Orthovisc

[bananaface]

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I am evaluating Orthovisc and making a formulary recommendation to a hospital pharmacy & therepeutics committee as a part of a medical liture evaluation course project and would like to solicit your input. Use of this drug would be reserved to those refratory to non pharmacologic treatments and simple analgesics. I lean towards recommending that the drug not be placed on formulary, because the cost:benefit ratio appears low (mostly because the efficacy isn't that great) and it doesn't seem to be something that would be used on-site on a regular basis. Does anyone have any opinions to the contrary?

Just to clarify, being off formulary at this institution would not mean the drug was unavailable for use. It would just mean that a prescriber would be consulted upon reciept of an order if they did not indicate DAW. Synvisc is not on formulary either. I don't know why one would favor Orthovisc over Synvisc, when Synvisc has a higher MW.

 

[SOUNDMAN]

I believe if you look at the studies for these Hyaluronic acid injections, there is a new big meta analysis out on them all. There are 4 total brands out I believe. Hyalgan, Synvisc, Orthovisc, and Supartz. I would definitely say the top 2 are Hyalgan and Synvisc. Synvisc has the possibility of an inflammatory reaction in a very small population, however most believe this is "operator error" meaning the injection didn't get in the joint.

Molecular weight DOES NOT correlate to increased benefit. If you look at the studies, you'll see this. Generally you see that 70% of people get some sort of relief for about 6-8 months, for any of the injections allthough supartz may be questionable.

If you are only looking at cost issue then supartz is probably the one to look at however there are some studies questioning it's efficacy and that it just doens't work as well as the others, even though it's been around the longest, and used the most for sure overseas.

Our office's personal preference is Hyalgan or Synvisc. But that's just me. Why not ask the docs what they want to use, or what preference they have?

 

[pharma marketer]

New studies correlate between MW and pharmacological actions e.g. anti-inflammatory, chondroprotective, analgesic, stimulating release of endogenous HA.

Mid-MW is highly recommended e.g. Hyalgan, the company mentions that it has an optimum MW.

New one-single-dose HA's are available in the market, but they are not approved from FDA, and they are very high MW.