Private Equity Interest in Clinical Research: What It Means for Independent Site Owners

Evergreen M&A partners with clinical research site founders to unlock the full value of their business. We manage the end-to-end sale process, from initial valuation and
preparation through buyer selection, deal negotiation, and post-close transition, all while reducing risk and protecting what you’ve built. Our approach ensures founders are informed, empowered, and positioned to achieve a smooth exit that preserves staff, sponsors, and the long-term success of their site. If you have questions as you’re
reviewing the material, reach out to Senior M&A Advisor, Hannah Huke,
hannah@evergreenforfounders.com.

Private Equity Is Pouring Into Clinical Research

The clinical research site landscape is changing rapidly. Over the past several years,
private equity (PE) firms have increasingly targeted site networks for acquisition,
attracted by recurring revenue, scalable operations, and the fragmented nature of the market. For independent site owners, this trend offers both opportunity and complexity.

1. Why PE is investing in clinical research sites

Several factors make clinical research sites attractive to private equity:

• Fragmentation: Most sites are small, independently owned, and geographically
  dispersed, creating opportunities for roll-ups into larger networks.
• Predictable cash flow: Contractual agreements with sponsors and CROs
  provide recurring revenue streams.
• Scalability: Modern sites with standardized processes and technology adoption
  can integrate easily into larger platforms.
• High demand therapeutic areas: Oncology, CNS, rare disease, gastroenterology, and metabolic are in strong growth, making specialized sites more valuable.

Recent transactions illustrate this trend. For example, Flourish Research (24 U.S.
sites) received a majority investment from Genstar Capital in 2024 to scale its network, while CenExel Clinical Research (18 sites) was acquired in 2025 by BayPine LP to build a digitally-enabled platform. These deals show that buyers are seeking scale, operational excellence, and growth potential.

2. Implications for independent site owners

For owners considering a sale, PE interest changes the dynamics:

• Valuation expectations: PE buyers often pay higher multiples for well-run
  platforms versus smaller standalone sites. Multiple ranges for platform-quality
  sites can reach at least 10x EBITDA, while smaller “add-on” sites may trade closer to 4–8x EBITDA.
• Deal structure: PE deals often include a mix of upfront cash, earn-outs, and
  equity stakes in the new platform. This can provide owners with ongoing upside but requires careful evaluation. A trusted advisor like Evergreen can help navigate the various offer structures to ensure they align with your goals and what’s actually possible for growth.
• Operational scrutiny: Buyers will examine financials, regulatory compliance,
  staff retention, sponsor relationships, and technology adoption. Sites that have
  clean audits, strong enrollment metrics, and diversified sponsors are more
  attractive.
• Transition planning: Many PE-backed platforms prefer the existing management team to stay on during integration, ensuring continuity for sponsors and trials.

3. Opportunities for owners

• Strategic exit timing: If your site has strong operations and a niche specialty,
  you may achieve a premium valuation by selling now, before the market becomes saturated with platform acquisitions.
• Partnership upside: Remaining involved in a PE-backed network can offer operational support, access to new sponsors, marketing resources, and shared
  best practices.
• Capital for growth: PE entry can mean investment opportunities for expansion,
  acquisition, or technology upgrades.

4. Risks and considerations

• Loss of control: Selling to a PE-backed platform often means a change in
  decision-making and site autonomy.
• Performance-based earn-outs: Some deals tie payouts to future revenue or
  enrollment targets, which introduces risk if targets are missed. It’s important to
  consider all aspects of the deal structure, and Evergreen can help with this.
• Integration challenges: Cultural fit, staff retention, and sponsor relationship
  management can be difficult during transitions.

Private equity is reshaping the clinical research site market, driving consolidation, and creating a new class of platform networks. For independent site owners, this
environment presents opportunities to achieve premium valuations, partner with larger networks, or access growth capital — but it also introduces new considerations around structure, timing, and operational readiness. Understanding the landscape and your own goals is critical to making an informed decision.

Get in Touch and Get Premium Guidance

If you’re an independent clinical research site owner evaluating your options in this
evolving market, Evergreen can provide guidance on potential buyers, deal structures, and strategic timing to maximize value while protecting your staff, sponsors, and trials. Reach out any time to Senior M&A Advisor, Hannah Huke, and she’ll be happy to have an introductory conversation: hannah@evergreenforfounders.com, 617.470.3462.