Many medtech companies design large trials where a tiny, clinically meaningless response can be statistically significant. Dr. Holman advises entrepreneurs to instead run rigorous trials that prove genuine clinical value, arguing that credible data is the ultimate moat, even if it carries a higher risk of failure.

Rather than waiting for late-stage development, biotech startups should integrate commercial planning into early trials. This means building in data collection for payers, pricing, and patient access from the start. This "think with the end in mind" approach ensures the company has the right data for pivotal trials and market access.

Unlike ventures in established biological pathways, startups tackling novel biology must first prove a specific drug product can work. The primary question isn't about the platform's potential applications but whether a single, tangible therapeutic is viable. Focusing on a broad platform too early is a mistake.

Before leaving academia, aspiring founders should have honest, non-fundraising conversations with potential investors. This "test drive" provides candid feedback on the idea's fundability, business structure, and necessary milestones, preventing them from launching a company that is misaligned with market expectations.

Successful MedTech innovation starts by identifying a pressing, real-world clinical problem and then developing a solution. This 'problem-first' approach is more effective than creating a technology and searching for an application, a common pitfall for founders with academic backgrounds.

For deep tech startups aiming for commercialization, validating market pull isn't a downstream activity—it's a prerequisite. Spending years in a lab without first identifying a specific customer group and the critical goal they are blocked from achieving is an enormous, avoidable risk.

The fundamental purpose of any biotech company is to leverage a novel technology or insight that increases the probability of clinical trial success. This reframes the mission away from just "cool science" to having a core thesis for beating the industry's dismal odds of getting a drug to market.

Moving from a science-focused research phase to building physical technology demonstrators is critical. The sooner a deep tech company does this, the faster it uncovers new real-world challenges, creates tangible proof for investors and customers, and fosters a culture of building, not just researching.

Airway Therapeutics' CEO founded a CRO to resolve the disconnect between academic research's discovery focus and industry's market-driven goals. This "translator" model aligned incentives and regulatory understanding, fostering more efficient drug development by merging clinical feasibility with commercial targets.