Patient-Level Health Economic Modeling in Excel Without VBA: A Tutorial

Area of Science:

• Health economics and outcomes research
• Computational modeling
• Health technology assessment

Background:

• Cohort-level models in Microsoft Excel are standard for cost-effectiveness analysis (CEA) in health technology assessment (HTA).
• These models have limitations in capturing patient heterogeneity, potentially introducing bias.
• Familiarity and lower computational burden contribute to the continued use of cohort models.

Purpose of the Study:

• To provide guidance on implementing individual-level discrete event simulation (DES) in Microsoft Excel.
• To demonstrate a flexible, patient-level modeling approach using contemporary Excel functions.
• To enable advanced modeling without Visual Basic for Applications (VBA).

Main Methods:

• Utilizing contemporary Microsoft Excel functions for calculations.
• Implementing a previously published individual-level discrete event simulation (DES) model.
• Avoiding the use of Visual Basic for Applications (VBA) code.

Main Results:

• Demonstration of a feasible patient-level discrete event simulation (DES) within native Excel.
• Successful implementation of a flexible cost-effectiveness model without VBA.
• Validation of contemporary Excel functions for advanced health economic modeling.

Conclusions:

• Contemporary Excel functions enable flexible, patient-level cost-effectiveness modeling for HTA.
• This approach overcomes limitations of traditional cohort models without requiring VBA.
• Spreadsheet-based individual-level discrete event simulation (DES) is a viable alternative for HTA.