ICON’s June 2025 survey of more than 100 investigators and site leaders reveals persistent bottlenecks in study startup driven by contract and budget delays, slow activation timelines, and insufficient collaboration from sponsors and CROs.
ICON plc has shared findings from its latest industry survey, highlighting challenges faced by clinical trial sites during study startup.1
The survey was conducted in June 2025 and features insights from over 100 principal investigators and senior clinical trial site personnel. Not limited to studies managed by ICON, data reinforced a widespread industry sentiment that sites are increasingly burdened by operational tasks including contract and budget delays and communication gaps.
Topline findings from the survey include:
In a company press release, Brian Mallon, ICON Executive Vice President, Site and Patient Solutions, said: “AI and operational advancements are opening new possibilities for smarter, faster trials, yet many sites still face persistent challenges that delay activation and disrupt momentum. These delays are solvable. Sponsors have a clear opportunity to improve communication and adopt approaches that center on the human experiences of site personnel. By simplifying documentation, smoothing negotiations, and fostering open collaboration, we can build a thriving ecosystem for trial start-ups—one that prioritizes site needs and accelerates access to new therapies.”
Earlier in September, Applied Clinical Trials was
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“We've talked a lot about how important communication and collaboration are. We've moved from this era where, ‘We need to communicate. We need to communicate,’ it's the dead horse, if you will, to this era of how important collaboration and how you take communication to the next level and actually work in concert, in partnership with industry insights. The other big thing is the feedback loop,” Bechtel said. “We talk a lot about, and we hear a lot of recurring themes, recurring challenges, recurring barriers at the site level, and I think we do a great job as an industry, especially in forums like this, of asking the questions and listening, but where the feedback loop starts to crumble a little bit is where we have an opportunity to then implement that feedback…”
In May, ICON shared findings from another industry survey on multi-indication cardiometabolic clinical research for therapies targeting obesity and its comorbidities.2
This survey featured insights from over 150 biotech and pharma professionals from the US and Europe. Findings were headlined by 83% of respondents sharing that they were pursuing multi-indication approaches in their obesity-related research at the time of the survey.
Some other figures included:
In a company statement from the time, Simon Bruce, MD, VP, Drug Development Solutions, Internal Medicine at ICON, said: “In the last few years, obesity-related drugs such as GLP-1s have surged in popularity, as has interest in their applicability for other health conditions and related commercial prospects. This survey has shown us that respondents realize that trial design is of paramount importance in devising a multi-indication approach, but don’t necessarily know the best way to go about it.”
1. ICON Survey Reveals Increasing Clinical Trial Startup Delays, Underscoring Need for Human-Centered Site Activation Solutions. News release. ICON. December 2, 2025. Accessed December 3, 2025.
2. Global ICON survey shows need for more efficient obesity clinical trial design to realize full potential of next-gen multi-indication therapies. News release. ICON. May 7, 2025. Accessed December 3, 2025.
