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Companion Diagnostics Market Size, Share & COVID-19 Impact Analysis, By Technology (Polymerase Chain Reaction, Immunohistochemistry, In-situ Hybridization, Next Generation Gene Sequencing, and Others), By Indication (Cancer, Neurological Diseases, Infectious Diseases, and Others), By End-user (Pharmaceutical & Biopharmaceutical Companies, Reference Laboratories, Contract Research Organizations, and Others), and Regional Forecast, 2022-2029

Published On : January 09, 2023 | Format: PDF | Report ID: FBI107097



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The companion diagnostics market size was valued at USD 6.80 billion in 2021 and is projected to grow from USD 7.67 billion in 2022 to USD 15.91 billion by 2029, exhibiting a CAGR of 11.0% during the forecast period (2022-2029). North America accounted for a market value of USD 2.35 billion in 2021. A companion diagnostic is a test used for the safe and effective application of a corresponding biological product or drug. Generally, these tests are used in the diagnosis of cancer. In this, as per the biomarker identified, a suitable drug is suggested. These tests provide individualized treatment based on the response of a specific patient.

  • For instance, Foundation Medicine’s companion diagnostic FOUNDATIONONE CDx analyzes more than 300 cancer-related genes to inform the use of precision cancer treatments across all solid tumors.

The rising prevalence of cancer globally is increasing the adoption of these tests, thereby propelling the growth of the market. Combined with this, regulatory approvals of these tests for different indications are estimated to boost the overall market.

  • For instance, in August 2022, the U.S. FDA approved the Oncomine Dx Target Test of Thermo Fisher Scientific Inc. as a companion diagnostic (CDx). This test identifies tumors that have HER2 (ERBB2) activating mutations (SNVs & Exon 20 Insertion) in non-small cell lung cancer.

Key Takeaways:

  • The global companion diagnostics market exhibited a growth of 1.5% in 2020 as compared to 2019.

  • North America holds the largest market share, contributing USD 2.35 billion in 2021.

  • Polymerase chain reaction technology dominated the global market and generated over 38% of the market share in 2021.

  • F. Hoffmann-La Roche Ltd, Agilent Technologies, Inc., and Abbott are leading players in the market.


Decline in the Number of Tests Performed during COVID-19 Owing to Lower Diagnosis of Cancer

The emergence of COVID-19 has impeded the demand for companion diagnostics. Also, key players operating in the market recorded a significant decline in revenues due to the COVID-19 pandemic owing to a decrease in the volume of testing and other factors. In terms of revenue, the market witnessed a slower growth of 15.1% in 2020 compared to 19.8% in 2019.

The major players witnessed a significant decline in revenue generated during 2020. For instance, Myriad Genetics, Inc. registered a decline of around 34.5% in revenues generated from molecular diagnostics in 2020 compared to 2019. Also, in 2020, Abbott Laboratories reported a decline of 4.0% in the revenues generated from core laboratory diagnostics compared to 2019.

However, revoking lockdown restrictions, stay-at-home orders in many countries, launches of novel diagnostics tests, and re-establishing the supply chain network were key factors responsible for the recovery of testing in 2021. Therefore, the resumption of cancer diagnostics testing & new diagnostic test launches positively impacted the demand in 2021.

  • For instance, in 2021, Abbott Laboratories’ core laboratory segment revenue increased by 14.6% as compared to that in 2020.


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Advances in Next-Generation Sequencing to Propel Market Progress

Clinicians use the Next-Generation Sequencing (NGS) technique to test the number of genes responsible for cancer development; this test is performed on the surgically removed patient’s tumor. NGS technique provides high output within a specific interval of time and technological advancements are developing for this technique. For example, according to an article published by the Centers for Disease Control and Prevention (CDC), next-generation sequencing has transitioned from research to clinical use during the past five years.

Moreover, key players are introducing technologically advanced testing solutions in the market. Hence, advancements in next-generation sequencing to detect genetic abnormalities, helpful in treating specific diseases, are one of the new companion diagnostics market trends.

  • For instance, in January 2022, Illumina, Inc. collaborated with SomaLogic Operating Co., Inc. to bring SomaScan, a proteomics assay onto Illumina's current and future high throughput next-generation sequencing platforms.


Increasing Prevalence of Cancer to Augment Market Growth

The prevalence of cancer is increasing significantly in recent years. The growing prevalence of cancer cases increases the need for effective CDx assays as genomic testing provides a clear picture of patients' tumors and offers precise insights to doctors about treatment protocols. Thus, the increasing prevalence of cancer is increasing the sales of products of CDx.

  • According to Canadian cancer statistics, in November 2021, 229,200 new cancer cases were diagnosed in Canada.

  • Also, according to the World Health Organization (WHO), in 2022, there were 2.26 million new cases of people diagnosed with breast cancer and 2.21 million issues of people diagnosed with lung cancer worldwide.

Moreover, to fulfill an increasing need, novel tests are being developed to diagnose specific types of mutations.

  • In August 2020, the U.S. FDA approved Guardant360 CDx. This first liquid biopsy companion diagnostic uses Next-Generation Sequencing (NGS) technology to identify patients with a specific types of mutations of the Epidermal Growth Factor Receptor (EGFR) gene in metastatic Non-Small Cell Lung Cancer (NSCLC).

This factor has led to global demand for these tests and is responsible for the market’s growth during the forecast duration.

Regulatory Approvals of New Tests for Different Indications to Stimulate Market Growth

The companion diagnostics industry is witnessing a significant number of new product approvals. As the number of new products approved is increasing, it is resulting in the adoption of several tests, thereby augmenting the market growth. Moreover, key manufacturers focus on the development of novel tests that lead to the companion diagnostics market growth. For instance, in May 2022, Illumina received CE approval for its TruSight oncology (TSO) comprehensive test. This kit assesses multiple tumor biomarkers to identify specific molecular profiles of a cancer patient. Also, in May 2022, Agilent Technologies Inc. received approval for its PD-L1 IHC 22C3 pharmDx, a qualitative immunohistochemical assay. This assay is used to identify cervical cancer patients, in which KEYTRUDA (anti-PD-1 therapy) may be an appropriate treatment option. Hence such factors will strongly support market growth.


Incompetent Reimbursement Scenario and Stringent Regulatory Framework to Restrict Market Growth

Despite increasing acceptance, there is a lack of a standardized method to set the reimbursement rate for a companion diagnostic test. Reimbursement is set on a case-to-case basis.

  • For instance, in June 2022, according to an article published by Taylor Wessing LLP in Germany, the reimbursement is different for inpatient and outpatient. For the inpatient care system, diagnostics are covered mainly by diagnosis-related groups. For outpatient treatment, the reimbursement is according to the specific catalog of reimbursable services.

Moreover, there is a lack of a standard regulatory framework for companion diagnostics (CDx). There are a number of challenges involved in the clinical development and regulation of companion diagnostics (CDx), which plays an important role with respect to sensitivity and specificity while making a therapeutic decision.

  • The European Union is currently in process of bringing into effect in vitro diagnostic medical devices regulation (IVDR). This new regulation is introducing a wide range of stringent requirements for scientific validity and clinical performance.

  • According to an article published in the National Library of Medicine by Biomarker Insights in 2021, the conformity assessment process for the companion diagnostic (CDx) must undergo a conformity procedure between a medical authority and notified body. The timeframe for the consultation is over 60 days, which can extend to another 60 days.

Generally, suitable reimbursement policies & regulations are the key factors responsible for the adoption of devices. Hence, the lack of reimbursement and stringent regulations hinder the possible global adoption and thereby market’s growth during the forecast duration.


By Technology Analysis 

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Polymerase Chain Reaction Segment to Dominate Backed by Launch of New Products & Regulatory Approvals

Polymerase chain reaction technology dominated the market share in 2021, owing to the introduction of new PCR kits by the key players such as QIAGEN N.V. and Thermo Fisher Scientific Inc. In May 2021, QIAGEN N.V. announced the launch of the therascreen KRAS RGQ PCR Kit. This test kit assists in identifying non-small cell lung cancer (NSCLC) patients eligible for the treatment with LUMAKRAS, a new therapy developed by Amgen Inc.

In March 2021, Thermo Fisher Scientific Inc. announced the launch of QuantStudio 5 Dx Real-Time PCR System which will give enhanced and accurate results to laboratory procedures and will help to maintain the molecular diagnostic workflows. Thus, launches of new products and regulatory approval led to the dominance of the segment in the market.

By Indication Analysis

Increasing Prevalence of Cancer and the Emphasis of Key Players on Innovative Technology Development Led to the Dominance of the Segment

 In terms of indication, the cancer segment is anticipated to exhibit a dominant companion diagnostics market share due to increasing prevalence of cancer and key players' focus on innovative technology to develop advanced tests for cancer drugs. Also, the number of biomarker assays used for targeted cancer drugs is increasing.

  • According to statistics published by the World Health Organization (WHO) in February 2022, approximately 400,000 children develop cancer worldwide every year. Also, according to the statistics published by the World Cancer Research Fund International, in 2020, there were 18,094,716 million cases of cancer diagnosed globally. 

  • In July 2020, F. Hoffmann-La Roche Ltd received approval from the U.S. FDA for the VENTANA HER2 Dual ISH DNA Probe Cocktail assay. This assay assists in detecting HER2 biomarkers in breast cancer and is a companion diagnostic for Herceptin (trastuzumab) therapy.

The neurology segment is estimated to grow at the highest CAGR due to the progression of Central Nervous System (CNS) disease such as Schizophrenia, Parkinson’s, and Alzheimer’s; this provides the opportunity to use precision medicine and companion diagnostic devices for better diagnostic tools.

  • In May 2022, Fujirebio launched two new tests, Lumipulse G β-Amyloid 1-42 Plasma and Lumipulse G β-Amyloid 1-40 Plasma assays for LUMIPULSE G, an immunoassay system. These chemiluminescent enzyme immunoassay (CLEIA) assays are able to measure the β-amyloid1-42 and β-amyloid1-40 in human plasma.

By End-user Analysis

Collaborations with Manufacturers Leading to the Significant Share of the Pharmaceutical & Biopharmaceutical Companies Segment

Pharmaceutical & biopharmaceutical companies generated the highest revenue in the market in 2021. Collaborations with companion diagnostic manufacturers led to the dominance of this segment.

  • For instance, in November 2021, Burning Rock Biotech Limited collaborated with Merck KGaA to develop the MET inhibitor tepotinib. This companion diagnostic test is based on the company’s self-developed next-generation sequencing liquid biopsy solution, referred to as the OncoCompass Target panel.

  • In August 2021, Burning Rock Biotech Limited entered into a global strategic collaboration with IMPACT Therapeutics. The collaboration aims to develop a companion diagnostic (CDx) test for the pipeline of drugs in the field of synthetic lethality.

Moreover, pharmaceutical & biopharmaceutical companies segment is estimated to grow at the highest CAGR during the forecast period owing to new product launches and technological advancements globally. These companies are continuously involved in the development of companion diagnostics tests for several indications.

  • In January 2022, Illumina Inc. collaborated with Boehringer Ingelheim with an aim to develop new tests for various programs of Boehringer Ingelheim's oncology pipeline. This collaboration accelerated the development of precision medicines for patients with advanced cancer.


North America Companion Diagnostics Market Size, 2021 (USD billion)

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North America dominated the global market with a share of 34.55% in 2021. The region's dominance is attributed to a higher prevalence of cancer and other chronic conditions along with rising adoption of advanced CDx assays in the region.

  • For instance, according to the National Cancer Institute, in 2020, an estimated 1,806,590 new cases of cancer were diagnosed in the U.S.

On the other hand, Europe is anticipated to be the second-most prominent region in terms of revenue in 2021 globally. The growth in this region is attributed to an increase in collaboration between pharmaceutical companies and companion diagnostic manufacturers in the area.

  • For instance, in December 2021, QIAGEN collaborated with Denovo Biopharma LLC, intending to develop a blood-based companion diagnostic (CDx) test to identify patients that are expressing Denovo Genomic Marker 1 (DGM1), who are likely to respond to Denovo's investigational cancer drug DV102, used for the treatment of diffuse large B-cell lymphoma in lymphoid cancers.

Asia Pacific is projected to grow at the highest CAGR during the forecast period. This factor is attributed to the rising prevalence of cancers, improving healthcare infrastructure, and the growing number of medical device companies developing diagnostic products for the treatment.

  • According to the Janssen Asia Pacific, Asia Pacific hosts 50% of the world’s new cancer cases each year, and deaths caused by cancer in Asia are expected to increase by 36.0% by 2030.

The market in Latin America and the Middle East & Africa is estimated to grow at a slower pace compared to Asia Pacific. Partnerships between key players and hospitals for the expansion of precision oncology diagnostic labs, providing extensive genetic testing to cancer patients, are estimated to be one of the major market drivers in the region.

  • For instance, in July 2022, Geneseeq announced teaming up with Hospital de Base in Sao José do Rio Preto, Brazil, to build an NGS-based precision oncology diagnostic lab to provide advanced clinical research and genetic research testing to cancer patients in Brazil.


F. Hoffmann-La Roche Ltd, Agilent Technologies, Inc., and Abbott Account for a Dominant Share in Terms of Revenues

F. Hoffmann-La Roche Ltd, Agilent Technologies, Inc., and Abbott are leading players in the market due to new product launches and the acquisition of competitive players. Furthermore, robust investment in research activities to develop a portfolio of superior treatment solutions has enabled the company to hold a leading position in the market.

  • For instance, in April 2021, Agilent Technologies, Inc. acquired Resolution Bioscience, Inc., one of the leading players in next-generation sequencing-based oncology solutions. This acquisition accelerated and expanded the company’s capabilities in NGS-based cancer diagnostics and provided the company with innovative technology that meets the fast-growing personalized medicine market.

Moreover, the market is further characterized by many small manufacturers in emerging nations focusing on developing relatively lower-cost products. Other key players offering a wide range of CDx involve Illumina, Inc., Guardant Health, Thermo Fisher Scientific Inc., BIOMERIEUX, QIAGEN, Myriad Genetics, Inc., and Sysmex Corporation. Illumina, Inc. partnered with leading biotechnology companies to develop companion diagnostics for best-in-class therapeutics. For instance, Illumina, Inc. partnered with Loxo Oncology for the development of next-generation sequencing-based companion diagnostics. Also, bioMérieux created a program to work with pharmaceutical and medical device companies.


  • Abbott (U.S.)

  • F. Hoffmann-La Roche Ltd. (Switzerland)

  • Agilent Technologies, Inc. (U.S.)

  • Illumina, Inc. (U.S.)

  • Guardant Health (U.S.)

  • Thermo Fisher Scientific Inc. (U.S.)

  • BIOMERIEUX (France)

  • QIAGEN (Germany)

  • Myriad Genetics, Inc. (U.S.)


  • October 2022: The U.S. FDA approved F. Hoffmann-La Roche Ltd.’s companion diagnostic- PATHWAY to identify patients with HER2 low metastatic breast cancer eligible for ENHERTU (HER2-directed antibody drug conjugate) treatment.

  • October 2022: HMNC Brain Health raised USD 14.2 million in funding series to boost the precision psychiatry programs, in which pharmaceuticals are co-developed with companion diagnostics to identify the patient groups to benefit from these treatments.

  • June 2022: Laboratory Corporation of America Holdings collaborated with OmniSeq Corporation and announced the launch of OmniSeq INSIGHTsm, a comprehensive genomic and immune profiling, a tissue-based test incorporating next-generation sequencing (NGS) technology. The test is designed to advance precision oncology and improve patients’ outcomes.

  • August 2021: QIAGEN N.V. collaborated with OncXerna Therapeutics, Inc. to develop Next-Generation Sequencing (NGS), a companion diagnostic for OncXernas's product candidate, Navicixizumab, a product candidate for the treatment of patients with ovarian cancer.

  • January 2021: Laboratory Corporation of America Holdings collaborated with OmniSeq Corporation and announced the launch of OmniSeq INSIGHTsm, a comprehensive genomic and immune profiling, a tissue-based test incorporating next-generation sequencing (NGS) technology. The test is designed to advance precision oncology and improve patient outcomes.

  • July 2020: Laboratory Corporation of America Holdings collaborated with OmniSeq Corporation and announced the launch of OmniSeq INSIGHTsm, a comprehensive genomic and immune profiling, a tissue-based test incorporating NGS technology. The test is designed to advance precision oncology and improve patients’ outcomes.


An Infographic Representation of Companion Diagnostics Market

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The research report elaborates on the global market dynamics and competitive landscape. The report presents various key insights, the prevalence of cancer in key countries, new product launches by key players, key mergers, acquisitions, and partnerships, the impact of COVID-19 on the market, the competitive landscape, and company profiles.

Report Scope & Segmentation 



Study Periods


Base Year


Estimated Year


Forecast Period


Historical Period



Value (USD billion)


By Technology, Indication, End-user, and Region

By Technology

  • Polymerase Chain Reaction

  • Immunohistochemistry

  • In-situ Hybridization

  • Next Generation Gene Sequencing

  • Others

By Indication

  • Cancer

  • Neurological Diseases

  • Infectious Diseases

  • Others

By End-user

  • Pharmaceutical & Biopharmaceutical Companies

  • Reference Laboratories

  • CROs

  • Others

By Geography

  • North America (By Technology, By Indication, By End-user, By Country)

    • U.S.

    • Canada

  • Europe (By Technology, By Indication, By End-user, By Country/Sub-Region)

    • Germany

    • U.K.

    • France

    • Italy

    • Spain

    • Scandinavia

    • Rest of Europe

  • Asia Pacific (By Technology, By Indication, By End-user, By Country/Sub-Region)

    • China

    • Japan

    • India

    • Australia

    • Southeast Asia

    • Rest of Asia Pacific

  • Latin America (By Technology, By Indication, By End-user, By Country/Sub-Region)

    • Brazil

    • Mexico

    • Rest of Latin America

  • Middle East & Africa (By Technology, By Indication, By End-user, By Country/Sub-Region)

    • GCC

    • South Africa

    • Rest of Middle East & Africa

Frequently Asked Questions

Fortune Business Insights says that the market was valued at USD 6.80 billion in 2021 and is projected to reach USD 15.91 billion by 2029.

In 2021, the market was valued at USD 6.80 billion.

Growing at a CAGR of 11.0%, the market will exhibit steady growth in the forecast period (2022-2029).

The polymerase chain reaction segment is expected to be the leading segment during the forecast period.

The increasing prevalence of cancer worldwide will drive the market's growth.

F. Hoffmann-La Roche Ltd, Agilent Technologies, Inc., and Abbott are the top players in the market.

North America is expected to hold the highest market share.

Asia Pacific is expected to grow at a higher CAGR over the forecast period in the market.

Launch of new tests would drive the adoption of the product in the forthcoming years.

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