Pros
Being a small team, every member has to take complete ownership of their work. I work on building customer applications, and I found that my successful contributions positively impacted the bottomline of the company (which was inspiring as well as an important responsibility to handle). Business development and sales folks are always pushing the boundaries to get new projects; over the years, there has never been a dearth of challenging work.
There is also a lot of flexibility in terms of choosing the nature of work, work hours, location (e.g. working remotely).
The team is super talented and a great work culture of mutual respect exists in the organization. If you like it here, you will probably stick on for quite long. Almost everyone I have worked with at the company (including those who chose to move on to other positions) was fantastic to work with.
Cons
Paradigm4 builds applications in collaboration with scientists and technologists at top R&D pharma companies in the world. Sometimes projects get waylaid due to internal reorganization within those companies, or market forces that are beyond the control of even those pharma giants. In those situations, some promising projects might not get sufficient exposure. Basically, Paradigm4 follows a sales driven development model, and as you can expect, such a model will have its pros (you do not develop something that the market does not want) and cons (like stated above).