Early health technology assessment of digital diabetes screening in Switzerland: cost-effectiveness and budget impact analyses
Journal
MedRxiv
Type
journal article
Date Issued
2026-02-11
Author(s)
;
;
Magdalena Fuchs
;
Qiuhan Jin
;
Benjamin Wirth
;
Stefan Bilz
;
Michael Brändle
;
;
;
Mia Jovanova
Abstract
Objectives
Digital biomarkers offer scalable screening for type 2 diabetes, yet adoption is stalled by uncertainty regarding economic viability. This study evaluates the cost-effectiveness and budget impact of digital screening compared to opportunistic screening from a Swiss payer perspective.
Methods A probabilistic Markov cohort model was developed to simulate at-risk Swiss adults (age ≥45, BMI ≥25 kg/m²) over a 40-year horizon. The model incorporates a digital attrition parameter, inputs derived from Swiss-specific sources (e.g., the CoLaus study and FSO life tables), and statutory tariffs. Costs and outcomes were discounted at 3.0%.
Results In the deterministic base-case, digital screening yielded an incremental cost-effectiveness ratio of CHF 2,912 per quality-adjusted life-year gained. Probabilistic sensitivity analysis indicated a 93.2% probability of cost-effectiveness at the CHF 50,000 threshold. The budget impact analysis estimated a Year 1 gross investment budget of CHF 27 million to identify prevalent cases, followed by long-term savings from averted complications.
Conclusions Digital screening can be highly cost-effective in Switzerland. While the required Year 1 gross investment poses a liquidity challenge, reimbursement via pathway-oriented models under the Swiss tariff could align incentives with long-term complication avoidance.
Digital biomarkers offer scalable screening for type 2 diabetes, yet adoption is stalled by uncertainty regarding economic viability. This study evaluates the cost-effectiveness and budget impact of digital screening compared to opportunistic screening from a Swiss payer perspective.
Methods A probabilistic Markov cohort model was developed to simulate at-risk Swiss adults (age ≥45, BMI ≥25 kg/m²) over a 40-year horizon. The model incorporates a digital attrition parameter, inputs derived from Swiss-specific sources (e.g., the CoLaus study and FSO life tables), and statutory tariffs. Costs and outcomes were discounted at 3.0%.
Results In the deterministic base-case, digital screening yielded an incremental cost-effectiveness ratio of CHF 2,912 per quality-adjusted life-year gained. Probabilistic sensitivity analysis indicated a 93.2% probability of cost-effectiveness at the CHF 50,000 threshold. The budget impact analysis estimated a Year 1 gross investment budget of CHF 27 million to identify prevalent cases, followed by long-term savings from averted complications.
Conclusions Digital screening can be highly cost-effective in Switzerland. While the required Year 1 gross investment poses a liquidity challenge, reimbursement via pathway-oriented models under the Swiss tariff could align incentives with long-term complication avoidance.
Language
English (United States)
Keywords
health technology assessment
digital health
prevention
cost-effectiveness
budget impact
HSG Classification
contribution to scientific community
Refereed
Yes
Subject(s)
Division(s)
File(s)![Thumbnail Image]()
open.access
Name
2026.02.10.26345992v1.full-2.pdf
Size
1.75 MB
Format
Adobe PDF
Checksum (MD5)
ec8bf0f487d83ff2fca43bc10b707d0e