Reply to the Editor

We thank Dr Medford1 for the valuable additional analysis concerning the cost benefits of cryobiopsy based on our recently published article in the Journal.2

We assume that routine use of a flexible cryoprobe to obtain tissue samples is cost-effective. However, it has to be considered that cryobiopsies generally require protected airways (ie, intubation). In addition, deep sedation using midazolam or disoprivan, if not general anesthesia, is required. In most countries, this makes additional personnel or an additional physician (eventually an anesthetist) necessary, which in turn leads to an increase in costs. Further, different health care systems may have different tariffs for bronchoscopic procedures, and this might cause a variation in final cost-effectiveness between different countries. Studies investigating the cost-effectiveness are under way. Most likely, cryobiopsy is a method that will result in cost savings over time. In this sense, we absolutely agree with Dr Medford.