Synexus and Radiant Clinical Research will integrate operations, forming a global site network for clinical research. The network will operate under the Synexus name and encompass 185 sites in 11 countries, with access to over 100 million patients.

Radiant Clinical Research is a U.S. network of 75 research sites with over 100 principal investigators and 500 clinical research professionals. Over its lifetime, Radiant has conducted over 14,000 clinical trials. Its scope encompasses a wide range of therapeutic areas, including women’s health, dermatology, endocrinology, nutrition and vaccines.

Synexus, headquartered in Europe, already had sites across Europe and in India, South Africa and the U.K. before acquiring U.S.-based Research Across America in early 2016. At the time, Synexus stated their goal was to continue its U.S. expansion. Christophe Berthoux, CEO of Synexus since 2010, said, “Our acquisition of Research Across America added five sites to Synexus, so this is a much larger scale.”

As separate entities, Synexus and Radiant randomized over 10,500 patients in 2016.  “Synexus-Radiant is now the largest clinical site network in the world,” said Berthoux. “Our integrated commercial approach means that we are reviewing our common value proposition to sponsors. Both companies are very complimentary, for example, in certain therapeutic areas. Radiant is strong in vaccine trials, and Synexus is strong in cardiovascular outcome trials. We are sharing best practices to learn from each other to enhance our offering to sponsors.”

These two mergers are not the only changes Synexus has undergone in the last year. Later in 2016, after acquiring Research Across America, Synexus was itself purchased by Jaguar, a holding company for Pharmaceutical Product Development (PPD). Other clinical research organizations are also making changes: since 2014, Bioclinica has absorbed Clinverse, Synowledge, MediciGroup, Blueprint Clinical and Compass Research.

David Blume, co-founder and managing director, Edgemont Capital Partners, a merger & acquisitions advisor to clinical research site companies, said, “I am aware of more than half a dozen clinical research site company transactions that are currently in the market or about to come to market. The interest in acquiring sites is both from private equity firms as well as from strategic players.”

Along with so many other industries, the clinical trials industry is truly going global. “The consolidation of sites is a global trend,” agreed Blume. “There are two very large international site networks: Synexus and Bioclinica. Both of those operate, to a large extent, outside the U.S. Most studies now rely on sites that are located globally, and this trend will continue. I predict that the site business will continue to scale by adding locations on a global basis.”

Consolidation is a growing trend and is seen as having many benefits for the companies involved. “Consolidation among research sites in the U.S. is accelerating,” said Blume. “I would say this is the last unconsolidated frontier in pharmaceutical services. This entire industry depends on the work of thousands of small sites and there are a lot of inefficiencies. There are substantial efficiencies that can be gained through scale. These include standardization of standard operating procedures (SOPs); the ability to leverage technology, recruit subjects and handle data; and centralization of other key functions like financial, business development and quality assurance. In almost all other sectors, companies have gained scale and been able to capitalize on the benefits that the scale affords. But the clinical research site sector is still tremendously fragmented. In fact, Synexus/Radiant is the largest clinical research site company in North America currently and, by our estimates, they still represent less than 1% of the market.”

Scott Ballenger, co-founder of HeroLinx and former president of the Trial Acceleration Institute, said, “The Radiant-Synexus merger arguably combines two of the largest and most experienced site networks, presumably yielding even more administrative dividends to address our industry’s site initiation pain points. Additionally, this new global network’s integration with the other key elements of the clinical trial value chain, PPD and Acurian, seemingly provides an opportunity to leverage end-to-end study execution inclusive of patient recruitment, another critical pain point for most of our trials. “

Consolidation also has many potential benefits for patients. “I believe that the consolidation of sites is going to improve subject recruitment because organizations can now utilize best practices across their sites to recruit subjects; they can leverage technology and social media investment; and they can use a centralized call center. Utilizing more sophisticated capabilities across a larger number of sites is one of the advantages that site consolidation affords,” said Blume.

Berthoux agreed, “Patients will have access to more trials, both independent trials and common trials across the ocean. International trials will depend on the sponsor, but there are similar trials on both sides of the ocean. Trial recruitment can increase because more trials will be available. We will learn from each other as far as recruitment capabilities and will be able to retain more patients.”

Synexus already has a strong track record in patient enrollment and retention. They have emphasized their patient-centric focus, prioritizing relationships between patients and physicians at the research sites. Their patient base is diverse, and their clients include pharmaceutical organizations, biotech companies and CROs. “We are very excited to bring the  two companies together. This will benefit patients globally. Patients will have more choices for clinical research on both sides of the ocean,” said Berthoux.

Blume clarified, “I think we’re still in the early innings of consolidation of clinical research sites. I fully anticipate that it is going to accelerate dramatically, and I think we are going to see an evolution of different models. There will be an owned model, where people will own the clinical research site; there will be a managed model, where people manage other sites that are doing research and provide a lot of the back-end services that sites require around financial and operations; and there will be hybrid models where people will own some sites and manage others. We are in the very early days of what is going to be an enormous consolidation wave in this sector.”

This article was reprinted from Volume 21, Issue 18, of CWWeekly, a leading clinical research industry newsletter providing expanded analysis on breaking news, study leads, trial results and more. Subscribe »