Exploring R's Advantages and Disadvantages in Health Economic Modeling for Health Technology Assessments: A Scoping Review

OBJECTIVES: Recently, R has been increasingly considered as an alternative to Microsoft Excel for health economic modelling (HEM). Further, it seems that R holds some key advantages over Excel, with its function as a statistical software allowing the user to combine and calculate in real-time the underlying statistics informing, HE decision problems. This scoping review examined the use of R for HEM, including the shared experience and advantages and disadvantages.

METHODS: A scoping review was conducted to systematically identify, collect, and critically assess scientific papers across databases of scientific literature, including PubMed, Embase and EconInfo. No time constraints were imposed. The eligibility criteria included all publications and preprints discussing experiences, advantages, and disadvantages of using R for HEM, regardless of study type or publication status. Data extractions were conducted by two reviewers independently and quotes/insights were coded in themes.

RESULTS: A total of 5178 records were identified. Following deduplication and screening, a total of 29 publications discussing advantages and disadvantages of R for HEM. Generally, publications were positive towards using R for HEM, with the most mentioned advantages being improved transparency (n = 17; 59%), improved reproducibility (n = 12; 41%) and the statistical capabilities of R (n = 12, 41%). The most mentioned disadvantages were related to the learning curve of R (n = 5; 17%), payers’ and modelers’ lack of experience with using R (n = 5; 17%), and the potential lack of transparency if R code is not clearly written and shared (n = 3, 10%).

CONCLUSIONS: R is a useful tool for HEM, with several key advantages over e.g., Microsoft Excel. While barriers to the implementation of R for HEM exist, these can be overcome by training and proper guidelines for sharing of materials.