Our Success Stories

Exploring Innovations in Health

Early Budgeting Impact Modelling on Antenatal and Postnatal Care Consultation Program

Problem Pregnant women in Kenya faced several economic and satisfaction-related challenges when seeking antenatal care (ANC) and other pregnancy-related consultations. The demand for maternal care and shortage of healthcare resources in Kenya make it difficult to perform the basic clinical requirement of eight antenatal visits as WHO outlines, and necessary tests, where only one-third of women receive this care compared to healthier women. Our client, a major provider of consultation and advice for maternal and infant outcomes, needed our help to develop an early economic model for reimbursement submission and payer-user benefits. ICON fast-track request We assessed the client's request through fast-track processes within 12 hours and validated the Icon report using internal expert knowledge on maternal care. We conducted a policy brief analysis and designed a logic model to identify the main regional actors and processes involved when patients access antenatal care (ANC) visits in Kenya. Our approach We discussed the client's objectives and recommended critical areas and opportunities for facilitating current maternal care provision in the region related to approval entry points, healthcare cost opportunities, and care quality. We conducted early budget impact modelling where we outlined tariff items and care utilization between the current and new intervention strategy for antenatal care (ANC) visits. In the new strategy, patients can access 24-hour consultation and advice from healthcare professionals for maternal and infant programs. Impact The client successfully received approval for the program's entry into the market. The services increased accessibility and care efficiency by 20-30% from the perspective of hospitals, reimbursement tariffs, and patient out-of-pocket expenses on maternal care in Kenya.

A Comparative Cost Analysis of the 25-fraction Versus 5-fraction Postoperative Radiotherapy Regimens for Breast Cancer

Problem Selecting the right radiotherapy treatments for breast cancer patients is crucial because they carry underlying cost and outcome implications for patients and healthcare resources. A major Swiss hospital faced challenges with raised costs of care for both patients and the healthcare system due to longer treatment durations and resource usage. The @Varian technology provided an option by allowing more precise treatment of breast tumors with higher doses and significantly reduced treatment durations, potentially benefiting patients. Our partner needed our help to compare the cost of conventional fractionation, which typically involved 25 daily fractions over 5 weeks, with hypofractionated regimens that patients could complete in as few as 5 fractions over 1 week. ICON fast-track request We assessed the partner's request and validated the scope of the project with internal key opinion leaders through online and offline meetings, including radiation oncologists and clinical scientists. Process maps were created to identify resources used for each radiotherapy (RT) option, from initial consultation to treatment completion. Cost comparisons represented the viewpoints of the hospital, insurance coverage, and society. Our approach We identified the key factors for cost savings and provided initial proposals related to the applied methodology for an accurate and scientifically validated economic evaluation. To estimate hospital costs, time-driven activity-based costing (TDABC) was used, including equipment purchase and personnel costs. For insurers, estimates were based on the TARMED tariff system in Switzerland, which is used for billing outpatient services and reflecting insurance coverage. The social cost was defined as productivity loss (e.g., absence from work) due to treatment appointments. Life impact The 5-fraction regimens successfully resulted in a 53% (972 CHF) lower hospital cost, including personnel and equipment resources, a 42% (3,153 CHF) reduction in charges to insurers, and a 62% (372 CHF) lower social burden in terms of productivity losses due to the patient's absence from work. Furthermore, a major number of patients treated with the 5-fraction regimen who are actively working could return to work earlier and to normal life.

Utility Analysis of Anterior Vertebral Body in Idiopathic Scoliosis

Problem Anterior vertebral body tethering (VBT) is a non-fusion, minimally invasive, growth-modulating procedure with some early positive clinical outcomes reported in pediatric patients with idiopathic scoliosis (IS). There is a need for an intervention that can correct spinal curvature deformities in pediatric patients aged >10 years while allowing for continued growth and preserved range of motion. Our client needed to investigate whether VBT is a cost-effective option for pediatric patients with moderate IS who have failed nonoperative management, and assigned us to map the SRS-22r questionnaire onto EuroQoL-5 dimension 5-level (EQ-5D-5L) utility scores comparing VBT to the spinal fusion procedure
ICON fast-track request
We thoroughly evaluated the client's request and developed a comprehensive project scope through internal collaboration with our specialized team and consultation with an experienced orthopedic surgeon. This multidisciplinary approach allowed us to determine the most effective next steps. Subsequently, we designed a robust template to analyze the distribution of patient responses across the five key dimensions of the EQ-5D-5L: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression comparing the efficacy of VBT to spinal fusion procedures.
Our approach
The cost-utility analysis (CUA) focused on patients aligned with FDA indications for VBT: skeletally immature individuals (>10 years old), Sanders stage ≤5, moderate to severe IS, who failed nonoperative management. Our client agreed to utilize the EQ-5D-5L descriptive system to compare scores across five domains in different patient groups and analyzed the overall distribution of utility values. A literature review was conducted to identify validated tests for analyzing health-related quality of life data, ensuring a robust and evidence-based approach to our analysis.
Our impact
The prospective analysis provided with the latest version of the validated HRQoL (EQ-5D-5L) report that could serve as a guide to perform further CUA in Idiopathic Scoliosis from a US perspective.

Early health economic evaluation of chronic wounds treatment in Germany

Context Chronic wounds affect over 4 million patients a year in Germany. DFU is the second most common type, with about 136,000 new cases a year. Mean annual cost per ulcer is €9,060: €8,288 direct and €772 indirect. Comparative and cost-effectiveness evidence across wound-care products remains uncertain.
Approach
Build an early 12-week budget impact model comparing standard of care (SoC) with SoC + Cutempa. Base cost inputs on German KBV outpatient tariffs and early-HTA principles. Align the methodology with the solution and its patient population.
Impact
Follow-up phase (3–12 months, extrapolated): a potential ~xx.x% cost reduction vs SoC. Combined annual impact: total costs could fall by ~xx.x%. This is an early, conservative estimate. Clear route to GKV reimbursement: positioning the product as a consumable within existing billable outpatient wound-care services.

Budget Impact Analysis of Peritoneal Dialysis versus Conventional In-Center Hemodialysis in Poland

Problem Poland’s “PD first” strategy faces major implementation barriers, with only 3.7% of dialysis patients accessing home automated peritoneal dialysis (APD) in Poland due to insufficient infrastructure, training requirements, and lack of national guidelines. Consequently, most patients rely on costly in-centre haemodialysis such as continuous ambulatory peritoneal dialysis (CAPD). Consequently, missing opportunities for cost savings and improved patient outcomes through more scalable, flexible, and efficient home-based care.
ICON fast-track request
Our client, a major innovator in medical equipment manufacture sought our support in developing a budgeting impact analysis to compare the two treatment modalities. The goal was to demonstrate to the stakeholders how expanding access to innovative home-based APD can deliver cost-effective, equitable, and high-quality care for people with kidney disease in Poland. Request We assessed the client's request within 8 hours and validated internally. We provided our initial feedbacks and how we could mutually proceed the client’s objective.
Our approach
We began by defining the requested perspectives of both the National Health Fund (NHF) as payer and the patient, then quantified the total dialysis population in Poland and identified those eligible for home-based peritoneal dialysis (PD) using prevalence data and clinical criteria. We mapped the current treatmen modalities, APD, and CAPD and collected evidence on usage rates and associated cost items for each modality. For the NHF, we gathered data on fixed reimbursement rates (e.g., 23,231 zł per 6 weeks for PD) and included all direct medical costs such as equipment, supplies, monitoring, and complication management; for patients, we identified out-of-pocket expenses like gloves and masks, as well as indirect costs such as travel and lost productivity. We then built a transparent model in Excel using a 6-week baseline as a reimbursement cycle set in Poland.
Our impact
Our budgeting impact analysis demonstrated that shifting to APD for home dialysis could yield significant cost savings for both patients and Poland’s NHF. These findings enabled our client to optimize dialysis technology, prioritizing efficiency and patient-centered care.

Winner, Innosuisse Innovation Challenge • AI-assisted ICD-10 coding for Swiss outpatient care

Problem Swiss doctors spend about 20% of their working time, roughly two hours a day, on administrative tasks such as documentation, insurance processing and claims. The burden is highest in outpatient care, where the switch from TARMED to TARDOC and ambulatory flat rates adds new coding complexity. Much of it stems from incompatible digital systems that fail to automate repetitive tasks.
Approach
ALIS Transformer, co-developed by d-fine AG and Gurmit Sandhu Consulting GmbH and winner of the Innosuisse Innovation Challenge, is an AI assistant for ICD-10 coding with built-in compliance checks. Stepval built its early budget impact model from the hospital perspective: Translated clinical workflows into measurable resource use: minutes per claim, FTEs and wage rates Modelled manual vs. rule-based coding scenarios under the new outpatient tariffs (TARDOC). Tested assumptions in a live pilot at a Basel hospital, so the estimates are credible and defensible.
Our impact
The MVP shows strong feasibility. Early economic data point to up to 30% time saved on coding and billing, plus fewer billing errors. Decision-makers get quantifiable endpoints instead of vague “efficiency gains”. The pilot is ongoing and results are indicative.