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HEORAgent MCP Server

npm version license node Try in ChatGPT Web UI EU AI Pact AI Transparency

AI-powered Health Economics and Outcomes Research (HEOR) agent as a Model Context Protocol server.

Try it now → HEORAgent on ChatGPT (ChatGPT Plus / Team) · Web UI (Claude, BYOK) · npx heor-agent-mcp for Claude Desktop / Claude Code

Automates literature review across 44 data sources, risk of bias assessment (RoB 2 / ROBINS-I / AMSTAR-2), EQ-5D value set impact estimation, state-of-the-art cost-effectiveness modelling, HTA dossier preparation for NICE / EMA / FDA / IQWiG / HAS / EU JCA, and a persistent project knowledge base — all callable as MCP tools from Claude.ai, Claude Code, and any MCP-compatible host.

Built for pharmaceutical, biotech, CRO, and medical affairs teams who need rigorous, auditable HEOR workflows without building infrastructure from scratch.


First 60 seconds

Verify your install works before wiring it into Claude / Cursor / Continue. Open two terminal tabs:

Tab 1 — start the server in HTTP mode:

MCP_HTTP_PORT=8080 npx heor-agent-mcp@latest

You should see:

HEORAgent MCP server running on HTTP port 8080

Tab 2 — confirm it responds:

curl -s http://localhost:8080/health

Expected output:

{"status":"ok","server":"heor-agent-mcp","version":"1.10.2"}

✅ If you see the JSON above, the npm package works on your machine. Any further issues are in your MCP client config (Claude Desktop / Cursor / Continue), not the server.

❌ If you see command not found, run node --version — you need Node ≥20. If you see a different error, file a quick issue at https://github.com/neptun2000/heor-agent-mcp/issues with the output.

Now stop Tab 1 (Ctrl+C) and pick your client below — you don't need the HTTP mode for the actual integration; Claude / Cursor / Continue all use stdio.


Related MCP server: FHIR MCP Server

Quick Start (per client)

Pick your MCP host:

Claude Code

claude mcp add heor-agent -- npx heor-agent-mcp

Then restart Claude Code.

Claude Desktop / claude.ai Desktop

Edit your MCP config file (~/Library/Application Support/Claude/claude_desktop_config.json on macOS) and add:

{
  "mcpServers": {
    "heor-agent": {
      "command": "npx",
      "args": ["heor-agent-mcp"]
    }
  }
}

Then restart Claude Desktop.

Cursor / Continue / Cline

Same config shape as Claude Desktop above; the file path differs by client:

  • Cursor: Settings → MCP → Add new MCP server

  • Continue: ~/.continue/config.json under the mcpServers key

  • Cline: Settings → MCP Servers → Edit MCP Settings

Hosted (no install)


Your first prompt

Once your MCP host is configured, paste any of these to verify end-to-end:

Run a literature search for semaglutide cost-effectiveness in T2D
using PubMed, NICE TAs, and ICER reports. Set runs=2.
Run irb_review for an industry-funded interventional Phase 2 trial in
relapsed MM — multi-site US+EU, pseudonymized data, greater-than-minimal
risk. I need the review tier, GDPR/HIPAA DMP, SAE framework, and the
ready-to-paste cover letter.
Run jca_pico_scope for osimertinib in EGFR-mutant 2L NSCLC across
DE/FR/IT/ES/NL. Then prepare an EU JCA dossier draft using the picos.

The first prompt exercises literature_search + validate_links (free, no API keys needed). The second exercises irb_review (pure decision tree, instant). The third exercises jca_pico_scopehta_dossier pipeline.


What's new

See CHANGELOG.md for full version history. Current: v1.23.0 (45 tools, 44 data sources).

v1.17.0–v1.23.0 — Living Evidence Intelligence (review → reimbursement)

A connected RWE + cross-deliverable layer (see docs/FEATURES.md for the full table):

  • RWE & real-world safety: rwe.method_select (study-design selection), pv.comparative_safety (class-level FAERS-style AE ranking), evidence.triangulation (per-outcome RCT↔RWE concordance).

  • Governed social listening: rwe.social_listening_protocol + pv.social_listening_triage (GVP Module VI ICSR triage — no scraping).

  • One source of truth: evidence.claim_registry (author/auto-import a figure once), evidence.consistency_check (detect drift across dossier/publication/payer), publication.draft (reuse claims; CONSORT/STROBE/PRISMA/CHEERS + GPP2022/ICMJE).

  • Living orchestration: evidence.gap_analysis (iEGP), workflow.living_evidence (SLR → living KB → JCA/HTA runbook), hta.living_gvd (regenerate only the GVD sections whose figures changed).

v1.13.0 — AI Transparency Disclosure (ISPOR ELEVATE-GenAI aligned)

16 tools now accept an ai_disclosure_level parameter:

Value

Behaviour

"off"

No disclosure block appended

"standard"

Model ID · tools called · data sources · date · human-review reminder

"submission"

Standard block + ISPOR ELEVATE-GenAI full citation

Default by tool tier: HTA/regulatory tools (hta_dossier, hta_workflow, jca_pico_scope, pv_classify, etc.) default to "submission"; analysis tools (risk_of_bias, cost_effectiveness_model, etc.) default to "standard". Pass ai_disclosure_level: "off" to suppress.

Environment-level default: set HEORAGENT_DISCLOSURE_LEVEL=off|standard|submission to override the built-in per-tool defaults globally.

Web UI persona defaults: payer and HTA-reviewer personas always use "submission"; analyst personas default to "standard" and switch to "off" for scratch / exploratory prompts.

v1.0.4 highlights (still in v1.6.3)

Pharmacovigilance + workflow orchestration:

  • pv_classify tool — classifies a planned study into its EMA pharmacovigilance regulatory category (PASS imposed/voluntary, PAES, RMP Annex 4, DUS, active surveillance registry, pregnancy registry, spontaneous reporting, ICH E2E plan). Returns the matching GVP module (V/VI/VIII/VIII Addendum I), ENCePP protocol template ID, RMP implications, FDA analogue, and submission obligations. Pure decision-tree per EMA GVP rev 4 + EU Regulation 1235/2010 Article 107a. <200ms response.

  • hta_dossier Pharmacovigilance Plan section — pass pv_classification from pv_classify to hta_dossier and the dossier output now includes a PV Plan section between RoB and CEA. Without it, a one-line "PV plan not provided" note flags the gap so reviewers see what's missing.

  • maic_workflow orchestrator (v1.0.6) — runs the full MAIC discovery+screening pipeline (ITC feasibility + parallel literature_search + screening + RoB + network) in one MCP call. Built for ChatGPT-5.3 surfaces where chaining 5+ tool calls in parallel is unreliable; works equally well from Claude.

  • examples tool (v1.0.5) — pre-filled JSON inputs for heavy-schema tools (CEA, BIA, survival, MAIC, Bucher) plus a maic_workflow_recipe multi-step prompt template for ChatGPT users.

  • CMS IRA awareness — when pv_classify is called with US jurisdiction, output explicitly notes that CMS IRA Medicare price-negotiation calculations exclude PV cost data — track those obligations in the regulatory budget, not the HEOR cost-effectiveness model.

  • GRADE I²-based inconsistency, GRADE upgrading (Guyatt 2011), Bucher consistency check, EQ-5D 5L baseline-utility-aware impact (v1.0.4) — see CHANGELOG.md.

  • ChatGPT Custom GPT support (v1.0.4) — OpenAPI 3.1 adapter at /api/openapi lets you build a Custom GPT in 5 minutes. See ChatGPT Custom GPT below.

  • Surface-tagged analytics (v1.0.4) — every tool_call PostHog event carries a surface property (claude_anthropic_web / chatgpt_adapter / claude_desktop / direct_mcp).

See CHANGELOG.md for the full diff.


Tools (28)

Tool

Purpose

literature_search

Search 44 data sources with a full PRISMA-style audit trail

screen_abstracts

PICO-based relevance scoring and study design classification

risk_of_bias

Cochrane RoB 2 / ROBINS-I / AMSTAR-2 with GRADE RoB domain summary

evidence_network

Build treatment comparison network and assess NMA feasibility

evidence_indirect

Bucher and frequentist NMA with automatic consistency check vs direct h2h evidence (NICE DSU TSD 18)

population_adjusted_comparison

MAIC and STC for population-adjusted indirect comparisons

survival_fitting

Fit 5 parametric distributions to KM data (NICE DSU TSD 14)

itc_feasibility

Assess the 3-assumption ITC framework and recommend Bucher / NMA / MAIC / STC / ML-NMR

cost_effectiveness_model

Markov / PartSA / decision-tree CEA with PSA, OWSA, CEAC, EVPI, EVPPI; QALY + evLYG support

budget_impact_model

ISPOR-compliant BIA with year-by-year output and treatment-displacement modelling

hta_dossier

Draft submissions for NICE, EMA, FDA, IQWiG, HAS, and EU JCA — GRADE table uses structured RoB when rob_results passed; inconsistency uses I² when heterogeneity_per_outcome passed; GRADE upgrading (Guyatt 2011) supported via upgrading_per_outcome

utility_value_set

EQ-5D-3L / 5L value-set reference + baseline-utility-aware Biz 2026 ICER impact estimator (UK 5L transition)

validate_links

HTTP validation of citation URLs before presentation

project_create

Initialize a persistent project workspace

knowledge_search

Full-text search across a project's raw/ and wiki/ trees

knowledge_read

Read any file from a project's knowledge base

knowledge_write

Write compiled evidence to the project wiki (Obsidian-compatible)

Searches across 44 sources in parallel. Every call returns a source selection table showing which of the 44 sources were used and why — essential for HTA audit trails.

Example call:

{
  "query": "semaglutide cardiovascular outcomes type 2 diabetes",
  "sources": ["pubmed", "clinicaltrials", "nice_ta", "cadth_reviews", "icer_reports"],
  "max_results": 20,
  "output_format": "text"
}

cost_effectiveness_model

Multi-state Markov model (default) or Partitioned Survival Analysis (oncology), following ISPOR good practice and NICE reference case (3.5% discount rate, half-cycle correction). Includes:

  • PSA — 1,000–10,000 Monte Carlo iterations, probability cost-effective at WTP thresholds

  • OWSA — one-way sensitivity analysis with tornado summary

  • CEAC — cost-effectiveness acceptability curve

  • EVPI — expected value of perfect information

  • WTP assessment — verdict against NHS (£25–35K/QALY, updated April 2026), US payer ($100–150K), societal thresholds

Example call:

{
  "intervention": "Semaglutide 1mg SC weekly",
  "comparator": "Sitagliptin 100mg daily",
  "indication": "Type 2 Diabetes Mellitus",
  "time_horizon": "lifetime",
  "perspective": "nhs",
  "model_type": "markov",
  "clinical_inputs": { "efficacy_delta": 0.5, "mortality_reduction": 0.15 },
  "cost_inputs": { "drug_cost_annual": 3200, "comparator_cost_annual": 480 },
  "utility_inputs": { "qaly_on_treatment": 0.82, "qaly_comparator": 0.76 },
  "run_psa": true,
  "output_format": "docx"
}

hta_dossier_prep

Drafts submission-ready sections for six HTA frameworks with gap analysis:

Body

Country

Submission types

NICE

UK

STA, MTA, early_access

EMA

EU

STA, MTA

FDA

US

STA, MTA

IQWiG

Germany

STA, MTA

HAS

France

STA, MTA

JCA

EU (Reg. 2021/2282)

initial, renewal, variation (with PICOs)

Accepts piped output from literature_search and cost_effectiveness_model.

risk_of_bias

Assesses risk of bias using the appropriate Cochrane instrument, auto-detected from study_type:

Study type

Instrument

RCT

RoB 2 (5 domains: randomization, deviations, missing data, measurement, reporting)

Observational

ROBINS-I (7 domains: confounding, selection, classification, deviations, missing data, measurement, reporting)

Systematic review

AMSTAR-2 (16 items, critical vs non-critical)

Returns a rob_results object you can pass directly to hta_dossier_prep — this replaces the heuristic RoB estimate in the GRADE table with structured domain judgments.

Example call:

{
  "studies": [{ "id": "pmid_1", "study_type": "RCT", "title": "...", "abstract": "..." }],
  "output_format": "json"
}

Pipeline:

literature_searchscreen_abstractsrisk_of_biashta_dossier_prep

Knowledge base tools

Projects live at ~/.heor-agent/projects/{project-id}/ with:

  • raw/literature/ — auto-populated literature search results

  • raw/models/ — auto-populated model runs

  • raw/dossiers/ — auto-populated dossier drafts

  • reports/ — generated DOCX files

  • wiki/ — manually curated, Obsidian-compatible markdown with [[wikilinks]]

Pass project: "project-id" to any tool and results are saved automatically.


Examples

Copy-paste prompts to try in Claude Code, Claude Desktop, or the web UI.

Single-tool examples

Literature search

Search the literature for tirzepatide cardiovascular outcomes in type 2 diabetes. Use PubMed, ClinicalTrials.gov, and NICE TAs.

Survival curve fitting

Fit survival curves to this OS data from KEYNOTE-189: time 0 survival 1.0, time 6 survival 0.88, time 12 survival 0.72, time 18 survival 0.60, time 24 survival 0.51, time 36 survival 0.38. Use months.

Budget impact

Estimate the 5-year NHS budget impact of semaglutide for obesity. 200,000 eligible patients, drug cost £1,200/year, comparator (orlistat) £250/year, uptake 15% year 1 to 40% year 5.

Cost-effectiveness model

Build a CE model for semaglutide vs sitagliptin in T2D, NHS perspective, lifetime horizon, with PSA.

Indirect comparison (Bucher)

I have two trials: SUSTAIN-1 showed semaglutide vs placebo HR 0.74 (0.58-0.95) for HbA1c, and AWARD-5 showed dulaglutide vs placebo HR 0.78 (0.65-0.93). Run a Bucher indirect comparison between semaglutide and dulaglutide.

MAIC (population-adjusted comparison)

Run a MAIC between SUSTAIN-7 (N=300, semaglutide vs placebo, HR 0.74, CI 0.58-0.95, age 56±10, BMI 33±5) and AWARD-11 (N=600, dulaglutide vs placebo, HR 0.78, CI 0.65-0.93, age 58±9, BMI 35±6). Adjust for age and BMI.

Multi-tool workflows

Abstract screening workflow

Search PubMed for pembrolizumab in NSCLC, then screen the results with population adults with NSCLC, intervention pembrolizumab, comparator chemotherapy, outcomes overall survival and PFS.

Evidence network + NMA feasibility

Search for GLP-1 receptor agonists in T2D using PubMed, build an evidence network from the results, and assess NMA feasibility.

CE model with scenarios

Build a CE model for dapagliflozin vs placebo in heart failure, NHS perspective, lifetime horizon, with PSA. Add scenarios: "20% price reduction" with drug cost 400, "10-year horizon" with time_horizon 10yr.

End-to-end HTA workflow

Full dossier preparation

Create a project for semaglutide in obesity targeting NICE and ICER. Search literature for evidence, screen the results for adults with obesity comparing semaglutide to placebo for weight loss outcomes, assess risk of bias on the screened studies, then draft a NICE STA dossier using the screened results and rob_results.

This single prompt exercises: project_createliterature_searchscreen_abstractsrisk_of_biashta_dossier_prep (GRADE RoB from structured assessment).


Data Sources

44 sources across 10 categories. Every literature_search call includes a source selection table showing used/not-used status and reason for each.

  • PubMed — 35M+ biomedical citations (NCBI E-utilities)

  • ClinicalTrials.gov — NIH/NLM trial registry (CT.gov v2 API)

  • bioRxiv / medRxiv — Life sciences and medical preprints

  • ChEMBL — Drug bioactivity, mechanisms, ADMET (EMBL-EBI)

  • Wiley Online Library — Pharmacoeconomics, Health Economics, Journal of Medical Economics, Value in Health (CrossRef, ~77% abstract coverage, no key required)

  • WHO GHO — WHO Global Health Observatory

  • World Bank — Demographics, macroeconomics, health expenditure

  • OECD Health — OECD health statistics (expenditure, workforce, outcomes)

  • IHME GBD — Global Burden of Disease (DALYs, prevalence across 204 countries)

  • All of Us — NIH precision medicine cohort

  • FDA Orange Book — Drug approvals and therapeutic equivalence

  • FDA Purple Book — Licensed biologics and biosimilars

  • NICE TAs (UK) · CADTH (Canada) · ICER (US) · PBAC (Australia)

  • G-BA AMNOG (Germany) · IQWiG (Germany) · HAS (France)

  • AIFA (Italy) · TLV (Sweden) · INESSS (Quebec, Canada)

  • CMS NADAC (US drug acquisition costs)

  • PSSRU (UK unit costs) · NHS National Cost Collection · BNF (UK drug pricing)

  • PBS Schedule (Australia)

  • DATASUS · CONITEC · ANVISA (Brazil)

  • PAHO (Pan American regional) · IETS (Colombia) · FONASA (Chile)

  • HITAP (Thailand)

Source

Env variable

Embase

ELSEVIER_API_KEY

ScienceDirect

ELSEVIER_API_KEY

Cochrane Library

COCHRANE_API_KEY

Citeline

CITELINE_API_KEY

Pharmapendium

PHARMAPENDIUM_API_KEY

Cortellis

CORTELLIS_API_KEY

Google Scholar

SERPAPI_KEY

  • ISPOR — HEOR methodology and conference abstracts

  • OHE (Office of Health Economics) — EQ-5D value set research and HEOR methodology

  • EuroQol Group — EQ-5D instruments, value sets, and registry


Output Formats

All tools support output_format:

  • text (default) — Markdown with formatted tables and headings

  • json — Structured objects for downstream tools

  • docx — Microsoft Word document, saved to disk, path returned in response

DOCX files are saved to ~/.heor-agent/projects/{project}/reports/ (when a project is set) or ~/.heor-agent/reports/ (global). The tool response contains the absolute path — ready to attach to submissions or share with stakeholders.


Audit Trail

Every tool call returns a full audit record:

  • Source selection table — all 44 sources with used/not-used and reason

  • Sources queried — queries sent, response counts, status, latency

  • Inclusions / exclusions — counts with reasons

  • Methodology — PRISMA-style for literature, ISPOR/NICE for economics

  • Assumptions — every assumption logged with justification

  • Warnings — data quality flags, missing API keys, failed sources

Suitable for inclusion in HTA submission appendices.


Configuration

# Optional — enterprise data sources
ELSEVIER_API_KEY=...        # Embase + ScienceDirect
COCHRANE_API_KEY=...        # Cochrane Library
CITELINE_API_KEY=...        # Citeline
PHARMAPENDIUM_API_KEY=...   # Pharmapendium
CORTELLIS_API_KEY=...       # Cortellis
SERPAPI_KEY=...             # Google Scholar

# Optional — knowledge base location
HEOR_KB_ROOT=~/.heor-agent  # Default

# Optional — localhost proxy for enterprise APIs behind corporate VPN
HEOR_PROXY_URL=http://localhost:8787

# Optional — hosted tier (future)
HEOR_API_KEY=...

Web UI

A companion chat interface is available at:

https://web-michael-ns-projects.vercel.app

  • Chat with Claude Sonnet 4.6 + all 22 HEOR tools

  • BYOK (Bring Your Own Key) — paste your Anthropic API key in the settings; it stays in your browser's localStorage and is never stored on our servers

  • Markdown rendering with styled tables, tool call cards with live progress timers, and theme-aware mermaid network diagrams

  • 12 example prompts covering literature search, CEA, BIA, NMA, ITC feasibility, RoB, EQ-5D 5L, EU JCA dossiers

  • Per-request MCP sessions (no cross-user session bleed)

The web UI calls the hosted MCP server on Railway for tool execution. No setup required — just add your API key and start querying.

Self-hosting the web UI

cd web
npm install
echo "ANTHROPIC_API_KEY=sk-ant-..." > .env.local  # optional server-side fallback
npm run dev -- -p 3456

Set MCP_SERVER_URL to point to your own MCP server instance (default: the public Railway deployment).


ChatGPT Custom GPT

🟢 Live: HEORAgent on ChatGPT →

Open in ChatGPT (Plus / Team / Enterprise account required), pick a conversation starter, and you're querying 44 HEOR data sources.

HEORAgent is also available as a ChatGPT Custom GPT — useful when you (or your team) prefer the ChatGPT interface or have a ChatGPT Plus/Team account but no Anthropic API access.

Behind the scenes, the web tier exposes an OpenAPI 3.1 adapter at /api/openapi, with one POST endpoint per tool at /api/v1/{tool_name}. ChatGPT speaks this contract natively.

What's different from the Anthropic surface

Web UI / MCP / Claude Desktop

ChatGPT Custom GPT

Streaming

yes (SSE)

no (45s single response)

psa_iterations

up to 10,000

capped to 1,000 (CEA) / 500 (BIA)

literature_search.runs

1–5

capped to 1

literature_search.max_results

up to 100

capped to 30

Auth model

BYOK Anthropic

optional X-API-Key header (server-side CHATGPT_ADAPTER_TOKEN)

Surface label in PostHog

claude_anthropic_web / claude_desktop

chatgpt_adapter

The caps exist because ChatGPT Actions hard-fail at the 45-second response timeout. PSA, multi-run literature search, and full max_results would routinely exceed it. The web UI and MCP clients are unaffected.

Build a Custom GPT (ChatGPT Plus / Team required)

  1. Visit chatgpt.com/gpts/editor and click Create.

  2. Configure tab — fill in name (e.g., "HEORAgent"), description, and conversation starters. Paste the system prompt from web/lib/claude.ts (or write your own — the tool descriptions are self-documenting).

  3. ActionsCreate new actionImport from URL → paste:

    https://web-michael-ns-projects.vercel.app/api/openapi

    ChatGPT auto-imports all 17 endpoints with their schemas.

  4. Authentication — choose None for the open public endpoint, or API Key with the CHATGPT_ADAPTER_TOKEN value if you've configured one (recommended for prod).

  5. Privacy policy URL — required by GPT Store. Use the web UI's privacy URL or your own.

  6. Test in the playground (right pane), then Publish → "Anyone with the link" or "GPT Store".

Securing the adapter for production

By default the /api/v1/* endpoint is open. Two layers of protection are recommended for any public-facing GPT:

# 1. Token-gate the endpoint
cd web
vercel env add CHATGPT_ADAPTER_TOKEN production   # generate a long random token
# Configure the same token in your Custom GPT under Authentication → API Key

# 2. Built-in rate limit
# 60 req/min per IP is enforced automatically (lib/rateLimit.ts).
# For multi-region/high-traffic prod, swap in @upstash/ratelimit + Vercel KV.

Sample call (manual, no GPT needed)

curl -X POST https://web-michael-ns-projects.vercel.app/api/v1/utility_value_set \
  -H "Content-Type: application/json" \
  -d '{
        "action": "estimate_impact",
        "indication_type": "non_cancer_qol_only",
        "baseline_utility": 0.85,
        "base_icer": 30000
      }'

Returns the Biz 2026 baseline-utility-adjusted ICER projection (the new EQ-5D 5L impact estimator).


HTTP Transport

The server supports both stdio (default, for local MCP clients) and Streamable HTTP (for hosted deployment).

# Stdio mode (default — for Claude Code, Claude Desktop)
npx heor-agent-mcp

# HTTP mode — for hosted deployment, Smithery, web UI backend
npx heor-agent-mcp --http                    # port 8787
MCP_HTTP_PORT=3000 npx heor-agent-mcp        # custom port

HTTP endpoints:

  • POST/GET/DELETE /mcp — MCP Streamable HTTP protocol

  • GET /health — health check

  • GET /.well-known/mcp/server-card.json — Smithery discovery


Development

git clone https://github.com/neptun2000/heor-agent-mcp
cd heor-agent-mcp
npm install
npm test          # 401 tests across 84 suites
npm run build     # Compile TypeScript to dist/
npm run dev       # Run with tsx (no build step)

Requires: Node.js ≥ 20.


Architecture

┌────────────────────────────────────────────┐
│  MCP Host (Claude.ai / Claude Code / etc.) │
└────────────────┬───────────────────────────┘
                 │ stdio
┌────────────────▼──────────────────────────┐
│  heor-agent-mcp server                    │
│  ┌──────────────────────────────────────┐ │
│  │ 17 MCP tools (Zod-validated)         │ │
│  ├──────────────────────────────────────┤ │
│  │ DirectProvider (default)             │ │
│  │   ├─ 44 source fetchers              │ │
│  │   ├─ Audit builder + PRISMA trail    │ │
│  │   ├─ Markov / PartSA economic models │ │
│  │   ├─ Markdown + DOCX formatters      │ │
│  │   └─ Knowledge base (YAML + MD)      │ │
│  └──────────────────────────────────────┘ │
└───────────────────────────────────────────┘
                 │
    ┌────────────┴─────────────┐
    ▼                          ▼
┌────────────┐         ┌──────────────────┐
│ ~/.heor-   │         │ External APIs    │
│ agent/     │         │ (PubMed, NICE,   │
│ projects/  │         │  ICER, CADTH, …) │
└────────────┘         └──────────────────┘

License

MIT — see LICENSE.


Trust & Transparency

HEORAgent is a research and analysis tool — not a clinical decision-support system. It is not classified as high-risk under the EU AI Act because it does not drive individual diagnosis, treatment, or monitoring; it falls under limited-risk transparency obligations only. Every output is intended for review by a qualified HEOR/HTA/PV professional before any action is taken.

  • EU AI Pact signatory — committed to AI governance, high-risk system mapping, and AI literacy promotion (voluntary commitments per the European Commission, ahead of the AI Act's August 2026 deadline).

  • PRISMA-style audit trail on every tool call (sources queried, succeeded, failed, assumptions applied).

  • AI commentary explicitly labelled — domain claims (ICERs, trial results, regulatory decisions) come exclusively from tool outputs, never from training-data recall.

  • Methodology cited inline — ISPOR, NICE DSU TSDs, NICE PMG36, Cochrane Handbook, GRADE, EMA GVP, Cope 2014, Phillippo 2016, Biz 2026.

Full statement: /ai-transparency — risk classification, human oversight model, methodological references, and reporting channel.


Disclaimer

All outputs are preliminary and for research orientation only. Results require validation by a qualified health economist before use in any HTA submission, payer negotiation, regulatory filing, or clinical decision. This tool does not replace professional HEOR expertise.


Distribution

Channel

How to use

Who pays

npm

npx heor-agent-mcp

User's Claude subscription

Smithery

smithery.ai/servers/neptun2000-70zu/heor-agent-mcp

User's Claude subscription

Web UI

web-michael-ns-projects.vercel.app

User's own Anthropic API key (BYOK)

Hosted MCP

https://heor-agent-mcp-production.up.railway.app

Free (tool execution only)


Available Tools

7 tools
cost_effectiveness_modelA

Build a cost-utility analysis (ICER, QALY, PSA, sensitivity analysis) for a drug vs comparator. Follows ISPOR good practice guidelines and NICE reference case. Includes probabilistic sensitivity analysis (PSA), one-way sensitivity, and cost-effectiveness acceptability curve (CEAC).

ParametersJSON Schema
NameRequiredDescriptionDefault
interventionYesDrug or treatment name
comparatorYesComparator (standard of care)
indicationYesDisease or condition
time_horizonYesModelling horizon: 'lifetime', '5yr', '10yr', or years as number
perspectiveYes
model_typeNoModel type. Default: markov. Use 'partsa' for oncology.
clinical_inputsYes
cost_inputsYes
utility_inputsNo
run_psaNoRun probabilistic sensitivity analysis (default: true)
psa_iterationsNoPSA iterations (default: 1000, max: 10000)
output_formatNo
projectNoProject ID for knowledge base persistence. When set, model run is saved to ~/.heor-agent/projects/{project}/raw/models/

TDQS

A3.7/5.0
Behavior2/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations provided, the description carries full burden but lacks critical behavioral details. It mentions analysis types but doesn't disclose whether this is a read-only or write operation, what permissions are needed, whether it's computationally intensive, or what happens to the output (e.g., where results are stored). The mention of 'project' parameter saving to a directory hints at persistence but isn't fully explained.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is efficiently structured in two sentences: the first states the core purpose and scope, the second enumerates specific analysis components. Every phrase adds value without redundancy, making it front-loaded and easy to parse despite the tool's complexity.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness3/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a complex tool with 13 parameters, nested objects, no output schema, and no annotations, the description provides good high-level context but leaves gaps. It explains the analytical approach but doesn't cover behavioral aspects like computational requirements, error handling, or output details. The absence of annotations increases the burden on the description, which it partially meets but not fully.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

The description adds significant value beyond the 62% schema coverage by explaining the analytical framework (cost-utility analysis with specific components like ICER, QALY, PSA) and referencing guidelines. While it doesn't detail individual parameters, it provides crucial context about what the tool fundamentally does that the schema alone doesn't convey, though some parameter relationships remain implicit.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states the specific action ('Build a cost-utility analysis') and the comprehensive scope of what it produces (ICER, QALY, PSA, sensitivity analysis, CEAC). It distinguishes itself from siblings by focusing on economic modeling rather than knowledge management or dossier preparation, with explicit mention of following ISPOR and NICE guidelines.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines3/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description implies usage through its reference to specific guidelines (ISPOR, NICE) and analysis types, suggesting it's for health economic evaluations. However, it doesn't explicitly state when to use this tool versus alternatives like 'hta_dossier_prep' or provide clear exclusions or prerequisites for usage.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

hta_dossier_prepA

Structure evidence into HTA body-specific submission format (NICE STA, EMA, FDA, IQWiG, HAS, EU JCA). Produces draft sections with gap analysis. Accepts output from literature_search and cost_effectiveness_model.

ParametersJSON Schema
NameRequiredDescriptionDefault
hta_bodyYesHTA body. Use 'jca' for EU Joint Clinical Assessment (EUHTA Reg. 2021/2282).
submission_typeYesSubmission type. Use 'initial'/'renewal'/'variation' for JCA.
drug_nameYes
indicationYes
evidence_summaryNoText summary or JSON array from literature_search output
model_resultsNoJSON output from cost_effectiveness_model
picosNoJCA: list of PICOs from the scoping decision. If omitted, a default PICO is generated.
output_formatNo
projectNoProject ID for knowledge base persistence. When set, dossier draft is saved to ~/.heor-agent/projects/{project}/raw/dossiers/

TDQS

A4.1/5.0
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations provided, the description carries the full burden of behavioral disclosure. It describes the tool's core function (structuring evidence into submission formats) and output (draft sections with gap analysis), but doesn't mention important behavioral aspects like whether this is a read-only or write operation, what permissions might be needed, how long processing takes, or error handling. The description adds value but leaves significant behavioral questions unanswered.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is perfectly concise with two sentences that each earn their place. The first sentence establishes the core function and scope, while the second specifies input requirements and integration points. There's zero wasted language, and the most important information (what the tool does) comes first.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness3/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a complex tool with 9 parameters, no annotations, and no output schema, the description is adequate but has clear gaps. It explains the tool's purpose and input relationships well, but doesn't describe the output format in detail (beyond 'draft sections with gap analysis'), doesn't mention error conditions or limitations, and leaves behavioral aspects unspecified. Given the complexity, more completeness would be expected.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters4/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

With 67% schema description coverage, the description compensates well by providing crucial context about parameter relationships and tool integration. The statement 'accepts output from literature_search and cost_effectiveness_model' clarifies the semantics of evidence_summary and model_results parameters, which is valuable information not captured in the schema descriptions alone. However, it doesn't explain all parameters beyond what the schema provides.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states the tool's purpose with specific verbs ('structure evidence', 'produces draft sections with gap analysis') and resources ('HTA body-specific submission format'). It explicitly distinguishes from sibling tools by mentioning it 'accepts output from literature_search and cost_effectiveness_model', showing it operates downstream of those tools rather than duplicating their functions.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description provides clear context for when to use this tool by specifying it processes outputs from two specific sibling tools (literature_search and cost_effectiveness_model). However, it doesn't explicitly state when NOT to use it or mention alternatives for similar formatting tasks, which prevents a perfect score.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

knowledge_readA

Read a file from a project's raw/ or wiki/ tree. Path is relative to project root. Only raw/ and wiki/ subtrees accessible.

ParametersJSON Schema
NameRequiredDescriptionDefault
projectYesProject ID
pathYesRelative path (e.g. 'wiki/trials/sustain-6.md' or 'raw/literature/pubmed_12345.md')

TDQS

A3.9/5.0
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations provided, the description carries full burden. It discloses the read-only nature implicitly through the verb 'Read' and specifies access limitations ('Only raw/ and wiki/ subtrees accessible'), but doesn't mention authentication requirements, rate limits, error conditions, or what happens with invalid paths. It adds some behavioral context but leaves important operational details unspecified.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

Three concise sentences with zero waste. The first states the core purpose, the second clarifies path semantics, and the third specifies access limitations. Every sentence earns its place by adding distinct, necessary information. The description is appropriately sized and front-loaded with the main functionality.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness3/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a read operation with 2 parameters, 100% schema coverage, and no output schema, the description provides adequate but not complete context. It covers the what, where, and access limitations, but lacks information about return format, error handling, authentication needs, or performance characteristics. Given the simplicity of the tool and good schema coverage, this is minimally viable but has clear gaps.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100%, so the schema already documents both parameters fully. The description adds minimal value beyond the schema by clarifying that path is 'relative to project root' and providing example formats, but doesn't explain parameter interactions or constraints beyond what's in the schema descriptions. This meets the baseline for high schema coverage.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states the specific action ('Read a file') and resource ('from a project's raw/ or wiki/ tree'), with explicit scope limitations ('Only raw/ and wiki/ subtrees accessible'). It distinguishes from sibling tools like knowledge_write (write vs read) and knowledge_search (search vs direct read).

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description provides clear context about when to use this tool ('Read a file from a project's raw/ or wiki/ tree') and path requirements ('Path is relative to project root'), but doesn't explicitly state when NOT to use it or name specific alternatives like knowledge_search for broader searching. The sibling tool list shows knowledge_search exists, but no direct comparison is made.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

knowledge_writeA

Write a file to the project's wiki/ tree. Path MUST start with 'wiki/' and end with '.md'. Use this to compile/organize evidence from raw/ files into a structured knowledge base. Supports Obsidian-style [[wikilinks]].

ParametersJSON Schema
NameRequiredDescriptionDefault
projectYesProject ID
pathYesRelative path starting with 'wiki/', ending with .md (e.g. 'wiki/trials/sustain-6.md')
contentYesMarkdown content. Can include YAML frontmatter and [[wikilinks]].

TDQS

A3.9/5.0
Behavior3/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations provided, the description carries full burden. It discloses that the tool writes files and supports Obsidian-style wikilinks, which is useful behavioral context. However, it doesn't mention important behavioral aspects like whether this overwrites existing files, what permissions are required, error conditions, or response format. For a write operation with zero annotation coverage, this leaves significant gaps.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is efficiently structured in three sentences: first states the core action and constraints, second provides usage context, third adds feature support. Every sentence adds value with zero wasted words, making it easy to parse quickly.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness3/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

For a write tool with 3 parameters, 100% schema coverage, but no annotations and no output schema, the description provides adequate purpose and usage context. However, it lacks important behavioral details about mutation effects (overwrite vs create), error handling, and response format that would be needed for complete understanding. The absence of output schema means the description should ideally address what the tool returns.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

Schema description coverage is 100%, so the schema already documents all three parameters. The description adds some value by clarifying the path format ('MUST start with wiki/ and end with .md') and content capabilities ('Can include YAML frontmatter and [[wikilinks]]'), but doesn't provide significant additional semantic context beyond what the schema descriptions offer.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states the specific action ('Write a file'), target resource ('to the project's wiki/ tree'), and distinguishes it from sibling tools like knowledge_read and knowledge_search by focusing on writing rather than reading/searching. It provides concrete purpose beyond just the tool name.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines4/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description provides clear context about when to use this tool ('to compile/organize evidence from raw/ files into a structured knowledge base') and mentions path format requirements. However, it doesn't explicitly state when NOT to use it or name specific alternatives among siblings like knowledge_read for reading existing files.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

project_createA

Initialize a new HEOR project workspace with directory skeleton and project.yaml metadata. Idempotent — returns existing project if already created. Required before using the project parameter in other tools.

ParametersJSON Schema
NameRequiredDescriptionDefault
project_idYesShort identifier (alphanumeric + hyphens, e.g. 'semaglutide-t2d')
drugYesDrug or intervention name
indicationYesDisease/condition being treated
hta_targetsNoHTA bodies to target (optional)
notesNoFree-text project notes (optional)

TDQS

A4.4/5.0
Behavior4/5

Does the description disclose side effects, auth requirements, rate limits, or destructive behavior?

With no annotations provided, the description carries the full burden of behavioral disclosure. It effectively reveals key traits: the idempotent nature ('Idempotent — returns existing project if already created'), the prerequisite requirement for other tools, and the initialization of specific resources. However, it doesn't mention potential side effects like file system changes or error conditions, leaving some behavioral aspects uncovered.

Agents need to know what a tool does to the world before calling it. Descriptions should go beyond structured annotations to explain consequences.

Conciseness5/5

Is the description appropriately sized, front-loaded, and free of redundancy?

The description is front-loaded with the core purpose in the first sentence, followed by critical behavioral notes. Every sentence earns its place by providing essential information without redundancy. The structure is logical and efficiently conveys key points in minimal text.

Shorter descriptions cost fewer tokens and are easier for agents to parse. Every sentence should earn its place.

Completeness4/5

Given the tool's complexity, does the description cover enough for an agent to succeed on first attempt?

Given the tool's complexity (initialization with idempotency) and the absence of both annotations and an output schema, the description does a good job covering purpose, usage, and key behavior. However, it lacks details on what the tool returns (since no output schema exists) and doesn't fully address all potential side effects or error cases, leaving some gaps in completeness.

Complex tools with many parameters or behaviors need more documentation. Simple tools need less. This dimension scales expectations accordingly.

Parameters3/5

Does the description clarify parameter syntax, constraints, interactions, or defaults beyond what the schema provides?

The schema description coverage is 100%, so the schema already documents all parameters thoroughly. The description doesn't add any meaningful semantic context beyond what's in the schema—it doesn't explain relationships between parameters or provide usage examples. This meets the baseline expectation when schema coverage is complete.

Input schemas describe structure but not intent. Descriptions should explain non-obvious parameter relationships and valid value ranges.

Purpose5/5

Does the description clearly state what the tool does and how it differs from similar tools?

The description clearly states the specific action ('Initialize a new HEOR project workspace'), the resources involved ('directory skeleton and project.yaml metadata'), and distinguishes this tool from siblings by explaining its prerequisite role for using the 'project' parameter in other tools. It goes beyond a simple tautology by detailing what initialization entails.

Agents choose between tools based on descriptions. A clear purpose with a specific verb and resource helps agents select the right tool.

Usage Guidelines5/5

Does the description explain when to use this tool, when not to, or what alternatives exist?

The description explicitly states when to use this tool ('Required before using the `project` parameter in other tools') and provides a clear alternative scenario ('returns existing project if already created'). This gives the agent precise guidance on timing and fallback behavior without misleading information.

Agents often have multiple tools that could apply. Explicit usage guidance like "use X instead of Y when Z" prevents misuse.

Tool Schema Changelog

Recent tool additions, removals, and schema changes observed during successful MCP inspections.

  1. 7 tool updatesv0.1.7
    • First observedcost_effectiveness_model
    • First observedhta_dossier_prep
    • First observedknowledge_read
    • First observedknowledge_search
    • First observedknowledge_write
    • First observedliterature_search
    • First observedproject_create

TDQS

A4.1/5.0

Scored across 7 tools

Disambiguation5/5

Each tool has a clearly distinct purpose with no overlap: cost-effectiveness modeling, HTA dossier preparation, knowledge base reading/searching/writing, literature searching, and project creation. The descriptions clearly differentiate their functions, making misselection unlikely.

Naming Consistency4/5

Most tools follow a consistent verb_noun pattern (e.g., literature_search, project_create). The only minor deviation is 'knowledge_read/write/search' which uses a noun_verb format, but this is internally consistent within the knowledge tools and still readable.

Tool Count5/5

With 7 tools, this is well-scoped for a Health Economics and Outcomes Research (HEOR) agent. Each tool earns its place by covering distinct aspects of the workflow: project setup, evidence gathering, analysis, and documentation.

Completeness5/5

The toolset provides complete coverage for the HEOR domain: project initialization, comprehensive literature searching, cost-effectiveness modeling, HTA dossier preparation, and knowledge management. There are no obvious gaps; it supports the full lifecycle from evidence collection to submission-ready outputs.

Maintenance

ActivityStale
ResponsivenessUnresponsive

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