Early-stage biotechs prioritize scientists to build the core platform. However, once a lead clinical program is identified, the critical hire becomes a Chief Medical Officer who can design the clinical strategy. This hire is timed to the program's maturation, not the company's age, reflecting a pivotal strategic shift.
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A CEO's primary role differs fundamentally based on company type. In an asset-centric biotech, the CEO must act as a hands-on program manager, micromanaging execution. In a platform company, the CEO must be deeply embedded in the science to predict and leverage the technology's long-term trajectory.
CEO Marc Salzberg wears CEO, CMO, and Board Chair hats, acknowledging it's a temporary "big stretch." This demonstrates a practical early-stage strategy where a leader covers multiple critical functions to save capital and ensure continuity, with a clear plan to hire dedicated experts as the company matures.
Kevin Pojasek credits his effectiveness to a deliberate 12-year journey through diverse roles—investing, company creation, research, and clinical operations. This broad experience allows a leader to understand how all parts of the company, from high-level strategy to detailed science, fit together.
A common failure mode for well-funded biotechs is growing headcount too rapidly. Immunocore's CEO advises new leaders to pace themselves, emphasizing that drug development is a marathon. Prematurely scaling creates fixed expenses that can drain capital before key scientific milestones are hit.
Transitioning a biotech from discovery to development is not just a scientific step but a cultural one. According to Ron Cooper, it requires moving from a flexible "innovation and ideation culture" to a rigorous "engineering culture" focused on process and precision in areas like clinical trials and large-scale manufacturing.
In Biotech, risk is removed pre-FDA approval via clinical trials, making a Chief Development Officer (clinical, regulatory, manufacturing) the most critical hire. In many MedTech sectors, risk is removed post-FDA approval via market adoption, making a Chief Commercial Officer paramount.
Drug development can take a decade, a timeframe that misaligns with typical investor horizons and employee careers. Success requires navigating fluctuating capital market cycles and implementing strategies to retain key scientific talent for the long haul.
The transition from a resource-rich environment like Novartis to an early-stage biotech reveals a stark contrast. The unlimited access to a global organization is replaced by a total reliance on a small, nimble team where everyone must be multi-skilled and hands-on, a change even experienced executives find jarring.
Unlike software startups that can "fail fast" and pivot cheaply, a single biotech clinical program costs tens of millions. This high cost of failure means the industry values experienced founders who have learned from past mistakes, a direct contrast to Silicon Valley's youth-centric culture.
Resolution Therapeutics' CEO builds his team with leaders from varied backgrounds across different diseases and drug modalities. He believes this diversity creates more robust problem-solving, as challenges that are novel in one area may have been solved in another, enabling faster and more informed decisions.
