To discover how data-driven healthcare can revolutionise today’s system, let’s mentally fast-forward to June 2025 and take a journey to East Africa.
In 2025 we have fortunately mastered the outbreak of the SARS-CoV-2 (also known as COVID-19) strain and are successfully deploying vaccines around the world. Unfortunately, strains are arduous characters and a new virus has recently appeared. Hypothetically we are calling this new virus SARS-CoV-3.
Thanks to the accumulated experience this time around, a vaccine is already available and can prevent greater worldwide suffering. However, the problem is that the effectiveness has not yet been proven and the costs are exorbitant. Luckily, in the year 2025, we live in an age of data-driven, value-based pricing!
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What does value-based pricing mean?
In simple words, it is a model in which the price of medicine depends on the result it achieves for the patient. There is no fixed price. This approach provides patients across the globe with access to better treatments at lower costs.
Back to the SARS-CoV-3 pandemic example. Imagine a family living close to Nairobi. Due to the cost of the vaccine, the mentioned family would usually not have access to treatment. With value-based pricing platforms, treatment is only paid if it is a success. To elaborate on the benefits of these new technology solutions, let’s focus on the perspective of three main parties: the patient, the health insurance and the manufacturer (e.g. pharmaceutical company).
To be able to offer value-based pricing the following technological conditions must be in place:
- an internet connection that transmits data about the patients’ health progression in real-time to the value-based pricing platform,
- a wearable sensor that measures the vaccine effectiveness in real-time, and
- a value-based pricing platform that enables the execution of value-based contracts based on objective measurable terms previously agreed upon between the health insurance and the manufacturer.
Given that Starlink’s satellite fleet now covers the entire world, a stable internet connection is worldwide. In preparation for future pandemics, the WHO has largely distributed wearables as a preventive measurement. Therefore, affordable (non-invasive) wearables that can capture data from sweat, which is equivalent to that of a blood test, are available. Last but not least, a value-based pricing system such as the Lyfegen platform provides an easily accessible gateway to the value-based pricing world.
Since the manufacturer of the SARS-CoV-3 vaccine has entered value-based agreements with the main insurances of each WHO country, it is easy for the family outside of Nairobi to get access to the vaccine. The only condition is that the family needs to monitor the vaccine’s effectiveness through the wearable.
The main stakeholders’ view
The patient
The parents and children are insured by a major insurance company through the mother’s employer. This grants them access to the vaccine and thus, great chances of being protected from the virus. As the SARS-CoV-3 virus starts to spread, the family calls a local doctor requesting access to the vaccine. They are granted the vaccination and agree to wear the tiny wearables for the upcoming three years, tracking whether they get infected or not.
The health insurance
The major insurance has entered a valued-based agreement with the vaccine manufacturer. For the sake of simplicity, the terms are: if there is no infection over the upcoming three years, the health insurance will pay for the distributed vaccine in full. Otherwise, should the vaccine fail, the manufacturer will not charge the insurance company any costs. Due to state-of-the-art tracking of real-world data captured by the wearables, it is possible to indicate in real-time whether someone is infected by the virus or not. At all times the Kenyan data privacy laws, that are level with European laws, are fully complied with. Personal data is handled with the greatest care. If the data suggests someone has been infected, Lyfegen’s platform triggers an alert. The affected person is tested and cared for. The proper testing at a clinic is part of the value-based agreement between the manufacturer and the health insurance. The final test result will be fed into the system by a medical doctor through a top-notch EHR system that connects with Lyfegen’s backend platform. The payments for the wearables are processed through Lyfegen’s platform.
The manufacturer
Since 2020, the manufacturer has strongly focused on the SARS-CoV strains. They have invested a significant amount of money for appropriate vaccines that can prevent a further crisis. With the outbreak of the new SARS-CoV strains, they can demonstrate that they are the global pioneer for vaccines against newly discovered pathogens. Thanks to value-based contracts, they are able to distribute vaccines worldwide. Due to technological advances, it is possible to directly drive a global prevention strategy.
Lyfegen view
The Lyfegen platform can connect to all hospital systems in order to retrieve patient outcomes for given cohorts. By doing this they can determine the price payable based on the conditions set by the manufacturer and health insurance. In this case, whether the patient has been infected after the vaccination. The smart integration engine also allows dealing with complex data sources, use data from different sources for the same patient, and conduct data quality checks on the go. Therefore, not only the family in Nairobi can be helped but any individual in WHO member countries worldwide!
By providing a technologically trusted, compliant, automated, and scalable healthcare pricing system, Lyfegen creates a win-win-win situation for all three stakeholders.
The solution enables health insurances and manufacturers, as well as care providers, to operationalize their value-based healthcare strategies for a more sustainable healthcare system in which the added value of a treatment for the patient determines the price.
In the data-driven healthcare future of 2025, Lyfegen sees:
- patients quickly accessing innovative medication
- health insurances only paying for medicine that provides a benefit and,
- manufacturers incentivized to continue to develop ground-breaking medication.
Author: Pascal Marco Caversaccio
