Reinforcing Strategies

Several executives stress the importance of face-to-face meetings with senior management on both sides and of internal training to reinforce the importance of collaboration in the relationship.

"Having senior staff of the CRO meeting face-to-face for whole-day meetings with senior pharma execs has been very helpful because the expectations are clearer and it creates a better team spirit to have face-to-face meetings with the core team," says a senior director at a pharmaceutical company. "It's role modeling for the trial team from both sponsor and CRO; they seem to like it, and it does help."

"We've invested in training exercises to help people shift away from their old ways of working to a more self-confident way. This involves senior management, middle management, a study team, and more consistent messages across the three teams," says the director of clinical contracts for a large pharma company.

Room for Improvement

While satisfaction with the CRO relationship is the prevailing experience of those Avoca interviewed, one exec disagrees. "That is not in line with what we have seen in the last year to 18 months. We have seen very poor recruitment, a lack of knowledge on countries. We think maybe the CROs are overselling themselves. We would like to see upfront awareness—CROs proactively telling us there are problems they are dealing with."

A clinical scientist for a top 20 pharmaceutical company notes that there is still a great deal of room for improvement with proactive responses to problems. "Ninety-nine percent of the time, the CRO teams are reactive, not proactive," she says.

Most of the executives acknowledge that within most clinical trials, there are going to be some problems. Given that reality, what's important is that the providers be proactive, honest, and that they take responsibility for the problems. "What's most important is that they act like they are employees, not waiting until they think they have a solution to a problem before telling us," says one executive.

When problems do arise, the worst possible scenario is when CROs try to push the blame away instead of taking responsibility. "We would much prefer to work with a group that says, 'We could have done this a lot better,' or, 'We screwed this up and are doing things to rectify it,' rather than looking to cover things up," says Babani.