A MULTINATIONAL PHARMACOECONOMIC ANALYSIS OF ORAL THERAPIES FOR ONYCHOMYCOSIS

Due to increased interest in economic evaluation and the rapid interna tional spread of new healthcare technologies across borders, there is a need to interpret economic evaluations on a worldwide basis. We cond ucted a multinational cost-effectiveness analysis, from a government p ayer perspective, comparing four primary oral treatment regimens for o nychomycosis of the fingernails and toenails: griseofulvin, itraconazo le, 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, Gre ece, Italy, The Netherlands, Portugal, Spain, Switzerland and the U.K. A worldwide meta-analysis of published clinical data served as the st atistical input for the pharmacoeconomic model, and demonstrated that terbinafine had the highest success rates (95.0% and 78.3%) of the cli nical 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 infe ctions in all health-care systems analysed.