Preparing for a new era in chronic cough management

Chronic cough, defined as cough lasting 8 weeks or more in adults, accounts for approximately 16 million outpatient visits per year. Chronic cough exerts a significant burden on the quality of life of patients, which is often why they initially seek treatment. Various factors have contributed to the high cost associated with the burden of chronic cough, from multiple referrals and unnecessary repeat testing to polypharmacy and development of comorbidities due to lack of proper treatment. Although treatment guidelines for chronic cough are available, they vary in their recommendations. There are no FDA-approved agents indicated specifically for chronic cough at this time, but medications such as inhaled corticosteroids and narcotic antitussives are frequently used for treatment, while speech and behavioral therapy have also been potential options. New targeted therapies in the clinical pipeline are expected to expand the treatment landscape and meet the unaddressed gaps for safe and efficacious agents that can provide relief and better management for patients. Access to appropriate care based on clinical guidelines is associated with favorable outcomes. Managed care organizations should consider treatment guidelines, patient factors, and emerging pharmacologic as well as nonpharmacologic treatment options to create a streamlined approach to managing chronic cough treatment in an evidence-based and cost-effective manner.