D4.5 – Publicly accessible software tool

When a new medicine reaches the market, health systems need to know what it will cost them over the coming years, not just today. This kind of forecast, known as a budget impact analysis, is central to decisions about which treatments to fund. Yet standard approaches often struggle when the real world gets complicated, for example when patients move between several treatments over time or when payment agreements tie reimbursement to results. This deliverable makes freely available a software tool that tackles exactly these situations, giving both payers and manufacturers a more realistic way to anticipate how the introduction of an innovation will affect health budgets.

The tool implements the flexible budget impact methodology developed in Deliverable 4.4 of the FLASH project. Its distinctive feature is that it applies Markov models, a technique common in the economic evaluation of health technologies but rarely used in budget impact analysis, to track how patient populations shift across treatments and over months of follow up. It is not tied to any single product, so the same code can be adapted to many different innovations simply by changing the input parameters, including treatment sequences, incidence and prevalence, transition probabilities and payment by results arrangements. Written in MATLAB and also compatible with the free, open source application OCTAVE, the tool runs from a single driver file and reproduces the worked example presented in Deliverable 4.4. It is released as open source under the GNU General Public License v3.0, and updated versions will be shared through the project’s Zenodo page.

What the deliverable contains:

• A publicly available MATLAB and OCTAVE compatible codebase for flexible budget impact analysis of pharmaceutical innovations
• A Markov model engine that builds transition matrices and patient traces across multiple treatments and time periods
• Cost routines that compute total and net costs, including savings from payment by results agreements
• A parameter file and driver script that let users adapt the model to their own case, reproducing the example from Deliverable 4.4
• A README with usage guidance and an open source GNU GPL v3.0 licence