Top 10 CROs in 2023

Significant shifts are underway in the clinical trial landscape. Accelerated adoption of eClinical technologies and AI tools, increased connectivity and globalization, and enhancements in big data and advanced analytics capabilities are changing what’s possible and opening the doors for revamped and even entirely new clinical trial models. Within these developments, the concept of patient centricity has taken center stage as a way to address recruitment challenges and improve the patient experience, and trial models such as fully remote and decentralized clinical trials (DCTs) have seen a huge increase in adoption.

As part of this shift, the prevalence of contract research organizations (CROs) has also exploded, as CROs offer specialized expertise and vastly customizable solutions and services to clinical trial sponsors. Especially in today’s rapidly changing clinical research landscape, partnering with a solid CRO can be an excellent way to stay up-to-date and remain competitive, ensuring compliance and operational excellence in your studies regardless of their complexity. A CRO can be contracted for isolated operations, for example to optimize a social media recruitment strategy or manage study data, or the entire trial can be outsourced, with the CRO taking care of almost everything beyond the initial conception and funding.

In this article, we share 10 top CROs currently leading the industry. Note that these top CROs are not ranked; the list follows no particular order. If you are looking for more background information to gain a deeper understanding of what CROs are, what they can offer to pharmaceutical companies and drug developers, and how to choose an appropriate CRO, scroll down - we cover these topics after the list of top CROs.

Top CROs leading the clinical research industry in 2023


IQVIA is a leading global provider of advanced analytics, technology solutions, and clinical research services. They are dedicated to providing innovations and insights based on a solid understanding of the connections underlying healthcare today, improving the lives of patients around the world in the process.

IQVIA partners with various clients to help them find innovative ways to streamline the development, testing, approval, and distribution of pharmaceuticals so that effective treatments can reach the patients who need them as quickly as possible.

IQVIA Connected Intelligence™ makes extraordinary discoveries possible by connecting data, advanced analytics, and innovative technologies—combining extensive healthcare and scientific expertise with unique insights. IQVIA’s advanced technological tools may be attractive to clients looking for cutting-edge yet tried and trusted research and data capabilities.

2. PPD

PPD is a global contract research organization (CRO) that provides drug development, laboratory, and lifecycle management services to the pharmaceutical, biotechnology, and medical device industries.

PPD has a network of offices and laboratories in more than 50 countries around the world. Some of the services offered by PPD include pre-clinical and clinical development, biopharmaceutical manufacturing, and regulatory affairs consulting. The company has a strong focus on quality and has been recognized for its commitment to ethical practices in the conduct of clinical trials, which are strong selling points for clients prioritizing these aspects.

3. Worldwide Clinical Trials

Worldwide Clinical Trials provides a range of services to the pharmaceutical, biotechnology, and medical device industries. The company offers a wide range of services including pre-clinical studies, clinical trials, regulatory affairs consulting, and post-marketing studies. Worldwide Clinical Trials has a strong focus on patient-centered research and has a reputation for conducting high-quality clinical trials that adhere to the highest ethical standards.

One of the key areas of focus for Worldwide Clinical Trials is patient recruitment, and the company claims to provide unmatched expertise in this area, which may be attractive to clients specifically looking for recruitment services. Another selling point is the range of technology and support services Worldwide Clinical Trials offers to help clients manage and analyze clinical study data.

4. Labcorp

Labcorp is a US-based, globally present life sciences and healthcare company dedicated to mobilizing science to improve peoples’ lives. Labcorp's skilled team of over 75,000 experts and healthcare professionals worldwide merge and leverage science, technology, and innovation to find solutions for the major questions facing health research. Labcorp utilizes cutting-edge diagnostics to improve patient care, and is constantly working to make new medical advances more accessible to patients.

Labcorp partners with communities, drug developers, biopharmaceutical companies, and other healthcare providers to provide numerous services, including clinical trials and trial operations. Its global presence and thorough expertise across all aspects of clinical research may be attractive factors for clients looking for a comprehensive partner, especially for international studies.

5. ICON plc

ICON helps their clients develop drugs that save lives and improve patient quality-of-life. ICON offers consulting, outsourcing, and commercialization services to pharmaceutical, biotechnology, and medical device companies. The company prides itself on offering “the most comprehensive suite of integrated clinical development and commercialization services in the industry,” enabled by ‘Healthcare Intelligence’ - the name it uses to refer to its unique synthesis of deep expertise, technology, data, insights, and human experience.

ICON focuses on 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. The company applies its expertise to a wide range of therapeutic areas, and is one of the top CROs worldwide, having won several prestigious industry awards. ICON’s singular focus on excellence in clinical research makes it a solid partner for a broad range of clients seeking assistance in just one aspect of their trials or throughout the entire process.

6. Parexel

Parexel is a global contract research organization that provides a range of services to support the development and testing of pharmaceutical, biotechnology, and medical device products. The company has a team of over 21,000 professionals who collaborate with clients to design and conduct clinical trials that are focused on patients and making clinical research accessible to anyone, anywhere.

Parexel has a strong focus on quality and a track record of success in the clinical research industry, and its services cover the full range of phases of clinical development, from Phase I through Phase IV trials. The company 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.

7. Charles River Laboratories

Charles River offers a wide range of services including various research models and services, safety assessments, and scientific and regulatory advisory services, across a wide variety of therapeutic areas and research phases. The company operates 110+ facilities in over 20 countries, and supported the development of 86% of the novel drugs approved by the FDA in 2021.[1]

In terms of clinical development, Charles River ensures that the testing methods they use in the nonclinical lab studies transition smoothly to the clinical development phase. The company has a broad portfolio of laboratory support services and expertise, and their team is often a part of the clients’ drug development process from the earliest stages of nonclinical work, making Charles River a top CRO partner for sponsors looking for assistance throughout their drug development journey.

8. Medpace

Medpace has a global network of offices and research sites in over 40 countries, which can be beneficial for clients seeking a top CRO with a global reach. It operates under a full-service model, which means it offers a range of services including clinical trial management, data management, and regulatory consulting.

Medpace adopts a therapeutically focused approach; their expertise in a range of therapeutic areas positions them to provide specialized, expert support to clients working on a broad range of research questions. Medpace has a unique global partnering philosophy and emphasizes an uncompromising commitment to clinical research and to the highest levels of ethical standards and performance. Standout traits that may make Medpace a particularly attractive CRO partner include their strong therapeutic expertise, global presence, and comprehensive yet customizable solutions.

9. Syneos Health

Syneos Health was founded in 2013 through the merger of two established top CROs, inVentiv Health and INC Research, and already has a strong track record in the industry. Syneos Health has a global network of offices and research sites in more than 60 countries - ideal for clients seeking a CRO with a global reach.

Syneos Health offers a range of services related to drug development, including clinical trial management, data management, and regulatory affairs consulting. The company also provides a range of technology and support services, including various eClinical solutions, to help clients manage clinical studies regardless of the trial’s complexity and design.

Syneos Health focuses on improving the efficiency of the drug development process and has a reputation for providing high-quality, efficient services to clients. This may be particularly attractive to clients seeking to streamline the drug development process and reduce costs while working with a single partner offering multiple services.

10. CTI

CTI Clinical Trial & Consulting Services is a global CRO supporting the development of new medical treatments and devices. CTI offers a variety of clinical research services, including regulatory development, numerous clinical services, and project management, across a wide range of therapeutic areas. CTI has thorough expertise in medical writing, quality assurance, pharmacovigilance, and many other areas, and also offers training and development services. CTI may offer a unique set of advantages to clients seeking a partner for research in highly specialized areas, but its comprehensive range of services also positions it as a solid partner for all-around support.

Further background: Introduction to CROs and what they offer

What is a CRO?

Contract research organizations (CROs) are third-party organizations contracted by pharmaceutical companies or other clinical trial sponsors to conduct clinical trials, either in part or in their entirety.

A capable CRO can generally handle everything from patient recruitment to data analysis, and a large part of their role in clinical trials is to ensure that the study is conducted in accordance with regulatory guidelines. Contract research organizations are sometimes also referred to as clinical research organizations.

A CRO will typically be hired by a pharmaceutical company, drug developer, or industry sponsor when the time comes for an investigational product to enter the clinical research phase of its clinical development. CROs usually 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 research hypothesis
  • Trial and protocol design
  • Screening and recruiting patients
  • 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 study drug distribution
  • Data management and analysis
  • Regulatory affairs and compliance
  • Reporting

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 may even networks of patients, investigators, and clinical sites. The staff team of a typical CRO might include specialists in pharmacology, biochemistry, medicine, statistics, data analytics, project management, regulations and legal frameworks, patient recruitment and engagement, and even marketing.

How do you choose a CRO for clinical trials?

There are several factors to consider in order to find and select the most appropriate CRO to partner with. Below is a list of 5 primary aspects you might want to consider when choosing a CRO:

  1. Services offered and capabilities: Most CROs offer services to support the full clinical research process, but some may offer only specific services or solutions. Some CROs specialize in smaller, simpler studies, while others handle complex and international trials that require more time and capital investment as well as highly customized solutions. Familiarize yourself with the options available; research the CRO thoroughly, enter into dialogue to clarify any concerns, and make sure that the capabilities of the CRO are explicitly matched to the specific needs of your specific trial.
  2. Specialized expertise: Especially for trials in highly specialized fields or therapeutic areas, it is important to find a CRO with strong experience in that specific area who will be able to support you and your trial and elicit quality results. For example, in rare disease studies, a partner with explicit experience studying that disease will be able to bring the necessary insights to the table to help you excel.
  3. Partnership and communication: A partnership with a CRO is a two-way relationship; sponsors and CROs work together closely, so it is important that there is mutual trust and clear communication. That’s another reason to begin open dialogue with potential partners before signing any agreement.
  4. Accreditation and regulatory compliance: All clinical trials must follow regulations set forth by the FDA (or the relevant regulatory authority in other regions, such as the EMA in the EU). Even when the entirety of the process is outsourced to a CRO, it is the sponsor who is ultimately responsible for regulatory and ethical requirements and responsibilities. Thus it is vitally important to choose a CRO with a proven track record in regulatory compliance, ideally with accreditations proving their adherence to safety and good practice regulations, such as GCP.
  5. Pre-trial assistance in study and protocol design: While CROs can be contracted to execute a trial after it has been designed, many CROs offer their expertise in trial design as well. An experienced CRO will be able to help you design a high-quality trial protocol and ensure that is it is feasible, supports efficiency in trial operations and the collection of robust and valid data, and is optimized for patient experience, safety, and regulatory compliance

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