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Journal of Orthopaedic Surgery and Research

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01-12-2020 | Osteoarthrosis | Research article

Knee OA cost comparison for hyaluronic acid and knee arthroplasty

Authors: Kevin L. Ong, Faizan Niazi, Edmund Lau, Michael A. Mont, Andrew Concoff, Peter Shaw, Steven M. Kurtz

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2020

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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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Title: Knee OA cost comparison for hyaluronic acid and knee arthroplasty
Authors: Kevin L. Ong
Faizan Niazi
Edmund Lau
Michael A. Mont
Andrew Concoff
Peter Shaw
Steven M. Kurtz
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Osteoarthrosis
Osteoarthrosis
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2020
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/s13018-020-01848-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Knee OA cost comparison for hyaluronic acid and knee arthroplasty

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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