Hyaluronic acid/viscosupplementation

Viscosupplementation, which involves an injection of hyaluronic acid (HA), provides an alternative to NSAIDs and corticosteroid injection, both of which have potential undesirable side effects and/or other drawbacks. HA is a normal component of synovial fluid and cartilage that acts as both a joint lubricant and a shock absorber.

Hyaluronic acid/Viscosupplementation for osteoarthritis of the knee was first reviewed by the HTA program in 2010.

  • In 2013, the HCA director selected hyaluronic acid/viscosupplementation for rereview based on a systematic review and meta-analysis that could change the original coverage determination.
  • In 2022, the HCA director selected hyaluronic acid for rereview for osteoarthritis treatment based on published evidence that could change the original coverage determination.

Status: Decision completed

Why is HA being reviewed?

Hyaluronic acid preparations have been approved by the Food and Drug Administration (FDA) for treatment of pain associated with osteoarthritis (OA) of the knee in patients who have not had an adequate response to nonpharmacological, conservative treatment and simple analgesics. No new indications have been approved since the 2010 report.

Primary criteria ranking

  • Safety = Medium
  • Efficacy = Medium
  • Cost = Medium

Documentation

Assessment timeline

  • Draft key questions published: October 13, 2022
    • Public comment period: October 13 to 27, 2022
  • Final key questions published: November 29, 2022
  • Draft report published: May 11, 2023
    • Public comment period: May 11 to June 12, 2023
  • Final report published: June 26, 2023
  • HTCC public meeting: July 21, 2023
  • Draft findings and decision published: July 27, 2023
    • Public comment period: July 27 to August 10, 2023
  • Final findings and decision published: November 20, 2023

 

All future dates are estimates and subject to change.