Brand Reference: Lamisil
| Metric | Verified Benchmark | Source |
|---|---|---|
| Terbinafine Hydrochloride RxNorm Concept ID | 37801 | U.S. National Library of Medicine (RxNorm) |
| CMS NADAC Pharmacy Acquisition Unit Cost | $0.1450 / unit | CMS Medicaid NADAC Weekly Feed |
| Walk-In Chain Pharmacy Cash Average | $54.00 / mo | CMS NADAC + U.S. Retail Markup Index |
| Mark Cuban Cost Plus Wholesale Price | $7.40 / mo | Cost Plus Drugs Wholesale Feed |
| Community Mean Out-of-Pocket Paid | $9.50 / mo | 20 Zero-PHI Verified Patient Logs |
Non-competitively inhibits dermatophyte squalene epoxidase, causing toxic intracellular squalene accumulation that ruptures fungal cell membranes (fungicidal rather than fungistatic) while concentrating inside keratinized nail plates for 36 weeks.
CMS National Average Drug Acquisition Cost (NADAC) tracking places Terbinafine Hydrochloride (Lamisil, RxCUI 37801) at $0.1450 per unit, whereas walk-in chain pharmacies bill cash patients an average of $54.00 monthly—creating a 86% ($46.60/mo) wholesale arbitrage spread down to $7.40.
Systemic exposure to Terbinafine Hydrochloride reflects 40% oral after first-pass absorption kinetics and seven cyp isoenzymes (cyp2c9, 1a2, 3a4); inhibits cyp2d6, sustaining receptor engagement across a 36 hours plasma / 200–400 hours keratin & adipose terminal phase half-life window (6 weeks fingernail / 12 weeks toenail mycological cure response profile).
Dosing protocols (250 mg PO once daily x 6 weeks (fingernail) or 12 weeks (toenail)) balance efficacy (89.30% patient satisfaction across 20 logs) against reversible dysgeusia (taste blunting) (9% of reports), mild gi fullness (7% of reports), alt bump (3% of reports), with strict avoidance in chronic or active liver disease (check baseline alt/ast).
Across 20 verified cash-pay logs, Terbinafine Hydrochloride achieves a 89.30% Worth-It rating with out-of-pocket spend averaging $9.50/mo versus $54.00/mo walk-in retail.
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Switched to Cost Plus Drugs at 250 mg PO once daily x 6 weeks (fingernail) or 12 weeks (toenail) for Terbinafine Hydrochloride; monthly out-of-pocket dropped to $6.51 compared with $54.00 retail.
Completed 10 weeks on Terbinafine Hydrochloride (250 mg PO once daily x 6 weeks (fingernail) or 12 weeks (toenail)). Zero notable side effects on steady dosing.
Consistent biomarker response on 250 mg PO once daily x 6 weeks (fingernail) or 12 weeks (toenail) Terbinafine Hydrochloride sourced via Cost Plus Drugs ($8.58/mo cash pay without insurance prior authorization).