Introduction The healthcare industry is witnessing unprecedented churn and transformation, leading to a surge in the adoption of IT and business process outsourcing. Driven by regulatory reforms, tenets of consumerization, market consolidation, and emergence of next-generation digital avenues, acceptance of outsourcing has accelerated in the space. The provider industry is coming to terms with the reforms mandate and tackling structural profitability issues. To tackle these, market participants are actively looking at technology as a lever of operational efficiency and transformational change. As HIX, ACOs, payer-provider convergence, and the overall shift to value-based reimbursement get operationalized; providers need to chalk out an effective IT strategy. With companies stepping up adoption of outsourced delivery, there is an uptick in demand for relevant research and market intelligence on demand and supply trends in healthcare outsourcing across each subvertical – payer, provider, and life sciences. The need is more pronounced for the vertical-specific IT outsourcing function, where business challenges are driving greater adoption. Everest Group’s healthcare outsourcing research program addresses this market requirement by analyzing outsourcing trends and service provider capabilities specific to ITO in the provider vertical. Content In this research, we present detailed profiles of the 16 service providers featured on the healthcare provider ITO PEAK Matrix. Each comprehensive profile presents a perspective of one provider’s service suite, scale of operations, scope, domain investments, transaction success, delivery locations, and Everest Group’s assessment of the service provider.

Introduction The healthcare landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with mobile computing, social media platforms, and “anytime-anywhere” information access). This combination of disruptive and legacy factors has driven healthcare firms to adopt new technologies, while also revamping their existing systems, processes, and interfaces. As the technology mandate for healthcare enterprises evolves, so do their relationships with IT service providers. This, in turn, is driving the need for relevant research and market intelligence on demand and supply trends in healthcare outsourcing across the three major market segments – payer, provider, and life sciences. Everest Group’s healthcare outsourcing research program addresses this market requirement by analyzing outsourcing trends and service provider capabilities specific to ITO in the healthcare vertical. In this report, we analyze the capabilities of 20 leading ITO service providers specific to the global life sciences sector. These service providers are mapped on the Everest Group PEAK Matrix, which is a composite index of a range of distinct metrics related to a service provider’s capability and market success. Scope of the analysis Industry: Life sciences (pharmaceuticals, biotechnology, and medical devices) Services: Large (TCV >US$25 million), multi-year (>three years), and annuity-based application outsourcing Geography: Global Sourcing model: Third-party ITO transactions; excludes shared services or captives Contents This report is structured across three key sections, each containing insights on the life sciences ITO service provider landscape, with a specific focus on large-sized contracts: Life sciences ITO service provider landscape: Analysis of individual service provider capabilities in the life sciences ITO space along the following dimensions: Delivery capability: Scale Scope Domain investments Delivery footprint Innovation Buyer satisfaction Market success: Transaction activity 2015 Life sciences ITO PEAK Matrix and analysis of PEAK clusters: Mapping of life sciences ITO service providers on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix Commentary on the specific characteristics of PEAK clusters (Leaders, Major Contenders, and Aspirants) Commentary on the capabilities of each service provider: Delivery capability characteristics (scale, scope, domain investments, delivery footprint, innovation, and buyer satisfaction) Market success characteristics (transaction activity) Upcoming service providers in the life sciences ITO space Implications for key stakeholders: Implications of the market dynamics and identified life sciences ITO service provider landscape characteristics for key stakeholders: Implications for service providers Implications for buyers Everest Group has a complimentary four-page PEAK Matrix preview document for this service provider landscape report.

Introduction The healthcare landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with mobile computing, social media platforms, and “anytime-anywhere” information access). Global life sciences industry is faced with narrowing margins, expiring patents for blockbuster drugs, dwindling drug pipeline, and rising adoption of personalized medicine as well as wearables. The European industry in particular is witnessing a spike in personalized medicine and several regulatory changes (around drug approvals, medical devices, pharmacovigilance, etc.), compounding the challenges for players in this market and compelling them to reengineer their strategic focus. This, in turn, is triggering the demand for analytics, data consolidation, and infrastructure & application modernization services. Evolving technology mandate for healthcare enterprises is driving the need for relevant research and market intelligence on demand and supply trends in healthcare outsourcing across the three major market segments – payer, provider, and life sciences. Everest Group’s healthcare outsourcing research program addresses this market requirement by analyzing outsourcing trends and service provider capabilities specific to ITO in the healthcare vertical. In this report, we analyze the capabilities of 15 leading ITO service providers specific to the European life sciences sector. These service providers are mapped on the Everest Group PEAK Matrix, which is a composite index of a range of distinct metrics related to a service provider’s capability and market success. Scope of the analysis Industry: Life sciences (pharmaceuticals, biotechnology, and medical devices) Services: Large (TCV >US$25 million), multi-year (>three years), and annuity-based application outsourcing Geography: Europe (including United Kingdom) Sourcing model: Third-party ITO transactions; excludes shared services or captives Contents This report is structured across three key sections, each containing insights on the European life sciences ITO service provider landscape, with a specific focus on large-sized contracts: European life sciences ITO market landscape: Analysis of the European life sciences ITO market along the following parameters: Current market opportunity and growth prospects Country analysis; differentiating market dynamics across key European countries European life sciences firms’ IT imperatives European life sciences ITO PEAK Matrix for 2015 and analysis of the different PEAK Matrix clusters: Analysis of service provider capabilities in the life sciences ITO space along delivery capability (scale, scope, domain investments, delivery footprint, innovation, and buyer satisfaction) and market success (transaction activity) Map life sciences ITO service providers on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix Commentary on the specific characteristics of the PEAK Matrix clusters (Leaders, Major Contenders, and Aspirants) Distinguishing service providers within the European life sciences ITO space Implications for key stakeholders: Implications of the market dynamics and identified European life sciences ITO service provider landscape characteristics for key stakeholders: Implications for service providers Implications for buyers Everest Group has a complimentary four-page PEAK Matrix preview document for this service provider landscape report.

Introduction The healthcare and life sciences (HLS) landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with mobile computing, social media platforms, and “anytime-anywhere” information access). This combination of disruptive and legacy factors has driven HLS firms to adopt new technologies and, at the same time, revamp their existing systems, processes, and interfaces. The digital play has moved from being a “nice-to-have” to a “necessary to survive and thrive” requirement in the modern age. As the technology mandate for HLS enterprises evolves, so do their relationships with IT service providers. This, in turn, is driving the need for relevant research and market intelligence on demand and supply trends in HLS IT across the three major market segments – payer, provider, and life sciences. Everest Group’s HLS IT research program addresses this market requirement by analyzing outsourcing trends and service provider capabilities specific to HLS IT. In this report, we analyze the capabilities of 15 IT service providers specific to the global life sciences digital space. These service providers are mapped on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix, which is a composite index of a range of distinct metrics related to a provider’s capability and market success. Scope of the analysis Industry: Life sciences (pharmaceuticals, biotechnology, and medical devices) Services: Digital IT services Geography: Global Sourcing model: Third-party IT transactions; excludes shared services or Global In-house Centers (GICs) Contents This report is structured across four key sections, each capturing insights into the life sciences digital IT service provider landscape, with a specific focus on large-sized contracts: Digital in life sciences: Context is everything Drivers of digital adoption in life sciences Definition of digital services – avoiding the “catch-all” trap Digitization needs in the life sciences industry value chain Focus of life sciences buyers on digitization Life sciences digital IT service provider landscape: Analysis of individual service provider capabilities in the life sciences digital IT space along the following dimensions: Delivery capability: Scale Scope Domain investments Delivery footprint Innovation Buyer satisfaction Market success: Transaction activity Life sciences digital IT PEAK Matrix 2015 and analysis of PEAK clusters: Mapping of life sciences digital IT service providers on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix Commentary on the specific characteristics of PEAK Matrix clusters (Leaders, Major Contenders, and Aspirants) Commentary on the capabilities of each service provider: Delivery capability characteristics (scale, scope, domain investments, delivery footprint, innovation, and buyer satisfaction) Market success characteristics (transaction activity) Implications for key stakeholders: Implications of the market dynamics and identified life sciences digital IT service provider landscape characteristics for key stakeholders: Implications for service providers Implications for buyers Everest Group has a complimentary four-page PEAK Matrix preview document for this service provider landscape report.

Introduction The healthcare landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with mobile computing, social media platforms, and “anytime-anywhere” information access). The life sciences industry, in particular, is faced with narrowing margins, expiring patents for blockbuster drugs, dwindling drug pipeline, and rising adoption of personalized medicine as well as wearables. There has also been an uptick in M&A/restructuring activities as stakeholders make efforts to revive margins by realigning the strategic focus. This combination of disruptive and legacy factors is driving the technology appetite among life sciences firms, which is translating into increased focus on analytics, infrastructure services, data consolidation, and application modernization efforts. The year 2014 brought some respite to life sciences firms with a record number of new drug approvals, highest in the last 18 years. This was a result of a greater number of drug approval applications, and revised policies by the FDA for speedy approval of innovative drugs. With companies emphasizing on innovation as means to survive the tapering margins, their IT investments for R&D and clinical trials are likely to witness a sizable uptick in the near future. As life sciences firms embark on their digitization journey, there has been a spike in the demand for digital enablers and tools that cater to specific value chain elements and help achieve desired business outcomes. However, digital initiatives have been staggered towards overhauling the fundamental consumer engagement model, while digitization of internal operations remains a pretty nascent domain. Also, stakeholders tend to struggle with digital enablement due to factors such as fragmented service provider landscape and non-standardized internal structures. Successful digital adoption would require life sciences stakeholders to transform their entire stack of services and adopt an integrated services strategy. In this annual report, we analyze the current trends and future outlook of large, multi-year ITO relationships in the life sciences market. The report also provides specific insights into the significance of integrated services for digital enablement. This report is structured across four key sections, each containing insights on the life sciences ITO market, with a focus on large-sized contracts: Healthcare IT outsourcing market overview: Analysis of the overall healthcare outsourcing market and transaction trends: Market size and growth Transaction trends for IT outsourcing in healthcare Segment-level analysis of healthcare outsourcing transactions, including: Business segments: Healthcare payer, provider, and life sciences Function segments: Applications Outsourcing (AO) and Infrastructure Outsourcing (IO) Geographic segments Life sciences ITO market overview: Analysis specific to the life sciences ITO segment with a focus on large transactions Transactions activity and growth trends Demand characteristics for life sciences ITO services by geography, ITO subfunctions, buyer type, and buyer size Delivery trends for life sciences ITO services, including offshore leverage and global delivery locations Renewal opportunity till 2020 Digitization in life sciences: Significance of integrated services for true digital enablement Digitization across the life sciences value chain Customer-facing vs. internal digitization Key elements for digital enablement in life sciences Services integration strategy for effective digital enablement Outlook for 2015-2016: Analysis of the outlook and implications for ITO for the coming year Outlook for overall healthcare IT outsourcing Outlook for life sciences IT outsourcing

Introduction The healthcare and life sciences (HLS) landscape has been subject to significant turbulence on account of a gamut of factors including escalating costs, widespread regulatory amendments, changing business models, and evolution of the patient-centric paradigm (with mobile computing, social media platforms, and “anytime-anywhere” information access). This combination of disruptive and legacy factors has driven HLS firms to adopt new technologies and, at the same time, revamp their existing systems, processes, and interfaces. Stakeholders are increasingly focusing on leveraging diverse sources of data for insights-driven decision making, leading to an uptick in demand for big data and analytics IT services. As the technology mandate for HLS enterprises evolves, so do their relationships with IT service providers. This, in turn, is driving the need for relevant research and market intelligence on demand and supply trends in HLS IT across the three major market segments – payer, provider, and life sciences. Everest Group’s HLS IT research program addresses this market requirement by analyzing outsourcing trends and service provider capabilities specific to HLS IT. In this report, we analyze the capabilities of 18 IT service providers specific to big data and analytics IT services for the global life sciences industry. These service providers are mapped on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix, which is a composite index of a range of distinct metrics related to a provider’s capability and market success. Scope of the analysis Industry: Life sciences (pharmaceuticals, biotechnology, and medical devices) Services: Big data and analytics IT services Geography: Global Sourcing model: Third-party IT transactions; excludes shared services or Global In-house Centers (GICs) Contents This report is structured across four key sections, each capturing insights around life sciences big data and analytics IT service provider landscape: Big data and analytics in life sciences Conventional vs. advanced analytics Value chain adoption of big data and analytics Deal trends for life sciences big data and analytics Life sciences big data and analytics IT service provider landscape: Analysis of individual service provider capabilities in the life sciences big data and analytics IT space along the following dimensions: Delivery capability: Scale Scope Domain investments Delivery footprint Innovation Buyer satisfaction Market success: Transaction activity Life sciences big data and analytics IT services PEAK Matrix 2015 and analysis of PEAK clusters: Mapping of IT service providers on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix Commentary on the specific characteristics of PEAK Matrix clusters (Leaders, Major Contenders, and Aspirants) Commentary on the capabilities of each service provider: Delivery capability characteristics (scale, scope, domain investments, delivery footprint, innovation, and buyer satisfaction) Market success characteristics (transaction activity) Implications for key stakeholders: Implications of the market dynamics and identified life sciences big data and analytics IT service provider landscape characteristics for key stakeholders: Implications for service providers Implications for buyers Everest Group has a complimentary four-page PEAK Matrix preview document for this service provider landscape report.

Introduction The healthcare landscape has been subject to significant turbulence on account of a gamut of factors, including escalating costs, widespread regulatory amendments, changing business models, and the evolution of the patient-centric paradigm (with mobile computing, social media platforms, and “anytime-anywhere” information access). This combination of disruptive and legacy factors has driven healthcare firms to adopt new technologies, and at the same time revamp their existing systems, processes, and interfaces. As the technology mandate for healthcare enterprises evolves, so do their relationships with IT service providers. This, in turn, is driving the need for relevant research and market intelligence on demand and supply trends in healthcare outsourcing across the three major market segments – payer, provider, and life sciences. Everest Group’s Healthcare and Life Sciences (HLS) IT research program addresses this market’s requirement by analyzing outsourcing trends and service provider capabilities specific to HLS IT. In this report, we analyze the capabilities of 16 IT service providers specific to clinical and R&D IT services in the global life sciences space. These service providers are mapped on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix, which is a composite index of a range of distinct metrics related to a provider’s capability and market success. Scope of the analysis Industry: Life sciences (pharmaceuticals, medical devices, biotechnology, and other life sciences) Services: Clinical and R&D IT services Geography: Global Sourcing model: Third-party IT transactions; excludes shared services or Global In-house Centers (GICs) Contents This report is structured across four key sections, each providing insights into the life sciences clinical and R&D IT service provider landscape, with a specific focus on large-sized contracts: Clinical and R&D in life sciences Key themes Clinical and R&D IT framework – scope vs. enablers Value chain adoption Service lines driving IT demand across categories Deal analysis Life sciences clinical and R&D IT service provider landscape: Analysis of individual service provider capabilities in the life sciences clinical and R&D IT space along the following dimensions: Delivery capability: Scale Scope Domain investments Delivery footprint Innovation Buyer satisfaction Market success: Transaction activity Life sciences clinical and R&D IT PEAK Matrix 2015 and analysis of individual Matrix clusters: Mapping of life sciences clinical and R&D IT service providers on the Everest Group Performance | Experience | Ability | Knowledge (PEAK) Matrix Commentary on the specific characteristics of PEAK Matrix clusters (Leaders, Major Contenders, and Aspirants) Commentary on the capabilities of each service provider: Delivery capability characteristics (scale, scope, domain investments, delivery footprint, innovation, and buyer satisfaction) Market success characteristics (transaction activity) Implications for key stakeholders: Implications of the market dynamics and identified life sciences clinical and R&D IT service provider landscape characteristics for key stakeholders: Implications for service providers Implications for buyers Everest Group has a complimentary four-page PEAK Matrix preview document for this service provider landscape report.

Global enterprises are investing in enhancing their Quality Management (QM) efforts in their pursuit to research and engineer products of utmost quality that meet global standards in their field. Superior quality of products act as a differentiating factor for quality conscious enterprises that keep the customer needs and experience at the center of all their quality management efforts. Enterprises have realized that lack of QM results in high cost and loss of brand image. Quality management in the engineering services industry covers all activities that are involved in the validation, verification, and testing of new products (hardware or software) during all stages of the product lifecycle. The demand for global sourcing of quality management services is expected to witness strong growth as enterprises look to reduce costs while battling margin pressures and at the same time ensure speed-to-market, continuous innovation, ability to meet evolving consumer needs, and incorporating next-generation technologies. This report provides a detailed analysis of quality management activities in the engineering services industry. It covers market landscape of quality management services and focuses on the central idea of how digital technology themes are reshaping the way enterprises look at their product quality management efforts in the engineering services industry. The report is divided into three broad sections: Detailed description of Quality Management (QM) in engineering services Trends shaping the QM market with a focus on the way digital technologies are transforming quality management activities An overview of the global sourcing industry for quality management activities, size of the market, growth trends, and demand drivers for sourcing of quality management in engineering services The scope of the report Industry: Engineering services (ES) Focus: Quality management ES segments: Software products Mechanical (automotive, aerospace, defense, and marine) Hi-tech (semiconductors, telecom, consumer electronics, and computing systems) Industrial, energy, chemicals, and natural resources Geography: Global Membership(s) Engineering Services

Enterprises are realigning their quality management efforts to meet their business objectives and drive competitive advantage. They are using global sourcing of quality management services as a lever to meet the challenges of high cost, time-to-market, and customer experience. Hence, it becomes critical to identify the right partners and assess advantages, opportunities, challenges, and risks associated with the engagement. This report provides information on the role of service providers and outsourcing engagement models. This report contains detailed profiles on each of the twenty-three leading engineering service providers in the quality management services space. This report also provides an overview of the quality management global sourcing landscape in engineering services and demand trends across major industry segments. The report is divided into three broad sections: Overview of Quality Management (QM) global sourcing landscape in engineering services and demand trends across major industry segments – software, mechanical, hi-tech, and industrial & energy Role of service providers and outsourcing engagement model Quality management service provider landscape and analysis of 23 service providers based on their focus, coverage, and functional expertise in QM management The scope of the report Industry: Engineering Services (ES) ES segments: Software products Mechanical (automotive, aerospace, defense, and marine) Hi-tech (semiconductors, telecom, consumer electronics, and computing systems) Industrial, energy, chemicals, and natural resources Testing capabilities: Mechanical Electrical Software System Regulatory Geography: Global Membership(s) Engineering Services

Increasing levels of interaction and intelligence built into machines, tools, and devices is creating a “new paradigm”- the age of human-machine nexus. Technology is moving to a state of “omnipresence” and multiple ambient technology components are getting inter-connected to form a global connected ecosystem. At the same time, new business models are evolving with a focus on creating and capturing more value for businesses. To evolve with this changing paradigm, enterprises need to adopt an approach based on ecosystem for strategizing and crafting value proposition in their products. Thus, they need to graduate from traditional design thinking to an ecosystem-centred design thinking approach. This report explores the ecosystem-centred design thinking approach, and delves into its constituents, the underlying principles, and the impact on businesses. It also covers some of the current and prospective examples for ecosystem-based design thinking, and discusses the challenges that enterprises need to overcome for successfully implementing this approach. The report is divided into three broad sections: Understanding the need for ecosystem-centred design thinking amid developments in ambient technology, global connected ecosystem, and business models The constituents and underlying principles for ecosystem-centred design thinking; the augmentation path from traditional to ecosystem-centred design thinking and the impact on businesses upon adopting this approach Examples from the present world, along-with some prospective use cases, where this approach is enabling businesses to create impactful products. Key challenges faced by enterprises in adopting this approach, and a checklist to gauge enterprise readiness for ecosystem-centred design thinking The scope of the report Industry: Engineering Services (ES) ES segments: Software products Mechanical (automotive, aerospace, defense, and marine) Hi-tech (semiconductors, telecom, consumer electronics, and computing systems) Industrial, energy, chemicals, and natural resources Geography: Global Membership(s) Engineering Services