eCOA has moved from a supporting tool to a foundational pillar of modern clinical trials, and Everest Group agrees. In its inaugural eCOA Products PEAK Matrix Assessment, Everest named Medable a Leader, citing strong market impact, accelerated timelines, and a platform built for real-world trial complexity. As the eCOA market surges toward nearly $1B in value, this recognition underscores how speed, patient experience, and AI-driven innovation are reshaping how trials are designed, launched, and scaled globally.

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“Big corporations can’t rely on their internal speed to match the transformation that is happening in the world. As soon as I know a competitor has decided to build something itself, I know it has lost.” 

These candid sentences from Sanofi CEO, showcase one of the most common questions that’s at the forefront of every pharmaceutical company’s mind; whether to build or buy your way into the agentic and generative AI revolutions. 

In life sciences, many teams start with the same instinct. They see a capable large language model, stand up a proof of concept, and feel close to a breakthrough. For most of us, AI prototypes can look magical. A chatbot summarizes visit reports, drafts emails, or answers protocol questions in minutes. The experience is so strong that teams assume production is a short step away.

Unfortunately, the gap is much bigger than it looks. 

According to a recent MIT study, 95% of AI pilots will fail, as they note that “Only 5% of custom GenAI tools survive the pilot-to-production cliff, while generic chatbots hit 83% adoption for trivial tasks but stall the moment workflows demand context and customization.”

Like MIT’s example shows, moving from prototype to production in clinical research means building something validated, compliant, scalable, and integrated into real workflows. That takes far more than clever prompts. It requires domain grounding, continuous monitoring, retraining loops, robust tool orchestration, and evidence that the system is safe and auditable under regulations like GxP, HIPAA, and 21 CFR Part 11.

Many organizations only discover the hidden costs after they have committed. Internal teams often invest for two years, spend millions in sunk cost, and still never reach a dependable clinical grade system. The illusion comes from how easy it is to get an early demo working, and how hard it is to make that demo survive contact with trial reality. 

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