#387 – How Mariano Garcia-Valiño proved he could save lives—but couldn't find anyone willing to pay

A story about how "everyone agrees" is the most dangerous lie in SaaS.

This episode is for SaaS founders frustrated watching their solution solve real problems—but wondering why no one actually buys it.

Most healthcare startups don't fail because their tech doesn't work. They fail because they can't find anyone willing to pay for it.

Mariano Garcia-Valiño, Founder and CEO of Axenya, spent 18 months proving his preventive care model worked clinically—reducing diabetes costs by 20% and mortality risk by 18%. Then he spent another year without selling a single dollar because insurers, hospitals, and patients all had reasons not to care enough to pay.

He found the answer by buying a healthcare broker and changing who he sold to: employers in Brazil who actually bear the cost and have the timeframe to benefit from prevention.

This inspired me to invite Mariano to my podcast. We explore why solving the right problem for the wrong buyer kills traction—and how changing your business model changes who cares. Mariano shares how he rejected the obvious paths (selling to insurers, doctors, or patients) and instead built a broker model that aligns incentives with outcomes. You'll discover why clinical proof means nothing without economic urgency.

We also zoom in on three of the 10 traits that define remarkable software companies:

• Acknowledge you cannot please everyone
• Master the art of curiosity
• Aim to be different, not just better

Mariano's story is proof that the best solution dies without the right buyer—and why changing your business model, not your product could be the easy way out.

Here's one of Mariano's quotes that captures the challenge he faced:

"It's one thing to actually see the problem and find a technical solution for the problem. It's a different thing to deploy it in the right place within a very complex value chain that has a lot of incentives that are not well aligned."

By listening to this episode, you'll learn:

• Why solving a highly valuable and critical problem alone won't create a market without economic incentive alignment
• What happens when you build for huge global humanity problems instead of expensive local ones
• Why focusing on who pays reveals better opportunities than focusing on who uses
• How buying your distribution channel creates stickiness competitors can't copy

For more information about the guest from this week:

Guest: Mariano Garcia-Valiño, Founder and CEO at Axenya

Website: axenya.com