Optimizing the choice of intervention
The London Respiratory Team(LRT)created a ‘value pyramid ’for COPD based on published health economic assessments using quality-adjusted life year(QALY)methodology. Value is equal to health outcome divided by the cost of delivering the outcome. It shows visually where more could be done(at the base of the pyramid)versus where less could be done(at the top of the pyramid)to deliver best value in COPD care. Initial work demonstrated the importance of ensuring treatments such as smoking cessation support have been provided in the right way before considering more expensive treatments.