title: Delivering cost-effective care for COPD in the USA: recent progress and current challenges.
abstract: Chronic obstructive pulmonary disease (COPD) imposes a significant and growing economic burden on the US health care system. A brief exploration of reviews on the therapeutic management of COPD reveals a range of pharmacologic and nonpharmacologic options for reducing deleterious and costly exacerbations. Consensus is that both forms of therapy provide the greatest benefit to all patients. However, prescribing physicians must account for availability of resources and patients' ability to pay, as well as patient response and their likely persistence or adherence to recommended therapies. The ongoing challenge is to overcome barriers to comprehensive, real-world economic evaluations in order to establish the most cost-effective mix of therapies for every patient in the heterogeneous COPD population. Only then can evidence-based guidelines be translated into the most cost-effective delivery of care.
authors.affiliation: Pharmaceutical Health Services Research, University of Maryland, School of Pharmacy, 220 Arch Street, 12th floor, Room 01-209, Baltimore, MD 21201, USA. ibreunig@rx.umaryland.edu
authors.forename: Ian M
authors.initials: IM
authors.lastname: Breunig
authors.forename: Fadia T
authors.initials: FT
authors.lastname: Shaya
authors.forename: Steven M
authors.initials: SM
authors.lastname: Scharf
mesh_terms: D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods*; D019317:Evidence-Based Medicine; D017048:Health Care Costs; D006801:Humans; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D014481:United States