What is the monthly cost of asfotase alpha (hypophosphatasia treatment)?

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Last updated: November 29, 2025View editorial policy

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Cost of Asfotase Alpha

The monthly cost of asfotase alpha is extremely high, with no specific pricing data available in the provided evidence, though comparable enzyme replacement therapies for rare genetic diseases range from approximately $13,000 to over $160,000 per year depending on dosing and patient weight.

Available Cost Context

Unfortunately, none of the provided evidence contains specific pricing information for asfotase alpha (Strensiq). However, the evidence does provide relevant context from similar enzyme replacement therapies for rare genetic diseases:

Comparable Enzyme Replacement Therapy Costs

  • Fabry disease treatment (agalsidase alfa/beta): Approximately $160,000 per year for a 70-kg patient in Europe, which translates to roughly $13,300 per month 1
  • This cost includes the medication plus infusion-related expenses 1

Dosing Considerations That Impact Cost

The actual cost for asfotase alpha will vary significantly based on:

  • Patient weight: Dosing is weight-based at 2 mg/kg three times weekly (standard maintenance dose) or up to 3 mg/kg three times weekly for perinatal/infantile-onset HPP 2
  • Formulation concentration: The higher concentration formulation (80 mg/0.8 mL) achieves approximately 25% lower systemic exposure compared to lower concentration formulations, which may affect dosing requirements 2
  • Disease severity: Some patients with less severe disease may respond to reduced doses (as low as 2 mg/kg/week has been reported in case studies) 3

Treatment Duration

  • Asfotase alpha is a lifelong therapy for hypophosphatasia 2, 4
  • Long-term studies demonstrate sustained treatment for over 7 years in pediatric patients 4
  • Adult patients also require ongoing treatment to maintain improvements in mobility and quality of life 5

Important Cost-Related Considerations

Given that enzyme replacement therapies for rare genetic diseases typically rank among the most expensive medications available, patients and families should:

  • Contact the manufacturer (Alexion Pharmaceuticals) directly for current pricing information
  • Explore patient assistance programs that may be available
  • Verify insurance coverage, as these medications are typically covered under medical benefits (Part B) rather than pharmacy benefits 1
  • Be aware that out-of-pocket costs can be substantial even with insurance coverage 1

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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