Trevb

Those of us who have followed the Collegenase journey for four of five years have seen this product sputter far too often. The trials are on. The trials are off. And on it goes.

That said, we have so much conformation that the trials are now resumed in earnest it's hard not to be hopeful. Still, even after the trials are finished it takes some time for final FDA approval. If I had to take a stab at it I'd say between 12-24 months from now. After six years in "the pipeline", that's almost as soon as tomorrow!

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Trevb

Those of us who have followed the Collegenase journey for four of five years have seen this product sputter far too often. The trials are on. The trials are off. And on it goes.

That said, we have so much conformation that the trials are now resumed in earnest it's hard not to be hopeful. Still, even after the trials are finished it takes some time for final FDA approval. If I had to take a stab at it I'd say between 12-24 months from now. After six years in "the pipeline", that's almost as soon as tomorrow!

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That's good news for people like me who have Dups in their one good hand which hasn't yet got contracture. I wonder if it was only available in the USA initially whether we'd see patients travelling over there, much like they went to France for NA or Germany for radiotherapy


Edited at 13.11.07 17:34

I always try to remain positive Jim on things that are vital to my well-being and this sure fits that category. If it was a financial donkey then I wouldn't have thought that we'd have got to the late stage we now seem to be at? I have to say that in life generally my glass is half empty. I'm prepared to take the opposite view for one time only with this and keep everything crossed I hope that my optimism isn't misplaced?

Does anyone know why it appears so difficult and expensive to produce this stuff. How much would a course cost if it is ever available

Edited at 14.11.07 17:13

I'm actually somewhat optimistic. BSTC/Auxilium execs have "worked" investors for many millions over the last 10 years, but in some maddengly slow way they continue inching towards the market. At this point, stalling the trials again on some pretext might cost them too much credibility to launch another round of fundraising.

The cost? In one of their glowing investor presentations, Auxilium stated that this drug should "command a premium price" as the only alternative to surgery. And that's clearly their plan. Insurance companies may decide to grant them that price if it's $10 below conventional surgery and PT.

BUT - Collagenase is in some ways a crude solution - you inject it into the cord and hope it disolves enough of it to allow it to be snapped. If the first injection doesn't do it, you pony up another $1,000 and shoot again, or give up. You can only have a very small number of these injections, lest they leak out and damage good tissue. Insurance companies might decide to fund only a couple of injections.

A skillful NA practicioner can keep sawing at that cord until it gives up. He's in full control of the cutting tool, it isn't just an injected chemical mindlessly dissolving its way through the tissue. As these guys acquire experience, they're going to get even better at releasing difficult contractures.

I think insurance will continue to pay for NA, especially if it's cheaper than collagenase. I also think NA can and should become even less expensive than it is today. Remember the Europeans have been doing it for decades for a fraction of the cost here in the U.S.

Right - the French MDs doing this procedure, whom I first learned about 10 years ago, were rheumatologists, not surgeons. We're incredibly uptight about medicine in this country, and we pay a big financial price for it. Sure this is an invasive procedure, but so is a root canal. In fact, I think a root canal is probably a lot riskier. It would be great to have heavyweight hand surgeons like Dr. Charles Eaton study, perfect and teach this procedure, but I think it could probably be safely performed by many skilled MDs.