Evaluating the Validation Process: Embracing Complexity and Transparency in Health Economic Modelling

Reimbursement decisions and price negotiation of healthcare interventions often rely on health economic model results. Such decisions affect resource allocation, patient outcomes and future healthcare choices. To ensure optimal decisions, assessing the validity of health economic models may be crucial. Validation involves much more than identifying (and hopefully correcting) errors in the model implementation. It also includes assessing the conceptual validity of the model and validation of the model input data, and checking whether the model’s predictions align sufficiently well with real-world data. In the context of health economics, validation can be defined as “the act of evaluating whether a model is a proper and sufficient representation of the system it is intended to represent in view of an application”, meaning that the model complies with what is known about the system and its outcomes provide a robust basis for decision making.
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Validation of health economic models should be seen as a critical component of evidence-based decision making in healthcare. However, as of today, it still faces several important challenges, including the lack of consensus guidance and standardised procedures, the need for greater rigour or the question of who should oversee the validation process. To address these challenges, we encourage model developers, agencies requiring models for their decision making and editors of journals that publish models to recommend the use of state-of-the-art tools for reporting (and conducting) validations of health economic models, such as those mentioned in this editorial.