<p>Cost-of-illness of knee osteoarthritis: potential cost savings by not undergoing arthroplasty within the first 2 years</p>

Abstract

PurposeAlthough knee arthroplasty (KA) is the largest source of hospitalization costs for knee osteoarthritis (OA), some studies have suggested reducing the use of “low-value” interventions, such as intra-articular hyaluronic acid (HA), to lower health care costs. However, those studies fail to consider that HA has demonstrated benefits in extending time to more costly KA or avoiding KA altogether. We evaluated 1) the overall knee OA costs (direct) within a 2-year period; 2) the relative contribution of HA and KA costs; 3) the direct cost savings from HA patients not undergoing KA.Patients and methodsKnee OA patients were identified from the Optum Clinformatics data set, which includes physician, facility, and pharmacy claims data from privately insured patients of all ages. Patients were stratified in the no HA, non-hylan G-F 20, and hylan G-F 20 cohorts. The cumulative costs (payer perspective) were evaluated for all knee OA-related claims (adjusted to Consumer Price Index Jan 2017$) for patients who had at least 2 years follow-up. Costs were stratified into various clinical categories.ResultsThe study cohort included 2,030,497 knee OA patients, of which 65,144 patients (3.2%) underwent KA. The cost of treating knee OA within the 2-year follow-up period was estimated to be $4.99 billion (B). The majority of the costs (69%) were attributed to KA patients (3.2% of patients). In all, 15.9% of the HA patients underwent KA within 2 years, but HA only contributed 1.7% to the total costs for these patients. The remaining 84.1% of HA patients did not undergo KA, which saved an estimated total of $1.54B (average $20,740 per patient) or 83.9%, after accounting for their non-KA therapies.ConclusionOur study estimated substantial cost savings through a large percentage of HA patients not undergoing KA. Although a fraction of patients moved on from their conservative therapy to undergo KA within the 2-year period, HA attributed to <2% of their total treatment costs.

Knee OA cost comparison for hyaluronic acid and knee arthroplasty

“…HA was found to only represent 1.2% of the mean costs, similar to our study. Costs following knee OA was also examined in a recent study [34], but only evaluated the costs over a 2-year period compared to 4 years in the present study. Moreover, the authors did not evaluate temporal changes in per-patient cost following knee OA and the corresponding extended time to cost increases for HA and knee arthroplasty patients.…”

Effectiveness of Tuina manipulation in patients with knee osteoarthritis: study protocol for a randomized controlled trial

“…Knee osteoarthritis (KOA) is a disease characterized by joint pain, joint inflammation, stiffness and dysfunction [1]. KOA is a worldwide disease that affects human health which needs to spend huge sums of money every year to bring a heavy financial burden to society [2]. Specific conditions contributing to KOA include gender old aging postmenopausal hormone replacement therapy educational attainment obesity [3].In people over the age of 55, the prevalence of pain and disability in knee osteoarthritis is 10%, and a quarter of them are severely disabled [4].According to the survey, approximately 14% of American adults and 40% of Britons and Australians over the age of 65 suffer from this disease; the prevalence of KOA is increasing year by year [5].…”

Effectiveness of Tuina manipulation in patients with knee osteoarthritis: study protocol for a randomized controlled trial

“…Knee osteoarthritis (KOA) is a disease characterized by joint pain, in ammation, stiffness and dysfunction [1]. KOA is a common musculoskeletal disorder that affects human health and brings a heavy nancial burden worldwide [2]. Speci c factors contributing to KOA include sex, advanced age, the use of postmenopausal hormone replacement therapy, educational attainment, and obesity [3].…”