Enquirer Consulting Group

Reachable Buyer Map

Prepared for Tanya Miladinovic · Atheris Group · August 2026
Life sciences consulting is bought on reputation, and in this market first contact usually happens through someone who has already worked with the people involved. That route reaches the part of the market a team has already met, and it is quiet about the rest. This map is the rest, counted in the United States, because that is where most sponsor-side medical and regulatory buying sits and where the registers are public. Where the clinical, medical and regulatory buyers sit, who signs inside each layer, and roughly how many there are.
Companies with a marketed US medicine or device
The layer that has crossed from development into launch, where medical affairs, field medical and evidence generation become standing functions rather than project work.
Who signs: chief medical officer, VP of medical affairs, head of field medical, head of regulatory affairs.
1,600 to 1,700
US manufacturers reporting under the federal physician payments program for the most recent program year, covering drug, biologic and device makers with a product in market
Registered drug and biologic establishments
The broadest countable layer, the one most lists are built from, and the one that misleads, because a registration is a site rather than a company.
Who signs: head of regulatory affairs, VP of quality, head of manufacturing science.
9,500 to 10,000
US sites on the federal drug establishment register; several sites often roll up to one company, so the company layer behind this is materially smaller
Clinical-stage developers with no approved product
The segment where senior fractional cover is bought most often, because the team is deliberately thin and one departure can stall a program.
Who signs: chief medical officer, head of clinical development, VP of clinical operations, and at the smallest companies the chief executive.
Not separately counted
no public register flags development stage; the federal trials register lists studies and sponsor names rather than a company count, so this layer is identified rather than counted
Rare and orphan disease programs
Rare disease is named on your own site as a therapy area strength, and this is structurally the hardest segment to buy a list for.
Who signs: chief medical officer, head of rare disease, head of regulatory strategy, head of patient advocacy.
Thousands of designations, far fewer sponsors
orphan designations granted since the program began run into the thousands and are public; the sponsor layer holding them is not separately enumerated anywhere
Device and diagnostics makers
Adjacent rather than core. The regulatory path is different, but clinical evidence, medical affairs and outcomes work behave the same way once a product is in market.
Who signs: VP of clinical and medical affairs, head of regulatory, head of health economics and outcomes research.
12,500 to 13,500
US device establishments on the federal register; sites again rather than companies
Research service firms and site networks
A channel rather than an end buyer. These groups buy senior cover for the same reasons a sponsor does, and they also refer.
Who signs: head of clinical operations, therapy area lead, business development director.
A channel, not an end market
not separately registered; identified from trial records and company disclosures rather than counted

Where the openings are

1
Registered sites are not companies. The two registered lines above come to roughly 22,000 to 23,500 sites in the United States, and a list bought straight off them reaches plants, packagers and labelers rather than the medical and regulatory seats that buy consulting. Reaching those seats takes identification rather than purchase.
2
The buyer is a role, and the role moves. VP of medical affairs, head of clinical development, head of regulatory. When one of those seats empties the work does not stop, which is the exact moment senior fractional cover gets bought. A channel built on named roles sees that window. Reputation hears about it afterwards.
3
Rare and chronic disease is the segment lists under-work. No public register flags therapy area, so an off-the-shelf life sciences list sorts by size and site instead. The sponsors best matched to a rare disease specialism are the ones least likely to appear on it.
4
Three named service lines rarely share one buyer. Fractional resourcing is usually bought by the person with a hole in the team, often at director level. Strategic planning is bought by whoever owns the plan, usually a level above. Execution and delivery tends to be bought after a decision has already been made. One channel tends to return to the same door.
Built from public United States federal life sciences registers and program reports, current to the most recent published year and banded deliberately. Establishment registrations count sites rather than companies. Development stage, therapy area and ownership are not published in any of these registers, so those lines are described rather than counted. It describes the market rather than your business, and there is nothing to buy at the end of it.
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