OBJECTIVES

The study objective was to examine whether economic evaluations of chronic obstructive pulmonary disease (COPD) incorporate patient-informed value elements.

METHODS

We performed a systematic review in PubMed and EMBASE to identify economic evaluations of COPD-specific pharmacologic treatments using the following concepts: COPD, (patient values or patient perspective) and (economic evaluation or cost effectiveness analysis (CEA)). Additionally, we searched the reference list of two systematic reviews of CEAs in COPD for relevant studies. Two reviewers scanned the titles and abstracts to exclude studies that did not meet the inclusion criteria. The remaining abstracts were marked for full-text extraction. During this step, the full text of these studies was reviewed to determine study type, key model parameters, study perspective and whether it considered specific patient values or perspectives.

RESULTS

The search returned 290 unique results, including those appearing in the reference list of two review articles. 54 met the inclusion criteria after title/abstract scanning. Full-text extraction of these references revealed the following results. Decision analytic modeling is the most common approach in the economic assessment of COPD, used by approximately 87% (n=47) of studies. Exacerbations and forced expiratory volume (FEV1) were the most frequently reported model parameters (n=49, 91% and n=30, 56%). No study explicitly mentioned incorporating patient values or patient perspectives in their methods. While the majority of studies reported a healthcare system or payer perspective, seven studies explicitly mentioned using a societal perspective.

CONCLUSIONS

While several CEAs included in this review used a societal perspective, it did not appear that key model parameters were informed by patients and were mainly based on clinical trial outcomes. Future studies that aim to use a societal or patient perspective should consider novel model parameters informed by patients.