Given my intelligence background, I get hired to profile leadership teams before PE/VC firms invest.

My observation (entirely empirical) suggests PE firms that understand who they're investing in perform better long-term.

I've seen it all: timid biotech scientists playing CEO, narcissists, sociopaths, egomaniacs, misogynists. And more.

Early-stage biotech typically runs on excellent scientists with brilliant ideas.

TechBio companies lean on stellar technologists.

What these small firms often lack? A sharp business operator with three critical skills:

— Strategic decision-making under uncertainty - evaluating complex information and making calls with incomplete data about markets, regulations, and competitors

— Cross-functional integration - coordinating across scientific, commercial, regulatory, and financial functions while managing limited resources

— Network-based market intelligence - leveraging relationships to gather information about customers, competitors, partners, and regulatory pathways

Academic research (look up Harvard Business Review) shows co-CEOs deliver 9.5% annual returns versus 6.9% for market indices.In biotech? It gets quite complicated.

Take Amylyx Pharmaceuticals. Co-CEOs Joshua Cohen and Justin Klee built something remarkable—until their ALS drug hit regulatory walls. Stock plunged 79% this year.

‍Summit Therapeutics, Inc. tells a different story. Their co-CEOs just bought $12M of their own shares after Phase III results.

Co-CEOs make decisions differently. When Amylyx's leaders disagree, they don't power struggle -- they gather more data. That's gold in an industry where 90% of programs fail.Biotech's future belongs to leaders who navigate both scientific uncertainty and commercial reality.

Whether that's one person or two depends on the challenge.

The question isn't whether co-CEOs work in biotech. It's whether your organization has complexity demanding shared expertise - and the governance structure to support it.

***Want to understand if your leadership team fits your business goals? My colleagues (or I) can map out a behavioral profiling exercise for you.

The economics of the business and the psychology of its leaders go hand in hand.

Illustration by Paul Blow.