Modex, a cloud-based, centralized health economic model marketplace to reduce costs and enhance equity in cancer

New cancer drugs have long been at the forefront of research and debate about rising healthcare expenditure in the United States; researchers and decision-makers rely on evidence to support fair pricing and ensure patient access. HE models support stakeholders in decision-making about the most cost-effective care for the available resources. Annually, stakeholders spend an estimated $1B on health economics and outcomes research (HEOR), much of it to create and recreate health economic (HE) models. Global government bodies use these models to formulate response and reimbursement decisions, aid resource allocation and suggest value-based pricing for new therapies. Sharing models by making their “source code” openly available would mitigate these problems, but prior initiatives to promote model sharing have had limited success in part because model authors fear the loss of their intellectual property and are not paid for their models being deposited. NCI’s own CISNET simulation modeling groups have still not influenced the impact of cancers on the US population. Approximately 60% of the 174 existing open source (OS) HE models are in Github, an online repository that does not consistently use tags or metadata to denote searchable elements and contains no HE model quality control mechanism. ModEx will be a decentralized, transparent, and accessible model exchange that facilitates all data and source code to be made openly available. It will address developers’ inertia by rewarding royalties to authors who deposit their models and Pharma will benefit from reduced cost and increased efficiency. ModEx will sustainably fund those royalty payments through fees collected from model users. In exchange for their payments, model users will gain access to model source code that has undergone validation and to additional (paid) modules containing, e.g., new data sources and premium services. Availability of open source models (OSMs) in an easily accessible platform (ModEx) facilitates stakeholder review, increasing model quality and making development more efficient. ModEx would target pharmaceutical manufacturers, researchers, educators, policy makers, and others. The ModEx team will engage with CISNET members to include cancer models and ontologies. There is currently no centralized OS exchange mechanism for vetted HE models. ModEx will increase model robustness by using the AdViSHE validation-assessment tool for model quality so end-users can have confidence in deposited models. This project will create, in collaboration with developers of the Tufts CEVR Open-Source Model Clearinghouse framework, a functional freemium/premium ModEx prototype. The model platform will contain options to pay modelers for premium aspects of OSMs, an ontology and search module, a user registration module, and a database search module. We will conduct usability testing of search, payment and collaboration on the ModEx prototype with 20 existing cancer models via a 10-member Expert Advisory Panel, using the AdViSHE validation assessment tool to document model quality.