Economic impact of monoshot and high molecular weight viscosuplementation in the management of knee osteoarthritis: Perspectives for the Brazilian Supplementary Health System
DOI:
https://doi.org/10.21115/JBES.v16.n3.p130-7Keywords:
knee osteoarthritis, intraarticular hyaluronic acid, costeffectiveness analysis, NASHA, supplementary health in BrazilAbstract
Introduction: Knee osteoarthritis (OA) is a chronic and degenerative condition that impacts patient quality of life. Viscosupplementation with high molecular weight hyaluronic acid (HA) using NASHA technology or Hylan G-F 20 technology can improve symptoms and delay the need for surgery. This study aimed to evaluate its cost-effectiveness in the Brazilian Supplementary Health System. Methods: A Markov model was constructed, following CHEERS guidelines, to compare intra-articular HA (IAHA) viscosupplementation with NASHA technology and Hylan G-F 20 technology for knee OA. A five-year time horizon with quarterly cycles was adopted. The model analyzed the incidence of surgery and mortality. Direct medical costs were considered through microcosting. A subgroup analysis was conducted to assess quarterly costs in outcomes of pain, medication reduction, and range of motion. Results: The annual use of IAHA with NASHA technology showed a lower incidence of surgeries (20.97%) compared to Hylan G-F 20 technology (23.02%), with a total cost calculated at R$ 16,819.59 versus R$ 20,599.29, respectively, standing out as a dominant option. In the subgroup, NASHA was dominant in the reduction of analgesics, presented improvements in pain intensity, reduction of NSAIDs, and range of motion with an incremental cost-effectiveness ratio of R$ 53.29, R$ 85.17, and R$ 293.10, respectively. Conclusion: IAHA with NASHA technology emerges as a more effective and economical therapeutic option for knee OA compared to IAHA with Hylan G-F 20, offering a cost-effective treatment strategy for the Brazilian supplementary health system.
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