Soothsayers like Nostradamus, Mother Shipton , and the Amazing Kreskin have a decidedly mixed record when it comes to predicting the future. Still, it’s an irresistible human impulse, especially as a year ends, to peer into the proverbial crystal ball in the hopes of seeing what’s coming down the road.
In that spirit, and as we turn the final calendar page for 2025, we asked AMRC members to give us their big predictions in clinical trials in 2026. These prognostications from clinical trial thought leaders offer interesting food for thought as we strategize for 2026 and beyond.
“When I think of 2026 and the trends we will see within our industry, my prediction is that we will continue to see Sponsors take advantage of what large site networks have to offer in terms of ease and efficiencies,” says Casey Orvin, Chief Commercial Officer at Alcanza.
Another likely trend, according to Javara Clinical Research CEO, Jennifer Byrne, is a clinical trial industry relying more on itself and less on government funding: “I think that with likely continued constraints on government funding of research continuing through 2026, we will see more large health systems; academic learning systems, for profit and not for profit health organizations prioritizing industry funded research.”
While he’s predicting “more difficult challenges” in 2026 for sites historically reliant on vaccines coupled with less interest among sites to conduct those trials, Kurt Mussina, CEO of Paradigm Clinical Research, also sees some silver linings up head for sites: “I see increasing recognition by CROs of the importance of having good working relationships with sites,” he says. Mussina also predicts 2026 will bring “increasing market influence and negotiation power for sites.”
AMRC members see more room for optimism when it comes to clinical trial operations. “Clinical trials in 2026 will be faster, smarter, and more personal,” says Corey Collins, CEO at Tekton Research, “we’re moving toward a future where technology supports, not replaces, the relationships between physicians, patients, and research teams. As trials get more complex, predictability will win. Sponsors will favor site networks that integrate data, simplify communication, and deliver consistent execution across studies. Organizations that balance innovation with integrity will set the standard for the industry.”
However, protocol complexity isn’t going anywhere in the near future, Orvin warns: “Protocols will continue to be more complex and both sponsors and CROs will need to work closely with sites, in particular the larger site networks with a robust infrastructure, to figure out unique and creative ways to meet enrolment goals.”
Looking deeper into the site space, Mussina also predicted a “continued consolidation of the site market but driven less by existing players and more by new PE entrants with portfolios in physician practice management organizations.”
Orvin also weighed in on possible shifting clinical trial dynamics in 2026, stating:“I believe more and more sponsors will bring feasibility and site selection in-house and will create more strategic relationships with larger site networks.”
