Historically, economic models for cost-effectiveness analyses have been developed with specialized commercial software (such as TreeAge) or more commonly with spreadsheet software (almost always Microsoft Excel). But more recently there has been increasing interest in using R and other programming languages for cost-effectiveness analysis which can offer advantages regarding the integration of input parameter estimation and model simulation, the evaluation of structural uncertainty, and the quantification of decision uncertainty, among others. Programming languages such as R also facilitate reproducibility of model-based cost-effectiveness analysis which is more relevant than ever given recent calls for increased transparency. While these tools are still relatively new, there is an increased interest in learning opportunities as evidenced by recent tutorials, workshops, and development of open-source software.

In this short course, participants will learn how to use R to develop a number of different types of economic models to perform cost-effectiveness analysis. Economic models will include time-homogeneous and time-inhomogeneous Markov cohort models, partitioned survival models, and semi-Markov individual patient simulations. The underlying assumptions of each model type will be summarized and the implementation in R will be presented in an accessible manner. Participants will be asked to modify the models in R (eg, adding health states, use of alternative time-to-event distributions) and run analyses (eg, cost-effectiveness analysis, probabilistic sensitivity analysis, evaluating structural uncertainty, and value of information analysis). To make this interactive aspect of the course as efficient as possible, all participants will have access to the GitHub repository prior to the course. It will contain R code to run the economic models and R Markdown files to explain and reproduce the analyses covered in the course.