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Sensitivity analyses confirmed the robustness of these findings survival outcomes and targeted therapy costs had the greatest impact on results. The incremental cost-effectiveness ratio (ICER) per life-year gained of NGS testing versus SGT was $7,224 (excluding post-diagnostic costs) the ICER for NGS-directed therapy was $148,786 versus SGT-directed therapy. In the base case, NGS improved the detection of actionable biomarkers by 74.4%, increased the proportion of patients receiving biomarker-driven therapy by 11.9%, and decreased the proportion of patients with biomarker-positive disease receiving non-biomarker driven first-line treatment by 40.5%. Inputs were obtained from published sources and included diagnostic performance, biomarker-positive disease rates, biomarker-directed recommendations for treatment, and survival outcomes. The study evaluated the diagnostic value and cost-effectiveness of next generation sequencing (NGS)-based testing versus various combinations of single-gene tests (SGT) for the selection of first-line treatment for patients with advanced/metastatic non-squamous non-small cell lung cancer (NSCLC) in the US.Ī dynamic decision analysis model was developed to compare NGS versus SGT from a payer perspective.