2026 SCRS Global Site Solutions Summit: Should the Industry Rethink What Scale Means?

Kurt Mussina, CEO, Paradigm Clinical Research, acknowledges that scale matters but pushes back on the idea that it should mean handing an entire study to a single site, however large.

He notes that while this has happened in a handful of recent cases, it isn’t the industry’s trajectory, pointing out that clinical research is a hyper risk-averse industry, and he doesn’t know of a sponsor CEO willing to put all their eggs in one basket with a single organization, a caution he considers sound business sense in its own right.

Where scale genuinely pays off, in his view, is in operational efficiency. He contrasts running a 100-patient study across two sites versus ten, noting that coordinating ten separate organizations is a significantly heavier lift than managing two, and that this kind of efficiency is a real and valuable benefit of scale. He expects market consolidation to continue, alongside growing attention to underserved geographies both domestically and globally.

Ultimately, Mussina argues that footprint and scale are secondary to a more fundamental question: does an organization have genuine access to patients, and can it actually enroll and retain them. For him, that patient-access and retention capability, not size or location count, is the real measure that should matter.