COST-EFFECTIVENESS OF 2 NEW TREATMENTS FOR ONYCHOMYCOSIS - AN ANALYSIS OF 2 COMPARATIVE CLINICAL-TRIALS

Background: Pharmacoeconomic analyses are becoming an increasingly int egral component of the overall profile of new drugs, This is particula rly true for terbinafine and itraconazole, because both agents have be en shown to be clinically effective and relatively safe. Objective: Th is study examined the cost-effectiveness of terbinafine and itraconazo le in two recent comparative clinical trials of these new agents for o nychomycosis of the toenails. Methods: Data as reported in the two cli nical trials were used as the basis for an analytic decision-tree mode l that included cost of drug, medical management of the disease and an y adverse reactions, and clinical efficacy data into calculations that estimated the relative cost effectiveness ratio for each drug on the basis of cost per disease-free day. Results: The total cost of terbina fine therapy ranged from $697.55 to $699.11, and the total cost of itr aconazole therapy ranged from $1216.40 to $1218.80. The expected cost per disease-free day of itraconazole was $2.05 and $2.37, in the Braut igam and De Backer trials, respectively; similar costs for terbinafine were $1.27 and $1.50. Relative to terbinafine, which was assigned a v alue of 1.0, the cost-effectiveness ratio of itraconazole was 1.62 and 1.58 in each trial, indicating a lower cost-effectiveness than terbin afine. Conclusion: Terbinafine is more cost-effective than itraconazol e in the treatment of toenail onychomycosis.