Benchmarking Study Finds Clinical Trial Performance Is Shaped by Operating Model Design, Not Sourcing Strategy

A benchmarking study conducted by the Tufts Center for the Study of Drug Development (CSDD) has produced a direct answer to one of clinical development's most debated questions: does your sourcing model determine your trial performance? Across 13 sponsor companies, 81 development programs, and 133 clinical trials, the answer is no.¹

The research, announced by Syneos Health, found that no single model, whether in-house, full-service contract research organization (CRO), or functional service provider (FSP), consistently outperformed the others across measures of timeline, quality, and execution.

The differences that did emerge in the data pointed elsewhere: to how operating models are designed, how partners are coordinated, and how accountability is structured across increasingly complex vendor ecosystems.

"Clinical development leaders have long held strong views about which sourcing models work best, but the industry has had limited objective data to compare how those decisions affect performance," said Ken Getz, executive director and research professor at Tufts CSDD, in a Syneos press release. "This study gives sponsors a more rigorous, evidence-based foundation for considering how development work should be structured around portfolio requirements and the unique scientific and executional demands of clinical trial activity."

What the data actually showed

One of the study's more actionable findings concerns vendor complexity. A greater number of service providers was associated with longer timelines from protocol approval to database lock, higher dropout rates in certain contexts, and more protocol amendments and quality events. The issue, the researchers note, is not simply how many partners are involved, but how effectively those partners are coordinated and how work is executed across them.

The broader implication is that sponsors who focus on sourcing decisions as the primary lever for improving trial performance may be solving the wrong problem. The data suggest performance is more tightly linked to operating model design and cross-partner alignment than to the specific type of organization doing the work.

"Taken together, these findings point to a bigger opportunity for sponsors: to rethink operating models as a strategic lever for next-generation drug development," added Michael Brooks, chief operating officer at Syneos Health, in the press release. "As science becomes more precise, timelines continue to compress and evidence expectations evolve, sponsors need fit-for-purpose operating models that can change with the work.

A shift already underway in how the industry thinks about CRO relationships

The study's findings connect to a broader evolution in how sponsors and CROs are structuring their relationships. A contributed article recently published on Applied Clinical Trials by Partha Anbil and Jayanthi Anbil examined how preclinical CRO partnerships have shifted from transactional, fee-for-service arrangements toward strategic alliances built on shared governance, mutual accountability, and continuity of scientific talent.²

The piece drew on market data showing outsourced pharmaceutical research and development spending crossed the 49% threshold by 2023 and has continued upward, with the global preclinical CRO market projected to grow at a compound annual growth rate of 13.9% through 2034. That growth is being driven not by cost pressures alone but by the complexity of modern pipelines, including cell and gene therapies, bispecific antibodies, and radiopharmaceuticals, which require specialized expertise that many sponsors do not maintain in-house.

The article also pointed to a trend that maps directly onto the Tufts CSDD findings: sponsors reducing vendor counts by 20% to 40% and moving from trial-level contracting to enterprise-wide partnerships that streamline oversight and improve consistency.

Performance-based contracting, tying commercial terms to outcomes such as cycle time reduction and data quality, was identified as an emerging mechanism for formalizing mutual accountability.

Taken together, the new research and the industry trend line point toward the question of who does the work is less important than how the work is governed, coordinated, and held to account across an increasingly distributed development ecosystem.

References

1. Syneos Health and Tufts CSDD Study Shows Clinical Trial Performance Depends More on Operating Model Design Than Sourcing Strategy. News release. Syneos Health. September 16, 2026. Accessed September 16, 2026. https://www.syneoshealth.com/news/Syneos-Health-and-Tufts-CSDD-Study-Shows-Clinical-Trial-Performance-Depends-More-on-Operating-Model-Design-Than-Sourcing-Strategy
2. The Evolution of Preclinical CRO Strategic Partnerships: From Transactional Services to Value-Driven Ecosystems in 2026. Applied Clinical Trials. September 15, 2026. Accessed September 16, 2026. https://www.appliedclinicaltrialsonline.com/view/evolution-preclinical-cro-strategic-partnerships-transactional-services