American Journal of Clinical Dermatology

, Volume 20, Issue 2, pp 311–313 | Cite as

Trends in Utilization and Expenditure for Onychomycosis Treatments in the United States in 2013–2016

  • Partik Singh
  • Jonathan I. SilverbergEmail author

To the Editor,

Onychomycosis is common in the US, affecting > 12% of the population [1]. Efinaconazole (Jublia®) and tavaborole (Kerydin®) are topical antifungal treatments that were approved by the US FDA in 2014 for onychomycosis. These novel agents, by some estimates, may incur costs of US$12,000–$180,000 per-treatment success [2]. Recent studies demonstrated that new agents such as efinaconazole are among the most expensive treatment modalities for onychomycosis compared with generic medications [3, 4]. We sought to characterize real-world utilization and expenditure patterns for these medications.

We examined data from the Center for Medicare and Medicaid Services’ (CMS) Part D 2013–2016 Public Use Files, including prescriber specialty and prescription year. Number and list prices of prescriptions were assessed for efinaconazole and tavaborole, as well as terbinafine (Lamisil®) and ciclopirox (Penlac®, Ciclodan®, Loprox®) for comparison. Prices were adjusted for inflation to 2016...


Author Contributions

PS and JS had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: PS, JIS. Analysis and interpretation of data: PS, JIS. Drafting of the manuscript: PS, JIS. Critical revision of the manuscript: PS, JIS. Statistical analysis: PS, JIS. Obtained funding: JIS. Administrative, technical, or material support: JIS. Study supervision: JIS.

Compliance with Ethical Standards


This publication was made possible with support from the Dermatology Foundation.

Conflict of interest

PS and JS have no conflicts of interest to declare.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Dermatology, Feinberg School of MedicineNorthwestern UniversityChicagoUSA
  2. 2.Department of Dermatology, Preventive Medicine and Medical Social Sciences, Feinberg School of MedicineNorthwestern UniversityChicagoUSA

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