. 2020 Jan 16;9(5):1683–1693. doi: 10.1002/cam4.2793

Table 2.

Base case and scenario analyses

Treatment Arm	Mean Cost ($)	Effect QALY (Mean)	Compared with	Incremental Cost($)	Incremental Effect	ICER ($)
Base cases in the United States
Chemotherapy	153 551	0.88
Pembro + Chemotherapy	256 421	1.66	Chemotherapy	102 870	0.78	132 392
PD‐L1 test(1% cut off)	234 795	1.93	Chemotherapy	81 244	1.04	77 754
PD‐L1 test(1% cut off)	234 795	1.93	Pembro + Chemotherapy	−21 626	0.27	Dominated
PD‐L1 test(50% cut off)	194 801	1.80	Chemotherapy	41 250	0.92	44 731
PD‐L1 test(50% cut off)	194 801	1.80	Pembro + Chemotherapy	−61 620	0.14	Dominated
Price reduction scenarios in the United States
Pembro cost reduced by 15%
Chemotherapy	145 615	0.88
Pembro + Chemotherapy	237 363	1.66	Chemotherapy	91 748	0.78	118 078
Pembro cost reduced by 40%
Chemotherapy	132 388	0.88
Pembro + Chemotherapy	205 600	1.66	Chemotherapy	73 211	0.78	94 222
Base cases in China
Chemotherapy	61 072	0.78
Pembro + Chemotherapy	115 637	1.37	Chemotherapy	54 565	0.59	92 533
PD‐L1 test(1% cutoff)	103 817	1.53	Chemotherapy	42 746	0.75	56 768
PD‐L1 test(1% cutoff)	103 817	1.53	Pembro + Chemotherapy	−11 820	0.16	Dominated
PD‐L1 test(50% cutoff)	83 081	1.42	Chemotherapy	22 009	0.64	34 388
PD‐L1 test(50% cutoff)	83 081	1.42	Pembro + Chemotherapy	−32 556	0.05	Dominated
Price reduction scenarios in China^a
Chemotherapy	46 942	0.78
Pembro + Chemotherapy	81 934	1.37	Chemotherapy	34 992	0.59	59 340
PD‐L1 test(1% cutoff)	74 209	1.53	Chemotherapy	27 267	0.75	36 211
PD‐L1 test(1% cutoff)	74 209	1.53	Pembro + Chemotherapy	−7 725	0.16	Dominated
PD‐L1 test(50% cutoff)	61 011	1.42	Chemotherapy	14 070	0.64	21 983
PD‐L1 test(50% cutoff)	61 011	1.42	Pembro + Chemotherapy	−20 923	0.05	Dominated

Abbreviations: ICER, incremental cost‐effectiveness ratio; Pembro, pembrolizumab; QALY, quality adjusted life years.

The cost of pembrolizumab was reduced by 50%. Chemotherapy, all patients treated with chemotherapy without tumor sample tested for PD‐L1 expression; Pembro + Chemotherapy, all patients treated with Pembro‐chemotherapy combination without tumor sample tested for PD‐L1 expression; PD‐L1 test(1% cutoff), patients with PD‐L1‐positive tumors (a positivity threshold of 1%) were treated with Pembro‐chemotherapy combination, and patients with PD‐L1‐negative tumors (below the positivity threshold) were treated with chemotherapy; PD‐L1 test(50% cutoff), patients with PD‐L1‐positive tumors (a positivity threshold of 50%) were treated with Pembro‐chemotherapy combination, and patients with PD‐L1‐negative tumors (below the positivity threshold) were treated with chemotherapy.