The melafind has a biopsy ratio of about 10 to 1, so you will get 10 biopsies for each true melanoma found. This is comparable to top skin cancer specialists and far better than average derms but it's not quite the pie in the sky scenario you are spinning. They do not do biopsied lightly now and they will not do so with MelaFind. Melanoma is a serious disease so yes, there will continue to be biopsies MelaFind was not designed to reduce let alone eliminate biopsies. That is not what it does.
biopsies are only unnecessary in retrospect. If mela proves to be as accurate in the field as it was in the trials it will have an impact on how many "just in case" lesions are biopsied. Right now melanonas, likely melanomas and "just in case" lesions are all biopsied and some that are unlikely (hardly a chance it's melanoma) are left untouched. With MelaFind they can scan the "just in case" type for an objective opinion and perhaps biopsy fewer of these. They can also scan the "hardly a chance it's melanoma" variety and turn up most of the 20%-30% of early stage melanomas that are currently missed by the average dermatologist.
The economics of this is what MELA hopes to document in order to get higher reimbursement that they otherwise might get but this is expected to take time. Probably at least 2 years or more. It's not clear if the situation is the same in Germany, it's probably easier but MELA has not spoken publicly about this topic as far as I know.
I have no ideal how painful a biopsy can be, but from the physical appearance standpoint, many patients do not like scars, and MelaFind is useful in preventing many UNNECESSARY scars resulting from many UNNECESSARY biposies.