A new report commissioned by The Lancet Respiratory Medicine reveals that patients with lung disease encounter significant challenges in accessing care with high treatment costs and hospitals failing to provide recommended standards of care. The report, written by 28 leading experts in the field of respiratory health, provides a comprehensive look at COPD care in the United States by interviewing caregivers, patient representatives, healthcare providers, insurance, and pharmaceutical companies to identify the challenges patients face on a daily basis and how these issues can be resolved.

According to a news release from The Lancet, the report finds that patients may face co-payments of $75 or more per drug even though access to drugs, such as inhalers, has improved. As such, a number of patients report skipping days, not collecting refills, and not taking full dosages. Among patients with COPD, only half of medication doses are taken as prescribed, while up to three-quarters of medication doses are taken correctly for other chronic diseases such as hypertension and diabetes. The high cost of COPD drugs is partly because there are no generic inhalers licensed for use in the US.

The report also notes that patients repeatedly describe pulmonary rehabilitation as the most helpful intervention in terms of improving their quality of life. However, access is still limited because of a shortage of programs that are geographically convenient for patients as well as variable insurance coverage. The Lancet news release indicates that the Commission highlights poor standards of care, with only one in three hospital admissions offering the standard recommended treatments to patients.

The report indicates that the absence of written protocols for inpatients has led to COPD being a low priority in hospital. In addition, the authors write most readmission for COPD are due to poor access to care or support outside the hospital and that preventing initial admission can be done with improved diagnosis, access to treatment, and care, which should be a priority. Finally, the report notes that caring for patients will require better education for patients and physicians to improve diagnosis and treatment, and better-coordinated action among physicians, insurers, and the pharmaceutical industry is needed to reduce the financial burden on patients.

“This report reveals a real patchwork of care for patients with chronic obstructive pulmonary disease. The disease is the third leading cause of death in the USA, and disproportionately affects some of society’s most vulnerable people, yet many patients lack access to basic therapies to improve their quality of life,” explains lead author of the Commission Dr MeiLan K Han. “This report aims to move us from debating what ideal care could look like, back to a discussion of what patients are actually facing on a day-to-day basis.”

Source: The Lancet