Increased outsourcing is seen in pharmaceutical and biotechnology companies, with 85 percent comprised of clinical segment, the global CRO market was estimated at $31.6 billion in 2018 and is expected to grow at a CAGR of 12 percent to reach $45.2 billion by 2022 according to a report.

Contract research organizations (CRO)’s are the companies that provide support to the pharmaceutical, biotechnology, and medical device industries in the form of research services outsourced on a contract basis. 

CRO’s provide services such as 

  • Biopharmaceutical development, 
  • Biologic assay development, 
  • Commercialization, 
  • Preclinical research, 
  • Clinical research, 
  • Clinical trials management, and 
  • Pharmacovigilance.

Drug discovery is the largest segment by service type and accounts for approximately 33%, of the total CRO market

The percent of CRO’s market in various regions is America: 45 to 50 percent, Europe: 35 to 40 percent, Asia: 12 to 15 percent, and others: 4 to 5 percent and most of the market revenue about more than 80% are from developed countries, such as the US, Canada, the EU, and Japan.

Now, the upcoming markets with great demand for regional CROs include China, Brazil, and Russia, which are strong in regulations and guidelines.

For services such as Biostatistics, Clinical Data Management, Pharmacovigilance, etc., are looking towards Asian countries like India as an emerging market due to cost-effective scenarios, which may further drive up the revenue of Asia-Pacific region in the future.

What makes the difference between large and small-medium scale companies?

Most of the small companies are stressed out with a focus on research and development while outsourcing pre-clinical and clinical development to CROs. Factors like budgeting, multiple regions selection and way of approaches differ while choosing CRO’s for large and small-medium scale companies. 

Here are some challenges for small, mid-size companies before outsourcing to CRO’s

  • Big companies afford financially and often go with big CROs to minimize risks, but small companies need to go with multiple bids and choose the best CROs that fit into their budget and obtain quality services.
  • Often best teams in CROs are engaged with big companies who commit for many clinical trials, and ‘B’ or ‘C’ teams are allocated to small companies.
  • Assigning one project manager for multiple areas is observed and is often seen with small company sponsor projects to cut the expenses.
  • Choosing big CROs results in high budgeting, but patient recruitment is a bit efficient due to their reputed name. Patients also prefer to participate in reputed organizations.
  • Understanding the patient recruitment capabilities of smaller CROs is critical, as they require sufficient resources, strategies, and time in recruiting patients.
  • Evaluating previous experience is also crucial before partnering and particularly in rare disease clinical trials, where patient recruitment is often challenging. Many start-ups and small companies are being working on rare disease drug developments, and choosing the best CRO for conducting clinical trials is challenging.
  • Global reach is another important factor to consider. How many regions does the CRO handle? Considering small CROs that lack global reach, and look to alliances with regional CRO’s, may increase the overall cost involved and difficulty in project management.

What should you look before you choose a CRO?

For many small and medium pharmaceutical and biotech companies, outsourcing a project is not a preference but a necessity. Conducting a clinical trial is a complex process and selecting the right CRO is crucial for any sponsor, as this will drive the fate of the drug further.

There is no formula for outsourcing, but there are several factors to consider before choosing a CRO. Let discuss some of the main points that we should look through.

Does the CRO provide the service you are looking for?

This question may look a little weird, but it is always important to clearly understand whether the CRO can provide the exact service you are looking for and how does it provide the service, whether it provides services through its employees or its subsidiary company or alliances.

Its always better to prefer that provides all the services under one umbrella as the project management and monitoring becomes easy.

If you are a smaller company, Its also important how CRO looks at your project, whether it provides adequate priority, if no then it’s good to go with a smaller CRO’s

What is the experience of a CRO?

It’s always important to evaluate the previous projects that are potentially similar to the proposed project and/or therapeutic area for an overview of the track record. 

  • CRO’s with no experience in the proposed project, may not be a good choice.
  • Look for research team composed of members with a wide range of expertise for the project. It’s advisable to conduct several meetings with the team members involving various expertise to gain knowledge on their capabilities and crisis handling skills. 
  • Evaluate the previously conducted projects thoroughly that are potentially similar to the proposed project and therapeutic area.
  • Obtain a comprehensive overview of the CRO, such as organizational structure, accreditation status, facility and equipment, quality assurance procedures, and compliance with national and international guidelines.
  • One of the crucial factors for CROs in conducting a clinical trial is recruiting a qualified investigator and site reach. The common mistakes made by most of the CROs are choosing a wrong investigator/site, which could be costly to the sponsor.
  • The trial managers involved in the process of recruiting the clinical investigator must possess the skills and knowledge to know how and what to look to recruit a clinical investigator.
  • The trial manager should also consider the number of patient visits and patient recruitment capability of that investigator, which is the determining factor for timely completion and obtain quality data for any clinical trial.

Status of the CRO

CROs operate with significant business risks, as the clinical trials may be stopped or canceled for ‘n’ number of reasons at any point in time. So choosing a CRO with sufficient bandwidth is very important.

Along with experience and potentiality, it’s also important to understand the CRO’s financial stability and capabilities to handle the downturns or crises and answers to questions like, Do they have sufficient infrastructure to handle and overcome the unexpected crisis? What strategies they would follow in extended timelines, poor patient recruitment scenarios, and adding more sites.

Service & delivery

Obtaining answers to the questions like,

  • Do they maintain confidentiality and follow regular validations for data security and management.
  • Does the CRO integrate with your team to understand the project status and team followups?
  • How do they communicate and respond to your queries?.
  • Does the CRO allows regular audits and inspect determined milestones.?
  • How will they organize data and share it with you.?

Would give an overview of how smoothly you would complete your project

Prefer using a single contact person assigned to that project who will be looking into various strategies involved in the project, such as budgeting, scheduling, and managing the project.

Review the feedback

It’s important to get the client’s references and feedback before choosing a CRO. This may be a projection tool to understand the organization’s performance. 

Getting as much feedback as possible before going with a CRO is always crucial as they may help to get confidence and strengthen the choice. 

What is the cost of services?

The service costs impacts the total development cost of the drug but should be considered as a secondary criterion after primary factors, such as producing quality data, and timely completion of the project.

  • For small and medium-sized companies, the cost will likely be a primary factor, and there is a tricky understanding between low and high-cost bids.
  • Very low bids may indicate the inexperience of CRO in poor understanding of the project depth, and moving with very high-cost bids may not guarantee to obtain high-quality data or timely completion of the project.
  • A well-balanced choice between quality and cost is tricky but important. 

Market research

Conducting market research before going with any CRO is also an advisable approach to reduce failures or burdens. For example, understanding the regional regulatory overview, patient population, patient pool available for the clinical trials and regional regulatory support is important. This is more prominent in rare disease clinical trials as many trials fail in recruiting and retaining patients.

Leading CROs

With expansions, consolidations, and innovations continuing throughout the CRO industry, here are top 10 CROs in 2019 considering market share and revenue

PPD, Medpace, Clintec, PRA Health Sciences, KCR, ICON, IQVIA, PSI, Parexel, Covance

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References

  1. https://www.ddw-online.com/business/p216817-partnering-with-the-right-cro-is-a-winning-strategy-for-companies-big-and-small.html
  2. https://weinberggroup.com/blog/7-things-consider-selecting-cro/
  3. https://www.clinicaltrialsarena.com/news/choosing-the-right-cro-4957433-2/
  4. https://www.proximacro.com/news/top-5-considerations-when-choosing-a-cro
  5. https://www.imarcresearch.com/blog/bid/336880/Five-Points-to-Consider-When-Choosing-a-CRO
  6. https://www.sharevault.com/blog/life-sciences/how-to-choose-a-contract-research-organization