Our Success Stories
Exploring Innovations in Health
Early Budgeting Impact Modelling on Antenatal and Postnatal Care Consultation Program
The 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.
Budgeting Impact Modelling of Antimicrobial Susceptibility Testing Technology
Problem At least 28% of antibiotic prescriptions in U.S. doctor's offices and emergency departments are unnecessary. Even when antibiotics are needed, issues often arise with inappropriate selection, dosing, and test duration. Manual testing is more susceptible to errors due to human interaction, potentially leading to inaccurate results and repetitive tests, with hourly expenditures ranging from $15 to $45. Our client, a major diagnostic system provider, sought our support in developing a budget impact model as part of the US market entry strategy for an automated diagnostic device. This device offers the potential to reduce testing inefficiency and increase result accuracy on the US lab centers. ICON fast-track We received the client's request through fast-track processes within 12 hours and sent back the validated report. We utilized our internal expert knowledge on medical laboratory procedures to help our team identify the value proposition of the automation devices. This focused on tests quantity, time to results, and overall efficiency in lab centers, comparing these metrics with manual testing as the gold standard in the US. Our approach We conducted a comprehensive market entry analysis for our client's diagnostic device, focusing on key areas to ensure success. Our approach involved synthesizing data from diverse sources, including published literature, databases, expert opinions, and custom surveys from lab centers. This allowed us to gain deeper insights into internal processes and define priority areas. To understand the broader financial implications, we engaged with insurance partners to determine US tariffs for major test providers and analyzed claims data, particularly focusing on Medicare and Medicaid packages. We then developed a flexible budget impact model, which could range from a simple cost calculator to a more complex decision-analytic model. Our impact A clear economic justification for adopting an automated testing system in U.S. healthcare settings has been established. The client has successfully completed the Analytical Performance Evaluation for their susceptibility testing system and prepared the necessary resources for U.S. market entry.