Table 8.
One-way sensitivity analysis (ICER €2014)
| Variable of interest | Input | CAN | ESP | SWE | UK |
|---|---|---|---|---|---|
| Base case | TIO dom | 4,281 | 1,137 | TIO dom | |
| Discount rates | Costs: 0%, effects: 0% | TIO dom | 4,505 | 1,442 | 81 |
| Costs: 6%, effects: 6% | TIO dom | 4,039 | 814 | TIO dom | |
| Costs: 6%, effects: 0% | TIO dom | 2,328 | 475 | TIO dom | |
| Time horizon | 5 years | TIO dom | 1,174 | TIO | TIO dom |
| 10 years | TIO dom | 3,617 | 227 | TIO dom | |
| 20 years | TIO dom | 4,212 | 1,047 | TIO dom | |
| Treatment duration | 1 year | TIO dom | 4,147 | 1,070 | TIO dom |
| 10 years | TIO dom | 4,458 | 1,316 | TIO dom | |
| Life (35 years) | TIO dom | 4,707 | 1,631 | TIO dom | |
| Sex | Males only | TIO dom | 4,174 | 1,048 | TIO dom |
| Females only | TIO dom | 4,364 | 1,213 | TIO dom | |
| Start age | 40 years | TIO dom | 3,504 | 216 | TIO dom |
| 80 years | 2,293 | 4,384 | 1,201 | TIO dom | |
| GOLD start distribution | All start in GOLD II | TIO dom | 4,136 | 1,402 | TIO dom |
| All start in GOLD III | TIO dom | 4,318 | 997 | TIO dom | |
| All start in GOLD IV | TIO dom | 4,661 | 770 | TIO dom | |
| Subgroup | GOLD II | TIO dom | 1,421 | 1,276 | TIO dom |
| GOLD III | TIO dom | 5,259 | 1,087 | TIO dom | |
| GOLD IV | TIO dom | 11,421 | 2,112 | TIO dom | |
| Mortality | GOLD state mortality = normal mortality (not adjusted for COPD) | TIO dom | 4,384 | 1,255 | TIO dom |
| 20% higher excess mortality (SevEx) | TIO dom | 4,440 | 1,355 | TIO dom | |
| 20% lower excess mortality (SevEx) | TIO dom | 4,088 | 876 | TIO dom | |
| Effect of tiotropium on SevEx | Low 95% CI from SPARKa (RR SevEx: 1.05) | 9,942 | 5,875 | 12,509 | 10,102 |
| High 95% CI from SPARKa (RR SevEx: 1.97) | TIO dom | 4,161 | 308 | TIO dom | |
| RR SevEx: 1.00 for GOLD II patients | TIO dom | 4,579 | 1,691 | TIO dom | |
| Direct costs of SevEx | 20% higher | TIO dom | 3,909 | 611 | TIO dom |
| 20% lower | TIO dom | 4,592 | 1,576 | TIO dom | |
| QoL loss of SevEx exacerbations | 0% loss | TIO dom | 4,309 | 1,145 | TIO dom |
| 20% loss | TIO dom | 4,195 | 1,113 | TIO dom |
Notes:
a
Base case: RR SevEx GLY versus TIO =1.43.
Abbreviations: ICER, incremental cost-effectiveness ratio; CAN, Canada; ESP, Spain; SWE, Sweden; GOLD, Global Initiative for Chronic Obstructive Lung Disease; GOLD II, GOLD classification indicating moderate COPD; GOLD III, GOLD classification indicating severe COPD; GOLD IV, GOLD classification indicating very severe COPD; COPD, chronic obstructive pulmonary disease; SevEx, severe exacerbation; CI, confidence interval; RR, relative risk; QoL, quality of life; TIO dom, tiotropium dominating; GLY dom, glycopyrronium dominating; TIO, tiotropium; GLY, glycopyrronium.