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
Does more complexity mean more value for Medical Nutrition?

Does more complexity mean more value for Medical Nutrition?

Does more complexity mean more value for Medical Nutrition?

In the past 10 years, the Medical Nutrition (“MN”) sector has shown significant evolution of its sales and marketing approach. For a long time, this sector targeted dietitian teams based in hospitals with relatively simple product lines segmented by age groups (paediatric vs. adult), product formats (enteral vs. sip) and flavours.

But the context changed as hospital budget constraints driven by national government cuts put pressure on the costs associated with MN, which has often been regarded by payers and healthcare professionals (“HCPs”) as a mere commodity.

In response, MN manufacturers started adopting a different go-to-market approach, focusing on specific therapeutic areas and bringing some disease-specific innovations to the market in order to fight back commoditisation. Disease-specific MN products are intended to be so uniquely suited for a specific patient group that they can justify a premium price and still obtain better payers’ subsidies, provided they are supported by enough scientific and health-economic evidence.

By offering something uniquely suited to a disease rather than a generic nutritional solution, Medical Nutrition Companies hope to gain broader hospital recognition (including from specialist doctors) instead of being systematically referred to the “Dieticians’ floor” or “the kitchen”. This subsequently increases their chances of becoming core components of treatment protocols alongside pharmaceutical drugs.

Where do MN companies stand today against the adoption of a “disease-specific” model?

By analysing the way the top 4 global MN manufacturers present their product portfolio on their global websites we can see a concerted shift towards a “disease-specific” model (see table below).

Among these companies, Nestle Health Science and Nutricia Advanced Medical Nutrition appear to be leading the shift toward a disease-specific approach; they are broadly spread across numerous adult and paediatric pathologies.

Fresenius seems to have opted for a narrower pathology focus, maintaining a more holistic positioning of MN, except for a few “star” therapeutic areas.

Finally, Abbott has maintained a more traditional segmentation by age group, which leads to a list of products which offer minimal mention on the underlying pathologies they target. This positioning is interestingly in exact contrast with Nestle’s and Nutricia’s although they cover a similar breadth of medical conditions.

Our analysis shows that none of these companies rely today on a broad malnutrition concept suitable for undefined sets of therapeutic areas. This exposes the (perceived) necessity among industry leaders of increased specialisation to cope with hospital budget pressures.

What does it mean for sales and marketing organisations?

The shift toward a disease-specific positioning of MN has many consequences on the way marketing and sales teams of MN companies operate.

First, marketers and sales representatives of MN companies should align their internal structure to the therapeutic areas they intend to play in. In sales, medical expertise becomes as critical as nutritional knowledge and commercial flair. This most likely entails hiring new talents with a pharma background and/or a medical degree. The cost of the sales force may subsequently increase to align with the pharmaceutical industry.

Second, it requires the addition of Medical Affairs team members dedicated to proving the health-economic benefits of an innovative disease-specific product vs. a more generic one; this is because, nowadays, few medical products and solutions, as effective as they may be, will get adopted by payers and HCPs without solid health-economic evidence proving better or quicker therapeutic outcomes and shorter hospital stays.

Finally, it adds layers of complexity to marketing teams’ portfolio management strategy at the country level. On one hand, they need to continue to serve their current markets, and on the other, they are expected to prioritise the adoption of therapeutic areas based on the incidence-based opportunity these represent. As a result, it wouldn’t be a surprise if marketing managers struggle to decide how to update their product mix without putting at risk the health of their P&L.

Balancing the future “Perfect” and the current “Good” is possible

These are some of the questions that may arise in these marketing organisations:

  • What medical conditions should we prioritise?
    • In which ones can we offer more value to patients?
    • Which ones are easier for us to support based on our current set-up, the current level of medical awareness and protocols and the structure of the medical channels they relate to?
    • As a result, which ones truly offer the best combination of patient value and capability fit, and should therefore be our priority number one?
  • Do we already have products in the market to support these medical conditions?
    • And if not, does our global company have adequate products that are not currently present in the target country that we could add and launch?
  • Assuming no incremental budget, can our team prioritise these disease-specific initiatives whilst still serving our current customers and the bestselling products in our existing portfolio?

In fact, there is often a fear that shifting the focus onto a specific pathology or new product can undermine the many efforts over the years by sales and marketing teams to develop their existing portfolio and sales.

But standing still is never a solution so how to go about it?

Can we help?

Sector & Segment can help MN companies to navigate through these complex issues and come up with solutions that measure the pros and cons of different portfolio “scenarios”.

Over the years, our team has conducted 80 strategic projects in 25 countries across 12 therapeutic areas of Specialist Nutrition, helping its clients to develop product and disease specific propositions.

For more information, please contact me at