在 ASTRUM-004 试验中，serplulimab 联合化疗显示出显着改善的生存率和可控的安全性。本研究从中国医疗保健系统的角度评估了serplulimab联合化疗治疗晚期鳞状非小细胞肺癌（sqNSCLC）的成本效益。构建决策树和马尔可夫模型来模拟治疗。有趣的结果包括总成本、生命年 (LY)、质量调整生命年 (QALY) 和增量成本效益比 (ICER)。采用情景分析、单向分析和概率敏感性分析来检查模型的不稳定性。与安慰剂加化疗相比，serplulimab 加化疗的 ICER 为 $55,539.46/QALY ($47278.84/LY)。肿瘤比例评分 (TPS) 的程序性死亡配体 1 表达水平 < 1%、1% ≤ TPS < 50% 和 TPS ≥ 50% 的住院患者的 ICER 估计为 $58706.03/QALY、$48978.34/QALY 和 $59709.54/QALY。在支付意愿门槛为 $12,574.30/QALY、$25,148.60/QALY 和 $37,722.90/QALY 时，serplulimab 的成本效益价格分别为 $168.276/100mg、$349.157/100mg 和 $530.039/100mg。患者体重和 serplulimab 的价格产生了最显着的影响。目前，serplulimab联合化疗具有成本效益的概率为14.15%。与安慰剂联合化疗相比，serplulimab联合化疗在晚期sqNSCLC的一线治疗中可能不具有成本效益。

In the ASTRUM-004 trial, serplulimab plus chemotherapy demonstrated significantly improved survival and controllable safety. This study assessed the cost-effectiveness of serplulimab plus chemotherapy in advanced squamous non-small cell lung cancer (sqNSCLC), considering the perspective of the Chinese healthcare system.A decision tree and a Markov model were constructed to simulate the treatment. The interesting results included total cost, life-years (LYs), quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs). Scenario, one-way and probabilistic sensitivity analyses were used to examine model instability.Compared with placebo plus chemotherapy, serplulimab plus chemotherapy had an ICER of $55,539.46/QALY ($47278.84/LY). The ICERs were estimated to be $58706.03/QALY, $48978.34/QALY and $59709.54/QALY inpatients with programmed death-ligand 1 expression level of tumor proportion score (TPS) < 1%, 1% ≤ TPS < 50% and TPS ≥ 50%. The cost-effective prices of serplulimab were $168.276/100 mg, $349.157/100 mg and $530.039/100 mg at the willingness-to-pay threshold of $12,574.30/QALY, $25,148.60/QALY and $37,722.90/QALY. Patient weight and price of serplulimab created the most significant impact. Presently, the probability of serplulimab plus chemotherapy being cost-effective was 14.15%.Compared with placebo plus chemotherapy, serplulimab plus chemotherapy might not be cost-effective in the first-line treatment for advanced sqNSCLC.