DOI: 10.36347/SAJP.2019.v08i11.003

Pages: 479-487

Objective: The main aim of this cohort study was to determine which option is more cost-effectiveness for treatment of Dupuytren´s contracture (DC); partial fasciectomy (FSC) or a single administration of collagenase Clostridium Histolyticum (CCH), with a six months follow-up thereafter. Material and Methods: The cohort study prospective compared FSC patients (n= 48) and CCH patients (n= 43). Incremental cost-utility ratios (ICUR) was calculated based on a case-control study (CCH vs. FSC) and extrapolated to a life-time horizon, adjusted by age and sex. We performed a deterministic, probabilistic (bootstrapping method) and structural sensitivity analysis to validate our results. Results: The effectiveness observed in patients who underwent FSC was 87.5% and 67.4% for those who received a CCH infiltration, with similar complications (18%). The average cost per patient in the CCH group was of 1168.19€ (CI95%: 1131.63 to 1204.74€) and 1420.19€ (CI95%: 1411.41 to 1428.97€) for FSC group. The most influential variable is the acquisition cost of CCH. If threshold decision is 20000 or 30000€/QALY, the probability to choose CCH versus FSC at finish follow-up is over 50%. Conclusions: We conclude that one CCH injection is a costeffectiveness alternative in the treatment of DC in comparison to FSC.