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Evaluating costs for onychomycosis treatments: a practitioner's perspective
1Department of Dermatology, University of Minnesota, Minneapolis, USA.
Journal of the American Podiatric Medical Association
|January 18, 2006
Summary
Terbinafine treatments offer the most cost-effective cure for onychomycosis (fungal nail infection). Continuous 3-month terbinafine therapy is generally the preferred approach for achieving a complete cure.
Area of Science:
- Dermatology
- Pharmacoeconomics
- Infectious Diseases
Background:
- Onychomycosis is a prevalent fungal nail infection with complete cure as the primary treatment goal.
- Evaluating the cost-effectiveness of various treatments is crucial for clinical and patient decision-making.
Purpose of the Study:
- To determine the cost-effectiveness of different onychomycosis treatments.
- To identify the most economical treatment strategies based on complete cure rates.
Main Methods:
- A cost-effectiveness analysis was performed using complete cure rates from randomized, blinded clinical trials (≥50 participants).
- Medication costs were assessed using commercial, average wholesale, and Veterans Affairs pharmacy prices.
- A computerized economic model incorporated all medical costs to calculate total cost per complete cure.
Main Results:
- Terbinafine-based treatments (pulse, continuous, or combination) were the most cost-effective.
- Itraconazole, griseofulvin, and fluconazole demonstrated lower cost-effectiveness.
- Ciclopirox nail lacquer was significantly more expensive, over three times the cost per complete cure.
Conclusions:
- Terbinafine treatment yields the lowest cost per complete cure for onychomycosis.
- Three months of continuous terbinafine therapy is supported by the most evidence for cost-effective outcomes.
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