Cost Effectiveness of Sequencing 34 Cancer-Associated Genes as an Aid for Treatment Selection in Patients with Metastatic Melanoma

Mol Diagn Ther. 2015 Jun;19(3):169-77. doi: 10.1007/s40291-015-0140-9.


Objective: To determine whether a next-generation sequencing (NGS) panel of 34 cancer-associated genes would cost-effectively aid in the treatment selection for patients with metastatic melanoma, compared with a single-site BRAF V600 mutation test.

Methods: A decision model was developed to estimate the costs and health outcomes of the two test strategies. The cost effectiveness of these two strategies was analyzed from a payer perspective over a 2-year time horizon with model parameters 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 life years (QALYs) per patient, whereas the single-site mutation test strategy resulted in a cost of US$128,965 and 0.704 QALYs. Thus, the gene sequencing panel strategy cost US$8943 less per patient and increased QALYs by 0.0174 per patient. Sensitivity analyses showed that, compared with the single-site mutation test strategy, the gene sequencing panel strategy had a 90.9% chance of having reduced costs and increased 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 patients with metastatic melanoma reduced costs and increased QALYs. If the base-case results were applied to the 8900 patients 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.

Publication types

  • Comparative Study

MeSH terms

  • Cost-Benefit Analysis
  • Decision Support Techniques
  • Genetic Predisposition to Disease
  • Health Expenditures
  • High-Throughput Nucleotide Sequencing / economics*
  • Humans
  • Melanoma / economics
  • Melanoma / genetics*
  • Models, Economic
  • Mutation
  • Neoplasm Metastasis
  • Proto-Oncogene Proteins B-raf / genetics*
  • Quality-Adjusted Life Years
  • Sensitivity and Specificity
  • Sequence Analysis, DNA / economics*


  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf