Health economic models simulate the costs and effects of health technologies for use in health technology assessment (HTA) to inform efficient use of scarce resources. Models have historically been developed using spreadsheet software (e.g., Microsoft Excel) and while use of R is growing, general purpose modeling software is still limited. hesim is an R package that helps fill this gap by facilitating parameterization, simulation, and analysis of economic models in an integrated manner. Supported model types include cohort discrete time state transition models (cDTSTMs), individual continuous time state transition models (iCTSTMs), and partitioned survival models (PSMs), encompassing Markov (time-homogeneous and time-inhomogeneous) and semi-Markov processes. A modular design based on R6 and S3 classes allows users to combine separate submodels for disease progression, costs, and utility in a flexible way. Probabilistic sensitivity analysis (PSA) is used to propagate uncertainty in model parameters to model outputs. Simulation code is written in C++ so complex simulations such as those combining PSA and individual simulation can be run much more quickly than previously possible. Decision analysis within a cost-effectiveness framework is performed using simulated costs and quality-adjusted life years (QALYs) from a PSA.

翻译：健康经济模型模拟卫生技术用于卫生技术评估的成本和影响,为有效使用稀缺资源提供信息。模型历来使用电子表格软件(例如微软Excel)开发,而R的使用正在增加,通用模型软件仍然有限。Hesim是一个R软件包,有助于通过综合促进参数化、模拟和对经济模型进行经济模型分析来填补这一差距。支持型号包括组群离散时间状态过渡模型(CDTSTMS)、单个连续时间状态过渡模型(ICSTMS)和分离生存模型(PSMS),包括Markov(时间-均匀和时间-不相容)和半马尔科夫进程。基于R6和S3级的模块设计允许用户以灵活的方式将疾病演变、成本和实用性的不同子模型结合起来。概率敏感度分析(PSA)用于传播模型参数中的不确定性。C++ 模拟代码,例如将PSA和个人模拟结合的复杂模拟模型,可以比以往高得多地运行。在PA质量框架内进行一个模拟成本分析。