4 ms·

From what I read of this, it's very expensive (thousands/mo), requires at least monthly injections at a facility, has a risk of anaphylaxis (so the injections c

From what I read of this, it's very expensive (thousands/mo), requires at least monthly injections at a facility, has a risk of anaphylaxis (so the injections can't be done at home), doesn't eliminate the risk of allergic reactions, and has no off-ramp (so you have to take it forever). Not exactly a silver bullet... My first thought was that it could be good for kids, who are less good at checking for trace amounts of allergens, but then I saw that it requires injections, which kids aren't so great at.

el_benhameen 3y ago
Right. But the selling point isn’t “start packing pb&js for lunch”, but rather “go to a restaurant for the first time” or “worry less about your kid’s life being at risk from a classmate’s snack”.
- jwineinger 3y ago
  We did achieve this with OIT for peanut allergy. Once we reached bite-safe levels, our lives literally changed for the better. We didn't have to worry about interrogating anyone serving us food (restaurants, friends, family), and we could go to some places that were just never an option before where cross contamination is likely or even expected, like ice-cream parlors. There's still a protocol we have to follow every day though, so an actual cure is still a dream for us.
  - el_benhameen 3y ago
    That’s fantastic! I’m glad to hear that it’s been successful.
nimbleplum40 3y ago
Far from a silver bullet, but still exciting as the first medicine of its kind! Accidental exposure happens to pretty much everyone with food allergies, so reducing the risk of anaphylaxis by ~70% is huge and will save lives.
monero-xmr 3y ago
It’s annoying to read “so and so new drug costs too much.” Creating new drugs is absurdly expensive. Most new drugs target small population groups, which is why treatments do not already exist - the low hanging fruit with large market potential gets targeted first. Just be happy a flag is planted in the ground. New drugs will be created from this that are different enough to avoid the patent, and new research will enhance it and reduce the side effects. This is just the beginning.
- spondylosaurus 3y ago
  To be fair, Xolair isn't a new drug at all (it's been around for 20-ish years, I think?), this is just a new thing that it's approved for. I'm not sure why a generic hasn't hit the market yet, though. Maybe there's not enough demand to make it lucrative enough, unlike the golden child adalimumab...
  - monero-xmr 3y ago
    I wasn’t aware of this, thanks for clarification. I will leave my comment as-is because it’s my take on the general “we need to ban price gouging on new drugs!” sentiment.
    - spondylosaurus 3y ago
      Ha, I certainly agree about the price gouging! I've stayed at jobs I hated just to keep my health insurance (and therefore my meds) :P
  - a_gnostic 3y ago
    What's the Mexican name? Asking for a Mexican friend.
    - duskwuff 3y ago
      Generic name for Xolair is omalizumab.
  - 3y ago
spondylosaurus 3y ago
Longtime Xolair patient here: as far as cost goes, there are copay programs that knock the price down to $5/mo, but the catch is that you have to be insured (via commercial health insurance, not Medicare/Medicaid) to qualify. A lot of drug manufacturers offer these programs: the bargain is essentially that they'll cover the brunt of your copay cost so long as your insurance company is still paying for the rest of it. Better to collect a few grand from the insurance company and reimburse the patient for a few hundred than to miss out on the sale entirely.
- 8ig8 3y ago
  So hard to believe that this is so complicated. People’s lives and health. I wish it was easier.
  - sundvor 3y ago
    Move to Australia? On a script, cost is AUD $31.60 per syringe, a rather stark saving from $410 . I wonder how that latter price compares to the price in the US, I couldn't quite get the prices I read without insurance to compute in my head. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/making-more-life-changing-medicines-available-to-all-australians https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/med... https://m.pbs.gov.au/medicine/item/10109c-10110d-10118m-10122r.html https://m.pbs.gov.au/medicine/item/10109c-10110d-10118m-1012...
    - roganartu 3y ago
      > I wonder how that latter price compares to the price in the US My guess is not favourably for the US. My wife was diagnosed with MS about a year before we moved to America and, since I knew we were moving and was thinking about insurance, I asked the pharmacist once what they billed the govt per dose (monthly). We paid $40 out of pocket and the govt paid $1300 AUD. Our insurance in the US pays nearly $10k USD/m for the same drug.
      - sundvor 3y ago
deleted 3y ago
[deleted]
TheCoelacanth 3y ago
Xolair can be injected at home after the first dose.
twothamendment 3y ago
Injections can be done at home, after you do some at the office and you get your doctor to agree. My wife gets it shipped to our door each month. In her case, this doesn't cure anything, but manages symptoms of MCAS. Not ideal, but way better than life without it.

el_benhameen 3y ago

Right. But the selling point isn’t “start packing pb&js for lunch”, but rather “go to a restaurant for the first time” or “worry less about your kid’s life being at risk from a classmate’s snack”.

jwineinger 3y ago
We did achieve this with OIT for peanut allergy. Once we reached bite-safe levels, our lives literally changed for the better. We didn't have to worry about interrogating anyone serving us food (restaurants, friends, family), and we could go to some places that were just never an option before where cross contamination is likely or even expected, like ice-cream parlors. There's still a protocol we have to follow every day though, so an actual cure is still a dream for us.
- el_benhameen 3y ago
  That’s fantastic! I’m glad to hear that it’s been successful.

nimbleplum40 3y ago

Far from a silver bullet, but still exciting as the first medicine of its kind! Accidental exposure happens to pretty much everyone with food allergies, so reducing the risk of anaphylaxis by ~70% is huge and will save lives.

monero-xmr 3y ago

It’s annoying to read “so and so new drug costs too much.” Creating new drugs is absurdly expensive. Most new drugs target small population groups, which is why treatments do not already exist - the low hanging fruit with large market potential gets targeted first. Just be happy a flag is planted in the ground. New drugs will be created from this that are different enough to avoid the patent, and new research will enhance it and reduce the side effects. This is just the beginning.

spondylosaurus 3y ago
To be fair, Xolair isn't a new drug at all (it's been around for 20-ish years, I think?), this is just a new thing that it's approved for. I'm not sure why a generic hasn't hit the market yet, though. Maybe there's not enough demand to make it lucrative enough, unlike the golden child adalimumab...
- monero-xmr 3y ago
  I wasn’t aware of this, thanks for clarification. I will leave my comment as-is because it’s my take on the general “we need to ban price gouging on new drugs!” sentiment.
  - spondylosaurus 3y ago
    Ha, I certainly agree about the price gouging! I've stayed at jobs I hated just to keep my health insurance (and therefore my meds) :P
- a_gnostic 3y ago
  What's the Mexican name? Asking for a Mexican friend.
  - duskwuff 3y ago
    Generic name for Xolair is omalizumab.
- 3y ago

spondylosaurus 3y ago

Longtime Xolair patient here: as far as cost goes, there are copay programs that knock the price down to $5/mo, but the catch is that you have to be insured (via commercial health insurance, not Medicare/Medicaid) to qualify. A lot of drug manufacturers offer these programs: the bargain is essentially that they'll cover the brunt of your copay cost so long as your insurance company is still paying for the rest of it. Better to collect a few grand from the insurance company and reimburse the patient for a few hundred than to miss out on the sale entirely.

8ig8 3y ago
So hard to believe that this is so complicated. People’s lives and health. I wish it was easier.
- sundvor 3y ago
  Move to Australia? On a script, cost is AUD $31.60 per syringe, a rather stark saving from $410 . I wonder how that latter price compares to the price in the US, I couldn't quite get the prices I read without insurance to compute in my head. https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/media/making-more-life-changing-medicines-available-to-all-australians https://www.health.gov.au/ministers/the-hon-greg-hunt-mp/med... https://m.pbs.gov.au/medicine/item/10109c-10110d-10118m-10122r.html https://m.pbs.gov.au/medicine/item/10109c-10110d-10118m-1012...
  - roganartu 3y ago
    > I wonder how that latter price compares to the price in the US My guess is not favourably for the US. My wife was diagnosed with MS about a year before we moved to America and, since I knew we were moving and was thinking about insurance, I asked the pharmacist once what they billed the govt per dose (monthly). We paid $40 out of pocket and the govt paid $1300 AUD. Our insurance in the US pays nearly $10k USD/m for the same drug.
    - sundvor 3y ago

deleted 3y ago

[deleted]

TheCoelacanth 3y ago

Xolair can be injected at home after the first dose.

twothamendment 3y ago

Injections can be done at home, after you do some at the office and you get your doctor to agree. My wife gets it shipped to our door each month. In her case, this doesn't cure anything, but manages symptoms of MCAS. Not ideal, but way better than life without it.