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Due to increased interest in economic evaluation and the rapid international spread of new healthcare technologies across borders, there is a need to interpret economic evaluations on a worldwide basis. We conducted a multinational cost-effectiveness analysis, from a government payer perspective, comparing four primary oral treatment regimens for onychomycosis of the fingernails and toenails: griseofulvin, itraconazole, 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, Greece, Italy, The Netherlands, Portugal, Spain, Switzerland and the U.K. A worldwide meta-analysis of published clinical data served as the statistical input for the pharmacoeconomic model, and demonstrated that terbinafine had the highest success rates (95.0% and 78.3%) of the clinical 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 infections in all health-care systems analysed.

Objective To determine the direct and indirect costs associated with a measles epidemic occurring between September 1996 and August 1997 in Palermo (Italy) in paediatric-aged patients. Design A total of 2,029 cases of measles in a paediatric patient population were identified from a total of 38 paediatricians databases (24% of total). An extrapolation to the general population was then performed to estimate a total of 9,059 cases. Patient information obtained from the database such as patient age, risk factors, complications, vaccination history, as well as caretaker’s profession were included in a questionnaire compiled for each patient. Setting Inpatient and outpatient clinics in Palermo, Italy. Patients and participants Participants were paediatric-aged patients who had been diagnosed with measles. Included in the study was a group of previously vaccinated patients (6%). Main outcome measures and results The average cost of care was 464.000 Italian lire (Lit.) per case with a total cost of Lit. 4,2 billion for the entire epidemic. The direct costs comprehended 46.6% (Lit. 217.000 per case) of the total costs related to the measles epidemic and were subdivided according to in-patient care (55.4%), paediatric outpatient visits (33.5%) and drugs (9.7%). The average health-care cost associated to previously vaccinated patients (6%) was lower than for non-vaccinated patients, Lit. 110.000 vs Lit. 223.000 per case, respectively. Conclusion The demographic and economic data obtained highlights not only the social and economic impact of the epidemic, but also provides relevant information useful for cost-effectiveness analysis.