Cost implications of introducing an alternative treatment for patients with osteoarthritis of the knee in a managed care setting.
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.
Waddell
D
D
Louisiana State University School of Medicine, Shreveport, USA.
Rein
A
A
Panarites
C
C
Coleman
P M
PM
Weiss
C
C
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
D001672:Biocompatible Materials; D004338:Drug Combinations; D006584:Hexamethonium Compounds; C070509:hylan gel; D013635:Tantalum; D002482:Cellulose; D006820:Hyaluronic Acid; D013917:Thrombin