New targeted eczema treatments such as Janus kinase (JAK) inhibitors and biologics have been approved and are available in Singapore, but many patients cannot afford them due to their high price [1]. About 20% of eczema sufferers with poorly controlled disease need systemic treatment beyond topicals and moisturisers, but these newer drugs cost around S$1,200 (US$940) per month [1].
Ms Chloe Ng, a patient who first tried an oral JAK inhibitor at the National Skin Centre in 2021, said the drug cleared about 95% of her eczema [1]. She described how the medication dramatically improved her quality of life: "I live a normal life after taking this new medicine. Otherwise, I can't sleep. Since 2008, until the day before I tried the new medicine, I didn't sleep well for all these years" [1].
However, Ms Ng also highlighted the financial barriers: "Eczema is what our grandmothers call ‘rich people’ kind of sickness. Because if you are financially okay, you can buy better medicine to treat yourself. But if you don’t have money, you have no choice. You just take cheaper medicine" [1].
Before these targeted treatments became available, severe eczema cases relied on oral immunosuppressants, which can cause serious side effects including high blood pressure, infections, and increased cancer risks with long-term use [1]. Singapore approved the use of a biologic drug for eczema in 2019 [1].
About one in five schoolchildren and one in ten adults in Singapore have atopic dermatitis, and many manage the condition with topical treatments, moisturisers, and avoiding triggers [1]. Yet a subset of patients with severe cases must depend on costly systemic therapies many cannot afford.
The next milestone for eczema treatment access in Singapore is yet unreported, but costs remain a critical barrier preventing wider use of JAK inhibitors and biologics among patients who could benefit from them [1].
