What changes between markets
A global model is a starting point, not a submission. Each market changes the perspective, discount rate, comparators, costs, resource use and sometimes the utility value set. The treatment pathway may differ, and so may the population that is eligible in practice. Budget impact models need local epidemiology and uptake.
Read our insight: Adapting a global cost-effectiveness model for NICE and NCPE.
What we deliver
- Local reference case: perspective, discounting, time horizon and outcomes
- Local comparators and treatment pathways, agreed with clinical input
- Local unit costs and resource use, with sources documented
- Budget impact models with local epidemiology and market share
- Scenario and probabilistic sensitivity analyses
- Technical validation and quality control
- Technical reports and user guides
- Conversion from Excel to R, with optional Shiny interfaces
Validation is part of the job
Adaptation introduces errors as easily as it fixes them. We check every changed input and formula, test the model against the original, and use recognised validation frameworks such as TECH-VER and AdViSHE. You receive a validation log alongside the model.
Why Evidaxia
We build and adapt cost-effectiveness, cost-utility, cost-comparison and budget impact models for NICE and NCPE submissions, in Excel/VBA, R and Python. Because we have reviewed models from the assessor's side, we know where adapted models usually break. See also UK HTA submissions and NCPE submissions.
Reference cases compared
The reference case sets the rules every adapted model has to follow. For the three reference cases we adapt models to most often, the core elements are:
| NICE (England) | SMC (Scotland) | HIQA guidelines (Ireland) | |
|---|---|---|---|
| Perspective on costs | NHS and personal social services | NHSScotland and social work (personal social services) | The publicly funded health and social care system (the HSE) |
| Perspective on outcomes | All relevant health effects, for patients and, when relevant, carers | Patient perspective as the base case, with a patient and carer perspective as additional analysis where relevant | All health benefits accruing to individuals |
| Discounting | 3.5% a year for costs and health effects; 1.5% may be considered when specific criteria are met | 3.5% a year on costs and benefits | 4.0% a year on costs and outcomes occurring after the first year |
| Health-related quality of life | EQ-5D preferred in adults; the UK EQ-5D-5L value set for appraisals with an invitation to participate issued after 27 August 2026 (PMG51) | EQ-5D preferred in adults | Generic preference-based measures such as EQ-5D or SF-6D recommended |
Sources: NICE technology appraisal and highly specialised technologies manual (PMG36) and interim methods statement PMG51; SMC guidance to submitting companies for completion of the New Product Assessment Form (October 2026); HIQA National Guidelines for the Economic Evaluation of Health Technologies in Ireland (March 2025). Our insight on the NICE EQ-5D-5L value set explains what the value set change means for adapted models.
Beyond the reference case
The reference case is the visible part of adaptation. Much of the value lies in the details that make a model feel native to the committee reading it:
- Model structure: NICE's manual asks that the type of model and its structure are justified for each new decision problem. An adapted model therefore benefits from a short, explicit rationale for why the global structure suits the local pathway.
- Comparators and pathway: The comparators in a local scope can differ from those in the global model, and so can treatment sequences and the setting of care.
- Confidential prices: SMC asks that, where a key comparator is available through a patient access scheme discount or a national contract price, the model allows the confidential discount to be entered.
- Local costs and resource use: Unit costs, administration and monitoring follow national sources and local practice.
- Budget impact: Each agency has its own budget impact conventions; see budget impact models.
What a strong adapted model looks like
- A change log that links every adapted input and formula to its local source
- Results that reconcile with the original model, so the effect of each local change can be traced
- Settings that run each market's reference case without editing the underlying logic
- Scenario analyses chosen around the questions the local committee is likely to ask
- Documentation that a local assessor can follow without access to the global team
Read more in our insight on adapting a global model for NICE and NCPE, and see SMC submissions for the Scottish context.