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Top 15 Contract Research Organizations (CROs) in 2024

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Post-pandemic, as drug development businesses recover and grow, CROs around the world continue to undergo profound transformation. As in previous years, 2023 will be all about mergers and acquisitions, with big players getting even bigger and smaller companies surviving thanks to niche advantages such as technological know-how or brilliant scientists among their employees.

The top 15 CROs globally would be in the following order based on 2023 revenue :

  • LabCorp (Covance) , with 15.05 billion USD (2023) and 75000 employees ( Labcorp , 2024).  In February 2015, Labcorp completes its $6 billion purchase of Covance, Inc., creating the world’s leading health care diagnostics company. The combination of Covance’s drug development leadership and Labcorp’s medical testing expertise builds the market leader in central laboratory and bioanalysis services. Labcorp’s clinical trials companies, Labcorp Clinical Trials and Tandem Laboratories, align under the Covance brand.  
  • IQVIA , with 14.85 billion USD  (2023) and 86000 employees (IQVIA, 2022). IQVIA, formerly Quintiles and IMS Health, Inc., is an American Fortune 500 and S&P 500 multinational company serving the combined industries of health information technology and clinical research.  IQVIA (NYSE:IQV) is a leading global provider of advanced analytics, technology solutions, and clinical research services to the life sciences industry. With approximately 86,000 employees, IQVIA conducts operations in more than 100 countries.  
  • ICON (PRA) , with 7.74 billion USD (2022) and 41160 employees (ICON, 2023). From a small team of 5 people in 1990, ICON now employs over 41,100 people.  ICON has been recognised as one of the world’s leading Contract Research Organisations through a number of high-profile  industry awards .  
  • Thermo Fisher Scientific (PPD) , with 7.02 billion USD (2023) and 35000 employees (Businesswire, 2023). Recognized as a global industry leader in accelerating promising medicines from early development through regulatory approval and market access, we serve pharma, biotech, medical device and government organizations with custom-tailored solutions, including full-service partnerships and functional service partnerships. As a strategic partner in clinical development and analytical services, we apply cutting edge technologies, therapeutic expertise and a firm commitment to quality to help customers deliver life-changing therapies.  
  • Lonza - 6.5 billion USD,   17896 employees. Though being a contract development and manufacturing organization (CDMO), rather than a CRO, takes the 10th position with the 5.9 billion USD in sales and over 17500 employees worldwide (2023), offering “proprietary line of in silico and in vitro services for manufacturability, immunogenicity, potency assessment, humanization and protein engineering” ( https://pharma.lonza.com , 2022). Founded in 1897 in the Swiss Alps, today, Lonza operates across five continents. With approximately 17,500 full-time employees, it comprises high-performing teams and individual talent that make a meaningful difference to our own business, as well as to the communities in which we operate. The business benefits from global supply chains, but we have worked to maintain the agility to address marketplace needs on a local level. CDMOs become reliable partners for Pharma companies as their “services reduce R&D costs while improving productivity and are essential to providing safe and effective treatment to patients” ( https://pharma.lonza.com , 2022.  
  • Wuxi AppTec with 5.8 billion USD revenue in 2021 and 44360 employees (Companiesmarketcap, 2022). As a global company with operations across Asia, Europe, and North America, WuXi AppTec provides a broad portfolio of R&D and manufacturing services that enable the pharmaceutical and healthcare industry around the world to advance discoveries and deliver groundbreaking treatments to patients. Through its unique business models, WuXi AppTec’s integrated, end-to-end services include chemistry drug CRDMO (Contract Research, Development and Manufacturing Organization), biology discovery, preclinical testing and clinical research services, and cell and gene therapies CTDMO (Contract Testing, Development and Manufacturing Organization), helping customers improve the productivity of advancing healthcare products through cost-effective and efficient solutions. WuXi AppTec received AA ESG rating from MSCI in 2023 and its open-access platform is enabling more than 6,000 customers from over 30 countries to improve the health of those in need – and to realize the vision that "every drug can be made and every disease can be treated."  

Syneos Health® is a leading fully integrated biopharmaceutical solutions organization built to accelerate customer success. We translate unique clinical, medical affairs and commercial insights into outcomes to address modern market realities.

We bring together a talented team of professionals, who work across more than 110 countries, with a deep understanding of patient and physician behaviors and market dynamics. Together we share insights, use the latest technologies and apply advanced business practices to speed our customers’ delivery of important therapies to patients.  

Cell and Gene Therapy CDMO Solutions has supported the development of 11 FDA approved cell and gene therapies and have conducted more than 900 studies in this field over the past year. Unsurpassed end-to-end offering results in enhanced access to scientific and regulatory expertise via multidisciplinary bench of experts to help you problem solve.   

Parexel (EQT Private Equity and Goldman Sachs Asset Management) with 3.8 billion USD in 2022 and 21000 employees (Parexel, 2023). Parexel is among the world’s largest clinical research organizations (CROs), providing the full range of Phase I to IV clinical development services to help lifesaving treatments reach patients faster. Leveraging the breadth of our clinical, regulatory, and therapeutic expertise, our team of more than 21,000 global professionals works in partnership with biopharmaceutical leaders, emerging innovators, and sites to design and deliver clinical trials with patients in mind, increasing access and participation to make clinical research a care option for anyone, anywhere.  

  • Medpace Holdings, Inc. with 1.135 billion USD revenue in 2021 and 5400 employees (Medpace, 2023). Integrating core clinical trial services delivers efficient and streamlined execution and higher quality results. Through its wholly-owned subsidiaries, Medpace offers clinical pharmacology, as well as supporting laboratory services including central labs, bioanalytical lab, ECG core lab, and imaging core labs.  

Worldwide Clinical Trials – 0.6 billion USD , 3000 employees, 60 countries.

Worldwide Clinical Trials started out more than 30 years ago as a small science team with a big goal: To always provide authentic, personalized attention to our partners. And as the industry has grown, CROs have merged, and trials have grown increasingly complex, we haven’t forgotten what truly matters: People.

With more than 3,000 employees in more than 60 countries around the world, we’re still staying true to those roots. Our team is dedicated to staying accessible, flexible, and solution-focused to ensure our partners not only have the best possible outcomes – but they also know their Worldwide team is only a call away.  

Allucent (CATO SMS and Pharm-Olam) – 0.36 billion USD, 1200+ employees .

Allucent originated with CATO SMS, itself created by the merger of Cato Research and SMS-oncology in 2019. Cato Research, founded in 1988, was known for its ability to design and execute successful development strategies and guide creative new products through the regulatory process.

Previous acquisitions by CATO SMS included Array Biostatistics, a full-service biostatistical and statistical programming CRO, and Nuventra Pharma Sciences, one of the industry’s leading providers of clinical pharmacology science and services. With these acquisitions, CATO SMS expanded its services to offer biostatistical consulting, analysis, programming, and cutting-edge modeling and simulation techniques to inform clinical trial designs and predict trial outcomes.

In early 2022, CATO SMS merged with Pharm-Olam, a global clinical research organization delivering clinical trial services to organizations around the world.  

KCR – 0.15 billion USD, 700 employees  

KCR is a clinical development solutions provider creating value for biotechnology and pharmaceutical organizations.

Founded in 1997, our expert teams support clients with full-service clinical development capabilities across three main areas: Trial Execution, Consulting, and Placement. KCR operates across North America, Europe, and Australia, with main office locations in Boston, US, Berlin, Germany, and Warsaw, Poland.

Our geographical coverage across 25+ countries, cutting-edge technical capabilities and tailored offerings allow for the optimized delivery of solutions to develop life-changing therapies. KCR offers access to an estimated population of 1.1 billion people.  

Advanced Clinical – 0.1 billion USD , 1100+ employees

Today, Advanced Clinical has grown organically, with coverage across North America, Eastern Europe, Western Europe and Asia-Pacific, providing contract research organization (CRO), FSP and strategic resourcing solutions. A research services and strategic resourcing organization committed to providing a better clinical experience by delivering comprehensive Contract Research Organization (CRO), Functional Service Provider (FSP) and Strategic Resourcing services that optimize effectiveness for both patients and sponsors throughout the clinical research journey.

Using our decades of experience, we strive to improve the lives of everyone touched by clinical research and help our clients achieve better outcomes through candid conversations, foresight, resilience and innovative solutions.  

CTI Clinical Trial and Consulting Services – 0.08 billion USD, 750 employees . CTI has grown consistently and significantly, becoming a global organization with associates in more than 60 countries across the world. We have worked on more than 10,000 projects, worked on every continent except Antarctica, and have contributed to more than 150 new drug and device approvals through global regulatory agencies such as the FDA, EMA, and others. Currently, we work with approximately 250 pharmaceutical and emerging biotechnology and medical device companies.

Among recent reasons for mergers and the whole new approach to conducting clinical research, apart from pursuit of new clients, talents, expertise, products, and markets, there have been notorious coronavirus crisis and military conflicts worldwide. We faced the advent of globalization, decentralization, remote monitoring, and personalized approach to drugs R&D. But we are now looking into the era of technology in clinical research. Processes that allow remote audits and monitoring, previously considered too risky, are now risk mitigators (Bahls, Christine, 2021), at least from that point of view. Clinical trial participants enrollment, and even participation itself, constantly moves into tech dimension.

Only few among the leading CROs escaped M&As for now, but this seems to be the matter of time. Savlovschi – Wicks, Theodora (2022) estimated that “in 2021, the global CRO market is expected to reach an impressive US$88 billion by 2028”. According to IQVIA , only in biopharma sector the total transaction value grew by 70% to reach 152 billion USD by the end of 2023, featuring prominent $43Bn Pfizer-Seagen deal, and other considerable M&As for BMS-Karuna ($14Bn), Merck-Prometheus ($10.2Bn), AbbVie-Immunogen ($10.1Bn), AbbVie-Cerevel ($8.7Bn), Biogen-Reata ($7.3Bn) and Roche-Telavant ($7.1Bn).

Among the CRO businesses the following M&As took place lately:

  • Charles River Labs acquires  MPI Research (2018), Citoxlab (2019), HemaCare (2020) and Cognate BioServices (2021)
  • IQVIA (formerly Quintiles and IMS Health) acquired Clintec and 40% of Q2 Solutions (2021)
  • ICON purchased PRA Health Services (2021)
  • Thermo Fisher Scientific bought PPD (2021)
  • Labcorp purchased Covance and Chiltern
  • Inotiv acquired Envigo (2021)
  • INC Research and inVentiv Health merged to later become Syneos Health
  • Parexel become the property of EQT Private Equity and Goldman Sachs Asset Management
  • CATO SMS and Pharm-Olam merged in 2022
  • Triley Bidco acquired Clinigen (2022)

The article by Nataliia Vietchinkina, MS in Clinical Research Administration

University of Liverpool. 

References:

  • Christine Bahls (2021) ‘The Post-Pandemic CRO Landscape’, Applied Clinical Trials, Applied Clinical Trials-09-01-2021, Volume 30, Issue 9 [online] Available from: https://www.appliedclinicaltrialsonline.com/view/the-post-pandemic-cro-landscape
  • Savlovschi – Wicks, Theodora (2022) ‘Top 10 CROs to watch in 2022’ [online]. Available from: https://www.proclinical.com/blogs/2022-3/top-10-cros-to-watch-in-2022
  • Labcorp (2022) Labcorp Announces 2021 Fourth Quarter and Full-Year Results, 10 February 2022 [online]. Available from” https://ir.labcorp.com/news-releases/news-release-details/labcorp-announces-2021-fourth-quarter-and-full-year-results#:~:text=Revenue%20was%20%2416.12%20billion%20%2C%20an,by%20divestitures%20of%20(0.1%25)
  • IQVIA (2022) IQVIA Reports Fourth-Quarter and Full-Year 2021 Results; Raises Full-Year 2022 Profit Guidance, 15 February 2022 [online]. Available from: https://ir.iqvia.com/press-releases/press-release-details/2022/IQVIA-Reports-Fourth-Quarter-and-Full-Year-2021-Results-Raises-Full-Year-2022-Profit-Guidance/default.aspx#:~:text=Revenue%20of%20%2413%2C874%20million%20for,12.4%20percent%20at%20constant%20currency
  • ICON (2022) ICON Reports Fourth Quarter and Full Year 2021 Results, 2022 [online]. Available from: https://www.iconplc.com/news-events/press-releases/icon-reports-fourth-quarter-and-full-year-2021-results/
  • Businesswire (2021) ‘PPD Reports Fourth Quarter and Full Year 2020 Results’, 23 February 2021 [online]. Available from: https://www.businesswire.com/news/home/20210223006094/en/PPD-Reports-Fourth-Quarter-and-Full-Year-2020-Results
  • Macrotrends (2022) ‘Syneos Health Revenue 2012-2021 | SYNH’ [online]. Available from: https://www.macrotrends.net/stocks/charts/SYNH/syneos-health/revenue
  • https://companiesmarketcap.com/ (2022) ‘Revenue for Charles River Laboratories (CRL)’ [online]. Available from: https://companiesmarketcap.com/charles-river-laboratories/revenue/
  • Vinluan, Frank (2021) ‘CRO Parexel changes private equity hands again, this time for $8.5B’ [online]. Available from: https://medcitynews.com/2021/07/cro-parexel-changes-private-equity-hands-again-this-time-for-8-5b/
  • Medpace (2021) ‘Medpace Holdings, Inc. Reports Third Quarter 2021 Results’ [online]. Available from: https://investor.medpace.com/news-releases/news-release-details/medpace-holdings-inc-reports-third-quarter-2021-results#:~:text=The%20Company%20forecasts%202021%20revenue,%24176.0%20million%20to%20%24180.0%20million%20 .
  • Companiesmarketcap (2022) ‘Revenue for WuXi AppTec (2359.HK) Revenue in 2021 (TTM)’ [online]. Available from: https://companiesmarketcap.com/wuxi-apptec/revenue/
  • https://pharma.lonza.com (2022) ‘Design, assess and optimize for clinical success’ [online]. Available from: https://pharma.lonza.com/offerings/early-development-services .

Clinical Research News

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What is a Functional Service Provider (FSP) in Clinical Research?

What is a Functional Service Provider (FSP) in Clinical Research?

The costs of drug development have been estimated to range from US$43 million all the way up to US$2.9 billion . One Phase III trial alone is expected to cost pharmaceutical sponsors nearly US$19 million . Considering the enormous financial implications and investments associated with running a clinical trial, the industry is constantly seeking innovative solutions to streamline processes and optimize resources for high-quality results in a timely and cost-effective manner. One such solution adopted by many pharmaceutical and biotechnological companies is the Functional Service Provider (FSP) model offered by an increasing number of contract research organizations (CROs) today. In this article, we will explore the concept of FSP, compare key features to those of other strategic resourcing models, and examine the impact of FSP on the clinical research industry.   

Overview of the Functional Service Provider (FSP) Model  

The FSP model enables sponsors to outsource specific functional components of a clinical trial to an external partner while still maintaining their control over the data and overall process . When collaborating with experienced FSP CROs like TFS HealthScience, pharmaceutical companies gain access to a more flexible resourcing model that allows them to maintain better data oversight .   

Key Considerations When Selecting an FSP Partner  

To select an ideal FSP partner tailored to their specific objectives, sponsors must carefully consider many critical factors. Most notably, the FSP must understand their needs and employ a customer-focused approach in their service offerings . Additional considerations include reviewing the CRO’s clinical trial experience and track record, whether they can adapt to changes in the sponsor’s needs, as well as how effectively they can send support personnel where and when they’re needed . The quality of training and onboarding provided to talent are also important to factor into the selection process . Ideally, the right FSP partner should have previously delivered similar projects successfully, on time, and on budget.   

Evolution of the Functional Service Provider (FSP) Model in Clinical Research  

The FSP model has been utilized in the clinical research industry for over two decades, initially serving to assist with discrete tasks in clinical operations and data management. However, today’s models are increasingly offering features customized to meet sponsors’ needs to adapt to changes in outsourcing patterns . Between 2018 and 2021, the popularity of the FSP model increased considerably, with its utilization going from 28% to 40% .

FSP CROs are becoming an increasingly popular choice among sponsors for several reasons, including the following :   

  • Potential for significant cost savings and improved efficiency  
  • Access to a flexible resourcing model that enables better control over data  
  • Access to talent that is not typically available  
  • Enhanced opportunities to focus on technological innovation  
  • Greater ability to maintain strong site relationships  

In the mid-2000s, interest in FSPs spiked when sponsors realized the value of resource flexibility . However, at the time, many trial companies and CROs were not fully equipped to establish successful FSP partnerships, resulting in the industry shifting back to the full-service outsourcing model . Since then, FSP models have changed to offer unit-based pricing options, greater administrative oversight, and increasing use of remote teams . As a result, today’s sponsors have access to a range of outsourcing options ranging from full-service to FSP models and a hybrid of both.   

Comparing FSP Model to Other Strategic Resourcing Options  

In addition to the FSP model, there are several other strategic resourcing models utilized in clinical research, which we provide an overview of in the table below . Each model has its pros and cons, but the FSP model stands out for its flexibility, scalability, and cost-effectiveness.  

 

 

 

Functional Resourcing (FSP) 

         

Full-Service Outsourcing (FSO) 

       

Insourcing or Staffing 

       

Business Process Outsourcing (BPO) 

       

Capacity Management 

       

Transformational Functional 

     

Hybrid 

       

Source: Birks (2011); KPS Life (2021)

Advantages of Enlisting Functional Service Providers (FSPs) in Clinical Research  

FSPs offer a range of advantages that make them an attractive option for pharmaceutical companies. They can help sponsors enhance productivity, enabling up to 30% more work to be done for the same cost . Enabling the help of FSPs also streamlines costs by outsourcing non-core activities from the sponsor to the service provider, which offers budget predictability and reduces infrastructure costs. Other financial advantages offered by this model is the lower risk of change order due to set costs, which helps simplify forecasting . FSPs also accelerate timelines while maintaining existing SOPs and systems, improve market access, and provide peace of mind due to quality management oversight and pricing predictability . Furthermore, because FSP CROs provide dedicated teams for projects, sponsors benefit from lower rates of turnover and better team continuity .   

Unlike many other outsourcing models, FSPs enable long-term relationships that develop greater efficiencies over time and provide a single functional service to a sponsor, often across multiple programs, to maximize resource utilization . They also offer increased control and oversight over deliverables, reduced risk of underutilization, and cost-effective contract rates. Lastly, by partnering with an FSP CRO like TFS, sponsors can unload significant operational burdens by transferring over the responsibility of certain time-consuming aspects of running clinical trials. These can include training and onboarding, performance management, staff oversight, and administrative tasks.  

TFS CRO’s Strategic Resourcing Solutions Unit Offers Functional Services (FSP)  

Founded in Lund, Sweden, in 1996, TFS was the first CRO in Europe to offer Functional Services (FSP) . Since then, they have become a leading company for client-centric FSP solutions with their teams based in 17 countries, which enables them to support both international and local sponsors . This means that no matter where a trial is taking place, TFS HealthScience can provide the necessary support and expertise. TFS offers a wide suite of services, including expertise in project management, clinical and medical monitoring, pharmacovigilance, strategic resourcing, and more.   

The company is a full-service, global, strategic CRO partner for clinical trial sponsors. The CRO’s FSP team also maintains an up-to-date understanding of today’s clinical trial landscape, which is why they successfully leverage various technology solutions to meet deliverables effectively. This includes their EDC partnerships with cutting-edge tools and software like Medidata Rave, TrialMaster, and Trial Online, as well as other solutions to ensure streamlined online project tracking . By leveraging modern technology and expertise in project management, TFS can deliver efficient, cost-effective solutions that ensure the success of their clients’ clinical studies.  

Conclusion  

In conclusion, FSPs in clinical research are an innovative solution to streamline processes, optimize resources, and manage costs effectively. With the unique ability to provide dedicated teams, retain data oversight, and adapt to evolving needs, FSP CROs are revolutionizing the way pharmaceutical and biotechnological companies conduct research. By collaborating with an experienced FSP such as TFS, sponsors can focus more on their core functions, while delegating certain aspects of their clinical trial operations to capable CROs.  

About TFS HealthScience CRO  

At TFS HealthScience , our global full-service CRO is more than a service provider; we are a trusted partner in the drug development journey for biotechnology and pharmaceutical companies. In partnership with our customers, we build solution-driven teams working toward a healthier future. Having provided FSP solutions for over 25 years, we understand the importance of providing affordable and scalable services while maintaining a partnership with synergistic value.    

Visit our Functional Services ( FSP ) page to learn more about the several resourcing models we offer for sponsors looking to benefit from our FSP services, or connect with a TFS representative today!  

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Research and development (R & D) service providers perform original investigation or apply research findings to gain new knowledge; they use this knowledge to create new or improved technologies intended to provide a competitive advantage for the business or organization which has requested their services. Industrial R & D is specifically defined as the process of obtaining new knowledge that will eventually result in new or improved products, processes, systems, or services that will benefit the company's sales or growth.

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  • Applied research involves investigation aimed at discovering new knowledge related to a specific commercial objective involving products, processes, or services.
  • Development is the application of obtained research to the production of useful or commercially viable materials, products, devices, systems, or methods. This also includes the production of prototypes and sample processes.

Internal vs. External vs. Joint R & D

Research and development services from Motortrend

The table below compares the advantages and disadvantages of these three types.

Company is sole owner of technology; benefit of developing internal learning for future R & D.

Time and resources in setting up corporate labs; likelihood of having to hire out research talent to augment team.

Specialization and efficiency of R & D provider; little to no equipment cost; lower overall costs (esp. with nonprofits).

No in-house learning; possible dependence on the contractor; potential difficulties with technology transfer.

Low cost; wide variety of researchers; ease of information sharing and technology transfer.

Strict antitrust laws; each entity must take extra time and resources to apply findings to its own unique products or processes.

Project Considerations

Industrial research and development is typically performed as a part of a large project with specific technical or business goals, assigned personnel, and time and money constraints. Project managers must determine whether contracting a research and development house will contribute to their long-term investment and probability of success.

In many instances, unique technology required to undertake a project or produce a product is available on the marketplace, albeit for a price. For this reason, corporate management or project managers should perform a "make or buy" analysis when justifying the time and resources necessary for an R & D service, as opposed to simply finding and purchasing the technology. Four factors must be considered as part of this analysis:

  • Proprietariness : if the technology can be safeguarded as proprietary and eventually patented, its value to the company will be much higher and R & D resources can easily be justified.
  • Timing and growth rates : if market growth is slow, R & D is probably the best option for obtaining new technology. If market growth is faster, the R & D process will likely be too long and costly to benefit the company or project.
  • Risk : investing in any R & D work is inherently risky. Careful forecasting and monitoring must be performed to maximize decision-making accuracy.
  • Cost : R & D involves a substantial up-front investment and longer periods of negative cash flow than simply purchasing the rights to a technology. The project should be analyzed with this fact in mind.

The rewards associated with research and development work are very high, but the process itself is costly and risky. While many companies use R & D processes to stay ahead of and gain a commercial advantage over competitors, failed projects — like successful ones — consume large amounts of resources regardless of their success rates.

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Software/systems

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In addition to specializing in niche markets, research and development service providers may also offer specific R & D services, some of which are described below.

Computer aided design (CAD) uses computer systems to assist in creation and optimization of a product or process design.

Applies human needs theory and other principles to design devices and products to improve well-being and performance.

 

Broad group of service providers that develops or enhances product designs.

 

The scientific study of the properties and applications of construction materials.

 

The development of conceptual representations to design, analyze, and predict responses of products or processes.

 

Design and creation of consumer and industrial packaging.

 

Development of new processes; optimization research.

 

Idea generation; concept development; prototyping and testing.

 

Also known as the “basic research” above.

 

The simulation of a product or process for testing or calibration purposes.

 

Creation of new software for the purpose of managing or aiding a process or procedure.

 

Design of modules, devices, interfaces, and system data with regards to predetermined specifications.

 

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  • AFR 80-3 -- R & D management in Air Force labs
  • DIN EN 12741 -- Biotechnology labs for research, development, and analysis
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A Quirk's resource guide covering panel research companies.

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When seeking respondents for research, companies can benefit from panels through their ability to provide quick and easy access to respondents, even those who belong to niche audiences. Panels also ensure a dedicated group of respondents for your research, decreasing instances of fraud or unengaged responses. 

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Founded 2012 | 30 employees, matt gaffney, ceo.

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Phone 1-888-848-2525 gobranded.com  

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Founded 2008

Adam berman, president.

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Founded 2008 | 25 employees, mayank bhanushali, founder and managing director.

Global Survey, as our name suggests, is one of the global leaders in using digital data collection to power analytics and insights. We provide data-driven decision-making for clients who listen to and interact with the world’s consumers and business professionals through Global Survey online panels, as well as mobile, digital and social media technologies. We apply the breadth of over 88 online consumer panels and communities across 70 countries to your market research studies. And we’re dedicated to continually fine-tuning our panel network to ensure quality and growth as your research needs change over time. Global Survey works with many of the world’s leading market research agencies, media agencies and corporations.

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GMO Research

Founded 2002 | 151 employees, shinichi hosokawa, ceo, christa arite, u.s. director, mariana dobre, eu director.

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Phone U.S. 1-626-720-3952 (LA); 1-516-884-9600 (NY) gmo-research.com

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Founded 2006 | 50 employees

Jeffrey kelsch, managing partner.

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Phone 1-208 809-7117 (U.S.) E-mail  [email protected] ; [email protected] www.holdendata.com

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Founded 2014 | 110 employees

Lisa wilding-brown, chief research officer.

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Phone 1-888-229-6664 www.InnovateMR.com

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Insights Opinion

Founded 2015 | 20 employees, sharoz ghauri, ceo and abrar ahmed, vice president, research services.

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Phone 91-971-183-0789 www.insightsopinion.com

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Logit Group Inc.

Founded 1997 | 250+ employees, sam pisani, managing partner and anthony molinaro, managing partner.

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Phone 1-866-84-LOGIT logitgroup.com/online_panel

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Mindfield Online Internet Panels

Founded 1980 | 110 employees, gary mcmillion, ceo.

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Phone 1-800-969-9235 MindFieldOnline.com

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Founded 2004 | 41 employees

Herbert höckel, ceo.

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Phone 0049-0-211-8282800 E-mail  [email protected]   www.mowebresearch.com

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myCLEARopinion Panel

Founded 2008 , mitch henderson, ceo.

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Phone 1-248-786-1274 www.myclearopinionpanel.com

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Founded 2001 | 276 employees

Ben boix, managing director u.s. and canada.

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Phone 1-267-475-9919 E-mail  [email protected] netquest.com

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Opinions 4 Good (Op4G)

Founded 2010 | 30 employees, frank nappo, ceo and frank hayden, coo.

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Phone 1-603-766-5858 www.op4g.com

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Founded 2017 

Jim whaley, ceo.

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Phone 1-212-653-8750 www.ovationmr.com

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Paradigm Sample

Founded 2009 | 67 employees, cyrus deyhimi, ceo.

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Phone 1-914-772-6030 corporate.paradigmsample.com

Quest Mindshare

Founded 2003 | 103 employees greg matheson, managing partner, joe farrell, managing partner.

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Phone 1-416-860-0404

[email protected] www.questmindshare.com

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Rare Patient Voice LLC

Founded 2013 | 15 full-time employees; 50 part-time patient advocates, wes michael, president and founder.

research service provider

Phone 1-410-218-0527 pam.rarepatientvoice.com www.rarepatientvoice.com

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Schlesinger Group

Founded 1966 | 1,200 employees, matt campion, cro.

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Phone 1-513-284-3265 SchlesingerGroup.com

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SurveyMonkey

Founded in 1999 | 1,300+ employees, zander lurie, ceo.

research service provider

E-mail  [email protected] www.surveymonkey.com/market-research

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Symmetric, A Decision Analyst Company

Founded 2016 | 150+ employees, jason thomas, president of symmetric.

research service provider

Phone 1-817-649-5243 www.symmetricsampling.com/panels

research service provider

Founded 2000 | 1,400 employees

Frédéric-charles petit, ceo.

research service provider

Phone 1-203-834-8585 www.tolunacorporate.com

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Considerations for experimental success

Your goal is to deliver results to your client on time and within budget. Before you begin your next project, consider these steps to achieve experimental success.

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PPD FSP

Meet Your Timelines with PPD Functional Service Partnership (FSP) Solutions

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PPD FSP solutions deliver the top-tier expertise you want and the on-time delivery you need

The pharmaceutical industry is constantly in motion — drug patents expire, new therapies emerge, portfolios expand, and life-changing compounds make their way to market. As a result, it’s critical for drug developers to engage a partner that can navigate these changes and predict and manage the resources needed for projects to be successful.

That’s why more companies are turning to functional service providers (FSP) for their outsourcing needs. FSP services help you advance your next drug development project — whether you need to fill small gaps in services or support large-scale programs with dedicated capacity management across functions. FSP models also increase flexibility and provide access to the exact expertise your project needs, when you need it, in just the right amount.

With over 25 years of experience across more than 160 countries, our FSP solutions help biotech and biopharmaceutical companies meet their timelines by delivering the best of the best: hard-to-find, top-tier staff who bring a customer-first, problem-solving mindset to the clinical development services we provide.

Explore the growth and utilization of FSP partnerships, the future of these models, and the keys to successfully leverage them

Discover key pharmacovigilance regulatory intelligence capabilities of top-tier FSP PV partners

Expand your clinical trial capabilities with a hybrid outsourcing model combining elements of FSP and FSO arrangements

  • The Right Expertise for Every FSP Engagement
  • Problem-solving Professionals
  • Effective Solutions to Resourcing Challenges
  • Dedicated Roles Drive On-time Delivery and Ongoing Support
  • Delivery Models Tailored To Your Needs
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  • Additional PPD FSP Services and Resources

Delivering the right expertise for every FSP engagement

Because you can’t always predict — or find and retain — the staff and services you need, our experts deliver more experience, knowledge and a wider breadth of expertise than other functional service providers, uniquely positioning us to provide the right experience and knowledge to fill immediate gaps.

PPD™ FSP solutions provide access to a wide range of reliable and customizable resources to support key functional areas, fill gaps in internal capabilities or enhance functional expertise. We act as a true partner to help solve your resource challenges and provide support for clinical and marketed products across every aspect of a drug development program — from site startup and monitoring to clinical data management to post-approval strategy. We position biotech and pharmaceutical companies for success.

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Accelerate the next generation of life-changing therapies

Explore the growth and utilization of FSP arrangements, the future of these models, and the keys to successfully leverage them.

Learn how our top-tier clinical development experts can help power your next big discovery

Problem-solving professionals provide the right expertise.

To attract the best of the best, we have a dedicated FSP recruitment team of over 130 professionals. Attracting top-tier talent is about creating an excellent culture and maintaining our commitment to upskilling and reskilling our employees, expanding skill sets, and training for future needs.

To keep employees on top of ever-evolving regulations and technology changes, we offer award-winning professional development programs, as demonstrated by our ranking as a leading business for employee learning and development for 11 consecutive years in Training  magazine’s Top 100 list. Our industry-leading retention, in turn, delivers business continuity and the confidence of knowing that your programs are supported by quality professionals who apply the right experience, knowledge and expertise.

Developing a team of reliable experts in hyper-competitive talent marketplaces also demands innovative training approaches. For FSP engagements, our FSP Academy delivers a series of training modules that provide information, guidance and best practices for managing the unique aspects and nuances of delivering FSP solutions. In addition, functional and therapeutic area tools (like our comprehensive cell and gene therapy training and forums), resources, and role-specific trainings (including our CRA Academy ) support employees throughout the entire project lifecycle – from startup to maintenance to closeout – to provide ongoing guidance and support.

Our professional development and learning culture help make us a great company to work for, leading to increased employee engagement and retention. We are a passionate group of can-do problem solvers, offering consistent staffing and low turnover to provide much-needed resource reliability and continuity, which translates to continuity and long-term dedication to your project.

Flexible, personalized solutions

It’s important to find the right solutions to your resourcing challenges. PPD ™  FSP solutions offer customized engagements tailored to your exact needs and requirements. Our FSP solutions are available across all functions, from clinical services to marketed products, and are available worldwide, for one-off and large-scale projects — and everything in between.

Industry-leading scale

When you need to scale a project, our FSP solutions have the scope to make it happen. Rely on our more than 30,000 research professionals across the globe who can provide you with the support you need, when you need it.

Ease of a single partner

The extensive breadth and depth of our services for clinical trials and marketed products spans all phases, therapeutic areas and levels (including senior roles) in 160 countries. This allows PPD FSP solutions to function as a single partner for your projects.

Dedicated roles drive on-time delivery and ongoing support

Through a functional service partnership, our professionals serve as an extension of your teams, supporting key functions that drug development programs can’t afford to leave to chance. Pharmaceutical companies of all sizes and at all phases of drug development need flexible, predictable, reliable and cost-effective options to support their evolving needs, and our FSP solutions deliver.

How our dedicated roles work for you:

  • Implementation lead (IL) : It starts with this role, dedicated to driving seamless onboarding and establishing our professionals as an extension of your team.
  • Operations delivery lead (ODL) : This role supports the duration of your FSP engagement. The ODL provides oversight, anticipates and responds to your needs with urgency, and ensures team members have the resources they need.

Throughout our engagement, we establish mutual trust so that accountability is shared, solutions are collaborative, and commitment is rewarded.

Implementation lead

You not only need quality FSP resources and services — you have milestones to reach and timelines to hit. That’s where the implementation lead comes in. This dedicated role focuses on the onboarding of resources so engagements with a significant scope or volume of work begin with a proactive partnership .

With the implementation lead, startup responsibilities usually managed solely by an operations delivery lead are divided to create an additional layer of project oversight that drives better outcomes and more efficient communication.

Through this approach, the implementation lead drives seamless onboarding and proactive customer service – in turn avoiding startup delays, ensuring a smooth transition and meeting timeline commitments.

Read the Contract Pharma article expanding on the significant role of implementation leads for research projects Learn more about how implementation leads keep our FSP projects a step ahead

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Operations delivery lead

To establish, maintain and nurture the partnership forged by the implementation lead, an operations delivery lead is dedicated to your project, serving as a single point of contact that provides oversight and aligns with the you on timelines, strategies and project delivery.

Through ongoing engagement and collaboration, the operations delivery lead provides dedicated oversight, planning and partnership-building that creates greater stability, productivity and satisfaction.

Ready to meet your timelines?

Delivery models tailored to your needs.

Strategically selecting the right outsourcing models can bend the cost and time curve of drug development by maximizing quality, operational success and financial efficiencies. Pharmaceutical companies employ a variety of models to meet that need, including FSP solutions. When using our solutions, models include:

  • the outsourcing of one or multiple functions, such as data management or monitoring,
  • a hybrid between FSP services and full-service outsourcing (FSO), and
  • customized FSP models.

Regardless of whether we support one or more functions through an FSP-only or hybrid delivery model, our FSP solutions support sponsors’ development of clinical and marketed products with an uncompromising commitment to quality , while providing resource flexibility, reliability and continuity.

No matter the scope of your project, our FSP teams deliver easy onboarding and continuous collaboration that establishes trust and accountability.

Flexible engagements to achieve project goals

The flexibility of using different engagement models — or a blend of those services — means you can always choose what is right for you. An engagement with our FSP solutions is always customized to your requirements.

We partner with you to offer the best FSP model for your project needs, including a flexible mix of systems, processes, oversight and facilities — yours or ours. Our customers benefit from innovative pricing models that accommodate various contract structures from the following:

  • fixed price
  • full-time equivalent (FTE)
  • output- or performance-based
  • time and materials

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Rebadging expertise

In today’s drug development climate, organizations must ensure proper utilization across programs. PPD FSP solutions help you navigate staffing challenges by offering a dedicated staff transfer team focused on change management and business continuity. The staff transfer team:

  • shifts costs from direct to indirect to give more flexibility and allow right-sized workforces,
  • has expertise in Acquired Rights Directive (ARD) laws and regulations with an 87% average transfer success rate,
  • eliminates risks involved in hiring and layoff cycles, and
  • condenses vendor contracts to reduce legal, financial and ongoing oversight burden.

PPD FSP solutions

By choosing an experienced, industry-leading functional service provider for one or multiple services to deliver the right experience and knowledge to fill immediate clinical development resource gaps, you gain flexibility and financial efficiencies, allowing you to focus on your areas of expertise.

Biostatistics and programming

Going beyond statistical analysis, our global biostatistics and programming team brings a deep understanding of the science of disease and compounds, and provides valuable upfront study design and comprehensive planning assistance.

Clinical data management

When it comes to clinical trial data management , collaboration across the project teams enables:

  • earlier identification of the critical risks to data delivery in a study,
  • the design of data capture systems to drive real-time data collection, and
  • implementation of processes to minimize errors from being introduced in the data collection process.

Data validations are put in place for all patient data sources, and we coordinate the delivery of data from internal and external sources to support interim and final data deliveries.

Clinical operations

Expert clinical operations professionals ensure accelerated end-to-end study execution through our bespoke solutions. Work with our frontline staff as they conduct on-site monitoring and management throughout the study to oversee data collection, ensure regulatory compliance and resolve data queries.

Global clinical supplies

Efficiently navigating logistical processes and global regulations can be challenging for biotech, biopharmaceutical and medical device organizations seeking to manage all aspects of their clinical trial supplies lifecycle. Our Global Clinical Supplies (GCS) solutions apply unique clinical site and patient insights along with the ease of a single partner to optimize and nimbly manage entire clinical supply chains.

Medical writing

Effective communication — with patients, sites and regulatory authorities — is a critical component of any study. Our medical writing team offers agile, expert support to help you communicate with your stakeholders. Pharmaceutical, biotech and medical device companies and government agencies have relied on PPD medical writers for more than 25 years to translate complex scientific information into high-quality, regulatory-compliant outputs across a comprehensive range of documents.

An unwavering dedication to excellence in patient safety is of the utmost importance, but it can be a challenge to keep pace with evolving regulations. Success requires proactive engagement with industry changes — and an approach that places quality and innovation first — whether your products are in development or on the market.

Project delivery

Partner with our experienced project managers , who have proven expertise across the full development continuum, to ensure your project runs smoothly. Project managers are closely aligned with your clinical operations to build trust, ensure clear accountability and tie our performance goals directly to our project team members.

Quality assurance

Ensuring the safety and integrity of clinical trials is critical for meeting ethical, regulatory and legal requirements that protect the rights and welfare of study participants. Our Quality Assurance (QA) solutions provide strategic and operational expertise, and our QA experts help you navigate the nuances of country-specific rules and regulations, mitigate risks, drive compliance and protect patients.

Regulatory affairs

Our strategic regulatory services span the full spectrum of activities and technical functions, so your project can be supported in regulatory development, licensing and life-cycle management, regulatory strategy input, and full-service regulatory partnerships. Regular deployment of process improvement techniques and use of the latest technology ensures quality of delivery.

Site contracts and payments

With growing pressure to accelerate therapeutic development, accelerating site contracting cycle times while ensuring site payments are accurate and on-time is critical. Our Site Contracts and Payments (SC&P) solutions help you get clinical trial sites activated and up and running sooner and deliver timely and precise payment processing and management so you become a sponsor of choice.

Site support

Study sites often struggle to recruit, train, and retain site staff, leaving them understaffed and overburdened. Our new Site Support Solutions help overcome site challenges to drive on-time study delivery and get new medications to patients faster. Our team works with you to create bespoke solutions and customized services that can be scaled to align with your needs as they evolve.

Study startup

Smooth site activations and accelerated start up cycle times are critical to meeting clinical trial timelines and grounding relationships with sites. Our Study Startup (SSU) solutions deliver the proven breadth and depth of expertise and apply tailored solutions needed to launch sites on-time.

Trusted FSP resources for drug development and post-marketing programs

Choosing the right FSP partner is critical to your drug development success. Nearly 300 companies have entrusted PPD FSP solutions to support critical components of their drug development and post-marketing programs . Your projects, goals and milestones become ours.

There’s a reason so many pharmaceutical companies trust in the quality of PPD FSP solutions. We’ve built our FSP expertise over many years, delivering a strong track record of reliable, high-quality services and support for clinical and marketed products, in addition to the convenience and ease of working with a single partner. PPD FSP solutions have capabilities in more than 160 countries, and our global footprint brings a nuanced understanding of local people, processes and regulatory landscapes , while enabling rapid onboarding across time zones.

We provide an extensive depth and breadth of talented, top-tier experts and unmatched therapeutic and functional expertise. Operational, functional, technical and therapeutic specialists — and laboratory services — are available for FSP engagements across all phases and therapeutic areas and at all levels, including senior roles. To ensure projects launch on time and stay on budget, our dedicated roles focus on rapidly ramping up engagements, keeping you informed with high-touch communications and applying on-demand staff and services as needed.

In our 25+ years of providing FSP solutions, our proven track record ensures we will deliver the top-tier expertise you want and the reliable on-time delivery you need.

Additional PPD FSP solutions and resources

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We offer various flexible, cost-effective support options to meet your evolving needs

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Explore the growth and utilization of FSP arrangements in the new trends report

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Explore more PPD FSP solutions resources in our Insights Hub

Choosing a service provider requires careful research

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  • Are they offering their services at prices that are too cheap compared to their competitors?
  • Are they spending too much on their infrastructure vis-a-vis their client base?
  • Do they have a history of retrenching people or of selling out their assets?
  • Do you have a documented procedure for handling customer problems and, if so, where is it?
  • Are there set targets for responding to customer problems?
  • Do you have an escalation procedure that goes all the way to top-level management when customer problems are not resolved in a timely manner (and can you get the contact numbers)? (This question can be an accurate indicator of how mature and serious the support organization is.)
  • Ensure that service availability hours match, if not exceed, your system’s committed availability hours.
  • Ask for service performance guarantees in writing. There should be some penalties associated with the inability to meet these agreed-on targets.
  • There should be a comprehensive list of responsibilities not only for the service supplier but also from your end. Again, this should be part of the service contract.
  • Support coverage hours should also be defined, including the different means of invoking this support, which should include more than one method and include access to real-time, live-person support when necessary. Ask to be assigned a primary and secondary contact person who will be in charge of your account for nonimmediate requirements.
  • Response times to support requests should be specified according to different problem types and their severity.
  • A good support policy should include escalation procedures that can go all the way to the outsource provider’s senior management team. If the provider is serious about providing good service, there is no reason why it should hold back on giving you contact information to those in its support hierarchy.
  • There should be contract termination clauses and the implications of such a situation for both parties. This includes the conditions for allowing the contract to end prematurely, penalties for either party, and exemptions, such as force majeure .
  • The contract should include terms and conditions for continuation of the contract. The contract should have an auto-renewal clause so that there is no service interruption just because of negligence by either party to renegotiate the contract.
  • The contract should include a clause that covers you against sudden permanent service interruption, such as assistance in finding and migrating to another provider and making available all required information pertaining to your service for a certain period after termination of the outsourcing service.
  • Terms and conditions on adjustments to pricing should be included in the contract, such as amount of time prior to effective date of adjustment, a range of percentage increase allowed, and price protection for a certain period of time.

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Functional Service Provider (FSP)

The proficiencies you need. Without the capital investment.

Flexible options for a fast-changing industry

Since 1998, Premier Research has partnered with leading pharmaceutical, biotech, and medical device sponsors worldwide to deliver long-term support for key functions as well as meet project-specific needs. We provide access to a dedicated corps of experts around the world, including key life sciences hubs in emerging markets such as India, China, and South Korea, who work alongside your study teams. Our global presence means we can swiftly scale to meet your growing needs — without the constraints and capital investment of hiring full-time staff.

  • Complete customization : Define the role, determine the reporting structure, choose embedded vs. remote — each engagement is structured to meet your precise needs
  • Ongoing adaptability : Adjust roles and responsibilities as study and industry requirements evolve
  • Optimal savings : Free your budget and eliminate searching, hiring, training, and management headaches
  • Trusted support : Leverage Premier’s clinical trial expertise and technical savvy, pairing people and systems to extend your core team
  • Demonstrated longevity: Benefit from proven, long-standing partnerships that make us an extension of your team in ways that can span a decade or more

Access to deep clinical development expertise & extensive resources where you need it

By submitting your information to us through this webform, your business details will be added to our database. In accordance with our Privacy Notice , we may then contact you with marketing information about Premier Research including products, services, and career opportunities that might be of interest to you. We will never sell your details to third parties. You can unsubscribe from marketing communications at any time.

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Pre-clinical through post-marketing: global FSP models to meet a range of needs

In a dynamic, demanding clinical research environment where regulations continue to evolve, our flexible sourcing approach gives you access to deep clinical development expertise and extensive resources where you need it.

Premier Research’s FSP models provide you with the functional resources to support your product development program anywhere and at every stage. You fine-tune your level of involvement, deciding how hands-on (or off) you want to be.

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Roles may include:

  • Data managers
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  • Pharmacovigilance professionals
  • Regulatory affairs professionals
  • Medical writers
  • Study management experts
  • TMF experts

One size doesn’t always fit all. As a full-service global CRO, Premier offers agile solutions to meet your unique needs. Our traditional FSP model fits seamlessly with our full-service model to allow you to customize the partnership:

  • Traditional model: We can provide teams of dedicated, centralized functional experts who can move from study to study supporting key areas — or a strategic few to support a very specialized area of your trial.
  • Hybrid model: Take advantage of Premier SOPs and systems for some study components under our full-service model, while centralizing and maintaining control of key functions through our traditional FSP model.

To succeed, today’s trials require new skills, understanding of changing clinical trial requirements and processes, and technology and data savvy — sometimes you need an entire department. We can deliver a complete package of support, such as supplying traveling CRAs, data managers, and central monitors to conduct study work while navigating the latest mHealth systems. To augment our FSP experts, Premier offers access to our ePremier study management technology platform, integrating all study data centrally and then applying powerful analytics and skilled analysts to deliver crucial insights.

* Part of the Premier One Ecosystem

For rapidly scaling global companies — whether focused on medical devices, cell and gene therapies, rare diseases, or other life-changing medicines — the path from concept to commercialization is multifaceted. You need expertise in a vast array of areas from operations to regulatory, strategy to product development. Rapid scale-up can pose a challenge — and Premier solves it. We supply localized or expanded functional leadership, services, and technologies related to key roles, helping advance your science without taxing your bottom line.

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HOW WE HELP

Getting started with premier fsp.

We have created a flexible sourcing approach that gives operational teams the benefit of our clinical research expertise and access to our extensive resources. Not ready to move to an FSP model? We can help you build out a framework for success.

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Flexibility and cost savings ahead.

Functional outsourcing can produce significant savings and greatly increase flexibility in assigning resources. But any big change in staffing requires care to avoid personnel disruptions, keep projects on track, and comply with laws governing use of contract employees.

Looking for something else?

For information about Premier Research’s in-house clinical development and consulting expertise or general requests, get in touch with us here .

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Optimove Recognized as a Contender Email Marketing Service Provider by Independent Research Firm

NEW YORK, Aug. 15, 2024 (GLOBE NEWSWIRE) -- Optimove, the first Customer-Led Marketing Platform, has been named a Contender in The Forrester Wave™: Email Marketing Service Providers, Q3 2024. The report cites Optimove's strength in improving marketer processes with real-time data, and delivering AI-generated recommendations, solidifying, for the company, its position as a powerhouse of both email and cross-channel marketing. The Forrester Wave™ report provides an in-depth analysis of the latest trends in the Email Service Provider (ESP) space and evaluates the most significant providers offering solutions to help businesses optimize their email marketing strategies.  

Optimove received the highest possible scores in the criteria of Personalization, Process and Workflow Innovation, Email Value, and Organizational Improvement. Optimove also ranked third highest out of all 12 vendors in the Current Offering category of an EMSP. Optimove believes the recognition underscores its commitment to data-driven insights and personalized customer experiences. This recognition reinforced Optimove’s ability to drive efficiency for cross-channel marketers both in their day-to-day work and their overall business 

Optimove believes its status in the report is further recognition of its continuous investment in customer engagement channels, accelerated by recent acquisitions in mobile marketing and digital personalization, and underscores its growing presence in the email marketing space. The company's focus on orchestrating personalized marketing campaigns across digital channels has established it as a reliable partner for businesses looking to enhance their customer engagement strategies. 

The report noted that “Optimove’s strength is improving marketer processes with real-time data. ‘Optibot’ – Optimove’s AI-generated recommendations, in-product guidance, and self-learning courses all help clients upgrade workflow and reduce reliance on promotions.”

The report stated that “Optimove makes sense for buyers consolidating their CDP and ESP or for those who value decisioning over message composition.”

Optimove’s Email Marketing Servic e   Optimove’s native  email personalization  and delivery platform powers all aspects of preparing, delivering, and tracking hyper-personalized  email marketing campaigns. Seamlessly integrated within Optimove, OptiMail offers marketers a rich email platform specially designed for personalized customer marketing. 

About Optimove    Optimove is the first Customer-Led Marketing Platform. Its solutions ensure that marketing always starts with the customer instead of a campaign or product. Customer-led marketing has been proven to deliver brands an average increase of 33% in customer lifetime value. 

It is the only customer-led marketing platform powered by the combination of 1) rich historical, real-time, and predictive customer data, 2) AI-led multichannel journey orchestration, and 3) statistically credible multitouch attribution of every marketing action. Optimove is a recognized leader in Multichannel Marketing Journey Orchestration. 

Optimove provides industry-specific and use-case solutions for leading consumer brands globally. For more information, go to Optimove.com.  

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Market Updates

What’s happening in the markets this week, schwab’s kathy jones on the big mistake bond investors should avoid, where to find value in japanese stocks, 5 undervalued stocks that crushed earnings, 3 stocks to buy with reliable dividends while they’re still cheap, putting recent market volatility in perspective, july cpi report forecasts: inflation softening trend intact, despite gas price pop, markets brief: will the cpi allow the fed to cut rates in september, stock picks, lumen stock has been on a wild ride. is it a buy, apple, meta, and salesforce released new dividends. is it too soon to celebrate, the best reits to buy, applied materials earnings: we like the firm’s growth opportunity, alibaba earnings: higher sales growth offset by increasing investments, after earnings, is eli lilly stock a buy, a sell, or fairly valued, walmart earnings: attractive prices and growing digital engagement propel market share gains, it’s not just warren buffett; we also think ulta beauty is a buy, sponsor center.

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How Payers Can Move Providers Along Value-Based Care Continuum

As providers move along the value-based care continuum, payers can offer financial and technical support, help them pursue primary care transformation, and present further research..

Kelsey Waddill

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Payers can offer essential support to providers starting their journey through the value-based care continuum, while further research on value-based care in Medicare Advantage can help inform payers about best practices in this endeavor.

Value-based care in Medicare Advantage helped maintain quality of care during the coronavirus pandemic, with Humana’s Medicare Advantage beneficiaries seeing a 20 percent lower hospitalization rate than traditional Medicare beneficiaries in 2020 . However, research on value-based care in Medicare Advantage is not as robust as studies on fee-for-service Medicare.

Brian Powers, MD, deputy chief medical officer at Humana, internal medicine physician at Newton-Wellesley Hospital, and assistant professor of Medicine at Tufts University School of Medicine, helped author a JAMA Network Open study and research letter that demonstrated the impact of upside-only and two-sided risk payment models on acute care utilization among Medicare Advantage provider partners.

Brian Powers, MD, deputy chief medical officer at Humana

When Powers set out with his colleagues to conduct the study on Medicare Advantage value-based payment’s impact, he anticipated that the results would affirm previous studies’ conclusions regarding value-based care’s impact on the healthcare industry. But he was not fully prepared for the level of difference between fee-for-service and value-based care.

“What was very striking was, when you look at the ‘all utilization’ measures, they were lower in the most advanced value-based payment models. But the magnitude of the difference was often about three times larger for those measures of avoidable utilization,” said Powers.

“To us, that painted the picture that these practices are delivering care differently. They're managing chronic diseases more effectively. They're engaging patients before they end up in the emergency department or end up in the hospital. We had a sense that it would go that way, but maybe not quite as stark as it was.”

Powers noted that the researchers chose to lump pay-for-performance models with fee-for-service reimbursement models. That decision could impact the difference between fee-for-service and upside-only risk.

The research letter that Powers co-authored and Powers’s own experience working as a provider and as a deputy chief medical officer at Humana illuminated how Medicare Advantage plans can support providers transitioning into value-based care and revealed future research areas.

The value-based care continuum

As payers prepare provider organizations to enter into value-based care contracts, they may find that providers need to ease into the most advanced value-based care models. 

As a result, a spectrum of value-based care agreements exists, from models that are most similar to fee-for-service reimbursement to advanced models that impose two-sided risk. For many payers, the ultimate goal is to move their provider partners into two-sided risk contracts in which providers receive incentives for high-quality care and penalties for low-quality care.

“We see anecdotally and qualitatively that those providers that are furthest along on the spectrum—that are bearing two-sided risk—have the most advanced population health management infrastructure, chronic disease management, etcetera,” said Powers.

In the study, nearly a third of the patient participants were covered under upside-only risk payment models (32.4 percent), and a little over half of the participants were covered under two-sided risk models (51.0 percent). Powers and his team conducted the study from January 2019 through December 2019 using claims data from over 489,000 Medicare Advantage beneficiaries.

For patients whose providers engaged in upside risk models, all-cause hospitalization rates were similar to the all-cause hospitalization rates in fee-for-service: 159.7 beneficiaries out of 1,000 beneficiaries were hospitalized in the upside-only model, versus 159.2 beneficiaries in a fee-for-service model, according to the study. 

Meanwhile, providers engaged in two-sided risk saw lower all-cause hospitalizations, with 152.5 beneficiaries out of 1,000 experiencing all-cause hospitalizations.

The same principle was true for avoidable hospitalization as well as all-cause and avoidable observation stays: fee-for-service reimbursement and upside-only risk model outcomes were similar, while two-sided risk models produced lower rates of undesirable outcomes.

However, while the outcomes were encouraging for those pursuing two-sided risk value-based care models, the study’s design presented some challenges in identifying the cause for these outcomes.

“The providers that do well move into more advanced models that reward them for the outcomes that they're delivering, so it's hard to tease out how much is the payment model and how much is the provider themselves,” Powers acknowledged.

Nevertheless, the critical role of the value-based care continuum is to create an environment that rewards providers for positive performance, the study highlighted.

Powers recommended that payers take certain actions to empower providers as they move along that value-based care continuum.

Offering payment support for value-based care transformation

Transformation payments are vital to transitioning providers into more advanced payment models. When entering into a value-based care model, providers may have to cover care coordination costs, practice transformation costs, and other expenses. 

Per member per month payments from payers alongside bonuses for positive performance can be essential to a provider’s progress in those early stages of the value-based care continuum, Powers said.

“It's really about seeding that transformation with practice transformation payments upfront and then moving into a total cost of care model where the performance is directly rewarded, and the incentives and investments capital is provided through shared savings,” Powers explained.

However, for beginner value-based care providers, Powers stressed the importance of basing payments on growth. 

Payers should not hold providers accountable for patient outcomes in the earliest stages of the transition into value-based care. Instead, they should reward providers for seeing a reasonable amount of change from a new process in the first year of implementation and apply graded incentives.

Initial financial support for the transition into value-based care can focus on one disease state or pathway. Then, as the providers can expand into other areas of care, payment structures can evolve into total cost of care payment models .

Giving technical support for value-based care transformation

In addition to financial support, payers can offer technical aid to providers starting their journeys on the value-based care continuum. In particular, providers in the initial stages of the value-based care continuum rely on payers for data and insights.

Powers shared that Humana offers providers online tools and reports that allow providers to compare their performance to their peers. These tools also help providers identify poor outcomes and low-value or excessive healthcare spending .

Aside from assessing trends, technical and data support can also inform providers about strategies that high-performing practices employ, and, likewise, high-performing providers can share their steps to success.

These tools are particularly useful for very small practices with one or two providers that do not have the same resources as a multi-specialty group practice, Powers noted.

Pursuing primary care transformation

An essential piece of transitioning providers into value-based care is primary care transformation . For a primary care practice that has traditionally relied on fee-for-service reimbursement to meet value-based care performance metrics, changes will have to occur.

“We are seeing evidence in this analysis with those avoidable utilization metrics that the practices that are engaging in value-based payment models, at least in our experience, are changing the way they deliver care in a way that really impacts patient outcomes,” Powers shared.

Primary care transformation is primarily the responsibility of the practice itself. However, payers institute appropriate metrics to help orient that process.

Powers emphasized that—while utilization and healthcare spending are helpful and important metrics, particularly for policymaking—primary care transformation is ultimately about patient-centered utilization outcomes.

“An avoidable hospitalization is sort of an abstract term, but what that means, in reality, is someone who didn't go to the hospital because of a COPD exacerbation or someone whose heart failure didn't get so bad that they know couldn't breathe and had to call an ambulance,” Powers said. 

By keeping patient experience at the center of value-based care utilization measures, payers and providers will better understand how providers redesigned their primary care practices to improve clinical outcomes.

Identifying areas for further value-based care research

While Medicare Advantage plans have played a key role in driving forward value-based care adoption, research on the impacts of value-based care in Medicare Advantage is still nascent compared to research on value-based care in traditional Medicare. Powers anticipated more extensive exploration in this area.

Specifically, Powers noted a lack of insights around incentives quantities and structures and the nature of two-sided risk incentives. 

Additionally, the healthcare industry should more closely track provider movement along the value-based care continuum in Medicare Advantage. Powers indicated that this is a topic that Humana is pursuing.

There is a lot to glean from studying value-based care changes at the practice level, Powers added. In particular, the industry should apply more effort to understanding transformational strategies in high-performing practices.

“If we can learn more about what works best from the performers, then we as a payer—and then the community more broadly—can think of ways to target fee-for-fee programs or target specific models along that continuum that may help less advanced providers in value-based care make investments in the right areas,” Powers shared.

Improving research on how value-based care payment models operate within Medicare Advantage can provide a deeper understanding of value-based care’s impact across the healthcare industry.

  • What Is Value-Based Care, What It Means for Providers?
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  • How Population Health, Risk Stratification Support Value-Based Care 

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Filing a complaint

If you have concerns about the quality of your care or other services, you can file a complaint (also called a "grievance").

Should I file a complaint or an appeal?

File a complaint if:

  • You have a problem with the quality of the care you got or are getting
  • You have a problem with how you’re being treated by your plans

File an appeal if:

  • You have an issue with a plans’ refusal to cover a service, supply, or prescription.
  • You got a bill for a claim you already submitted.
  • Learn more about appeals.

How do I file a complaint?

To file a complaint about:You can:

or follow the instructions in your plan membership materials to submit a complaint about your Medicare health or drug plan. Generally, you can find your plan's contact information on your plan membership card.

Contact your State’s health department.

Contact your State medical board

Call the home health agency and ask to speak to the administrator. If you don’t believe your complaint has been resolved, call your state home health hotline. Your home health agency should give you this number when you start getting home health services.

Contact your
Durable Medical Equipment (DME)

Can I file a complaint anonymously?

Yes, you can file a complaint anonymously. The method for filing a complaint anonymously will also depend on what type of complaint you are filing, so refer to the contacts above for more information.

Can I get help filing a complaint?

  • State Health Insurance Assistance Program (SHIP): Visit shiphelp.org to get the phone number for your local SHIP and get free, personalized health insurance counseling. SHIPs are state programs that get money from the federal government to give free local health insurance counseling to people with Medicare.
  • Medicare: You can also contact us for help. Talk or live chat with a real person , 24 hours a day, 7 days week (except some federal holidays) by calling 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.
  • Representative: If you have a family member or friend helping you with a complaint, you can appoint them as a representative. How do I appoint a representative?

More From Forbes

Service lifecycle management: the future of manufacturing automation.

Forbes Technology Council

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Malik Saadi, Vice President, Strategic Technologies, ABI Research .

Today, automation/robotics original equipment manufacturers (OEMs) find themselves focusing primarily on scaling product development and innovating their solutions as demand increases. Unfortunately, this can negatively impact the vendor’s ability to provide product lifecycle services that enterprises require upon purchase. Therefore, third-party Service Lifecycle Management (SLM) providers are an essential partner of automation providers going forward.

Below is ABI Research’s understanding of what is required of the automation/robotics industry to unlock its full potential in the future:

Product Innovation Takes Precedence: While manufacturing represents the most immense market opportunity for automation, vendors must also cater to other industries, such as retail warehousing, supply chain, construction, agriculture, real estate, retail and other emerging markets. As demand for automated/robotics solutions increases across many verticals, vendors must focus on product development and innovation to remain competitive in the future.

Customer Centricity Cannot Be Neglected: This resource realignment will impede post-sales service quality, such as customer support tickets, maintenance, operations and training. At the same time, failing to offer these customer-centric services will cause the manufacturing industry to hesitate to adopt automated solutions.

Third Parties Are Essential For Quality Post-Sales Services: Automation vendors must provide scalable, flexible and replicable solutions across many use cases, environments and regions. To concurrently meet the demand for post-sales services, vendors must build long-term partnerships with SLM providers. Once a relatively rare arrangement designated for limited use cases, the future of automation hinges upon these third-party SLM arrangements to deliver the perks that manufacturers expect from vendors.

Changing Market Ecosystem: Relying on third parties for customer assistance will cause a foundational shift in the automation market, as it will be split between vendors for product development and ecosystem partners for value-added services.

What Is SLM?

SLM includes all the services an enterprise requires for technology adoption, such as prospecting, design & planning, implementation integration with legacy infrastructure, compliance with regulations and safety frameworks, maintenance, workforce training, etc. SLM is an essential factor for enterprises when choosing an automation technology partner. To many enterprises, automation/robotics adoption is a new project they are unfamiliar with, necessitating expert help on-demand.

For these reasons, ABI Research sees third-party SLM providers as must-have partners of automation vendors with an eye on the future.

Challenges After Purchasing Automated Solutions

Automation OEMs should first step in the shoes of potential manufacturing customers and consider their main challenges regarding automation/robotics adoption.

Installation Difficulties: Site-wide automation/robotics is a new implementation for many companies, making the installation process challenging without outside help. Additionally, hardware and software solutions often have interoperability issues due to their heterogeneous nature. Manufacturers also require any new solution to be backward compatible with their legacy infrastructure and enterprise resources planning systems.

Maintenance And Repair Costs: Robotics systems are bound to require maintenance/repairs, with 81% of manufacturers reporting robot-led production shutdowns. Paying for maintenance/repairs inevitably lengthens the time it takes for a return on investment (ROI) to materialize. While larger companies can wait years for the ROI, the wider manufacturing industry requires a shorter path to recouping costs.

Data Analytics Inefficiencies: Data analytics is a big selling point for vendors, but many solutions lack context and timeliness. Manufacturers seek automated solutions that they can act upon swiftly.

Failed Deployments: Due to technological complexity issues, initial automation deployments can carry a high risk of failure. Manufacturers need assurance that their automation partner will provide ongoing assistance with remedying algorithm failure and other technical problems.

Employee Training: Different departments have different levels of technical knowledge, and manufacturing sites differ in equipment requirements. This makes employee training needs diverse in nature.

Opportunities With Third-Party SLM Providers

It’s been reported that 61% of industrial companies lack experience with automation, making post-sales services crucial to your potential customers. The challenges outlined in the previous section can be alleviated through a partnership between automation/robotics vendors and third-party service providers. The latter allows the former to offer manufacturers robust SLM, making these strategic partnerships the future of automation.

Outsource Installation Process: Automation vendors typically must provide installation assistance for engineering teams across multiple regions, increasing travel and integration costs. Partnering with specialized SLM providers makes more sense for ensuring efficient merging between different and/or legacy-to-new hardware stacks in these scenarios.

Software Integration: The customized software offered by most automation vendors lacks compatibility with other robotic systems, management systems (e.g., warehouse management system (WMS) and enterprise resources planning (ERP) solutions) and external information technology (IT) infrastructure. Outside experts specializing in software interoperability can significantly streamline the onboarding process for manufacturing customers.

Reduce Burden Of Repairs: SLM providers can manage all the maintenance calls your manufacturing clients place, resulting in quicker assistance and reduced operational costs.

Robotics-As-A-Service (RaaS): A great differentiator for automation vendors would be to offer a RaaS model whereby customers get customer service, 24/7 hotlines, on-site inspections and consulting, employee training, installation, operations and redeployment from a single vendor. It’s unrealistic for most automation/robotics vendors to provide all these services alone, making strategic partnerships with third-party SLMs that assist with onboarding and post-sales functions an advantage.

Future Outlook For Automation In Manufacturing

Manufacturers are increasingly adopting automated solutions such as robotics to address complex technology supply chains, rising labor costs in regions historically known for their cost-effective workforce (like parts of Asia, notably China), growing geopolitical tensions and the need to cater to multiple stakeholders.

Automation vendors will find it difficult to balance their product scalability and innovation aspirations with a full SLM plan on their own. In light of that, automation vendors that fully understand the value of third parties are ahead of the curve and hold the most tremendous promise for market capture. Although only a handful of third parties are currently capitalizing on the SLM void, ABI Research expects many more to appear in the coming years.

Forbes Technology Council is an invitation-only community for world-class CIOs, CTOs and technology executives. Do I qualify?

Malik Saadi

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