[Kyoto (Japan) = E-Daily Reporter KIM SAE-MI ] “If immunotherapy is precision bombing, then ‘omalizumab’ is like a carpet bombing.”

This somewhat dramatic analogy was used during an educational seminar at the World Allergy Congress (WAC 2026), held on the 16th at the Kyoto International Conference Center in Japan. Professor Kimihiro Okubo of Nippon Medical School, who served as the session chair, cited the words of a former Japanese allergy specialist.

Professor Okubo said, “Professor Take Ishikawa, a former president of the Japanese Society of Allergy, explained the difference between allergen immunotherapy and omalizumab in this way.” This means that, unlike immunotherapy—which modulates the immune response to specific allergens—omalizumab targets immunoglobulin E (IgE), which is involved in allergic reactions.

Professor Okubo is a leading expert in Japan on the treatment of allergic rhinitis and hay fever. He graduated from Nippon Medical School, conducted basic research on allergies at the U.S. National Institutes of Health (NIH), and has served as a professor in the Department of Otolaryngology at Nippon Medical School since 2010. He has served as chairman of the Japanese Society of Otorhinolaryngology, Immunology, and Allergy and has contributed to research on the diagnosis and treatment of hay fever as well as allergen immunotherapy, including serving as a key author on Japan’s clinical guidelines for allergic rhinitis.

The seminar featured a lecture on the treatment of severe allergic rhinitis and asthma, followed by a comprehensive discussion on treatment efficacy and patient burden in actual clinical practice. Professor Okubo served as moderator, and Kayoko Kawashima, Ph.D., Head of the Department of Otolaryngology at Osaka Habikino Medical Center, and Yasuhiro Kon, Professor of Respiratory Medicine at Nihon University School of Medicine, participated in the discussion. In particular, they expressed interest in whether the launch of the omalizumab biosimilar could lead to new treatment opportunities for patients beyond simply replacing existing therapies.

“It’s become so much easier this year”… Voices from the front lines of hay fever treatment in Japan

Professor Okubo first posed a question to Dr. Kawashima.

He said, “Professor Kon mentioned evaluating the effectiveness of omalizumab after four months of use, but the pollen allergy season treated in otolaryngology runs from February to April—a period of less than four months,” and asked, “How do you determine whether it’s effective for these patients?” He was pointing out that the timeline for evaluating treatment efficacy differs between conditions requiring continuous treatment, such as asthma, and hay fever, where symptoms are concentrated in a specific season.

Dr. Kawashima responded based on his actual clinical experience. He said, “Although the period between the first and second doses coincides with peak pollen season, patients whose symptoms could not be controlled with conventional treatments tell me, ‘I’m really feeling better this year,’” adding, “I believe the effects tend to appear relatively quickly.”

This suggests that even for seasonal conditions where it is difficult to wait until a predetermined evaluation point, it is necessary to consider the initial improvement in symptoms as perceived by the patient. However, since this is based on the experience of individual patients, it cannot be generalized to mean that the effect appears at the same rate for all patients.

“Such Expensive Medication for Pollen Allergies?”… The Burden on Adult Patients

The discussion naturally turned to the issue of medication costs. Professor Okubo asked whether the number of patients actually receiving treatment would increase if drug prices fell following the launch of biosimilars.

Dr. Kawashima explained that the reactions of pediatric and adult patients differ. He said, “Many guardians of children express a desire for treatment because they can receive financial assistance for medical expenses,” adding, “In contrast, adults often ask, ‘Do I really need to use such expensive medication for pollen allergies?’”

It was also noted that even when healthcare providers explain the need for treatment, it is difficult to secure a prescription if patients do not perceive their condition as serious enough to justify the cost of the medication. In particular, since hay fever is not widely recognized as a life-threatening condition, there is a psychological barrier to using high-cost treatments.

Dr. Kawashima emphasized, “Although patients are aware that their symptoms are not being properly controlled, they often have strong reservations about treatment,” adding, “I want to present new options to demonstrate the potential for symptom improvement.”

Professor Okubo also asked Professor Yasuhiro Gon of the Department of Respiratory Medicine at Nihon University School of Medicine whether biosimilars would lead to an increase in new patients or whether more patients would switch from existing antibody therapies.

Professor Kon noted, “Among patients who do not receive medical expense subsidies, many say that even if their asthma worsens, they find it difficult to use biologics because of the cost,” and expressed his hope that “if drug prices decrease, it will become an option that doctors can more readily suggest to patients.”

Will

Omriclo Change the Landscape of Japan’s Allergy Market? Medical Professionals Are Watching Closely

In Japan, Celltrion(068270)’s omalizumab biosimilar “Omliclo” (CT-P39) is set to launch within the year. With the drug expected to be priced about 40% lower than the originator drug “Xolair,” the question of how this will impact actual prescribing practices has become a hot topic.

Whether the launch of this biosimilar will be limited to switching existing patients to the new drug or lead to expanded treatment for new patients is a key factor in Celltrion’s strategy for the Japanese market. While switching existing patients from Xolair to Omriclo is essentially a competition for market share, if patients who previously abandoned treatment due to high costs begin treatment anew, the omalizumab market itself could expand.

The fact that the required dosage varies depending on the medical specialty and patient characteristics was also discussed. Professor Okubo noted, “In otolaryngology, total IgE levels are often not very high, so a dose of around 300 mg is frequently used,” and then asked Professor Gon about the dosage for asthma patients.

Professor Gon replied, “It varies by patient,” adding, “Depending on IgE levels and body weight, some patients require about 600 mg.” Since higher dosages can lead to greater out-of-pocket costs, the price competitiveness of biosimilars may be an even more critical consideration for patients requiring high-dose therapy.

Finally, Professor Okubo expressed his anticipation, saying, “Although Omriclo is scheduled to be launched later this year and isn’t available for immediate use yet, it will be very interesting to see how we’ll utilize these newly emerging biosimilars in the field of allergy in the future.”