Prurigo nodularis: cross-border specialty drug access for international patients

Quick orientation

Prurigo nodularis affects an estimated 70 to 150 per 100,000 adults in the US, with similar relative prevalence in many international markets.

Typical age of onset. Most commonly diagnosed between ages 40 and 60.

Severity tiers. Severity ranges from limited disease to severe and disabling forms with substantial pruritus burden.

Why specialty drugs for Prurigo nodularis are hard to access internationally

Nemluvio (nemolizumab) and Dupixent (dupilumab) are FDA-approved biologics for prurigo nodularis. International registration of the indication-specific labels varies.

Treatments approved by the FDA

• Nemluvio (nemolizumab) — FDA approval: 2024 (prurigo nodularis). Mechanism: IL-31 receptor A antagonist. Route: Subcutaneous injection every 4 weeks. US WAC ballpark: Approximately USD 45,000 per year. Country pricing: Saudi Arabia · Egypt · Oman.
• Dupixent (dupilumab) — FDA approval: 2022 (prurigo nodularis). Mechanism: IL-4 and IL-13 receptor alpha antagonist. Route: Subcutaneous injection every 2 weeks. US WAC ballpark: Approximately USD 45,000 per year. Country pricing: UAE · Saudi Arabia · India · Egypt.

Cross-border pathways used for Prurigo nodularis

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 prurigo nodularis diagnosis and rule out other pruritic dermatoses.
• Document chronicity and severity.
• Screen for atopic and systemic disease.
• Dermatologist co-management is recommended.

Common questions

How do Nemluvio and Dupixent compare?

Both are biologics with the prurigo nodularis label. Selection depends on prior therapy, atopy, and patient factors.

Are they available outside the US?

Registration is rolling out. We confirm by destination.

How long until I see improvement?

Many patients see meaningful pruritus reduction within 4 to 8 weeks.

Can I use both biologics?

No. Sequential use is more typical if switching.

What documents are required?

Dermatologist's prescription, photographic documentation, 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 Prurigo nodularis, 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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