Sugemalimab是PD-L1程序性死亡配体的新型抑制剂。Sugemalimab加化疗（Sugema-Chemo）作为转移性非小细胞肺癌（NSCLC）的一线治疗已被证明有效，但其成本效益尚未确定。本研究的目的是从中国卫生保健角度评估Sugema-Chemo的成本效益。采用分层存活模型，根据GEMSTONE-302试验获取患者的临床特征和预后。结果是成本、质量调整后的寿命年数（QALYs）、增量成本效益比（ICER）、增量净健康效益（INHB）和增量净货币效益（INMB）。模型的鲁棒性和亚组分析也得到了进一步评估。当ICER低于愿意支付阈值（$38,017 / QALY或$86,376 / QALY）时，即将其定义为一般地区和北京地区的人均国内生产总值的三倍时，Sugema-Chemo的成本效益将适用于一般地区或北京地区。与单独化疗相比，Sugema-Chemo导致0.82个QALYs的增量收益，1.26个寿命年的增量收益，平均成本增加$ 72,472。 ICER为$ 88,744 / QALY。模型结果对平均体重和Sugemalimab成本敏感。如果平均体重低于62.44 kg或sugemalimab的价格 <$ 2.996 / mg，则Sugema-Chemo在86,376 / QALY的WTP阈值下是经济的。同样，如果sugemalimab的价格低于$ 1.839 / mg，则Sugema-Chemo在$ 38,017 / QALY的WTP阈值下也是经济的。在86,376 / QALY阈值下，Sugema-Chemo在大多数亚组中有超过50％的概率被认为是经济的。但是，当WTP被设定为$ 38,017 / QALY时，Sugema-Chemo在任何亚组中都没有达到经济性（0％）。Sugema-Chemo可能在中国转移性NSCLC患者中不具备成本效益性。在Sugema-Chemo和单独化疗之间做决策时，考虑患者的体重和sugemalimab的价格是至关重要的。减少sugemalimab在国家医疗保障局的价格可能是提高药物成本效益性的有效措施。版权所有©2023年Liang，Chen，Li，Liu和Li。

Sugemalimab is a newly developed inhibitor of programmed death ligand 1 (PD-L1). As a first-line treatment for metastatic non-small-cell lung cancer (NSCLC), sugemalimab plus chemotherapy (Sugema-Chemo) has been proven effective. Still, its cost-effectiveness has not yet been determined. The objective of this study was to assess the cost-effectiveness of Sugema-Chemo from a health care perspective in China.A partitioned survival model was used. According to the GEMSTONE-302 trial, the clinical characteristics and outcomes of the patients were obtained. The outcomes were costs, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), incremental net health benefits (INHB) and incremental net monetary benefits (INMB). The robustness of the model was further evaluated, as well as subgroup analyses. When the ICER was lower than the willingness to pay (WTP) threshold ($38,017/QALY or $86,376/QALY, defined as three times the per capita gross domestic product value of the general region and Beijing), the cost-effectiveness of Sugema-Chemo was assumed for general regions or Beijing.Compared with chemotherapy alone, Sugema-Chemo resulted in an incremental gain of 0.82 QALYs, an incremental gain of 1.26 life-years, as well as an average increase cost of $72,472. The ICER was $88,744/QALY. Model outcomes were susceptible to average body weight and cost of sugemalimab. Sugema-Chemo was cost-effective at a WTP threshold of 86,376/QALY if the average body weight was <62.44 kg or if the price of sugemalimab was <$2.996/mg. As well, Sugema-Chemo was also cost-effective when the cost of sugemalimab was <$1.839/mg for a WTP threshold of $38,017/QALY. Sugema-Chemo had a probability of > 50% being considered cost-effective in most subgroups at the $86,376/QALY threshold. However, Sugema-Chemo did not achieve cost-effectiveness (0%) in any of the subgroups when WTP was set at $38,017/QALY.Sugema-Chemo might not be cost-effective in patients with metastatic NSCLC in China. In deciding between Sugema-Chemo and chemotherapy alone, it is essential to consider both the body weight of patients and the price of sugemalimab. A price reduction of sugemalimab under the National Healthcare Security Administration may be an effective measure to improve the cost-effectiveness of the drug.Copyright © 2023 Liang, Chen, Li, Liu and Li.