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Background: COPD is a major healthcare burden in the UK. A prior cost effectiveness pyramid has been proposed suggesting that triple inhaled pharmacotherapy was one of the least cost effective interventions. CBT is thought to reduce anxiety and minimise panic-associated COPD admissions. When we looked at COPD interventions in Hartlepool and Stockton, we discovered that CBT wasn9t currently commissioned. Despite this, within the stakeholder groups, we learnt through discussion that the consensus was that CBT would be a very beneficial intervention. Methods: Our Star-COPD team used a modelling approach to calculate the cost effectiveness of known interventions in COPD within Hartlepool and Stockton. We speculatively included CBT and analysed this alongside other COPD interventions. Results: Our model provides some practical consensus-derived evidence that commissioning CBT services would be beneficial for patients with COPD. CBT was second only to smoking cessation and way ahead of more conventional inhaled drug therapies. Conclusions: Our modelling suggests that focussing on using non-pharmacotherapy based interventions including CBT may offer benefits in the management of COPD. Using the Star approach in a local health economy provides a pragmatic solution incorporating stakeholder consensus and service user input.