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Companion Diagnostics Market - Strategic Insights and Forecasts (2026-2035)

Global Companion Diagnostics Market Size, Growth & Trends By Product Type (Assays, Kits & Reagents, Instruments & Systems, Software & Services), Technology (Polymerase Chain Reaction (PCR), Next-Generation Sequencing (NGS), Immunohistochemistry (IHC), In Situ Hybridization (ISH), Others), Biomarker Type (Genomic Biomarkers, Proteomic Biomarkers, Gene Expression Biomarkers, Others), Indication (Lung Cancer, Breast Cancer, Colorectal Cancer, Melanoma, Ovarian Cancer, Hematological Malignancies, Others), Sample Type (Tissue Biopsy, Liquid Biopsy, Other Biological Samples), End User (Hospitals, Diagnostic Laboratories, Academic & Research Institutes, Others), and Geography

Market Size in 2026
USD 8.10 billion
Market Size in 2031
USD 20.9 billion
CAGR
11.1%
Study Period
2021-2031
$3,950
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The Global Companion Diagnostics market is set to reach USD 20.9 billion in 2035, growing at a CAGR of 11.1% between 2026 and 2035, from USD 8.10 billion in 2026.

Companion Diagnostics Market - Strategic Insights and Forecasts (2026-2035) market growth projection from $8.10B in 2026 to $20.90B by 2031 at a CAGR of 11.1%.
Companion Diagnostics Market - Strategic Insights and Forecasts (2026-2035) market growth projection from $8.10B in 2026 to $20.90B by 2031 at a CAGR of 11.1%.

Highlights:

  1. 1
    Precision oncology adoption
    Companion diagnostics increasingly guide targeted treatment selection by identifying biomarkers associated with likely therapeutic benefit, helping clinicians personalize treatment decisions and avoid ineffective therapies.
  2. 2
    Multi-biomarker testing
    Genomic and molecular profiling technologies are broadening companion-diagnostic applications, enabling identification of multiple actionable alterations from patient tumor samples.
  3. 3
    Therapy-diagnostic co-development
    Regulatory frameworks increasingly encourage pharmaceutical and diagnostic developers to coordinate development, supporting companion-diagnostic availability alongside corresponding therapies.
  4. 4
    Expanding oncology applications
    Companion diagnostics are increasingly supporting broader therapeutic classes and indications, particularly where biomarker information can improve treatment selection, safety, or response monitoring.

Key Highlights

Market Overview

The Global Companion Diagnostics Market includes tests that help identify which patients are most likely to benefit from specific targeted therapies. The market is expanding beyond cancer into other diseases, driven by increasing regulatory approvals, growing adoption of NGS-based liquid biopsies, wider use of biomarker testing, and stronger partnerships between pharmaceutical and diagnostic companies.

  • J&J builds its oncology drugs around a matched biomarker test. RYBREVANT (amivantamab) was approved alongside a companion diagnostic, tying eligibility directly to the EGFR exon 20 insertion mutation in non-small cell lung cancer.

  • Each drug typically has multiple testing options available. Guardant Health's Guardant360 CDx liquid biopsy test was approved as the first companion diagnostic for RYBREVANT, and Thermo Fisher's Oncomine Dx Target Test was later approved as a tissue-based alternative for the same drug.

  • The same pattern shows up in J&J's bladder cancer drug. BALVERSA (erdafitinib) was approved alongside Qiagen's therascreen FGFR test, which identifies roughly one in five advanced bladder cancer patients who carry the FGFR alterations the drug targets.

  • Liquid biopsy testing is moving from single-gene tests toward broad genomic panels. In May 2026, Guardant Health won approval for Guardant360 Liquid CDx, the largest approved liquid biopsy panel, covering more than 740 genes.

  • Blood tests are also expanding into monitoring, not just initial diagnosis. Natera's Signatera CDx was approved in 2026 to detect residual cancer in the blood after treatment for bladder cancer, alongside Tecentriq.

  • Testing companies are consolidating to build broader platforms. Foundation Medicine is expanding its monitoring capabilities through Roche's roughly $595 million acquisition of SAGA Diagnostics, expected to close by Q3 2026.

  • Diagnostic companies are forming extensive partnerships rather than entering into one-time agreements. Foundation Medicine's collaboration with Merck KGaA to develop shared companion diagnostics for multiple drugs reflects a partnership model other diagnostics companies are now copying.

  • J&J's approach to these partnerships is increasingly seen as a model for the industry. Conferences currently hold dedicated sessions on how J&J aligns its drug and diagnostics teams early to accelerate regulatory approval.

  • Regulators are updating their systems to keep up with this activity. The FDA, for instance, renamed and updated its list of authorized companion diagnostics in July 2026 to reflect that approvals come through several different pathways.

Market Drivers

  • Expansion of Precision Oncology Drug Development: Precision oncology represents the primary demand driver for companion diagnostics because targeted therapies require validated biomarker identification before treatment initiation. Oncology pipelines are increasingly incorporating molecular selection criteria that define patient eligibility during clinical development. This evolution increases dependence on accurate diagnostic testing throughout drug commercialization.

  • Increasing Adoption of Next-Generation Sequencing: Next-generation sequencing enables simultaneous analysis of numerous clinically relevant biomarkers through a single workflow. Multiplex testing improves diagnostic efficiency while reducing tissue consumption in patients with limited biopsy material. This capability supports increasingly complex precision oncology treatment algorithms.

  • Rising Pharmaceutical–Diagnostic Co-development Partnerships: Companion diagnostics require synchronized clinical evidence demonstrating both therapeutic efficacy and diagnostic performance. Pharmaceutical companies collaborate with diagnostic developers throughout drug discovery, clinical trials, and regulatory submission processes. These partnerships reduce development uncertainty while improving regulatory coordination.

  • Expansion of Liquid Biopsy Applications: Liquid biopsy complements traditional tissue biopsy by enabling minimally invasive detection of circulating tumor DNA and other molecular biomarkers. This approach supports repeated sampling throughout treatment, providing a dynamic assessment of disease progression and therapeutic response. Companion diagnostics extend beyond initial treatment selection into longitudinal disease management.

Rising Prevalence of Cancer and Other Chronic Diseases

Global cancer incidence continues to rise, with the World Health Organisation (WHO) reporting that almost 20 million new cancer cases were reported in 2022 alone, and following the latest outlook by WHO/IARC, worldwide annual cases are projected to exceed almost 35 million by 2050. This is creating an expanding identifiable patient population needing biomarker testing and treatment-selection diagnostics.

  • Cancer is still a major cause of mortality globally; for instance, in 2024, cancer was responsible for almost 10 million deaths worldwide, as per the WHO 2026 news release.

  • Cancer is becoming more relevant for multiple tumor types. Lung cancer accounted for 2.6 million new cases, followed by breast cancer at 2.4 million, then colorectal cancer at 2.0 million. It is essential to conduct earlier molecular characterization and select targeted treatments for these three types of cancer, leading to an increasing demand for companion diagnostic solutions.

  • Furthermore, as indicated in the WHO data, prostate cancer was responsible for about 1.5 million new cases and skin and gastric cancer for 1.1 million and 0.9 million new cases per year, respectively, affirming a greater requirement for biomarker-based diagnosis beyond just a small number of known cancer indications.

  • The rising incidence of cancer and the growing burden of chronic diseases are increasing the number of patients receiving molecular characterization. As biomarker-driven therapies become more widely available, there is an increasing need for companion diagnostics to identify patients who are most likely to benefit from these targeted therapy treatments.

  • According to the NIH, the new FDA drug approvals in 2025, cancer therapy products made up 35% of all new drug approvals and were the major components of approvals. This means that the growing burden of cancer increases the clinical importance of precision medicine and is expected to promote the market.

Market Restraints and Challenges

  • Regulatory validation requirements increase development timelines because companion diagnostics and therapeutics frequently undergo coordinated review processes.

  • Limited reimbursement consistency across healthcare systems restricts routine adoption of comprehensive molecular testing despite demonstrated clinical utility.

  • Advanced sequencing infrastructure, specialized laboratory personnel, and bioinformatics capabilities increase implementation costs for many healthcare providers.

Market Opportunities

  • Integration of Artificial Intelligence into Molecular Interpretation: Genomic testing generates increasingly complex datasets requiring efficient interpretation before clinical decision-making. Artificial intelligence supports automated variant classification, workflow optimization, and clinical reporting. Diagnostic providers are incorporating machine-learning algorithms that improve consistency while reducing analytical turnaround time.

  • Expansion Beyond Oncology: Oncology remains the dominant application area for companion diagnostics, yet biomarker-guided therapies increasingly emerge within autoimmune diseases, neurological disorders, and rare genetic conditions. Pharmaceutical companies are investigating biomarker-driven therapeutic approaches across diverse disease areas where patient heterogeneity influences treatment response. Diagnostic developers consequently broaden assay portfolios supporting future precision medicine applications.

  • Increasing Use of Real-World Evidence: Clinical utility increasingly depends on demonstrating long-term patient outcomes following biomarker-guided therapy selection. Healthcare systems are expanding the collection of genomic and clinical outcome data supporting real-world evidence generation. Companion diagnostics benefit from broader evidence demonstrating clinical effectiveness.

  • Global Expansion of Precision Medicine Programs: National precision medicine initiatives strengthen molecular testing infrastructure through coordinated investments in genomic research, sequencing capacity, and clinical implementation. Governments are supporting broader integration of genomics into healthcare systems because precision medicine improves treatment efficiency and patient outcomes.

Disease & Epidemiology Analysis

Cancer incidence continues to increase worldwide, creating sustained demand for biomarker-guided therapeutic strategies. Companion diagnostics, therefore, become increasingly important because molecular heterogeneity influences treatment response across numerous malignancies. Precision medicine increasingly replaces empirical treatment selection with biomarker-directed clinical decision-making.

Non-small cell lung cancer remains one of the largest companion diagnostic markets because actionable biomarkers, including EGFR, ALK, ROS1, BRAF, MET, RET, KRAS, HER2, and NTRK, influence therapeutic eligibility. Pharmaceutical companies continue expanding targeted therapy development across these molecular subgroups, increasing demand for comprehensive genomic testing.

Breast cancer increasingly relies on HER2, BRCA1/2, PIK3CA, ESR1, and additional genomic biomarkers for treatment optimization. Companion diagnostics, therefore, support therapeutic selection across both early-stage and metastatic disease settings. Clinical laboratories continue to adopt multiplex testing platforms that improve biomarker detection efficiency.

Melanoma, colorectal cancer, ovarian cancer, and hematological malignancies also demonstrate increasing dependence on biomarker-directed therapies. Precision medicine consequently expands molecular testing requirements across multiple oncology specialties while supporting broader clinical implementation of companion diagnostics.

Treatment Guidelines Landscape

Organization

Guideline Focus

Companion Diagnostic Relevance

National Comprehensive Cancer Network (NCCN)

Precision oncology treatment pathways

Recommends biomarker testing before targeted therapy selection in multiple cancers

American Society of Clinical Oncology (ASCO)

Evidence-based oncology management

Supports validated molecular testing for treatment stratification

European Society for Medical Oncology (ESMO)

Precision medicine recommendations

Encourages comprehensive genomic profiling in selected advanced cancers

College of American Pathologists (CAP)

Molecular pathology standards

Establishes laboratory quality requirements for biomarker testing

Major Segment Analysis

By Biomarker Type

Genomic biomarkers represent the largest segment because most targeted oncology therapies rely on identifying actionable DNA alterations that predict therapeutic response. Demand is increasing as next-generation sequencing replaces sequential single-gene testing across multiple cancer indications. Molecular complexity strengthens dependence on comprehensive genomic profiling capable of detecting numerous clinically relevant variants simultaneously. Pharmaceutical sponsors continue expanding biomarker-directed clinical development programs, reinforcing long-term adoption of genomic companion diagnostics.

By Sample Type

Liquid biopsy is becoming an increasingly important sample type because minimally invasive blood collection supports repeated molecular assessment throughout treatment. Clinical adoption is expanding as circulating tumor DNA technologies demonstrate improved analytical sensitivity and broader clinical utility. Tissue availability constraints encourage physicians to incorporate blood-based testing into diagnostic workflows where appropriate. Continued technological improvements strengthen confidence in liquid biopsy as a complementary companion diagnostic approach.

By End User

Diagnostic laboratories represent the leading end-user segment because advanced molecular testing requires specialized sequencing platforms, bioinformatics infrastructure, and quality-controlled analytical workflows. Testing volumes are increasing as oncology treatment pathways incorporate broader biomarker profiling requirements. Laboratory networks continue expanding high-throughput genomic capabilities supporting pharmaceutical partnerships and clinical healthcare providers. These investments strengthen centralized testing capacity while improving nationwide access to precision diagnostics.

By Technology

By technology, the companion diagnostics market is segmented into polymerase chain reaction (PCR), next-generation sequencing (NGS), immunohistochemistry (IHC), in-situ hybridization (ISH), and others. PCR technology is set to expand considerably, fueled by continued growth in biomarker development.

Specific therapeutic interventions followed by investment in precision oncology have shaped the market outlook for companion diagnostics. The polymerase chain reaction (PCR) segment is expected to grow at a CAGR of 8.0% from USD 2,657.5 million in 2026 to USD 5,318.4 million in 2035.

  • Continued development in precision medicine has bolstered PCR companion diagnostics development. Studies indicate that CDx integration in FDA novel oncology drug approvals reached 75% in 2025 and continues to progress, which is expected to enhance the development of PCR-based CDx.

  • High cancer prevalence, with an annual rate of 20.6 million new cases globally and projections of 35 million by 2050 (WHO Projections), has expanded the market outlook for CDx, with PCR assays providing targeted molecular tests for genetic mutations, especially for cancer-related genes such as KRAS, BRAF, and EGFR.

  • Companies like QIAGEN N.V. provide an extensive portfolio of PCR-based CDx kits. Through strategic partnerships with global pharmaceutical manufacturers, such as AstraZeneca, the company aims to commercialize QIAstat-Dx-based CDx development for AstraZeneca’s future therapies.

  • Initiation of pilot projects supporting development of a rapid companion diagnostics PCR test, followed by strategic collaborations for CDx development and clinical validation in global regions such as Europe, Japan, and the United States, supports the market trajectory.

  • Regulatory support such as the EU’s “In Vitro Diagnostic Regulations 2017/746” and FDA-synchronized IVD policies in the United States has provided new growth prospects for PCR-based CDx kits and assays development, thereby transforming the market outlook.

Regional Analysis

North America Market Analysis

North America represents the largest regional market for companion diagnostics because the region combines advanced molecular diagnostics infrastructure with a robust precision oncology ecosystem. The United States maintains leadership through extensive biomarker-guided drug development, widespread availability of next-generation sequencing (NGS), and close collaboration among pharmaceutical companies, diagnostic manufacturers, academic medical centers, and clinical laboratories. These structural advantages support rapid clinical integration of companion diagnostics across oncology care pathways. Demand is increasing as the U.S. Food and Drug Administration (FDA) continues approving targeted therapies that require companion diagnostic testing before treatment initiation.

The United States Companion Diagnostics Market is projected to show considerable growth with a 10.45% CAGR to account for a market size of USD 6,905.9 million in 2035 from USD 2,822.2 million in 2026.

  • The growing burden of cancer in the United States is driving the underlying patient population for companion diagnostics. The American Cancer Society (ACS) estimates that the country is expected to have 2,114,850 new cancer cases in 2026, which is about 5,790 cancers/day and around 626,140 cancer-related deaths.

  • ACS also states that incidence continues to rise for some of the most significant cancers such as breast, prostate, pancreatic, oral cavity, and uterine cancers, creating a larger potential population that could be treated within biomarker-driven treatment pathways.

  • The growing specificity of approved targeted therapies per cancer type testing has become an important link between cancer diagnosis and treatment. For example, in 2026, the FDA approved therapies based on biomarkers such as ESR1, HER2, BRAF, HRR, among others, increasing the number of patients who must undergo molecular characterization before receiving a selected therapy.

  • NGS and liquid biopsy are significantly increasing the biomarker information that can be derived from a single patient sample. For instance, in May 2026, the FDA approved Guardant360 Liquid CDx, a next-generation sequencing assay for patients with advanced cancer based on blood samples that is marketed as the largest FDA-approved liquid-biopsy panel and has been referred to by its maker, Guardant Health, as having a genomic footprint 100 times larger than that of the previous Guardant360 CDx.

  • The biomarker testing demand is fueled by the expansion of Johnson & Johnson’s oncology portfolio with targeted therapies connected with molecularly defined populations. New therapies, including RYBREVANT (amivantamab) for EGFR-altered NSCLC and BALVERSA (erdafitinib) for FGFR3-altered urothelial cancer, in its oncology portfolio exemplify how drug commercialization can directly drive the need for companion diagnostic testing.

  • The regional pharmaceutical–diagnostic partnerships are bolstering the country’s companion diagnostic pipeline. The companion diagnostic landscape authorized by the FDA continues to expand, with regional companies such as Guardant Health, Foundation Medicine, Myriad, and Agilent advancing their platforms while also developing new platforms that integrate multiple drug-specific companion diagnostic claims.

Europe Market Analysis

Europe maintains a significant position within the companion diagnostics market because precision medicine continues expanding across national healthcare systems supported by harmonized regulatory oversight and increasing genomic medicine initiatives. Public healthcare organizations prioritize evidence-based therapeutic selection, creating sustained demand for validated biomarker testing that improves clinical outcomes while supporting efficient healthcare resource utilization. Demand is shifting toward comprehensive genomic profiling as European oncology centers increasingly adopt molecular tumor boards and multidisciplinary precision medicine programs. Diagnostic laboratories are expanding sequencing capacity to comply with evolving clinical practice recommendations issued by organizations, including the European Society for Medical Oncology (ESMO). These developments improve access to molecular testing while supporting broader implementation of targeted therapies. The implementation of the European Union In Vitro Diagnostic Regulation (IVDR) is increasing analytical and clinical evidence requirements for companion diagnostics.

Asia Pacific Market Analysis

Asia Pacific represents the fastest-evolving regional market because healthcare investment, cancer incidence, and genomic medicine programs continue expanding across several major economies. Countries including China, Japan, South Korea, Australia, Singapore, and India are strengthening precision medicine infrastructure while increasing access to molecular diagnostic technologies. These developments create substantial opportunities for companion diagnostic manufacturers and pharmaceutical companies pursuing regional expansion.

Demand is increasing as governments invest in genomic sequencing programs and national cancer control strategies that emphasize personalized treatment approaches. Healthcare providers are adopting comprehensive molecular profiling because targeted oncology therapies increasingly require biomarker confirmation before clinical use. Diagnostic laboratories are consequently expanding NGS platforms and molecular pathology services throughout both public and private healthcare sectors.

Rest of the World

The Rest of the World, comprising Latin America, the Middle East, and Africa, represents an emerging opportunity for companion diagnostics because oncology care continues transitioning toward precision medicine despite differences in healthcare infrastructure and reimbursement maturity. Large urban medical centers increasingly provide molecular testing services, creating entry points for advanced diagnostic technologies across these regions.

Demand is increasing as multinational pharmaceutical companies introduce targeted oncology therapies requiring biomarker-guided patient selection. Healthcare providers are expanding partnerships with international reference laboratories where domestic molecular testing capacity remains limited. These collaborations improve patient access while supporting broader implementation of precision oncology across tertiary healthcare facilities.

Regulatory Landscape

Companion diagnostics operate within one of the most highly regulated segments of in vitro diagnostics because therapeutic effectiveness depends directly on accurate biomarker identification. Regulatory authorities require analytical validation, clinical validation, manufacturing quality assurance, and coordinated evidence demonstrating that the diagnostic reliably identifies patients who are likely to benefit from the associated therapy. These requirements create higher development standards but improve confidence among physicians, healthcare systems, and patients.

The U.S. Food and Drug Administration continues emphasizing the simultaneous development of companion diagnostics and corresponding therapeutics through coordinated review pathways. Pharmaceutical sponsors increasingly incorporate diagnostic strategy during early clinical development because synchronized regulatory submissions reduce commercialization delays. Diagnostic manufacturers, therefore, expand strategic partnerships that integrate assay development with pivotal oncology trials.

The European Union is implementing the In Vitro Diagnostic Regulation (IVDR), which introduces more comprehensive conformity assessment procedures, stronger clinical evidence requirements, and enhanced post-market performance monitoring. Diagnostic developers are strengthening quality management systems while expanding clinical validation programs supporting regulatory compliance. These investments improve long-term product reliability and facilitate broader adoption across European healthcare systems.

Regulatory authorities in Japan, China, South Korea, Australia, and several other Asia-Pacific countries continue modernizing precision medicine frameworks to accommodate biomarker-guided therapeutics. Governments are encouraging greater alignment with international regulatory standards while supporting accelerated review pathways for innovative diagnostics addressing unmet clinical needs.

Pipeline Analysis

Companion diagnostic pipelines increasingly mirror the evolution of precision oncology drug development because nearly every major targeted therapeutic program now incorporates biomarker selection strategies. Pharmaceutical companies continue identifying novel genomic, transcriptomic, proteomic, and epigenetic biomarkers that improve patient stratification while increasing therapeutic response rates. Diagnostic manufacturers consequently expand assay portfolios capable of supporting increasingly complex biomarker panels rather than individual molecular targets.

Demand is shifting toward multiplex companion diagnostics that simultaneously detect numerous actionable alterations within a single specimen. Next-generation sequencing platforms are supporting this transition because comprehensive genomic profiling reduces tissue requirements while improving clinical efficiency. Drug sponsors increasingly incorporate these assays into Phase II and Phase III oncology studies, allowing broader biomarker assessment during pivotal clinical development.

Reimbursement Landscape

Reimbursement remains a critical determinant of companion diagnostic adoption because advanced molecular testing requires substantial laboratory investment and specialized analytical expertise. Healthcare payers increasingly evaluate diagnostics according to demonstrated clinical utility, impact on treatment outcomes, and potential reductions in unnecessary healthcare expenditure. Companion diagnostics, therefore, achieve broader reimbursement when supported by robust evidence linking biomarker-guided therapy selection with improved patient outcomes.

The United States continues expanding reimbursement pathways for validated molecular diagnostics through Medicare and commercial insurers where sufficient clinical evidence exists. Europe generally incorporates reimbursement decisions within national health technology assessment frameworks that evaluate both clinical benefit and economic value. Asia-Pacific countries are progressively expanding reimbursement coverage for selected precision oncology diagnostics, although policies remain heterogeneous across individual healthcare systems.

Manufacturers increasingly generate real-world evidence demonstrating improved survival, reduced adverse events, and optimized healthcare resource utilization following biomarker-guided treatment selection. These data strengthen reimbursement negotiations while supporting broader clinical implementation. Diagnostic developers, therefore, invest in post-market evidence generation alongside pharmaceutical partners, reinforcing the long-term sustainability of precision medicine reimbursement models.

Competitive Landscape

Abbott

Abbott strengthens its position through a diversified molecular diagnostics portfolio and global laboratory presence supporting precision medicine. The company continues expanding companion diagnostic collaborations with pharmaceutical developers to align biomarker testing with targeted oncology therapies.

Agilent Technologies, Inc.

Agilent differentiates itself through its expertise in pathology, genomics, and companion diagnostic assay development. The company is strengthening strategic partnerships with biopharmaceutical sponsors to co-develop biomarker-driven diagnostic solutions.

QIAGEN N.V.

QIAGEN is a leading provider of molecular testing technologies with a broad portfolio of PCR and NGS-based companion diagnostics. The company continues expanding pharmaceutical collaborations to support biomarker identification and regulatory-approved precision therapies.

F. Hoffmann-La Roche Ltd

Roche maintains one of the strongest integrated pharmaceutical and diagnostics ecosystems in the companion diagnostics market. The company is continuously co-developing companion diagnostics alongside targeted oncology drugs, enabling synchronized regulatory approvals.

Thermo Fisher Scientific Inc.

Thermo Fisher Scientific pursues a companion diagnostics (CDx) strategy centered on accelerating precision oncology through strategic biopharmaceutical partnerships and decentralized testing. By utilizing Next-Generation Sequencing (NGS) and real-time PCR platforms, the company enables drug developers to identify predictive biomarkers, stratify patients in clinical trials, and launch targeted therapies alongside FDA-approved assays.

Thermo Fisher focuses heavily on creating standardized, automated workflows, such as sample-to-report solutions, that lower hands-on time and allow local laboratories worldwide to adopt regulatory-ready genomic profiling. This distributed model bridges the gap between drug discovery and clinical adoption, ensuring timely global access to personalized cancer treatments.

Illumina, Inc.

Illumina leads the market in next-generation sequencing platforms that underpin comprehensive genomic profiling for companion diagnostics. The company continues advancing regulatory-approved NGS-based assays to support precision medicine worldwide.

Siemens AG

Siemens Healthineers provides advanced molecular diagnostic and laboratory automation solutions that facilitate precision medicine workflows. The company is strengthening its oncology diagnostics capabilities through digital pathology and molecular testing innovations.

bioMérieux SA

bioMérieux focuses on molecular diagnostics and infectious disease expertise while expanding its oncology precision medicine capabilities. The company is investing in biomarker technologies and strategic collaborations to broaden its companion diagnostic offerings.

Myriad Genetics, Inc.

Myriad Genetics specializes in hereditary cancer and molecular diagnostic testing with strong expertise in genomic biomarker analysis. The company continues enhancing companion diagnostic capabilities through precision oncology partnerships and evidence-based testing solutions.

Guardant Health, Inc.

Guardant Health is a leader in liquid biopsy technologies for comprehensive genomic profiling and treatment monitoring. The company is expanding blood-based companion diagnostics through collaborations with pharmaceutical sponsors developing targeted cancer therapies.

Recent Developments

  • July 2026: NeoGenomics launched PTEN IHC CDx, the first FDA-approved immunohistochemistry companion diagnostic for prostate adenocarcinoma, supporting identification of patients eligible for targeted treatment with a precision-oncology approach.

  • June 2026: Guardant Health expanded Guardant360 CDx with a companion-diagnostic indication detecting ERBB2/HER2 activating mutations in non-small-cell lung cancer, supporting identification of patients eligible for zongertinib treatment.

  • May 2026: Leica Biosystems and CellCarta expanded their collaborative companion diagnostic development model to accelerate commercialization globally, introducing a flexible global framework for CDx development designed to adapt to diverse biopharma development needs, combining CellCarta's biomarker expertise with Leica Biosystems' advanced tissue-based diagnostic workflow solutions to streamline companion diagnostics development for pharmaceutical companies.

  • September 2025: Lunit Oncology and CellCarta announced a strategic collaboration to accelerate AI-enabled digital pathology for companion diagnostic (CDx) programs, combining Lunit's platform-agnostic AI pathology algorithms with CellCarta's global CDx development and laboratory execution services, making Lunit's SCOPE suite AI pathology solutions available as part of CellCarta's services for global clinical trials to enable faster, more scalable insights into tumor biology through AI-powered analysis of H&E and IHC whole slide images, supporting biomarker discovery, IHC strategies optimization, and immunotherapy response prediction.

Strategic Insights and Future Market Outlook

Companion diagnostics are becoming an essential component of precision medicine because targeted therapies increasingly depend on accurate biomarker identification for patient selection. Pharmaceutical companies are integrating biomarker strategies earlier in drug discovery, which is increasing demand for synchronized diagnostic development throughout clinical trials. Diagnostic manufacturers continue investing in next-generation sequencing, liquid biopsy, and artificial intelligence-enabled data interpretation to support increasingly complex precision oncology programs. These developments are strengthening long-term collaboration between therapeutics and diagnostics while improving clinical decision-making.

Regulatory agencies continue refining frameworks for co-development and analytical validation, encouraging higher-quality clinical evidence for companion diagnostics. Healthcare systems are expanding molecular testing infrastructure as comprehensive genomic profiling becomes a standard component of oncology care. Pharmaceutical sponsors are also broadening biomarker-driven research beyond oncology into immunology, neurological disorders, and rare diseases, creating additional opportunities for companion diagnostic developers. This diversification is supporting sustained innovation across the market.

Future competition will increasingly depend on integrated platforms rather than standalone diagnostic assays. Companies that combine sequencing technologies, bioinformatics, real-world evidence generation, regulatory expertise, and global laboratory networks are expected to strengthen their competitive position. Strategic partnerships between diagnostic manufacturers, pharmaceutical companies, healthcare providers, and research institutions are likely to accelerate commercialization while improving patient access to precision therapies worldwide.

Companion diagnostics are transitioning from supporting targeted therapies to becoming foundational tools within personalized healthcare. Continued advances in biomarker discovery, regulatory harmonization, and reimbursement support are expected to expand their clinical adoption, reinforcing their strategic importance in the future development of precision medicine.

Companion Diagnostics Market Scope:

Report Metric Details
Total Market Size in 2026 USD 8.10 billion
Total Market Size in 2031 USD 20.9 billion
Forecast Unit USD Billion
Growth Rate 11.1%
Study Period 2021 to 2031
Historical Data 2021 to 2024
Base Year 2025
Forecast Period 2026 – 2031
Segmentation Technology, Technology, Biomarker Type, Indication, Sample Type, End User, Geography
Companies
  • Abbott Laboratories
  • Agilent Technologies Inc.
  • QIAGEN N.V.
  • Thermo Fisher Scientific Inc.
  • F. Hoffmann-La Roche Ltd

Market Segmentation

By Geography

North America
Europe
South America
Middle East & Africa

Global Companion Diagnostics Market Country Analysis (2021–2035)

United States
Canada
Germany
United Kingdom
France
Italy
Spain
Japan
China
India
South Korea
Australia
Brazil
Mexico
Saudi Arabia
South Africa

Table of Contents

1. EXECUTIVE SUMMARY

1.1. Market Snapshot

1.2. Key Findings

1.3. Analyst Insights

1.4. Strategic Recommendations

2. GLOBAL COMPANION DIAGNOSTICS MARKET OVERVIEW, SIZE & FORECAST

2.1. Market Definition & Scope

2.2. Industry Overview

2.3. Industry Evolution

2.4. Key Market Trends

2.5. Historical Market Size Analysis (2021–2025)

2.6. Market Forecast Analysis (2026–2035)

2.7. Oncology Biomarker Landscape

2.8. Companion Diagnostics Development Ecosystem

2.9. Disease Burden and Precision Medicine Trends

2.10. Patient Testing and Adoption Analysis

3. MARKET DYNAMICS

3.1. Market Drivers

3.2. Market Restraints

3.3. Market Opportunities

3.4. Market Challenges

4. INDUSTRY LANDSCAPE

4.1. Industry Value Chain Analysis

4.2. Reimbursement Landscape

4.3. Pricing Analysis

5. INNOVATION LANDSCAPE

5.1. Emerging Diagnostic Technologies

5.2. Product Innovation Analysis

5.3. Clinical Trial Analysis

5.4. Companion Diagnostics Pipeline Analysis

5.5. AI Integration in Companion Diagnostics

5.6. Digital Pathology and Next-Generation Sequencing Integration

6. REGULATORY LANDSCAPE

6.1. Regulatory Framework

6.2. Approval Pathways

6.3. Compliance Requirements

7. GLOBAL COMPANION DIAGNOSTICS MARKET SEGMENTATION OVERVIEW

7.1. Analysis by Product Type

7.2. Analysis by Technology

7.3. Analysis by Biomarker Type

7.4. Analysis by Indication

7.5. Analysis by Sample Type

7.6. Analysis by End User

8. GLOBAL COMPANION DIAGNOSTICS MARKET SEGMENT ANALYSIS (2021–2035)

8.1. By Product Type

8.1.1. Assays, Kits & Reagents

8.1.2. Instruments & Systems

8.1.3. Software & Services

8.2. By Technology

8.2.1. Polymerase Chain Reaction (PCR)

8.2.2. Next-Generation Sequencing (NGS)

8.2.3. Immunohistochemistry (IHC)

8.2.4. In Situ Hybridization (ISH)

8.2.5. Others

8.3. By Biomarker Type

8.3.1. Genomic Biomarkers

8.3.2. Proteomic Biomarkers

8.3.3. Gene Expression Biomarkers

8.3.4. Others

8.4. By Indication

8.4.1. Lung Cancer

8.4.2. Breast Cancer

8.4.3. Colorectal Cancer

8.4.4. Melanoma

8.4.5. Ovarian Cancer

8.4.6. Hematological Malignancies

8.4.7. Others

8.5. By Sample Type

8.5.1. Tissue Biopsy

8.5.2. Liquid Biopsy

8.5.3. Other Biological Samples

8.6. By End User

8.6.1. Hospitals

8.6.2. Diagnostic Laboratories

8.6.3. Academic & Research Institutes

8.6.4. Others

9. GLOBAL COMPANION DIAGNOSTICS MARKET GEOGRAPHICAL ANALYSIS (2021–2035)

9.1. North America

9.2. Europe

9.3. Asia-Pacific

9.4. South America

9.5. Middle East & Africa

10. GLOBAL COMPANION DIAGNOSTICS MARKET COUNTRY ANALYSIS (2021–2035)

10.1. United States

10.2. Canada

10.3. Germany

10.4. United Kingdom

10.5. France

10.6. Italy

10.7. Spain

10.8. Japan

10.9. China

10.10. India

10.11. South Korea

10.12. Australia

10.13. Brazil

10.14. Mexico

10.15. Saudi Arabia

10.16. South Africa

11. COMPETITIVE LANDSCAPE

11.1. Market Share Analysis

11.2. Strategic Developments

11.3. Mergers & Acquisitions, Partnerships & Collaborations

11.4. Product Launches

12. COMPANY PROFILES

12.1. Abbott Laboratories

12.1.1. Company Overview

12.1.2. Financials

12.1.3. Product Portfolio

12.1.4. Recent Developments

12.2. Agilent Technologies, Inc.

12.2.1. Company Overview

12.2.2. Financials

12.2.3. Product Portfolio

12.2.4. Recent Developments

12.3. QIAGEN N.V.

12.3.1. Company Overview

12.3.2. Financials

12.3.3. Product Portfolio

12.3.4. Recent Developments

12.4. Thermo Fisher Scientific Inc.

12.4.1. Company Overview

12.4.2. Financials

12.4.3. Product Portfolio

12.4.4. Recent Developments

12.5. F. Hoffmann-La Roche Ltd

12.5.1. Company Overview

12.5.2. Financials

12.5.3. Product Portfolio

12.5.4. Recent Developments

12.6. Illumina, Inc.

12.6.1. Company Overview

12.6.2. Financials

12.6.3. Product Portfolio

12.6.4. Recent Developments

12.7. Siemens AG

12.7.1. Company Overview

12.7.2. Financials

12.7.3. Product Portfolio

12.7.4. Recent Developments

12.8. Myriad Genetics, Inc.

12.8.1. Company Overview

12.8.2. Financials

12.8.3. Product Portfolio

12.8.4. Recent Developments

12.9. Guardant Health, Inc.

12.9.1. Company Overview

12.9.2. Financials

12.9.3. Product Portfolio

12.9.4. Recent Developments

12.10. Foundation Medicine, Inc.

12.10.1. Company Overview

12.10.2. Financials

12.10.3. Product Portfolio

12.10.4. Recent Developments

12.11. Labcorp

12.11.1. Company Overview

12.11.2. Financials

12.11.3. Product Portfolio

12.11.4. Recent Developments

13. INVESTMENT & FUNDING ANALYSIS

13.1. Venture Capital Trends

13.2. Government Funding

13.3. R&D Investments

14. FUTURE OUTLOOK

14.1. Key Growth Opportunities

14.2. Future Industry Trends

15. RESEARCH METHODOLOGY

15.1. Research Design

15.2. Data Collection Methodology

15.3. Market Size Estimation

15.4. Forecasting Model

15.5. Assumptions & Limitations

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Report IDKSI-009046
Last updated
Pages174
FormatPDF, Excel, PPT, Dashboard
Frequently Asked Questions

The Companion Diagnostics Market is forecasted to experience robust growth, with a Compound Annual Growth Rate (CAGR) of 11.1% from 2026 to 2035. This growth is expected to increase the market value from USD 8.10 billion in 2026 to an impressive USD 20.93 billion by 2035, driven by expanding applications and therapeutic needs.

Precision oncology currently represents the largest application area, significantly driving the demand for companion diagnostics due to the increasing number of biomarker-directed therapies. However, the report highlights a gradual expansion into other critical fields such as immunology, neurology, and rare genetic disorders, broadening the clinical utility beyond oncology.

The primary market driver is the expansion of precision oncology drug development, as targeted therapies necessitate validated biomarker identification. Furthermore, pharmaceutical companies are incorporating biomarker strategies earlier in drug discovery, leading to increased dependence on diagnostic partnerships throughout clinical development, which fuels demand.

Strategic competition increasingly hinges on platform scalability, the breadth of biomarker coverage, strong regulatory experience, and the expansion of laboratory networks. Crucially, established pharmaceutical partnerships are essential, with companies integrating sequencing technologies, bioinformatics, and global regulatory expertise strengthening their market position as precision medicine adoption grows.

Key highlights include the increasing clinical adoption of liquid biopsy technologies, which offer minimally invasive sampling for longitudinal disease monitoring. Additionally, Next-Generation Sequencing (NGS) panels are replacing single-gene testing, thereby reducing diagnostic turnaround times and improving biomarker coverage, further enhancing clinical utility.

Regulatory agencies are strengthening expectations for analytical validation, clinical validation, and the coordinated review of therapeutic products with companion diagnostics. While these requirements add complexity to development, they also improve confidence in clinical utility, leading diagnostic manufacturers to expand collaborations with pharmaceutical sponsors for accelerated assay validation and compliance.

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