The strategic focus of a world-wide operating medical device company is to improve its position in the intramedullary nail market by offering a competitive reaming solution. Reamers (instrument) are used to prepare the bone before nails (implant) are inserted. Preliminary research shows that the current reaming solution is not comprehensive compared to competitors. Therefore, a business case shall be created that identifies customer needs, assesses the current market and competitors, and suggests features and options a future reaming solution should have.

The company’s current business case template was used as a basis to address the problem. However, literature review performed showed critical factors for a satisfying business case and examined the medical necessity of reaming but also benefits and downsides. Afterwards, internal surveys with surgeons and market research helped to identify customer needs and desires. Furthermore, available competitor solutions were compared to the company's solution. Additionally, the trauma and nail market were analyzed to address the market and financial aspect.

The intramedullary nail market’s projected and current growth is above the trauma average suggesting a lucrative opportunity to invest. During reaming, surgeons seem to be most concerned about intramedullary bone pressure, heat generation and sharpness of reamers. However, all three are connected as an increased and ensured sharpness reduces pressure and heat generation. Furthermore, the most desired features are a fixed-head option, smaller starting reamer and increased power tool compatibility. The suggested solution could lead to increased sharpness and cost benefits for hospitals as it reduces reprocessing costs. The launch is recommended only for the US market as it seems to be less price sensitive than Europe. Additionally, a fixed-head solution should be offered for Europe and United States to increase the portfolio and attract surgeons that prefer this option. Both products would help the company to offer a comprehensive and broad reaming solution. Additionally, the company should consider adjusting its business cases to include hypothesizes or alternatives in the beginning and a cross-functional team should be formed prior to the creation not after its approval.