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The data supporting the benefits of home non-invasive ventilation (NIV) in patients with severe chronic obstructive pulmonary disease (COPD) have been accumulating over the last decade. Historically, there was debate about the potential benefits of home NIV in this patient population, with early small-scale studies in specialist centres demonstrating physiological changes;1–3 however, these findings did not translate into a clinical benefit in the initial large-scale randomised clinical trials.4 5 Two pivotal trials made clear the potential improvements in overall and admission-free survival in patients with moderately severe chronic hypercapnic respiratory failure, with NIV titrated to control hypoventilation.6 7 Analysis of the data highlighted the importance of both population selection and the optimal delivery and timing of the intervention. It is clear that home NIV is only a valuable treatment for selected patients with COPD and that the intervention itself must be delivered to target control of hypercapnic respiratory failure. Further analysis of the current clinical trial data has further demonstrated clinically meaningful differences in patient-relevant outcomes including exacerbations and mortality8 as well as system benefits such as healthcare costs.9 10