Supplementary materials: Cost–effectiveness analysis of pembrolizumab for patients with advanced esophageal cancer at PD-L1 combined positive score ≥10

<b>These are peer-reviewed supplementary materials for the article '</b><b>Cost–effectiveness analysis of </b><b>pembrolizumab for patients with advanced </b><b>esophageal cancer at PD-L1 combined </b><b>positive score ≥10</b><b>' published in the</b><b> </b><b><i>Journal of Comparative Effectiveness Research</i></b><b>.</b><b>Supplementary materials</b><b>Aim:</b> Due to the high price of pembrolizumab, it is still unknown whether the use of pembrolizumab for advanced esophageal cancer would be a cost-effective option for patients whose PD-L1 combined positive score is ≥10. <b>Methods:</b> A Markov simulation model was performed based on clinical trial KEYNOTE-181. Incremental cost–effectiveness ratios were calculated to compare the two treatments. <b>Results:</b> The total costs were US$193,575.60 and $8789.24 for pembrolizumab and chemotherapy treatment, respectively. The pembrolizumab group produced 0.93 quality-adjusted life years (QALYs), while the chemotherapy group produced 0.58 QALYs. Thus, patients in the pembrolizumab group spent an additional US$184,786.36 and produced 0.35 QALYs more than the chemotherapy group, which resulted in an incremental cost–effectiveness ratio of US$527,961.03 per QALY. <b>Conclusion:</b> For patients with advanced esophageal cancer whose PD-L1 combined positive score is ≥10, pembrolizumab is not a cost-effective second-line therapy versus chemotherapy from the US payer perspective.