# Medable Financial Model Cloud platform for decentralized clinical trials (DCTs) connecting patients, sites, and sponsors remotely - Canonical: https://finamodel.com/startups/medable - Excel download: https://finamodel.com/startup-models/medable.xlsx - Category: Health-tech - Model type: SaaS ARR / Valuation - Funding round: Series D - Funding: $304M - Founded: 2022 - Geography: Global - 60+ countries [DECK, slide 7] - Customer: B2B2C ## About the company Medable is a cloud platform for decentralised clinical trials, connecting patients, sites, and sponsors remotely. It supports trial operations in which recruitment, data collection, and participant experience can move beyond conventional site-only research workflows. Enterprise pharmaceutical customers generate committed ARR, with services supporting deployment and live trials. The commercial model depends on sponsor contracts, trial launches, implementation timing, services attach, platform expansion, and retention across multiple programmes within a customer account. The model forecasts sponsor contracts, subscription ARR, implementation, services attach, expansion, retention, and delivery margin. It separates services staffing from software revenue, then includes enterprise sales cycles, product investment, customer support, cash burn, working capital, and runway. ## What's included - 5-year monthly revenue build with stage-appropriate growth assumptions - Full P&L, headcount plan, and operating-expense schedule - Cash-flow statement, runway, and burn-rate tracking - Valuation via exit multiple with a DCF cross-check - Returns analysis with MOIC and IRR - Unit economics including CAC, LTV, payback, and cohort retention ## Product & value proposition Three-app unified cloud platform purpose-built for decentralized clinical trials: - **Patient app** (iOS/Android): eCOA, eDiary, eConsent, remote screening, wearables/device integration, televisits, notifications/rewards - **Clinician/Site app**: screen, enroll, enter patient data in user-friendly format - **Study management app**: real-time patient data, next-generation analytics End-to-end workflow: recruitment → eligibility screening → TeleConsent → data capture (eDiary, image, questionnaires) → direct-to-patient shipping → TeleVisits → real-time data management → data lock Compliance stack: FDA 21 CFR Part 11, HIPAA, GDPR, HITRUST, GxP; pathway to EN ISO 13485:2016 (SaMD classification) ## Market No TAM/SAM/SOM slide present in deck. Market context provided via problem framing: - Only 3% of eligible patients participate in clinical trials - Average cost per drug approval: $2.6B - Average time to approval: 12 years - <7% of trial participants from diverse backgrounds COVID-19 tailwind cited: prior to 2020, 37% of sites failed to meet enrollment targets and 10% recruited zero patients; post-2020, enrollment accelerated 3x across therapeutic areas and phases ## Revenue model Two explicit revenue streams named in deck section headers: 1. **Subscription Revenue** - recurring platform license (SaaS ARR model) 2. **Committed Annual Recurring Revenue (ARR)** - headline KPI; defined as year-end or year-to-date committed ARR Additional implied revenue stream: **Professional/implementation services** - referenced via "Reducing cost of delivery / ROI in product to reduce services" section, implying current services attach to platform deals with a stated strategic goal of reducing that services component over time. Customers: pharma sponsors and CROs. Named penetration: 5 of top 10 pharma companies; 5 of top 7 CROs. 50+ clients total. Pricing unit: per-study or per-patient subscription (standard DCT SaaS); ACV tracked as a KPI ("Average annual contract value"). Actual ACV figures are redacted. ## Traction & metrics All figures from slides 6 and 7: - **Clients**: 50+ - **Client Retention**: 100% - **Revenue Growth**: 300% - period not specified, context implies 2020 vs 2019 - **Patients**: 1M+ - **Global DCTs deployed**: 125+ - **Countries**: 60+ - **Languages**: 60+ KPI table (slide 14) covers 2019, 2020 annual and 2020 Q4, 2021 Q1 - but all numeric columns are redacted (solid purple blocks in the image). Metrics tracked: Committed ARR, New Committed ARR, New ARR vs prior year, Topline Revenue, Net Revenue Retention, S&M Spend, Headcount, Human Capital Efficiency, Organic ARR growth, Blended CAC Ratio, Sales Efficiency Ratio, Average ACV. Bookings chart (slide 13): "Q1 2021 Bookings" and "Cumulative Medable Net Bookings" bar charts present but redacted. Operating Plan (slide 16): quarterly P&L template for FY2021 (Q1–Q4 + full year) present but all numeric cells are redacted. ## Unit economics No explicit unit economics numbers disclosed. The KPI definitions slide confirms the company tracks: - **Blended CAC Ratio**: Fully Loaded S&M / End Gross Committed ARR - **Blended CAC Ratio (New ARR methodology)**: YE Fully Loaded S&M / YE New Gross Committed ARR - **Sales Efficiency Ratio**: Net new Committed ARR (current quarter) / S&M (prior quarter) - **Net Revenue Retention**: Existing customer Committed ARR current period over prior period All underlying values are redacted. 100% client retention implies strong gross retention; NRR likely >100% given "300% revenue growth" with 50+ clients. Gross margin structure implied by Operating Plan line items: Revenue → Cost of Sales → Gross Profit → OpEx (Sales, Marketing, R&D, G&A) → EBITDA. Services costs likely embedded in Cost of Sales; strategic goal is to reduce services component. ## Competition / moat No explicit competitive landscape slide. Stated moat: - "Clean slate strategy" - purpose-built for DCT from the ground up, not a legacy eClinical retrofit - "Nimble and fast" and "Leaders in space" - Regulatory expertise: proactive FDA/GDPR/HIPAA guidance embedded in product - Network effects: 125+ global DCTs, 1M+ patients, 60+ country/language coverage creates data and operational depth - Mission-driven brand differentiation: founded by a clinician (Dr. Michelle Longmire, MD, CEO) - Success metrics framed around patient outcomes: access/diversity, retention/NPS, enrollment speed, partner satisfaction ## Team & funding ask / use of funds Team: - Michelle Longmire, MD - CEO & Co-Founder (clinician background) - Tim Smith - CTO & Co-Founder - Alison Holland - Head of Decentralized Trials Strategy - Eric Peper - EVP, Business Development - Parag Vaish - Chief Product Officer - Andrea Valente - Chief Operating Officer (noted as no longer at Medable at time of publication) --- ## Recommended financial model - **Archetype + why**: **SaaS ARR / DCT subscription model with services attach.** The company tracks Committed ARR as its north-star KPI, has 100% client retention, B2B enterprise pharma customers, and a stated roadmap to reduce services as % of revenue. Classic SaaS cohort-based ARR model is the right structure. Services revenue should be modelled separately and declining as % of mix over the forecast period (consistent with the "ROI in product to reduce services" strategic slide). - **Forecast horizon & granularity**: 5 years (2021–2025), quarterly for Years 1–2, annual for Years 3–5. The existing operating plan is quarterly (FY2021) so match that granularity for the near term. - **Key drivers & assumptions**: - **Starting Committed ARR** - : redacted; placeholder; back-solve from 300% growth on a $1–5M base range - starting value to be filled when actual ARR is known - **ARR growth rate** - : 300% implied FY2020 growth; deceleration curve: 150% FY2021, 100% FY2022, 70% FY2023, 50% FY2024, 35% FY2025 - growth-stage clinical SaaS comps - **New logo adds** - : ~10–15 new clients/year, ramping; starting base 50+ - **Average ACV** - : tracked but redacted; $200K–$500K per study contract for enterprise pharma DCT platforms; flag as key sensitivity - **Net Revenue Retention** - : 100% client retention implies strong NRR; 115–125% NRR (expansion through additional studies/modules per existing client) - **Services revenue as % of total** - : ~40–50% in 2021 declining to ~15–20% by 2025, consistent with stated "reduce services" strategy - **Gross margin (platform)** - : 70–80% on subscription revenue; 20–35% on services; blended margin expanding from ~50% to ~65%+ as mix shifts - **S&M as % of revenue** - : S&M spend tracked; 40–50% of revenue in early years, declining as ARR scales - **R&D as % of revenue** - : 25–35%, typical for clinical SaaS platform investment phase - **G&A as % of revenue** - : 15–20% - **EBITDA margin** - : tracked in operating plan; deeply negative in 2021–2022, approaching breakeven by 2024–2025 - **Headcount** - : tracked as KPI; scale with revenue at declining ratio (Human Capital Efficiency metric in deck) - **Blended CAC Ratio** - : tracked; 0.8–1.2x (S&M / New ARR), typical B2B SaaS - **Sales Efficiency Ratio** - : tracked; target >0.7x net new ARR / prior quarter S&M - **Cash burn / runway** - operating plan tracks Net Burn and Ending Cash Balance; model to show runway vs. raise proceeds - **Scenarios (Base / Bull / Bear)**: - **Bull**: ARR growth 200%+ FY2021, NRR 130%+, gross margin expansion faster as services shrink rapidly, regulatory tailwinds accelerate DCT adoption - **Base**: ARR growth 100–150% FY2021, NRR 115–120%, services decline on plan, cash flow breakeven ~2024 - **Bear**: growth slows to 60–80% as pharma budgets tighten post-COVID DCT hype cycle, NRR reverts to 100–105%, services cost remains sticky, extended burn - **Required sheets / outputs**: 1. **Assumptions** - all driver inputs, toggle for scenarios 2. **ARR Waterfall** - beginning ARR + new logos + expansion − churn = ending ARR, quarterly 3. **Income Statement** - Revenue (subscription + services), COGS, Gross Profit, OpEx (S&M, R&D, G&A), EBITDA 4. **Cash Flow** - EBITDA → FCF; Net Burn; Ending Cash Balance (mirrors operating plan structure in slide 16) 5. **KPI Dashboard** - Committed ARR, New ARR, NRR, ACV, headcount, Human Capital Efficiency, CAC Ratio, Sales Efficiency Ratio (mirrors slide 14 KPI set) 6. **Bookings Bridge** - New bookings → Revenue recognition (backlog/deferred) 7. **Scenario Toggle** - Base / Bull / Bear outputs side-by-side ## Frequently asked questions ### Is the Medable financial model free? Yes. The Medable model is a free Excel download with live formulas. ### Can I change the assumptions? Yes. The workbook is editable and its live formulas recalculate when assumptions change.