SemperVirens invests in Trial Library

SemperVirens is proud to back Hala Borno and the incredible team at Trial Library as we co-lead their Series A with NEXT VENTŪRES and join the board alongside Deena Shakir and Jordan Pascasio. This round reflects a major step on Trial Library's mission to bring access to clinical trials to the point of care.

The more time I spend with payers and employers in our network, the clearer one thing becomes: specialty drugs are breaking the budget. Oncology drugs are not only the largest portion, representing $250B today, but also the fastest growing one. Payers are desperately seeking ways to reduce oncology drug costs, but one strategy remains sorely underutilized: clinical trials.

Clinical trial optimization creates a rare win-win-win-win: pharma gets the recruitment it needs, providers expand their therapeutic toolkit, patients gain access to innovative care, and payers can shift a significant portion of drug costs onto sponsors, who pay the majority of treatment costs for enrolled patients.

Despite this clear incentive alignment, only 5% of eligible patients ever enroll in a trial because the system lacks adequate infrastructure to recruit, refer, enroll, and navigate patients. Trial Library is building that infrastructure.

Why We Invested in Trial Library

One of the core pillars of my oncology thesis was that the most successful companies will align incentives across the "Four P's": patients, providers, payers, and pharma, to increase access, improve outcomes, and reduce costs. As I spent time with the payers and employers in our network, one area repeatedly surfaced as desperate for innovation: specialty pharma. Digging into the data made the picture even clearer - oncology dominates the specialty drug budget as not only the leading cost category, representing $250B in 2024, but also the fastest-growing one. While payers are aggressively seeking strategies to curb oncology drug costs, one of the most powerful cost reduction tools remains sorely underutilized: clinical trials.

Clinical trial optimization creates a rare win-win-win-win: pharma gets the recruitment it needs, providers expand their therapeutic toolkit, patients gain access to innovative care, and payers can shift a significant portion of drug costs onto sponsors, who pay the majority of treatment costs for enrolled patients. Despite this clear incentive alignment, only about 5% of cancer patients ever enroll in a trial - not for lack of science, but for lack of access. Up until now, access to clinical trials has been stifled by the absence of centralized infrastructure to recruit, refer, enroll, and navigate patients. Trial Library is building that infrastructure.

By connecting life sciences organizations, community providers, and patients, Trial Library is building a first of its kind, end-to-end solution that brings research to the point of care and expands who gets access to the future of medicine. Their recent entry into the payer and employer market, anchored by a groundbreaking partnership with AccessHope, marks another major step toward aligning incentives across the entire oncology ecosystem.

As we co-lead Trial Library's $10 million Series A with NEXT VENTŪRES, we're backing more than a company, we're backing a mission to make access to innovative treatments the standard of care. Our investment in Trial Library also reflects a theme that's central to our philosophy at SemperVirens VC: when all stakeholders win, innovation scales sustainably.

Backing a Clinical Leader with a Proven Track Record

Trial Library is led by Dr. Hala Borno (Founder and CEO), a Medical Oncologist and Associate Professor at UCSF with extensive experience in oncology trials. She previously led the UCSF recruitment science lab, served as Medical Director of the UCSF oncology clinic, and has over 100 peer reviewed studies, many focused on increasing diversity and inclusion in clinical trials.

Hala's inspiration for starting Trial Library stemmed from direct experience. At UCSF, she developed a provider-facing search platform that reshaped how trial availability was communicated within the health system. Her rare combination of deep industry knowledge, relevant professional experience, and mission-driven leadership give her a unique edge to build the next generation clinical trial ecosystem.

Improving Efficiency for Trial Sponsors

The market for clinical trials is expected to grow from $126 billion in 2025 to $187 billion by 2034. Despite a massive TAM, existing approaches for recruiting patients for clinical trials are highly inefficient, leading to longer trial times, increased costs for sponsors and diminished access to care for patients.

These inefficiencies are extremely costly. About 80% of clinical trials are delayed due to recruitment issues and with the average cost of a new drug at ~$2.6 billion, each day delayed can result in $8 million of additional costs for sponsors. By improving recruitment and enrollment workflows with AI, Trial Library boosts enrollment efficiency and reduces delay costs for sponsors. They currently work with some of the world's leading pharma companies, including Johnson & Johnson Innovative Medicine.

Engaging Community Providers in Research

In the U.S., dependency on provider engagement in research remains a major driver of slow recruitment in clinical trials. 77% of patients that enroll in an oncology trial do so after a provider recommendation, but only 13% of U.S. oncologists participate in research, and the majority practice at large, urban, academic medical centers. Despite research being centralized at large academic centers, 85% of patients with cancer are diagnosed and treated in community settings.

Trail Library bridges this gap by empowering community-based providers to identify and refer eligible patients at the point of care, using AI to match clinical profiles to open studies and navigate patients through enrollment. Today, the platform operates across 320+ clinics and 1,500+ providers nationwide, representing one of the largest networks of community oncology providers.

Removing Barriers for Patients

Social determinants of health (SDoH) like income, transportation, housing, and access to care account for up to 50% of health outcomes, yet remain significantly underaddressed in most healthcare solutions. In oncology, these factors often determine whether a patient even learns about a clinical trial, let alone participates in one.

Trial Library addresses this gap directly not just by recruiting patients, but also helping them overcome real-world barriers to trial participation. Through AI-enabled navigation and partnerships with payers and advocacy groups, Trial Library connects patients to transportation, financial counseling, language support, and coordination resources that make enrollment possible. Trial Library's focus on addressing SDoH barriers also leads to a more diverse recruitment pipeline: 69% of patient referrals were non-white, 29% were on Medicaid and 44% required transportation support.

For me, this investment represents a continuation of a deeply personal thesis: the most transformative healthcare companies don't just build technology, they increase access and rebuild trust in systems that have long lacked them.