SAN FRANCISCO (Dow Jones)--Auxilium Pharmaceuticals Inc. (AUXL) continues to anxiously await a Food and Drug Administration decision on Xiaflex in treating a hand disorder, but the company said it remains confident the drug will get approved and is prepared for its launch.

The Malvern, Pa., biotech has been waiting for a decision since the fall, after an FDA panel of outside experts recommended approval of the enzyme, which breaks down collagen. It treats Dupuytren's contracture, the buildup of collagen in the hands ...



The above was copied from an article on Xiaflex. Another article said approval late this month is likely. I have no way to know how accurate these reports are, as most of the articles are in financial journals not medical publications.

When Xiaflex becomes FDA approved and a CHS prescribes it for a patient, the insurance companies will have little to say about the matter, at least not under a PPO.
Besides, given a choice between Xiaflex and OS, the cost is similar. Insurance carriers will break even on this. But that's not the only choice that's available.

It's a drop in the bucket but I would guess that by now NA has been performed on at least 5,000 hands in the US. Given NA's greatly reduced need for PT as opposed to Open Surgery, stating that NA is $5,000 cheaper than OS would not be unreasonable.

5,000 x 5,000 = $25,000,000 has been saved so far because of NA. Perhaps we should nock off a few mill due to NA's higher rate of recurrence, but then again, repeat NA Vs repeat OS just adds to the savings. If only health care had thousands of Silver Bullets like NA we wouldn't be grappling with the need for reform! :-)

In short, I have yet to see any advantage of Xiaflex over NA other than it transfers profit to the patient holders. If the majority CHS knew the actual facts abut NA, Xiaflex would be a financial disaster.

Those statements represent the CEO reassuring investors that big profits are on the way. But in reality, Auxilium may not be able to set the price that high.