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We measured benefits in terms of lifetime QALYs gained. Model inputs were taken from the literature. We calculated the ICER, or the cost per additional QALY gained, of VADs and performed multiple sensitivity analyses to test how our assumptions influenced the results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to watchful waiting, VADs produce 0.97 more QALYs for an additional $156\u00a0639, leading to an ICER of $162\u00a0123 per QALY gained from a healthcare perspective. VADs have 17% chance of being cost\u2010effective given a cost\u2010effectiveness threshold of $100\u00a0000 per QALY gained. Sensitivity analyses suggest that VADs can be cost\u2010effective if the costs of implantation decrease or if hospitalization costs or mortality among watchful waiting patients is higher.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As a bridge to transplant, VADs provide a health benefit to children who develop stable, inotrope\u2010dependent heart failure, but immediate implantation is not yet a cost\u2010effective strategy compared to watchful waiting based on commonly used cost\u2010effectiveness thresholds. Early VAD support can be cost\u2010effective in sicker patients and if device implantation is cheaper. In complex conditions such as pediatric heart failure, cost\u2010effectiveness should be just one of many factors that inform clinical decision\u2010making.<\/jats:p><\/jats:sec>","DOI":"10.1111\/petr.13975","type":"journal-article","created":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T03:32:39Z","timestamp":1611372759000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cost\u2010effectiveness of implantable ventricular assist devices in older children with stable, inotrope\u2010dependent dilated cardiomyopathy"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4903-870X","authenticated-orcid":false,"given":"Anton L. 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