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Top 10 CROs in 2024
2024 is poised to be an exciting year in clinical research. Advanced technology-assisted solutions have become commonplace in trial operations, and increased connectivity, availability of multi-source healthcare data, and enhanced analytics capabilities have opened up new ways to gain insights into health outcomes and offer significantly streamlined processes throughout the drug development process.
Contract research organizations (CROs) are companies dedicated to offering specialized expertise and various clinical trial services to pharma and biotech companies and other clinical trial sponsors. Partnering with one of the top CRO companies listed in this article is an excellent way to optimize resource utilization, remain competitive, and ensure operational excellence in your clinical studies, regardless of their complexity. A CRO can be contracted for isolated operations, for example to optimize a social media recruitment strategy or to manage study data, or the entire trial can be outsourced to the CRO. The global CRO industry is massive, valued at over $100 billion USD in 2023, and is expected to continue to grow steadily through 2030.
In this article, we discuss the 10 top CROs in 2024, compiled as a mix between established industry leaders and new players making waves in the scene. These top CROs are not listed in any particular order. If you want to start with the basics, scroll down to the bottom of the article where we discuss some background information. By the end of the article, we hope to have empowered you to understand the landscape of top CROs in 2024 and to answer the following questions:
- What is a CRO?
- What does a CRO do?
- What partnering with a CRO means for your trial
- What CRO is right for your organization or your trial?
- What are the largest CROs?
Developments in the CRO industry in 2023
Throughout 2023, we’ve seen not only continuation but also acceleration in the adoption of mHealth, eClinical software solutions, and AI tools, alongside increasingly massive amounts of digital health data available and advanced data analytics capabilities that allow us to gain high-resolution insights into health outcomes and trends. The concept of patient centricity is receiving increasing interest as a way to address recruitment challenges and improve patient engagement and satisfaction, and next-generation clinical research designs, such as remote and decentralized clinical trials (DCTs) and master protocol designs have continued to expand in prevalence. Top CROs stay at the top of the industry by staying ahead of the curve, rapidly integrating these technological supports and new trial models into their repertoires of CRO services to offer sponsors shorter study timelines and optimized resource use.
Another trend among contract research organizations is that of consolidation – integrating broad capacities to offer comprehensive end-to-end clinical trial services, which also often involves merging companies, which we discuss next.
Mergers and acquisitions among contract research organizations in 2023
Mergers and acquisitions (M&A) are common in the contract research organization industry, as companies seek strategic partnerships to expand their capabilities, enhance their global reach, incorporate new technologies and expertise, and achieve improved operational efficiency.
Notable mergers that closed or were announced in 2023 or earlier include:
- Syneos Health was acquired by a private investment consortium consisting of Elliott Investment Management, Patient Square Capital, and Veritas Capital in September 2023, a deal worth $7 billion USD which saw Syneos Health shares (SYNH) removed from the Nasdaq.
- In January 2023, Charles Rivers Laboratories acquired SAMDI Tech, Inc., which was a provider of label-free high-throughput screening (HTS) for drug discovery research. The deal was worth approximately $50 million USD.
- Charles River Laboratories acquired Explora Biolabs Holdings, Inc. in April of 2022, for a total of just under $300 million USD.
- PPD was acquired by Thermo Fisher Scientific for $17.4 billion USD in late 2021, becoming a wholly owned subsidiary.
- PRA Health Sciences was acquired by ICON plc in 2021, for $12 billion USD.
- Parexel was acquired by EQT and Goldman Sachs in November of 2021.
In 2024, we’re likely to witness further mergers and acquisitions among CROs. Mergers between contract research organizations are being driven by factors such as market consolidation, increasing demand for specialized CRO services, and the need for increasing efficiency in drug development processes. Mergers are helping CROs meet current market demands and provide end-to-end solutions for pharmaceutical and biotechnology companies, which are increasingly sought-after to support their clinical development programs.
Top 10 CROs: Top clinical research organizations in 2024
The following is a list of the top CRO companies to check out in 2024. Most are global CROs, and are not listed in any particular order
1. ICON plc
ICON plc has a market capitalization of $22 billion USD, being one of the largest CROs worldwide, with over 41,000 employees spread across 53 countries. ICON is headquartered in Ireland, and acquired PRA Health Sciences. The ICON PRA merger was closed in 2021 for $12 billion USD.
ICON offers consulting, outsourcing, and commercialization services to pharma, biotech, and medical device companies, and boasts its offer of “the most comprehensive suite of integrated clinical development and commercialization services in the industry.” ICON knows what matters most to its clients – reducing the time it takes to get new products and services into the hands of consumers, and at accessible prices.
ICON is one of the top CROs worldwide and has won multiple industry awards, such as “PharmaTimes Clinical Research Company of the Year” in 2021 and “Best Contract Research Organisation” at the Scrip Awards in 2022. ICON’s singular focus on excellence in clinical research makes it a solid partner for a wide range of sponsors.
For more information on ICON clinical research services and ICON icon clinical trials services, head over to their website: ICON plc
Charles River Laboratories International, Inc. (“Charles River Laboratories”) employs over 21,000 people across 20 countries, and has a market capitalization of about $10 billion USD.
Charles River Laboratories offers a wide range of clinical trial services, safety assessments, and regulatory and scientific advisory services, across the whole spectrum of therapeutic areas and clinical research phases. Their team often becomes part of the clients’ drug development process from the earliest stages of preclinical development/testing, making Charles River a top CRO partner for sponsors looking for assistance throughout the entire drug development journey.
According to Charles River Laboratories, they were involved in some way or another in the development of 86% of the novel drugs approved by the FDA in 2021.[1]
3. IQVIA
IQVIA has a network of around 86,00 employees across 100 countries, and is one of the largest CROs worldwide with a market capitalization of $37 billion USD. Many of the IQVIA competitors listed here have market shares of half or less that amount, but that is only meant to illustrate the extent of their operations. IQVIA was recently identified as a market Leader in the Everest Group Life Sciences Operations PEAK Matrix® Assessment of 2023.[2]
As a leading provider of advanced analytics, technology solutions, and clinical research services, IQVIA is dedicated to providing innovations and insights based on a solid understanding of the healthcare landscape, motivated by the desire to improve the lives of patients around the world in the process.
IQVIA offers 5 comprehensive product suites (Planning Suite, Site Suite, Patient Engagement Suite, Trial Management Suite, Clinical Data Analytics Suite), representing solutions for all types of clients looking for cutting-edge yet tried and trusted clinical research and data capabilities.
IQVIA Connected Intelligence™ makes extraordinary discoveries possible by connecting data, advanced analytics, and innovative technologies—combining extensive healthcare and scientific expertise with unique insights.
4. PPD
PPD, which stands for Pharmaceutical product Development, is a wholly owned subsidiary of Thermo Fisher Scientific as of 2021. PPD is based in North Carolina, USA, and employs over 27,000 people in more than 50 countries. PPD CRO is a global contract research organization focused on delivering life-changing therapies. PPD provides drug development, laboratory, and lifecycle management services to companies from across the pharmaceutical, biotechnology, and medical device sectors.
Some of the CRO services currently offered by PPD include preclinical development, clinical development, regulatory affairs, product development and consulting, site solutions and patient-centric solutions, and a diverse array of laboratory services. PPD has a strong focus on quality and has been recognized for its commitment to ethical practices in the conduct of clinical trials, which might be good motivators for sponsors who hold these considerations in high priority.
5. Labcorp
https://biopharma.labcorp.com/home-page.html
Labcorp is another globally prevalent CRO, with a market capitalization of about $18 billion USD, over 75,000 employees, and a network of 36 clinical laboratories in the US alone.
Labcorp is headquartered in the US but globally present, and is dedicated to ‘mobilizing science to improve peoples’ lives’, merging and leveraging science, technology, and innovation to find solutions for the major important questions being asked in healthcare and by clinical researchers. Labcorp studies are supported by their deep scientific rigor and expertise across many areas, and they also provide assistance with drug candidate testing.
Under its Biopharma arm, Labcorp provides contract research services centered in 4 areas:
- Clinical trials
- Nonclinical studies
- Data, insights and AI
- Consulting
6. Parexel
Parexel International is a global contract research organization with a market capitalization of about $4.5 billion USD, employing 21,000 people across many different countries. Parexel has been in clinical trial operations for 40 years, and has a solid track record of success in the clinical research industry. With a strong underlying emphasis on quality, Parexel provides clinical development services across Phase I to Phase IV trials. Expertise in regulatory affairs, clinical services, and a vast range of therapeutic areas are some of Parexel’s stand-out characteristics.
Parexel is committed to quality, respect, empowerment, accountability, and above all to patients, aiming to make a difference in the lives of patients through its work. The range of CRO services offered by Parexel include:
- Early development and innovation
- Integrated clinical development
- Approval and access
- Value substantiation lifecycle management
- Therapeutic expertise
- Patient solutions
- Site solutions
Syneos Health was recently acquired by a private investment consortium for $7 billion USD, a testament to its position as an established top contract research organization. Syneos Health has a network of 28,000 employees across offices and research sites in more than 60 countries - ideal for sponsors looking for a CRO with an extended global reach.
The CRO services offered by Syneos Health are split into 5 broad categories:
- Clinical Development
- Medical Affairs
- Commercial Delivery
- Consulting
- Syneos One®, a “dedicated interdisciplinary asset development team that designs fully-integrated solutions that achieve greater efficiencies and maximize asset value.”
Syneos Health also provides a range of technology and support services, including various eClinical solutions, to help all kinds of clients manage clinical trials, regardless of study complexity and design. In general, Syneos Health focuses on improving the efficiency of the drug development process and has a reputation for providing high-quality, efficient services to clients.
8. Medpace
Medpace is another top CRO, with a market cap of $8.6 billion USD and 5,400 employees and a global network of offices and research sites in over 40 countries. Medpace is headquartered in the US and has been in operations since 1992.
Medpace operates under a full-service model, meaning it offers a comprehensive range of CRO services including clinical trial management, data management, and regulatory consulting. Medpace adopts a therapeutically focused approach, with expertise in a variety of therapeutic areas allowing them to provide specialized and expert support to clients working on diverse clinical trials.
In 2023, Medpace was recognized in 5 CRO Leadership Awards in the ISR’s annual CRO Quality Benchmarking survey. Medpace received awards for their reliability, quality, expertise, compatibility, and capabilities, and stood out amongst 46 CROs included in the survey designed to identify which CROs exceed their clients’ expectations.
9. WuXi AppTec
https://www.wuxiapptec.com/services/clinic
WuXi AppTec (pronounced woo-shee) was founded in Shanghai, China in 2000, and currently has over 14,000 employees. It was initiated as a company offering services in synthetic chemistry, but has since expanded to become a global biopharmaceutical, pharmaceutical and medical device company.
WuXi offers services across the entire drug development lifecycle, through five arms of operations:
- Small molecule therapeutics, R&D, manufacturing, and testing
- Biologics R&D and manufacturing
- Cell therapy and gene therapy R&D and manufacturing
- Medical device testing
- Genomics and molecular testing
WuXi Clinical is a subsidiary of WuXi AppTec, and is the company’s global CRO. WuXi Clinical has extensive expertise across diverse therapeutic areas, and offers solutions delivered by an experienced, creative, highly responsive, and nimble team with a heavily patient-centric focus.
WuXi Clinical offers CRO services categorized in the following areas:
- Early clinical development
- Clinical operations
- Biometrics
- Medical affairs
- Regulatory affairs
- Quality system management & consulting
- Phase I-IV pharmaceutical and medical device site operation
- Patient recruitment, patient management, and patient education
- Site selection/feasibility, clinical development consulting
- Clinical trial quality control, auditing, quality management
Worldwide Clinical Trials is a US-based global CRO, and consists of a team of over 3,000 employees spanning more than 60 countries.
Worldwide Clinical Trials offers CRO services to the pharmaceutical, biotechnology, and medical device industries. Worldwide Clinical Trials has a strong focus on patient-centered research and has a reputation for adherence to high quality and ethical standards. Their specific strengths and capabilities cover data management, consulting, regulatory affairs, medical writing, quality assurance, trial optimization, clinical trial monitoring, site management, patient recruitment, and more.
Worldwide Clinical Trials is specialized in the therapeutic areas of cardiovascular and metabolic diseases, cell & gene therapy, rare diseases, neurology, and oncology.
CRO services offered by Worldwide Clinical Trials are provided through the following solutions:
- Bioanalytical lab services
- Early-phase development & clinical pharmacology (full-service phase I support)
- Full-service phase II-IV trials
- Real world evidence (RWE) studies
- Rescue studies
Background: CRO meaning and what CRO partnerships offer
What does CRO stand for?
CRO stands for contract research organization (or contract research organisation), sometimes known as clinical research organizations.
What is a CRO?
Contract research organizations (CROs) are specialized companies that offer clinical services and conduct clinical trials, either in part or in entirety. A CRO offering comprehensive solutions will be able to handle everything from patient recruitment to data analysis, to entire trials. Contract research organizations are sometimes also referred to as clinical research organizations.
Most CROs offer a wide range of clinical research services, and can be tasked with conducting the trial entirely, or with only specific aspects of trial operations, such as:
- Formulation of initial research hypothesis (hypotheses)
- Study design and protocol improvements
- IRB submissions
- Site identification, selection, activation, and management (some CROs may have a network of sites they work with regularly, or may have their own sites)
- Logistics and distribution of the study drug and trial supplies
- Pre-screening, screening, and patient recruitment
- Patient engagement and patient centricity
- Data collection, data analysis, and reporting
- Data management, data security and privacy, HIPAA compliance
- Study close-out and archiving
- Regulatory affairs
Why are CROs important in clinical trials?
With the multifaceted and complex nature of clinical research, finding an appropriate partner to support the trial’s execution can lead to significant savings as well as smoother and faster trials. This may be especially true for sponsors who are new to the clinical trial scene, under tight timelines, or who don’t have solid experience in the multitude of operational aspects necessary for conducting trials.
CROs are essentially experts in clinical trials, and this experience can translate into improved efficiency, high-quality results, and excellence in patient safety and ethical and regulatory compliance. Top CROs often have access to cutting-edge technology, an internal team of experts in different therapeutic areas and trial operations, and even networks of patients, investigators, and clinical sites. The team of a leading CRO might consist of specialists in pharmacology, biochemistry, medicine, statistics, data analytics, project management, regulations and legal frameworks, patient recruitment and engagement, and even marketing.
What CRO is right for your trial? Choosing a CRO
Finding the best CRO for your specific trial or to partner with on a longer-term basis requires some background research and clear communication to ensure that their capabilities meet your needs. Below is a list of 5 questions to ask when choosing a CRO:
1. What services does the CRO offer?
Most CROs, particularly the top CRO companies listed above, offer comprehensive services to support the full drug development process. However, some may offer only specific services or solutions, for example in certain medical specializations. Research the CRO thoroughly and make sure their services and capabilities match your needs. Reach out and make sure you’re able to clarify any concerns you might have.
2. What is the CRO’s specialty?
It’s important to find a CRO with experience in the specific therapeutic area relevant to your trial, to ensure they understand the disease mechanisms, patient characteristics, regulatory landscape, etc. This is particularly important for trials in specialized therapeutic areas and rare disease studies, wherein the expertise of the sponsor can support you throughout the trial with familiarity and insights they’ve gained through working on other studies in a similar area.
3. Does the CRO have a strong history of client satisfaction?
If you haven’t worked with a given CRO before, you’ll be basing a decision with relatively high stakes on relatively limited information. Insights into past or present clients’ satisfaction with a given CRO provide important insights into not only how well they meet expectations, but also how easy they are to work with and whether any issues seem to be a recurring theme. This information may not always be publicly available, but it might be wise to reach out to contacts in the industry and even ask for recommendations. In general, the largest CROs who are well-established worldwide and who have decades of operational experience are likely in those positions for a reason. With CROs who are newer to the field, it’s particularly important to check feedback from past clients, if you can access it. While newer players may certainly offer excellent services, those with a shorter track record should simply be treated with more caution.
4. What accreditations does the CRO have, and what’s their track record with regulatory compliance?
Clinical trials are subject to regulations set forth by the FDA, outlined in Title 21 CFRs, and by the HHS, outlined in Title 45 CFR (the Common Rule). Even when a CRO is tasked with an entire trial, the sponsor is ultimately responsible for regulatory compliance and adherence to ethical and quality guidelines such as those set out in GCP.
You can check a CRO’s compliance with FDA regulations by reviewing Form FDA-483s, and checking for any FDA warning letters and documents pertaining to suspensions of clinical operations, corrective actions, or penalties dealt to the CRO. Form FDA 483 copies can be accessed online from this FDA webpage:
ORA FOIA Electronic Reading Room | FDA
5. Do your communication approaches fit together well?
A partnership with a CRO is a two-way relationship, in which clear communication and trust are absolutely essential. It’s generally recommended to engage in open dialogue with potential CRO partners before entering into any agreement. Beyond the actual content of the discussions, you should pay attention to clarity in their communications, how easily you reach conclusions to negotiations, and whether you notice any untrustworthy or suspicious behavior (red flags).
Conclusion
We hope that this top 10 list of top CRO companies has been useful for orienting you in the right direction in your search for the clinical research organization that’s best suited to your specific research needs. Follow the links in the descriptions to reach the website of each of the top CROs and explore their offering of clinical research services, and remember that if you’re looking specifically for patient recruitment services, then here at Power, we’ve built the most advanced, patient-friendly solution available today. Our platform empowers patients to find clinical trials and determine their eligibility, while in turn providing sponsors with a quality database of high-intent patients.