title: "Show me the money": a fair criticism of economic studies on inhaled bronchodilators for COPD.
abstract: Chronic obstructive pulmonary disease (COPD) represents a significant burden for healthcare systems that is expected to grow further in the future. Inhaled long-acting bronchodilators, including tiotropium, represent the cornerstone of management of COPD patients. Economic studies evaluating the cost-effectiveness ratio of inhaled bronchodilators have to take into account several parameters, including the reduction of COPD exacerbations and related hospitalizations, as well as disease modification and improvement in quality of life and mortality. At an era when the healthcare resources are unlikely to grow as quickly as demand, economic analyses remain the cornerstone for the justification of the broad use of medication with an acceptable cost-effectiveness ratio. The greatest importance of such studies in COPD is the identification of subgroups of patients that will have the most benefit with an acceptable cost-effectiveness ratio for the healthcare providers. The development of models that will incorporate a global evaluation of the different aspects of this multi-component disease, in order to provide the best available care to each individual patient is urgently needed.
authors.affiliation: Department of Pneumonology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Kostikas
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Bouros
mesh_terms: D001993:Bronchodilator Agents / Q000191:economics* / Q000627:therapeutic use; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000191:economics*; D012602:Scopolamine Derivatives / Q000191:economics* / Q000627:therapeutic use; D000069447:Tiotropium Bromide
chemical_list: D001993:Bronchodilator Agents; D012602:Scopolamine Derivatives; D000069447:Tiotropium Bromide