Compared with chemotherapy, serplulimab plus chemotherapy achieved additional 0.27, 0.23 and 0.43 QALYs with marginal $33,460.86, $30,363.35 and $45,455.77, which resulted in the ICERs of $124,483.07, $134,637.42 and $105,589.71 per QALY gained in advanced ESCC patients with PD-L1-positive, PD-L1 1 ≤ CPS < 10 and CPS ≥ 10, respectively. The gene discussed is CD274; the disease is esophageal squamous cell carcinoma.