Cost-effective inhaler device prescribing for COPD

Chronic obstructive pulmonary disease (COPD) is defined by a post-bronchodilator FEV1/FVC ratio of less than 0.7.¹ It is a progressive condition marked by persistent and largely irreversible airflow obstruction that leads to worsening shortness of breath, reduced exercise capacity, a persistent cough, and increased sputum production. The systemic inflammation present in COPD results in weight loss, skeletal muscle dysfunction, cardiovascular disease, and osteoporosis.²

COPD is thought to affect about 1.2 million people in the UK, and 4.5% of the population of over 40-year-olds are diagnosed with COPD.³ In England, a death occurs every 20 minutes due to COPD.⁴ However, National Institute for Health and Care Excellence⁵ estimates that two thirds of people who have COPD in the UK are, as yet, undiagnosed and suggest the total number of cases present in the population is around 3 million. The UK ranks 12th for COPD mortality across the world, and 3rd in Europe behind Denmark and Hungary, respectively.³ In the NHS, 1.4 million GP consultations per year are COPD-related and COPD accounts for 1 in 8 emergency hospital admissions.⁵ In the UK, the direct cost to the NHS of treating COPD is said to be £1.9 billion.³