There is no denying that large contract research organizations (CROs) are increasing their share of the outsourced drug development market. Preferred provider lists are dominated by the large CROs and it seems every week brings a new announcement of a "strategic partnership" between a large pharmaceutical company and a large CRO. However, one thing ISR has learned over the years of measuring delivery quality and loyalty is that being viewed as the "leader" does not guarantee a CRO a spot among the most favored. Similarly, record sales generation does not always translate to ensuring the most loyal customer base. 

In ISR's new CRO Quality Benchmarking – Phase II/III Service Providers report, the data indicate the pendulum is swinging back toward the small or midsize CROs, at least from a delivery perspective (see chart below). 

ISR is not suggesting that the large CROs possess disloyal, disgruntled customers Some are, in fact, quite strong. But four of the top five loyalty ratings in this year's Benchmarking study belong to small or midsize CROs.   

The great news for study sponsors is they have choices. Whether the choice is driven by delivery quality, capabilities, relationship management, or something else, sponsors have viable options. 