Healthcare Costs and Resource Use of Patients with Dupuytren Contracture Treated with Collagenase Clostridium Histolyticum or Fasciectomy: A Propensity Matching Analysis

Overview

Journal Clinicoecon Outcomes Res

Publisher Dove Medical Press

Specialty Health Services

Date 2020 Nov 12

PMID 33177851

Citations 5

Authors

Vladimir Zah

Jovana Pelivanovic

Simona Tatovic

Djurdja Vukicevic

Martina Imro

Jane Ruby

David Hurley

Affiliations

Soon will be listed here.

Abstract

Objective: Studies examining differences in US healthcare resource utilization (HCRU) and associated healthcare costs between collagenase clostridium histolyticum (CCH) and fasciectomy for Dupuytren contracture (DC) are limited. This study evaluated US HCRU and direct healthcare cost for the treatment of DC in privately insured patients using insurance claims.

Methods: This retrospective observational cohort study analyzed data from large nationwide insurance claims databases; it included individuals diagnosed with DC between July 1, 2011, and June 30, 2017, who were adults at index date (date of first treatment: CCH or fasciectomy). Participants had continuous health plan coverage 24 months pre-index and 12 months post-index date. All-cause and DC-related HCRU and healthcare costs from the payers' perspective were compared between propensity score-matched cohorts. Generalized linear models assessed factors associated with all-cause total healthcare costs.

Results: Of 83,983 patients diagnosed with DC, 1932 adults receiving fasciectomy and 953 adults receiving CCH were included. The mean ± standard deviation total all-cause healthcare cost was significantly lower with CCH than with fasciectomy (US$11,897 ± US$14,633 versus US$15,528 ± US$22,254, respectively; <0.001). After propensity score matching, 702 and 999 patients remained in the CCH and fasciectomy cohorts, respectively. In this analysis, all-cause and DC-related total costs were significantly lower in the CCH cohort versus the fasciectomy cohort (all-cause: US$11,044 ± US$12,856 versus US$12,912 ± US$19,237, respectively, =0.02; DC-specific: US$3417 ± US$3671 versus US$5800 ± US$4985, <0.001), mainly due to the lower frequency of outpatient visits. CCH treatment and the use of a consumer-driven healthcare plan were associated with lower healthcare costs.

Conclusion: Based on matched cohort data, adjusted 1-year healthcare costs for CCH-treated individuals were significantly lower compared with costs for fasciectomy-treated individuals.

Citing Articles

Collagenase injection versus limited fasciectomy surgery to treat Dupuytren's contracture in adult patients in the UK: DISC, a non-inferiority RCT and economic evaluation.

Dias J, Tharmanathan P, Arundel C, Welch C, Wu Q, Leighton P Health Technol Assess. 2024; 28(78):1-262.

PMID: 39644138 PMC: 11647555. DOI: 10.3310/KGXD8528.

Randomized Controlled Trial Comparing the Clinical Effectiveness of Collagenase Injection (Xiaflex) and Palmar Fasciectomy in the Management of Dupuytren's Contracture.

Thoma A, Murphy J, Gallo L, Ayeni B, Thabane L Plast Surg (Oakv). 2024; 32(4):659-666.

PMID: 39430272 PMC: 11489938. DOI: 10.1177/22925503231161066.

Analysis of a National Database Investigating Development of Trigger Finger after Treatment of Dupuytren Disease.

Gehring M, Constantine R, Le E, Wolfe B, Greyson M, Iorio M Plast Reconstr Surg Glob Open. 2023; 11(6):e5063.

PMID: 37313482 PMC: 10259645. DOI: 10.1097/GOX.0000000000005063.

Real-world Medicare Healthcare Costs of Patients with Dupuytren's Contracture Treated with Collagenase or Fasciectomy.

Zah V, Stanicic F, Ruby J, Vukicevic D, Hurley D Plast Reconstr Surg Glob Open. 2022; 10(8):e4480.

PMID: 35999874 PMC: 9390814. DOI: 10.1097/GOX.0000000000004480.

Oral doxycycline prevents skin-associated adverse effects induced by injectable collagenase in a rodent model of capsular contracture around silicone implants.

Diehm Y, Kotsougiani-Fischer D, Porst E, Haug V, Siegwart L, Overhoff D PLoS One. 2022; 17(7):e0270112.

PMID: 35793344 PMC: 9258873. DOI: 10.1371/journal.pone.0270112.

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