The Contribution of Epidemiology to Pharmacoeconomic Research

Epidemiologic principles provide important guidelines for the conduct of pharmacoeconomic research. Inclusion of economic outcomes in clinical trials often requires longer study periods, nontraditional measurement instruments, and nontraditional data sources, all of which are common attributes of epidemiologic studies. When outcomes are delayed or infrequent, nonexperimental epidemiologic study designs offer advantages over clinical trials. In nonexperimental study designs, control and evaluation of bias and confounding are essential for enhancing causal inference. Such techniques are the cornerstone of epidemiologic research methods. Methodologic issues for which epidemiologic principles provide guidance include biases in: choice of study population, ascertainment of drug use, ascertainment of diagnoses, ascertainment of confounders, and ascertainment of resource use.