Pricing for biologic antibody drug "Xolair"

[voyagerUSA]

I have been recommended to try Xolair to help control chronic hives that are not fully controlled with antihistamine. This is a quite expensive medication that must be injected monthly. At Bumrungrad I was quoted 40,000 per dose, and at another private hospital (Vichayut) it was 27,000. I suspect it might be cheaper at a government hospital but I never dealt with one before and not sure how to go about finding out this information. Would I need to make a specialist appointment first? Which govt hospital would be likely to have this sort of medication?

[Sheryl]

 

Suggest you go to the "after hours" clinic at Chulalongkorn University Hospital . Ask for an acharn  (professor) specializing in allergy/immunology. You will have to go in person to make the appointment and there may be a wait list.https://chulalongkornhospital.go.th/kcmh/en/dept/คลินิกพิเศษนอกเวลาราชก/

 

It will still be quite expensive there, as it is imported and under patent. There is no locally made version. But it will be less than the private hospitals.

 

 

[voyagerUSA]

Thank you Sheryl for pointing me in the right direction. I might have a Thai friend call them first see if they could give us a price for the medicine because I already have an allergy/immunology doctor at a private hospital. Of course, if I do decide to go on Xolair and to use Chula clinic as the source I know I will have to see the doctor there to prescribe it etc. I know there is no generic version despite this medicine being like 20 years old and so best case it will be 15-20,000 baht per dose :(

[Sheryl]

15 hours ago, voyagerUSA said:

Thank you Sheryl for pointing me in the right direction. I might have a Thai friend call them first see if they could give us a price for the medicine because I already have an allergy/immunology doctor at a private hospital. Of course, if I do decide to go on Xolair and to use Chula clinic as the source I know I will have to see the doctor there to prescribe it etc. I know there is no generic version despite this medicine being like 20 years old and so best case it will be 15-20,000 baht per dose :(

Yes I think that is about right. Not under 20k.

 

Getting information by phone seldom works with government hospitals.  A vidit in person may be needed. 

[JackB24]

@voyagerUSA

 

Hi voyagerUSA,

 

you have the same problem that I also have.

 

what are you currently taking here in Thailand to suppress the hives, I was diagnosed back in 2019 with CIU, Chronic Idiopathic Urticaria.

 

 Luckily in the United Kingdom through the NHS I could get the xolair injections free of charge, with a 100% success at suppression without any side effect, I took the injections at 300mg per appointment which was every 4 weeks, 

 

did you get any closer to finding a hospital that administered the injections and at what cost ?

 

 

TIA

Edited March 4 by Sheryl
added tag

[voyagerUSA]

I am on levocetirizine now which works to some degree, but I still get break through hives whenever I have some sort of infection. I found that Vichayut hospital offers Xolair for about 18,000 baht per 150mg. I have heard it is a bit cheaper at some public hospitals but difficult to access that. However, it seems that in Thailand they do not have the prefilled syringes that you can self administer, instead they use powder that must be especially prepared and dissolved so as a result you can only get the shots at the hospital. 

[JackB24]

Thanks for the reply, I know the substance has to be kept refrigerated but never heard of it being made up as a mix prior to administering, i was looking at Bangkok hospital but I’ll take a look at Vichayut. 
 

It’s such a nightmare condition, unfortunately the Xolair does not cure Urticaria but only suppresses it for so long, I don’t know why it’s so expensive especially when it’s supposed to be administered monthly. I was on it for over two years every 4 weeks at 300ml 2x injections in each arm at 150ml, it’s amazing stuff. Antihistamines and H2 blockers do absolutely nothing for me, iam currently on Prednisolone but it’s so bad for the body long term. Have you ever tried Ciclosporin ? Its supposedly also an effective medication.

[voyagerUSA]

I think Xolair was originally introduced as powder and later they switched it to prefilled syringes for convenience, but maybe that given the cost of this medication there is not so much demand for the syringes in Thailand and they have a limited shelf life even if refrigerated, whereas powder prob has much longer shelf life so they stick to powder at most hospitals. It is possible that the top hospitals like Bumrungrad do offer syringes but the price they quoted me was crazy, like 2x the price at Vichayut. Unfortunately, Xolair is expensive because even after like 20 years there is no generic substitute available so the branded can charge whatever they want for it. The question if Xolair can create a long term remission of urticaria or only suppress it is controversial and I got different replies to that from different specialists. Never tried ciclosporin, it is a somewhat risky medication and requires frequent blood monitoring. In my case antihistamines do help but need to take a huge dose, 3-4x the normal dose used for standard allergy treatment. My urticaria tends to quiet down, then flare up after any sort of infection like a flu or covid that revvs up my immune system.