Severe Asthma Biologic Drug Cost Calculator

Severe Asthma Biologic Drug Cost Calculator helps estimate Korea-related chronic treatment, biologic drug, dialysis, obesity medication, and long-term management assumptions in English.

Health cost scenario inputs

Enter Korea-related chronic care, eldercare, therapy, procedure, fertility, diagnostic, or medical tourism assumptions. Results are simplified planning estimates.

Treatment cost over period

₩192,331,152

Monitoring or support cost

₩0

Increase reserve

₩57,699,346

Planning window cost

₩250,030,498

12 months

This English page explains Korea severe-asthma biologic drug costs. Severe asthma stays uncontrolled despite high-dose inhaled corticosteroids plus long-acting bronchodilators (LABA/LAMA) or depends on frequent exacerbations and oral steroids; biologics are add-on maintenance therapy that block a specific inflammatory target (they do not cure). Six biologics are used in Korea: omalizumab (Xolair, anti-IgE, weight/IgE-based 75-600 mg SC every 2-4 weeks, reimbursed 2020, 150 mg about KRW 271,700), mepolizumab (Nucala, anti-IL5, 100 mg SC every 4 weeks, 2023), reslizumab (Cinqair, anti-IL5, 3 mg/kg IV every 4 weeks, 2023), benralizumab (Fasenra, anti-IL5R, 30 mg SC three doses every 4 weeks then every 8 weeks, 2024), dupilumab (Dupixent, anti-IL4R / type-2, 600 mg then 300 mg SC every 2 weeks, reimbursed for severe type-2 asthma from January 2026, 300 mg benefit-ceiling about KRW 696,852/syringe, roughly KRW 16 million/year at 100% and about KRW 4.76 million/year at a 30% copay as reported), and tezepelumab (Tezspire, anti-TSLP, 210 mg SC every 4 weeks, approved 2023 but NOT reimbursed in Korea as of 2026 - fully out of pocket). The decisive point: unlike idiopathic pulmonary fibrosis or severe atopic dermatitis (rare / severe-refractory special case, 10% copay), severe asthma is NOT a copayment special-case condition in Korea, so even when a biologic is covered the patient pays the ordinary benefit copay (30% at a pharmacy/clinic, up to 60% at a tertiary hospital outpatient, 20% inpatient), and the medical-expense tax credit keeps its ordinary KRW 7,000,000 cap (no special-case exemption). Patient groups and specialists are lobbying to add severe asthma to the special-case list. Coverage still requires meeting eosinophil-count and exacerbation criteria, and switching between biologics is generally not reimbursed (only Xolair-to-Fasenra is allowed case by case). The annual out-of-pocket ceiling still refunds covered self-pay above the income-tier cap (about KRW 900,000-8,430,000 in 2026), and private indemnity insurance reimburses part of the burden. Only Xolair (KRW 271,700 / 150 mg) and Dupixent (KRW 696,852 / 300 mg) prices are exact list figures; the others are estimates around KRW 8 million/year that you should replace with the actual HIRA tariff. It is planning guidance based on 2026 Korean rules, not medical advice or an insurer decision.

Related calculators

What is the severe asthma biologic cost calculator?

This calculator estimates the annual drug cost and the real out-of-pocket burden of biologic (injectable) therapy for uncontrolled severe asthma in Korea.
You pick omalizumab (Xolair), mepolizumab (Nucala), reslizumab (Cinqair), benralizumab (Fasenra), dupilumab (Dupixent), or tezepelumab (Tezspire), and it applies coverage, the annual out-of-pocket ceiling, private indemnity insurance, and the medical-expense tax credit, step by step.

The decisive point is that severe asthma is NOT a copayment special-case condition in Korea.
Unlike idiopathic pulmonary fibrosis (rare disease, 10%) or severe atopic dermatitis (severe-refractory, 10%), severe asthma has no special case, so even a covered biologic is billed at the ordinary benefit copay (30–60% outpatient).

Korea-based estimate. This calculator is built on Korean National Health Insurance rules for 2026 — the fact that severe asthma is not a copayment special case, the ordinary benefit copay rates (National Health Insurance Act Article 44), the annual out-of-pocket ceiling, private indemnity insurance, and the medical-expense tax credit. Drug prices are benefit-ceiling figures that change with actual transaction price and risk-sharing agreements. It is an educational estimate, not medical advice, and does not replace diagnosis, treatment decisions, a hospital quote, or an insurer/benefit decision.

Severe asthma and biologics

Severe asthma stays uncontrolled despite high-dose inhaled corticosteroids (ICS) plus long-acting bronchodilators (LABA/LAMA), or depends on frequent exacerbations and oral steroids.
For these patients, biologics that block a specific inflammatory target (IgE, eosinophils, type-2 inflammation, TSLP) are used as add-on maintenance therapy.

Biologics do not cure asthma; they are maintenance therapy that reduces exacerbations and oral-steroid use and improves quality of life.
Response is usually assessed after about 4 months before deciding whether to continue, and if there is no response a different mechanism is considered.

Biologics by target (mechanism)

  • • Omalizumab (Xolair) · anti-IgE: allergic (IgE-mediated) severe asthma. 75–600 mg SC every 2–4 weeks based on weight and serum IgE. Reimbursed 2020
  • • Mepolizumab (Nucala) · anti-IL5: severe eosinophilic asthma. 100 mg SC every 4 weeks (self-injection). Reimbursed 2023
  • • Reslizumab (Cinqair) · anti-IL5: severe eosinophilic asthma. 3 mg/kg IV every 4 weeks (in-hospital, weight-based). Reimbursed 2023
  • • Benralizumab (Fasenra) · anti-IL5Rα: severe eosinophilic asthma. 30 mg SC three times every 4 weeks, then every 8 weeks. Reimbursed July 2024
  • • Dupilumab (Dupixent) · anti-IL4Rα: severe type-2 inflammatory asthma. 600 mg then 300 mg SC every 2 weeks. Reimbursed January 2026
  • • Tezepelumab (Tezspire) · anti-TSLP: blocks an upstream inflammation switch regardless of phenotype. 210 mg SC every 4 weeks. Non-covered in Korea as of 2026

Patients with eosinophilic inflammation may respond to Nucala, Cinqair, Fasenra, or Dupixent, while Xolair is considered first for allergic (IgE-mediated) disease.
Drug choice weighs eosinophil count, serum IgE, type-2 markers (FeNO), comorbidities (nasal polyps, atopic dermatitis), and convenience together with your physician.

Severe asthma is not a copayment special case

Many people expect a high-cost biologic to bring the copay down to 10% (or 5%) through the special case, but as of 2026 severe asthma is not a special-case condition.
It is listed in neither the cancer (5%) nor the rare/severe-refractory (10%) categories of the Ministry of Health and Welfare notice “Standards for Special Cases of Copayment” (Notice No. 2026-101).

What changes without a special case

  • • Copay rate: the ordinary benefit copay applies, not 10% — 30% at a pharmacy/clinic, 40% at a hospital, 50% at a general hospital, 60% at a tertiary hospital outpatient, 20% inpatient.
  • • Tax-credit cap: registered special-case patients have no KRW 7,000,000 cap on the medical-expense tax credit, but severe asthma keeps the ordinary KRW 7,000,000 cap (those 65+ or with a disability are exempt on separate grounds).
  • • Safety net: covered self-pay is still subject to the annual out-of-pocket ceiling, so the excess above the income-tier cap is refunded.
  • • Policy gap: specialists and patient groups argue that “severe asthma is also a serious illness” and are asking for both reimbursement and special-case designation.

The basis is the National Health Insurance Act Article 44 and Enforcement Decree Article 19(1) Annex 2 (benefit copay rates) and the notice “Standards for Special Cases of Copayment” (No. 2026-101), which does not list severe asthma.
This calculator also shows a “what if severe asthma were a special case” comparison (current 30–60% vs a hypothetical 10%) to visualize the extra burden from this policy gap.

Coverage criteria and switching restrictions

A biologic is billed at 30–60% copay only when reimbursement criteria are met; otherwise it is fully non-covered.
The common requirement is asthma uncontrolled on high-dose ICS/LABA (±LAMA) in patients aged 12+, plus drug-specific thresholds for blood eosinophil count and annual exacerbations.

Switching between biologics is generally not reimbursed

  • • Dupixent’s reimbursement criteria explicitly state that switching among Nucala, Cinqair, Fasenra, and Xolair is not reimbursed.
  • • So if you change from one biologic to a different mechanism, the new drug may not be covered.
  • • The exception: after 3–6 months of Xolair with insufficient effect, switching to Fasenra is reimbursed case by case with a physician’s opinion letter.
  • • The first biologic choice therefore matters, and picking the drug that fits your phenotype (eosinophils, IgE, type-2 inflammation) is also better for cost.

Tezepelumab (Tezspire) was approved in 2023 but is not on the Korean benefit list as of 2026, so its full cost is paid out of pocket regardless of criteria.
This calculator automatically treats Tezspire as non-covered and shows a warning badge.

How much does the drug cost?

Most severe-asthma biologics cost several million to over ten million KRW a year.
If covered you pay the copay rate (30–60%); if non-covered you pay 100%.

  • • Omalizumab (Xolair): about KRW 271,700 per 150 mg prefilled syringe (benefit ceiling); 300 mg every 4 weeks example → about KRW 7.06 million/year at 100% (varies with dose)
  • • Mepolizumab / reslizumab (anti-IL5): about KRW 615,000 per dose (estimate), every 4 weeks → about KRW 8 million/year
  • • Benralizumab (Fasenra): every-8-week maintenance means fewer doses → about KRW 7.15 million/year (estimate)
  • • Dupilumab (Dupixent): about KRW 696,852 per 300 mg, every 2 weeks → about KRW 16 million/year at 100%; when covered, about KRW 4.76 million/year at 30% as reported
  • • Tezepelumab (Tezspire): about KRW 600,000 per dose (estimate), every 4 weeks → about KRW 7.8 million/year (fully non-covered)

Dupixent is dosed every 2 weeks, so its annual drug cost is roughly twice that of the every-4-week biologics.
Except for Xolair and Dupixent, the prices are estimates based on “around KRW 8 million/year” media reports, so confirm the exact benefit-ceiling price in the HIRA drug tariff.

Out-of-pocket ceiling and medical-expense tax credit

Even without a special case, the annual out-of-pocket ceiling and the medical-expense tax credit lower the real burden of these long-term, high-cost drugs.
Both are based on covered copay and the burden remaining after private-insurance reimbursement.

Two programs — key points

  • • Annual out-of-pocket ceiling: if annual covered copay exceeds the income-tier cap (about KRW 900,000–8,430,000 in 2026), the excess is refunded, and it applies again every year during long-term treatment.
  • • Medical-expense tax credit: 15% of medical spending above 3% of gross salary, excluding private-insurance reimbursement and the ceiling refund.
  • • Ordinary KRW 7,000,000 cap: because severe asthma has no special case, the ordinary KRW 7,000,000 tax-credit cap applies (Income Tax Act Article 59-4).
  • • Private indemnity insurance: reimburses covered copay and non-covered drug cost at your generation’s coinsurance rate, subject to per-visit and annual limits.

Non-covered drug cost (Tezspire) is not eligible for the ceiling refund, but as a treatment drug it is eligible for the medical-expense tax credit.
Amounts refunded by the ceiling and reimbursed by private insurance must be excluded from the tax credit to avoid double-counting.

How to use this calculator

Step 1: Choose the drug

Pick Xolair, Nucala, Cinqair, Fasenra, Dupixent, or Tezspire, then set coverage and treatment period.
Choosing Tezspire is computed automatically as non-covered with a warning badge.

Step 2: Copay conditions

Set the care setting (pharmacy 30% up to tertiary 60%), income tier, and the out-of-pocket ceiling.
There is no special-case toggle because severe asthma is not a special case, and choosing non-covered removes the ceiling automatically.

Step 3: Insurance and tax credit

Enter your private indemnity insurance generation and gross annual salary to reflect reimbursement and the medical-expense tax credit.

Step 4: Review results

See annual copay, current vs hypothetical 10% special case, covered vs non-covered, the ceiling refund, private-insurance reimbursement, the tax credit, and the final real burden at a glance.

Frequently asked questions (FAQ)

Q. Does severe asthma get a 10% special-case copay?

A. No. As of 2026 severe asthma is not a special-case condition, so even a covered biologic is billed at the ordinary copay (30–60% outpatient).
Unlike IPF or severe atopic dermatitis (10%), specialists and patient groups are still asking for special-case designation.

Q. Which biologics are covered?

A. Xolair (2020), Nucala (2023), Cinqair (2023), Fasenra (2024), and Dupixent (2026) are reimbursed.
Tezspire (tezepelumab) was approved in 2023 but is not on the Korean benefit list as of 2026, so it is fully out of pocket.

Q. Is switching between biologics covered?

A. Switching between biologics is generally not reimbursed.
The exception is switching from Xolair to Fasenra after 3–6 months with insufficient effect and an opinion letter, so the first choice matters.

Q. Why is Dupixent’s annual cost higher?

A. Dupixent is dosed every 2 weeks (about 23–26 doses/year), roughly twice as often as every-4-week drugs (about 13/year).
At about KRW 696,852 per 300 mg, that is about KRW 16 million/year at 100%, and about KRW 4.76 million/year at a 30% copay as reported.

Q. Can private insurance reimburse the drug cost?

A. Therapeutic biologic drug cost is eligible for private indemnity insurance.
It reimburses covered copay and non-covered drug cost at your generation’s coinsurance rate, subject to per-visit and annual limits — check your policy.

Important notes

  • Reference estimate: prices vary with actual transaction price and risk-sharing agreements; this calculator uses 2026 public drug prices. Only Xolair and Dupixent are exact list figures; the others are estimates.
  • Coverage is individual: whether criteria (eosinophil count, exacerbations) are met depends on the patient, so confirm with your physician and HIRA.
  • No special case: severe asthma has no special case, so covered use is billed at 30–60% and the tax credit keeps its ordinary KRW 7,000,000 cap.
  • Tezspire is non-covered: tezepelumab is not on the Korean benefit list as of 2026, so it is fully out of pocket with no ceiling.
  • Rules change: reimbursement listing, drug prices, and the out-of-pocket ceiling can change yearly — check the latest notice.

Estimate your severe asthma biologic cost now

Enter the drug, coverage, care setting, and income tier to see the annual real burden of all six biologics.

Compare current (no special case) vs a hypothetical 10%, covered vs non-covered, and the out-of-pocket ceiling refund in one place.