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We live in a world of great advances in respiratory care, but at the same time, we are facing increasing budget constraints. In such a world, the use of any intervention is associated with “opportunity loss”: the benefit forgone by not using alternative interventions. Take the example of biologicals for severe asthma ( e.g. mepolizumab) or lung cancer ( e.g. nivolumab), annually costing around €15 000 and u003e€100 000 per patient respectively. The concept of opportunity loss applies whenever decisions are made: either by physicians in clinical practice who have to decide which treatment patients receive, or by health policymakers during the approval process of new interventions for market entrance: if resources are spent on these medications, it means that there will be less budget available for other interventions. In respiratory medicine, interventions could involve pharmacological treatments, but also new bronchoscopic procedures, biomarker tests, diagnostics or other health technologies [1–4].Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Van de Hei has nothing to disclose.Conflict of interest: Dr. Sadatsafavi has nothing to disclose.Conflict of interest: Dr. van Boven has nothing to disclose.

Making sense of cost-effectiveness analyses in respiratory medicine: a practical guide for non-health economists