Understanding the Current Site Sector Consolidation Trend

About our in-house industry expert, Barry Lake, Co-Founder and President of Devana Solutions: Before co-founding Devana Solutions, Barry Lake gained hands-on experience in site operations at a clinical research site in Charleston, South Carolina. In addition to managing his own site, he was part of a management team that established an early “network” of high-performing, independent yet affiliated sites that shared marketing and sales resources. He witnessed the emergence of strategic acquisitions and site consolidations, notably in 2015 when PPD acquired Synexus’s approximately 100+ sites and ICON acquired PMG Research’s 12 U.S. sites. In 2019, ICON further expanded by combining PMG’s U.S. footprint with MeDiNova’s European sites, forming the Accellacare Global Site Network, now comprising approximately 112 sites. 

The clinical research industry is undergoing a profound transformation, driven by market consolidation and technological innovation. To adapt, clinical research sites are embracing innovation, increased collaboration, and strategic positioning to thrive. The site consolidation trend shows no sign of abating. In this blog post, we caught up with Barry Lake, co-founder at Devana Solutions, a RealTime Software Solutions Company. We wanted to better understand the driving forces behind the site consolidation trend and uncover key investment areas for sites aspiring to accelerate their growth and enhance their appeal to sponsors and investors. 

Interview with Barry Lake

Q: Can you share your background and how it influenced your journey in the clinical trials industry? 

Barry Lake: Before co-founding Devana Solutions, I gained experience in site operations at a clinical research site in Charleston, South Carolina. This first-hand experience of the pain points of running a site, coupled with witnessing the emergence of strategic acquisitions and site consolidations, inspired me to pioneer the Devana Solution platform. Launched in 2016, Devana built a category-defining product that addresses the challenge with study start-up, pipeline management and business intelligence for sites, sponsors, and CROs. 


Q: Can you share your observations on the current trends shaping the clinical research landscape, particularly regarding site success and market consolidation? 

Barry Lake: Absolutely. We have been witnessing a significant shift in the clinical research industry, characterized by the consolidation of site networks. Strategic acquisitions and private equity investments are driving this trend, leading to the emergence of larger, integrated site networks. This consolidation presents both opportunities and challenges for sites as they maneuver through the complexities of modern clinical trials.  

Organizations transitioning from “boutique” businesses to sustainable enterprises are leveraging capital to increase their scale and value. Successful execution necessitates securing sufficient capital to sustain competitive advantage and drive growth. In the site sector consolidation, winners emerge by executing profitably and strategically accessing capital. 

If an organization makes the commitment to move beyond being a boutique business towards building truly sustainable enterprise value through a leading position therapeutically or through scale across a geographic footprint, over time, the leadership will face relentless and ever-increasing pressures stemming from their own commercial success. The good news for these site organizations is they will certainly be much more valuable in private equity’s eyes, assuming their leadership is open to leveraging more capital to increase their scale. Successful execution inevitably requires increasingly larger tranches of capital for any organization to sustain a balance sheet that enables them to maintain a competitive advantage and continue scaling and increasing their enterprise value over the long term.  

In other words, when an industry sector consolidates fueled by the efficient deployment of a massive amount of capital at scale (the role of the financial sector in every industry) it envelopes both types of companies in the sector: the losers and the winners. The losers in the clinical trial site sector will be those site organizations that cannot evolve into a becoming one of leaders either by not performing profitably or, if they do, in fact, become profitable their ownership fails to seek sufficient capital to shore up their balance sheet and drive their growing dominance.  

I foresee that those organizations that fail to access more capital when they need it will be outmaneuvered over the long run by more savvy competitors with stronger balance sheets. As a result, the site organizations on the wrong side of market forces will either go out of business if they are unprofitable or, if they don’t seek more capital to shore up their balance sheet, be forced to eventually sell at a depressed value to a competitor or industry aggregators. 

The ultimate winners in this consolidation battle will be those site organizations who execute profitably and then attract and, are willing to accept, additional capital on reasonable terms at numerous inflection points along their growth journey. 


Q: How does essential site-based technology contribute to site success in this site consolidation market? 

Barry Lake: Technology can be a game-changer for clinical research sites looking to succeed in today’s competitive environment. Electronic solutions that replace error-prone paper-based processes, like Devana, enhance transparency, streamline workflows, and facilitate integration with the industry’s top CTMS providers including RealTime, CRIO and Clinical Conductor. Devana improves site business operations, accelerates study startup processes, and fosters efficiency across the entire clinical trial journey, from study start-up, execution to closeout. By leveraging advanced eClinical technology, sites can improve data accuracy, accountability, and position themselves as leaders within larger site networks. 


Q: What are some key strategies that clinical research sites can employ to capitalize on growth opportunities? 

Barry Lake: Strategic positioning is essential for clinical research sites. By focusing on areas of expertise, building strong relationships with sponsors and CROs, and investing in eClinical technology solutions built for clinical trials, sites can enhance their value proposition and attract increased investments. Additionally, collaboration and networking within larger site networks can open doors to new opportunities for growth and expansion. 


Q: What role does Devana play in shaping the future of clinical trials? 

Barry Lake: The private equity fueled site sector consolidation has continued to accelerate at a rapid pace heading in 2024 and Devana remains at the forefront of innovative eClinical solutions purpose-built to help sites scale faster. Devana delivers crucial transparency to site leadership and operating managers, shedding light on the upstream pipeline of trial opportunities and automating study startup workflows. In fact, on average, sites that have adopted Devana report 76% reduced contract budget and turnaround time, 14 hours saved in study activation, and 40% increased revenue. 

And the platform continues to shape the future of clinical trials through strategic partnerships like seamless integrations with industry-leading CTMS providers and cutting-edge new features such as our Query Feature, which allows central team members to query all sites within their network based on a given trial’s specific criteria for capabilities, equipment, and more. They can send new trial opportunities directly within PROPEL and receive real-time site responses and turnaround timing metrics in return. 

Today, we partner with many of the industry’s largest site networks to drive efficiency, compliance, and patient engagement. That’s why Devana is humbled to call virtually every major site network a partner-client. In fact, eight of the top 10 site networks in the world have already adopted Devana. The exponential growth of our site network clients spotlights the tangible benefits of leveraging advanced eClinical technology across the entire clinical trials journey.  

Final Thoughts

The momentum behind the site sector consolidation trend is undeniable and continues to gain traction. Whether it’s backing a single large site as a platform investment or spearheading a network roll-up strategy, private equity sponsors are actively seeking opportunities to deploy capital and drive site consolidation efforts.  

At RealTime Software Solutions, our team predicts that the consolidation trend will continue to play out similarly across the site sector as it did from the 1990’s through the early 2020’s in the CRO sector. The site consolidation wave will continue until the site space is largely dominated by only a handful of major global site organizations in much the same manner as just a handful of major global CROs control almost 80% of the pharmaceutical sponsors outsourcing spend on clinical trials that run through CROs. As such, it’s crucial for independent site owners to position themselves as market leaders in their respective fields, recognizing that acquisition by larger networks is inevitable for long-term success. By staying ahead of the curve and strategically investing in growth areas, sites can still emerge as industry leaders. 

Decoding How Sponsors Evaluate Research Sites for Clinical Trials

When selecting clinical research sites for their trials, sponsors look for a blend of capabilities, resources, and a proven track record that promises the best outcomes for their studies. With sponsors seeking top-performing sites that align with their trial objectives, the ability to showcase expertise, efficiency, and reliability is key component of successful to success. This selection process is crucial as the chosen sites directly impact the efficiency, compliance, and ultimately the success of the clinical trials.  

In this blog, we’ll explore the key factors that sponsors consider when evaluating potential clinical research sites. From the expertise of the staff and the facility’s infrastructure to patient recruitment strategies and regulatory compliance, understanding what sponsors are looking for can help clinical sites not only meet but exceed these expectations. Whether you’re a seasoned investigator or a site looking to attract more trials, this insight into sponsor priorities will provide valuable guidance on how clinical research sites can use purpose-built technology, like PROPEL, built by Devana Solutions, to demonstrate that they are a high-performing site that stands out in a competitive field. 

Site Experience and Expertise 

One of the primary considerations for sponsors during site selection is experience and expertise. Sponsors prefer sites with a proven track record of successfully conducting similar trials, demonstrated by a history of patient recruitment, retention, and data quality. Additionally, sites and Physician Investigators (PIs) having expertise in specific therapeutic areas or specialized procedures relevant to the trial protocol is also highly valued.   

By centralizing data management, PROPEL is a pioneering platform that enables sites to efficiently track and report on key performance metrics. This consolidation of data within a single system streamlines operations, offering unprecedented visibility into trial progress and site performance. With its powerful analytics and reporting capabilities, PROPEL enables research sites to transparently showcase their past and current performance metrics to sponsors. From patient recruitment statistics in a given indication to site activation timelines, PROPEL generates customizable reports highlighting a site’s efficiency and effectiveness.  With PROPEL, sites can effectively monitor their performance, identify areas for improvement, and demonstrate their capabilities to sponsors with unparalleled precision and efficiency. Sponsors appreciate sites that can provide transparent and timely performance data, as it allows them to make informed decisions when selecting partners for their trials. Moreover, this transparency enhances the site’s reputation and ultimately strengthens the overall partnership between sites and sponsors. 

Patient Population and Recruitment Potential 

Patient retention and recruitment is another pivotal factor for success in clinical trials. Access to diverse patient pools is particularly important. Clinical research sites are assessed by sponsors based on their access to the target patient population and their innovative strategies for patient recruitment. Sponsors assess clinical research sites based on their access to the target patient population and their strategies for patient recruitment.   

In recent years, there has been a growing mandate to improve diversity in clinical trial populations. This push is driven by the recognition that diverse populations may respond differently to treatments, which has significant implications for the generalizability of trial results. In fact, regulatory bodies like the FDA in the United States have issued guidelines that encourage the inclusion of varied demographic groups in clinical trials to ensure that the findings are applicable to a broader population. These guidelines recommend that trial designs consider factors such as age, gender, and racial and ethnic backgrounds. Sites that have established relationships with patient communities often have an advantage. These relationships facilitate trust and communication, which are crucial for encouraging participation and ensuring participants remain engaged throughout the trial.   

Sponsors value sites that can leverage past and real-time data analytics to drive continuous improvement and ensure the success of their trials. PROPEL’s advanced analytics capabilities provide clinical research sites with invaluable insights into trial performance. By analyzing site metrics, patient recruitment trends, and operational efficiency indicators, sites can make data-driven decisions that optimize trial strategies and resource allocation. Additionally, sites can track which patient recruitment methods have worked the best in the past to inform future decisions. Plus, PROPEL’s seamless integrations with the leading CTMS providers allows for a full-cycle view of past trial performance and patient recruitment.  

Site Facility and Resources 

The physical infrastructure and resources available at a site are carefully evaluated by sponsors. This includes the availability of state-of-the-art facilities for patient visits, laboratory capabilities for sample processing, and access to necessary equipment and technology. Adequate staffing, including trained research personnel and support staff, is essential for efficient trial conduct.  

Using comprehensive site profiles, PROPEL makes it easy to see all the key capabilities, equipment, and staff members in one place. For larger site networks, PROPEL enables central teams to query all their sites and filter by specific criteria, including equipment and therapeutic specialties. This makes it easy for research site organizations of all sizes to respond quickly to sponsors about how their available resources match up to the trial opportunity.

Regulatory Compliance and Quality Assurance 

Sponsors are increasingly vigilant about regulatory compliance, given its impact on the integrity and validity of trial results. Sites that can demonstrate that they prioritize and manage regulatory aspects effectively are often more attractive to sponsors. This includes compliance with Good Clinical Practice (GCP) guidelines, adherence to protocol requirements, and timely reporting of adverse events. Sites with robust quality assurance processes and a culture of continuous improvement tend to be favored by sponsors.  

PROPEL simplifies regulatory compliance for sites, offering a comprehensive platform for tracking all necessary regulatory documents. The platform includes automated compliance workflows, which significantly reduces the potential for human error and improves the efficiency of compliance processes. Furthermore, PROPEL provides detailed audit trails for sites to consistently verify and document their compliance status throughout the clinical trial process. Altogether, PROPEL helps sites demonstrate their commitment to maintaining high-quality standards. 

Budget and Contract Negotiation 

While not the sole determining factor, budget considerations play another significant role in site selection. Sponsors evaluate potential sites based on their proposed budgets, which include personnel costs, overhead expenses, and any additional services required. Additionally, a site’s negotiation skills and their ability to offer flexible contract terms can also influence site selection decisions.  

PROPEL further optimizes trial management by centralizing tasks and automating many routine workflows, thereby improving efficiency, reducing the administrative burden, saving time and money, and minimizing errors. The platform’s ability to capture real-time data allows research sites to document these efficiencies and cost savings through detailed reports and key performance indicators (KPIs). This capability helps sites distinguish themselves in a competitive field.  Sponsors are drawn to sites that can demonstrate streamlined operations, as it signifies a commitment to excellence and a focus on delivering high-quality data within stipulated timelines. 

Communication and Collaboration 

Effective communication and collaboration between sponsors and clinical research sites are essential for the smooth conduct of clinical trials. Sponsors further evaluate sites based on their responsiveness, transparency, and willingness to collaborate on trial-related activities. Sites that demonstrate proactive communication and a commitment to addressing sponsor concerns are more likely to be selected as effective collaboration is a cornerstone of successful clinical trials.   

PROPEL is purpose-built to facilitate seamless communication and collaboration among site teams, sponsors, CROs, and other stakeholders. Real-time sharing of information, progress updates, and feedback fosters a collaborative environment that instills confidence in sponsors. Sites that leverage PROPEL to enhance collaboration and data-sharing are more likely to stand out to sponsors seeking reliable partners. 

Stand Out with PROPEL 

Selecting the right clinical research sites is a critical step in the success of clinical trials. Sponsors carefully evaluate sites based on various factors, including experience, patient recruitment potential, facilities, and more. Devana Solutions’ one-of-a-kind PROPEL platform empowers sites to elevate their performance and stand out to sponsors. By streamlining and automating operations, enhancing collaboration, enabling data-driven decision-making, ensuring regulatory compliance, and providing transparent performance metrics, PROPEL equips sites with the tools they need to showcase their expertise and reliability. As sponsors seek out top performing sites to partner with, PROPEL emerges as a key differentiator that enables research sites to shine and win more trial opportunities from sponsors and CROs.  

Devana Solutions  

A RealTime Software Solutions Company, Devana Solutionsis an innovative cloud-based clinical trial software provider that supports real-time collaboration between central research operations professionals and decentralized clinicians serving patients in diverse communities. Devana Solutions even bridges the technology access and data divide by seamlessly and securely connecting decentralized researchers to other mission-critical clinical trials systems.   

Let us show you in more detail what Better Data, Better Decisions, Better Outcomes could do for your clinical trial processes.Book a demo with Devana Solutions today to learn about our cloud-based data analytics clinical trial software for the clinical trials industry that integrates seamlessly with CTMS and other key systems to keep success in the crosshairs.  

Read More: Case Study – Accellacare (ICON’s Global Site Network) & Oncacare (specialized oncology site network)