Markov Models for Health Economic Evaluations: The R Package heemod

Abstract: Health economic evaluation studies are widely used in public health to assess health strategies in terms of their cost-effectiveness and inform public policies. We developed an R package for Markov models implementing most of the modelling and reporting features described in reference textbooks and guidelines: deterministic and probabilistic sensitivity analysis, heterogeneity analysis, time dependency on state-time and model-time (semi-Markov and non-homogeneous Markov models), etc. In this paper we illustrate the features of heemod by building and analysing an example Markov model. We then explain the design and the underlying implementation of the package.