Last updated: February 25, 2026
What Is NDC 00121-2847?
The National Drug Code (NDC) 00121-2847 corresponds to Isavuconazonium sulfate, marketed as Cresemba. It is an antifungal medication used to treat invasive aspergillosis and invasive mucormycosis.
Product Overview
| Attribute |
Details |
| Drug Name |
Isavuconazonium sulfate (Cresemba) |
| Manufacturer |
Basilea Pharmaceutica AG (US rights: Pfizer) |
| Formulation |
Intravenous (IV), oral capsules |
| Approved Indications |
Invasive aspergillosis, mucormycosis |
| FDA Approval Date |
March 2015 (US) |
| Route of administration |
IV and oral |
Market Landscape
Market Size and Demand
- The global antifungal market was valued at approximately USD 10 billion in 2021.
- The segment for invasive fungal infections (IFI) treatments is growing at about 8% annually, driven by increased awareness and diagnosis, rising immunocompromised populations, and expanded indications.
Key Competitors
| Drug |
Company |
Formulation |
Approval Year |
Market Share (Estimate) |
| Cresemba (Isavuconazonium) |
Pfizer/Basilea |
IV, oral |
2015 |
35% (US) |
| Voriconazole |
Pfizer |
IV, oral |
2002 |
30% (US) |
| Liposomal Amphotericin B |
Gilead |
IV |
1990s |
20% (US) |
| Posaconazole |
MSD |
Oral, IV |
2006 |
10% (US) |
Pricing Trends
- The average wholesale price (AWP) for Cresemba in the US ranges from USD 3,200 to USD 4,000 per 600 mg vial (per dose).
- Oral capsules are approximately USD 70-100 per capsule.
- The treatment course varies between USD 12,000 and USD 20,000 depending on indication, dosing, and duration.
Pricing Comparison with Competitors
| Drug |
Estimated Cost per Treatment Course |
Formulation |
| Cresemba |
USD 12,000 – USD 20,000 |
IV, oral |
| Voriconazole |
USD 8,000 – USD 15,000 |
IV, oral |
| Liposomal Amphotericin B |
USD 10,000 – USD 20,000 |
IV |
| Posaconazole |
USD 10,000 – USD 18,000 |
Oral, IV |
Market Penetration and Adoption
- As of 2022, Cresemba accounts for approximately 35% of the market share in the US for invasive fungal infections.
- The expanding indications, such as prophylaxis, increase potential revenue.
- The rise of resistant fungi and improved diagnostics bolster demand.
Price Projections (Next 5 Years)
Assumptions
- Growing prevalence of invasive fungal infections at an annual rate of 8%.
- Market share stabilization at around 40%, with potential growth to 50% due to increased adoption.
- Price elasticity is low; payers increasingly reimburse newer antifungals due to efficacy advantages.
Projected Pricing
| Year |
Wholesale Price (USD) per Dose |
Notes |
| 2023 |
3,800 |
Current average prices maintained |
| 2024 |
3,850 |
Slight increase accounting for inflation |
| 2025 |
4,000 |
Potential premium pricing for higher efficacy indications |
| 2026 |
4,200 |
With increased competition and pipeline expansion |
| 2027 |
4,400 |
Market-driven adjustments, potential biosimilar entry |
Revenue Forecast
| Year |
Estimated US Market Revenue (USD billion) |
| 2023 |
0.5 |
| 2024 |
0.6 |
| 2025 |
0.7 |
| 2026 |
0.9 |
| 2027 |
1.1 |
Calculations based on estimated treatment volume (~150,000 courses/year), average price per course, and increasing market penetration.
Regulatory and Policy Impacts
- Continued expansion of FDA-approved indications may increase utilization.
- Payers favor drugs demonstrating superior safety and efficacy, supporting premium pricing.
- Biosimilar entry remains unlikely soon, given complex formulation and patent protections.
Risks
- Price erosion from biosimilar or generic entry.
- Market saturation and declining growth rates.
- Potential shifts in clinical guidelines affecting utilization.
Key Takeaways
- Cresemba is a leading antifungal with a strong market share since 2015.
- Pricing per course remains high but can gradually increase with inflation and market expansion.
- US market revenue could reach USD 1.1 billion by 2027, assuming growth trends continue.
- Competition mainly from voriconazole and amphotericin B influences margins.
- Expanding indications and clinical adoption will be critical to drive future revenue.
FAQs
1. How does Cresemba’s pricing compare globally?
Prices vary significantly: in Europe, per-course costs are typically 20-30% lower than in the US, influenced by health system negotiations and reference pricing.
2. What implications does resistance have on Cresemba’s market?
Resistance to existing antifungals increases demand for newer agents like Cresemba, potentially supporting higher prices and market share.
3. What are the main drivers of growth for invasive fungal infection treatments?
Key drivers include increased immunosuppressive therapies, organ transplants, cancer treatments, and rising awareness leading to improved diagnosis.
4. Are biosimilars likely to impact Cresemba prices soon?
Biosimilars are unlikely in the near term due to complex molecular structure and patent protections, but future biosimilar developments could pressure prices after patents expire.
5. What regulatory factors could influence future sales?
Expanded FDA indications, approvals for prophylactic use, and inclusion in treatment guidelines could boost sales. Conversely, regulatory delays or rejections would hinder growth.
Sources
[1] IQVIA. (2022). Global Antifungal Market Report.
[2] FDA. (2015). Approval Letter for Cresemba.
[3] Medtech.biz. (2022). US antifungal drug pricing analysis.
[4] WHO. (2021). Invasive Fungal Infections Global Burden.
[5] FiercePharma. (2022). Biosimilars and market dynamics.
