The biopharmaceutical industry’s outsourcing strategy has enabled the eight members of the Association of Clinical Research Organizations (ACRO) to double in size over the past 10 years, today employing more than 100,000 professionals worldwide with a global payroll of nearly $6 billion.

During the same period, member companies, who conduct clinical trials in 142 countries, saw revenues increase 180% to an estimated $14.2 billion—or about two-thirds of contract biopharmaceutical development spending, according to a new ACRO survey.

The eight members—the largest U.S. and European headquartered CROs—are are INC Research, Icon, PPD, Covance, Parexel, Quintiles, InVentiv Health and PRA Health Sciences.

“As ACRO members, we pride ourselves on the safety, quality and efficiency of the research we conduct,” said ACRO chairman Ciaran Murray, CEO of Icon. “We also are at the forefront of innovation, which is enhancing the development process and delivering better outcomes for our customers.”

The survey also reported the CROs have focused on adaptive trial designs, enhanced patient access, data analytics, predictive technologies and access to real-world evidence data.

Among other key findings:

• ACRO members contributed to the development of 85 of the 88 new drugs approved by the FDA and EMA last year, including all of the 20 top-selling drugs.
• Last year, ACRO members conducted more than 9,000 clinical trials involving 1.4 million patients worldwide.
• Among the most researched indications by the eight CROs are breast cancer, Alzheimer’s disease, hepatitis, diabetes , asthma, hypertension and vaccines.
• The average number of participants in a clinical trial by phase across all therapeutic areas are 26 for phase I, 92 for phase II, 399 for phase III and 772 for phase IV.
• On average, each ACRO member works with more than 500 sponsors and about 27,000 sites annually.
• Within in the U.S., the states with the highest CRO employment are North Carolina, Pennsylvania, Massachusetts, New Jersey, Texas and California. The European countries with the highest CRO employment are the U.K., Germany, France and Spain.
• Although the FDA has not approved any biosimilars in the U.S, ACRO members overseas, mostly in Europe, have contributed to the development of 19 of the 20 approved biosimilars.

“While the main driver has been outsourcing of clinical trials, our members also increased their scope of services, as they are doing regulatory consulting and technology work, more late phase studies and laboratory services,” said John Lewis, ACRO senior vice president of policy and public affairs.

Last week, ACRO named Rep. Fred Upton (R-Mich.), chairman of the House Energy & Commerce Committee, and Sen. Tom Carper (D-Del.) the organization’s first Legislators of the Year. Upton was cited for his leadership on the bipartisan 21^st Century Cures initiative, while Carper was commended for his introduction of the COMPLETE Act, which permanently extends and modernizes the R&D tax credit while acknowledging the role contract research plays in helping to bring new medical products to market.