Treatment costs of three nail lacquers used in onychomycosis.

Objective: To assess the daily treatment costs and the average cost-effectiveness of three topical onychomycosis therapies - amorolfine 5% and ciclopirox 8% nail lacquers and tioconazole 28% nail solution - when used as indicated in France, the UK, Germany and Italy.

Methods: The quantity of drug required and nail size measurements were investigated and, knowing the cost per bottle of each study drug, used to calculate the average treatment cost per patient. Using the prevalence of infection data, the weighted average total treatment cost per patient and hence the weighted average daily treatment cost and cost per patient cured, were calculated.

Results: Amorolfine was consistently more cost-effective in terms of weighted average daily treatment cost and cost per patient cured than ciclopirox and tioconazole, when all therapies were used as indicated to treat onychomycosis. In France, for example, the weighted average daily treatment cost of amorolfine was found to be euro 0.23 and euro 0.40 when used once and twice a week, respectively; the cost per patient cured for amorolfine was euro 84. By comparison, the weighted average daily treatment cost of ciclopirox was found to be euro 0.81; the cost per patient cured was euro 252.

Conclusions: When used as indicated, amorolfine 5% nail lacquer is more cost-effective than ciclopirox 8% and tioconazole 28% for onychomycosis of toenail, fingernail or both in males and females in France, UK, Germany and Italy.