The pharmacoepidemiology of COPD: Recent advances and methodological discussion

This article reviews the important factors to consider in the design of economic evaluations or cost-effectiveness analyses (CEAs) of chronic obstructive pulmonary disease (COPD) treatments. The relevant costs associated with COPD can be divided into direct (direct medical and direct nonmedical) and indirect (programme and productivity) costs. The differences between the human-capital and friction-cost approaches to evaluate the impact of productivity loss are discussed. Since the primary cost-driver for COPD is hospital care for exacerbations, this may be the major outcome measure of interest in COPD economic evaluation studies. Robust CEA evaluations that take into account all of these factors will aid decisionmakers in evaluating COPD therapies.