ICON Survey Highlights Rising Delays in Clinical Trial Startups, Emphasizing the Importance of Human-Centered Site Activation Solutions
Survey Findings: ICON plc's recent survey highlights significant challenges faced by clinical trial sites, including operational bottlenecks, contract and budget delays, and poor communication, with 55% of respondents reporting activation times exceeding 5 months.
Need for Improvement: A majority of respondents (66%) frequently encounter contract and budget delays, and 92% believe that sponsors and CROs need to enhance their support, particularly in communication.
Actionable Strategies: The accompanying whitepaper outlines strategies for improving trial startup processes, such as implementing site engagement approaches, utilizing predictive analytics, and adopting data-informed site selection methods.
Industry Context: The survey reflects a growing concern in the industry, with site pre-selection decline rates increasing from 35% to 47% between 2021 and 2023, emphasizing the urgency of addressing these operational challenges.
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- Full Exit: Trinity Street Asset Management LLP disclosed on January 22, 2026, that it liquidated its entire holding of 770,919 shares in Axalta Coating Systems, with an estimated transaction value of $22.06 million, indicating a lack of confidence in the company's growth prospects.
- Asset Allocation Shift: This transaction reduced Axalta's representation to 0% of Trinity's 13F AUM, while its top five holdings include Taiwan Semiconductor valued at $293.8 million, or 18.5% of AUM, reflecting a preference for companies with better growth potential.
- Poor Market Performance: As of January 21, 2026, Axalta's share price stood at $33.47, down 9.5% over the past year, significantly underperforming the S&P 500 by 23.2 percentage points, highlighting sluggish growth in the coatings sector.
- Investor Strategy: Trinity sold a small position representing about 1.5% of its assets in Q3, possibly for tax-loss harvesting or due to diminished confidence in Axalta's growth, while simultaneously increasing investments in other major holdings like Taiwan Semiconductor, indicating a shift towards companies with higher growth potential.
ETF Performance: The SP Funds S&P World ex-US ETF saw significant trading activity on Friday, with Infosys rising approximately 6.3% and Wipro increasing about 7.2%.
Trading Volume: Infosys had over 80.4 million shares traded, while Wipro had over 26.6 million shares changing hands during the session.
Icon's Performance: In contrast, Icon was underperforming compared to other ETF components, trading down by about 1.3%.
Author's Disclaimer: The opinions expressed in the article are those of the author and do not necessarily represent the views of Nasdaq, Inc.

- Industry Resilience: ICON's global biotech survey reveals that 92% of 163 respondents expect to reach their next investment milestone, indicating strong confidence in the industry despite funding pressures, which drives innovation and collaboration.
- Increased R&D Spending: The survey shows that 75% of biotech firms plan to increase R&D spending over the next two years, reflecting resilience and a commitment to innovation in the face of drug development complexities.
- Changing Funding Sources: APAC biotechs report that venture capital constitutes 60% of their current funding sources, compared to 32% for the US and 30% for Europe, highlighting a deepening reliance on VC in the APAC market.
- Talent Shortage Issues: In APAC, 47% of respondents identified talent shortages as an operational impact factor, nearly three times the global average, underscoring the challenges in attracting and retaining talent in the region.

- Survey Reveals Bottlenecks: ICON's recent industry survey indicates that 55% of respondents report activation times exceeding 5 months from site selection, highlighting significant challenges in the clinical trial startup phase that hinder timely access to new therapies.
- Prevalence of Contract and Budget Delays: 66% of respondents frequently experience contract and budget delays, with 92% identifying these as critical areas for improvement by sponsors and CROs, underscoring the urgent need for enhanced support efficiency in the industry.
- Communication Quality Needs Improvement: 47% of respondents rated sponsor and CRO communication as average or poor, emphasizing the importance of a site-centric collaborative model to address current communication gaps and accelerate trial processes.
- Whitepaper Proposes Solutions: ICON's newly released whitepaper outlines actionable strategies, including implementing site engagement approaches that balance alignment with competing priorities, to address rising site attrition rates and promote efficient clinical trial startups.

Survey Findings: ICON plc's recent survey highlights significant challenges faced by clinical trial sites, including operational bottlenecks, contract and budget delays, and poor communication, with 55% of respondents reporting activation times exceeding 5 months.
Need for Improvement: A majority of respondents (66%) frequently encounter contract and budget delays, and 92% believe that sponsors and CROs need to enhance their support, particularly in communication.
Actionable Strategies: The accompanying whitepaper outlines strategies for improving trial startup processes, such as implementing site engagement approaches, utilizing predictive analytics, and adopting data-informed site selection methods.
Industry Context: The survey reflects a growing concern in the industry, with site pre-selection decline rates increasing from 35% to 47% between 2021 and 2023, emphasizing the urgency of addressing these operational challenges.








