Inside Inato’s Bold Pivot: How Killing Their SaaS Product Led to 600% Growth in Clinical Trial Marketplace

Four years of work, gone in an instant. Most founders wouldn’t dare to completely restart their company after building a working product with paying customers. But in a recent episode of Category Visionaries, Kourosh Davarpanah revealed how this radical decision transformed Inato from a struggling SaaS company into a rapidly growing clinical trial marketplace.

The Warning Signs

Inato’s original mission was clear: solve the devastating problem of clinical trial access. Less than 5% of patients can participate in trials, and diversity among participants is alarmingly low. Their initial approach was building a SaaS platform to help pharmaceutical companies identify research sites more effectively.

But something wasn’t working. No matter how much data they provided, pharmaceutical companies kept returning to the same handful of large academic hospitals. As Kourosh explains, “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.”

The Bold Reset

After four years of building, Kourosh and his team made an extraordinary decision. “We pivoted after four years,” he recalls. “And when I say pivoted, it was a hard pivot. We went back to no clients, no revenue, no product, nothing.”

This wasn’t a gentle transition or gradual evolution—it was a complete reset. The team abandoned their SaaS product to build a two-sided marketplace connecting hospitals with pharmaceutical companies. The goal shifted from helping pharma companies find sites to helping hospitals find the right trials for their patients.

Building Trust in a Complex Market

The pivot required rethinking their entire go-to-market approach. “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 of disruption, they focused on building trust through expertise. They assembled 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 Results

The market validated their decision quickly. “We did more revenue on year two with the new model than we did on year four of the previous one,” Kourosh shares. 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.

Key Lessons for Founders

1. Look Beyond Surface Problems: While the lack of clinical trial access was obvious, the root cause—concentration among top hospitals—took years to understand fully.
2. Listen to Market Behavior: No amount of improved data changed how pharmaceutical companies selected sites, signaling a deeper problem with the SaaS approach.
3. Make Clean Breaks: Rather than trying to gradually transition, Inato made a complete reset, allowing them to rebuild from first principles.
4. Build Trust Progressively: They focused exclusively on the core matching problem for three years before expanding to additional features, ensuring they got the foundations right.

Today, Kourosh envisions making clinical trial access as seamless as booking accommodation: “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.”

For B2B founders facing similar challenges, Inato’s story demonstrates that sometimes the bravest decision is to start over. The key is recognizing when incremental improvements won’t solve the fundamental problem—and having the courage to reset everything in pursuit of the right solution.