Scenario analyses; impact on the incremental cost-effectiveness ratios (ICERs)
| Country | Scenario | ICER tiotropium/olodaterol versus tiotropium | ICER LABA/ICS versus tiotropium | ICER tiotropium/olodaterol versus LABA/ICS |
| Finland | Base case* | €11 013 | Dominated† | Dominant‡ |
| Effect on: FEV1 only | €52 438 | NA | NA | |
| Effect on: exacerbations only | €16 225 | Dominated | €251 | |
| Effect on: exacerbations+FEV1 | €10 265 | Dominated | €251 | |
| Hazard rates interpreted as risk ratios | NA | Dominated | Dominant | |
| 5000 simulated patients | €10 203 | Dominated | Dominant | |
| No discounting | €9726 | Dominated | Dominant | |
| Limited societal perspective | Dominant | Dominated | Dominant | |
| Sweden | Base case§ | €6193 | Dominated | Dominant |
| Effect on: FEV1 only | €36 165 | NA | NA | |
| Effect on: exacerbations only | €7977 | Dominated | Dominant | |
| Effect on: exacerbations+FEV1 | €5610 | Dominated | Dominant | |
| Hazard rates interpreted as risk ratios | NA | Dominated | Dominant | |
| 5000 simulated patients | €5662 | Dominated | Dominant | |
| No discounting | €6531 | Dominated | Dominant | |
| Healthcare perspective | €7130 | Dominated | Dominant | |
| The Netherlands | Base case¶ | €14 398 | €5902** | €9243 |
| Effect on: FEV1 only | €38 401 | NA | NA | |
| Effect on: exacerbations only | €15 849 | €9211** | €12 319 | |
| Effect on: exacerbations+FEV1 | €14 176 | €9211** | €12 319 | |
| Hazard rates interpreted as risk ratios | NA | €4732** | €8248 | |
| 5000 simulated patients | €13 898 | €6229** | €9296 | |
| No discounting | €18 674 | €10 168** | €13 513 | |
| Healthcare perspective | €3638 | Dominated | Dominant | |
| Societal perspective without unrelated medical costs in life years gained | €6715 | Dominated | €754 |
*Payer perspective, 2000 simulated patients, discount rate 3%, and effect on FEV1, exacerbations and pneumonias.
†A treatment is dominated by the comparator when the treatment results in less health effects and higher costs.
‡A treatment is dominant versus a comparator when the treatment results in better health effects and savings in costs.
§Societal perspective, 2000 simulated patients, discount rate 3% and effect on FEV1, exacerbations and pneumonias.
¶Societal perspective, 2000 simulated patients, discount rate 1.5% for effects and 4% for costs and effect on FEV1, exacerbations and pneumonias.
**ICER should be interpreted as cost saved per QALY lost.
FEV1, forced expiratory volume in 1 s; ICER, incremental cost-effectiveness ratio; NA, not applicable; QALY, quality-adjusted life year.