Sanafin

Money moves when outcomes do.

The funder commits the money up front. Sanafin verifies the outcome and instructs settlement the moment the threshold is met. Either side can re-compute the verdict.

Book a discovery call

For digital therapeutics, medicines and advanced therapies, and the funders behind their evidence · 4 signed letters of intent

Demo workspace · example data, not a customer

Type 2 diabetes digital programme

CHF 60,000 of CHF 180,000

  • Month 6 · HbA1c thresholdReleased
  • Month 12 · sustainedHeld
  • Adherence bonusHeld
Illustrative preview with example data.

Recognised by Swiss innovation programmes · Research from ETH Zurich and HSG

  • Innovation Booster Sustainable Digital FinanceWinner
  • Kick FoundationProgramme
  • SICProgramme

The problem

Healthcare has decided to pay for outcomes.
Every programme settles it backward.

The condition is already law in all four. None of them built the layer that holds the money and releases it on an outcome either side can verify.

  • Medicines · Switzerland

    CHF 9.7bn17

    of 2025 OKP spend went on medicines — a fifth of the total

    Settles backward — the insurer pays, then collects the rebate.

  • GLP-1 · Switzerland

    52%19

    of GLP-1 patients stop within twelve months

    Settles on paper — forms, and a check every six months.

  • Health apps · Germany

    EUR 25m+20

    of repayment claims at risk. Nine manufacturers insolvent

    Settles through claims — against companies that may be gone.

  • Gene therapy · United States

    11 years15

    reconciling outcomes CMS negotiated for 32 states, DC and Puerto Rico

    Settles by reconciliation — paid first, rebated later.

Today

  • Evidence built by hand, per payer: CHF 100k to 250k a project.12
  • No payer money until the evidence already exists.
  • The verdict lives in a spreadsheet nobody can re-run.

With Sanafin

  • The funder commits up front; a licensed custodian holds it.
  • The result is checked against a threshold fixed in advance.
  • Either side re-computes the proof from the export.

Why now

Three jurisdictions wrote the rule.
None built the settlement.

In two years the US, Germany and Switzerland moved from paying for access to paying for results — gene therapy, apps, medicines, chronic care. Every one wrote the condition and left out the settlement.

  1. Mar 2025United States

    CMS negotiated outcomes for gene therapy

    CMS negotiates outcomes-based agreements for 32 states, DC and Puerto Rico. It settles by rebate, over eleven years.

    32 states

  2. Jan 2026Germany

    Outcome-linked pricing became law for apps

    At least 20% of an app's price must depend on measured performance (§ 134 SGB V). How it settles is left to the parties. No product has done it yet.

    ≥ 20%

  3. Feb 2026Switzerland

    A legal basis for outcome rebates on medicines opened

    Art. 52b E-KVG went to consultation with CHF 350M of annual savings attached — the first Swiss rule tying a medicine's price to the result.

    CHF 350M

  4. Jul 2026Switzerland

    A reimbursement path opens, with a proof requirement

    Product group 40 opened for digital health applications. The first listing was admitted under evaluation only, to 31 December 2026.

    MiGeL Ch. 40

  5. Jul 2026United States

    Chronic care payment tied to measured results

    The CMS ACCESS model starts. Payment depends on the share of patients meeting biomarker or PROM thresholds — well beyond drugs and devices.

    Thresholds

  6. Today
    15 Apr 2027Germany

    The first outcome data falls due

    Fifteen months after the pricing rule, the first performance data is due. The deadlines do not line up, and nothing holds the money in between.

    Evidence due

Where this goes

One settlement layer,
three sizes of money.

The money waits for the outcome, whatever the outcome is about. We start where proof is cheapest and move to where paying first costs the most.

  1. Proving ground

    Now

    CHF 6M22

    Digital therapeutics before listing · Switzerland

    Study budgets available a year, in a market where seven of eight published decisions were rejected for want of evidence.6

    Cheapest place to prove that a funder will commit money to a threshold.

  2. First revenue

    2029

    CHF 350M18

    Outcome-conditional drug payment · Switzerland, then Germany

    Outcome rebates targeted a year under Art. 52b E-KVG, in consultation since February 2026.

    The same contract, two orders of magnitude more money per arrangement.

  3. The destination

    2030

    USD 5.9bn21

    Advanced therapies · Europe, then the United States

    Spent on advanced therapies in 2023, growing about 65% a year. Instalment payment is already the agreed model.

    Where paying first and reconciling later costs the most to get wrong.

Each figure is the money in play in that venue — a ceiling on what could settle against an outcome, not a forecast of what Sanafin earns. None of these programmes has a settlement layer today.

How it works

First, it refuses to pay.
Then it pays. Then it proves it.

A funder commits only if refusal is automatic. If the system cannot say no, its yes is worth nothing. Eight seconds of film, then the three moments that matter.

Teal marble = patient outcomeOrange marble = payment
  1. Outcome verifiedChecked against the pre-agreed threshold
sanafin verify --contract t2d_programme --cohort a
L4  WZW EVALUATION
  wirksamkeit               54 / 100
  zweckmässigkeit           34 / 100
  wirtschaftlichkeit        0 / 100
  composite                 29 / 100 · insufficient
  released to manufacturer  CHF 0
  returned to funder        CHF 180,000
L6  SETTLEMENT          returned_to_funder

One hundred patients, CHF 180,000 committed before the first enrolment. The composite comes in at 29 against a cut-off of 75. Nothing is released; the money returns to the funder.

A teal marble stopped against a closed brass gate, with an amber marble held back behind it
Verification certificatesynthetic
verdict
insufficient
composite
29 / 100 cutoff 75
certificate
7aaa8b486159…
recomputed
7aaa8b486159… · match

Synthetic cohort · illustrative figures

“If the system cannot say no, its yes is worth nothing. Every buyer in this market has already seen a demo that only ever says yes.”

Dr. Wasu Mekniran, CEO · PhD in healthcare financing, ETH Zurich
Meet the team

The product

Sanafin Outcome Studio.
Five stages, one API.

01 · Collect · 02 · Monitor

The data you already send a payer, watched over time.

FHIR R4 or CSV intake, consent check, baseline. Then a biomarker stream with dropout guardrails, so evidence gaps show before anyone commits to a threshold.

  • Care app
  • EHR · FHIR R4
  • Lab results
  • CGM
  • Pharmacy
  • Wearables
Type 2 diabetes digital programmeMonth 5
Enrolled
100
Active
94
Evidence gaps
2
Data freshness
Live

03 · Verify

Checked against the contract.

WZW-native scoring under Art. 32 KVG, pass or fail against the pre-agreed threshold.

HbA1c · 6 monthsPass · −0.65 pp
TARGET −0.5 pp (7.1%)

04 · Finance

Committed up front, held by a custodian.

Pay-for-performance, shared savings or bundled terms. Funds sit with a licensed custody partner, never with Sanafin.

contract t2d_programme
  committed  CHF 180,000
  held_by    licensed_custodian
  when       hba1c.delta <= -0.5
  at         month = 6
  release    CHF 60,000
  else       return_to_funder

05 · Settle

Released when the threshold is met.

One settlement instruction, a Swiss-conformant invoice, a signed audit record. Unmet milestones return to the funder.

Month 6 · HbA1c threshold
CHF 60,000Released
Month 12 · sustained
CHF 90,000Held
Adherence bonus
CHF 30,000Held

One REST API, one audit chain. Every value hashed on entry; the certificate re-computable from the exported file.

POST /v1/verifications → { "verdict": "meets_wzw", "certificate": "7aaa8b48…" }
See it on your data

Where we start

Metabolic health first.
Longevity next.

Measurable endpoints, rising spend, funders already asking for conditional terms. One example contract design, not customer data.

Example contract · illustrative

Type 2 diabetes screening

1,000 adults at risk, screened digitally

Committed by the funder
CHF 180,000
Duration
12 months

Settlement is instructed when

  • Screening completed≥ 60% of invited by month 3
  • HbA1c reduction in confirmed cases≥ 0.5 pp at month 6
  • Remission (optional bonus)HbA1c < 6.5% for ≥ 3 months off medication11

Release schedule

  • Month 6CHF 60,000
  • Month 12CHF 90,000
  • Adherence bonusCHF 30,000

Unmet milestones return to the funder.

Evidence from

  • Screening app
  • Lab HbA1c
  • EHR · FHIR R4

Why this team

Four years researching why outcome-based payment stalls.
Then we built the tool.

Health economics, clinical outcomes and financial engineering in one team. Eight publications behind the incentive model and the risk structures.

  • Dr. Wasu Mekniran

    Dr. Wasu Mekniran

    CEO

    Designs the verification model and leads the payer conversations.

    PhD in healthcare financing, ETH Zurich · MBA, MSc Computation · first author on the EDEN papers

  • Dr. Susanne Oudbier

    Dr. Susanne Oudbier

    Chief Medical Officer

    Defines the outcomes and signs off on the clinical side.

    MD PhD · resident physician at HOCH Ostschweiz

  • Anej Rozman

    Anej Rozman

    Quantitative Scientist

    Develops the risk and health-economic models.

    MSc Quantitative Finance, UZH/ETH

  • Djata Sigam

    Djata Sigam

    Software Engineer

    Builds Outcome Studio, the audit chain and settlement.

    MSc Mathematics, Imperial College London and ETH Zurich · 8+ years of fintech software

Advisory board

  • Dr. Ajintha Pathmanathan

    Clinical advisor

    • MD, MPH
    • 20+ years of medical leadership across UK, US and Australian systems

  • Niklaus Neddermann

    Financial advisor

    • CEO of a FINMA-licensed asset manager
    • Formerly Julius Bär and the Swiss National Bank

  • Prof. Dr. Thomas Giroux

    Academic advisor

    • Professor for Sustainable Finance, D-MTEC, ETH Zurich

Selected research

8 publications behind the model

  1. 2026Health Technology Assessment of Swiss Digital Diabetes ScreeningMekniran W et al. · medRxiv preprintDOI
  2. 2026Digital health incentives in type-2 diabetes preventionMekniran W, Diethelm W, Stalder V, Fleisch E, Kowatsch T, Jovanova M · Digital HealthDOI
  3. 2026Assessment of B2C Model for Digital Diabetes ScreeningMekniran W, Kowatsch T · BMC Health Services ResearchDOI

Research carried out by the founding team at ETH Zurich, the University of St. Gallen and HOCH Ostschweiz. Institutions do not endorse Sanafin.

Traction

Four partners, one pathway.

From signed letter to proof of concept, into care, across sites. Anonymised by agreement; letters available to investors under NDA.

  • Swiss cantonal hospital

    Diabetes care proof of concept · signed Jun 2026

  • Swiss digital health company

    Digital-health partner in the proof of concept

  • University longevity medicine centre

    Workflow validation

  • Preventive health provider

    Workflow validation

For investors

The verification layer for outcome-conditional healthcare payments.

Pre-seed, built on ETH Zurich and HSG research. Swiss digital therapeutics are the proving ground; the same layer settles drug payment and advanced therapies. Request the deck — Wasu sends it personally.

What's in the deck

  1. 01Why now: three jurisdictions wrote the condition, none built the settlement
  2. 02How verification, custody and settlement work
  3. 03The ladder: digital therapeutics, then drugs, then advanced therapies
  4. 04Traction, team, research, the next 24 months

Opens a pre-filled email in your mail app. Dr. Wasu Mekniran, CEO, replies personally within one working day with a view-only link. No mailing lists; your details go nowhere else.

FAQ

The questions
each side asks first.

Anything else? Book a discovery call and we'll walk you through it.

What does Sanafin cost?

A platform licence, a per-patient fee on enrolment into an outcome-linked pathway, and a success fee on funds recovered when a cohort misses its threshold. The first pilot is a fixed price agreed on the call.

How is this different from an HTA consultant or a CRO?

A consultancy appraises evidence by hand, per project; a CRO runs the study but brings no money. Sanafin makes the funding conditional and the verification repeatable: the outcome definition, the threshold and the settlement rule are written once, and the verdict can be re-run by anyone from the exported file.

What happens when data is missing or a patient drops out?

Dropout and data-freshness rules are part of the contract. Monitoring surfaces gaps early, and unmet or unverifiable milestones are held or returned to the funder rather than paid on trust.

How fast can a pilot start?

Our target is a scoped pilot within two weeks of the first call: data connected in week one, rules live with a first verification report in week two. Going live depends on data access and the funder's sign-off.

Fund the outcome, not the promise.

Manufacturers, insurers, hospitals

Design your first outcome-conditional contract in a 25-minute call.

Book a discovery call

Reply within one working day · NDA on request

Investors

Investing in healthcare payments or fintech infrastructure?

Request the deck

Sent personally by the CEO · view-only link