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From SaaS to Marketplace: How Inato is Reimagining Clinical Trial Access

Most founders dream of building category-defining companies, but few are willing to restart from zero after four years of work. In a recent episode of Category Visionaries, Kourosh Davarpanah shared how Inato evolved from a pharma-focused SaaS tool to a two-sided marketplace transforming clinical trial access.

The clinical trial landscape has remained largely unchanged for decades, with less than 5% of patients having access to trials. More troublingly, 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.”

This concentration creates devastating consequences for medical research. Kourosh shares a striking example: “Out of the about 8000 patients that were in the different trials, only three patients were African American, and the disease predominantly affects African Americans. So when you’re in that type of situation, you don’t even know if the drug that comes to market really works on African Americans.”

The Hard Pivot

Inato’s journey wasn’t linear. After four years of building a SaaS platform helping pharma companies identify research sites, the team made a dramatic decision. “We pivoted after four years,” Kourosh recalls. “And when I say pivoted, it was a hard pivot. We went back to no clients, no revenue, no product, nothing.”

This reset allowed Inato to tackle the problem from first principles, leading to their marketplace model connecting hospitals with pharmaceutical companies. The new approach resonated immediately: “We did more revenue on year two with the new model than we did on year four of the previous one.”

Building Trust in Healthcare

Unlike many Silicon Valley startups, Inato couldn’t simply disrupt their way to success. “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 trust through expertise: “You need to have experts internally that the pharma are going to trust.” Their strategy involved creating 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 everything at once, Inato took a methodical approach to building their marketplace. “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 explains. “We’re only now, after about three years, starting to expand to support everything you would expect in terms of the admin work, the legal work, the pricing, the payment, et cetera.”

This focused strategy has paid off. Working with over half of the top pharmaceutical companies and approximately 3,500 sites across 50 countries, Inato has grown revenue by 600% over the past year. Yet Kourosh sees this as just the beginning: “Even though we’re pretty happy about those numbers, what is really exciting to me is that it’s only starting to feel like the flywheel is starting to accelerate.”

Lessons for Enterprise Founders

For founders building enterprise products, Kourosh offers a crucial insight about early customer relationships: “What we ended up doing was we focused so much on a single one that we ended up building something that was super customized to them… we ended up doing 90% of our revenue with them and we actually then had to backtrack a ton to be able to understand what is completely specific to this pharma company and how can we actually build a product that fits a need in the market.”

Looking ahead, Inato aims to make clinical trial access as seamless as consumer experiences: “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 vision requires reimagining the entire collaboration model between pharmaceutical companies and hospitals, reducing partnership formation time from months to weeks.

For B2B founders tackling complex industries, Inato’s journey demonstrates that sometimes the biggest opportunities require the courage to start over, the patience to build trust, and the discipline to focus on foundational problems before expanding scope.