Last updated: February 17, 2026
Product Overview
NDC 69452-0115 corresponds to Xerava (eravacycline) for injection, an antibiotic indicated for complicated intra-abdominal infections (cIAI). Approved by the FDA in August 2018, Xerava is a tetracycline-class antibiotic developed by Tetraphase Pharmaceuticals. It is marketed for multi-drug resistant infections, particularly where standard therapies may fail.
Market Landscape
Market Size and Segmentation
- Target Population: The primary segment includes hospitalized adult patients with cIAI. The U.S. has approximately 250,000 cases annually (source: CDC, 2022).
- Market Penetration: As of 2023, Xerava's market penetration remains limited, with most prescriptions used in hospital settings for multi-drug resistant strains.
- Competitors: Other contemporary antibiotics include carbapenems (e.g., meropenem), tigecycline, and newer agents like cefiderocol.
Clinical Adoption Factors
- Spectrum: Effective against gram-positive and gram-negative bacteria, including carbapenem-resistant Enterobacteriaceae (CRE).
- Regulatory Status: FDA approval for cIAI with limited indications; no additional approvals for other infections as of 2023.
- Pricing and Reimbursement: Currently priced around $4,000–$5,000 per vial. Reimbursement is variable, with private insurers and Medicare adjusting accordingly.
Market Dynamics
-
Growth Drivers: Rising antibiotic resistance, scarcity of effective therapies, and hospital protocols favoring novel agents for resistant infections.
-
Market Limitations: High cost, limited indication scope, and competition from established antibiotics reduce adoption rates.
Price Projections
Current Pricing
- Per Vial Price: Estimated at $4,500–$5,000.
- Average Treatment Course: 5–7 days, requiring approximately 10–14 vials.
- Total Cost Per Treatment: $45,000–$70,000.
Forecast Factors
- Market Penetration Increase: With improved awareness and expanded indications, market share could grow modestly over the next 5 years.
- Pricing Trends: Anticancer and antimicrobial drugs with limited competition typically see price stabilization or moderate increases. Price hikes driven by inflation and manufacturing costs are estimated at 3–5% annually.
5-Year Price Projection (2023–2028)
| Year |
Estimated Per Vial Price |
Treatment Course Cost |
Notes |
| 2023 |
$4,750 |
$47,500 |
Current market price |
| 2024 |
$4,898 |
$48,980 |
3% increase due to inflation |
| 2025 |
$5,046 |
$50,460 |
Slight market expansion potential |
| 2026 |
$5,198 |
$51,980 |
Possible additional indication approvals |
| 2027 |
$5,353 |
$53,530 |
Increased hospital adoption expected |
| 2028 |
$5,514 |
$55,140 |
Market stabilization with steady demand |
Note: Prices reflect average retail estimates; actual prices may vary based on negotiations, insurance coverage, and hospital purchasing agreements.
Key Market Risks and Opportunities
Risks
- Emergence of new antibiotics could reduce Xerava's market share.
- Clinical data limitations and safety profile concerns restrict broader use.
- Reimbursement challenges due to high cost.
Opportunities
- Expansion of indications (e.g., other resistant infections) could elevate sales.
- Growing antimicrobial resistance crisis enhances demand for broad-spectrum agents like Xerava.
- Strategic partnerships or licensing might increase market reach.
Summary
Xerava (eravacycline) remains a niche but potentially growing asset within the antibiotic segment, with pricing projected to rise gradually over the next five years, assuming stable market conditions and regulatory support. Its high cost provides a revenue ceiling but also shows a willingness among hospitals and payers to pay for its efficacy against multi-drug resistant pathogens.
Key Takeaways
- Current price per vial: approximately $4,750.
- Treatment courses cost $45,000–$70,000.
- Price growth forecast: 3–5% annually over next five years.
- Market expansion likely driven by rising resistance and potential label extensions.
- Competition and reimbursement challenges may cap growth and pricing.
FAQs
1. What is the primary market for Xerava?
Hospitals treating patients with complicated intra-abdominal infections, especially those caused by resistant bacteria.
2. How does Xerava's price compare to other antibiotics?
It is significantly higher than traditional antibiotics like ceftriaxone (~$15 per dose) but comparable to other last-resort agents, such as tigecycline (~$200–$300 per vial).
3. What factors influence Xerava's market adoption?
Regulatory approvals, clinical efficacy, resistance profiles, healthcare provider familiarity, and reimbursement policies.
4. Are there opportunities to expand Xerava’s use?
Yes, expanding into other resistant infections or gaining approvals for additional indications could increase sales.
5. How might future developments impact pricing?
Emergence of new antibiotics or biosimilars could pressure prices downward; conversely, increased resistance could sustain or elevate pricing.
Citations
[1] CDC. Antibiotic Resistance Threats in the United States, 2022.
[2] FDA. Xerava (eravacycline) prescribing information, 2018.
[3] EvaluatePharma, 2023. Antibiotic market reports.
