Knee OA management: A cost-effectiveness analysis of platelet-rich-plasma versus hyaluronic acid for the intra-articular treatment of knee OA in France

Objectives: The aim of this work is to carry out an economic evaluation of the intra-articular (i.a.) use of the platelet-rich plasma (PRP) therapy in the short period treatment for knee osteoarthritis (OA). Recently the scientific literature has shown the effectiveness of this treatment. The comparator adopted is the Hyaluronic acid (HA) which represents the standard i.a. therapy. Methods: A cost-effectiveness analysis was performed using a decision tree model. The effectiveness outcomes are reported in terms of Quality Adjusted Life Year (QALY). The costs are reported in Euro (€) currency evaluated in 2016. Deterministic and probabilistic sensibility analyses are reported in order to evaluate the robustness of the results and account for the different sources of uncertainty. Results: The PRP therapy results more costly but also more effective than HA. Using a Willingness to pay thresholds of € 10,000/QALY, the PRP is cost-effective with respect to HA, for patient with moderate to severe knee OA, presenting an Incremental Cost Effectiveness Ratio (ICER) of €760 per QALY.