Estimand when treatment delays disease onset

I think the estimates framework is dramatically overhyped but still offers a bit. Particular judgments are key; the same as saying that a utility function needs to be considered before revealing the results. For a weight loss study the clear estimand would be the final weight, ignoring the journey. For a pain study, any day pain-free is good so using a Markov longitudinal model to estimate pain-free days or days with pain level < 2 would be appropriate. I’m not as clear on the clinical setting for the vanc study.