Zhou K, et al. - For treating extensive-stage small-cell lung cancer, the cost-effectiveness of atezolizumab plus chemotherapy as first-line therapy was evaluated from an American perspective. Researchers extracted basic medical information from a double-blind, placebo-controlled, phase 3 trial (IMpower133, NCT02763579). They used published resources to determine utilities and costs. They also developed a Markov model to mimic the process of small-cell lung cancer. An increase in costs by $52,881 was seen with the use of atezolizumab plus chemotherapy vs chemotherapy alone; a gain of 0.10 quality adjusted life years (QALYs) was seen with this addition. This led to an incremental cost-effective ratio of $528,810 per QALY. From an American perspective, no cost-effectiveness was seen by the combination of atezolizumab, carboplatin and etoposide when used as first-line therapy to treat patients with extensive-stage SCLC.