Liquid Biopsy: Early Detection of a Huge Investment Opportunity

The Cowen Insight

Liquid biopsies use a blood draw to identify genetic signatures associated with cancer. Recent advancements are enabling the use of these tools in cancer screening, therapeutic selection, drug trial optimization, and recurrence monitoring. Five years after our original primer, the promise is becoming a reality. We estimate that the market opportunity across all classes of liquid biopsies ranges between at least $30B and $130B in the United States alone.

What are liquid biopsies?

Liquid biopsies are non-invasive diagnostics tests that should improve early detection of cancer, optimize drug treatment decisions (neoadjuvant and adjuvant) for cancer patients based on cancer-specific genetic information, and allow for quicker identification of cancer recurrence. Beyond clinical applications, liquid biopsies provide important information as part of drug development efforts.

How big is the market opportunity?

We estimate that the market opportunity across all classes of liquid biopsies is at least $30-130B in the United States alone. This does not include a very large international opportunity, and it does not fully capture biopharmaceutical service revenue or the revenue opportunity for the companies that sell enabling technologies. We expect that liquid biopsy revenue will grow at robust double-digit rates through most of the next decade and possibly beyond.

What is the current stage of development?

The liquid biopsy market has changed drastically since our initial liquid biopsy primer, A Closer Look at Liquid Biopsy: Background, Key Players & Market Opportunity, which we published over five years ago. There are now >100 companies developing or commercializing liquid biopsy products. Test development and advancement increasingly proliferates.

There has been regulatory progress both in the U.S. (multiple FDA approvals) and overseas (C.E. markings). Several tests have been granted breakthrough device designation from the FDA. Additionally, Medicare and commercial reimbursement have been established for several companies.

All that said, the opportunity remains large, promising, and under-penetrated — especially in the clinical setting. Liquid biopsy tools for cancer screening and survival monitoring are only now advancing towards market commercialization. Penetration of the therapeutic selection market is well below 10%.

What types of companies comprise the industry?

There are many companies (including start ups) that are focused on driving liquid biopsy advancements. There are also many promising private innovators in the industry.  Additionally, there are a number of traditional life science tools companies that play an important role in the advancement of the industry with key enabling tools.