To evaluate the cost-utility of camrelizumab in combination with apatinib and sorafenib in the first-line treatment of advanced unresectable hepatocellular carcinoma（uHCC）.

Based on the clinical trial data of CARES-310, a partitioned survival model was constructed to simulate the cost and outcomes of camrelizumab in combination with apatinib and sorafenib in the first-line treatment of advanced uHCC, and the incremental cost-effectiveness ratio（ICER）of the two strategies was calculated using the cost-utility analysis from the perspective of Chinese medical and health system. Single factor sensitivity analysis and probabilistic sensitivity analysis were used to evaluate the stability of the results.

The total cost of camrelizumab in combination with apatinib regimen was 285 459 yuan, and 0.999 QALYs was obtained. The total cost of sorafenib regimen was 238 948 yuan, and 0.726 QALYs was obtained. The ICER of camrelizumab in combination with apatinib regimen against sorafenib regimen was 170 112 yuan·QALY^-1, which did not exceed the willingness-to-pay threshold of 257 094 yuan·QALY^-1 in China. The results of sensitivity analysis indicated that the basic analysis was robust.

From the perspective of Chinese healthcare system, camrelizumab combined with apatinib is cost-effectiveness compared with sorafenib in the first-line treatment of advanced uHCC.