Cost Effectiveness of Intra-Articular Hyaluronic Acid and Disease-Modifying Drugs in Knee Osteoarthritis

Jean-Hugues Salmon (), Anne-Christine Rat (), Isabelle Charlot-Lambrecht, Jean-Paul Eschard (), Damien Jolly () and Bruno Fautrel ()
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Jean-Hugues Salmon: VIEFRA - EA 3797 - Vieillissement, Fragilité - URCA - Université de Reims Champagne-Ardenne
Anne-Christine Rat: VIEFRA - EA 3797 - Vieillissement, Fragilité - URCA - Université de Reims Champagne-Ardenne
Isabelle Charlot-Lambrecht: Hôpital Maison Blanche - CHU Reims - Hôpital universitaire Robert Debré [Reims]
Jean-Paul Eschard: Hôpital Maison Blanche - CHU Reims - Hôpital universitaire Robert Debré [Reims]
Damien Jolly: VIEFRA - EA 3797 - Vieillissement, Fragilité - URCA - Université de Reims Champagne-Ardenne, Hôpital Robert Debré - Hôpital Robert Debré - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - CHU Reims - Hôpital universitaire Robert Debré [Reims]
Bruno Fautrel: iPLESP - Institut Pierre Louis d'Epidémiologie et de Santé Publique - INSERM - Institut National de la Santé et de la Recherche Médicale - SU - Sorbonne Université

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Abstract: Background: The place of disease modifying osteoarthritis drugs and intra-articular hyaluronic acid in the therapeutic arsenal of knee osteoarthritis remains uncertain. Indeed, these treatments have demonstrated symptomatic efficacy but no efficacy for disease modification. Objective: This report reviews the cost effectiveness of intra-articular hyaluronic acid (IAHA) and disease modifying osteoarthritis drugs (DMOADs) used in the treatment of knee osteoarthritis. Methods: A systematic literature search of MEDLINE, Scopus, EMBASE and Cochrane databases for articles was performed independently by 2 rheumatologists who used the same predefined eligible criteria. Papers without abstracts and in languages other than English or French were excluded. Extracted costs were annualized and converted to 2015 euros (€) by using the Consumer Price Index of the relevant countries and the 2013 Purchasing Power Parities between these countries and the European Union average. Results: A total of 95 abstracts were selected, and 13 articles were considered for the review. Nine articles were on IAHA and 4 articles on DMOADs. Only one article directly compared different IAHA compound. Articles showed substantial heterogeneity in methodological approaches. The incremental cost-effectiveness ratios (ICER) ranged from 4,000 to 57,550€ and from 240 to 53,225€ per QALY gained for DMOADs and IAHA respectively. Conclusions: This review highlights substantial heterogeneity between studies, ranging from cost saving (or dominating) position to very high ICERs, far above the acceptability threshold of 50,000 €/QALY. Additional research is needed to display reliable and robust ICER estimates for knee OA therapies.

Keywords: Osteoarthritis; Cost-effectiveness; Hip; Knee; Systematic review (search for similar items in EconPapers)
Date: 2018
Note: View the original document on HAL open archive server: https://hal.science/hal-03584953v1
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Published in PharmacoEconomics, 2018, 36 (11), pp.1321 - 1331. ⟨10.1007/s40273-018-0695-5⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-03584953

DOI: 10.1007/s40273-018-0695-5

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