Chronic hand eczema (CHE): cross-border specialty drug access for international patients

Quick orientation

Chronic hand eczema affects approximately 4 to 10 percent of the general adult population at some point. Moderate to severe forms requiring systemic therapy are less common but disabling.

Typical age of onset. Adolescence and adulthood; occupational exposures often contribute.

Severity tiers. Severity ranges from mild localized to severe and disabling. Severe forms can prevent work and daily activities and substantially impair quality of life.

Why specialty drugs for Chronic hand eczema (CHE) are hard to access internationally

Anzupgo (delgocitinib cream), approved by the FDA in 2025 for moderate to severe CHE, is the first topical JAK inhibitor specifically labeled for this indication. International registration is in early stages. Dupixent (dupilumab) is also used off-label for severe CHE in some markets, and oral JAK inhibitors are sometimes prescribed for refractory disease.

Treatments approved by the FDA

• Anzupgo (delgocitinib cream) — FDA approval: 2025. Mechanism: Topical pan-JAK inhibitor. Route: Topical twice daily. US WAC ballpark: Approximately USD 1,200 to 1,800 per month. Country pricing: Saudi Arabia · Bahrain · Oman.
• Dupixent (dupilumab) — FDA approval: 2017 (AD indication). Mechanism: IL-4 and IL-13 receptor alpha antagonist (atopic dermatitis label often applied to CHE). Route: Subcutaneous injection every 2 weeks. US WAC ballpark: Approximately USD 3,400 per month. Country pricing: UAE · Saudi Arabia · India · Egypt.
• Rinvoq (upadacitinib) — FDA approval: 2019 (atopic dermatitis 2022). Mechanism: Oral selective JAK1 inhibitor (atopic dermatitis label often used for CHE). Route: Oral once daily. US WAC ballpark: Approximately USD 5,500 per month. Country pricing: UAE · Saudi Arabia · India · Egypt.

Cross-border pathways used for Chronic hand eczema (CHE)

Most patients use one or more of the following regulatory pathways, depending on the destination country and the specific drug:

• Named Patient Program (NPP)
• Personal Import Scheme
• Cross-border Prescription

What your physician needs to know

• Confirm chronicity (greater than 3 months) and severity classification.
• Document failure or intolerance of topical corticosteroids and emollients.
• Screen for contact allergens; patch testing where indicated.
• Some destination countries require a dermatologist co-sign for biologic supply requests.
• For oral JAK inhibitors, perform baseline lipid panel, CBC, and screen for tuberculosis and hepatitis B and C.

Common questions

Is Anzupgo available in my country?

It is newly approved in the US and EU. International registration is in early stages. We confirm by destination.

Can Dupixent be used for CHE?

Dupixent is FDA-approved for atopic dermatitis. Some dermatologists prescribe it off-label for severe CHE; your treating physician determines appropriateness.

How long until I see improvement?

Topical JAK responses are often seen within 4 to 8 weeks; biologic responses within 12 to 16 weeks.

Are systemic JAK inhibitors an option?

Oral JAK inhibitors are sometimes prescribed for severe disease. Your dermatologist weighs benefits and risks.

What documents are required?

Dermatologist prescription, photographs of affected areas at baseline (helpful), and a clinical summary.

Where Reserve Meds fits in

Reserve Meds is a cross-border specialty drug access platform. We support international patients whose prescribed FDA-approved medicine is not registered locally, is not reimbursed by their payer, or is otherwise unavailable through standard channels. For Chronic hand eczema (CHE), our role is to coordinate the regulatory pathway, source the medicine from a DSCSA-compliant US wholesaler, and arrange validated cold-chain or controlled-temperature shipment to the destination country.

We do not replace your treating physician. We do not bill insurance. We operate a cash-pay model, and we work alongside the clinical team that knows your case. Every prescription is reviewed by a US-licensed pharmacist before dispense, and a US-licensed physician reviews the supply request before shipment.

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