Cost-effectiveness of tiotropium versus usual care and glycopyrronium in the treatment of chronic obstructive pulmonary disease in Sweden

Table 9 One-way sensitivity analysis (ICER in SEK 2014)

Variable of interest	Value	TIO vs UC	TIO vs GLY
Base case		224,850	10,456
Discount rate	0 %	187,684	13,206
Discount rate	5 %	249,658	8523
Time horizon	5 years	592,149	Dominating
	10 years	326,192	2233
	20 years	235,715	9641
Treatment duration	1 year	102,727	9849
	10 years	294,652	12,081
	Life (35 years)	330,299	14,962
Sex	Males only	230,862	9646
Sex	Females only	220,021	11,141
Start age	40	320,470	2119
Start age	80	240,894	11,043
GOLD start dist	All start in GOLD II	225,925	12,878
	All start in GOLD III	224,903	9172
	All start in GOLD IV	217,926	7084
Mortality	Normal mortality (not adjusted for COPD) for all GOLD states	232,402	11,522
	20 % higher excess mortality (Sev Ex)	204,979	12,424
	20 % lower excess mortality (Sev Ex)	247,036	8093
Effect of tiotropium on Sev Ex	Low 95 % CI from studies^a (RR Sev Ex)	103,232	114,589
Effect of tiotropium on Sev Ex	High 95 % CI from studies^a (RR Sev Ex)	5,845,054	2859
Direct costs of Sev Ex	20 % higher	221,336	5665
Direct costs of Sev Ex	20 % lower	228,367	15,246
QoL loss of Sev Ex exacerbations	0 % loss	225,934	10,528
QoL loss of Sev Ex exacerbations	20 % loss	221,429	10,235

“Dominating” tiotropium is dominating, “dominated” tiotropium is dominated
Base case: RR SevEx GLY vs TIO = 1.43
^aTIO vs UC, Hettle et al.; TIO vs GLY, RR SevEx in SPARK 1.43 (CI 1.05–1.97, P: 0.025)

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