The Brief
A growing mid-sized European CRO was invited to bid on a large Phase III atrial fibrillation study for a major US pharmaceutical sponsor based in the United States. The trial required rapid activation and high patient enrolment across Bulgaria, Romania, Croatia, and Hungary.
While the CRO had cardiovascular experience, they did not have an immediately deployable monitoring team with deep, study-specific atrial fibrillation expertise in each of these countries. The sponsor made it clear that proven local CRA experience in large-scale AF Phase III programmes would be a decisive factor — particularly given the complexity of endpoint adjudication, ECG review requirements, and high-enrolling cardiology centres.
Competing against global CROs with established regional monitoring teams, the CRO engaged Upsilon Global to strengthen its operational credibility.
The Solution
Upsilon Global focused on solving the sponsor’s biggest perceived risk: monitoring quality and speed.
Within a compressed timeline, Upsilon identified and secured a pre-approved freelance CRA team consisting of two highly experienced CRAs in each country — eight in total — all with extensive atrial fibrillation and cardiovascular Phase III backgrounds. Each CRA had prior experience managing high-recruiting cardiology sites and complex protocol requirements.
Crucially, these CRAs were fully vetted, CVs approved in advance, and availability confirmed before bid submission. This allowed the CRO to present named, country-specific monitoring teams with immediate start capability rather than a proposed hiring plan.
Upsilon also helped structure a clear regional oversight model, combining local CRA expertise with centralised senior clinical leadership. The proposal highlighted reduced start-up lag, continuity of site relationships, and lower training risk due to therapeutic familiarity.
The Outcome
The sponsor awarded the study to the mid-sized CRO, citing confidence in the ready-to-deploy, AF-experienced monitoring team as a key differentiator from competitors.
By presenting a fully formed, pre-approved CRA structure across Bulgaria, Romania, Croatia, and Hungary, the CRO eliminated concerns around resourcing delays and therapeutic inexperience. With Upsilon Global’s support, they secured a flagship Phase III programme and demonstrated that strategic freelance deployment can rival the infrastructure of much larger global CROs.
