Currently, there are seven hyaluronate acid products that have been approved by
the U.S. Food and Drug Administration (FDA) to treat osteoarthritis of the
knee: Euflexxa[
]?[], Gel-One[
]?[], Hyalgan[
]?[], Orthovisc[]?[], Supartz[]?[], Synvisc[]?[], and Synvisc-One[]?[]. These products have demonstrated
equivalent therapeutic results when used for this indication.
Effective April 1, 2013, IBC has designated Orthovisc[]?[],
Synvisc[]?[], and Synvisc-One[]?[] as our preferred
hyaluronate acid products for the treatment of osteoarthritis of the knee.
These preferred products were selected based on their demonstrated
cost-effectiveness. Choosing one of these preferred products does not affect
the member?s costsharing for the drug.
We encourage providers to choose one of the three preferred products when
treating members who have osteoarthritis of the knee.
At this time, we will continue to cover all seven hyaluronate acid products in
accordance with the criteria listed in the Medical Policy #11.14.07i:
Intra-articular Injection of Hyaluronan for the Treatment of Osteoarthritis.
For more details about the medical policy on hyaluronate acid products, visit
the []Medical Policy Portal[],
select Accept and Go to Medical Policy Online, and then type the policy name or
number in the Search box.