Barrington DA, et al. - Pembrolizumab was assessed for its cost-effectiveness in comparison to pegylated liposomal doxorubicin (PLD) or bevacizumab for the treatment of women suffering recurrent endometrial cancer after the failure of first-line chemotherapy (carboplatin and paclitaxel). For this purpose, a model was proposed in this study that included 4400 patients; 800 patients were assumed to have microsatellite instability-high (MSI-H) tumors. PLD costs were $33.2 million (M) and bevacizumab costs were $167.9 M. For non-microsatellite instability-high (non-MSI-H) patients vs MSI-H patients, the cost of pembrolizumab therapy was $318.3 M vs $57.9 M, respectively. With an incremental cost-effectiveness ratio of $147,249, cost-efficacy of pembrolizumab was evident for MSI-H patients, compared to PLD, while bevacizumab was subjected to extended dominance. Compared to other single agent drugs, pembrolizumab was shown to be cost-effective for patients with MSI-H recurrent endometrial cancers who had failed first-line chemotherapy. A substantial decline in the cost of pembrolizumab is required so that it could be cost-effective in non-MSI-H patients.