Opzelura Cost: US $2,136 per 60 g, England £657 per 100 g

Opzelura is a cream for vitiligo, the condition that leaves pale patches where skin loses its colour. Its active ingredient is ruxolitinib, a drug that dampens part of the immune system.¹ In the US, its maker Incyte lists a 60 g tube at $2,136.²

England's NHS now pays for it too, from a list price of £657 for a 100 g tube.³ France reimburses it at a listed price of €838.39 for the same size.⁴ This article sets out what the cream costs in each country, who pays, and who qualifies.

Opzelura cost at a glance

The prices are in different currencies and for different tube sizes, so we have not converted them. Per 100 g, the US wholesale list price works out at about $3,560.²

United States: a list price few patients pay in full

Incyte must publish its wholesale price for prescribers in Colorado. Its January 2026 notice lists a 60 g tube at $2,136.² A year earlier the same notice said $2,094.⁵ Incyte's own cost page still showed $2,094 when we checked in October 2026.⁶

A wholesale list price comes before rebates and discounts. Incyte's notice says the price a patient pays "may differ and is dependent upon the individual patient's insurance".²

Without insurance, the price can be higher. SingleCare, a discount-card company, put the retail price of a 60 g tube at $2,839 in November 2025.⁷ It said its coupon cut that to about $1,837.⁷

Incyte runs a copay card for patients with commercial insurance. Covered patients "may pay as little as $0 per tube".⁶ If the plan does not cover the cream, the card brings the price to $35 at participating pharmacies.⁶ Patients on Medicare, Medicaid or other government plans cannot use it, and neither can people paying cash.⁶

Insurers set their own conditions. Cigna's policy, reviewed in August 2026, approves the cream for vitiligo for six months at a time.¹ The patient must be 12 or over, with vitiligo on no more than 10% of the body.¹ They must first have tried a strong steroid cream or a calcineurin inhibitor cream, another type of anti-inflammatory, for at least 12 weeks.¹

England: NHS funding after other creams fail

NICE published its final guidance in March 2026. It recommends the cream for non-segmental vitiligo on the face, the common type that appears on both sides of the body, in people aged 12 and over.⁸ The NHS can use it only after first-line creams have not worked or are not suitable.⁸

NICE gives a list price of £657 for a 100 g tube.³ Incyte has a commercial arrangement that gives the NHS a discount, and the size of that discount is confidential.³ The NHS in England must fund the cream within 90 days of the guidance.⁸

The price is what changed. NICE describes the March 2026 guidance as a rapid review of its earlier appraisal, TA1088, prompted by a revised commercial arrangement from Incyte.⁸ The evidence gaps remained. NICE's committee found trial results showed more skin regained colour than with a placebo cream.⁸ But it judged a comparison with light therapy too uncertain to show which works better.⁸

The Pharmaceutical Journal reported that NICE estimates more than 80,000 adults and teenagers in England could benefit.⁹ It described the cream as the first licensed vitiligo treatment approved for NHS use.⁹

France: reimbursed, at a different price

France moved earlier. A government order of 26 January 2024 gave the cream full reimbursement through a fast-track scheme. It was dispensed only through hospital pharmacies.¹⁰

The terms have since changed. The French drug database Vidal, updated in September 2026, lists a 100 g tube at €838.39.⁴ It shows a 65% reimbursement rate, and says only dermatologists can prescribe it.⁴ We did not find a published notice explaining the move from full to 65% reimbursement.

What the headline numbers leave out

The licences differ. In the UK and the EU, the cream is licensed for vitiligo that involves the face.¹¹ Cigna's policy describes the US licence as covering non-segmental vitiligo in patients 12 and over, without that facial condition.¹

The dose sets the bill. The UK product information says to use no more than two 100 g tubes a month.¹¹ At England's list price, that ceiling would be £1,314 a month, before the NHS discount.³¹¹

Results take months. The same document says to consider stopping if less than 25% of the treated skin has regained colour at week 52.¹¹ A tube price says little about the cost of a year's treatment.

Real prices are hidden. England's discount is confidential.³ US rebates to insurers are not published.² The prices above are the only ones in public documents.

How to use these numbers

If you are in the US with commercial insurance, ask your dermatologist to file for prior approval, then apply for the copay card. Keep a record of the steroid or calcineurin creams you have tried, and for how long.¹

If you are in England, ask your dermatologist whether you meet NICE's criteria. You will need to show that first-line creams did not work.⁸

If you are thinking of buying it abroad, compare the price per gram, not per tube. A US tube is 60 g; the UK and French tubes are 100 g. For another drug where the NHS and other systems differ on who pays, see whether Wegovy is covered by the NHS.