Model Details

Technical overview of the deterministic decision-modeling logic. Intended for reviewers and analysts; most clinical users can use the dashboard without this section.

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This section is intended for technical and reviewer audiences. Most clinical users can use the main dashboard without reviewing these details.

Model overview

The Iron Deficiency Value Explorer uses simplified deterministic decision-modeling logic to demonstrate dashboard functionality. All values are illustrative US demonstration values. Final values would be confirmed through evidence review, ASH expert input, and model validation.

Diagnostic model

trueCases = cohortSize × prevalence
nonCases = cohortSize − trueCases
truePositives  = trueCases × sensitivity
falseNegatives = trueCases − truePositives
trueNegatives  = nonCases × specificity
falsePositives = nonCases − trueNegatives

testingCost      = cohortSize × diagnosticTestCost
falsePositiveCost= falsePositives × unnecessaryTreatmentCost
missedCost       = falseNegatives × missedDiagnosisCost
followUpCost     = truePositives × followUpCostPerPatient
totalCost        = testingCost + falsePositiveCost + missedCost + followUpCost

qalyGain = truePositives  × utilityGain × timeHorizonYears
qalyLoss = falseNegatives × utilityLoss × timeHorizonYears
totalQALYs = qalyGain − qalyLoss

netMonetaryBenefit = totalQALYs × WTP − totalCost
ICER = (cost_strategy − cost_comparator) / (QALYs_strategy − QALYs_comparator)

Treatment model

responders     = cohort × responseRate × adherenceRate
nonResponders  = cohort − responders
switchToIV     = nonResponders × escalationRate
adverseEvents  = cohort × adverseEventRate

treatmentCost   = cohort × baseTreatmentCost
escalationCost  = switchToIV × ivEpisodeCost
monitoringCost  = cohort × monitoringCost
adverseEventCost= adverseEvents × adverseEventCost
totalCost       = treatmentCost + escalationCost + monitoringCost + adverseEventCost

totalQALYs = responders × utilityGain × T
            − nonResponders × nonResponseUtilityLoss × T
            − adverseEvents × adverseEventUtilityLoss × T

netMonetaryBenefit = totalQALYs × WTP − totalCost

Special population pathway model

Pathway models combine diagnostic sensitivity/specificity, treatment mix (oral, step-up, IV), missed-diagnosis cost, and overall response into a single end-to-end estimate.

detected = trueCases × pathwaySensitivity
missed   = trueCases − detected
treated  = detected
responding = treated × overallResponse
totalCost  = diagnosticCost + treatmentCost + followUpCost + missedCost
netMonetaryBenefit = (responding × utilityGain × T − missed × utilityLoss × T) × WTP − totalCost

Key assumptions

Assumption	Current value
WTP threshold	$100,000 / QALY
Time horizon	1 year(s)
Perspective	Healthcare system
Ferritin test	$42
TSAT / iron panel	$38
CRP	$32
Oral iron course	$36
IV iron episode	$1,630

Sensitivity analysis

The prototype includes tornado-chart analysis (one-way sensitivity on key drivers), threshold analysis across willingness-to-pay values, and a placeholder cost-effectiveness acceptability curve. Final implementation would include probabilistic sensitivity analysis with parameter distributions and Monte Carlo simulation.

Data status

All current values are illustrative US demonstration values. Final values would be confirmed through systematic evidence review, ASH expert panel input, and model validation prior to public release.

Limitations

Not final clinical guidance.
Not validated economic results.
No patient-level data.
No payer claims integration.
No live EHR integration.
No final systematic review inputs.

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