Over the last 10 years, the top nine global CROs have more than doubled their workforce, which now exceeds 72,000 employees, and their revenues have increased at a compound annualized rate of 11% as they increasingly play a larger and more integral role in the drug development infrastructure, according to a new Association of Clinical Research Organizations (ACRO) member survey.

ACRO says its nine member companies—Covance, Icon, Kendle, Parexel, PharmaNet, PPD, PRA, Quintiles and RPS—comprise nine of the top 10 global CROs and hold about half of the total global CRO market, estimated at $27 billion by market analyst Frost & Sullivan.

The survey results highlight the growing influence of CROs as sponsors, looking to save time and costs, increasingly outsource all stages of R&D, from drug discovery to pre-clinical and clinical phases. In 2010, ACRO members conducted more than 11,500 clinical trials involving two million research participants in 114 countries. The average ACRO member CRO in 2010 worked with about 1,000 different companies. In addition, these leading CROs contributed to the development of the 20 top-selling prescription medicines and were involved in the development of at least 33 of the 38 new medicines approved for use last year in 2010 in United States and Europe.

“There is virtually no drug that is developed now that does not have the involvement of some CRO. We are touching every drug that is being developed in some way,” said John Lewis, vice president of public affairs at ACRO. “The survey results make a strong case that during the last few years, CROs have become the global infrastructure for drug development, in some ways replacing or adding onto the pharma infrastructure.

ACRO Executive Director Doug Peddicord said during the past decade, top CROs have expanded the range and scope of their services, from drug discovery through post-approval studies, and have developed expertise in complex areas such as vaccines, biosimilars, comparative effectiveness research and regenerative medicine. On average, in 2010 each ACRO member conducted research on 300 unique developmental drugs and therapies, including multiple studies for diseases such as cancer, diabetes, Alzheimer’s, multiple sclerosis, hepatitis C, asthma, HIV, influenza and hypertension.

“The growth of the industry is impressive,” said Peddicord. “From our perspective, the growth isn’t just year-on-year, but a longer-term trend.”

In 2010, almost 17% of the clinical trials conducted by ACRO members were in oncology; these studies involved more than 250,000 patients. Other common areas included CNS (9.4%), infectious disease (6.8%), metabolic (5.4%) and cardiovascular (5.2%).

The survey also quantified the idea that top CROs have a large global footprint in terms of facilities, labs and the ability to run trials in multiple countries. In 2010, ACRO members managed nearly one million square feet of accredited laboratory facilities on five continents that handled more than 16 million samples and processed in excess of two million bioanalytical assays.

“The capability of ACRO members to provide the full spectrum of drug development services required to bring new medicines to market has led to tremendous growth in the industry during the past 10 years,” said ACRO Chairman Joe Herring, chairman and CEO of Covance.

As the industry continues to evolve, and drug sponsors have moved from transactional relationships to strategic alliances with top CROs, the survey indicated future growth for its members. In 2010, member companies recorded more than $26 billion in backlog, which is the amount of business that has been committed, but not yet conducted. From 2009 to 2010, backlog for those nine companies grew by nearly 17%.

“ACRO members now constitute a large—and growing—share of the global drug development infrastructure,” said Herring.

Karyn Korieth