A roadmap to right-size clinical operations with local experts in emerging markets.

How to Scale Global Trials Without Scaling Headcount

April 2025 | Elizabeth Thomson

As clinical trials continue to globalise, emerging markets like Latin America, Southeast Asia, India, and Eastern Europe are becoming increasingly attractive for sponsors seeking faster recruitment, cost efficiencies, and diverse patient populations.

But global expansion doesn’t need to mean organisational bloat. In fact, scaling too quickly with internal hires can introduce inefficiencies, delays, and cost overruns.

The solution? Smarter, right-sized operational models that prioritise flexibility, localisation, and targeted expertise.

Here’s how sponsors are executing global trials—without scaling their headcount.

1. Deploy Local Experts, Not Entire Teams

Bringing in local talent—Clinical project managers, CRAs, regulatory consultants—on a fractional or contract basis allows sponsors to benefit from in-region knowledge without permanent hires. These professionals understand the regulatory landscape, site culture, and enrolment drivers in their markets.

 Instead of building full teams in each geography, sponsors can embed regionally based expertsonly where needed, for as long as needed.

2. Leverage Vetted Networks, Not New Infrastructure

Setting up new in-country operations is expensive and time-intensive. Through trusted outsourcing platforms and expert networks, sponsors can access established site relationships, investigator connections, and compliant workflows—without standing up new infrastructure.

This approach reduces:

• Start-up time
• Oversight burden
• Vendor onboarding friction

3. Maintain Strategic Oversight While Localising Execution

Sponsors often face a tension between centralised strategy and decentralised execution. With the right operational model, you can preserve strategic alignment at the global level while executing efficiently at the local level.

This means:

• A centralised program or project lead coordinating across regions
• Local experts executing site selection, regulatory submissions, and patient engagement
• Tight integration across functions to preserve data quality and consistency

4. Prioritise Flexibility Over Fixed Resourcing

The needs of a Phase I trial in a single country look very different from a global Phase III program. Yet too often, sponsors build fixed teams that are misaligned with the trial’s actual demands.

By using fractional resourcing, sponsors can:

• Scale up support during start-up or enrolment surges
• Scale down during long observational or follow-up periods
• Avoid paying for full-time resources that are underutilised

Final Thoughts

Running a global trial doesn’t require a global headcount.
It requires smart deployment of expertise, strong vendor governance, and a flexible model that can adapt to regional complexity without losing control.

As global development continues to evolve, sponsors who rethink how they resource trials will gain a competitive edge—not just in cost, but in speed, quality, and reach.

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