Boosting both brains – commercial opportunities for probiotic supplements and the gut-brain axis

Boosting both brains – commercial opportunities for probiotic supplements and the gut-brain axis

Boosting both brains – commercial opportunities for probiotic supplements and the gut-brain axis

In recent years, the intricate connection between gastrointestinal and mental well-being has emerged as a promising avenue for scientific exploration. Termed the gut-brain axis, the complex communication network between the gut microbiota and the central nervous system has revealed a new frontier in understanding the interplay between one’s gastrointestinal wellbeing and multiple facets of brain function, most notably mental health and cognitive performance. As our understanding of the link between the gut and the brain deepens, the theoretical case for utilizing probiotics to enhance both mental health and cognitive performance grows stronger. Although the evidence for consuming probiotics for mental well-being is still in its infancy, this class of probiotics, commonly referred to as psychobiotics, has firmly captured the attention of both academia and industry. As psychobiotics become an increasingly popular topic of discussion in mainstream media, consumer demand has also rapidly begun to grow. Amazon sales data from ClearCut Analytics1 showed that whilst the American probiotic market as a whole grew by 18% in 2022, sales of probiotic products marketed for mood support grew by 33%.

In this paper, we delve into some of the key factors driving this consumer demand, and consequently why psychobiotics are a promising investment opportunity for VMHS companies in both the present and future. We provide a quick overview of the current regulatory landscape in some of the largest markets, which depicts a cautiously optimistic outlook for the future. We conclude with some strategic considerations for how manufacturers should position their psychobiotics.


The current state of the evidence

The benefits of consuming probiotics for “gut health”, i.e., helping to prevent and/or alleviate gastrointestinal symptoms and/or illnesses, have been well established2. What is less well established is how, through the gut-brain axis, many of the same probiotic strains can have positive influences on both an individual’s cognitive performance and mental health. This research is still very much in its infancy. A decade ago, much of the evidence supporting this connection came from animal studies, with limited research conducted in humans. In recent years, however, there has been a notable shift towards human studies, demonstrating progress towards establishing proven psychobiotic effects in individuals. Table 1 summarises some of the most prominent literature reviews restricted to humans only.

Eastwood et. al (2021)3 conducted a systematic review on the effect of administering probiotics on cognition and reported a positive effect in 21/25 studies. Den et. al (2020)4 focused their meta-analysis on patients with Alzheimer’s and mild cognitive impairment and found that cognitive performance was greatly improved in both groups. Gambaro et. al (2020)5 focused their review instead on the effect on anxiety and depression, demonstrating that probiotics improved depression and anxiety symptoms in 53.83% and 43.75% studies, respectively. Chao. et al (2020)6 conducted a meta-analysis of RCTs comparing patients with anxiety or depression against healthy patients. They found probiotics to reduce depression scores for patients with anxiety and/or depression, as well as healthy patients under stress. However, they found no reduction in anxiety symptoms amongst any of these groups. Similarly, El Dib et. al (2021)7 found probiotics to improve depression and anxiety symptoms only when certain depression and anxiety indices were used. Finally, Silva et. al (2021)8 found probiotics to have a significant effect on depressive symptoms in patients already diagnosed with depression, but not in healthy patients.

Table 1: A selection of recently published literature reviews limited to human studies
Table 1: A selection of recently published literature reviews limited to human studies
*5 studies on young children were excluded due to confounding factors, particularly neurocognitive development being too rapid at this age to see any effect of probiotic intervention

The evidence to date remains mixed, with most reviews concluding that more large scale RCTs are required. And the lack of available RCTs means strain-specific reviews are, to date, unavailable. That being said, most reviews to date conclude on an optimistic note regarding the potential of strains developed specifically for mental wellbeing. The large number of studies demonstrating at least a modest cognitive benefit, combined with the low cost and risk profiles of probiotics, make it a very appealing area to watch for academics, healthcare professionals, and consumers alike.  

Although more evidence will be needed to achieve widespread acceptance in the eyes of both academia and regulators, increased demand for psychobiotics is likely also being driven by the rapidly growing body of evidence of the gut-brain axis in general. Between 2018 and 2022, the number of papers published referencing the gut-brain axis more than doubled from 15,000 to 32,000 (see below).

Number if oybkusged artuckes avaukabke ib Giigke Sgickar rekated to the search term
Figure 1: Number of published articles available on Google Scholar related to the search term “Gut-Brain Axis”

Meanwhile, a 2021 survey by the IFIC (International Food Information Council)9 found that the most common reason cited for consuming probiotics was to support gut health (51%), ahead of general health and wellness (38%). Since probiotics are considered almost synonymous with the gut, an increased understanding of the gut-brain axis will likely drive probiotic demand without all consumers demanding causal evidence. Despite the relative novelty of the gut-brain axis in contemporary discourse, the same survey showed that 13% of probiotics consumers already claim to take probiotics for their mood and emotional health.


Mental health, wellness, and choosing a supplement

Demand for psychobiotics is also likely being driven by rapidly increasing prevalence rates of mental health disorders. A 2022 study by Healthy Marketing Team found that mental wellbeing has become the top health trend expected to drive consumer supplement choices10. The World Health Organisation estimates that approximately 280 million people in the world have depression, a comparable number of people have anxiety, and that both these figures increased by roughly 25% during the COVID-19 pandemic11.

Increased emphasis, awareness and destigmatisation around seeking treatment for mental health issues, particularly in high-income and western markets, may also be driving demand. A 2019 survey by Alight showed that 2,500 US office workers ranked mental health as the second most important aspect of their wellbeing, ahead of physical and social (the number one aspect was financial)12.

Conversely, mental health still carries a significant stigma in many societies. The simplicity, discretion, and relative affordability of integrating psychobiotics into one’s lifestyle may appeal to those who have been hesitant to explore traditional mental health treatments.

The broader wellness and self-care movements have also heavily contributed to the increase in psychobiotic demand. A 2021 survey by McKinsey of 7500 consumers located in the US, UK, China, Japan, Brazil, and Germany showed an increase in the prioritisation of wellness across all six markets13. 42% of respondents considered wellness to be a top priority, and respondents unanimously defined wellness as encompassing both physical and mental health.

Consumers are now more proactive in taking charge of their health and well-being than ever, seeking out products that offer preventive benefits beyond merely addressing symptoms. Additionally, these consumers have shown increased demand for products which they deem ‘natural’, as well as products which can offer multiple health benefits at once. Psychobiotics align perfectly with this trend, offering a proactive and preventive strategy for maintaining both mental and gastrointestinal wellbeing. As psychobiotics are widely available in multiple forms, including supplements, fortified foods, and functional beverages, the ease of incorporating them into one’s daily routine, as well as finding the psychobiotics best suited to one’s own body, is very appealing to those consumers who value wellness.


The current state of the psychobiotic supplement market

As previously mentioned, sales of probiotics marketed for mood grew at 33% on Amazon in the US in 2022, making it the fastest growing segment of the probiotic market. Despite this sharp increase in demand, the market for psychobiotics has a long way to go to catch up to probiotics marketed for gut health. Sales for probiotics with a pure digestive health focus actually experienced a slight decline (-0.2%) in 2022, but remained the largest segment at $130 million, compared to a mere $4.4m for mood-focused probiotics.

We focused our analysis on the US supplement market as it has a uniquely high use of supplements, with 30% of consumers choosing to get their probiotics from supplements rather than natural foods like yogurt (the next closest market was the EU at 14%)14. provides a good lens through which to analyse the US supplement market, as a survey by Trust Transparency showed that 55% of US consumers purchased their supplements online15  and Amazon naturally accounts for the lion’s share of those sales. Online supplement sales have also been the fastest growing sector for supplement sales throughout the last decade, which was further accelerated due to the COVID-19 pandemic.

A quick analysis of the Amazon marketplace for psychobiotics shows that it is particularly fragmented. Research by Clavis Insights16 shows that the minimum number of reviews needed for a product on Amazon to be competitive is 21. Of the hundreds of psychobiotics available on Amazon which meet this minimum criterion, the average number of reviews is well below 100. Only three products received over 1,000 reviews, of which the clear market leader is Garden of Life’s “Mood+” with 6000 reviews and over 10,000 bottles sold per month. Figure 2 showcases the current top three highest selling psychobiotics on Amazon, contrasted with four of the most popular probiotics positioned for gut health.’s best-selling probiotic supplements positioned for both gut and mental health
Figure 2:’s best-selling probiotic supplements positioned for both gut and mental health.

Such fragmentation may demonstrate a lack of consumer loyalty (a survey by Accelerate Associates showed that 75% of consumers would be willing to switch supplement brands17), but the lack of a dominant company or product can also be interpreted as a signal that the market has yet to be ‘won’. The barrier to entry for psychobiotics will be comparatively lower than other probiotic market segments with strong incumbents, and the lack of consumer loyalty means that anyone can currently compete. Finally, fragmented markets offer a greater opportunity for product differentiation. Manufacturers have the ability to tailor their products to specific mental health concerns and carve out a distinct market presence.

One of the more surprising findings is that, despite the comparative lack of evidence for probiotics and mental wellbeing, consumer reviews are largely comparable to the average of probiotics across categories. An examination of consumer reviews by Lumina Intelligence between 2017 and 2020 across 1400+ brands and 25 markets showed an average review of 4.47 stars out of 5 for probiotics positioned for mental wellbeing, as opposed to 4.53 across all probiotics18.

Analysing the consumer reviews of the top three products on highlights how probiotics align well with the aforementioned trends of holistic health, products with multifaceted benefits, and general wellness, which in turn results in consumer satisfaction.

GBA customer reviews

Where to play

Although official health claims are not the only way to build credibility with consumers, regulatory hurdles have presented the biggest challenge so far for VMHS companies looking to market their probiotic strains as psychobiotics. Nevertheless, our long-term outlook remains positive, as regulatory authorities in certain EU markets, USA, Canada, and Brazil are gradually adapting to the growing scientific evidence and consumer demand for psychobiotics.

psychobiotics EU

The EU has historically been the most reserved. Guidance issued by the European Commission in 2007 on article 1924/2006 stated that the average consumer perceives the term probiotic as “implying a health benefit”, and the phrase “contains probiotics” should therefore require a health claim authorisation. In practice, “contains probiotics” cannot be authorised as a health claim, due to the fact that a health claim requires the phrase to imply a relationship between a food or supplement and a constituent of health, which it lacks (see information published by International Probiotics Association for more details). As a result, European markets have suffered a de facto ban on using the phrase probiotics on their supplement packaging.

As a result of this, and without any further guidance from the commission, multiple EU markets have instead adopted their own approach on the use of the term probiotic and any associated health claims. National guidelines already exist in Italy, Spain, France, Bulgaria, and the Czech Republic, whereas many other European countries have been turning a blind eye to using the term probiotic on labels and in communication.

Manufacturers seeking regulatory approval from the EU may also consider a riskier but potentially more lucrative route of marketing the product as a Neuromodulator, making it subject to Regulation 1924/2008. Guidance on this regulation published in 2012 covers some of the scientific requirements for health claims related to the nervous system but does not clearly state the data requirements/study outcomes. More than 50 probiotics have attempted to make claims related to cognition under this regulation, but no claims have been authorised so far. That said, Vitamin B7 was granted the claim “contributes to normal psychological function” in 2010, despite academia not knowing the full extent of the role it plays in the nervous system.


psychobiotics US

The US has been more liberal so far, offering multiple regulatory routes that manufacturers can take to bring their products to market. Firstly, if a dietary supplement has been on the market since before October 15, 1994, the FDA does not need to be notified about the product. If a manufacturer chooses to submit a health claim, defined as “a product that is intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease, and that its intended use affects the structure or any function of the body” then an Investigational New Drug (IND) application needs to be file with the FDA, which requires clinical trials. However, if the manufacturer instead chooses to submit a structure function claim, defined as “the effect that a substance has on the structure or function of the body, which does not make reference to a disease” it does not need to be authorised or reviewed by the FDA. Instead, the manufacturer must cite publicly available literature on human and animal trials which support the truthfulness of the claim.


psychobiotics are Canada (2016) and Brazil (2019),

Finally, two particular cases of encouraging legislation directly related to psychobiotics are Canada (2016) and Brazil (2019), where in both cases strain-specific health claims were approved related to stress and anxiety.


Authorised psychobiotic health claims in Canada & Brazil
Table 2: Authorised psychobiotic health claims in Canada & Brazil

Positioning your product

So how should manufacturers position new probiotic products? Assuming for simplicity that the strain(s) in question have shown promise in aiding both gut and mental health, there are still a number of strategic considerations which need to be taken into account.

Positioning for gut health offers a mature market, a large evidence base (leading to more regulatory freedom), and high awareness among the general population, at the cost of lower growth and market saturation. Positioning for mental health allows manufacturers to differentiate themselves and tap into a rapidly growing segment. It also may be easier for manufacturers to create a more compelling emotional connection with their consumers, thereby increasing brand loyalty. Nevertheless, the segment has a long way to go to reach the size of the gut health probiotics market. Furthermore, regulatory concerns may limit market access. Some manufacturers may choose to add extra active ingredients to ease regulatory burden, at the cost of complicating the manufacturing process and impacting margins.

There is an opportunity to capitalise on the trend of holistic health by marketing for digestive and mental health simultaneously. As many consumers are beginning to recognize the interconnectedness of various aspects of health, including gut health and emotional well-being, a comprehensive messaging may resonate better with individuals who understand that a healthy gut can positively influence mood (and vice versa) but are unsure what supplements can aid in this process. In theory, a probiotic marketed for both would have a larger addressable market, as it could address the needs of both consumers seeking primarily gut health solutions as well as those prioritising mood enhancement. By highlighting both benefits, a manufacturer can also amplify the perceived effectiveness and therefore value of the supplement. Not only could this be a way to justify a premium price, but also to differentiate a product within the saturated market for probiotics.

The challenge of this strategy lies in the complexity of the messaging required to reach consumers. Consumer understanding of probiotics and the gut-brain axis has a long way to go before it reaches the public eye (like probiotics for gut health has). Choosing not to address the gut-brain axis may lead to consumer confusion due to two seemingly unrelated health claims.  This may in turn increase scepticism of the supplement’s efficacy. Addressing the gut-brain axis requires condensing an increasingly complex field of ongoing research into a language that not only consumers can understand, but which also resonates with them. Whether manufacturers can unlock the aforementioned benefits will therefore depend heavily on their branding and marketing campaigns.

Mapping out the pros and cons of each strategy reveals a complex landscape with no clear winner or one-size-fits-all approach. Each approach has its own set of pros and cons, and the optimal strategy depends on various factors such as available scientific evidence, target audience, market dynamics, and regulatory considerations.

Some potential Pros & Cons of positioning a supplement for gut health, mental health, or both
Figure 3: Some potential Pros & Cons of positioning a supplement for gut health, mental health, or both

How we can help

Sector & Segment has extensive experience supporting companies through every stage of launching a new product or campaign. Some of our areas of expertise include:

  • Sizing market demand and identifying key client segments
  • Conducting digital listening and identifying trends in consumer voices
  • Translating consumer insights into improving your product offering, pipeline, and positioning
  • Developing a tailored go-to-market strategy
  • Concept testing new products or campaigns with consumers and healthcare professionals


Christopher-James Dewilde, Consultant at

1. ‘ClearCut Analytics
2. Das et. al, ‘Current status of probiotic and related health benefits’, 2022
3. Eastwood et. al, ‘The effect of probiotics on cognitive function across the human lifespan: A systematic review’, 2021
4. Den et. al, ‘Efficacy of probiotics on cognition, and biomarkers of inflammation and oxidative stress in adults with Alzheimer’s disease or mild cognitive impairment — a meta-analysis of randomized controlled trials’, 2020
5. Gambaro et. al, ‘“Gut–brain axis”: Review of the role of the probiotics in anxiety and depressive disorders’, 2020
6. Chao et. al, ‘Effects of Probiotics on Depressive or Anxiety Variables in Healthy Participants Under Stress Conditions or With a Depressive or Anxiety Diagnosis: A Meta-Analysis of Randomized Controlled Trials’, 2020
7. El Dib et. al, ‘Probiotics for the treatment of depression and anxiety: A systematic review and meta-analysis of randomized controlled trials’, 2021
8. Silva, ‘The effect of probiotics on depressive symptoms: A meta-analysis of randomized controlled trails’, 2021
9. ‘Consumer Insights on Gut Health & Probiotics’,IFIC, 2021
10. ‘Healthy Marketing Team’, 2022
11. ‘World mental health report: Transforming mental health for all – executive summary’, World Health Organisation
12. ‘The state of employee wellbeing’, Alight, 2019
13. ‘Feeling good: The future of the $1.5 trillion wellness market’, McKinsey, 2021
14. ‘International Probiotics Association
15. ‘What’s Happening to Consumer Trust in Buying Supplements Online’, Trust Transparency, 2021
16. ‘Turning Amazon traffic into Amazon sales’,Clavis Insights, 2018
17. ‘Food supplements: Consumer buying trends’, Accelerate Associates, DATA
18.‘The Rise of Psychobiotics’, Lumina Intelligence

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Navigating Early Cancer Detection: Promises and Integration Challenges in Healthcare Systems

Navigating Early Cancer Detection: Promises and Integration Challenges in Healthcare Systems

Navigating Early Cancer Detection: Promises and Integration Challenges in Healthcare Systems

Early detection in cancer is crucial for improving patient outcomes, reducing treatment burden, and lowering healthcare costs for one of our largest global health concerns. Biomarker sequencing, enabled by advancements in genomics and sequencing technologies, has revolutionised cancer diagnostics by identifying specific molecules indicative of cancer development and progression. Multi-cancer early-detection liquid biopsies offer a promising approach for non-invasive and comprehensive cancer screening. However, successful implementation and adoption of these technologies require careful consideration of ethical, logistical, and regulatory challenges. To navigate these challenges, manufacturers must segment target populations to avoid overdiagnosis, facilitate the implementation of relevant technologies to allow the scaling of tests, as well as foster relationships with KOLs to ensure they are incorporated into clinical guidelines respectively.


The burden of cancer

Cancer poses significant challenges to our health, well-being, and the global healthcare community. As the second leading cause of global mortality, after cardiovascular diseases [1], it demands substantial attention and resources. Efforts to comprehend its complexities and develop effective treatment strategies persist, with the oncology pipeline representing more than a third of all speciality drugs in development in the US [2]. Our calculations have revealed that the direct medical costs incurred by the economy due to the treatment of the five most prevalent cancers exceed an astounding $520 billion annually.

An alternative approach to lowering the burden of cancer, aside from improving treatments, is through cancer screening and early diagnosis. When cancer care is delayed there is a lower chance of survival, greater problems associated with treatment and higher costs of care. In fact, the 5-year survival rate for the three most common cancers (breast, bowel, lung) is more than 6 times higher when the disease is diagnosed at the earliest stage compared to late-stage diagnosis [3]. Additionally, medical expenses have been shown to escalate significantly with each stage of cancer, as depicted in Table 1 [4]. The data highlights that, on average, a savings of $25,000 per patient can be achieved in the first 12 months by diagnosing the disease just one stage earlier.

Tumour Stage Average Costs per Patient (12 months after diagnosis) (USD)
0 $60,000
I/II $82,000
III $130,000
IV $135,000

Table 1: Estimated average 12-month costs following diagnosis for each cancer stage [4]


While tissue biopsy serves as a reliable tool for detecting and assessing cancer, its accessibility can be invasive and challenging, particularly in cases of metastatic diseases like late-stage lung cancer. Furthermore, tissue biopsy is impractical for early cancer screening when tumours have not yet formed. Although existing screening methods, such as mammograms for breast cancer, Pap tests for cervical cancer, and low dose computed tomography for colorectal cancer, have demonstrated effectiveness for specific types, they are limited in terms of sensitivity, specificity, and applicability to a single cancer type. In the United States, guidelines only recommend routine screening for four cancer types (breast, cervical, colorectal, and lung) [5], leaving approximately 70% of cancer deaths without standardised screening protocols [6]. Evidently, there is a pressing need for a comprehensive, cost-effective, and widely applicable cancer screening protocol to meet the demands of large-scale screening efforts.


Unleashing the potential of cancer biomarkers

Biomarkers have the potential to assume a critical role in cancer diagnostics as they encompass unique molecules, including genes, proteins, or other substances, that act as measurable indicators essential for detecting, diagnosing, and monitoring cancer within the body. DNA sequencing methods serve as a powerful tool for identifying cancer biomarkers, as they enable the precise determination of the sequence of nucleotide bases within a sample, allowing for the detection of genetic alteration and patterns of gene expression that are indicative of cancer development and progression. However, traditional methods of biomarker identification and DNA sequencing, such as Sanger sequencing, often involved studying one or a few genes or proteins at a time, which was laborious, time-consuming, and expensive. For instance, the sequencing of the entire human genome, encompassing the complete set of genetic information in humans, was achieved through the Sanger sequencing method. This monumental endeavour demanded nearly 15 years of intensive collaborations among numerous laboratories worldwide and cost approximately 100 million USD [7]. This bottleneck was preventing us from using these biomarkers to their full potential.

However, advancements in genomics and sequencing technologies over the last two decades, spearheaded by Illumina Technologies, Pacific Biosciences and Thermo-Fisher Scientific, to name a few, have successfully unlocked this opportunity. The development of second and third-generation sequencing technologies, often termed next-generation sequencing (NGS), offer a high-throughput and cost-effective approach to reading large amounts of DNA or RNA. The major market leader Illumina, which controls about 80% of the global DNA sequencing market, unveiled their NovaSeq X series late last year, which will reduce the sequencing cost to 200 USD per human genome while having the power to sequence more than 20,000 genomes per year [8]. This dramatic cost reduction and expanding capacity have significantly increased the accessibility of the technology, exemplified by the recent collaboration between Thermo Fisher Scientific and Pfizer to extend its reach to over 30 countries lacking affordable access to advanced genomic testing [9].

By leveraging the power of NGS, researchers have made significant strides in identifying novel cancer biomarkers across various cancer types. These biomarkers can be used for early detection, stratification of patients into appropriate treatment groups, and monitoring of treatment response, ultimately leading to more precise and personalised cancer care. The industry is now poised for rapid growth because of recent advances in the field, including more sophisticated diagnostic technologies and a great understanding of disease heterogeneity.


Biomarker sequencing has paved the way for liquid biopsies

With these NGS technologies in their arsenal, researchers and start-ups have now cast their eyes on liquid biopsies – a revolutionary blood test designed to detect circulating cancer DNA. As cells die, DNA fragments are expelled and circulate within the bloodstream. The rapid proliferation of tumour cells results in heightened cell death, leading to an excess of cell-free DNA being released into the blood, commonly referred to as circulating tumour DNA (ctDNA). The tumour-specific mutations in the ctDNA sequence can act as a new type of cancer biomarker and help to identify cancer patients from a group of healthy individuals, as described in Figure 1. Several companies are leveraging these markers to develop a single liquid biopsy test that can diagnose several cancers. These innovative screening tests, referred to as multi-cancer early detection (MCED) tests, employ NGS and artificial intelligence to identify and analyse ctDNA patterns. By doing so, they can accurately identify and locate cancerous tumours. In comparison to the conventional approach of cancer diagnosis using tissue biopsies, these MCED liquid biopsy tests offer earlier detection, scalability, minimally invasive procedures, and hold great potential for detecting rarer forms of cancer.

A basic overview of the MCED test journey.
Figure 1: A basic overview of the MCED test journey. [Illustration made by S&S]

A brief overview of the current MCED landscape

There are several early detection tests harnessing these concepts that are currently in development, some of which are presented in Figure 2. The competitive landscape is rapidly evolving, with numerous companies and start-ups actively pursuing advancements in the field. A few key players have emerged, each striving to develop their own proprietary technologies and methodologies for comprehensive cancer screening.
A non-exhaustive mapping of the current MCED market landscape.
Figure 2: A non-exhaustive mapping of the current MCED market landscape.

The Galleri test developed by GRAIL stands out as particularly promising. This innovative test harnesses the power of NGS and machine-learning algorithms to analyse indicative methylation patterns observed in ctDNA. The test boasts the capability to identify a distinct signal that is shared by more than 50 different types of cancer, and their latest findings provide compelling support for this performance claim [10]. To enhance the adoption and reach of the product, GRAIL is undertaking multiple strategic initiatives, including a collaborative effort with the U.S. Department of Veterans Affairs to screen 10,000 veterans [11]. Furthermore, the company is currently conducting a large-scale study with the National Health Service involving approximately 140,000 participants in the UK [12]. This ambitious endeavour is projected to conclude by early 2026, aiming to provide the necessary evidence required to prove its efficacy for early detection. Although Galleri is yet to obtain Food and Drug Administration (FDA) approval, the test is available to older patients in the U.S. with a higher cancer risk under a Clinical Laboratory Improvement Amendments (CLIA) waiver [13].

Acknowledging the immense potential of this technology, GRAIL was acquired in 2021 by Illumina Technologies, the aforementioned front-runner in NGS technologies, for an astounding $7.1 billion [14]. However, to foster competition and lower market entry barriers, regulators in the United States and Europe have mandated Illumina to divest GRAIL in early April of 2023 [15]. This action by the Federal Trade Commission underscores their recognition of the technology as a critical solution, indicating ample room for further growth and the entry of other players into the market.

In 2019, Thrive entered the field of multi-cancer early detection with their CancerSEEK technology backed by $110 million in Series A funding, marking the largest investment ever for a John Hopkins-licensed technology [16]. Their MCED liquid biopsy test combines genetic mutations in cfDNA with the analysis of nine proteins, enabling screening for eight prevalent cancer types that account for over 60% of cancer-related deaths in the U.S. Notably, this includes four cancer types for which there are currently no available screening tests. Conducting a comprehensive study involving over 1,000 patients, Thrive achieved an impressive average detection rate of 70%, catching 98% of ovarian cancers [16]. Despite the scope of CancerSEEKs screening range being narrower than that of Galleri, Thrive was still acquired by Exact Sciences (a molecular diagnostics multinational) for up to $2.15 billion just 2 years after its establishment [17].

Although these tests are not meant to replace existing screening methods (mammograms, Pap tests, colonoscopy, PSA blood tests, etc.), they can serve as valuable complements to current screening strategies and aid in the detection of other types of cancers lacking established screening protocols. But of course, much work is needed, and with experience and larger samples, these assays will improve. With sequencing consistently becoming cheaper and more accessible, it is only a matter of time before this technology is made viable. This leads us to the next considerable challenge – how will this technology be implemented?

Charting the path to successful market adoption

Companies with new early cancer detection technologies need to be vigilant and address several key aspects to ensure successful implementation and adoption:

regulatory landscape Firstly, the regulatory landscape plays a vital role in the implementation of MCED tests. Striking a balance between facilitating innovation and ensuring rigorous oversight is essential. Regulatory authorities need to establish clear guidelines and standards for the use of these tests, positioning the technology to promote public trust whilst fully leveraging its potential. This undertaking is far from simple, as exemplified by the utilisation of prostate-specific antigen (PSA) in cancer screening, where the ongoing controversy regarding the trade-off between screening benefits and the risks of overdiagnosis and overtreatment has resulted in divergent protocols between the US and UK [19-20]. It is evident that regulatory guidelines can differ across countries, further complicating the journey towards achieving global market access.

the integration of multi-cancerFurthermore, the integration of multi-cancer early detection tests into the existing healthcare system presents logistical and economic challenges. These tests often involve complex technologies, such as the discussed NGS technologies and advanced data analytics, requiring specialised infrastructure and expertise. Implementing these tests on a large scale demands substantial investments in laboratory capabilities, efficient workflows, and healthcare professional training.

To drive market adoptionTo drive market adoption, active engagement with stakeholders is essential. Key opinion leaders (KOLs) play a crucial role in disseminating best practices, establishing guidelines, and advocating for the adoption of MCED tests. Collaborating with healthcare professionals enables education and heightened awareness about the numerous benefits of early cancer detection. Moreover, establishing favourable reimbursement policies through collaboration with insurers and policymakers facilitates the seamless integration of these tests into healthcare systems. By actively engaging with stakeholders, manufacturers can accelerate the widespread adoption of MCED tests and enhance the impact of early cancer detection efforts.

ground-breaking technology Lastly, the successful implementation of this ground-breaking technology necessitates a comprehensive strategic analysis to identify the target populations. Certain individuals without symptoms may harbour a non-life-threatening cancerous tumour that has minimal impact on their quality of life. It raises ethical considerations about whether it is justifiable to impose upon them the stress of a diagnosis and the potential side effects of treatments. Moreover, the issue of false-positive results should be considered. Galleri, for instance, currently boasts a sensitivity of 99%, implying that 1 in 200 individuals may receive a false-positive result [18]. While these statistics are likely to improve as the product evolves, it begs the question of whether subjecting the general population to the emotional burden of a false-positive outcome is sensible. Alternatively, it may be more prudent to categorise populations into risk groups based on factors such as age, genetics or specific exposures.

How can Sector & Segment help?

After all this extensive research into the technology and the validation of its efficacy, companies now need to begin considering their implementation strategies to ensure optimal market adoption. With a wealth of experience, the Sector & Segment team excels in researching and quantifying the specific needs, attitudes, and preferences of key stakeholders. By leveraging our expertise, we can help companies in the early cancer detection space pinpoint the differentiating factors that will drive success in the market. Specifically, our experts can provide support through:

  • Providing strategic guidance and expertise in the context of a merger or acquisition, including assessing target companies, conducting due diligence, and identifying synergies to maximize value creation during the deal process.
  • Assisting in patient segmentation and stratification, considering how oncologists from different cancer fields profile their patients, to facilitate the adoption of MCEDs.
  • Conducting market analysis and assessing the landscape for multi-cancer early detection tests, including market potential, competitive landscape, and regulatory considerations.
  • Conducting feasibility studies and financial analysis to assess the economic viability and potential ROI.



Luca Flury, Consulting Analyst at 

1. H. Ritchie, F. Spooner, and M. Roser, ‘Causes of death’, Our World in Data, 14-Feb-2018
2. M. Gavidia, ‘Growing innovation, cost expected in the Oncology Drug Pipeline’, AJMC, 15-Oct-2022
3. ‘Why is early cancer diagnosis important?’, Cancer Research UK, 30-Mar-2023
4. Blumen H, Fitch K, Polkus V. Comparison of Treatment Costs for Breast Cancer, by Tumor Stage and Type of Service. Am Health Drug Benefits. 2016 Feb;9(1):23-32. PMID: 27066193; PMCID: PMC4822976.
5. ‘Cancer screening tests’, Centers for Disease Control and Prevention, 20-Jun-2023
6. ‘Grail presents real-world experience with the Galleri® multi-cancer early detection test at 2023 ASCO annual meeting’, Business Wire, 03-Jun-2023
7. M. Kchouk, J. F. Gibrat, and M. Elloumi, “Generations of sequencing technologies: From First to next generation,” Biology and Medicine, vol. 09, no. 03, 2017
8. ‘Illumina unveils revolutionary NovaSeq X series to rapidly accelerate genomic discoveries and improve human health’, Illumina
9. ‘Thermo Fisher Scientific & Pfizer Partner to Expand Localized Access to Next Generation Sequencing-Based Testing for Cancer Patients in International Markets
10. ‘Grail announces final results from the Pathfinder Multi-Cancer Early Detection Screening Study at ESMO congress 2022’, GRAIL, 11-Sep-2022
11. ‘Grail announces collaboration with U.S. Department of Veterans Affairs and the Veterans Health Foundation to evaluate Galleri® Multi-Cancer Early Detection Test’, GRAIL, 31-May-2022
12. ‘Grail and National Health Service (NHS) England complete enrollment of 140,000 participants in largest study of multi-cancer early detection test’, GRAIL, 18-Jun-2022
13. ‘Grail receives New York State approval for Galleri Multi-Cancer Early Detection Blood Test’, GRAIL, 20-Sep-2021
14. ‘Illumina acquires Grail to accelerate patient access to life-saving multi-cancer early-detection test’, Illumina, Inc. – Illumina Acquires GRAIL to Accelerate Patient Access to Life-Saving Multi-Cancer Early-Detection Test, 18-Aug-2021
15. A. Kim Constantino, ‘FTC orders Illumina to divest $7.1 billion acquisition of Cancer Test Developer Grail
16. A. A. Idrus, ‘With $110M and Johns Hopkins Tech, thrive aims to make early cancer screening routine’, Fierce Biotech, 30-May-2019
17. A. A. Idrus, ‘Exact Sciences snaps up liquid biopsy company thrive in $2.15B deal’, LIVRO, DATA
18. ‘Grail announces positive new data with multi-cancer early detection blood test from CCGA study’, GRAIL, 31-May-2019
19. ‘American Cancer Society recommendations for Prostate Cancer Early Detection’, Information and Resources about for Cancer: Breast, Colon, Lung, Prostate, Skin, 24-Feb-2023
20. ‘PSA testing’, NHS choices, 18-Oct-2021

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Successful patient outcomes through patient-centric education: the role manufacturers should play

Successful patient outcomes through patient-centric education: the role manufacturers should play

Successful patient outcomes through patient-centric education: the role manufacturers should play

Patient education plays a key role in patient outcomes1 however it is often overlooked due to time constraints and patient shock at diagnosis, resulting in worst-case scenarios for the patient. A good example of this is diabetes. By managing diabetes, patients can prevent the worsening of the condition, and complications such as the need for a foot amputation. Nevertheless, almost 8,000 diabetes-related amputations are still conducted every year in the UK2. Why does this happen, if it is so preventable?

How informed a patient is will shape the trajectory or their journey, their treatment, and their interaction with their healthcare professionals (HCP). On the one hand, if patients are not informed, they can struggle to understand the causes and effects of their condition, the impact of the treatment and how their own lifestyle changes could affect their journey and recovery. This is particularly important for the 1 in 3 adults living with multiple chronic conditions3, as these are often both complex and require increased focus on the side of patients for effective management. On the other hand, a lack of patient awareness also creates challenges for the HCP, as they struggle to maintain patient compliance with monitoring visits and treatment engagement. Without effective education, patient needs suffer.

Patient education needs to be improved to positively impact patient outcomes. However, as HCPs have limited time to offer additional services to patients, manufacturers have the opportunity to play a big role in supporting patients from the start and throughout their journeys, becoming a life-long value partner.

Patients experience a significant life shift during diagnosis

Being diagnosed with a chronic condition brings forward several obstacles for the patient. Firstly, patients must understand their situation and what the course of treatment entails. This is often combined with the psychological need for an acceptance of the disease or ailment, as most patients experience shock, anxiety, depression and worry at the beginning of their journey4.

Additionally, patients must accept that the course of their life may now turn out differently. For example, in the case of diabetes, patients need to make adjustments to their diet. In the case of vascular disease, they have to give up certain physical hobbies. In the case of an ostomy, they have to adjust basic daily necessities. A large part of this relates to understanding the causes of their condition and how making changes in their lifestyle can help improve their health and prevent themselves from worsening.

Patients have a lot to ramp-up on about their condition, however, the majority of patients have low awareness and understanding of their ailment. Sector & Segment’s research has identified that this is not only the case at diagnosis but even years after living with the condition. As a result, patients do not make sufficient life adjustments and significantly hinder their health outcomes. These are the most common challenges that we have identified throughout our work in the healthcare sector.

Patients can experience complications if they don’t understand their condition straightaway

At the beginning of their journey, patients often receive a lot of material, which naturally results in them becoming overwhelmed. These patients may not process all the information and may have difficulty remembering key aspects once home from the doctor.

At the same time, HCPs have a lot to communicate to the patient at this time. In some cases, HCPs may see that the patient is overwhelmed and may not cover every topic in depth or from every nuance. In other cases, HCPs may simply forget to cover some of the peripheral health topics (such as nutrition) if they are not the essential treatment. In some cases, if the information is not understood immediately by the patient, it can cause complications to a procedure or treatment.

Sector & Segment conducted a multi-country project where we spoke with patients who developed surgical wound dehiscence following an operation. We observed that all the patients who experienced this complication were unlikely to have a deep understanding of what was expected of them post-surgery. Patients could not recall any specific advice from their HCP – which could have been resting, not smoking or drinking alcohol, eating healthily or not touching the wound. Consequently, these patients clearly could not understand how their behaviour resulted in a surgical incision not healing but were also unaware that their actions would have affected this outcome. This causes patients to disengage from their recovery and lose trust in their HCPs as well as the products that they are using for their treatment.

Without knowing the cause, patients have no solution

With some conditions, treatment alone is not enough – understanding and reversing the cause of the problem is essential. This is the case with chronic ulcers – while there is treatment for the wound itself, the main necessity is to treat the underlying condition which is causing the ulcer (e.g. diabetes or vascular insufficiency). By not treating the cause and only the wound, the patient can expect the ulcer to recur.

Sector & Segment conducted research across 4 countries which focused on the behaviour of patients with chronic ulcers. It was observed that awareness and understanding about the underlying condition was a key element missing across most interviewees. The research found that less than 10% of patients could confidently say that they understood the link between the underlying condition and how it has caused their ulcer. The remaining patients were not confident and could not explain the connection, and therefore were not following all the treatment recommendations for the underlying condition. Some of these patients had had their ulcers for over 2 years, but were still struggling to understand the cause and the treatment. The sample contained a variety of ages, work status, professions, and education levels, with no clear link found to the patient’s background. Without this awareness, patients are stuck in an endless loop with their chronic wounds, as they are not targeting the cause of the problem. The longer they are stuck in the loop, the less trust they have in the brands they are using for their treatment and the more likely they are to abandon the treatment altogether, potentially blaming the quality of the product and not their compliance levels.

Misleadingly, the situation doesn’t look that bad

One common issue seen with patients is them believing that “the worst case will not happen to me”. Patients often misunderstand how important it is for them to change their lifestyle after being diagnosed with a chronic condition. In most cases, the symptoms of the disease appear slowly, hence patients struggle to grasp the real impact of the diagnosis and often fail to make significant changes quickly enough.

While researching the diabetes patient journey, Sector & Segment heard from nurses in multiple countries that patients who are diagnosed with type 2 diabetes often struggle to understand how dangerous their diagnosis really is. The symptoms are often detected through routine blood tests and patients rarely feel a large difference in their daily lives. For example, it has been proven often that if patients lose a significant amount of weight, then they may be able to reverse the diagnosis5. However, given the lack of will and understanding from patients, this occurs infrequently.

Likewise, patients who severely mismanage their diabetes can develop diabetic foot ulcers which can result in amputation – a drastic complication all patients are taught about. However, wound care nurses comment that they regularly see patients with diabetic foot ulcers who have tried to treat it at home with aloe vera, only coming to see an HCP months later when the wound has significantly deteriorated. If patients were guided to treatment earlier on in their journey, they may be more inclined to follow the treatment and use the products available for their treatment, improving their outcomes and quality of life.

Misinformation online knocks patients off-course

Once the initial shock after the diagnosis subsides, curious and proactive patients may decide to begin conducting their own research on the condition, which mostly involves online research. Patients trust reliable sources such as government healthcare websites or patient association materials – however there is also a lot of other misleading information on the internet which could point the patient in the wrong direction, such as websites which may have the word “health” in the title but don’t have HCP backing.

Sector & Segment has observed oncologists across many markets complain that cancer patients believe that “sugar feeds cancer”, after reading this online. Happening upon this information, patients cut down on their eating and begin to lose weight. In reality, a consistent calorie intake is important for cancer treatment as the patient will require this energy to recover6. Oncologists spend a large proportion of their monitoring sessions “debunking” this myth and convincing patients to continue their normal eating habits.

It would be logical to assume that those patients who conduct online research about their condition are generally more interested in their care and would therefore have better clinical outcomes. However, the amount of misinformation available can hinder their healing process. Likewise, some conditions can have varying degrees of co-morbidities and severity, and patients may read correct advice for their condition, but one which does not necessarily apply to them due to various factors which they, themselves, may not understand. Patient-centric materials which focus on the main challenges patient face could raise condition understanding and improve patient compliance long term.

Patient-centric tools and services are needed to support patient engagement

To support patients, the education resources available to them should focus on their needs and their challenges. For example, if patients find it difficult to assimilate necessary information following diagnosis, then resources in the form of physical or online leaflets should provide them with an easy-to-read guide of “essential things to know after diagnosis” – this would allow patients to read in their own time and be able to refer to it as needed. Currently, this information is available on the internet, but not necessarily in one place for each condition.

Resources should be designed with the patient in mind, as often patients must rely on medical websites which are geared towards HCPs and are therefore quite difficult to understand. Hence, websites with a more approachable tone may educate the patient more holistically.

Endorsements by knowledge opinion leaders and expert HCPs can also help provide credibility and show patients that a source can be trusted. Whatever the resource, it should not only educate patients broadly, but also meet the patients’ needs and challenges, to support them on their journey.

Manufacturers need to play a large role in patient support, because no one else will

HCPs and healthcare systems alone do not have the resources to develop and provide the education and materials which patients require, hence product manufacturers have a large role to play in this regard to improve patient outcomes. By supporting the patient in the beginning, they can become a value partner and gain patient loyalty throughout the journey. It is important to engage patients early on, to ensure that they have a good understanding of how their own lifestyle changes can affect their treatment and to ensure there is trust between the patient and the healthcare ecosystem. Later on, as the patient progresses with their condition and accepts it, they may have other needs which need addressing such as the variety of products and treatments available to them. Simultaneously the manufacturer can support the HCPs by lessening their burden.

By supporting the patients throughout their condition, manufacturers can improve patient compliance and engagement, as well as improving clinical outcomes and patient quality of life. Depending on the condition and the needs of the patients, manufacturers could be providing a variety of solutions.

One option would be providing bespoke educational materials, such as the dedicated website about nutrition and cancer which has been designed by Nestlé Health Science7, which is a one-stop, verified source on everything a patient may want to investigate.

Similarly, manufacturers can provide tools for patients to track their daily activities and condition-related markers, an example of which is the My Ostomy Journey App by Convatec8, which allows patients to track daily intake, log foods, explore products and get instant help if needed.

Companies can also be offering emotional support for patients to avoid feeling alone in their fight. Pfizer designed their LivingWith app9, which not only provides cancer patients with information and trackers but allows patients to find support groups and make connections with other patients in their zip code.

Sector & Segment can support you with your patient-centric strategy

Sector & Segment has extensive experience deep diving into a market to understand the true challenges the patients and HCPs experience, as well as the patient needs that are not currently being met. Our experts can tailor your strategy according to the existing market dynamics, to best support the patient population and become a valued partner throughout the patient journey.

We can leverage our experience to help you:

  • Map out the patient journey and identify the largest pain points at each stage
  • Identify, segment, and quantify your customers by needs and drivers
  • Conduct digital listening and identify trends in consumer voices
  • Translate consumer insights into improving your product offering, pipeline, and positioning
  • Build materials such as patient testimonials, or working with your marketing team to script testimonial videos
  • Test online content with patients or with doctors


Margarita Svarceva at

1. Adams, ‘Improving health outcomes with better patient understanding and education’, Risk Management and Healthcare Policy, 2010
2. Office for Health Improvement and Disparities UK, ‘National Diabetes Footcare Report’, updated 2021
3. Hajat C, ‘The global burden of multiple chronic conditions: A narrative review’, Preventive Medicine Reports, 2018
4. DeJean et al. ‘Patient Experiences of Depression and Anxiety with Chronic Disease’, Ontario Health Technology Assessment Series, 2013
5. ‘Reversing Type 2 Diabetes’, Diabetes UK
6. Ravasco P. ‘Nutrition in Cancer Patients’, Journal of Clinical Medicine 2019
7. Nestle Health Science: My Cancer My Nutrition
8. Convatec: My Ostomy Journey App
9. Pfizer: LivingWith
Key Insights and Takeaways: GIANT Health Conference in London

Key Insights and Takeaways: GIANT Health Conference in London

Key Insights and Takeaways: GIANT Health Conference in London

In December 2022, our Consulting Managers Margarita Svarceva and Peter Hays attended the GIANT Health Conference in London. The two days were filled with engaging workshops, panels, and exhibitors. The conference was attended by many key stakeholders in the healthcare and innovation ecosphere including medical innovation start-ups, health and pharmaceutical companies, investors and regulators. Attendees were a mix of British, European and North American companies. We were immersed into the world of healthcare innovation, and we saw several key trends emerging. GIANT stands for ‘Global Innovation and New Technology’ show. The yearly event brings together individuals and companies in the healthcare innovation space through a 2-day exposition with 4 thematic presentation programmes. This year’s presentations were focused on Digital Pharma, the Future of Hospitals, Mental HealthTech and the new Integrated Care Structure in the NHS. The event aims to improve health and well-being of people around the world by facilitating healthcare innovation and supporting health-tech entrepreneurs and investors. The types of exhibitors present at GIANT Health 2022 can be segmented into the following categories, albeit not exclusively:

Figure 1: Lumeus app which uses music to encourage positive emotions (

Many companies are naturally offering a product or service through an app which can be easily accessed by the user or patient on their phone at any moment. A large majority were offering an app or included an app as part of their offering, either:
  • Offering a service through an online platform or phone app. Examples of this included mental health apps which support patients with chronic depression or anxiety, or platforms which allow patients with complex conditions to combine records from all their physicians in one platform, and to connect these physicians to share information and facilitate more integrated care.
  • Providing an app which links to a medical device or physical service. In this case, the companies are using technology for tracking and monitoring purposes but are collecting data through a physical device. This includes start-ups which are producing wearable devices for a specific patient group (e.g., Parkinson’s or Kidney disease) with the aim of alleviating symptoms, tracking essential daily markers or facilitating remote monitoring and communication, with the aim of assisting the care and treatment of a patient. These devices link to a platform or app, which is used for data collection, monitoring, communication and assistance.

Figure 2: The CUE1 is a wearable device designed by Charco Neurotech to help decrease symptoms of Parkinson’s disease (

Some of the start-ups offered more traditional medical devices independent of an app. These innovations provide either an improvement to healthcare infrastructure or a direct solution for a patient condition. This includes small-scale point-of-care testing, which are small devices that can provide various on the spot blood tests with results being available instantly. It also includes start-ups which had created a company around a new scientific approach or method. One example includes a company using genetic materials to identify bespoke treatment approaches for Oncology patients to improve outcomes. The companies that exhibited at GIANT Health in 2022 were on a spectrum of maturity. Some were newly created start-ups and still in development phases, while others were more mature companies with demonstrable success in one country looking to expand to new markets to find new patients or customers. A large proportion of companies were in-between, with a well-established offering but looking for investment and further support.

Our Key GIANT Takeaways

S&S sat in on various panels and industry discussions about the current challenges for MedTech and digital therapy companies and in particular the challenges new health technology companies have to navigate. We took the following lessons with us.

There is a lack of funding for implementation for MedTech and digitally enabled therapeutics

Across countries, but particularly in the UK, we are currently seeing an under-funded and under-staffed healthcare system. One remedy would be new technologies and innovation to supplement care with digital systems which provide support, monitoring and/or treatment to patients who are unable to access other forms of care. The challenge, however, is that while funding is readily made available for research and development of innovative technologies, this does not extend to implementation in the UK. This results in a large pocket of innovation, which is followed by brain drain, in which start-ups are seeking to launch somewhere they will receive more support. Consequently, the UK is losing out on many of the good ideas it helped foster.

Reimbursement is highly challenging for MedTech, particularly due to the need for real-world and clinical data

Figure 3: The PL Mini is a point-of-testing device which offers 37 different tests (

Most innovative digital therapies have a clear cost saving, process improvement or outcome improvement evidenced in their design. However, the current reimbursement frameworks treat these as a medical device rather than a treatment which comes with challenging regulatory hurdles. These start-ups are required to fulfil extensive evidence-based reimbursement criteria which can be challenging for many start-ups. Randomised control trials are expensive to conduct. Real-world data, which is collected from real patients or users as they engage with the digital treatment, are not always accepted, or are accepted with strict criteria. As a result, many digital therapies, which could complement the healthcare service, struggle to gain any reimbursement. On top of that, the NHS is a highly fragmented organisation with 42 ‘Integrated Care Systems’ (ICS). Once a new digital tool has enough evidence to even be reimbursed, they must deal with each ICS on an individual basis, which can be resource-draining for small start-ups. In reality, digital therapies are very scalable and easy to implement elsewhere once they are up and running – it is difficult to understand why they need to jump through the same hurdles again. A more open-minded NHS could integrate digital therapies to provide care to patients struggling to gain access to healthcare professionals.

There is a lack of understanding around the value of MedTech and digital therapies

Figure 4: Moonbird is an app-linked device which helps with anxiety by helping a patient control their breathing (

Tech tools and innovative platforms have been used in every industry for decades now. However, the healthcare system remains very slow at adopting organisational or monitoring technology which can lessen the current burden on care services. While there is constant news and updates about new ways technology is being used to make healthcare more accessible and equitable, as the GIANT Health London 2022 conference demonstrates, the existing systems are not realising the value that this technology brings. Healthcare has been the slowest at incorporating simple organisational tools into its daily function (e.g. online booking systems), hence advanced digital therapies such as specialised remote monitoring platforms, apps which deliver anxiety-reducing support or platforms which help track patients with chronic conditions, have not been incorporated into the NHS. The sheer low level of technological solutions available to patients, points to a clear lack of understanding on the value these could bring. Overall, most healthcare systems are not designed to be open to digital therapies and MedTech, and fail to take into account how their approach needs to be adjusted to bring them into the fold.

We can help guide you through the MedTech landscape

Sector & Segment has extensive experience working with Medtech companies to tackle the challenges we identify above. Challenges of funding, reimbursement and awareness are key pain points faced by most companies in the healthcare space. We have successfully worked with MedTech clients to identify whether public reimbursement is the best solution or if direct-to-consumer channels are more lucrative; whether a product is not being used due to awareness or due to negative perceptions; whether new market entry is an attractive strategy. Our experts could help you:
  • Map out drivers and inhibitors in the market
  • Size market demand and identify key client segments
  • Develop a go-to-market strategy tailored to your company and products
  • Concept test a new platform or product with healthcare professionals or patients


Margarita Svarceva at Peter Hays at
Enzymes: A New Frontier in Health Supplements

Enzymes: A New Frontier in Health Supplements

Enzymes: A New Frontier in Health Supplements

Within the rapidly evolving market of health supplements, enzymes have emerged as a powerful way for brands to distinguish themselves from competition. This type of innovation is crucial since consumers are increasingly discerning about ingredients and health impacts. This opportunity continues to grow rapidly – the dietary supplements market alone is projected to reach $340 billion by 2030 1. Incorporating enzymes can be a challenge, however, since their benefits are not always intuitive to consumers.

Enzyme supplements have a wide range of health benefits including alleviating digestive issues and boosting immunity. For example, consumers who can’t metabolise lactose in dairy, can take lactase supplements to avoid bloating and diarrhoea. Alternatively, they can help elderly consumers to increase their absorption of key nutrients from foods to prevent malnutrition (or sarcopenia). Malnutrition creates opportunities for infections and diseases, therefore enzymes can be critical for developing robust immunity. This can also apply to consumers keen on wellbeing and fitness since enzymes can increase nutrient absorption from meals and help them to achieve their goals. In short, enzyme supplements come with the promise of significant impacts on consumers, but their value proposition and the correct mode of use needs to be expressed clearly and convincingly.

Without clear communication, consumers can get confused or even get dissuaded from using enzyme supplements. Our research shows that when it comes to enzymes, most consumers are struggling to fully understand their benefits, their mechanism of action, and even how to consume them. This confusion can directly affect consumer perception of whether they are receiving the desired results from these products. We identified three common complexities faced by consumers and also draw inspiration from marketing strategies of successful businesses leveraging the science of enzymes in an increasingly crowded supplements market.

Taking the Pulse of the Consumer Experience around Enzymes

Figure 1: Instagram – “You don’t need digestive enzymes. You are just wasting your money on false claims”

A thorough understanding of the unmet needs and challenges faced by consumers is critical for marketing and business development teams. We monitored and analysed the opinions of consumers that use enzyme supplements across digital social platforms to identify how the enzyme supplements are received by consumers. Our research shows that many consumers in this space are primarily driven to test enzymes out of some digestive discomfort they experience. And among these consumers we were able to identify their key concerns around efficacy, directions of use, and perceived potential risks.

A common hesitation of consumers around using enzyme supplements stems from a general concern about their efficacy. There are two parts to this problem: Firstly, there is limited awareness on how the enzymes work, and secondly there is limited scientific evidence showing health benefits. Consumers struggle to fully understand the benefits of enzymes. While the “good bacteria for gut microbiome” tagline helps put benefits of probiotics in layman’s terms, our research found that the consumer experience is not the same for enzymes. The issue is further complicated when Healthcare Professionals chime in on social media to highlight that there is limited clinical evidence on the effectiveness of enzyme supplements.

Figure 2: Twitter – “I do take lactase enzyme pills, but they don’t work very well. I usually just try to eat cheese in moderation”

Owing primarily to a poor understanding of how enzymes work, consumers struggle to interpret labels on enzyme supplements. Since there are no regulated “daily values” (DV) assigned for enzymes, consumers can make assumptions about the optimal amount and use frequency for enzyme supplements. While some consumers express that they take their enzymes before/after an occasional risky meal, others state that they take them on a daily basis to boost their immunity or to build tolerance. Information such as the source of enzymes and “fillers” used to stabilise capsules are among the key information on the labels confounding consumers. And while some of this information can be found in technical details on the labels, consumers end up lost in the jargon.

Figure 3: Reddit – “Thank you everyone for your input!!!! I have a better overall opinion now due to everyone’s thoughts. I will still use enzymes because they do help me on a daily basis, but they aren’t an excuse to have whatever I want whenever I want. I will try fodzyme perhaps but I know that I cannot lean on that.”

Figure 4: Reddit – “My understanding is that the enzymes, including fodzyme, beano, lactaid, are meant to be used only on the occasional meal.”

Figure 5: Twitter – “I wish it said the individual doses of the ingredients. If it has a huge dose of serrapeptase I know some people have bad reactions to that. It’s up to you. The individual ingredients look good and I like the enteric coating.”

Consumers are also often hesitant to take enzyme supplements because they believe there is a risk of negative side effects, or a worsening of their condition. For example, although enzymes can be useful in treating bloating or irritable bowel syndrome (IBS) symptoms, some consumers worry that enzymes only offer a temporary relief or that they could worsen present symptoms with additional pain and cramping. In extreme cases, consumers fear that the enzyme supplements could induce acid reflux or even severe pain as a side-effect.

Enzyme supplements are primarily seen as digestive aids by consumers, and this perspective has constrained the expansion of these products to mass clientele. The prospect of expanding the consumer base beyond this segment is further hindered by the technical complexities explained above. Ignoring these concerns can foster uncertainty and consumer distrust.

How Can the Businesses Build Winning Propositions?

Neglecting or miscommunicating the health benefits of enzymes could mean failing to capture otherwise interested consumers. Effective consumer communication is dependent on good consumer research and a clearly defined and scalable consumer segmentation. As part of our research, we identified some ideas and best-practices from firms leveraging the science of enzymes:

Figure 6: Facebook – “It’s Official!”

When it comes to enzyme supplements, efficacy or correct use concerns can be addressed by building consumer trust with scientific evidence. One strategy for achieving both of these can be partnering with universities. For example, Fodzymes received “Monash University Low FODMAP Certification,” which adds credibility to their health benefit claims. The company (Kiwi Biotech) also announced that it has plans to conduct more peer-reviewed clinical studies with universities. Not only do these studies and certifications help with gaining consumer approval, but they can also offer persuasive evidence for Health Care Professionals. Since the FDA does not regulate the dietary supplements, organisations such as United States Pharmacopeia (USP) can provide a verification mark to confirm the claims on the labels of supplements which can help build consumer trust. Naturemade CoEnzymes is among enzyme supplements that have received this verification.

Figure 7: Wheat Rescue

Another way to demonstrate efficacy and build consumer trust can be by offering “mixed supplements” that include enzymes complementing probiotics or vitamins. This approach offers something patients can recognize while they are gradually acquainted with enzymes. This can be particularly attractive for businesses that already offer a spectrum of vitamin products. Since enzymes can increase the absorption and digestion of the complementing nutrients, these “mixed” supplements would also allow consumers to maximize the health benefits from the product. Some businesses are already taking this approach to target consumers that are interested in improving their “gut health.”

Figure 08: Facebook – Fodzyme AMA

To address any perceived risks, businesses should be ready to address these concerns directly with their customers. Successful businesses understand that being attuned to unaddressed consumer needs is critical for research and innovation. By holding “Ask Me Anything” (AMA) sessions, or offering short explanatory videos, businesses can educate their customers about the health benefits of their products. Listening on the online conversations on platforms such as the Reddit, can help businesses determine a coordinated communication approach that can effectively engage target customers in a dialogue. This would provide a real-time opportunity for businesses to hear and engage with the “voice of the customer.”

Figure 9: Reddit – Fodzyme AMA

When consumers find labels confusing to follow, they can miss out on the intended benefits. In absence of scientific evidence and standardised labelling requirements, businesses can evaluate the existing labels to alleviate the confusion over the amount and frequency of use. Addressing this challenge can also mean an opportunity for product development and allow a newcomer to innovate their way into the supplements market. For example, rather than relying on capsules that can be used before or after meals, FODZYMES comes in powder form sachets which is sprinkled over food and consumed with meals.

Reaching New Customer Segments

Businesses have an opportunity to capture additional consumers through clear and direct communication. Each consumer challenge can hold opportunities to win market share from competitors and also to grow the market size by shaping consumer habits. Furthermore, it creates opportunities for product development in ways that address consumer concerns.

Sector & Segment partners with businesses to better understand the challenges and opportunities presented by consumers globally, and build go-to-market strategies accordingly. Our research experience is tailored to capturing the needs to consumers and patients in both consumer health and healthcare spaces, including:

  • Segmenting and sizing their consumers by need
  • Conducting competitive research to understand best-in-class practices, and
  • Delivering primary research with consumers, key decision-makers and healthcare professionals to develop informed marketing strategies.