对于广泛期小细胞肺癌（ES-SCLC）患者来说，伴随化疗的舒普利单抗作为一线治疗是有益的。伴随化疗的舒普利单抗在成本效益方面尚不确定。本研究的目的是从中国卫生保健系统的角度评估伴随化疗的舒普利单抗治疗ES-SCLC患者的成本效益。本研究采用了分割生存模型。模型中的患者根据他们的临床特征和结果从ASTRUM-005中选取。为了评估模型的鲁棒性，我们进行了确定性的单方敏感性分析和概率性敏感性分析。还进行了亚组分析。分析了成本、调整后的生命年（QALYs）、生命年、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）。根据基线分析结果，伴随化疗的舒普利单抗导致0.826年的生命年增加和0.436个QALYs的增加；增加了52,331美元的成本，产生了120,149美元/QALY的ICER。根据37,669美元/QALY和86,569美元/QALY的支付意愿（WTP）阈值，INHB分别为-0.954个QALYs和-0.169个QALYs，INMB分别为-35,924美元和-14,626美元。根据概率性敏感性分析结果，伴随化疗的舒普利单抗在37,669美元/QALY和86,569美元/QALY的WTP阈值下不太可能具有成本效益。单方敏感性分析表明，舒普利单抗的成本和体重对模型影响最大。当舒普利单抗的成本低于5.24美元/毫克或患者的体重低于40.96 kg时，伴随化疗的舒普利单抗可能在86,569美元/QALY的WTP阈值下具有成本效益。无论37,669美元/QALY抑或86,569美元/QALY的WTP阈值如何，伴随化疗的舒普利单抗在所有亚组中均不具有成本效益。尽管伴随化疗的舒普利单抗在临床上有益且与化疗相比具有相对安全性，但却不具有成本效益。随着舒普利单抗价格的降低，接受伴随化疗的ES-SCLC患者可能能够获得良好的成本效益比率。版权所有 © 2023年 梁，陈，李和李。

For patients with extensive-stage small cell lung cancer (ES-SCLC), serplulimab plus chemotherapy is beneficial as the first-line treatment. It is uncertain whether serplulimab plus chemotherapy will be more cost-effective. The aim of this study was to evaluate from the perspective of the Chinese healthcare system to assess the cost-effectiveness of serplulimab plus chemotherapy for patients with ES-SCLC.This study employed a partitioned survival model. Patients in the model were selected from ASTRUM-005 for their clinical characteristics and outcomes. In order to assess the robustness of the model, we conducted deterministic one-way sensitivity analyzes as well as probabilistic sensitivity analyzes. Subgroup analyzes were also conducted. Costs, quality-adjusted life-years (QALYs), life-years, incremental cost-effectiveness ratio (ICER), incremental net health benefits (INHB), and incremental net monetary benefits (INMB) were analyzed.Based on the base-case analysis, serplulimab plus chemotherapy contributed to an increase in 0.826 life-years and 0.436 QALYs; an incremental cost of $52,331, yielded ICER of $120,149/QALY. Based on the willingness to pay (WTP) threshold of $37,669/QALY and $86,569/QALY, the INHB was -0.954 QALYs and - 0.169 QALYs and the INMB was -$35,924 and -$14,626, respectively. Based on the probabilistic sensitivity analysis results, serplulimab plus chemotherapy was unlikely to be cost-effective at a WTP threshold of $37,669/QALY and $86,569/QALY. One-way sensitivity analysis indicated that cost of serplulimab and body weight had the greatest impact on the model. Serplulimab plus chemotherapy could be cost-effective at a WTP threshold of $86,569/QALY when the cost of serplulimab was less than $5.24/mg or when the weight of the patient was less than 40.96 kg. Regardless of the WTP threshold at $37,669/QALY or $86,569. Serplulimab plus chemotherapy was not cost-effective in all subgroups.Serplulimab plus chemotherapy was not cost-effective, despite having a prior clinical benefical and a relative safety profile compared with chemotherapy. With the reduction in the price of serplulimab, ES-SCLC patients treated with serplulimab plus chemotherapy may be able to achieve a favorable cost-effectiveness rate.Copyright © 2023 Liang, Chen, Li and Li.