The delivery of targeted oncology therapies is primarily concentrated in hospitals and integrated health systems, naturally positioning them as the largest end-user segment for companion diagnostics. Hospitals accounted for a leading market share in 2024, a position they are projected to maintain, reaching an estimated value of over $8 billion by 2034. This dominance stems from their comprehensive clinical infrastructure and pivotal role in the patient care pathway.

Hospitals are the primary points of care where cancer diagnosis, treatment planning, drug administration, and ongoing patient monitoring occur. They possess the necessary pathology laboratories, skilled oncologists, and surgical capacity to handle tissue acquisition and perform the subsequent companion diagnostic testing, whether it is an IHC assay or a complex NGS panel. Their ability to integrate the diagnostic result directly with the therapeutic intervention streamlines the process, reducing the lag time between diagnosis and the start of treatment, which is clinically vital for cancer patients.

The consistent high volume and clinical necessity of hospital-based companion diagnostics are critical factors underpinning the financial trajectory of the entire market. As hospitals continue to adopt advanced technologies, their market share remains robust. The integration of clinical decision support systems and electronic health records (EHRs) within the hospital setting further solidifies their role, ensuring that the diagnostic results are translated efficiently and safely into appropriate patient care decisions.

Future trends in this segment involve establishing centralized ‘precision medicine centers’ within large hospital networks. These centers will standardize the molecular testing process, ensuring consistent quality and rapid turnaround times for all companion diagnostic assays. Furthermore, increased collaboration between hospital labs and pharmaceutical companies on clinical trials and post-market surveillance will accelerate the in-house development and utilization of the latest CDx technologies, cementing the hospital as the epicenter of precision oncology.