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On the M&A dimension, notable transactions shaping the current competitive structure include ICON's acquisition of PRA Health Sciences in 2021, Thermo Fisher Scientific's acquisition of PPD in 2021, and Fortrea's spin-off from Labcorp in 2023 each consolidating scale at the full-service CRO tier while the technology-native segment remains more fragmented and acquisitive
Frey et al., 2007
