Meribel

• label: Procedure Time

value: "10 min" sub: avg per patient

• label: Pain-Free Rate

value: "92%" sub: 0 pain in 5 post-op days

• label: 5-Year Efficacy

value: "87%" sub: asymptomatic at 5 years

• label: Clinics Operating

value: "0" sub: Seattle under construction

What's Happening

Meribel Health is a pre-launch MedTech company commercializing Thermal Submucosal Hemorrhoidopexy (TSH) — a patented, 10-minute, minimally invasive hemorrhoid treatment. The company holds IP on a proprietary anoscope device, has published clinical outcomes for 248 patients (5-year follow-up), and is building its first owned clinic in Seattle. No marketing platforms are live. No patients have been treated in the US. The Seattle clinic is under construction with an opening date TBD.

The consumer-facing procedure brand is FAST (visible in Figma website design). Meribel Health is the corporate entity behind FAST, mirroring how Align Technology operates behind Invisalign.

Why It Matters

This is a category creation moment. TSH directly addresses the largest unmet need in hemorrhoid care: the gap between ineffective OTC treatment and feared surgical hemorrhoidectomy. An estimated 10.4 million Americans suffer from hemorrhoids annually. The majority avoid treatment due to fear of surgery. TSH's near-zero pain profile and same-day recovery directly removes this barrier — but patients cannot self-refer to a procedure they've never heard of. Every month without a website, a Google Ads campaign, and a functioning clinic is a month of zero revenue and zero brand-building in a market that will be won by whoever captures patient awareness first.

What We Do About It

Three actions unlock everything else:

Finding 1: The procedure brand is FAST — and that's a strategic asset. The Figma website design shows a clean, modern brand called "FAST" distinct from "Meribel Health." This mirrors Invisalign (vs. Align Technology) and is the right call. Patients will search for "FAST procedure" not "Meribel Health." The brand must be built around FAST, with Meribel as the corporate credibility layer.

Finding 2: The biggest competitive threat is CRH O'Regan — not surgeons. CRH has 3,000+ locations, established insurance coverage, and is entrenched with GI physicians. TSH's single-session advantage and superior Grade III outcomes are the differentiators. But CRH has distribution; TSH does not. Distribution must be built urgently.

Finding 3: THD/HAL is weakening — and TSH can own that vacancy. As of March 2025, major payers have classified THD as "investigational for all indications." This is a significant competitor exit from the middle-market. TSH can position as the next-generation minimally invasive alternative with published evidence and no investigational designation.

Finding 4: Insurance is the medium-term unlock, not the launch constraint. Cash-pay at $3,000–$5,000 limits the total addressable market but is viable at launch (LASIK and Sono Bello proved cash-pay models work). The Paris and NYC controlled trials (H2 2026) are the insurance pathway — positive RCT data is what payers need to assign CPT codes and extend coverage.

Finding 5: The published journal article is underutilized. Sias & Milone (2025), Journal of Surgery, is the most valuable marketing asset in the portfolio. It is the basis for every clinical claim, the physician referral packet anchor, and the credibility signal that separates FAST from unproven alternatives. It must be front-and-center on the website, in press outreach, and in every physician conversation.

Market Size

TSH's serviceable market at Seattle launch: 10,000–15,000 potential candidates in the metro, with base capacity of ~1,440 procedures/year (120/month). Year 1 target captures less than 10% of the eligible self-pay population — demand is not the constraint, supply and awareness are.

Seasonality

Hemorrhoid treatment demand follows a well-documented seasonal pattern aligned with GI procedure calendars:

Unit Economics Model

Working assumption for Year 1 planning: $600 blended PAC — accounting for the ramp period and mix of paid search, SEO, and early physician referrals.

Channel Economics (Benchmarked)

Max CPL Guardrails

At $4,000 revenue per procedure and target margins:

Current State: Zero Baseline

No live platforms, no data. All figures below are benchmark targets based on LASIK, Sono Bello, and CRH O'Regan analogs.

Target Funnel — Google Ads (Month 6)

Target Funnel — Physician Referral (Month 6)

Procedure Competitor Landscape

Competitive Analysis: Where FAST Wins and Where It's Vulnerable

FAST's durable advantages:

• Single 10-minute session vs. CRH's 3-session protocol over 6 weeks
• 92% zero pain vs. moderate-to-severe for all surgical alternatives
• Zero stenosis, incontinence, or infection in 248-patient published study
• Anatomical restoration (repositions tissue) vs. destruction (banding) or removal (excision)
• Published 5-year follow-up data — stronger than CRH's published evidence for Grade III
• THD vacancy: THD is being abandoned by payers; FAST can capture the "minimally invasive, not surgery" position

FAST's current vulnerabilities:

• Insurance coverage undefined — limits to self-pay patients (~30% of eligible population)
• Zero US clinical locations vs. CRH's 3,000+
• Level IV evidence (case series) — cannot make comparative superiority claims
• No sedation-free option — anesthesia requirement vs. CRH's anesthesia-free approach
• Brand awareness: zero — patients cannot seek a procedure they've never heard of

GTM Model Comparables

Website Audit (Figma Design — Pre-Launch)

The FAST website design is clean, modern, and credibly medical. Key findings from design review:

Content Gaps

Priority 1: Website Live + Tracked (Weeks 1–6)

Priority 2: Google Ads — Seattle Geo (Weeks 4–8)

Priority 3: Physician Referral Program (Weeks 4–10)

Priority 4: Google Business Profile + Review Generation (Week 1, ongoing)

Phase Roadmap

This review is based on pre-launch benchmarks, published clinical data (Sias & Milone 2025), and GTM model analysis of comparable patient-direct procedure companies (LASIK, Sono Bello, CRH O'Regan). All financial projections are estimates. No live platform data is available.

Prepared by MH1 | Meribel Health | Confidential | April 2026