Medpace Holdings Under Investigation After Book-to-Bill Miss Exposes Cancellation Surge and Pipeline Fragility
(NASDAQ: MEDP)
NEW YORK, Feb. 18, 2026 /PRNewswire/ -- Levi & Korsinsky, LLP is investigating Medpace Holdings, Inc. (NASDAQ: MEDP) concerning potential securities law claims on behalf of shareholders. The investigation centers on whether the company and its senior officers made statements about the health of its clinical-trial booking pipeline that were inconsistent with internal data showing elevated cancellation rates and a deteriorating book-to-bill ratio. Investors who suffered losses in MEDP shares may obtain more information about this investigation and their legal rights by contacting Levi & Korsinsky.
Medpace is one of the largest contract research organizations (CROs) in the clinical-trial industry, providing Phase I through Phase IV drug development services to pharmaceutical and biotechnology companies worldwide. In the CRO sector, the book-to-bill ratio serves as the primary forward-looking indicator of business health. Because CRO revenues are recognized over multi-year contract timelines, booking metrics carry outsized significance for valuation and investor expectations. Historically, Medpace has maintained book-to-bill ratios in the range of 1.10 to 1.25, making a 1.04 reading a significant departure from the company's established trend. The CRO industry experienced record demand during the post-pandemic period, making any reversal in booking momentum particularly material to investor assessments of forward growth.
On February 9, 2026, Medpace reported Q4 2025 earnings. While the company posted revenue of $708.5 million and GAAP EPS of $4.67, both exceeding consensus estimates, the results disclosed a Q4 book-to-bill ratio of 1.04, which was lower than Medpace expected. CEO August Troendle acknowledged that cancellations were "the highest in over a year" resulting in the lower-than-anticipated book-to-bill ratio, stating that cancellations "skewed towards metabolic area," but "no single large project" responsible.
These disclosures contrasted sharply with statements made during prior earnings calls. On the Q3 2025 call on October 23, 2025, Troendle stated: "Cancellations were well behaved in Q3, permitting record net bookings and a net book-to-bill of 1.20." On the Q2 call on July 22, 2025, he said cancellations were "down across the pipeline" and predicted a "strong potential for book-to-bills returning to above 1.15x in Q3." On the Q1 call on April 22, 2025, Troendle projected a "path to improved backlog growth reflected in book-to-bill ratios above 1.15 in Q3 and Q4."
The ending backlog stood at approximately $3 billion as of December 31, 2025, reflecting just 4.3% year-over-year growth. Following the Q4 disclosure, Medpace shares fell approximately 15.9% on February 10, 2026. Multiple financial outlets, including Investor's Business Daily, Seeking Alpha, and GuruFocus, identified the bookings miss as the primary driver of the sell-off.
Levi & Korsinsky, LLP is a nationally recognized firm with offices in New York, California, Connecticut, and Washington, D.C. that prosecutes securities, consumer, and shareholder class actions; more information is available at www.zlk.com.
CONTACT:
Joseph E. Levi, Esq.
Levi & Korsinsky, LLP
33 Whitehall Street, 27th Floor
New York, NY 10004
Tel: (212) 363-7500
Fax: (212) 363-7171
Email: [email protected]
www.zlk.com
SOURCE Levi & Korsinsky, LLP
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