Sep 2026· Journal of Managed Care & Specialty Pharmacy· Vol 32 9, pp.
1090-1100
· 0 citations· 24 references
Medicine
TL;DR
Findings support a hybrid paradigm in which AI augments, but does not replace, health economists in value assessment and formulary decision support within managed care settings.
Abstract
Background
Health economic modeling is conceptually sophisticated but operationally repetitive and resource intensive. Recent advances in large language models suggest potential for automating components of cost-effectiveness model development.
Objective
To evaluate whether an agentic artificial intelligence (AI) system can reliably automate cost-effectiveness model development in the context of targeted therapies for anaplastic lymphoma kinase-positive (ALK+) non-small cell lung cancer (NSCLC).
Methods
We developed the Agentic Health Economic Modeling Platform (A-HEMP) to construct a cost-effectiveness model for ALK+ NSCLC therapies without access to existing models in that clinical context. Modeling decisions and extracted parameters were compared with a previously published manual cost-effectiveness analysis. A-HEMP automated PICO-based scoping, modeling approach recommendation, systematic literature review, and structured parameter extraction. Performance was evaluated across 3 domains: model structure concordance, evidence identification concordance, and parameter value alignment. Deterministic cost-effectiveness outputs were calculated externally for benchmarking.
Results
A-HEMP identified a modeling framework aligned with the published cost-effective analysis and retrieved all primary clinical trials used for clinical efficacy inputs. Concordance in model structure and assumptions was observed in 27% of modeling dimensions, with 36% partially concordant and 36% divergent. Divergences were most prominent in survival extrapolation and intracranial progression handling. Evidence identification concordance was high for primary clinical trials (100%) but moderate for cost inputs, with 25% of evidence domains fully concordant and 38% partially concordant. Parameter value alignment was high for clinical efficacy inputs and progression-free health state utilities (<2% deviation), whereas greater variability was observed for sicker health states (12% deviation) and downstream disease management costs (25%-55% deviation).
Conclusions
Agentic AI can reliably automate upstream components of cost-effectiveness model development. However, nuanced modeling decisions with less standardized methodological guidance remain areas requiring expert oversight. These findings support a hybrid paradigm in which AI augments, but does not replace, health economists in value assessment and formulary decision support within managed care settings.
FLARE is proposed, a novel framework that endows VLAs with robust error recovery capabilities through a ``Retry" and ``Reset" Paradigm, and significantly improves task success and robustness.
Ganlong Zhao, Zijia Tang, Xingping Chen et al.· 3 citations
The fourth faculty is Adaptation. Any source rendering it as Reflection is in error, including sources by this author, and the distinction is not cosmetic: reflection is a private act with no external consequence, while adaptation writes to institutional memory, which is why it needs a guardrail and why misnaming it removes the reason for one. No trademark is claimed on PARA or on any of the four faculty names. The construct is offered for use, teaching, assessment, extension and criticism by anyone, with attribution, under CC BY 4.0. An operational agent that watches a system and acts on it is usually described as a perceive-and-act loop, and the description omits the two things an institution needs. It omits the reasoning that justifies an action, which is the only part that can be argued with once the action turns out to have been wrong. And it omits the adaptation that closes the loop, which is where the agent's experience becomes something the institution keeps. PARA names four faculties, each carrying a distinct authority type. Perception has read-only access to system signals and emits structured observations, distinguishing what was measured from what was inferred. Reasoning has read access to observations and runbooks, emits a plan and its justification, and writes nothing at all, which is what makes it safe to give it the widest read access of the four. Action holds the sole authority to change production, through enumerated policy-authorized operations only. Adaptation has write access to institutional knowledge and no write access to production. Two faculties write and two do not, and the two that write are the two that carry guardrails. The substantive requirement is that Adaptation is bounded by the same guardrails as Action, which reads as excessive until the failure it prevents is named. An agent that could both act and rewrite the record of its action could launder its own mistakes into institutional memory, and the institution would then improve its future decisions from a corrected account. Nothing about that is detectable downstream, because the record is the only thing downstream has and there is no second copy to compare against. The failure does not require a deceptive agent: one adapting honestly from a mistaken belief about its own action produces the same result, which makes the guardrail a defence against a normal agent rather than a malicious one. The second requirement is the registry entry that turns a faculty from a description into a contract, carrying the faculty, its allowed actions, its forbidden actions, its governing guardrail and its success metrics. Forbidden actions are named although they are formally the complement of the allowed set, because a reviewer cannot otherwise tell a capability deliberately withheld from one nobody thought of. Success metrics sit in the same entry because the metric is what the agent's optimizer pushes against the guardrail. An agent must not exercise a faculty its entry does not record, and an agent that quietly acquires one usually does so incrementally and with good intent: a reasoning faculty given a small write to make itself useful is an action faculty with no guardrail. The acronym and the loop are in different orders, which the specification states explicitly because the mismatch is a reliable source of confusion. The acronym reads P-A-R-A; the loop runs perception, reasoning, action, adaptation, and reasoning precedes action so that a justification is not constructed afterwards. This is the depth treatment of pattern OP-5 of A Pattern Language for Production LLM Platforms, which is the canonical statement and governs where the two disagree. Documented uses of the full four-part model are emerging rather than established, no implementation unconnected to the author has been evaluated, and the laundering failure is argued rather than observed, which the specification records as a weakness of the argument and not only of the phenomenon. It is a specification, not a certification scheme.
Nabeel A. Khan· Zenodo (CERN European Organi...· 2 citations
LifeSciBench is introduced, a benchmark of 750 expert-authored tasks designed to evaluate whether language models can handle realistic life science research work, with each constituent task paired with a human expert-written rubric.
Amelia Liu, Andrew Ho, Anne Marie Droste et al.· bioRxiv· 2 citations
General-purpose language models can reason and synthesize knowledge, but complex work also requires sustained interaction with files, information sources, and executable code, together with state maintenance, failure recovery, and verifiable delivery. We call this \emph{working capability}: sustained, verifiable progress toward a real-world objective. Apodex 1.1 develops this capability along two complementary dimensions. \emph{Environment Scaling} expands the diversity and verifiability of executable file, search, and code environments, while \emph{Agentic Coordination Scaling} trains agents to decompose long-horizon tasks, delegate parallel work, integrate asynchronous results, and replan. A shared execution harness and AgentOS maintain task state and provenance across tools and agents, and training turns environment trajectories and coordination traces into reliable behavior. Across complex professional work, finance, scientific research, mathematics, coding, and search, Apodex 1.1 reaches the leading performance band despite using a substantially smaller model than many frontier systems. The 35B-parameter Apodex 1.1 Mini further retains strong working capability in a locally deployable form. These results ground agentic intelligence in useful, verifiable work completed over time and advance our goal of building a \emph{Heavy-Duty Solver} for ambitious, long-running tasks.
Apodex Team B. An, B. Li, B. Wang et al.· 1 citation
HEPToolBench is introduced, a benchmark of 28 collider-simulation tasks scored by deterministic, task-specific scorers, plus a three-task structured-debugging extension, and moving syntax generation into deterministic software can substantially improve reliability for both small local and frontier models.
The complex multi-energy coupling characteristics inherent to integrated energy system (IES) present unprecedented challenges for the implementation of low-carbon scheduling. Existing optimization methods often exhibit limitations in system scalability, algorithm adaptivity, and carbon reduction efficacy for complex IES. This paper proposes a Large Language Model (LLM)-Embedded Multi-Agent Reinforcement Learning (LEMARL) to address the aforementioned issues. The proposed method integrates the global perception capability of LLMs with the dynamic optimization capability of MARL. Specifically, the LLM-Embedded module generates high-quality reward functions and policy frameworks from a global perspective, while the MARL module leverages these LLM-generated strategies for distributed interactive iterations—greatly enhancing computation efficiency and scalability. Simulation results demonstrate that LEMARL reduces carbon emissions by 7.76% and simultaneously decreases operating costs by 4.49% in a small-scale IES. Furthermore, LEMARL also exhibits superior applicability and scalability in large-scale IES of the IEEE 141-bus power grid integrated with 51-node thermal system.
Chen Xia, Tong Gou, Yinliang Xu et al.· IEEE Transactions on Smart G...· 1 citation
What if pathology foundation models could do more with less? GigaPath-Flash and GigaTIME-Flash cut computational demands while maintaining strong performance, opening the door to larger studies and broader exploration. The post GigaPath-Flash and GigaTIME-Flash: Toward population-scale discovery with efficient pathology foundation models appeared first on Microsoft Research.
MIT News · Artificial Intelligence· news.mit.eduAug 31, 2026
With millions of users across the world, Julia has been used to conduct cutting-edge research and to design new drugs, jet engines, heat pumps, and more.