Toenail fungus, also known as onychomycosis, is a common condition that, while not life-threatening, can seriously affect someone’s quality of life. It can cause pain, discomfort, and embarrassment.
One treatment option is a topical medication called Kerydin (tavaborole). It’s applied directly to the infected toenail, and it’s often prescribed when oral medications aren’t suitable.
But here’s the rub: many people are surprised by how expensive Kerydin is. One person, for example, was shocked to find out that her out-of-pocket cost for Kerydin would be more than \$500!
Why is Kerydin so expensive? This article will explore some of the factors that contribute to Kerydin’s high price tag.
What is Kerydin and how does it work?
Kerydin is a prescription antifungal medicine you put directly on the toenail to treat onychomycosis, or toenail fungus. It’s different from oral antifungal medications, which come in pill form. Some of those oral treatments for toenail fungus are cheaper and may work just as well.
The active ingredient in Kerydin is tavaborole, which stops the fungus from growing.
How well does Kerydin work, and for how long?
Clinical trials showed that Kerydin isn’t always effective. In one trial, a year-long treatment of Kerydin completely cleared up toenail fungus in only 6.5 to 9.1 percent of patients.
The estimated treatment time for toenail fungus with Kerydin is 11 months.
The Price Tag: Factors Contributing to Kerydin’s Cost
When you find out that a medication your doctor prescribed will cost hundreds of dollars, it makes you wonder why.
Here are a few of the reasons Kerydin is so expensive:
Patent Protection and Market Exclusivity
When a pharmaceutical company develops a new medication, it can obtain a patent, which gives it the sole right to produce and sell the drug for a set period of time. With Kerydin, the manufacturer has exclusive rights, meaning no other company can create a generic version. This lack of competition allows the manufacturer to set a high price, knowing consumers have no cheaper alternatives.
For many people, this kind of monopoly is frustrating. They wonder why certain medications aren’t available as generics.
Research and Development Costs
Developing a new drug and bringing it to market is a costly process. Pharmaceutical companies invest significant resources in research, clinical trials, and regulatory approvals. To recoup these costs, they often justify high prices for their medications.
Marketing and Promotion
Pharmaceutical companies spend a lot of money marketing their drugs to healthcare providers and patients. These costs can contribute to the overall price of the medication.
Lack of Generic Alternatives
One of the biggest reasons for Kerydin’s high cost is the absence of generic versions. Generic drugs are typically much cheaper than brand-name medications because they don’t require the same level of research and development investment. Without generic alternatives, Kerydin remains expensive, leaving patients with few affordable options.
The role of insurance and pharmacy benefit managers
You’d think that having health insurance would help you afford the medications you need. But even with insurance, medications can be too expensive to afford.
Insurance coverage and formularies
Insurance companies decide which drugs they’ll cover under their plans. The list of covered drugs is called a formulary. Whether Kerydin is on your plan’s formulary depends on the specifics of your insurance policy.
Health plans often cover older, more established treatments first. They are less likely to cover newer treatments like Kerydin.
Some plans require that you get prior authorization before they’ll cover Kerydin. Others use a process called “step therapy.” In these cases, they require you to try cheaper medications first to see if they work. If they don’t work, then they’ll cover Kerydin.
Pharmacy benefit managers (PBMs)
Pharmacy benefit managers (PBMs) work with insurance companies to manage prescription drug costs. PBMs negotiate drug prices with manufacturers.
PBM contracts are complex, and they can significantly impact how much you pay for your prescriptions.
One of the biggest problems is the lack of transparency around PBM negotiations.
Leslie Pott, Sandoz vice president of communications, told the publication STAT, “We have no visibility into the extent to which these discounts are passed onto patients or payers.”
Patient experiences and the financial burden
Medications can be expensive, and the actual cost can be a mystery until you’re standing at the pharmacy counter. The high price of Kerydin can be a real problem for people who need it.
High out-of-pocket costs
Take the story of Anne Soloviev, for example. Anne’s doctor prescribed Kerydin for a toenail fungus, and the medication cost her $1,496.09. Since Anne had a high-deductible insurance plan, the unexpected cost wiped out her entire health reimbursement account (HRA).
For people with high-deductible plans or limited insurance coverage, the price of Kerydin can be a heavy burden. Many people simply can’t afford the medication, even if it’s the best treatment option for their condition.
Lack of cost transparency
One of the biggest problems is that doctors, pharmacists, and patients don’t always talk about medication costs. Doctors may prescribe a drug without knowing how much it will cost, and pharmacists may not warn patients about the price until they’re ready to pay.
It’s important to talk to your doctor and pharmacist about the cost of Kerydin before you start treatment. Ask if there are any cheaper alternatives, and find out if there are any patient assistance programs that can help you afford the medication.
As Anne Soloviev says, “I just find it is outrageous for a fungal medicine to cost $1,400, to be prescribed for 11 months, and for neither the P.A. nor the pharmacy to warn you.”
Exploring alternative and more affordable treatments
Before you fill that Kerydin prescription, it’s worth discussing your treatment options with your doctor. For example, oral antifungal medications tend to be cheaper and can be just as effective as topical treatments for toenail fungus, or you could consider the best nail fungus medicine over the counter.
Of course, every treatment has its own pros and cons. Oral medications, while effective, can sometimes come with more side effects than topical ones. It’s important to weigh these factors with your healthcare provider to figure out the best approach for you.
Don’t be afraid to ask your doctor about the cost of any new prescription and whether there are alternative, more affordable treatments available. You might be surprised at what you find!
Frequently Asked Questions
How much does Kerydin cost?
Kerydin is notoriously expensive, and the exact cost can vary depending on your pharmacy and insurance coverage. However, it’s common to see prices ranging from $700 to over $1000 for a single bottle. This high cost is often a significant barrier for patients needing treatment.
Does Kerydin really work?
Kerydin’s effectiveness is a mixed bag. While clinical trials showed it can improve nail fungus infections, the success rate isn’t as high as some other treatments. Many factors can influence how well it works, including the severity of the infection and how consistently it’s applied. Some people see significant improvement, while others don’t find it worth the high price.
What is the most expensive nail fungus treatment?
Kerydin is often considered one of the most, if not the most, expensive topical nail fungus treatments available on the market. The price point consistently places it at the higher end compared to alternatives like Jublia or ciclopirox.
Is there a generic for Kerydin?
Unfortunately, as of now, there is no generic version of Kerydin available. This lack of generic alternatives contributes to its high cost, as there’s no competition to drive prices down. Patients are essentially limited to the brand-name option if their doctor prescribes Kerydin, but other brand name options like Loceryl Nail Lacquer are also available.
Summary
Kerydin is expensive because of the resources required to develop and manufacture it, the lack of direct competition, and the way insurance companies negotiate drug prices.
It’s important to know how much your medications will cost before you get them. If a medication is too expensive, talk with your doctor about alternatives or ways to lower your out-of-pocket expenses.
Drug pricing is complex and not always transparent. We need more transparency in drug pricing and insurance coverage so that more people can afford the medications they need. If you agree, contact your elected officials and let them know that you want more affordable access to necessary medications.