Decluttering Complexity: A Pragmatic Framework for Simplifying Global Health Economic Models for HTA
Author(s)
Mrunmayee Godbole, MSc1, Bea Massó de Rafael, MSc2, Marc Manau, MBA3, Miriam Fernández Delgado, MSc4, Madhusubramanian Muthukumar, MSc5.
1Consultant, Global HEOR, Alira Health, Barcelona, Spain, 2Senior Corporate Market Access Manager, Ferrer, Barcelona, Spain, 3Principal, Alira Health, Barcelona, Spain, 4Head of Global Market Access, Ferrer, Barcelona, Spain, 5Senior Consultant, Global HEOR, Alira Health, London, United Kingdom.
1Consultant, Global HEOR, Alira Health, Barcelona, Spain, 2Senior Corporate Market Access Manager, Ferrer, Barcelona, Spain, 3Principal, Alira Health, Barcelona, Spain, 4Head of Global Market Access, Ferrer, Barcelona, Spain, 5Senior Consultant, Global HEOR, Alira Health, London, United Kingdom.
OBJECTIVES: Health economic models developed for NICE often contain more detail than required by other HTA agencies, limiting usability and adaptability for global and local affiliates with fewer modelling resources. In the absence of formal guidance on simplification, we propose a systematic methodology to simplify and streamline global cost-effectiveness (CE) and budget impact (BI) models while preserving analytical integrity. The methodology is illustrated using Ferrer’s inhaled treprostinil model for pulmonary hypertension associated with interstitial lung disease.
METHODS: We analyzed the existing combined CE and BI model to identify sources of complexity, including redundant inputs, dispersed settings across multiple sheets, and intricate data flows. Three simplification principles were applied: omission (removing non-influential parameters), aggregation (combining similar parameters), and substitution (replacing complex settings). Deterministic sensitivity analyses classified inputs by ICER impact: "Potentially Not Needed" (<10%), "Nice to Have" (10-30%), and "Must-have" (>30%), considering clinical and access relevance. Each setting's impact on deterministic results was tested individually and in combination. Of 54 analysed inputs, 19 were "Must have" and 35 were simplification candidates. User-centric improvements included centralized input sheets and intuitive interfaces.
RESULTS: Simplification consolidated the user inputs into four primary sheets and reduced the number of model sheets overall from over 50 to 30. Parameters were restructured into two groups: localized “Country & Costs” sheets for adaptation and centralized “Efficacy & Quality of Life” sheets for core effectiveness inputs. CE and BI models were decoupled to allow independent customization. User testing confirmed improved model transparency and usability, while validation demonstrated analytical equivalence with the original model.
CONCLUSIONS: This framework enables structured simplification of global health economic models without compromising robustness. It enhances usability and adaptability for global HTA needs. Further research could refine the methodology through broader use cases, and stakeholder-informed criteria.
METHODS: We analyzed the existing combined CE and BI model to identify sources of complexity, including redundant inputs, dispersed settings across multiple sheets, and intricate data flows. Three simplification principles were applied: omission (removing non-influential parameters), aggregation (combining similar parameters), and substitution (replacing complex settings). Deterministic sensitivity analyses classified inputs by ICER impact: "Potentially Not Needed" (<10%), "Nice to Have" (10-30%), and "Must-have" (>30%), considering clinical and access relevance. Each setting's impact on deterministic results was tested individually and in combination. Of 54 analysed inputs, 19 were "Must have" and 35 were simplification candidates. User-centric improvements included centralized input sheets and intuitive interfaces.
RESULTS: Simplification consolidated the user inputs into four primary sheets and reduced the number of model sheets overall from over 50 to 30. Parameters were restructured into two groups: localized “Country & Costs” sheets for adaptation and centralized “Efficacy & Quality of Life” sheets for core effectiveness inputs. CE and BI models were decoupled to allow independent customization. User testing confirmed improved model transparency and usability, while validation demonstrated analytical equivalence with the original model.
CONCLUSIONS: This framework enables structured simplification of global health economic models without compromising robustness. It enhances usability and adaptability for global HTA needs. Further research could refine the methodology through broader use cases, and stakeholder-informed criteria.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE319
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)