An AIC in possession of a well-trained staff and a trial-ready location must be in want of a lucrative clinical trial agreement. Especially at first, finding and landing these types of contracts is daunting and potentially difficult. On one hand, identifying the studies that create the possibility of favorable margins is a skillset by itself. On the other, access, visibility, and consideration are difficult to create out of thin air.

The first step for a would-be site is to be clear-eyed about its strengths. Starting with patient population, researcher background and domain expertise, and normal course of business operations and specialties, the site’s operator can list out the factors that make successful trial recruitment and completion more likely. From there, it’s possible to look at the application of those advantages to the set of treatment areas or investigational drugs that would be a particularly good fit and evaluate them on the basis of how well they serve longer-term strategic goals.

For example, an AIC that was new to research might seek out simpler trials with smaller scopes and shorter time horizons to start building a history of knockout performance. Or an AIC that was motivated more by a desire to gain experience with new treatments before they come to market might seek trials of drugs that would be additive to their existing offerings.

In any case, the likeliest source of trials with enough funding behind them to make profitable outcomes possible for the AIC will most likely be pharma companies. The cost to take a new drug through trials is in the billions of dollars, and at this point pharma is funding a significant portion of all research into new drugs—as much as 80% of total annual drug research funding in the US, depending on the source of the estimate and the specific window you choose to look through.

Within the universe of pharma, there are several avenues an AIC can explore to find trials that meet their current strategic needs and budget appetite.

The first place an AIC can look is pharma itself. Some of the major manufacturers operate their own site databases, which sites can proactively join to show up in their internal searches. For manufacturers that don’t, the best path is often to network with the contacts that the AIC already has—most sufficiently established AICs have preexisting connections to pharma companies and can ask for introductions through that path.

Another is to keep an eye on drugs in development in earlier phases and wait for them to move to the phases the AIC intends to participate in. Clinicaltrials.gov offers that visibility as the investigational product moves through the process, and also contains relatively up-to-date information on the sites that are participating in any given trial. Just about every pharma company’s website has either a pipeline page or a search page for clinical trials in progress, so AICs can look for relevant treatments under investigation and then keep tabs on development by compound name. The process of site selection is often long, and as sites are identified, networking to the sponsor’s site selection team through the medical director listed on one of the earlier-chosen sites can generate a warm intro for a specific study.

A third path, as we mentioned in chapter 2, is to join a site network. Because they offer the convenience of a simple interface between a sponsor and many sites, they often enjoy regular access to many of a sponsor’s trials, although they also typically come with costs.

If an AIC is willing to pay for visibility, the last path is among the most likely to succeed on a shorter timeline and with a minimum of effort from the site—brokers and intermediaries exist that can help a site market itself to sponsors and CROs. The most commonly recommended of these providers are Interspond and Inato. Helpfully, providers in this space typically also offer services for streamlining study start-up beyond just finding and landing the contracts, or operate site networks in addition to working on an individual site’s behalf.