Trial reportValue in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research2026
The Cost-Effectiveness of Collagenase Injection Versus Limited Fasciectomy for Moderate Dupuytren's Contracture: An Economic Evaluation of the Dupuytren's Interventions Surgery Versus Collagenase Trial and a Decision Analytical Model.
Trial report in Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
8 authors.
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Abstract
objectivesTo compare the cost-effectiveness of collagenase injection (collagenase) and limited fasciectomy (LF) surgery in treating moderate Dupuytren's contracture (DC) in the United Kingdom over different time horizons.
methodsAn incremental cost-effectiveness analysis was conducted alongside a multicenter, pragmatic, parallel randomized controlled trial (Dupuytren's Interventions: Surgery versus Collagenase trial), to determine the short-term cost-effectiveness of collagenase compared with LF. A Markov decision analytic model was developed to assess long-term cost-effectiveness.
resultsCollagenase was associated with significantly lower cost and insignificantly lower quality-adjusted life-year (QALY) gain compared with LF at 1 year. The probability of collagenase being cost-effective was more than 99% at willingness-to-pay thresholds of £20 000 to £30 000 per QALY. At 2 years, collagenase was both significantly less costly and less effective compared with LF, and LF became cost-effective above a threshold of £25 488. There was a high level of uncertainty surrounding the 2-year results. Over a lifetime horizon, collagenase generated a cost saving of £2968 per patient but was associated with a mean QALY loss of -0.484. The probability of collagenase being cost-effective dropped to 22% and 16% at £20 000 to £30 000 per QALY, respectively.
conclusionsCollagenase was less costly and less effective than LF in treating Dupuytren's contracture. The cost-effectiveness of collagenase compared with LF was time dependent. Collagenase was highly cost-effective 1-year after treatment; however, the probability of collagenase being cost-effective declined over time. The Markov model suggested that LF is more cost-effective over a lifetime horizon. These findings emphasize the importance of longer follow-up when comparing surgical and nonsurgical interventions to fully capture overall costs and benefits.
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