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Article History

Accepted: 30 September 2020

First Online: 2 November 2020

Declarations

:

: Financial support for this study was provided by the Canadian Lung Association Breathing as One Studentship Award and a grant from the Canadian Institutes of Health Research (Application number 142238). The funding agreement ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report.

: KJ, MS, AA, HT, LL, and SB declare that they have no conflicts of interest. Mark Harrison is supported by a Young Investigator Salary Award 2016 from The Arthritis Society (YIS-16-104) and a Michael Smith Foundation for Health Research Scholar Award 2017 (#16813). Mark Harrison holds the UBC Professorship in Sustainable Health Care, which between 2014 and 2019 was funded by Amgen Canada, AstraZeneca Canada, Eli Lilly Canada, GlaxoSmithKline, Merck Canada, Novartis Pharmaceuticals Canada, Pfizer Canada, Boehringer Ingelheim (Canada), Hoffman-La Roche, LifeScan Canada, and Lundbeck Canada. In the past 24 months, DS has received research funding from AstraZeneca and honoraria for speaking engagements from Boehringer Ingelheim, and AstraZeneca.

: The development of the simulation model involved original analyses of data from the Canadian Cohort of Obstructive Lung Disease (CanCOLD) study. Ethics approval for CanCOLD was obtained from the relevant institutional review board at each study site.

: Written informed consent was obtained from all participants in CanCOLD prior to study entry.

: Consent to publish was not required by the study funders or participants.

: The data used in model development are not publicly available but may be made available from the CanCOLD Research Group upon reasonable request. The simulated data used in this study are publicly available.

: EPIC is publicly available and can be run as an R package (). Code for replicating these results is available at.

: KMJ, MS, and SB formulated the study idea. KMJ and AA contributed to model development with supplementary data analyses from HT. KJ performed cost-effectiveness analysis and wrote the first draft of the manuscript. LL, MH, DDS, MS, and SB contributed to interpretation of findings. All authors critically commented on the manuscript and approved the final version. KMJ is the guarantor of the manuscript.