ACRO’s State of the Industry Report
Data collected from 15 member companies reveals the industry’s impact on drug development.
Published: March 2026 with data collected for 2025
Trials and Participants Revenue & Companies AI Adoption FDA Vaccines Additional Metrics
Overview & Methodology
In early 2026, ACRO conducted an online survey of its member companies evaluating their activities throughout 2025. The survey was held among 15 ACRO member companies to better understand the activities and demographic makeup of ACRO member organizations and to demonstrate the impact of our industry on drug development. Below are the key findings from the survey.
Trials & Participants
In 2025, ACRO members conducted or participated in 7,634 studies involving 1.4 million patients and volunteers across a wide range of therapeutic areas and geographies that provide drugs, biologics, and medical devices integral to delivering better health outcomes.
Staff Metrics
ACRO member companies employ more than 470,000 individuals worldwide. These CROs and CTOs conduct research in every global region and, last year, generated an estimated $89.4 billion in revenue. The largest number of ACRO member staff can be found in the U.S. (125,498), India (48,794), the United Kingdom (15,061), and China (12,582).
Note: Totals and percentages do not represent 162,000 employees reported by member companies but whose location was not specified.
Revenue & Companies Represented
In 2025, ACRO member companies generated $89.4 billion in revenue, supporting the work of an estimated 592 sponsor companies.
How ACRO Members are Embracing AI
AI is being used at every single step—from project development to study closeout.
Each of our member companies are strategically applying artificial intelligence to improve efficiency. Artificial Intelligence helps to streamline data management, launch new studies, and research new study sites.
Each of our member companies are strategically applying artificial intelligence to improve efficiency. Artificial Intelligence helps to streamline data management, launch new studies, and research new study sites.
AI Usage Highlights
AI Improves Efficiency for ACRO Members
When asked about their usage of artificial intelligence to improve efficiency, ACRO members reported deploying technology in the following areas.
Observations on the FDA’s Performance
As part of our survey, we asked ACRO members about their current experiences communicating and working with the FDA—a critical partner for our industry. Members noted FDA performance across several categories has largely remained the same in the past in year. In some cases, performance has declined.
Members have experienced slower review times, delays in audits or inspections, reduced availability of or anomalies in scientific advice or consultation on trial design, reduced availability of FDA meetings or listening sessions and delays in communication.
Half of our members shared that they have experienced reduced availability of and/or anomalies in scientific advice or consultation on trial design as well as interactions with FDA staff that seems to be less experienced than in the past.
When asked about their concerns around the FDA Commissioner’s National Priority Voucher (CNPV) Pilot Program and its impacts on business, 36% expressed uncertainty around the impact of the program on their business indicating that additional clarity is needed.
Overall, these challenges appear to be affecting sponsors more than they are CROs and CTOs. About 60% of ACRO members observed changes in sponsor behavior in the last year that they attribute to recent shifts at the FDA; however, these changes seem to have a less direct effect for members, with 82% reporting no impact on their company.
Member Feedback on the FDA
36% of ACRO members expressed some concern that the Commissioner’s National Priority Voucher (CNPV) pilot program could impact business.
Innovation in Vaccines
Nearly 950 of the studies conducted in 2025 were active vaccine trials—a figure that grew from 562 in 2024—which spanned all study phases. ACRO members also contributed to the development or commercialization of several key vaccine markets: 86% to COVID-19 and seasonal influenza, 71% to Hepatitis B, and 64% to mRNA vaccines.
Trial Metrics
Studies by Geography
Read the report from 2024. For more information about ACRO and membership in our organization, please contact us.