In my experience, they are different (speaking as someone witnessing it from layman's perspective). Here is what I have seen in Phase II & III trials:
a) Pharma identities the type of patients they need (e.g., 25-50 female, not pregnant, with specific ailment if Phase III), specific tests, and measurements required throughout the study.
b) pharma contacts third party (3P) to manage study patients.
c) 3P has relationship with dozens or even hundreds of doctors' offices, knowing what office can fulfill the test & measure requirement, and has the potential trial patient pool.
d) 3P has existing contract with these doctors' & hospitals. They get patients onto the study. ( <--- #1 reason this is farmed out in my opinion)
e) Doctors & hospitals perform the study and collect the data.
f) doctors & hospitals pass the data to the 3P
g) 3P passes it to the pharma
h) repeat e) through g) as many times as the study requires it. This can be once, or many times over years.
i) pharma pays 3P, 3P pays doctors & hospitals, and they pay the trial patients - each taking their cut along the way.
There are variations on how this is done, sometimes no 3P, sometimes pharma will have their own pool of patients and 3P. Also this is a very rough flow as there are often checks, audits, and validations (should be) done during the study.
a) Pharma identities the type of patients they need (e.g., 25-50 female, not pregnant, with specific ailment if Phase III), specific tests, and measurements required throughout the study.
b) pharma contacts third party (3P) to manage study patients.
c) 3P has relationship with dozens or even hundreds of doctors' offices, knowing what office can fulfill the test & measure requirement, and has the potential trial patient pool.
d) 3P has existing contract with these doctors' & hospitals. They get patients onto the study. ( <--- #1 reason this is farmed out in my opinion)
e) Doctors & hospitals perform the study and collect the data.
f) doctors & hospitals pass the data to the 3P
g) 3P passes it to the pharma
h) repeat e) through g) as many times as the study requires it. This can be once, or many times over years.
i) pharma pays 3P, 3P pays doctors & hospitals, and they pay the trial patients - each taking their cut along the way.
There are variations on how this is done, sometimes no 3P, sometimes pharma will have their own pool of patients and 3P. Also this is a very rough flow as there are often checks, audits, and validations (should be) done during the study.