Filmora by Fast Clinical
GTM strategy for Meribel Health's FILMORA hemorrhoid solution — a 15-minute, minimally invasive procedure backed by 400+ cases and published 5-year outcomes.
by Meribel Health · Publicly Traded MedTech · 1,000+ Employees
Executive Brief
Six decisions that define the FILMORA launch across Paris, Italy, and Seattle.
Company
Meribel Health is a 20+ year publicly traded MedTech company (~1,000 employees, 3-4 continents). This is a new disease-state vertical ("MedTech 3.0") for an established platform — not a startup bet. The FILMORA device by Fast Clinical is FDA/CE clearance-pending (expected June/July 2026).
Primary ICP: Marcus — The Reluctant Avoider (45% of TAM)
Male, 42-55, Grade III, 2-5 years OTC, $80K+ HHI. He is choosing between FILMORA and continued suffering. 6.9M Americans are in this position.
Core positioning: "Between ointments and surgery, there's a 15-minute option backed by 400+ procedures and published 5-year data."
FILMORA is the first patient-direct hemorrhoid procedure brand.
Channel priority (in order)
(1) Physician outreach — Gareth's trade show network + referring physician education. (2) Google Search — high-intent symptom + comparison queries, Seattle DMA, $5-10K/mo post-clearance. (3) Reddit/Facebook communities — pre-clearance signal testing + post-clearance engagement. (4) SEO/content — compound organic starting now.
Geo strategy: Three clinics launching simultaneously
Paris (Francesco's practice), Italy (existing), Seattle (new US market). Seattle is the US proof-of-concept. National expansion waits until Seattle unit economics are proven. Medical tourism (NY→Paris) is a viable secondary channel to test.
Day 90 success (Gareth's own words: "we are not testing, we're acquiring patients")
20-30 procedures/month in Seattle, CPL <$150, 3+ active referring physicians, landing page CVR >8%. If below 15/month at Day 90, diagnose before scaling.
Key risk: FDA clearance timeline
If the June/July clearance slips, all downstream plans shift. We cannot legally market FILMORA until clearance is received. Secondary risk: the September-November demand peak — every week the website isn't live is lost indexing time.
Growth Operating Principles
Physicians first, patients second
Build the referral pipeline before spending on patient acquisition. Gareth's trade show relationships and surgeon waitlists are the foundation.
Pre-clearance is the gold zone
Pressure test messaging, build community, lock infrastructure. We cannot sell — but we can build everything that makes Day 1 post-clearance a launch, not a setup.
Evidence is the moat
400+ procedures, published 5-year data, named physicians. No competitor has this. Every claim traces to the published study or Francesco's clinical experience.
Cash-pay is the model, not a limitation
LASIK, Sono Bello, and Invisalign prove $2-4K cash-pay medical procedures scale. Insurance coverage is the medium-term unlock, not the launch blocker.
Start local, prove economics, then scale
Seattle first for the US market. Prove unit economics before national expansion. 100 procedures/month = trigger for adding another facility.
The Opportunity
A clinically validated procedure entering an underserved, high-suffering market.
Market & Competitive Landscape
10.4M US affected, ~20M globally. 2.1M Grade II-III eligible. A single Seattle clinic addresses 10K-15K of them.
Market Funnel: Global to Seattle
| Segment | Annual Volume | Notes |
|---|---|---|
| Global hemorrhoid prevalence | ~20M/yr | 3-4% of population across multiple geographies |
| US hemorrhoid prevalence | 10.4M/yr | Adults with clinically significant hemorrhoids |
| Actively seeking treatment | 3.5M/yr | Willing to research and act |
| Grade II-III eligible for FILMORA | 2.1M/yr | Published study cohort: 12% Grade II, 88% Grade III |
| Seattle DMA addressable | 35K-50K/yr | Population-weighted estimate |
| Self-pay capable + clinically eligible (Seattle) | 10K-15K/yr | Realistic near-term TAM |
Procedure Comparison
| Procedure | Sessions | Pain | Recovery | Insurance | Cases/Evidence | Threat |
|---|---|---|---|---|---|---|
| CRH O'Regan | 3 over 6 wks | Mild-moderate | Same day | Covered | Limited published data | HIGH |
| THD/HAL | 1 | Moderate | 1-2 wks | Investigational (Mar 2025) | Higher recurrence | WEAKENING |
| Hemorrhoidectomy | 1 | SEVERE (48-72hr) | 2-4 wks | Covered | 95% (gold standard) | MEDIUM |
| FILMORA | 1 (15 min) | 92% zero pain | Same day | TBD (cash-pay launch) | 400+ procedures, 248 published, 5-yr <10% recurrence | — |
Competitive Insights
CRH O'Regan: Primary Competitive Threat
3,000+ physician locations and established insurance coverage. Their multi-session model (3 appointments over 6 weeks) and tissue-necrosis mechanism are exploitable. They use a physician-network model, not patient-direct.
Hemorrhoidectomy Fear = Largest Unmet Demand
2-4 weeks of severe post-operative pain is the #1 reason patients delay or avoid treatment. 6.9M Americans with Grade II-III disease remain untreated. Fear, not ignorance, is the primary barrier.
THD Decline = Physician Referral Window
THD's "investigational" insurance status (March 2025) means GI physicians have no credible referral destination. This vacancy is time-limited — the first alternative to fill it wins.
Insurance: Medium-Term Unlock
Cash-pay at $2,000-$3,500 has proven precedent: LASIK ($2K-$4K/eye), Sono Bello, Invisalign. Build the cash-pay business now. Use RCT results for insurance submission.
White Space Analysis
| Dimension | Current Market State | FILMORA Opportunity |
|---|---|---|
| Patient-direct acquisition | No branded procedure markets directly to patients for hemorrhoid treatment the way LASIK or Sono Bello do | First-mover as a patient-direct hemorrhoid procedure brand |
| Published long-term outcomes | CRH has limited published data. THD has higher recurrence. No competitor has published 5-year data | 248 published patients + 400+ total performed. 5-year recurrence <10%. Unmatched evidence moat |
| Single-session Grade III | Banding requires 3 sessions. THD has 1-2 week recovery. Hemorrhoidectomy has 2-4 week recovery | 15-minute procedure + same-day recovery + published Grade III outcomes |
| Cash-pay procedure brand | No equivalent to LASIK or Invisalign exists in hemorrhoid treatment | Build the category brand before insurance coverage arrives. First-mover advantage compounds |
Competitive Moat Assessment
| Moat Type | Current Strength | Source | Durability |
|---|---|---|---|
| IP / Device Patent | Strong | Patented FILMORA device, <$150 cost per unit | High — patent protection duration |
| Evidence Moat | Strong | 248 published patients + 400+ total. 90% never returned. <10% 5-year recurrence. Deliberately published in low-impact Australian journal | High — competitors need years to match |
| Physician Credibility | Strong | Francesco (PhD optics, 400+ procedures), named co-inventor physicians | High — cannot be replicated by spend |
| Owned-Clinic Model | Moderate (pre-launch) | Full control over experience, pricing, and brand | High once operational |
What the Research Changed
10 findings that shifted the strategy from initial assumptions to evidence-backed positioning.
Brand is Filmora by Fast Clinical, Not "Meribel Health"
Patients search for procedures (LASIK, Invisalign), not holding companies. Meribel Health is the corporate credibility layer. FILMORA and Fast Clinical are patient-facing.
Competes With Patient Inaction (6.9M Untreated), Not Other Procedures
The primary competitive barrier is the assumption that nothing between ointments and surgery exists. The real competitor is continued suffering.
THD Investigational = Physician Referral Vacancy
THD's insurance reclassification removes a primary alternative. GI physicians who previously referred to THD now have nowhere to send Grade II-III patients.
Existing Explainer Video Is a Regulatory Liability
Video contains claims not legally permissible under FDA regulations. Archive immediately. Every new asset must be independently substantiated.
Published Study Data Discrepancy (220+128≠248) Must Be Resolved
Published study states "220 male and 128 female" (sums to 348, not 248). Only cite "248 patients" until clarified with the authors.
Physician Referral Channel Has Near-Zero Competition
THD's decline means GI physicians have no credible referral destination. Gareth's 2+ years of trade show presence gives us a warm pipeline of interested surgeons.
Seattle Launch Must Target Sept-Nov 2026 Demand Peak
If clearance arrives June/July 2026, the first revenue window is September. All timelines reverse-engineer from that date.
Cash-Pay Comparables Prove the Model
LASIK ($2K-$4K/eye), Sono Bello, Invisalign all prove cash-pay medical procedures at $2-4K scale. €2,000 is current Italian pricing; $2,000-$3,500 is the US target.
Regulatory Badges Need Legal Verification Before Website Goes Live
Website design displays FDA, CE, and EU-MDR badges. Confirm exact regulatory status with Gareth and legal before the site goes live.
FDA Clearance (June/July) Is the Master Timeline Constraint
Everything phases around clearance. We cannot legally market until it is received. Pre-clearance is for building infrastructure, physician pipeline, and community engagement.
Strategic Shifts Summary
- Brand identity: Patient-facing brand is FILMORA by Fast Clinical, not Meribel Health
- Competitive frame: The real competitor is patient inaction (6.9M untreated), not other procedures
- Market timing: THD's reclassification creates a physician referral vacancy — fill it before someone else does
- Evidence strategy: 400+ procedures + published 5-year data is the most valuable marketing asset
- Launch sequencing: Physicians first, then infrastructure, then patient channels
- Channel priority: Physician outreach → Google Search → Reddit/FB communities → SEO
- Pricing model: Cash-pay $2,000-$3,500 is the launch model, proven by LASIK/Sono Bello/Invisalign
- Data integrity: Only cite "248 patients" until the gender count discrepancy is resolved with the authors
The Patient & Positioning
Understanding the human behind the search query — then building the message that reaches them.
Patient Intelligence
A 6-stage patient journey, ranked pain points, emotional drivers, and the trust hierarchy that governs every conversion.
Patient Journey
| Stage | Trigger | Patient State | What They Do | Reach Strategy |
|---|---|---|---|---|
| Denial | Occasional discomfort | "It'll go away" | Nothing | Not meaningfully reachable |
| Awareness | Recurring pain or bleeding | "I need to look into this" | Google symptom searches | SEO content, Reddit/FB communities |
| Research | Consistent, worsening symptoms | "What are my options?" | Comparing procedures, reading forums | Google Ads (comparison), content, GBP |
| Consideration | Decided to act | "Where do I go?" | Checking providers, reading outcomes | Retargeting, GBP posts, physician referrals |
| Decision | Ready to book | "I want this done" | Calling clinics, submitting forms | Paid search (brand + treatment), GBP calls |
| Post-procedure | 30-day follow-up | "I feel great" | Talking to friends, writing reviews | Review capture, referral asks |
Pain Point Ranking
| Rank | Pain Point | Frequency |
|---|---|---|
| 1 | Fear of surgery pain — hemorrhoidectomy recovery is routinely described as "the most painful" common procedure. 6.9M Americans remain untreated because of this. | Very Common |
| 2 | Embarrassment barrier — patients avoid disclosing symptoms, delay seeing a physician, and strongly prefer anonymous digital information-gathering. | Very Common |
| 3 | Multi-session fatigue — CRH banding requires 3 sessions over 6 weeks. Busy professionals resist multi-appointment protocols. | Very Common |
| 4 | Insurance uncertainty — "Will this be covered?" is a primary question. Cash-pay at $2,000-$3,500 reduces this friction vs. higher-priced alternatives. | Common |
| 5 | Skepticism about "new" procedures — healthy skepticism demands clinical evidence: named study, named physicians, specific numbers. | Common |
| 6 | Loss of normal life — the real motivation is restoration: exercising, sitting, traveling without anxiety. | Common |
Emotional Driver Map
| Emotion | Intensity | Trigger | FILMORA Messaging Hook |
|---|---|---|---|
| Fear (of surgery) | Very High | "Hemorrhoidectomy recovery" searches | "No surgery. No stitches. Back to work the same day." |
| Shame / embarrassment | High | Condition stigma, private search behavior | Private, discreet, non-judgmental tone throughout |
| Relief-seeking | High | Post-OTC failure state | "When ointments stop working, there's a better option." |
| Skepticism | Medium | New procedure, aggressive medical marketing | Published study, named physicians, specific numbers |
| Control | Medium | Patient wanting to self-direct care | "Get the facts. Decide for yourself." |
| Hope | High | Discovery of FILMORA for first time | Patient outcome stories (when consented patients exist) |
| Loss aversion | High | Years of suffering already behind them | "You don't have to keep living like this." |
Trust Hierarchy
| Rank | Source | Trust Level |
|---|---|---|
| 1 | Other patient experiences (forums, reviews) — patients overwhelmingly seek peer validation first | Highest |
| 2 | Specialist doctor recommendation — colorectal surgeon or GI, but only after self-education | High |
| 3 | Specific recovery timelines — "back to work in 1 day" beats "minimal recovery" | High |
| 4 | Clinical studies / success rates — PubMed carries more weight than clinic websites | Moderate |
| 5 | Online reviews (Google, Healthgrades) — star ratings and volume matter for choosing a provider | Moderate |
| 6 | Clinic/procedure website — patients read these but approach with skepticism | Low-Moderate |
| 7 | Social media ads — high skepticism. "If it sounds too good to be true" is a common refrain | Low |
Persona Validation Required
Personas below are our recommendation based on market research. They should be validated with Meribel's 400-patient dataset from Francesco's Italian practice.
The Three Patients
Three distinct personas represent the reachable TAM. Each searches differently, fears differently, and converts differently.
ICP Priority Matrix
| Persona | TAM % | Primary Channel | Entry Hook | Time to Decision | Retention Value |
|---|---|---|---|---|---|
| Marcus — "The Reluctant Avoider" | 45% | Google Search (symptom-intent) | "Back to work the same day" | 2-6 weeks | High — becomes quiet advocate |
| Sarah — "The Informed Advocate" | 30% | SEO content / Study link | "Published 5-year outcomes" | 1-3 weeks | Very High — shares research |
| Robert — "The Repeat Sufferer" | 25% | Physician referral | "One session. Lasting results." | 1-2 weeks | Highest — vocal advocate |
Marcus
The Reluctant Avoider
Snapshot: Marcus has been dealing with Grade III hemorrhoids for 2-5 years. He has tried every OTC remedy. He has employer-sponsored insurance but would pay $2,000-$3,500 out-of-pocket to avoid a surgical hemorrhoidectomy. He searches on his phone in private browsing mode late at night.
Core Fears
- Surgery pain and 2-4 week recovery — he has read hemorrhoidectomy recovery stories and decided he would rather live with the condition
- Embarrassment and disclosure — he has not told his spouse or doctor. Any marketing that feels public or social will lose him immediately
- Losing work time — taking days off for an undisclosed condition is a nonstarter. Same-day recovery is conversion-critical
What Converts Marcus
"Back to work the same day" + 92% pain-free data + named physician credentials. These three proof points, in this order, move Marcus from avoidance to action. He needs to believe the 15-minute procedure is real, safe, and fast enough to fit into a normal workday.
Sarah
The Informed Advocate
Snapshot: Sarah approaches health decisions with thorough research. She will read the actual published study, look up the physicians on PubMed, and evaluate the complication data before booking. Her conversion barrier is trust, not fear.
Core Fears
- Incomplete or hidden data — she will leave any site making vague claims without sources
- Unvetted physicians — she checks credentials. Physician bios without institutional affiliations are a red flag
- Being sold to rather than informed — marketing-speak triggers her skepticism. She wants data, not testimonials
What Converts Sarah
Full published study linked + detailed physician bios + honest FAQ with complications (15.3% minor bleeding, 12.9% retreatment). Sarah converts when she can verify every claim independently. She becomes a vocal advocate who shares the research with others.
Robert
The Repeat Sufferer
Snapshot: Robert has been through 2-3 prior treatments that did not last. He has had banding that recurred and possibly a procedure that failed. He is skeptical of promises and cynical about "new" options. His GI doctor is his most trusted source, and a physician referral is the most likely path to FILMORA.
Core Fears
- Recurrence — every prior treatment failed him. "Will this one last?" is the central question
- Wasted money on another temporary fix — he needs durability data, not marketing claims
- Another painful recovery — even if pain is lower, he has experienced post-procedure complications before
What Converts Robert
5-year recurrence <10% + his GI physician recommending FILMORA specifically + honest disclosure of 12.9% retreatment rate (which compares favorably to banding). Robert converts through trust transfer from his physician. He becomes the most vocal advocate post-procedure.
Lead with Marcus
He is 45% of TAM, highest volume, and the most reachable through Google Search. Sarah converts through the published study. Robert converts through physician referrals.
Positioning & Messaging
Narrative kernel, core positioning, differentiator hierarchy, and persona-specific messaging.
Narrative Kernel
"For the millions who've been told their only option is living with hemorrhoids or enduring weeks of surgical recovery — there is now a 15-minute, evidence-backed alternative. FILMORA exists so patients can finally act on a solution they've been searching for, backed by 400+ procedures and published 5-year data from real physicians."
The Narrative Kernel
Core Positioning Statement
"For adults with Grade II-III internal hemorrhoids who have failed conservative treatment and fear surgical hemorrhoidectomy, FILMORA by Fast Clinical is the 15-minute minimally invasive procedure with near-zero pain and same-day recovery, backed by 400+ procedures and published 5-year outcomes."
Differentiator Hierarchy
| Rank | Differentiator | Defensibility | Patient Impact | Evidence Source |
|---|---|---|---|---|
| 1 | 15-minute procedure, same-day recovery | High | Highest | Published + clinical |
| 2 | 92% zero pain in 5 post-op days | High | Highest | Published |
| 3 | Zero stenosis, incontinence, and infection | High | High | Published |
| 4 | <10% 5-year recurrence (400+ cases) | High (unique dataset) | High | Published + clinical |
| 5 | Anatomical restoration vs tissue removal | High (mechanism) | Medium | Published |
| 6 | FILMORA device — patented, <$150 per unit | High (IP + economics) | Low (patient-facing) | Patent filings |
| 7 | Multi-clinic model (Paris, Italy, Seattle) | High (operational) | Medium | Strategic |
Messaging by Persona
| Persona | Primary Hook | Proof Point | CTA | Tone |
|---|---|---|---|---|
| Marcus | "Back to work the same day. No surgery." | 92% pain-free, 15 min, 400+ procedures | "See if you're a candidate" | Direct, empathetic, private |
| Sarah | "Published 5-year outcomes. Real data." | 248 published patients, <10% recurrence | "Read the research" | Clinical, thorough, evidence-respectful |
| Robert | "One session. Lasting results." | <10% 5-year recurrence, 400+ cases | "Talk to a physician" | Direct, honest, no overselling |
Messaging by Channel
| Channel | Audience | Message Emphasis | Format | Guardrail |
|---|---|---|---|---|
| Google Search (symptom-intent) | Marcus, Sarah | Pain-free, same-day, 15-minute | Responsive search ad | No absolute claims; cite study |
| Google Search (comparison) | Sarah, Robert | Single session vs 3 bandings, published data | Responsive search ad | Fair balance on comparison claims |
| Reddit/Facebook communities | Marcus, Sarah | Educational, empathetic, evidence-linked | Community participation + AMA | No promotional language; educational only |
| Physician referral | Robert | Published outcomes, mechanism, physician-to-physician | Leave-behind, study reprint | Clinical language for physician audience |
| Email nurture | Marcus, Sarah | Evidence progression: study → physician → FAQ → financing | 3-email sequence | CAN-SPAM compliance |
| Meta awareness | Marcus, Sarah | Category education — "between ointments and surgery" | Static/video carousel | No health condition targeting |
The Plan
Physician-first strategy, launch phases, channel playbook, 30/60/90 actions, and measurement.
Phase 0 — Physician-First Strategy
Gareth was explicit: physician and referring physician awareness comes BEFORE patient marketing.
The Initial GTM Is Physician Education and Relationship Building
Gareth's 2+ years of trade show presence generated universally positive surgeon feedback ("I wish I had that patent," "Tell me when"). There are existing waitlists on both the supply side (surgeons who want the device) and demand side (patients asking about the procedure). The physician channel activates before any patient-facing marketing dollar is spent.
Surgeon Outreach Priorities
Target GI and colorectal practices in Seattle, Paris, and Reno metro areas
Start with practices that previously referred to THD — they have motivated patients and no credible referral destination. Reno is a potential secondary US geo.
Clinician education materials: mechanism, published study, patient selection
Grade II-III patient selection criteria, mechanism of action (thermal repositioning), published outcomes, and complication rates. Physician-to-physician language.
Referral packet: clinical summary, full study, referral form, clinic contact
Physical and digital leave-behind. Full published study reprint, one-page clinical summary, simple referral form, and direct contact information.
"Ask your doctor about..." pharma-style model for patient awareness
Patients who encounter FILMORA through community channels or SEO should be guided to ask their physician. This bridges the physician-first and patient-direct channels.
Surgeon Waitlist Activation
Communicate "clearance imminent" to the waiting physicians from Gareth's trade show network. Convert interest to commitment — which surgeons will refer patients in Month 1 post-clearance? Which practices want to add FILMORA capability via wholesale?
Surgeon Testimonial Limitations
Francesco associates marketing with propaganda. Luca is switching hospitals. Andrew is hesitant. We recommend planning for text testimonials at most — no video. AI-generated clinical education content is the primary creative vehicle for physician-facing materials.
Wholesale Device Opportunity
| Variable | Value | Notes |
|---|---|---|
| Device cost (FILMORA) | <$150 | Manufacturing cost per unit |
| Wholesale price | $600 | Sold to practices that want to add FILMORA |
| Margin to Meribel | 75%+ | High-margin recurring revenue per procedure |
| Practice charges patient | $2,000-$3,500 | Practice sets their own pricing |
| Practice margin | $1,400-$2,900/procedure | Compelling economics for adding the capability |
Launch Strategy
Four phases from pre-clearance through scale. Everything gates on FDA clearance (June/July 2026).
Launch Phases
Pre-Clearance (NOW → June/July)
Cannot sell. Build infrastructure, physician pipeline, SEO foundation, community engagement. This is the "gold zone" for pressure testing messaging without regulatory risk. Website (informational only), GBP, CRM, Reddit/FB observation, physician education materials.
Post-Clearance Launch (July – September)
FDA cleared. Three clinics activate simultaneously: Paris, Italy, Seattle. Google Ads live in Seattle DMA. First procedures. First revenue. Physician referral program activated. Surgeon waitlist converts to active referrers.
First Revenue Peak (September – November)
All channels firing. Optimize CPL, conversion rates. Reddit/FB shift from observation to active participation. Target: 40-60 procedures/month by end of this window across all locations.
Scale & Evidence (2027+)
RCT results published. Insurance submission package. Multi-city US expansion. Portfolio cross-sell across Meribel's platform. Wholesale device supply to additional practices.
Geo Strategy: Three Markets, One Proof-of-Concept
Paris and Italy leverage Francesco's existing practice and 400+ case history. Seattle is the US proof-of-concept — the market where we prove unit economics from scratch. Medical tourism (e.g., NY→Paris) is a viable secondary channel to test. National US expansion only after Seattle demonstrates sustainable economics. Reno, Nevada is the potential secondary US geo.
Supply vs. Demand: 4 Clinic Models
- Full M&A: Meribel acquires or builds the clinic. Full brand control, highest investment.
- Wholesale device supply at $600: Sell FILMORA to practices at 75%+ margin. They market and operate. Fastest to scale.
- Hybrid cap-table: Co-own with a local surgeon. Shared economics and risk.
- OR time arbitrage: Use idle operating room capacity at existing surgical centers. Lowest fixed cost.
We recommend owned-clinic for Seattle (brand control), wholesale for expansion. Francesco's capacity: 16 procedures per 8-hour day (30 min turnaround each). 100 procedures/month = trigger for adding another facility.
Channel Strategy
Phased by regulatory status. Pre-clearance channels are live NOW. Post-clearance channels activate on FDA approval.
Phase 0 Channels (Pre-Clearance — NOW)
Physician outreach
Gareth's trade show network activation. Communicate "clearance imminent" to waitlisted surgeons. Begin in-person meetings with GI/colorectal practices in Seattle, Paris, Reno. Distribute clinician education materials.
Website build (informational, not procedure marketing)
Fast Clinical website with educational content. No procedure claims until clearance. GA4, GTM, CRM infrastructure. Brand architecture finalization.
Reddit community engagement
Monitor and engage in r/hemorrhoids and related communities. Educational participation, not promotion. Test messaging resonance. Identify common patient language and fears.
Facebook group monitoring
Monitor hemorrhoid support groups. Understand patient conversations, objections, and information gaps. Prepare community engagement strategy for post-clearance.
Phase 1 Channels (Post-Clearance)
| Tier | Channel | Budget | Primary KPI |
|---|---|---|---|
| Tier 1 | Google Search (Seattle DMA) | $5-10K/mo | CPL <$150 |
| Tier 1 | Google Business Profile | $0 | Review count + rating |
| Tier 1 | Physician referrals | Variable (Gareth's time + materials) | Active referrers/month |
| Tier 2 | SEO / Content | Included in operations | Organic traffic, rankings |
| Tier 2 | Email nurture | Included | Open rate, click rate |
| Tier 2 | Reddit/Facebook (active participation) | Included | Engagement, referral traffic |
| Tier 3 | Meta awareness ($2-5K/mo) | $2-5K/mo | Impressions, site visits |
| Tier 3 | Retargeting | $500-1K/mo | Return visit rate |
| Tier 3 | KOL pilot | Variable | Credibility transfer |
NOT DOING
Channels We Recommend Against at Launch
TV/Radio, Print, TikTok, Programmatic display, PR — all premature for a pre-revenue launch. These channels require brand awareness that does not yet exist and budgets that should go to high-intent capture and physician relationships first.
Per-Persona Channel Strategy
| Persona | Primary Channel | Secondary Channel | Avoid |
|---|---|---|---|
| Marcus | Google Search + Meta | Reddit communities | Phone outreach — he values privacy |
| Sarah | SEO + published study link | Email nurture | Vague ads without data sources |
| Robert | Physician referral + branded search | GBP | Broad awareness — he trusts his doctor, not ads |
Budget Scenarios
| Scenario | Monthly Spend | Expected Procedures/Mo | Target CPL |
|---|---|---|---|
| Conservative | $10-15K/mo | 20-30 | $150 |
| Base | $30-50K/mo | 50-80 | $120 |
| Aggressive | $75-150K/mo | 100-200+ | $100 |
Budget Recommendation
Gareth indicated willingness to invest $30K-$150K/month. We recommend starting at $10-15K to prove unit economics, then scaling aggressively once CPL and conversion rates are validated.
30/60/90 Day Plan
Three phases mapped to the regulatory timeline. Days 0-60 are pre-clearance. Day 60-90 is post-clearance launch.
Days 0-30 (Pre-Clearance): BUILD + EDUCATE
| Action | Owner | Success Metric |
|---|---|---|
| Launch informational website (Fast Clinical brand, educational content only) | Amanda + Eric | Website live with GA4/GTM tracking |
| Configure GA4 + GTM conversion events | Amanda | Conversions verified in GA4 |
| Claim + optimize Google Business Profile | Amanda | Profile 100% complete |
| Configure CRM (lead stages, pipeline, contact properties) | Amanda | Test lead flows through pipeline |
| Publish 5 foundational SEO pages (condition overview, procedure detail, FAQ, comparison, physician bios) | Amanda | Pages published, schema verified |
| Build physician target list (50 GI + colorectal practices in Seattle/Reno) | Gareth | 50 practices identified, referral packet ready |
| Begin Reddit/Facebook community observation | Amanda | Community language patterns documented |
Testing: Community response to educational content, physician interest level.
Gate: Website live, physician pipeline of 20+ targets identified
Days 30-60 (Pre-Clearance → Clearance): ACTIVATE PHYSICIANS + PREP LAUNCH
| Action | Owner | Success Metric |
|---|---|---|
| Build Google Ads campaigns (not live — waiting clearance) | Amanda | 3 campaigns ready to activate |
| Distribute physician education materials to target practices | Gareth | 20+ practices contacted |
| Build email sequences (nurture + post-procedure) | Amanda | Sequences built and tested |
| Communicate "clearance imminent" to surgeon waitlist | Gareth | Waitlist re-engaged, commitments gathered |
| Finalize creative assets (AI-generated clinical education) | Amanda | Assets approved for post-clearance launch |
| Create Healthgrades/RealSelf profiles | Amanda | Profiles live |
Testing: Physician response rate, waitlist conversion intent.
Gate: FDA clearance received → immediately activate patient-facing channels
Days 60-90 (Post-Clearance): LAUNCH + LEARN
| Action | Owner | Success Metric |
|---|---|---|
| Google Ads live at $5-10K/mo (Seattle DMA) | Amanda | Ads live, first leads tracked |
| Physician referral program activated | Gareth | 3+ physicians actively referring |
| First procedures performed | Clinical | First 5-10 procedures completed |
| Review capture from first patients (Day 7 post-procedure) | Amanda + Clinical | First Google reviews posted |
| Retargeting live for website visitors | Amanda | Retargeting pixel firing |
| Reddit/Facebook shift to active participation | Amanda | Community engagement, referral traffic |
Testing: CPL, landing page CVR, consultation-to-procedure rate, cash-pay acceptance.
Gate: If <15 procedures/month at Day 90, diagnose root cause before scaling spend
Gareth's success metric: "by 90 days, when we have the FDA, we are not testing, we're acquiring patients."
Measurement & Success
North Star metric, KPI dashboard, unit economics, scenario analysis, and Day 90 diagnostic framework.
North Star: Monthly Procedures
KPI Dashboard
| KPI | Month 1 | Month 3 | Month 6 | Month 12 |
|---|---|---|---|---|
| Monthly procedures | 5-10 | 20-30 | 40-60 | 80-100 |
| Revenue | $10K-$35K | $40K-$105K | $80K-$210K | $160K-$350K |
| Patient acquisition cost (PAC) | $800 | $600 | $500 | $400 |
| Cost per lead (CPL) | $150 | $120 | $100 | $80 |
| Lead → Consultation rate | 40% | 50% | 55% | 60% |
| Consultation → Procedure rate | 40% | 50% | 55% | 60% |
| Landing page CVR | 5% | 8% | 10% | 12% |
| Active physician referrals/month | 1-2 | 3-5 | 5-7 | 8-10 |
Unit Economics by Model
| Model | Avg Price | Facility Cost | Margin | Notes |
|---|---|---|---|---|
| Owned clinic | $2,500 avg | Varies | ~60% | Full patient experience control |
| Wholesale device | $600 wholesale | <$150 device cost | 75%+ | Physician buys, markets, operates |
| OR arbitrage | $2,500 price | $500-1,500 facility fee | Variable | Uses idle OR capacity |
Scenario Analysis
| Scenario | Monthly Spend | Avg Procedures/Mo | Year 1 Revenue (Seattle) |
|---|---|---|---|
| Conservative | $10-15K | 30 | $1.5M |
| Base | $30-50K | 60 | $2.9M |
| Aggressive | $75-150K | 100+ | $4.5M |
Risk Matrix
| Risk | Likelihood | Severity | Mitigation |
|---|---|---|---|
| FDA clearance delay | Medium | Critical | All downstream plans shift. Pre-clearance work continues to build value. No patient marketing until clearance. |
| CPL exceeds $200 | Medium | High | Pause and redesign landing page. Test new keyword clusters. Do not scale broken unit economics. |
| Physician referrals don't activate | Low-Medium | High | Increase Gareth's visit cadence. Provide published study reprints. Host lunch-and-learn events. |
| Negative patient outcome | Low | Critical | Transparent complication disclosure from Day 1. Rapid response protocol. Published rates build credibility. |
| Brand damage from premature/generic marketing | Medium | High | Amanda's explicit concern. No generic stock content. Every asset must reflect legitimate clinical credibility. |
Day 90 Scenarios
Below Expectations
Procedures: <15/month
CPL: >$200
Referrals: <2 active physicians
CVR: <5%
On Track
Procedures: 20-30/month
CPL: $120-$150
Referrals: 3-5 active physicians
CVR: 8%+
Exceeding
Procedures: >30/month
CPL: <$100
Referrals: 5+ active physicians
CVR: >10%
The Creative Toolkit
Brand architecture, hook library, ad concepts, patient journey, and the KOL reality check.
Brand & Voice
Brand architecture, tone guidelines, and the language guardrails that protect clinical credibility.
Brand Architecture
| Brand Layer | Role | Audience | Usage |
|---|---|---|---|
| Meribel Health | Publicly traded parent | Investors, press, regulators | Corporate credibility, SEC filings, investor communications |
| Fast Clinical | Clinical brand | Physicians, regulators | Physician outreach, regulatory filings, published studies |
| FILMORA | Device brand | Physicians + patients | The physical product name, clinical references |
| FAST (pending) | Patient-facing procedure name | Patients, consumers | Website, ads, GBP, all patient touchpoints (pending confirmation vs FILMORA) |
Tone Guidelines
| Dimension | We Are | We Are Not |
|---|---|---|
| Confidence | Confident — "backed by 400+ procedures and published data" | Arrogant — "the best/only solution" |
| Empathy | Empathetic — "we understand this is hard" | Condescending — "you should have done this sooner" |
| Evidence | Evidence-first — "248 published patients, 5-year follow-up" | Vague — "clinically proven results" |
| Simplicity | Clear — "15-minute procedure, same-day recovery" | Jargon-heavy — "minimally invasive hemorrhoidopexy" |
| Authenticity | Genuine — real physicians, real data, real cases | Generic — stock imagery, unattributed claims |
Brand Language Guardrails
DO Say
- "92% of patients reported zero pain" (cite published study)
- "Back to work the same day"
- "400+ procedures performed, 248 published with 5-year outcomes"
- "A 15-minute outpatient procedure"
- "$2,000-$3,500 with financing options available"
- "15.3% experienced minor bleeding" (when asked)
DO NOT Say
- "Painless" or "guaranteed" or "100% effective"
- "Miracle cure" or "revolutionary breakthrough"
- "Better than surgery" without fair balance
- "FDA approved" until clearance is legally confirmed
- "No side effects" or "completely risk-free"
- Unsubstantiated claims from the archived explainer video
Amanda's #1 Priority: Brand Protection and Authenticity
No generic stock content. Every creative asset must reflect legitimate clinical credibility. AI-generated clinical education content is acceptable. Generic marketing content that could belong to any procedure is not.
Hooks & Ad Concepts
20 hooks mapped to persona and channel, plus 4 Google Ads campaigns ready to launch post-clearance.
Hook Library
| # | Hook | Type | Persona | Channel |
|---|---|---|---|---|
| 1 | "When ointments stop working, most patients give up. Here's what they don't know." | PAS | Marcus | Google, Meta |
| 2 | "You've been managing hemorrhoids for years. The creams help less and less." | PAS | Marcus | Meta, Reddit |
| 3 | "Three banding sessions. Six weeks. And they came back. Sound familiar?" | PAS | Robert | Google (comparison) |
| 4 | "You've Googled 'hemorrhoid treatment without surgery' at 2 AM." | PAS | Marcus | Google (symptom) |
| 5 | "92% of patients reported zero pain in the 5 days after the procedure." | Evidence | All | Google, landing page |
| 6 | "90% of patients never returned for treatment. Published 5-year follow-up." | Evidence | Robert, Sarah | Google, physician |
| 7 | "400+ procedures. Published outcomes. Named physicians. Real data." | Evidence | Sarah, Robert | Google, landing page |
| 8 | "15 minutes. One session. Published 5-year results." | Evidence | All | Google headlines, GBP |
| 9 | "I was out of work for 3 weeks after hemorrhoid surgery. I wish I'd known." | Persona | Marcus | Meta, retargeting |
| 10 | "15 minutes. The doctor used a specialized device. I went back to work the next day." | Persona | Marcus | Meta, video |
| 11 | "I read the actual study before I booked. The data convinced me." | Persona | Sarah | Meta, SEO |
| 12 | "Hemorrhoid banding requires 3 appointments over 6 weeks. This takes 15 minutes, once." | Persona | Robert | Google, landing page |
| 13 | "The surgery you're afraid of isn't your only option." | Contrarian | Marcus | Meta, SEO |
| 14 | "Between ointments and surgery, there's a 15-minute option most doctors don't know about yet." | Contrarian | Marcus, Sarah | Meta, Google |
| 15 | "Your hemorrhoids aren't getting better because creams don't fix Grade II-III disease." | Contrarian | Marcus | SEO, Reddit |
| 16 | "A published study followed 248 patients for 5 years. Here's what happened." | Curiosity | Sarah | Meta, SEO, email |
| 17 | "Why 6.9 million Americans with hemorrhoids are suffering unnecessarily." | Curiosity | Marcus, Sarah | SEO, Reddit |
| 18 | "A procedure backed by 400+ cases and a PhD in optics." | Curiosity | Sarah | SEO, physician |
| 19 | "$2,000-$3,500 for a 15-minute procedure. Here's why it costs less than you'd expect." | Trust | Marcus | Landing page, email |
| 20 | "No phone call required. Start with a private online consultation request." | Trust | Marcus | Landing page, Google |
Google Ads Campaigns
| Campaign | Headline 1 | Headline 2 | Headline 3 | Description |
|---|---|---|---|---|
| Treatment-intent | Hemorrhoid Treatment Seattle | 15-Minute Procedure, Same Day | Published 5-Year Outcomes | Near-zero pain. $2,000-$3,500. Back to work same day. 400+ procedures performed. Learn if you qualify. |
| Comparison | Not Ready for Surgery? | Grade III Hemorrhoid Alternative | One Visit. Lasting Results. | 92% zero pain. 15-minute procedure. Published 5-year data. Board-certified physicians. Seattle clinic. |
| Symptom-intent | Hemorrhoids Won't Go Away? | Creams Stopped Working? | 15-Min Treatment Option | A 15-minute minimally invasive option. 400+ procedures performed. Published outcomes. Seattle clinic. |
| Physician-referred | Referred by Your Doctor? | The FILMORA Procedure | Peer-Reviewed Outcomes | Your physician referred you here. 15 minutes. $2,000-$3,500. See published data for 248 patients. |
Creative Compliance Guardrails
- No absolute claims ("painless," "guaranteed," "100%"). Use "near-zero pain" or "92% reported zero pain."
- Every clinical claim must cite the published study or Francesco's clinical data.
- No before/after imagery without explicit patient consent and HIPAA compliance.
- Meta: no health condition targeting. Use interest/behavioral targeting only.
- No patient marketing of any kind until FDA clearance is received.
- All creative assets reviewed by Amanda for brand authenticity before publishing.
Patient Journey & KOL
From first touch through advocacy — every touchpoint mapped. Plus the KOL reality check given surgeon reluctance.
Patient Journey Map
First Touch
Google search / Reddit / Physician referral / Facebook group — Patient discovers FILMORA exists. Visits website. Spends 2-5 minutes on procedure page and FAQ.
Inquiry
Online form (preferred) or phone call — Patient submits consultation request. Immediate confirmation email. CRM creates lead. Same-day callback from clinic.
Nurture
3-email sequence over 7 days — Day 0: Confirmation + physician bio. Day 3: Clinical evidence + FAQ. Day 7: Financing + scheduling CTA.
Consultation
In-person clinical evaluation — Physician confirms Grade II-III candidacy (80% qualify). Discusses the 15-minute procedure, outcomes, honest complication rates. Addresses fears. Financing at $2,000-$3,500.
Procedure
15-minute outpatient session — Local anesthesia. FILMORA device. Patient walks out same day. Digital post-procedure instructions via email and text.
Recovery & Follow-Up
Day 1-90 activation sequence — Day 1: Text check-in. Day 7: Satisfaction survey + review request. Day 30: Outcome survey + referral ask. Day 90: Case study consent.
Advocacy
Patient becomes acquisition channel — Google review published. Referral to 1-2 friends. Case study consent. The patient who arrived through Google Ads now generates zero-cost referrals.
Post-Procedure Activation
| Timing | Touchpoint | Purpose | Channel |
|---|---|---|---|
| Day 1 | Follow-up check-in | Patient wellbeing, answer questions | Text message |
| Day 7 | Satisfaction survey + Google review request | Feedback capture, GBP review velocity | Email + text |
| Day 30 | Outcome survey + referral ask | Outcome data, activate word-of-mouth | |
| Day 90 | Long-term follow-up + case study consent | Durability tracking, content pipeline |
KOL Reality Check
Surgeon Testimonials Are Limited
Video testimonials are unlikely at launch. Francesco distrusts marketing (associates it with propaganda). Luca is switching hospitals. Andrew is hesitant. We recommend planning for text testimonials from select surgeons at most. AI-generated clinical education content is the primary creative approach for physician-facing materials.
| Tier | Profile | Role | Reality Check | Timeline |
|---|---|---|---|---|
| Tier 1: Physician KOLs | Francesco, named co-inventors | Clinical credibility, published authorship | Text-only. No video. Francesco is reluctant. | Month 1+ (text only) |
| Tier 2: Referring Physicians | GI/colorectal practices in target geos | Referral network, physician-to-physician trust | Activated through Gareth's relationships | Month 1+ |
| Tier 3: Patient Advocates | Consented post-procedure patients | Peer validation (highest trust source) | Requires first US procedures. Italian patients may consent. | Month 3+ |
Engagement & SOW
What we committed to, what the engagement covers, and what happens next.
Engagement & SOW
Two-week trial deliverables, ongoing coverage, and the path from trial to execution.
Two-Week Trial Deliverables
SEO audit of Fast Clinical site
Technical audit, content gap analysis, and keyword opportunity map for the existing Fast Clinical web presence.
Brand strategy via AI intelligence
Competitive positioning, messaging framework, and brand architecture recommendation (delivered in this report).
Content roadmap and blog development strategy
Prioritized content calendar for pre-clearance and post-clearance phases, mapped to patient journey stages and SEO targets.
Creative testing recommendations
Hook library (20 hooks), Google Ads campaigns (4 ready to build), and messaging-by-persona framework.
Landing page identification
Core landing page structure, conversion elements, and A/B test plan for post-clearance patient acquisition.
Community engagement strategy (Reddit/Facebook)
Pre-clearance observation plan, post-clearance participation strategy, and compliance guardrails for community engagement.
What $30K/Month Covers
| Included | Description |
|---|---|
| CMO strategic leadership | Ongoing strategy, channel prioritization, budget allocation, performance review |
| AI-driven creative | Ad copy, landing pages, email sequences, clinical education content |
| Channel strategy + execution | Google Ads management, SEO content, community engagement, physician materials |
| Reporting + analytics | Weekly performance reports, KPI tracking, optimization recommendations |
What Requires Additional Investment
| Item | Notes |
|---|---|
| Large-scale photo/video production | Professional shoots, clinic photography, procedure video. Can be scoped separately. |
| Physical clinic signage/brochures | We can design and produce — requires scoping based on clinic needs. |
| Media spend | Google Ads, Meta, retargeting budgets are pass-through, not included in the $30K. |
Next Steps
Kickoff
Two-week trial begins. Deliver the six items above. Gareth reviews this GTM strategy report.
Business Review + CMO Assignment
Assign a dedicated CMO to the account. Conduct a full business review with Gareth, Amanda, and Eric.
Channel Plans with Copilot
CMO + copilot build detailed channel execution plans. Google Ads built (not live until clearance). SEO calendar finalized. Physician materials produced.
Execution
Pre-clearance work begins immediately. Post-clearance channels activate on FDA approval. Gareth's bar: "by Day 90 post-clearance, we are acquiring patients, not testing."