Delphi expert consensus on postmenopausal hormonal therapy sequencing: 65 authors, published in peer-reviewed journal

Postmenopausal hormonal therapy offered clinicians multiple sequencing options, with different agents appropriate at different stages of disease and different patient profiles. But the clinical literature had not crystallised into a working consensus — different thought leaders in different countries advocated different approaches, and no international guideline body had formally addressed sequencing.

The absence of consensus had downstream consequences. HCPs in non-specialist settings were uncertain about sequencing decisions. Reimbursement bodies were using the lack of consensus to justify restrictive prescribing conditions. The brand's own medical positioning was complicated by the competing voices of equally credible experts.

A properly conducted, methodologically transparent Delphi process was the only approach that could produce a credible consensus — one that would be taken seriously by guideline bodies and HTA committees.

A Delphi consensus is not a marketing document. It is a scientific methodology with strict requirements for participant independence, question design, and statistical analysis. Done correctly, it produces something no individual expert statement can: a credible collective position.