Delivering high value therapies in COPD: the secret is in the marketing

There are a wide range of therapies now available for people suffering with chronic obstructive pulmonary disease (COPD), both pharmacological and non-pharmacological [1]. However, there has been recent recognition that non-pharmacological approaches (for example smoking cessation and pulmonary rehabilitation) deliver the highest value in terms of patient benefit in relation to cost [2]. It is also evident that the provision of high value therapies in clinical practice is frequently sub-optimal, as illustrated in figure 1 summarising data from a recent, comprehensive primary care audit of COPD care in Wales [3]. In healthcare systems such as Australia and the UK, where 90% of healthcare is delivered in primary care [4], there is now a need to investigate how best to implement such high value interventions in primary care.