Identify the patient, the decision-maker and the payer
In healthcare, the person receiving a service may not choose it or pay its full cost. A clinician can recommend treatment, a hospital can provide it, and a government programme or insurer can fund it. In life sciences, a product’s commercial opportunity also depends on evidence, approval, access and adoption.
Quick Prep’s healthcare and life sciences primer helps you reason through those relationships. The focus is business analysis for consulting interviews: how services reach patients, how organisations are funded and how a proposed change affects access, quality and resources.
WHO describes health financing through functions including revenue raising, pooling and purchasing. This provides a useful basis for separating who funds care from who delivers it. The FDA’s drug-development overview also distinguishes development, research, review and subsequent monitoring; it should not be treated as a description of every jurisdiction’s process. WHO: Health financing, FDA: Drug development process
Choose the relevant branch of the sector
Providers include clinics, hospitals and other care organisations. Cases can involve waiting times, staffing, patient flow, service capacity or financial sustainability. The unit of activity might be a visit, procedure, episode or covered patient.
Payers and purchasers decide how resources fund care under a particular system. Payment can be linked to activity, budgets, enrolled populations or other arrangements. Ask which mechanism applies; increasing activity may increase revenue in one model but only increase cost in another.
Pharmaceutical and biotechnology businesses develop and commercialise treatments. A market estimate must move from the relevant population to eligible, diagnosed, accessible and treated patients. Scientific uncertainty and development timing affect investment decisions.
Medical technology and diagnostics businesses can sell equipment, consumables, tests, software or services. Installation, workflow changes, training and ongoing usage may matter as much as the initial sale.
Build a patient pathway before a revenue forecast
A useful pathway might run from symptoms or screening through diagnosis, referral, eligibility assessment, treatment and follow-up. Identify where patients leave or wait in the pathway.
For a product case, a simplified model is:
Treated patients = relevant patient population × diagnosed share × eligible share × access share × adoption share.
Define each share as conditional on the previous stage and check for overlap. If the access estimate already includes eligibility, multiplying both can understate the market. Keep prevalent patients distinct from newly diagnosed patients, and specify whether treatment is one-time or recurring.
For a provider, map demand against the resources required to serve it. Adding appointments may not help if diagnostic capacity or discharge coordination is the bottleneck. Improving utilisation also needs to preserve appropriate clinical time and service quality.
Measures that balance performance
| Measure | Interview use | Limitation to recognise |
|---|---|---|
| Waiting time | Access and flow | Averages can conceal long waits for some groups |
| Completed appointments | Delivered activity | More activity does not automatically mean better outcomes |
| No-show rate | Lost scheduled capacity | Reasons may differ by patient group |
| Cost per episode | Resource use | Adjust comparisons for case complexity |
| Eligible treated patients | Product adoption | Eligibility and access must be defined |
| Quality or safety measure | Checks consequences of change | Use the measure supplied or a clearly justified one |
Country, care setting and payment model matter. Avoid presenting a reimbursement assumption from one system as a global rule.
Worked exercise: improve clinic access
Illustrative operational interview exercise. These fictional figures are not clinical benchmarks.
A clinic schedules 200 appointments a day, 20 days a month. Its no-show rate is 15%, producing 200 × 20 × 85% = 3,400 completed visits.
An intervention combining reminders and easier rescheduling is expected to reduce no-shows to 10%. With unchanged scheduling capacity, completed visits rise to 3,600: an additional 200 a month.
Assume a payment model in which each additional completed visit contributes 40 after its incremental delivery costs. The monthly contribution gain is 8,000. If the intervention costs 3,000 a month, the net operating benefit is 5,000 per month.
The financial result depends on the payment assumption. Under a fixed budget, the same change may improve access without generating extra revenue. Staff capacity must also support the extra completed visits, and the intervention must reach patients who face language, connectivity or transport barriers.
A useful recommendation would pilot the change, compare results with an appropriate baseline, and monitor waiting times, staff workload and differences across patient groups. It would not simply book more patients into every slot.
Questions to practise across life sciences
For a treatment launch, distinguish approval from patient access and adoption. Ask what evidence decision-makers need, who controls the budget and how the treatment fits into existing care.
For a diagnostic service, map the installed equipment base, test frequency, consumable economics and workflow. For a hospital expansion, examine demand by service line and the supporting staff and facilities. For a cost programme, identify whether savings reflect lower waste, shifted costs or reduced service.
Prepare to explain the objective in patient and organisational terms. State which outcome improves, who benefits and which constraint remains. Use Social & Public Sector for outcome evaluation and Market Analysis for patient-based demand estimation.
