From France to Global: How Inato Built an International B2B Marketplace from Day One
Starting a company in a small market forces hard choices. In a recent episode of Category Visionaries, Kourosh Davarpanah revealed how building Inato in France shaped their decision to go global from day one, eventually connecting hospitals and pharmaceutical companies across 50 countries.
The Small Market Challenge
Before Inato, Kourosh built a startup in logistics that never took off. This experience taught him crucial lessons about market size: “There’s this sense when you’re in France, it’s an amazing country to live in, but it’s a very small market.”
This realization shaped Inato’s strategy from inception. “This is how I ended up starting Inato, even though I knew literally nothing about clinical research at the time,” Kourosh shares. “I was really excited about the idea of serving patients, about the idea of doing something for the greater good. And I love the fact that research overall is very global, and it was a perfect opportunity for us to build something global from day one.”
Finding a Naturally Global Market
Clinical trials presented a unique opportunity. Unlike many industries that require localization or market-specific adaptations, clinical research is inherently international. The problem they were solving—less than 5% of patients having access to trials—was universal.
The concentration of trials in top hospitals was also a global phenomenon. “The 5% top hospitals in the world run about 70 plus percent of trials. So if as a patient, you’re not treated in one of those hospitals, chances are that you have no way of participating to a trial,” Kourosh explains.
Building Trust Across Borders
Expanding globally in healthcare required a different approach than typical tech startups. “Silicon Valley often has this notion of tech outsiders that come in and single handedly revolutionize a sector. And I think clearly in the healthcare industry, this is something that never works,” Kourosh emphasizes.
Instead, they focused on building deep expertise that would translate across markets. They created an “amazing customer success team with dozens of years of pharma experience” to guide pharmaceutical companies through processes that were “partly product and partly still human based.”
The Marketplace Evolution
Rather than trying to solve every aspect of international collaboration immediately, Inato took a methodical approach. “What was quite unique to us is we ended up focusing on the discovery piece, on the matching piece for a really long period of time,” Kourosh notes. This core matching problem was universal across markets.
Only after perfecting this foundation did they expand to “support everything you would expect in terms of the admin work, the legal work, the pricing, the payment, et cetera.” This patience helped them build a robust platform that could scale globally.
Results of Global-First Thinking
Today, Inato works with over half of the top pharmaceutical companies and approximately 3,500 sites across 50 countries, growing revenue by 600% in the past year. Their vision remains globally ambitious: “The big picture for us is making it as easy for any hospital in the world to offer trials to their patients as it is to book a place on Airbnb.”
This global scale is crucial for their mission. When Kourosh cites examples like finding “only three patients were African American” in an 8,000-patient trial for a disease that predominantly affects African Americans, it highlights why global diversity in clinical trials matters.
Key Lessons for Global Expansion
- Choose markets that are naturally global
- Focus on universal problems that transcend borders
- Build expertise that translates across markets
- Perfect core features before tackling market-specific challenges
- Use patience and methodical expansion to build trust globally
For founders starting companies outside major markets, Inato’s journey offers valuable insights. Sometimes a small home market can be an advantage, forcing you to think globally from day one. The key is finding problems that are universal enough to solve at global scale, then building the expertise and trust needed to execute across borders.