Digital Pathology Net Present Value Model

Turn complex planning into clear decisions with a calculator that helps you assess value, optimize strategy, and communicate impact.

Digital pathology (DP) is transforming clinical practice profoundly. Workflows optimization, enhanced collaboration among professionals and institutions, access to new digital biomarkers (AI), etc. The benefits of digital pathology are numerous and highly impactful. However, its implementation does not come without challenges, being the most prominent one the big upfront financial investment required. This fact remains the main barrier for faster and broader adoption of DP. Hospital managers wonder if the investment is worth it and affordable, pathologists lack the arguments to support the case and pitch for DP funding.

Alira Health, in collaboration with leading KOLs of eight pathology laboratories in Europe and AstraZeneca, developed a Net-Present-Value Model (NPV) to assess the financial impact of investing in and implementing digital pathology. Outcomes of this assessment were published in a research paper titled “Implementing digital pathology: qualitative and financial insights from eight leading European laboratories” in Virchows Archiv (Matias-Guiu et al. (2025)). Both, the development of this NPV model and the research paper were funded by AstraZeneca.

About This Digital Pathology NPV Model

The current NPV model is based on Matias-Guiu et al. (2025) and it has been adjusted and simplified to be easily used by pathologists across various laboratory sizes and levels of digital pathology implementation.

Its key purpose is to be used as a decision support tool for the economics of digital pathology roll-out at a pathology lab site or network. It estimates the 7-year Net Present Value of implementing digital pathology, considering benefits in economic terms versus investments. It shows annual cash flows and allows users to compare different implementation strategies. In doing so, the model aims to balance relevance with simplicity by focusing on those inputs that, based on the literature and our experience, are expected to capture the majority of the costs and benefits of digital pathology implementation.

The model has been extrapolated and calibrated from a literature-based evidence set, supplemented by qualitative insights, then generalized across three lab size archetypes (small/medium/large) and three DP adoption levels (selective, operational hybrid, all-digital). As such, several inputs are benchmarks/proxies rather than site-specific measures and should be replaced with local data wherever available.

Gain clear, data-driven insight into the financial impact of digital pathology. Use this calculator to model NPV, compare scenarios, and strengthen the business case.

How This Model Can Help Pathology Laboratories

The tool is designed for anyone involved in planning or evaluating digital pathology implementation, including pathologists, pathology department heads, hospital managers, and hospital financial/administrative staff.

It can help users to:

Understand if investing in digital pathology is financially justifiable in the specific lab setting
Help develop the business case to the hospital board/ leadership team, showing return on investment and cash flow evolution along years
Identify and quantify the different cost and income streams of digital pathology
Explore “what-if” scenarios, such as different adoption levels or equipment strategies

Experts Behind This NPV Model

Alira Health deployed its Market Access team to capture qualitative and quantitative insights from eight leading laboratories in Europe.

The leading success factors for the NPV model were the following:

Expert co-creation: Assessed, endorsed and supported by 16 Pathologists, leading KOLs in the field digital pathology.

Real-world data foundation: Model developed and adjusted based on real-life data from 8 leading hospital across 5 countries (EU4+UK).

Leading diagnostics and DCP expertise with industry support: Alira Health’s leading expertise in diagnostics and digital/computational pathology, combined with strong methodological capabilities.

How to Use This NPV Model

The model is built around separated into six tabs: instructions, live inputs, live outputs, scenario A vs B, Profit & Loss, and Limitations.

Instructions

The “Instructions” tab sets out all key elements that a user needs to know before using the model, from formatting rules to general information and key limitations, and most importantly the model’s key structural elements, model live inputs and outputs. Please make sure to read through this tab in order to ensure proper model understanding; you can always defer back to this tab in case questions arise.

Live Inputs

The “Live Inputs” tab consists of all key elements that the user should input for the model to run and provide NPV outputs. Parameters are categorized into different layers of detail and then values can be edited or provided as default. Certain notes (e.g. display only, suggested values) are also provided to ensure clear understanding and model reliability.
Scenario and setting input: To simplify the process and provide directional guidance, the model defines default archetypes. Three setting sizes (small, medium, large) and three adoption levels (pilot, operational hybrid, and almost fully digital) come with default parameters that have been carefully defined according to targeted literature research and pathologist input.
Editable parameter inputs: Users can override any default parameter/assumption to calibrate the model according to their laboratory’s specific information. Parameters are further categorized into clinical operations, reimbursement, case management systems, scanner, facility setup, and case review and collaborations.
Scanner calculator: the scanner/equipment category in the editable parameters requires the average per scanner in order to proceed with calculations. In cases where different scanners at different price points have or will be purchased, users can use the scanner calculator tab to identify the average price per scanner.
Restore and compare scenarios: At the last part of the live inputs, users can clean all inputs or save different scenarios in case they want to compare different settings.

Live Outputs

As soon as the user inputs the model with their parameters, the model provides the relevant outputs in terms of NPV digital pathology benefits, investment needed and total NPV model at a 7-year horizon. The live outputs further detail in the business case (yearly benefits and yearly investment needs), cash flow, cumulative cash flow and case investment and benefits. All outputs update automatically as soon as the user changes any inputs.

Scenario A vs B

Either by saving scenario A and B in the “Live inputs” tab, or directly in the “Scenario A vs B” tab, the user can compare NPV outputs from 2 different scenarios. This function may help pathologists that would like to compare different digital pathology implementation strategies side by side and pathologists in laboratories of a specific size or level of implementation that would like to understand the effects of further investing in any elements of digital pathology. The user can any moment go back to the “Live Input” tab and update the scenario with new assumptions overriding the last configuration.

Profit & Loss

‘The “P&L” tab is the model’s view-only calculation engine, pulling assumptions from Live Inputs to turn baseline activity, tariffs, staffing, and scanner capacity into year-by-year (set up;Y7) benefit and cost lines, apply the chosen discount rate, compute net and cumulative cash flows, and aggregate these into headline KPIs, that power the Live Output visuals.

Limitations

The model is based on a combination of literature, expert opinion, and real-world data from a subset of European laboratories. As such, it provides directional guidance, not an exact prediction for every laboratory.
Some inputs are benchmarks or proxies and may not match the local context.
Small and independent private laboratories are under-represented in the underlying sample.
Results will vary depending on how closely inputs reflect local activity, costs, and reimbursement.

For a full list of assumptions and caveats, please refer to the “Limitations” tab within the model.

Disclaimer

This model is intended solely for informational and educational use; it does not constitute a clinical, financial, legal, or investment tool, nor does it offer clinical, financial, legal, or investment advice or serve as a basis for decision making. Users are responsible for verifying all inputs and outputs and assume full responsibility for any decisions made in reliance on the results of model simulations.

The model is provided “as is” without any warranties, including those related to accuracy, completeness, merchantability, fitness for a particular purpose, or non-infringement. All assumptions reflect conditions as of the preparation date, and outcomes will vary depending on user input; Alira Health assumes no obligation to update the model; Alira Health assumes no obligation to any use, adaptation, modification or reuse that recipients may implement.

Forecasts generated by the model rely on information available as of the date of the model’s creation. Recipients acknowledge that actual results may differ materially from projected outcomes.

By accepting this model, recipients agree that Alira Health bears no responsibility or liability for any outcome, misstatement, omission, fact, or opinion expressed herein, nor for any consequences resulting from reliance on any result, statement, conclusion, or opinion contained within the model, or for the accuracy or completeness of the model or its underlying information.