Before considering offering an intervention for COPD, it is important to consider the value the intervention will have in relation to other proven interventions. The London Respiratory Network, working with the London School of Economics developed an economic value model for COPD interventions, comparing the cost of each increased QALY for various COPD interventions. This is the QALY Pyramid.
The higher up the pyramid, the less cost effective the intervention is per adjusted life year. Triple therapy, for example, is far less cost effective than smoking cessation in COPD management. Unfortunately, the findings from the National COPD Audit in Wales shows that there is still not enough investment and referral of patients with COPD for the more cost effective interventions.