Paul Evans, President & CEO, Velocity Clinical Research

Invest: sat down with Paul Evans, president and CEO of Velocity Clinical Research, to discuss the state of the clinical research industry, from policy uncertainty and trial complexity to patient recruitment, workforce pressures, and the growing role of technology. “Nobody likes uncertainty, and the pharmaceutical industry is no different,” Evans said.

What changes over the past year have most impacted Velocity Clinical Research, and how have those changes shaped your priorities?

We operate clinical trial sites that help pharma companies get new drugs approved by the FDA and other regulators. Over the last 12 months, we have seen a degree of upheaval. The changes in the White House have introduced a lot for pharma to think about, including tariffs, the most favored nation status policy, and significant upheaval at the FDA with changes in management and reductions in headcount.

It has been a tough 12 months, and the industry has had to adapt and figure out the way forward. Some of those issues may be settling, but new tariffs introduced recently show how quickly conditions can change. Nobody likes uncertainty, and the pharmaceutical industry is no different.

The net effect has been a slowdown in new clinical trial startups, or as I like to frame it: pausing for breath right now. I think we are coming toward the end of that period, but politics has had a significant impact on the industry.

Beyond policy shifts, what key trends are shaping the clinical research landscape today?

Science always moves on at pace, so there is constant innovation driving new opportunities and new drugs. GLP-1s are a clear example and a big development in the obesity space. Science continues to reshape the industry.

Additionally, broader macro conditions matter. Geopolitical issues and economic uncertainty affect pharma as much as any sector. When you look more closely, increasing trial complexity is a major trend. Clinical trials are becoming more complex, and protocols are more demanding.

Protocols are increasingly focused on specific patient populations, which makes recruitment more challenging. Patient recruitment has always been one of the biggest challenges in our industry, and that complexity only adds to it.

Where are you seeing the biggest gaps or inefficiencies in the clinical trial process?

Historically, clinical trials were done part-time by investigators with full-time clinical workloads. That led to what we call the one-and-done phenomenon, where many investigators run one trial and never do another because of the time and complexity involved.

That has driven the evolution of full-time clinical research organizations like Velocity. We do not run clinical practices. This is our full-time focus. That allows us to bring consistency across multiple sites. We now operate over 70 sites in four countries, all working in the same way.

That consistency improves outcomes, data quality, systems, and repeatability. It also reflects the reality that running clinical trials requires dedicated focus.

Most clinical trials fail because the compound does not work. That is part of a highly controlled process designed to prove safety and efficacy. When you consider the rigor involved, it is not surprising that it can take 12 years to bring a drug to market.

How does patient recruitment influence the clinical trial process today?

Patient recruitment remains one of the biggest challenges. Before Operation Warp Speed, most people were not aware of clinical trials or how to participate. One of our biggest tasks is making patients aware that trials exist, that they may be eligible, and what participation involves.

Without patients taking part, there is no data, and without data, there are no approvals. Clinical trial participants are essential to the process.

The challenge is that protocols define specific eligibility criteria. It is not enough to find any patient with a condition. You need the right patient. In the traditional model, a physician might identify a small number of potential participants, but not all will be willing or eligible. That pool can shrink quickly.

The dedicated research site model allows us to reach a broader patient population. We engage a wider community and bring patients into trials more effectively.

How does diversity influence where and how trials are conducted?

Diversity is critical because drugs can react differently depending on genetic makeup. Regulators now focus on ensuring trial populations reflect the populations that will ultimately receive the drug.

That means aligning trial recruitment with census data. In the United States, that includes a mix of white, African American, Asian, and Hispanic populations. Trials are managed to reflect that balance.

One way to achieve this is by selecting sites in areas with specific demographic characteristics. That helps ensure the study population reflects the real-world population.

What makes the Triangle a strong place for Velocity to do business?

The Triangle offers a strong demographic mix. Durham is a majority African American city, Cary has a large Asian population, and there is also a strong Hispanic population in the region. That diversity aligns well with clinical trial needs.

It also has a strong pharmaceutical services sector, which gives us access to our client base. Equally important, there is a highly-qualified workforce that supports our hiring needs as a growing company.

How are workforce constraints affecting the business?

Workforce constraints are significant. We operate in a competitive labor market, and there is strong demand for skilled professionals. As a growth company, we need people who are committed and capable, and there is competition for that talent.

We compete with large pharmaceutical companies and CROs that can offer attractive compensation packages. Our employees are also attractive to those organizations, and we do see movement into our client base.

We accept that as part of the ecosystem, but it reinforces the importance of having a strong pipeline of talent to support growth.

Looking ahead, what are your key priorities for the next three to five years?

We are still a growing company, and dedicated clinical research sites are still a relatively new segment within the industry. In the last 12 months, we have been founder members of the Association of Multi-Site Research (Corporations AMRC), which aims to support and advance this model.

One priority is expanding our site base. While 70 sites is significant, there are many more globally, and we currently operate in four countries: the United States, the UK, Germany, and Poland. Geographic expansion remains a key focus.

Another priority is therapeutic expansion. Historically, much of our work has been in primary care therapeutic areas, but we have been expanding into other areas over the past few years. Obesity has been a major focus, and we are also moving into areas like oncology, where we opened our first capable site about a year ago.

Growth will continue to follow the pharmaceutical pipeline and emerging areas of research.

What role will technology play in that evolution?

Technology will play an increasingly important role, particularly in patient recruitment. Not every patient is willing to participate in a clinical trial, and identifying those who are willing is critical.

We are using AI-driven methodologies to identify and engage those patients more effectively. There is no benefit in engaging patients who are not willing to participate.

We have developed our own in-house, AI-driven technology to support this, including tools that help screen patients more efficiently. This improves both speed and accuracy in recruitment.

Technology has long been used in the pharmaceutical industry, but less so at the research site level. That is changing, and organizations like ours have the scale to lead that shift.