“If we can prove we’re better, the market will choose us.”
It’s a rational assumption.
Better outcomes. Better economics. Better performance. Build the evidence, make the case, and give the market a reason to switch.
But better is always judged through a lens the market already has.
And when you’re trying to create a new standard of care, that lens is what has to change.
Markets don’t go from questioning the old way to embracing a new one in a single leap.
The first shift is questioning what it already accepts—the focus of last month’s briefing.
Once the status quo is harder to defend, an opening exists. But an opening doesn’t tell the market what should replace it.
Every market has an accepted definition of success: what good care is supposed to accomplish.
That definition shapes what physicians expect, what outcomes get measured, and what evidence matters.
To change the standard of care, the market has to see something it didn’t value before as essential to what good care should deliver.
That’s the next move: Define the New Category.
For decades, cardiogenic shock care centered on surviving the crisis. Despite advances in treatment, mortality remained near 50%, and the clinical objective reflected that reality: stabilize the patient, maintain circulation, get them through the acute event.
Abiomed advanced a different therapeutic idea with Impella:
What if success wasn’t simply supporting the failing heart, but helping the native heart recover?
The National Cardiogenic Shock Initiative turned that idea into a standardized treatment approach built around early ventricular unloading, hemodynamic monitoring, and reducing reliance on inotropes. Native-heart recovery became an outcome worth tracking alongside survival.
The results gave that new definition of success clinical credibility. NCSI reported 71% survival to discharge, with more than 90% native-heart recovery in surviving patients.
And once recovery mattered, the clinical questions changed with it: when to initiate support, how to escalate, when to wean.
In 2022, Johnson & Johnson acquired Abiomed for $16.6 billion.
Before your next evidence review, ask: What does our market believe success looks like today—and what do we need it to value differently?
Abiomed didn’t change how the heart was supported.
It changed what successful treatment was expected to deliver.
Changing the definition of success gives the market a new way to think about the problem.
But understanding a new standard isn’t the same as preferring it.
What makes the market trust the new standard enough to switch?
Every market is already somewhere on the Market Belief Ladder. The Belief Engineering Framework maps the four belief shifts required to turn a new idea into a new standard of care.
