<p>Cost-effectiveness and budget impact analysis of viscosupplementation with hylan G-F 20 for knee and hip osteoarthritis</p>

Abstract

Purpose To estimate the cost-effectiveness and budget impact of viscosupplementation with one intra-articular (IA) injection of 6 mL hylan G-F 20 (Synvisc-One ® ) and with three injections of 2 mL hylan G-F 20 (Synvisc ® 3×2) in knee osteoarthritis (OA) patients compared with conventional support therapy (CST – eg, NSAIDs and acetaminophen) and the cost-effectiveness of one IA injection of 2 mL hylan G-F 20 (Synvisc ® 1×2) in hip OA patients compared with CST from an Italian Health System perspective. Methods The model used was a Markov model with states for stages II–IV on the Kellgren–Lawrence scale and runs on 6-month cycles over a 5-year time horizon. A 3.5% discount was applied to both costs and utilities. Direct costs were determined from the perspective of the Italian National Health Service. A one-way and probabilistic sensitivity analysis was conducted for both comparisons. Results Hylan G-F 20 1×6 mL and hylan G-F 20 3×2 mL for knee OA were very likely to be cost-effective when compared to acetaminophen (ICER = €3,160.61 and €3,845.81 per QALY, respectively) and NSAIDs as both ICERs are below €25,000. The hip OA treatment by hylan G-F 20 1×2 mL was dominant compared to NSAIDs and very likely compared to acetaminophen. The results of the cost-effectiveness analysis were confirmed by one-way sensitivity analysis. The budget impact analysis for knee and hip OA showed a small increase in expenditure during 5 years. Conclusions Hylan G-F 20 1×6 mL/hylan G-F 20 is a cost-effectiveness treatment compared to NSAIDs and acetaminophen in the treatment of knee/hip OA in Italy. The treatment of hip and knee OA resulted in cost-saving with hylan G-F 20 1×2 mL and economically sustainable with hylan G-F 20 1×6 mL. However, Real Word Evidence studies should be conducted in order to estimate costs associated with both prosthetics and to understand the reduction of physiotherapy and medication due to hylan G-F 20.

Intra-articular Hyaluronic Acid for Osteoarthritis of the Knee in the United States: A Systematic Review of Economic Evaluations

“…57 Similarly, in Italy IAHA use resulted in reduced economic burden by decreasing medication consumption and drug-related AEs and by delaying surgery; the authors note that IAHA was likely cost-effective. 58 Reducing total medical care costs, minimizing opioid and analgesic utilization to an appropriate amount, and improving patient quality of life should be treatment goals of physicians selecting therapies for patients with knee OA. Achieving these goals will be ever more crucial with the movement from traditional fee-for-service payment models to value-based payment models.…”

A Comprehensive Review of Viscosupplementation in Osteoarthritis of the Knee

“…However, a similar study by Migliore and colleagues indicated that Hylan g-f20 is a cost-effective treatment, even when compared to NSAIDs. 38 This suggests that Hylan g-f20 may be cost-effective when compared to pharmacologic treatment but cost-ineffective when compared to other viscosupplementation formulations SUMMARY In summary, the data suggests that Hylan g-f20 may be an effective interventional treatment for knee OA and may delay time for total knee replacement surgery. The clinical benefit of Hylan g-f20 seems to be most clinically noticeable two to nine months following the initiation of treatment.…”

Cost Effectiveness of Pharmacological Management for Osteoarthritis: A Systematic Review

“…The quality of most of the included studies assessed by QHES was high (mean QHES score 84). Six studies [34][35][36][37][38][39] missed the 75-point threshold demarcating 'low-quality' studies from 'high-quality' ones (Appendix 5, see ESM).…”

“…Characteristics of the included studies are reported in Table 2. The time periods of publication were 2000-2004 (n = 6) [40][41][42][43][44][45], 2005-2009 (n = 10) [34,35,37,[46][47][48][49][50][51][52], 2010-2014 (n = 10) [53][54][55][56][57][58][59][60][61][62], and post-2015 (n = 17) [36,38,39,[63][64][65][66][67][68][69][70][71][72][73][74][75][76]. The studies were conducted in Europe (n = 15), North America (n = 19) [36, 37, 39, 42, 45, 46, 48, 51, 54-56, 59, 60, 67-72, 75], South America (n = 1) [65], and Asia (n = 7) [35,44,…”

“…The payer perspective was typically adopted, including third-party payer, private payer, National Health Service (NHS), and Healthcare System (HCS). The majority of articles adopted NHS (n = 8) [38,43,49,50,53,57,58,74], third-party payer (n = 3) [55,56,65], or HCS perspectives (n = 7) [38,48,58,70]. A number of CEAs offered societal perspectives (n = 8) [35,37,41,44,46,54,60,69].…”