Which antifungal agent for onychomycosis? A pharmacoeconomic analysis

The incidence of fungal nail infections is increasing and this is possibly because of several factors: better methods of detection, a growing population of immunocompromised patients who have a greater susceptibility to such infections, the increased use of immunosuppressive drugs, the increasing nu...

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Bibliographic Details
Published in:PharmacoEconomics 2001, Vol.19 (10), p.983-1002
Main Authors: JOISH, Vijay N, ARMSTRONG, Edward P
Format: Article
Language:English
Subjects:
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antifungal Agents - economics
Antifungal Agents - therapeutic use
Antifungals
Antiviral agents
Biological and medical sciences
Cost analysis
Fluconazole
Griseofulvin
Health technology assessment
Humans
Itraconazole
Ketoconazole
Medical sciences
Onychomycosis
Onychomycosis - drug therapy
Onychomycosis - economics
Onychomycosis - epidemiology
Onychomycosis - therapy
Pharmacoeconomics
Pharmacology. Drug treatments
Quality of Life
Terbinafine
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Summary:The incidence of fungal nail infections is increasing and this is possibly because of several factors: better methods of detection, a growing population of immunocompromised patients who have a greater susceptibility to such infections, the increased use of immunosuppressive drugs, the increasing number of elderly people, worldwide travel, and the use of communal bathing facilities. Onychomycosis is a fungal infection of the fingernails and toenails that accounts for about 30% of all superficial fungal infections. It is characterised by nail discoloration, thickening and ultimately destruction of the nail plate. Management of this disease has improved significantly and treatment patterns have dramatically changed in recent years as a result of advances in new treatment options (e.g. oral antifungal agents) and changes in treatment regimens (e.g. pulse therapy). Also, newer drugs for onychomycosis have improved tolerability profiles compared with older agents. The overall costs of treating onychomycosis are substantial, and it has been estimated that direct cost for US Medicare patients with the disease is 43 million US dollars per year (year of costing not available). Pharmacoeconomic studies help in the decision-making process when selecting the most cost-effective antifungal agents to treat onychomycosis. To date there have been a number of national and international economic studies aimed at effectively assessing the efficacy and costs of the treatment options available to cure onychomycosis. The objectives of this paper are to (i) review the published findings regarding the epidemiology of onychomycosis; (ii) summarise the original pharmacoeconomic studies that describe the economic impact of the disease; and (iii) address the impact of the disease on patients' health-related quality of life.
ISSN:1170-7690
1179-2027
DOI:10.2165/00019053-200119100-00002