Based on 70 interviews DeciBio has conducted with NGS labs, Illumina currently dominates the clinical oncology NGS sequencer market and ThermoFisher comfortably commands the second position, especially given its strong position ex-U.S. Interestingly, ~60% of interviewed institutions are looking to buy new instruments, indicating that the market is not yet saturated.

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While Illumina currently commands ~80% of surveyed institutions’ install base, Illumina is expected to account for only ~60% of new instruments among labs planning to expand their sequencing infrastructure within the next 12 months. Meanwhile, several new entrants in the space have launched novel platforms with long-read capabilities and lower per-sample sequencing costs. While these novel platforms currently represent <5% of instruments used by our survey pool, ~20% of adoptions are planned to be instruments from Oxford Nanopore, Element Bio, PacBio, or Singular Genomics.

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Institutions report that sequencer accuracy is their top priority, while reagent cost and sequencer cost closely follow. Illumina’s high accuracy, low error rates, and strong lab relationships keep them in the driver's seat. However, cost-efficient and flexible sequencers like ElementBio Aviti and Singular Genomics’ G4 and long-read sequencers such as PacBio and Oxford Nanopore appear to be gaining traction in clinical settings. Long-read sequencers can become an even greater threat to Illumina as databases become available to make sense of the clinical significance of structural variants.

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These insights come from our 2023 NGS Oncology DxBook, where we interview labs in the U.S. and Europe that perform NGS panels in-house and/or send out NGS panels. Our first data delivery covering 100 institutions is available for purchase and includes rich detail about labs’ workflows, use cases, and future NGS plans.

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The NGS DxBook can enrich the depth of these insights, by answering key questions such as:

1. What platforms and panels are institutions currently using? What are the current testing volumes across applications? 
2. Which institution types are looking to adopt new instruments and do certain institution types prefer novel sequencers?
3. Which sequencer features matter most to different types of labs?
4. Will labs look for FDA-approved sequencers if the Valid ACT passes?

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