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Knee OA cost comparison for hyaluronic acid and knee arthroplasty
Journal article   Open access   Peer reviewed

Knee OA cost comparison for hyaluronic acid and knee arthroplasty

Kevin L Ong, Faizan Niazi, Edmund Lau, Michael A Mont, Andrew Concoff, Peter Shaw and Steven M Kurtz
Journal of orthopaedic surgery and research, v 15(1), pp 305-305
06 Aug 2020
DOI: https://doi.org/10.1186/s13018-020-01848-7
PMID: 32762712
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1186/s13018-020-01848-7View
Published, Version of Record (VoR)CC BY V4.0,  Open

Abstract

Arthroplasty, Replacement, Knee - economics Arthroplasty, Replacement, Knee - methods Cohort Studies Cost of Illness Databases, Factual Delivery of Health Care - economics Delivery of Health Care - statistics & numerical data Female Health Care Costs Humans Hyaluronic Acid - administration & dosage Hyaluronic Acid - economics Hyaluronic Acid - therapeutic use Injections, Intra-Articular Male Osteoarthritis, Knee - diagnosis Osteoarthritis, Knee - therapy Practice Guidelines as Topic Time Factors United States - epidemiology Viscosupplements - administration & dosage Viscosupplements - economics Viscosupplements - therapeutic use
Limiting treatment to those recommended by the American Academy of Orthopaedic Surgeon Clinical Practice Guidelines has been suggested to decrease costs by 45% in the year prior to total knee arthroplasty, but this only focuses on expenditures leading up to, but not including, the surgery and not the entire episode of care. We evaluated the treatment costs following knee osteoarthritis (OA) diagnosis and determined whether these are different for patients who use intra-articular hyaluronic acid (HA) and/or knee arthroplasty. Claims data from a large commercial database containing de-identified data of more than 100 million patients with continuous coverage from 2012 to 2016 was used to evaluate the cumulative cost of care for over 2 million de-identified members with knee OA over a 4.5-year period between 2011 and 2015. Median cumulative costs were then stratified for patients with or without HA and/or knee arthroplasty. Knee OA treatment costs for 1,567,024 patients over the 4.5-year period was $6.60 billion (mean $4210/patient) as calculated by the authors. HA and knee arthroplasty accounted for 3.0 and 61.5% of the overall costs, respectively. For patients who underwent knee arthroplasty, a spike in median costs occurred sooner for patients without HA use (around the 5- to 6-month time point) compared to patients treated with HA (around the 16- to 17-month time point). Non-arthroplasty therapies, as calculated by the authors, accounted for about one third of the costs in treating knee OA in our cohort. Although some have theorized that limiting the use of HA may reduce the costs of OA treatment, HA only comprised a small fraction (3%) of the overall costs. Among patients who underwent knee arthroplasty, those treated with HA experienced elevated costs from the surgery later than those without HA, which reflects their longer time to undergoing knee arthroplasty. The ability to delay or avoid knee arthroplasty altogether can have a substantial impact on the cost to the healthcare system.

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19 citations in Web of Science
19 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Industry collaboration
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Web of Science research areas
Orthopedics
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