PBAC's latest decision on Hylan g-f 20: Not recommended (2006). Considered for intra-articular treatment for osteoarthritis of the knee in patients who have not responded to non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections, or are unable to take NSAIDs or receive corticosteroid injections for safety reasons.
PBAC outcome
Not recommended
2006
ICER (AUD/QALY)
$45k/QALY
Range: $15k/QALY–$45k/QALY
Submissions
1
first 2006
Submissions
1
2006 → 2006
Eligible population
patients with osteoarthritis of the knee who have not responded to NSAIDs or corticosteroid injections, or are unable to take NSAIDs or receive corticosteroid injections for safety reasons
Therapy area
Musculo-skeletal
Evidence base
RCT
Primary endpoint
pain on weight bearing (WOMAC assessment scale)
Key trials
six trials comparing hylan G-F 20 and saline or placebo; two trials comparing hylan G-F 20 and NSAIDs; two trials comparing hylan G-F 20 and intra-articular corticosteroids; two trials comparing hylan G-F 20 and 'conventional' care
Comparator
all standard non-pharmacological and pharmacological therapies including NSAIDs and corticosteroid injections
Economic model
CUA, CEA
Why PBAC said no
Reasons cited in the latest PSD: uncertain clinical benefit, uncertain and unacceptable cost-effectiveness, observer bias in pragmatic trial, small and doubtful clinical importance of benefit, largest longest-follow-up trial did not demonstrate statistically significant difference, no information on important outcomes such as ability to exercise or activities of daily living, uncertainty over predicted usage