Objective <p>To assess the cost-effectiveness of cadonilimab plus chemotherapy compared to chemotherapy alone as first-line treatment for metastatic cervical cancer from the Chinaese medical healthcare perspective.</p> Methods <p>We developed a partitioned survival mode to simulate the costs and outcomes associated with the two treatment strategies over a lifetime horizon. Clinical data, cost resource utilization, and health-related quality of life data were obtained from the COMPASSION-16 trial and published literature. The model’s robustness was tested through sensitivity analyses.</p> Results <p>The total cost of treatment for the cadonilimab group in this study was $86,839.48, whereas the cost for the chemotherapy group was $36,770.38. The cadonilimab group demonstrated an incremental gain of 0.70 quality-adjusted life years, resulting in an additional cost of $50,069.10. The incremental cost-effectiveness ratio for the cadonilimab group was determined to be $71,527.28 per QALY, which surpasses the willingness to pay threshold of $40,343.68. Sensitivity analyses demonstrated that the results were robust across varying assumptions of key parameters.</p> Conclusion <p>The use of cadonilimab plus chemotherapy as a first-line treatment for metastatic cervical cancer was not a cost-effective strategy compared to chemotherapy alone in China.</p>