Emphysema remains a difficult problem to treat. Destruction of lung tissue and the anatomic and functional problems cannot be reversed with medications. Some patients have tried lung transplantation but currently one of the hot topics and areas of research is the use of small coils that are placed in the airway of the lungs that help to reverse some of these anatomic and functional issues. Not everyone is a candidate for these procedures and there are recognized complications.
A recent study has shown improvement in quality of life with coil therapy compared to regular medical management. Over 50% of the coil group had at least one serious complication compared with only 38% of the medical group. As I see it, this complication rate is not the biggest problem with coils. A quality-associated life year (QALY) is one way to assess the cost-effectiveness of a procedure or therapy. It is generally felt among those that calculate these things that 50,000 to 100,000 dollars per QALY is acceptable.
This procedure has a cost-effectiveness ratio of 782,598 dollars per QALY and if the patient’s quality of life remains the same over a three year period this ratio is reduced to 270,000 dollars. My point with all these numbers and statistics is to say nothing is simple, and definitely not cheap. I really do not know if we can afford some of the therapies we now have for a variety of diseases. As far as emphysema is concerned, prevention seems much cheaper.