In conclusion, the cost-effectiveness analysis of atezolizumab versus pembrolizumab with the two cut-offs of IMpower110-study (Sept’18 and Feb’20) shows a similar gain in terms of QALYs and therefore, it can be determined that both therapies are equally effective as first-line treatment in metastatic NSCLC patients expressing high levels of PD-L1 (≥ 50%) and without EGFR and ALK mutations. This evidence concerns the gene CD274 and non-small cell lung carcinoma.