Evaluation of cost-utility of varenicline compared with existing smoking cessation therapies in South Korea.

OBJECTIVE This study aimed to evaluate the cost-effectiveness of varenicline compared with the other smoking cessation interventions, bupropion, nicotine replacement therapy (NRT), and willpower. METHODS The Benefits of Smoking Cessation on Outcomes model was modified to reflect major smoking-related diseases in Korea. Transitional probabilities, resource utilization, and costs were obtained from Korean public data. The analysis was carried out from a societal perspective for the lifetime period. Also, series of sensitivity analyses, including probabilistic sensitivity analysis, were performed. RESULTS With the exclusion of bupropion, which is subject to extended dominance, the incremental cost-effectiveness ratio (ICER) for varenicline versus NRT was analyzed as $US4809 per quality-adjusted life-year (QALY) during the lifetime. The results of sensitivity analysis are quite stable across most of the included parameters. The acceptability curves showed that the probability of varenicline being cost-effective was 83.3% at the willingness to pay of $US15,000. CONCLUSIONS Even though the maximum willingness to pay for a QALY has not officially been defined, varenicline can be regarded as cost-effective because the ICER is at the 24.0% level of per capital gross domestic product, which is an implicit reference for decision-making in Korea.