Why We Decided To Build For CROs First

I was having a conversation with a tech company in the site identification and selection space, and they were surprised that we do not sell to pharma: that we had decided Yendou is a CRO vendor. Based on their experience, CROs just aren't into buying technology. They asked, "How the hell did we even get the idea to focus on them?"

I admit it might seem suicidal. It is not. It is hyper-specific. Here's what I think:

You can't convince a CRO to buy technology that isn't built for them.

Most tech companies in the clinical research space build tech they want to sell to everyone: large pharma, big biotech, small biotech, large CROs, small CROs, mid-sized CROs. The assumption is, "Well, they all run clinical trials." That's the most ridiculous argument you could make in this context.

At Yendou, we believe large pharmaceutical companies are different from big biotech, which are different from small biotech, which are certainly different from small and midsize CROs, which again differ from large CROs. (I know, what an insight!) It seems obvious. But look around. No company has the guts to do the job right. They want to sell more than they want to solve real problems.

Sure, all these companies run clinical trials. But the trials and the operational problems they face are different. So are the consequences of those problems. We can't build a product that fits them all. As long as companies try to build one-size-fits-all software, sales will always be hard. In that context, picking CROs might indeed sound suicidal. (But again, what do all missionary founders have in common? Exactly.)

You have to pick one customer. Understand their problem. Fix it for them. That decision takes courage because it means saying no to everyone else.

Yendou is a venture-backed company. Investors like big logos. Big logos equals Big Pharma. So you'll hear it, I certainly do:

"Just get a big logo before the next fundraise." And I reply: "I don't care about big pharma logos. Not today." That's not the metric we're tracking. The same when they say, "Increase the ACV," and I say, "$$$ isn't the currency Yendou tracks today." This strategy drives a lot of people mad. But it's mine.

I'll admit, it helps that I'm a scientist by background. Business people assume scientists are difficult by design. So they forgive a missionary style of leadership, one that thinks in terms of product value over logo value.

Building a company isn't different from science. You have to start with first principles. You have to know what problem you're solving. You have to know what your mission is today. There's always a big vision.

But what do you want now? So what do we want? What do I want?

At Yendou, we want studies to be initiated at the right sites on the fastest timeline possible. The only barrier we can't crush (yet) is the regulatory one. That should be the only delay between site ID and FPI. That's what I want. That's what everyone in this company wants. And believe me, knowing what you want makes things simple.

How do we get there fastest? That's what surprises most companies.

[Belief #1: CROs > Sponsors]

At Yendou, we bet on CROs. We bet on CROs to deliver the medical progress future generations need. We don't bet on pharma. We don't bet on biotech. We bet on the infrastructure that runs clinical trials today and will still run them tomorrow.

Don't get me wrong. I bet on scientists and sponsors to discover and fund. Yet, I bet on infrastructure to deliver. And CROs are the infrastructure.

I could fix operational inefficiencies for 10 biotech companies, or fix it once for a CRO that serves those 10 biotechs every year. I love scale, we bet on impact at scale.

[Belief #2: Sites > Patients]

Here the other thing I believe in: I believe in sites above patients, because the smartest way to reach patients at scale is to back the institutions that already serve them. It's easier to bet on a site welcoming 5,000 patients a year than to go after 5,000 individuals. As I said: impact at scale. Let your impact go downstream.

The same logic applies to CROs. They run over 70% of trials worldwide. Impact at scale.

[Belief #3: Data = Truth]

At Yendou, we bet on performance. We're the first company moving the industry from subjective, survey-based reported site performance to data-driven, measurable site performance. Why?

Because we want studies to be initiated at the right sites, on the fastest timeline possible. By the "right site," I mean one that actually has access to the patient population the trial needs.

Many site-matching platform founders talk about internal conflict: "serving their own sites" vs. serving all sites. At Yendou, we don't have that conflict. We believe that conflict only exists when your values are wrong. We don't favor community sites over academic centers. We don't favor site networks over independent sites. We don't favor one region over another. Our bias is toward execution speed, access to patients, and infrastructure.

Our favorite sites are the ones that deliver. Why? Because the only way to get breakthroughs to all patients, everywhere, is to get the data that proves it works, as fast as possible. That's our view of patient centricity.

[Belief #4: Efficiency]

At Yendou, we bet on the efficiency of scale. As far as I know, we're the only platform offering site-centric data infrastructure, not study-centric. And our pricing reflects that philosophy. Companies running a large number of clinical trials have an edge: they can separate operations from protocols. That allows them to generate data that benefits the entire organization, across all pipelines, and not just one study team. But that's only possible with the right infrastructure. So we build for those who want to win at scale.

[Belief #5: Incentives build favorable outcomes]

Our fifth philosophy: profit is the best incentive. So use it. How?

At Yendou, we bet on capitalism. There is this anecdote at Yendou: once at an internal product workshop a former employee stated, "Capitalism is bad," to which I snapped back, "Why is being rewarded for your effort bad?" Since then, reading Ayn Rand's Manifesto on Capitalism is pflichtlektüre at Yendou. You can find a copy here under "Why capitalism benefits everyone." We believe that capitalism is a meritocratic instrument that rewards value creation. And this quote by Ayn Rand in Atlas Shrugged best describes why:

"To trade by means of money is the code of the men of good will. Money rests on the axiom that every man is the owner of his mind and his effort. Money allows no power to prescribe the value of your effort except the voluntary choice of the man who is willing to trade you his effort in return. Money permits you to obtain for your goods and your labor that which they are worth to the men who buy them, but no more. Money permits no deals except those to mutual benefit by the unforced judgment of the traders. Money demands of you the recognition that men must work for their own benefit, not for their own injury, for their gain, not their loss—the recognition that they are not beasts of burden, born to carry the weight of your misery—that you must offer them values, not wounds—that the common bond among men is not the exchange of suffering, but the exchange of goods. Money demands that you sell, not your weakness to men’s stupidity, but your talent to their reason; it demands that you buy, not the shoddiest they offer, but the best that your money can find. And when men live by trade—with reason, not force, as their final arbiter—it is the best product that wins, the best performance, the man of best judgment and highest ability—and the degree of a man’s productiveness is the degree of his reward. This is the code of existence whose tool and symbol is money." - Ayn Rand, Atlas Shrugged

The best way to make speed the norm is to make speed profitable. In a capitalist society that rewards speed with profit, we want to build products that do the same. Every feature we build should help customers grow their pipeline and revenue. Yendou should make the customer more money. That’s that simple.

People blame CROs for slow timelines, for chasing billable hours. But that's just market demand in action. Sponsors want billable hours because they're easy to track. CROs deliver them because that's what gets paid for. Choosing CROs as customers means answering the question: Can we turn efficiency and shorter timelines into profit for a thin-margin industry? Can CROs reach software margins in a decade from now?

That’s our plan. It's not easy. But we didn't build Yendou to solve easy problems. We built it to break eroom’s law.

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