Ramji Srinivasan - Cofounder and former CEO of Counsyl. Providing genetic screens at key times in life.

Ramji Srinivasan is a cofounder and former CEO of Counsyl, a genetic screening company that tests for hundreds of mutations and genetic disorders in parents who are planning to have children. After testing 1M patients, Counsyl was successfully acquired by Myriad Genetics in 2018. At the time of acquisition, Counsyl was one of the fastest growing health tech startups in Silicon Valley.?

Ramji is an accomplished operator in the life sciences space. But how did he get his start??

Upon graduation from Stanford University in 2003, Ramji went to work on Wall Street in investment research. He covered the top Silicon Valley startups. Seeing the Google IPO inspired Ramji to get involved in tech and after experiencing a difficult work environment at the bank, Ramji realized he didn’t want to work for anyone other than himself.?

After reading Paul Graham’s book, Hackers and Painters, Ramji made the decision to quit his job and blaze his own trail. However, he wasn’t sure what type of business to start. He applied and got into Stanford Business School. But Ramji got impatient, and caught the startup bug. And after the first year, Ramji dropped out of the MBA program to start his first company.?

Ramji was initially pitched on a genomics-related business idea by his brother and another eventual cofounder, Eric. Ramji had been focusing on mobile internet ideas but was intrigued when he learned that genomics was the next internet. The idea was extremely ambitious - they wanted to write software applications on top of a genome, which could theoretically cure diseases like Alzhiemers. However, after spending a year banging their heads against the wall, they eventually threw in the towel. They felt like scientists with a solution in search of a problem. It was just too challenging of a business and they wanted to start with something more feasible.?

They focused on Mendelian inheritance, which refers to how traits are passed from parents to offspring. The breakthrough occurred when they realized no one had made it easy to screen prospective parents for recessive conditions to identify the presence of potentially concerning genetics, such as risk of serious childhood diseases. They knew that their DNA screening process could be extremely useful to prospective parents, and after raising money, the team set out to productize their idea.?

The first two years were extremely tough. Ramji spent them mostly on a plane and on a futon. They worked near Stanford and spent their days cobbling a prototype together. They spoke to sperm donor banks and egg donor banks and were met with rejection. They then started introducing their tests to fertility clinics. Because the clinics were already doing a form of the testing, they were much more receptive to implementing the tests.?

And after product market fit was identified, the next step was to scale the organization.?

They began to invest in testing equipment as well as building the sales and engineering team. They worked with more and more IVF and OB clinics all over the country. And at the same time, the company expanded its test offerings. Counsyl raised numerous rounds to fuel their growth, and had some of prestigious investors on their cap table, including Founders Fund.?

In 2017, Counsyl pursued a dual M&A strategy. They would prepare for an IPO while at the same time consider acquisition bids. In 2018, Counsyl was purchased by Myriad Genetics for $375 million. Prior to the acquisition, Counsyl served ~1m patients, hit ~$150m in annualized revenue, and built a team of 500 employees.?

The acquisition was nearly 11 years from the start of the company and represented a huge achievement for Ramji, his cofounders, and the team.?

Ramji is now the cofounder and CEO of Teiko Bio, a company that performs immune profiling from blood.