JAK inhibitors are similarly expensive, ranging from S$500 to about S$2,000 a month, said Clinical Associate Professor Mark Koh, head and senior consultant at KK Women’s and Children’s Hospital’s (KKH) dermatology department.
Of the targeted therapies, only one – abrocitinib (Cibinqo), a JAK inhibitor – is subsidised under the Ministry of Health’s Medication Assistance Fund, after being added to the list in March 2024. Singaporeans can qualify for up to 75 per cent off, depending on their household income, bringing higher-dose pills to between S$300 and S$900 a month.
Why do these drugs cost so much? Drug patents last about 20 years, granting manufacturers a monopoly that eliminates competition. For biologics specifically, the manufacturing process – biological rather than chemical – is costlier and harder to reproduce, said Dr Yew.
Dupixent is subsidised in parts of Europe, Canada and Australia, but not in Singapore. In November 2024, then-Senior Minister of State for Health Dr Janil Puthucheary said in parliament that Dupixent was not recommended for subsidy as its benefits did not justify its cost at the price proposed by the manufacturer.
Cibinqo, an oral medication, was assessed as at least as effective and available at a lower price, he said.
“If patients face issues affording dupilumab, they may approach medical social workers at our public healthcare institutions to apply for financial assistance through MediFund,” Dr Janil said.
However, JAK inhibitors like Cibinqo may not be suitable for all patients – those who are older or have more comorbidities may not be recommended the drug due to its lower safety profile, Dr Uma said.
For children aged below 12, only Dupixent and baricitinib (Olumiant) are approved in Singapore.
Mr Quek, 43, who declined to give his full name, secured a 75 per cent Dupixent subsidy for his primary school-aged son through a medical social worker. The improvement was immediate.
“Ever since the injection, the skin started healing, his sleep is a lot better. And because he’s sleeping better, school-wise is better – he pays attention, has more energy. He’s growing better,” said the educator.
His son is also no longer as self-conscious about his skin. While he used to insist on wearing long sleeves and long pants, he’s now happy to wear T-shirts and shorts, he added.
But the subsidy lasted only 20 weeks. “We can see that there are times the eczema is coming back, and then we may have to visit this S$900 jab in the future,” said Mr Quek.
KKH’s Dr Koh, who sees mostly paediatric cases, said better access to newer treatments will help, given the condition’s broader impact.
“Having a good sleep at night is everyone’s right, especially children. And eczema, although it’s just on the skin … it’s a systemic disease,” said Dr Koh.
Patients may not grow well, or may not want to go to school or socialise, he added.
