Cost–effectiveness of adjuvant atezolizumab for patients with stage II–IIIA PD-L1+ non-small-cell lung cancer

AIMS: Atezolizumab improved disease-free survival (DFS) versus best supportive care (BSC) as adjuvant treatment following resection and platinum-based chemotherapy for stage II–IIIA PD-L1+ NSCLC in IMpower010. MATERIALS & METHODS: This cost–effectiveness study evaluated atezolizumab versus BSC (US commercial payer perspective) using a Markov model with DFS, locoregional recurrence, first- and second-line metastatic recurrence and death health states, and a lifetime time horizon with 3% annual discounting. RESULTS: Atezolizumab provided 1.045 additional quality-adjusted life-years (QALY) at an incremental cost of $48,956, yielding an incremental cost–effectiveness ratio of $46,859/QALY. Scenario analysis showed similar findings in a Medicare population ($48,512/QALY). CONCLUSION: At a willingness-to-pay threshold of $150,000/QALY and an incremental cost–effectiveness ratio of $46,859/QALY, atezolizumab is cost-effective versus BSC for adjuvant NSCLC treatment.