OrthogenRx, Inc., today announced that “The Journal of Bone and Joint Surgery (JBJS)” has published a response in the journal’s Orthopaedic Forum, titled “Consequences on Private Insurance Coverage: The AAOS Clinical Practice Guidelines and Hyaluronic Acid Injection”, authored by C. Thomas Vangsness Jr., MD, Thomas C. Adamson III, MD, FACP and OrthogenRx Co-CEO, Michael Daley, PhD.
The purpose of the response is to point to a more judicious approach for the treatment of OA knee pain highlighting: 1) The need for a more comprehensive treatise to include considerations from recent publications, 2) Additional considerations of the risks and benefits for the target patient population of all treatment options for treating chronic OA knee pain, and 3) Reported benefits that might be afforded by intra-articular (IA) hyaluronic acid (HA) therapy. The full article can be found here.
“We continue to focus on optimizing patient care & access, and believe that IA HA plays a central role in the armamentarium for clinicians in the optimal management of OA knee pain,” said Michael Daley, Ph.D., co-CEO at OrthogenRx. “Clinical Practice Guidelines (CPGs) can be useful but can also lead to denying coverage which effectively denies patient access to safe and effective treatment options. We believe this is an unintended consequence of CPGs and is clearly not in the best interest of patients.”
A previously published study, Impact of Clinical Practice Guidelines on Use of Intra-Articular Hyaluronic Acid and Corticosteroid Injections for Knee Osteoarthritis, Bedard et al. (2018) examines the impact of the 2013 American Academy of Orthopedic Surgeons (AAOS) Clinical Practice Guidelines (CPGs) on intra-articular treatment for osteoarthritis knee pain over the past 5 years. The study investigators concluded “Subtle but significant changes in hyaluronic acid injections occurred following the publication of the clinical practice guidelines.” The authors cited that decreased utilization of HA injections may have been warranted due to the cost of treatment and questionable efficacy.
The recently published response counters this position and addresses some recently reported economic and medical benefits not acknowledged within the AAOS CPGs. The response also documents the negative impact of the recommendations on private insurance coverage decisions for almost 30% of the insured U.S. patients.
The authors of the published response state: “We believe that eliminating the use of IA HA as one of the nonsurgical treatment options available to clinicians would not be prudent. While there may be some debate on the efficacy of HA injections, several meta-analyses and systematic reviews support their use with minimal safety concerns.”
OrthogenRx continues to advocate for the use of HA injections as a safe, effective, and cost-considerate treatment for reducing the effects of OA knee pain.