The Drug Information Association website (www.diahome.org) includes a directory of Contract Service Organizations. You can search by company, service, or by keyword. Several other directories are available commercially. The CenterWatch Industry Directory is available from CenterWatch (www.centerwatch.com). Technomark (www.technomark.com) publishes regional CRO directories for North America and Europe.

A more selective approach to identifying those CROs best suited to your particular project is to "prequalify" vendors according to your specific needs (e.g., therapeutic area, range of services, geography). The steps in prequalifying CROs were described in an article entitled, "A Case Study in Evaluating and Selecting a CRO", that appeared in Applied Clinical Trials, 5 (6), 30-36, 1996. Reprints are available at www.pharmaportal.com. The process is also described elsewhere on this website under Find Qualified Service Providers.

Preferred provider agreements are negotiated with the expectation that both the pharmaceutical sponsor and the CRO will benefit. The sponsor hopes to limit the number of vendors with which it works and to receive discounts in return for an increased volume of work. The CRO expects to reduce its business development costs and to receive a steady stream of work from the sponsor. Both parties anticipate greater efficiency as they become more accustomed to each other's standards and procedures. Some useful metrics for managing preferred provider relationships are:

• Personnel qualifications (e.g., training and experience level of personnel who will be assigned to the CRO team)
  
• Cycle times (e.g., time from completion of a site-monitoring visit to receipt of the monitoring report by the sponsor, time from patient completion to entry of the CRF in the database, time from last patient completion to database lock.)
  
• Timing, format, and content of reports
  
• Acceptable error rates in critical and non-critical areas of the database
• Billing practices (e.g., how to ensure that pass-through costs are promptly reimbursed while service fees are tied to deliverables)
  
• Efficiency of the relationship (e.g., ratings by the sponsor and CRO of the quality and timeliness of information for making key decisions)

Many preferred provider agreements fail to reach sponsor and CRO expectations because the two parties are not measuring the "same thing". Sponsors typically focus on process, i.e., whether the CRO is doing things "our way". CROs usually focus on outcome such as using the most efficient approach. For this reason, it is important that the sponsor and CRO mutually define the metrics that will be used to manage their relationship. Some of the metrics will be applicable to a range of projects while others may be project-specific. Simply imposing the sponsor's pre-conceived metrics on the CRO is not advisable.