A generic version of Xeljanz® (tofacitinib) is now available in the United States, with prices reported as low as $25–$150 per month at some pharmacies and through certain discount programs. Actual costs will vary depending on the pharmacy, dosing, and available discounts. Tofacitinib is a Janus kinase (JAK) inhibitor approved by the U.S. Food and Drug Administration (FDA) to treat several inflammatory diseases, including rheumatoid arthritis. While it is not FDA approved to treat alopecia areata (AA), some dermatologists prescribed tofacitinib “off label” before JAK inhibitors specifically approved for alopecia areata became available. Off-label prescribing means a medication is prescribed for a condition other than its FDA-approved indication. This is a common and legal medical practice when a healthcare provider determines it is appropriate based on available scientific evidence and the individual patient’s circumstances. Even with new, approved therapies, some dermatologists may continue prescribing Xeljanz for patients with alopecia areata who are doing well on the medication and prefer not to switch to an FDA-approved treatment. The availability of a lower-cost generic may also provide another off-label treatment option for those who cannot access FDA-approved therapies because of insurance coverage or cost.
