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Icon was founded in Ireland, by John Climax and Ronan Lambe in 1990. Since January 2010, Climax has held a position on the board of directors. Lambe retired from the board of directors in 2018.
Between 1991 and 1996, Icon opened offices in the United Kingdom, United States, Germany, and Japan. Two years later, Icon shares began trading on Nasdaq, providing the company with additional capital to support international expansion and acquisitions.
In 2006, Icon acquired Ovation Research Group, expanding its capabilities in health outcomes research and health economics. In 2014, Icon expanded its capabilities in adaptive clinical trial design and execution with the acquisition of Aptiv Solutions.
In 2021, Icon completed its US$12 billion acquisition of PRA Health Sciences. The transaction expanded the company's global clinical research operations and created one of the largest contract research organizations.
On September 4, 2025, Icon announced that Steve Cutler would be stepping down from his position as CEO. Barry Balfe, the company's Chief Operating Officer, was promoted to Chief Executive Officer.