The Pheonix, Ariz.-based site group Clinical Research Advantage (CRA) is expanding.
Nineteen-year-old CRA has acquired Destiny Clinical Research in Evansville, Ind., which has two locations and four employees. This gives the equity-backed group a total of 32 sites in seven states—Arizona, California, Iowa, Nevada, Colorado, Nebraska and Indiana.
And more are coming, according to CEO Mark Hanley. “We are creeping east,” he said. The goal is to try to establish a presence on the East Coast, specifically in the Carolinas, and also to move into the South, specifically Texas. Hanley said moving into the Northwest also is on the agenda.
With its expansion plans, CRA joins a handful of other site groups also growing and expanding.
Last week, Benchmark Research, an Austin, Texas-based group of six investigative sites, announced it had hired away PharmaNet/i3‘s executive director of global strategic outsourcing, as well as the long-time clinical research director of a successful, five-location site in Kansas. In May, Maryland-based site group and consultancy RxTrials hired Adam Chasse, head of Quintiles’ Prime Sites program, as well as Dan Milam, regional clinical trials manager for Sanofi Pasteur. These high-level hires signal impending growth.
Also in May, Jacksonville, Fla.-based site group JaxResearch Systems and Wilmington, N.C.-based recruiting company Inclinix together launched Encore Integrated Clinical Research, an affiliation of independent clinical research sites that share SOPs and a technology platform. A few months earlier, JaxResearch opened a new site in Panama.
CRA uses the physician-practice model as opposed to the standalone site model. Hanley said the group prefers to establish relationships with practices—preferably in internal and family medicine—and install at least one full-time coordinator in each. CRA handles all study-related operations for the site, including data collection, regulatory, financials and procurement of studies.
“We integrate into physicians’ practices, basically building a research department within them,” said Hanley, adding that outside of the principal investigator, only CRA employees work on the studies—not the practices’ clinical staff.
“We think this is significantly superior to the standalone model,” said Hanley, pointing to each P.I.’s patient base as a convenient pool of potential trial participants.
Hanley said he knows how close CRA’s model is to the ill-fated SMO model in which many invested in the 1990s and which never quite took off. In fact, many companies that bought into the concept crashed and burned. But Hanley said CRA wards against that by trying to acquire only sites with a similar culture, and making sure each site adopts a rigid set of SOPs so that operations at one are virtually indistinguishable from operations at another. It even extends to how the binders are arranged.
“We’ve McDonald’s-ized it,” he said. “McDonald’s is very strict with its SOPs and so are we. They have a proven model of continuity, and that’s what we try to do.”
CRA’s last acquisition before Destiny was a two-location site in Nevada owned by a large company Hanley declined to name. That was 18 months ago.
CRA mostly has grown organically but is getting ready for more acquisitions. “We try to find small sites that give us a foothold in a geographic region, acquire them and then expand out from there organically to physicians’ offices,” he said.
CRA was founded as one site in 1992 by a couple who grew it over the next 15 years to a six-site group. In 2007, it was acquired by private equity firm Kinderhook Industries.
CRA handles phases II-IV, but most of its work is in phases II-III, said Hanley. Vaccine trials make up 40% to 50% of the trials it handles. Hanley said that’s because CRA recruited 2,000 to 3,000 patients for an H1N1 vaccine trial and since then word has spread. Currently, CRA has about 250 trials either enrolling or ongoing.