OBJECTIVES This analysis described healthcare costs over time—excluding ipilimumab drug costs—stratified by survival duration and baseline ECOG status, in patients receiving ipilimumab for advanced melanoma in the US community setting. METHODS We analyzed data from a retrospective chart review of patients with unresectable stage III/IV melanoma treated with ipilimumab as first-line monotherapy between 04/2011 and 09/2012. Hospitalizations, emergency department visits, subsequent chemotherapy, radiation, surgeries, nursing home, and hospice visits costs were estimated using published sources and tariffs. Total costs, excluding ipilimumab drug costs, were calculated for 3 periods: treatment regimen (between first and last ipilimumab doses); post-regimen; and pre-death (within 90 days of death). Monthly costs were compared for the total population and stratified by baseline ECOG status (0 vs. ≥1, when available) and survival (<1 year vs. ≥1 year) using Wilcoxon rank sum tests. RESULTS Data were abstracted from 273 patient charts at 34 sites. Excluding ipilimumab drug costs, total monthly costs during the treatment regimen, post-regimen, and pre-death periods were $690, $2151, and $5123, respectively. Total monthly costs across all study periods were higher for patients with ECOG ≥1 (n=135) vs. ECOG=0 (n=104) (p=0.0294), particularly in the pre-death period ($5987 vs. $3460, respectively; p=0.0143). A similar pattern was observed for patients surviving <1 year (n=109) vs. ≥1 year (n=122) (p<0.0001), with a difference of $9524 vs. $2955 (p<0.0001) during the pre-death period (42 patients still alive after <1 year follow-up were excluded from this analysis). Key cost drivers were hospitalizations (32.4% of total costs), followed by non-ipilimumab chemotherapy (23.1%), hospice care (19.1%), and nursing home stays (12.5%). CONCLUSIONS In this population, monthly costs were significantly lower during the treatment regimen period than in subsequent periods. Survival ≥1 year and baseline ECOG=0 were associated with significantly lower total monthly costs, particularly in the pre-death period.