Background: Type 2 diabetes (T2D) represents a rapidly growing public health and economic burden. Although early intervention can reverse the progression of prediabetes, traditional risk screening remains underutilized. Digital biomarkers derived from smartphones and wearables offer scalable real-time detection, yet financial barriers constrain their integration into health systems. This study assesses the viability of a Business-to-Consumer (B2C) digital diabetes screening venture within the Swiss healthcare system. Methods: The Innovating in Healthcare Framework was applied to evaluate system alignment across six factors: structure, financing, public policy, technology, consumers, and accountability. Financial viability was modeled using a Monte Carlo program for probabilistic breakeven estimation, and one- and two-way sensitivity analyses for key funnel, price, and CAC variables. A discounted cash flow model assessed value creation. Sustainability was evaluated across four dimensions: revenue potential, cost efficiency, managerial scalability, and technological adaptability. Results: The venture showed strong alignment with consumer readiness, technology, and accountability, but weak fit in financing, public policy, and system structure. Financial modeling indicated positive cash flow in Year 4, with a 57% probability of breakeven within seven years. At 2917 users in Year 7, cumulative cash flow was slightly below zero. Profitability becomes feasible only when price ≥CHF 40, CAC ≤CHF 200, and screening participation ≥10%. Against a-priori thresholds, breakeven probability and NPV remain insufficient, while IRR often exceeds 20%. Long-term viability requires these conditions or transitioning to reimbursed B2B pathways. Conclusions: A B2C model can reach financial viability under favorable price and acquisition thresholds, but its long-term sustainability ultimately depends on regulatory validation that enables reimbursement.
Mekniran et al. (Wed,) studied this question.