Top 10 CROs to watch in 2025

Contract research organisations – also called clinical research organisations (CROs) – are essential to the pharma, biotech, and medtech industries, supporting their efforts to test, refine and market their latest drugs and devices. According to , reports show the global CRO market was estimated to be worth up to $82 billion in 2024, and is expected to reach USD 139.42 billion by 2029. Over the years, the growth of Contract Research Organisations (CROs) has been driven by increased investment in research and development, a rise in clinical trials and the patent expirations of blockbuster drugs.

M&A in the CRO marketplace

A few years ago, mergers and acquisitions (M&As) surged as CROs focused on post-pandemic recovery, but 2023 saw a slowdown due to macroeconomic challenges. A new trend then emerged, and continued into 2024, with M&As centred on emerging markets, digital capabilities, and digital integration. Over the past five years, the CRO sector has seen major M&As, including:

• Syneos Health: Acquired by a private investment consortium for US$7 billion in September 2023

• Fortrea: Divested from Labcorp in 2023, returning to its Covance roots, alongside the further divestment of Endpoints

• PPD: Acquired by Thermo Fisher for US$17.4 billion in 2021, and further consolidated with the addition of CorEvitas, LLC, a leading provider of regulatory-grade, real-world evidence

• Parexel: Acquired by EQT and Goldman Sachs in 2021

The CRO market in 2025

Whilst during the height of the Covid-19 years, we saw record numbers of hires across the industry, by 2023 it became apparent that the pandemic-driven acceleration has slowed, and the last few years have been marked by challenges leading to consolidation, reorganisations and cautious hiring. The dramatic shift in the market was driven not only by a lack of funding and investment, rising interest rates and global recession concerns, but also by a slowdown in R&D in certain areas like vaccines and the ongoing impact of geopolitical changes, which continue to reshape the dynamics of global markets.

Reflecting efforts to leverage more cost-effective clinical trial sites, there has also been increasing interest in partnerships and acquisitions in Asia, LATAM and Eastern Europe, as well as access to diverse patient populations. Additionally, Decentralised Clinical Trials (DCT) and AI-driven platforms have gained traction, with more CROs acquiring companies with DCT capabilities or developing their own in-house solutions.

With expansions, partnerships and innovations continuing throughout the CRO industry, 2025 is set to be another dynamic year. The top ten CROs to watch in 2025 are listed below, in no particular order, and include both industry leaders by market share and revenue, as well as up-and-comers steadily increasing their presence through strategic collaboration and innovative service offerings.

The top 10 CROs in 2025

1. IQVIA

In 2016, Quintiles and IMS Health merged and rebranded as IQVIA, becoming the largest CRO in the world. As a leading global provider of advanced analytics, technology solutions and clinical research services to the life sciences industry, IQVIA has solidified its position at the forefront of the CRO world through a series of strategic acquisitions, including the recent purchase of MCRA, a renowned provider of regulatory and reimbursement services.

In 2024, , reflecting a 2.8% growth compared to the previous year. The company’s Research & Development Solutions revenue not only met but surpassed expectations, with bookings exceeding forecasts despite a turbulent CRO market. Meanwhile, Technology & Analytics Solutions performed strongly, maintaining momentum and positioning the company for continued success into 2025. At the end of 2024, Laboratories, underlining its ongoing commitment to innovation and strengthening its ability to provide comprehensive services for the biopharma industry. As a global leader in healthcare intelligence, IQVIA is well-positioned to continue shaping the CRO landscape.

2. ICON

In 2021, ICON bought PRA and 2024 saw them further solidify and harmonise their joined teams. Operating from 40+ countries across the world, the top-tier CRO, ICON, offers a full range of consulting, clinical development and commercialisation services.

In recent years, ICON has worked to advance the speed and efficiency of clinical development, which has supported a growing number of customer partnerships. In 2024, , a year-on-year increase of 2.0%.

In 2024, ICON embarked on a series of strategic acquisitions to expand its capabilities and market presence. In February, , bolstering its expertise in government-sponsored research and enhancing its capabilities in vaccines and infectious diseases. Later that month, , a company renowned for its organised library of digital measurement tools, their supporting evidence, and insights into their use in clinical trials. This acquisition adds to ICON’s growing portfolio, complementing its position as a leader in clinical trials and related services.

Six months later, , a contract research organisation with 27 years of experience and approximately 900 employees. KCR brings expertise in over 20 therapeutic areas, including oncology, immunology, CNS, vaccines and rare diseases. This acquisition strengthens ICON’s offerings in full-service and functional service provision (FSP), integrates KCR’s biotech division into ICON Biotech, and enhances its presence in Central and Eastern Europe. Together, these acquisitions reflect ICON’s commitment to delivering innovative, patient-focused solutions while solidifying its leadership in clinical research and drug development.

3. Parexel

Founded over 40 years ago and providing the full range of Phase I to IV clinical development services to help speed up and ensure the drug approval process runs smoothly, Parexel remains one of the biggest CROs in the world. With a team of more than 21,000 professionals worldwide, the company has a wide range of service offerings, covering nearly every type of clinical trial service to assist sponsors in running successful clinical studies.

At the end of 2021, Parexel was acquired by EQT Private Equity and Goldman Sachs for $8.5 billion. Together, Parexel and Goldman Sachs remain committed to delivering on the patient-first trajectory and driving advancements in drug development.

. The partnership combines clinical research expertise with artificial intelligence capabilities to help drug developers better understand the probability of clinical success for their innovative medical advancements.

2024 saw a significant shake-up in the leadership team, with Keri Mattox stepping in as Chief Business Officer and Peyton Howell taking the reins as Chief Executive Officer, succeeding Jamie Macdonald, who had led the company for over six years. In May 2024, Howell made history as the first female CEO of a major company in this sector, marking a groundbreaking