The effectiveness in a specific cycle was calculated as the sum of (1) the health utility for progression-free survival multiplied by the number of patients in the progression-free survival state in the midpoint of the cycle and (2) the health utility for progression multiplied by the number of patients in the progression state in the midpoint of the cycle. Sensitivity Analysis The sensitivity of the calculated costs and effectiveness to uncertainties in the parameter estimates was examined using @Risk software (version 6.1, Palisade Corporation) for Microsoft Office Excel 2010. would cost-effectively aid SIBA in the treatment selection for individuals with metastatic melanoma, compared with a single-site V600 mutation test. Methods A decision model was developed to estimate the costs and health results of the two test strategies. The cost performance of these two strategies was analyzed from a payer perspective over a 2-12 months time horizon with model guidelines taken from the literature. Results In the base case, the gene sequencing panel strategy resulted in a cost of US$120,022 and 0.721 quality-adjusted existence years (QALYs) per patient, whereas the single-site mutation test strategy resulted in a cost of US$128,965 and 0.704 QALYs. Therefore, the gene sequencing panel strategy cost US$8943 less per patient and improved QALYs by 0.0174 per patient. Sensitivity analyses showed that, compared with the single-site mutation test strategy, the gene sequencing panel strategy experienced a 90.9?% chance of having reduced costs and improved QALYs, with the cost of the gene sequencing panel test having minimal effect on the incremental cost. Conclusion Compared with the single-site mutation test, the use of an NGS panel of 34 cancer-associated genes as an aid in selecting therapy for individuals with metastatic melanoma reduced costs and improved QALYs. If the base-case results were applied to the 8900 individuals diagnosed with metastatic melanoma in the USA each year, the gene sequencing panel strategy could result in an annual savings of US$79.6 million and a gain of 155 QALYs. Electronic supplementary material The online version of this article (doi:10.1007/s40291-015-0140-9) contains supplementary material, which is available to authorized users. Key Points Genetic checks of tumors are used to inform treatment selection for individuals with metastatic melanoma. A gene sequencing panel test can interrogate mutations in multiple cancer-associated genes, while a single-site mutation test decides the genotype of a single variant.From a Smcb US health-care payer perspective, testing and selecting first-line targeted treatment for metastatic melanoma using a next-generation sequencing panel of 34 cancer-associated genes can lower the medical costs and increase the individuals quality and length of life, compared with a single-site mutation test. Therefore, the gene sequencing panel test merits concern in the medical management of individuals with metastatic melanoma. Open in a separate window Intro Melanoma is one of the most common cancers in the USA, with an estimated 76,690 newly diagnosed SIBA instances and 9480 deaths yearly [1]. About 2C5?% of newly diagnosed melanomas present with metastatic disease [2]. SIBA Prior to recently authorized therapies, individuals with SIBA metastatic melanoma generally experienced a poor prognosis, having a median survival time of 6C9?weeks and a 5-12 months survival of less than 15?% [3, 4]. Newer therapies statement improved survival occasions [5C7]. For individuals with metastatic melanoma, the National Comprehensive Malignancy Network (NCCN) recommends systemic therapy, enrollment inside a medical trial, or best supportive care [2]. Systemic therapy can improve individual survival and includes immunotherapies and targeted therapies. The authorized immunotherapies are ipilimumab for first-line treatment and pembrolizumab and nivolumab for second-line treatment. Ipilimumab binds CTLA-4 (cytotoxic T lymphocyte-associated antigen 4), therefore obstructing the inhibition of cytotoxic T lymphocytes by CTLA-4 and consequently enabling cytotoxic T lymphocytes to recognize and destroy malignancy cells. Although ipilimumab can elicit long-lasting antitumor effects, it has a relatively low response rate (28?%) and may cause severe adverse events [5]. Several targeted therapies SIBA have also been authorized for individuals with metastatic melanoma [8]. For example, the BRAF kinase inhibitor vemurafenib is definitely a first-line treatment option for individuals transporting a V600E mutation. Clinical studies have also shown that individuals with activating mutations in may respond to therapy with imatinib, an inhibitor of tyrosine kinase receptors [9C11]. In addition, individuals with additional mutations may be candidates for treatment with treatments approved for use in tumors of different origins or newer treatments that are becoming.