,
Kevin Schlidt,
Michael Ha,
Kevin Zhu,
Ledibabari Ngaage,
Jessica El-Mallah,
Sami Tuffaha,
Yvonne Rasko
Background: Dupuytren’s contracture is a fibroproliferative disorder that often results in contractions of the fourth and fifth digits of the hand. While there is no definitive cure, symptomatic relief can be achieved via open fasciotomy, percutaneous aponeurotomy, or through collagenase Clostridium Histolyticum injections (CCH). Despite these therapeutic options, the insurance coverage of these modalities is not clearly defined. Methods: The authors evaluated American insurance companies’ coverage for the treatment of Dupuytren’s and compared the coverage of open fasciotomy, percutaneous aponeurotomy, or CCH. A cross-sectional analysis of US insurance policies for coverage of Dupuytren’s treatment was performed. Companies were selected based on those with the largest enrollment and their market share. Results: Of the 100 companies examined, only 5% of companies had an established policy that covered an open fasciotomy treatment, 6% had a policy that covered a percutaneous fasciotomy, whereas 37% had a policy for CCH. There were significantly more policies for CCH compared to open fasciotomy and percutaneous fasciotomy (CCH vs open fasciotomy: p<0.001; CCH vs percutaneous fasciotomy: p<0.001). The most common criterion for treatment options was the involvement of the MP joint or PIP (Open fasciotomy n = 5 (100%); percutaneous fasciotomy n = 5 (83.3%); CCH n = 30 (81.1%). Conclusion: There are noted coverage discrepancies between companies for the coverage of Dupuytren’s management. This variability is overall lacking in surgical, minimally invasive, and injection options.
| Published in | Advances in Surgical Sciences (Volume 12, Issue 2) |
| DOI | 10.11648/j.ass.20241202.12 |
| Page(s) | 51-56 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
Insurance, Dupuytren’s, Collagenase
| [1] | Mella JR, Guo L, Hung V. Dupuytren's Contracture: An Evidence Based Review. Ann Plast Surg. 2018; 81 (6S Suppl 1): S97-S101. |
| [2] | Grazina R, Teixeira S, Ramos R, Sousa H, Ferreira A, Lemos R. Dupuytren's disease: where do we stand? EFORT Open Rev. 2019; 4(2): 63-9. |
| [3] | Wilburn J, McKenna SP, Perry-Hinsley D, Bayat A. The impact of Dupuytren disease on patient activity and quality of life. J Hand Surg Am. 2013; 38(6): 1209-14. |
| [4] | Turesson C, Kvist J, Krevers B. Experiences of men living with Dupuytren's disease-Consequences of the disease for hand function and daily activities. J Hand Ther. 2020; 33(3): 386-93. |
| [5] | Dibenedetti DB, Nguyen D, Zografos L, Ziemiecki R, Zhou X. Prevalence, incidence, and treatments of Dupuytren's disease in the United States: results from a population-based study. Hand (N Y). 2011; 6(2): 149-58. |
| [6] | Walthall J, Anand P, Rehman UH. Dupuytren Contracture. StatPearls. Treasure Island (FL) ineligible companies. Disclosure: Prashanth Anand declares no relevant financial relationships with ineligible companies. Disclosure: Uzma Rehman declares no relevant financial relationships with ineligible companies.2023. |
| [7] | Denkler KA, Vaughn CJ, Dolan EL, Hansen SL. Evidence-Based Medicine: Options for Dupuytren's Contracture: Incise, Excise, and Dissolve. Plast Reconstr Surg. 2017; 139(1): 240e-55e. |
| [8] | Salari N, Heydari M, Hassanabadi M, Kazeminia M, Farshchian N, Niaparast M, et al. The worldwide prevalence of the Dupuytren disease: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2020; 15(1): 495. |
| [9] |
American Association for Hand Surgery. Dupytren's FOundation [cited 2021. Available from:
https://handsurgery.org/multimedia/files/public/dupuytren-foundation.pdf |
| [10] |
American Association for Hand Surgery. Dupuytren’s contracture FAQ. Available from:
https://handsurgery.org/multimedia/files/public/dupuytrencont.pdf |
| [11] | Drinane JJ, Gemoets D, Hoftiezer YAJ, Hoehn J, Eberlin KR. Initial Treatment Choice Affects Cost-Effectiveness and Reintervention Rates for Dupuytren Contracture: A National Census Among Veterans Affairs Patients. Hand (N Y). 2023; 18(5): 885-90. |
| [12] | Leafblad ND, Wagner E, Wanderman NR, Anderson GR, Visscher SL, Maradit Kremers H, et al. Outcomes and Direct Costs of Needle Aponeurotomy, Collagenase Injection, and Fasciectomy in the Treatment of Dupuytren Contracture. J Hand Surg Am. 2019; 44(11): 919-27. |
| [13] | Herrera FA, Benhaim P, Suliman A, Roostaeian J, Azari K, Mitchell S. Cost comparison of open fasciectomy versus percutaneous needle aponeurotomy for treatment of Dupuytren contracture. Ann Plast Surg. 2013; 70(4): 454-6. |
| [14] | Sefton AK, Smith BJ, Stewart DA. Cost Comparison of Collagenase Clostridium Histolyticum and Fasciectomy for Treatment of Dupuytren's Contracture in the Australian Health System. J Hand Surg Asian Pac Vol. 2018; 23(3): 336-41. |
| [15] | Yabroff KR, Valdez S, Jacobson M, Han X, Fendrick AM. The Changing Health Insurance Coverage Landscape in the United States. Am Soc Clin Oncol Educ Book. 2020; 40: e264-e74. |
| [16] | Brazzelli M, Cruickshank M, Tassie E, McNamee P, Robertson C, Elders A, et al. Collagenase clostridium histolyticum for the treatment of Dupuytren's contracture: systematic review and economic evaluation. Health Technol Assess. 2015; 19(90): 1-202. |
| [17] | van Rijssen AL, Werker PM. Percutaneous needle fasciotomy in dupuytren's disease. J Hand Surg Br. 2006; 31(5): 498-501. |
| [18] | Feldman G, Rozen N, Rubin G. Dupuytren's Contracture: Current Treatment Methods. Isr Med Assoc J. 2017; 19(10): 648-50. |
| [19] | Hirase T, Suresh R, Cotton MO, Han A, Burn MB, Harris JD, et al. Percutaneous Needle Fasciotomy versus Collagenase Injection for Dupuytren's Contracture: A Systematic Review of Comparative Studies. J Hand Microsurg. 2021; 13(3): 150-6. |
| [20] | Duquette S, Kuster R, Evans T, Wooden W, Munshi I, Cohen A, et al. Treatment of Dupuytren Contracture With Injectable Collagenase Within the Veterans Affairs System. JAMA Surg. 2017; 152(2): 204-5. |
| [21] | Zhao JZ, Hadley S, Floyd E, Earp BE, Blazar PE. The Impact of Collagenase Clostridium histolyticum Introduction on Dupuytren Treatment Patterns in the United States. J Hand Surg Am. 2016; 41(10): 963-8. |
| [22] | Cocci A, Russo GI, Salamanca JIM, Ralph D, Palmieri A, Mondaini N. The End of an Era: Withdrawal of Xiapex (Clostridium histolyticum Collagenase) from the European Market. Eur Urol. 2020; 77(5): 660-1. |
| [23] | Jones CA, Gray L, Liu K. Fertility treatment decision-making: the effect of insurance coverage for fertility medications. J Obstet Gynaecol Can. 2012; 34(11): 1066-72. |
| [24] | Shih B, Bayat A. Scientific understanding and clinical management of Dupuytren disease. Nat Rev Rheumatol. 2010; 6(12): 715-26. |
| [25] | Hueston JT. The table top test. Hand. 1982; 14(1): 100-3. https://doi.org/10.1016/s0072-968x(82)80053-3 |
| [26] | Townley WA, Baker R, Sheppard N, Grobbelaar AO. Dupuytren's contracture unfolded. BMJ. 2006; 332(7538): 397-400. |
APA Style
Hricz, N., Schlidt, K., Ha, M., Zhu, K., Ngaage, L., et al. (2024). Understanding the Insurance Landscape of Dupuytren’s Contracture Management. Advances in Surgical Sciences, 12(2), 51-56. https://doi.org/10.11648/j.ass.20241202.12
ACS Style
Hricz, N.; Schlidt, K.; Ha, M.; Zhu, K.; Ngaage, L., et al. Understanding the Insurance Landscape of Dupuytren’s Contracture Management. Adv. Surg. Sci. 2024, 12(2), 51-56. doi: 10.11648/j.ass.20241202.12
AMA Style
Hricz N, Schlidt K, Ha M, Zhu K, Ngaage L, et al. Understanding the Insurance Landscape of Dupuytren’s Contracture Management. Adv Surg Sci. 2024;12(2):51-56. doi: 10.11648/j.ass.20241202.12
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Download@article{10.11648/j.ass.20241202.12,
author = {Nicholas Hricz and Kevin Schlidt and Michael Ha and Kevin Zhu and Ledibabari Ngaage and Jessica El-Mallah and Sami Tuffaha and Yvonne Rasko},
title = {Understanding the Insurance Landscape of Dupuytren’s Contracture Management
},
journal = {Advances in Surgical Sciences},
volume = {12},
number = {2},
pages = {51-56},
doi = {10.11648/j.ass.20241202.12},
url = {https://doi.org/10.11648/j.ass.20241202.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20241202.12},
abstract = {Background: Dupuytren’s contracture is a fibroproliferative disorder that often results in contractions of the fourth and fifth digits of the hand. While there is no definitive cure, symptomatic relief can be achieved via open fasciotomy, percutaneous aponeurotomy, or through collagenase Clostridium Histolyticum injections (CCH). Despite these therapeutic options, the insurance coverage of these modalities is not clearly defined. Methods: The authors evaluated American insurance companies’ coverage for the treatment of Dupuytren’s and compared the coverage of open fasciotomy, percutaneous aponeurotomy, or CCH. A cross-sectional analysis of US insurance policies for coverage of Dupuytren’s treatment was performed. Companies were selected based on those with the largest enrollment and their market share. Results: Of the 100 companies examined, only 5% of companies had an established policy that covered an open fasciotomy treatment, 6% had a policy that covered a percutaneous fasciotomy, whereas 37% had a policy for CCH. There were significantly more policies for CCH compared to open fasciotomy and percutaneous fasciotomy (CCH vs open fasciotomy: ppn = 5 (100%); percutaneous fasciotomy n = 5 (83.3%); CCH n = 30 (81.1%). Conclusion: There are noted coverage discrepancies between companies for the coverage of Dupuytren’s management. This variability is overall lacking in surgical, minimally invasive, and injection options.
},
year = {2024}
}
TY - JOUR T1 - Understanding the Insurance Landscape of Dupuytren’s Contracture Management AU - Nicholas Hricz AU - Kevin Schlidt AU - Michael Ha AU - Kevin Zhu AU - Ledibabari Ngaage AU - Jessica El-Mallah AU - Sami Tuffaha AU - Yvonne Rasko Y1 - 2024/09/26 PY - 2024 N1 - https://doi.org/10.11648/j.ass.20241202.12 DO - 10.11648/j.ass.20241202.12 T2 - Advances in Surgical Sciences JF - Advances in Surgical Sciences JO - Advances in Surgical Sciences SP - 51 EP - 56 PB - Science Publishing Group SN - 2376-6182 UR - https://doi.org/10.11648/j.ass.20241202.12 AB - Background: Dupuytren’s contracture is a fibroproliferative disorder that often results in contractions of the fourth and fifth digits of the hand. While there is no definitive cure, symptomatic relief can be achieved via open fasciotomy, percutaneous aponeurotomy, or through collagenase Clostridium Histolyticum injections (CCH). Despite these therapeutic options, the insurance coverage of these modalities is not clearly defined. Methods: The authors evaluated American insurance companies’ coverage for the treatment of Dupuytren’s and compared the coverage of open fasciotomy, percutaneous aponeurotomy, or CCH. A cross-sectional analysis of US insurance policies for coverage of Dupuytren’s treatment was performed. Companies were selected based on those with the largest enrollment and their market share. Results: Of the 100 companies examined, only 5% of companies had an established policy that covered an open fasciotomy treatment, 6% had a policy that covered a percutaneous fasciotomy, whereas 37% had a policy for CCH. There were significantly more policies for CCH compared to open fasciotomy and percutaneous fasciotomy (CCH vs open fasciotomy: ppn = 5 (100%); percutaneous fasciotomy n = 5 (83.3%); CCH n = 30 (81.1%). Conclusion: There are noted coverage discrepancies between companies for the coverage of Dupuytren’s management. This variability is overall lacking in surgical, minimally invasive, and injection options. VL - 12 IS - 2 ER -
Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, The United States
Department of Surgery, Sinai Hospital of Baltimore, Baltimore, The United States
Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, The United States
Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, The United States
Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, The United States
Department of Surgery, Penn State College of Medicine, Hershey, The United States
Department of Plastic & Reconstructive Surgery, Johns Hopkins Hospital, Baltimore, The United States
Division of Plastic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, The United States
