title: Cost implications of introducing an alternative treatment for patients with osteoarthritis of the knee in a managed care setting.
abstract: OBJECTIVE
  To illustrate the current cost of treating osteoarthritis (OA) of the knee and to demonstrate potential savings associated with the new treatment modality of viscosupplementation in a managed care setting.
  
  
  METHODS
  Pharmacoeconomic model with inputs obtained from peer-reviewed medical literature, clinical trial data, clinical expert opinion, and claims data.
  
  
  METHODS
  A spreadsheet-based model was developed to define a treatment pathway for OA of the knee, illustrate the current costs of treating patients with the condition, and demonstrate the potential savings associated with introduction of Hylan G-F 20. A hypothetical cohort of patients categorized as having mild, moderate, or severe OA of the knee was followed over a 3-year time period. The analysis was conducted from the perspective of a managed care plan with a large Medicare population.
  
  
  RESULTS
  The 3-year savings associated with adding 1 or more courses of Hylan G-F 20 therapy to the standard treatment pathway for OA of the knee was $8,810,771. The total savings per OA patient receiving Hylan G-F 20 was $4706. The number of total knee replacements (TKRs) avoided was 808. The model was highly sensitive to the durability of Hylan G-F 20; increasing and decreasing durability within a reasonable range resulted in 3-year savings of $9,131,879 and $2,012,082, respectively.
  
  
  CONCLUSIONS
  Hylan G-F 20 has proven to be an effective treatment for patients with OA of the knee. Appropriate use of Hylan G-F 20 could delay the need for TKRs and generate savings in the managed care setting.
authors.affiliation: Louisiana State University School of Medicine, Shreveport, USA.
authors.forename: D
authors.initials: D
authors.lastname: Waddell
authors.forename: A
authors.initials: A
authors.lastname: Rein
authors.forename: C
authors.initials: C
authors.lastname: Panarites
authors.forename: P M
authors.initials: PM
authors.lastname: Coleman
authors.forename: C
authors.initials: C
authors.lastname: Weiss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000191:economics / Q000627:therapeutic use*; D002482:Cellulose / Q000627:therapeutic use; D015331:Cohort Studies; D017046:Cost Savings; D004338:Drug Combinations; D005260:Female; D017048:Health Care Costs; D006584:Hexamethonium Compounds / Q000627:therapeutic use; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D008297:Male; D008329:Managed Care Programs / Q000191:economics*; D008875:Middle Aged; D017059:Models, Econometric; D020370:Osteoarthritis, Knee / Q000191:economics* / Q000628:therapy*; D013582:Synovial Fluid / Q000187:drug effects; D013635:Tantalum / Q000627:therapeutic use; D013917:Thrombin / Q000627:therapeutic use; D014481:United States
chemical_list: D001672:Biocompatible Materials; D004338:Drug Combinations; D006584:Hexamethonium Compounds; C070509:hylan gel; D013635:Tantalum; D002482:Cellulose; D006820:Hyaluronic Acid; D013917:Thrombin