As previously communicated in a
Partners in Health UpdateSM
article, as of January 1, 2020, our medical policy on hyaluronate acid (HA) products reflects new coverage criteria, including the addition of Monovisc® as a fourth preferred product in the HA class, along with Orthovisc®, Synvisc®, and Synvisc-One®. As a result, Monovisc®
no longer requires precertification for AmeriHealth members.
Medical Policy #11.14.07u: Intra-Articular Injection of Hyaluronan for the Treatment of Osteoarthritis is
effective as of January 1, 2020.
Background
There are sixteen HA products that have been approved by the U.S. Food and Drug Administration to treat osteoarthritis of the knee:
- Durolane®
- Euflexxa®
- Gel-One®
- Gelsyn-3™
| - GenVisc 850®
- Hyalgan®
- Hymovis®
- Monovisc®
| - Orthovisc®
- Supartz®
- Synojoynt™
- Synvisc®
| - Synvisc-One®
- Triluron™
- TriVisc®
- VISCO-3™
|
Although there are many HA products on the market for the treatment of osteoarthritis of the knee, there is no reliable evidence of the superiority of any one brand compared to the others.
Coverage criteria
All HA products are eligible for coverage in accordance with the member’s benefit plan and the criteria listed in our medical policy. Cost-sharing (e.g., copayment, deductible, and coinsurance) applies to all HA products for members who are enrolled in Commercial FLEX products and select plans that have a cost-share component.
Learn more
To view this medical policy, visit our
Medical Policy Portal.