Response to Letter Regarding Article, “Cost-Effectiveness Analysis of Continuous Flow Left Ventricular Assist Devices as Destination Therapy”

We appreciate the comments from Dr Moreno regarding our evaluation of the cost effectiveness of continuous flow left ventricular assist devices (LVADs) implanted as destination therapy. By their nature, health economic models involve a degree of uncertainty. As noted in a review by NICE (National Institute for Health and Clinical Excellence), “all forms of sensitivity analysis, notably both deterministic and probabilistic approaches, have their supporters and their detractors” (http://www.hta.ac.uk/fullmono/mon1329.pdf). We used a decision analytic model adapted from the Blue Cross Blue Shield Technology Evaluation Center (BCBS TEC) assessment, a leading technology assessment organization in the United States. We applied …