Welcome to Launch Code, an executive briefing designed to surface the hidden risks that derail healthcare launches. Each edition isolates one risk and equips leaders with decision infrastructure to reduce exposure, accelerate adoption, and protect valuation before reversing course becomes costly.
“We’re still early.”
Every year, leadership teams explain slow adoption and missed forecasts with some version of that phrase.
Physician behavior takes time.
The market needs more education.
Reimbursement has to mature.
Different explanations. One underlying assumption: the market isn’t ready.
But giving the market time isn’t the answer.
In this briefing:
- Why the market you’re waiting for isn’t coming
- How a less accurate test won a market it had no business winning
- What a weak signal is actually telling you
- The question no diagnostic can answer for you
- Download: the Commercial Growth Boardroom Brief
Most leadership teams talk about market readiness as if it’s weather.
Something that arrives. Something you monitor. Something you wait for.
But markets don’t become ready because enough time passes. They become ready when enough people decide the old way no longer makes sense.
That’s not something you wait for. It’s something you create.
Consider colorectal cancer screening.
Colonoscopy is the gold standard. It finds polyps and removes them in the same procedure, and it catches roughly 95% of the large ones. The stool-DNA test Exact Sciences launched in 2014, Cologuard, catches about 42% of those same lesions and can’t remove anything it finds.
By every measure of accuracy, this is settled. The better test should win.
But accuracy was never the real problem. Tens of millions of eligible Americans weren’t getting screened at all. The choice that mattered was never colonoscopy versus Cologuard. It was screening versus nothing.
Colonoscopy is the best test for the people who show up. Exact Sciences built for the people who don’t. It didn’t set out to win the accuracy argument. It set out to reach the patient who was never going to book a colonoscopy.
The outcome that mattered was never polyps found. It was people screened. Cologuard has been used more than 20 million times, national guidelines now recognize it, and the share of eligible people getting screened went up.
The most accurate test didn’t win. The test that got people screened did. That wasn’t the market lowering its bar. Exact changed what the bar measured: not the most accurate test, but the one people would actually take.
Now turn that on your own market.
Last month, we gave you the Commercial Growth Scorecard: a way to read where your market stands. When the signals come back weak, the easy read is that the market isn’t ready.
But readiness won’t just happen. The market isn’t unwilling—it’s unaddressed. A weak signal isn’t a verdict on your product. It’s a market that hasn’t been given a reason to change yet.
Markets don’t come around because time passes. They come around when they reach a different conclusion.
A diagnostic can tell you where your market stands today. It can’t tell you whether you’ll change it.
A weak signal isn’t a closed door. It just means the market hasn’t reached a different conclusion—yet.
Whether it ever does isn’t the data’s call. It’s yours.
A Pivotal Commercial Design Review (PCDR) identifies the beliefs, behaviors, and barriers most likely to prevent your launch from achieving the growth your forecast assumes.
To receive the Launch Code in your inbox monthly, enter your email at the bottom of the page.
An executive briefing on why some commercial growth curves bend while others flatten—and how companies intentionally create the market conditions that make growth compound.
Get the Boardroom Brief
