OBJECTIVES: To identify evidence gaps for future economic modelling of Chronic Obstructive Pulmonary Disease (COPD) by reviewing published Conceptual Models and studies reporting associations between end-points and disease outcomes. METHODS: A systematic literature search was undertaken to identify English language publications since 2000 in Medline and Embase describing Conceptual Models of COPD and studies reporting associations between end-points and disease outcomes. Studies were reviewed against inclusion/exclusion criteria and those including therapeutic interventions were excluded at screening. RESULTS: Forty-one published papers were identified: 7 conceptual models of COPD and 34 articles on associations between endpoints and disease outcomes. Of the 7 conceptual models, 6 described single aspects of COPD (cognitive function, dyspnoea, brain function, design of patient related interventions, activity and functional performance). Only 1 described a broader set of determinants of health status in COPD patients (physiological functioning, patient complaints, functional impairment and quality of life.) 2 review papers on cognitive function and functional performance and 1 reporting determinants of functional performance and dyspnoea based on patient/expert interviews were identified. 31 studies using regression analyses to estimate associations between relevant parameters in COPD, including symptoms (mainly dyspnoea), health status, exercise, lung function, exacerbations, quality of life, biomarkers, co-morbidities, mortality and healthcare utilization were found. No studies on the use of conceptual models for economic modelling in COPD were identified. None of the studies presented a comprehensive set of determinants of disease progression and outcomes. CONCLUSIONS: It is recommended that models used to support economic evaluations of health care interventions are based on conceptual models capturing all relevant aspects of the disease and outcomes of value. The available evidence does not provide a full spectrum of relationships between diagnosis, disease progression and outcomes needed for a comprehensive disease based economic model in COPD.