Inflammatory bowel disease (Crohn's disease and ulcerative colitis): cross-border specialty drug access for international patients

Quick orientation

Inflammatory bowel disease affects an estimated 6 to 8 million people globally, with the highest prevalence in North America and Europe and rapid rise in Asia and the Middle East.

Typical age of onset. Most commonly diagnosed between ages 15 and 35, with a smaller second peak in older adults.

Severity tiers. Severity ranges from mild localized disease to severe and disabling forms with complications including strictures, fistulas, and dysplasia.

Why specialty drugs for Inflammatory bowel disease (Crohn's disease and ulcerative colitis) are hard to access internationally

Multiple biologics and small molecules have been approved for IBD over the past decade. Several newer agents including IL-23 antagonists and JAK inhibitors are not yet registered in many MENA and South Asian countries.

Treatments approved by the FDA

• Skyrizi (risankizumab) — FDA approval: 2019 (Crohn's 2022; UC 2024). Mechanism: IL-23p19 antagonist. Route: Subcutaneous injection every 8 weeks. US WAC ballpark: Approximately USD 18,000 to 24,000 per dose. Country pricing: UAE · Saudi Arabia · India · Qatar · Egypt.
• Omvoh (mirikizumab) — FDA approval: 2023 (Crohn's 2025). Mechanism: IL-23p19 antagonist for UC and Crohn's. Route: Intravenous induction then subcutaneous maintenance. US WAC ballpark: Approximately USD 110,000 per year.
• Rinvoq (upadacitinib) — FDA approval: 2019 (UC 2022; Crohn's 2023). Mechanism: Oral selective JAK1 inhibitor. Route: Oral once daily. US WAC ballpark: Approximately USD 70,000 per year. Country pricing: UAE · Saudi Arabia · India · Egypt.
• Stelara (ustekinumab) — FDA approval: 2009 (Crohn's 2016; UC 2019). Mechanism: IL-12/23 antagonist. Route: Subcutaneous injection every 8 weeks. US WAC ballpark: Approximately USD 14,000 to 18,000 per dose. Country pricing: UAE · Saudi Arabia · India · Egypt.
• Humira (adalimumab) — FDA approval: 2002 (Crohn's 2007; UC 2012). Mechanism: Anti-TNF monoclonal antibody. Route: Subcutaneous injection every 2 weeks. US WAC ballpark: Approximately USD 6,000 to 8,000 per dose. Country pricing: UAE · Saudi Arabia · India · Egypt.

Cross-border pathways used for Inflammatory bowel disease (Crohn's disease and ulcerative colitis)

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 IBD subtype (Crohn's versus UC), location, behavior, and prior treatment.
• Document failure or intolerance of prior therapy as required by destination payer or pathway.
• Screen for tuberculosis, hepatitis B and C, and update vaccinations before biologic initiation.
• Therapeutic drug monitoring is increasingly used to optimize biologic dosing.
• Gastroenterologist co-management is the standard.

Common questions

Which biologic is right for me?

Choice depends on disease subtype, severity, location, prior therapy, comorbidities, and patient preference. Your gastroenterologist decides.

Can I switch biologics?

Switching is common in IBD care. We support sequential international supply.

Are biosimilars available?

Multiple biosimilars are FDA-approved. Some are available through our pathway.

How long does shipment take?

Five to ten business days for most biologics.

What documents are required?

Gastroenterologist's prescription, recent disease activity assessment, and 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 Inflammatory bowel disease (Crohn's disease and ulcerative colitis), 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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