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The pharmacoepidemiology of COPD: Recent advances and methodological discussion

2003; European Respiratory Society; Volume: 22; Issue: 43 suppl Linguagem: Inglês

10.1183/09031936.03.00060003

1399-3003

Peter Burney, Samy Suissa, Joan B. Soriano, W M Vollmer, Giovanni Viegi, Sean D. Sullivan, Leonardo M. Fabbri, Don D. Sin, Pierre Ernst, David Coultas, Jean Bourbeau, Douglas W. Mapel, K Weiss, T. McLaughlin, David Price, Miriam Sturkenboom, R Taylor, Gerry Hagan,

Asthma and respiratory diseases

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.Possible sources of bias in observational studies of the effectiveness of inhaled corticosteroids in COPD S. Suissa SummaryThe possible sources of bias that can arise from observational studies using computerised claims databases are discussed.The four classes of bias are selection (asthma versus chronic obstructive pulmonary disease) and confounding (indication, age, duration and severity of disease), choice of outcome (morbidity or mortality), timing of the drug exposure (i.e.cohort or case-control design), or time-related issues (incident or prevalent cohort and immortal time concerns).