SAPANEL Yoann, DBA

Yoann Sapanel specializes in bridging payer perspectives with medical technology development. As the Head of Health Innovation, at the Institute for Digital Medicine (WisDM) at the National University of Singapore, he accelerates cross-industry collaborations to validate, implement and scale innovative digital technologies in clinical settings. His consulting experience spans leading firms including PricewaterhouseCoopers, Blue Ocean Strategy, Medtronic, and MetLife.

He defended his Executive Doctorate of Business Administration (EDBA) in October 2025 on “The Economic Value Drivers for Digital Therapeutics” under the supervision of Professor Martin Cloutier, Professor at the University of Quebec at Montreal (Canada).

Prof Cloutier Martin

Comprehending the economic value drivers for digital therapeutics: a mixed methods based approach

Digital Therapeutics (DTx), defined as evidence-based therapeutic treatments powered by high-quality software, are recognized as the “next paradigm” of modern healthcare (Khirasaria et al., 2020). Emerging clinical evidence suggests that DTx can effectively prevent, manage, or treat a spectrum of medical disorders and diseases (Huh et al., 2022). However, despite this promising potential, the adoption of these therapeutics remains low (Cirkel et al., 2024; Johnson et al., 2024; Prodan et al., 2022; Wang et al., 2023; Williams et al., 2020).
While economic factors have been identified as both barriers and facilitators to adoption (Vicki et al., 2020), and increasingly drive healthcare decision-making( 2020), including payers’ reimbursement and pricing decisions (Yan et al., 2021), relatively little is known about the capacity of DTx to provide economic value in care (HealthXL, 2021; Kario et al., 2021; Sapanel et al., 2023). Moreover, the factors driving DTx economic value have not been thoroughly researched, neither in terms of what they are nor how they should be considered (Halminen et al., 2021; Gomes et al., 2022). Recognizing the importance of these economic considerations, recent recommendations for bridging the gap between digital health tool development and implementation emphasize integrating economic considerations into the early stages of technological development (Keogh et al., 2024).

This DBA thesis addresses this important knowledge gap by examining the following main research question: What are the economic value drivers of DTx and how are they considered throughout the product development lifecycle? Through complementary qualitative and mixed method-based approaches, this thesis is structured around three core cascading research studies that include a systematic literature review, group concept mapping (GCM) and a qualitative research approach.

The first paper (Chapter 4) systematically reviews and summarizes the published evidence regarding the cost-effectiveness of clinical-grade mobile app–based DTx. The findings, encompassing 18 studies, indicate that DTx, at least in some use cases and local contexts, can be cost-effective and offer economic value to payers while simultaneously improving care for patients. To date, this study represents the first review reporting costs and factors that influence the economic impact of DTx interventions, such as healthcare resource utilization, pharmaceutical treatment costs, and participants’ baseline characteristics. The paper also identifies important methodological shortcomings that must be addressed in future economic evaluations of DTx to reduce the uncertainty surrounding their widespread adoption.

The second paper (Chapter 5) employs GCM, a participatory mixed methods-based approach, to comprehend how healthcare professionals, researchers, industry stakeholders, and public sector representatives collectively conceptualize factors influencing DTx economic value. The study, building upon the initial factors identified in the first paper, extends this foundation by identifying 59 distinct factors, categorized into eight clusters. These factors were evaluated by 62 participants in terms of their importance and current consideration in practice. Three clusters emerged as universal priorities: DTx Implementation, DTx Monetization Models, and DTx Associated Costs. Notably, these areas, while recognized as crucial, are identified as receiving insufficient attention during DTx development, particularly from the research community’s perspective. With robust internal reliability estimates and careful examination of external validity threats, the study presents key findings for future research and offers a conceptual framework of priority clusters and factors potentially driving DTx economic value.

Building on these insights, the third paper (Chapter 6) utilizes critical realism (CR) as a philosophical foundation to examine the underlying mechanisms and contextual conditions that shape researchers’ decision-making processes regarding economic factors in DTx development. Specifically, this study aims to understand why certain economic factors are insufficiently taken into consideration by researchers throughout the DTx development process. Through 17 in-depth interviews with researchers involved in DTx development—including research engineers, health systems researchers, clinician-researchers, and practitioner-researchers— three interrelated generative mechanisms that systematically influence how researchers approach economic considerations are uncovered: (1) the Professional Norms mechanism, operating through a reinforcing loop that systematically prioritize clinical validation while marginalizing economic considerations; (2) the Researcher Experience mechanism, revealing how professional training and limited economic literacy create cognitive biases that systematically obscure economic factors; and (3) the Adoption Uncertainties mechanism, demonstrating how implementation concerns influence development decisions through both reinforcing and balancing dynamics. The paper discusses the theoretical and practical implications of the findings and provides actionable recommendations for research organizations, individual researchers, and policymakers to enhance economic consideration integration throughout the DTx development lifecycle.

Collectively, the three cascading research studies yield significant theoretical and practical contributions that are important to: (1) understand and characterize the concept of economic value in the context of DTx and identify key factors influencing such economic value, (2) gain a deeper understanding of how these factors are considered early on by various stakeholders involved in DTx development and clinical validation, and (3) develop methodological recommendations to guide these stakeholders in creating conditions that may drive the economic value of DTx. These contributions provide valuable intervention points for strengthening the DTx development process, moving toward a more comprehensive assessment of clinical, technical, and economic value throughout DTx development, ultimately potentially supporting the adoption of these innovations in healthcare systems.