Rutten‐van Molken 2007.

Methods	Study design: cost‐effectiveness analysis (CEA) and cost‐utility analysis (CUA), Markov model based on Oostenbrink 2005 Time horizon: 5 years with a 1‐year cycle duration Currency used, year of study: Euro, 2005
Participants	Analytic perspective: Spanish National Health System (NHS) and societal perspective Setting, country of study: primary and secondary care in Spain Population: patients with stable moderate‐to‐severe COPD Effectiveness data: exacerbations, hospitalisations from 6 RCTs (Brusasco 2003; Casaburi 2002; Vincken 2002) Utility scores: utilities were obtained from a subset of patients in the UPLIFT trial (Tashkin 2008) Resource use and costs: visits to respiratory physicians inside and outside of the hospital, visits to the general practitioner, pulmonary function tests, blood tests, imaging tests and respiratory medications, hospital admissions and visits to the emergency room (ER), and cost of absence from work due to illness were primarily derived from 2 studies performed in Spain (Miravitlles 2002; Miravitlles 2003). Unit costs of healthcare resources from SOIKOS health database, costs of pulmonary drugs based on public prices.
Interventions	Intervention: tiotropium 18 μg once daily Control 1: salmeterol 50 μg twice daily Control 2: ipratropium 40 μg 4 times daily
Outcomes	Exacerbations, exacerbation‐free months and quality‐adjusted life‐years (QALYs)
Notes	Sensitivity analysis: probabilistic sensitivity analysis based on severity of COPD, discount rate Funded by: Boehringer Ingelheim and Pfizer (manufacturer and co‐promoter of tiotropium)