Case #272

Updated by Martti Virtanen about 5 years ago

National ID: HD-0034
Initiated: 2014-02-24
Initiator: Norwegian Directorate of Health

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*Problem*

A new conservative treatment for Dupuytren’s contracture has been introduced. The actual product is called Xiapex, administered by local injection of collagenase. Around 24 hours after the injection, the finger can then be straightened by performing a ‘finger extension procedure’ whereby it is stretched out for around 10 to 20 seconds to help disrupt the cord. Only one cord should be treated at a time. If one injection and finger extension has not brought about a satisfactory response, the procedure may be repeated at monthly intervals up to a maximum of three injections per cord.

It has been possible to register the treatment since 2012 with a Norwegian procedure code WBGM70 combined with ATC-code, but the registration is not complete and we don’t know with certainty how often this treatment is used. Our data indicates a frequency on appr. 3000 cases per year.

The cost for one injection is about 9000 NOK. The Norwegian hospitals have therefore suggested that cases with this treatment should be assessed in a “better” DRG.

*Analysis*

*Suggestion*

*Norwegian directorate of health – 2014-02-25*

We suggest that NordDRG Experts discuss a potential DRG assessment for Xiapex treatment.
We have no idea about the treatment practice in other Nordic countries, and whether other countries have identified this issue.

*Decided changes*

*DRG change*

To be discussed.

*Technical change*

*Introduction*

NordDRG [year] [version]

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