Currently, clinical trials are experiencing a rise in complexity, encompassing multiple regions and demanding substantial resources. This trend significantly impacts sponsors, who face the timelines and cost control constraints. As a result, the establishment of an appropriate partnership structure becomes important, particularly during the feasibility and commencement stages.
Mid-sized CROs and extensive site networks spanning a single continent synergistically combine complementary scale, shared mindset, and operational efficiency. This collaboration enables them to overcome challenges faced by large global structures, such as expedited site identification, streamlined contracting processes, and enhanced trial initiation.
This article will explore how these partnerships work in practice, why they are increasingly favoured by sponsors in Europe, and how the broader regulatory push, such as the ACT EU initiative, is accelerating this shift.
Why regional alignment speeds up feasibility and improves site selection
When considering feasibility, it is not all about identifying available sites; it is also about making well-informed decisions promptly and with minimal conjecture. When both the CRO and site network are integrated within the same region, feasibility becomes a focused and efficient process predicated on firsthand knowledge rather than assumptions.
A mid-sized, pan-European CRO can offer sponsors pre-qualified site options with recruitment potential, regulatory compatibility, and infrastructure readiness already validated. Site networks operating in the same region bring additional insight into investigator engagement, historical performance, and trial competition, all of which influence site activation timelines.
This alignment facilitates more effective site selection decisions, thereby expediting the path to securing the first patient’s participation from sponsors. This is achieved by reducing the frequency of back-and-forth communication and accelerating the feasibility timelines.
Faster start-up through simplified contracting and shared priorities
Contracting is one of the most common sources of delay in clinical trial start-up. Misaligned expectations, rigid templates, and long legal review cycles can stall even the best-prepared studies. When CROs and site networks have a history of working together and operate with compatible governance models, these hurdles are significantly reduced.
There is a need for more flexible contracting frameworks. These frameworks are typically offered by mid-sized CRO’s, and are designed to adapt to local requirements without compromising oversight. When paired with a site network accustomed to similar terms and timelines, the process becomes more predictable and efficient.
In practice, this translates into fewer negotiation cycles, faster document finalisation, and once again reduced time between feasibility confirmation and site activation.
Why One-Continent partnerships work
Global partnerships may offer reach, but they often introduce unnecessary complexity. Managing trials across continents can lead to delays caused by misaligned timelines, incompatible systems, and fragmented oversight. By contrast, a one-continent approach reduces operational variability and accelerates coordination.
In Europe, where regulatory frameworks are increasingly harmonised through initiatives like ACT EU, this focus becomes even more effective. A regionally anchored CRO can manage submissions and regulatory requirements across countries, while the site network ensures localised trial conduct that meets both sponsor needs and national expectations.
With fewer handovers and a shared set of tools and timelines, sponsors benefit from faster execution, better oversight, and fewer costly adjustments mid-trial.
How ACT EU strengthens the case for regional CRO–site collaboration
The European Commission, EMA, and HMA launched the ACT EU initiative to modernise how clinical trials are conducted across the region. The focus is on making Europe more attractive for sponsors by encouraging faster, more transparent, and better-coordinated trials.
This regulatory push has created a more favourable environment for regional partnerships. Under ACT EU, streamlined processes and centralised trial applications only deliver their full value when CROs and sites are operationally ready to respond. That’s where mid-sized CROs and site networks stand out, they’re structured to act quickly and adapt to the evolving regulatory landscape.
Rather than building new processes from scratch, these organisations are already aligned with ACT EU’s priorities: faster trial initiation, greater use of digital tools, and stronger integration across trial partners. For sponsors, this makes regional partnerships not just a tactical choice, but a strategic one, well-positioned to leverage regulatory change for faster, more efficient trials.
Conclusion
As clinical development timelines tighten and expectations rise, sponsors are reevaluating the kind of partnerships that truly support trial success. The combination of a mid-sized CRO and a focused site network offers a practical model: fast, coordinated, and built on shared priorities.
It’s a partnership structure that doesn’t just meet operational goals, it aligns with the regulatory direction set by ACT EU and reflects the evolving needs of today’s clinical trials.
If you’re exploring how to accelerate your next study across Europe, join us for our upcoming webinar:
‘The Perfect Partnership: How Mid-Sized CROs and Site Networks Deliver Clinical Trial Success’
When: 27th of May, 1 pm CET
Where: https://us06web.zoom.us/webinar/register/WN_U_rqmcuQTGmUqRE3Gz2hHQ
We’ll share real-world examples, explore collaboration models, and take your questions live.
