Cost-Effectiveness of Different Forms of Intra-Articular Injections for the Treatment of Osteoarthritis of the Knee.
Cost-Effectiveness of Different Forms of Intra-Articular Injections for the Treatment of Osteoarthritis of the Knee.
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DOI：
10.1007/s12325-016-0331-8
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发表时间：
2016-06
影响因子：
3.8
通讯作者：
Bedi A
中科院分区：
文献类型：
--
作者：
Rosen J;Sancheti P;Fierlinger A;Niazi F;Johal H;Bedi A
骨关节炎（OA）是导致残疾的主要原因之一，它降低了患者的生活质量，并造成了巨大的经济负担。关节内透明质酸（HA）可以缓解骨性关节炎的症状，并规定了多种透明质酸产品。本研究的目的是检查单一付款人的成本效益的各种HA产品在治疗膝关节OA。对Synvisc®（赛诺菲，美国）、Durolane®（Bioventus，美国）、Hyalgan®（Fidia Pharma Inc.，美国）、Supartz™（Bioventus，美国）和Euflexxa®（Ferring Pharmaceuticals Inc.，美国）进行单一付款人经济评价。通过从随机对照试验中提取西安大略省和麦克马斯特大学关节炎指数疼痛、僵硬和功能，并将其转换为健康效用指数3分，获得HA产品的效用评分。治疗费用包括HA注射的费用、膝关节注射的费用和每次注射所需的医生就诊费用。计算每个HA产品在2015年节省的每质量调整生命年（QALY）的成本效用，并计算增量成本效益比，以比较HA产品之间的有效性以及与传统护理的有效性。与传统护理相比，假设愿意支付门槛为50,000美元/QALY，所有被调查的HA产品都具有成本效益。与所有其他HA品牌相比，HA产品Euflexxa具有最有利的成本效用比（5785.52美元/QALY）。目前的研究表明，与传统护理相比，几种透明质酸产品具有成本效益，与其他透明质酸产品相比，Euflexxa具有最有利的成本/质量增益比。费林制药有限公司本文的在线版本（doi:10.1007/s12325-016-0331-8）包含补充资料，仅供授权用户使用。
Osteoarthritis (OA), as one of the leading causes of disability, decreases the quality of life for those suffering from the disease and creates a substantial financial burden. Intra-articular hyaluronic acid (HA) can provide relief from the symptoms of OA and multiple HA products are prescribed. The purpose of this study is to examine the single payer cost-effectiveness of various HA products in the treatment of knee OA. A single payer economic evaluation was conducted comparing Synvisc® (Sanofi, USA), Durolane® (Bioventus, USA), Hyalgan® (Fidia Pharma Inc., USA), Supartz™ (Bioventus, USA), and Euflexxa® (Ferring Pharmaceuticals Inc., USA). Utility scores for HA products were obtained by extracting Western Ontario and McMaster Universities Arthritis Index pain, stiffness and function from randomized controlled trials and converting them to health utilities index mark 3 scores. The cost of a treatment included the cost of the HA injection, cost of a knee injection procedure and cost of a doctor’s visit for each required injection. Cost–utility in 2015 USD per quality-adjusted life years (QALY) saved was calculated for each HA product, and incremental cost-effectiveness ratios were calculated to compare the effectiveness of HA products to one another and to conventional care. When compared to conventional care, all investigated HA products were cost-effective, assuming a willingness-to-pay threshold of $50,000/QALY gained. The HA product Euflexxa had the most favorable cost–utility ratio ($5785.52/QALY) when compared to all other HA brands. The present study showed several HA products to be cost-effective in comparison to conventional care, with Euflexxa having the most favorable cost/QALY gained ratio compared to the other HA products. Ferring Pharmaceutics Inc. The online version of this article (doi:10.1007/s12325-016-0331-8) contains supplementary material, which is available to authorized users.