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Eligible studies were included if they were (1) conducted among adults ages 18\u2009years old and older who were smokers attempting to quit for the first time; (2) compared varenicline to behaviour support with bupropion or NRT, behaviour support alone and unaided cessation; and (3) performed a CEA or cost\u2010utility analysis. The INBs were calculated and pooled across studies stratified by country income level and study perspective using the random\u2010effects model. Statistical heterogeneity between studies was assessed using the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistic and Cochrane <jats:italic>Q<\/jats:italic> statistic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 1433 identified studies, 18 studies were included in our review. Our findings from healthcare system\/payer perspective suggested that the use of varenicline is statistically significantly cost\u2010effective compared with bupropion (pooled INB, $830.75 [95% confidence interval, $208.23, $1453.28]), NRTs ($636.16 [$192.48, $1079.84]) and unaided cessation ($4212.35 [$1755.79, $6668.92]) in high\u2010income countries. Similarly, varenicline is also found to be cost\u2010effective compared to bupropion ($2706.27 [$1284.44, $4128.11]), NRTs ($3310.01 [$1781.53, $4838.50]) and behavioural support alone ($5438.22 [$4105.99, $6770.46]) in low\u2010 and middle\u2010income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Varenicline is cost\u2010effective as a smoking cessation aid when compared with behavioural support with bupropion or nicotine replacement therapies and behavioural support alone in both high\u2010income countries and low\u2010 and middle\u2010income countries, from the healthcare system\/payer perspective in adult smokers who attempt to quit for the first time.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.16464","type":"journal-article","created":{"date-parts":[[2024,3,23]],"date-time":"2024-03-23T07:00:05Z","timestamp":1711177205000},"page":"1188-1202","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Incremental net monetary benefit of using varenicline for smoking cessation: A systematic review and meta\u2010analysis of economic evaluation studies"],"prefix":"10.1111","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-9622","authenticated-orcid":false,"given":"Chayutthaphong","family":"Chaisai","sequence":"first","affiliation":[{"name":"School of Pharmacy Monash University Malaysia  Selangor Malaysia"},{"name":"Department of Pharmaceutical Care, Faculty of Pharmacy Chiang Mai University  Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanthawat","family":"Patikorn","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy University of Utah  Salt Lake City Utah USA"},{"name":"Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kednapa","family":"Thavorn","sequence":"additional","affiliation":[{"name":"School of Epidemiology and Public Health University of Ottawa  Ottawa Ontario Canada"},{"name":"Ottawa Hospital Research Institute  Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun Wen Huey","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Pharmacy Monash University Malaysia  Selangor Malaysia"},{"name":"School of Medicine Taylor's University  Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4572-8794","authenticated-orcid":false,"given":"Nathorn","family":"Chaiyakunapruk","sequence":"additional","affiliation":[{"name":"School of Pharmacy Monash University Malaysia  Selangor Malaysia"},{"name":"Department of Pharmacotherapy University of Utah  Salt Lake City Utah USA"},{"name":"IDEAS Centre Veterans Affairs Salt Lake City Healthcare System  Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajesh K.","family":"Veettil","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy University of Utah  Salt Lake City Utah USA"},{"name":"School of Medicine Taylor's University  Selangor Malaysia"},{"name":"School of Pharmacy, Department of Pharmacy Practice International Medical University  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Tobacco","author":"World Health Organization","year":"2022"},{"key":"e_1_2_11_3_1","volume-title":"WHO report on the global tobacco epidemic, 2017: monitoring tobacco use and prevention policies","author":"World Health Organization","year":"2017"},{"key":"e_1_2_11_4_1","volume-title":"WHO report on the global tobacco epidemic 2021: addressing new and emerging products","author":"World Health Organization","year":"2021"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.12899"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1551"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/08870446.2017.1325890"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/14622200802163142"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0091562"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-203"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-2023"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.25019"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2008.04.009"},{"key":"e_1_2_11_14_1","unstructured":"RigottiNA.Pharmacotherapy for smoking cessation in adults.2022[cited 2022 25 October]. 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