Purpose
To examine the cost-effectiveness of a series (total of 3 injections) of intra-articular
platelet-rich plasma (PRP) injections in comparison to that of hyaluronic acid (HA)
viscosupplementation for the treatment of symptomatic knee osteoarthritis.
Methods
Outcome data regarding the use of PRP or HA injections for the treatment of symptomatic
knee osteoarthritis were determined from the highest-quality data (Level I) available
in the literature until 2015. Health utility values were then derived from these high-quality
data. Costs were determined by examining typical charges for patients undergoing a
series of either PRP or HA injections for the treatment of this condition at a large
private orthopaedic practice. These health utility values and costs were used to create
an expected-value decision analysis model.
Results
The results of the model revealed that the cost per quality-adjusted life-year (QALY)
of a series of PRP injections was $8,635.23/QALY and that of a series of HA injections
was $5,331.75/QALY. A series of PRP injections was associated with a higher initial
cost than a series of HA injections (difference, $1,433.67); however, PRP was also
more effective (higher utility value) than HA by 0.11 QALYs (0.69 vs 0.58, P = .0062) at 1 year. The incremental cost-effectiveness ratio of the use of PRP injections
as opposed to HA was $12,628.15/QALY.
Conclusions
Although a series of either PRP ($8,635.23/QALY) or HA ($5,331.75/QALY) injections
for the treatment of symptomatic knee osteoarthritis would be considered cost-effective
(cost per QALY < $50,000), PRP injections were not more cost-effective than HA injections.
However, PRP was significantly more effective at 1 year, and being associated with
an incremental cost-effectiveness ratio of $12,628.15/QALY when compared with HA,
a series of PRP injections should be considered a reasonable and acceptable alternative
to HA injections for the treatment of symptomatic knee osteoarthritis.
Level of Evidence
Level II, economic and decision analysis of Level I studies.
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Article info
Publication history
Published online: July 25, 2020
Accepted:
July 18,
2020
Received:
February 12,
2020
See commentary on page 3079Footnotes
The authors report no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2020 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Platelet-Rich Plasma and Hyaluronic Acid Injection for Knee Osteoarthritis Are Both Cost EffectiveArthroscopyVol. 36Issue 12
- PreviewKnee osteoarthritis is associated with an annual cost to society exceeding US$27 billion. Value-based treatment is an important consideration, and cost-benefit analyses are crucial to determine the benefits to both patients and society. The quality-adjusted life year (QALY) is a generic measure of burden including both quality and quantity. Recent studies have suggested that intra-articular injection of platelet-rich plasma (PRP) is effective treatment for knee osteoarthritis and comparable to hyaluronic acid (HA).
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