Size does matter
Avoca's data certainly suggest that there is a feeling in this industry that size does matter. It is important to consider
what is at play behind the issue of size in organizations, such as the belief that infrastructure and training at a large
global CRO are better, especially in emerging markets. There are already concerns about having trained staff in these parts
of the world and investigators who really understand the clinical trials. The large CROs have invested in these regions, and
they have hired big teams, and have a big global footprint and an infrastructure already in place. So if Big Pharma is looking
for a strategic partnership, they tend to pick from the top five CROs. Big sponsors are consolidating their relationships
and creating strategic relationships.
On the surface, it might appear that the small- to mid-sized CROs would have a difficult time competing against the larger
CROs. Yet, according to the survey, many pharmaceutical executives stated that on a day-to-day, project-team basis, the small
to mid-sized CROs provide better service because they're able to be flexible and provide better teams. This explains why respondents
from Big Pharma, medium-sized pharmaceutical companies, and small, revenue-generating pharmaceutical companies were all most
likely to feel best served by mid-sized CROs as opposed to the top five CROs or smaller providers.
For a mid-sized CRO, this is great news, because while the top pharmaceutical sponsors are spending most of their money in
the top-sized CROs, it does not mean they necessarily feel the biggest CROs are the best service providers. And that perception
creates opportunity for the smaller CRO, which does specialty work in its realm of expertise with any size company.
Investing in the relationship.
No matter what size organizations work with each other, it is going to come down to being clear about expectations, building
trust, and taking time to invest in the relationships so that no matter what size the organizations are, they are optimal
relationships and outcomes. As long as the organizations have the resources and capabilities to be able to run the trial,
success depends on the relationship that sponsor companies and providers build with each other. If the relationship between
the two partners is strong, the trials are going to run better—no matter what size organizations are working together on a
Bidirectional, mutual respect.
It is important that there be a continued shift in Big Pharma's relationship with CROs toward one that demonstrates respect
for the fellow professionals they are working with on a given project. The attitude that "you are my vendor—do as I say" has
been moving toward "we should have respect for each other." More sponsor organizations are examining themselves and asking
if their team is doing its best to foster these mutually respectful relationships with clinical service providers. They are
acknowledging that it is crucial to provide training on how to manage effectively, and respectfully, the CROs and to collaborate
to build trust and transparency.
There is a difference among sponsor companies and CROs on which companies contracts with each other, and there is a difference
in perceptions about capabilities, resources, infrastructure, and expertise. Despite these differences, they share common
interests for safety and efficiency, and the drug is likely to be tested in clinical trials globally, making the CRO-sponsor
relationship adaptable to companies of varying sizes.
Janice Hutt is chief operating officer of The Avoca Group. firstname.lastname@example.org
1. Avoca Group, State of Clinical Outsourcing Survey (Princeton, NJ, 2011).