Table 4:

Total budget impact (no case detection–case detection) results

Outcome	S1a	S1b	S1c	S2a	S3a	S3b	S3c	S3d
No case detection strategy costs (million $)
Case detection: physician time^*	0
Case detection: use cost^*	0
Treatment	2300
Hospital admission	4786
Outpatient^†	7666
Total	14 752
Case detection strategy costs (million $)
Case detection: physician time^*	107	107	107	69	44	44	44	44
Case detection: use cost^*	293	228	314	155	89	139	99	132
Treatment	2365	2325	2312	2329	2306	2337	2321	2314
Hospital admission	4772	4779	4780	4779	4781	4777	4779	4780
Outpatient^†	7637	7649	7652	7648	7660	7649	7654	7657
Total	15 175	15 087	15 165	14 980	14 880	14 947	14 898	14 927
Budget impact (million $)^‡
Case detection: physician time^*	−107	−107	−107	−69	−44	−44	−44	−44
Case detection: use cost^*	−293	−228	−314	−155	−89	−139	−99	−132
Treatment	−65	−25	−12	−29	−6	−37	−21	−14
Hospitalization	13	7	6	7	5	9	7	6
Outpatient^†	29	17	14	18	7	17	12	9
Total	−423	−335	−412	−228	−128	−195	−146	−175

Note: S1a = CDQ ≥ 17 points for all patients, S1b = flow metre (with bronchodilator) all patients, S1c = CDQ ≥ 17 points + flow metre (with bronchodilator) all patients, S2a = flow metre (without bronchodilator) among symptomatic patients, S3a = CDQ ≥ 19.5 points among patients aged ≥ 50 yr with a smoking history, S3b = CDQ ≥ 16.5 points among patients aged ≥ 50 yr with a smoking history, S3c = flow metre (without bronchodilator) among patients aged ≥ 50 years with a smoking history, S3d = CDQ ≥ 17 points + flow metre (with bronchodilator) among patients aged ≥ 50 yr with a smoking history.
Results based on a single run of EPIC per scenario.
↵* Case detection costs have been split by time (time-related cost of physician implementing case detection) and use cost (cost of flow meter technology and outpatient spirometry diagnosis).
↵† Outpatient care are the remaining costs not included in case detection, treatment or hospital admission and includes COPD maintenance costs, routine diagnosis, and costs associated with mild and moderate exacerbations which are assumed not to result in hospital admission.
↵‡ Negative budget impact indicates budget expansion.