Although there have been prior publications addressing the cost-effectiveness of checkpoint inhibitors in the treatment of advanced melanomas, most of these prior reports addressed the cost effectiveness between different checkpoint inhibitors (e.g. anti-programmed cell death-1 (PD-1) vs. anti-cytotoxic T-lymphocyte-associated protein 4—CTLA-4) or their use in combination. The gene discussed is CTLA4; the disease is melanoma.