Wan N, Zhang TT, Hua SH, et al. - From the United States and China public payers’ perspective, the cost-effectiveness of pembrolizumab (Pembro) plus chemotherapy (combination therapy) for nonsquamous non-small cell lung cancer (NSCLC) was evaluated in this study, using a literature-based Markov model. Researchers compared three treatment strategies, ie, Pembro-chemotherapy combination and chemotherapy strategy without programmed death ligand 1 (PD-L1) test, and treatment strategy according to their PD-L1 status, focusing on cost and quality-adjusted life years (QALYs), using KEYNOTE-189 trial data. Findings revealed that the combination strategy vs chemotherapy was not cost-effective for NSCLC treatment in the American and Chinese healthcare system at willingness to pay threshold of $100,000/QALY and $27,351/QALY for the United States and for China, respectively. Improved cost-effective possibilities of immunotherapy for nonsquamous NSCLC could be achieved by using the PD-L1 test for patient selection and price reduction.