Rethinking FSP outsourcing

Rethinking FSP outsourcing

BY Paula Benge, Integrated Solutions - Senior Director, Parexel FSP and Chris Baker, EVP and Global Head of Parexel FSP - 10.4.21 -

FSP is a popular and growing outsourcing model in our industry, allowing customers to tap into additional expertise and easily flex resources up or down as situations demand. In the past, FSP was viewed as a transactional solution or a shortcut to savings. However, over the past 20 years, the model has significantly evolved as experienced providers have honed and improved their approach. Today’s modern FSP offers much more than cost savings. 

To fully harness the power of FSP, we encourage customers to treat it as a long-term relationship: engaging a partner for a unified part of a portfolio’s execution rather than a series of smaller arrangements. In an ongoing engagement, the CRO can develop a comprehensive strategy to improve staff retention, create economies of scale, and strengthen bonds between our organizations through transparency and trust. 

For some customers, a partnership is a new way of thinking about FSP outsourcing. So how do you make your CRO a partner? By working programmatically. When you fully outsource one or more functions or a portfolio of work to them, they can become an extension of your organization. 

Let’s talk about four benefits of adopting a programmatic FSP approach. 

Reduce costs and create efficiencies 
Outsourcing can be used for short-term staff augmentation, and in some situations, that’s a good way to go. But when you design a programmatic strategy using FSP, the focus is long-term staffing, with a single team working on the same compound and filling multiple job roles. One clear benefit here is cost savings through scale. As in any outsourcing arrangement, greater work volumes result in lower average costs, and outsourcing multiple roles certainly creates that volume. 

But savings happen in other ways, too. In an FSP relationship, your CRO team gains, and shares product knowledge that only grows over the duration of the engagement. That experience improves productivity and can result in shorter timelines. Knowledge capital also benefits staff in site-facing roles. Investigators want to work with CRAs who understand a compound or indication. We’ve found that sites are often more responsive to seasoned staff they’ve come to know and respect professionally.  

Develop talent and improve retention 
We know our customers want to retain outsourced staff and avoid gaps in service delivery. Programmatic FSP helps us do both. 

The key is career ladders. For example, instead of outsourcing a single role (such as CRAs), we urge our customers to include clinical trial associates (CTAs), CRAs, line managers, and clinical team leads in their outsourcing strategy. Building ladders into FSP partnerships allows team members to grow their skills and advance without leaving the engagement. 

Career ladders within a single engagement make it easier to attract great talent. Clinical trial professionals want longevity and a clear path to promotion. If we can offer that through FSP, our pool of candidates will only improve. 

We can also use ladders to significantly curb staff turnover. Clinical trial professionals won’t stay indefinitely in entry-level or the same roles, so it’s in our collective best interest to offer paths to promotion. Given the right circumstances, some CRO staff will stay with an engagement for a decade or more, building a career as they work in concert with the customer’s team. 

Finally, engaging a single CRO partner for programmatic outsourcing helps control labor costs. The current demand for employees in clinical trials outweighs supply, which is driving up average salaries. Cost pressures only intensify when customers outsource work for the same compound to multiple CROs that must then race against each other to hire necessary talent.  

Discourage silos and strengthen teams 
Programmatic outsourcing — in which a customer’s staff works closely with their CRO counterparts — naturally creates camaraderie. Practically speaking, this helps reduce silos and inefficiency because people who work closely have more open communication. We’ve often seen ideas for process improvements come out of these collaborations — ideas that save time and money and can then be passed on to larger groups. 

But a team-focused environment also encourages staff loyalty and continuity. When FSP employees are integrated into a customer’s program, they develop relationships with their full-time colleagues, building trust and increasing job satisfaction. That helps trials run smoother — and if FSP staff feel valued and included, they’re less likely to leave.  

Create strong ties with sites 
A clinical trial’s success hinges on the performance of its sites: the speed of enrollment, the quality of patient engagement, the level of adherence to the protocol. Sites are closest to patients — without sites, we don’t have volunteers. And investigators naturally prioritize the sponsors and CROs with whom they’ve had good experiences. So when CRAs can develop strong relationships with study teams, site involvement often increases. 

At the site level, CRAs are one of the key integration points for the customer. In building relationships with investigators, the CRA becomes a critical link between sites and sponsors. But if the same CRAs don’t remain in those roles, rapport will be impossible. In a programmatic FSP engagement, customers and CROs create consistency with staff across assets, portfolios, and therapeutic areas. And site-level relationships pave the way for real progress. 

Choosing an FSP solution 
While there are many advantages to programmatic FSP outsourcing, we recognize there can be challenges in implementing the model. One of the most common: differing priorities between a customer’s clinical and procurement groups. If a customer’s clinical group prioritizes experience and quality, but procurement focuses on the lowest possible rates, the CRO can’t deliver an optimal FSP experience. We encourage customers to agree internally on what’s most important to them prior to engaging with their CRO partner for the best outcomes. 

While we believe in the power of the FSP partnership, we know it isn’t the right model for every situation. It’s a long-term strategy, and it can take time to realize FSP’s total value. When you invest in FSP, however, you tap into potential beyond staff augmentation. 

As a long-term strategy, FSP models can provide: 

  • Opportunities for in-house innovation and process improvement. 

  • Development of SOPs and work instructions to streamline and boost productivity. 

  • Reduced cost of quality by applying best practices. 

  • Levels of management to oversee certain functions, freeing your staff to focus their efforts in other areas. 

  • Protocol optimization from an operational perspective. 

In our most fruitful FSP engagements, we’ve been welcomed as a partner who is invested in the trial’s success. Because FSP doesn’t just offer cost savings — it allows us to support customers with an integrated team that is seamless in its approach to delivering high-quality solutions for the patients we serve. 


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