BackgroundThe　addition　of　atezolizumab　to　bevacizumab　plus　platinum　regimen　has　demonstrated　notable　improvements　in　treating　metastatic,　persistent,　or　recurrent　cervical　cancer,　but　its　cost-effectiveness　requires　further　investigation.　From　a　US　payer　perspective,　we　aimed　to　evaluate　the　cost-effectiveness　of　atezolizumab　plus　bevacizumab　and　chemotherapy　vs.　standard　chemotherapy　as　a　first-line　treatment　for　metastatic,　persistent,　or　recurrent　cervical　cancer.MethodsA　partitioned　survival　model　based　on　the　data　from　the　BEATcc　trial　was　used　to　calculate　the　incremental　cost-effectiveness　ratio　(ICER),　using　cost　and　health　utility　information　obtained　from　literature　and　publicly　accessible　databases.　One-way　and　probabilistic　sensitivity　analyses　were　performed　to　evaluate　the　model＇s　responsiveness　to　variations　in　parameters.ResultsThe　addition　of　atezolizumab　resulted　in　an　additional　0.839　quality-adjusted　life　years　(QALY)　at　an　additional　cost　of　$458,237,　leading　to　an　ICER　of　$545,943/QALY.　One-way　sensitivity　analysis　indicated　that　the　cost　of　atezolizumab　had　the　greatest　impact　on　the　ICER,　followed　by　the　utility　value　of　progression-free　survival　(PFS)　and　follow-up　costs.　Probabilistic　sensitivity　analysis　showed　a　0%　cost-effectiveness　probability　at　the　current　willingness-to-pay　(WTP)　threshold　of　$150,000　per　QALY.ConclusionAdding　atezolizumab　to　chemotherapy　is　cost-prohibitive　in　the　US　and　may　not　be　cost-effective　for　patients.