Chondroitin sulfate in osteoarthritis

Jacobsen JH, McLeod R, Scarfe A, Vreugdenburg T, Tivey D
Record ID 32018000307
Authors' objectives: Chondroitin sulfate (CS) is available in Switzerland through mandatory health insurance for patients diagnosed with symptomatic osteoarthritis. The clinical effectiveness of CS, and consequently its reimbursement status, are being reviewed considering recently published evidence. To inform the coverage policy decision, this health technology assessment (HTA) report investigates the efficacy, effectiveness, safety, costs and cost-utility of CS used to treat osteoarthritis in the knees, hips and hands. Legal, social, ethical and organisational issues are also explored.
Authors' results and conclusions: The clinical findings of this report are extracted from a substantial body of evidence of low to moderate quality. Patients treated with CS report slightly greater reductions in osteoarthritic pain up to 6 months compared to placebo, but no difference compared to NSAIDs. The relative benefits are not demonstrated beyond 6 months. The rate of serious adverse events related to CS use is low, noting that this estimate is based on evidence with limited sample sizes and 12 months of follow-up. Results of the economic and budget impact analyses should be interpreted with caution given the limitations in the evidence base and uncertainty in the findings. CS is associated with a 60% probability of being cost-effective compared to placebo, and a 34% probability of being superior to COX-2 selective NSAIDs. The impact that delisting CS will have on the overall healthcare budget depends on the number of patients that change to alternative medications reimbursed through the mandatory health insurance.
Authors' methods: Safety, effectiveness and efficacy were assessed from 26 randomised controlled trials (RCTs). A cost-utility analysis compares CS to placebo and cyclooxygenase-2 (COX-2) inhibitors in patients with knee osteoarthritis. Other indications (hips and hands) are not modelled due to the absence of available clinical data.
Project Status: Completed
Year Published: 2021
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Switzerland
MeSH Terms
  • Chondroitin Sulfates
  • Osteoarthritis
  • Cost-Benefit Analysis
  • Joint Diseases
  • PROMs
  • efficacy
  • effectiveness
  • safety
  • costs
  • economics
  • cost-effectiveness
  • budget impact
  • legal
  • social
  • ethical
  • organisational
  • chondroitin
  • chondroitin sulfate
  • osteoarthritis
  • knee
  • hip
  • hand cartilage
  • glycosaminoglycan
  • joint disease
Organisation Name: Swiss Federal Office of Public Health (FOPH)
Contact Address: Federal Office of Public Health, Schwarzenburgstrasse 157, CH-3003 Berne, Switzerland
Contact Name: Stephanie Vollenweider
Contact Email:
Copyright: Swiss Federal Office of Public Health
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.