[Oral treatment of onychomycosis of the toe nails; comparison of cost-effectiveness of griseofulvin, itraconazole, ketoconazole and terbinafine].
OBJECTIVE
Determination of the most cost-effective oral drug treatment of onychomycosis of the toenails in the Dutch situation, by comparing griseofulvin, itraconazole, ketoconazole and terbinafine.


METHODS
Calculation of cost prices using a published meta-analysis.


METHODS
The Netherlands.


METHODS
Published efficacy and adverse reactions of treatment with griseofulvin, itraconazole, ketoconazole or terbinafine were related to 1993 Dutch cost prices of treatment.


RESULTS
Itraconazole and terbinafine offered similar chances of success, but itroconazole treatment had to be repeated more often. On average, the costs of the treatment with itraconazole were 1.5 times as high as those of treatment with terbinafine. Griseofulvin treatment was cheapest but required the longest treatment course.


CONCLUSIONS
A treatment with terbinafine is the most cost-effective, provided that onychomycosis has actually been established mycologically and all possible measures have been taken to prevent recurrence. It remains to be seen whether this drug treatment should be offered to all people affected by this essentially cosmetic problem.
Academisch Ziekenhuis, afd. Dermatologie, Leiden.
W
W
Bergman
F F
FF
Rutten
D000284:Administration, Oral; D000935:Antifungal Agents / Q000008:administration & dosage*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006118:Griseofulvin / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D007654:Ketoconazole / Q000627:therapeutic use; D009281:Naphthalenes / Q000627:therapeutic use; D014009:Onychomycosis / Q000188:drug therapy*; D010105:Oxygenases / Q000037:antagonists & inhibitors; D000077291:Terbinafine; D014034:Toes
D000935:Antifungal Agents; D009281:Naphthalenes; D017964:Itraconazole; D006118:Griseofulvin; D010105:Oxygenases; D000077291:Terbinafine; D007654:Ketoconazole
Orale behandeling van onychomycose van de teennagels; vergelijking van kosteneffectiviteit van griseofulvine, itraconazol, ketoconazol en terbinafine.