OBJECTIVES: The aim of this study is to evaluate the cost-effectiveness of Nilotinib compared with the other CML interventions, dasatinib, and high dose imatinib in CML patients whose stage are chronic phase, accelerate phase, and blast crisis. METHODS: A Markov model was developed from a societal perspective to estimate long-term health benefit, drug cost and CML-related cost. The model simulates cost and outcomes in a hypothetical cohort of CML patients being CP and AP during the lifetime with 5% discount rate. Markov cycle length is a quarter of year. The model includes three-potential phase: chronic phase, accelerate phase, blast crisis. Transition probabilities were obtained from published literature. Quality adjusted life years (QALYs) were estimated as an Effectiveness measure. Resource utilization and costs were calculated with public institutional data and clinical expert opinion. One-way sensitivity analyses were performed on crucial parameters (discount rate, time horizons, patient age, drug costs). RESULTS: Nilotinib is 0.043 QALYs smaller and less US$ 6,775 than dasatinib during the life time. Relative cost-effectiveness was assessed using the net monetary benefit approach and the NMB for threshold of US$ 4,858, $9,716, $14,574 is bigger than zero, respectively. Compared to high dose Imatinib, Nilotinib is a dominating alternative plan since its effect is 0.472 QALYs bigger and its total cost is less US$ 14,964. The results of sensitivity analysis showed quite stable across most of the included parameters. CONCLUSIONS: The NMB of nilotinib vs. dasatinib is greater than zero even for the threshold of US$ 4,858(Korean Currency: 5 million won). Even though cost effective threshold for NMB is not yet decided in Korea, Nilotinib can be regarded as cost-effective alternative in the long term for the management of CML.