Presentation (CTI)

OBJECTIVES: The use of R, an open-source programming software, is increasing due to its flexibility, transparency, and strong community support, making it an attractive alternative to Excel. Despite these advantages, its use in health technology assessment (HTA) submissions to the National Institute for Health and Care Excellence (NICE) remains limited. This study aims to explore the current landscape of R adoption in HTA submissions and identify reasons and barriers to the widespread adoption of R.
METHODS: We contacted all NICE Technology Assessment Groups (TAGs), requesting information on the prevalence of R use in company submissions and multiple technology appraisal (MTA) modelling over the past five years. TAGs were also asked to discuss any technical or organisational challenges faced, and comment on potential facilitators and common barriers for adoption.
RESULTS: Out of 11 TAGs, 8 responded (73%). None reported any company submissions using R for economic modelling in HTA over the past five years. Internal use of R for de novo analyses is limited, with 1/8 (13%) of TAGs reporting using R in MTAs. 3/8 TAGs (38%) used R for decision analytic reports or early value assessments, but not for MTAs. Barriers included technical challenges, validation concerns, limited training and expertise among modellers. TAGs highlighted the need for formal guidance, collaborative code development, and targeted training initiatives to support uptake in HTA.
CONCLUSIONS: R is emerging as a powerful tool for economic modelling, but its adoption in NICE HTA submissions remains extremely limited. Our findings highlight a disconnect between the potential benefits of open-source modelling and current practice, with barriers including limited precedents, guidance, academic and professional training, global adaptation concerns and lack of incentive to use R. Further exploration is needed to clarify the value proposition of R in HTA and understand how these challenges might be addressed.