Digital Diabetes Screening in Switzerland: A cost-effectiveness analysis
Journal
Annual Meeting of the Swiss Society of Endocrinology and Diabetology (SGED-SSED 2025)
Type
conference poster
Date Issued
2025-11-14
Author(s)
;
;
Fuchs, Magdalena
;
Jin, Qiuhan
;
Wirth, Benjamin
;
Bilz, Stefan
;
Brändle, Michael
;
;
Jovanova, Mia
Abstract
Early identification of individuals at risk for type 2 diabetes (T2D) is critical for timely
lifestyle intervention and prevention. While digital health applications offer a scalable and accessible
approach to risk screening, their value depends on achieving sufficient accuracy to justify widespread
use. This study aims to assess the cost-effectiveness of digital diabetes screening in Switzerland.
A decision-analytic model was developed comprising a 1-year budget impact component
and a 5-year cost-effectiveness analysis, consistent with established economic evaluation frameworks
for diabetes screening. The target population consisted of 7 million Swiss adults aged 20 and above,
with a 6% prevalence of T2D, of which 33% were assumed to be undiagnosed. The risk score was
modeled as a two-step screening process, with assumed sensitivities ranging from 60% to 95% and
specificities ranging from 90% to 99%, followed by confirmatory laboratory testing (e.g., HbA1c, FPG).
Uptake scenarios ranged from 20% to 80%. Screening costs were considered based on available
market prices, ranging from CHF 5 to CHF 120 per user, confirmatory testing at CHF 40, and initial
treatment at CHF 200. Outcomes included new cases of T2D detected and quality-adjusted life years
(QALYs) gained. Early detection was assumed to reduce the incidence of diabetes-related
complications by 15% over 5 years. All parameters were sourced from published literature and Swiss
public health data.
In the base-case scenario (50% uptake, CHF 5 screening cost), the program identified
55,440 new T2D cases, with a 1-year net cost of CHF 38 million, equating to CHF 680 per case for
statutory insurers (LaMal). Outpatient providers experienced a predominantly positive or neutral
financial impact, benefiting from a larger diabetic population that allowed for earlier disease
management. Over five years, the screening cost CHF 528.5 million and generated 528,917 QALYs,
compared to CHF 657.2 million and 522,000 QALYs without screening. The incremental costeffectiveness
ratio (ICER) was –CHF 18,565 per QALY gained, indicating that the screening was
dominant (lower cost, higher benefit). Sensitivity analysis showed cost-effectiveness was maintained
when specificity exceeded 90% and uptake surpassed 30%. These thresholds mark critical conditions
under which the screening remains economically viable.
Our analysis indicates that integrating digital diabetes screening into outpatient care in
Switzerland is economically dominant under realistic assumptions. This approach offers substantial
potential for cost-effective early detection and significant system-level savings, making it a valuable
addition to national preventive health strategies.
lifestyle intervention and prevention. While digital health applications offer a scalable and accessible
approach to risk screening, their value depends on achieving sufficient accuracy to justify widespread
use. This study aims to assess the cost-effectiveness of digital diabetes screening in Switzerland.
A decision-analytic model was developed comprising a 1-year budget impact component
and a 5-year cost-effectiveness analysis, consistent with established economic evaluation frameworks
for diabetes screening. The target population consisted of 7 million Swiss adults aged 20 and above,
with a 6% prevalence of T2D, of which 33% were assumed to be undiagnosed. The risk score was
modeled as a two-step screening process, with assumed sensitivities ranging from 60% to 95% and
specificities ranging from 90% to 99%, followed by confirmatory laboratory testing (e.g., HbA1c, FPG).
Uptake scenarios ranged from 20% to 80%. Screening costs were considered based on available
market prices, ranging from CHF 5 to CHF 120 per user, confirmatory testing at CHF 40, and initial
treatment at CHF 200. Outcomes included new cases of T2D detected and quality-adjusted life years
(QALYs) gained. Early detection was assumed to reduce the incidence of diabetes-related
complications by 15% over 5 years. All parameters were sourced from published literature and Swiss
public health data.
In the base-case scenario (50% uptake, CHF 5 screening cost), the program identified
55,440 new T2D cases, with a 1-year net cost of CHF 38 million, equating to CHF 680 per case for
statutory insurers (LaMal). Outpatient providers experienced a predominantly positive or neutral
financial impact, benefiting from a larger diabetic population that allowed for earlier disease
management. Over five years, the screening cost CHF 528.5 million and generated 528,917 QALYs,
compared to CHF 657.2 million and 522,000 QALYs without screening. The incremental costeffectiveness
ratio (ICER) was –CHF 18,565 per QALY gained, indicating that the screening was
dominant (lower cost, higher benefit). Sensitivity analysis showed cost-effectiveness was maintained
when specificity exceeded 90% and uptake surpassed 30%. These thresholds mark critical conditions
under which the screening remains economically viable.
Our analysis indicates that integrating digital diabetes screening into outpatient care in
Switzerland is economically dominant under realistic assumptions. This approach offers substantial
potential for cost-effective early detection and significant system-level savings, making it a valuable
addition to national preventive health strategies.
HSG Classification
contribution to scientific community
Refereed
Yes
Publisher place
Lucerne
Event Title
Annual Meeting of the Swiss Society of Endocrinology and Diabetology (SGED-SSED 2025)
Event Location
KKL Luzern
Event Date
14.11.2025
Division(s)
Contact Email Address
wasu.mekniran@unisg.ch
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