University of Malta. Department of Pharmacy & The Malta Pharmaceutical Association
Abstract
Objective: To evaluate whether collagenase injections
would be a cost-effective alternative to surgery for
Dupuytren’s contracture in Malta.
Method: An average of fifty patients per year requires
surgery to correct Dupuytren’s contracture in Malta. The
price of collagenase injections was obtained from published
pharmacoeconomic studies in Spain, United Kingdom and
United States. The cost to treat multiple affected joints
using collagenase injections at the different prices was
compared to the costs associated with surgery in both
the government and private hospital setting. A proposed
price at which collagenase injections would be more costeffective
than surgery to treat two affected joints in Malta
was calculated.
Key findings: The cost of surgery in the private
hospital setting is significantly higher than that in the
government hospital setting. The price of collagenase in the
United States is significantly higher than in Europe. At the
prices available in Europe, collagenase use in Malta would
not confer significantly increased costs when treating one,
two or three affected joints, both in the government and
private hospital setting. Treating two affected joints rather
than one affected joint does not significantly increase
costs, however treating three affected joints significantly
increases costs, in both hospital settings. For collagenase
injections to be cost-effective in Malta, they would need to
be priced at 77 Euro per vial or less.
Conclusion: If all patients were to be administered
the injection instead of undergoing surgery, the hospital
would be able to accommodate 20 additional total knee
replacements each year. With surgery costs in Malta being
much less than in other European countries, there could
be a possibility for Malta to attract patients from other
countries. Collagenase injections would offer a less invasive
treatment for the patients, and if priced at 77 Euro per vial
or less, would provide a more cost-effective option to the
government hospital.peer-reviewe