Viscosupplementation: Managed Care Issues for Osteoarthritis of the Knee

Arnold, W; Fullerton, Dwight S.; Holder, Sharon M.; May, Coral S

doi:10.18553/jmcp.2007.13.s4.3

Cited by 31 publications

(25 citation statements)

References 55 publications

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“…64 Viscosupplementation treatments cost $1700 to $3700 annually. 65 As OA progresses, the cost of treatments concomitantly rises. The 3.6 million patients in the United States with end-stage knee OA spend almost $4000 per year on associated conservative treatments, 45–58,63–66 resulting in $14.4 billion in annual costs.…”

Section: Long-term Consequences Of Chronic Conservative Carementioning

confidence: 99%

Conservative management of symptomatic knee osteoarthritis: a flawed strategy?

Crawford

Miller

Block³

2013

Orthop Rev

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Conservative management of medial compartment knee osteoarthritis (OA) is a misleading term used to describe the application of medical, orthotic, and/or rehabilitative therapies exclusive of surgical interventions. The implication of this nomenclature is that these therapies offer satisfactory symptom relief, alter disease progression, and have limited side effects. Unfortunately, conservative therapeutic options possesses few, if any, characteristics of an ideal treatment, namely one that significantly alleviates pain, improves knee function, and reduces medial compartmental loading without adverse side effects. As uncompensated mechanical loading is a primary culprit in the development and progression of knee OA, we propose that the therapeutic perspective of conservative treatment should shift from pharmacological treatments, which have no influence on joint loading, minimal potential to alter joint function, substantial associated risks, and significant financial costs, towards minimally invasive load absorbing therapeutic interventions. A safe and effective minimally invasive medical device specifically engineered for symptomatic relief of medial knee OA by limiting joint contact forces has the potential to reduce the clinical and economic knee OA burden. This review characterizes the current standard of care recommendations for conservative management of medial compartment knee OA with respect to treatment efficacy, risk profile, and economic burden.

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Section: Long-term Consequences Of Chronic Conservative Carementioning

confidence: 99%

Conservative management of symptomatic knee osteoarthritis: a flawed strategy?

Crawford

Miller

Block³

2013

Orthop Rev

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“…The stages of the disease, as prescribed by clinical plus radiographic criteria according to the American College of Rheumatology [30–32], were as follows: Stage 1: mild symptoms, Stage 2: strong symptoms, Stage 3: stronger symptoms which may lead to immobility, Stage 4: severe symptoms, which may lead to surgery and which are not the subject of this study.…”

Section: Methodsmentioning

confidence: 99%

How much do rheumatologists and orthopaedists doctors’ modalities impact the cost of arthritis in Cyprus?

Andrioti

Kyprianou

Charalambous

2015

BMC Musculoskelet Disord

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BackgroundOsteoarthritis is one of the primary causes of long-term functional disability. With an estimated 13.5 % prevalence in the general population contributes to a significant financial burden both for patients and healthcare systems. The purpose of this research is to highlight the direct annual cost of the disease to the private healthcare sector of Nicosia.MethodsA questionnaire based on Greek and international research was completed between 10/1/2012 and 11/30/2012, with a sample of 20 doctors specialists in orthopaedics and rheumatology (50 % of practising physicians in the private sector). An assessment of the annual cost of medical procedures and tests, pharmacologic therapies (modalities) and supplies per patient followed, based on current costs. Direct costs were assessed through the micro-costing “bottom-up” approach. We isolated and separately priced the original diagnosis, followed by each stage of the disease.ResultsThe cost for the six predominant medical tests to establish a diagnosis and exclude mainly RA such as ESR, CPR, and X-ray as well as a physician’s office visit was 150€ per patient. The average direct cost per patient during stages 1, 2 and 3 of the disease was 280.54€, 1,834.64€ and 5,641.72€ annually, respectively, with an annual average of 2,573€ per patient.ConclusionsEven though during the period of the study, the country had not yet established clinical guidelines, the participating physicians followed international practices. Significant rise in the cost in each stage of the disease was found, with additional increases in the following years as a result of the expected increased prevalence of the disease. It is noted here that uninsured patients, as well as those who qualified for free medical care, they seek these services in the private sector, and had to pay out of pocket money for examination and treatment. These patients, thus, contended with a serious financial burden. Therefore, it is important to inform them very extensively regarding evidence-based management of the disease to aid them in coping with this chronic illness.

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“…[20] HA physicochemical characteristics (i.e hydrophilic, rheologic, signaling, and viscoelastic properties) and biologic functions (e.g involvement in embryogenesis, inflammation, metastasis, tumor progression, tissue turnover, and wound healing) depend on its molecular weight and interactions with specific binding proteins called ‘hyaladherins’ These interactions modify the conformation of HA The best characterized hyaladherins are structural hyaluronan-binding proteins of the ECM (i.e link protein and the aggregating proteoglycans aggrecan, versican, brevican, and neurocan), and the cell surface hyaluronan receptor CD44 These molecules all have structurally similar hyaluronan-binding domains, which are termed link modules The receptor for hyaluronic acid-mediated motility (RHAMM) is another hyaladherin, but this molecule does not have link modules. [21]…”

Section: Hyaluronic Acidmentioning

confidence: 99%

Intra-Articular Injections for the Treatment of Osteoarthritis

2011

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Osteoarthritis (OA), also called degenerative joint disease, is the most frequently occurring chronic musculoskeletal disease, particularly affecting the aging population. The use of viscosupplementation, i.e. intra-articular (IA) hyaluronic acid (HA) drug therapy, to treat OA, is growing worldwide, due to important results obtained from several clinical trials, which reported IA HA-related improvements in functional activity and pain management. This review is an update of the IA use of this compound in the treatment of OA, with clinical evidence from the last few years being discussed and used to delineate new trends for the future.

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Viscosupplementation: Managed Care Issues for Osteoarthritis of the Knee

Cited by 31 publications

References 55 publications

Conservative management of symptomatic knee osteoarthritis: a flawed strategy?

Conservative management of symptomatic knee osteoarthritis: a flawed strategy?

How much do rheumatologists and orthopaedists doctors’ modalities impact the cost of arthritis in Cyprus?

Intra-Articular Injections for the Treatment of Osteoarthritis

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