Medpace Q2 2026 shows strong new business and backlog, but valuation remains high.

Medpace Holdings reported strong Q2 2026 results with a net book-to-bill ratio of 1.13x and a $3.0 billion backlog, driven by robust oncology bookings despite a decline in cardiometabolic awards. Management expects a normalization of business mix over the next year and has raised guidance based on improved RFP trends, broader biotech funding, and fewer cancellations. However, the stock's valuation remains historically high with a price-to-earnings ratio around 35 and price-to-free-cash-flow above 24, making it a less attractive buy despite positive business momentum.