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Q. I’ve had fungus in all my toenails since the summer I spent three weeks hiking through snow. Most of my toenails and the outer skin of my feet sloughed off then, about 44 years ago.

I asked my physician to prescribe Jublia despite its low cure rate. At the pharmacy, I was told it needed pre-approval. If I wanted to pay cash, though, a 4 ml bottle to be applied daily for 10 months would cost me $418.00 per bottle!

I laughed and said no thanks. I can live with this just as I have been for all these years.

A. Efinaconazole (Jublia) is a new topical anti-fungal medication that is being widely advertised on television.

Cure Rates

Actual cure rates are not mentioned in the commercials. There were two clinical trials to get FDA approval.

In one, a “complete cure” was achieved in 17.8 percent of the subjects after 48 weeks of Jublia applications. In the other study, 15.2 percent of the volunteers achieved a cure after 48 weeks.

A Pricey Prescription

Chain pharmacies near us charge between $539 and $589 for a 4 milliliter (ml) bottle. You would need at least one drop per infected toenail each day.

If all your nails are infected, that could be 12 ml daily (the big toes get two drops). There are roughly 80 drops in a 4 ml bottle, so one bottle would last about a week. After 48 weeks you could be out over $20,000 if your insurance company won’t pay.

Home Remedies for Nail Fungus

A few days ago we received an interesting message from a retired physician:

“Joe & Terry,

“Thanks for your publication about the amazing cost of Jublia. No wonder they could justify ads on the Super Bowl!

“I’ve looked into the popular suggestions for my own long standing toenail fungus such as  original Listerine and Vicks VapoRub. They’re acidic and share some fungicidal contents, at rather low concentrations.

“My thinking immediately came to two critical factors: 1) you’ll have to treat for the total growth time of toenails, about 12 months, and 2) you need to find a way of keeping the tissue wet with the “medication” for hours at a time to assure adequate “soak-in”.

“It appears to be working! For the past 3 or 4 months I’ve been treating for 2 to 3 hours several times a week. At this point the new growth of the nails appears pink and healthy.

“And the treatment; several cc’s of amber “original” Listerine in the toe of each of a pair of molded plastic gardening moccasins I found in the garden department of our local Lowes. No socks, just my foot in a small puddle of Listerine.

“A year is a long time to do anything, but so far I’m sticking with this, usually when I’m sitting around in the evening.

“It’s hard to believe drug companies can charge about $70.00 per drop to treat what amounts to a cosmetic problem!

“All the best to the two of you.” David M., M.D. (retired)

Many people would prefer to try home remedies, even though we don’t know their cure rates. At least they won’t cost you as much as Jublia. You can learn more about various approaches such as vitamin E oil, tea tree oil, Vicks VapoRub or Listerine and vinegar soaks in our Guide to Hair and Nail Care.

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  1. dean
    ohio
    Reply

    I did not try Jublia yet. I’m just reading about it. May not able to get Jublia due to the high price. If only the company would work on volume and lower the price so more people could afford it.

  2. Thomas
    Louisiana
    Reply

    I have been on Jublia for 18 months and never missed a day. I still have the fungus, and now they have raised the price since insurance doesn’t pay. The low cure rate is discouraging but my dermatologist says that the laser has much higher cure rate, and it is only a fraction of the cost of Julia, so I am going that route.

  3. Peter
    AB, Canada
    Reply

    I have been using Jublia on two big toes for about 10 months. It comes in 8 ml bottles here. And treating two big toes once a day, I find that a bottle lasts me approximately 3 weeks. The instructions that come with the medication indicate that it is important to squeeze a drop from the bottle onto the nail, and not to just paint it on with the brush head supplied. Doing this I get approximately 40 drops per bottle, which is less than one might expect, but I put this down to the drop size being governed by the size of the applicator brush. I infer from previous comments that others find it lasts much longer than I do, and would greatly appreciate quantitative comments from others to compare with my own experience. After 10 months of treatment, my nails are only about half clear.

  4. Barb
    oklahoma
    Reply

    I don’t know why its so expensive. I had toe fungus for 30 years, and after 6 months I am fungus free. I love this stuff. I have pretty feet again. I got samples from a friend who is a foot doctor and apply it now once a month. And if I needed to buy it I would. Because it works.

  5. John
    NJ
    Reply

    After almost three years on Jublia, it just can’t get the job done. Applying it once daily during the week, and twice a day on on the weekends, it just fails to clear up the fungus under the toenail. It did help somewhat, but just couldn’t clear up the fungus more than half way. Jublia is about $600.00 for a small bottle paid by my insurance, and feel that they are taking advantage of the insurance companies with a product that just can’t do the job. I gave the product a two, because it did clear up half way. I really wanted it to work, but unfortunately, it doesn’t.

  6. Peter
    Ontario
    Reply

    Just discovered Jublia yesterday and a small bottle(4_6 ml.) cost $112CDN. My insurance will reduce that cost to $21. I will try it as the comments here are encouraging. I am 68 and have had fungus since age 14. I want to get rid of this curse before I die.

  7. Jerome
    El Paso TX
    Reply

    Well I do think that this drug is way too expensive! Sorry to offend you all.
    I’m going to try the listening approach, I bet you have to work, and my feet will smell soooo nice at the same time! Yummy!

  8. Anil
    India, Andhra Pradesh
    Reply

    Hello…hii…
    My self Anil Chejarla
    i have 24 years old…
    so..my nails are effected by fungus…before 1 year….
    so that reason i want to Jublia nail solution…
    thanking you sir….

  9. Maikamu
    Reply

    Thanks for that idea because I have that fungus. Now I am not getting any treatment because of money, but how much does it cost to buy that. I am in Uganda, and so I so I don’t know. I need help, please, and am waiting

  10. Chris
    GA
    Reply

    I’ve bee using Jublia now for 2 months. I’m on my second 4ml dose and I have to say this stuff really works. I’ve had pretty bad toenail fungus for about 20 years. This is the first time anything has ever worked! I was very skeptical when my Dr. gave me the prescription, and I wouldn’t have done it at $500 a bottle, but my insurance paid 3/4 of it, so at $125, I decided to give it a try. Pretty amazing results I must say. My 2 big toes that looked like I had gang green nails could only be cut with a Dremel tool. Now they are more like pale yellow and have started to thin out considerably to where I can actually cut them with a cuticle scissor. The three smaller toes have gone from deep yellow to pale white and are also much thinner. One is starting to turn clear and look like a real healthy nail should. I’m going to keep at it because I’m finally getting results and feel like I can show my feet in public for the first time in what seems like an eternity. definitely give it a try. I would also recommend you wash and dry your feet well before each use, spray your shoes and sneakers everyday with Lysol, and frequently change your socks at least twice a day. If you keep at it, you might great results like I’m getting. Nail fungus can be quite a curse and very disheartening. Jublia seems to give us sufferers a fighting chance. Good luck.

  11. Lu
    BC, Canada
    Reply

    In Canada the price for Jublia is much lower than what is described here, 6ml for $80 CAD. In my case each bottle lasted 3 months, it was only $320 total cost for one year of treatment for the 4 bottles that took me to clear my nail fungus ($27 per month). I understand that if you have all ten toenails with fungus, you may need more than the 4 bottles, but for my case it worked, it was hassle free and inexpensive.

  12. Monica B
    Sacramento, CA.
    Reply

    As a medical pedicurist, I’ve witnessed many recovered nails after consistent use of Jublia. After years of laser treatment & regular sterile pedicures with little result I consider Jublia to be the most effective treatment I’ve ever witnessed. It’s an absolute shame the greed of this company! If only all of my clients were able to fill a prescription of Jublia at a reasonable rate. Consider the fact that most of my clients actually can afford this but will not based on principle!

  13. Sharon
    Reply

    I was at the point where a podiatrist told me the only way I’d get rid of the nail fungus on my big toes was to remove the nails, because fungus was all the way into the nail bed. I actually considered it because I’d tried it all and just couldn’t get rid of it. I mean I tried EVERYTHING. Not only was it ugly, my toenails actually hurt and were ingrowing,misshapen,thick, and smelly.

    I was lucky; my insurance covered Julia except for $40 co-pay. But it does take persistence, a lot of time, and a hefty sum in co-pays. But my nails are better than in many many years. I am cured. No more discomfort, or thick, smelly, ugly toenails. I sure as heck won’t be returning to any nail salons again. I think my pharmacy was anxious to sell as much as they could (my pharmacist told me only 1 other person was getting it from her pharmacy) because it was constantly being filled, to the point I have sitting here 10 new unused bottles.

    This was such a relief, and it sure feels good to have pretty feet. I don’t even wear polish! After years of suffering and embarrassment. I love Jublia. Wish I’d taken some “before” photos to show how well this worked for me.

  14. Don
    Chicago
    Reply

    I am trying Jublia also. One bottle (8ml) has lasted about 4 months so far. I have been embarrassed for years and was concerned about complications with ingrown toenails with fungus in the future. No one else has a solution, other than taking pills (which to me is much worse, the problem is in my external toenail, not my stomach) which have also proven ineffective.

    So far I am getting good results, my nails are looking like they are growing normally. It’s expensive and they could make it cheaper, but I am glad to use it.

  15. john d
    new york city
    Reply

    what can i say —my insurance company was charged 649 of which i paid 40 dollars and the stuff works like desonex –would rate it close to a zero on a scale of 1-10 … in this country when a drug vendor charges 649 dollars for a toenail infection and the government allows it then we are in trouble –still looking for the gun and mask when they sold to me –who is the owner of this drug …………..would avoid at all cost .

  16. Donna
    Canada
    Reply

    I read your article and it actually makes me sad to think that had I read it before starting Jublia I may not have even tried it

    I have suffered with fingernail fungus for nearly 20 years and while I lived with it ( thanks to dirty tools used to get my nails done ) it has been a horrible painful and most of all imbarrasing on so many occasions experience I had all but lost hope of ever finding a cure

    I have been using it 73 days now and yes it’s expensive and yes it takes a lot of patience and effort to follow the program but for me it is working
    I mean if it wasn’t so gross to look at I would post photos but to me it is so imbarrasing I will keep it to myself and my doctor

    But for the people who know me and know how bad it had gotten for me Jublia is freeing me from a prison my imbarrasment over my nails had had me locked in.
    My nails are actually starting to look like finger nails again

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