Starting in business development at a large firm like Genentech provides a holistic understanding of the entire drug lifecycle—from discovery and regulation to clinical trials and marketing. This "full spectrum" view offers invaluable training for a future CEO.
Shifting a drug's focus from treating an unpredictable illness (like severe influenza) to preventing a known side effect of a scheduled treatment (cancer immunotherapy) creates a much stronger, de-risked commercial case with a clear, prophylactic point of intervention.
Even when a startup fails to secure investment, maintaining strong relationships with VCs who passed can lead to new opportunities. Impressed by your efforts, they may hire you as a consultant or BD lead for their other portfolio companies, providing a valuable segue.
For a smaller company, conducting a clinical trial within one country like the UK is highly efficient. It streamlines regulation under one agency (the MHRA), reduces costs, and allows for rapid patient enrollment by leveraging a tight-knit national network of clinical specialists.
When developing a drug for treatment side effects, pursue partnerships with two distinct groups simultaneously: the large pharma companies that make the primary drug and specialized "supportive care" companies. This dual-track approach creates competitive tension and expands potential exit opportunities.
The economic case for a prophylactic drug isn't just clinical. Its real value is enabling expensive, multi-week inpatient procedures (like CAR-T side effect observation) to become outpatient treatments, freeing up hospital beds and massively reducing healthcare system costs.