Wasu Mekniran

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Mekniran
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Wasu
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wasu.mekniran@unisg.ch
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    Item type:Publication,
    Early health technology assessment of digital diabetes screening in Switzerland: cost-effectiveness and budget impact analyses
    (2026-02-11)
    Wasu Mekniran  
    ;
    Victoria Brügger  
    ;
    Magdalena Fuchs
    ;
    Qiuhan Jin
    ;
    Benjamin Wirth
    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.
    Type:journal article
    Journal:MedRxiv
    URL:https://www.medrxiv.org/content/10.64898/2026.02.10.26345992v1
    DOI:10.64898/2026.02.10.26345992
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/125108
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    Item type:Publication,
    Digital health technologies and innovation patterns in diabetes ecosystems
    (SAGE Publications, 2025-01)
    Odile-Florence Giger  
    ;
    Estelle Pfitzer
    ;
    Wasu Mekniran  
    ;
    Hannes Gebhardt
    ;
    Elgar Fleisch  
    Background The global rise in type-2 diabetes (T2D) has prompted the development of new digital technologies for diabetes management. However, despite the proliferation of digital health companies for T2D care, scaling their solutions remains a critical challenge. This study investigates the digital transformation of T2D ecosystems and seeks to identify key innovation patterns. We examine: (1) What are emerging organizations in digital diabetes ecosystems? (2) What are the value streams in digital T2D ecosystems? (3) Which innovation patterns are present in digital T2D ecosystems? Methods We conducted a literature review and market analysis to characterize organizations and value streams in T2D ecosystems, pre- and post-digital transformation. We used the e3-value methodology to visualize T2D ecosystems (RQ1 and RQ2) and conducted expert interviews to identify emerging innovation patterns in digital diabetes ecosystems (RQ3). Results Our analyses revealed the emergence of eight organization segments in digital diabetes ecosystems: real-world evidence analytics, healthcare management platforms, clinical decision support, diagnostic and monitoring, digital therapeutics, wellness, online community, and online pharmacy (RQ1). Visualizing the value streams among these organizations highlights the crucial importance of individual health data (RQ2). Furthermore, our analysis revealed four major innovation patterns within the digital diabetes ecosystem: open ecosystem strategies, outcome-based payment models, platformization, and user-centric software (RQ3). Conclusions Our findings illustrate the transition from traditional value chains in T2D care to platform-based and outcome-oriented models. These innovation patterns can inform strategic decisions for companies and healthcare providers, potentially helping anticipate new digital trends in diabetes care and across other chronic disease ecosystems.
    Type:journal article
    Journal:DIGITAL HEALTH
    Volume:11
    DOI:10.1177/20552076241311740
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/121937
    Scopus© Citations 12
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    Item type:Publication,
    Incentive Systems for Diabetes Prevention with Digital Health
    (2024-11-15)
    Wasu Mekniran  
    ;
    Mia Jovanova
    ;
    Tobias Kowatsch  
    Background/Introduction: The global rise in noncommunicable diseases necessitates innovative prevention technologies. In Switzerland, nearly half of 2017 healthcare expenditures were for those aged over 65, with 75% spent on noncommunicable diseases (Stucki, 2021), particularly costly metabolic diseases like diabetes (Wieser et al., 2014). Companies are developing digital health tools for early prevention (Cohen et al., 2020). However, the benefits of implementation still need to be justified due to the fragmented healthcare market and stakeholders (Borges do Nascimento et al., 2023). This study aims to identify incentives and business models that promote the implementation of diabetes prevention with digital health. Methods: This study uses a multi-method approach: a literature review and a market analysis to identify incentives for preventive care and a business model analysis to pinpoint digital delivery models focused on diabetes prevention. Finally, we conducted expert interviews to triangulate the results and refine incentive patterns (Hermes et al., 2020; Retterath and Braun, 2020). Results: Evaluating the benefits of preventive interventions is challenging due to their long-term impact on all stakeholders in the healthcare system. However, our results reveal promising both financial and non-financial incentives for users, payers, and care providers. Incentive patterns like universal access through integrated care platforms and shared savings programs with care providers can potentially address user reach and retention challenges in preventive care implementation. Conclusion: The presented incentive patterns can overcome the challenges of unclear benefits in preventive care. Numerous recognized systems aim to provide personalized, cost-effective care by leveraging health technologies and ecosystems, enhancing adoption rate and participation. Innovative delivery methods, including creative marketing and social entrepreneurship, are highlighted to engage patients and effectively promote long-term preventive intervention adherence
    Type:conference poster
    Journal:Annual Meeting of the Swiss Society of Endocrinology and Diabetology (SGED-SSED 2024)
    DOI:10.3929/ETHZ-C-000784773
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/124013
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    Item type:Publication,
    Integrating Prevention Into Health Systems: A Prevention-first Framework for Noncommunicable Diseases
    (SSRN, 2026-02)
    Wasu Mekniran  
    ;
    Jakob Robert
    ;
    Jacqueline Mair
    ;
    Kai Gand
    ;
    Hannes Schlieter
    The global healthcare system confronts a growing crisis due to the rising prevalence and escalating costs of noncommunicable diseases (NCDs). Although lifestyle intervention and targeted public health initiatives can considerably prevent NCDs, prevention efforts consistently receive inadequate funding, as healthcare budgets predominantly prioritize treatment. This article argues that healthcare systems can systematically address integration friction. We propose a multidisciplinary "Reach, Retain, Report, and Reimburse" framework, developed from existing prevention models and focus group discussions, to integrate NCD prevention effectively into current healthcare systems. This analytical lens recommends customizing the reach of prevention programs for at-risk populations, sustaining their engagement, developing relevant outcome reports, and reforming reimbursement structures to incentivize prevention. Ultimately, this multi-sector, interdisciplinary framework offers decision-makers a structure to expand access, sustain engagement, measure outcomes, and align reimbursement.
    Type:working paper
    Journal:SSRN
    URL:https://papers.ssrn.com/sol3/papers.cfm?abstract_id=6256938
    DOI:10.2139/ssrn.6256938
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/125278
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    Collaboration and Innovation Patterns in Diabetes Ecosystems
    (2024)
    Odile-Florence Giger  
    ;
    Estelle Pfitzer
    ;
    Wasu Mekniran  
    ;
    Hannes Gebhardt
    ;
    Elgar Fleisch  
    Background: The global prevalence of diabetes is increasing and has stimulated new tech-nological advancements in disease management. Although there are many digital health companies with a focus on diabetes, building them up at scale is difficult due to a hetero-geneous, inefficient, and fragmented healthcare system. While ecosystems, or collaborative value creation, could help address system fragmentation; the current diabetes ecosystem remains not fully understood. Therefore, this paper analyzes the digital transformation of the diabetes ecosystem and deducts innovation patterns. We address the following research questions: (1) What are emerging organizations in the current diabetes ecosystem? (2) What are the value streams in the current diabetes ecosystem? (3) Which innovation patterns are present in the ecosystem? Methods: We conduct a literature review and a market analysis to describe the organiza-tions and value streams in the diabetes ecosystem, both before and after the digital trans-formation. We visualize the diabetes ecosystem using the e3-value methodology (RQ1 and RQ2). Next, expert interviews are conducted to validate the resulting diabetes ecosystem and deduce innovation patterns (RQ3). Results: First, we show that the digital transformation gives rise to emerging organizations across eight segments: real-world evidence analytics, healthcare management platforms, clinical decision support, diagnostic and monitoring, digital therapeutics, wellness, online community, online pharmacy (RQ1). Secondly, we visualize the value streams between emerging organizations in the current diabetes ecosystem, highlighting the key role of pa-tient data as currency (RQ2). Ultimately, we derive four innovation patterns in the current diabetes ecosystem (RQ3); namely open ecosystem strategy, outcome-based payments, plat-formization (connecting stakeholders), and user-centric software. Conclusions: We demonstrate how traditional value chains in the diabetes ecosystem tran-sition to platforms and outcome-based payment models, guiding strategic decisions for companies and healthcare providers. These innovation patterns may apply to similar eco-systems in other disease areas, aiding organizations in forecasting future dynamics.
    Type:working paper
    Journal:medRxiv
    DOI:10.1101/2024.04.25.24306351
    URI:https://www.alexandria.unisg.ch/handle/20.500.14171/119998