Market fragmentation in clinical trial recruitment organizations: Accessing new capabilities for clinical operations

This has created a complex competitive environment for clinical operations leaders seeking to identify the best-fit patients and trial participants to prove the safety and efficacy of their medicines in development.

On the one hand, competition encourages innovation. Market fragmentation means there are more options than ever before for clinical stage pharmaceutical and biotechnology companies to pursue diverse and varied recruitment tactics. Many new entrants in trial recruitment are leveraging AI, advanced data analytics, consumer-centric digital marketing, and collaborations with healthcare providers and sites, to identify and engage potential trial participants in new ways.

However, market fragmentation in clinical trial recruitment can also lead to inefficiencies and a higher administrative burden for trial sponsors and sites. As sponsors collaborate with a larger number of vendor partners, the proliferation of tools, technologies, different geographic approaches, and increasing therapeutic areas contribute to an administrative patchwork that trial sponsors must navigate.

The on-the-ground implications of market fragmentation is that pharmaceutical companies are less likely to turn to a single Clinical Recruitment Organization (CRO) to manage all attributes of a trial – or even of its recruitment. Instead, pharmaceutical companies might choose one organization for top-of-funnel digital marketing, another for deep-dives into medical registries or claims data, another to analyze the electronic health records of potential participants, an organization to collaborate with a network of trial sites, and another to manage the process – to say nothing of trial conduct once the trial participants have been recruited.

The vast array of service providers in trial recruitment can lead to FOMO (fear of missing out) among clinical operations executives who face significant pressure to quickly and efficiently recruit patients for a trial. There is temptation, certainly, to try one of everything but that approach can backfire by causing excessive administrative complexity, concealing the approach or tools that work, and diluting team members’ attention from the core task at hand (trial recruitment) by instead forcing them to focus on managing multiple vendors’ delivery. Even if every service provider offers a high-quality service, the administrative burden of managing them all and orchestrating an effective process may limit the full potential of new technologies and capabilities.

Therefore, a key challenge is to identify the right combination of capabilities that a particular study or therapeutic area requires, onboard them in a focused way, and rigorously manage their delivery. In our experience working on trial recruitment involving multiple service providers, we have identified several opportunities that clinical operations leaders can pursue to accelerate their drugs into clinics, and beyond.

Consider platform-based solutions

A platform-based solution can provide the backbone to a complicated process like end-to-end patient recruitment. This type of solution is especially valuable if multiple services can be integrated into its workflows and/or tracking and reporting capabilities. For example, StudyKIK is a patient recruitment platform that leverages social media and mobile technology to engage patients and facilitate trial recruitment. Solutions such as this are often interoperable, scalable digital platforms that unify disparate data sources, reducing administrative friction and streamlining workflows. While there are several recruitment technology platform organizations on the market that may be ready for implementation off-the-shelf, some large pharmaceutical companies may prefer to leverage in-house capabilities to build their own recruitment technology platform, whicht can be scaled to meet their specific needs.

Target partnerships to meet specific needs

There is a huge amount of activity and investment in recruitment for trials in high-value therapeutic areas, such as oncology, neurology, gastroenterology, and rare disease. For organizations developing drugs in these therapeutic areas, it may be advisable to form strategic alliances with specialized firms and tech-driven startups to access hard-to-reach patient groups. Leal Health, for example, is a technology company that helps cancer patients easily discover and access clinical trials. In 2025, Lilly partnered with Leal Health on its ‘Two Words’ oncology trial advertising campaign, targeting patients and linking to Leal Health so patients could search for a cancer trial that may fit their needs.

Prioritize global recruitment opportunities

As clinical research is increasingly global, we see more recruitment organizations targeting previously under-represented geographies such as Asia-Pacific and Latin America. These geographies have significant unmet medical needs, and technology can support accessing patients who may not have previously had the opportunity to participate in clinical research. Organizations can align recruitment strategies with evolving regulatory guidance on diversity by targeting underrepresented populations and new geographies.

Support standardization

Leaders should advocate for, and adopt, industry-wide interoperability and data standards (such as those promoted by Clinical Data Interchange Standards Consortium (CDISC) to enhance efficiency and scalability in recruitment efforts. Industry fragmentation will remain operationally burdensome as long as different data standards and systems are in use, so a concerted effort to standardize approaches and output can make a meaningful difference in efficiency.

With ongoing growth in clinical development, trial recruitment will remain a core requirement in clinical operations, but the capability itself is likely to change with technology innovation and industry fluctuation. By collaborating with innovative organizations that can support multiple recruitment operations and use cases, clinical operations leaders can meet their recruitment objectives more quickly and affordably.

This article was first published in Clinical Leader.