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Site comparison

Amavita Research vs. CRO-Owned & PE-Backed Site Networks

How an independent investigator-led site differs from a typical CRO-owned or private-equity-backed multi-site network — by criteria sponsors care about.

Over the past five years, much of the U.S. clinical trial site landscape has consolidated into private-equity-backed and CRO-owned multi-site networks. These networks operate dozens to hundreds of sites under shared management services organizations (MSOs) and centralized operations. Independent investigator-led sites — sites operating inside an active private cardiology practice with the practicing physicians serving as Principal Investigators — represent a different operating model. Both can run high-quality trials. The differences that matter to sponsor decision-making are PI continuity, patient-flow source, cost structure, decision-authority, and trial-cohort competition within the network. Here's how Amavita Research compares to a typical CRO-owned or PE-backed network site on each.

Side-by-side: decision criteria

Educational summary. We describe the typical CRO-owned / PE-backed network model and do not make claims about any specific network's current operations.

CriterionAmavita ResearchTypical CRO-owned / PE-backed network site
Site typeIndependent investigator-led, inside amavita Heart and Vascular Health® private cardiology practiceSite operated by a multi-site network under MSO governance; typically 20–300+ sites in the portfolio
Principal InvestigatorPracticing cardiologist who treats trial-eligible patients in routine clinic every business dayOften a part-time or contracted PI; some networks rotate PIs across sites or pair a single PI with several locations
PI continuitySame PI from site selection through study close-out; PI is a co-owner of the cardiology practicePI turnover can be higher; network-employed PIs may move between sites or leave between protocols
Patient flowTrial-eligible patients walk into amavita Heart and Vascular Health® clinics for routine cardiology care every business day; screened in real time by the same physicians who serve as PIsPatient flow depends on database recruitment, advertising spend, and centralized referral programs; varies by site within the network
Decision authoritySingle PI on each protocol; site-level decisions in daysDecisions often require MSO sign-off, network operations review, and contracting through a central legal/finance function
Cost structure20–30% lower than high-end private-equity-backed Miami site networks; no MSO carve-out, no network overhead allocationNetwork overhead, MSO fees, and centralized G&A allocated to each protocol budget; budgets typically benchmarked at network-portfolio rates
Trial-cohort competitionNo competing trials within the same indication unless sponsor approves co-enrollment; site qualifies for trials before accepting themNetworks commonly run multiple competing trials within the same indication across portfolio sites; co-enrollment and patient cannibalization risk varies by network's portfolio governance
Quality frameworkIAOCR GCSA recertified May 2026 (valid through Feb 2027), ICH-GCP E6(R3) compliant, SCRS member, Zero FDA inspection findings to dateNetworks vary widely; large networks typically have centralized quality programs but inspection histories range from clean to FDA Form 483 findings depending on site
Cardiology subspecialty depthTriple-board-certified electrophysiologist on staff (Dr. Hans C. Rutzen-Lopez, MD); interventional cardiology PI (Dr. Pedro Martinez-Clark, MD, FACC); structural heart leadership (Dr. William W. O'Neill, MD, FACC)Networks often staff sites with general-practice PIs or non-cardiology subspecialists for cardiovascular trials
Hybrid US + Latin America designsAvailable via tight integration with sister organization bioaccess® (Latin America first-in-human CRO)Most networks don't offer integrated cross-border designs

When to choose Amavita Research

  • You want a named, practicing cardiologist as Principal Investigator with no risk of PI turnover mid-study
  • You want predictable patient flow from a continuously-recruiting cardiology practice, not from database recruitment
  • You're running a cardiovascular trial where subspecialty depth (EP, structural heart, interventional) matters
  • You're cost-sensitive and want to avoid network overhead and MSO carve-outs
  • You want decision authority at the site, not contingent on MSO sign-off
  • You want a Latin America arm under the same protocol via bioaccess® integration

When a CRO-owned or PE-backed network site may fit better

  • You need geographically distributed enrollment across many U.S. sites within a single contract
  • Your protocol benefits from very high patient-database volume rather than walk-in clinical flow
  • Your sponsor program has an existing master agreement with a specific network and procurement prefers single-contract execution
  • You're running a Phase 4 or registry-style study optimized for high-volume, low-acuity enrollment
  • Your protocol fits a therapeutic area outside cardiology that the network specializes in

Decision-criteria summary

For most cardiovascular feasibility, pivotal, and first-in-human trials in 2026, the PI continuity, subspecialty depth, and capital-efficiency advantages of an independent investigator-led site outweigh the breadth advantages of a multi-site network — assuming the indication fits the site's qualification scope. Sponsors who choose Amavita Research are typically optimizing for named-PI accountability, predictable patient flow, and protocol economics that don't carry MSO overhead.

Next step

Talk to Amavita Research about your protocol

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Related: FDA DAP and cardiovascular site selection →