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Why choose Xiaflex instead of NA?
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01/12/2013 15:29
callie 
01/12/2013 15:29
callie 
Why choose Xiaflex instead of NA?

I can't understand the reasoning (other than marketing for the associated drug company) for choosing Xiaflex instead of having NA? Don't both procedures have the same result of breaking the cord and leaving diseased tissue in the hand? Actually not much different than having a fasciotomy a hundred years ago, but less invasive.

Xiaflex in most cases is considerably more painful and invasive than NA and at a much greater cost. My idea is that Xiaflex was being developed when NA was in its infancy (or before) and now is being heavily marketed to recoup the costs of development and making a profit for the pharmaceutical companies. What could be the advantage of Xiaflex instead of NA? In my case, I would have surgery before Xiaflex.

01/12/2013 18:14
yosh01 
01/12/2013 18:14
yosh01 
Re: Why choose Xiaflex instead of NA?

Your reasoning is essentially the same as my hand surgeon's. He was trained in both, but only does NA due to its simplicity, effectiveness, and low cost.

01/12/2013 21:46
Randy_H 
01/12/2013 21:46
Randy_H 

Re: Why choose Xiaflex instead of NA?

What most of our existing Users/members here don't know is that it was a company called Bio Specifics that invented "collegenase" for Dups. As a marketing device they started a Patient forum which was effectively the predecessor to this one. Then, much to their chagrin, people who had done NA in France began to introduce the idea to other readers. It was through this effort that a patient gave a video of French NA to Dr. Eaton. This one act changed everything. Eaton was so amazed by what he saw he actually granted his patient's wish to try NA on her. He had no other influence other than that one video made my a patient.

This first US NA was so successful Eaton went to France to lean all he could from NA's inventors. The rest is history. BioSpecifics helped launch it in the US as a competitive procedure to their invention. I love the irony.

Many of us thought that the success of NA in the US would put a damper on the introduction of Xiaflex, but it didn't. And that goes to your reasoning Callie about why people would choose Xiaflex over NA. I agree, in most cases NA is equal to or superior to Xiaflex. How did the makers of Xiaflex get the insurance companies to agree to pay for Xiaflex when it's so much more expensive?

Marketing, Marketing, Marketing. They got the majority of Hand Surgeons to be interested in it when these same MD's rejected NA. Amazing!! This really opened my eyes to the influence that Big Pharma has in the medical community. There was no money behind NA because you can't patient it. Xiaflex on the other hand is worth spending millions on because it's makers are looking to recoup the cost of FDA approval and then making a good profit.

People, NA and Xiaflex do almost exactly the same thing. I have never heard a good argument put forth as to Xiaflex's superiority. Are there any out there that we can debate?


yosh01, your surgeon has it right and was not swayed by the cash behind Xiaflex. Anyone considering dong Xiaflex should look into NA and not trust a hand surgeon who has not been trained in both to have an unbiased opinion.

01/13/2013 02:46
hammer 
01/13/2013 02:46
hammer 
Re: Why choose Xiaflex instead of NA?

NA is not as effective on scar tissue as Xiaflex.Having had failed NA do to my scar tissue from all my surgeries.Xiaflex actually softens scar tissue and will bust them cords that NA just bounces off.Recurance with NA is alot shorter.Dr Bourland in Memphis was tellin me his patients come back every 3,6,9 12 months to be released.He coined it "like doin an oil change" He likes it a 1,000 bucks a pop.If all goes well he can do a release in 15 or 20 minutes and I was number 1,200 4 years ago.So dont think these fellas are on welfare doin the NA.If you could just see his office.Big Bucks.Dave

01/13/2013 03:28
callie 
01/13/2013 03:28
callie 
Re: Why choose Xiaflex instead of NA?

Maybe that is why I would prefer surgery to NA or Xiaflex, but again it depends on personal preference and how each is affected by Dupuytren's.

01/13/2013 08:02
wach 

Administrator

01/13/2013 08:02
wach 

Administrator

Re: Why choose Xiaflex instead of NA?

Actually, in Germany the coordinating health committee (G-BA) stated that there is no proven benefit of Xiaflex vs. NA and they would pay for Xiaflex only if it is sold at the price of NA. Consequently Xiaflex was withdrawn from the German market in May 2012 http://www.dupuytren-online.info/dupuytren_collagenase.html. Pfizer will completely withdraw from marketing collagenase in Europe by April 2013. Probably some other company will then market Xiaflex in Europe (the brand name in Europe is Xiapex).

I should add that German public insurances pay for NA only about 100 Euros (130 USD). That makes it a little tough to meet this price target with Xiaflex.

Wolfgang

Randy_H:
... How did the makers of Xiaflex get the insurance companies to agree to pay for Xiaflex when it's so much more expensive?

...


Edited 01/13/13 10:04

01/13/2013 12:22
hammer 
01/13/2013 12:22
hammer 
Re: Why choose Xiaflex instead of NA?

Wolfgang,what happens if NA does not work for you and there is no Xiaflex?If surgery is all that is left, then that will cost more than Xiaflex and NA put together.With every case being so different we need as many treatments as possible for people like me who fall between the cracks.I was poked at least 500 times while having NA performed on me,it went on for an hour or so.My wife had to leave the room,she couldnt watch him poke me anymore and she is a Registered Nurse.Then 4 Surgeries in 3 years.That wasnt working either.So 15 months ago I start Xiaflex injections.I had my hand measured just 3 days ago and my ring finger is at zero contracture,so in my case Xiaflex released the contracture when NA wouldnt and kept the contracture from comin back a lot longer than surgery did.My point is that one shoe doesnt fit all when it come to DD.I am scheduled for a multiple Xiaflex injection next Monday on my left hand that measures 100 degrees.I will keep you posted on my progress.Dave

01/13/2013 15:06
wach 

Administrator

01/13/2013 15:06
wach 

Administrator

Re: Why choose Xiaflex instead of NA?

hammer, I didn't argue against Xiaflex (had one myself a year ago) and agree with you that the more options the better for us patients. I just described the German situation. In German Dupuytren's surgery is mostly outpatient and then cheaper than Xiaflex. But surgery causes a major trauma and may e.g. trigger new nodules. Surgery is an important option but it should not be the only one.

BTW, getting 500+ stitches during NA is a lot. Also 1 hour is long. Maybe your Dupuytren's was extremely difficult. Where did you have NA done?

Regarding the a "multipe shoes treatment concept" you might have a look at http://www.dupuytren-online.info/dupuytr..._therapies.html. There is an attempt to a multiple treatment scheme for Dupuytren's.

Wolfgang

hammer:
Wolfgang,what happens if NA does not work for you and there is no Xiaflex?If surgery is all that is left, then that will cost more than Xiaflex and NA put together.With every case being so different we need as many treatments as possible for people like me who fall between the cracks.I was poked at least 500 times while having NA performed on me,it went on for an hour or so.My wife had to leave the room,she couldnt watch him poke me anymore and she is a Registered Nurse.Then 4 Surgeries in 3 years.That wasnt working either.So 15 months ago I start Xiaflex injections.I had my hand measured just 3 days ago and my ring finger is at zero contracture,so in my case Xiaflex released the contracture when NA wouldnt and kept the contracture from comin back a lot longer than surgery did.My point is that one shoe doesnt fit all when it come to DD.I am scheduled for a multiple Xiaflex injection next Monday on my left hand that measures 100 degrees.I will keep you posted on my progress.Dave

01/13/2013 17:01
hammer 
01/13/2013 17:01
hammer 
Re: Why choose Xiaflex instead of NA?

Dr Bourland in Memphis did my NA.WE dicussed it before doing it and I was his first failure.Scar tissue is a big concern with NA and alot of people are turned away because of previous surgery.So that leaves us Xiaflex,for now.Maybe someone is out there working on the Miracle cure right now and I bet it wont be cheap either.Just keep pluggin away one finger at a time thats all we can do.Dave

01/14/2013 07:23
wach 

Administrator

01/14/2013 07:23
wach 

Administrator

Old BioSpecifics forum

Hi Randy,

I just checked the old BioSpecifics forum. It still exists but does not support Dupuytren's and Ledderhose anymore but still Peyronie's and a couple of other diseases. Until 2005/2006 it had been used mostly by Dupuytren's patients but then drowned completely in spam, similar to the French NA forum. The posts of the old BioS forum have been archived here, without the spam.

Wolfgang

Randy_H:
What most of our existing Users/members here don't know is that it was a company called Bio Specifics that invented "collegenase" for Dups. As a marketing device they started a Patient forum which was effectively the predecessor to this one. Then, much to their chagrin, people who had done NA in France began to introduce the idea to other readers. It was through this effort that a patient gave a video of French NA to Dr. Eaton. This one act changed everything. Eaton was so amazed by what he saw he actually granted his patient's wish to try NA on her. He had no other influence other than that one video made my a patient.
...

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