Key takeaways:
Xolair (omalizumab) is an injectable medication that’s FDA approved to treat moderate-to-severe allergic asthma. It can also treat chronic rhinosinusitis with nasal polyps, treat chronic hives, and help lower the risk of severe allergic reactions to foods.
Xolair is covered by most health insurance plans, including the majority of commercial, Medicare, and Medicaid plans. In many cases, though, a prior authorization or step therapy is required before Xolair is covered.
There are ways to reduce the cost of Xolair. Xolair’s manufacturer provides several options for cost savings.
Save on related medications
Many people use medication to manage their asthma. Sometimes, an inhaler alone isn’t enough to treat a person’s asthma, though, and an injectable medication may be necessary to help make breathing easier.
Xolair (omalizumab) is a biologic medication that works by blocking immunoglobulin E (IgE), an antibody that triggers allergic reactions. It’s FDA approved to treat moderate-to-severe allergic asthma, chronic rhinosinusitis with nasal polyps (a type of sinus inflammation), and chronic spontaneous urticaria (hives). It’s also prescribed for food allergy risk reduction. Xolair is given as an under-the-skin injection, and your dosage will likely depend on the condition being treated.
While Xolair is an effective treatment overall, the cost can deter some people from starting or continuing treatment. What you’ll pay can depend on several factors, such as where you fill your prescription and whether you have insurance or qualify for savings programs. Here’s what you should know about how much Xolair costs and how to save.
How much does Xolair cost without insurance?
Xolair is a reference (“brand-name”) medication. According to its manufacturer, Genentech, Xolair’s current list price can be as high as $60,000 a year. That’s up to $5,000 a month.
While Xolair’s list price is set by the manufacturer, its retail price is influenced by pharmacies and wholesalers. This may be closer to what you’d pay out-of-pocket without insurance or discounts. GoodRx estimates suggest that the average retail price of Xolair is around $4702.83 per prescription.
Does Xolair have a biosimilar?
Yes, a biosimilar to Xolair was FDA approved in March 2025. Xolair’s biosimilar is called Omlyclo (omalizumab-igec), but it’s not commercially available quite yet. It’s expected to hit U.S. markets by September 2026.
Good to know: Biologics don’t have generics. Instead, they have biosimilars. While traditional generics are chemical copies of their brand-name counterparts, biosimilars are made from living systems and are only highly similar — not identical — to the reference biologic. Small, natural variations can occur, but these don’t affect how well the medication works or how safe it is.
What factors affect the cost of Xolair?
Health insurance may cover some or all of the costs of Xolair. But if insurance isn’t an option, then there are several factors that could affect the cost of the medication, including:
Pharmacy: Different pharmacies may offer different prices for the same medication.
Location: Medication costs can vary based on your location in the U.S. For example, people in Denver or Houston may pay less than those living in New Orleans or New York.
Quantity and dosage form: Your out-of-pocket costs can depend on how much of the medication you’re prescribed and how often you need to fill your prescription. The price may also be affected by whether you’re using Xolair as an autoinjector or prefilled syringe.
Also, keep in mind that medications like Xolair are often dispensed from specialty pharmacies. If you do have insurance, your cost can depend substantially on whether you use your plan’s preferred specialty pharmacies. We’ll discuss this more below.
Does insurance cover Xolair?
Most health insurance plans cover Xolair. This includes commercial insurance plans — including those purchased through the Affordable Care Act (ACA) marketplace — as well as Medicare and Medicaid plans.
If you have insurance, review your plan’s summary of benefits and coverage and formulary (list of covered medications) to determine whether Xolair is covered. If not, contact your plan provider and ask about your coverage options. You can also discuss alternative medications with your prescriber or pharmacist.
How different insurance plans cover Xolair
The following chart shows the likelihood of having coverage for Xolair with different types of insurance plans. It also shows the likelihood of needing to get prior authorization or do step therapy.
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Insurance type | Enrollees covered for Xolair 75 mg and 150 mg prefilled syringes | Enrollees required to get prior authorization | Enrollees required to do step therapy |
|---|---|---|---|
93.6% | 93.6% | 81.9% | |
Commercial plans (excluding ACA plans) | 97.6% | 90.6% | 85.9% |
Medicare (original Medicare and Medicare Advantage plans) | 99.9% | 99.9% | 94.3% |
Medicaid, including state-run and managed care plans | 98.7% | 87.9% | 68.6% |
Source: Managed Markets Insight & Technology, LLC™, as of September 11, 2025. (See methodology below.)
If your insurance doesn’t cover Xolair, try these options:
Ask your prescriber if there are other medications that could meet your needs. There might be an option that costs less, has a generic or biosimilar version available, or is preferred by your insurance plan.
Request a formulary exception from your insurance company. If your request is denied, you have the right to file an appeal with your plan.
Compare your health insurance options during open enrollment to find a plan that better fits your coverage needs.
Ways to save on Xolair
Whether or not you have insurance, Xolair can be tough on your budget. Here are four ways to potentially save on your Xolair prescription.
1. See if you qualify for a copay savings card
Ask your prescriber or pharmacist if you qualify for the manufacturer’s copay savings program. Through the Xolair Co-pay Program, you could pay as little as $0 per prescription and even receive support for injection administration costs. The program offers up to $15,000 each year in savings on Xolair, and up to $1,500 per year for injection administration support.
You may qualify for the program if you:
Have commercial (private) insurance
Are using Xolair for an FDA-approved condition
Aren’t receiving other financial assistance for Xolair
2. Check if you’re eligible for a patient assistance program
Patient assistance programs (PAPs) help provide financial assistance to people who are underinsured or don’t have insurance. They typically offer medications at no cost to enrollees.
The Genentech Patient Foundation offers one option to look into. There are a few ways to qualify for this manufacturer-sponsored PAP:
Being uninsured and making less than $150,000 per year
Being insured, but not having coverage for Xolair and making less than $150,000 per year
Having coverage for Xolair, but also having an out-of-pocket maximum greater than 7.5% of your yearly household income
Other, independent PAPs are also available. The majority of them — such as those through the Patient Access Network (PAN) Foundation, HealthWell Foundation, and The Assistance Fund — are currently closed, but you may be able to join their waitlists for when they reopen.
3. Tap into your HSA, FSA, or HRA
Another option is using your flexible spending account (FSA), health savings account (HSA), or health reimbursement arrangement (HRA) to pay for Xolair. These types of accounts have tax benefits when the funds are used for qualified healthcare expenses. This can reduce your out-of-pocket costs through tax savings. But be sure to review your account’s contribution limits, rollover limits, and eligible expenses.
4. Review your insurance plan
If you have insurance, be sure that you’re filling Xolair through one of your insurance plan’s preferred pharmacies. The pharmacy you use can have a sizable impact on the cost of the medication.
Check with your insurance company to see which pharmacies are considered in network with your plan. You can check through your plan’s online portal or call the customer service number on the back of your insurance card.
The bottom line
Xolair (omalizumab) is an injectable medication used for asthma, food allergy risk reduction, and other allergic health conditions. The average retail price of Xolair is $4702.83 per prescription.
Xolair’s cost may make it difficult for some people to afford beginning or continuing treatment. If you have health insurance, that’s generally the best way to save on Xolair. But other options to save include signing up for a manufacturer copay savings card or patient assistance program.
Why trust our experts?
Methodology
We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of September 2025.
We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel.
We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.
Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel.
These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).
References
American College of Allergy, Asthma, and Immunology. (2021). Chronic rhinosinusitis with nasal polyps.
Celltrion. (2025). Omlyclo (omalizumab-igec) injection, for subcutaneous use [package insert].
HealthWell Foundation. (n.d.). Asthma.
Kang, J. (2025). Omalizumab interchangeable biosimilar Omlyclo gets FDA approval. Medical Professionals Reference.
Medicaid.gov. (n.d.). Managed care.
The Assistance Fund. (n.d.). Disease program hub.
Xolair. (n.d.). Financial assistance options. Genentech.
Xolair. (n.d.). Xolair pricing and financial support. Genentech.
