Methods: This was a retrospective analysis of the Blue Cross/ Blue Shield (BCBS) claims database from October 1st, 2010 through September 30th, 2015. The primary outcome was the median annual OA related cost of healthcare for patients who received IA-HA vs those who did not for treatment of their knee OA. Additionally, annual costs for patients who have progressed to TKA will be compared between people who have received IA-HA and those who did not receive IA-HA prior to their TKA. Annual cost data specific to professional and facility claims between the two groups are also summarized. Due to the large sample size, comparisons between healthcare costs were conducted using Mann-Whitney U test.  The large sample size has eliminated the need to report p-values, as interpretability is minimal.

Results: A total of 744,734 patients were included in the analysis. Of these, 181,631 received IA-HA injections, while 563,103 did not receive an IA-HA injection. In all patients who received TKA, annual costs separated by professional and facility claims are included within Table 1. The analysis demonstrated that the annualized median healthcare costs of patients treated with IA-HA who progressed to TKA was $871.31 (IQR $3.82), while the annualized median healthcare costs of patients who did not receive IA-HA was $2697.28 (IQR $8.25). In all patients, the annualized costs over the course of the study timeframe was $22.20 (IQR $0- $71.52) for patients who received HA, and $21.12 (IQR $0 – $225.88) for patients who did not receive HA.

Conclusion: This database analysis concludes that from the initiation of treatment for knee OA until TKA, patients who receive IA-HA have a lower median annual healthcare cost than knee OA patients who do not receive IA-HA. In particular, for individuals who eventually progressed to TKA, receiving IA-HA prior to their TKA resulted in significantly lower annual healthcare costs than those who did not receive IA-HA as a treatment.

Table 1: Total Annual Costs for Included TKA Patients