You should read the following discussion and analysis of our financial condition
and results of operations in conjunction with our condensed consolidated
financial statements and the related notes thereto included elsewhere in this
Quarterly Report on Form 10-Q and with our audited consolidated financial
statements and related notes thereto included in our Annual Report on Form 10-K
for the year ended December 31, 2019, as superseded by, and solely to the extent
set forth in, our first Current Report on Form 8-K filed on May 21, 2020 (the
"May 2020 Form 8-K"). This discussion may contain forward-looking statements
based upon current expectations that involve risks and uncertainties. Our actual
results may differ materially from those anticipated in these forward-looking
statements as a result of various factors, including the impact from the
COVID-19 pandemic and other factors set forth in other sections of this
Quarterly Report on Form 10-Q, as well as the risk factors set forth in our
Annual Report on Form 10-K for the year ended December 31, 2019. For important
information regarding these forward-looking statements, please see "Special Note
Regarding Forward-Looking Statements."
Company Overview
We are a leading provider of drug development services to the biopharmaceutical
industry, focused on helping our customers bring their new medicines to patients
around the world. We have been in the drug development business for more than 30
years, providing a comprehensive suite of clinical development and laboratory
services to pharmaceutical, biotechnology, medical device, government
organizations and other industry participants. We have deep experience across a
broad range of rapidly growing areas of drug development and engage with
customers through a variety of commercial models, including both full-service
and functional service partnerships and other offerings tailored to address the
specific needs of our customers. Our company is currently organized and managed
around two reportable segments, Clinical Development Services and Laboratory
Services. See Part I, Item 1, "Business," in our Annual Report on Form 10-K for
the year ended December 31, 2019, as superseded by, and only to the extent set
forth in our May 2020 Form 8-K, for additional information on our Clinical
Development Services and Laboratory Services segments.
Our purpose and mission are to improve health by helping our customers deliver
life-changing therapies. We pursue our purpose and mission through our clinical
development and laboratory services and our strategy to bend the cost and time
curve of drug development and optimize value for our customers. Our customers
benefit from accelerated time to market because it results in lengthened periods
of market exclusivity, and our real-world evidence solutions support the
superior efficacy and value of their novel therapies. We believe our medical,
scientific and drug development expertise, along with our innovative
technologies and knowledge of global regulatory requirements, help our customers
accelerate the development of safe and effective therapeutics and maximize
returns on their research and development ("R&D") investments.
Initial Public Offering
On February 6, 2020, our common stock began trading on The Nasdaq Global Select
Market under the symbol "PPD." On February 10, 2020, we completed our initial
public offering ("IPO") of our common stock at a price to the public of $27.00
per share. We issued and sold 69.0 million shares of common stock in the IPO,
including 9.0 million shares of common stock issued pursuant to the full
exercise of the underwriters' option to purchase additional shares. We raised
net proceeds of $1,773.0 million through the IPO, after deducting underwriting
discounts and other offering expenses totaling $90.0 million.
We used a portion of the net proceeds from the IPO to (i) redeem $550.0 million
in aggregate principal amount of unsecured 7.625%/8.375% Senior PIK Toggle Notes
(the "Initial HoldCo Notes"), plus accrued and unpaid interest thereon and $5.5
million of redemption premium and (ii) redeem $900.0 million in aggregate
principal amount of unsecured 7.75%/8.50% Senior PIK Toggle Notes (the
"Additional HoldCo Notes" and, together with the Initial HoldCo Notes, the
"HoldCo Notes"), plus accrued and unpaid interest thereon and $9.0 million of
redemption premium. The redemption of the HoldCo Notes resulted in a total loss
on extinguishment of debt of $50.1 million.
Issuance of New Notes and Redemption of OpCo Notes
On June 5, 2020, we issued $1,200.0 million of unsecured senior notes consisting
of (i) $500.0 million aggregate principal amount of 4.625% senior notes due 2025
(the "2025 Notes") and (ii) $700.0 million aggregate principal amount of 5.0%
senior notes due 2028 (the "2028 Notes" and, together with the 2025 Notes, the
"New Notes"). We used the proceeds from the issuance of the New Notes to redeem
$1,125.0 million in aggregate principal amount of unsecured 6.375% senior notes
(the "OpCo Notes"), plus accrued and unpaid interest thereon and a $35.9 million
redemption premium. The redemption of the OpCo Notes resulted in a total loss on
extinguishment of debt of $43.5 million.




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Recent Developments - COVID-19
In March 2020, the World Health Organization declared COVID-19 a global pandemic
that has resulted in travel and business disruption and volatile conditions in
the capital and credit markets and overall economy. Globally, governments have
implemented travel bans, stay at home or total lock-down mandates and other
social distancing measures to combat the spread of COVID-19. In response to the
global pandemic, we have created a pandemic response committee of company
leaders, including our chief medical officer, to help manage our response to the
pandemic focused on (i) the health and safety of our employees and patients and
(ii) business continuity, preserving the integrity of the work we do for our
customers, including support for vaccines and anti-viral therapies for COVID-19.
To implement social distancing measures and maximize work productivity, we have
limited personnel in our facilities, with remote-capable employees throughout
our company working remotely. We have also significantly limited domestic and
international travel of our employees.
To date, the COVID-19 pandemic has impacted our business across both our
Clinical Development Services and Laboratory Services segments. The impacts
include the ability of our employees to visit hospitals and other clinical
research sites to conduct monitoring and other critical site visits and patient
recruitment and enrollment activities as part of services offered within our
Clinical Development Services segment, as well as a temporary shutdown of our
Phase I clinics beginning in March 2020. Furthermore, we have had customers
delay new studies and/or pause ongoing studies or certain activities thereof,
such as patient recruitment, patient enrollment, site visits and site
monitoring, impacting our Clinical Development Services segment. Additionally,
at the onset of the pandemic, our Laboratory Services segment experienced
limited reductions in central lab services due to delays in clinical trial
activity that impacted sample volumes.
During the second quarter of 2020, as travel restrictions were lifted and phased
reopenings began in jurisdictions in which we operate, we began to reopen a
limited number of our offices and also allow business-critical travel to occur,
including employee visits to hospitals and other clinical research sites, as
well as the activation of new sites. We also began a phased reopening of all of
our Phase I clinics. Due to safety measures we implemented shortly following the
onset of the COVID-19 pandemic, our laboratory facilities have continued to
operate at near full capacity during the pandemic. While we saw improvements
over the course of the second quarter of 2020 in relation to fewer customers
delaying new or ongoing studies, steady improvements in site-based activities
and the return of pre-pandemic testing volumes at our central labs, these delays
have impacted and will continue to impact the timing and extent to which backlog
has and will convert to revenue.
In response to the COVID-19 pandemic, we have taken measures to mitigate the
impact of the aforementioned factors across both of our segments. Such
mitigation activities include, but are not limited to, (i) winning new awards
for services to help our customers treat or combat the spread of COVID-19 with
anti-viral therapies and vaccines, which includes more than 85 COVID-19 related
awards to date across both of our segments, (ii) the continued adoption of
digital and virtual strategies and (iii) cost reduction strategies, including
reducing travel and related expenses, limiting increases in employee headcount
in certain non-billable areas, voluntary and limited temporary involuntary
employee furloughs and reduced working hours. We may also implement other cost
mitigation or reduction measures in the future depending on the progression of
the COVID-19 pandemic and the resulting impacts to our business.
We do not yet know nor can we predict the full extent of the impact the COVID-19
pandemic will have on our business, financial condition, results of operations
or the global economy as a whole, as the ultimate impact of the pandemic is
highly uncertain and subject to change. While the COVID-19 pandemic has impacted
our business and results of operations, we have been able to partially offset
the financial impact due to the mitigation activities discussed above. However,
the operational and financial impacts from COVID-19 could significantly increase
in the future due to the magnitude, continued duration, geographic reach,
ongoing impact on the global economy and capital and credit markets, and current
travel and other restrictions relating to the COVID-19 pandemic. In addition, we
might not be able to mitigate future impacts as we have done to date.
Furthermore, federal, state and local governments have implemented economic and
other stimulus measures to support individuals and businesses impacted by the
COVID-19 pandemic, and while we have utilized such measures where applicable,
there can be no assurance that such measures will benefit us or otherwise offset
any or all of the financial impacts from the COVID-19 pandemic. To date, such
measures have not been material to our results of operations.
If the pandemic continues for an extended period or worsens, such as the recent
increase in COVID-19 cases in the United States or a second global wave, and/or
governments' actions to contain the spread of COVID-19 are ineffective, these
factors could result in a material negative impact on our business, growth,
reputation, prospects, financial condition, results of operations (including
components of our financial results), cash flows and liquidity. Such impacts
could include, but are not limited to, additional customer delays or
cancellations of awarded services, reductions in R&D drug development pipelines
which could result in lower growth to our industry, additional costs related to
restructuring activities, non-cash impairments of goodwill and other long-lived
assets, decreases in the value of our investments, loss of hedge accounting and
restrictions on our ability to obtain additional financing, if needed, or
refinancing of our senior secured credit facilities.

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We are closely monitoring the changing landscape with respect to the COVID-19
pandemic and taking actions to manage our business and support our employees,
patients and customers. We will continue to evaluate the nature and extent of
the impact to our business, results of operations, financial condition and
liquidity. For further discussion of the risks related to our business and the
COVID-19 pandemic, see Part II, Item 1A, "Risk Factors," included elsewhere in
this Quarterly Report on Form 10-Q.
Sources of Revenue
Revenue is comprised of direct, third-party pass-through and out-of-pocket
revenue from providing services to our customers. Direct revenue represents
revenue associated with the direct services provided under our contracts.
Third-party pass-through and out-of-pocket revenue (collectively, "indirect
revenue") represents the reimbursement by customers of third-party pass-through
and out-of-pocket costs incurred by us under our contracts.
We record the reimbursement of indirect revenue and the related costs incurred
as revenue and reimbursed costs on the condensed consolidated statements of
operations. These reimbursed costs are included as revenue as we (i) are the
principal in the relationship, (ii) are primarily responsible for the services
provided by third parties and (iii) significantly integrate the services of the
third parties with our own services in delivering a combined output to the
customer.
We assess our revenue based on our primary businesses, Clinical Development
Services and Laboratory Services. Our Clinical Development Services segment
represented 80.6% and 83.6% of revenue for the three months ended June 30, 2020
and 2019, respectively, and 80.9% and 83.8% of revenue for the six months ended
June 30, 2020 and 2019, respectively, with the remainder generated from our
Laboratory Services segment.
We have a diverse customer mix, with one customer accounting for approximately
11% of our revenue for the three months ended June 30, 2020 and no one customer
accounting for more than 10% of our revenue for the three months ended June 30,
2019 or the six months ended June 30, 2020 and 2019. Our top 10 customers
accounted for approximately 53.6% and 45.2% of our revenue for the three months
ended June 30, 2020 and 2019, respectively, and 51.1% and 46.2% for the six
months ended June 30, 2020 and 2019, respectively. Based on the diversity of our
customer base, we do not believe we have significant customer concentration
risk. We do not have any significant product revenues.
Operating Costs and Expenses
Our operating costs and expenses primarily consist of direct costs, reimbursed
costs, selling, general and administrative ("SG&A") expenses and depreciation
and amortization.
Direct Costs
Direct costs represent costs for providing services to customers. Direct costs
primarily include labor-related costs, such as compensation and benefits for
employees providing services, an allocation of facility and information
technology costs, supply costs, costs for certain media-related services for
patient recruitment, stock-based compensation expense, other overhead costs and
offsetting R&D incentive credits. Direct costs typically increase or decrease
with changes in revenue and may fluctuate significantly from period to period as
a percentage of revenue due to staff labor utilization, project labor mix, the
type of services, changes to the timing of work performed and project
inefficiencies, among other factors.
Reimbursed Costs
Reimbursed costs include third-party pass-through and out-of-pocket costs which
are generally reimbursable by our customers at cost. Third-party pass-through
and out-of-pocket costs include, but are not limited to, payments to
investigators, payments for the use of third-party technology, shipping costs
and travel costs related to the performance of services, among others.
Third-party pass-through and out-of-pocket costs are incurred across both of our
reportable segments.
Because services associated with reimbursed costs are generally provided by us
without profit or mark-up and fluctuate from period to period without being
important to our underlying performance over the full term of a contract, these
costs do not have a significant impact on our income from operations. While
fluctuations from period to period are not meaningful over the full term of a
contract, actual and estimated reimbursed costs can impact revenue recognized,
consolidated income from operations and segment operating income throughout the
duration of a contract.
Selling, General and Administrative Expenses
SG&A expenses represent costs of business development, administrative and
support functions. SG&A expenses primarily include compensation and benefits for
employees, costs related to employees performing administrative tasks,
stock-based compensation expense, sales, marketing and promotional expenses,
employee recruiting and relocation expenses, employee training costs, travel
costs, an allocation of facility and information technology costs and other
overhead costs.

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Depreciation and Amortization
Depreciation and amortization represents the costs charged for our property and
equipment and intangible assets. We record depreciation and amortization on
property and equipment using the straight-line method, based on the estimated
useful lives of the respective assets. We depreciate leasehold improvements over
the shorter of the lease term or the estimated useful lives of the improvements.
We amortize software developed or obtained for internal use over the estimated
useful life of the software or term of the licensing agreement. Amortization
expense primarily comes from acquired definite-lived intangible assets. We
amortize definite-lived intangible assets using either the straight-line method
or sum-of-the-years digits method over the estimated useful lives of the assets.
How We Assess the Performance of Our Business
We manage and assess our business based on segment performance and allocate
resources utilizing segment revenues and segment operating income. We also
assess the performance of our reported consolidated business using a number of
metrics including backlog and net authorizations. Historically, we have assessed
backlog and net authorizations on a basis which excluded indirect revenues and
the impact of Accounting Standards Codification ("ASC") Topic 606, Revenue from
Contracts with Customers ("ASC 606") on direct revenue ("Historical Basis").
Starting in the first quarter of 2020, we began to assess backlog and net
authorizations on an ASC 606 total direct and indirect revenue basis ("Backlog
and Net Authorizations - ASC 606 Basis"). Our discussion of backlog and net
authorizations below is applicable to both of the aforementioned backlog and net
authorization metrics.
Our backlog represents anticipated revenue for work not yet completed or
performed (i) under signed contracts, letters of intent and, in some cases,
awards that are supported by other forms of written communication and (ii) where
there is sufficient or reasonable certainty about the customer's ability and
intent to fund and commence the services within six months. Backlog and backlog
conversion (defined as quarterly revenue for the period divided by opening
backlog for that period) vary from period to period depending upon new
authorizations, contract modifications, cancellations and the amount of revenue
recognized under existing contracts. We adjust backlog for foreign currency
fluctuations and exclude from backlog revenue that has been recognized as
revenue in our statements of operations.
Although an increase in backlog will generally result in an increase in future
revenue to be recognized over time (depending on future contract modifications,
contract cancellations and other adjustments), an increase in backlog at a
particular point in time does not necessarily correspond to an increase in
revenue during a particular period. The timing and extent to which backlog will
result in revenue depends on many factors, including the timing of commencement
of work, the rate at which we perform services, scope changes, cancellations,
delays, receipt of regulatory approvals and the nature, duration, size,
complexity and phase of the studies. Our contracts generally have terms ranging
from several months to several years. In addition, delayed projects remain in
backlog unless they are canceled.
As noted elsewhere in this Quarterly Report on Form 10-Q, due to the COVID-19
pandemic, we have had customers delay new studies and/or pause ongoing studies
or certain activities thereof, such as patient recruitment, patient enrollment,
site visits and site monitoring. These delays have impacted and will continue to
impact the timing and extent to which backlog has and will convert to revenue.
We have not adjusted backlog to remove the backlog associated with these studies
as our customers for these studies have not canceled or notified us of their
intent to cancel these studies and because we cannot estimate the length of
delay. As a result of these and other factors, our backlog might not be a
reliable indicator of future revenue and we might not realize all or any part of
the revenue from the authorizations in backlog as of any point in time. Once
work begins, we recognize revenue over the life of the contract as we perform
services under such contract. We have included new business awards associated
with COVID-19 in our net authorizations and backlog.
We add new authorizations to backlog based on the aforementioned criteria for
backlog. Net authorizations represent new business awards, net of award or
contract modifications, contract cancellations, foreign currency fluctuations
and other adjustments. New authorizations vary from period to period depending
on numerous factors, including customer authorization volume, sales performance
and overall health of the biopharmaceutical industry, among others. New
authorizations have varied and will continue to vary significantly from quarter
to quarter and from year to year. In addition to net authorizations, we also
assess net book-to-bill, which represents the amount of net authorizations for
the period divided by revenue recognized in that period.





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Backlog and Net Authorizations The following table provides selected information related to our backlog and net authorizations as of and for the three months ended June 30, 2020:


                            Historical Basis             ASC 606 Basis
(dollars in millions)      2020          2019         2020          2019
Net authorizations      $ 1,052.2     $  936.4     $ 1,580.2     $ 1,256.2
Backlog                   7,581.3      6,692.0      11,189.4       9,758.9
Backlog conversion           10.7 %       11.9 %         9.5 %        10.5 %
Net book-to-bill            1.34x        1.20x         1.56x         1.26x


The increase in net authorizations and backlog in 2020 for the metrics above as
compared to the same period in the prior year was primarily due to a higher win
rate on competitive decisions (which represents the total dollar amount of new
business on which we bid), new business awards related to the COVID-19 pandemic
and favorable net foreign currency fluctuations, partially offset by
cancellations.
Acquisitions
On September 3, 2019, we acquired 100% of the issued and outstanding equity of
Synarc, Inc. ("Synarc"), the global site network of Bioclinica, Inc., expanding
our global footprint into China and Latin America and expanding our central
nervous system offering in the United States. Additionally, on July 1, 2019, we
acquired 100% of the issued and outstanding equity of Medimix International
("Medimix"), a global technology company that provides real-world evidence
insights and information to the pharmaceutical, diagnostic and medical device
industries. See Note 4, "Business Combinations," to our condensed consolidated
financial statements included elsewhere in this Quarterly Report on Form 10-Q
for additional information.
Incremental Public Company Expenses
As a new public company, we have and will incur additional expenses on an
ongoing basis that we did not incur as a private company. Those costs include
additional director and officer liability insurance expenses, as well as
third-party and internal resources related to accounting, auditing,
Sarbanes-Oxley Act compliance, legal, investor and public relations expenses and
additional stock-based compensation expense as we align our long-term incentive
plan with other comparable public company plans. These costs are expected to
generally be SG&A expenses.
Results of Operations
We have included the results of operations of acquired companies in our
condensed consolidated results of operations from the date of their respective
acquisitions, which impacts the comparability of our results of operations when
comparing results for the three and six months ended June 30, 2020 to the three
and six months ended June 30, 2019. We have noted in the discussion below, to
the extent meaningful and quantifiable, the impact on the comparability of our
condensed consolidated results of operations to prior year results due to the
inclusion of acquired companies when comparing the three and six months ended
June 30, 2020 to the three and six months ended June 30, 2019.
During the first quarter of 2020, our Chief Operating Decision Maker began
assessing performance and making resource allocation decisions based on total
segment revenue, including direct and indirect revenue, and segment operating
income, including reimbursed costs. Previously, certain revenue amounts were not
allocated to segments, whereas following the change, all revenue and reimbursed
costs are allocated to the respective segment. As a result, we have updated our
segment presentation and all prior period information has been recast to reflect
the change in the measurement of segment performance measures.
Three Months Ended June 30, 2020 versus Three Months Ended June 30, 2019
Consolidated Results of Operations
Revenue                       Three Months Ended June 30,
(dollars in thousands)             2020                 2019           Change
Revenue                  $      1,010,918            $ 996,531    $ 14,387    1.4 %



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Revenue increased $14.4 million, or 1.4%, to $1,010.9 million for the three months ended June 30, 2020 as compared to the same period in 2019. Revenue increased 1.6% from inorganic growth primarily due to our acquisitions of Synarc and Medimix (the "2019 Acquisitions"). The increase in revenue was partially offset by a 0.2% decrease from the unfavorable impact from foreign currency exchange rates. Direct Costs

                                 Three Months Ended June 30,
(dollars in thousands)                         2020               2019                Change
Direct costs, exclusive of
depreciation and amortization            $     374,839       $     375,503     $  (664 )     (0.2 )%
% of revenue                                      37.1 %              37.7 %


Direct costs decreased $0.7 million to $374.8 million for the three months ended June 30, 2020 as compared to the same period in 2019. The decrease in direct costs was primarily due to (i) a reduction in certain project delivery costs, including contract labor and media-related costs for patient recruitment services, (ii) the impacts of limited voluntary and involuntary temporary furloughs of certain employees as a result of COVID-19 related cost reduction measures and (iii) a 1.6% decrease from the favorable impact from foreign currency exchange rates. The decrease in direct costs was partially offset by an increase in laboratory supply costs and the impact of the 2019 Acquisitions. As a percentage of revenue, direct costs decreased slightly to 37.1% for the three months ended June 30, 2020 as compared to 37.7% in the same period in 2019 primarily due to the factors identified above. Reimbursed Costs

             Three Months Ended June 30,
(dollars in thousands)         2020               2019              Change
Reimbursed costs         $     223,807       $     221,873     $ 1,934    0.9 %
% of revenue                      22.1 %              22.3 %


Reimbursed costs increased $1.9 million to $223.8 million for the three months
ended June 30, 2020 as compared to the same period in 2019. Reimbursed costs
increased primarily due to the increase in revenue and our overall growth as
well as the general timing of costs incurred across our portfolio of work, which
will vary over the course of clinical trials due to the timing of the work
performed, scope changes and the complexity and phase of the study, among other
factors. The increase in reimbursed costs was also due to a 0.7% increase from
the unfavorable impact of foreign currency exchange rates. As a percentage of
revenue, reimbursed costs decreased slightly to 22.1% for the three months ended
June 30, 2020 as compared to 22.3% in the same period in 2019 primarily due to
the factors identified above.
Selling,
General and Administrative Expenses         Three Months Ended June 30,
(dollars in thousands)                       2020                 2019                Change
Selling, general and administrative
expenses                               $      237,616       $      236,055     $ 1,561        0.7 %
% of revenue                                     23.5 %               23.7 %


SG&A expenses increased $1.6 million to $237.6 million for the three months ended June 30, 2020 as compared to the same period in 2019. The increase in SG&A expenses was primarily due to (i) compensation increases and (ii) the impact of the 2019 Acquisitions. The increase in SG&A expenses was partially offset by (i) lower travel and associated expenses as a result of COVID-19 related cost reduction measures and (ii) a 1.3% decrease from the favorable impact from foreign currency exchange rates. As a percentage of revenue, SG&A expenses decreased slightly to 23.5% for the three months ended June 30, 2020 as compared to 23.7% in the same period in 2019 primarily due to the factors identified above. Interest Expense, Net Three Months Ended June 30, (dollars in thousands)

              2020                 2019
Interest expense, net    $       51,403                $ 76,870

Interest expense, net, was $51.4 million for the three months ended June 30, 2020 as compared to $76.9 million in the same period in 2019. The decrease in interest expense was primarily related to the redemption of our HoldCo Notes and a decrease in the interest rate on our term loan under our senior secured credit facilities, partially offset by the impact from unfavorable interest rate swaps.



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Loss on Extinguishment of Debt Three Months Ended June 30, (dollars in thousands)

                     2020                2019
Loss on extinguishment of debt   $            (43,469 )       $   -


Loss on extinguishment of debt was $43.5 million for the three months ended June 30, 2020. The loss resulted from the early extinguishment of our OpCo Notes and consisted of a redemption premium of $35.9 million and the write off of our unamortized deferred debt issuance costs of $7.6 million. There was no loss on extinguishment of debt for the three months ended June 30, 2019. Gain on Investments

            Three Months Ended June 30,
(dollars in thousands)               2020                  2019
Gain on investments      $        96,621                 $ 6,490


Gain on investments was $96.6 million for the three months ended June 30, 2020
as compared to a gain of $6.5 million in the same period in 2019. The gains for
both periods were primarily a result of changes in the fair values of the net
asset values of our investments, partially offset by changes to the discounts on
certain investments in the prior year. The increase in net asset value for the
three months ended June 30, 2020 reflects primarily an increase in fair value
resulting from one of the underlying investments becoming publicly traded in the
second quarter, as well as the subsequent increases in the trading stock price
during the remainder of the quarter.
The gains or losses from our investments will likely continue to fluctuate from
period to period primarily based on the changes in fair value of the underlying
holdings of the limited partnerships and changes in the discounts applied to
such investments for our lack of control and lack of marketability, where
applicable.
Other (Expense) Income, Net       Three Months Ended June 30,
(dollars in thousands)               2020                2019
Other (expense) income, net   $       (26,238 )     $      11,986

Other expense, net, was $26.2 million for the three months ended June 30, 2020 as compared to other income, net, of $12.0 million in the same period in 2019. Foreign exchange rate movement resulted in transaction and re-measurement losses of $23.2 million for the three months ended June 30, 2020 and transaction and re-measurement gains of $12.7 million in the same period in 2019. Undesignated interest rate swap activity resulted in losses of $3.3 million for the three months ended June 30, 2020 and no losses or gains for the three months ended June 30, 2019. Provision for Income Taxes Three Months Ended June 30, (dollars in thousands)

             2020                2019
Provision for income taxes   $       17,230       $      6,642
Effective income tax rate              21.2 %             17.0 %


Our provision for income taxes was $17.2 million, resulting in an effective income tax rate of 21.2%, for the three months ended June 30, 2020 as compared to a provision of $6.6 million, or an effective income tax rate of 17.0%, in the same period in 2019. Our provision for income taxes for the three months ended June 30, 2020 was primarily due to the estimated tax effect on our pre-tax income. Our provision for income taxes for the three months ended June 30, 2019 was primarily due to the estimated tax effect on our pre-tax income, partially offset by the impact from favorable discrete items.



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Segment Results of Operations
Clinical Development Services and Laboratory Services segment revenue, segment
direct costs, segment reimbursed costs, segment SG&A expenses and segment
operating income for the three months ended June 30, 2020 and 2019 are detailed
below.
Clinical Development Services
                                 Three Months Ended June 30,
(dollars in thousands)                2020                 2019             Change
Segment revenue            $       815,250              $ 833,341    $ (18,091 )   (2.2 )%
Segment direct costs               283,378                293,596      (10,218 )   (3.5 )
Segment reimbursed costs           198,226                202,713       (4,487 )   (2.2 )
Segment SG&A expenses              135,518                132,081        3,437      2.6
Segment operating income   $       198,128              $ 204,951    $  (6,823 )   (3.3 )


Segment Revenue
Clinical Development Services' revenue was $815.3 million for the three months
ended June 30, 2020, a decrease of $18.1 million as compared to the same period
in 2019. Revenue decreased (i) 4.0% from organic volume primarily due to the
impacts of COVID-19 on our business and (ii) 0.1% from the unfavorable impact
from foreign currency exchange rates. The decrease in revenue was partially
offset by a 1.9% increase from inorganic growth due to the 2019 Acquisitions.
Segment Direct Costs
Clinical Development Services' direct costs were $283.4 million for the three
months ended June 30, 2020, a decrease of $10.2 million as compared to the same
period in 2019. The decrease in direct costs was primarily due to (i) a
reduction in revenue as well as a reduction in certain project delivery costs,
including contract labor and media-related costs for patient recruitment
services, (ii) the impacts of limited voluntary and involuntary temporary
furloughs of certain employees as a result of COVID-19 related cost reduction
measures and (iii) a 2.0% decrease from the favorable impact from foreign
currency exchange rates.
Segment Reimbursed Costs
Clinical Development Services' reimbursed costs were $198.2 million for the
three months ended June 30, 2020, a decrease of $4.5 million as compared to the
same period in 2019. Reimbursed costs decreased primarily due to the decrease in
revenue, as well as due to the general timing of costs incurred across our
portfolio of work, which will vary over the course of clinical trials due to the
timing of the work performed, scope changes and the complexity and phase of the
study, among other factors. The decrease in reimbursed costs was partially
offset by a 0.9% increase from the unfavorable impact from foreign currency
exchange rates.
Segment SG&A Expenses
Clinical Development Services' SG&A expenses were $135.5 million for the three
months ended June 30, 2020, an increase of $3.4 million as compared to the same
period in 2019. The increase in SG&A expenses was primarily due to (i)
compensation increases and (ii) the impact of the 2019 Acquisitions. The
increase in SG&A expenses was partially offset by (i) lower travel and
associated expenses as a result of COVID-19 related cost reduction measures and
(ii) a 1.7% decrease from the favorable impact from foreign currency exchange
rates.
Laboratory Services
                                 Three Months Ended June 30,
(dollars in thousands)                2020                 2019            Change
Segment revenue            $       195,668              $ 163,190    $ 32,478    19.9 %
Segment direct costs                89,748                 75,466      14,282    18.9
Segment reimbursed costs            25,581                 19,160       6,421    33.5
Segment SG&A expenses               21,863                 19,904       1,959     9.8
Segment operating income   $        58,476              $  48,660    $  9,816    20.2



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Segment Revenue
Laboratory Services' revenue was $195.7 million for the three months ended
June 30, 2020, an increase of $32.5 million as compared to the same period in
2019. Revenue increased from organic volume growth across all our laboratory
services in part due to higher opening backlog at the beginning of the year and
overall growth in new business awards during 2020, including those associated
with COVID-19 work. The higher opening backlog was primarily due to increased
net authorizations across all of our lab businesses in 2019.
Segment Direct Costs
Laboratory Services' direct costs were $89.7 million for the three months ended
June 30, 2020, an increase of $14.3 million as compared to the same period in
2019. The increase in direct costs was primarily due to (i) a $9.1 million
increase from growth in employee headcount to support current growth in revenue
as well as compensation increases and (ii) a $4.8 million increase in laboratory
supply costs associated with the growth in revenue.
Segment Reimbursed Costs
Laboratory Services' reimbursed costs were $25.6 million for the three months
ended June 30, 2020, an increase of $6.4 million as compared to the same period
in 2019. Reimbursed costs increased primarily due to the increase in revenue and
our overall growth, as well as higher shipping costs and the general timing of
costs incurred across our portfolio of work.
Segment SG&A Expenses
Laboratory Services' SG&A expenses were $21.9 million for the three months ended
June 30, 2020, an increase of $2.0 million as compared to the same period in
2019. The increase in SG&A expenses was primarily due to a $2.9 million increase
from growth in employee headcount to support current growth in revenue as well
as compensation increases.
Six Months Ended June 30, 2020 versus Six Months Ended June 30, 2019
Consolidated Results of Operations
Revenue                      Six Months Ended June 30,
(dollars in thousands)          2020               2019             Change
Revenue                  $    2,083,380        $ 1,960,269    $ 123,111    6.3 %

Revenue increased $123.1 million, or 6.3%, to $2,083.4 million for the six months ended June 30, 2020 as compared to the same period in 2019. Revenue increased 5.5% from organic volume growth due to increased net authorizations and backlog growth in 2020 and 2019 and 1.4% from inorganic growth primarily due to the 2019 Acquisitions. The increase in revenue was partially offset by a 0.6% decrease from the unfavorable impact from foreign currency exchange rates.

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