In choosing a contract research organization to run clinical trials, pharmaceutical companies are showing an increasing preference for large, global CROs, a reflection of the industry trend that has pharmas outsourcing bigger and more comprehensive drug testing projects.

Durham-based Quintiles (NYSE:Q) leads the largest CROs in measures such as customer loyalty and overall satisfaction in the annual survey by Industry Standard Research. Kevin Olson, CEO of the Cary-based firm, said the high marks given to Quintiles and other large CROs comes as pharmas and CROS are increasingly striking strategic alliances where the CRO takes on bigger pieces of a pharma’s drug development and even drug commercialization efforts. These projects require a breadth of services along with global scale.

“The large organizations are winning because they’re well positioned, size wise and capability wise to field the kind of work that is being outsourced,” Olson told WRAL Tech Wire.

Quintiles, for example, announced last week an alliance with German company Merck Serono that will make Quintiles the exclusive provider of services to the German pharma company as the partners work together on drug development strategy. Smaller and mid-sized CROs are less able to take on projects of such size.

It’s the fifth year that Cary-based Industry Standard Research has conducted the survey. This year’s survey included responses from 157 executives and professionals from 77 different pharmaceutical companies who evaluated their experiences working with 29 different CROs.

North Carolina, which has the largest concentration of CROs in the industry, had several CROs rank high in the survey. PPD, headquartered in Wilmington, ranked among the highest in terms of preference, according to the ISR survey. Raleigh-based INC Research, among the top seven CROs in terms of size, also had a strong showing.

But size and scale is not everything. Some clinical work, such as oncology or medical devices, may call for a smaller provider that offer specialization in a particular area. Survey respondents showed the highest overall preference for MedPace, a mid-sized CRO based in Ohio. The Duke Clinical Research Institute made the ISR survey for the first time, standing out in the eyes of survey respondents as industry leaders in therapeutic expertise. DCRI had not been excluded from earlier surveys. This year is the first time that a sufficient number of survey respondents listed encounters with DCRI to make it to ISR’s reports. And those respondents had favorable comments on all of DCRI’s measures, save for its narrower range of services compared to larger organizations.

“There’s always room for specialist providers in the clinical world,” Olson said.

Where CROs can improve is the cost of clinical trials. Competition has improved service quality for all CROs, Olson said. That means that pharmas, who outsource to CROs as a way of reducing their own costs, now see CRO pricing as an increasingly important factor in selecting an outsourcing provider. That pricing pressure could pinch some CROs.

This ISR survey focused on CROs doing phase II and phase III clinical trials. Last year, ISR broke out phase I research as a separate study because of the differences in the services measured. Post-marketing studies have also been broken out as a separate ISR study. Those separate survey results will be released later this year.