Table 4

Scenario analyses; impact on the incremental cost-effectiveness ratios (ICERs)

CountryScenarioICER tiotropium/olodaterol versus tiotropiumICER
LABA/ICS versus tiotropium
ICER tiotropium/olodaterol versus LABA/ICS
FinlandBase case*€11 013Dominated†Dominant‡
Effect on: FEV1 only€52 438NANA
Effect on: exacerbations only€16 225Dominated€251
Effect on: exacerbations+FEV1€10 265Dominated€251
Hazard rates interpreted as risk ratiosNADominatedDominant
5000 simulated patients€10 203DominatedDominant
No discounting€9726DominatedDominant
Limited societal perspectiveDominantDominatedDominant
SwedenBase case§€6193DominatedDominant
Effect on: FEV1 only€36 165NANA
Effect on: exacerbations only€7977DominatedDominant
Effect on: exacerbations+FEV1€5610DominatedDominant
Hazard rates interpreted as risk ratiosNADominatedDominant
5000 simulated patients€5662DominatedDominant
No discounting€6531DominatedDominant
Healthcare perspective€7130DominatedDominant
The NetherlandsBase case¶€14 398€5902**€9243
Effect on: FEV1 only€38 401NANA
Effect on: exacerbations only€15 849€9211**€12 319
Effect on: exacerbations+FEV1€14 176€9211**€12 319
Hazard rates interpreted as risk ratiosNA€4732**€8248
5000 simulated patients€13 898€6229**€9296
No discounting€18 674€10 168**€13 513
Healthcare perspective€3638DominatedDominant
Societal perspective without unrelated medical costs in life years gained€6715Dominated€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.