This spotlight on the ROBO Global Healthcare Technology and Innovation Index highlights Grail (GRAL), a standout within the Genomics subsector. It is a key component of the $53.6 million ROBO Global Healthcare Technology and Innovation ETF (HTEC ). We examine what sets Grail apart and review its recent performance.
Grail is a pioneer in multi-cancer early detection (MCED) technology. Its mission is to detect cancer early, when it can be more effectively treated. The company developed Galleri, an MCED blood test that can detect a signal shared by over 50 types of cancer. Galleri analyzes cell-free DNA (cfDNA) in the bloodstream, identifying changes that may indicate the presence of cancer. It is the company’s flagship MCED test.
Launched in 2021, Galleri can detect a shared cancer signal across more than 50 types of cancer. Many of these lack recommended screening today, such as pancreatic, ovarian, esophageal, and liver cancers. The Galleri test demonstrates a low false-positive rate (less than 1%) and can also predict the location of the cancer signal with high accuracy to help guide the next steps for diagnosis. The product is designed for individuals with an elevated risk, including those aged 50 and above. However, it theoretically could see adoption go down to much lower age groups who are at higher risk for genetic or environmental reasons.
Grail's Growth Potential
Despite being a prescription-only test not yet covered by insurance, Galleri has seen significant commercial interest. It’s had year-over-year revenue growth of 52%, reaching $25 million, and over 250,000 tests sold since its launch. Following the spin-off from Illumina, Grail maintains a strong cash balance of $853.6 million, providing a financial runway through 2028. This period is expected to include two key milestones. First, results from an 140,000 person NHS early adoption study will be released in 2026. Second, potential FDA approval in 2027 could enable broader reimbursement and adoption in the U.S. and U.K.
The global MCED market presents a significant growth opportunity, with an estimated 400 million people in the U.S. and Europe who could benefit from early detection solutions. As populations age and the advantages of identifying cancers at earlier, more treatable stages become increasingly clear, Grail’s pursuit of regulatory approval and reimbursement is expected to drive substantial revenue growth.
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VettaFi LLC (“VettaFi”) is the index provider for HTEC, for which it receives an index licensing fee. However, HTEC is not issued, sponsored, endorsed or sold by VettaFi, and VettaFi has no obligation or liability in connection with the issuance, administration, marketing, or trading of HTEC.
