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Most health economic analyses are undertaken with the aid of computers.However, the ethical dimensions of implementing health economic models assoftware (or computational health economic models (CHEMs)) are poorlyunderstood. We propose that developers and funders of CHEMs share ethicalresponsibilities to (i) establish socially acceptable user requirements anddesign specifications; (ii) ensure fitness for purpose; and (iii) supportsocially beneficial use. We further propose that a transparent (T), reusable(R) and updatable (U) CHEM is suggestive of a project team that has largelyfulfilled these responsibilities. We propose six criteria for assessing CHEMs:(T1) software files are open access; (T2) project team contributions andjudgments are easily identified; (R1) programming practices promotegeneralisability and transferability; (R2) licenses restrict only unethicalreuse; (U1) maintenance infrastructure is in place; and (U2) new releases aresystematically retested and appropriately deprecated. To facilitate CHEMs thatmeet TRU criteria, we have developed a prototype software framework in theopen-source programming language R. The framework comprises six code librariesfor authoring CHEMs, supplying CHEMs with data and undertaking analyses withCHEMs. The prototype software framework integrates with services for softwaredevelopment and research data archiving. We determine that an initial set ofyouth mental health CHEMs we developed with the prototype software frameworkwholly meet criteria T1-2, R1-2 and U1 and partially meet criterion U2. Ourassessment criteria and prototype software framework can help inform andimprove ethical implementation of CHEMs. Resource barriers to ethical CHEMpractice should be addressed by research funders.

A prototype software framework for transparent, reusable and updatable computational health economic models