OBJECTIVES: Prior to availability of novel agents such as vemurafenib and ipilimumab, poor outcomes were associated with advanced melanoma treatment. In Brazil, vemurafenib (VEM) is an oral therapy for BRAF-V600E-mutated unresectable or metastatic melanoma in all treatment lines meanwhile ipilimumab (IPI) is an intravenously administered drug for metastatic melanoma in second-line. Whereas IPI is compulsorily reimbursed in private system as labeled, this study aims to estimate the potential budget impact of second-line VEM coverage in Brazilian Private Healthcare System. METHODS: The study focused in second-line setting since IPI has no indication for first-line in Brazil. Based on an epidemiologic approach, the potential pool of patients for each drug was estimated. It was adopted that private market accounts for 40% oncology patients. BRAF-V600E mutation positivity rates of 50% were assumed. Treatment costs were assessed evaluating drugs acquisition expenses (considering the ex-factory prices) based on labeled posology and when applicable mutation testing costs or infusion fees. Mean treatment durations were 6 months (VEM) and 3 months or 4 cycles (IPI). Reports were made in Brazilian Reais (BRL1.00~USD0.51 Feb/2013). RESULTS: In 2013, a potential of 408 advanced melanoma patients in second-line would be expected in the private system. Screening all patients and treating those eligible with VEM (204 patients), would result mean treatment costs per patient of BRL110,633 (VEM) and BRL182,852 (IPI). Therefore, system would be charged by expenses of BRL59,906,137 instead of BRL74,647,411  in a scenario with no testing and all second-line patients treated with IPI. CONCLUSIONS: Considering VEM availability in private healthcare system for advanced melanoma in second-line, BRL14.7Mio savings could be achieved in 2013. Testing all patients and reimbursing VEM seems to be economically advantageous mainly due to lower cost associated to VEM and the opportunity of testing patients with BRAF-mutation, identifying those who has more chance to respond to the treatment.