Guidance on the use of complex systems models for economic evaluations of public health interventions

Penny R. Breeze*, Hazel Squires, Kate Ennis, Petra Meier, Kate Hayes, Nik Lomax, Alan Shiell, Frank Kee, Frank de Vocht, Martin O’Flaherty, Nigel Gilbert, Robin Purshouse, Stewart Robinson, Peter J Dodd, Mark Strong, Suzy Paisley, Richard Smith, Andrew Briggs, Lion Shahab, Jo‐An OcchipintiKenny Lawson, Thomas Bayley, Robert Smith, Jennifer Boyd, Visakan Kadirkamanathan, Richard Cookson, Monica Hernandez‐Alava, Christopher H. Jackson, Amanda Karapici, Franco Sassi, Peter Scarborough, Uwe Siebert, Eric Silverman, Luke Vale, Cathal Walsh, Alan Brennan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)
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To help health economic modelers respond to demands for greater use of complex systems models in public health. To propose identifiable features of such models and support researchers to plan public health modeling projects using these models. A working group of experts in complex systems modeling and economic evaluation was brought together to develop and jointly write guidance for the use of complex systems models for health economic analysis. The content of workshops was informed by a scoping review. A public health complex systems model for economic evaluation is defined as a quantitative, dynamic, non‐linear model that incorporates feedback and interactions among model elements, in order to capture emergent outcomes and estimate health, economic and potentially other consequences to inform public policies. The guidance covers: when complex systems modeling is needed; principles for designing a complex systems model; and how to choose an appropriate modeling technique. This paper provides a definition to identify and characterize complex systems models for economic evaluations and proposes guidance on key aspects of the process for health economics analysis. This document will support the development of complex systems models, with impact on public health systems policy and decision making.
Original languageEnglish
Pages (from-to)1603-1625
Number of pages23
JournalHealth Economics
Issue number7
Early online date20 Apr 2023
Publication statusPublished - Jul 2023


  • complex systems
  • economic modeling
  • public health


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