OBJECTIVES

: Calculate the budgetary impact of delaying total knee replacement (TKR) in patients with severe knee osteoarthrosis (KO) (grade III and IV), without adequate response to non-pharmacological therapy or simple analgesics, who are candidates for treatment with Hylan GF-20, in comparison with low molecular weight hyaluronates (LMWHA) and corticosteroids since the Colombian Healthcare System perspective.

METHODS

Target population was patients over 60 years with severe KO (grade III and IV), without adequate response to non-pharmacological therapy or simple analgesics. A set of delaying TKR scenarios were simulated based on different time horizons, to show that Hylan GF-20, LMWAH and corticosteroids are related with different times to make patients need a TKR. Clinical data were obtained from literature. Direct medical and follow-up costs were obtained from public databases; 4 accumulated budget impacts were obtained for different time horizon scenarios (as if all patients had been treated during 3, 6, 8 or 10 years).

RESULTS

: 208.482 patients were calculated. Scenario 1: 9,75% of patients getting a TKR at year 3, with savings for US$ 56 million vs LMWAH and financial effort for US$ 28 million vs corticosteroids. Scenario 2: 19,5% of patients getting a TKR at year 6, with savings for US$ 119 million (US$102 million vs LMWAH and US$ 17 million vs corticosteroids). Scenario 3: 26% of patients getting a TKR at year 8, with savings for US$ 192 million (US$ 139 million vs LMWAH and US$ 53 million vs corticosteroids). Scenario 4: 32.5% of patients getting a TKR at year 10, with savings for US$ 265 million (US$ 175 million vs LMWAH and US$ 90 million vs corticosteroids).

CONCLUSIONS

: Potential savings were observed due the delay of TKR with Hylan GF-20 in comparison with LMWAH and corticosteroids. Savings were higher when the time horizon was longer.