One point in there - data management. It varies in cost because on the upper end, that includes support for data change requests for the life of the trial. Zillions of people involved, human error, need paper trails and sign offs to fix most things.
This is usually downstream of the CROs, or, at least contracted out. What's most interesting to me about the post is that the author doesn't mention any efficiencies gained by moving to electronic data collection. But, I also understand why it isn't mentioned -- I work for an EDC/eCOA provider, and our biggest competitor for new business isn't our competitors in the space, it is paper-based data collection.
