Evaluation of Cost-Utility of Varenicline Compared with Existing Smoking Cessation Therapies in South Korea


Eui Kyung Lee, Graduate School of Clinical Pharmacy, SookMyung Women's University, Hyochangwongil 52, Yongsan-Ku, Seoul 140-742, South Korea. E-mail: ekyung@sm.ac.kr


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.