Akebia Therapeutics and its investors had hit a crossroads familiar to many startup biotechs last year. Its lead drug, AKB-6548, a pill for the anemia people get when their kidneys are failing, had just produced good enough data to move it into a Phase 2b study. If that went well too, the company would need to do a pricey late-stage trial if the drug were to have a chance to make it to market. So more money was needed—a lot of it. Meanwhile, rival drugs, some further along in development, were advancing.
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