Sana CEO Steve Harr actively questions whether the company's groundbreaking science can translate into a scalable, commercially viable therapy. This internal pressure focuses the team on solving not just the scientific challenges ("does it work?"), but also manufacturing ("can you scale it?") and the commercial model required for a true cure.

The foundation of a successful biotech is scientific innovation. Business leaders who openly respect scientists as the focal point for value creation can build trusting, effective relationships that accelerate development and commercialization.

Successful biotech leadership requires a clear decision-making hierarchy. Dr. Bahija Jallal advocates for a framework where patient welfare is paramount, followed by scientific rigor. Financial success is treated as a byproduct of excelling in the first two areas, not the primary goal.

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.

Fundraising as a first-time biotech CEO is not a single skill. Ron Cooper's experience at Albareo involved executing seven different financial transactions in two years, most of which were new to him. This demonstrates that success requires intense persistence ("wearing out your shoe leather"), a compelling story, and creativity in pursuing non-traditional financing.

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.

A biotech investor's role mirrors that of a record producer by identifying brilliant talent (scientists) who may lack commercial experience. The investor provides the capital, structure, and guidance needed to translate raw scientific innovation into a commercially successful product.