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New York • The marriage of two of the biggest U.S. drugmakers is not without consequences for the rest of health- care supply chain, particularly for the firms that handle their outsourced research and development work.

Pfizer and Allergan agreed Monday to a $160 billion deal that gives Pfizer a suite of new therapeutic development areas like eye care, women's health and antibiotics. With the merging of any two pharmaceutical giants comes overlap and cuts, in part from research and development.

That could be disruptive for the contract researcher organizations, or CROs, that do everything from helping run clinical trials to regulatory consulting and reimbursement strategy work. Pfizer has said it uses CROs including Parexel International Corp., Icon Plc, and Pharmaceutical Product Development LLC, known as PPD.

"I would have a bit more concern for the contract research companies, a lot of them rely on Big Pharma for their livelihood," said Mike Bailey, director of research at FBB Capital Partners. "If Pfizer even in the meantime hits the pause button, that could slow things down for contract research companies."

There's also the risk that future drug industry consolidation could impact the companies, which are heavily dependent on just a few customers for large parts of their revenue.

Parexel said in a regulatory filing that 14 percent of its fiscal 2015 revenue came from Pfizer, and that almost half of sales were from its top five clients. Icon's customer base is even more consolidated — the company said in its 2014 annual report that 31 percent of its revenue came from a single customer, without saying who. For either company, if one of their top customers were acquired or decided to switch CROs, that could mean a significant hit.

In the case of Pfizer and Allergan's merger, it wouldn't be unusual for there to be some slowdown in research and development spending while companies are being integrated. Pfizer has already flagged that a third of its total projected merger cost savings of more than $2 billion would come from cuts to research.

Parexel has said it doesn't see downside. "We really don't expect any fallout from this, certainly not negatively," Chief Executive Officer Josef von Rickenbach said on an Oct. 29 conference call, before the Pfizer-Allergan deal was finalized. "If anything, as I said, this would be a net positive for us." He did say that some projects could be temporarily delayed.

A Pfizer spokesman said it was premature to discuss plans for its clinical research organization relationships post- merger. Spokeswomen for Parexel and Icon did not respond to requests for comment, and a PPD spokesman declined to comment. Pfizer and Allergan have said they don't expect the deal to close until the second half of next year.

Longer term, the merger could be a boon for the industry since Pfizer has been a leader in using these research outsourcing groups over the past few years, said one analyst.

"Pfizer's use of CROs has been very successful — it's become a bit of a role model in some ways for how to drive efficiency into your R&D process by using outsourcing," said Tim Evans, a research analyst at Wells Fargo. He said the $600 million to $700 million in cuts to research spending from the deal aren't that significant, compared to other big mergers Pfizer has done.

"Don't be surprised if you see a quarter or two of depressed bookings," Evans said. "In the longer run, it's a positive."

Use of CROs has become more and more common as drugmakers cut internal R&D. John Lewis, a spokesman for the Association of Clinical Research Organizations, said that employment at CROs has more than doubled to 110,000 people from less than 50,000 a decade ago, and that revenue in the industry has grown to $25.6 billion from about $9 billion over that time period.

"The overall trend is toward using more CROs," Lewis said.

Investors don't seem worried. Parexel shares are up about 6.5 percent since an Oct. 29 report by the Wall Street Journal that Pfizer and Allergan were in talks.