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

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