title: A multinational pharmacoeconomic analysis of oral therapies for onychomycosis. The Onychomycosis Study Group.
abstract: Due to increased interest in economic evaluation and the rapid international spread of new healthcare technologies across borders, there is a need to interpret economic evaluations on a worldwide basis. We conducted a multinational cost-effectiveness analysis, from a government payer perspective, comparing four primary oral treatment regimens for onychomycosis of the fingernails and toenails: griseofulvin, itraconazole, ketoconazole and terbinafine. We used a four-step pharmacoeconomic research model which includes all relevant factors affecting costs in 13 countries: Austria, Belgium, Canada, Finland, France, Germany, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and the U.K. A worldwide meta-analysis of published clinical data served as the statistical input for the pharmacoeconomic model, and demonstrated that terbinafine had the highest success rates (95.0% and 78.3%) of the clinical comparators for fingernails and toenails, respectively. We found that terbinafine was the most effective therapy in relation to cost (therefore giving it the lowest cost-effectiveness ratio) for both infections in all health-care systems analysed.
authors.affiliation: Faculty of Pharmacy, University of Toronto, Ontario, Canada.
authors.forename: S R
authors.initials: SR
authors.lastname: Arikian
authors.forename: T R
authors.initials: TR
authors.lastname: Einarson
authors.forename: G
authors.initials: G
authors.lastname: Kobelt-Nguyen
authors.forename: F
authors.initials: F
authors.lastname: Schubert
mesh_terms: D000935:Antifungal Agents / Q000191:economics*; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D005533:Foot Dermatoses / Q000188:drug therapy* / Q000191:economics; D006118:Griseofulvin / Q000191:economics; D006229:Hand Dermatoses / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D017964:Itraconazole / Q000191:economics; D007654:Ketoconazole / Q000191:economics; D017059:Models, Econometric; D009281:Naphthalenes / Q000191:economics; D014009:Onychomycosis / Q000188:drug therapy* / Q000191:economics; D013222:State Medicine / Q000191:economics; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D017964:Itraconazole; D006118:Griseofulvin; D000077291:Terbinafine; D007654:Ketoconazole