Last updated: February 16, 2026
Overview of the Drug
NDC 61748-0111 corresponds to Xerava (reboxed), the brand name for eravacycline, an intravenous (IV) antibiotic developed by Tetraphase Pharmaceuticals. It is indicated for complicated intra-abdominal infections (cIAI). The drug gained FDA approval in August 2018 under accelerated pathways, with full approval following later.
Market Context
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Indications and Patient Population
- Targets complicated intra-abdominal infections, involving severe bacterial infections caused by susceptible pathogens.
- Approximate annual market size in the U.S.: 1.2 million cases of cIAI, with about 400,000 receiving IV antibiotics, representing a market with an estimated value exceeding $1.2 billion (source: GlobalData, 2022).
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Competitive Landscape
- Primary competitors include carbapenems (meropenem, ertapenem), cephalosporins (ceftriaxone), and newer antibiotics such as merivon and avycaz.
- Limited direct competition from other tetracyclines, as eravacycline's broad-spectrum activity against resistant strains like carbapenem-resistant Enterobacteriaceae (CRE) offers differentiation.
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Market Dynamics
- Growing antibiotic resistance drives demand for innovative agents like eravacycline.
- Increasing recognition of resistant pathogens in hospital settings supports uptake.
- Prescriber adoption is influenced by formulary inclusion, hospital protocols, and antibiotic stewardship programs.
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Regulatory and Reimbursement Environment
- Coverage primarily through private insurers and Medicare Part D for outpatient use; inpatient coverage via Medicare, Medicaid, and commercial payers.
- Price negotiations at hospital and insurer levels may impact net revenue.
Pricing History and Projections
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Current Price Point
- Wholesale Acquisition Cost (WAC): Approximately $600-$700 per vial (average 50 mg).
- Average course: 3-4 vials for a typical adult treatment course, translating to estimated $1,800-$2,800 per treatment.
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Pricing Trends (2022-2023)
- Initial launch price (2018): Around $600 per vial.
- Market-entry discounts and formulary negotiations have not significantly reduced the list price but may influence net prices upon broader adoption.
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Forecasted Price Changes (2024-2028)
- External Factors: Increased antimicrobial resistance and newer competitor development is likely to sustain or elevate eravacycline’s price point.
- Internal Factors: Expansion of indications, line extensions, and potential formulations (e.g., oral) could lead to price adjustments.
Estimated WAC increase of 2-4% annually, driven by inflation and development costs.
| Year |
Estimated WAC per vial |
Notes |
| 2024 |
$730-$760 |
Stable market, moderate inflation |
| 2025 |
$750-$790 |
Possible formulary gains |
| 2026 |
$770-$830 |
Resistance growth, new formulations |
| 2027 |
$790-$870 |
Competition may influence pricing |
| 2028 |
$820-$900 |
Market consolidation possible |
Revenue Projections
Key Market Opportunities and Risks
-
Opportunities
- Growing prevalence of resistant infections boosts demand.
- New formulations, especially oral versions, could expand the patient base.
- Potential for expanded indications (e.g., urinary tract infections, skin infections).
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Risks
- Off-label use and safety data limitations may hinder uptake.
- Competition from generics and emerging antibiotics could erode pricing power.
- Reimbursement and formulary access barriers limit rapid growth.
Key Takeaways
- NDC 61748-0111 (eravacycline) is positioned in a niche with growing antibiotic resistance concerns.
- Current WAC per vial is ~$600-$700, with modest annual price increases forecasted.
- Market potential hinges on prescriber adoption, formulary access, and resistance trends.
- Revenue projections suggest substantial growth if market share goals are met, but competitive dynamics pose risks.
- Expansion into new indications and formulations could materially improve pricing and sales.
FAQs
Q1: What is the current approved indication for eravacycline?
A1: Approved for complicated intra-abdominal infections in adults.
Q2: How does the price of eravacycline compare to similar antibiotics?
A2: Its WAC (~$600-$700/vial) is comparable to other broad-spectrum IV antibiotics, but specific comparisons depend on formulations and dosing.
Q3: What are the main factors influencing eravacycline’s future pricing?
A3: Resistance patterns, competition, formulary access, and approval of new formulations or indications.
Q4: What is the likely market size for eravacycline?
A4: Approximately 400,000 patients annually in the U.S. receiving IV antibiotics for cIAI, representing a potential $1 billion+ market.
Q5: What regulatory developments could impact the drug’s market?
A5: FDA approval of oral formulations or additional indications can significantly expand its market.
References
- GlobalData. (2022). Antimicrobial Market Analysis.
- FDA. (2018). Eravacycline Approval Documentation.
- Medicare & Medicaid Services. (2023). Reimbursement Policy Overview.
- IQVIA. (2022). Pharmaceutical Pricing Trends.
