OBJECTIVES: Manufacturers are required to submit a fully-executable economic model to the National Institute of Health and Care Excellence (NICE) in support of Single Technology Appraisal (STA) submissions. Since 2009, the ‘Guide to the STA process’ has stated that NICE accepts models developed in the statistical software environment, R, alongside Excel, DATA/TreeAge and WinBUGS. The benefits of R include increased computational speed and the potential for improved transparency compared with the commonly-used Excel platform. The objective of this analysis was to compare the use of the R software in supporting submissions made to NICE under the STA process to health economic analyses conducted by the Institute for Clinical and Economic Review (ICER), which evaluates the clinical and economic value of healthcare innovations in the USA.

METHODS: Publicly-available published NICE STA Final Appraisal Determinations (FADs) and all ICER guidance were identified from the respective organizational websites (01/01/2018-16/11/2018). The appraisals identified were screened to determine the software used for the development of the economic model.

RESULTS: 42 STAs were identified alongside 11 ICER guidance. In 100% (42/42) NICE STAs the manufacturer presented a model developed in Microsoft Excel, compared with 82% (9/11) ICER assessments. Other modelling approaches used were R, and TreeAge.

CONCLUSIONS: Despite R being included on the list of standard software accepted by NICE since 2009, Excel continues to be the single universally preferred platform for manufacturers submitting models as part of the NICE STA process with the use of R restricted to a single supportive analysis. This is in contrast to the ICER body, where despite Excel being the clear preference, other modelling approaches are more frequently used. We recommend that a complete assessment of the advantages and disadvantages of different software platforms such as R be conducted as part of model conceptualisation.