ContentsCOPD Commissioning Pack Cost-Benefit ToolContentsSummarySummaryMain control panel for the model. Allows users to select their PCT, then summarises main results and allows user to flex certain key inputsAdditional costsAllows users to enter locally specific costsModel resultsSummarises key outputs of the model for every PCT (using default assumptions)Spirometry and AssessmentSpirometry & Assessment pathwaySee specification document for this informationMain data & assumptions - S&ASummarises the key data inputs and assumptions of the S&A element modelS&A impact over timeCalculates the potential costs and benefits of Spirometry and Assessment over a 20-year periodReferral to serviceEstimates the number of people in a PCT who would be referred to a S&A Service on the basis of certain characteristicsDiagnosis of COPDEstimates the number of people in a PCT who would be diagnosed with COPD as a result of an audit of GP practice records (case-finding)ExacerbationsSummarises key data and assumptions on exacerbations and calculates average cost of exacerbations at different stages of the diseaseOngoing treatmentEstimates the average annual per person cost of regular, ongoing treatment for COPDSwedish cost apportionmentApportions the cost of COPD medication to the different severity stages of COPDCost of drugsSummarises key data on the cost of COPD medication to the NHSQALY gainsSummarises the key data on COPD Quality of Life and calculates QALY benefits from S&AS&A service costsCalculates the cost of commissioning a S&A Service, as set out in the COPD commissioning pack specificationPulmonary RehabilitationPR pathwaySee specification document for this informationMain data & assumptions - PRSummarises the key data inputs and assumptions of the PR element of the modelNumber eligible for PRCalculates the number of people in the selected PCT who are likely to be eligible for PRDetails of PR serviceSets out the key details of the PR Service and the key assumptions used to calculate the cost of service (e.g. drop out rates at each stage)PR service costsCalculates the cost of commissioning a PR Service, as set out in the COPD commissioning pack specificationBenefits and cost savingsSummarises the costs, savings and QALY benefits of commissioning a PR ServiceDataAPHO COPD exp prevalence GPPredicted rates of underlying COPD prevalence by GP practice, based on the APHO modelExpected COPD prevalence by PCTData from the above worksheet, aggregated to the PCT levelCOPD prevalence PCTDiagnosed prevalence rates of COPD by PCT from QOFDifference betw exp & diagnosedDifference between predicted and diagnosed rates of COPD by PCTCOPD prevalence GPDiagnosed prevalence rates of COPD by GP practice from QOFAsthma prevalence PCTDiagnosed prevalence rates of asthma by PCT from QOFWorkforce assumptionsWorkforce costs, as calculated in the Dementia commissioning pack modelSmoking dataSmoking prevalence data from the General Household Survey broken down by agePopulation dataONS population data broken down by agePopulation data by PCTONS population data broken down by age and PCTCough dataData on cough prevalence rates from academic studiesPCT listList of PCT names and codesPrimary care COPDData on primary care usage by COPD patients (e.g. number of GP consultations)Primary care generalData on general primary care usage (e.g. number and type of consultations)Literature on PR benefitsSummary of key estimates from the academic literature on PRHES HRG dataSummary of data relating to hospital admissions with a COPD diagnosisLife expectancyData on survival rates for people with Very Severe COPDProgression analysisThese worksheets relate to work which informed the analysis but do not link directly into the modelImpact assumptionsSummary of assumptions relating to the effects of quitting smoking and appropriate medication on lung function declineYears at stage diagnosed at 55Summary of disease progression for a 55-year-old man with average rate of lung function declineAnalysis - smokers - menModelling of lung function decline in men under various scenariosFEV1 ref values - menNormal lung function levels for men at different ages

SummarySpirometry & Assessment pathwayMain data & assumptions - S&AS&A impact over timeReferral to serviceDiagnosis of COPDExacerbationsOngoing treatmentSwedish cost apportionmentCost of drugsQALY gainsS&A service costsPR pathwayMain data & assumptions - PRNumber eligible for PRDetails of PR servicePR service costsBenefits and cost savingsModel resultsAPHO COPD exp prevalence GPExpected COPD prevalence by PCTCOPD prevalence PCTDifference betw exp & diagnosedCOPD prevalence GPAsthma prevalence PCTWorkforce assumptionsSmoking dataPopulation dataPopulation data by PCTCough dataPCT listPrimary care COPDPrimary care generalLiterature on PR benefitsHES HRG dataLife expectancySpirometry and AssessmentPulmonary RehabilitationDataProgression analysisAdditional costs

SummarySummary of costs and benefits: COPD commissioning packBack to ContentsSelect your PCT from the drop down boxClick here to enter additional local costsCOPD diagnosis rate (your PCT)37%Diagnosis rate = Number of people diagnosed with COPD as % of estimated total number of people with COPDCOPD diagnosis rate (national)50%Choose services to commissionNet costsSpirometry and Assessment ServiceNet cost of S&A Service over 20 years 2,520,769Pulmonary Rehabilitation ServiceNet cost of PR Service in Year 1 563,761Spirometry and Assessment ServiceKey inputsCosts and benefits over 20 yearsDefaultEnter local data here% of GP practices which agree to participate100%Cost of running S&A Service in Year 1 639,448% of those invited likely to turn up30%Discounted net cost of healthcare 1,881,321Proportion of population over 35 who smoke19.7%Number of patients diagnosed by S&A2,552Proportion of population over 35 who are ex-smokers29.9%Discounted QALY benefits36% of current smokers who quit on diagnosis10%Cost per QALY gained 69,500Year-by-year costs and benefitsYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Cost of S&A running service in Year 1$639,448Discounted cost of additional treatment$331,590$279,829$231,188$185,518$165,404$146,439$128,568$159,138$134,426$111,204$98,158$76,359$55,922$36,781$18,870$13,621$8,707$4,109($188)($4,199)Discounted savings from reduced exacerbations($41,731)($34,988)($28,653)($22,707)($19,978)($17,407)($14,987)($18,571)($15,611)($12,830)($17,353)($14,074)($10,997)($8,112)($5,409)($4,664)($3,962)($3,303)($2,684)($2,103)Discounted net cost of healthcare$289,859$244,841$202,535$162,811$145,427$129,033$113,581$140,567$118,815$98,374$80,805$62,285$44,926$28,669$13,460$8,958$4,744$805($2,872)($6,302)Discounted QALY benefits0.870.760.640.530.470.420.370.540.470.413.513.403.283.173.062.992.932.872.822.76Cost per QALY gained$331,459$324,183$316,785$309,116$307,461$306,665$307,000$262,127$250,562$237,704$22,994$18,344$13,699$9,055$4,405$2,992$1,617$280($1,020)($2,285)Pulmonary Rehabilitation ServiceKey inputsCosts and benefits in Year 1DefaultEnter local data hereCost of running PR Service 649,168PR completion rate66%Cost per patient completing programme 491Savings in secondary care- 85,407QALY benefits40Cost per QALY gained 14,203For information (costs not borne by commissioner)Net cost in primary care 8,787PCT code5QNPCT number15Choice of services to commissionYesNo11PCT name (definitive)Ashton, Leigh and WiganBarking and DagenhamBarnetBarnsleyBassetlawBath and North East SomersetBedfordshireBerkshire EastBerkshire WestBexleyBirmingham East and NorthBlackburn with DarwenBlackpoolBoltonBournemouth and PooleBradford and AiredaleBrent TeachingBrighton and Hove CityBristolBromleyBuckinghamshireBuryCalderdaleCambridgeshireCamdenCentral and Eastern CheshireCentral LancashireCity and Hackney TeachingCornwall and Isles of ScillyCounty DurhamCoventry TeachingCroydonCumbriaDarlingtonDerby CityDerbyshire CountyDevonDoncasterDorsetDudleyEalingEast and North HertfordshireEast LancashireEast Riding of YorkshireEast Sussex Downs and WealdEastern and Coastal KentEnfieldGatesheadGloucestershireGreat Yarmouth and WaveneyGreenwich TeachingHalton and St HelensHammersmith and FulhamHampshireHaringey TeachingHarrowHartlepoolHastings and RotherHaveringHeart of Birmingham TeachingHerefordshireHeywood, Middleton and RochdaleHillingdonHounslowHullIsle of Wight National Health ServiceIslingtonKensington and ChelseaKingstonKirkleesKnowsleyLambethLeedsLeicester CityLeicestershire County and RutlandLewishamLincolnshireLiverpoolLutonManchesterMedwayMid EssexMiddlesbroughMilton KeynesNewcastleNewhamNorfolkNorth East EssexNorth East LincolnshireNorth LancashireNorth LincolnshireNorth SomersetNorth StaffordshireNorth TeesNorth TynesideNorth Yorkshire and YorkNorthamptonshireNorthumberlandNottingham CityNottinghamshire CountyOldhamOxfordshirePeterboroughPlymouth TeachingPortsmouth City TeachingRedbridgeRedcar and ClevelandRichmond and TwickenhamRotherhamSalfordSandwellSeftonSheffieldShropshire CountySolihullSomersetSouth BirminghamSouth East EssexSouth GloucestershireSouth StaffordshireSouth TynesideSouth West EssexSouthampton CitySouthwarkStockportStoke on TrentSuffolkSunderland TeachingSurreySutton and MertonSwindonTameside and GlossopTelford and WrekinTorbayTower HamletsTraffordWakefield DistrictWalsall TeachingWaltham ForestWandsworthWarringtonWarwickshireWest EssexWest HertfordshireWest KentWest SussexWestern CheshireWestminsterWiltshireWirralWolverhampton CityWorcestershire

Back to ContentsClick here to enter additional local costs

Additional costsAdditional costsBack to ContentsEnter cost estimates hereSpirometry and Assessment ServicePulmonary Rehabilitation ServiceStaff training0.000.00Booklets and patient information packs0.000.00Interpreters for non-English speaking patients0.000.00Interpreters for patients with impaired hearing0.000.00Total cost of patient travel0.000.00Additional costs0.000.00Sum of specific costs0.000.00

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Model resultsModel resultsThese are generated by the macro "PCT loop" using the default assumptions. NB: The macro will not automatically update when changes are made to the model (e.g. worksheet names are changed) and will need to be edited manuallyBack to ContentsPCT name (definitive)NumberTotal cost of S&ATotal cost of PRCost of running S&A ServiceDiscounted cost of treatmentNumber of patients diagnosed by S&ADiscounted QALY benefits (S&A)Cost per QALY gained (S&A)Cost of running PR ServiceCost per patient who completes PR programmeSavings in secondary careQALY benefits (PR)Cost per QALY gained (PR)Net cost in primary careAshton, Leigh and Wigan12,128,467889,268539,6121,588,8552,1553169,4861,049,054424- 159,7867411,97516,440Barking and Dagenham21,040,965373,138266,048774,9171,0511569,678439,700426- 66,5623112,0626,848Barnet32,405,709613,064614,4281,791,2812,4303569,662722,253427- 109,1895112,08111,234Barnsley41,517,619927,055384,8391,132,7791,5372269,4921,093,741424- 166,6867711,96717,150Bassetlaw5783,046327,108198,321584,7257931169,463385,912424- 58,8042711,9696,050Bath and North East Somerset61,313,007390,848333,356979,6511,3291969,520460,947424- 70,0993311,9977,212Bedfordshire73,018,581854,811766,9162,251,6653,0554369,5371,007,900425- 153,0897112,01515,751Berkshire East82,768,038698,280705,9792,062,0592,7974069,629822,861426- 124,5825812,06112,818Berkshire West93,342,046810,546851,1432,490,9033,3794869,594955,383426- 144,8386712,04214,902Bexley101,542,496510,437393,4391,149,0571,5592269,630601,463427- 91,0264212,0669,365Birmingham East and North112,589,760989,235657,7211,932,0392,6213769,5281,166,939424- 177,7048311,97818,284Blackburn with Darwen12927,146479,210235,447691,6999381369,526565,366424- 86,1564011,9688,864Blackpool13982,308555,816248,949733,3599951469,478655,773423- 99,9574611,96510,284Bolton141,827,696829,902463,7421,363,9541,8502669,506978,994424- 149,0926911,97715,340Bournemouth and Poole152,520,769814,521639,4481,881,3212,5523669,500960,697424- 146,1766811,99015,040Bradford and Airedale162,967,7021,433,916753,6402,214,0623,0044369,5261,691,713424- 257,79712011,96826,524Brent Teaching172,279,504459,046582,3581,697,1472,3023369,669540,803427- 81,7573812,0828,412Brighton and Hove City181,935,220528,024491,5661,443,6551,9582869,532622,725424- 94,7014411,9989,743Bristol192,501,2071,043,448636,8121,864,3952,5293669,5871,230,536425- 187,0888712,00119,249Bromley202,295,511663,299585,3081,710,2042,3203369,622781,564427- 118,2655512,06812,168Buckinghamshire213,858,675951,409981,9592,876,7163,9035569,5761,121,387426- 169,9787912,04417,489Bury221,264,713503,209320,752943,9621,2811869,495593,602424- 90,3924211,9799,300Calderdale231,427,123523,471361,6161,065,5071,4452169,474617,569424- 94,0984411,9709,681Cambridgeshire244,197,2551,351,3951,065,6483,131,6074,2486069,5211,593,741425- 242,34611311,99924,934Camden251,349,725387,048346,0191,003,7061,3621969,752455,862428- 68,8143212,1037,080Central and Eastern Cheshire263,423,7771,156,135867,3432,556,4343,4684969,4681,363,829424- 207,6939711,97821,369Central Lancashire273,094,4251,226,828784,2982,310,1263,1344569,4801,447,357424- 220,53010211,97022,690City and Hackney Teaching281,507,894394,465386,1331,121,7611,5222269,725464,684427- 70,2193312,0887,225Cornwall and Isles of Scilly294,087,0901,435,8211,033,3513,053,7394,1435969,4221,694,312423- 258,49112011,95226,595County Durham303,408,5251,868,034863,7932,544,7323,4524969,4772,204,031423- 335,99715611,96334,570Coventry Teaching312,076,678826,260527,6631,549,0152,1013069,539974,609424- 148,3496911,98515,263Croydon322,545,757580,947649,7201,896,0362,5723769,644684,479427- 103,5324812,07410,652Cumbria333,788,8411,505,824959,0372,829,8043,8395569,4491,776,599424- 270,77612611,96627,859Darlington34699,499323,677177,240522,2607091069,473381,881424- 58,2042711,9665,988Derby City351,812,852686,338459,9371,352,9141,8352669,504809,684424- 123,3465711,97312,691Derbyshire County365,111,0751,981,1401,294,2663,816,8095,1787469,4592,337,295424- 356,15516611,96936,644Devon375,797,5241,804,3401,466,4054,331,1195,8768369,4322,128,937423- 324,59815111,96133,397Doncaster381,928,2811,048,037489,0061,439,2741,9532869,4931,236,430424- 188,3928811,97019,383Dorset393,202,9821,010,108810,9052,392,0763,2454669,4541,191,516424- 181,4088411,98118,665Dudley402,216,004736,440561,2471,654,7562,2453269,463868,833424- 132,3936211,96913,622Ealing412,335,706554,030596,8591,738,8472,3593469,674652,717427- 98,6874612,08010,154East and North Hertfordshire423,961,5521,191,6411,003,4642,958,0884,0135769,4661,405,934424- 214,29310011,96522,048East Lancashire432,500,9851,169,513634,0011,866,9842,5333669,4841,379,772424- 210,2599811,96921,633East Riding of Yorkshire442,357,543861,427596,3821,761,1612,3893469,4351,016,401423- 154,9747211,96115,945East Sussex Downs and Weald452,674,076879,786677,6251,996,4522,7083869,4751,037,682424- 157,8957311,98916,245Eastern and Coastal Kent465,253,1112,012,7071,332,8573,920,2545,3187669,5052,373,871424- 361,16516811,99137,159Enfield471,874,877478,972478,7121,396,1651,8942769,655564,321427- 85,3484012,0768,781Gateshead481,296,030697,650328,576967,4541,3121969,487823,090424- 125,4405811,96712,906Gloucestershire494,413,5601,398,7741,118,7653,294,7954,4706469,4831,649,901424- 251,12611711,98525,838Great Yarmouth and Waveney501,631,135714,096412,9061,218,2291,6532369,451842,543423- 128,4476011,96313,216Greenwich Teaching511,544,097522,227394,7111,149,3871,5592269,683615,297427- 93,0714312,0749,576Halton and St Helens521,986,1051,091,449503,9551,482,1512,0112969,5071,287,545424- 196,0959111,97620,176Hammersmith and Fulham531,073,820315,875274,968798,8521,0841569,724372,070427- 56,1942612,0955,782Hampshire549,671,1422,700,4772,455,9567,215,1869,78813969,5263,184,134425- 483,65722512,01449,762Haringey Teaching551,634,563350,791417,9381,216,6251,6512369,688413,255427- 62,4642912,0846,427Harrow561,596,230338,891407,3781,188,8521,6132369,644399,281427- 60,3912812,0756,213Hartlepool57575,295334,754145,865429,431583869,489394,969423- 60,2152811,9626,195Hastings and Rother581,373,412501,073347,8451,025,5671,3912069,463591,082424- 90,0104211,9789,261Havering591,755,126587,929447,4081,307,7191,7742569,616692,820426- 104,8914912,06110,792Heart of Birmingham Teaching601,527,370400,156388,8581,138,5121,5452269,586472,053424- 71,8973311,9767,397Herefordshire611,404,889434,735355,3861,049,5041,4242069,434512,913424- 78,1783611,9658,044Heywood, Middleton and Rochdale621,366,765635,790346,8831,019,8821,3842069,512750,004424- 114,2145311,97811,751Hillingdon631,708,407512,399436,2881,272,1191,7262569,659603,735427- 91,3364212,0719,397Hounslow641,549,477379,401396,0201,153,4571,5652269,679446,996427- 67,5953112,0776,955Hull651,593,635830,129404,4471,189,1881,6132369,511979,507423- 149,3786911,95815,369Isle of Wight National Health Service661,098,319349,327278,199820,1201,1131669,465412,045424- 62,7182911,9856,453Islington671,109,226403,868284,395824,8311,1191669,754475,713427- 71,8453312,0967,392Kensington and Chelsea681,269,305335,867324,540944,7651,2821869,688395,589428- 59,7232812,1016,145Kingston691,196,878306,799305,748891,1301,2091769,667361,460427- 54,6622512,0775,624Kirklees702,686,480961,808681,1712,005,3092,7203969,4891,134,691424- 172,8848011,97117,788Knowsley71862,043692,221219,067642,9768721269,542816,610424- 124,3895811,97412,798Lambeth722,070,611532,948530,4441,540,1672,0893069,734627,762427- 94,8144412,0959,755Leeds734,551,1491,962,0331,156,2123,394,9374,6066569,5352,314,554424- 352,52116411,97636,270Leicester City741,991,914656,342506,1141,485,8002,0162969,539774,275424- 117,9335511,97512,134Leicestershire County and Rutland754,849,8951,464,4611,228,6883,621,2064,9137069,4701,727,580424- 263,11912211,97627,072Lewisham761,814,857512,264464,0351,350,8221,8332669,688603,488427- 91,2244212,0839,386Lincolnshire775,376,1032,064,7431,360,5594,015,5445,4487769,4452,436,163423- 371,42017311,96238,214Liverpool782,554,0651,683,345649,3181,904,7482,5843769,5521,985,858424- 302,51414111,97331,125Luton791,205,846353,940307,341898,5051,2191769,613417,254425- 63,3142912,0296,514Manchester802,354,6471,412,729600,8301,753,8162,3793469,6401,666,377424- 253,64811811,98426,097Medway811,813,489646,189461,3471,352,1421,8342669,568761,867425- 115,6785412,02011,902Mid Essex822,755,411702,637699,5002,055,9112,7894069,518828,538425- 125,9025912,00912,954Middlesbrough83840,186516,875213,356626,8298501269,525609,824424- 92,9494311,9669,563Milton Keynes841,652,865517,287420,4431,232,4221,6722469,565609,899425- 92,6124312,0199,529Newcastle851,491,196773,194378,9391,112,2571,5092169,542912,194424- 139,0006511,96914,301Newham861,803,590463,000461,7461,341,8441,8202669,719545,492427- 82,4913812,0778,487Norfolk875,319,2551,916,3501,346,2393,973,0165,3907769,4462,261,055423- 344,70516011,96235,466North East Essex882,260,930813,823573,3711,687,5602,2893369,493959,918424- 146,0956811,98615,031North East Lincolnshire891,111,916492,276281,743830,1731,1261669,474580,808423- 88,5314111,9659,109North Lancashire902,377,489995,967602,0571,775,4312,4093469,4591,175,062424- 179,0968311,96618,427North Lincolnshire911,190,018437,981301,218888,8001,2061769,449516,764423- 78,7833711,9628,106North Somerset921,538,594525,385390,0351,148,5591,5582269,484619,677424- 94,2924411,9899,701North Staffordshire931,482,397582,501375,3121,107,0851,5022169,454687,267423- 104,7664911,96410,779North Tees941,217,833553,090308,659909,1741,2331869,480652,566423- 99,4764611,96410,235North Tyneside951,450,263618,797367,4281,082,8351,4692169,471730,052424- 111,2565211,96811,447North Yorkshire and York965,778,5901,850,4521,463,2904,315,3005,8548369,4592,183,077424- 332,62515511,97134,223Northamptonshire974,743,3791,644,7061,203,3163,540,0634,8036869,5011,939,948424- 295,24213711,98730,377Northumberland982,303,4461,041,949583,2691,720,1772,3343369,4581,229,273424- 187,3248711,96919,273Nottingham City991,654,512706,939421,0021,233,5101,6732469,573833,996424- 127,0575911,97213,073Nottinghamshire County1004,643,0601,742,0721,176,1253,466,9354,7036769,4662,055,226424- 313,15414611,97032,220Oldham1011,464,747636,553371,7611,092,9851,4832169,513750,898424- 114,3465311,97911,765Oxfordshire1024,602,2021,220,3761,169,5603,432,6424,6576669,5431,438,960425- 218,58410212,01322,490Peterborough1031,108,013387,369281,337826,6761,1211669,523456,905424- 69,5363211,9877,154Plymouth Teaching1041,606,242704,301407,2691,198,9731,6272369,489831,035423- 126,7335911,95813,039Portsmouth City Teaching1051,172,734490,780298,587874,1461,1861769,588578,745425- 87,9654112,0059,051Redbridge1061,702,599403,044434,6511,267,9481,7202469,651474,911427- 71,8673312,0677,394Redcar and Cleveland107871,353480,474220,844650,5098821369,480566,868424- 86,3944011,9678,889Richmond and Twickenham1081,416,759321,547361,4691,055,2911,4322069,637378,830427- 57,2842712,0785,894Rotherham1091,634,126834,425414,2071,219,9191,6552469,482984,477424- 150,0527011,96615,439Salford1101,267,575905,909322,482945,0931,2821869,5691,068,584424- 162,6757611,98316,737Sandwell1112,105,028856,102533,9821,571,0462,1313069,5001,009,968424- 153,8667211,97215,831Sefton1121,928,778922,132488,7161,440,0621,9542869,4731,087,872424- 165,7407711,97217,053Sheffield1133,347,9871,439,834849,4042,498,5833,3904869,5031,698,747424- 258,91412011,96626,639Shropshire County1142,253,489713,612570,1081,683,3812,2843269,437841,958423- 128,3466011,96413,205Solihull1151,577,293533,113399,7491,177,5441,5972369,479628,866424- 95,7524411,9809,852Somerset1163,994,8621,372,4671,011,3522,983,5094,0475869,4531,619,164424- 246,69711511,97125,382South Birmingham1172,252,038911,889571,8621,680,1762,2793269,5241,075,727424- 163,8387611,97616,857South East Essex1182,570,847895,681652,4711,918,3762,6033769,5121,056,283425- 160,6027512,00016,524South Gloucestershire1191,770,485527,392449,4431,321,0421,7922569,517621,958425- 94,5664412,0009,730South Staffordshire1204,486,6751,425,0971,136,1373,350,5384,5456569,4591,681,250424- 256,15311911,97126,355South Tyneside121911,620673,527231,285680,3359231369,504794,650424- 121,1245611,96512,462South West Essex1222,748,5871,001,000699,5862,049,0012,7804069,5801,180,053425- 179,0538312,02918,422Southampton City1231,351,158648,927344,3121,006,8461,3661969,608765,252425- 116,3245412,00411,968Southwark1241,721,374568,831441,0581,280,3161,7372569,739670,028427- 101,1974712,09510,412Stockport1252,054,065824,844520,8811,533,1842,0803069,492972,945424- 148,1006911,98415,238Stoke on Trent1261,751,646801,214444,0061,307,6401,7742569,482945,333423- 144,1196711,96214,828Suffolk1274,423,0741,407,3631,120,8353,302,2394,4806469,4761,660,140424- 252,77711711,98026,008Sunderland Teaching1281,680,4411,109,114426,2881,254,1521,7012469,5011,308,590423- 199,4779311,96420,524Surrey1298,480,6082,180,2052,160,3486,320,2608,57412269,6002,569,228426- 389,02418112,05940,026Sutton and Merton1302,542,882719,350649,2391,893,6432,5693769,654847,546427- 128,1966012,07413,190Swindon1311,406,333509,045357,4681,048,8651,4232069,548600,249425- 91,2044212,0109,384Tameside and Glossop1321,488,317793,421377,7761,110,5401,5072169,515935,907424- 142,4866611,98214,660Telford and Wrekin1331,106,511446,474280,420826,0911,1211669,477526,763424- 80,2893711,9668,261Torbay1341,081,077416,406273,415807,6621,0961669,429491,348423- 74,9433511,9567,711Tower Hamlets1351,130,312443,655290,393839,9191,1391669,803522,615427- 78,9603712,0908,124Trafford1361,585,168539,292402,0191,183,1501,6052369,495636,120424- 96,8284511,9849,962Wakefield District1372,240,7911,218,727568,2741,672,5172,2693269,4941,437,750424- 219,02310211,97322,535Walsall Teaching1381,717,498742,294435,4641,282,0341,7392569,488875,737424- 133,4436211,96913,730Waltham Forest1391,653,984423,935422,6531,231,3321,6702469,674499,479427- 75,5433512,0757,772Wandsworth1402,038,505500,519521,8861,516,6192,0572969,719589,618427- 89,1004112,0879,167Warrington1411,354,773483,125343,4191,011,3541,3721969,483569,910424- 86,7864011,9788,929Warwickshire1423,943,8191,216,531999,6272,944,1923,9945769,4811,434,969424- 218,43910211,98422,475West Essex1431,998,487641,746508,8011,489,6862,0212969,586756,396426- 114,6505312,04411,796West Hertfordshire1444,085,6121,136,5401,034,6393,050,9744,1395969,4601,340,925424- 204,3849511,96521,029West Kent1455,019,2041,486,4421,276,7213,742,4835,0777269,5651,752,226426- 265,78512412,03427,346West Sussex1466,129,2501,882,9301,555,9514,573,2996,2048869,5172,220,254425- 337,32415712,01134,706Western Cheshire1471,861,846631,282471,6481,390,1981,8862769,468744,714424- 113,4325311,97511,671Westminster1481,475,211345,494377,7351,097,4761,4892169,723406,929428- 61,4352912,1016,321Wiltshire1493,363,967999,819853,2652,510,7033,4064869,4981,179,149424- 179,3308311,99718,451Wirral1502,226,5411,026,848564,3191,662,2222,2553269,4801,211,403424- 184,5558611,97218,988Wolverhampton City1511,652,008608,505418,8311,233,1771,6732469,487717,900424- 109,3955111,96911,255Worcestershire1524,260,6141,306,9271,078,7533,181,8614,3176169,4561,541,822424- 234,89510911,97224,168Average across PCTs2,382,785850,902605,1401,777,6452,4123469,5401,003,571425- 152,6687112,00215,708

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>> Spirometry and AssessmentBack to ContentsSpirometry and AssessmentSpirometry & Assessment pathwaySummarises the main elements of the Spirometry and Assessment pathwayMain data & assumptions - S&ASummarises the key data inputs and assumptions of the S&A element modelS&A impact over timeCalculates the potential costs and benefits of Spirometry and Assessment over a 20-year periodReferral to serviceEstimates the number of people in a PCT who would be referred to a S&A Service on the basis of certain characteristicsDiagnosis of COPDEstimates the number of people in a PCT who would be diagnosed with COPD as a result of case-findingExacerbationsSummarises key data and assumptions on exacerbations and calculates average cost of exacerbations at different stages of the diseaseOngoing treatmentEstimates the average annual per person cost of regular, ongoing treatment for COPDSwedish cost apportionmentApportions the cost of COPD medication to the different severity stages of COPDCost of drugsSummarises key data on the cost of COPD medication to the NHSQALY gainsSummarises the key data on COPD Quality of Life and calculates QALY benefits from S&AS&A service costsCalculates the cost of commissioning a S&A Service, as set out in the COPD commissioning pack specification

Spirometry & Assessment pathwayMain data & assumptions - S&AReferral to serviceDiagnosis of COPDExacerbationsOngoing treatmentSwedish cost apportionmentCost of drugsQALY gainsS&A service costsS&A impact over timeBack to Contents

S&A impact over timeImpact of Spirometry and Assessment Service over timeBack to ContentsKey inputs% of those who have ever smoked that are ex-smokers60%% of current smokers that quit on diagnosis10%SmokersNumber diagnosed through S&AEx-smokersNon-quittersQuittersMild136382248754Moderate98659435239Severe203122738Very Severe0000Total25521539912101General profileProfile for quitters diagnosed at severeYears at stageTotal yearsYears at stageTotal yearsAdditional years at severe if diagnosed and quit at severeSource: Years at each stage of disease are assumptions informed by discussion with clinicians. See explanatory slides for more detail.Mild20202020Moderate14341434Severe84216508Source: Assumption of additional 8 years is based on average rate of lung function decline of 55-year-old man (see Progression Analysis for more detail)Very Severe345353Source: 3 years is average life expectancy with Very Severe COPD (see Life Expectancy tab for data)Cost of ongoing treatmentExacerbations - NumberExacerbations - costDiagnosedUndiagnosedDiagnosedUndiagnosedMild$90.940.040.0680.9580.95Moderate$147.300.851.13116.42116.42Severe$513.971.341.79144.12144.12Very Severe$1,828.782.002.67262.24262.2410Summary of cost implicationsYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Total cost of running service639,448Total additional cost of treatment331,590289,623247,655205,687189,805173,924158,043202,468177,014151,560138,461111,48284,50357,52330,54422,82115,0977,374-350-8,074Discounted additional cost of treatment331,590279,829231,188185,518165,404146,439128,568159,138134,426111,20498,15876,35955,92236,78118,87013,6218,7074,109-188-4,199Total exacerbation reductions-348-306-264-221-202-182-162-181-158-134-195-164-132-101-70-62-53-45-37-29Total cost saved from reduced exacerbations-41,731-36,213-30,694-25,176-22,925-20,674-18,422-23,627-20,557-17,486-24,478-20,547-16,617-12,686-8,756-7,813-6,871-5,928-4,985-4,043Discounted cost savings from reduced exacerbations-41,731-34,988-28,653-22,707-19,978-17,407-14,987-18,571-15,611-12,830-17,353-14,074-10,997-8,112-5,409-4,664-3,962-3,303-2,684-2,103Net cost289,859253,410216,960180,511166,881153,250139,620178,841156,457134,074113,98390,93467,88644,83721,78815,0078,2271,446-5,335-12,116HMT Green Book discount rateDiscounted net cost3.5%289,859244,841202,535162,811145,427129,033113,581140,567118,81598,37480,80562,28544,92628,66913,4608,9584,744805-2,872-6,302Net Present Value1,881,321Total QALY gain from delayed progression0.000.000.000.000.000.000.000.130.130.133.593.593.593.593.593.593.593.593.593.59Total QALY gain from reduced exacerbations0.870.770.660.550.500.450.400.470.410.350.490.410.330.260.180.160.140.110.090.07Total QALY gains0.870.770.660.550.500.450.400.600.530.474.084.003.923.843.763.743.723.703.683.66QALY discount rateDiscounted QALY gains1.5%0.870.760.640.530.470.420.370.540.470.413.513.403.283.173.062.992.932.872.822.76Net Present Value of QALY gains36.27Discounted cost per discounted QALY331,459324,183316,785309,116307,461306,665307,000262,127250,562237,70422,99418,34413,6999,0554,4052,9921,617280-1,020-2,285Smokers who continue to smokeCounterfactual - no interventionDisease ProfileYear of DiagnosisNon-quitters12345678910111213141516171819201234567891011121314151617181920Stage of diseaseNumber in group diagnosed by S&A at each stageNumber in group diagnosed in counterfactual in each yearStart year of disease following diagnosisYear in which diagnosedYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20MildMild48724101MildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24102MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate01111111111111111111Mild24103MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00111111111111111111Mild24104MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00011111111111111111Mild24105MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00001111111111111111Mild24106MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000111111111111111Mild24107MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000011111111111111Mild24108MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000001111111111111Mild24109MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000111111111111Mild241010MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000011111111111Mild241011MildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000001111111111Mild241012MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000111111111Mild241013MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000011111111Mild241014MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000001111111Mild241015MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000111111Mild241016MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000011111Mild241017MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000001111Mild241018MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000000111Mild241019MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000000011Mild241020MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000000001ModerateModerate35223271ModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23272ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD01111111111111111111Moderate23273ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00111111111111111111Moderate23274ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00011111111111111111Moderate23275ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00001111111111111111Moderate23276ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000111111111111111Moderate23277ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000011111111111111Moderate23278ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000001111111111111Moderate23279ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000000111111111111Moderate232710ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000000011111111111Moderate232711ModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000000001111111111Moderate232712ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000000000111111111Moderate232713ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000000000011111111Moderate232714ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000000000001111111Moderate232715ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD00000000000000111111SevereSevere7318381SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD11111111111111111111Severe18382SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD01111111111111111111Severe18383SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD00111111111111111111Severe18384SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD00011111111111111111Factual - S&A interventionDisease ProfileYear of DiagnosisStage of diseaseNumber in group diagnosed by S&A at each stageNumber in group diagnosed in counterfactual in each yearStart year of disease following diagnosisYear in which diagnosed in counterfactualYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20MildMild48724101MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24102MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24103MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24104MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24105MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24106MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24107MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24108MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild24109MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241010MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241011MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241012MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241013MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241014MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241015MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241016MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241017MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241018MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241019MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Mild241020MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111ModerateModerate35223271ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23272ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23273ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23274ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23275ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23276ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23277ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23278ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate23279ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate232710ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate232711ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate232712ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate232713ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate232714ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111Moderate232715ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEAD11111111111111111111SevereSevere7318381SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD11111111111111111111Severe18382SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD11111111111111111111Severe18383SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD11111111111111111111Severe18384SevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEADDEAD11111111111111111111CostsTreatment cost changeStage of diseaseNumber in group diagnosed by S&A at each stageNumber in group diagnosed in counterfactual in each yearYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Mild487240.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00242215.290.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.290.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.290.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.290.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.290.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.290.000.000.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.290.000.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.290.000.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.290.000.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.290.000.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.070.000.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.070.000.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.073588.070.000.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.073588.073588.070.000.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.073588.073588.073588.070.000.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.073588.073588.073588.073588.070.000.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.073588.073588.073588.073588.073588.070.000.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.073588.073588.073588.073588.073588.073588.070.000.00242215.292215.292215.292215.292215.292215.292215.292215.292215.292215.293588.073588.073588.073588.073588.073588.073588.073588.073588.070.00Moderate352230.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00233460.830.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.830.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.830.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.830.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.830.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.830.000.000.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.830.000.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.8312076.080.000.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.8312076.0812076.080.000.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.8312076.0812076.0812076.080.000.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.8312076.0812076.0812076.0812076.080.000.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.8312076.0812076.0812076.0812076.0812076.080.000.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.8312076.0812076.0812076.0812076.0812076.0812076.080.000.000.000.000.000.000.00233460.833460.833460.833460.833460.833460.833460.8312076.0812076.0812076.0812076.0812076.0812076.0812076.080.000.000.000.000.000.00Severe73180.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00189323.440.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00189323.449323.440.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00189323.449323.449323.440.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.000.00TOTAL ADDITIONAL TREATMENT COST1185121035138851373514678386216256485111116968258253380597649334926933605179401435210764717635880Exacerbation cost changeNumber of exacerbations - CounterfactualCost of exacerbations - CounterfactualStage of diseaseNumber in group diagnosed by S&A at each stageNumber in group diagnosed in counterfactual in each yearYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Mild487241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.105665309788.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.105665309788.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.105665309788.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.105665309788.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.105665309788.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.105665309788.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.105665309788.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.105665309788.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.105665309788.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4620.7120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530972410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6120.7120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6120.7120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6127.6120.7120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021233214.19282021232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6127.6127.6120.7120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021233214.19282021233214.19282021232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6127.6127.6127.6120.7120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021233214.19282021233214.19282021233214.19282021232410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6127.6127.6127.6127.6120.7120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021232410.64461515922410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6127.6127.6127.6127.6127.6120.7120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021232410.64461515922410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6127.6127.6127.6127.6127.6127.6120.7120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021232410.64461515922410.6446151592241.461.461.461.461.461.461.461.461.461.4627.6127.6127.6127.6127.6127.6127.6127.6127.6120.71118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.1056653097118.10566530973214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021233214.19282021232410.6446151592Moderate3522319.9719.9719.9719.9719.9719.9719.9731.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.002325.16076355782325.16076355782325.16076355782325.16076355782325.16076355782325.16076355782325.16076355784537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6319.9719.9719.9719.9719.9719.9731.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141042325.16076355782325.16076355782325.16076355782325.16076355782325.16076355782325.16076355784537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6319.9719.9719.9719.9719.9731.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141042325.16076355782325.16076355782325.16076355782325.16076355782325.16076355784537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6319.9719.9719.9719.9731.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141042325.16076355782325.16076355782325.16076355782325.16076355784537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6319.9719.9719.9731.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141042325.16076355782325.16076355782325.16076355784537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6319.9719.9731.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141042325.16076355782325.16076355784537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6319.9731.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141042325.16076355784537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6331.4831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141044537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6341.9831.4831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141046049.83572033624537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6341.9841.9831.4831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141046049.83572033626049.83572033624537.37679025214537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6341.9841.9841.9831.4831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141046049.83572033626049.83572033626049.83572033624537.37679025214537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6341.9841.9841.9841.9831.4831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141046049.83572033626049.83572033626049.83572033626049.83572033624537.37679025214537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6341.9841.9841.9841.9841.9831.4831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141046049.83572033626049.83572033626049.83572033626049.83572033626049.83572033624537.37679025214537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6341.9841.9841.9841.9841.9841.9831.4831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141046049.83572033626049.83572033626049.83572033626049.83572033626049.83572033626049.83572033624537.37679025214537.376790252112323.070679209312323.070679209312323.0706792093002326.6326.6326.6326.6326.6326.6326.6341.9841.9841.9841.9841.9841.9841.9831.4846.9946.9946.990.000.003100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141043100.21435141046049.83572033626049.83572033626049.83572033626049.83572033626049.83572033626049.83572033626049.83572033624537.376790252112323.070679209312323.070679209312323.070679209300Severe731824.3124.3124.3124.3136.2836.2836.280.000.000.000.000.000.000.000.000.000.000.000.000.003503.12178659173503.12178659173503.12178659173503.12178659179514.13545086019514.13545086019514.135450860100000000000001832.4124.3124.3124.3136.2836.2836.280.000.000.000.000.000.000.000.000.000.000.000.000.004670.82904878893503.12178659173503.12178659173503.12178659179514.13545086019514.13545086019514.135450860100000000000001832.4132.4124.3124.3136.2836.2836.280.000.000.000.000.000.000.000.000.000.000.000.000.004670.82904878894670.82904878893503.12178659173503.12178659179514.13545086019514.13545086019514.135450860100000000000001832.4132.4132.4124.3136.2836.2836.280.000.000.000.000.000.000.000.000.000.000.000.000.004670.82904878894670.82904878894670.82904878893503.12178659179514.13545086019514.13545086019514.13545086010000000000000Number of exacerbations - FactualCost of exacerbations - FactualStage of diseaseNumber in group diagnosed by S&A at each stageNumber in group diagnosed in counterfactual in each yearYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Mild487241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.579248982388.57924898232410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.64461515922410.6446151592241.091.091.091.091.091.091.091.091.091.0920.7120.7120.7120.7120.7120.7120.7120.7120.7120.7188.579248982388.579248982388.579248982388.579248982388.57924898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DIFFERENCE-124.4374406489-109.3130040671-94.1885674853-79.0641309035-72.0422704615-65.0204100195-57.9985495776-77.8401555018-66.9806570075-56.1211585132-104.0959321689-86.6992923246-69.3026524803-51.9060126361-34.5093727918-27.6074982334-20.7056236751-13.8037491167-6.90187455840-14914.8739267493-12942.586660372-10970.2993939947-8998.0121276175-8193.4321234374-7388.8521192574-6584.2721150774-10941.5295065174-9399.544160106-7857.5588136945-13281.7695658138-10965.7624306766-8649.7552955395-6333.7481604024-4017.7410252653-3214.1928202122-2410.6446151592-1607.0964101061-803.54820505310Smokers who quit on diagnosisCounterfactual - no interventionDisease ProfileYear of DiagnosisQuitters12345678910111213141516171819201234567891011121314151617181920Stage of diseaseNumber in group diagnosed by S&A at each stageNumber in group diagnosed in counterfactual in each yearStart year of disease following diagnosisYear in which diagnosedYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20MildMild54310111111111111111111111Mild3102MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild01111111111111111111Mild3103MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00111111111111111111Mild3104MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00011111111111111111Mild3105MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00001111111111111111Mild3106MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00000111111111111111Mild3107MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00000011111111111111Mild3108MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00000001111111111111Mild3109MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00000000111111111111Mild31010MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00000000011111111111Mild31011MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild00000000001111111111Mild31012MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000111111111Mild31013MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000011111111Mild31014MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000001111111Mild31015MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000111111Mild31016MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000011111Mild31017MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000001111Mild31018MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000000111Mild31019MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000000011Mild31020MildMildMildMildMildMildMildMildMildMildModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000000000000000001ModerateModerate393271ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3272ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate01111111111111111111Moderate3273ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00111111111111111111Moderate3274ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00011111111111111111Moderate3275ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00001111111111111111Moderate3276ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000111111111111111Moderate3277ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000011111111111111Moderate3278ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate00000001111111111111Moderate3279ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevere00000000111111111111Moderate32710ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevere00000000011111111111Moderate32711ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevere00000000001111111111Moderate32712ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevere00000000000111111111Moderate32713ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevere00000000000011111111Moderate32714ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevere00000000000001111111Moderate32715ModerateModerateModerateModerateModerateModerateModerateSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevereSevere00000000000000111111SevereSevere82421SevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEAD11111111111111111111Severe2422SevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEAD01111111111111111111Severe2423SevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEAD00111111111111111111Severe2424SevereSevereSevereSevereSevereSevereSevereSevereVery SevereVery SevereVery SevereDEADDEADDEADDEADDEADDEADDEADDEADDEAD00011111111111111111Factual - S&A interventionDisease ProfileYear of DiagnosisStage of diseaseNumber in group diagnosed by S&A at each stageNumber in group diagnosed in counterfactual in each yearStart year of disease following diagnosisYear in which diagnosed in counterfactualYear 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12Year 13Year 14Year 15Year 16Year 17Year 18Year 19Year 20MildMild54310111111111111111111111Mild3102MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild3103MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild3104MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild3105MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild3106MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild3107MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild3108MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild3109MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31010MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31011MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31012MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31013MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31014MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31015MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31016MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31017MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31018MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31019MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111Mild31020MildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMildMild11111111111111111111ModerateModerate393271ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3272ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3273ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3274ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3275ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3276ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3277ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3278ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate3279ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate32710ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate32711ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate32712ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate32713ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate32714ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111Moderate32715ModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerateModerate11111111111111111111SevereSevere82421SevereSevereSevereSevereSevereSevereSevereSevereVery SevereVe