on pages 38 to 43 respectively. The Directors do not propose the payment of a dividend for the year ended 31 December 2023.

The following table sets forth for the periods indicated certain financial data as a percentage of revenue and the percentage change in these items compared to the prior period, being the key performance indicators used by management. The trends illustrated in the following table may not be indicative of future results.
31 December
2023
31 December
2022
Percentage increase/decrease
As a percentage of revenue
Revenue100 %100 %5.0 %
Costs and expenses
Direct costs excluding exceptional items70.4 %71.4 %3.6 %
Other operating expenses excluding exceptional items16.6 %17.3 %1.0 %
Operating profit excluding exceptional items13.0 %11.3 %20.0 %
Transaction and integration related expenses0.5 %0.5 %11.3 %
Restructuring expenses0.6 %0.4 %45.7 %
Operating profit including exceptional items11.9 %10.4 %19.5 %
Twelve months ended 31 December 2023 compared to twelve months ended 31 December 2022

Revenue    
31 December
2023
31 December
2022
Change
$’000$’000$’000%
Revenue8,120,176 7,733,386 386,790 5.0 %

Revenue for the year ended 31 December 2023 increased by $386.8 million, or 5.0%, to $8,120.2 million from $7,733.4 million for the year ended 31 December 2022. For the year ended 31 December 2023 we derived approximately 40.4%, 48.7% and 10.9% of our revenue in the United States, Europe and Rest of World, respectively. The increase in revenues in the year ended 31 December 2023 is due to the continued organic growth across the Company's markets.

Revenues from our top five customers amounted to $2,174.8 million in the year ended 31 December 2023 compared to $2,187.4 million in the year ended 31 December 2022 or 26.8% and 28.3% respectively. New customer accounts are continually added across the full portfolio of large pharma customer, mid-tier pharma customers and biotech customers.

Revenue in Ireland increased by $392.5 million in the year ended 31 December 2023, to $2,377.1 million, compared to $1,984.6 million for the year ended 31 December 2022. Revenue in Ireland during the year ended 31 December 2023 increased by 19.8% compared to an overall increase in Group revenue of 5.0%. Revenue in Ireland is principally a function of our global contracting model (see note 2 - Segmental information).

Revenue in the Rest of Europe decreased by $43.6 million or 2.7%, to $1,574.8 million, compared to $1,618.4 million for the year ended 31 December 2022. Revenue in the U.S. decreased by $282.8 million or 7.9%, to $3,283.8 million, compared to $3,566.6 million for the year ended 31 December 2022. Revenue in our Rest of World (‘Other’) region increased by $320.6 million or 56.9%, to $884.5 million compared to $563.9 million for the year ended 31 December 2022.








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Directors’ Report (continued)

Direct costs    
31 December
2023
31 December
2022
Change
Direct costs ($'000)5,719,025 5,521,522 197,503 
% of revenue 70.4 %71.4 %3.6 %

Direct costs for the year ended 31 December 2023 increased by $197.5 million or 3.6%, to $5,719.0 million from $5,521.5 million for the year ended 31 December 2022. 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 increase in direct costs arose due to an increase in personnel related costs, laboratory costs, travel and other direct project driven costs. This was offset by a decrease in third party investigator and other reimbursable costs in the year. As a percentage of revenue, direct costs have decreased to 70.4% compared to 71.4% for the year ended 31 December 2022.

Other Operating Expenses    
31 December
2023
31 December
2022
Change
Other operating expenses excluding exceptional items ($'000)1,347,694 1,334,235 13,459 
% of revenue excluding exceptional items16.6 %17.3 %1.0 %
Other operating expenses including exceptional items ($'000)1,437,260 1,405,073 32,187 
% of revenue including exceptional items17.7 %18.2 %2.3 %

Other operating expenses for the year ended 31 December 2023 increased by $13.5 million, or 1.0%, to $1,347.7 million compared to $1,334.2 million for the year ended 31 December 2022 (excluding exceptional items). Other operating costs comprise primarily of compensation, related fringe benefits and routine share based compensation expense for non-project-related employees, recruitment expenditures, professional service costs, advertising costs, costs related to facilities and information systems, depreciation and amortisation. As a percentage of revenue, other operating expenses decreased to 16.6% of revenue, compared to 17.3% of revenue for the year ended 31 December 2022 (excluding exceptional items). The decrease in costs for the year ended 31 December 2023 primarily reflects decreases in general overhead, personnel costs, share compensation expense, amortisation of intangible assets and marketing costs offset by movements in professional fees, foreign exchange, depreciation, and facilities costs. Further the Group recorded a gain of $6.2 million related to the Oncacare acquisition during the year ended 31 December 2023.

Exceptional items - Restructuring, transaction and integration-related expenses associated with the Merger

31 December
2023
31 December
2022
Change
Transaction and integration related ($'000)44,176 39,695 4,481 
% of revenue0.5 %0.5 %11.3 %
Restructuring ($'000)45,390 31,143 14,247 
% of revenue0.6 %0.4 %45.7 %

During the year ended 31 December 2023, the Group incurred $89.6 million for restructuring, transaction and integration-related expenses. The charge includes transaction and integration costs of $44.2 million associated with professional fees, retention agreements and ongoing integration activities.

The Group has also undertaken a restructuring programme aimed at realigning its workforce as well as reviewing its global office footprint and optimising its locations to best fit the requirements of the Company. This programme has resulted in a charge of $45.4 million in the year ended 31 December 2023 ( 31 December 2022: $31.1 million).

We expect to incur some additional expenses associated with the Merger; however, the timing and the amount of these expenses depends on various factors including the execution of integration activities.
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Directors’ Report (continued)
Operating profit
31 December
2023
31 December
2022
Change
Operating profit excluding exceptional items ($'000)1,053,457 877,629 175,828 
% of revenue excluding exceptional items13.0 %11.3 %20.0 %
Operating profit including exceptional items ($'000)963,891 806,791 157,100 
% of revenue including exceptional items11.9 %10.4 %19.5 %

Operating profit increased by $175.8 million, or 20.0%, to $1,053.5 million ($963.9 million including exceptional items) for the year ended 31 December 2023 from $877.6 million for the year ended 31 December 2022 ($806.8 million including exceptional items) . As a percentage of revenue, operating profit increased to 13.0% (11.9% including exceptional items) of revenues for the year ended 31 December 2023 compared to 11.3% of revenues for the year ended 31 December 2022 (10.4% including exceptional items).

Financing income and expense
31 December
2023
31 December
2022
Change
$’000$’000$’000%
Financing income5,014 2,345 2,669 113.8 %
Financing expense excluding exceptional items(340,871)(234,201)106,670 45.5 %

Financing expense for the period increased to $340.9 million for the year ended 31 December 2023 from $234.2 million for the year ended 31 December 2022 due to impact of rising interest rates incurred on the Group's debt facilities, notwithstanding significant repayments of the Group's loan facilities (see note 23 - Bank credit lines and loan facilities). Financing income for the year increased to $5.0 million for the year ended 31 December 2023 from $2.3 million for the year ended 31 December 2022.

Income tax expense
31 December
2023
31 December
2022
Change
Income tax expense excluding exceptional items ($'000)32,830 79,679 (46,849)(58.8 %)
Income tax expense including exceptional items ($'000)18,627 65,514 (46,887)(71.6 %)
Effective income tax rate (%)3.0 %11.5 %

Income tax expense for the period decreased to $18.6 million (including exceptional items) for the year ended 31 December 2023 from $65.5 million for the year ended 31 December 2022. The Group’s effective tax rate for the year ended 31 December 2023 was 3.0% (4.6% excluding the effect of exceptional items) compared with 11.5% (12.4% excluding the effect of exceptional items) for the year ended 31 December 2022; primarily due to the release of significant unrecognised tax benefits acquired in connection with the merger which was partially offset by a deferred tax provision on unrepatriated earnings. With the exception of the foregoing, the Group's effective tax rate remains principally a function of the distribution of pre-tax profits amongst the territories in which it operates.

Risks and uncertainties

Under Irish Company Law (Section 327 the Companies Act), the Directors are required to give a description of the principal risks and uncertainties which it faced at 31 December 2023. Details of the principal risks and uncertainties facing the Group are set out in Appendix A of this annual report and form an integral part of the Directors’ Report.





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Directors’ Report (continued)
Financial risk management

Group financial risk management is governed by policies and guidelines which are reviewed and approved annually by the Board of Directors. These policies and guidelines primarily cover foreign exchange risk, credit risk, liquidity risk and interest rate risk. The principal objective of these policies and guidelines is to ensure the minimisation of financial risk at reasonable cost. The Group’s financial instruments comprise cash and cash equivalents, current asset investments, lease obligations and negotiated debt facilities. The main purpose of these financial instruments is to fund the working capital requirements of the Group, the cost of new acquisitions and ensure continued growth. The Group also occasionally uses derivative financial instruments to reduce exposure to fluctuations in foreign exchange rates. The principal financial risk facing the Group is foreign exchange risk and interest rate risk. Other financial risks include credit risk and liquidity risk. Further details are set out in note 26 to the Consolidated Financial Statements and note 10 to the Company Financial Statements. The Group does not undertake any trading activity in financial instruments nor does it enter into any leveraged derivative transactions. The Group treasury function centrally manages the Group’s funding and liquidity requirements.

Financing

On 1 July 2021, the Company completed the acquisition of PRA Health Sciences, Inc. ("PRA") by means of a merger whereby Indigo Merger Sub, Inc., a Delaware corporation and subsidiary of ICON, merged with and into PRA, the parent of the PRA Health Sciences ("the Merger"). In conjunction with the completion of the Merger, on 1 July 2021, ICON entered into a credit agreement providing for a senior secured term loan facility of $5,515 million and a senior secured revolving loan facility in an initial aggregate principal amount of $300 million (the "Senior Secured Credit Facilities"). The Senior Secured Credit Facility and Senior Secured Notes were issued at a discount of $27.6 million. On 2 May 2023, the Company agreed with its lenders to increase the aggregate principal amount of the senior secured revolving loan facility from $300 million to $500 million.

Principal repayments, comprising mandatory and voluntary repayments, during the year ended 31 December 2023 and 31 December 2022 were as follows:

Principal repayments
31 December 2023
31 December 2022
$’000$’000
Quarter 1
250,000300,000
Quarter 2
150,000100,000
Quarter 3
300,000200,000
Quarter 4
250,000200,000
Total
950,000800,000

During the year ended 31 December 2023, the Company drew down $370.0 million (31 December 2022: $75.0 million) of the senior secured revolving loan facility and repaid $315.0 million (31 December 2022: $75.0 million ). As at 31 December 2023, $55 million (31 December 2022: $nil) was drawn under the senior secured revolving loan facility in addition to $3.7 million (31 December 2022: $4.5 million) in letters of credit given to landlords to guarantee lease arrangements.

In addition to the Senior Secured Credit Facilities, on 1 July 2021, a subsidiary of the Company issued $500 million in aggregate principal amount of 2.875% senior secured notes due 2026 in a private offering (the “Offering”). The Senior Secured Notes will mature on 15 July 2026.

The Company has contractual liabilities for lease arrangements of $176.9 million which will be predominantly settled over the next five year period through cash payments.

Subsequent events

Details of subsequent events are set out in note 31 to the Consolidated Financial Statements.

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Directors’ Report (continued)
Directors

The following table sets forth information concerning the composition of the Company’s Board committees as of 31 December 2023:

Name
Position
Ciaran Murray
Chair and Director
Dr. Steve Cutler (1)(5)
Chief Executive Officer and Director
Rónán Murphy (2)(3)(5)
Lead Independent Director
Dr. John Climax
Director
Joan Garahy (2)(4)
Director
Eugene McCague (3)(4)
Director
Julie O'Neill (3)(4)
Director
Dr. Linda Grais (2)
Director

(1)Executive Officer of the Company.
(2)Member of Compensation and Organisation Committee.
(3)Member of Audit Committee.
(4)Member of Nominating, Sustainability and Governance Committee.
(5)Member of Execution Committee.

Details required by Companies Act, section 329, of Directors’ interests in the Group’s shares are set out in note 10 to the Consolidated Financial Statements.

Directors’ remuneration

Details of the Directors’ remuneration and interests are set out in note 6 and note 10 to the Consolidated Financial Statements.

Directors’ power to purchase and allot company shares

Subject to the provisions of the Companies Act, the Company may purchase any of its own shares. Every contract for the purchase of shares, or under which the Company may become entitled or obliged to purchase shares in the Company shall be authorised by a special resolution of the Company. The Company may cancel any shares so purchased or may hold them as treasury shares or re-issue them.

A resolution was passed at the Company’s Annual General Meeting (“AGM”) on 22 July 2016, which authorised the Directors to purchase (buyback) up to 10% of the outstanding shares in the Company. This resolution has been renewed annually thereafter. On 18 February 2022, the Company commenced a share buyback program which was fully complete at 31 March 2022. Under this buyback program, 420,530 ordinary shares were redeemed by the Company for total consideration of $100.0 million.

All ordinary shares that were redeemed under the buyback program were cancelled in accordance with the Constitution of the Company and the nominal value of these shares transferred to other undenominated capital as required under Irish Company law.

Rights and Obligations attaching to the Company’s shares

The authorised share capital of the Company is €6,000,000 divided into 100,000,000 ordinary shares of €0.06 at 31 December 2023. Holders of ordinary shares will be entitled to receive such dividends as may be recommended by the Board of Directors of the Company and approved by the shareholders and/or such interim dividends as the Board of Directors of the Company may decide. On liquidation or a winding up of the Company, all assets available for distribution will be paid out to the holders of the Company's ordinary shares. Holders of ordinary shares have no conversion or redemption rights. On a show of hands, every holder of an ordinary share present in person or proxy at a general meeting of shareholders shall have one vote with no individual having more than one vote.



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Directors’ Report (continued)
Change of control
A certain number of the Group’s customer contracts allow the customer to terminate the contract in the event of a change in control of the Company.
The Senior Secured Credit Facilities, details of which are set out in note 23 to the Consolidated Financial Statements, provides that, upon the occurrence of a change of control, the obligations thereunder may be accelerated.

Furthermore, certain Group companies have entered capital grant agreements with the Irish government agency, Enterprise Ireland, whereby the Group covenants that the controlling interest in the Company will not change without Enterprise Ireland’s prior written consent, which will not be unreasonably withheld.

Additionally, the Company's share option and restricted share unit plans contain change in control provisions which provide for the acceleration of the vesting and exercisability of outstanding options and awards of restricted share units in the event that a change in control occurs with respect to the Company.

Corporate Governance

The Company is listed on the NASDAQ Global Select Market. The Company complies with the corporate governance listing requirements under the NASDAQ marketplace rules.

NASDAQ may provide exemptions from certain NASDAQ corporate governance standards to a foreign private issuer if, among other reasons those standards are contrary to a law, rule or regulation of a public authority exercising jurisdiction over such issuer or contrary to generally accepted business practices in the issuer’s home country of domicile, provided, that, the foreign private issuer properly notifies NASDAQ and makes the required disclosure except to the extent that such exemptions would be contrary to United States federal securities laws.

The exemptions that the Company relies on, and the practices the Company adheres to, are as follows:

The Company is exempt from provisions set forth in NASDAQ Rule 5620(c), which requires each issuer (other than limited partnerships) to provide for a quorum in its by-laws for any meeting of the holders of common stock, which shall in no case be less than 33.33% of the outstanding shares of the issuer’s common voting stock. The Company’s Constitution requires that only 3 members be present, in person or by proxy, at a shareholder meeting to constitute a quorum. This quorum requirement is in accordance with Irish law and generally accepted business practices in Ireland.

The Company is exempt from provisions set forth in NASDAQ Rule 5635(c) which requires (other than for certain specified exceptions) shareholder approval prior to the establishment or material amendment of a stock option or purchase plan or other equity compensation arrangement made or materially amended, pursuant to which stock may be acquired by officers, Directors, employees or consultants. Irish law does not require shareholder approval with respect to equity compensation arrangements. Accordingly, the 2019 Consultants and Directors Restricted Share Unit Plan, the 2013 Employees Restricted Share Unit Plan and the amendments to the Employee Share Option Plan 2008 and Consultants Share Option Plan 2008 were adopted by the Board of Directors without shareholder approval.

The Company is exempt from provisions set forth in NASDAQ Rule 5605(b)(2), which requires independent Directors to hold regularly scheduled meetings at which only independent Directors are present. Irish law does not require independent Directors to hold regularly scheduled meetings at which only independent Directors are present. The Company holds regularly scheduled meetings which all of the Directors may attend and the Lead Independent Director may call meetings of the independent Directors and non-employee Directors of the Board, as appropriate, in accordance with the Lead Independent Director Charter.

The Company's practices with regard to these requirements are not prohibited by Irish law.

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Directors’ Report (continued)
Audit Committee

The Audit Committee meets a minimum of four times a year. It reviews the quarterly and annual financial statements, the effectiveness of the system of internal control and recommends the appointment and removal of the external auditors. It monitors the adequacy of internal accounting practices and addresses all issues raised and recommendations made by the external auditors. The Audit Committee pre-approves all audit and non-audit services provided to the Company by its external auditors on a quarterly basis. The Audit Committee, on a case by case basis, may approve additional services not covered by the quarterly pre-approval, as the need for such services arises. The Audit Committee reviews all services which are provided by the external auditor to review the independence and objectivity of the external auditor, taking into consideration relevant professional and regulatory requirements. The Chief Financial Officer, the Head of Internal Audit, the Chief Administrative Officer and General Counsel and the external auditors normally attend all meetings of the Audit Committee and have direct access to the Committee Chairperson at all times. The Audit Committee Charter was updated in February 2024 to include specific responsibilities in respect to the oversight and monitoring of the external reporting on environmental, social and governance (ESG) matters included in the financial statements and data quality related to such reporting in coordination with the Nominating, Sustainability and Governance Committee. The Audit Committee is currently comprised of three independent Directors: Rónán Murphy (Chairperson), Eugene McCague and Julie O'Neill.

Significant shareholdings

The Company has been notified of the following shareholdings in excess of 3% of the issued share capital of the Company as at 31 December 2023:
Name%Number of Shares
WCM Investment Management8.3 6,869,881
Massachusetts Financial Services Company6.7 5,532,676
Wellington Management Company, LLP4.2 3,427,415
Lazard Asset Management, L.L.C.3.4 2,761,425
Boston Partners3.2 2,671,730
Fidelity Management & Research Company LLC3.2 2,645,041
Ninety One UK Limited3.1 2,593,526
Capital Research Global Investors3.1 2,553,673
All Directors and Officers as a group (1)
1.2 987,551

(1)Includes 319,729 ordinary shares issuable upon the exercise of stock options granted by the Company, 31,856 RSUs awarded by the Company to Directors, officers and other key employees and 86,936 PSUs awarded by the Company to Directors, officers and other key employees. Of the PSUs, performance conditions determine how many of them will vest and, if performance targets are exceeded, additional PSUs will be issued and vest in accordance with the terms of the relevant PSU award, the figure included is the maximum amount of PSUs that may be issued.

Further detailed breakdown of the Directors' interest is included in Note 10 Payroll and related benefits.

Subsidiary undertakings

The information required by the Companies Act in relation to subsidiary undertakings is presented in note 32 Subsidiary undertakings to the Consolidated Financial Statements.

Political donations

The Group made no disclosable political donations in the period.

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Directors’ Report (continued)
Going concern

The time period that the Directors have considered in evaluating the appropriateness of the going concern basis in preparing the 2023 Consolidated Financial Statements is a period of at least twelve months from the date of approval of these financial statements (the "period of assessment").

The Group has considerable financial resources and a large number of customers across different geographic areas. Having assessed the relevant business risks (see Appendix A) the Directors believe that the Group is well placed to manage these risks successfully and they have a reasonable expectation that ICON plc, and the Group as a whole, has adequate financial and other resources to continue in operational existence for the period of assessment with no material uncertainties. For this reason, the Group continues to adopt the going concern basis in preparing the consolidated financial statements.

Accounting records

The Directors are responsible for ensuring that adequate accounting records as outlined in Section 281-285 of the Companies Act, are kept by the Company. The Directors are also responsible for the preparation of the Annual Report. The Directors have appointed professionally qualified accounting personnel with appropriate expertise and have provided adequate resources to the finance function in order to ensure that those requirements are met. The accounting records of the Company are maintained at the Group’s principal executive offices at its registered office at South County Business Park, Leopardstown, Dublin 18.

Statement of relevant audit information

The Directors believe that they have taken all steps necessary to make themselves aware of any relevant audit information and have established that the Company's statutory auditors are aware of that information. In so far as they are aware, there is no relevant audit information of which the Company's statutory auditors are unaware.

Disclosure of non-financial information

The European Union (Disclosure of Non-Financial and Diversity Information by certain large undertakings and groups) Regulations 2017 require disclosure of certain non-financial information by certain large undertakings and groups.

We have sought to address the requirements of the legislation in the sections following.
Business Model
Our mission is to improve the lives of patients by accelerating the development of our customers’ drugs and devices through innovative solutions. We are passionate about providing innovative solutions for customers, we are better together working as one team, we value diversity and care about the success of our people, and we care about doing the right thing. We are advancing clinical research while offering customers broader and deeper experience, scale, and focus, complemented by continuity of delivery and speed to market. Consistent with our values, we seek to not only operate in compliance with applicable laws but also to positively influence our global workforce, the communities that we operate in, the environment and society as a whole. Doing so makes us a stronger, more resilient organisation by every measure.

Our business model is described in the "Principal activities, business review and future developments" section of the Directors’ Report.

Our core values underpin our mission and drive a culture and mind-set of ownership at ICON. "Own it at ICON", as set out below, is a statement of values that has remained at the very heart of ICON’s culture, encouraging our people to seize the opportunity and bring flexibility, innovation, and determination to every situation. We believe our culture of ownership personifies who we are as a company — it also helps us apply our expertise, collaborate to get things done, and succeed at our mission.


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Directors’ Report (continued)
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Our values underpin how we work together to deliver on our mission to improve the lives of patients by accelerating the development of our customers’ drugs and devices through innovative solutions. These values and our Code of Ethical Conduct, which underpins these values, form the core of what we do, and how we do it. It applies to all of our officers, directors, employees, consultants and agents globally. All employees and temporary workers are mandated to complete annual global ethics training.

At ICON, we care about conducting business sustainably. We care about our people, patients, and the communities in which we live. We care about doing the right thing and we are committed to working to the highest ethical standards and demonstrating our commitment to honesty, transparency, and quality. As a testament to our commitment, we launched our “ICON Cares” program at the start of 2023 which incorporates all our Environment, Social and Governance (ESG), Diversity, Inclusion and Belonging (DIB), and CSR initiatives into one program. ICON’s Environment, Social, and Governance Committee ('ESG Committee') brings together all these initiatives and efforts under one umbrella to ensure consistency, enhance monitoring, reveal areas for development and facilitate reporting to the Board. The ESG Committee is chaired by the Chief Administrative Officer and General Counsel (CAO), who is responsible for reporting to the ICON executive leadership team, the Nominating, Sustainability and Governance Committee and the Board on ESG matters. The CAO reports on ESG matters to the Nominating, Sustainability and Governance Committee quarterly and reports to the Board at least annually whilst also providing periodic ESG updates to the executive leadership team.

The ESG Committee is focused on developing our strategy and initiatives relating to the environment, social matters, health and safety, community engagement, corporate governance, sustainability, and other public policy matters relevant to the Company. The ESG Committee is a cross-functional management committee of the Company including representation from facilities, health and safety, corporate communications, finance, legal, investor relations, procurement, commercial, marketing, and human resources departments. The Committee meets regularly to assist and support executive management and the Nominating, Sustainability and Governance Committee of the Company in:

determining and setting the strategy relating to ESG matters;
developing, implementing and monitoring initiatives and policies based on that strategy; and
communicating these strategies, initiatives, and their results.

We are committed to building and developing our ESG strategies and reporting. In 2020 we launched our ESG page on the ICON website and have an internal ICON Cares ESG page on our MyICON intranet portal to engage with our employees and provide information and updates relating to ESG matters and our commitment to sustainability. In 2021, as a testament to our commitment to managing ICON responsibly and sustainably, we became a participant in the United Nations Global Compact (UNGC), a set of Ten Principles covering the areas of human rights, labor, environment, and anti-corruption. In our
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Directors’ Report (continued)
2022 ESG report, released in 2023, we reported under the Global Reporting Initiative (GRI, 2021) standards, the Task Force on Climate-Related Financial Disclosures (TCFD) and the Sustainability Accounting Standards Board (SASB) index. Our report summarises our current policies, priorities, commitments, achievements, and progress in respect to ESG matters. ICON received a gold medal from EcoVadis for our 2023 submission in recognition of our environment, social and governance efforts throughout ICON. The ESG page on our website is available at https://www.iconplc.com/about/esg/.

The global landscape in respect to regulatory and legislative requirements relating to ESG reporting and disclosure requirements is rapidly evolving, and we are monitoring potential requirements so that we are positioned to adhere to any additional requirements in due course. This includes mandatory reporting under the Corporate Sustainability Reporting Disclosure (CSRD) from the EU and the SEC Climate Risk Disclosure Rule which is pending finalisation.

Building a sustainable future – our commitment to the United Nations Sustainable Development Goals

As a global company, we maintain an ethical and sustainable presence in hundreds of locations worldwide. At its core, ICON’s mission is to improve health and lives. We are also committed to contributing to the 2030 United Nations Sustainable Development Goals (SDGs) and are proud that our work contributes to their advancement.

Our research, our work with customers and patients and our on-the-ground efforts to meet the diverse needs across our communities align with the SDGs. We focus these efforts on a subset of themes where we have identified the greatest opportunity to effect change:
SDG 3 – Good health and well-being
SDG 5 – Gender equality
SDG 9 – Industry, innovation and infrastructure
SDG 10 – Reduced inequalities
SDG 12 – Responsible consumption and production
SDG 13 – Climate action
SDG 17 – Partnerships for the goals

Further details on the ways ICON contributes to these SDGs and their targets are set out in our ESG Report.

Environmental Matters: Conducting business sustainably

ICON is committed to delivering excellence in care to our communities. To improve our overall sustainability, this commitment means tracking and improving our environmental performance across all business activities. We achieve this by pursuing sustainability strategies that recognise the impact of our operations as a CRO on the environment, addressing greenhouse gas (GHG) emissions, energy use, waste generation and procurement-related activities. Our employees, directors, officers, contractors, and temporary workers are expected to support our sustainability objectives.

Our Global Environmental Management Policy and Environmental Management Plan is part of our ICON Cares program for managing environmental sustainability initiatives. The implementation of the plan is led by our facilities team, reporting to our Chief Administrative Officer and General Counsel (CAO). The CAO is responsible for reporting on the ICON Cares program and environmental initiatives and progress to the ICON executive leadership team and Nominating, Sustainability and Governance Committee and the Board.

ICON set environmental goals around the use of renewable energy and carbon emissions in 2019 and we are working towards achieving these goals which are as follows:
100% renewable electricity by 2025
20% reduction in kilowatt hours (kWh) of electricity by 2030
Net zero carbon emissions on Scope 1 & 2 by 2030

In April 2023, following Board approval, ICON made a commitment to the Science Based Targets initiative (SBTi), when we submitted our near-term commitment letter to the SBTi. In February 2024, the Board approved furthering our SBTi commitment to include a long-term company-wide emissions reduction target in line with science-based net-zero. Accordingly, we have submitted our commitment letter to SBTi to set net-zero targets, including a long-term science-based target and are preparing to submit both our near-term and long-term science-based targets for validation.

We have programs in place to manage and minimise climate impacts of business activities. To continue to improve processes and reduce our environmental impact, we track, calculate, and report our Scope 1, Scope 2 and Scope 3 business travel GHG footprint. We apply the GHG Protocol Corporate Standard, which is the global corporate accounting and reporting standard for calculating carbon emissions. Carbon Trust provides annual verification of our Scope 1 and 2
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Directors’ Report (continued)
GHG emissions data. In 2023, we worked with Carbon Trust to conduct a full Scope 3 footprint, which we are analysing with a view to annual public reporting in due course.

Aligned with our goal to be net-zero on Scopes 1 and 2 by 2030, ICON’s combined Scope 1 and 2 GHG emissions have decreased since 2018. We recognize that although the combined Scopes 1 and 2 emissions have fallen year-on-year, ICON’s Scope 1 emissions have increased slightly each year. To reach our net-zero goal, our decarbonization strategy is currently focused on reducing Scope 2 emissions, the largest contributor to our Scope 1 and 2 footprint. Following on from our Scope 2 emissions reduction efforts, we plan to launch efforts that target our Scope 1 emissions in the coming years.

In 2020, following pandemic-related closures and a reduction in business travel, our Scope 3 GHG emissions declined significantly. Since 2021, as more normal operations resumed, we have seen an overall increase in our total GHG emissions driven by an increase in business travel (Scope 3).

Although Scope 1 and 3 emissions have increased, we remain below our 2018 pre-COVID overall emissions, and are committed to continue our work towards reducing emissions. Additionally, our emissions intensity has decreased substantially as our business has grown. Since 2018, our emissions intensity per million in revenue and our emissions intensity per FTE employee has decreased.

Moving forward, ICON expects to see further emission reductions relative to revenue and the number of employees due to a reduction in offices, strategic energy efficiency projects and a flexible work policy that allows eligible employees to work from home 40% of the time.

ICON participates in CDP (formerly the Carbon Disclosure Project) on an annual basis. CDP is a globally recognised organisation that allows companies to measure and manage their environmental impacts. We received a B score from CDP for 2023 on our 2022 Climate Change response which was an improvement on the C score that we received from CDP in 2022 on our 2021 Climate Change response. The improved score is a reflection of our efforts and the progress that we are making in respect to environmental sustainability. Our CDP responses are available at https://www.cdp.net/en/.

We are focused on reducing energy use and increasing renewable energy use across our global operations as specific environmental goals. Waste reduction is embedded into our environmental policies and practices and is one of the objectives of ICON’s Environmental Management Policy.

ICON leases most of our offices and facilities, and therefore we work closely with our landlords and leasing agents to implement measures to ensure we operate in an environmentally sustainable manner. Throughout 2023, we continued real estate harmonisation efforts which resulted in downsizing or closing 19 locations to align with new working styles and business needs, this also helps to reduce our environmental footprint. Experts from our real estate team factor environmental considerations into decisions around new office locations or building improvements. We’ve also implemented a series of measures globally to reduce the local footprint of our offices while promoting comfort and efficiency. These include:
Installing energy-efficient LED lighting.
Using motion detectors.
Purchasing recycled office supplies.
Reducing paper consumption by promoting paperless office processes and defaulting double-sided output.
Building recycling areas into business centers and kitchens/canteens.
Planting green spaces to improve internal air quality.
Selecting building materials and vendors for their low environmental impact.

We require our suppliers to abide by our Global Supplier Code of Conduct which includes a commitment to comply with applicable environmental laws and regulations, our expectations around waste management and sustainable use of resources.

We care about making a positive impact on the communities in which we work and live and we have aligned our community efforts to a broader vision for social impact, including by aligning priorities with our organisational goals of diversity, inclusion, and belonging.

For further details on risks relating to environmental, social and governance matters refer to Appendix A: Risk Factors.


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Directors’ Report (continued)
Social and Employee matters

Community Engagement

Our community engagement activities are focused on two core areas:

Supporting education and building closer ties between industry and academia; and
Improving the welfare of people in the communities in which we live.

Supporting education and building closer ties between industry and academia

A core area of community support includes building ties between industry and academia to inspire the next generation of leaders in business and science. Our existing partnerships continue with the following organisations:

The ICON-McKeon Research Fellowship in Motor Neuron Disease ('MND') in honor of Mr. Declan McKeon, former Board member, acting Chairman, Lead Independent Director and Chair of the ICON Audit committee. The ICON-McKeon Research Fellow in MND carries out research in the areas of machine-learning and artificial intelligence to derive insights from multimodal clinical, imaging neuro-electric signaling, in the context of the neurodegenerative disease of ALS.

Partnership with Trinity Centre for People with Intellectual Disabilities ('TCPID') - TCPID situated within the School of Education, Trinity College Dublin, aims to promote the inclusion of people with intellectual disabilities in education and society. The Centre provides people who have intellectual disabilities with the opportunity to participate in a higher education program designed to enhance their capacity to fully participate in society as independent adults. The 2-year education program includes work placements and internships to enable students to experience and participate in the work environment. In 2023, we were delighted to host a student visit from TCPID students to our global headquarters in Dublin, where they enjoyed learning about the different phases of a clinical trial and also experienced a working laboratory during a tour of the facility.

Partnership with Junior Achievement to inspire schoolchildren. Junior Achievement encourages young people to remain in education and teaches them the skills they need to succeed in a changing world. ICON volunteers take time out of their working day to deliver Junior Achievement programs, teaching primary and secondary-level students valuable business, STEM (Science, Technology, Engineering & Mathematics) and entrepreneurship skills that will serve them throughout their professional lives.

Aligned with our ambitions to build closer ties between industry and academia, create a more diverse graduate pool of talented and ambitious STEM professionals who can help to ensure the future success of the life sciences industry, and provide increased opportunities for underrepresented groups to study STEM courses, our STEM scholarship program continued in 2023. Through the program, ICON is partnering with three universities in Ireland – Dublin City University (DCU), Trinity College Dublin (TCD) and the University of Limerick (UL) – as well as with the Thurgood Marshall College Fund (TMCF) in the US, to fund 33 scholarships for students of STEM courses. TMCF is a not-for-profit organisation that supports nearly 300,000 students attending its 47 member-schools that include publicly-supported Historically Black Colleges and Universities (HBCUs).

Improving the welfare of people in the communities in which we live

Through volunteering, donations and other charitable initiatives, our employees across the world are making a positive difference to their communities. We support causes that are important to our employees and have several programs that support the welfare of people in our local communities. In November 2023, 360 ICON colleagues from across the globe united in person and virtually to take part in Run in the Dark for the fourth conservative year. Team ICON raised $10,000 to support Mark Pollock's Collaborative Cures foundation whose mission is to bring people together to cure paralysis in our lifetime. A team of 125 ICON cyclists from 24 countries also participated in our annual ICON cycle challenge, which covered 350km from Zurich to Munich, across 3 days and which raised funds for Mission Rabies, a global charity that aims to control the spread of rabies through vaccination of dogs in endemic areas.

Since 2012, ICON’s annual employee-nominated charity donation program has supported over 100 charities worldwide, donating $10,000 to each organisation. The selected organisations focus on a range of critical issues, such as building a more inclusive society, improving child welfare and supporting patients who are battling chronic diseases. The chosen charities align with ICON’s corporate mission, our ICON Cares program diversity and inclusion goals and support our efforts to advance the United Nations Sustainable Development Goals (SDGs). In addition, ICON donated to UNICEF in support of humanitarian efforts following the devastating earthquakes in Syria and Turkey.

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Directors’ Report (continued)
Talent and People

Our people are core to our ability to deliver our services and drive better patient outcomes. Through diversity, inclusion and belonging, industry-leading talent management practices, a sincere attention to our employees’ needs, well-being and health and safety, we continue to power the potential of together.

At the core of our strategy is our people

People have long been central to our mission to improve the lives of patients by accelerating the development of our customers’ drugs and devices through innovative solutions. We encourage our people to bring flexibility, innovation, and determination to every situation. By doing so, our people can build exciting and rewarding careers, and deliver results to bring life-changing medicines to market and to maintain our success as an industry leader.

Learning and development of our staff is a key focus for us

Our leadership and talent programs contribute to the enhanced retention of our employees, better project deliverables for our customers and the enhanced financial performance of the business.

We aim to be an industry leader where talented people come to do important work and where our employees can shape the future of healthcare, grow their careers, and reach their full potential. We have long held a deep commitment to cultivating strong people practices. This includes competitive total rewards packages along with a focus on continuous learning. We nurture a culture of development and aim to boost engagement by supporting our people’s growth, both personally and professionally. We are dedicated to finding opportunities for our employees to grow and develop.

Our success depends on the knowledge, capabilities, and quality of our people. To improve their skills, we are committed to providing continuous learning. This commitment is underpinned by clearly defined competencies, which offer employees a clear path along which to develop skills and advance their careers.

To support employees at every stage of their career journeys, training and development programs are aimed at advancing scientific, technical, and business knowledge as well as behavioural competencies. Programs include Corporate and Functional Onboarding for all ICON employees tailored CRA academies; Data Management and Biostats & Programming Academies; a Commercial Skills Academy; a range of project management curricula, therapeutic-focused programs, and People Leader development programs.

Our People Leader development program focuses on providing our People Leaders with the relevant skills to effectively manage themselves, their team and their business, including leveraging psychometrics to raise awareness of their behavioural preferences and the preference of others. ICON also invests in Harvard Manage Mentor, an online learning platform providing People Leaders with access to learning available at any time with topics ranging from change management, diversity & inclusion, retaining employees and developing employees.

We provide our people with a personalised and flexible learning experience, delivered through a combination of in-person and technology-driven programs that suit their learning styles and can flex to suit their schedules. Through our industry leading Career Hub, ICON employees are encouraged to broaden their scientific, technical, leadership, and business knowledge. By tapping into development programs and partnerships with leading academic institutions, team members can use the hub to develop competencies that advance their careers. We also collaborate with UCD Smurfit School Executive Development to deliver customised leadership development programs for global employees.

As an organisation we are keen to hear directly from our employees

To attract and retain the best talent, we must listen and respond to employees’ needs. This begins with a focus on diversity, inclusion and belonging, and extends to every aspect of our work, from recruitment and onboarding, to training, engagement, enablement, and reward. We pursue best-in-class approaches to building employee engagement and these include, among others:

Comprehensive global employee surveys, which measure how people feel about their work and whether they feel they have the tools to do their jobs well. Feedback from these studies informs detailed action plans at the group, function, and team level.
Pulse check surveys, which are smaller-scale studies designed to measure employee sentiment on specific topics and initiatives.
Fostering an environment of diversity, inclusion and belonging where everyone is valued.
Stay interviews to help managers understand why staff stay and to uncover what might put them at risk of departing.
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Directors’ Report (continued)
Skip-level meetings to develop trust and rapport between senior leaders and employees.

Our listening strategy supports our efforts to reduce employee turnover, which we monitor closely through analytics. Qualitative information is collected through formal exit interviews and, where we believe they’ll make an impact, we intervene via retention plans and related efforts.

Employee well-being

ICON’s commitment to improving health and enriching lives extends beyond the work we do with our customers. Employees worldwide have access to tools and resources designed to support all facets of their well-being, from physical to financial to psychological and beyond.

Our global Employee Assistance Program (EAP) ensures that all employees, and their families, have access to a range of different, confidential resources and experts to help them better manage their working life and personal life. Employees can also access a wide range of tools, information and support services online in local languages.

Health and safety

At ICON, the health and safety of our employees, customers and clinical trial patients are our most important priorities. We take guidance from global and regional health authorities and governments to protect the safety and welfare of employees, as well as abide by government directives. Our global health and safety management system ensures we deliver on all local and national requirements. Our priority objectives are the safety of our staff, clinical trial patients, protecting the environment, maintaining business continuity, and ensuring all sensitive health and safety data is protected.

We are committed to providing a safe working environment for our people. We achieve this goal by working in ways that protect the safety, health, and welfare of all our employees, clinical trial patients, and visitors. Risk assessment is the basis of the safety management system, and we work to identify, mitigate, and monitor existing and emerging health or environment risks that may be associated with our business activities.

Fostering diversity, inclusion and belonging

We are committed to being a workplace where all employees are included and feel a sense of belonging. As a global, values-driven organisation, we acknowledge and celebrate our differences in gender, ethnicity, culture and abilities. Respecting diverse viewpoints and experiences is foundational to our interactions with each other and with our patients, customers and suppliers. Moreover, we strive to build teams that reflect the various geographies and communities in which we live and work and the patients we serve.

We recognise the critical importance of diversity in clinical trials ensuring all types of patients who will eventually receive therapies are represented on clinical trials, as well as offering clinical trials as a care option for those who may not otherwise have access to medical treatment. In furtherance of our aim to increase diversity within clinical trials, we appointed a Global Head of Diversity in Clinical Trials to lead a team of cross functional experts who can advise customers how to build diversity at every stage of the clinical trial.

Diversity, inclusion, and belonging (DIB) are fundamental to our culture and values. Diversity makes us more innovative and more creative. ICON’s approach to DIB is a key focus area. To reflect this, inclusion is one of our core values and our DIB strategy revolves around four key ambitions: our people, our patients, our customers, and our communities.


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Directors’ Report (continued)
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For each of these ambitions, ICON’s DIB Operating Committee brings together individuals from across the company to create and execute work streams that are committed to advancing our DIB strategy. A central team manages the overarching efforts, ensuring alignment and collaboration across each of the ambitions. Each ambition has a sponsor from ICON’s executive leadership team who advocates for and supports the agenda, in addition to providing leadership.

The growth of community groups enabled ICON to retire the role of the DIB advocates who were recruited from across the organisation to support leadership and the DIB Operating Committee with DIB strategy and activities. Now, all community group members and allies act as advocates across the company. Their aim: to align activities, promote events and share information back to their service lines. It is our aspiration that all our employees will act as DIB advocates.

We believe in a workplace culture that embraces diverse perspectives and empowers our team members to grow — at work, at home and in their communities. The key areas of focus for our diversity, inclusion, and belonging agenda include talent management, country-level inclusion policies, rewards, training, mentoring and communications.



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Directors’ Report (continued)
The DIB community groups we have at ICON are:

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DAWN:
The Disability Awareness Network is a community group focused on developing and fostering a mind-set towards creating an inclusive workplace and working environment where everyone is treated equally with respect and dignity, irrespective of any visible or hidden disabilities.
https://cdn.kscope.io/aae9119eee5cb3cb2f30963bb4b278d9-image5.jpg
EmbRACE:
EmbRACE is a community group supporting all race and ethnic backgrounds in creating an inclusive workplace culture. Our ambition is to build a culture that is inclusive, collaborative and accountable, supporting all our people and removing barriers that prevent them from doing their best work and being their true selves at ICON.
https://cdn.kscope.io/aae9119eee5cb3cb2f30963bb4b278d9-image6.jpg
NOW@ICON:
The Networking Organization for Women at ICON is committed to inspiring and connecting current and potential leaders through an inclusive environment of targeted initiatives and supportive mentorship.
https://cdn.kscope.io/aae9119eee5cb3cb2f30963bb4b278d9-image7.jpg
Pride@ICON:
The Pride group supports LGBTQ+ colleagues and allies, ensuring that no matter where employees are in the world, our offices are a safe space where they are welcomed, respected, and valued.
https://cdn.kscope.io/aae9119eee5cb3cb2f30963bb4b278d9-image8.jpg
SPACE:
SPACE is a Community Group that Supports Parents And Carers Everywhere. We aim to create awareness and education, with a view to building an effective SPACE community that provides individual, group and regional support connections for parents and carers.

In 2023 each community group launched a mentoring program to support networking and career development at ICON. This was a huge success with over 300 mentor and mentee matches across the five community groups with mentors and mentees receiving training and toolkits to make the most of their mentoring relationship.

As a testament to our commitment to diversity, ICON are aiming for gender parity at the VP level and above by 2025. As at 31 January 2024, women represent 46% of the positions at the VP level and above. Our strong focus on talent management, succession planning and talent development ensures we work towards building strong talent pipelines for VP level roles with equal number of female and male candidates shortlisted for all our senior roles.

Establishing a truly inclusive workplace requires offering fair pay. Using best-in-class methodology, we regularly review salary ranges to establish fair pay among employees regardless of gender, race or ethnicity. We also consider legitimate business factors that explain differences, such as performance, tenure and experience. ICON has made and will continue to make significant investments in organisational design structures, tools and education that uphold and support our pay principles.

We are committed to ensuring fair employment practices. For every jurisdiction in which we operate, we act in compliance with relevant laws relating to labour rights and labour relations as well as market competitive benefits. We believe in fair and equal treatment for all our people, without regard to gender, race, ethnicity, sexual orientation, marital status, physical or mental disability, age, pregnancy, veteran status, nationality, religion, or any other legally protected status. We do not tolerate our employees being subjected to physical, sexual, racial, psychological, verbal, or any other form of harassment. We encourage our employees to report any issues of harassment or discrimination. We prohibit retaliation against any employee who rejects, protests, or complains about unlawful discrimination or harassment.

For further details on risks relating to employee matters refer to Appendix A: Risk Factors.


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Directors’ Report (continued)
Human rights

ICON is committed to human rights and in 2021, ICON became a participant in the UN Global Compact (UNGC), signalling our commitment to uphold the UNGC’s 10 Principles, including those related to human rights across our global operations. Our business model and our policies, including our Global Code of Ethical Conduct and Global Supplier Code of Conduct, are intended to fully comply with applicable human rights legislation in the countries where we operate. Our zero-tolerance policy on forced labour, slavery, and human trafficking is defined clearly in these policies, which are available to employees, suppliers, customers, and the public.

We are opposed to forced labour, slavery, and human trafficking. We will not knowingly support or conduct business with any organisation involved in such activities. We do not employ anyone below the minimum employment age in the jurisdictions in which we operate.

Our Global Supplier Code of Conduct incorporates the Pharmaceutical Supply Chain Initiative (PSCI) principles for responsible supply chain management, including for labour. Before doing business with ICON, suppliers must certify that they will comply with the ICON Global Supplier Code of Conduct or their own materially equivalent internal code, which includes human rights protections. We perform pre-engagement due diligence on our suppliers, including in relation to labour issues, which we support through periodic re-screening. We hold our suppliers accountable for meeting their contractual obligations. Contract non-compliance can result in termination of the business relationship with the supplier and exclusion from future business.

For further details on risks relating to environmental, social and governance matters refer to Appendix A: Risk Factors.

Ethics and Compliance

ICON’s commitment to ethics and integrity is embedded in our company values. We act with integrity and integrate ethical principles into our business practices and culture. ICON’s Global Code of Ethical Conduct (the Code) establishes our core principles and standards for honest, fair, and ethical behaviour. This Code addresses the core values expected of our people in our internal interactions with each other as well as in external dealings with patients, customers, healthcare professionals, regulators, investors, vendors and other third parties.

Our Ethics and Compliance program is designed to protect the interests of the company and its shareholders by preventing, detecting, investigating and responding to potential misconduct and violations.

The Ethics & Compliance team (E&C) provides day-to-day independent oversight for the program. The team works collaboratively with risk and compliance functions and leadership across the business to align on and optimise its reach and impact. The Head of E&C provides day-to-day independent oversight for the program. The team is independent of the business and reports to the Deputy General Counsel, who reports to the Chief Administrative Officer and General Counsel (CAO). The CAO reports on the program to ICON’s executive leadership team, the Nominating, Sustainability and Governance Committee and the Board. The program supports all functional areas globally and is dedicated to the implementation of standardised global policies, procedures, training, guidance, communications, monitoring, investigations, issue management, assessing compliance-related risk and mitigations, and reporting to ensure the overall compliance program is effectively functioning. Where appropriate, the program also implements regional and/or country specific policies, procedure, training and guidance.

ICON has incorporated a third-party system, Ethics Line, for employees and third parties to confidentially report ethics and compliance questions, as well as concerns, and to track reports through follow-up and resolution. An independent company administers this hotline, which is available all hours of every day and can accommodate calls in over 75 languages. These tools also provide visibility into our risks while highlighting opportunities to address them. ICON’s Ethics and Compliance program will continue to grow and evolve in response to changes in our business and in the global business climate.

All personnel are required to receive ethics and compliance training during initial onboarding and through annual refresher sessions. Training modules explain the many channels available for reporting suspected unethical or illegal practices. The training supports our values and our ways of working and incorporates the key principles of our policies and codes and includes interactive scenarios where applicable.

At ICON, we promote a Speak Up culture that encourages compliance, openness, and accountability without retaliation. The Speak Up Policy aims to support our culture and values and seeks to encourage the prompt reporting or surfacing of concerns or violations about values, ethics or other standards without fear of retaliation. Reported ethics concerns and other ethics and compliance-related data are reported via the CAO to the Board as appropriate.

For further details on risks relating to ethics and compliance refer to Appendix A: Risk Factors.

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Directors’ Report (continued)
Anti-bribery and Corruption

ICON is guided by the foundational principle that we do not tolerate bribery or any other form of corruption or fraud. Our anti-bribery and anti-corruption (ABAC) program is a core element of our Ethics and Compliance program. ICON and all ICON directors, employees, consultants, agents and all third parties acting on ICON's behalf must act in compliance with international laws and regulations relating to bribery, corruption, and illicit payments, including the US Foreign Corrupt Practices Act and the UK Bribery Act 2010.

ICON maintains the ISO 37001:2016 certification for our Anti-Bribery Management System, which establishes the framework for the controls that prevent, detect and mitigate the risk of bribery. Our program is designed to ensure our compliance with anti-corruption laws, including due diligence, training, policies, procedures, and internal controls.

Bribery and corruption remain a business risk as we conduct our business across the globe and enter partnerships and collaborations. There is no certainty that all employees and third-party business partners (including our vendors, suppliers, agents, contractors, and other partners) will comply with anti-bribery laws. When working with third parties, we are committed to working with only those who embrace high standards of ethical behaviour consistent with our own. Bribery and corruption risks are a focus of our third-party diligence and management process. We hold our suppliers accountable for meeting their contractual obligations with ICON, including commitments that are made with regard to our Global Supplier Code of Conduct and regulatory compliance. Contract non-compliance can result in termination of the business relationship with the supplier and exclusion from future business with ICON.

ICON's internal audit teams conduct ABAC program audits. Internal Audit focuses on testing for compliance and design effectiveness of the overall ABAC program. Internal Audit incorporates an assessment of ABAC measures in all audits, as appropriate. In this approach, bribery and corruption risks are incorporated into the risk assessment and scoping process of each audit.

For further details on risks relating to Anti-bribery and Corruption refer to Appendix A.

Privacy and Information Security

Data privacy and information security are fundamental to our business and key to retaining customers, building investors’ trust, protecting patients, and complying with global and regional regulations. We recognise and respect that our customers, employees, patients, and all those who do business with us expect that we will protect their personal information in accordance with our legal obligations and policy commitments.

Our Global Data Protection Policy regulates the processing of personal data in accordance with the applicable data protection laws of the countries where we operate, including Europe’s General Data Protection Regulation (GDPR) framework. This policy governs ICON’s and its employees’ obligations concerning the processing of personal data, including core privacy issues such as how we address data subject rights, data protection impact assessments and our obligations to maintain records of processing activities (ROPAs).

ICON has a separate Personal Data Incident and Breach Response Policy and Process that governs the management of personal data incidents and breaches within ICON. The policy requires incidents to be reported to ICON’s Global Data Protection Officer (DPO) and Privacy Team, who manage them in collaboration with relevant internal stakeholders (e.g., IT Security, Quality & Compliance), to ensure we comply with our legal and contractual obligations, including our reporting obligations. In 2023, in combination with our existing ISO 27001 certification, ICON’s data protection policies and procedures were certified to ISO 27701. Our privacy program is overseen by the CAO.

Our people and partners play a critical role in safeguarding data. ICON has training in place for all employees and contingent workers on information security and privacy practices so that they understand their responsibilities with respect to data security and privacy. ICON has also established a robust Privacy and Security Champion (PSC) network. The PSC network acts as an extension of the Privacy and Information Security teams. In line with the PSC charter, champions provide a key touch point in relevant business units, bolster awareness of ICON’s respective privacy and security programs and provide direct support in response to priorities dictated by ICON’s Privacy and Security Council (chaired by ICON’s Global Data Protection Officer and Head of Information Security).

For further details on risks relating to information security and privacy refer to Appendix A.


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Directors’ Report (continued)
Sustainable procurement

ICON maintains policies and processes to support responsible, sustainable, and ethical business practices. Our goal is to source from suppliers whose values align with our own, who share our commitment to diversity and inclusion, and who are socially and environmentally responsible and conscious.

We manage our suppliers through our Global Procurement department. The onboarding of all new suppliers is completed through a robust centrally managed due diligence process. Environmental sustainability, bribery, and corruption risks are a focus of our third-party assessment and management process.

ICON performs pre-engagement due diligence on our suppliers. This includes screening of sanctions lists, debarment, and adverse media. Suppliers are continuously monitored against sanctions and debarment lists and are periodically re-screened. Suppliers deemed higher risk are subject to enhanced due diligence and controls, which may include periodic training, auditing, and assessments.

We require our suppliers to abide by our Global Supplier Code of Conduct which incorporates the Pharmaceutical Supply Chain Initiative (PSCI) principles for Responsible Supply Chain Management and sets out our standards and expectations regarding:

Ethics and compliance
Labor and human rights
Health and safety
Environmental stewardship

Our Global Supplier Code of Conduct also outlines channels to report concerns or grievances related to our suppliers, such as our Ethics Line. We operate a strict anti-retaliation policy and expect suppliers to do the same. We hold our suppliers accountable for meeting their contractual obligations, including commitments relating to the Global Supplier Code of Conduct and regulatory compliance. Contract non-compliance can result in termination of the business relationship and exclusion from future business with our company.

To further support the development of our sustainable procurement program, ICON has engaged with EcoVadis, CDP and Supplier IO to help assess our key suppliers and gather data around sustainability maturity, GHG emissions and diversity status and classifications. This data allows us to factor sustainability related factors into our supplier selection activities and embed sustainability into our procurement practices.

For further details on risks relating to sustainable procurement refer to Appendix A: Risk Factors.

Directors’ compliance statement

The Directors, in accordance with Section 225(2) of the Companies Act, acknowledge that they are responsible for securing the Company’s compliance with its relevant obligations as defined within the Companies Act, (hereinafter called the relevant obligations).

The Directors confirm that:

a compliance policy statement has been drawn up setting out the Company’s policies with regard to such compliance;
appropriate arrangements and structures that, in their opinion, are designed to secure material compliance with the Company’s relevant obligations, have been put in place; and
a review has been conducted, during the financial year, of the arrangements and structures that have been put in place to secure the Company’s compliance with the relevant obligations.

Auditor

In accordance with Section 383(2) of the Companies Act, KPMG, Chartered Accountants, will continue in office.

While there has been no change yet in our auditor, in 2023, the Audit Committee of the Company engaged in a competitive audit tender process for the position of statutory auditor. Based on the results of this process, the Audit Committee is recommending that Ernst & Young be appointed as statutory auditors and independent registered public accounting firm to the Company in respect of the financial year ending 31 December 2025. Ernst & Young's appointment will be subject to the passing of an ordinary resolution confirming the appointment at the Company's 2025 Annual General Meeting.

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Directors’ Report (continued)
KPMG, our current auditor, who will audit the financial statements for the year ending 31 December 2024, is expected to resign shortly after completion of the audit of the Company's financial statements for the year ending 31 December 2024.

During the two years ended 31 December 2023 and 31 December 2022 and any subsequent interim period there were no disagreements with KPMG on any matter of accounting principles or practices, financial statement disclosure, or auditing scope or procedures, which disagreements if not resolved to their satisfaction would have caused them to make reference in connection with their opinion to the subject matter of the disagreement.


On behalf of the Board




Steve Cutler
Rónán Murphy
23 April 2024
Chief Executive Officer
Director
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Statement of Directors’ Responsibilities in respect of the Directors’ report and the financial statements
The directors are responsible for preparing the annual report and the financial statements in accordance with applicable law and regulations.
Company law requires the directors to prepare Group and Company financial statements for each financial year. Under that law, the directors are required to prepare the Group financial statements in accordance with IFRS as adopted by the European Union. The directors have elected to prepare the Company financial statements in accordance with FRS 101 Reduced Disclosure Framework and applicable law.
Under company law the directors must not approve the Group and Company financial statements unless they are satisfied that they give a true and fair view of the assets, liabilities and financial position of the Group and Company and of the Group’s profit or loss for that year.
In preparing the Group and Company financial statements, the directors are required to:
select suitable accounting policies and then apply them consistently;
make judgements and estimates that are reasonable and prudent;
state whether applicable Accounting Standards have been followed, subject to any material departures disclosed and explained in the financial statements;
assess the Group and Company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern; and
use the going concern basis of accounting unless they either intend to liquidate the Group or Company or to cease operations, or have no realistic alternative but to do so.
The directors are responsible for keeping adequate accounting records which disclose with reasonable accuracy at any time the assets, liabilities, financial position of the Group and Company and the profit and loss of the Group and which enable them to ensure that the financial statements comply with the provision of the Companies Act 2014. The directors are also responsible for taking all reasonable steps to ensure such records are kept by its subsidiaries which enable them to ensure that the financial statements of the Group comply with the provisions of the Companies Act 2014. They are responsible for such internal controls as they determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error, and have a general responsibility for safeguarding the assets of the Company and the Group, and hence for taking reasonable steps for the prevention and detection of fraud and other irregularities. The directors are also responsible for preparing a directors’ report that complies with the requirements of the Companies Act 2014.
The directors are responsible for the maintenance and integrity of the corporate and financial information included on the Group’s and Company’s website www.iconplc.com. Legislation in the Republic of Ireland concerning the preparation and dissemination of financial statements may differ from legislation in other jurisdictions.

On behalf of the Board




Steve Cutler
Rónán Murphy
Chief Executive Officer
Director
30





Independent Auditor’s Report to the members of ICON plc
Report on the audit of the financial statements

Opinion

We have audited the financial statements of ICON plc (‘the Company’) and its consolidated undertakings (together, “the Group”) for the year ended 31 December 2023, set out on pages 38 to 148, which comprise the Consolidated Statement of Profit and Loss, Consolidated Statement of Comprehensive Income, Consolidated Statement of Financial Position, Consolidated Statement of Changes in Equity, Consolidated Statement of Cash Flows, Company Statement of Financial Position, Company Statement of Changes in Equity, and related notes, including the material accounting policies set out in note 1 of the consolidated financial statements.

The financial reporting framework that has been applied in the preparation of the Group financial statements is Irish Law and International Financial Reporting Standards (IFRS) as adopted by the European Union and, as regards the Company financial statements, Irish Law and FRS 101 Reduced Disclosure Framework issued in the United Kingdom by the Financial Reporting Council.

In our opinion:

the financial statements give a true and fair view of the assets, liabilities and financial position of the Group and the Company as at 31 December 2023 and of the Group’s profit for the year then ended;

the Group financial statements have been properly prepared in accordance with IFRS as adopted by the European Union; and

the Company financial statements have been properly prepared in accordance with FRS 101 Reduced Disclosure Framework issued by the UK’s Financial Reporting Council; and

the Group and Company financial statements have been properly prepared in accordance with the requirements of the Companies Act 2014.
Basis for opinion

We conducted our audit in accordance with International Standards on Auditing (Ireland) (ISAs (Ireland)) and applicable law. Our responsibilities under those standards are further described in the Auditor's responsibilities for the audit of the financial statements section of our report. We have fulfilled our ethical responsibilities under, and we remained independent of the Company in accordance with ethical requirements that are relevant to our audit of financial statements in Ireland, including the Ethical Standard issued by the Irish Auditing and Accounting Supervisory Authority (IAASA), as applied to listed entities.

We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our opinion.

Conclusions relating to going concern

In auditing the financial statements, we have concluded that the director's use of the going concern basis of accounting in the preparation of the financial statements is appropriate. Our evaluation of the director’s assessment of the entity’s ability to continue to adopt the going concern basis of accounting included:
considered liquidity and available financial resources to maintain operations;

recalculated the financial and liquidity metrics noted in the assessment with reference to the primary financial statements;

evaluated ICON’s probable financial obligations, being expected debt payments and commitments over the next twelve months; and

considered ongoing legal matters

Based on the work we have performed, we have not identified any material uncertainties relating to events or conditions that, individually or collectively, may cast significant doubt on the Group’s or the Company’s ability to continue as a going concern for a period of at least twelve months from the date when the financial statements are authorised for issue. Our responsibilities and the responsibilities of the directors with respect to going concern are described in the relevant sections of this report.

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Independent Auditor’s Report to the members of ICON plc (continued)


Detecting irregularities including fraud

We identified the areas of laws and regulations that could reasonably be expected to have a material effect on the financial statements and risks of material misstatement due to fraud, using our understanding of the entity's industry, regulatory environment and other external factors and inquiry with the directors. In addition, our risk assessment procedures included:

Inquiring with the directors as to the Group’s policies and procedures regarding compliance with laws and regulations, identifying, evaluating and accounting for litigation and claims, as well as whether they have knowledge of non-compliance or instances of litigation or claims.

Inquiring of directors as to the Group’s policies and procedures to prevent and detect fraud, as well as whether they have knowledge of any actual, suspected or alleged fraud.

Inquiring of directors and the audit committee, regarding their assessment of the risk that the financial statements may be materially misstated due to irregularities, including fraud.

Inspecting the Group’s legal correspondence.

Reading Board and audit committee meeting minutes.

Performing planning analytical procedures to identify any usual or unexpected relationships.

We discussed identified laws and regulations, fraud risk factors and the need to remain alert among the audit team.

Firstly, the Group is subject to laws and regulations that directly affect the financial statements including companies and financial reporting legislation. We assessed the extent of compliance with these laws and regulations as part of our procedures on the related financial statement items, including assessing the financial statement disclosures and agreeing them to supporting documentation when necessary.

Secondly, the Group is subject to many other laws and regulations where the consequences of non-compliance could have a material effect on amounts or disclosures in the financial statements, for instance through the imposition of fines or litigation. We identified the following areas as those most likely to have such an effect: health and safety, anti-bribery, employment law, environmental law, regulatory capital and liquidity.

Auditing standards limit the required audit procedures to identify non-compliance with these non-direct laws and regulations to inquiry of the directors and inspection of regulatory and legal correspondence, if any. These limited procedures did not identify actual or suspected non-compliance.

We assessed events or conditions that could indicate an incentive or pressure to commit fraud or provide an opportunity to commit fraud. As required by auditing standards, we performed procedures to address the risk of management override of controls and the risk of fraudulent revenue recognition. We identified a fraud risk in relation to the Group and Component clinical trial service revenue, being the contract realizable value.

Further detail in respect of the clinical trial service revenue is set out in the key audit matter disclosures of this report.

In response to the fraud risks, we also performed procedures including:

Identifying journal entries to test based on risk criteria and comparing the identified entries to supporting documentation.

Assessing significant accounting estimates for bias.

Assessing the disclosures in the financial statements.

As the Group is regulated, our assessment of risks involved obtaining an understanding of the legal and regulatory framework that the Group operates and gaining an understanding of the control environment including the entity’s procedures for complying with regulatory requirements.

Owing to the inherent limitations of an audit, there is an unavoidable risk that we may not have detected some material misstatements in the financial statements, even though we have properly planned and performed our audit in accordance with auditing standards. For example, the further removed non-compliance with laws and regulations (irregularities) is from the events and transactions reflected in the financial statements, the less likely the inherently limited procedures required by auditing standards would identify it.

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Independent Auditor’s Report to the members of ICON plc (continued)


Detecting irregularities including fraud (continued)

In addition, as with any audit, there remains a higher risk of non-detection of irregularities, as these may involve collusion, forgery, intentional omissions, misrepresentations, or the override of internal controls. We are not responsible for preventing non-compliance and cannot be expected to detect non-compliance with all laws and regulations.

Key audit matters: our assessment of risks of material misstatement

Key audit matters are those matters that, in our professional judgement, were of most significance in the audit of the financial statements and include the most significant assessed risks of material misstatement (whether or not due to fraud) identified by us, including those which had the greatest effect on: the overall audit strategy; the allocation of resources in the audit; and directing the efforts of the engagement team. These matters were addressed in the context of our audit of the financial statements as a whole, and in forming our opinion thereon, and we do not provide a separate opinion on these matters.

In arriving at our audit opinion above, the key audit matters were as follows (unchanged from 2022):

Group Key Audit Matters

Revenue recognition for certain clinical trial service contracts included in the total of $982 million (2022: $944 million)

Refer to note 1 on page 56 (significant accounting policies) note 3 on page 61 (financial disclosures)

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Independent Auditor’s Report to the members of ICON plc (continued)


The key audit matterHow the matter was addressed in our audit
As discussed in Note 3 to the consolidated financial statements, the Company recognized revenue of US$8,120 million for the year ended 31 December 2023, a portion of which relates to clinical trial service revenue. As discussed in Note 1 to the consolidated financial statements, clinical trial service revenue is recognized over time, using an input measure, being total project costs (inclusive of third-party costs, principally pass-through/ reimbursable expenses) incurred at each reporting period as a percentage of forecasted total project costs, to measure progress towards satisfying the Company’s performance obligation. The transaction price is based on the contract or latest change order value, adjusted to reflect the estimated realizable contract value.

We identified the evaluation of revenue recognition for a subset of clinical trial service revenue as a key audit matter. Complex and subjective auditor judgment was required to evaluate the Company’s estimate of total forecast project costs and the estimated realizable contract values.

For the reasons outlined above the engagement team determine this matter to be a key audit matter.

Our audit procedures included:

We evaluated the design and tested the operating effectiveness of certain internal controls related to the revenue process, including controls over total forecast project costs and estimated realizable contract values.

We tested the total forecast project costs and the realizable contract values for a selection of clinical trial service contracts, by evaluating:

direct costs incurred, both during the year and cumulative over the life of the contracts. We tested the accuracy and completeness of the direct costs by comparing the amounts to source data

third-party costs incurred, both during the year and cumulative over the life of the contracts. We tested the accuracy and completeness of the third-party costs incurred by comparing the costs to invoices received

findings from interviews with operational personnel of the Company to assess progress to date, the estimate of remaining costs to be incurred and factors impacting the amount of time and costs to complete the selected contracts, including an understanding of the nature and complexity of the work to be performed

correspondence of amendments to the scope or contract value, if any, between the Company and the customer for the selected contracts as part of our evaluation of contract progress

quarterly movements in forecast project costs and project margins and investigating the reasons for those movements, and

the reasonableness of the Company’s adjustments from total contract value to arrive at realizable contract value. We confirmed total contract value with customers and compared the assumptions used to derive the adjustments from total contract value to realizable contract value to underlying records.

We also evaluated the Company’s methods, assumptions and data used to accurately estimate total forecast project costs and realizable contract values, by comparing historical estimates developed at contract inception to actual results for a selection of clinical trial service contracts.

We found that the estimates and judgements used in determining the progress towards completion and realisable contract value related to revenue recognition for clinical trial services contracts were appropriate.



















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Independent Auditor’s Report to the members of ICON plc (continued)


Company key audit matters

Investment in subsidiary undertakings $7,149 million (2022: $7,086 million)

Refer to note 1 on page 54 (significant accounting policies) and note 2 on page 139 (financial disclosures)


The key audit matterHow the matter was addressed in our audit
The carrying amount of the Company’s investments in subsidiary undertakings represents 97.2% (2022: 97.8%) of the Company’s total assets.

The investment in subsidiary undertakings is carried in the Balance Sheet of the Company at cost less impairment. At December 31, 2023, the investment carrying value was $7,149 million.

We do not consider there to be a significant risk of error related to the carrying value of these investments, or to be subject to a significant level of judgements or estimation due to the Group’s market capitalisation at year end. However, due to their materiality in the context of the Company financial statements, they are considered an area of audit focus and of significance to the audit of the Company financial statements

For the reasons outlined above the engagement team determine this matter to be a key audit matter.
Our audit procedures included:

We compared the carrying value of investments in the Company’s Balance Sheet to the net assets of the subsidiary financial statements.

We compared the carrying value of subsidiaries to the market capitalisation of the Company at December 31, 2023.

Based on evidence obtained, we found management’s assessment of the key assumptions used in assessing the carrying value of investments in subsidiary undertakings to be appropriate.



Our application of materiality and an overview of the scope of our audit

Materiality for the Group financial statements as a whole was set at US$30.0 million (2022: US$30.0 million), determined with reference to a benchmark of expected Group profit before tax (this estimated amount was based on earnings guidance available at the planning stage of the audit adjusted for exceptional items) (of which it represents 4.2% (2022: 4.8%). Group profit before tax is the most relevant metric to the users of the financial statements in assessing the financial performance of the Group. The stability of the business environment was the key qualitative factor in determining the percentage to be applied to the benchmark.

With respect to the Company, we based our calculation of materiality on total assets due to its nature as a holding company. As the calculated materiality was higher than Group materiality, we restricted our materiality to US$30.0 million (2022: US$30.0 million).

Performance materiality for the Group financial statements and Company financial statements as a whole was set at US$22.5 million (2022: US$22.5 million) and US$22.5 million (2022: US$22.5 million) respectively, determined with reference to benchmarks of expected Group profit before tax for the Group and total assets for the Company (of which it represents 3.96% (2022: 3.57%) and 0.13% (2022: 0.31%) respectively). We applied this percentage in our determination of performance materiality based on the level of identified control deficiencies during the prior period.

We reported to the Audit Committee any corrected or uncorrected identified misstatements exceeding US$1.5 million (2022: US$1.5 million), in addition to other identified misstatements that warranted reporting on qualitative grounds. Our audit was undertaken to the materiality and performance materiality level specified above and we applied materiality to assist us determine what risks were significant risks and the procedures to be performed.




35





Independent Auditor’s Report to the members of ICON plc (continued)


Our application of materiality and an overview of the scope of our audit (continued)


The structure of the Group’s finance function is such that the majority of transactions and balances are accounted for by the central Group finance team. We performed comprehensive audit procedures, including those in relation to the significant risk set out above, on those transactions accounted for at Group level. Our audit covered 91% of total Group revenue and 98% of total Group assets, including 100% of the Company’s revenue and total assets.

We identified 4 (2022: 4) components in the scope of our audit, we subjected 1 (2022:1) to a full scope audit for group purposes.

Other information

The directors are responsible for the other information presented in the Annual Report together with the financial statements. The other information comprises the information included in the directors’ report and appendix A. The financial statements and our auditor’s report thereon do not comprise part of the other information. Our opinion on the financial statements does not cover the other information and, accordingly, we do not express an audit opinion or, except as explicitly stated below, any form of assurance conclusion thereon.

Our responsibility is to read the other information and, in doing so, consider whether, based on our financial statements audit work, the information therein is materially misstated or inconsistent with the financial statements or our audit knowledge. Based solely on that work we have not identified material misstatements in the other information.

Based solely on our work on the other information undertaken during the course of the audit we report that in those parts of the Directors specified for our consideration:

we have not identified material misstatements in the directors’ report or appendix A;

in our opinion, the information given in the directors’ report and appendix A is consistent with the financial statements;

in our opinion, the directors’ report has been prepared in accordance with the Companies Act 2014.

Our opinions on other matters prescribed by the Companies Act 2014 are unmodified

We have obtained all the information and explanations which we consider necessary for the purpose of our audit.

In our opinion, the accounting records of the Company were sufficient to permit the financial statements to be readily and properly audited and the Company’s financial statements are in agreement with the accounting records.

We have nothing to report on other matters on which we are required to report by exception

The Companies Act 2014 requires us to report to you if, in our opinion:

the disclosures of directors’ remuneration and transactions required by Sections 305 to 312 of the Act are not made.

the Company has not provided the information required by section 5(2) to (7) of the European Union (Disclosure of Non-Financial and Diversity Information by certain large undertakings and groups) Regulations 2017 for the year ended 31 December 2023 as required by the European Union (Disclosure of Non-Financial and Diversity Information by certain large undertakings and groups) (amendment) Regulations 2018.

We have nothing to report in this regard.

Respective responsibilities and restrictions on use

Responsibilities of directors for the financial statements

As explained more fully in their statement set out on page 30, the directors are responsible for: the preparation of the financial statements including being satisfied that they give a true and fair view; such internal control as they determine is necessary to enable the preparation of financial statements that are free from material misstatement, whether due to fraud or error; assessing the Group and Company’s ability to continue as a going concern, disclosing, as applicable, matters related to going concern; and using the going concern basis of accounting unless they either intend to liquidate the Group or the Company or to cease operations, or have no realistic alternative but to do so.

36





Independent Auditor’s Report to the members of ICON plc (continued)


Auditor’s responsibilities for the audit of the financial statements

Our objectives are to obtain reasonable assurance about whether the financial statements as a whole are free from material misstatement, whether due to fraud or error, and to issue an auditor’s report that includes our opinion. Reasonable assurance is a high level of assurance, but is not a guarantee that an audit conducted in accordance with ISAs (Ireland) will always detect a material misstatement when it exists. Misstatements can arise from fraud or error and are considered material if, individually or in the aggregate, they could reasonably be expected to influence the economic decisions of users taken on the basis of these financial statements.

A fuller description of our responsibilities is provided on IAASA’s website at
https://iaasa.ie/publications/description-of-the-auditors-responsibilities-for-the-audit-of-the-financial-statements/

The purpose of our audit work and to whom we owe our responsibilities

Our report is made solely to the Company’s members, as a body, in accordance with Section 391 of the Companies Act 2014. Our audit work has been undertaken so that we might state to the Company’s members those matters we are required to state to them in an auditor’s report and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the Company and the Company’s members, as a body, for our audit work, for our report, or for the opinions we have formed.



John Corrigan                                           24 April 2024
for and on behalf of
KPMG
Chartered Accountants, Statutory Audit Firm
1 Stokes Place
St. Stephen’s Green
Dublin 2
Ireland


37




Consolidated Statement of Profit and Loss
for the year ended 31 December 2023
31 December 202331 December 2022
Pre-exceptionalExceptional
(Note 9)
Total Pre-exceptionalExceptional
(Note 9)
Total
Note$’000$’000$’000$’000$’000$’000
Revenue8,120,176  8,120,176 7,733,386 — 7,733,386 
Direct costs(5,719,025) (5,719,025)(5,521,522)— (5,521,522)
Other operating expenses(1,347,694)(89,566)(1,437,260)(1,334,235)(70,838)(1,405,073)
Operating profit1,053,457 (89,566)963,891 877,629 (70,838)806,791 
Share of equity method investment losses19(383) (383)(3,136)— (3,136)
Financing income45,014  5,014 2,345 — 2,345 
Financing expense5(340,871) (340,871)(234,201)— (234,201)
Profit before taxation6717,217 (89,566)627,651 642,637 (70,838)571,799 
Income tax expense7(32,830)14,203 (18,627)(79,679)14,165 (65,514)
Profit for the financial year684,387 (75,363)609,024 562,958 (56,673)506,285 
Earnings per share
Basic87.42 6.21 
Diluted87.36 6.13 

On behalf of the Board


Steve Cutler
Rónán Murphy
Chief Executive Officer
Director
38




Consolidated Statement of Comprehensive Income
for the year ended 31 December 2023
Note31 December
2023
31 December
2022
$’000$’000
Profit for the financial year609,024 506,285 
Other comprehensive income/(loss)
Items that will not be reclassified to profit or loss:
Re-measurement of defined benefit liability525 13,265 
525 13,265 
Items that are or may be reclassified subsequently to profit or loss, net of tax:
Currency translation differences2526,221 (88,444)
Tax benefit on defined benefit pension (754)
Gain/(loss) on cash flow hedge251,567 (3,728)
27,788 (92,926)
Other comprehensive income/(loss) for the year, net of tax28,313 (79,661)
Total comprehensive income for the financial year 637,337 426,624 

On behalf of the Board


Steve Cutler
Rónán Murphy
Chief Executive Officer
Director













39




Consolidated Statement of Financial Position
as at 31 December 2023
Note31 December
2023
31 December
2022
ASSETS$’000$’000
Non-current assets
Property, plant and equipment13161,970 178,227 
Right-of-use assets27137,264 151,199 
Goodwill149,074,884 9,024,479 
Intangible assets 144,055,079 4,450,752 
Other non-current assets1878,470 76,861 
Financial assets19 46,804 32,631 
Deferred tax assets7105,229 98,117 
Total non-current assets13,659,700 14,012,266 
Current assets
Inventories168,442 7,063 
Trade receivables171,790,322 1,731,388 
Unbilled revenue (contract assets)17951,936 957,655 
Other current assets18189,460 187,617 
Current taxes receivable91,254 70,170 
Current asset investments191,954 1,713 
Cash and cash equivalents20378,102 288,768 
Total current assets3,411,470 3,244,374 
Total assets17,071,170 17,256,640 
EQUITY
Share capital246,699 6,649 
Share premium25523,646 472,723 
Other undenominated capital251,162 1,162 
Share-based payment reserve25354,183 381,098 
Other reserves2510,183 7,601 
Foreign currency reserve25(148,844)(175,065)
Merger reserve255,656,195 5,656,195 
Retained earnings252,919,591 2,219,619 
Total equity9,322,815 8,569,982 
LIABILITIES
Non-current liabilities
Non-current bank credit lines and loan facilities233,665,439 4,599,037 
Non-current lease liabilities27126,321 131,644 
Non-current other liabilities2143,950 37,752 
Non-current provisions92,048 510 
Deferred tax liabilities7898,335 987,927 
Total non-current liabilities4,736,093 5,756,870 
Current liabilities
Accounts payable131,584 81,194 
Unearned revenue (contract liabilities)17 1,654,507 1,507,449 
Accrued and other liabilities21910,448 999,512 
Provisions4,951 5,512 
Current tax payable200,622 280,971 
Bank credit lines and loan facilities23 110,150 55,150 
Total current liabilities3,012,262 2,929,788 
Total liabilities7,748,355 8,686,658 
Total equity and liabilities17,071,170 17,256,640 

On behalf of the Board


Steve Cutler
Rónán Murphy
Chief Executive Officer
Director
40




Consolidated Statement of Changes in Equity
for the year ended 31 December 2023
Number
of shares
Share
Capital
Share
Premium
Merger ReserveOther
Undenominated
Capital
Share-based
Payment Reserve
Other
Reserves
Foreign Currency
Reserve
Retained
Earnings
Total
$’000$’000$’000$’000$’000$’000$’000$’000$’000
Balance at 1 January 202381,723,555 6,649 472,723 5,656,195 1,162 381,098 7,601 (175,065)2,219,619 8,569,982 
Profit for the year attributable to the Group— — — — — — — — 609,024 609,024 
Other Comprehensive Income
Foreign currency translation— — — — — — — 26,221 — 26,221 
Re-measurement of defined benefit liability— — — — — — — — 525 525 
Gain on cash flow hedge— — — — — — 1,567 — — 1,567 
Total other comprehensive income— — — — — — 1,567 26,221 525 28,313 
Total comprehensive income for the year— — — — — — 1,567 26,221 609,549 637,337 
Transactions with owners, recorded directly in equity
Share-based payment— — — — — 47,171 — — — 47,171 
Exercise of share options535,705 35 50,923 — — — — — — 50,958 
Transfer of exercised and expired share–based awards— — — — — (91,454)— — 91,454 — 
Issue of restricted share units/ performance share units235,826 15 — — — — — — — 15 
Share issue costs— — — — — — — — (16)(16)
Tax benefit excess on exercise of options— — — — — 4,323 — — — 4,323 
Deferred tax movement on unexercised options— — — — — 13,045 — — — 13,045 
Non-distributable reserves— — — — — — 1,015 — (1,015)— 
Total contributions by and distributions to owners771,531 50 50,923 — — (26,915)1,015 — 90,423 115,496 
Balance at 31 December 202382,495,086 6,699 523,646 5,656,195 1,162 354,183 10,183 (148,844)2,919,591 9,322,815 
Further details of the reserves above are detailed in note 25
41





Consolidated Statement of Changes in Equity
for the year ended 31 December 2023
Number
of shares
Share
Capital
Share
Premium
Merger ReserveOther
Undenominated
Capital
Share-based
Payment Reserve
Other
Reserves
Foreign Currency
Reserve
Retained
Earnings
Total
$’000$’000$’000$’000$’000$’000$’000$’000$’000
Balance at 1 January 202281,554,683 6,640 436,916 5,656,195 1,134 420,973 12,438 (86,621)1,728,023 8,175,698 
Profit for the year attributable to the Group— — — — — — — — 506,285 506,285 
Other Comprehensive (Loss)/Income
Foreign currency translation— — — — — — — (88,444)— (88,444)
Re-measurement of defined benefit liability— — — — — — — — 13,265 13,265 
Tax benefit on defined benefit pension— — — — — — (754)— — (754)
Loss on cash flow hedge— — — — — — (3,728)— — (3,728)
Total other comprehensive loss— — — — — — (4,482)(88,444)13,265 (79,661)
Total comprehensive income for the year— — — — — — (4,482)(88,444)519,550 426,624 
Transactions with owners, recorded directly in equity
Share-based payment— — — — — 55,874 — — — 55,874 
Exercise of share options348,286 21 35,807 — — — — — — 35,828 
Transfer of exercised and expired share–based awards— — — — — (71,708)— — 71,708 — 
Issue of restricted share units/ performance share units241,116 16 — — — — — — — 16 
Share issue costs— — — — — — — — (17)(17)
Repurchase of ordinary shares(420,530)(28)— — 28 — — — (99,983)(99,983)
Share repurchase costs— — — — — — — — (17)(17)
Tax benefit excess on exercise of options— — — — — 1,739 — — — 1,739 
Deferred tax movement on unexercised options— — — — — (25,780)— — — (25,780)
Non-distributable reserves— — — — — — (355)— 355 — 
Total contributions by and distributions to owners168,872 35,807 — 28 (39,875)(355)— (27,954)(32,340)
Balance at 31 December 202281,723,555 6,649 472,723 5,656,195 1,162 381,098 7,601 (175,065)2,219,619 8,569,982 
Further details of the reserves above are detailed in note 25

42




Consolidated Statement of Cash Flows
for the year ended 31 December 2023
Note31 December
2023
31 December
2022
$’000$’000
Profit for the financial year609,024 506,285 
Adjustments to reconcile net income to net cash generated from operating activities
Depreciation of property, plant and equipment1348,158 48,692 
Depreciation of right-of-use assets2741,982 45,215 
Impairment of long lived assets98,686 28,767 
Amortisation of intangible assets14537,792 518,656 
Loss on equity method investments
19383 3,136 
Share-based payment1251,380 55,790 
Acquisition related gain15(6,160)— 
Financing income4(5,014)(2,345)
Financing expense5340,871 234,201 
Defined benefit costs319 744 
Income tax expense718,627 65,514 
Unrealised foreign exchange19,706 (13,009)
Other non cash items24,332 11,324 
Operating cash inflow before changes in working capital1,690,086 1,502,970 
Accounts receivable(83,296)(420,695)
Unbilled revenue4,716 (332,592)
Unearned revenue134,566 200,944 
Other net assets(58,086)(13,501)
Cash provided by operations1,687,986 937,126 
Income taxes paid(163,778)(116,322)
Employer contribution defined benefit pension scheme(741)(508)
Interest received45,014 2,345 
Interest paid(317,975)(206,448)
Net cash inflow from operating activities1,210,506 616,193 
Investing activities
Purchase of property, plant and equipment(29,326)(52,205)
Purchase of intangible assets14(111,366)(89,955)
Purchase of subsidiary undertakings15(71,766)— 
Sale/maturity of current asset investments192,616 481 
Purchase of current asset investments19(2,857)(482)
Proceeds from sale of financial assets 1,906 
Purchase of financial assets19(13,954)(5,612)
Net cash used in investing activities(226,653)(145,867)
Financing activities
Drawdown of bank credit lines and loan facilities23370,000 75,000 
Repayment of bank credit lines and loan facilities23(1,265,000)(875,000)
Repayments of obligations under lease liabilities(53,802)(54,617)
Tax benefit from the exercise of share options4,323 1,739 
Proceeds from exercise of share options, RSUs and PSUs50,973 35,844 
Share issuance costs(16)(17)
Repurchase of ordinary shares (99,983)
Share repurchase costs (17)
Net cash used in financing activities(893,522)(917,051)
Net increase / (decrease) in cash and cash equivalents90,331 (446,725)
Effect of exchange rate changes(997)(16,720)
Cash and cash equivalents at start of year288,768 752,213 
Cash and cash equivalents at end of year378,102 288,768 
43




Notes to Consolidated Financial Statements
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies
Statement of accounting policies

The Group Financial Statements have been prepared in accordance with International Financial Reporting Standards ("IFRS") issued by the International Accounting Standards Board (“IASB”) as adopted by the European Union ("EU") that are effective for financial year ending 31 December 2023, and with those parts of the Companies Act applicable to companies reporting under IFRS. IFRS adopted by the EU differs in certain respects from IFRS issued by the IASB. Reference to IFRS hereafter refers to IFRS adopted by the EU.

The Company Financial Statements are prepared under the historical cost convention, in accordance with Financial Reporting Standard 101 Reduced Disclosure Framework (‘FRS 101’) and the Companies Act 2014. The Company meets the definition of a qualifying entity under Financial Reporting Standard (FRS) 100 issued by the Financial Reporting Council (FRC). Accordingly, in the year ended 31 December 2023, the Company transitioned from reporting under International Financial Reporting Standards adopted by the European Union (IFRS) to FRS 101 Reduced Disclosure Framework as issued by the FRC. The transition was not considered to have had a material effect on the financial statements.

In preparing the Company Financial Statements, the Company applies the recognition, measurement and disclosure requirements of IFRS as adopted by the EU, but makes amendments where necessary in order to comply with the Companies Act 2014 and has set out below where advantage of the FRS 101 disclosure exemptions has been taken. The Company has taken advantage of the following disclosure exemptions under FRS 101:

A cash flow statement and related notes;
Comparative period reconciliation for share capital;
Disclosures in respect of transactions with wholly owned subsidiaries;
Disclosures in respect of capital management;
The effects of new but not yet effective IFRS; and
Disclosures in respect of the compensation of key management personnel.

As the consolidated financial statements of the Group are prepared in accordance with IFRS as adopted by the EU and include the equivalent disclosures, the Company has also taken the exemptions under FRS 101 available in respect of the following disclosures:

Certain disclosures required by IFRS 2 Share-Based Payments;
Certain disclosures required by IFRS 13 Fair Value Measurement; and
The disclosures required by IFRS 7 Financial Instruments: Disclosures.

In accordance with Section 304(2) of the Companies Act 2014, the Company is availing of the exemption from presenting its individual income statement to the Annual General Meeting and from filing it with the Companies Registration Office. The Company’s loss for the financial year determined in accordance with IFRS is $9.0 million (2022: $2.6 million).
Basis of preparation

The Group and Company Financial Statements are presented in United States dollars ("U.S. dollars") and all values are rounded to the nearest thousand ($‘000), except where otherwise indicated. They are prepared on the historical cost basis, except for the measurement at fair value on date of grant of share based payments, pension plan assets, derivative financial instruments and certain financial asset investments. Other than the amended standards adopted by the Group, accounting policies are applied consistently with the prior year. Certain comparative financial information has been reclassified to reflect current period classifications.

The principal accounting policies adopted in the Company Financial Statements are the same as those set out for the Group financial statements except as noted below. The accounting policies for the Group and Company Financial Statements have, unless otherwise stated, been applied consistently to all periods presented in these financial statements.












44




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


New standards and interpretations

The following standards and interpretations became effective for the Group during the financial year but do not have a material effect on the results or financial position of the Group:

IFRS 17 Insurance Contracts
Amendments to IAS 1 and IFRS Practice Statement 2, Disclosure of Accounting Policies
Amendments to IAS 8 Accounting Policies, Changes in Accounting Estimates and Errors: Definition of Accounting Estimates
Amendments to IAS 12 Income Taxes - Deferred Tax related to Assets and Liabilities arising from a Single Transaction
Amendments to IAS 12 Income Taxes - International Tax Reform — Pillar Two Model Rules

The following standards and interpretations are not yet effective for the Group and are not expected to have a material effect on the results or financial position of the Group:

Amendments to IAS 1- Classification of Liabilities as Current or Non-current and Non-current Liabilities with Covenants (Effective date: 1 January 2024)
Amendments to IAS 7 and IFRS 7 - Supplier Finance arrangements (Effective date: 1 January 2024)
Amendments to IFRS 16 - Leases - Lease liability in a sale and leaseback (Effective date: 1 January 2024)
Amendments to IFRS 21 - Lack of Exchangeability (Effective date: 1 January 2025)

Critical accounting judgements and key sources of estimation uncertainty

The preparation of consolidated financial statements requires management to make estimates and judgments that affect the reported amounts of assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reported period.
 
We base our estimates and judgments on historical experience and on the other factors that we believe are reasonable under current circumstances. Actual results may differ from these estimates if these assumptions prove to be incorrect or if conditions develop other than as assumed for the purposes of such estimates. The following is a discussion of the accounting policies used by us, which we believe are critical in that they require estimates and judgements by management. The application of these critical accounting policies and estimates is discussed with the Audit Committee of the Board of Directors.

Revenue recognition

Significant management judgments and estimates must be made and used in connection with the recognition of revenue in any accounting period. Material differences in the amount of revenue in any given period may result if these judgments or estimates prove to be incorrect or if management’s estimates change on the basis of development of the business or market conditions. To date there have been no material differences arising from these judgments and estimates. We earn revenues by providing a number of different services to our clients. These services, which are integral elements of the clinical development process, include clinical trials management, contract staffing, consulting and laboratory services. The criteria for revenue recognition is based on five steps: (1) identify the contract(s) with a customer; (2) identify the performance obligation in the contract; (3) determine the transaction price; (4) allocate the transaction price to the performance obligations in the contract; and (5) recognise revenue when (or as) the entity satisfies the performance obligation.

Clinical trial services are a single performance obligation satisfied over time i.e. the full-service obligation in respect of a clinical trial (including those services performed by investigators and other parties) is considered a single performance obligation. Promises offered to the customer are not distinct within the context of the contract. We have concluded that ICON is the contract principal in respect of both direct services and in the use of third parties (principally investigator services) that support the clinical research project. The transaction price is determined by reference to the contract or change order value (total service revenue and pass-through/ reimbursable expenses) adjusted to reflect a realisable contract value. An assessment of the realisable contract value is judgmental in nature. The realisable value assessment is updated at each reporting period, having regard to (i) contract terms and (ii) customer experience.

Revenue is recognised on a percentage completion basis as the single performance obligation is satisfied. The progress towards completion for clinical service contracts is measured therefore based on an input measure being total project costs (inclusive of third party costs) at each reporting period. Measurement of the progress towards completion involves judgment and estimation.




45




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Revenue recognition (continued)

Assessment of completion requires an evaluation of labour and related time cost incurred at the reporting date and third party costs incurred at the reporting date. The assessment of third party costs incurred (principally investigator costs) requires a review of activity performed and recorded by the third party services providers. The timing of payments to third parties in respect of cost incurred reflect invoicing by third parties. The timing difference between the activity performed and receipt of invoices from third parties may result in significant accrued amounts at reporting periods.

The assessment of progress towards completion also requires an up to date evaluation of the forecast costs to complete in respect of these projects. Given the long-term nature of the clinical trials, and the complex nature of those trials, the forecast costs to complete (being internal direct costs and costs that will be incurred by third parties (principally investigators)) is judgmental. Forecast time (and related costs) is determined by reference to (i) contract terms and (ii) past experience. Forecast third party costs to complete are determined by project by reference to (i) contract terms and (ii) past experience.
The Company provides data services to customers based on agreed-upon specifications, including the timing of delivery, which is typically either weekly, monthly, or quarterly. If a customer requests more than one type of data report or series of data reports within a contract, each distinct type of data report is a separate performance obligation. The contracts provide for the Company to be compensated for the value of each deliverable. The transaction price is determined using list prices, discount agreements, if any, and negotiations with the customers, and generally includes any out-of-pocket expenses.

The Company enters into contracts with some of its larger data suppliers that involve non-monetary terms. The Company issues purchase credits to be used toward the data supplier's purchase of the Company's services based on the fair value of the data obtained. In exchange, the Company receives monetary discounts on the data received from the data suppliers. The fair value of the revenue earned from the customer purchases is recognised as services are delivered as described above. At the end of the contract year, any unused customer purchase credits may be forfeited or carried over to the next contract year based on the terms of the data supplier contract. The calculation of the fair value of certain non-monetary terms involves management judgement and estimation.

Intangible assets acquired in a business combination
Significant management judgments and estimates must be made and used in connection with the recognition of intangible assets associated with a business combination. The cost of a business combination is measured as the aggregate of the fair values at the date of exchange of assets given, liabilities incurred or assumed and equity instruments issued in exchange for control. The assets, liabilities and contingent liabilities of businesses acquired are generally measured at their fair values at the date of acquisition. When the initial accounting for a business combination is determined provisionally, any subsequent adjustments to the provisional values allocated to the identifiable assets, liabilities and contingent liabilities are made within twelve months of the acquisition date and presented as adjustments to goodwill in the reporting period in which the adjustments are determined.
Measurement of intangible assets involves the use of estimates for determining the fair value at the acquisition date. The determination of the fair values of assets and liabilities, as well as of the useful lives of the assets is based on management’s judgment. The valuation of intangible assets required management to develop discounted cash flow models which required the use of reasonable and supportable inputs such as customer attrition data, discount rates developed from various weighted average cost of capital assumptions, growth rates, margin forecasting and assessment of useful lives (see note 14 - Goodwill and intangible assets). Management utilised external valuation experts, where necessary, to ensure the valuation process was sufficiently detailed and robust to develop reliable valuations.

Taxation

Given the global nature of our business and the multiple taxing jurisdictions in which the Group operates, the determination of the Group’s provision for income taxes requires significant judgments and estimates, the ultimate tax outcome of which may not be certain. Although we believe our estimates are reasonable, the final outcome of these matters may be different than those reflected in our historical income tax provisions and accruals.

Taxable profit differs from net profit as reported in the Consolidated Statement of Profit and Loss because it excludes items of income or expense that are taxable or deductible in other years and further excludes items that are not taxable or deductible. The Group’s liability for income tax is calculated using rates that have been enacted or substantively enacted at the reporting date. Income tax is recognised in the Consolidated Statement of Profit and Loss except to the extent that it relates to items recognised directly in equity.




46




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Taxation (continued)

Deferred income tax is provided, using the liability method, on all differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for taxation purposes except those arising from non-deductible goodwill or on initial recognition of an asset or liability which affects neither accounting nor taxable profit. Deferred tax assets and liabilities are measured at the tax rates that are expected to apply in the year when the asset is expected to be realised or the liability to be settled.

Recognition of deferred tax assets is based on management’s belief that it is more likely than not that the income tax benefit associated with certain temporary differences, income tax operating loss, capital loss carryforwards, and income tax credits, would be realised. The carrying amount of deferred income tax assets is reviewed at each reporting date and reduced to the extent that it is no longer probable that sufficient taxable profit would be available to allow all or part of the deferred income tax asset to be utilised. The Group accounts for the impact of GILTI (“global intangible low-taxed income”) in the period it arises and therefore have not provided for deferred taxes in respect of this item. The Group recognises the effect of income tax positions only if those positions will more likely than not be sustained. If the estimate of future taxable income or tax strategies changes at any time in the future, the Group would record an adjustment to the deferred tax asset. Recording such an adjustment could have a material effect on the Group's financial condition or results of operations.

Accounting policies

The following accounting policies have been applied consistently in dealing with items which are considered material in relation to the Group’s Financial Statements.

Basis of consolidation

The Group’s Financial Statements consolidate the financial statements of ICON plc and its subsidiaries. Subsidiaries are consolidated from the date on which control is transferred to the Group and cease to be consolidated from the date on which control is transferred out of the Group. The Group controls an entity when it is exposed to, or has rights to, variable returns from its involvement with the entity and has the ability to affect those returns through its power over the entity. Financial statements of subsidiaries are prepared for the same reporting year as the Company and where necessary, adjustments are made to the results of subsidiaries to bring their accounting policies into line with those used by the Group. The Group will continue to prepare the individual statutory financial statements of subsidiary companies under GAAP applicable in their country of incorporation but adjustments have been made to the results and financial position of such companies to bring their accounting policies into line with those of the Group.

All intercompany balances and transactions, including unrealised profits arising from inter-group transactions, have been eliminated in full. Unrealised losses are eliminated in the same manner as unrealised gains except to the extent that there is evidence of impairment.

Foreign currency translation

The presentation and functional currency of the Company is US dollars ($). The presentation currency of the Group is US dollars ($). The determination of the USD as the functional currency of the Company reflects consideration of the primary and secondary indicators as set out in IAS 21. The directors considered in particular the currency in which funds from financing activities are generated (debt and equity) and the currency in which receipts from operating activities are usually retained. This assessment is consistent with the assessment that the functional currencies of the main subsidiary trading entities are USD. The Company Financial Statements are presented in US dollars. Results and cash flows of non-dollar denominated undertakings are translated into dollars at the actual exchange rates at the transaction dates or average exchange rates for the year where this is a reasonable approximation.

The related statements of financial position are translated at the rates of exchange ruling at the reporting date. Goodwill and fair value adjustments arising on acquisition of a foreign operation are regarded as assets and liabilities of the foreign operation, are expressed in the functional currency of the foreign operation and are recorded at the exchange rate at the date of the transaction, and subsequently retranslated at the applicable closing rates. Adjustments arising on translation of the results of non-dollar undertakings at average rates, and on the restatement of the opening net assets at closing rates, are recorded in the translation reserve within equity.







47




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Foreign currency translation (continued)

Transactions in currencies different to the functional currencies of operations are recorded at the rate of exchange ruling at the date of the transaction. Monetary assets and liabilities denominated in foreign currencies are retranslated into the functional currency at the rate of exchange at the reporting date. All translation differences, with the exception of translation differences on long-term intercompany balances in the Consolidated Financial Statements where repayment is not foreseen, are recorded in the Consolidated Statement of Profit and Loss. Translation differences on long-term intercompany balances, in the Consolidated Financial Statements, where repayment is not foreseen are recorded within other comprehensive income in the Statement of Comprehensive Income.

On disposal of a foreign operation, accumulated currency translation differences, together with any exchange differences on foreign currency borrowings that provide a hedge of the net investment are recognised in the Consolidated Statement of Profit and Loss as part of the overall gain or loss on disposal.

The principal exchange rates used for the translation of results, cash flows and statements of financial position into US dollars were as follows:
AverageYear end
31 December 202331 December 202231 December 202331 December 2022
Euro 1:$
1.07951.05121.10391.0705
Pound Sterling 1:$
1.23821.23471.27311.2083

Property, plant and equipment

Items of property, plant and equipment are stated at cost less accumulated depreciation and any provisions for impairment losses. Depreciation is calculated to write off the original cost of property, plant and equipment less its estimated residual value over its expected useful life on a straight line basis. Residual values and useful lives of property, plant and equipment are reviewed and adjusted if appropriate at each reporting date. At present it is estimated that all items of property, plant and equipment have no residual value. The estimated useful lives applied in determining the charge to depreciation are as follows:
Years
Buildings
40
Computer equipment
2-8
Office furniture and fixtures
8
Laboratory equipment
5
Motor vehicles
5

Leasehold improvements are amortised using the straight-line method over the estimated useful life of the asset or the lease term, whichever is shorter.

On disposal of property, plant and equipment the cost and related accumulated depreciation and impairments are removed from the financial statements and the net amount, less any proceeds, is taken to the Consolidated Statement of Profit and Loss.

The carrying amounts of the Group’s property, plant and equipment are reviewed at each reporting date to determine whether there is any indicator of impairment. Where such an indicator exists an impairment review is carried out. An impairment loss is recognised whenever the carrying amount of an asset or its cash-generating unit exceeds its recoverable amount. Impairment losses are recognised in the Consolidated Statement of Profit and Loss.

Subsequent costs are included in an asset’s carrying amount or recognised as a separate asset, as appropriate, only when it is probable that future economic benefits associated with the item will flow to the Group and the cost of the replaced item can be measured reliably. All other repair and maintenance costs are charged to the Consolidated Statement of Profit and Loss during the financial period in which they are incurred.



48




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Right-of-use assets and lease liabilities

ICON determines if an arrangement is a lease at inception and recognises the rights and obligations on the Consolidated Statements of Financial Position as right-of-use (ROU) assets with corresponding lease liabilities.

The right-of-use assets comprise the initial measurement of the corresponding lease liability, plus lease payments made at or before the commencement day and any initial direct costs, less any lease incentives received. They are subsequently measured at cost less accumulated depreciation and impairment losses. Right-of-use assets are depreciated over the lease term.

The right-of-use assets are presented as a separate line in the Consolidated Statement of Financial Position. The Group applies IAS 36 to determine whether a right-of-use asset is impaired and accounts for any identified impairment loss as described in the ‘Property, Plant and Equipment’ policy.

Lease liabilities are recognised based on the present value of future minimum lease payments over the lease term at commencement date or date of transition with the interest element of the finance lease charged to financing expense. As most of ICON's leases do not provide an implicit rate, the discount rate used is based on the Group's incremental borrowing rate derived from the rate of traded corporate bonds available at the commencement date adjusted for country risk, liquidity and lease term.

Current lease liabilities are included in accrued and other liabilities in the Consolidated Statement of Financial Position and non-current lease liabilities are presented as a separate line. The lease liability is subsequently measured by increasing the carrying amount to reflect interest on the lease liability (using the effective interest method) and by reducing the carrying amount to reflect the lease payments made.

Lease terms may also include options to extend or terminate. Such options are actively reviewed and adjustments to the ROU asset and lease liability are made when it is reasonably certain the option will be exercised.

The Group accounts for lease and non-lease components separately with the exception of motor vehicle leases for which lease and non-lease components are accounted as a single lease component. Lease components are reflected in the Consolidated Statements of Financial Position and non-lease components expensed directly to the Consolidated Statements of Profit and Loss.

The Group has elected to account for short-term leases using the practical expedient. Instead of recognising a right-of-use asset and lease liability, the payments in relation to these are recognised as an expense in the Consolidated Statement of Profit and Loss on a straight-line basis over the lease term.

In some cases, ICON enters into sublease agreements and becomes both a lessee and a lessor for the same underlying asset. When the Group is an intermediate lessor, it accounts for the head lease and the sub-lease as two separate contracts. Subleases are accounted for in the same way as other leases. The sub-lease is classified as a finance or operating lease by reference to the right-of-use asset arising from the head lease.

Business combinations

Business combinations are accounted for using the acquisition method when control is transferred to the Group. The consideration transferred is measured at fair value, as are the identifiable assets acquired and liabilities assumed. Where a business combination agreement provides for an adjustment to the cost of the acquisition which is contingent upon future events, the amount of the estimated adjustment is recognised on the acquisition date at the acquisition date fair value of this contingent consideration. The accounting treatment of any changes to this estimate in subsequent periods will depend on the classification of the contingent consideration. If the contingent consideration is classified as equity it shall not be re-measured and the settlement shall be accounted for within equity. If the contingent consideration is classified as a liability any adjustments to the assessment of contingent consideration determined as at acquisition date will be accounted for through the Consolidated Statement of Profit and Loss, as the liability is measured at fair value at each reporting date.

The assets, liabilities and contingent liabilities of businesses acquired are measured at their fair values at the date of acquisition. In the case of a business combination which is completed in stages, the fair values of the identifiable assets, liabilities and contingent liabilities are re-determined at the date of each transaction until control is obtained. When the initial accounting for a business combination is determined provisionally, any subsequent adjustments to the provisional values allocated to the identifiable assets, liabilities and contingent liabilities are made within twelve months of the acquisition date and presented as adjustments to the original acquisition accounting. Acquisition costs are expensed as incurred.

49




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Goodwill

The Group measures goodwill at the acquisition date as the fair value of the consideration transferred plus the recognised amount of any non controlling interests in the acquiree, if the business combination is achieved in stages, the fair value of the pre-existing equity interest in the acquiree, less the net recognised amount (generally fair value) of the identifiable assets acquired and liabilities assumed. Goodwill on the acquisition of subsidiaries is included in ‘intangible assets – goodwill and other’.

At the acquisition date, any goodwill acquired is allocated to the cash-generating units expected to benefit from the combination's synergies. Impairment is determined by assessing the recoverable amount of the cash-generating unit to which the goodwill relates. Where goodwill forms part of a cash-generating unit and part of the operation within that unit is disposed of, the goodwill associated with the operation disposed of is included in the carrying amount of the operation when determining the gain or loss on disposal of the operation. Goodwill disposed of in this circumstance is measured on the basis of the relative values of the operation disposed of and the proportion of the cash-generating unit retained.

Following initial recognition, goodwill is measured at cost less any accumulated impairment losses. Goodwill is reviewed for impairment annually or more frequently if events or changes in circumstances indicate that the carrying value may be impaired. Impairment losses in respect of goodwill are not reversed.

Intangible assets

Other intangible assets are stated at cost less accumulated amortisation and impairment losses. Useful lives of intangibles are reviewed and adjusted if appropriate at each reporting date. Amortisation is charged to the Consolidated Statement of Profit and Loss on a straight-line basis over the estimated useful lives of intangible assets, currently estimated as follows:
            
Years
Computer software2-8
Customer relationships16-23
Order backlog
Tradenames
Technology asset    
Non-compete arrangements
Patient database

The Group assesses at the end of each reporting period whether there is objective evidence that an intangible asset is impaired. An intangible asset is impaired and impairment losses are incurred only if there is objective evidence of impairment as a result of one or more events that occur after the initial recognition of the intangible asset (a 'loss event') and that loss event (or events) has an impact on the estimated future cash flows of the intangible asset that can be reliably estimated.

Impairment losses in respect of intangible assets are reversed if there has been a change in the estimates used to determine recoverable amount. Impairment losses are reversed only to the extent that the carrying amount of the intangible asset does not exceed the carrying value that would have been determined, net of amortisation, if no impairment loss had been recognised.

Inventories

Inventories, which comprise laboratory inventories, are stated at the lower of cost and net realisable value. Cost is based on the first-in, first-out principle and includes all expenditure incurred in acquiring the inventories and bringing them to their present location and condition. Cost in the case of raw materials comprises the purchase price and attributable costs, less trade discounts. Net realisable value is the estimated selling price in the ordinary course of business, less selling expenses.

Accounts payable

Trade and other payables are presented as current liabilities unless payment is not due within 12 months after the reporting period. They are recognised initially at fair value and subsequently measured at amortised cost using the effective interest rate method.

50




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Government grants

Government grants received that compensate the Group for the cost of an asset are recognised in the Consolidated Statement of Financial Position initially as deferred income when there is reasonable assurance that it will be received and that the Group will comply with the conditions attaching to it. Such grants are recognised in the Consolidated Statement of Profit and Loss over the useful economic life of the asset which is consistent with the depreciation policy of the relevant asset.

Grants that compensate the Group for expenses incurred are recognised in the Consolidated Statement of Profit and Loss in the same periods in which the expenditure to which they relate is charged.

Under grant agreements, amounts received may become repayable in full or in part should certain circumstances specified within the grant agreements occur, including downsizing by the Group, disposing of the related assets, ceasing to carry on its business or the appointment of a receiver over any of its assets. The Group has not recognised any such loss contingency having assessed as remote the likelihood of these events arising.

Provisions

A provision is recognised in the Consolidated Statement of Financial Position when the Group has a present or legal or constructive obligation as a result of a past event, and it is probable that an outflow of economic benefits will be required to settle the obligation. If the effect of the time value of money is material, provisions are determined by discounting the expected future cash flows at a pre-tax rate that reflects the time value of money and, where appropriate, the risks specific to the liability. Where discounting is used, the increase in the provision due to the passage of time is recognised as a finance cost.

A provision for restructuring is recognised when the Group has approved a detailed and formal restructuring plan, and the restructuring has either commenced or has been announced publicly. Future operating costs are not provided for.

Financial Instruments

Financial assets and financial liabilities are recognised on the Consolidated Balance Sheet when the Group becomes party to the contractual provisions of the instrument.

Financial assets are recognised and derecognised on a trade date basis, being the date the Group commits to purchase or sell the asset under a contract.

Financial assets and liabilities are offset and presented on a net basis in the Consolidated Balance Sheet, only if the Group holds an enforceable legal right of set off for such amounts and there is an intention to settle on a net basis or to realise an asset and settle the liability simultaneously. In all other instances they are presented gross in the Consolidated Balance Sheet.

At initial recognition, the Group measures a financial asset at its fair value plus, in the case of a financial asset not at fair value through profit or loss (FVPL), transaction costs that are directly attributable to the acquisition of the financial asset. Transaction costs of financial assets carried at FVPL are expensed in profit or loss.

For assets measured at fair value, gains and losses will either be recorded in profit or loss or OCI. The classification depends on the entity's business model for managing financial assets and the contractual terms of the cash flows. For investments in equity instruments that are not held for trading, this will depend on whether the Group has made an irrevocable election at the time of initial recognition to account for the equity investment at fair value through other comprehensive income (FVOCI).

Subsequent measurement of debt instruments depends on the Group's business model for managing the asset and the cash flow characteristics of the asset. There are three measurement categories into which the Group classifies its financial instruments:

Amortised cost: Assets that are held for collection of contractual cash flows where those cash flows represent solely payments of principal and interest are measured at amortised cost. Interest income from these financial assets is included in finance income using the effective interest rate method. Any gain or loss arising on derecognition is recognised directly in profit or loss and presented in other gains/(losses) together with foreign exchange gains and losses.


51




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Financial Instruments (continued)

FVOCI: Assets that are held for collection of contractual cash flows and for selling the financial assets, where the assets' cash flows represent solely payments of principal and interest, are measured at FVOCI. Movements in the carrying amount are taken through OCI, except for the recognition of impairment losses. When the financial asset is derecognised, the cumulative gain or loss previously recognised in OCI is reclassified from equity to profit or loss and recognised in other gains/(losses). Interest income from these financial assets is included in finance income using the effective interest rate method.

FVPL: Assets that do not meet the criteria for amortised cost or FVOCI are measured at FVPL. A gain or loss on a debt investment that is subsequently measured at FVPL is recognised in profit or loss.

The Group assesses on a forward-looking basis the expected credit losses associated with its debt instruments carried at amortised cost. The impairment methodology applied depends on whether there has been a significant increase in credit risk.

The Group reclassifies debt investments when and only when its business model for managing those assets changes.

(a)    Cash and cash equivalents

Cash and cash equivalents include cash and highly liquid investments with original maturities of three months or less and are stated at fair value on initial recognition followed by amortised cost, which approximates fair value.

(b)    Trade receivables

Trade receivables are amounts due from customers for services performed in the ordinary course of business. Trade receivables are recognised initially at the amount of consideration that is unconditional unless they contain significant financing components. The amount of consideration that is unconditional approximates to fair value. The Group holds the trade receivables with the objective to collect the contractual cash flows and therefore measures them subsequently at amortised cost using the effective interest method.

Where the Group enters into arrangements to sell certain trade receivables, such arrangements are accounted for in accordance with IFRS 9, Financial Instruments (“IFRS 9”).  The underlying trade receivables are derecognised to the extent that substantially all of the risks and rewards of ownership of the trade receivables are transferred, under the terms of the arrangements. Cash proceeds received from such sales are included in operating cash flows.

(c)    Interest bearing loans and borrowings

Borrowings are initially recognised at fair value, net of transaction costs incurred. Borrowings are subsequently measured at amortised cost. Subsequent to initial recognition, current and non-current interest bearing loans and borrowings are measured at amortised cost with any difference between cost and redemption value being recognised in the Consolidated Statement of Profit and Loss over the period of the borrowings on an effective interest rate basis. Fees paid on the establishment of loan facilities are recognised as transaction costs of the loan to the extent that it is probable that some or all of the facility will be drawn down. In this case, the fee is deferred until draw down will occur. Where there is no evidence that it is probable that some or all of the facility will be drawn down, the fee is capitalised as a prepayment and amortised over the period of the facility to which it relates.

Borrowings are classified as current liabilities unless the Group has an unconditional right to defer settlement of the liability for at least 12 months after the reporting date.

Borrowings are removed from the Consolidated Statement of Financial Position when the obligation specified in the contract is discharged, cancelled or expired. The difference between the carrying amount of a financial liability that has been extinguished or transferred to another party and the consideration paid, including any non-cash assets transferred or liabilities assumed, is recognised in profit or loss as other income or finance costs.

(d)    Equity instruments

The Group entered into subscription agreements with a number of funds. The Group subsequently measures all equity investments, including fund subscriptions, at FVPL. Changes in the fair value of equity investments and fund subscriptions measured at FVPL are recognised in the Consolidated Statement of Profit and Loss. Dividends or interest from such investments continue to be recognised in the Consolidated Statement of Profit and Loss when the Group’s right to receive payments is established.

52




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Financial instruments (continued)

(e)    Current financial assets

The Group classifies short term investments as current financial assets. Short-term investments comprise highly liquid investments with maturities of greater than three months. Current financial assets are subsequently measured at fair value through OCI.

(f)    Impairment of financial assets

The Group's financial assets measured at amortised cost, the most significant of which are trade receivables and unbilled receivables, are subject to IFRS 9's expected credit loss model.

For trade receivables and unbilled revenue, the Group applies the simplified approach permitted by IFRS 9, which requires expected lifetime losses to be recognised from initial recognition of the receivables. See notes 17 and 26 for further details. The expected credit losses on these financial assets are estimated based on the Group’s historical credit loss experience, adjusted for factors that are specific to the debtors, general economic conditions and an assessment of both the current, as well as the forecast direction of conditions, at the reporting date.

The Group writes off a financial asset when there is information indicating that the debtor is in severe financial difficulty and there is no realistic prospect of recovery, e.g. when the debtor has been placed under liquidation or has entered into bankruptcy proceedings. Financial assets written off may still be subject to enforcement activities under the Group’s recovery procedures, taking into account legal advice where appropriate. Any recoveries made are recognised in profit or loss.

(g)    Derivative financial instruments and hedging

Derivatives are initially recognised at fair value on the date a derivative contract is entered into and are subsequently remeasured to their fair value at the end of each reporting period. The accounting for subsequent changes in fair value depends on whether the derivative is designated as a hedging instrument, and if so, the nature of the item being hedged.

The Group designates certain derivatives as either:

hedges of the fair value of recognised assets or liabilities or a firm commitment (fair value hedges)
hedges of a particular risk associated with the cash flows of recognised assets and liabilities and highly probable forecast transactions (cash flow hedges), or
hedges of a net investment in a foreign operation (net investment hedges).

At inception of the hedge relationship, the Group documents the economic relationship between hedging instruments and hedged items including whether changes in the cash flows of the hedging instruments are expected to offset changes in the cash flows of hedged items. The Group documents its risk management objective and strategy for undertaking its hedge transactions.

The fair value of derivative financial instruments designated in hedge relationships are disclosed in note 26Financial instruments. Movements in the hedging reserve are shown in shareholders' equity. The full fair value of a hedging derivative is classified as a non-current asset or liability when the remaining maturity of the hedged item is more than 12 months. It is classified as a current asset or liability when the remaining maturity of the hedged item is less than 12 months.

Cash flow hedges that qualify for hedge accounting

The effective portion of changes in the fair value of derivatives that are designated and qualify as cash flow hedges is recognised in the cash flow hedge reserve within equity. The gain or loss relating to the ineffective portion is recognised immediately in profit or loss, within other gains/(losses).









53




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Financial Instruments (continued)

When a hedging instrument expires or is sold or terminated, or when a hedge no longer meets the criteria for hedge accounting, any cumulative deferred gain or loss and deferred costs of hedging in equity at that time remains in equity until the forecast transaction occurs.

Changes in the fair value of any derivative instrument that does not qualify for hedge accounting are recognised immediately in profit or loss.

During the year ended 31 December 2022, the Group entered into two interest rate cap agreements ("2022 Caps") and an interest rate swap agreement ("2022 Swap") to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities. The interest rate caps and swap are accounted for as cash flow hedges and were considered effective hedges on application of the provisions of IFRS 9. The effective portion of the hedges is recorded as a movement within Other Reserves for the years ended 31 December 2023 and 31 December 2022.

Fair value hierarchy

The Group reports using the fair value hierarchy in relation to its assets and liabilities which are measured at fair value expect for those which are exempt as defined under IFRS 13, Fair Value Measurement. The fair value hierarchy categorises the inputs to valuation techniques to measure fair value into three levels:

Level 1: Inputs are based upon unadjusted quoted prices for identical instruments traded in active markets.
Level 2: Inputs are based upon quoted prices for similar instruments in active markets, quoted prices for identical or similar instruments in markets that are not active and model-based valuation techniques for which all significant assumptions are observable in the market or can be corroborated by observable market data for substantially the full term of the assets or liabilities.
Level 3: Inputs are generally unobservable and typically reflect management’s estimates of assumptions that market participants would use in pricing the asset or liability.

Investments in subsidiaries - Company

Investments in subsidiary undertakings are stated at cost less any accumulated impairment and are reviewed for impairment if there are indicators that the carrying value may not be recoverable.

Intercompany loans receivable and payable are initially recognised at fair value. These are subsequently measured at amortised cost, less any loss allowance, calculated on an expected credit loss basis.

Share capital

Ordinary shares are classified as equity. Incremental costs directly attributable to the issue of new shares or options are shown in equity as a deduction, net of tax, from the proceeds.

Where ordinary shares are re-purchased by the Company they are cancelled and the nominal value of the shares is transferred to other undenominated capital within equity.

Equity Method Investments

The Company’s investments that are not consolidated are accounted for under the equity method if the Company exercises significant influence that is considered to be greater than minor. The Company records its pro rata share of the earnings/losses of these investments in Share of equity method investments in the Consolidated Statements of Profit and Loss. The Company reviews these for impairment whenever events or changes in circumstances indicate that the carrying amounts may not be recoverable.







54




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Employee benefits

(a) Pension and other post-employment benefits

Certain companies within the Group operate defined contribution pension plans. A defined contribution plan is a pension plan under which the Group pays fixed contributions into a separate entity. The Group has no legal or constructive obligations to pay further contributions if the fund does not hold sufficient assets to pay all employees the benefits relating to employee service in the current and prior periods. Contributions to defined contribution pension plans are expensed as incurred.

The Group operates defined benefit pension plans for certain of its United Kingdom and Swiss employees through subsidiary companies. A defined benefit plan is a pension plan that is not a defined contribution plan. Typically, defined benefit plans define the amount of pension benefit that an employee will receive on retirement, usually dependent on one or more factors such as age, years of service and compensation. Obligations for contributions to defined benefit pension plans are recognised as an expense in the Consolidated Statement of Profit and Loss as service is received from the relevant employees.

The Group’s net obligation in respect of the defined benefit pension plans is calculated separately by estimating the amount of future benefit that employees have earned in return for their service in the current and prior periods. This benefit is discounted to determine its present value, and the fair value of plan assets deducted. The discount rate used in respect of the UK scheme is determined by the UK corporate bond yields at the reporting date. The discount rate used in respect of the Swiss schemes is determined by the Swiss corporate bond yields at the reporting date. The calculation is performed by a qualified actuary using the projected unit credit method. The net finance income/cost are recorded in operating costs in the Consolidated Statement of Profit and Loss. When benefits of a plan are improved, the portion of the increased benefit relating to the past service by employees is recognised as an expense in the Consolidated Statement of Profit and Loss on a straight line basis over the average period until the benefits become vested. To the extent that the benefits vest immediately, the expense is recognised immediately in the Consolidated Statement of Profit and Loss.

(b) Share-based payments

Share-based payments comprise options to acquire ordinary shares in the Company, Restricted Share Units ('RSUs') and and Performance Share Units ('PSUs') in the form of ordinary share entitlements after a certain period of time. These are awarded to certain key employees and Directors of the Group based on service conditions such as term of employment and individual performance. The fair value of options, RSUs and PSUs granted is recognised as an employee expense with a corresponding increase in equity. The fair value is measured at grant date and spread over the period during which the Directors and other employees become unconditionally entitled to the options, RSUs or PSUs. The fair value of options granted is measured using a model taking into account the terms and conditions upon which the options were granted. The fair value of RSUs and PSUs is equal to the market price of a share at date of grant. The total amount to be expensed is determined by reference to the fair value of the options, RSUs or PSUs granted. The amount recognised as an expense is adjusted to reflect the actual number of share options, RSUs or PSUs that vest.

Forfeitures are estimated on the date of grant and revised if actual or expected forfeiture activity differs materially from original estimates.

Share-based payment expense is recognised over the requisite service period for awards of equity instruments to employees based on the grant date fair value of those awards expected to ultimately vest.

Replacement awards

In connection with the completion of the Merger, the Company issued replacement awards to the holders of PRA equity awards on 1 July 2021. An exchange of share-based compensation awards in a business combination is treated as a modification under IFRS 2. The replacement awards and the original acquiree awards are measured at fair value at the acquisition date and calculated using the fair-value-based measurement principles in IFRS 2. Amounts attributable to pre-combination vesting are accounted for as part of the consideration transferred for the acquiree. Amounts attributable to post-combination vesting are accounted for separate from the business combination and are recognised as compensation cost in the post-combination period.

(c) Share-based payments – Company

The Company operates a number of share-based payment plans the details of which are presented in note 12 Share-based Payments to the Consolidated Financial Statements. The share-based payment expense associated with the share-based payment plans is recognised by the entity which receives services in exchange for the share-based compensation.

55




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Employee benefits (continued)

The Statement of Profit and Loss of the Company is charged with the expense related to the services received by the Company. The remaining portions of the share-based payments represent a contribution to Company’s subsidiaries and are added to the carrying amount of those investments. Under an agreement, with certain subsidiaries, on the date of exercise the Company is paid an amount equal to the fair value of the ordinary shares issued that is in excess of the award exercise price with such amount reducing the Company’s investment in its subsidiaries. The net effect of the grant date fair value of the Company’s share-based compensation to employees of the Company’s subsidiaries and recharges received from those subsidiaries is presented as a movement in financial fixed assets (see note 2 Investment in subsidiaries, to the Company only financial statements).

Revenue Recognition

The Company primarily earns revenues by providing a number of different services to its customers. These services, which are integral elements of the clinical development process, include clinical trials management, consulting, contract staffing, data services and laboratory services. These services, which are described below, can be purchased collectively or individually as part of a clinical trial contract. There is not significant variability in how economic factors affect these services. Contracts range in duration from a number of months to several years.

Revenue Recognition - Clinical trial service revenue

Under IFRS 15 Revenue from Contracts with Customers ('IFRS 15'), a clinical trial service is a single performance obligation satisfied over time i.e. the full service obligation in respect of a clinical trial (including those services performed by investigators and other parties) is considered a single performance obligation. Promises offered to the customer are not distinct within the context of the contract. ICON is the contract principal in respect of both direct services and in the use of third parties (principally investigator services) that support the clinical research project. The transaction price is determined by reference to the contract or change order value (total service revenue and pass-through/reimbursable expenses) adjusted downwards to reflect a realisable contract value. Revenue is recognised as the single performance obligation is satisfied. The progress towards completion for clinical service contracts is measured based on an input measure being project costs incurred as a proportion of total project costs (inclusive of third-party costs) at each reporting period.

Revenue Recognition - Contracting services revenue

The Company has availed of the practical expedient which results in recognition of revenue on a right to invoice basis. Application of the practical expedient reflects the right to consideration from the customer in an amount that corresponds directly with the value to the customer of the performance completion to date. This reflects hours performed by contract staff.

Revenue Recognition - Consulting services revenue

Consulting services contracts represent a single performance obligation satisfied over time. The transaction price is determined by reference to contract or change order value. Revenue is recognised as the performance obligation is satisfied. The progress towards completion for consulting contracts is measured based on total project inputs (time) at each reporting period as a percentage of forecasted total project inputs.
Revenue Recognition - Laboratory services revenue

Revenue is recognised when, or as, obligations under the terms of a contract are satisfied, which occurs when control of the products or services are transferred to the customer. Revenue for laboratory services is measured as the amount of consideration we expect to receive in exchange for transferring products or services. Where contracts with customers contain multiple performance obligations, the transaction price is allocated to each performance obligation based on the estimated relative selling price of the promised good or service. Service revenue is recognised over time as the services are delivered to the customer based on the extent of progress towards completion of the performance obligation. The determination of the methodology to measure progress requires judgement and is based on the nature of services provided. This requires an assessment of the transfer of value to the customer. The right to invoice measure of progress is generally related to rate per unit contracts, as the extent of progress towards completion is measured based on discrete service or time-based increments, such as samples tested or labour hours incurred. Revenue is recorded in the amount invoiced since those amounts corresponds to the value of the Company's performance and the transfer of value to the customer.





56




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Revenue Recognition (continued)

Revenue Recognition - Data services revenue

The Company provides data reports and analytics to customers based on agreed-upon specifications, including the timing of delivery, which is typically either weekly, monthly, or quarterly. If a customer requests more than one type of data report or series of data reports within a contract, each distinct type of data report is a separate performance obligation. The contracts provide for the Company to be compensated for the value of each deliverable. The transaction price is determined using list prices, discount agreements, if any, and negotiations with the customers, and generally includes any out-of-pocket expenses. Typically, the Company bills in advance of services being provided with the amount being recorded as unearned revenue.

When multiple performance obligations exist, the transaction price is allocated to performance obligations on a relative standalone selling price basis. In cases where the Company contracts to provide a series of data reports, or in some cases data, the Company recognises revenue over time using the “units delivered” output method as the data or reports are delivered. Expense reimbursements are recorded to revenue as the expenses are incurred as they relate directly to the services performed.

Certain arrangements include upfront customisation or consultative services for customers. These arrangements often include payments based on the achievement of certain contractual milestones. Under these arrangements, the Company contracts with a customer to carry out a specific study, ultimately resulting in delivery of a custom report or data product. These arrangements are a single performance obligation given the integrated nature of the service being provided. The Company typically recognises revenue under these contracts over time, using an output-based measure, generally time elapsed, to measure progress and transfer of control of the performance obligation to the customer. Expense reimbursements are recorded to revenue as the expenses are incurred as they relate directly to the service performed.

The Company enters into contracts with some of its larger data suppliers that involve non-monetary terms. The Company issues purchase credits to be used toward the data supplier's purchase of the Company's services based on the fair value of the data obtained. In exchange, the Company receives monetary discounts on the data received from the data suppliers. The fair value of the revenue earned from the customer purchases is recognised as services are delivered as described above. At the end of the contract year, any unused customer purchase credits may be forfeited or carried over to the next contract year based on the terms of the data supplier contract.

Commissions

Incremental costs of obtaining a contract are recognised as an asset on the Consolidated Statement of Financial Position in respect of those contracts that exceed one year. Where commission costs relate to contracts that are less than one year, the practical expedient is applied as the amortisation period of the asset which would arise on deferral would be one year or less.

Reimbursable expenses

Reimbursable expenses comprise investigator payments and certain other costs which are reimbursed by clients under terms specific to each contract to the investigators. The Company includes reimbursed expenses in revenue and direct costs as the Company is primarily responsible for fulfilling the promise to provide the specified service, including integration of the related services into a combined output to the customer.

Direct costs

Direct costs consist of compensation, associated employee benefits and share-based payments for project-related employees and other direct project-related costs.

Reimbursable expenses are presented within direct costs. This presentation is to align the presentation of costs with our assessment that our clinical trial service is a single performance obligation satisfied over time. Reimbursable expenses are recorded once the activity which forms the basis for the cost has occurred. Payments are made based on predetermined contractual arrangements. Timing of payments may differ from the timing of the expense.

Other operating expenses

Other operating expenses consist of compensation, associated employee benefits and share-based payments for non-project-related employees and other indirect costs associated with the business. Other operating expenses also include depreciation expense and the amortisation of intangible assets.

57




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)


Exceptional items

The Company has used the term “exceptional” to describe certain items which, in management’s view, warrant separate disclosure by virtue of their size or incidence, or due to the fact that certain gains or losses are determined to be non-recurring in nature. Exceptional items may include restructuring, transaction and integration-related expenses, significant impairments, and material changes in estimates. Also see the replacement awards accounting policy described above.

Transaction and integration-related expenses
Transaction and integration-related expenses are the incremental costs directly attributable to completion and integration activities associated with the Group’s recent acquisitions. The costs consist of investment banking fees, advisory costs, professional fees, retention agreements with employees, accelerated share-based compensation charges and ongoing integration activities. The Group accounts for these transaction and integration-related costs as expenses in the period in which the costs are incurred and the services are received.

Restructuring
Restructuring charges reflect certain one-time and associated unavoidable costs arising from reorganisation programmes announced by Group management. These programmes generally result in asset impairments and workforce reductions in order to optimise the Group’s structure and facilitate improved long-term performance. Impairment charges are taken when the value-in-use of the asset is less than the asset’s carrying value. Workforce related charges are taken when an approved reorganisation programme is communicated to the relevant employee groups.

Research and development credits

Research and development credits are available to the Group under the tax laws in certain jurisdictions, based on qualifying research and development spend as defined under those tax laws. Research and development credits may be recognised as a reduction of income tax expense. However, certain tax jurisdictions provide refundable credits that are not wholly dependent on the Group's ongoing income tax status or income tax position. In these circumstances the benefit of these credits is not recorded as a reduction to income tax expense, but rather as a reduction of operating expenditure.

Financing income

Interest income is recognised in the Consolidated Statement of Profit and Loss as it accrues using the effective interest rate method and includes interest receivable on investments.
Financing expense

Financing expense comprises interest payable on borrowings calculated using the effective interest rate method, finance charges on leases, foreign exchange gains and losses on bank loans and gains and losses on hedging instruments that are recognised in the Consolidated Statement of Profit and Loss.

Financing expense also includes fees paid on the establishment of loan facilities which are recognised as transaction costs of the loan to the extent that it is probable that some or all of the facility will be drawn down. These fees are deferred and recognised in the Statement of Financial Position and are then amortised to the Consolidated Statement of Profit and Loss over the term the facility is available to the Group.

Income tax

Income tax expense in the Consolidated Statement of Profit and Loss represents the sum of income tax currently payable and deferred income tax.

Income tax currently payable is based on taxable profit for the year. Taxable profit differs from net profit as reported in the Consolidated Statement of Profit and Loss because it excludes items of income or expense that are taxable or deductible in other years and further excludes items that are not taxable or deductible. The Group’s liability for income tax is calculated using rates that have been enacted or substantively enacted at the reporting date. Income tax is recognised in the Consolidated Statement of Profit and Loss except to the extent that it relates to items recognised directly in equity.

Deferred income tax is provided, using the liability method, on all differences between the carrying amounts of assets and liabilities for financial reporting purposes and the amounts used for taxation purposes except those arising from non-deductible goodwill or on initial recognition of an asset or liability which affects neither accounting nor taxable profit. Deferred income tax assets and liabilities are measured at the tax rates that are expected to apply in the year when the asset is expected to be realised or the liability to be settled.

58




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

1. Basis of preparation and statement of accounting policies (continued)
Income tax (continued)

Deferred tax assets are recognised for all deductible differences, carry forward of unused tax credits and unused tax losses, to the extent that it is probable that taxable profit will be available against which the deductible temporary differences and the carry forward of unused tax credits and unused tax losses can be utilised. The carrying amount of deferred income tax assets is reviewed at each reporting date and reduced to the extent that it is no longer probable that sufficient taxable profit would be available to allow all or part of the deferred income tax asset to be utilised.

The Group has determined that the global minimum top-up tax – which it is required to pay under Pillar Two legislation – is an income tax in scope of IAS 12. The Group has applied a temporary mandatory relief from deferred tax accounting for the impacts of the top-up tax and accounts for it as current tax when it is incurred.

Earnings per ordinary share

Basic earnings per share is computed by dividing the profit for the financial year attributable to ordinary shareholders of the Company by the weighted average number of ordinary shares outstanding during the financial period.

Diluted net income 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 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 used for basic and diluted net income per ordinary share.

Segment reporting

An operating segment is a component of the Group that engages in business activities from which it may earn revenues and incur expenses, including revenues and expenses that relate to transactions with any of the Group’s other components. The Group determines and presents operating segments based on the information that internally is provided to the Chief Executive Officer (CEO) and Chief Financial Officer (CFO) who together are considered the Group’s chief operating decision makers, the ‘CODM’. An operating segment’s operating results are reviewed regularly by the CODM to make decisions about resources to be allocated to the segment and assess its performance, and for which discrete financial information is available.

Segment results that are reported to the CODM include items directly attributable to a segment as well as those that can be allocated on a reasonable basis. Segment capital expenditure is the total cost incurred during the period to acquire property, plant and equipment and right-of-use assets.

Debt issuance costs

Debt issuance costs relating to the Group’s long-term debt are recorded as a direct reduction of long-term debt; these costs are deferred and amortised to interest expense using the effective interest method, over the respective terms of the related debt. Debt issuance costs relating to the Group’s revolving credit facilities are recorded as an asset; these costs are deferred and amortised to interest expense using the straight-line method. Early repayment of debt facilities can result in modification of the debt and the acceleration of the amortisation of debt issuance costs.



















59




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

2. Segmental information
The Company has the expertise and capability to conduct clinical trials in most major therapeutic areas on a global basis and has the operational flexibility to provide development services on a stand-alone basis or as part of an integrated "full-service" solution. The Company has expanded through internal growth, together with a number of strategic acquisitions to enhance its expertise and capabilities in certain areas of the clinical development process.

The Company determines and presents operating segments based on the information that is internally provided to the chief operating decision maker, together the ('CODM') in accordance with IFRS 8 Operating Segments. The Company determined that the CODM was comprised of the Chief Executive Officer and the Chief Financial Officer.

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.

The Group’s listing for its shares is the NASDAQ market in the United States. Consequently, information reviewed by the chief operating decision makers is prepared in accordance with US generally accepted accounting principles (“US GAAP”) however, the information presented below is prepared in accordance with IFRS reporting standards. Reconciliations of the Group’s profit for the financial year and shareholders’ equity from US GAAP to IFRS are set out on pages 145 to 148 of this report.

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 our global contracting model and the Group’s transfer pricing model.

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 Group on the basis of an arm’s length return 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 the assets owned, risks borne, and functions performed by each entity from these intercompany transactions. The arm’s length return is reviewed annually to ensure that it is market appropriate. The integration of entities acquired through the Merger into this global network and global transfer pricing model has been completed.

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 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 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.

Geographical segment information
31 December
2023
31 December
2022
$’000$’000
Revenue
Ireland 2,377,104 1,984,567 
Rest of Europe 1,574,783 1,618,350 
United States 3,283,790 3,566,610 
Rest of World 884,499 563,859 
Total8,120,176 7,733,386 

60




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

2. Segmental information (continued)

31 December
2023
31 December
2022
$’000$’000
Property, plant and equipment and right-of-use assets
Ireland50,851 51,654 
Europe91,080 98,641 
United States110,575 132,615 
Rest of World46,728 46,516 
Total299,234 329,426 
3. Revenue
Revenue disaggregated by customer profile is as follows:
31 December
2023
31 December
2022
$’000$’000
Top client721,309 682,840 
Clients 2-51,453,508 1,504,530 
Clients 6-101,188,943 1,111,486 
Clients 11-251,743,539 1,584,100 
Other3,012,877 2,850,430 
Total revenue8,120,176 7,733,386 
Our customers have similar profiles and economic characteristics, and therefore have similar degrees of risk and growth opportunities.

4. Financing income
31 December
2023
31 December
2022
$’000$’000
Interest receivable5,0142,345
Total finance income5,0142,345

All of the above relate to items not at fair value through profit and loss.

5. Financing expense

31 December
2023
31 December
2022
$’000$’000
Interest payable on borrowings311,019209,189
Interest on lease liabilities4,172 4,470 
Facility fees (including amortisation)16,40217,749
Other financing costs*9,278 2,793 
Total finance expense340,871234,201
*includes costs associated with the senior secured revolving loan facility.

The Company incurred interest costs from various financing arrangements during the years ended 31 December 2023 and 31 December 2022 as set out in the table above. These costs have been charged in the financing expense line of the Consolidated Statement of Profit and Loss. All of the above relate to items not at fair value through profit and loss.

61




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

6. Profit before taxation
Profit before taxation is stated after charging the following:

Auditor's remuneration
31 December 202331 December 2022
Statutory auditorAffiliated firmsTotalStatutory auditorAffiliated firmsTotal
$’000$’000$’000$’000$’000$’000
Audit fees (1)
3,405 59 3,464 4,361 59 4,420 
Other assurance fees: audit related fees (2)
317 137 454 178 116 294 
Other Non-audit fees: Tax compliance and the preparation of tax returns and refund claims495 436 931 214 106 320 
Total audit, audit related and tax compliance fees4,217 632 4,849 4,753 281 5,034 
Other tax planning and consulting services (3)
249  249 749 430 1,179 
Tax advice relating to integration of ICON and PRA (4)
897  897 3,720 — 3,720 
Total non-audit service fee / tax advisory fees1,146  1,146 4,469 430 4,899 
Total fees5,363 632 5,995 9,222 711 9,933 
(1)Audit fees include annual audit and quarterly review fees for ICON Plc.
(2)Audit related fees principally consist of fees for assurance and related services, such as financial due diligence services, fees for the audit of employee benefit plans, fees for pension reviews and audit fees of the Company's subsidiaries.
(3)Other tax planning and consulting services represents services across a number of areas including in relation to the Group's financing facilities and other ad hoc tax advisory and planning.
(4)Tax advice relating to the integration of ICON and PRA are fees directly related to the Merger and subsequent integration of PRA and are not expected to recur in future periods. These fees directly related to tax advice on the steps required to integrate and eliminate legal entities of PRA and ICON following the merger. The fees also included detailed transfer pricing advice on business model integration.

Depreciation and amortisation

31 December
2023
31 December
2022
$’000$’000
Depreciation of property, plant and equipment (note 13)48,158 48,692 
Depreciation of right-of-use assets (note 27)41,982 45,215 
Amortisation of intangible assets (note 14)537,792 518,656 
Total depreciation and amortisation627,932 612,563 

Directors’ remuneration
31 December
2023
31 December
2022
$’000$’000
Emoluments3,5323,730
Benefits under long-term incentive schemes5,3047,130
Gain on exercise of share options13,0093,771
Pension contributions (defined contribution)125125
Directors' remuneration disclosures as required by Section 305 of the Companies Act are set out above. Retirement benefits accrue to one Director (2022: one Director) under a defined contribution scheme. Further details regarding Directors’ shareholdings, share options and compensation are shown in note 10 – Payroll and related benefits. Included in the benefits under long-term incentive scheme are amounts relating to share entitlements, the calculation of which was based on the share-based payment charge calculated under IFRS 2 Share-Based Payments.
62




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

7. Income tax expense

The components of the current and deferred tax expense for the years ended 31 December 2023 and 2022 were as follows:
31 December
2023
31 December
2022
$’000$’000
Current tax expense
Current year
-    Ireland
80,427 55,073 
-    Other
16,112 132,612 
96,539 187,685 
Deferred tax credit
Origination and reversal of temporary differences(67,209)(119,671)
Over provided in prior years
Current tax
4,936 (3,602)
Deferred tax
(15,639)1,102 
Over provided in prior years (10,703)(2,500)
Total income tax expense in profit and loss18,627 65,514 
Tax recognised directly in equity
Deferred tax recognised directly in equity(13,045)25,780 
Current tax recognised directly in equity(4,323)(1,739)
Total tax recognised in equity(17,368)24,041 
Income tax recognised in other comprehensive income
Fair value of cash flow hedge301
Tax on currency impact on long-term funding(3,903)7,211
Tax impact of pension contributions754 
Total income tax recognised in other comprehensive income(3,602)7,965

The total tax expense of $18.6 million and $65.5 million for the years ended 31 December 2023 and 31 December 2022 respectively, reflects tax at standard rates on taxable profits in the jurisdictions in which the Group operates, foreign withholding tax and the availability of tax losses.

The deferred tax credit of $67.2 million for the year ended 31 December 2023 and the deferred tax credit of $119.7 million for the year ended 31 December 2022, relates to deferred tax arising in respect of net operating losses and temporary differences in property, plant and equipment, the timing of certain goodwill amortisation on US acquisitions and the timing of tax deductions available relating to the Group’s share-based compensation schemes.

63




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

7. Income tax expense (continued)

A reconciliation of the expected tax expense, computed by applying the standard Irish tax rate to income before tax to the actual tax expense, is as follows:

31 December
2023
31 December
2022
$’000$’000
Profit before tax627,651 571,799 
Irish standard tax rate12.5 %12.5 %
Taxes at Irish standard tax rate
78,456 71,475 
Over provision in respect to prior years(10,703)(2,500)
Foreign and other income taxed at higher rates46,481 52,463 
Rate differential from amortisation of intangible assets(71,223)(59,330)
Effect of change in tax rates3,154 (300)
(Decrease)/ increase in unrecognised tax benefits(54,347)8,392 
Losses for which no benefit has been recognised(1,068)(777)
Research and development tax incentives(3,868)(2,608)
Impact of stock compensation(5,035)520 
Investor tax expense on foreign subsidiaries earnings39,165 — 
Share of loss of associate already tax effected 392 
Other(2,385)(2,213)
Tax expense on profit for the year18,627 65,514 

The net deferred tax asset at 31 December 2023 and 31 December 2022 was as follows:
31 December
2023
31 December
2022
$’000$’000
Deferred taxation assets
Net operating losses carried forward81,362 45,498 
Accrued and other liabilities84,748 66,753 
Property, plant and equipment9,082 6,010 
Deferred revenue23,748 66,566 
Share-based payment49,180 43,048 
Other15,783 17,748 
Total deferred taxation assets263,903 245,623 
Less: offset against deferred tax liabilities(158,674)(147,506)
Deferred tax asset disclosed on Consolidated Statement of Financial Position105,229 98,117 

64




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

7. Income tax expense (continued)

31 December
2023
31 December
2022
$’000$’000
Deferred taxation liabilities
Property, plant and equipment7,547 10,927 
Goodwill and related assets39,014 37,150 
Other intangible assets950,055 1,078,302 
Investments in foreign subsidiaries52,408 1,587 
Other 7,985 7,467 
Total deferred taxation liabilities1,057,009 1,135,433 
Less: offset against deferred tax assets(158,674)(147,506)
Deferred tax liability disclosed on Consolidated Statement of Financial Position898,335 987,927 
Net deferred taxation liability(793,106)(889,810)

The movement in temporary differences during the year ended 31 December 2023 was as follows:
1 January 2023Recognised in IncomeRecognised in Other Comprehensive IncomeRecognised in Equity31 December 2023
$’000$’000$’000$’000$’000
Deferred taxation assets
Net operating loss carry forwards45,498 35,864 — — 81,362 
Accrued and other liabilities66,753 17,995 — — 84,748 
Property, plant and equipment6,010 3,072 — — 9,082 
Share-based payment43,048 (6,563)— 13,045 49,530 
Deferred revenue66,566 (42,818)— — 23,748 
Other17,748 (1,958)(357)— 15,433 
Total deferred taxation assets
245,623 5,592 (357)13,045 263,903 
Deferred taxation liabilities
Property, plant and equipment
10,927 (3,380)— — 7,547 
Goodwill and related assets37,150 1,864 — — 39,014 
Investments in Foreign subsidiaries1,58750,82152,408
Other 7,467 1,686 — (1,168)*7,985 
Other intangible assets 1,078,302 (128,247)— — 950,055 
Total deferred taxation liabilities
1,135,433 (77,256) (1,168)1,057,009 
Net deferred taxation liability(889,810)82,848 (357)14,213 (793,106)
* These adjustments relate to foreign currency translation on the deferred tax liabilities.

65




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

7. Income tax expense (continued)

The movement in temporary differences during the year ended 31 December 2022 was as follows:
1 January 2022Recognised in IncomeRecognised in Equity31 December 2022
$’000$’000$’000$’000
Deferred taxation assets
Net operating loss carry forwards43,451 2,047 — 45,498 
Accrued and other liabilities 71,934 (5,181)— 66,753 
Property, plant and equipment5,619 391 — 6,010 
Share-based payment81,903 (13,075)(25,780)43,048 
Deferred Revenue62,871 3,695 — 66,566 
Other4,330 13,418 — 17,748 
Total deferred taxation assets
270,108 1,295 (25,780)245,623 
Deferred taxation liabilities
Property, plant and equipment
19,606 (8,679)— 10,927 
Goodwill on acquisition33,354 3,796 — 37,150 
Investments in Foreign subsidiaries10 1,577 — 1,587 
Other1,751 1,627 4,089 *7,467 
Other intangible assets1,193,897 (115,595)— 1,078,302 
Total deferred taxation liabilities
1,248,618 (117,274)4,089 1,135,433 
Net deferred taxation liability(978,510)118,569 (29,869)(889,810)
* These adjustments relate to foreign currency translation on the deferred tax liabilities.

Unrecognised deferred tax assets

Deferred tax assets relating to the following net operating losses have not been recognised to the extent that it is considered unlikely that a benefit will be received in the future.

At 31 December 2023, non-US subsidiaries had operating loss carry-forwards for income tax purposes that may be carried forward indefinitely, available to offset against future taxable income, if any, of approximately $42.9 million (31 December 2022: $37.9 million). At 31 December 2023, non–US subsidiaries also had additional operating loss carry forwards of $12.9 million which are due to expire between 2024 and 2030 and operating loss carry forwards of $0.03 million which are due to expire between 2031 and 2040.

In total, the Company has unrecognised deferred tax assets of $42.9 million at 31 December 2023 and $43.4 million at 31 December 2022. The Company has not recognised these remaining deferred tax assets because it believes that it is more likely than not that the losses and other deferred tax assets will not be utilised given their history of operating losses.

Unrecognised deferred tax liabilities

The Company has recognised a deferred tax liability of $52.4 million (2022: $1.6 million) for investments in foreign subsidiaries where the Company does not consider the earnings to be indefinitely reinvested. Given changes in various tax laws during 2023, the group has taken the decision to repatriate certain excess earnings which will not be permanently reinvested and consequently have provided for the relevant tax in the current year. For the deferred tax liability not recognised in respect of temporary differences related to investments in foreign subsidiaries which are considered to be indefinitely reinvested, it is not practicable to calculate the exact unrecognised deferred tax liability, however, it is not expected to be material as Ireland allows a tax credit in respect of distributions from foreign subsidiaries at the statutory tax rate in the jurisdiction of the subsidiary so that no material tax liability would be expected to arise in Ireland in the event these earnings were ever remitted. In addition, withholding taxes applicable to remittances from foreign subsidiaries would not be expected to be material given Ireland’s tax treaty network and the EU parent subsidiary directive.

The Group operates in a number of jurisdictions which have enacted new legislation to implement the global minimum top-up tax. The Group expects to potentially be subject to the top-up tax in relation to certain jurisdictions where the statutory rate is below 15%. Additionally, the application of local tax laws in certain jurisdictions, particularly with regard to certain incentives, has typically resulted in effective tax rates of below 15%. This is expected to create future top-up tax liabilities in these jurisdictions. However, since the newly enacted tax legislation in Ireland is only effective from 1 January 2024, there is no current tax impact for the year ended 31 December 2023.
66




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

7. Income tax expense (continued)


The Group has applied a temporary mandatory relief from deferred tax accounting for the impacts of the top-up tax and accounts for it as a current tax when it is incurred.

The application of the Pillar Two global minimum tax rules would have been reasonably estimated to increase the Group’s annual effective tax rate by around 1 to 2 percentage points.


8. Earnings per share

The following table sets forth the computation for basic and diluted net earnings per share for the years ended 31 December 2023 and 31 December 2022:

31 December 202331 December 2022
Pre-exceptionalExceptional
(Note 9)
Total Pre-exceptionalExceptional
(Note 9)
Total
Numerator ($'000)
Profit attributable to equity holders684,387 (75,363)609,024 562,958 (56,673)506,285 
Denominator (Number of shares)
Basic weighted average ordinary shares outstanding82,101,813 82,101,813 82,101,813 81,532,320 81,532,320 81,532,320 
Effect of dilutive potential ordinary shares637,626 637,626 637,626 1,004,506 1,004,506 1,004,506 
Diluted weighted average ordinary shares outstanding82,739,439 82,739,439 82,739,439 82,536,826 82,536,826 82,536,826 
Earnings per Share ($ per share)
Basic earnings per ordinary share8.34 (0.92)7.42 6.90 (0.70)6.21 
Diluted earnings per ordinary share8.27 (0.91)7.36 6.81 (0.69)6.13 

The Company had 165,129 anti-dilutive shares in issue at 31 December 2023 (31 December 2022: 46,973) comprised of 165,129 options (31 December 2022: 23,486) and nil RSUs (31 December 2022: 23,487).

67




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

9. Exceptional items




Exceptional items are comprised of transaction and integration related, restructuring and financing expenses.

31 December 202331 December 2022
 $'000$'000
Transaction and integration related44,176 39,695 
Restructuring charges45,390 31,143 
Other operating expenses89,566 70,838 
Income tax expense(14,203)(14,165)
Exceptional items (net)75,363 56,673 

Transaction and integration related
In the years ended 31 December 2023 and 31 December 2022, the Company incurred $44.2 million and $39.7 million, respectively, of merger-related expenses which were accounted for separately from the business combination and expensed as incurred within the “Other operating expenses” line item of the Consolidated Statement of Profit and Loss. These costs relate to professional fees, retention agreements and ongoing integration activities.

Restructuring charges
A restructuring charge of $45.4 million was recognised during the year ended 31 December 2023 (2022: $31.1 million) under a restructuring plan adopted following a review of operations and are included within the “Other operating expenses” line item of the Consolidated Statement of Profit and Loss. The restructuring program aims at realigning the Company's workforce as well as reviewing its global footprint and optimising its locations to best fit the requirements of the Company. The restructuring program resulted in a charge of $34.1 million (2022: $2.7 million) relating to workforce reductions, an impairment of ROU assets of $8.7 million (2022: $24.5 million), a fixed asset impairment of $nil (2022: $4.0 million) and other costs associated with the office consolidation program of $2.6 million (2022: $nil).

At 31 December 2023 and 31 December 2022 a total liability of $7.0 million and $6.0 million, respectively, was included in the Consolidated Statement of Financial Position relating to restructuring activities. At 31 December 2023, the total liability included $3.0 million from facilities related liabilities, of which $1.0 million is recorded in provisions and $2.0 million is included within non-current provisions.The remaining provision of $4.0 million relates to workforce reduction and is included within provisions.
31 December 202331 December 2022
$'000$'000
Opening liability6,022 10,311 
Additional charges in the year36,704 4,364 
Utilisation(35,727)(8,653)
Ending liability6,999 6,022 
68




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits

Payroll costs

The aggregate payroll costs of employees of the Group for the year ended 31 December 2023 and 31 December 2022 were as follows:
Note31 December 202331 December 2022
$’000$’000
Wages and salaries3,052,039 2,952,242 
Social welfare costs533,629 579,714 
Pension costs for defined contribution pension schemes11115,266 116,179 
Pension costs for defined benefit pension schemes11319 744 
Termination benefits934,080 2,714 
Share-based payment1251,380 55,790 
Total charge to income3,786,713 3,707,383 
Re-measurement of post-employment benefit obligations11(525)(13,265)
Total payroll and related benefit costs3,786,188 3,694,118 


Average employee numbers

The average number of employees, including executive Directors, employed by the Group during the year ended 31 December 2023 and 31 December 2022 was as follows:
31 December 202331 December 2022
Marketing
556 530 
Administration3,580 3,560 
Clinical research33,458 32,421 
Laboratory2,809 2,653 
Total40,403 39,164 

Directors’ remuneration

Remuneration policy

The Compensation and Organisation Committee seeks to achieve the following goals with the Company’s executive compensation programmes: to attract, motivate and retain key executives and to reward executives for value creation. The Committee seeks to foster a performance-oriented environment by ensuring that a significant portion of each executive’s cash and equity compensation is based on the achievement of performance targets that are important to the Company, its shareholders and other stakeholders.

The Company’s executive compensation program has three main elements: base salary, a bonus plan and equity incentives in the form of share related awards granted under the Company’s equity incentive plans. All elements of key executives’ compensation are determined by the Compensation and Organisation Committee based on the achievement of the Group’s and individual performance objectives. Base salary, bonus awards and Directors’ fees were determined by the Compensation and Organisation Committee in U.S. dollars, Euro or British pound sterling. 

Non-Executive Directors’ remuneration

Non-Executive Directors are remunerated by way of Directors’ fees and are also eligible for participation in the share equity incentive schemes. During 2023, each Non-Executive Director (excluding the Board Chair) was paid an annual retainer of $90,000 and additional fees for Board Committee service.





69




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits (continued)



Mr. Ciaran Murray’s Executive Chair term expired on 12 May 2018 and he transitioned to the role of Non-Executive Chair. The current arrangement with the Chair provides for payment of €330,000 (translated at average rate for the year: $356,235) annually.

Mr. Rónán Murphy was appointed as Lead Independent Director with effect from 1 January 2019 and receives an additional fee of $40,000 for this role.

Non-Executive Directors are not eligible for performance related bonuses and no pension contributions are made on their behalf. The Compensation and Organisation Committee sets non-Executive remuneration.

Executive Directors’ and Key Executive Officers’ remuneration

Total cash compensation is divided into a base salary portion and a bonus incentive portion. The Committee targets total cash compensation with regard to healthcare/ biopharmaceutical companies of similar market capitalisation and peer CRO companies, adjusted upward or downward based on individual performance and experience and level of responsibility. The Compensation and Organisation Committee believes that the higher the executive’s level of responsibility within the Company, the greater the percentage of the executive’s compensation that should be tied to the Company’s performance. Target bonus incentive for executive officers range between 75% and 125% of salary with actual pay outs for 2023 ranging from 64% to 100%, of salary, based on Group and individual performance.

A total bonus of $1.6 million was awarded to the following individuals; Dr. Steve Cutler, Chief Executive Officer ($1.2 million) and Mr. Brendan Brennan, Chief Financial Officer ($0.4 million) to reflect their contribution to the performance of the Company during 2023. These amounts were approved by the Compensation and Organisation Committee and will be paid during the year ended 31 December 2024.

The Company’s executives are eligible to receive equity incentives, including stock options, Restricted Share Units and Performance Share Units, granted under the Company’s equity incentive plans. If executives receive equity incentive grants, they are normally approved annually at the first scheduled meeting of the Committee in the fiscal year. The grant date and value is determined by the Committee and the number of units granted is determined based on the closing price of the Company's shares on the day of grant. Newly hired executives may receive sign-on grants. In addition, the Committee may, at its discretion, issue additional equity incentive awards to executives if the Committee determines such awards are necessary to ensure appropriate incentives are in place. The equity awards granted to each participant are determined by the Committee at the start of each year based on peer group data, advice from independent compensation consultants, and Committee judgment.

During 2023, Performance Share Units (“PSUs”) which were awarded subject to vesting in 2020 vested for Dr. Steve Cutler Chief Executive Officer in the amount of 22,404 from a potential grant of 22,404. The percentage granted reflects service and the Company's achievements of diluted non GAAP specified EPS targets over the three year period from 2020 - 2022.

During 2023, Performance Share Units (“PSUs”) which were awarded subject to vesting in 2020 vested for Mr. Brendan Brennan Chief Financial Officer in the amount of 4,850 from a potential grant of 4,850. The percentage granted reflects service and the Company's achievements of diluted non GAAP specified EPS targets over the three year period from 2020 - 2022.

All executive officers are eligible to participate in pension plans. The Company’s contributions are generally a fixed percentage of their annual compensation, supplementing contributions by the executive. The Company has the discretion to make additional contributions if deemed appropriate by the Committee. The Company’s contributions are determined at the peer group median of comparable Irish companies and peer CRO companies. Contributions to this plan are recorded as an expense in the Consolidated Statement of Profit and Loss.

70




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits (continued)



The Directors, Executive Officers and Company Secretary have the following interests, all of which are beneficial, other than as stated, in the shares and share options of the Company or other Group companies at the following dates:

Interest atInterest at
31 December 202331 December 2022
NameName of company and description of sharesNumber of sharesOptionsNumber of sharesOptions
Ciaran MurrayICON plc
Ordinary Shares €0.0619,343  1,680 58,646 
Dr. Steve CutlerICON plc
Ordinary Shares €0.0637,098 222,001 42,377 208,885 
Brendan BrennanICON plc
Ordinary Shares €0.0622,105 32,952 23,547 53,105 
Rónán MurphyICON plc
Ordinary Shares €0.062,121 8,084 1,680 9,622 
Dr. John ClimaxICON plc
Ordinary Shares €0.06449,775 23,255 509,297 33,255 
Joan GarahyICON plc
Ordinary Shares €0.062,121 5,005 1,680 5,005 
Eugene McCagueICON plc
Ordinary Shares €0.062,121 5,005 1,680 5,005 
Julie O'NeillICON plc
Ordinary Shares €0.061,931  1,490 — 
Dr. Linda GraisICON plc
Ordinary Shares €0.064,435  3,994 — 
Diarmaid CunninghamICON plc
Ordinary Shares €0.067,980 23,427 7,456 27,893 



























71




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits (continued)



Further details regarding the above share options are as follows:
NameOptionsExercise priceGrant dateExpiry date
Dr. Steve Cutler15,284 $83.47 3 March 20173 March 2025
29,613 $115.11 3 March 20183 March 2026
32,272 $140.38 3 March 20193 March 2027
42,386 $159.33 3 March 20203 March 2028
37,461 $174.96 3 March 20213 March 2029
35,869 $231.68 3 March 20223 March 2030
29,116 $233.88 3 March 20233 March 2031
Brendan Brennan1,760 $140.38 3 March 20193 March 2027
9,176 $159.33 3 March 20203 March 2028
8,842 $174.96 3 March 20213 March 2029
7,401 $231.68 3 March 20223 March 2030
5,773 $233.88 3 March 20233 March 2031
Rónán Murphy3,079 $90.03 19 May 201719 May 2025
5,005 $125.74 18 May 201818 May 2026
Dr. John Climax10,557 $65.60 20 May 201620 May 2024
7,693 $90.03 19 May 201719 May 2025
5,005 $125.74 18 May 201818 May 2026
Joan Garahy5,005 $125.74 18 May 201818 May 2026
Eugene McCague5,005 $125.74 18 May 201818 May 2026
Diarmaid Cunningham1,103 $140.38 3 March 20193 March 2027
5,737 $159.33 3 March 20203 March 2028
5,528 $174.96 3 March 20213 March 2029
6,194 $231.68 3 March 20223 March 2030
4,865 $233.88 3 March 20233 March 2031


























72




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits (continued)



The Directors, Executive Officer and Company Secretary held the following Restricted Share Units (“RSUs”) and Performance Share Units (“PSUs”) awards as at 31 December 2023:
NameRSUsAward dateVesting DatePSUs(1)Award DateVesting date
Ciaran Murray1,389 22 May 202322 May 2024
Dr. Steve Cutler2,959 3 March 20213 March 202410,354 3 March 20213 March 2024
3,018 3 March 20223 March 202410,565 3 March 20223 March 2025
3,050 3 March 20233 March 202410,675 3 March 20233 March 2026
3,019 3 March 20223 March 2025
3,050 3 March 20233 March 2025
3,050 3 March 20233 March 2026
Brendan Brennan698 3 March 20213 March 20242,444 3 March 20213 March 2024
622 3 March 20223 March 20242,179 3 March 20223 March 2025
604 3 March 20233 March 20242,116 3 March 20233 March 2026
624 3 March 20223 March 2025
604 3 March 20233 March 2025
606 3 March 20233 March 2026
Rónán Murphy926 22 May 202322 May 2024
Dr. John Climax926 22 May 202322 May 2024
Joan Garahy926 22 May 202322 May 2024
Eugene McCague926 22 May 202322 May 2024
Julie O'Neill926 22 May 202322 May 2024
Dr. Linda Grais926 22 May 202322 May 2024
Diarmaid Cunningham437 3 March 20213 March 20241,528 3 March 20213 March 2024
521 3 March 20223 March 20241,824 3 March 20223 March 2025
521 3 March 20223 March 20251,783 3 March 20233 March 2026
509 3 March 20233 March 2024
509 3 March 20233 March 2025
510 3 March 20233 March 2026
(1)Of the issued PSUs, performance conditions will determine how many vest. If performance targets are exceeded, additional PSUs will be issued and will vest in accordance with the terms of the relevant PSU award. The PSUs vest based on service and specified EPS targets over the periods 2021 – 2023, 2022 – 2024 and 2023 - 2025. Depending on the actual amount of EPS from 2021 to 2025, up to a maximum of 38,333 additional PSUs may also be granted to Dr. Steve Cutler and Mr. Brendan Brennan.

Details of transactions entered into by the Directors, Executive Officers and Company Secretary in shares and share options of the Company during the year ended 31 December 2023 were as follows:

Share options exercised and sold

Name

Number of Share Options
Average
Exercise
price
Average
Sales
price
Dr. Steve Cutler16,000 $79.06 $265.46 
Brendan Brennan25,926 $110.61 $267.79 
Diarmaid Cunningham9,331 $120.06 $255.21 
Dr. John Climax10,000 $68.39 $200.80 
Rónán Murphy1,538 $90.03 $275.28 
Ciaran Murray41,646 $71.95 $222.78 

73




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits (continued)




Share options exercised and held

Name

Number
of Shares
Average
Exercise
Price
Ciaran Murray17,000 $95.97 

Shares sold

Name

Number
of Shares
Average
Sales
Price
Dr. John Climax60,000 $274.67 

RSUs and PSU's vested

Name

Number
of Shares
Average
Vest
Price
Dr. Steve Cutler31,581 $233.88 
Brendan Brennan6,864 $233.88 
Ciaran Murray1,388 $212.78 
Rónán Murphy925 $212.78 
Dr. John Climax925 $212.78 
Joan Garahy925 $212.78 
Eugene McCague925 $212.78 
Julie O'Neill925 $212.78 
Diarmaid Cunningham4,424 $233.88 
Dr. Linda Grais925 $212.78 
Shares (vested RSUs and PSU's) sold

Name

Number
of Shares
Average
Sales
Price
Dr. Steve Cutler36,860 $255.85 
Brendan Brennan8,306 $252.15 
Ciaran Murray725 $213.33 
Rónán Murphy484 $213.36 
Dr. John Climax447 $213.41 
Joan Garahy484 $213.38 
Eugene McCague484 $213.36 
Julie O'Neill484 $213.38 
Diarmaid Cunningham3,900 $243.20 
Dr. Linda Grais484 $213.38 

The price the Company’s ordinary shares during the year ended 31 December 2023 moved in the range of $181.92 to $288.50 (year ended 31 December 2022: in the range of $173.90 to $296.03). The closing share price at 31 December 2023 was $283.07 (at 31 December 2022: $194.25).

74




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits (continued)



Summary compensation table - Year ended 31 December 2023


Name


Year


Salary
Company pension contributionPerformance related compensation
All other compensation


Subtotal
Share-based
payments
***
Directors’ fees
Total
compensation
$’000$’000$’000$’000$’000$’000$’000$’000
Ciaran Murray2023— — — — — 300 356 656 
Dr. Steve Cutler20231,191 125 1,197 31 2,544 5,980 44 8,568 
Brendan Brennan2023587 73 381 31 1,072 1,103 — 2,175 
Rónán Murphy2023— — — — — 200 159 359 
Dr. John Climax2023— — — — — 200 90 290 
Joan Garahy2023— — — — — 200 123 323 
Eugene McCague2023— — — — — 200 123 323 
Julie O'Neill2023— — — — — 200 115 315 
Dr. Linda Grais2023— — — — — 200 103 303 
Total20231,778 198 1,578 62 3,616 8,583 1,113 13,312 

***Share-based payments is the IFRS 2 expense related to share options, RSUs and PSUs. The aggregate amount of the gains earned by the Directors on the exercise of share options during the financial year is disclosed in Note 6 Profit before taxation under ‘Directors’ emoluments’.

75




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

10. Payroll and related benefits (continued)



Summary compensation table - Year ended 31 December 2022
NameYearSalaryCompany pension contributionPerformance related compensationAll other compensationSubtotalShare-based
payments
***
Directors’ feesTotal
compensation
$’000$’000$’000$’000$’000$’000$’000$’000
Ciaran Murray2022— — — — — 267 363 630 
Dr. Steve Cutler20221,168 125 1,173 31 2,497 7,504 44 10,045 
Brendan Brennan2022556 70 342 30 998 1,385 — 2,383 
Rónán Murphy2022— — — — — 200 150 350 
Professor Hugh Brady*2022— — — — — 67 54 121 
Dr. John Climax2022— — — — — 202 90 292 
Joan Garahy2022— — — — — 200 123 323 
Professor William Hall*2022— — — — — 69 58 127 
Eugene McCague2022— — — — — 200 125 325 
Julie O'Neill2022— — — — — 200 110 310 
Mary Pendergast*2022— — — — — 69 54 123 
Colin Shannon**2022— — — — — — 85 85 
Dr. Linda Grais2022— — — — — 133 98 231 
Total20221,724 195 1,515 61 3,495 10,496 1,354 15,345 
* Professor Hugh Brady, Professor William Hall and Ms. Mary Pendergast resigned from the Board of Directors on 26 July 2022.
** Mr. Colin Shannon resigned from the Board of Directors on 9 December 2022.
***Share-based payments is the IFRS 2 expense related to share options, RSUs and PSUs. The aggregate amount of the gains earned by the Directors on the exercise of share options during the financial year is disclosed in Note 6 Profit before taxation under ‘Directors’ emoluments’.




















76




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11.    Retirement benefit obligations
The Group operates a number of defined contribution schemes and defined benefit pension schemes. The Group accounts for pensions in accordance with IAS 19R Employee Benefits (“IAS 19R”).

(i)Defined Contribution Schemes

Certain employees of the Group are eligible to participate in a defined contribution or profit sharing plans (the "Plans"). Participants in the Plans may elect to defer a portion of their pre-tax earnings into a pension plan, which is run by an independent party. The Group matches each participant's contributions up to certain levels of the participant's annual compensation. Contributions to the plan are recorded as a remuneration expense in the Consolidated Statement of Profit and Loss. Contributions to Non-US Plans for the year ended 31 December 2023 and year ended 31 December 2022 were $74.9 million and $70.4 million respectively.

The Group's United States operations maintain retirement plans (the "U.S. Plans") that qualify as deferred salary arrangements under Section 401(k) of the Internal Revenue Code. Participants in the U.S. Plans may elect to defer a portion of their earnings, up to the Internal Revenue Service annual contribution limit. The Group matches participant's contributions at varying amounts, subject to a maximum of 4.5% of the participant's annual compensation. Contributions to the U.S. Plans are recorded, in the year contributed, as an expense in the Consolidated Statement of Profit and Loss. Contributions for the year ended 31 December 2023 and year ended 31 December 2022 were $40.4 million and $45.8 million respectively.


(ii)Defined Benefit Plans

ICON Development Solutions Limited Pension Plan

One of the Group’s subsidiaries, ICON Development Solutions Limited, which was acquired by the Group in 2003, operates a defined benefit pension plan in the United Kingdom for certain employees, which is now closed to new members.

The plan is managed externally and the related pension costs and liabilities are assessed in accordance with the advice of a professionally qualified actuary. Plan assets at 31 December 2023 and 31 December 2022 consist of units held in independently administered funds.

Financial assumptions

The following assumptions were used in determining the fair value of the plan assets and the present value of the projected benefit obligation at 31 December 2023:
31 December
2023
31 December
2022
Discount rate4.8 %4.9 %
Inflation rate3.0 %3.1 %
Future salary increases3.0 %3.6 %

A single discount rate is used which, when used to discount the projected benefit cashflows underlying a pension scheme with a 19 year duration, gives the same result as a full AA corporate bond yield curve.

The following assumptions were used at the commencement of the year in determining the net periodic pension cost for the year ended 31 December 2023:
31 December
2023
31 December
2022
Discount rate4.9 %1.8 %
Future salary increases3.6 %3.7 %

77




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11. Retirement benefit obligations (continued)

Mortality assumptions

Assumptions regarding mortality experience are set based on actuarial advice in accordance with published statistics and experience. The mortality assumptions adopted at 31 December 2023 are 111%/105% of the standard tables S3PMA/S3PFA_M, Year of Birth, no age rating for males and females, projected using CMI_2022 converging to 1.25% p.a.. These imply the following life expectancies, for persons retiring at age 65 (2022: 62):
31 December
2023
31 December
2022
Male retiring in 2023/202223.4 years24.4 years
Female retiring in 2023/202224.8 years26.2 years
Male retiring in 2048/204225.8 years25.8 years
Female retiring in 2048/204227.3 years27.8 years

Consolidated Financial Statements

Funding status
31 December
2023
31 December
2022
$’000
$’000
Projected benefit obligation(20,999)(19,558)
Fair value of plan assets27,320 26,050 
Retirement benefit plan net asset6,321 6,492 

Movement in the net benefit asset recognised in other non-current assets was as follows:
Present Value of ObligationsFair Value of Plan AssetsTotal
$’000
$’000
$’000
At 1 January 2023(19,558)26,0506,492
Current service costs
(35)(35)
Interest (expense)/income(975)1,301326
(20,568)27,3516,783
Re-measurements
Return on plan assets(1,133)(1,133)
Gain or loss from change in demographic assumptions
470470
Gain or loss from change in financial assumptions
(382)(382)
Experience gain or loss
239239
327(1,133)(806)
Exchange differences(1,057)1,331274
Contributions:
- Employers
7070
- Plan participants
(19)19
Benefit payments
318(318)
299(229)70
At 31 December 2023(20,999)27,3206,321


78




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11. Retirement benefit obligations (continued)

Present Value of Obligations
Fair Value of Plan Assets

Total
$’000
$’000
$’000
At 1 January 2022(41,813)36,198(5,615)
Current service costs
(117)(117)
Interest (expense)/income(672)580(92)
(42,602)36,778(5,824)
Re-measurements
Return on plan assets(6,626)(6,626)
Gain or loss from change in demographic assumptions
2727
Gain or loss from change in financial assumptions
18,98318,983
Experience gain or loss
(393)(393)
18,617(6,626)11,991
Exchange differences
3,932(3,677)255
Contributions:
- Employers
7070
- Plan participants
(19)19
Benefit payments
514(514)
495(425)70
At 31 December 2022(19,558)26,0506,492

Re-measurements are recognised in the Consolidated Statement of Comprehensive Income as follows:
31 December
2023
31 December
2022
$’000$’000
Return on plan assets (excl. amounts included in interest income/expense)
(1,133)(6,626)
Gain or loss from change in demographic assumptions
470 27 
Gain or loss from change in financial assumptions
(382)18,983 
Experience gain or loss
239 (393)
Comprehensive income at end of year(806)11,991

Defined benefit pension expense recognised in the Consolidated Statement of Profit and Loss was as follows:
31 December
2023
31 December
2022
$’000$’000
Current service cost recognised in profit or loss
35 117 
Net interest (income)/expense recognised in profit or loss(326)92 
Expenses
63 — 
Net periodic pension (credit)/cost(228)209 

Plan Assets Fair Value

The fair value of plan assets at 31 December 2023 is analysed as follows:
31 December
2023
31 December
2022
$’000$’000
Unit funds27,320 26,050 

79




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11. Retirement benefit obligations (continued)

The plan’s assets do not include any of the Group’s own financial instruments, nor any property occupied by, or other assets used by the Group.

At 31 December 2023 the long-term expected rate of return on cash is determined by reference to traditional corporate bond rates at the latest reporting date. The long-term expected returns on traditional corporate and government bonds are determined by reference to corporate bond yields and gilt yields respectively at the reporting date.

The underlying asset split of the funds at 31 December 2023 and 31 December 2022 was as follows:
31 December
2023
31 December
2022
Government Bonds78 %88 %
Diversified Bonds22 %12 %

The assets of the scheme are held on an investment platform with Mercer Limited which invests in a number of investment funds with MGI and Mercer Sterling. The overall investment strategy is that approximately 78% of investments are in government bonds and index linked gilts and 22% in diversified bonds. There is no self-investment in employer related assets.

Sensitivity assumptions

The sensitivity of the defined benefit obligation to changes in the weighted principal assumptions is:
Change in AssumptionChange in Liabilities
Discount RateIncrease of 0.5% p.a.Decrease by 8.5%
Rate of InflationIncrease of 0.25% p.a.Increase by 1.0%
Rate of Salary GrowthIncrease of 0.25% p.a.Increase by 0.1%
Rate of MortalityIncrease in life expectancy of 1 yearIncrease by 2.7%

The sensitivities shown above are approximate. Each sensitivity considers one change in isolation.

The plan typically exposes the Company to actuarial risks such as investment risk, interest rate risk, salary growth risk, mortality risk and longevity risk. A decrease in bond yields, a rise in inflation or an increase in life expectancy would result in an increase to plan liabilities. This would impact the Statement of Financial Position and may give rise to increased charges in future Statements of Profit and Loss. This effect would be partially offset by an increase in the value of the plan’s bond holdings, and in qualifying death in service insurance policies that cover mortality risk. Additionally, caps on inflationary increases are in place to protect the plan against extreme inflation.

Cash flows and Maturity Profiles

The Group expects to contribute approximately $0.1 million of normal contribution to the defined benefit pension scheme for the year ended 31 December 2024. The average duration of the defined benefit obligation at the period ending 31 December 2023 is 19 years.













80




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11. Retirement benefit obligations (continued)

Aptiv Solutions Pension Plan

On 7 May 2014, the Company acquired 100% of the common stock of Aptiv Solutions (“Aptiv”). The acquisition of Aptiv was accounted for as a business combination in accordance with IFRS 3 Business Combinations. The Company has a defined benefit plan covering its employees in Switzerland as mandated by the Swiss government. Benefits are based on the employee’s years of service and compensation. The plan is managed externally and the related pension costs and liabilities are assessed in accordance with the advice of a professionally qualified actuary. Plan assets at 31 December 2023 and 31 December 2022 consist of units held in independently administered funds.

Funding status
31 December
2023
31 December
2022
$’000$’000
Projected benefit obligation(6,441)(5,806)
Fair value of plan assets6,261 5,681 
Retirement benefit plan net obligation(180)(125)

Movement in the net benefit obligation recognised in non-current other liabilities was as follows:
Present Value of ObligationsFair Value of Plan Assets
Total
$’000$’000$’000
At 1 January 2023(5,806)5,681(125)
Current service costs(109)(109)
Interest (expense)/income(136)133(3)
Past service cost1313
(6,038)5,814(224)
Re-measurements
Gain or loss from change in financial assumptions(506)(506)
Gain or loss from change in experience(5)356351
(511)356(155)
Exchange differences(578)562(16)
Contributions:
- Employers215215
- Plan participants(93)93
Benefit payments779(779)
686(471)215
At 31 December 2023(6,441)6,261(180)

81




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11. Retirement benefit obligations (continued)

Present Value of Obligations
Fair Value of Plan Assets

Total
$’000
$’000
$’000
At 1 January 2022(7,644)6,965(679)
Current service costs
(146)(146)
Interest (expense)/income(30)29(1)
Past service cost
2323
(7,797)6,994(803)
Re-measurements
Gain or loss from change in financial assumptions
1,4791,479
Gain or loss from change in experience 48(985)(937)
1,527(985)542
Exchange differences
148(126)22
Contributions:
- Employers114114
- Plan participants(82)82
Benefit payments398(398)
316(202)114
At 31 December 2022(5,806)5,681(125)


82




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11. Retirement benefit obligations (continued)

PRA Switzerland AG Pension Plan

On 1 July 2021, the Company completed the Acquisition of PRA. PRA Switzerland AG, a subsidiary of the Company has a defined benefit plan covering its employees in Switzerland as mandated by the Swiss government. Benefits are based on the employee's years of service and compensation. The plan is managed externally and the related pension costs and liabilities are assessed in accordance with the advice of a professionally qualified actuary. Plan assets at 31 December 2023 and 31 December 2022 consist of units held in independently administered funds.

Funding status
31 December
2023
31 December
2022
$’000$’000
Projected benefit obligation(7,747)(5,345)
Fair value of plan assets5,529 4,059 
Retirement benefit plan net obligation(2,218)(1,286)

Movement in the net benefit obligation recognised in non-current other liabilities was as follows:        
Present Value of ObligationsFair Value of Plan Assets
Total
$’000$’000$’000
At 1 January 2023(5,345)4,059 (1,286)
Current service cost(417)— (417)
Interest (expense)/income(132)101 (31)
Past service cost   
(5,894)4,160 (1,734)
Re-measurements
Gain or loss from change in financial assumptions(574)(52)(626)
Gain or loss from change in experience(137)— (137)
(711)(52)(763)
Exchange differences (644)467 (177)
Contributions:
- Employers— 456 456 
- Plan participants(456)456 — 
Benefit payments(795)795 — 
Settlement753 (753)— 
(498)954 456 
At 31 December 2023(7,747)5,529 (2,218)
83




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

11. Retirement benefit obligations (continued)

Present Value of ObligationsFair Value of Plan Assets
Total
$’000$’000$’000
At 1 January 2022(4,990)3,017 (1,973)
Current service cost(404)— (404)
Interest (expense)/income(20)12 (8)
(5,414)3,029 (2,385)
Re-measurements
Gain or loss from change in financial assumptions1,293 106 1,399 
Gain or loss from change in experience(667)— (667)
626 106 732 
Exchange differences 49 (7)42 
Contributions:
- Employers— 325 325 
- Plan participants(325)325 — 
Benefit payments(1,125)1,125 — 
Settlement844 (844)— 
(606)931 325 
At 31 December 2022(5,345)4,059 (1,286)


12. Share-based payments
Share Options
On 21 July 2008 the Company adopted the Employee Share Option Plan 2008 (the “2008 Employee Plan”) pursuant to which the Compensation and Organisation Committee of the Company’s Board of Directors may grant options to any employee, or any director holding a salaried office or employment with the Company or a Subsidiary for the purchase of ordinary shares. On the same date, the Company also adopted the Consultants Share Option Plan 2008 (the “2008 Consultants Plan”), pursuant to which the Compensation and Organisation Committee of the Company’s Board of Directors may grant options to any consultant, adviser or non-Executive Director retained by the Company or any Subsidiary for the purchase of ordinary shares.
On 14 February 2017 both the 2008 Employee Plan and the 2008 Consultants Plan (together the “2008 Option Plans”) were amended and restated in order to increase the number of options that can be issued under the 2008 Consultants Plan from 0.4 million to 1.0 million and to extend the date for options to be granted under the 2008 Option Plans.
An aggregate of 6.0 million ordinary shares have been reserved under the 2008 Employee Plan, as reduced by any shares issued or to be issued pursuant to options granted under the 2008 Consultants Plan, under which a limit of 1.0 million shares applies. Further, the maximum number of ordinary shares with respect to which options may be granted under the 2008 Employee Option Plan, during any calendar year to any employee shall be 0.4 million ordinary shares. There is no individual limit under the 2008 Consultants Plan. No options may be granted under the 2008 Option Plans after 14 February 2027.
Each option granted under the 2008 Employees Plan or the 2008 Consultants Plan (together the “2008 Option plans”) will be evidenced by a Stock Option Agreement between the optionee and the Company. The exercise price will be specified in each Stock Option Agreement, however, option prices will not be less than 100% of the fair market value of an ordinary share on the date the option is granted. Share option awards are granted with an exercise price equal to the market price of the Company's shares at date of grant. Share options typically vest over a period of five years from date of grant and expire eight years from date of grant.




84




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

12. Share-based payments (continued)

PRA Equity Incentive Plans

The following represents the legacy PRA equity incentive plans, which still have equity outstanding but have been terminated as of 1 July 2021, as to grants of future awards.

Pursuant to the Merger Agreement, effective on 1 July 2021, each outstanding stock option and restricted stock unit under the PRA Plans was assumed by the Company and converted into a stock option or Restricted Share Unit exercisable for or payable in Ordinary Shares based on the ratio of the average trading price per Ordinary Share for the ten days prior to 1 July 2021, and the corresponding value of the Merger consideration for each PRA Share. Accordingly, the plans as detailed below were assumed by the Company.

PRA Health Sciences, Inc. 2020 Stock Incentive Plan (the "2020 Plan”), 2018 Stock Incentive Plan (the "2018 Plan") and 2014 Omnibus Incentive Plan (the "2014 Plan") were amended and restated and assumed by the Company effective as of 1 July 2021.

The 2020 Stock Incentive Plan (“the 2020 Plan”), was approved by the PRA stockholders at their annual meeting on 18 May 2020. The 2020 Plan allowed for the issuance of stock options, stock appreciation rights, restricted shares and restricted stock units, other stock-based awards, and performance compensation awards as permitted by applicable laws. The 2020 Plan authorised the issuance of 2,500,000 shares of common stock plus all shares that remained available under the prior plan on 18 May 2020.

The 2018 Stock Incentive Plan (the “2018 Plan”), was approved by the PRA stockholders at their annual meeting on 31 May 2018. The 2018 Plan allowed for the issuance of stock options, stock appreciation rights, restricted shares and restricted stock units, other stock-based awards, and performance compensation awards as permitted by applicable laws. The 2018 Plan authorised the issuance of 2,000,000 shares of common stock plus all shares that remained available under the 2014 Plan on 31 May 2018 (which included shares carried over from the 2013 Plan).

On 23 November 2014, the PRA Health Sciences, Inc. Board of Directors approved the formation of the 2014 Plan for Key PRA Employees. The 2014 Plan allowed for the issuance of stock options, stock appreciation rights, restricted shares and restricted stock units, other stock-based awards, and performance compensation awards as permitted by applicable laws.

Overall

Share option awards are granted with an exercise price equal to the market price of the Company’s ordinary shares at date of grant. Share options typically vest over a period of five years from date of grant and expire eight to ten years from date of grant. Share options granted to non-executive directors during 2018 vest over 12 months and expire eight years from the date of grant. The maximum contractual term of options outstanding at 31 December 2023 is ten years.

Set out below is a summary of the total number of options outstanding and number of options available to grant under each plan as at 31 December 2023:
OutstandingAvailable to Grant
31 December
2023
31 December
2022
31 December
2023
31 December
2022
2008 Stock Option Plans 902,806 1,378,119 2,787,687 2,854,964 
Total902,806 1,378,119 2,787,687 2,854,964 


















85




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

12. Share-based payments (continued)

The total number of share options outstanding and exercisable at 31 December 2023 is as follows:
Number of
Options
Weighted Average
Exercise Price
Outstanding at 31 December 20211,695,460 $110.38 
Granted108,643 $229.94 
Exercised(348,286)$102.87 
Cancelled/expired(77,698)$143.08 
Outstanding at 31 December 20221,378,119 $119.86 
Granted82,472 $232.48 
Exercised(535,705)$95.12 
Cancelled/expired(22,080)$196.20 
Outstanding at 31 December 2023902,806 $142.96 
Exercisable at 31 December 2023654,386 $119.67 

The weighted average intrinsic value of the Company’s shares on date of exercise of share options during the year ended 31 December 2023 was $150.09 (31 December 2022: $120.36).

At 31 December 2023, the range of exercise prices and weighted average remaining contractual life of outstanding and exercisable options was as follows:
Options OutstandingOptions Exercisable
Range Exercise
Price
Number of
Shares
Weighted
Average
Remaining
Contractual Life
Weighted Average Exercise PriceNumber of
Shares
Weighted Average Exercise Price
$20.83 - 96.15201,306 2.29— 201,306 — 
$103.81 - 121.68132,964 4.54— 132,964 — 
$125.74 - 147.26249,194 4.45— 233,371 — 
$159.33 - 233.88319,342 5.69— 86,745 — 
$20.83 - 233.88
902,806 4.42142.96 654,386 119.67 
 
Share option fair values 2023

The weighted average grant date fair value of share options granted by the Company during the year ended 31 December 2023 was $85.12 based on the following grants:
Grant DateNumber of SharesWeighted Average Exercise Price
3 March 2376,066 $233.88 
22 May 236,406 $215.91 
82,472 $232.48 

86




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

12. Share-based payments (continued)

Share option fair values 2022

The weighted average grant date fair value of share options granted by the Company during the year ended 31 December 2022 was $65.72 based on the following grants:
Grant DateNumber of SharesWeighted Average Exercise Price
3 March 2296,525 $231.68 
21 May 2212,118 $216.10 
108,643 $229.94 

Fair value of share options – Assumptions

The fair values of options granted during the year ended 31 December 2023 were calculated using the Black Scholes option pricing-model (2022: binomial option pricing-model) utilising the following assumptions:
31 December 202331 December 2022
Annual AwardsAnnual Awards
Weighted average grant date fair value$85.12 $65.72 
Expected volatility (1)
33.0 %28.0 %
Expected dividend yield — 
Risk-free rate (2)
4.18 %1.1% - 2.8%
Expected life5.0 years5.0 years
Rate of forced early exercisen/a10% per annum
Minimum gain for voluntary early exercisen/a
25% of exercise price
Rate of voluntary early exercise at minimum gainn/a75% per annum
(1) Expected volatility has been determined based upon the volatility of the Company’s share price over a period which is commensurate with the expected term of the options granted.
(2) Risk-free rate is dependent on the grant date and term of the award.

Restricted Share Units and Performance Share Units

On 23 April 2013 the Company adopted the 2013 Employees Restricted Share Unit and Performance Share Unit Plan (the “2013 RSU Plan”) pursuant to which the Compensation and Organisation Committee of the Company’s Board of Directors may select any employee, or any Director holding a salaried office or employment with the Company, or a Subsidiary to receive an award under the plan. On 11 May 2015 the 2013 RSU Plan was amended and restated in order to increase the number of shares that can be issued under the RSU Plan by 2.5 million shares. Accordingly, an aggregate of 4.1 million ordinary shares have been reserved for issuance under the 2013 RSU Plan. The shares are awarded at zero cost and vest over a service period. Awards under the 2013 RSU Plan may be settled in cash or shares at the option of the Company. No awards may be granted under the 2013 RSU Plan after 11 May 2025.
On 30 April 2019 the Company approved the 2019 Consultants and Directors Restricted Share Unit Plan (the “2019 Consultants RSU Plan”), which was effective as of 16 May 2019, pursuant to which the Compensation and Organisation Committee of the Company’s Board of Directors may select any consultant, adviser or non-executive Director retained by the Company, or a Subsidiary to receive an award under the plan. 250,000 ordinary shares have been reserved for issuance under the 2019 Consultants RSU Plan. The awards are at par value and vest over a service period. Awards granted to non-executive directors vest over twelve months. No awards may be granted under the 2019 Consultants RSU Plan after 16 May 2029.

87




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

12. Share-based payments (continued)

The Company has awarded RSUs and PSUs to certain key individuals of the Group. The fair value of RSUs is based on the share price at the date of grant, with the expense spread over the vesting period. The following table summarises RSU and PSU activity for the year ended 31 December 2023:
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 31 December 2022152,420 $192.29 582,612 $207.73 
Granted60,374 $232.51 308,963 $218.86 
Shares vested(47,026)$159.57 (188,800)$187.68 
Forfeited(60,512)$198.70 (81,764)$216.03 
Outstanding at 31 December 2023105,256 $226.29 621,011 $218.27 

The PSUs vest based on service and specified EPS targets over the period 2021 – 2023, 2022 – 2024 and 2023 – 2025. Depending on the actual amount of EPS from 2021 to 2025, up to an additional 49,340 PSUs may also be granted.

Share-based payment expense

Operating profit for the year ended 31 December 2023 is stated after charging $51.4 million in respect of share-based payment expense. Share-based payment expense has been allocated as follows:
31 December
2023
31 December
2022
$’000$’000
Direct costs25,672 17,331 
Other operating expenses25,708 38,459 
Total51,380 55,790 


88




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

13. Property, Plant and Equipment
LandBuildingsLeasehold
improvements
Computer
equipment
Office
furniture &
fixtures
Laboratory
equipment
Motor
vehicles
Total
$’000$’000$’000$’000$’000$’000$’000$’000
Cost
At 1 January 20233,724 70,880 65,167 111,146 50,600 59,946 79 361,542 
Additions— 1,4995,01912,4812,8257,50229,326
Disposals / Reclassification— (3,188)(15,419)(47,591)(8,794)(13,781)(5)(88,778)
Acquisition— 48 11 1,049 — 1,112 
Foreign exchange movement— 881 229 1,024 1,214 1,501 4,854 
At 31 December 20233,724 70,072 55,000 77,108 45,856 56,217 79 308,056 
Depreciation
At 1 January 2023— 30,908 20,826 64,471 25,675 41,357 78 183,315 
Charge for year— 1,583 9,614 21,893 8,046 7,016 48,158 
Disposals / Reclassification— (3,604)(10,859)(49,492)(11,632)(12,561)(5)(88,153)
Foreign exchange movement— 493 165 673 478 960 (3)2,766 
At 31 December 2023 29,380 19,746 37,545 22,567 36,772 76 146,086 
Net book value
At 31 December 20233,724 40,692 35,254 39,563 23,289 19,445 3 161,970 
At 31 December 20223,724 39,972 44,341 46,675 24,925 18,589 178,227 

Depreciation expense of $48.2 million has been charged to “other operating expenses” in the Consolidated Statement of Profit and Loss.




89




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

13. Property, Plant and Equipment (continued)

LandBuildingsLeasehold
improvements
Computer
equipment
Office
furniture &
fixtures
Laboratory
equipment
Motor
vehicles
Total
$’000$’000$’000$’000$’000$’000$’000$’000
Cost
At 1 January 20224,574 67,202 72,495 107,544 103,342 15,647 61 370,865 
Additions— 1,29122,91114,5356,46845,205
Disposals / Reclassification(850)7,488 (6,166)(11,370)(63,058)39,489 20 (34,447)
Foreign exchange movement— (3,810)(2,453)(7,939)(4,219)(1,658)(2)(20,081)
At 31 December 20223,724 70,880 65,167 111,146 50,600 59,946 79 361,542 
Depreciation
At 1 January 2022— 22,035 21,628 69,870 59,352 3,054 14 175,953 
Charge for year— 1,748 12,397 20,191 9,620 4,731 48,692 
Impairment charge— — 1,791 — 2,174 — — 3,965 
Disposals / Reclassification— 9,277 (13,589)(20,980)(42,655)34,124 61 (33,762)
Foreign exchange movement— (2,152)(1,401)(4,610)(2,816)(552)(2)(11,533)
At 31 December 2022 30,908 20,826 64,471 25,675 41,357 78 183,315 
Net book value
At 31 December 20223,724 39,972 44,341 46,675 24,925 18,589 1 178,227 
At 31 December 20214,574 45,167 50,867 37,674 43,990 12,593 47 194,912 

Depreciation expense of $48.7 million has been charged to “other operating expenses” in the Consolidated Statement of Profit and Loss.

90




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

14. Goodwill and intangible assets



Computer Software
Customer Relationships
Volunteer List
Order Backlog
Technology
Asset
Trade Name and Non-Competes
Patient Database
Goodwill
Total
$’000
$’000
$’000
$’000
$’000
$’000
$’000
$’000
$’000
Cost
At 1 January 2023388,951 4,081,827 1,325 537,541 119,382 204,914 170,381 9,024,479 14,528,800 
Additions111,366 — — — — — — — 111,366 
Disposals (27,460)— — — — — — — (27,460)
Acquisitions96 12,525 — 3,850 20,010 — — 36,750 73,231 
Foreign exchange movement57 1,434 — 518 263 29 128 13,655 16,084 
At 31 December 2023473,010 4,095,786 1,325 541,909 139,655 204,943 170,509 9,074,884 14,702,021 
Amortisation
At 1 January 2023216,858 368,513 1,325 284,038 41,679 103,915 37,241 — 1,053,569 
Amortised in the year 77,938 176,476 — 168,496 23,200 67,332 24,350 — 537,792 
Disposals (21,036)— — — — — — — (21,036)
Foreign exchange movement36 985 — 364 262 29 57 — 1,733 
At 31 December 2023273,796 545,974 1,325 452,898 65,141 171,276 61,648  1,572,058 
Net book value
At 31 December 2023199,214 3,549,812  89,011 74,514 33,667 108,861 9,074,884 13,129,963 
At 31 December 2022172,093 3,713,314 — 253,503 77,703 100,999 133,140 9,024,479 13,475,231 

Amortisation expense of $537.8 million has been charged to ‘other operating expenses’ in the Consolidated Statement of Profit and Loss.





91




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

14. Goodwill and intangible assets (continued)



Computer Software
Customer Relationships
Volunteer List
Order Backlog
Technology
Asset
Trade Name and Non-Competes
Patient Database
Goodwill
Total
$’000
$’000
$’000
$’000
$’000
$’000
$’000
$’000
$’000
Cost
At 1 January 2022361,881 4,085,029 1,325 538,622 119,905 204,987 170,667 9,053,482 14,535,898 
Additions89,955 — — — — — — — 89,955 
Disposals / Reclassification(55,651)— — — — — — — (55,651)
Foreign exchange movement(7,234)(3,202)— (1,081)(523)(73)(286)(29,003)(41,402)
At 31 December 2022388,951 4,081,827 1,325 537,541 119,382 204,914 170,381 9,024,479 14,528,800 
Amortisation
At 1 January 2022220,349 193,434 1,325 114,461 20,004 36,654 12,987 — 599,214 
Amortised in the year57,734 176,903 — 170,141 22,200 67,334 24,344 — 518,656 
Disposals / Reclassification(55,651)— — — — — — — (55,651)
Foreign exchange movement(5,574)(1,824)— (564)(525)(73)(90)— (8,650)
At 31 December 2022216,858 368,513 1,325 284,038 41,679 103,915 37,241  1,053,569 
Net book value
At 31 December 2022172,093 3,713,314  253,503 77,703 100,999 133,140 9,024,479 13,475,231 
At 31 December 2021141,532 3,891,595 — 424,161 99,901 168,333 157,680 9,053,482 13,936,684 

Amortisation expense of $518.7 million has been charged to ‘other operating expenses’ in the Consolidated Statement of Profit and Loss.


92




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

14. Goodwill and intangible assets (continued)



Impairment review of goodwill

Goodwill is subject to impairment testing on an annual basis, or more frequently if there are indicators of impairment. These assets are allocated to groups of cash generating units (CGUs). The recoverable amount of each of the CGUs is determined based on value-in-use calculations. Goodwill acquired through business combinations has been allocated to the Group’s three CGUs. The CGUs identified represent the lowest level within the Group at which goodwill is monitored and are not larger than the operating segment determined in accordance with IFRS 8 Operating Segments.

The Group has identified three CGUs in accordance with the provisions of IAS 36 Impairment of Assets.

A summary of the allocation of the carrying value of goodwill by CGU, is as follows:
31 December
2023
31 December
2022
$’000
$’000
Clinical Research7,334,6497,284,244
Strategic Solutions1,372,6481,372,648
Data Solutions367,587367,587
Total Goodwill9,074,8849,024,479

Impairment testing methodology and results

Cash flow forecasts employed for the value-in-use calculations are for a five year period approved by management and a terminal value which is applied to the year five cash flows. The terminal value reflects the discounted value of the cash flows beyond year five which is based on the weighted average long-term growth rates for each CGU.

Management’s estimates of future cash flows are based upon current budgets and strategic plans and are reflective of anticipated growth rates within the CRO industry, expected growth in the Group’s market share and reflective of past experience. Key assumptions applied in determining expected future cash flows for these plans include management’s estimate of future profitability, replacement capital expenditure requirements, trade working capital investment needs and tax considerations. The Group’s cash flow projections are adjusted each year for actual and expected changes in performance.

The following assumptions were applied in determining the ten year projected cash flows of the three CGUs at 31 December 2023:
31 December 2023
Clinical ResearchStrategic SolutionsData Solutions
Expected revenue growth rate6.1%7.6%7.9%
Expected growth rate for operating costs5.9%7.4%6.1%
Expected effective tax rate16.5%16.5%16.5%
Discount rate10.8%10.8%10.8%
Long term growth3.0%3.0%3.0%



93




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

14. Goodwill and intangible assets (continued)



Expected revenue growth and the expected growth in operating costs are determined based upon the expected growth rates used in preparing the Group’s budgets and strategic plans. In estimating budget revenue, consideration is given to current levels of backlog (i.e. the value of new business awards not yet recognised in revenue) and the estimated timeframe over which this is expected to be recognised within revenue, together with an estimate of revenue expected to be generated from new awards not currently within backlog. In estimating revenue from new awards, consideration is given to current RFP (request for proposals) volumes, expected growth rates in both the CRO industry and the Group’s market share, and of past experience. In estimating budgeted operating costs, consideration is given to required staffing levels, project related costs, facility and information technology costs and other costs. Staff costs and project related costs generally increase in line with revenue and are therefore estimated based on revenue growth expectations, while facility and IT costs and other costs are relatively fixed and are therefore projected based upon a lower growth rate. An expected long-term average tax rate of 16.5% (2022: 15.5%) has been applied in determining the projected after tax cash flows.

Expected annual working capital growth and expected capital expenditure growth are based upon the expected growth rates used in preparing the Group’s budgets and strategic plans. Long term growth rates were based on global macroeconomic data.

A pre-tax discount rate of 10.8% (2022: 11.5%) has been applied to the projected cash flows of the CGUs in determining its value-in-use. This rate is reflective of both the time value of money and risks specific to the CGUs. The discount rate is based upon the Group’s weighted average cost of capital which has been determined by applying the Group’s long-term optimal capital structure to its costs of debt and cost of equity. The Group’s cost of debt has been calculated by applying an appropriate margin over the risk-free interest rate. The Group’s cost of equity has been calculated using the capital asset pricing model and includes an appropriate equity risk premium over the available risk-free interest rate. The Group’s weighted average cost of capital is adjusted to reflected additional risk premiums associated with each CGU.

No impairment was recognised in 2023 or 2022 as a result of the impairment testing which identified headroom in the recoverable amount of the related CGUs as compared to their carrying value.

Sensitivity Analysis
A sensitivity analysis to determine if reasonable changes in key assumptions could lead to an impairment was conducted at 31 December 2023. The table below identifies the amounts by which each of the specified assumptions may either decline or increase to arrive at a zero excess of the present value of future cash flows over the carrying value of goodwill in the CGU:
31 December 2023
Clinical ResearchStrategic SolutionsData Solutions
Expected revenue growth rate decreased by*
3.0 %6.0 %3.0 %
Discount rate increased by*
10.7 %17.4 %3.6 %
*All other inputs remained constant
Management believes that the assumptions originally used in the value-in-use models are sufficiently prudent to ensure no reasonable change, in normal circumstances, in any of the above key assumptions would cause the carrying value of any CGU to exceed its recoverable amount.





94




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

15. Business combinations


(a)    BioTel Research LLC Acquisition     

On 2 October 2023, the Company acquired the entire outstanding equity interests of BioTel Research LLC (“BioTel”), a leading provider of medical imaging and cardiac safety monitoring services, from BioTelemetry Inc. in exchange for initial cash consideration of $68.1 million. Cash acquired amounted to $1.4 million. The purchase price allocation, as of the date of acquisition, was based on a preliminary valuation and may be subject to revision. Preliminarily, the BioTel acquisition resulted in the initial recognition of intangible assets of $36.5 million and goodwill of $23.4 million. Preliminary goodwill arising in connection with the acquisition is primarily attributable to the assembled workforce of BioTel and the expected synergies of the acquisition.


(b)     Oncacare Limited Acquisition

On 20 April 2023, the Company completed the purchase of the majority investor's 51% majority voting share capital of Oncacare Limited ("Oncacare") for $5.1 million, such that Oncacare and its subsidiaries became wholly-owned subsidiaries of the ICON Group. The Oncacare acquisition resulted in goodwill of $13.4 million and also gave rise to an acquisition-related gain of $6.2 million.

(c)     PRA Health Sciences, Inc. Acquisition

On 1 July 2021 (the "Merger Date"), the Company completed the Acquisition of PRA by means of a merger whereby Indigo Merger Sub, Inc., a Delaware corporation and subsidiary of ICON, merged with and into PRA Health Sciences, Inc., the parent of the PRA Health Sciences Group ("the Acquisition" and "the Merger"). The combined Group has retained the name ICON and brought together approximately 38,000 (as at the Merger date) employees across the globe, creating one of the world’s most advanced healthcare intelligence and clinical research organisation. The Merger was accounted for as a business combination using the acquisition method of accounting in accordance with IFRS 3 'Business Combinations'.

The combined Company leverages its enhanced operations to transform clinical trials and accelerate biopharma customers’ commercial success through the development of much needed medicines and medical devices. The new ICON has a renewed focus on leveraging data, applying technology and accessing diverse patient populations to speed up drug development.

Upon completion of the Merger, pursuant to the terms of the Merger Agreement, PRA became a wholly owned subsidiary of the ICON Group. Under the terms of the Merger, PRA shareholders received per share $80 in cash and 0.4125 shares of ICON stock.

In the years ended 31 December 2023 and 31 December 2022, the Company incurred approximately $44.2 million and $39.7 million, respectively, of Merger-related expenses which were accounted for separately from the business combination and expensed as incurred within the Other Operating Expenses line item of the Consolidated Statement of Profit and Loss. These costs consist primarily of investment banker fees, advisory costs, professional fees, retention agreements with employees, accelerated share-based compensation charges, and ongoing integration activities.

In the years ended 31 December 2023 and 31 December 2022, the Company incurred approximately $16.4 million and $17.7 million, respectively, of Merger-related financing fees which are included in the “Financing Expense” line item in the Consolidated Statement of Profit and Loss.

The Merger Date fair value of the consideration transferred consisted of the following:

$'000
Fair value of cash consideration5,308,646 
Fair value of ordinary shares issued to acquiree stockholders5,658,126 
Fair value of replacement share-based awards issued to acquiree employees267,607 
Repayment of term loan obligations and accrued interest *865,800 
12,100,179 
* This represents the portion of PRA debt paid by ICON. PRA also paid $401.6 million from available cash to settle debt obligations that existed at the Merger Date.

The following table summarises the allocation of the consideration transferred based on the Merger Date fair values of assets acquired and liabilities assumed, with the excess of the purchase price over the fair values of the identifiable net assets acquired recorded as goodwill:
95




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

15. Business combinations (continued)




Fair Value1 July 2021
$'000
Cash and cash equivalents259,971 
Accounts receivable and unbilled revenue934,308 
Other current assets125,156 
Property, plant and equipment101,743 
Operating lease right-of-use assets180,679 
Goodwill *8,123,003 
Intangible assets4,974,119 
Deferred tax assets28,587 
Other assets33,928 
Accounts payable(50,259)
Accrued expenses and other current liabilities(380,342)
Current portion of operating lease liabilities(36,775)
Unearned revenue(723,278)
Non-current portion of operating lease liabilities(146,903)
Deferred tax liabilities(1,119,762)
Other non-current liabilities(203,996)
Net assets acquired12,100,179 

* The goodwill in connection with the Merger is primarily attributable to the assembled workforce of PRA and the expected synergies of the Merger. None of the goodwill recognised is deductible for income tax purposes.
The following table summarises the fair value of identified intangible assets and their respective useful lives as of the Merger Date:
Estimated Useful LifeEstimated Fair Value
$'000
Customer relationships23 years3,938,000 
Order backlog3 years500,000 
Trade names3 years202,000 
Patient database7 years168,000 
Technology assets5 years111,000 
Software2-8 years55,119 
4,974,119 
At 30 June 2022, the Company completed its review of the 1 July 2021 acquisition balance sheet of PRA and completed the final valuation associated with certain assets acquired and liabilities assumed. During the year ended 31 December 2022, the Company recognised certain measurement period adjustments as shown in the table below:
Measurement period adjustments
$'000
Goodwill(36,579)
Intangible assets 33,000 
Deferred tax assets(2,910)
Deferred tax liabilities7,188 
Other non-current liabilities(699)

The impact of these measurement period adjustments has been incorporated with effect from the Merger Date.

96




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

16. Inventories

31 December
2023
31 December
2022
$’000$’000
Laboratory inventories8,442 7,063 

The cost of inventories is recognised as an expense and included in direct costs in the Consolidated Statement of Profit and Loss. For the year ended 31 December 2023, $79.0 million (2022: $74.0 million) was charged to the Consolidated Statement of Profit and Loss. There was no material difference between the Consolidated Statement of Financial Position value of inventories and their replacement costs.

17. Accounts receivable, unbilled services (contract assets) and unearned revenue (contract liabilities)

Accounts receivables and unbilled revenue are as follows:
31 December
2023
31 December
2022
$’000$’000
Billed services (accounts receivable)1,821,855 1,751,950
Unbilled services (unbilled revenue)951,936957,655
Trade accounts receivable and unbilled revenue, gross2,773,791 2,709,605 
Allowance for credit losses(31,533)(20,562)
Trade accounts receivable and unbilled revenue, net2,742,258 2,689,043 

Accounts receivables are amounts due from customers for services performed in the ordinary course of business. They are generally due for settlement within 30-90 days and therefore are all classified as current. Accounts receivable are recognised initially at the amount of consideration that is unconditional. Accounts receivable balances do not contain significant financing components. The Group holds the accounts receivable with the objective to collect the contractual cash flows and therefore measures them subsequently at amortised cost.

All receivables are due within twelve months of the year ended 31 December 2023. Due to the short-term nature of the current receivables, their carrying amount is considered to be the same as their fair value.

Unbilled services and unearned revenue (contract assets and liabilities) were as follows:
31 December
2023
31 December
2022
Change% Change
$’000$’000$’000
Unbilled services (unbilled revenue)951,936 957,655 (5,719)(0.6)%
Unearned revenue (payments on account)(1,654,507)(1,507,449)(147,058)9.8 %
(702,571)(549,794)(152,777)27.8 %

Timing may differ between the satisfaction of performance obligations and the invoicing and collection of amounts related to our contracts with customers. We record assets for amounts related to performance obligations that are satisfied but not yet billed and/or collected. These assets are recorded as unbilled revenue and therefore contract assets rather than accounts receivables when receipt of the consideration is conditional on something other than the passage of time. Liabilities are recorded for amounts that are collected in advance of the satisfaction of performance obligations or billed in advance of the revenue being earned.

Unbilled services/revenue balances arise where invoicing or billing is based on the timing of agreed milestones related to service contracts for clinical research. Contractual billing arrangements in respect of certain reimbursable expenses (principally investigators) require billing by the investigator to the Company prior to billing by the Company to the customer.






97




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

17. Accounts receivable, unbilled services (contract assets) and unearned revenue (contract liabilities) (continued)















The Company is the contract principal in respect of both direct services and in the use of third parties (principally investigator services) that support a clinical trial. The progress towards completion for clinical service contracts is measured based on total project costs (including reimbursable costs). Reimbursable expenses are included within direct costs and are recorded based on activity undertaken by the third-party. Amounts owed to investigators and others in respect of reimbursable expenses was $333.0 million at 31 December 2023 and $406.3 million at 31 December 2022 (see note 21 Accrued and other liabilities).

Unbilled services as at 31 December 2023 decreased by $5.7 million as compared to 31 December 2022. Unearned revenue increased by $147.1 million resulting in an increase of $152.8 million in the net balance of unbilled services and unearned revenue between 31 December 2022 and 31 December 2023. These fluctuations are primarily due to the timing of payments and invoicing related to the Company's clinical trial management contracts. Billings and payments are established by contractual provisions including predetermined payment schedules which may or may not correspond to the timing of the transfer of control of the Company's services under the contract. Unbilled services arise from long-term contracts when a cost-based input method of revenue recognition is applied and revenue recognised exceeds the amount billed to the customer.
As of 31 December 2023 approximately $14.8 billion (2022: $13.7 billion) of revenue is expected to be recognised in the future in respect of unsatisfied performance obligations. The Company expects to recognise revenue on approximately 52% (2022: 52%) of the unrealised performance obligation over the next 12 months, with the remainder recognised thereafter over the duration of the customer contracts.

Impairment of financial assets

At 31 December 2023, the Group maintained an impairment provision of $31.5 million (2022: $20.6 million). The credit loss expense recognised on the Group's receivables and unbilled services was $24.6 million and $17.8 million for the twelve months ended 31 December 2023 and 2022, respectively.

The Group's estimate of expected credit losses considers historical credit loss information that is adjusted, where necessary, for current conditions and reasonable and supportable forecasts. Historical credit loss experience provides the basis for the estimation of expected credit losses. The Group's receivables and unbilled services are predominantly due from large and mid-tier pharmaceutical and biotechnology companies that share similar risk characteristics. The Group monitors their portfolio of receivables and unbilled services for any deterioration in current or expected credit quality (for example expected delinquency level), and adjusts the allowance for credit losses as required. Receivables for which an impairment provision was recognised were written off against the provision when there was no expectation of recovering additional cash.

The Group considered that there was evidence of impairment if any of the following indicators were present:

significant financial difficulties of the debtor
probability that the debtor will enter a financial restructuring process
default or late payment

The closing loss allowance for trade receivables and contract assets as at 31 December 2023 and 31 December 2022 reconciles to the opening loss allowances as follows:

31 December
2023
31 December
2022
$’000$’000
Balance at start of year 20,562 7,081 
Receivables written off during the year as uncollectible(13,358)(3,913)
Increase in loss allowance recognised in profit or loss during the year24,550 17,800 
Foreign currency translation
(221)(406)
Balance at end of year31,533 20,562 

98




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

17. Accounts receivable, unbilled services (contract assets) and unearned revenue (contract liabilities) (continued)















Further analysis of the Group’s accounts receivable balances at 31 December 2023 and 31 December 2022 is as follows:
31 December
2023
31 December
2022
$’000$’000
Gross accounts receivable
Not past due1,239,075 1,298,520 
Past due 0 to 30 days157,673 185,282 
Past due 31 to 60 days102,556 86,059 
Past due 61+ days322,551 182,089 
Accounts receivable1,821,855 1,751,950 

The carrying amounts of the Group’s accounts receivables are denominated in the following currencies:
31 December
2023
31 December
2022
$’000$’000
Currency
US Dollar1,394,414 1,310,111 
Euro327,816 348,194 
Sterling13,785 19,641 
Other currencies85,840 74,004 
 Total1,821,855 1,751,950 


18. Other assets
31 December
2023
31 December
2022
$’000$’000
Non-current other assets
Lease deposits17,667 15,210 
Deferred employee savings scheme assets21,086 24,260 
Other receivables39,717 37,391 
Total78,470 76,861 

Lease deposits paid in respect of certain premises leased by the Group are refundable on expiry of the related leases. Discounting of the non-current element has not been applied because the discount would be immaterial. However, discounting may apply in the future if the non-current element becomes significant such that the discounting impact would be material.
31 December
2023
31 December
2022
$’000$’000
Other current assets
Personnel related prepayments2,655 954 
Facility and information system related prepayments69,881 58,342 
General overhead prepayments39,529 57,258 
Sales tax recoverable32,183 24,029 
Other receivables45,212 47,034 
Total189,460 187,617 

99




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

18. Other assets (continued)
Other current assets do not contain any impaired assets. The maximum exposure to credit risk at the reporting date is the carrying value of each receivable, other than prepayments which do not have credit risk. The Group does not hold any collateral as security.

19. Financial asset investments

(a) Current asset investments - fair value through OCI

31 December 202331 December 2022
$’000$’000
At start of year1,713 1,712 
Additions2,857 482 
Disposals/maturities(2,616)(481)
At end of year
1,954 1,713 

Current asset investments comprise highly liquid investments with maturities of greater than three months and minimum “A-” rated fixed and floating rate securities.

(b) Non-current financial assets - fair value through profit or loss

The Company entered into subscription agreements with a number of funds. During the year ended 31 December 2023, capital totalling $14.0 million had been advanced under the terms of the subscription agreements (2022: $3.7 million).

The Company determined that the interests in the funds meet the definition of equity securities without readily determinable fair values. The valuation technique is based on the net asset value of the fund as prepared by an independent appraiser. Inputs are generally unobservable as the funds are not traded on an exchange and data is not published in respect of the funds. The fair value of interests in the funds are therefore represented by Level 3 fair value measurements.

There was an increase in fair value of $0.2 million (2022: $6.3 million) recognised in the Consolidated Statement of Profit and Loss during the year bringing the carrying value of the subscriptions to $46.8 million at 31 December 2023 (2022: $32.6 million).

At 31 December 2023, the Company had committed to future investments of $66.4 million in respect of these funds.

(c) Equity method investments

On 24 July 2020, the Company obtained a 49% interest in the voting share capital of Oncacare Limited ("Oncacare") in exchange for consideration of $4.9 million. At that time, the Company’s investment in Oncacare was accounted for under the equity method due to the Company's ability to exercise significant influence over Oncacare which was considered to be greater than minor. The Company recorded its pro rata share of the earnings/losses of the investment in 'Share of equity method investment losses' in the Consolidated Statement of Profit and Loss (see note 1 Basis of preparation and statement of accounting policies).

During the year ended 31 December 2023, the Company recorded losses of $0.4 million representing its pro rata share of the losses in Oncacare (2022: $3.1 million).

On 20 April 2023, the Company completed the purchase of the majority investor’s 51% majority voting share capital of Oncacare, such that Oncacare and its subsidiaries became wholly owned subsidiaries of the ICON Group.






100




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

20. Cash and cash equivalents

31 December
2023
31 December
2022
$’000$’000
Cash at bank and in hand378,102 288,768 

21. Accrued and other liabilities

31 December
2023
31 December
2022
$’000$’000
Non-current other liabilities
Personnel related liabilities
109 155 
Deferred government grants (note 22)854 1,115 
Retirement plans net obligation 14,738 13,033 
Deferred employee savings scheme liabilities13,228 11,220 
Other liabilities15,021 12,229 
Total43,950 37,752 

Deferred employee savings scheme liabilities are payable more than 5 years from the reporting date (see note 26 Financial instruments). Discounting of the non-current element has not been applied because the impact would be immaterial. However, discounting may apply in the future if the non-current element becomes significant such that the discounting impact would be material.

31 December
2023
31 December
2022
$’000$’000
Current accrued and other liabilities
Personnel related liabilities385,499 395,862 
Facility related liabilities11,078 16,896 
General trade and overhead liabilities*463,882 530,204 
Lease liabilities (note 27)36,414 43,656 
Other liabilities13,532 12,852 
Short-term government grants (note 22)43 42 
Total910,448 999,512 
*includes amounts due to third parties in respect of accrued reimbursable investigator expenses of $333.0 million at 31 December 2023 and $406.3 million at 31 December 2022.














101




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

22. Deferred government grants
31 December
2023
31 December
2022
$’000$’000
At beginning of year1,157 780 
Grant additions24 536 
Amortised during the year(281)(155)
Foreign exchange movement(3)(4)
At end of year897 1,157 
Current (note 21)43 42 
Non-current (note 21)854 1,115 
Total897 1,157 
Under grant agreements amounts received may become repayable in full or in part should certain circumstances specified within the grant agreements occur, including downsizing by the Group, disposing of the related assets, ceasing to carry on its business or the appointment of a receiver over any of its assets.

23. Bank credit lines and loan facilities

The Company had the following debt outstanding as at 31 December 2023 and 31 December 2022:

 Interest rate as ofPrincipal amount
Maturity Date31 December 202331 December 202231 December 202331 December 2022
$'000$'000
Senior Secured Term LoanJuly 20287.860 %7.092 %3,251,213 4,201,213 
Senior Secured Notes
July 20262.875 %2.875 %500,000 500,000 
Senior Secured Revolving LoanJanuary 20246.720 %— 55,000 — 
Total debt3,806,213 4,701,213 
Less current portion of debt(110,150)(55,150)
Total long-term debt3,696,063 4,646,063 
Less debt issuance costs and debt discount
(30,624)(47,026)
Total long-term debt, net3,665,439 4,599,037 

As of 31 December 2023, the contractual maturities of the Company's debt obligations were as follows:

Current maturities of debt:$'000
2024110,150 
202555,150 
2026555,150 
202755,150 
2028 and thereafter3,030,613 
Total3,806,213 

The Company's primary financing arrangements are its senior secured credit facilities (the "Senior Secured Credit Facilities"), which consists of a senior secured term loan and a revolving credit facility, and the senior secured notes (the "Senior Secured Notes").

102




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

23. Bank credit lines and loan facilities (continued)
Senior Secured Credit Facilities

On 1 July 2021, the Company completed the acquisition of PRA Health Sciences, Inc. ("PRA") by means of a merger whereby Indigo Merger Sub, Inc., a Delaware corporation and subsidiary of ICON, merged with and into PRA, the parent of the PRA Health Sciences ("the Merger"). In conjunction with the completion of the Merger, on 1 July 2021, ICON entered into a credit agreement providing for a senior secured term loan facility of $5,515 million and a senior secured revolving loan facility in an initial aggregate principal amount of $300 million (the "Senior Secured Credit Facilities"). The Senior Secured Credit Facility and Senior Secured Notes were issued at a discount of $27.6 million. On 2 May 2023, the Company agreed with its lenders to increase the aggregate principal amount of the senior secured revolving loan facility from $300 million to $500 million.

Borrowings under the senior secured term loan facility amortise in equal quarterly installments in an amount equal to 1.00% per annum of the principal amount, with the remaining balance due at final maturity. The interest rate margin applicable to borrowings under the senior secured term loan facility is USD Term SOFR and a Term SOFR Adjustment depending on the interest period chosen plus an applicable margin which is dependent on the Company's net leverage ratio. As of 31 December 2023, the applicable margin is 2.25%. The senior secured term loan facility is subject to a floor of 0.50%.

The interest rate margin applicable to borrowings under the revolving loan facility will be, at the option of the borrower, either (i) the applicable base rate plus an applicable margin of 1.00%, 0.60% or 0.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively, or (ii) Term SOFR plus a Term SOFR Adjustment on the interest period chosen plus an applicable margin of 2.00%, 1.60% or 1.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively. In addition, lenders under the revolving loan facility are entitled to commitment fees as a percentage of the applicable margin at the time of drawing and utilisation fees dependent on the proportion of the facility drawn. At 31 December 2023, $445 million remained undrawn under the senior secured revolving loan facility.

The Borrowers’ (as defined in the credit agreement) obligations under the Senior Secured Credit Facilities are guaranteed by ICON and the subsidiary guarantors. The Senior Secured Credit Facilities are secured by a lien on substantially all of ICON’s, the Borrowers’ and each of the subsidiary guarantor’s assets (subject to certain exceptions), and the Senior Secured Credit Facilities will have a first-priority lien on such assets, which will rank pari passu with the lien securing the Senior Secured Notes, subject to other permitted liens. The Company is permitted to make prepayments on the senior secured term loan without penalty. The Company's long-term debt arrangements contain customary restrictive covenants and, as of 31 December 2023, we were in compliance with our restrictive covenants in all material respects.

Principal repayments, comprising mandatory and voluntary repayments, during the year ended 31 December 2023 and 31 December 2022 were as follows:

Principal repaymentsDecember 31, 2023December 31, 2022
$'000$'000
Quarter 1250,000 300,000 
Quarter 2150,000 100,000 
Quarter 3300,000 200,000 
Quarter 4250,000 200,000 
Total950,000 800,000 

The voluntary repayments made during the year resulted in an accelerated charge associated with previously capitalized fees of $7.9 million (31 December 2022: $7.8 million).

During the year ended 31 December 2023, the Company drew down $370.0 million (31 December 2022: $75 million) of the senior secured revolving loan facility and repaid $315.0 million (31 December 2022: $75 million) as shown below. As at 31 December 2023, $55 million (31 December 2022: $Nil million ) was drawn under the senior secured revolving loan facility.
103




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

23. Bank credit lines and loan facilities (continued)
Drawdown RepaymentClosing Balance
$'000$'000$'000
31 December 2022— — — 
Quarter 1, 2023180,000 100,000 80,000 
Quarter 2, 202350,000 80,000 50,000 
Quarter 3, 202375,000 50,000 75,000 
Quarter 4, 202365,000 85,000 55,000 
370,000 315,000 

Senior Secured Notes

In addition to the Senior Secured Credit Facilities, on 1 July 2021, a subsidiary of the Company issued $500 million in aggregate principal amount of 2.875% senior secured notes due 2026 in a private offering (the “Offering”). The Senior Secured Notes will mature on 15 July 2026.

Fair Value of Debt
The estimated fair value of the Company’s debt was $3,793.5 million and $4,650.3 million at 31 December 2023 and 31 December 2022, respectively. The fair values of the Senior Secured Credit Facilities and Senior Secured Notes were determined based on Level 2 inputs, which are based on rates at which the debt is traded among financial institutions. The fair value of the senior secured revolving loan facility is recorded as its carrying value due to the short term duration.

Derivatives

The Company has entered into interest rate cap and swap agreements for purposes of managing its exposure to interest rate fluctuations. These financial derivative agreements are designated as Cash Flow Hedges. See note 26 - Financial Instruments for related information and disclosures.

Net Debt

The movement in net debt by category is as follows:

 1 Jan
 2023
Net cash inflow/ (outflow)Other non-cash adjustmentsEffects of exchange rates31 Dec 2023
$'000$'000$'000$'000$'000
Net cash and cash equivalents288,768 90,331 — (997)378,102 
Financial assets at fair value through other comprehensive income1,713 241 — — 1,954 
Total cash and cash equivalents290,481 90,572  (997)380,056 

 1 Jan
2023
Drawn down RepaidNet cash (inflow)/ outflowOther non-cash adjustmentsEffect of exchange rates31 Dec 2023
$'000$'000$'000$'000$'000$'000$'000
Lease liabilities(175,300)— 53,802 53,802 (41,365)128 (162,735)
Revolving Credit Facility— (370,000)315,000 (55,000)— — (55,000)
Senior Secured Credit Facilities(4,156,676)— 950,000 950,000 (14,743)— (3,221,419)
Senior Secured Notes(497,511)— — (1,659)— (499,170)
Total borrowings and lease liabilities(4,829,487)(370,000)1,318,802 948,802 (57,767)128 (3,938,324)


104




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

24. Share capital
Group and Company
Authorised share capital:No. of Ordinary Shares
Ordinary shares of par value €0.06100,000,000

31 December
2023
31 December
2022
$’000$’000
Allotted, called up and fully paid
82,495,086 (31 December 2022: 81,723,555) ordinary shares of €0.06 each6,699 6,649 
Issued, fully paid share capital
At beginning of year6,649 6,640 
Employee share options exercised35 21 
Restricted share units/ performance share units15 16 
Repurchase of ordinary shares (28)
At end of year6,699 6,649 

Holders of ordinary shares will be entitled to receive such dividends as may be recommended by the Board of Directors of the Company and approved by the Shareholders and/or such interim dividends as the Board of Directors of the Company may decide. On liquidation or a winding up of the Company, the par value of the ordinary shares will be repaid out of the assets available for distribution among the holders of the ordinary shares of the Company. Holders of ordinary shares have no conversion or redemption rights. On a show of hands, every holder of an ordinary share present in person or proxy at a general meeting of shareholders shall have one vote, for each ordinary share held with no individual having more than one vote.
(a)    Employee share based payments
During the year ended 31 December 2023, 535,705 options were exercised by employees at an average exercise price of $95.12 per share for total proceeds of $51.0 million. During the year ended 31 December 2023, 188,800 ordinary shares were issued in respect of certain RSUs and 47,026 ordinary shares were issued in respect of PSUs previously awarded by the Company.
During the year ended 31 December 2022, 348,286 options were exercised by employees at an average exercise price of $102.87 per share for total proceeds of $35.8 million. During the year ended 31 December 2022, 195,029 ordinary shares were issued in respect of certain RSUs and 46,087 ordinary shares were issued in respect of PSUs previously awarded by the Company.
(b)    Share repurchase programme
A resolution was passed at the Company’s Annual General Meeting (“AGM”) on 22 July 2016, which authorised the Directors to purchase (buyback) up to 10% of the outstanding shares in the Company. This resolution has been renewed annually thereafter. On 18 February 2022, the Company commenced a share buyback program which was fully complete at 31 March 2022. Under this buyback program, 420,530 ordinary shares were redeemed by the Company for total consideration of $100.0 million.
All ordinary shares that were redeemed under the buyback program were cancelled in accordance with the Constitution of the Company and the nominal value of these shares transferred to other undenominated capital as required under Irish Company law.
105




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

24. Share capital (continued)

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.  

25. Capital and reserves
31 December
2023
31 December
2022
$’000$’000
Share premium523,646 472,723 
Other undenominated capital 1,162 1,162 
Share-based payment reserve354,183 381,098 
Other reserves10,183 7,601 
Foreign currency reserve(148,844)(175,065)
Merger reserve5,656,195 5,656,195 
Retained earnings2,919,591 2,219,619 
Total9,316,116 8,563,333 

Other undenominated capital
Other undenominated capital comprises the nominal value of shares repurchased and cancelled by the Company and transferred from share capital to other undenominated capital as required under Irish Company Law. During the year ended 31 December 2023, nil ordinary shares were repurchased and cancelled by the Group (2022: 420,530).

Share-based payment reserve
The share-based payment reserve is used to account for share-based payments. The fair value of share-based payments is expensed to the Consolidated Statement of Profit and Loss over their respective period the related services are received, with a corresponding increase in equity. Details of options, RSU's and PSU's granted under their respective plans and the terms attaching thereto are provided in note 12 to the financial statements.

Other reserves
The Group has recognised a non-distributable reserve of $6.2 million in accordance with agreements made between the Group and Enterprise Ireland, an Irish government agency. The requirement for these non-distributable reserves will expire between the period 2025 and 2028. In addition, in 2005 the Group also recognised a capital contribution of $6.1 million being the fair value of outstanding ordinary shares transferred to Mr Peter Gray, formerly Vice Chair of the Board of Directors and formerly Chief Executive Officer, by founding Directors, Dr. John Climax and Dr. Ronan Lambe.

The Group entered into two interest rate cap agreements and an interest rate swap agreement to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities. The interest rate caps and swap are accounted for as cash flow hedges and were considered effective hedges on application of the provisions of IFRS 9. The effective portion of the hedges for the year ended 31 December 2023 is recorded as a movement of $1.6 million (31 December 2022: $3.7 million) within Other Reserves.

Foreign currency reserve
The currency reserve comprises all foreign exchange differences arising from the translation of the financial statements of foreign currency denominated operations of the Group. As at 31 December 2023, this amounted to a cumulative loss of $148.8 million (2022: loss of $175.1 million).


106




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

25.    Capital and reserves (continued)

Merger reserve
On 1 July 2021, the Company completed the Acquisition of PRA by means of a merger whereby Indigo Merger Sub, Inc., a Delaware corporation and subsidiary of the Company, merged with and into PRA, the parent of the PRA Health Sciences Group. Upon completion of the Merger, pursuant to the terms of the Merger Agreement, PRA became a wholly owned subsidiary of the Company. The transaction resulted in the issuance of 27,372,427 shares to the former stockholders of PRA. The Company issued these shares at the prevailing market price and recognised the premium of $5,656.2 million on issuance of these shares as a merger reserve as required under Irish Company Law.

Retained earnings
In addition to the profit for the financial year the Group has also recognised the re-measurement of the defined benefit pension scheme in this reserve. In 2023, the Group recognised a re-measurement gain on the defined benefit pension scheme of $0.5 million (31 December 2022: a re-measurement gain of $13.3 million). The Group has recognised a credit of $91.5 million (2022: credit of $71.7 million) in respect of exercised and expired share-based awards that have been transferred from the share-based payment reserve.

A resolution was passed at the Company’s Annual General Meeting (“AGM”) on July 22, 2016, which authorised the Directors to purchase (buyback) up to 10% of the outstanding shares in the Company. This resolution has been renewed annually thereafter. On February 18, 2022, the Company commenced a share buyback program which was fully complete at 31 March 2022. Under this buyback program, 420,530 ordinary shares were redeemed by the Company for total consideration of $100.0 million.

26.    Financial instruments
The Board of Directors have overall responsibility for the establishment and oversight of the Group’s risk management framework. The Group is exposed to various financial risks in the normal course of its business. The principal financial risks to which it is exposed include credit risks related to the creditworthiness of its customers and counterparties, with which it invests surplus cash funds, liquidity risk associated with the availability of sufficient financial resources to meet liabilities as they fall due, foreign currency risks, including both translation and transaction risk, and interest rate risk.
The Group’s risk management policies are established to identify and analyse the risks faced by the Group, to set appropriate risk limits and controls, and to monitor risks and adherence to limits. Risk management policies and systems are reviewed regularly to reflect changes in market conditions and the Group’s activities. The Group, through its training and management standards and procedures, aims to develop a disciplined and constructive control environment in which all employees understand their roles and obligations. The Audit Committee of the Board oversees how management monitors compliance with the Group’s risk management policies and procedures and reviews the adequacy of the risk management framework in relation to the risks faced by the Group.
Credit risk
Credit risk arises from cash and cash equivalents, contractual cash flows of debt investments carried at fair value through other comprehensive income and at fair value through profit or loss, favourable derivative financial instruments and deposits with banks and financial institutions, as well as credit exposures to customers, including outstanding accounts receivable, unbilled receivables and other receivables.
Credit risk is managed on a group basis. The ratings required for banks and financial institutions are a minimum rating of BBB+ for overnight maturities and a minimum of A- for any bank deposits greater than overnight and up to three months.
Current asset investments (recorded at fair value through other comprehensive income) comprise investments with maturities of greater than three months. The minimum ratings required for investment are as follows: bank deposits (A-), money market funds (AAA), liquidity funds (AAA) and fixed rate corporate bonds or floating rate notes (A- non-financial, AA- financial).  
The Group’s exposure to credit risk arises predominately in respect of the credit risk assessment of customers. Customer credit risk is managed through application of credit procedures, in particular through risk assessment of new customers, through assessment of credit quality, taking into account their financial position, past experience and other factors. The compliance with credit terms is regularly monitored by line management.
Contract terms may range from several weeks to several years depending on the nature of the work to be performed. Contracts are generally fixed price or unit based. In most cases, a portion of the contract fee is paid at the time the study or trial is started. The balance of the contract fee is generally billable in instalments over the study or trial duration and may be based on the delivery of certain performance targets or "milestones" or based on units delivered, or on a fixed monthly payment schedule such as patient enrolment or database delivery.
107




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

26. Financial instruments (continued)
Where customers request changes in the scope of a trial or in the services to be provided, a change order or amendment is issued which may result either in an increase or decrease in the contract value. The Group also contracts on a "fee-for-service" or "time and materials" basis.
During the course of a study, the Group will generally incur reimbursable expenses. Reimbursable expenses are typically estimated and budgeted within the contract and are generally invoiced on a monthly basis based on actual expenses incurred. Reimbursable expenses include payments to investigators, travel and accommodation costs and various other expenses incurred over the course of the clinical trial which are fully reimbursable by the client.
Most of the Group’s contracts are terminable immediately by the customer with justifiable cause or with 30 to 90 days' notice without cause. In the event of termination, the Group is usually entitled to all sums owed for work performed through the notice of termination and certain costs associated with termination of the study. Termination or delay in the performance of a contract occurs for various reasons, including, but not limited to, unexpected or undesired results, production problems resulting in shortages of the drug, adverse patient reactions to the drug, the client's decision to de-emphasise a particular trial, inadequate patient enrolment or investigator recruitment.
The Group’s top five customers accounted for approximately 26.8% and 28.3% of revenue during the years ended 31 December 2023 and 31 December 2022 respectively. During the year ended 31 December 2023, 8.9% of the Group’s revenues were derived from its top customer (2022: 8.8%). The addition of new customer accounts, particularly large and mid-tier pharma customers and biotech customers have resulted in a reduction in the concentration of revenues from our top five customers.
The maximum exposure of credit risk pertaining to customers is the carrying value of accounts receivable and unbilled revenue balances. The gross value of accounts receivable and unbilled revenue balances, by geographic region, at 31 December 2023 was as follows:

Accounts ReceivableUnbilled Revenue
31 December
2023
31 December
2022
31 December
2023
31 December
2022
$’000$’000$’000$’000
Europe1,184,454 1,024,777 402,797 380,932 
United States566,497 690,465 472,368 468,304 
Rest of World70,904 36,708 76,771 108,419 
Gross balance1,821,855 1,751,950 951,936 957,655 
Allowance for for credit losses(31,533)(20,562)— — 
Total, net of allowance for credit losses1,790,322 1,731,388 951,936 957,655 

The Group has four types of financial assets that are subject to the expected credit loss model:
trade receivables (billed amounts) for services provided to customers
unbilled receivables (contract assets) for services provided to customers
other receivables
cash and cash equivalents

Trade receivables, contract assets and other receivables
The Group applies the IFRS 9 simplified approach to measuring expected credit losses which uses a lifetime expected loss allowance for all trade receivables and contract assets.
To measure the expected credit losses, trade receivables and contract assets have been grouped based on shared credit risk characteristics and the days past due. The contract assets relate to unbilled work in progress and have substantially the same risk characteristics as the trade receivables for the same types of contracts. The Group has therefore concluded that the expected loss rates for trade receivables are a reasonable approximation for the loss rates for the contract assets.
The expected loss rates are based on the payment profiles of revenue over a period of 36 months before 31 December 2023. The historical loss rates are adjusted to reflect current and forward-looking information on macroeconomic factors affecting the ability of the customers to settle receivables. The group has identified the GDP and the unemployment rate of the countries in which it sells its services to be the most relevant factors, and accordingly adjusts the historical loss rates based on expected changes in these factors. See note 17 - Accounts receivable, unbilled services (contract assets) and unearned revenue (contract liabilities) for assessment of the allowance for credit losses for both trade receivables and contract assets.
108




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

26. Financial instruments (continued)
Trade receivables, other receivables and contract assets are written off when there is no reasonable expectation of recovery. Indicators that there is no reasonable expectation of recovery include, amongst others, the failure of a debtor to engage in a repayment plan with the group, and a failure to make contractual payments for a period of greater than 120 days past due. Impairment losses on trade receivables, other receivables and contract assets are presented as net impairment losses within operating profit. Subsequent recoveries of amounts previously written off are credited against the same line item.

Liquid and capital resources
The Group’s liquid and capital resources at 31 December 2023 were as follows:
31 December
2023
31 December
2022
$’000$’000
Current asset investments (note 19)1,954 1,713 
Cash and cash equivalents (note 20)378,102 288,768 
Total liquid resources380,056 290,481 
Shareholders’ equity9,322,815 8,569,982 

The principal operating cash requirements of the Group include payment of salaries, office rents, travel expenditures and payments to investigators. Other cash requirements include capital expenditures for facilities and information system enhancements and cash required to fund acquisitions and other growth opportunities. The CRO industry is generally not capital intensive. The Group primarily finances its operations and growth through cash flows from operations, together with amounts drawn under negotiated facilities as required.

The Group’s primary objectives in managing its liquid and capital resources are as follows:

to maintain adequate resources to fund its continued operations,
to ensure availability of sufficient resources to sustain future development and growth of the business,
to maintain sufficient resources to mitigate risks and unforeseen events which may arise.

The Group manages risks associated with liquid and capital resources through ongoing monitoring of actual and forecast cash balances and by reviewing the existing and future cash requirements of the business. It ensures that sufficient headroom is available under the Group’s existing negotiated facilities and negotiates additional facilities as required. Details of the Group’s negotiated facilities are set out in note 23 Bank credit lines and loan facilities.

In conjunction with the completion of the Merger Agreement, on 1 July 2021, ICON entered into a credit agreement providing for a senior secured term loan facility of $5,515 million and a senior secured revolving loan facility in an initial aggregate principal amount of $300 million (the "Senior Secured Credit Facilities"). The Senior Secured Credit Facility and Senior Secured Notes were issued at a discount of $27.6 million. On 2 May 2023, the Company agreed with its lenders to increase the aggregate principal amount of the senior secured revolving loan facility from $300 million to $500 million.

Borrowings under the senior secured term loan facility amortise in equal quarterly instalments in an amount equal to 1.00% per annum of the principal amount, with the remaining balance due at final maturity. The interest rate margin applicable to borrowings under the senior secured term loan facility is USD Term SOFR and a Term SOFR Adjustment depending on the interest period chosen plus an applicable margin which is dependent on the Company's net leverage ratio. As of 31 December 2023, the applicable margin is 2.25%. The senior secured term loan facility is subject to a floor of 0.50%.

The interest rate margin applicable to borrowings under the revolving loan facility will be, at the option of the borrower, either (i) the applicable base rate plus an applicable margin of 1.00%, 0.60% or 0.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively, or (ii) Term SOFR plus a Term SOFR Adjustment on the interest period chosen plus an applicable margin of 2.00%, 1.60% or 1.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively. In addition, lenders under the revolving loan facility are entitled to commitment fees as a percentage of the applicable margin at the time of drawing and utilisation fees dependent on the proportion of the facility drawn. As at 31 December 2023, $445.0 million remained undrawn under the senior secured revolving loan facility.

The Borrowers' (as defined in the Senior Secured Credit Facility) obligations under the Senior Secured Credit Facilities are guaranteed by ICON and the subsidiary guarantors. The Senior Secured Credit Facilities are secured by a lien on substantially all of ICON’s, the Borrowers' and each of the subsidiary guarantor’s assets (subject to certain exceptions), and the Senior Secured Credit Facilities will have a first-priority lien on such assets, which will rank pari passu with the lien
109




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

26. Financial instruments (continued)
securing the Senior Secured Notes, subject to other permitted liens. The Company is permitted to make prepayments on the senior secured term loan without penalty.

In addition to the Senior Secured Credit Facilities, on 1 July 2021, a subsidiary of the Company issued $500 million in aggregate principal amount of 2.875% senior secured notes due 2026 in a private offering (the “Offering”). The Senior Secured Notes will mature on July 15, 2026.

The following table sets out details of the maturity of the Group’s financial liabilities into the relevant maturity groupings based on the remaining period from the financial year end date to contractual maturity date:

Year ended 31 December 2023    


Carrying
amount
Contractual cash flowsLess than
1 year
1-2 years2-5 yearsMore than
5 years
$’000$’000$’000$’000$’000$’000
Bank credit lines and loan facilities(3,775,589)(3,806,213)(110,150)(55,150)(3,640,913) 
Interest on bank credit lines and loan facilities(8,758)(1,179,097)(272,501)(267,396)(639,200)— 
Lease liabilities(162,735)(176,926)(40,894)(34,585)(67,449)(33,998)
Non-current other liabilities*(28,358)(28,358)— — — (28,358)
Accounts payable(131,584)(131,584)(131,584)— — — 
Accrued and other liabilities**(865,233)(865,233)(865,233)— — — 
(4,972,257)(6,187,411)(1,420,362)(357,131)(4,347,562)(62,356)

Year ended 31 December 2022


Carrying
amount
Contractual cash flowsLess than
1 year
1-2 years2-5 yearsMore than
5 years
$’000$’000$’000$’000$’000$’000
Bank credit lines and loan facilities(4,654,187)(4,701,213)(55,150)(55,150)(665,450)(3,925,463)
Interest on bank credit lines and loan facilities(8,334)(1,677,091)(314,947)(311,799)(887,590)(162,755)
Lease liabilities(175,300)(189,668)(47,479)(34,400)(62,724)(45,065)
Non-current other liabilities*(23,604)(23,604)— — — (23,604)
Accounts payable(81,194)(81,194)(81,194)— — — 
Accrued and other liabilities**(947,480)(947,480)(947,480)— — — 
(5,890,099)(7,620,250)(1,446,250)(401,349)(1,615,764)(4,156,887)
*Non-current other liabilities above excludes retirement plan net benefit obligation (2023: $14.7 million and 2022: $13.0 million) and deferred government grants (2023: $0.9 million and 2022: $1.1 million).

**Accrued and other liabilities excludes interest on senior notes presented separately above, deferred government grants (2023: $0.04 million and 2022: $0.04 million) and current lease liabilities (2023: $36.4 million and 2022: $43.7 million).

Foreign currency risk
The Group is subject to a number of foreign currency risks given the global nature of its operations. The principal foreign currency risks to which the business is subject includes both foreign currency translation risk and foreign currency transaction risk. Although domiciled in Ireland, the Group presents its results in U.S. dollars. As a consequence, the results of non-U.S. based operations, when translated into U.S. dollars, could be affected by fluctuations in exchange rates between the U.S. dollar and the currencies of those operations.

The Group is also subject to foreign currency transaction exposure as the currency in which contracts are priced can be different from the currencies in which costs relating to those contracts are incurred. The Group’s operations in the United States are not materially exposed to such currency differences as the majority of revenues and costs are in U.S. dollars. However, outside the United States the multinational nature of the Group’s activities means that contracts are usually priced in a single currency, most often U.S. dollars, Euros or pounds Sterling, while costs arise in a number of currencies, depending on, among other things, which of the Group’s offices provide staff for the contract and the location of investigator sites.

110




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

26. Financial instruments (continued)
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 the results of the Group’s operations. The Group regularly reviews its foreign currency exposures and usually negotiates currency fluctuation clauses in its contracts which allow for price negotiation if certain exchange rate triggers occur.

The following significant exchange rates applied during the year:

Average RateClosing Rate
2023202220232022
Euro:US Dollar1.07951.05121.10391.0705
Pound Sterling: US Dollar1.23821.23471.27311.2083

A simultaneous ten percent strengthening or weakening of the US Dollar, Euro and Sterling against all other currencies (which remained constant) would have increased or decreased profit by $104.4 million, $25.0 million and $72.1 million respectively (31 December 2022: $37.2 million, $19.6 million and $22.1 million respectively) as a consequence of the retranslation of foreign currency denominated financial assets and liabilities at those dates. This change in profit is excluding the effect of foreign currency denominated long term loans.

Interest rate risk
The Group is exposed to interest rate risk in respect of our cash and cash equivalents and available for sale investments. Our treasury function actively manages our available cash resources and invests significant cash balances to ensure optimum returns for the Company. Financial instruments are classified either as cash and cash equivalents or current asset investments depending upon the maturity of the related investment. Funds may be invested in the form of floating rate notes and medium term minimum “A-” rated corporate securities. We may be subject to interest rate risk in respect of interest rate changes on amounts invested. Interest rate risk is managed by monitoring the composition of the Company’s investment portfolio on an ongoing basis having regard to current market interest rates and future trends.

In conjunction with the completion of the Merger, on 1 July 2021, ICON entered into a credit agreement providing for a senior secured term loan facility of $5,515 million and a senior secured revolving loan facility in an initial aggregate principal amount of $300 million (the "Senior Secured Credit Facilities"). As of 31 December 2023, $2,264 million of the senior secured term loan facility has been repaid from cash generated by the Company in the period since the completion of the Merger. On 2 May 2023, the Company agreed with its lenders to increase the aggregate principal amount of the senior secured revolving loan facility from $300 million to $500 million.

As at the 31 December 2023, the outstanding principal amount of the Senior Secured Term Loan Facility was $3,251 million. The applicable interest rate for the next quarterly interest period is expected to be 7.860% Borrowings under the Senior Secured Term Loan facility amortise in equal quarterly instalments in an amount equal to 1.00% per annum of the principal amount, with the remaining balance due at final maturity. The interest rate margin applicable to borrowings under the senior secured term loan facility is USD Term SOFR and a Term SOFR Adjustment depending on the interest period chosen plus an applicable margin of 2.25%. The Senior Secured Term Loan Facility is subject to a floor of 0.50%.

In addition to the Senior Secured Facilities, on 1 July 2021, the Company issued $500 million in aggregate principal senior notes in a private offering. The Senior Secured Notes will mature in July 2026 and pay a fixed semi annual coupon to investors of 2.875% per annum. This debt is not subject to movements in interest rate conditions.

We regularly evaluate our debt arrangements, as well as market conditions, and we will explore the opportunity to modify our existing arrangements or pursue additional financing arrangements that may result in the issuance of new debt securities by us or our affiliates.

The sensitivity analysis below represents the hypothetical change in the interest income and interest expense of a 1% movement in market interest rates.
Interest IncomeInterest Expense*
2023202220232022
$’000$’000$’000$’000
As reported5,014 2,345 336,699 229,731 
1% Increase8,073 8,322 376,036 277,546 
1% Decrease1,953 297,362 181,982 
*Interest expense excludes interest on lease liabilities.
111




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

26. Financial instruments (continued)
Derivatives
The Company has entered into interest rate cap and swap agreements for purposes of managing its exposure to interest rate fluctuations. These financial derivative agreements are designated as Cash Flow Hedges.

On 29 November 2022, the Company entered into two interest rate cap agreements ("2022 Caps") with an initial total notional value of $2,101 million to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities. Interest on the 2022 Caps began accruing on 30 December 2022 and the interest rate cap expires on 31 December 2024. The Company pays a fixed rate of 0.42% and receives a variable rate equal to the amount that the three-month SOFR rate exceeds 4.75%.

On 29 November 2022, the Company entered into an interest rate swap agreement ("2022 Swap") with an initial notional value of $1,101 million to limit its exposure to changes in the variable interest rate on its Senior Secured Credit Facilities. Interest on the 2022 Swap begins accruing on 31 December 2024 and the interest rate swap expires on 30 September 2026. The Company will pay a fixed rate of 3.4% and receive a variable rate of interest equal to the three-month SOFR on the 2022 Swap.

The critical terms of the caps and swap are substantially the same as the underlying borrowings. The interest rate caps and swap are accounted for as cash flow hedges as these transactions were executed to hedge the Company's interest payments and for accounting purposes are considered highly effective. As such, the effective portion of the hedges is recorded as unrealised gains/(losses) on derivatives in Other Reserves.

The fair value of these cash flow hedges represents the present value of the anticipated net payments the Company will make to the counterparty, which, when they occur, are reflected as interest expense in the consolidated statement of income.

The fair values of the Company’s derivative financial instruments, on a gross basis, are summarized in the following table:

31 December 202331 December 2022
AssetLiabilityNotionalAssetLiabilityNotional
$'000$'000$'000$'000$'000$'000
Derivatives designated as hedging instruments:
Interest Rate Caps— 1,871 1,600,606 12 3,363 2,100,606 
Interest Rate Swap— 540 1,100,606 — 307 1,100,606 
Total derivatives designated as hedging instruments— 2,411 2,701,212 12 3,670 3,201,212 

As of 31 December 2023, the Company recognised a current derivative liability of $1.9 million within other liabilities (2022: $3.3 million within other liabilities and $0.01 million within other receivables) and a non current derivative liability of $0.5 million (2022: $0.4 million) within non-current other liabilities.

During the year ended 31 December 2023, the Company recognised a gain of $1.6 million within the Statement of Comprehensive Income (2022: $3.7 million loss) after a reclassification of $2.4 million from Other Reserves to the Statement of Profit and Loss (2022: $0.1 million).

During 2024, the Company estimates that an additional $3.2 million million will be reflected as interest expense in the Consolidated Statement of Profit and Loss.

Fair values
Certain financial instruments are measured in the Statement of Financial Position at fair value using a fair value hierarchy of valuation inputs. The fair value of financial assets together with the carrying amounts shown in the Statement of Financial Position is as follows:
112




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

26. Financial instruments (continued)
31 December 202331 December 2022


Carrying
Amount
Level 1Level 2Level 3Carrying
Amount
Level 1Level 2 Level 3
$’000$’000$’000$'000$’000$’000$’000$’000
Financial assets measured at fair value
Financial assets at fair value through other comprehensive income1,954 1,954   1,713 1,713 — — 
Financial assets at fair value through profit and loss46,804   46,804 32,631 — — 32,631 
Derivative instruments at fair value through other comprehensive income    12  12  
Total Assets48,758 1,954  46,804 34,356 1,713 12 32,631 
Financial liabilities measured at fair value
Derivative instruments at fair value through other comprehensive income(2,411) (2,411) (3,670) (3,670) 
Total Liabilities (2,411) (2,411) (3,670)— (3,670)— 

The carrying values of accounts receivable (less provision for loss), unbilled revenue (contract assets), other current assets, cash and cash equivalents and other non-current assets are carried at amortised cost and assumed to be approximate to their fair values due to the short-term nature of these balances. As such their fair values have not been disclosed.

Current asset investments carried at fair value result in gains or losses being recognised in the Consolidated Statement of Comprehensive Income. The fair value of current asset investments is their market price at the financial year end date. They are measured on the basis of Level 1 inputs.

Long-term financial assets carried at fair value result in gains or losses being recognised in the Consolidated Statement of Profit and Loss. The fair value of long-term financial assets meet the definition of equity securities without readily determinable fair values and are measured on the basis of level 3 inputs as the funds are not traded on an exchange and data is not published in respect of the funds. The valuation model is based on the net asset value of the fund as prepared by an independent appraiser.

The carrying values of accounts payable, accrued and other liabilities and provisions and other non-current liabilities are carried at amortised cost and assumed to be approximate to their fair values.
Each category of asset and liability has remained within the same level of hierarchy as the prior year as there has been no change in the extent to which the inputs used in measuring fair value are or are not observable within the market.

The following table shows reconciliation from the opening balances to the closing balances for Level 3 fair values:
31 December 202331 December 2022
$’000$’000
Opening balance32,631 22,592 
Additions/(payments) made during the year13,954 5,612 
 Increase in fair value
219 4,427 
Closing balance46,804 32,631 

There have been no transfers between level 1/2 financial instruments and level 3 financial instruments during the current or prior financial year.

113




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

27. Leases
Right-of-use assets
The Group has recorded the following for right-of-use assets:
PremisesEquipmentMotor vehiclesTotal
$'000$'000$'000$'000
Depreciation charge for 2023
38,728 200 3,054 41,982 
Right-of-use assets at 31 December 2023123,378 444 13,442 137,264 
Depreciation charge for 202242,847 207 2,161 45,215 
Right-of-use assets at 31 December 2022137,519 1,194 12,486 151,199 
Additions to right-of-use assets during 2023, net of early termination options now reasonably certain to be exercised, were $37.7 million (2022: $28.7 million).
The weighted average remaining lease term at 31 December 2023 was 6.72 years (2022: 6.90 years).
During the year ended 31 December 2023, as a result of office consolidations, certain ROU assets have been impaired to the extent they are considered onerous and an impairment loss of $8.7 million was recorded (2022: $24.5 million). See note 9 Exceptional items.
Lease liabilities
Set out below are the carrying amounts of lease liabilities at each reporting date. Current lease liabilities have been included in accrued and other liabilities on the balance sheet.
31 December 202331 December 2022
$’000$’000
Current36,414 43,656 
Non-Current126,321 131,644 
Total 162,735 175,300 
Total lease payments for the year ended 31 December 2023 were $53.8 million (2022: $54.6 million).
Future minimum lease payments under non-cancelable leases as of 31 December 2023 were as follows:
31 December 2023
$'000
202440,894 
202534,585 
202629,172 
202723,254 
202815,023 
Thereafter33,998 
Total future minimum lease payments 176,926 
Lease imputed interest(14,191)
Total162,735 




114




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

27. Leases (continued)
Amounts recognised in profit or loss
The following amounts were recognised in profit and loss:
31 December 202331 December 2022
$'000$'000
Depreciation of right-of-use assets41,982 45,215 
Interest on lease liabilities4,172 4,470 
Of the total cost of $46.2 million incurred in the year ended 31 December 2023, $34.9 million is recorded within other operating expenses, $7.1 million is recorded within direct costs and $4.2 million is recorded within financing expense. During 2023, the Group had income from sub-leases of $1.1 million.
Of the total cost of $49.7 million incurred in the year ended 31 December 2022, $41.6 million is recorded within other operating expenses, $3.6 million is recorded within direct costs and $4.5 million is recorded within financing expense. During 2022, the Group had income from sub-leases of $1.2 million.
During the year ended 31 December 2023 and the year ended 31 December 2022, the Group did not incur any costs related to variable lease payments or short-term leases.

28. Commitments and contingencies

a)    Capital commitments

The following capital commitments for the purchase of property, plant, equipment and computer software were authorised by the Group at 31 December 2023 and 31 December 2022:

31 December
2023
31 December
2022
$’000$’000
Contracted for101,65386,478
Total101,65386,478

(b)    Contractual obligations

The following represents Group contractual obligations and commercial commitments as at 31 December 2023:

Payments due by period
TotalLess than
1 year
1 to 5
years
More than
5 years
$’000$’000$’000$’000
Capital commitments101,653 93,256 8,397 — 
Total contractual obligations101,653 93,256 8,397  

The Group expects to spend between $150 million to $200 million in the next 12 months on further investments in information technology comprising both capital authorised and contracted and capital authorised and not contracted. The Group believes that it will be able to fund additional foreseeable cash needs for the next twelve months from cash flow from operations and existing cash balances. In the future, the Group may consider acquiring businesses to enhance service offerings and global presence. Any such acquisitions may require additional external financing and the Group may, from time to time, seek to obtain funds from public or private issues of equity or debt securities. There can be no assurance that such financing will be available on terms acceptable to the Group.




115




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

28. Commitments and contingencies (continued)
The Company entered into subscription agreements with a number of funds (see note 19 Financial asset investments). During the year ended 31 December 2023, capital totalling $14.0 million had been advanced under the terms of the subscription agreements (2022: $3.7 million). The Company had committed to future investments of $66.4 million in respect of these funds. The timing of the commitment is not specified in the subscription agreements.

(c)    Guarantees

(i) Guarantees in respect of borrowings of subsidiaries

ICON plc and certain other subsidiaries within the Group have guaranteed the Senior Secured Credit Facilities and Senior Secured Notes as set out in note 23 Bank credit lines and loan facilities. The Group does not expect any material loss to arise from these guarantees.

(ii) Section 357 Guarantees

The Company has guaranteed all of the commitments and liabilities referred to in Section 357(1) (b) of the Companies Act in respect of the whole of the financial year ending 31 December 2023 for the subsidiary companies listed below. These subsidiaries are availing of the exemption under Section 357 of the Companies Act not to file statutory financial statements.

ICON Clinical Research Limited
DOCS Resourcing Limited
ICON Holdings Unlimited Company
ICON Clinical Research Property Holdings (Ireland) Limited
ICON Clinical Research Property Development (Ireland) Limited
ICON Holdings Clinical Research International Limited
ICON Clinical International Unlimited Company
ICON Investments Four Unlimited Company
Accellacare Limited
ICON Global Treasury Unlimited Company
ICON Clinical Global Holdings Unlimited Company
ICON Operational Financing Unlimited Company
ICON Operational Holdings Unlimited Company
Research Pharmaceutical Services (Outsourcing Ireland) Limited
ICON Clinical Research Holdings (Ireland) Unlimited Company
Oncacare Limited

29.    Litigation

The Group is not party to any litigation or legal proceedings that the Group believes could reasonably be expected to have a material adverse effect on the Group’s business, results of operations and financial position. 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.

116




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

30.    Related parties
(i)    Transactions with Directors and Executive Officers

The total compensation of the Directors and Executive Officers (key management remuneration) for the years ended 31 December 2023 and 2022 was as follows:

31 December
2023
31 December
2022
$’000$’000
Salary and fees2,891 3,078 
Bonus1,578 1,515 
Other benefits62 61 
Pension contributions198 195 
Share-based payment expense8,583 10,496 
Total13,312 15,345 

Details of ordinary shares, share options, RSUs and PSUs held by the Directors and Executive Officers and details of transactions entered into by Directors and Key Executive Officers in shares and share options of the Company during the year ended 31 December 2023 are set out in note 10 Payroll and related benefits.

(ii)    Other related party transactions

Subsidiaries of the Company earned revenue of $243,000 (31 December 2022: $428,000) from Corvus Pharmaceuticals during the year. Dr. Linda Grais serves as a Director and shareholder of Corvus Pharmaceuticals. $101,000 (31 December 2022: $231,000) was noted as due from Corvus Pharmaceuticals at 31 December 2023.

Subsidiaries of the Company earned revenue of $45,000 (31 December 2022: $235,000) from Afimmune Limited during the year. Dr. John Climax is Chief Executive Officer and a Director and shareholder of Afimmune Limited. $47,000 was noted as due from Afimmune Limited at 31 December 2023 (31 December 2022: $263,000).

On 24 July 2020, a subsidiary of the Company, ICON Clinical Research Limited, entered into an agreement to jointly establish a new company, Oncacare Limited ("Oncacare"), a specialised oncology site network in the US and EMEA regions, with a third party. The Company invested $4.9 million to obtain a 49% interest in the voting share capital of Oncacare. On 20 April 2023, the Company completed the purchase of the majority investor’s 51% majority voting share capital of Oncacare. The consideration paid by ICON to purchase the 51% majority voting share capital was $5.1 million. As a result of this transaction (the "Oncacare acquisition"), Oncacare and its subsidiaries became wholly owned subsidiaries of the ICON Group. Prior to the Oncacare acquisition, the Company recorded losses of $0.4 million and $3.1 million representing its pro rata share of the losses in Oncacare during the year ended 31 December 2023 and 31 December 2022, respectively. The Oncacare acquisition also resulted in goodwill of $13.4 million and gave rise to an acquisition-related gain of $6.2 million.

31. Subsequent events

The Company has evaluated subsequent events from the Balance Sheet date through 23 April 2024, the date at which the consolidated financial statements were available to be issued.

On 20 February 2024, the Company's Board of Directors authorised a new buyback program of up to $500 million of the outstanding ordinary shares of the Company. All ordinary shares that are redeemed under the buyback program will be cancelled 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 share buyback 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.

The Company has determined that there are no other items to disclose.
117




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings
As at 31 December 2023 the Group had the following principal subsidiary undertakings:

NameRegistered Office**********Nature of businessProportion held by
Group
ICON Clinical Research S.A.Cecilia Grierson 255, Floor 6°
City of Buenos Aires
C1107CPE
Argentina
Clinical research services100%
ICON Clinical Research PTY LimitedSuite 201,
Level 2, 2-4 Lyon Park Road,
North Ryde,
NSW 2113
Australia
Clinical research services100%
Medpass International Pty LtdLevel 2,
Pier 8, Shop 9,
23 Hickson Road,
Millers Point,
NSW 2000
Australia
Clinical research services100%
ICON Clinical Research Austria GmbH Pyrkergasse 10/6
1190 Vienna
Austria
Clinical research services100%
DOCS International Belgium N.V.**E19 Business Park
Battelsesteenweg 455D
2800 Mechelen, Belgium
Clinical research services100%
ICON Pesquisas Clínicas LTDA.Av. Ibirapuera 2332,
Torre II 4º Andar,
São Paulo, SP,
Brazil,
CEP 04028-003
Clinical research services100%*
ICON Clinical Research EOOD2A, Saborna Str.,
4th floor, Sofia – 1000,
Republic of Bulgaria
Clinical research services100%
ICON Clinical Research (Canada) Inc.7405 Trans-Canada Highway,
Suite 300 Saint-Laurent,
Quebec, H4T 1Z2
Canada
Clinical research services100%
Oxford Outcomes LTD.19th Floor
885 West Georgia Street
Vancouver BC V6C 3H4
Canada
Clinical research services100%
ICON Life Sciences Canada Inc.3455 North Service Road
Unit #400
Burlington ON L7N 3G2
Canada
Clinical research services100%
ICON Chile LimitadaAvenida Mariano Sánchez Fontecilla 310
Las Condes
Santiago
Región Metropolitana
7550296
Chile
Clinical research services100%
ICON Clinical Research (Beijing No.2) Co., LtdFloor 2, Building 5,
Hongda Industrial park,
No. 8, Hongda North Road,
Beijing Economic-Technological Development Area,
Beijing
Clinical research services100%
ICON Clinical Research (Beijing) Co., LtdFloor 1
Building No. 5,
No. 8 Hongda North Road,
Beijing Economic-Technologies
Developement Zone,
Beijing, China
Clinical research services100%
118




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
ICON Clinical Research s.r.o.V parku 2335/20,
Praha 4 - Chodov,
PSČ 148 00
Czech Republic
Clinical research services100%
DOCS International Nordic Countries A/Sc/o BuusMark Advokater
Sankt Ols Gade 4
4000 Roskilde
Denmark
Clinical research services100%
DOCS International Finland OyMannerheimintie 12B,
00100 Helsinki
Finland
Clinical research services100%
ICON Clinical Research S.A.R.L. 55 Avenue des Champs Pierreux
Immeuble le Capitole
92000 Nanterre
France
Clinical research services100%
Mapi Research Trust***27 rue de la Villette,
69003 Lyon,
France
Clinical research services100%
ICON Clinical Research Germany GmbHHeinrich-Hertz-Straße 26
63225
Langen
Hessen
Germany
Clinical research services100%
ICON Clinical Research Hong Kong LimitedUnit 4333 & 4335C, 43/F
AIA Tower
183 Electric Road
North Point
Hong Kong
Clinical research services100%
Accellacare LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Clinical research services100%
DOCS Resourcing LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Clinical research services100%
ICON (LR) LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Ireland
Clinical research services100%
ICON Clinical Global Holdings Unlimited Company South County Business Park,
Leopardstown,
Dublin 18
Ireland
Investment holding company100%*
ICON Clinical International Unlimited Company South County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Holding company100%
ICON Clinical Research LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Ireland
Clinical research services100%
ICON Clinical Research Property Development (Ireland) LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Property management company100%
ICON Clinical Research Property Holdings (Ireland) LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Property management company100%*
119




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
ICON Holdings Clinical Research International LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Investment holding company100%
ICON Holdings Unlimited Company South County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Investment holding company100%
ICON Investments Five Unlimited CompanySouth County Business Park,
Leopardstown,
Dublin 18
Ireland
Investment holding and financing company100%*
ICON Investments Four Unlimited CompanySouth County Business Park,
Leopardstown,
Dublin 18
Republic of Ireland
Investment holding and financing company100%
ICON Operational Financing Unlimited Company South County Business Park,
Leopardstown,
Dublin 18
Ireland
Investment holding and financing company100%
ICON Operational Holdings Unlimited Company South County Business Park,
Leopardstown,
Dublin 18
Ireland
Investment holding company100%
ICON Global Treasury Unlimited CompanySouth County Business Park,
Leopardstown,
Dublin 18,
Ireland
Investment holding and financing company100%
ICON Clinical Research Israel LTD.Building E, 13th Floor
4 Haharash Street
Hod Hasharon 4524402 Israel
Clinical research services100%
ICON Investments Limited 22 Grenville Street
St Helier
JE4 8PX
Jersey
Investment holding company100%*
ICON Luxembourg S.à r.l.61, rue de Rollingergrund
L-2440 Luxembourg
Holding and Investment Company100%
ICON CRO Malaysia SDN. BHD.Level 11
1 Sentral
Jalan Rakyat
Kuala Lumpur Sentral
50470 Kuala Lumpur
Malaysia
Clinical research services100%
ICON Clinical Research México, S.A. de C.V.Av. Barranca del Muerto
329 3rd Floor
Col. San Jose Insugentes
03900 Mexico D.F.
Clinical research services100%
DOCS International B.V. ****Boeing Avenue 62-68
1119PE Schiphol-Rij
The Netherlands
Clinical research services100%
ICON Clinical Research (New Zealand) LimitedLevel 33, 29 Albert Street, Auckland Central,
New Zealand.
Clinical research services100%
ICON Clinical Research Perú S.A.Av. Paseo de la República 5895
Oficina 606
Miraflores
Lima 18
Perú
Clinical research services100%
120




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
ICON Clinical Research Services Philippines, Inc.24th Floor Salcedo Towers,
169 H.V. Dela Costa Street,
Salcedo Village,
Makati City,
Philippines 1227
Clinical research services100%
ICON Clinical Research S.R.L. 8th Floor,
246c Caleca Floresca, Sector 1,
Bucharest 14476
Romania
Clinical research services100%
ICON Clinical Research (Rus) LLCPremises 2/4, 9 Zemlyanoy Val, Moscow, 105064,
Russian Federation
Clinical research services100%
ICON Clinical Research (Pte) Limited30 Loyang Way
#02/12
Loyang Industrial Estate
508769
Singapore
Clinical research services100%
Mapi Life Sciences Singapore Pte. Ltd.30 Loyang Way
#02/12
Loyang Industrial Estate
508769
Singapore
Dormant100%
ICON Clinical Research Slovakia, s.r.o.Karadžičova 2 Bratislava -mestskáčasťStaréMesto ,
Slovenská republika, 81109,
Slovakia
Clinical research services100%
Accellacare South Africa (PTY) LTDBlock 29 Second Floor
The Highlands Estate
The Woodlands
Woodlands Drive
Woodmead, Gauteng
2191
Johannesburg
South Africa
Clinical research services100%
ICON Clinical Research España, S.L. Calle Josep Pla
Numero 2, Torre Diagonal Mar
Piso 11, Modulo 1
Barcelona
Spain
Clinical research services100%
Accellacare España S.L.Calle Marques de Valdavia 103
Portal 5
28100
Alcobendas
Madrid
Spain
Clinical research services100%
DOCS International Sweden ABKolonivagen 1
SE-226 60 Lund, Sweden
Clinical research services100%
DOCS International Switzerland GmbHc/o Experfina AG
Picassoplatz 8
4052 Basel
Switzerland
Clinical research services100%
ICON Clinical Research (Switzerland) GmbHc/o Experfina AG
Picassoplatz 8
4052 Basel
Switzerland
Clinical research services100%
ICON Clinical Research Taiwan Limited *****6th Floor No. 2, Sec 5
Xinyi Road
Xinyl District
Taipei
Taiwan
Clinical research services100%
121




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
ICON Clinical Research (Thailand) Limited 1 Empire Tower,
24th Floor, Unit 2408,
South Sathorn Road,
Yannawa, Sathorn,
Bangkok, 10120
Thailand
Clinical research services100%
ICON Ankara Klinik Arastirma Dis Ticaret Anonim SirketiSöğütözü mah.
Eskişehir Yolu Cad. 2176. SK No:9
Posta Kodu:06510
Çankaya Ankara
Turkiye
Clinical research services100%
DOCS Ukraine LLC4th Floor,
St. Poleva 24,
Kiev,
Ukraine, 03056
Clinical research services100%
ICON Clinical Research LLC4th Floor,
St. Poleva 24,
Kiev,
Ukraine, 03056
Clinical research services100%
Accellacare UK Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
DOCS International UK Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON (LR) Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Clinical Research (U.K.) Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Clinical Research (U.K.) No. 2 Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Clinical Research (U.K.) No. 3 Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Clinical Research (U.K.) No. 4 Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Clinical Research (U.K.) No. 5 Limited 500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Development Solutions Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Investments (UK) Ltd500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
Improving Treatments Limited 500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
122




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
Medeval Group Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
MeDiNova Lakeside Clinical Research Limited 500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
MeDiNova Merc (UK) Limited 500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
VSK (Kenilworth) Limited 500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research services100%
ICON Clinical Research (U.K.) No. 6 Limited500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Holding company100%
ICON Clinical Research, LP731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
ICON Early Phase Services, LLC 8307 Gault Lane,
San Antonio,
TX 78209-1015
United States
Clinical research services100%
Addplan, Inc.731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
Beacon Bioscience, Inc 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
C4 MedSolutions, LLC 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
CHC Group, LLC731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Holding company100%
CRN Holdings, LLC3 Parkway North
Suite 200
Deerfield, IL 60015
United States
Clinical research services100%
Global Pharmaceutical Strategies Group, LLC 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
ICON Clinical Investments, LLC731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Investment Company100%
ICON Clinical Research LLC731 Arbor Way Suite 100 Blue Bell, PA United States, 19422Clinical research services100%
ICON Laboratory Services, Inc.123 Smith Street,
Farmingdale,
NY 11735
United States
Clinical research services100%
123




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
ICON Tennessee, LLC320 Seven Springs Way,
Suite 500,
Brentwood,
TN 37027
Holding company100%
ICON US Holdings Inc. 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Holding Company 100%
MMMM Consulting, LLC731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
MMMM Group, LLC 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
MolecularMD Corp.731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
PriceSpective LLC731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
PubsHub LLC 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
Accellacare of Christie Clinic, LLC101 West University Avenue
Champaign
IL 61820
United States
Clinical research services100%
DOCS Global, Inc.731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
Managed Care Strategic Solutions, L.L.C. 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
Accellacare of Charlotte, LLC3541 Randolph Road
Suite 101W
Charlotte
North Carolina 28211
USA
Clinical research services100%
Accellacare of Hickory, LLC221 13th Ave Place NW
Suite 201
Hickory
North Carolina 28601
United States
Clinical research services100%
Accellacare of Raleigh, LLC3521 Haworth Drive
Suite 100
Raleigh
North Carolina 27609
United States
Clinical research services100%
Accellacare of Rocky Mount, LLC901 N. Winstead Avenue
Rocky Mount
North Carolina 27804
United States
Clinical research services100%
Accellacare of Salisbury, LLC410 Mocksville Avenue
Salisbury
North Carolina 28144
United States
Clinical research services100%
124




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
Accellacare of Wilmington, LLC1907 Tradd Court
Wilmington
North Carolina 28401
United States
Clinical research services100%
Accellacare of Winston-Salem, LLC1901 S. Hawthorne Road
Suite 306
Winston-Salem
North Carolina 27103
United States
Clinical research services100%
Accellacare US Inc. 1901 S. Hawthorne Road
Suite 306
Winston-Salem
North Carolina 27103
United States
Clinical research services100%
Complete Healthcare Communications LLC731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
Complete Publication Solutions, LLC 731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research services100%
Accellacare of Charleston, LLC180 Wingo Way
Suite 203
Mt. Pleasant
South Carolina 29464
United States
Clinical research services100%
Accellacare of Bristol, LLC1958 West State Street
Bristol
Tennessee 37620
United States
Clinical research services100%
ICON Government and Public Health Solutions, Inc.1265 Ridge Road, Suite A
Hinckley
OH 44233
United States
Clinical research services100%
RPS Research S.A.Cecilia Grierson 255 Floor 6
City of Buenos Aires C1107CPE Argentina
Clinical research services100%
Pharmaceutical Research Associates Pty LimitedC/- ICON Clinical Research Pty Ltd.
Suite 201, Level 2
2-4 Lyon Park Road
Macquarie Park NSW 2113 Australia
Clinical research services100%
RPS Research Austria GmbHTegetthoffstraße 7
1010 Vienna, Austria
Clinical research services100%
IMP-Logistics Bel, FLLC28, Malinina st. bld.4, Liter A 1-2/k,
Office #3, Minsk Republic of Belarus 220101
Clinical research services100%
Pharmaceutical Research Associates Belgium B.V. ******E19 Business Park
Battelsesteenweg 455D
2800 Mechelen, Belgium
Clinical research services100%
RPS Bermuda, Ltd.Victoria Place, 5th Floor
31 Victoria Street
Hamilton HM 10 Bermuda
Holding company100%
RPS do Brasil Serviços de Pesquisas LTDA.Av. Ibirapuera 2332,
Torre II 4º Andar,
São Paulo, SP,
Brazil,
CEP 04028-003
Clinical research services100%
125




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
RPS China Inc.c/o Tricor Services BVI Limited
P.O. Box 3340
Road Town
Tortola, British Virgin Islands
Holding company100%
Pharmaceutical Research Associates Bulgaria EOOD51b Bulgaria Blvd., Floor 4
Sofia, Bulgaria 1404
Clinical research services100%
3065613 Nova Scotia Company1741 Lower Water Street, Suite 600
Halifax, Nova Scotia B3J 0J2
Holding company100%
Pharmaceutical Research Associates ULC1741 Lower Water Street, Suite 600
Halifax, Nova Scotia B3J 0J2
Clinical research services100%
Services de Recherche Pharmaceutique Srl1741 Lower Water Street, Suite 600
Halifax, Nova Scotia B3J 0J2
Clinical research services100%
PRA Health Sciences Chile SpAMiraflores 222 piso 28
Santiago, Chile
Clinical research services100%
PRA Health Sciences China, Inc.Room 301, Floor 3, Building No. 5, Hongda Industrial Park, No. 8 Hongda North Road, Beijing
Economic-Technological
Development Area, Beijing
Clinical research services100%
PRA Health Sciences Colombia Ltda.Calle 116 No. 7 – 15
Torre Cusezar Oficina 1002
Bogotá
Cundinamarca
Colombia
110111
Clinical research services100%
Research Pharmaceutical Services Costa Rica, LTDA.Sabana Business Center, piso 11
Bulevar Rohrmoser y Calle 68
San José, Costa Rica 10108
Clinical research services100%
Pharm Research Associates d.o.o. za klinicka ispitivanjaRadnička cesta 180,
10 000 Zagreb, Croatia
Clinical research services100%
Pharmaceutical Research Associates Denmark ApSc/o BuusMark Advokater
Sankt Ols Gade 4
4000 Roskilde
Denmark
Clinical research services100%
RPS Estonia OÜPärnu road 22
10141 Tallinn, Republic of Estonia
Clinical research services100%
Pharmaceutical Research Associates Finland OyVattuniemenranta 2
00210 Helsinki, Finland
Clinical research services100%
ReSearch Pharmaceutical Services France S.A.S.55 Avenue des Champs Pierreux
Immeuble le Capitole
92000 Nanterre
France
Clinical research services100%
IMP Logistics Georgia LLCMtatsminda District
Freedom Square N4 (Plot 66/4)
Tbilisi, Georgia
Clinical research services100%
Pharmaceutical Research Associates Georgia LLC42-42a (Building No. 1)
Alexander Kazbegi Avenue
Vake-Saburtalo District
Tbilisi, Georgia
Clinical research services100%
Pharmaceutical Research Associates Greece A.E.81 Ifigeneias Street
Nea Ionia 142 31
Attikis, Athens, Greece
Clinical research services100%
126




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
RPS Guatemala, S.A.5 Avenida 5-55, Zona 14
Edificio Europlaza World Business Center
Torre II, Nivel 9
Guatemala City, Guatemala
Clinical research services100%
PRA Health Sciences (Hong Kong) LimitedUnit 4321 & 4336A, 43/F
AIA Tower, 183 Electric Road
North Point, Hong Kong
Clinical research services100%
RPS Iceland ehf.Skipholti 50D
105 Reykjavik, Iceland
Clinical research services100%
Pharmaceutical Research Associates India Private Limited*******Regus Kaledonia, Unit No 1B
Office No 538, Floor 5 Sahar Road
Off Western Express Highway Andheri(E) Mumbai
Mumbai City
400059 IN
India
Clinical research services100%
Research Pharmaceutical Services (Outsourcing Ireland) LimitedSouth County Business Park,
Leopardstown,
Dublin 18
Ireland
Clinical research services100%
Pharmaceutical Research Associates Israel Ltd.Building E, 13th Floor
4 Haharash Street
Hod Hasharon 4524402 Israel
Clinical research services100%
Pharmaceutical Research Associates Italy S.r.l.Via Porlezza, No. 12
Milan
20123
Italy
Clinical research services100%
PRA Health Sciences Kenya LimitedLR No. 1870/1/176, ALN House,
Eldama Ravine Close,
off Eldama Ravine Road, Westlands
PO Box 764, Sarit Centre, Nairobi, Kenya 00606
Clinical research services100%
RPS Latvia SIABlaumaņa iela 22
1011 Riga, Latvia
Clinical research services100%
UAB RPS LithuaniaUpês street 21,
LT-08128 Vilnius, Lithuania
Clinical research services100%
RPS Malaysia Sdn. Bhd.Level 13, Menara 1 Sentrum
201, Jalan Tun Sambanthan
Brickfields
50470 Kuala Lumpur
Wilayah Persekutuan
Malaysia
Clinical research services100%
Pharmaceutical Research Associates Mexico S. de R.L. de C. V. ********Ave. Insurgentes Sur No. 1602, Desp. 503
Col. Credito Constructor Mexico
Benito Juarez, Distrito Federal
C.P. 03940 Mexico
Clinical research services100%
RPS Research México, S. de R.L. de C.V.Ave. Insurgentes Sur No. 1602, Desp. 502
Col. Credito Constructor Mexico
Benito Juarez, Distrito Federal
C.P. 03940 Mexico
Holding company100%
RPS Research Servicios, S. de R.L. de C.V.Ave. Insurgentes Sur No. 1602, Desp. 502
Col. Credito Constructor Mexico
Benito Juarez, Distrito Federal
C.P. 03940 Mexico
Clinical research services100%
Pharmaceutical Research Associates Group B.V.Van Swietenlaan 6
9728 NZ, Groningen
The Netherlands
Clinical research services100%
127




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
PRA International Operations B.V.Van Swietenlaan 6
9728 NZ, Groningen
The Netherlands
Clinical research services100%
ReSearch Pharmaceutical Services Netherlands B.V.Eduard van Beinumstraat 28,
2 Amsterdam Tower, 12e verdieping, 1077CZ
Amsterdam
Clinical research services100%
Pharmaceutical Research Associates New Zealand LimitedGrant Thornton New Zealand Limited,
L3, 134 Oxford Terrace,
Christchurch, 8140 , New Zealand
Clinical research services100%
RPS Research Norway ASc/o EconPartner AS
Dronning Mauds gate 15
0250 Oslo, Norway
Clinical research services100%
RPS Panama Inc.Urbanización Nuevo Reparto el Carmen No. 58
Calle Primera, Edificio Moreno & Moreno. Local Planta Baja,
Distrito de Panamá, Panamá
Clinical research services100%
RPS Perú S.A.C.Av. Paseo de la República 5895
Oficina 606
Miraflores
Lima 18
Perú
Clinical research services100%
RPS Research Philippines, Inc.24th Floor,
Salcedo Towers
.V. Dela Costa St
Barangay Bel-Air
Salcedo Village
 City, Philippines
Clinical research services100%
Pharmaceutical Research Associates Sp. z o.o.Proximo 1, ul. Prosta 68
Warsaw
Poland
Clinical research services100%
PRA International Portugal, Unipessoal, Lda.Av. da Republica, 50-10
1069-211, Lisboa, Portugal
Clinical research services100%
Research Pharmaceutical Services Puerto Rico, Inc.257 Calle Tetuan
2nd Floor
San Juan
00901
Puerto Rico
Clinical research services100%
Pharmaceutical Research Associates Romania S.R.L.8th Floor, Sky Tower
246c Caleca Floresca
Bucharest 14476 Romania
Clinical research services100%
Joint Stock Company IMP Logistics 8, Energetikov str, v. Lesnoy Gorodok Odintsovsky city disctrict
Moscow region Russia 143080
Clinical research services100%
Pharmaceutical Research Associates Singapore Pte. Ltd.#02-06/10, 21 Biopolis Road
Nucleos, Singapore 138567
Clinical research services100%
Pharmaceutical Research Associates SK s.r.o.Karadžičova 2 Bratislava -Old Town District
Slovenská republika, 81109,
Slovakia
Clinical research services100%
PRA Pharmaceutical S A (Proprietary) Limited2nd Floor Building 29 Highlands Estate
Woodlands Office Park
20 Woodlands Drive Woodmead
Gauteng 2191 South Africa
Clinical research services100%
128




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
Pharmaceutical Research Associates Korea Limited142 Taeheran-ro
Gangnam-gu,
18th Floor (Yeoksam-dong, Capital Tower)
Seoul
Republic of Korea
Clinical research services100%
Pharmaceutical Research Associates España, S.A.U.Avenida de Europa, 19
Edificio 1, 2a Planta
Pozuelo de Alarcon (Madrid)
Spain 28224
Clinical research services100%
RPS ReSearch Ibérica, S.L.U.Avenida de Europa, 19
Edificio 1, 2a Planta
Pozuelo de Alarcon (Madrid)
Spain 28224
Clinical research services100%
RPS Spain S.L.Avenida de Europa, 19
Edificio 1, 2a Planta
Pozuelo de Alarcon (Madrid)
Spain 28224
Clinical research services100%
PRA International Sweden ABKolonivagen 1
SE-226 60 Lund, Sweden
Clinical research services100%
PRA Switzerland AGLange Gasse 15
Basel 4052 Switzerland
Clinical research services100%
Pharmaceutical Research Associates Taiwan, Inc.Aurora Building, 5th Floor
No. 2, Sec 5, Xinyi Road,
Xinyi District, Taipei, Taiwan
Clinical research services100%
RPS Research (Thailand) Co., Ltd.24th Floor, Empire Tower, Tower 3
Unit 2408, 1 South Sathorn Road
Yannawa Sub-District, Sathorn District
Bangkok 10120 Thailand
Clinical research services100%
Pra Turkey Sağlik Araştirma Ve Geliştirme Limited Şirketi Kisikli Caddesi; No. 28, K:1-2
Altunizade, Istanbul
Turkey 34662
Clinical research services100%
Pharmaceutical Research Associates Ukraine, LLC4th Floor,
St. Poleva 24,
Kiev,
Ukraine, 03056
Clinical research services100%
IMP Logistics UK LimitedCannon Place, 78 Cannon Street
London EC4N 6AF England
Clinical research services100%
Pharm Research Associates (UK) LimitedCannon Place, 78 Cannon Street
London EC4N 6AF England
Clinical research services100%
Sterling Synergy Systems LimitedCannon Place, 78 Cannon Street
London EC4N 6AF England
Holding company100%
ClinStar LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
Nextrials, Inc.731 Arbor Way, Suite 100
Blue Bell, PA 19422
Clinical research services100%
Pharmaceutical Research Associates CIS, LLC 4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
Pharmaceutical Research Associates Eastern Europe, LLC 4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
Care Innovations, Inc.950 Iron Point Road, Ste. 160
Folsom, CA 95630
Clinical research services100%
129




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
Care Innovations, LLC950 Iron Point Road, Ste. 160
Folsom, CA 95630
Clinical research services100%
CRI NewCo, Inc.4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
CRI Worldwide, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
International Medical Technical Consultants, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
Parallel 6, Inc.4131 Parklake Avenue, Suite 600, Raleigh, North Carolina 27612Clinical research services100%
PRA Early Development Research, Inc. 9755 Ridge Drive
Lenexa, Kansas 66219
Clinical research services100%
PRA Health Sciences, Inc.4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
PRA Holdings, Inc.4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
PRA International, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
PRA Receivables, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
ReSearch Pharmaceutical Services, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
ReSearch Pharmaceutical Services, Inc.731 Arbor Way, Suite 100
Blue Bell, PA 19422
Clinical research services100%
Roy RPS Holdings LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
RPS Global Holdings, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
RPS Parent Holding LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
Source Healthcare Analytics, LLC731 Arbor Way, Suite 100
Blue Bell, PA 19422
Clinical research services100%
Sunset Hills, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Holding company100%
Symphony Health Solutions Corporation731 Arbor Way
Suite 100
Blue Bell, PA 19422
Clinical research services100%
CRI International, LLC4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
Lifetree Clinical Research, LC1255 East 3900 South, Salt Lake City, Utah 84124Clinical research services100%
130




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
Pharmaceutical Research Associates, Inc.4131 Parklake Avenue
Suite 600
Raleigh, NC 27612
Clinical research services100%
RPS Global S.A.Plaza Cagancha 1145, 4th Floor
Montevideo, Uruguay 11100
Clinical research services100%
RPS Latin America S.APlaza Cagancha 1145, 4th Floor
Montevideo, Uruguay 11100
Clinical research services100%
PRA Clinical Limited*********South County Business Park,
Leopardstown,
Dublin 18
Ireland
Clinical research services100%
ICON Clinical Research Holdings (U.K.) Limited500 South Oak Way Green Park Reading RG2 6AD United KingdomInvestment holding company100%
ICON Clinical Research Holdings (Ireland) Unlimited CompanySouth County Business Park,
Leopardstown,
Dublin 18
Ireland
Investment holding company100%
RPS do Brasil Serviços de Pesquisas Ltda. Av. Ibirapuera 2332,
Torre II 4º Andar,
São Paulo, SP,
Brazil,
CEP 04028-003
Clinical research
services
100%
ICON Clinical Research Czech Republic s.r.o. Prague 7,
Jankovcova 1569/2c, 170 00,
Czech Republic
Clinical research
services
100%
ICON Clinical Research Egypt Limited Liability Company40 Road 254, Shell Building, 5th
Floor
Degla, Maadi, 11431 Cairo,
Egypt
Maadi 11431, Cairo, Egypt
Clinical research
services
100%
Oncacare France SASImmeuble le Capitole
55 Avenue des Champs Pierreux
92000
Nanterre
France
Clinical research
services
100%
Oncacare (Germany) GmbH Heinrich-Hertz-Strabe 26
63225
Langen
Hessen
Germany
Clinical research
services
100%
Averion Europe GmbH i.LKonrad-Zuse-Platz 11
81829 München
Germany
Clinical research
services
100%
ICON Clinical Research Limited Liability CompanySzepvolgyi ut 39
HU-1037 Budapest
Hungary
Clinical research
services
100%
131




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
Oncacare LimitedSouth County Business Park
Leopardstown
Dublin 18
D18 X5R3
Ireland
Clinical research
services
100%
Oncacare Italy S.r.lVia Benigno Crespi, n. 19, 20159, Milano
Italy
Clinical research
services
100%
ICON Clinical Research GK1-3 Kyutaro-machi 4-chome,
Chuo-ku, Osaka 541-0056
Japan
Clinical research
services
100%
Symphony Clinical Research Sp z.o.o.ul. Potokowa 26
80-283
Gdansk
Poland
Clinical research
services
100%
ICON Clinical Research Poland Sp z o.o.Proximo 1
ul. Prosta 68
Warsaw
Poland
Clinical research
services
100%
ICON Clinical Research doo Beograd4th Floor,
Bulevar Zorana Djindjica 64a,
11070 Belgrade,
Serbia
Clinical research
services
100%
Pharmaceutical Research Associates doo Belgrade 19th Avenue
Vladimira Popovica 38-40
Belgrade, 11070 Serbia
Clinical research
services
100%
RPS Research South Africa (Proprietary) Limited 15 Greenwich Grove, Station
Road, Rondebosch, Western
Cape, 7700, South Africa
Clinical research
services
100%
Mapi Korea Yuhan Hoesa/ Mapi Korea LLC16th Floor
396 Seocho-daero
Seocho-gu
Seoul 06619
Republic of Korea
Dormant100%
ICON Clinical Research Korea Limited142 Taeheran-ro
Gangnam-gu,
18th Floor (Yeoksam-dong,
Capital Tower)
Seoul
Republic of Korea
Clinical research
services
100%
Oncacare (Spain), S.L.Calle Josep Pla
Numero 2, Torre Diagonal Mar
Piso 11, Modulo 1
Barcelona
Spain
Clinical research
services
100%
IMP-Logistics Ukraine LLC 8,Viskozna st. Kyiv Ukraine
02094
Logistics100%
132




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
Aptiv Solutions (UK) Ltd 500 South Oak Way Green Park
Reading
RG2 6AD
United Kingdom
Clinical research
services
100%
OncaCare (U.K.) Limited500 South Oak Way
Green Park
Reading
Berkshire
RG2 6AD
United Kingdom
Clinical research
services
100%
VirtualScopics, LLC 155 Corporate Woods
Suite 180
Rochester
NY
14623
Clinical research
services
100%
BioTel Research, LLC 155 Corporate Woods
Suite 180
Rochester NY 14623
United States
Clinical research
services
100%
ICON HF Corp. **********731 Arbor Way
Suite 100
Blue Bell, PA
United States, 19422
Clinical research
services
100%
Oncacare, Inc.c/o Corporation Service Company
251 Little Falls Drive
Wilmington
County of New Castle DE 19808
United States
Clinical research
services
100%
ICON Research Ltd. Radnicka cesta 80,
Zagreb,
Croatia
Clinical research
services
100%
Pharmaceutical Research Associates Hungary Research and Development Ltd. Szepvolgyi ut 39
HU-1037 Budapest
Hungary
Clinical research
services
100%
ICON Clinical Research India Private LimitedCHENNAI ONE IT PARK ITE/
ITES SEZ North Block
Block B, 4th Floor,
Thoraipakkam
Chennai, Tamil Nadu-TN
600097, India
Clinical research
services
100%
CRN NORTH AMERICA, LLC3 Parkway North
Suite 200
Deerfield, IL 60015
United States
Clinical research
services
100%
Pharmaceutical Research Associates Ltda.Av. Ibirapuera 2332,
Torre II 4º Andar,
São Paulo, SP,
Brazil,
CEP 04028-003
Clinical research services100%
Clinical Resource Network, LLC3 Parkway North
Suite 200
Deerfield, IL 60015
United States
Clinical research
services
100%
133




Notes to Consolidated Financial Statements (continued)
for the year ended 31 December 2023

32. Subsidiary undertakings (continued)
NameRegistered Office**********Nature of businessProportion held by
Group
* majority of which is held directly by ICON plc.
** DOCS International Belgium N.V. merged out of existence on 1 January 2024.
*** Mapi Research Trust is an association, its members are ICON Subsidiary entities.
****DOCS International B.V. changed registered address as at 31 March 2024 to Van Swietenlaan 6, 9728 NZ Groningen, The Netherlands.
***** ICON Clinical Research Taiwan Limited changed registered address as at 5 February 2024 to 5th Floor No. 2, Sec 5 Xinyi Road, Xinyi District, Taipei, Taiwan
******Pharmaceutical Research Associates Belgium B.V. changed name to ICON Clinical Research Belgium B.V. with effect from 1 January 2024 and changed registered address as at 19 February 2024 to Kardinaal Mercierplein 2, 2800 Mechelen, Belgium.
*******Pharmaceutical Research Associates India Private Limited changed registered address as at 24 February 2024 to Level 3 & 4, Prestige Blue Chip Software Park, Municipal No 9, Hosur Road, Adugodi, Madiwala Range, Ward No 63, Bangalore – 560029, Karnataka.
********Pharmaceutical Research Associates Mexico S. de R.L. de C. V. changed registerd address as at 26 March 2024 to Avenida Insurgentes Sur 1271, Piso 16, Interior 1601, Colonia Extremadura Insurgentes, CP 03740, Benito Juarez, CDMX,
Mexico.
*********PRA Clinical Limited was struck off 8 January 2024.
**********ICON HF Corp. merged out of existence on 9 January 2024.
***********Principal office address used for U.S. entities

33.    Approval of financial statements

The Board of Directors approved these financial statements on 23 April 2024.
134





Company Statement of Financial Position
for the year ended 31 December 2023

Note31 December 202331 December 2022
$’000$’000
ASSETS
Non-current assets
  Property, plant and equipment1311 276 
  Right-of-use assets 816 727 
  Investment in subsidiaries27,149,445 7,086,423 
  Other non-current assets 35 32 
  Deferred tax asset3399 329 
Total non-current assets7,150,206 7,087,787 
Current assets
  Other current assets41,313 2,437 
  Amounts due from subsidiary undertakings5191,711 146,898 
  Deferred tax asset2 
  Cash and cash equivalents8,433 6,944 
Total current assets201,459 156,281 
Total assets7,351,665 7,244,068 
EQUITY
  Share capital6,699 6,649 
  Share premium523,646 472,723 
  Merger reserve5,656,195 5,656,195 
  Other undenominated capital1,162 1,162 
  Share-based payment reserve282,520 326,803 
  Other reserve27,405 6,071 
  Foreign currency reserve(112,848)(114,392)
  Retained earnings949,128 866,648 
Total equity attributable to equity holders7,333,907 7,221,859 
LIABILITIES
Non-current liabilities
  Non-current other liabilities6 5,353 
Total non-current liabilities 5,353 
Current liabilities
  Accounts payable269 773 
  Amounts due to subsidiary undertakings5798 1,001 
  Accrued and other liabilities616,517 14,748 
  Current taxes payable174 334 
Total current liabilities17,758 16,856 
Total liabilities17,758 22,209 
Total equity and liabilities7,351,665 7,244,068 

On behalf of the Board


Steve Cutler
Rónán Murphy
Chief Executive Officer
Director
135





Company Statement of Changes in Equity
for the year ended 31 December 2023
Number
of shares
Share
Capital
Share
Premium
Merger ReserveOther Unde- nominated
Capital
Share
Based
Payment
Reserve
Other
Reserve
Foreign Currency ReserveRetained
Earnings
Total Equity
$’000$’000$’000$’000$’000$’000$’000$’000$’000
Balance at 1 January 202381,723,555 6,649 472,723 5,656,195 1,162 326,803 6,071 (114,392)866,648 7,221,859 
Loss for the year— — — — — — — — (8,958)(8,958)
Other comprehensive income
  Foreign currency translation— — — — — — — 1,544 — 1,544 
Total other comprehensive income— — — — — — — 1,544 — 1,544 
Total comprehensive income for the year — — — — — — — 1,544 (8,958)(7,414)
Transactions with owners, recorded directly in equity
  Share-based payment— — — — — 47,171 — — — 47,171 
  Exercise of share options535,705 35 50,923 — — — — — — 50,958 
  Share issue costs— — — — — — — — (16)(16)
  Issue of restricted share units/ performance share units235,826 15 — — — — — — — 15 
  Group reorganisation (note 2)— — — — — — 21,334 — — 21,334 
  Transfer of exercised and expired share-based awards  — — — — — (91,454)— — 91,454 — 
Total contributions by and distributions to owners 771,531 50 50,923 — — (44,283)21,334 — 91,438 119,462 
Balance at 31 December 202382,495,086 6,699 523,646 5,656,195 1,162 282,520 27,405 (112,848)949,128 7,333,907 

As permitted by section 504 of the Companies Act, the Company has not presented a Company Statement of Profit and Loss. The loss for the 2023 financial year of the Company amounted to $8,958,000 (2022: $2,552,000).

136





Company Statement of Changes in Equity
for the year ended 31 December 2023
Number
of shares
Share
Capital
Share
Premium
Merger ReserveOther Undenominated
Capital
Share-
based
Payment
Reserve
Other
Reserve
Foreign Currency ReserveRetained
Earnings
Total Equity
$’000$’000$’000$’000$’000$’000$’000$’000$’000
Balance at 1 January 202281,554,683 6,640 436,916 5,656,195 1,134 342,637 6,071 (113,914)897,509 7,233,188 
Loss for the year— — — — — — — — (2,552)(2,552)
Other comprehensive loss
  Foreign currency translation— — — — — — — (478)— (478)
Total other comprehensive loss— — — — — — — (478)— (478)
Total comprehensive loss for the year — — — — — — — (478)(2,552)(3,030)
Transactions with owners, recorded directly in equity
  Share-based payment— — — — — 55,874 — — — 55,874 
  Exercise of share options348,286 21 35,807 — — — — — — 35,828 
  Share issue costs— — — — — — — — (17)(17)
  Issue of restricted share units/ performance share units241,116 16 — — — — — — — 16 
  Repurchase of ordinary shares(420,530)(28)— — 28 — — — (99,983)(99,983)
  Share repurchase costs— — — — — — — — (17)(17)
  Transfer of exercised and expired share-based awards  — — — — — (71,708)— — 71,708 — 
Total contributions by and distributions to owners 168,872 35,807 — 28 (15,834)— — (28,309)(8,299)
Balance at 31 December 202281,723,555 6,649 472,723 5,656,195 1,162 326,803 6,071 (114,392)866,648 7,221,859 


137




Notes to Company Financial Statements
for the year ended 31 December 2023

1.    Property, plant and equipment
PLC
Leasehold improvementsComputer equipmentOffice furniture & fixturesTotal
$’000$’000$’000$’000
Cost
At 1 January 2023353 630 903 1,886 
Additions929217255
Disposals(10)(45)(460)(515)
Foreign currency movement38 66 70 174 
At 31 December 2023390 680 730 1,800 
Depreciation
At 1 January 2023348 621 641 1,610 
Charge for the year11 65 84 
Disposals(10)(45)(303)(358)
Foreign currency movement38 65 50 153 
At 31 December 2023384 652 453 1,489 
Net book value
At 31 December 20236 28 277 311 
At 31 December 2022262 276 
Leasehold improvementsComputer equipmentOffice furniture & fixturesTotal
$’000$’000$’000$’000
Cost
At 1 January 2022965 1,910 1,775 4,650 
Additions32932
Disposals(533)(1,125)(765)(2,423)
Foreign currency movement(79)(158)(136)(373)
At 31 December 2022353 630 903 1,886 
Depreciation
At 1 January 2022958 1,886 1,437 4,281 
Charge for the year16 81 98 
Disposals(533)(1,125)(764)(2,422)
Foreign currency movement(78)(156)(113)(347)
At 31 December 2022348 621 641 1,610 
Net book value
At 31 December 20225 9 262 276 
At 31 December 202124 338 369 
138




Notes to Company Financial Statements (continued)
for the year ended 31 December 2023

2.    Investment in subsidiaries


Investment in Subsidiary Undertakings
$’000
Cost
At 1 January 20226,974,348 
Additions183,051 
Redemptions(83,000)
Share-based payment42,431 
Share subscription payment from subsidiary companies(30,407)
At 31 December 20227,086,423 
Additions265,086 
Redemptions(105,936)
Share-based payment41,832 
Share subscription payment from subsidiary companies(137,960)
At 31 December 20237,149,445 
On 1 July 2023, ICON plc transferred the trade of its Italian branch to ICON Holdings Clinical Research International Limited in exchange for the allotment and issuance of 9,214 ordinary shares of €1.00 each in the share capital of ICON Holdings Clinical Research International Limited, issued at a premium of €2,086.85 per share. The disposal of the trade has resulted in a gain of $13.5 million being recorded in Other Reserves in the Company Statement of Changes in Equity.
On 26 July 2023, ICON plc subsequently contributed its interest in ICON Holdings Clinical Research International Limited to ICON Holdings Unlimited Company. The transaction resulted in ICON Holdings Clinical Research International Limited moving from a direct to indirect subsidiary and had no impact on the Company’s financial assets.

On 1 October 2023, ICON plc transferred its interest in ICON Japan, with a carrying value of $3.1 million, to PRA Health Sciences KK in exchange for a loan note of amounting to $10.9 million. The transaction resulted in the Company recording a gain on disposal of $7.8 million in Other Reserves in the Company Statement of Changes in Equity.


139




Notes to Company Financial Statements (continued)
for the year ended 31 December 2023

3.    Deferred taxation
The net deferred tax asset at 31 December 2023 and 31 December 2022 was as follows:

31 December
2023
31 December
2022
$'000$'000
Deferred taxation assets
Accrued expenses and payments on account387 318 
Property, plant and equipment12 11 
Total deferred taxation assets399 329 

1 January 2023Recognised in Income31 December
2023
$'000$'000$'000
Deferred taxation assets
Accrued expenses and payments on account
318 69 387 
Property plant and equipment
11 12 
Total deferred taxation assets329 70 399 

1 January 2022Recognised in Income31 December
2022
$'000$'000$'000
Deferred taxation assets
Accrued expenses and payments on account
435 (117)318 
Property, plant and equipment
11 
Loans to subsidiaries
50 (50)— 
Total deferred taxation assets491 (162)329 

At 31 December 2023 and 31 December 2022 the Company had no operating loss carry forwards for income tax purposes. At 31 December 2023 the Company had an unrecognised deferred tax asset in respect of unutilised foreign tax credits carried forward of $8.8 million (2022: $8.8 million).
140




Notes to Company Financial Statements (continued)
for the year ended 31 December 2023

4.    Other current assets
31 December
2023
31 December
2022
$’000$’000
Prepayments407 301 
Other receivables906 2,136 
Total1,313 2,437 


5.    Amounts due from/to subsidiary undertakings
31 December
2023
31 December
2022
$’000$’000
Amounts due from subsidiary undertakings191,711 146,898 
Amounts due to subsidiary undertakings(798)(1,001)

Amounts owed by subsidiary undertakings are non-interest bearing and repayable on demand. All amounts fall due within one year. No allowance for expected credit losses has been recorded as amounts are expected to be fully recovered.


6.    Accrued and other liabilities

31 December
2023
31 December
2022
$’000$’000
Non-current other liabilities
Lease Liabilities 364 
Other liabilities 4,989 
Total 5,353 

31 December
2023
31 December
2022
$’000$’000
Current liabilities
Current lease liabilities16 832 
Accruals and other liabilities16,501 13,916 
Total16,51714,748

7.    Related parties

Directors and Executive Officers of the Parent Company are the same as those for the Group. For information on transactions with Directors and Executive Officers see note 30 Related parties, to the Consolidated Financial Statements, and for information on Directors’ remuneration see note 10 Payroll and related benefits.


141




Notes to Company Financial Statements (continued)
for the year ended 31 December 2023

8.    Leases
Right-of-use assets
The Company has the following right-of-use assets:
PremisesEquipmentTotal
$'000$'000$'000
Depreciation charge for 2023453  453 
Right-of-use assets at 31 December 202316  16 
Depreciation charge for 20221,041 1,042 
Right-of-use assets at 31 December 2022727 — 727 
Additions to right-of-use assets during 2023 were $0.04 million (2022: $0.30 million).
The weighted average remaining lease term as at 31 December 2023 is 0.46 years (2022: 1.09 years).
Lease liabilities
Future minimum lease payments under non-cancellable leases as of 31 December 2023 were as follows:
Minimum rental payments
$'000
202416 
Total future minimum lease payments 16 
Lease imputed interest— 
Total16 
Lease liabilities are presented as current and non-current. Current lease liabilities of $0.02 million have been included in accrued and other liabilities as at 31 December 2023 (2022: $0.8 million).
Amounts recognised in profit or loss
The following amounts were recognised in profit and loss:
31 December
2023
31 December
2022
$'000$'000
Depreciation of right-of-use assets453 1,042 
Interest on lease liabilities 

The depreciation cost of right-of-use assets is recorded within other operating expenses and interest on lease liabilities is recorded within finance costs.
During the year ended 31 December 2023 and the year ended 31 December 2022, the Company did not incur any costs related to variable lease payments.

9. Litigation

The Company is not party to any litigation or other legal proceedings that the Company believes could reasonably be expected to have a material adverse effect on the Company’s business, results of operations and financial position. 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.
142




Notes to Company Financial Statements (continued)
for the year ended 31 December 2023

10.    Financial instruments


The Company is exposed to various financial risks in the normal course of the business. The Company’s financial instruments typically comprise cash and accounts payable. The main purpose of these financial instruments is to provide finance for the Company’s operations. The main risks arising from the Company’s financial instruments are credit risk, liquidity risk, foreign exchange risk and interest rate risk.

Credit risk
Intercompany loans receivable and payable are initially recognised at fair value. These are subsequently measured at amortised cost, less any loss allowance. An expected credit loss assessment was performed in respect of the receivables at 31 December 2023 and 31 December 2022. The identified impairment loss was immaterial.

Credit risk is the risk of financial loss to the Company if a customer or counterparty to a financial instrument fails to meet its contractual obligations. Credit risk in respect of the Company arises on balances due from group companies. As the Group is financially sound and the subsidiary entities that the Company trades with are in a position to make payments as and when they fall due, the Company has assessed the exposure to credit risk as low.

Liquidity risk
Liquidity risk is the risk that the Company will not be able to meet its financial obligations as they fall due. The Company’s liquidity risk arises from the repayment of short-term debt and other obligations as they fall due. The Company minimises liquidity risk by ensuring that sufficient cash balances and committed bank lines of credit are available to meet its obligations as they fall due. The Company’s bank credit lines and facilities are the same as the Group. Details of the Group’s bank credit lines and facilities are set out in note 23 Bank credit lines and loan facilities.

The following table sets out details of the maturity of the Company’s financial liabilities into the relevant maturity groupings based on the remaining period from the financial year end date to the contractual maturity date:

Year ended 31 December 2023:



Carrying
Amount
$’000
Contractual Cashflows
$’000
Under 1 year
$’000
1 to 2
years
$’000
2 to 5
years
$’000
More than
5 years
$’000
Accounts payable— — — — — — 
Lease liability 16 16 16 — — — 
Accruals and other liabilities16,501 16,501 16,501 — — — 
16,517 16,517 16,517    

Year ended 31 December 2022:



Carrying
Amount
$’000
Contractual Cashflows
$’000
Under 1 year
$’000
1 to 2
years
$’000
2 to 5
years
$’000
More than
5 years
$’000
Accounts payable— — — — — — 
Lease liability1,196 1,199 832 295 72 — 
Accruals and other liabilities18,905 18,905 13,916 234 1,616 3,139 
20,101 20,104 14,748 529 1,688 3,139 

Foreign currency risk
While the functional currency of the Company is USD, the functional currency of the branches is Euro. As a consequence, the results, when translated into U.S. dollars, could be affected by fluctuations in exchange rates against the U.S. dollar. At 31 December 2023 the Company had $Nil US dollar denominated bank loans (2022: $Nil).

Interest rate risk
The Company finances its operations through a mixture of shareholders’ funds, borrowings and working capital. The Company borrows in required currencies at both fixed and floating interest rates. In general the Company borrows at floating rates of interest but may borrow at fixed rates depending on rates available having regard to current market rates and future trends. The Company has no external borrowings.
143




Notes to Company Financial Statements (continued)
for the year ended 31 December 2023

10.    Financial instruments (continued)
Fair values
Financial instruments are measured in the Statement of Financial Position at fair value using a fair value hierarchy of valuation inputs. The hierarchy prioritises the inputs into three levels based on the extent to which inputs used in measuring fair value are observable in the market. Each fair value measurement is reported in one of three levels, which is determined by the lowest level input that is significant to the fair value measurement in its entirety.

The carrying values of amounts due from subsidiary undertakings, cash and cash equivalents, other current assets, accounts payable and accruals and other liabilities are carried at amortised cost and assumed to be approximate to their fair values due to the short-term nature of these balances.

Amounts owed by subsidiary undertakings are non-interest bearing and repayable on demand. All amounts are therefore recorded as due within one year. Fair value is deemed to equal carrying value on this basis.

Each category of asset and liability has remained within the same level of hierarchy as the prior year as there has been no change in the extent to which the inputs used in measuring fair value are or are not observable within the market.

11.    Approval of financial statements

The Board of Directors approved the Company Financial Statements on 23 April 2024.

144






Reconciliation from IFRS to US Accounting Policies
The Consolidated Financial Statements set out on pages 38 to 134 have been prepared in accordance with International Financial Reporting Standards (“IFRS”), as adopted by the European Union (“EU IFRS”), which differ in certain significant respects from generally accepted accounting principles applicable in the U.S. (“U.S. GAAP”). The material differences as they apply to the Consolidated Financial Statements are as follows:

(a) Financial statement format

The format of the financial statements and certain note disclosures differ under U.S. GAAP from those under EU IFRS. The Group prepared a U.S. Securities and Exchange Commission Form 20-F Report which was made available to all shareholders in February 2024. The financial statements included in such Form 20-F are prepared in accordance with U.S. GAAP.

(b) Merger with PRAI

The Group accounts for business combinations under EU IFRS in accordance with the IFRS 3 Business Combinations. As permitted by IFRS 1 First Time Adoption of International Financial Reporting Standards the Group has only restated business combinations from 1 June 2001 onwards. Business combinations prior to this date have not been restated. In addition, goodwill has no longer been amortised since 1 June 2001, but rather is tested annually for impairment. U.S. GAAP adopts different criteria to EU IFRS for establishing the method of accounting to be adopted for business combinations. On 28 January 2000, the Group completed a transaction with Pacific Research Associates Inc. (“PRAI”), a Group specialising in data management, statistical analysis and medical and regulatory consulting based in San Francisco, USA. The merger with PRAI was accounted for using acquisition accounting principles in accordance with EU IFRS whilst U.S. GAAP required that the merger be accounted for using the pooling-of-interest method of accounting. U.S. GAAP pooling-of-interest accounting has resulted in a number of adjustments. Most significantly:

(i)the Group’s historic U.S. GAAP financial statements have been restated to reflect the combined results of ICON and PRAI;
(ii)the costs of the merger were expensed for U.S. GAAP purposes and included in the cost of acquisition for IFRS;
(iii)goodwill arising on IFRS has been amortised over its expected useful life up to 31 May 2001. No goodwill arose on the merger under U.S. GAAP;
(iv)the tax charge arising on the conversion of PRAI from an S-Corporation to a C-Corporation is treated as a pre-acquisition charge under IFRS.

(c) Share-based payment expense

IFRS requires that the fair value of share-based payments be expensed to the Consolidated Statement of Profit and Loss over the period the related services are received, with a corresponding increase in equity. The Group has accounted for share-based payments under U.S. GAAP in accordance with ASC 718, Compensation – Stock Compensation, which also requires that the fair value of share-based payments be expensed to the Consolidated Statement of Profit and Loss over the period the related services are received, with a corresponding increase in equity.

There is a difference in recorded expense. U.S. GAAP requires that the accelerated graded vesting attribution approach is applied in respect of awards with straight line graded vesting. IFRS requires that each instalment of an award where there is graded vesting is treated as a separate grant with a different fair value. Each instalment is therefore separately measured and charged to the Consolidated Statement of Profit and Loss over the related vesting period. This results in accelerated expense recognition under IFRS.

(d) Stock-based Compensation Arrangements in a Business Combination

An exchange of share-based payment awards in a business combination is treated as a modification under IFRS 2. The replacement awards and the original acquiree awards should both be measured at fair value at the acquisition date and calculated using the fair-value-based measurement principles in IFRS 2.

U.S. GAAP requires the attribution of compensation cost for the acquirer’s replacement awards in the post-combination financial statements to be based on the acquirer’s attribution policy (i.e., straight-line approach or graded-vesting approach). Under IFRS, however, the graded vesting approach is required for all awards with graded vesting features based on the requirements in IFRS 2.




145






Reconciliation from IFRS to US Accounting Policies (continued)
(e) IAS 19R Defined Benefit Pensions

The Group has recognised the net interest expense of the defined benefit pension scheme within payroll costs (operating expenses) in the Consolidated Statement of Profit and Loss under IAS19R which is consistent with the U.S. GAAP treatment of this cost. Additional net credits related to the defined benefit pension schemes refer to the adjustment required to reverse the application of the corridor approach permitted under U.S. GAAP and the different net interest expense recorded under IFRS and U.S. GAAP.

(f) Current tax and deferred tax assets

Deferred tax asset

U.S. GAAP, ASC 740, Income Taxes requires recognition of a deferred tax asset in respect of the cumulative amount of compensation cost recognised in the financial statements in respect of unexercised options that will give rise to a future tax deduction. The tax deduction is based on the intrinsic value of the options, with the full tax deduction recorded in profit or loss in the year of exercise.

IFRS also requires that a deferred tax asset is recognised in respect of options not yet exercised where a tax deduction will arise. IAS 12 Income taxes requires that the tax deduction is estimated. The fair value estimate is based on the share price at the exercise date.

Current tax benefit

U.S. GAAP, ASC 740, Income Taxes requires recognition of a current tax benefit of certain tax deductions arising from Share-based payment windfall gains in the Consolidated Statement of Operations. IFRS requires that the current tax benefit of these Share-based payment windfall gains is recognised through Equity, in the Share-based payment reserve.

(g) IFRS 16 Leases

Under U.S. GAAP, ASC 842 Leases, lessees account for leases as operating or finance. Costs in respect of operating leases are charged to the Consolidated Statement of Operations on a straight-line basis over the lease term. Lease costs for all leases under IFRS 16 are comprised of the depreciation of right-of-use assets and the interest charge in respect of the associated lease liability.

(h) Contract Assets and Contract Liabilities in a Business Combination

In October 2021, the FASB issued ASU 2021-08 "Business Combinations (Topic 805) - Accounting for Contract Assets and Contract Liabilities from Contracts with Customers". The amendments in this ASU require that an entity (acquirer) recognise and measure contract assets and contract liabilities acquired in a business combination in accordance with Topic 606. At the acquisition date, an acquirer should account for the related revenue contracts in accordance with Topic 606 as if it had originated the contracts. The Company has adopted the amendments in this ASU for year ended 31 December 2021 and has applied the amendments of this ASU to the Merger with PRA, completed on 1 July 2021.

IFRS 3 Business Combinations does not have a similar fair value measurement exception for contract assets and contract liabilities. As a result, contract liabilities will have a lower valuation under IFRS compared to U.S. GAAP with the valuation adjustment being charged to revenue over the life of the contract with the customer.

(i) Measurement period adjustments (acquisition accounting)

Under U.S. GAAP, ASC 805 Business Combinations, any adjustments which are made to provisional acquisition accounting (i.e., measurement period adjustments) are reflected in the current period. Under IFRS, measurement period adjustments are reflected through retrospective application to the period in which the acquisition occurred. As such, measurement period adjustments recorded during 2022, in connection with the finalisation of acquisition accounting for the PRA Acquisition, have been applied retrospectively for IFRS purposes. Measurement period adjustments primarily consist of final acquisition accounting adjustments to goodwill, intangible assets and the related deferred tax impact.

146






Reconciliation from IFRS to US Accounting Policies (continued)
The following is a summary of the material adjustments to profit for the financial year and shareholders’ equity, which would be required, had the Consolidated Financial Statements been prepared in accordance with U.S. GAAP:

(i)Effect on profit for the financial year
31 December
2023
31 December
2022
$’000$’000
Profit for the financial year attributable to equity holders of the Company as stated under IFRS609,024 506,285 
U.S. GAAP adjustments
Share-based payment expense under IFRS (c) (d)51,380 55,790 
Share-based payment expense under U.S. GAAP (c) (d)(55,665)(70,523)
Fair value adjustment to unearned revenue under IFRS (h) 8,000 
Amortisation adjustment related to measurement period adjustment under IFRS (i) (2,167)
Right-of-use asset amortisation adjustment under IFRS (g)436 1,179 
Deferred tax adjustments on share-based payments (f)2,664 6,572 
Current tax adjustments on share-based payments (f)4,323 (313)
Deferred tax adjustments on leases (f)(108)(156)
Additional costs of defined benefit pension scheme (e)281 637 
Net income as stated under U.S. GAAP612,335 505,304 
Basic earnings per Ordinary Share under U.S. GAAP$7.46 $6.20 
Diluted earnings per Ordinary Share under U.S. GAAP$7.40 $6.13 







147






Reconciliation from IFRS to US Accounting Policies (continued)
(ii) Effect on shareholders’ equity
31 December
2023
31 December
2022
$’000$’000
Total equity attributable to the owners of the Company as stated under IFRS9,322,815 8,569,982 
U.S. GAAP adjustments
Goodwill (net) arising on PRA merger related stock compensation (d)(58,199)(58,199)
Fair value adjustment to unearned revenue under IFRS (h)16,000 16,000 
Right-of-use asset amortisation adjustment under IFRS (g)3,070 2,634 
Deferred tax adjustments on leases (f)(942)(834)
Taxes on unearned revenue (f)(4,104)(4,104)
Goodwill (net) arising on merger with PRAI (b)(14,009)(14,009)
Deferred tax adjustments on share-based payments (f)(23,888)(13,507)
Total equity attributable to the owners of the Company as stated under U.S. GAAP9,240,743 8,497,963 

(iii) Effect on total assets
31 December
2023
31 December
2022
$’000$’000
Total assets as stated under IFRS 17,071,170 17,256,640 
U.S. GAAP adjustments
Right-of-use asset amortisation adjustment under IFRS (g)3,070 2,634 
Goodwill (net) arising on PRA merger related stock compensation (d)(58,199)(58,199)
Goodwill (net) arising on merger with PRAI (b)(14,009)(14,009)
Goodwill on fair value adjustment to unearned revenue under IFRS (h)16,000 16,000 
Deferred tax adjustments on share-based payments (f)(27,995)(17,614)
Goodwill (net) arising on PRA merger related right-of-use assets (g)(174)(174)
Total assets as stated under U.S. GAAP16,989,863 17,185,278 

(iv) Effect on total liabilities
31 December
2023
31 December
2022
$’000$’000
Total liabilities as stated under IFRS 7,748,355 8,686,658 
U.S. GAAP adjustments
Deferred tax adjustments on leases (f)765 657 
Total liabilities as stated under U.S. GAAP7,749,120 8,687,315 
148







Appendix A: Risk Factors
Risk Related to Our Business and Operations

The potential loss or delay of our large contracts, or of multiple contracts, could adversely affect our results.

Our clients may discontinue using our services completely or cancel some projects either without notice or upon short notice. The termination or delay of a large contract, or of multiple contracts, could have a material adverse effect on our revenue and profitability. Historically, clients have canceled or discontinued projects and may in the future cancel their contracts with us for reasons including, amongst others:
 
the failure of products being tested to satisfy safety or efficacy requirements;
unexpected or undesired clinical results of the product; 
a decision that a particular study is no longer necessary or viable;
poor project performance, quality concerns, insufficient patient enrollment or investigator recruitment; and 
production problems resulting in shortages of the drug.
 
As a result, contract terminations, delays or other changes are part of our clinical services business. In the event of termination, our contracts often provide for fees for winding down the trial but these fees may not be sufficient for us to maintain our margins, and termination may result in lower resource utilisation rates. In addition, we may not realise the full benefits of our unsatisfied performance obligation of contractually committed services if our clients cancel, delay or reduce their commitments under our contracts with them. Therefore, the loss, early termination or delay of a large contract or contracts could adversely affect our revenues and profitability.

If we do not generate new business awards, or if new business awards are delayed, terminated, reduced in scope or fail to go to contract, our business, financial conditions, results of operations or cash flows may be materially adversely affected.

Our business is dependent on our ability to generate new business awards from new and existing customers and maintain existing customer contracts. If we were unable to generate new business awards on a timely basis and contract for those awards, that could have a material impact on our business, financial condition, results of operations or cash flows.

We depend on a limited number of customers and a loss of, or significant decrease in, business from one or more of them could affect our business.
 
While no customers individually contributed more than 10% of our revenues during the years ended 31 December 2023 and 31 December 2022, our top five customers represented 26.8% and 28.3% of our revenues, respectively. The loss of, or a significant decrease in, business from one or more of these key customers could have a material adverse impact on our results of operations and financial results.

The inability of biotechnology customers to raise adequate financing or funding could affect our business.

A portion of our revenue is generated from sales and services to the biotechnology industry. The clients we serve are commonly subject to financial pressures, including, but not limited to, the ability to obtain adequate financing or generate sufficient funding. To the extent our clients face such pressures, or they change how they utilise our offerings, the demand for our services, or the prices our clients are willing to pay for those services, may decline. Any such decline could have a material adverse effect on our business, operating results and financial condition.

Our financial results may be adversely impacted if we underprice our contracts, overrun our cost estimates or fail to receive approval for, or experience delays in, documenting change orders.
 
Many of our contracts are long-term fixed price or fixed unit price contracts for services. As a result, variations in the timing and progress of large contracts may materially adversely affect our results of operations. Revenue recognised on these service contracts are based on an assessment of progress towards completion being the cost of time and other third party costs as a percentage of total estimated time and other third party costs to deliver our services. As a result, variations in the timing and progress of large contracts may materially adversely affect our results of operations. Estimating time and costs to complete requires judgment and includes consideration of the complexity of the study, the number of geographical sites where trials are to be conducted and the number of patients to be recruited at each site. We regularly review the estimated hours on each contract to determine if the budget accurately reflects the agreed tasks to be performed, taking into account the state of progress at the time of review.

We bear the risk of cost overruns unless the scope of activity is revised from the contract specifications and we are able to negotiate a contract modification. We endeavor to ensure that any changes in scope are appropriately monitored and change orders or contract modifications are promptly negotiated and documented for changes in scope. If we fail to successfully negotiate change orders for changes in the resources required or the scope of the work to be performed, and
149







Appendix A: Risk Factors (continued)
the costs of performance of these contracts exceeded their fixed fees, it could materially adversely affect our operations and financial results.

If we are unable to successfully develop and market new services or enter new markets, our growth, results of operations or financial condition could be adversely affected.

A key element of our growth strategy is the successful development and marketing of new services or entering new markets that complement or expand our existing business. As we develop new services or enter new markets, we may not have or be able to adequately build the competencies necessary to perform such services satisfactorily, may not receive market acceptance for such services or may face increased competition. If we are unable to succeed in developing new services, entering new markets or attracting a client base for our new services or in new markets, we will be unable to implement this element of our growth strategy, and our future business, reputation, results of operations could be adversely impacted.

If we fail to attract or retain key personnel, our performance may suffer.
 
Our business, future success and ability to continue to expand operations depends upon our ability to attract, hire, train and retain qualified professional, scientific and technical operating people. We compete for qualified professionals with other Clinical Research Organisations (“CROs”), temporary staffing agencies and the in-house departments of pharmaceutical, biotechnology and medical device companies. An inability to attract and retain a sufficient number of high caliber clinical research professionals (in particular, key personnel and executives) at an acceptable cost would impact our ability to provide our services, our future performance and results of operations.

We may face challenges retaining employees which could cause disruption to our integration plans and day-to-day activities, which may result in additional costs to the business.

The attraction, development and retention of our talent is critical to the success of the Company, and we continue to strengthen processes around these areas to minimise retention risk. The Company, led by the Chief Human Resource Officer, is taking meaningful action to retain employees. Through our annual Talent Review process we have identified opportunities for improvement as it relates to employee retention. Our People Plans have set specific goals for each functional area in terms of three critical areas: talent attraction, development and retention. However, we can provide no assurances that our efforts in this respect will be successful.

Our leadership and talent programs contribute to the enhanced retention of our employees, better project deliverables for our customers and the enhanced financial performance of the business. We aim to be an industry leader: a company where talented people come to do important work, a place where our employees can shape the future of healthcare, grow their careers, and reach their full potential. We have long held a deep commitment to cultivating strong people practices. This includes competitive total rewards packages along with a focus on continuous learning. Our success depends on the knowledge, capabilities, and quality of our people.

Our ability to perform clinical trials is dependent upon the ability to recruit suitable willing patients.

The successful completion of clinical trials is dependent upon the ability to recruit suitable and willing patients on which to test the drug under study. The availability of suitable patients for enrollment in studies is dependent upon many factors including, amongst others, the size of the patient population, the design of the study protocol, eligibility criteria, the referral practices of physicians, the perceived risks and benefits of the drug under study and the availability of alternative medication, including medication undergoing separate clinical trials. Insufficient or inappropriate patient enrollment may result in the termination or delay of a study which could have a material adverse impact on our results of operations.

The Company is focused on continuing to develop its expertise in patient recruitment with the establishment in 2020 of Accellacare, a global clinical research network, offering patients easier and faster access to innovative treatments and offering customers the option to deploy decentralised trials. The focus is on making it easier for the site and the patient to actively participate in a trial to ensure increased predictability, enrollment and retention. Our site and patient solutions group includes upfront planning of site and patient management including identification, enrollment and engagement.

Improved site selection is achieved through:

leading technology to identify where the patients are that match the protocol;
assessment of the qualification of sites based on real data;
partnerships with leading technology vendors and developing the capability to enable Electronic Medical Record (EMR) interrogation into clinical insights such as sub-populations and larger pre-screened pools where the technology and regulations are enabled.

150







Appendix A: Risk Factors (continued)
The burden on the site, in ensuring patient enrollment and engagement, is achieved through integrated site networks. ICON has a number of site alliance partners. During 2018, we enhanced our site and patient recruitment capabilities with an expansion of the PMG Research network through a partnership with the DuPage Medical Group. During 2019, we further enhanced our site and patient recruitment abilities through the strategic acquisitions of MeDiNova and CRN. In 2020, ICON announced the launch of Accellacare, a global clinical research network offering patients easier and faster access to innovative treatments and offering customers the option to deploy decentralised trials. The site network includes previously acquired PMG Research, MeDiNova and CRN. Also in 2020, we entered into an agreement to jointly establish a new company, Oncacare Limited ("Oncacare"), with a third party. Oncacare operates as a specialised oncology site network in the US and EMEA regions. This site network is focused on implementing a range of commercial models with specialist oncology healthcare providers in the US and EMEA, to accelerate the recruitment and retention of patients into oncology trials. The oncology site network was operated as a joint venture between the Company and a third party until April 2023, at which point the Company acquired the third party's interest in Oncacare such that Oncacare became a wholly-owned subsidiary of the Company. We also use digital solutions to drive site performance, including pre-screening, eConsent, learning management, document tracking and management with key applications.

Our ability to perform clinical trials is dependent upon our ability to recruit suitable willing investigators.

We contract with physicians located in hospitals, clinics or other similar sites, who serve as investigators in conducting clinical trials to test new drugs on their patients. Investigators supervise administration of the study drug to patients during the course of the clinical trial. The successful conduct of a clinical trial is dependent upon the integrity, experience and capabilities of the investigators conducting the trial. Insufficient investigator recruitment, which in turn may lead to insufficient or inappropriate patient enrollment, may result in the termination or delay of a study which could have a material adverse impact on our results of operations.

Climate change, extreme weather events, earthquakes and other natural disasters could adversely affect our business.

In recent years, extreme weather events and changing weather patterns such as storms, flooding, droughts and temperature changes have become more common. As a result, we are potentially exposed to varying natural disaster or extreme weather risks such as hurricanes, tornadoes, droughts or floods, or other events that may result from the impact of climate change on the environment, such as sea level rise. As a result, we could experience increased costs, business interruptions, destruction of facilities, and loss of life, all of which could have a material adverse effect on our business, financial condition, or results of operations. The potential impacts of climate change may also include increased operating costs associated with additional regulatory requirements and investments in reducing energy, water use and greenhouse gas emissions.

A disease outbreak, epidemic or pandemic, such as COVID-19, could adversely affect our business performance.

A disease outbreak, such as influenza or coronavirus, could negatively impact our operations. We could experience restrictions on our ability to travel, or the ability of patients or other service providers to travel, to monitor our clinical trials and to ensure laboratory samples are collected and analyse don time as a result of an outbreak. The potential impact of an epidemic or pandemic may also result in increased operating costs and result in a requirement to increase investment in impact prevention. COVID-19 has affected, and may continue to affect, our business performance and could adversely affect the economies and financial markets worldwide, resulting in an economic downturn that could impact our business, financial condition and results of operations.

Our business depends on the continued effectiveness and availability of our information systems, including the information systems we use to provide our services to our clients, and any system failures of, security breaches of or cyber attacks to these systems may materially limit our operations or have a material adverse effect on our results of operations.

Due to the global nature of our business and our reliance on information systems to provide our services, we use web-enabled and other integrated information systems in delivering our services. We will continue to increase the use of these systems and such systems will either be developed internally or provided in conjunction with third parties. We also provide access to similar information systems to certain clients in connection with the services we provide them. As the use, scope and complexity of our information systems continue to grow, we are exposed to, and will increasingly be exposed to, the risks inherent in the development, integration and ongoing operation of evolving information systems, including:
disruption or failure of data centers, telecommunications facilities or other key infrastructure platforms;
security breaches, cyber attacks or other failures or malfunctions in our application or information systems or their associated hardware or other systems that we have access to, or that we rely upon, or that have access to our systems;
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Appendix A: Risk Factors (continued)
security breaches, cyber attacks or malfunctions with key suppliers or partners who we rely on to provide services to customers; and
excessive costs, excessive delays or other deficiencies in, or problems with, systems development and deployment.

The materialisation of any of these risks may impede our ability to provide services, the processing of data, the delivery of databases and services and the day-to-day management of our business and could result in the corruption, loss or unauthorised disclosure of proprietary, confidential or other data, as well as reputational harm.

In addition, as Artificial Intelligence (“AI”) powered cyber threats evolve, our cybersecurity program strives to keep pace through the development of advanced detection and mitigation mechanisms. However, the dynamic nature of AI-driven attacks poses an ongoing challenge, as staying one step ahead requires constant adaptation and innovation in defensive strategies to effectively protect the organisation against emerging threats.

While we have cybersecurity controls and disaster recovery plans in place, they might not adequately protect us in the event of a system failure, security breach or cyber attack. To date, no cyber attacks have had a material impact on operations or financial reporting. Additionally, despite any precautions we take, damage from fire, floods, hurricanes, power loss, telecommunications failures, computer viruses, information system security breaches, cyber attacks and similar events that impact our various computer facilities could result in interruptions in the flow of data to our servers and from our servers to our clients. Corruption or loss of data may result in the need to repeat a trial at no cost to the client, but at significant cost to us, or result in the termination of one or more contracts, legal proceedings or claims against us or damage to our reputation. Additionally, significant delays in system enhancements or inadequate performance of new or upgraded systems once completed could damage our reputation and harm our business. Long-term disruptions in the infrastructure caused by events such as security breaches, cyber attacks, natural disasters, the outbreak of war, the escalation of hostilities and acts of terrorism, particularly involving cities in which we have offices, could adversely affect our business.
 
Unauthorised disclosure of sensitive or confidential data, whether through system failure or employee negligence, fraud or misappropriation, could damage our reputation and cause us to lose clients. Similarly, despite investing in information and cybersecurity controls, there is a risk that unauthorised access to our information systems or those we develop for our clients, whether by our employees or third parties, including a cyber attack by computer programmers and hackers who may attack ICON systems, develop and deploy viruses, worms, ransomware or other malicious software programs, could result in negative publicity, significant remediation costs, legal liability, loss of customers and damage to our reputation and could have a material adverse effect on our results of operations and financial results. In addition, our liability insurance might not be sufficient in type, the cover provided or amount to adequately cover us against claims related to security breaches, cyber attacks and other related breaches.

We may also face cybersecurity risks due to our reliance on hybrid work arrangements, which could create additional opportunities for cybercriminals to exploit vulnerabilities.

Upgrading the information systems that support our operating processes and evolving the technology platform for our services pose risks to our business.

Continued efficient operation of our business requires that we implement standardised global business processes and evolve our information systems to enable this implementation. We have continued to undertake significant programs to optimise business processes with respect to our services. A failure to effectively manage the implementation and adapt to new processes designed into these new or upgraded systems in a timely and cost-effective manner may result in disruption to our business and negatively affect our operations.

We have entered into agreements with certain vendors to provide systems development and integration services that develop or license to us the IT platform for programs to optimise our business processes. If such vendors fail to perform as required or if there are substantial delays in developing, implementing and updating the IT platform, our customer delivery may be impaired and we may have to make substantial further investments, internally or with third parties, to achieve our objectives. Additionally, our progress may be limited by parties with existing or claimed patents who seek to prevent us from using preferred technology or seek license payments from us.

Meeting our objectives is dependent on a number of factors which may not take place as we anticipate, including obtaining adequate technology-enabled services, creating IT-enabled services that our customers will find desirable and implementing our business model with respect to these services. We are continuing to develop opportunities for automation across ICON using state of the art automation tools including Robotic Process Automation (RPA), the development of new applications and capabilities, and enabling deeper integration across our digital ecosystem. To remain competitive within our industry and keep pace with the rapid evolution of the technological landscape, it is critical that we continue to innovate and expand the capabilities of our current technologies. This applies in particular to our ICONIK, Firecrest, ADDPLAN, Integrated Dataverse (IDV®) and One Search services. Also, increased requirements for investment in information technology may negatively impact our financial condition, including profitability.
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Appendix A: Risk Factors (continued)

Failure to meet productivity objectives under our business improvement objectives could adversely impact our competitiveness and therefore our operating results.

We continue to pursue business transformation initiatives to embed technology and innovation and deliver operational efficiencies. As part of these initiatives, we seek to improve our productivity, flexibility, quality, functionality and cost savings by our on-going investment in global technologies, continuous improvement of our business processes and functions to deliver economies of scale. These initiatives may not deliver their intended gains or be completed in a timely manner which may adversely impact our competitiveness and our ability to meet our growth objectives and therefore, could adversely affect our business and operating results, including profitability.

We rely on our interactive response technologies to provide accurate information regarding the randomisation of patients and the dosage required for patients enrolled in the trials.

We develop and maintain computer run and web based interactive response technologies to automatically manage the randomisation of patients in trials, assign the study drug and adjust the dosage when required for patients enrolled in trials we support. An error in the design, programming or validation of these systems could lead to inappropriate assignment or dosing of patients, which could give rise to patient safety issues and invalidation of the trial and/or liability claims against the Company, amongst other things, any of which could have a material effect on our financial condition and operations.

A failure to identify and successfully close and integrate strategic acquisition targets could adversely impact our ongoing business and financial results.

We have made a number of acquisitions, including the Merger, and continue to review new acquisition opportunities. If we are unable to identify suitable acquisition targets, complete an acquisition or successfully integrate an acquired company or business, our business may be disrupted. The success of an acquisition will depend upon, among other things, our ability to:
 
effectively and quickly assimilate the operations and services or products of the acquired company or business; 
integrate acquired personnel; 
retain and motivate key employees; 
retain customers; and 
minimise the diversion of management's attention from other business concerns.

In the event that the operations of an acquired company or business do not meet our performance expectations, we may have to restructure the acquired company or business or write-off the value of some, or all, of the assets of the acquired company or business.
 
Improper performance of our services could adversely impact our reputation and our financial results.

The performance of clinical development services is complex and time-consuming. We or vendors we engage may make mistakes in conducting a clinical trial that could negatively impact or damage the usefulness of the clinical trial or cause the results to be reported improperly. If the clinical trial results are compromised, we could be subject to significant costs or liability, which could have an adverse impact on our ability to perform our services. Large clinical trials are costly, and while we endeavor to contractually limit our exposure to such risks, improper performance of our services could have an adverse effect on our financial condition, damage our reputation and result in the cancellation of current contracts or failure to obtain new contracts from affected or other clients.

Our relationships with existing or potential customers who are in competition with each other may adversely impact the degree to which other customers or potential customers use our services, which may adversely affect our results of operations.

The biopharmaceutical industry is highly competitive, with biopharmaceutical companies each seeking to persuade payers, providers and patients that their drug therapies are better and more cost-effective than competing therapies marketed or being developed by competing companies. In addition to the adverse competitive interests that biopharmaceutical companies have with each other, biopharmaceutical companies also have adverse interests with respect to drug selection and reimbursement with other participants in the healthcare industry, including payers and providers. Biopharmaceutical companies also compete to be first to market with new drug therapies. We regularly provide services to biopharmaceutical companies who compete with each other and we sometimes provide services to such customers regarding competing drugs in development. Our existing or future relationships with our biopharmaceutical customers may therefore deter other biopharmaceutical customers from using our services or may result in our customers seeking to place limits on our ability to serve other biopharmaceutical industry participants. In addition, our further expansion into the broader healthcare market may adversely impact our relationships with biopharmaceutical customers and such customers may elect
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Appendix A: Risk Factors (continued)
not to use our services, reduce the scope of services that we provide to them or seek to place restrictions on our ability to serve customers in the broader healthcare market with interests that are adverse to theirs. Any loss of customers or reductions in the level of revenues from a customer could have a material adverse effect on our results of operations, business and prospects.

We have only a limited ability to protect our intellectual property rights and these rights are important to our success.

Our success depends, in part, upon our ability to develop, use and protect our proprietary methodologies, analytics, systems, technologies and other intellectual property. Existing laws of the various countries in which we provide services or solutions offer only limited protection of our intellectual property rights and the protection in some countries may be very limited. We rely upon a combination of trade secrets, confidentiality policies, non-disclosure, invention assignment and other contractual arrangements and patent, copyright and trademark laws, to protect our intellectual property rights. These laws are subject to change at any time and certain agreements may not be fully enforceable, which could further restrict our ability to protect our innovations. Intellectual property rights may not prevent competitors from independently developing services similar to, or duplicative of, ours. Further, the steps we take in this regard might not be adequate to prevent or deter infringement or other misappropriation of our intellectual property by competitors, former employees or other third parties and we might not be able to detect unauthorised use of, or take appropriate and timely steps to enforce our intellectual property rights. Enforcing our rights might also require considerable time, money and oversight and we may not be successful in enforcing our rights.

The biopharmaceutical industry has a history of patent and other intellectual property litigation and we might be involved in costly intellectual property lawsuits.

The biopharmaceutical industry has a history of intellectual property litigation, and these lawsuits will likely continue in the future. Accordingly, we may face patent infringement legal proceedings by companies that have patents for similar business processes or other legal proceedings alleging infringement of their intellectual property rights. Legal proceedings relating to intellectual property could be expensive, take significant time and divert management’s attention from other business concerns, regardless of the outcome of the litigation. If we do not prevail in an infringement lawsuit brought against us, we might have to pay damages and we could be required to stop the infringing activity or obtain a license to use technology on unfavorable terms. Any infringement or other legal processing related to intellectual property could have a material adverse effect on our operations and financial condition.

We act as authorised representative or legal representative for some clients pursuant to certain jurisdictional requirements for sponsors of clinical trials to appoint an authorised representative or legal representative with a local presence within the relevant jurisdiction.

We act as authorised representative pursuant to Medical Devices Directive 93/42/EEC (“MDD”), Medical Devices Regulation 2017/745 (“MDR”) and Active Implantable Medical Devices Directive 90/385/EEC (“AIMD”) for certain clients who are located outside of the European Union. As authorised representative, we act on behalf of medical device manufacturers in relation to specified tasks with regard to their obligations under MDR.

We also act as legal representative pursuant to European Clinical Trials Directive (2021/20/EC) (“CTD”), EU Clinical Trials Regulation (No.536/2014) (“CTR”), MDD, MDR and AIMD, for certain clients who are located outside of the European Union with respect to clinical trials being carried out by those clients in the European Union. We also perform similar legal representative services for certain clients in other non-EU jurisdictions, where the client is located outside the relevant local jurisdiction, ICON has an established local legal entity in that jurisdiction and analogous local regulations have a similar requirement for a local legal representative for clinical trials being carried out in those jurisdictions. As legal representative, we are responsible for ensuring compliance with the client’s obligations pursuant to CTD, CTR and MDR or analogous local legislation and we are the addressee for all communications with the client provided for under CTD, CTR and MDR or analogous local legislation.

We provide these services subject to certain terms and conditions which are contained in our agreements with clients pertaining to these services. We aim to reduce any potential liability associated with these activities by seeking contractual indemnification from our clients and by maintaining an appropriate level of insurance cover. However, there is no guarantee that the specific insurance will be available or that a client will fulfill its obligations in relation to their indemnity.


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Appendix A: Risk Factors (continued)
We rely on third parties to provide certain data and other information to us. Our suppliers or providers might increase our cost to obtain, restrict our use of, or refuse to license data, which could lead to our inability to access certain data or provide certain services and, as a result, materially and adversely affect our operating results and financial condition.

Our services are derived from, or include, the use of data we collect from third parties. We have several data suppliers that provide us with a broad and diverse scope of information that we collect, use in our business and sell.

We generally enter into long-term contractual arrangements with many of our data suppliers. At the time we enter into a new data supply contract or renew an existing contract, suppliers may increase our cost to obtain and use the data provided by such supplier, increase restrictions on our ability to use or sell such data, or altogether refuse to license the data to us. Also, our data suppliers may fail to meet or adhere to our quality control standards or fail to deliver the data to us. Although no single supplier is material to our business, if suppliers that collectively provide a significant amount of the data we receive or use were to increase our costs to obtain or use such data, further restrict our access to or use of such data, fail to meet or adhere to our quality control standards, refuse to provide or fail to deliver data to us, our ability to provide data-dependent services to our clients may be adversely impacted, which could have a material adverse effect on our business, results of operations, financial condition or cash flow.

We rely on third parties for important products, services and licenses to certain technology and intellectual property rights. If there was failure in delivery by these parties, we might not be able to continue to obtain such products, services and licenses.
We depend on certain third parties to provide us with products and services critical to our business. Such services include, among others, suppliers of drugs for patients participating in trials, suppliers of kits for use in our laboratories, suppliers of reagents for use in our testing equipment and providers of maintenance services for our equipment. The failure of any of these third parties to adequately provide the required products or services, or to do so in compliance with applicable regulatory requirements, could have a material adverse effect on our business.

Some of our services rely on intellectual property, technology and other similar property owned and/or controlled by third parties. Our licenses to this property and technology could terminate or expire and we might not be able to replace these licenses in a timely manner. Also, we might not be able to renew these licenses on similar terms and conditions. Failure to renew these licenses, or renewals of these licenses on less advantageous terms, could have a material adverse effect on our business, results of operations, financial condition or cash flow.


Risk Related to Our Industry

Outsourcing trends in the pharmaceutical, biotechnology and medical device industries and changes in spending on research and development could adversely affect our operating results and growth rates.

We are dependent upon the ability and willingness of the pharmaceutical, biotechnology and medical device companies to continue to spend on research and development and to outsource the services that we provide. We are therefore subject to risks, uncertainties and trends that affect companies in these industries that we do not control. We have benefited to date from the tendency of pharmaceutical, biotechnology and medical device companies to outsource clinical research projects. Any downturn in these industries or reduction in spending or outsourcing could materially adversely affect our business. The following could each result in such a downturn:

if pharmaceutical, biotechnology or medical device companies expanded upon their in-house clinical or development capabilities, they would be less likely to utilise our services;
if governmental regulations were changed, it could affect the ability of our clients to operate profitably, which may lead to a decrease in research spending and therefore this could have a material adverse effect on our business; and
if unfavorable economic conditions or disruptions in the credit and capital markets negatively impacted our clients.

Large pharmaceutical companies are increasingly consolidating their vendor base and entering strategic partnership arrangements with a limited number of outsource providers.

Large pharmaceutical companies are continually seeking to drive efficiencies in their development processes to both reduce costs associated with the development of new drug candidates and accelerate time to market. As a result, large pharmaceutical companies, in particular, are increasingly looking to consolidate the number of outsource providers with which they engage, with many entering strategic partnership arrangements with a limited number of outsource providers. The failure to enter strategic partnership arrangements with customers or the loss of existing customers as a
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Appendix A: Risk Factors (continued)
result of them entering strategic partnership arrangements with our competitors could have a material adverse impact on our results of operations.

Increased collaboration amongst pharmaceutical companies in research and development activities may lead to fewer research opportunities.

Certain pharmaceutical companies have begun to collaborate in seeking to develop new drug candidates. Increased collaboration amongst pharmaceutical companies may lead to fewer research opportunities, which in turn may lead to fewer outsource opportunities for companies within the CRO industry. A reduction in outsource opportunities as a result of this increased collaboration could have a material adverse impact on our results of operations.

We operate in a highly competitive and dynamic market.

The CRO industry is highly competitive. In particular, we compete with other large global CROs for strategic relationships with large pharmaceutical companies. If we are unable to retain and renew existing strategic relationships and win new strategic relationships, there could be a material adverse impact on our results. Similarly, we compete with other CROs for work which comes outside of these strategic relationships and being unable to win work outside of these strategic relationships could have a material adverse impact on our results.

The type and depth of services provided by CROs has changed in recent years. Failure to develop and market new services or expand existing service offerings could adversely affect our business and operations.

New entrants may also enter the market which would further increase competition and could adversely affect our business and operations.

We may be adversely affected by industry, customer or therapeutic concentration.
We provide services to biopharmaceutical, biotechnology, medical device and government organisations and our revenue is dependent on expenditures by these customers. Our business could therefore be adversely impacted by mergers, consolidation, business failures, distress in financial markets or other factors resulting in a decrease in the number of potential customers or therapeutic products being developed through the drug development progress. There has been consolidation in the biopharmaceutical market in recent years. If the number of our potential customers were to decline in the future, they may be able to negotiate price discounts or other terms for services that are less favorable to us than they have been historically.

Risk Related to Our Financial Results and Financial Position

Our quarterly results are dependent upon a number of factors and can fluctuate from quarter to quarter. They may fall short of prior periods, our projections or the expectations of securities analysts or investors, which may adversely affect the market price of our stock.
Our results of operations in any quarter can fluctuate or differ from expected or forecast results depending upon or due to, among other things, the number and scope of ongoing client projects, the commencement, postponement, variation, cancellation or termination of projects in a quarter, the mix of activity, cost overruns, employee hiring, employee attrition and other factors. Our revenue in any period is directly related to the number of employees who were working on billable projects together with investigator activity during that period. We may be unable to compensate for periods of under-utilisation during one part of a fiscal period by earning revenue during another part of that period. We believe that operating results for any particular quarter are not necessarily a meaningful indicator of future results.

Also, if in future quarters, we are unable to continue to deliver operational efficiencies and our expenses grow faster than our revenues, our operating margins, profitability and overall financial condition may be materially adversely impacted.

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Appendix A: Risk Factors (continued)
Our exposure to exchange rate fluctuations could adversely affect our future results of operations.

Our contracts with clients are sometimes denominated in currencies other than the currency in which we incur expenses related to such contracts. Where expenses are incurred in currencies other than those in which contracts are priced, fluctuations in the relative value of those currencies could have a material adverse effect on our results of operations.

In addition, we are also subject to translation exposures as our consolidated financial results are presented in U.S. dollars, while the local results of a certain number of our subsidiaries are prepared in currencies other than U.S. dollars, including, amongst others, the pound sterling and the euro. Accordingly, changes in exchange rates between the U.S. dollar and those other currencies will affect the translation of subsidiary companies' financial results into U.S. dollars in reporting our consolidated financial results.

Inflation and rising labor costs could adversely affect our future results of operations.

Inflation and rising labor costs may result in significant increases to the cost of our services, which we may not be able to recover from our customers. Our contracts with clients are often fixed price or fixed price-per-unit contracts. If macroeconomic forces, such as inflation, cause the cost of inputs required to deliver these contracts to increase significantly, we may be unable to pass along these cost to our customers. A sustained increase in these costs may require us to increase the price of future service offerings. These actions could adversely affect our future revenue, gross margin, or both.

Our effective tax rate may fluctuate from quarter-to-quarter, which may adversely affect our results of operations.

Our quarterly effective tax rate has depended and will continue to depend on the geographic distribution of our taxable earnings amongst the multiple tax jurisdictions (such as Ireland, United States and United Kingdom) in which we operate and the tax laws in those jurisdictions. Changes in the geographic mix of our results of operations amongst these jurisdictions may have a significant impact on our effective tax rate from quarter-to-quarter. Changes in tax law in one or more jurisdictions could also have a significant impact on our tax rate and results. In addition, as we operate in multiple tax jurisdictions, we may be subject to audits in certain jurisdictions. These audits may involve complex issues which could require an extended time period before being resolved. The resolution of audit issues may lead to additional taxes, interest as well as fines and/or penalties being imposed which could have a material adverse impact on our effective tax rate and our consolidated financial results.

In terms of recent legislative changes which could potentially impact our effective tax rate, on August 16, 2022, the U.S. government enacted the Inflation Reduction Act of 2022 ("IRA"). The IRA introduced a 15% minimum tax on book income of certain large corporations, a 1% excise tax on net stock repurchases, and several tax incentives to promote clean energy, with those tax changes becoming effective in 2023. While these changes did not have any impact on the Company for the year ended 31 December 2023, we are continuing to monitor any potential future tax impacts in this regard.

In terms of a global minimum tax rate, the organisation for Economic Co-operation and Development's ("OECD") Global Anti-Base Erosion ("GloBE") Model Rules proposed a global minimum tax rate of 15% and recommended that it be effective from 2024. European Union member states adopted a global minimum tax in December 2022 and member states were obliged to implement the rules by 31 December 2023, which impact large multinational groups with a consolidated revenue of over €750 million. Although there is no assurance that every country in which ICON has a presence will implement GloBE, where a particular jurisdiction has a minimum effective tax rate of less than 15%, the head office location may be obliged to pay a top-up tax. Ireland has also recently implemented global minimum tax legislation which will apply from 2024. The global tax environment is becoming increasingly complex and management continues to review the impact of a global minimum tax on the Company’s financial performance.

Our unsatisfied performance obligation may not convert to revenue and the rate of conversion may slow.

Our unsatisfied performance obligation is the amount of awards that has not yet converted to revenue. This value is not necessarily a meaningful predictor of future results due to the potential for the cancellation or delay of projects included in the unsatisfied performance obligation. No assurances can be given that we will be able to realise this unsatisfied performance obligation in full as revenue. A failure to realise these awards could have a material adverse impact on our results of operations. In addition, as the length and complexity of projects increases, the rate at which awards convert to revenue may be slower than in the past. A significant reduction in the rate of conversion could have a material impact on our results of operations.


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Appendix A: Risk Factors (continued)
The Company is exposed to various risks in relation to our cash and cash equivalents and short term investments.
 
The Company’s treasury function manages our available cash resources and invests significant cash balances in various financial institutions to try to ensure optimum returns for our surplus cash balances. These balances are classified as cash and cash equivalents, or short term investments, depending on the maturity of the related investment. Cash and cash equivalents comprise cash and highly liquid investments with maturities of three months or less. Short term investments comprise highly liquid investments with maturities of greater than three months and minimum “A-” rated fixed and floating rate securities.

     Given the global nature of our business, we are exposed to various risks in relation to these balances including liquidity risk, credit risk associated with the counterparties with whom we invest, interest rate risk on floating rate securities, sovereign risk (our principle sovereign risk relates to investments in U.S. Treasury funds) and other factors.

Although we have not recognised any significant losses to date on our cash and cash equivalents or short term investments, any significant declines in their market values could have a material adverse effect on our financial position and operating results.
 
Changes in accounting standards may adversely affect our financial statements.

We prepare our financial statements in accordance with generally accepted accounting principles in the United States of America ("U.S. GAAP") which are revised on an on-going basis by the authoritative bodies. It is possible that future accounting standard updates may require changes to the accounting treatment that we apply in preparation of our financial statements. These changes may also require significant changes to our reporting systems. These updates may result in unexpected variability in the timing of recognition of revenue or expenses and therefore in our operating results.

Risk Related to Our Indebtedness

We have incurred substantial additional indebtedness in connection with the Merger, which could impair our flexibility and access to capital and could adversely affect the Company’s business, financial condition or results of operations.

Following completion of the Merger and the other transactions contemplated by the Merger Agreement, the Company has a substantial amount of debt. ICON borrowed approximately $6,015.0 million in order to pay PRA stockholders the cash consideration due to them as merger consideration under the Merger Agreement, pay related fees and transaction costs in connection with the transactions, and refinance existing indebtedness. The total remaining transaction related debt balance at 31 December 2023 was $3,751.2 million. This level of borrowings could adversely affect the Company in a number of ways, including, but not limited to, causing us to incur substantial fees from time to time in connection with debt amendments or refinancing, making it more difficult for the Company to satisfy its obligations with respect to its debt or to its trade or other creditors, requiring a substantial portion of the Company’s cash flows from operations for the payment of interest on the Company’s debt, reducing the Company’s flexibility to respond to changing business and economic conditions, and reducing funds available for the Company’s investments in research and development, capital expenditures and other activities. If ICON cannot service its debt, it may have to take actions such as selling assets, seeking additional debt or equity, or reducing or delaying capital expenditures, strategic acquisitions, investments and alliances.

Covenants in our credit agreement and the indenture governing the Senior Secured Notes may restrict our business and operations. Our financial condition and results of operations could be adversely affected if we do not comply with those covenants.

The Senior Secured Credit Facilities and the indenture include certain customary covenants that limit our ability to, amongst other things, subject to certain exceptions:

make dividends, investments and other restricted payments;
enter into sale and leaseback transactions;
engage in share buybacks;
incur or assume liens or additional debt;
engage in mergers or reorganisations; or
enter into certain types of transactions with affiliates.

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Appendix A: Risk Factors (continued)
On December 8, 2023, ICON notified the holders of the Senior Secured Notes of the upgrade of the instrument rating to investment grade and the consequent suspension of certain of the covenants under the Indenture. The suspension of these covenants remains in place so long as the instrument remains at investment grade.

The revolving credit facility also includes a financial covenant that requires us to comply with a maximum consolidated leverage ratio. Our ability to comply with this financial covenant may be affected by events beyond our control.

Interest rate fluctuations may materially adversely affect our results of operations and financial conditions due to the variable interest rate on our senior secured term loan facility, our revolving credit facility or in respect of any future issuances of debt.

Borrowings under the senior secured term loan facility amortise in equal quarterly installments in an amount equal to 1.00% per annum of the original principal amount, with the remaining balance due at final maturity. The interest rate margin applicable to borrowings under the senior secured term loan facility is USD Term SOFR and a Term SOFR Adjustment depending on the interest period chosen plus an applicable margin of 2.25%. The senior secured term loan facility is subject to a floor of 0.50%.

The interest rate margin applicable to borrowings under the revolving loan facility will be, at the option of the borrower, either (i) the applicable base rate plus an applicable margin of 1.00%, 0.60% or 0.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively, or (ii) Term SOFR plus a Term SOFR Adjustment on the interest period chosen plus an applicable margin of 2.00%, 1.60% or 1.25% based on ICON’s current corporate family rating assigned by S&P of BB- (or lower), BB or BB+ (or higher), respectively. In addition, lenders under the revolving loan facility are entitled to commitment fees as a percentage of the applicable margin at the time of drawing and utilisation fees dependent on the proportion of the facility drawn. At 31 December 2023, $55.0 million was outstanding under the revolving loan facility while there was also $3.7 million (2022: $4.5 million) in letters of credit given to landlords to guarantee lease arrangements.

Because the Company has variable rate debt, fluctuations in interest rates affect our business. We attempt to minimise interest rate risk and lower our overall borrowing costs through the utilisation of interest rate cap and interest rate swap derivative financial instruments. We have entered into certain interest rate cap and interest rate swap agreements with three financial institutions with respect to a portion of our outstanding debt. Accordingly, any change in market value associated with these agreements may be offset by the opposite market impact on the portion of the debt covered by such agreements.

Risk Related to Political, Legal or Regulatory Environment

We may lose business opportunities as a result of healthcare reform and the expansion of managed care organisations.
 
Numerous governments, including the U.S. government, have undertaken efforts to control growing healthcare costs through legislation, regulation and voluntary agreements with medical care providers and drug companies. If these efforts are successful, pharmaceutical, biotechnology and medical device companies may react by spending less on research and development and therefore this could have a material adverse effect on our business.

In addition to healthcare reform proposals, the expansion of managed care organisations in the health care market may result in reduced spending on research and development. Managed care organisations' efforts to cut costs by limiting expenditures on pharmaceuticals and medical devices could result in pharmaceutical, biotechnology and medical device companies spending less on research and development. If this were to occur, we would have fewer business opportunities and our revenues could decrease, possibly materially.

Healthcare reform legislation, other changes in the healthcare industry and in healthcare spending could adversely affect our business model, financial condition or results of operations.

Our results of operations and financial conditions could be affected by changes in healthcare spending and policy.  The healthcare industry is subject to changing political, regulatory and other influences. It is possible that legislation will be introduced and passed in the United States repealing, modifying or invalidating the current healthcare reform legislation, in whole or in part, and signed into law. Because of the continued uncertainty about the implementation of the current healthcare reform legislation, including the potential for further legal challenges or repeal of that legislation, we cannot quantify or predict with any certainty the likely impact of the current healthcare reform legislation or its repeal on the healthcare sector, on our customers and ultimately on our financial condition or results of operations.

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Appendix A: Risk Factors (continued)
As previously noted, on August 16, 2022, the U.S. government enacted the IRA, which among other things, authorises the U.S. Department of Health and Human Services to establish prices for certain single-source drugs and biologics within the Medicare program, commencing in 2026. Furthermore, the IRA contains provisions which impose rebate obligations on manufacturers if price increases outpace inflation. While the full impact of these IRA provisions on our customers in the biopharmaceutical industry remains somewhat uncertain, any resultant pressure on our customers’ operating results could lead to a reduction in research and development spend and related outsourcing activities, which could have an adverse impact on our operating results and financial condition.

Our international operations expose us to risks as a result of changes in global political conditions which could adversely affect our results of operations.

Political and/or financial instability and armed conflict in various regions of the world, including, but not limited to, Ukraine, Israel and the conflict area in the Middle East, can lead to sanctions, economic uncertainty and currency exchange rate fluctuations and may interrupt our operations in those areas, which may adversely impact our results of operations. The current conflict in Ukraine has led to, among other things, hardship and the imposition of international economic sanctions aimed at the region. While the situation is subject to change, there remains the possibility of additional and harsher sanctions if the conflict intensifies. If that were to happen, our operations in the region may be severely curtailed or eliminated, which could adversely affect our results of operations. In addition, if the current unrest broadens or further escalates, our operations may be severely curtailed, which could adversely affect our results of operations.

We continue to monitor developments in Israel and the conflict area in the Middle East. Further broadening or escalation of the conflict, or the imposition of international economic sanctions, could adversely affect our results of operations.

We may lose business as a result of changes in the regulatory environment.

Various regulatory bodies throughout the world may enact legislation, rules and guidance which could introduce changes to the regulatory environment for drug development and research. The adoption and implementation of such legislation, rules and guidance is difficult to predict and therefore could have a material adverse effect on our business.

Failure to comply with the regulations and requirements of the U.S. Food and Drug Administration and other regulatory authorities could result in substantial penalties and/or loss of business.

The U.S. Food and Drug Administration, ("FDA"), and other regulatory and government authorities and agencies inspect and audit us from time to time to ensure that we comply with their regulations and guidelines, including environmental, health and safety matters, and other requirements imposed in connection with the performance of government contracts.  We must comply with the applicable regulatory requirements governing the conduct of clinical trials and contracting with the government in all countries in which we operate.
If we or vendors we engage fail to comply with any of these requirements we could suffer some or all of: 
termination of or delay in any research;
disqualification of data;
denial of the right to conduct business;
criminal penalties;
financial penalties;
other enforcement actions including debarment from government contracts;
loss of clients and/or business; and
litigation from clients and/or patients and/or regulatory authorities and/or other affected third parties, and resulting material penalties, damages and costs.

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Appendix A: Risk Factors (continued)
We are subject to political, regulatory, operational and legal risks associated with our international operations.

We are one of a small group of organisations with the capability and expertise to conduct clinical trials on a global basis. We believe that this capability to provide our services globally in most major and developing pharmaceutical markets enhances our ability to compete for new business from large multinational pharmaceutical, biotechnology and medical device companies. We have expanded geographically in the past and intend to continue expanding in regions that have the potential to increase our client base or increase our investigator and patient populations. We expect that revenues earned in emerging markets will continue to account for an increasing portion of our total revenues. However, emerging market operations may present several risks, including civil disturbances, health concerns, cultural differences such as employment, regulatory and business practices, compliance with economic sanctions laws and regulations, volatility in gross domestic product, economic and governmental instability, the potential for nationalisation of private assets and the imposition of exchange controls. In addition, operating globally means the Company faces the challenges associated with coordinating its services across different countries, time zones and cultures.

Changes in the political and regulatory environment in the international markets in which we operate such as price or exchange controls could impact our revenue and profitability and could lead to penalties, sanctions and reputational damages if we are not compliant with those regulations. Political uncertainty and a lack of institutional continuity in some of the emerging, developing or other countries in which we operate could affect the orderly operation of markets in these economies. In addition, in countries with a large and complicated structure of government and administration, national, regional, local and other governmental bodies may issue inconsistent decisions and opinions that could increase our cost of regulatory compliance and/or have a material adverse effect on our business. The ongoing conflict in Ukraine has resulted in an increasingly complex economic sanctions and export controls environment applicable to our business operations in the region (including Russia and Belarus) as a result of additional trade compliance measures enacted by the United States, United Kingdom and European Union member states. These economic sanctions and export controls restrict our ability to do business with sanctioned entities, require additional compliance resources, and could have a material adverse effect on the results of our operations.

Uncertainty of the legal environment in some emerging countries could also limit our ability to enforce our rights. In certain emerging and developing countries we enjoy less comprehensive protection for some of our rights, including intellectual property rights, which could undermine our competitive position. Proceedings to enforce our future patent rights, if any, in foreign jurisdictions could result in substantial cost and divert our efforts and attention from other aspects of our business.

If any of the above risks or similar risks associated with our international operations were to materialise, our results of operations and financial condition could be materially adversely affected.

We operate in many different jurisdictions and we could be adversely affected by violations of anti-corruption laws, including the United States Foreign Corrupt Practices Act of 1977 ("FCPA"), UK Bribery Act of 2010 ("UK Bribery Act") and similar anti-corruption laws in other jurisdictions as well as laws and regulations relating to trade compliance and economic sanctions.

The FCPA, UK Bribery Act and similar anti-corruption laws in other jurisdictions prohibit us and our officers, directors, employees and third parties acting on our behalf, including agents, from corruptly offering, promising, authorising, or providing anything of value to a "foreign official" for the purposes of influencing official decisions or obtaining or retaining business or otherwise obtaining favorable treatment. In addition, the FCPA imposes certain books, records and accounting control obligations on public companies and other issuers. The UK Bribery Act also prohibits "commercial" bribery and accepting bribes.

Our global business operations also must be conducted in compliance with applicable export controls and economic sanctions laws and regulations, including those administered by the U.S. Department of the Treasury’s (the “U.S. Treasury”) Office of Foreign Assets Control, the U.S. Department of State, the U.S. Department of Commerce, the United Nations Security Council, the European Union, His Majesty’s Treasury and other relevant trade compliance authorities.

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Appendix A: Risk Factors (continued)
Our internal policies mandate compliance with these anti-corruption and trade compliance laws and regulations. We also operate in many jurisdictions in which bribery or corruption can be common and compliance with anti-bribery laws may conflict with local customs and practices. Despite our training and compliance program safeguards, we cannot assure that our internal control policies, procedures and safeguards will protect us from acts in violation of anti-corruption and trade compliance laws and regulations committed by employees or other third parties associated with us and our continued expansion, including in developing countries, could increase such risk in the future. Violations of anti-corruption, economic sanctions and trade control laws and regulations, or even allegations of such violations, could disrupt our business and result in a material adverse effect on our financial condition, results of operations, cash flows and reputation. For example, violations of anti-corruption and trade compliance laws can result in restatements of, or irregularities in, our financial statements, disgorgement of profits, related stockholder lawsuits as well as severe criminal or civil sanctions. In some cases, companies that violate anti-corruption and trade compliance laws might be debarred by the U.S. government and/or lose their U.S. export privileges. In addition, the U.S. government or other governments may seek to hold us liable based on successor liability for violations of anti-corruption and trade compliance laws committed by companies that we acquire or in which we invest. Changes in anti-corruption and trade compliance laws or enforcement priorities could also result in increased compliance requirements and related costs which could materially adversely affect our business, financial condition, results of operations and cash flows. The recent increase in economic sanctions and trade controls, particularly relating to our ongoing operations in Russia, Ukraine and Belarus, has increased the amount of resources necessary to ensure compliance in this area.

Current and proposed laws and regulations regarding the protection of personal data could result in increased risks of liability or increased costs to us or could limit our service offerings.

ICON has a strong privacy posture, driven by the implementation of a core privacy governance strategy and the adoption of policies and procedures designed to help ensure that ICON, including our employees and contractors, can comply with applicable data protection laws (including, but not limited to, the General Data Protection Regulation (“GDPR”) (EU) 2016/679). Notwithstanding these measures, failure to comply with applicable data protection laws may occur and could result in increased risk of liability or increased costs to us or could limit our service offerings.

Administrative fines. The GDPR introduced a new regime of administrative fines for data protection infringements and provided for a tiered penalty structure based on the nature of the infringement. The EU supervisory authorities for the GDPR can directly impose fines on organisations found to be in breach of the GDPR. Lower tier administrative fines allow for fines of up to 2% of worldwide turnover of the group in the preceding financial year. Higher tier administrative fines allow for fines of up to 4% of worldwide turnover of the group in the preceding financial year. Higher tier administrative fines are more likely to be levied for major infringements of the GDPR and core data protection principles (e.g. transparency, data retention, accountability).

Penalties. The GDPR also permits Member States to implement rules on other penalties applicable to infringements of the GDPR, in particular, for infringements which are not subject to administrative fines under the GDPR itself. Therefore, Member States may legislate for further fines or penalties that may be criminal in nature.

Any fines levied under the GDPR must be effective, proportionate, and dissuasive. Supervisory authorities have been strengthening enforcement activities across the EU in recent years in respect of breaches of GDPR. The risk of fines and penalties under the GDPR carries increased risk of liability to ICON and can result in increased costs and disruption to the delivery of our services.

Right to compensation of data subjects. In addition to the risk of administrative and criminal penalties, the GDPR also provides that any person who has suffered material or non-material damage as a result of an infringement of the GDPR shall have the right to receive compensation for the damage suffered, from the controller or processor responsible for the infringement. The level of award of damages is set by the competent court in the applicable EU Member State. This carries increased risk of liability for ICON.

Corrective Powers of the supervisory authorities. Each supervisory authority across the Member States of the EU also has corrective powers. Supervisory authorities have the power to order ICON to bring processing operations into compliance with the provisions of the GDPR in a specified manner within a specified time period, or to impose a temporary or definitive limitation including a ban on processing, and to order the suspension of data flows to a recipient in a third country or to an international organisation. Supervisory authorities also have powers to conduct audits and investigations of ICON and instruct ICON to take certain actions. The exercise of these powers by supervisory authorities has the potential to increase costs for ICON and cause disruption to the business and delivery of our services.
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Appendix A: Risk Factors (continued)

From a US perspective, the confidentiality, collection, use and disclosure of personal data, including clinical trial patient-specific information, is subject to governmental regulation generally in the country that the personal data was collected or used. For example, United States federal regulations under the Health Insurance Portability and Accountability Act of 1996, or ("HIPAA"), and as amended in 2014 by the Health Information Technology for Economic and Clinical Health (“HITECH”) Act, require individuals’ written authorisation, in addition to any required informed consent, before Protected Health Information may be used for research. HIPAA specifies standards for de-identifications and for limited data sets. We are both directly and indirectly affected by the privacy provisions surrounding individual authorisations because many investigators and organisations with whom we are involved in clinical trials and in our other services are directly subject to them as a HIPAA “covered entity” and because we obtain identifiable health information from third parties that are subject to such regulations. As there are some instances where we are a HIPAA “business associate” of a “covered entity”, we can also be directly liable to the covered entity contractually for mishandling protected health information and, under HIPAA’s enforcement scheme, we can be subject to up to $1.9 million per year in civil money penalties for identical HIPAA violations. The per violation penalties and calendar year cap on penalties are adjusted annually for inflation under the Federal Civil Penalties Inflation Adjustment Act.

The foundational principles of the GDPR have helped shape the development of many other privacy laws globally. Internationally, data protection laws continue to be introduced at a rapid rate, with greater protections afforded to personal data than ever before, and greater risk of liability to organisations processing that personal data. As a global organisation, ICON must ensure that our privacy posture continues to adapt to these new laws and regulations.

Additional legislation or regulation of this type might, among other things, require us to implement new security measures and processes which may require substantial expenditures or limit our ability to offer some of our services. Additionally, if we violate applicable laws, regulations or duties relating to the use, processing or security of personal data, we could be subject to civil liability or criminal prosecution, be forced to alter our business practices or suffer reputational harm.

Our employees may engage in misconduct or other improper activities, including noncompliance with regulatory standards and requirements, which could have a material adverse effect on our business.

We are exposed to the risk of employee fraud or other misconduct. Misconduct by employees could include intentional failures to comply with governmental regulations, comply with federal and state healthcare fraud and abuse laws and regulations, report financial information or data accurately or disclose unauthorised activities to us. In particular, sales, marketing and business arrangements in the healthcare industry are subject to extensive laws and regulations intended to prevent fraud, kickbacks, self-dealing and other abusive practices. These laws and regulations may restrict or prohibit a wide range of pricing, discounting, marketing and promotion, sales commission, customer incentive programs and other business arrangements. Employee misconduct could also involve the improper use of information obtained in the course of clinical studies or data or documentation fraud or manipulation, which could result in regulatory sanctions and serious harm to our reputation. It is not always possible to identify and deter employee misconduct, and the precautions we take to detect and prevent misconduct may not be effective in controlling unknown or unmanaged risks or losses or in protecting us from governmental investigations or other actions or lawsuits stemming from a failure to be in compliance with such laws or regulations. If any such actions are instituted against us, and we are not successful in defending ourselves or asserting our rights, those actions could have a significant impact on our business and results of operations, including the imposition of significant fines or other sanctions.

The failure to comply with our government contracts or applicable laws and regulations could result in, among other things, fines or other liabilities, and changes in procurement regulations could adversely impact our business, results of operations or cash flows.
 
Revenues from our government customers are derived from sales to federal, state and local governmental departments and agencies through various contracts. Sales to public segment customers are highly regulated. Noncompliance with contract provisions, government procurement regulations or other applicable laws or regulations (including but not limited to the False Claims Act) could result in civil, criminal and administrative liability, including substantial monetary fines or damages, termination of government contracts or other public segment customer contracts, and suspension, debarment or ineligibility from doing business with the government and other customers in the public segment. In addition, generally contracts in the public segment are terminable at any time for convenience of the contracting agency or upon default. The effect of any of these possible actions by any governmental department or agency could adversely affect our business, results of operations or cash flows. In addition, the adoption of new or modified procurement regulations and other requirements may increase our compliance costs and reduce our gross margins, which could have a negative effect on our business, results of operations or cash flows.

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Appendix A: Risk Factors (continued)
Liability claims brought against us could result in payment of substantial damages, costs and liabilities and decrease our profitability.

We may face legal claims involving stockholders, consumers, clinical trial subjects, competitors, regulators and other parties. See 'Legal Proceedings' in Part A, Item 8 of this Form 20-F. Litigation and other legal proceedings are inherently uncertain, and adverse rulings could occur, including monetary damages, or an injunction stopping us from engaging in business practices, or requiring other remedies, including, but not limited to, compulsory licensing of patents.

    Customer Claims

If we breach the terms of an agreement with a customer (for example if we fail to comply with the agreement, all applicable regulations or Good Clinical Practice) this could result in claims against us for substantial damages which could have a material adverse effect on our business. As we provide staff to deliver our services, there is a risk that our management, quality and control structures fail to quickly detect a failure by one or more employees or contractors to comply with all applicable regulations and Good Clinical Practice and our internal requirements and standard operating procedures thereby exposing us to the risk of claims by customers.

    Claims relating to Investigators

We contract with physicians who serve as investigators in conducting clinical trials to test new drugs on their patients. These patients will generally have underlying health conditions and this testing creates the risk of liability for personal injury to the patient or the risk of a serious adverse event occurring. Although investigators are generally required by law to maintain their own liability insurance, we could be named in lawsuits and incur expenses arising from any professional malpractice or other actions brought against the investigators with whom we contract.

    Indemnification from Customers

Indemnifications provided by our customers against the risk of liability for personal injury to or death of the patients arising from a study drug vary from customer to customer and from trial to trial and may not be sufficient in scope or amount, or our customer may not have the financial ability to fulfill their indemnification obligations. Furthermore, we would be liable for our own negligence and negligence of our employees which could lead to litigation from customers or action or enforcement by regulatory authorities.

    Insurance

We maintain what we believe is an appropriate level of worldwide Professional Liability/Error and Omissions Insurance. In the future we may be unable to maintain or continue our current insurance coverage on the same or similar terms. If we are liable for a claim or settlement that is beyond the level of insurance coverage, we may be responsible for paying all or part of any award or settlement amount. Also, the insurance policies contain exclusions which mean that the policy will not respond or provide cover in certain circumstances.

    Claims to Date

To date, we have not been subject to any liability claims that are expected to have a material effect on our business; however, there can be no assurance that we will not become subject to such claims in the future or that such claims will not have a material effect on our business.

Environmental, social and governance matters may impact our business and reputation.

Increasingly, in addition to the importance of their financial performance, companies are being judged by their performance on a variety of environmental, social and governance (ESG) matters, which are considered to contribute to the long-term sustainability of companies’ performance. A variety of organisations measure the performance of companies on such ESG topics, and the results of these assessments are widely publicised. Customers may have specific ESG related requirements or targets and if we fail to meet these targets, we may lose business.

In addition, investment in funds that specialize in companies that perform well in such assessments are increasingly popular, and major institutional investors have publicly emphasised the importance of such ESG measures to their investment decisions. Topics taken into account in such assessments include, among others, the Company’s efforts and impacts on climate change and human rights, ethics and compliance with law, and the role of the Company’s board of directors in supervising various sustainability issues. We actively manage a broad range of such ESG matters, taking into consideration their expected impact on the sustainability of our business over time, and the potential impact of our business on society and the environment. However, in light of stakeholders’ increased focus on ESG matters, there can be no certainty that we will manage such issues successfully, or that we will successfully meet society’s perceived expectations as
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Appendix A: Risk Factors (continued)
to our proper role. Any failure or perceived failure by us in this regard could have a material adverse effect on our reputation and on our business, share price, financial condition, or results of operations, including the sustainability of our business over time.

Increasing focus on ESG matters has resulted in, and is expected to continue to result in, the adoption of legal and regulatory requirements designed to mitigate the effects of climate change on the environment, as well as legal and regulatory requirements requiring climate, human rights and supply chain-related disclosures. If new laws or regulations are more stringent than current legal or regulatory requirements, we may experience increased compliance burdens and costs to meet such obligations.

In addition, our selection of voluntary disclosure frameworks and standards, and the interpretation or application of those frameworks and standards, may change from time to time or may not meet the expectations of investors or other stakeholders. Our ability to achieve our ESG commitments is subject to numerous risks, many of which are outside of our control.

Risk Related to Our Common Stock

Volatility in the market price of our common stock could lead to losses by investors.

The market price of our common stock has experienced volatility in the past and may experience volatility in the future which could lead to losses for investors. Factors impacting volatility in the market price of our common stock include, amongst others:

general market and economic conditions;
our results of operations;
issuance of new or changed securities analysts’ reports or recommendations;
developments impacting the industry or our competitors;
declines in the market prices of stocks generally;
strategic actions by us or our competitors;
announcements by us or our competitors of significant contracts, new products, acquisitions, joint marketing relationships, joint ventures, other strategic relationships or capital commitments;
the public's reaction to press releases, other public announcements by us or third parties, including our filings with the SEC;
guidance, if any, that we provide to the public, any changes in this guidance or failure to meet this guidance;
changes in the credit rating of our debt;
sale, or anticipated sale, of large blocks of our stock;
additions or departures of key personnel;
regulatory or political developments;
our performance on ESG matters
litigation and governmental investigations;
changing economic conditions;
exchange rate fluctuations;
changes in accounting principles; and
other events or factors, including those resulting from natural disasters, war, acts of terrorism or responses to those events.                        

In addition, stock markets have from time to time experienced significant price and volume fluctuations unrelated to the operating performance of particular companies. Future fluctuations in stock markets may lead to volatility in the market price of our common stock which could lead to losses by investors.

An investor's return may be reduced if we lose our foreign private issuer status.

We are a “foreign private issuer,” as such term is defined in Rule 405 under the U.S. Securities Act 1933, and, therefore, we are not required to file quarterly reports on Form 10-Q or current reports on Form 8-K with the SEC. In addition, the proxy rules and Section 16 reporting and short-swing profit recapture rules are not applicable to us. If we lose our status as a foreign private issuer by our election or otherwise and we become subject to the full reporting regime of the United States securities laws, we will be subject to additional reporting obligations and proxy solicitation obligations under the Exchange Act and our officers, directors and 10% shareholders would become subject to the short-swing profit rules. The imposition of these reporting rules would increase our costs and the obligations of those affected by the short-swing rules.

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Appendix A: Risk Factors (continued)
We do not expect to pay any cash dividends for the foreseeable future.

We currently do not expect to declare dividends on our common stock and have not done so in the past. We continue to anticipate that our earnings will be used to provide working capital, to support operations, to make debt repayments and to finance the growth and development of our business. They may also be used to continue our share repurchase program. Any determination to declare or pay dividends in the future will be at the discretion of our board of directors, subject to relevant laws and dependent on a number of factors, including our earnings, capital requirements and overall financial condition. Therefore, the only opportunity for stockholders to achieve a return on their investment may be if the market price of our common stock appreciates and shares are sold at a profit. The market price for our common stock may not appreciate and may fall below the price stockholders paid for such common stock.

A future transfer of ICON ordinary shares, other than one effected by means of the transfer of book entry interests in the Depositary Trust Company (DTC), may be subject to Irish stamp duty.

Transfers of ICON ordinary shares effected by means of the transfer of book entry interests in the DTC should not be subject to Irish stamp duty where ICON ordinary shares are traded through DTC, either directly or through brokers that hold such shares on behalf of customers through DTC. However, if ICON ordinary shares are held as of record rather than beneficially through DTC, any transfer of ICON ordinary shares could be subject to Irish stamp duty (currently at the rate of 1% of the higher of the price paid or the market value of the shares acquired). Payment of Irish stamp duty is generally a legal obligation of the transferee. The potential for Irish stamp duty to arise could adversely affect the price of ICON ordinary shares.

Forward-looking statements

To the extent any statements made in this annual report deal with information that is not historical, these statements are necessarily forward-looking. Because forward-looking statements relate to the future, they are subject to inherent uncertainties, risks and changes in circumstances that are difficult to predict and many of which are outside of the Group’s control. Any forward-looking statement made by the Group is based only on information currently available as at the time of publication of this report. Forward-looking statements are subject to the occurrence of many events outside of the Group’s control and are subject to various risk factors that would cause our results to differ materially from those expressed in any forward-looking statement. These risk factors described in Appendix A include, without limitation, the inherent risk of dependence on pharmaceutical and biotechnology industries and certain clients, termination or delay of large contracts, risk of cost overruns, the risk of clinical outcomes, regulatory risks and market competition.
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