At a glance
Medpace Holdings Inc is worth $19.38B, about 45 times its fiscal 2025 earnings. Revenue grew 20.0% to $2.53B in fiscal 2025, with 17.8% kept as profit; over 5 years it has grown 22.3% a year. It pays no dividend; it spent $2.14B buying back its shares over FY2021–FY2025. The stock returned +19.3% over the past year with dividends reinvested and +25.8% a year over five years, against +11.5% and +11.7% for the S&P 500. At its worst it fell 39.5% in the 2020 crash (S&P 500: 33.7%) and 39.2% in the 2022 bear market (S&P 500: 24.5%), and was back at its earlier high 4 months and 6 months after the lows.
The business in plain English
Medpace is a clinical contract research organization, or CRO. Drug, biotech and medical device companies hire it to run clinical trials, the human studies a new treatment generally must pass before regulators approve it. Medpace covers every stage, from Phase I (early safety testing) to Phase IV (studies after approval). Its work includes designing studies, choosing trial sites, recruiting patients, monitoring sites, analyzing data, writing regulatory filings and tracking side effects. It also runs central labs in Cincinnati, Ohio; Leuven, Belgium; Shanghai, China; and Singapore, plus clinics on its Cincinnati campus.
Customers range from small and mid-sized biotech and drug companies to large pharmaceutical firms, and Medpace sees itself as a partner of choice for the smaller ones. It is paid under service contracts, some at fixed fees. Revenue was $2.53 billion in fiscal 2025, which ended December 31, 2025. By disease area, cancer (oncology) trials made up 29.5% of revenue, metabolic diseases 16.1%, antiviral and anti-infective work 10.1%, central nervous system disorders 9.5% and heart (cardiology) studies 5.3%. Other areas supplied the remaining 29.4%.
Major rivals include IQVIA, ICON, PPD (now part of Thermo Fisher Scientific) and Fortrea, plus many smaller CROs and drug companies' in-house research teams. Medpace aims to stand out with its full-service model, medical specialists and ClinTrak, its own trial-management software.
Price history
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MEDP +19.3% over the year to Oct 28, 2026, total return with dividends reinvested.
How it makes money
By product or service
| Oncology | $747.6M | 29.5% |
| Other | $745.0M | 29.4% |
| Metabolic | $408.5M | 16.1% |
| AVAI | $254.8M | 10.1% |
| Central Nervous System | $239.4M | 9.5% |
| Cardiology | $134.9M | 5.3% |
Latest results
- In Q3 FY2026 (ended Sep 30, 2026), revenue was $716.0M, up 8.5% from a year earlier, and net income was $137.5M (+23.7%).
- For fiscal 2025, revenue was $2.53B (+20.0% year over year; +22.3% a year from FY2020 to FY2025) with a 17.8% net margin.
Financial health check
| Revenue growth a year (FY2020–FY2025) | +22.3% good |
|---|---|
| Operating margin | 21.1% good |
| Free cash flow margin | 26.9% good |
| Return on equity (FY2025) | 98.3% (lifted by a small equity base, often the result of years of buybacks) good |
| Return on assets (FY2025) | 22.8% good |
| Cash and investments | $705.3M (no borrowings found in the filings) good |
| Fiscal year | Revenue | Net income | Free cash flow |
|---|---|---|---|
| FY2020 | $925.9M | $145.4M | $227.3M |
| FY2021 | $1.14B | $181.8M | $235.1M |
| FY2022 | $1.46B | $245.4M | $351.2M |
| FY2023 | $1.89B | $282.8M | $396.7M |
| FY2024 | $2.11B | $404.4M | $572.3M |
| FY2025 | $2.53B | $451.1M | $681.9M |
Valuation snapshot
| Market value | $19.38B |
|---|---|
| P/E ratio | 45.3 |
| Dividend yield | None |
Rank among 1514 US companies
Market value at each year end
Medpace Holdings’s market value went from $1.47B at the end of 2016 to $19.38B on Oct 28, 2026, about 13.2 times as much; since the end of 2025 it is up 22%.
Show as a table
| Year end | Market value | Change |
|---|---|---|
| Oct 28, 2026 | $19.38B | +22.5% |
| 2025 | $15.82B | +53.2% |
| 2024 | $10.33B | +9.8% |
| 2023 | $9.41B | +42.4% |
| 2022 | $6.61B | -15.5% |
| 2021 | $7.82B | +57.1% |
| 2020 | $4.98B | +64.4% |
| 2019 | $3.03B | +60.7% |
| 2018 | $1.88B | +38.2% |
| 2017 | $1.36B | -7.2% |
| 2016 | $1.47B |
Price behavior
| YTD | 1 yr | 3 yr | 5 yr | 10 yr | |
|---|---|---|---|---|---|
| MEDP price data to Oct 28, 2026 | +23.3% | +19.3% | +40.4% | +25.8% | +37.4% |
Show as a table
| Year | Price data |
|---|---|
| 2026 (to date) | +23.3% |
| 2025 | +69.0% |
| 2024 | +8.4% |
| 2023 | +44.3% |
| 2022 | -2.4% |
| 2021 | +56.4% |
| 2020 | +65.6% |
| 2019 | +58.8% |
| 2018 | +46.0% |
| 2017 | +0.5% |
| 2008 financial crisis stocks fell Oct 9, 2007 – Mar 9, 2009 | Before this security existed |
|---|---|
| 2020 COVID crash stocks fell Feb 19, 2020 – Mar 23, 2020 | Lost 38.4% over that stretch · deepest drop along the way 39.5%, back to its old high 3.9 months after the low |
| 2022 bear market stocks fell Jan 3, 2022 – Oct 12, 2022 | Lost 27.1% over that stretch · deepest drop along the way 39.2%, back to its old high 5.9 months after the low |
Insider activity
Form 4 filings from 2025-11-03 to 2026-11-03 (25 read): 0 open-market purchases and 28 sales ($199.6M).
| Date | Insider | Type | Value |
|---|---|---|---|
| Sep 22, 2026 | August J. Troendle President & CEO, Director, 10% owner | sell | $30.8M |
| Sep 24, 2026 | August J. Troendle President & CEO, Director, 10% owner | sell | $17.3M |
| Aug 20, 2026 | August J. Troendle President & CEO, Director, 10% owner | sell | $16.8M |
| Sep 29, 2026 | August J. Troendle President & CEO, Director, 10% owner | sell | $16.6M |
| Sep 30, 2026 | August J. Troendle President & CEO, Director, 10% owner | sell | $13.7M |
Who owns it
Large shareholders (13G filings)
| T. Rowe Price Associates, Inc. | 7.2% | Jun 30, 2026 |
ETFs with the most weight in MEDP
| HELX Franklin Genomic Advancements ETF | 3.64% |
| AMID Argent Mid Cap ETF | 2.82% |
| RISN Inspire Tactical Balanced ETF | 2.72% |
| JSMD Janus Henderson Small/Mid Cap Growth Alpha ETF | 2.26% |
| CSMD Congress SMid Growth ETF | 2.23% |
| GRPM Invesco S&P MidCap 400 GARP ETF | 1.87% |
| FTXH First Trust Nasdaq Pharmaceuticals ETF | 1.82% |
| XMHQ Invesco S&P MidCap Quality ETF | 1.74% |
What could go wrong
- Trials can be canceled, delayed or unpaid. Customers can end or postpone trials, or fail to pay for work already done. Each lost or delayed contract removes revenue Medpace expected to earn.
- Backlog may not turn into revenue. Backlog is signed work not yet performed. If trials are canceled, shrink or run slower, less of it may turn into revenue than in the past.
- Fixed-price contracts can squeeze profits. Some contracts pay a set fee. If Medpace underprices one, overruns its cost estimates, or can't get customers to approve change orders for added work, profits suffer.
- Concentration in cancer trials and key customers. Oncology supplied 29.5% of fiscal 2025 revenue. Medpace warns that leaning heavily on one disease area or a few customers could hurt results if spending there drops.
- Founder controls a large stake. Founder and CEO August J. Troendle controls a substantial amount of the stock, and Troendle's interests may differ from other shareholders'. The company also does business with related persons, raising possible conflict-of-interest questions.
- Drug industry cutbacks or mergers. Demand depends on drug companies spending on research and outsourcing it. Smaller R&D (research and development) budgets, less outsourcing, healthcare reform or mergers among customers could reduce the need for Medpace's services.
Recent events
- Quarterly results released; Other company announcement
- Quarterly results released
- Executive or board change
- Bylaws or fiscal year changed; Shareholder vote results
- Quarterly results released; Executive or board change
- Quarterly results released
For income and retirement investors
Medpace pays no dividend and paid none from fiscal 2021 through fiscal 2025, so the stock provides no regular income. Any return comes from share price changes, and a retiree who needs cash would have to cash in shares. Medpace instead returns cash through buybacks: about $2.14 billion over those five years, including $917.4 million in fiscal 2025. Shares outstanding fell 22.2%, from about 35.9 million in October 2021 to about 28.0 million in October 2026, giving each remaining share a larger slice of profits.
The stock has fallen hard in downturns. It dropped 39.5% in the 2020 COVID crash, then recovered by July 15, 2020, about 3.9 months after its low. In the 2022 bear market it fell 39.2% between January 3 and April 27, 2022, recovering by October 25, 2022. Its deepest drop in the year to October 28, 2026 was 36.6%. A single stock like Medpace carries more risk than a diversified fund.
Questions investors ask
How does Medpace make money?
Medpace makes money by running clinical trials for other companies. Biotech, pharmaceutical and medical device makers hire it as a contract research organization (CRO) to handle trials from Phase I through Phase IV. Its work includes study design, site selection, patient recruitment, monitoring, data analysis, regulatory documents and lab testing. Revenue was $2.53 billion in fiscal 2025, and net income was $451.1 million. Cancer trials were the largest single disease area, at 29.5% of revenue.
Does Medpace pay a dividend?
No. Medpace paid no dividends from fiscal 2021 through fiscal 2025, so the stock provides no regular income. It returns cash through buybacks instead, spending about $2.14 billion on its own shares over those five years. The share count fell 22.2% between October 2021 and October 2026, to about 28.0 million. Investors who rely on portfolio income would have to cash in shares to draw money from a Medpace holding.
Is Medpace still growing?
Yes, though growth slowed in the latest reported quarter. Revenue rose 20% to $2.53 billion in fiscal 2025 and grew about 22.3% a year on average over the five years from fiscal 2020. In the quarter ended September 30, 2026, revenue was $716 million, up 8.5% from a year earlier, while net income rose 23.7% to $137.5 million. Medpace warns that its backlog of signed work may not turn into revenue at past rates.
Is Medpace stock expensive?
It is priced for strong growth. As of October 28, 2026, Medpace traded at about 45.3 times its fiscal 2025 earnings of $15.28 per diluted share, for a market value of about $19.4 billion. That price-to-earnings (P/E) ratio means investors paid roughly $45 for each $1 of yearly profit per share. A high P/E can shrink quickly if growth disappoints. In the year to October 28, 2026, the stock fell as much as 36.6% from a high.
Has Medpace's CEO been selling shares?
Yes. Founder and CEO August J. Troendle, also listed as a 10% owner, sold stock repeatedly in August and September 2026, including about $30.8 million on September 22, 2026. Insider filings for October 29, 2025 to October 29, 2026 include 29 sales worth about $212.7 million and no purchases. Insider sales happen for many reasons, such as taxes or diversification. Medpace's annual report also warns that the founder controls a substantial amount of the stock and may have interests that differ from other shareholders'.