For smaller biotechs, the key to a successful CRO relationship is treating them as a genuine partner. This requires moving beyond a transactional, fear-based dynamic to one of open communication and mutual respect. Biotechs should actively solicit CRO feedback, as they possess valuable cross-industry insights and can identify sponsor-side behaviors that need to change.
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A key "aha moment" was realizing the goal is to be seen not as an outside seller, but as a contributing member of the client's own team. This mindset shifts the relationship from transactional to a collaborative partnership focused on shared success, fundamentally changing the sales dynamic.
Some CEOs encourage tension between sales and marketing. A more effective model is for the CRO and CMO to build enough trust to handle all disagreements—like lead quality or follow-up—behind closed doors. This prevents a culture of finger-pointing and presents a united front to leadership.
A common failure mode for new CROs is attempting to create the sales playbook in isolation. Core pillars like ICP and value proposition are company-level decisions. The CRO's role is to be interdependent, facilitating this cross-functional creation process, not dictating it.
The best agency relationships are partnerships, not just vendor transactions. Asking what they will teach you reframes the engagement towards collaboration and empowerment. A good partner should aim to educate you and your team, leaving your organization more knowledgeable than when they started.
To avoid an adversarial relationship, actively reposition gatekeeper functions like legal and compliance as essential partners. Their role is to ensure the company's long-term success by keeping it safe. This partnership mentality leads to more creative and collaborative problem-solving.
Beyond not competing with partners, genuine trust is built by preventing "extreme favoritism to the bigger partner." Partners watch to see if you provide a level playing field for everyone, regardless of size. Trust is also solidified by how you act when things go wrong; a vendor that "shows up" during a crisis builds loyalty.
To get company-wide buy-in for CRO, focus reporting on program-level metrics, not just individual test results. Share high-level insights like win/loss rates and cross-departmental impact in quarterly reviews. This frames CRO as a strategic business function, not just a series of tactical marketing experiments.
Clinical trial sites are increasingly leveraging their power to demand protocol modernization from sponsors. Merck changed its internal processes to allow non-physician sub-investigators only after a site refused to participate without that flexibility. This shows that operational change can be driven from the ground up by partners, not just top-down by sponsors.
Merck uses a functional service provider (FSP) model, integrating CRO staff directly into their teams. They follow Merck processes and use Merck systems, creating a seamless experience for trial sites and avoiding the transactional conflicts and change orders common in fully outsourced models, which allows for greater agility.
The defining characteristic of a great agency relationship isn't just delivering work, but true integration. They should feel like an extension of the internal team—challenging existing ideas, helping the team grow, and working as a complementary partner rather than a transactional vendor.
