In February 2024, the IQVIA Institute for Human Data Science released their annual report here on global trends in clinical trials Research and Development (R&D) for 2024. The report highlighted several exciting developments driving innovation and progress within the pharmaceutical clinical research industry, from predictive biomarkers to technology-enabled digital and decentralized trial designs. This has been made possible largely with the growing reliance of industry sponsors on partnerships with contract research organizations (CROs), which are specialized providers that are outsourced on a contractual basis by pharmaceutical, biotechnology, and medical device companies. In North America alone, the pharmaceutical CRO market is expected to reach a projected revenue of $13.73 billion by 2030, with a compound annual growth rate (CAGR) of 5.6% between 2025 and 2030.

As we approach the new year, the clinical research industry is poised for rapid growth and significant advancements, with CROs at the forefront of these changes. This article highlights the top 10 CROs that are expected to make waves in 2025, in no particular order, showcasing their unique strengths, innovative approaches, and potential impact on the future of drug development. Continue reading as we dive into the profiles of these industry leaders and explore how they’re positioned to influence the pharmaceutical clinical trials landscape in 2025 and beyond.

 

1. Medpace Holdings Inc.

Founding Year: 1992

Company HQ Location: Ohio, United States

Medpace stands out as a top CRO to watch for in 2025 due to its unique strengths and strategic positioning in the clinical trials industry. The company’s mission is to help biotech and biopharma companies accelerate the development of their medical therapeutics, offering a full breadth of clinical services and a collaborative approach across several areas of expertise. As a full-service global CRO, Medpace provides continuous insights from their medical experts across all major areas, including oncology, cardiology, metabolic disease, as well as crossovers such as rare diseases, cell and gene therapy, women’s health, and more. Partnering with Medpace CRO also lends sponsors access to a variety of their integrated central and bioanalytical laboratory services, the Medpace Core Lab for imaging and safety services, and even a Phase I unit with solutions for navigating early-phase clinical trials.

Notable Milestones: In 2022, Medpace invested a capital of $150 million into expanding its headquarters in Cincinnati, Ohio. The company has also been recognized with multiple industry awards, from being named a 2021 SCRS Eagle Award finalist to ranking among Forbes America’s Best Mid-size Companies in 2021. In 2023, Medpace received 5 CRO Leadership Awards for reliability, quality, expertise, compatibility, and capabilities.

2. TFS HealthScience CRO

Founding Year: 1996

Company HQ Location: Lund, Sweden

3. PPD, a Subsidiary of Thermo Fisher Scientific

Founding Year: 1985

Company HQ Location: North Carolina, United States

PPD has been a leader within the pharmaceutical and CRO industries, delivering consistent and reliable research services in over 100 countries. In December 2021, PPD became a wholly owned subsidiary of Thermo Fisher Scientific, operating under their clinical research business as a high-quality provider of end-to-end drug development and study design capabilities. From early development through regulatory approval and market access, PPD offers local and global experts across more than 20 key therapeutic areas, including oncology and hematology, infectious diseases, dermatology, and critical care. For over 40 years, their combined clinical development and laboratory services have helped streamline the complex drug development process for sponsors, enabling faster and more informed decisions about investigational products without compromising safety and efficacy.

Notable Milestones: In September 2024, PPD and Thermo Fisher Scientific launched the international CorEvitas Adolescent Atopic Dermatitis (AD) Registry to promote novel therapeutic development for AD, the most common inflammatory skin condition in adolescent patients. The company also announced in October 2024 a collaboration with DHL Express’ GoGreen Plus service to invest in sustainable aviation fuel (SAF) to reduce emissions from air transportation within the PPD clinical research business.

 

4. Premier Research

Founding Year: 1989

Company HQ Location: North Carolina, United States

Premier Research is a mid-sized CRO made up of therapeutically focused teams of clinical professionals who have the knowledge and experience necessary to effectively manage complex clinical trials in all major areas. This CRO’s expertise spans oncology and hematology, rare disease, cell and gene therapy, analgesia, dermatology, women’s health, internal medicine and immunology, MedTech, and more. Beyond their clinical development offerings, Premier provides sponsors access to product development and regulatory consulting, nonclinical and early development services, Functional Service Provider (FSP) models, and real-world and late phase study capabilities. With over 35 years of experience in the pharmaceutical industry, Premier Research consistently leverages the latest technology and therapeutic expertise to deliver faster development timelines, access to the right patients, and globally compliant clinical trials.

Notable Milestones: In October 2024, Premier Research announced the first patient dosed in their first-in-class INVISE (Injectable Vectors for In Situ Engineering) clinical trial in partnership with Interius BioTherapeutics. INVISE is a Phase I study that is evaluating the safety of a single INT2104 infusion in adults with refractory/relapsing B cell malignancies, as the first human clinical trial of an in vivo Chimeric Antigen Receptor (CAR) gene therapy.

 

5. Charles River Laboratories International Inc.

Founding Year: 1947

Company HQ Location: Massachusetts, United States

Charles River Laboratories is a leading full-service global CRO that specializes in preclinical research, drug discovery, and development services. In addition to its preclinical and clinical laboratory, gene therapy, and cell therapy capabilities, Charles River also specializes in cell sourcing, regulatory advisory consulting, and contract development and manufacturing (CDMO) services, among others. For over 75 years, the company’s industry-experienced, multidisciplinary teams have maintained a successful track record of supporting scientific clients from basic research, discovery, and safety assessment, to manufacturing and commercialization. As of 2024, Charles River had over 150 facilities, operating in 21 countries with over 21,000 people employed worldwide. Their global footprint also encompasses over 80% of all drugs approved by the United States (U.S.) Food and Drug Administration (FDA) in the last five years.

Notable Milestones: Earlier this year, Charles River announced strategic CDMO manufacturing collaborations with organizations including FOXG1 Research Foundation and AAVantgarde, dedicated to providing therapeutic treatments for rare disease patients. They are also providing comprehensive adeno-associated virus (AAV) gene therapy manufacturing collaboration to support early phase trials in the Asia-Pacific (APAC) region.

 

6. IQVIA

Founding Year: 1982

Company HQ Location: Connecticut, United States

IQVIA is one of the largest and most experienced CROs in the world, with a global network of over 85,000 employees in more than 100 countries and long-standing expertise across 17 major therapeutic areas. For nearly 45 years, this global CRO has been transforming clinical research, supporting therapeutic breakthroughs, and helping expedite new therapies for conditions in oncology, dermatology, nephrology, pediatrics, rheumatology, and many more. The company also offers a variety of technological innovations, including IQVIA Connected Intelligence^TM, IQVIA Healthcare-grade AI^TM (Artificial Intelligence), IQVIA AI Assistant, and Human Data Science Cloud. IQVIA-powered trials also benefit from this CRO’s patient experience solutions which are integrated with Apple devices for greater personalization of healthcare delivery.

Notable Milestones: This September, Frost & Sullivan, a leading independent research and consulting firm, awarded IQVIA with the 2024 Global Customer Value Leadership Award for excellence in the global AI quality and regulatory solutions space for the healthcare industry. Similar to all IQVIA AI-powered solutions, IQVIA’s SmartSolve’s eQMS platform is grounded in IQVIA Healthcare-grade AI™. The following month, the CRO also announced its IQVIA AI Assistant, a user-friendly, conversational text interface that allows customers to ask complex questions about their business and receive fast, comprehensive, and reliable answers.

 

7. Worldwide Clinical Trials Inc.

Founding Year: 1986

Company HQ Location: North Carolina, United States

Worldwide Clinical Trials is a leading full-service global CRO that creates customized strategies to support biotech and biopharma companies in clinical drug development. This mid-size CRO’s solutions span bioanalytical laboratory services, Phase I to Phase IV clinical trials, rescue study support, as well as post-approval and real-world evidence (RWE) studies. Worldwide’s therapeutic expertise consists of five key areas: cardiovascular and metabolic diseases, oncology, neuroscience, rare disease, cell and gene therapy, and immune-mediated inflammatory diseases. Across each of these therapeutic areas, sponsors can take advantage of Worldwide’s cross-functional teams specializing in a variety of capabilities, from trial optimization and protocol development to consulting and global regulatory guidance, among others.

Notable Milestones: In November, Worldwide Clinical Trials was named a finalist in Fierce Healthcare’s 2024 Fierce Diversity, Equity, and Inclusion (DEI) Awards in the category of Innovative Education and Training. In May 2023, the CRO also announced a partnership with the data-based non-profit organization, Every Cure, to accelerate the discovery of treatments for rare disease patients. In this collaboration, Worldwide will use its clinical development and rare disease expertise to assist in identifying links between rare diseases and generic drugs on the market using Every Cure’s open-source database of drug-repurposing opportunities.

 

8. ICON plc

Founding Year: 1990

Company HQ Location: Dublin, Ireland

Over the last 35 years, ICON has become a renowned leading global CRO provider of outsourced development services to the pharmaceutical industry, with over 42,000 professionals employed worldwide. The company has a vast geographic footprint, operating out of 106 locations across 55 countries and delivering its comprehensive clinical trials support services in 93 countries worldwide. ICON CRO offers a broad range of specialized clinical, consulting, and commercial solutions to ensure sponsors across various industry sectors meet the full potential of their clinical trials. These include central laboratory services, medical imaging capabilities, decentralized clinical trial support, real-world intelligence, site and patient solutions, and several more. ICON’s services are built to handle complex studies across several therapeutic and cross-therapeutic areas, from cardiovascular and infectious diseases to medical devices and the development of biosimilars/vaccines. With these capabilities and more, ICON is one of the top CROs to watch in 2025.

Notable Milestones: In July 2024, ICON was recognized for its excellence in clinical research in all categories at the CRO Leadership Awards 2024. They also received Individual Attribute Awards in the areas of data quality, meeting project timelines, operational excellence, technology for access to data, and therapeutic expertise. In the technology sector, ICON’s AI solution, Cassandra, won for Excellence in Use of Real-World Data/Evidence at the Citeline 2024 awards, which are held to recognize excellence in clinical trial design and technological advancements. Additionally, ICON’s site network, Accellacare, was named Best Clinical Trial Network at the 2024 Vaccine Industry Excellence Awards.

 

9. Fortrea Holdings, Inc.

Founding Year: 1978

Company HQ Location: North Carolina, United States

Another top CRO to watch in 2024 is Fortrea, a subsidiary of Labcorp’s (formerly known as Covance) Clinical Development business. Fortrea is a leading global life sciences CRO that provides comprehensive drug and medical device development services across Phase I-IV clinical trials to empower patients and providers. With their team of 19,000 clinical professionals, Fortrea provides sponsors access to a wide array of services including bioanalytical testing, data management, biostatistical analysis, and more. This CRO supports several stakeholders, from patients and physicians to health organizations and biopharma clients. For sponsors, Fortrea also offers robust capabilities in clinical trial management, central lab services, and commercialization services, which ensure their clinical trials generate accurate, reliable results in accordance with rigorous regulatory and data privacy standards. With these comprehensive services, Fortrea supported 84% of all new drugs and therapeutic products approved in 2023 by the FDA.

Notable Milestones: In November 2024, Fortrea launched new enhancements to Global Trial Connect, the company’s suite of digital, data and operational solutions for clinical trials and investigative sites. These updates improved site workflow facilitation and integrated sample collection with data tracking to promote earlier decision-making with actionable analytics that help both sites and sponsors reduce queries. In October, they also announced the availability of the VENTANA® CLDN18 (43-14A) RxDx Assay in the U.S., the first companion diagnostic assay to identify patients with gastric cancer who may be eligible for treatment with VYLOY™.

 

10. Syneos Health^®

Founding Year: 1998

Company HQ Location: North Carolina, United States

Last, but not least, Syneos Health^® is the final company on our list of top 10 CROs to watch in 2025. Syneos is a widely recognized global CRO with operations in over 110 countries worldwide. This leading biopharmaceutical solutions organization’s mission is to translate unique clinical, medical affairs and commercial insights into outcomes that address modern market realities in the clinical research industry. Their offered solutions include clinical development, medical affairs, commercial delivery, and consulting services, which span 16 therapeutic areas, including dermatology, endocrinology, neuroscience, women’s health, medical device and diagnostics, respiratory, and several others. Syneos is also a technologically forward CRO that provides its clients with access to innovative platforms such as StudyKik (Patient Recruitment for Clinical Trials), Kinetic (Healthcare Business Intelligence Platform), AnswerSuite (Biopharmaceutical Syndicated Data Platform), RxDataScience (Biopharma Analytics Platform), and more. With a tech-enabled problem-solving approach, sponsors benefit from this CRO’s ability to navigate real-world challenges using customized technology solutions for streamlined clinical trials.

Notable Milestones: In June 2024, Syneos Health was recognized on the Forbes list of America’s Best Management Consulting Firms 2024 for their commitment to delivering high-value customer solutions. In 2023, the CRO also expanded its strategic collaboration with Oracle to leverage the Oracle Cerner Learning Health Network (LHN) and elements of Oracle’s suite of study startup solutions to improve patient recruitment timelines and help close diversity gaps in patient recruitment.

 

Conclusion

In conclusion, these are the top 10 CROs at the forefront of the clinical research industry and its rapidly evolving drug development landscape. From pioneering AI-driven solutions to supporting novel therapeutic discovery in high-demand disease areas, each of these organizations will help shape clinical trial advancements in 2025. With their unique blend of technological innovation, strategic partnerships, and therapeutic expertise, these 10 CROs are poised to help deliver significant improvements to patient outcomes and drug development processes.

Interested in learning more about what a CRO does to support sponsors? Read more here.

 

About TFS HealthScience CRO

TFS HealthScience is a global CRO that supports biotechnology and pharmaceutical companies throughout their entire clinical development journey. In partnership with customers, we build solution-driven teams working for a healthier future. As a trusted mid-sized CRO partner throughout the entire clinical development journey, we understand the importance of providing essential and diverse services to streamline clinical trials for our clients.

Visit our website to learn more about the proactive solutions TFS can offer for your next clinical trial or connect with a TFS representative today!