COPD Stakeholder Summit: Utilizing Peak Inspiratory Flow Rates to Individualize Treatment and Improve Outcomes - Episode 7

COPD Device Selection: Payer Reflections

Tools and resources that help payers with coverage decisions for devices used to treat chronic obstructive pulmonary disease.

Neil Minkoff, MD: At some point, we’re going to get more into GOLD [Global Initiative for Chronic Obstructive Lung Disease] and how guidelines are driving this. But I want to pull Dr Lopes in and ask: When you’re looking at the management of COPD [chronic obstructive pulmonary disease] for the population as a combination of molecule and device selection, what’s going on with your members? How do you feel comfortable that they’re in the right place?

Maria Lopes, MD, MS: As a payer, our objective is to provide enough choice and to understand the clinical differentiation among these products. We really appreciate the background, what we now know about some of these devices, and the degree of personalization and how this can connect with better outcomes. Because in the end, from a total cost perspective, we’re paying for [emergency department visits], hospitalizations, and readmissions. It’s fascinating to hear some of these predictive tools around PIF [peak inspiratory flow] and how they can help patients connect to the right device and the education that should follow.

Real-world data are so powerful in terms of helping us understand that degree of differentiation. What else can be done? The best practices around the approach include the need for a respiratory care team, care coordination—sometimes between the hospital care manager and transitions in care, and knowing what happens in the patient’s home.

As a payer, we have lots of data. We have data that span our pharmacy data and medical resource use, but it’s not always possible to have PIF, or some of these metrics that are potentially actionable. More obviously needs to be done. But I totally agree that it is about choice and connecting patients to the right device, the right solution, the right support, education, and the appropriate information.

Apps like CAT, the COPD Assessment Test, are helping on the care management side and even potentially on the practice and delivery sides. But certainly, what’s been highlighted is critical if we’re going to achieve the outcomes that we want to see for patients with COPD.

This activity is supported by an educational grant from Boehringer Ingelheim.