This January, thousands of healthcare leaders from around the world gathered in San Francisco for the 44th Annual J.P. Morgan Healthcare Conference. The city buzzed with meetings and conversations, and the mood was cautiously optimistic. After a late-2025 rebound in biotech venture financing, the days leading into JPM brought notable early-stage activity, including AirNexis’s $200M Series A and SonoThera’s $125M Series B.
For biotech executives, it was a clear signal that momentum is building again. But optimism alone doesn’t close a round. Even in a good market, capital doesn’t come easy. Investors remain disciplined, and expectations around preparation and professionalism have only increased. As Patrik Frei, founder and CEO of Venture Valuation, puts it:
“There are always more people looking for money than there is money available. You have to have something that investors are looking for.”
What separates the companies that get funded from those that don’t? Often, it’s a handful of early decisions. Here’s what first-time CEOs need to get right.
Start with a plan and start early
Many first-time CEOs keep their strategy in their heads, believing it gives them flexibility. It rarely does. Mental plans shift, and that lack of clarity becomes obvious the moment investors start asking detailed questions.
“It’s good to have a plan outlined on paper that covers what you want to do, your strategy, your product and where you compete,” Patrik explains. “Often, we see a mismatch between the strategy the company wants to pursue and what their financial resources actually allow.”
A credible plan goes beyond the next year. Map out your preclinical phase, clinical costs, five-year trajectory, along with contingency plans for when things go wrong. Include clear go and no-go decision points. What data would cause you to stop development? What would trigger a pivot? Investors want to see that you’ve thought through everything, not just success scenarios. And be realistic about timelines. As Patrik notes, “It will likely take double the time and double the money.”
The fundraising process can take 12 to 18 months from first conversation to closed round, which means you need to be talking to investors well before you actually need capital. “It’s much better to talk to them when you don’t need the money,” Patrik advises. “Then you have the relationship—it’s not a cold call where you need money tomorrow.”
This is one reason why events like JPM matter, especially for early-stage companies. The relationships you build at conferences, founder meetups and industry events may not pay off immediately, but they often prove invaluable when fundraising begins.
Once you begin those conversations, be strategic about who you approach. Not every investor is a fit. Different firms have different preferences, whether that’s therapeutic area focus, stage preference or geographic concentration. What investors are looking for can also shift from year to year, so do your research. If you’re raising a small seed round, approaching a large VC probably isn’t the best use of anyone’s time.
As those conversations progress, keep track of them. Investor interactions can stretch over months or years, and details get lost quickly if you rely on memory or scattered notes. A simple CRM helps you track every conversation, follow-up, commitment and preference. Showing up to each meeting informed and consistent signals professionalism and momentum, which are qualities investors notice.
Know your value, and how to present it
At some point, every investor will ask what your company is worth. “If the company tells the investor, ‘tell me what you think I’m worth,’ that’s probably not the best starting point,” Patrik warns. “It signals you haven’t done your homework.”
You need a realistic valuation range based on comparable companies at similar development stages, your specific assets and data and current market conditions. Overvaluing your company creates serious downstream problems. It can scare off investors, or make future rounds harder, since you’ll need to show increasing value over time. “We see companies in their first seed round set too high a valuation,” Patrik notes. “Then they go to VCs, who ask about the last round and realize it’s way out of scope.”
Going too low, on the other hand, means unnecessary dilution that compounds through every subsequent round. Getting valuation right matters not just for this round but for every round that follows. It’s crucial for your company’s long-term development.
The way you tell your story also shapes how investors see your company. First-time CEOs often err in one of two directions. Scientists tend toward excessive modesty, only willing to discuss findings they’re completely certain about. Others swing too far the other way, making grandiose claims about curing diseases and changing the world. “You have to be self-confident and really sell the company,” Patrik advises. “But not too much. If companies have unrealistic claims, investors shut down.”
The companies that succeed find the middle ground: confident but credible, ambitious but grounded. Part of that credibility means acknowledging risk openly. Every business carries risk, and sophisticated investors know it. Rather than trying to hide it, address it directly and explain how you’re mitigating each one. That kind of candor builds trust.
Raise more than you think you need
Nearly every experienced investor and CEO agrees that it’s best to raise enough to reach your next major milestone, plus a meaningful buffer. How much buffer is enough? There’s no universal answer, but many experienced CEOs target 18 to 24 months of runway after each raise, assuming the funds will carry them past at least one significant value-creating milestone.
Some first-time CEOs hold back because they’re worried about dilution. They want to retain control and do everything themselves. But running out of money is far worse than giving up equity. “Take the money when you can,” Patrik says. “You don’t know what’s going to happen tomorrow.” That extra runway is invaluable. It lets you focus on the science instead of constantly fundraising.
That said, fundraising is one responsibility a CEO should never delegate. You can, and should, outsource in areas where others have more expertise. After all, you can’t be good at everything, and trying to do it all yourself is a common trap. But investor relationships must be owned by the CEO. Investors are backing you as much as your science, and that relationship simply can’t be delegated.
The bottom line
The optimism at JPM 2026 is a promising signal, but capital still flows to the companies that are prepared. That means having a documented plan, building investor relationships early, targeting the right partners, understanding your valuation, presenting with confidence and credibility and raising enough to see you through.
At KreaMedica, we partner with first-time biotech CEOs building their companies from the ground up, helping them navigate the critical early decisions that determine whether promising science reaches the patients who need it.
This article is adapted from The First-Time Biotech CEO Playbook, our comprehensive guide to the early decisions that matter most. Download the full eBook here to explore additional chapters on regulatory strategy, preclinical development, partnerships and more.