Schluckebier L, Caetano R, Garay OU, et al. - The best treatment choice for advanced non–small cell lung cancer (NSCLC) is based on the presence of certain alterations, so researchers assessed the cost-effectiveness of a unique test utilizing NGS (next generation sequencing) compared to other routinely used tests involving RT-PCR and FISH (in situ hybridization). NSCLC, adenocarcinoma, and candidates to first-line therapy formed the target population. Authors implemented two strategies: strategy 1 included sequential assessments with epidermal growth factor receptor (EGFR) RT-PCR, then FISH for ALK (anaplastic lymphoma kinase) and ROS1 (receptor tyrosine kinase 1). In strategy 2, ALK and ROS1 translocation testing were done simultaneously by FISH. Strategy 3 involved single test next-generation sequencing, a platform including EGFR, ALK and ROS1 genes. While NGS added 24% extra true cases, it also added extra costs. The Incremental cost-effectiveness ratio was US$3,479.11/correct case detected when comparing NGS with sequential tests. A slight gain in life years and QALYs was seen with NGS. Findings supported the precision of molecular diagnosis by NGS of patients with advanced stage NSCLC adenocarcinoma histology, however, this strategy was not identified as cost-effective in terms of quality-adjusted life years from the point of view of the Brazilian supplementary health system.