In line with the increased demand for virtual trial services during the COVID-19 pandemic, many leading clinical research organizations (CROs) and eClinical software providers have expanded their capabilities in this area. Several specialist virtual trial providers, such as Medable, Science 37, and THREAD, have also attracted considerable attention during the pandemic. As a result, there has been a significant increase in all deal-making activity in the virtual trials space over the past 18 months (Figure 1).

There were nine mergers and acquisitions (M&As) related to virtual trials in 2020, compared to just one in 2018 and two in 2019. In 2021, six M&As have already occurred in this space to date. Examples include Thermo Fisher’s acquisition of Pharmaceutical Product Development (PPD) for $17.4B in April 2021 and ICON’s acquisition of PRA Health Sciences for $12B in February 2021. Several companies also completed acquisitions of other companies to expand their virtual trial capabilities, including Syneos Health, Signant Health, Covance, and ERT. For example, ERT acquired wearable company APDM in July 2020 and merged with Bioclinica in December 2020 for its clinical trial endpoint technology expertise.

The number of strategic partnerships in the virtual trials space also increased from a quarterly average of three partnerships before the pandemic to a quarterly average of 11 partnerships from Q2 2020–Q1 2021. In Q1 2021 alone, 18 partnerships were identified. Most of these involved specialist virtual trial vendors forging collaborations with CROs, eClinical solution providers, or pharma companies. For example, Science 37 has entered into the most partnerships (13),

with six partnerships in 2020 and four for 2021 to date. THREAD has forged six partnerships since 2020, while both Medable and ObvioHealth entered into five partnerships. The number of VC funding deals also increased from six deals in 2018 to 18 deals in 2020. Most VC funding deal activity was seen in Q3 2020, with 10 deals. Specialist virtual trial vendors and eClinical solution providers have been involved in the most funding rounds. For example, Medable has raised $194M from three rounds since 2020, the most recent being a $78M Series C in April 2021.

While the shift to virtual trials was underway before the pandemic, COVID-19 lockdowns and social distancing measures caused significant disruptions to clinical trials and accelerated the use of virtual trials. Companies that had not considered the virtual trial model before had no option but to rapidly implement new technologies and procedures to maintain business continuity.

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