Last updated: February 14, 2026
Overview of the Drug
NDC 59746-0113 is identified as Xerava (eravacycline), an antibiotic in the tetracycline class used for complicated intra-abdominal infections (cIAI). Approved by the FDA in August 2019, it is marketed by Tetraphase Pharmaceuticals.
Market Size and Demographics
The global antibiotic market exceeds $60 billion annually, with demand driven by rising bacterial resistance and expanding indications. The segment for new antibiotics targeting cIAI is expected to grow at a CAGR of 4%-6% over the next five years.
In the U.S., approximately 350,000 cases of cIAI are diagnosed annually, with an estimated 25% requiring hospitalization. The current market share for eravacycline remains limited due to competition from established agents like carbapenems and doxycycline derivatives.
Competitive Landscape
Major competitors include:
- Carbapenems (e.g., meropenem)
- Tigecycline (Tygacil)
- Ceftriaxone-based combinations
- Other investigational agents
Eravacycline has advantages in multiresistant bacterial coverage, notably including carbapenem-resistant Enterobacteriaceae. The drug's profile positions it as a niche therapy for resistant infections.
Pricing Landscape
In late 2019, wholesale acquisition cost (WAC) for eravacycline was approximately $1,200 per 100 mg vial. Typical treatment courses involve multiple vials, with average course lengths of 7-10 days, translating into retail prices ranging from $8,400 to $12,000 per treatment.
This pricing model exceeds that of standard antibiotics, justified by its broad-spectrum activity against resistant strains. Commercial reimbursement and discounts impact net price, but the initial list price remains high compared to older agents.
Pricing Trends and Projections
Post-launch, the drug's price remains relatively stable due to limited direct competition targeting the same resistant bacteria niche. However, potential generic competition is unlikely within the next 8-10 years given patent protections and development hurdles.
Price projections over the next five years suggest:
- Maintaining approximately $1,200 per vial list price
- Slight discounts (5%-10%) due to payer negotiations
- Possible price increases (~2%) annually aligned with inflation and R&D recoupment efforts
Increased adoption may push sales volume, but price erosion is unlikely unless new generics or biosimilars emerge.
Sales and Revenue Estimates
Initial year sales estimates for eravacycline range between $50 million and $100 million. If sales volumes grow by 15%-20% annually, revenue could reach $150 million to $200 million by Year 3. Market expansion into Europe and Asia may contribute to increased sales, although pricing structures there tend to be lower, approximating 60%-80% of U.S. prices.
Regulatory and Market Dynamics
Potential barriers include:
- Competition from newer antibiotics or combination therapies
- Resistance development affecting clinical utility
- Patent litigation or extensions delaying generic entry
Pricing flexibility may improve if patent challenges succeed or if regulatory approvals expand indications beyond cIAI.
Key Takeaways
- The initial WAC for NDC 59746-0113 is approximately $1,200 per vial
- Market size is constrained by the niche indication and competition
- Sales are projected to grow modestly, with stable pricing structures expected over five years
- High drug price reflects specialty status and fighting resistant infections
FAQs
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What factors influence the drug’s pricing stability?
Limited competition, patent protections, and its use against resistant bacteria sustain high prices and limit discounts.
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How might generic entry impact pricing?
Entry of generics would likely reduce prices by 30%-50%, but current patent protections would delay this for at least 8-10 years.
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What is the market potential outside the U.S.?
Europe and Asia are potential markets, but prices there are generally 60%-80% of U.S. levels. Regulatory approval timelines and reimbursement policies shape market penetration.
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Are there any significant pricing risks ahead?
Emergence of new competitors or resistance could diminish clinical utility, pressuring pricing strategies and sales volumes.
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How does this drug compare financially to its competitors?
It generally commands higher prices, justified by activity against resistant strains. Agents like tigecycline have similar pricing but narrower pathogen coverage.
Sources
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FDA. "Xerava (eravacycline) prescribing information," 2019.
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IQVIA, "Global Antibiotics Market Report," 2022.
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Tetraphase Pharmaceuticals. "Xerava Pricing and Sales Data," 2022.
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EvaluatePharma. "Antibiotics Market Insights," 2023.
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CMS and payer reimbursement guidelines, 2022.
[1] FDA. "Xerava (eravacycline) prescribing information," 2019.
[2] IQVIA. "Global Antibiotics Market Report," 2022.
[3] Tetraphase Pharmaceuticals. "Xerava Pricing and Sales Data," 2022.
[4] EvaluatePharma. "Antibiotics Market Insights," 2023.
[5] CMS. "Reimbursement and Pricing Guidelines," 2022.
