A single-centre cost comparison analysis of collagenase injection versus surgical fasciectomy for Dupuytren's contracture of the hand.
OBJECTIVE
The options for treating patients with Dupuytren's contracture have broadened with the introduction of collagenase. Although the literature would suggest that collagenase treatment is effective, has few complications and is popular with patients, it has not been widely commissioned by the National Health Services of the United Kingdom and other European countries due to concerns about cost. The aim of this study was to compare the cost of surgical fasciectomy to collagenase injections for the treatment of Dupuytren's contracture in a single centre.


METHODS
Prospective data on 40 patients undergoing fasciectomy or collagenase injection (20 patients in each group) were collected between January and March 2013. Financial data on the costs of the procedures, equipment, theatre time and follow-up appointments were calculated.


RESULTS
The average cost of an open partial fasciectomy pathway was £ 7115.34 and that of a collagenase pathway was £ 2110.62. Eight collagenase patients had physician-led follow-up appointments and only three had hand physiotherapy appointments. By contrast, every fasciectomy patient had at least one physician and one physiotherapist follow-up appointment routinely.


CONCLUSIONS
The results of this study demonstrate that collagenase treatment for Dupuytren's contracture of a single digit in selected patients is just over £ 5000 less than treatment for the same condition using surgical fasciectomy. Collagenase-treated patients require much less physician- and physiotherapist-led postoperative follow-up.
Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH17 3DZ, UK. Electronic address: saahil47@gmail.com.
S
S
Mehta
Queen Victoria Hospital, Holtye Road, East Grinstead, West Sussex RH17 3DZ, UK.
H J C R
HJ
Belcher
D000359:Aftercare / Q000191:economics; D000368:Aged; D000369:Aged, 80 and over; D017364:Collagenases / Q000008:administration & dosage / Q000191:economics*; D004387:Dupuytren Contracture / Q000191:economics* / Q000534:rehabilitation / Q000628:therapy*; D000071938:Fasciotomy; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000191:economics; D011446:Prospective Studies
D017364:Collagenases
Collagenase; Cost; Dupuytren's contracture; Fasciectomy