Scottish Medicines Consortium Approves Pfizer’s Xiapex

The Scottish Medicines Consortium (SMC) has authorised the use of Pfizer’s Xiapex (collagenase clostridium histolyticum) on the NHS for patients with Dupuytren’s contracture, reversing their earlier decision to reject the drug.

Xiapex is the first medication available for the condition, which previously was only treatable with surgery, meaning that the SMC’s endorsement good news for patients who are entitled to receive it.

Dupuytren’s contracture is a progressive disease that affects the connective tissue beneath the skin in the palm. As the disease progresses, collagen deposits form a cord that stretches from the palm to the base of the finger, causing them to contract.

The condition affects roughly two million people across the UK, and can harm a person’s capability to carry out everyday tasks such as driving, washing or shaking hands.

The Scottish Medicines Consortium has endorsed Xiapex as an alternative for adult patients with Dupuytren’s contracture of moderate severity, who have a palpable cord and up to two affected joints per hand and are suitable for limited fasciectomy (removal of part of the cord), but for who percutaneous needle fasciotomy (dividing the cord without excision) is not considered a possibility.

Application resubmitted

The backing for controlled NHS use follows a resubmission by Pfizer in January this year, after the Scottish Medicines Consortium decided that the use of Xiapex within its licensed indication and up to two affected joints per hand as a substitute for established surgical interventions would not be a cost effective use of funds.

In their submission, Pfizer estimated that treatment with their medicine would cost £1,723, whereas a fasciectomy, in comparison, would cost £2,560, resulting in savings of £837 per patient, although the agency noted that weaknesses in the comparison meant the cost-minimisation analysis is uncertain.

Still, the economic case deliberated was valid for the new target patient population proposed in the submission, the SMC added.


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