Pharmacoeconomic analysis of topical treatments for tinea infections.
BACKGROUND
A payor-perspective economic analysis of the topical creams ciclopirox, clotrimazole, ketoconazole, miconazole, and terbinafine (TER) used to treat dermatophytosis has been made. This pharmacoeconomic evaluation was conducted in Austria, Germany, and Switzerland.


METHODS
A four-phase approach was used. Phase 1: experts were assembled to identify the standard approach for management of fungal infections and a decision tree was constructed to model the process. Phase 2: meta-analysis was used to determine success, failure, and relapse rates. Phase 3: economic analyses performed included cost of regimen, total expected cost, and cost-effectiveness. Phase 4: sensitivity analyses (robustness analysis) were also executed to determine the validity of the assumptions.


RESULTS
In the total expected cost analysis, TER demonstrated the lowest overall cost of treating patients. Terbinafine also provided the highest number of disease-free days during the analytic time horizon and, consequently, the lowest cost per disease-free day. Sensitivity analyses suggest that TER is the most cost-effective topical product for treating dermatophytosis in Austria, Germany, and Switzerland.


CONCLUSIONS
All analytic scenarios suggest that TER therapy demonstrates lower expected costs and generates more DFDs when compared with the fungistatic topical therapies included in this pharmacoeconomic analysis. Terbinafine is expected to be the most cost-effective choice in Austria, Germany, and Switzerland for treatment of dermatophytosis minor.
Shear
N H
NH
Faculty of Medicine, Department of Medicine and Pharmacology, Sunnybrook Health Science Center, Toronto, Ontario, Canada.
Einarson
T R
TR
Arikian
S R
SR
Doyle
J J
JJ
van Assche
D
D
D000287:Administration, Topical; D000935:Antifungal Agents / Q000191:economics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000191:economics; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D006801:Humans; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care / Q000191:economics*; D014005:Tinea / Q000188:drug therapy* / Q000191:economics
D000935:Antifungal Agents