OBJECTIVES

Chronic Obstructive Pulmonary Disease (COPD) is a progressive condition and it is the third leading cause of death worldwide. The present study provides an overview of disease and economic models published during recent years with a focus on their underlying assumptions about COPD progression.

METHODS

A systematic literature review was conducted to retrieve publications in English between January 2009 and May 2020 from Medline, Embase and York Centre for Reviews and Dissemination database. Most recent abstracts from relevant conferences and reports from health technology assessment bodies have also been screened. Primary focus was on identifying disease models assessing COPD progression and economic models of pharmacological products or vaccines.

RESULTS

We have identified 5,041 abstracts after removing duplications and citation-chasing of systematic reviews. Following the abstract and full text screening, 66 unique models have been identified for final review and data extraction. COPD progression was captured in eight of the 39 disease models and 24 of the 27 economic models. From the eight disease models, half of them measured progression as a definition of decline in forced expiratory volume in 1 second (FEV₁) over time and the other half estimated based on multiple variables. Twenty of the economic models were Markov-state (16 cohort, 4 individual-based), three of them were non-Markov individual-based simulation models and one was a non-Markov cohort-based model. Disease progression was solely based on FEV₁ decline in 16 of the economic models, seven used multiple variables and there was no detailed information found about one.

CONCLUSIONS

The models identified by the current SLR were heterogenous; COPD progression was included in only less than a quarter of the disease models, but almost all in the economic models. FEV₁ as a single explanatory variable was the most commonly used approach to estimate disease progression.