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Background: Both clinical outcomes and safety of second-line therapy of Icotinib or Gefitinib for advanced non-small cell lung cancer(NSCLC)patients harboring the mutation of epidermal growth factor receptor(EGFR)have been well clarified,but little is known about the cost-effectiveness of this approach.Methods: A Markov model was applied to assess the data of randomized clinical trials and the direct medical costs from the Perspective of Chinese Healthcare System.Five-year quality-adjusted life years(QALYs)and incremental cost-effectiveness ratios(ICERs)were calculated.One-way and probabilistic sensitivity analyses(PSA)were conducted.Results:Our model suggests that the median progression-free survival(PFS)is 4.2 months in the Icotinib group and 3.5 months in the Gefitinib group while they were 4.6 months and 3.4 months respectively in the trials.The 5-year QALYs is 0.279 in the Icotinib group and 0.269 in the Gefitinib group.The most sensitive parameter to the ICER is utility of PFS,ranging from $-1,259,991.25 to $-182,296.61,accordingly the Icotinib treatment consistently represents a dominant cost-effectiveness strategy.Conclusions: The Icotinib treatment,as a second-line therapy for the advanced NSCLC patients with EGFR positive gene in China,is the preferred strategy relative to Gefitinib because of the dominant cost-effectiveness.In addition,Icotinib shows a good curative effect and high efficiency,resulting in a strong demand for the Chinese market.