Of note, when the price of serplulimab was reduced by 70%, the probability of serplulimab plus chemotherapy being cost-effective increased from 0% to 81.42%, 67.74% and 96.75%, respectively, in advanced ESCC patients with PD-L1-positive, PD-L1 1 ≤ CPS < 10 and CPS ≥ 10. This evidence concerns the gene CD274 and esophageal squamous cell carcinoma.