On September 5, 2018, the Institute for Clinical and Economic Review (ICER) (https://icer-review.org) will release its first draft evidence report with estimates of cost-effectiveness based on a model developed in hēRo3 (heroapps.io) rather than Microsoft® Excel. hēRo3 is the new web-based modeling platform for building, running, and sharing cost-effectiveness models as interactive web apps. Excel has been the dominant software application used to develop models for health technology assessment (HTA) submissions for more than 20 years.
hēRo3 addresses a number of problems people often confront when developing models in Excel. These include: (1) difficulties in finding programming errors; (2) limited graphics functionality; (3) the need to develop a bespoke user interface for every model; (4) the need to use Visual Basic to program some desired functionality; (5) difficulties with model version control and life-cycle management; and (6) limited options for usage analytics and statistics. Other software applications used to develop health economics models include WinBUGS, TreeAge©, and R.
hēRo3 was developed originally to support early economic assessments of drugs in clinical development, where tight timelines and limited budgets often prevent robust economic models from being developed in Excel. hēRo3 achieves efficiencies in part by using an open-source modeling package in R to perform all of its calculations. During pilot testing, users reported that hēRo3 reduced model development times by 50% or more compared with the time required to program the same models in Excel. These savings were a result of both the ease with which many complicated calculations could be programmed in hēRo3, and the fact that hēRo3 automatically generated output displays after a model was programmed.
Use of the hēRo3 platform may help contribute to improved transparency of methods and scientific exchange, two areas of interest to the HTA community. ICER recently launched a pilot program designed to bring greater transparency to its modeling methods, and it has started to share executable versions of its draft models with drug manufacturers during ICER evidence reviews. With its draft report slated for release on September 5th, 2018, for the first time ICER will share its model with manufacturers by giving them a token that they can use to enter as guests into ICER’s hēRo3 platform. Once in the platform, they will be able to review and manipulate ICER’s model, but they won’t be able to export it outside of the platform. And when their token expires in 21 days, their access to the model will end.
hēRo3 was the product of an 18-month joint development initiative led by Policy Analysis Inc. (PAI) (pai2.com), a Boston-based health economics and outcomes research consultancy, and three pharmaceutical manufacturers (Amgen, Merck, and Novartis), which jointly provided almost $400,000 in seed money. Pilot testing of the platform spanned eight months and involved more than 100 modelers from biomedical companies, academic institutions, and health technology assessment groups worldwide.
Licenses for commercial use of hēRo3 may be purchased from PAI, and non-commercial or academic access is provided free of charge to full-time students, faculty members, and researchers in academic institutions. Medical and health policy students at Johns Hopkins University will be using hēRo3 in their economic modeling class in the fall semester.
Gerry Oster, PhD, Managing Partner of PAI, reports that their group has spoken with other HTA agencies besides ICER about using hēRo3. The platform could be particularly useful, Oster noted, as a means of rapidly checking manufacturer models in Excel for errors. While models in Excel may still be common, the launch of new platforms like hēRo3 and potential interest by HTA groups suggest an openness to new technologies for modeling that hold the promise of reducing development times, lowering costs, and increasing transparency of evidence assessment.