med-market-sizing

Methodology inspired by publicly taught patient-flow sizing approaches; all text is an original paraphrase.

Defaults

Parameter	Default Value	Rationale
funnel_stages	7	prevalence → diagnosed → interested → affordable → covered → treated → persistent
affordability_rule	~10% monthly budget	Income-share rule per cohort and country
scenario_grid	bull/base/bear	Never a single point number
analog_anchors	named	Statins for penetration, tech S-curves for adoption
capacity_state	explicit	Supply-constrained vs demand-limited + flip condition

Preflight

Run canonical pre-flight per contracts/preflight.md. Include the X-Agentii-Trace header on every tool call per contracts/x-agentii-trace-header.md — carry the _run_id from your first tool result and name yourself (and your parent, if you were spawned). Confirm ticker resolution via search_companies before market queries.

Triggers

• "What is the TAM for [therapy area]?"
• "Size the market for [drug/device] in [indication]."
• "What has to be true for the bear case in [class]?"
• "Walk me through the patient funnel for [indication]."
• "Is [class] supply-constrained or demand-limited?"
• "What capacity ceiling do [company]'s plants impose?"
• "Anchor [class] adoption to a historical analog."
• "Bull/base/bear sizing for [indication] with drivers."
• "How does the income-share rule cap affordability?"
• "What penetration rate is realistic for [class]?"
• "How much API does [class] need per patient-year?"

Production Grounding

• Funnel: prevalence → diagnosed → interested → affordable (income-share rule, ~10% of monthly budget) → covered → treated → persistent; every stage carries an explicit rate or a coverage_gap. Price as price × duration per cohort and country; never skip a stage silently.
• Capacity check is mandatory: plants × units/yr, API kg/patient/yr, fill-finish lead times. State whether the market is supply-constrained or demand-limited and the condition that flips it.
• Analog anchoring: named historical analogs (statins for penetration, tech S-curves for adoption); every anchor carries its citation.
• Scenario discipline: bull/base/bear with a named-driver assumption grid; uncertainty at market level, POS at asset level; model-vs-consensus delta always explicit; abstain where unquantifiable.
• Badges: [FACT]/[DEDUCTED]/[VIEW] with the summary table.

Data Source Priority

1. Prevalence/epidemiology: search_documents (epidemiology sources) + read_source_outline / read_source_pages.
2. Universe + mechanism: search_universe_drugs / search_universe_devices; search_drug_knowledge / search_drugs_by_indication (spec 054 silver).
3. Pricing/coverage: search_sec_filings (net price, GTN) + payer coverage via search_documents.
4. Capacity: filings and transcripts (plants, API supply, fill-finish).
5. Knowledge: search_investment_strategies / search_investment_cases (sectors=med) for sizing frameworks and prior TAM cases.

Methodology

Retrieval Scope

unstructured_document_search

Retrieval Strategy

1. Resolve indication and product scope via search_companies + search_universe_drugs / search_universe_devices.
2. Collect prevalence/diagnosis rates from epidemiology documents; cite each stage rate.
3. Pull pricing (net price, GTN) and coverage evidence from filings and payer documents.
4. Pull capacity evidence (plants, API supply, fill-finish) from filings/transcripts.
5. Anchor penetration to named analogs; retrieve prior TAM cases (sectors=med); cite /v/ records.
6. Build the bull/base/bear grid.

Temporal Scope

See frontmatter temporal_scope block. Ramp and capacity paths may extend to max_quarters.

Tool Allowlist

See frontmatter allowed_tools.

Protocol

1. Indication framing
2. Funnel build (stage rates cited or coverage_gap)
3. Cohort pricing (price × duration)
4. Capacity check + constraint state
5. Analog anchoring
6. Bull/base/bear grid

Modes

• Drug / biologic (default): prevalence-based funnel with payer/coverage stages.
• Device: placements/procedures and installed-base stages replace script stages.
• Vaccine: healthy-population cohorts, ACIP-gated uptake, procurement value.
• Single indication: one indication × country with full cohort splits.

Tool Fallbacks

Failure	Fallback
Prevalence source absent	coverage_gap at the stage; list required inputs — never fabricate a rate
No pricing disclosure	Bracket net price from filings; label [DEDUCTED] / [VIEW]
Drug absent from silver layer	Universe + filings; annotate knowledge coverage_gap
Capacity undisclosed	State the flip-condition logic qualitatively [VIEW]

Output File

{ticker}/{YYYY-MM-DD_HHMM}_med-market-sizing_{affix}.md (market-level: _sector/{YYYY-MM-DD_HHMM}_med-market-sizing_{affix}.md)

Output Structure

1. Executive Summary — TAM stance + constraint state, 2-3 sentences
2. Patient-Flow Funnel — stage-by-stage rates, each cited or coverage_gap
3. Cohort Pricing — price × duration per cohort/country
4. Capacity Check — ceiling + supply-constrained vs demand-limited + flip condition
5. Analog Anchors — named penetration/adoption analogs with citations
6. Scenario Grid — bull/base/bear with named-driver assumptions
7. Coverage Gaps — missing sources and degraded stages

Error Handling

Error	Fallback
Missing prevalence data	coverage_gap at the stage; state the required input — never fabricate a rate
Conflicting prevalence sources	Show both with provenance; use the range in the scenario grid
No consensus comparator	State model vs consensus as unavailable; keep the bull/base/bear internal consistency

Memory Load

See contracts/memory-load.md.

Snapshot

See contracts/snapshot-synthesis.md.

Final Summary (TUI)

Include ### Key Citations block with 0-10 clickable /v/ URLs.

References

• contracts/citation-and-memory.md
• contracts/output-frontmatter-schema.md
• contracts/memory-load.md
• contracts/snapshot-synthesis.md
• contracts/preflight.md
• references/knowledge-frameworks.md