Topography Health

Topography Health was a clinical trials company that built a "full-stack, white-glove" product and service offering to identify, train and support community-based physicians so they could conduct clinical drug trials within their own practices. The company positioned itself against a market structure in which most trials are run by pharmaceutical sponsors through academic medical centers, large health systems or established trial sites concentrated in major metropolitan areas. Topography cited that roughly 98% of physicians do not participate in clinical research, that 86% of trial sites fail to enroll the necessary patients and that 50% never enroll a single patient.

The offering combined operational services and software: helping practices understand their patient populations, recommending studies with high likely uptake, recruiting patients, and hiring, managing and supporting research staff. A digital workflow layer let physicians manage clinical data in one place and integrated with existing practice technology, while a data science platform analyzed patient records to match and personalize studies for patients, including populations historically underrepresented in trials. Topography also supplied regulatory training, business development and working capital — lending practices the funds needed to stand up trial infrastructure, to be repaid by pharmaceutical sponsors during or after a trial. Investor a16z described the model as a bottoms-up managed marketplace of new "trialist" supply, with both active and passive income models allowing practices to ramp into research at their own pace.

At launch in January 2022 the company was in beta with several community physicians, with an initial therapeutic focus on metabolic disease, and was recruiting physician investigators nationally. By the time of its acquisition by FOMAT Medical Research, Topography operated 10 sites across six states with a strong gastroenterology focus.

Founding story

Topography Health was founded in 2020 by Alexander Saint-Amand, Andrew Kirchner and Mac Parish, who had each seen family members struggle to access clinical trials. Saint-Amand spent nearly 20 years leading expert-insights firm Gerson Lehrman Group (GLG), where he built a network of 170,000 physicians; he has said his mother's illness during his college years — first the difficulty of diagnosis, then the inability to enroll her in a trial — motivated first GLG and then Topography. Kirchner is described as an energy and clean technology industry veteran and Parish as a finance executive; the two had previously co-founded a company together and led product and operations at early- and mid-stage companies.

Business model

Topography operated as a tech-and-service platform sitting between pharmaceutical sponsors and community physician practices. It took on the administrative, regulatory, staffing and patient-recruitment burden of running trials inside private practices, and coordinated with pharmaceutical companies that reimburse and fund the studies. It also extended working capital to practices for the initial setup of clinical trial infrastructure, repaid by pharmaceutical sponsors during or after the trial.

Sources describe the company working with pharmaceutical industry and other trial sponsors to provide reimbursement and funding for trials run at partner practices, with practices offered both active and passive income models for participating in research; specific pricing or fee structures are not disclosed in the sources.

Traction

At its January 2022 launch the company was in beta with several community physicians and had signed five to 10 physician practices into a pilot program. By the time of the FOMAT acquisition it operated 10 sites across six states, with therapeutic strength in gastroenterology.

Latest developments

FOMAT Medical Research, a California-based community research network, acquired Topography Health, adding 10 locations across six states. FOMAT CEO Nick Focil said the deal accelerated FOMAT's embedded research model nationally, cited overlapping gastroenterology strength as a driver, and noted FOMAT's regulatory support, trained site staff and IRB relationships would be extended across all former Topography locations.