How Axenya achieved cash flow positive before Series A by proving recontract capability | Mariano García-Valiño

Axenya is rebuilding healthcare around chronic disease prevention through AI-powered continuous monitoring. Covering 100,000 lives in Brazil and processing 95 million clinical inferences monthly, the company pivoted from clinical technology provider to healthcare broker - achieving cash flow positive status before their Series A. In this episode of BUILDERS, I sat down with Mariano García-Valiño, CEO and Founder of Axenya, to learn how they spent $3 million building the "perfect product" before discovering no one would pay for it, why they acquired a small broker to unlock their revenue model, and their regulatory-constrained approach to geographic expansion. Topics Discussed: Axenya's shift from infectious disease to chronic disease management through wearables and AI The 12-month zero-revenue period after spending $3 million on product development Why doctors, patients, and health plans all failed as buyers despite clinical validation The broker acquisition that unlocked their business model Performance-based pricing: zero fees upfront, revenue from cost savings only Regulatory barriers determining expansion (Mexico viable, Argentina impossible, Europe requires model redesign) Field-force-driven GTM with 30+ salespeople for complex, high-ACV enterprise deals Path to cash flow positive before Series A and scaling playbook for 2026 // Sponsors: Front Lines — We help B2B tech companies launch, manage, and grow podcasts that drive demand, awareness, and thought leadership. www.FrontLines.io The Global Talent Co. — We help tech startups find, vet, hire, pay, and retain amazing marketing talent that costs 50-70% less than the US & Europe. www.GlobalTalent.co // Don't Miss: New Podcast Series — How I Hire Senior GTM leaders share the tactical hiring frameworks they use to build winning revenue teams. Hosted by Andy Mowat, who scaled 4 unicorns from $10M to $100M+ ARR and launched Whispered to help executives find their next role. Subscribe here: https://open.spotify.com/show/53yCHlPfLSMFimtv0riPyM