To the Editor The Research Letter by Schmajuk et al1 includes important conceptual errors, which result in an inappropriate conclusion about the value of intra-articular hyaluronic acid injections for treating knee osteoarthritis. Foremost, the authors incorrectly use the term value. Value is specifically defined in health economics as the incremental cost of a treatment divided by its incremental effectiveness.2 Though the authors’ analysis of Medicare costs for intra-articular hyaluronic acid injections is interesting, their analysis does not include a denominator (ie, incremental effectiveness) and therefore cannot allow any estimation of value.
Band PA. Using Medicare Data to Understand Health Care ValueMeasures of Incremental Cost and Effectiveness are Both Needed to Estimate Value. JAMA Intern Med. 2015;175(3):462. doi:10.1001/jamainternmed.2014.7189