Dermatology biologic · London
Dupilumab (Dupixent) for atopic dermatitis - London.
A fortnightly self-injected biologic for moderate to severe eczema - prescribed by a consultant dermatologist with a real biologics caseload, in a London clinic that runs a proper pathway with pharmacy and nursing support.
Why patients choose us
- 01
A named consultant dermatologist, in a biologics-experienced unit
Not a general dermatology list. A consultant with a real dupilumab caseload, in a clinic that runs a proper biologics pathway with pharmacy and nursing support.
- 02
The right biologic for your eczema
Dupilumab is not the only answer. For some patients, tralokinumab, lebrikizumab or a JAK inhibitor fits better. We recommend the option that fits your disease, not the clinic.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
What dupilumab is
A precise biologic that switches off the Th2 signal driving eczema.
Dupilumab, sold as Dupixent by Sanofi and Regeneron, is a fully human monoclonal antibody. It blocks the IL-4 receptor alpha subunit and, through it, the IL-4 and IL-13 signalling that drives type-2 inflammation in the skin.
How it works
Blocks the IL-4Rα subunit, shutting down IL-4 and IL-13 signalling - the two cytokines that drive Th2 inflammation in atopic dermatitis.
What it treats
Licensed for moderate to severe atopic dermatitis, asthma, chronic rhinosinusitis with nasal polyps, eosinophilic oesophagitis and prurigo nodularis.
Who makes it
Developed and marketed by Sanofi and Regeneron under the brand name Dupixent. First approved in 2017 and now one of the most-used biologics in dermatology.
Indicative pricing
What private dupilumab costs in London.
Indicative ranges across our London network. Send your history and photos and we quote firm figures across two or three clinics.
In short
Private dupilumab in London: £2,400–£3,200 per month, or roughly £30,000–£40,000 per year plus workup.
| Item | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Consultant dermatology assessment and biologic workup | £350–£550 | 45–60 min | Same visit |
| Baseline bloods (FBC, U&E, LFT, IgE optional) | £150–£280 | 15 min | 2–3 days |
| Dupilumab loading dose in clinic (600 mg) | £1,400–£1,800 | 60 min | Same visit |
| Dupilumab maintenance (300 mg fortnightly) | £1,200–£1,600 / dose | 10 min self-injection | Home delivery |
| Monthly cost of maintenance (two doses) | £2,400–£3,200 | — | Ongoing |
| Second-opinion review of biologic options | £250–£450 | 30 min | 48 hours |
NHS dupilumab is available through specialist dermatology for eligible patients under NICE TA534 (adults) and TA681 (children 6 to 11), but waiting times for a first biologics-clinic appointment vary widely. Going privately typically accelerates access rather than accessing a different drug.
The problem
The right biologic, the right clinic, the right monitoring.
Starting a biologic without proper eligibility scoring, ophthalmology awareness and a plan for the 16-week response check is how patients end up disappointed and switched around unnecessarily.
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Is dupilumab even the right drug?
For some patients tralokinumab, lebrikizumab or a JAK inhibitor is a better first choice - we give you the honest read.
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Worried about eye side effects?
Conjunctivitis in 8 to 22 percent. Managed early and well most of the time - with ophthalmology on standby if it is not.
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Want it delivered properly?
A consultant with a real biologics caseload, a nurse for the loading dose and training, and a specialist pharmacy delivering to your door.
The journey
From enquiry to 16-week review - what happens, in order.
One team from first message to long-term follow-up - including the pharmacy delivery and the self-injection training.
Phase 1 · Before starting
Concierge, off-stage for you
Phase 2 · Loading day
An hour at the clinic
Phase 3 · At home
Fortnightly, from your fridge
- 01
Before
You send us your history and photos
A short, confidential form. Current and previous treatments, EASI or DLQI if known, and photos of the affected areas.
- 02
Before
We come back with a recommendation
Within one working day: whether dupilumab fits, or whether a different biologic or a JAK inhibitor is the better call. Indicative price. An honest read either way.
- 03
Before
We arrange the consultation and workup
A consultant appointment, EASI/BSA/DLQI scoring, baseline bloods and ophthalmology if you have a history of eye disease.
- 04
Loading day
Loading dose in clinic
600 mg subcutaneous injection (two 300 mg pens) given by a nurse. A short observation period and written aftercare.
- 05
Loading day
You are trained to self-inject
The nurse teaches pen technique, injection sites, storage and sharps disposal - so you can inject at home from week two onwards.
- 06
After
Home dosing every 2 weeks
300 mg subcutaneous self-injection fortnightly. Prescriptions delivered from a specialist pharmacy in a cool-chain box.
- 07
After
Review at 16 weeks, then annually
EASI/DLQI reassessed at 16 weeks to confirm response. If well controlled, reviews move to 6 to 12 monthly with the consultant.
Typical enquiry to loading dose: 2–4 weeks. Response check: 16 weeks. Long-term reviews: 6–12 monthly.
Who dupilumab is for
When dupilumab is the right step - and when it is not.
Eligibility follows the NICE criteria for adults (TA534) and children (TA681): moderate to severe disease, an inadequate response to a proper trial of potent topical steroids and optimal skincare, and documented EASI or DLQI thresholds.
Efficacy at 16 weeks
EASI-75 in 45–50% of adults (SOLO 1 and 2 trials)
A 75 percent reduction in eczema severity by 16 weeks, with further gains through to week 52.
Quality of life
Meaningful DLQI, itch and sleep improvement
The trial and real-world data show consistent gains in itch scores, sleep and day-to-day function.
Real-world response
60–70% response in ARIETTA and similar registries
Registry data broadly mirror the trials - most patients get a meaningful and durable response.
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Moderate to severe atopic dermatitis in adults
EASI 16 or above, or DLQI 10 or above, that has failed a proper trial of optimal skincare and potent topical steroids.
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Paediatric atopic eczema (age 6 months and above)
Licensed from 6 months of age. In the UK, NICE TA681 covers ages 5 to 11 who meet severity criteria; below 5 is off-NICE but on-licence.
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Adolescent eczema (12–17 years)
A well-established indication with strong trial and registry data - covered by NICE TA681 and typically funded when severity criteria are met.
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Head-and-neck predominant eczema
Often the hardest phenotype to control with topicals - and one where dupilumab performs well, though a small subset develop facial redness.
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Steroid-dependent or steroid-phobic patients
When potent topical steroids are needed daily to keep control, or when a patient cannot tolerate them, a biologic breaks the cycle.
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Eczema plus asthma, EoE, CRSwNP or prurigo nodularis
Dupilumab is licensed across the Th2 disease spectrum - one drug can treat co-existing asthma, nasal polyps, eosinophilic oesophagitis or prurigo.
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Failure or intolerance of ciclosporin or methotrexate
Where traditional systemic immunosuppressants have not worked, have been stopped for side effects, or are contraindicated.
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Not right for: active infection, pregnancy planning
Active herpetic eczema or serious infection needs treating first. Pregnancy data are limited - we discuss options before starting.
Compared to other biologics and JAKs
Dupilumab is well-established - but not the only choice.
Dupilumab has the longest track record and no routine monitoring bloods. IL-13-specific antibodies and oral JAK inhibitors are real alternatives, each with different trade-offs on speed, monitoring and warnings.
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Dupilumab (Dupixent) - IL-4Rα
The workhorse: a fully human monoclonal antibody blocking the IL-4 receptor alpha subunit, inhibiting IL-4 and IL-13 Th2 signalling. Fortnightly injection, no routine monitoring bloods.
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Tralokinumab (Adtralza) - IL-13
IL-13-specific antibody, fortnightly then monthly if well controlled. A useful alternative when dupilumab is not tolerated, particularly for conjunctivitis.
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Lebrikizumab (Ebglyss) - IL-13
Newer IL-13 antibody, monthly maintenance dosing after induction. NICE approved for adults and adolescents from 12 years with moderate to severe eczema.
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Upadacitinib (Rinvoq) - JAK1
Oral JAK1 inhibitor - fast onset, higher EASI-90 rates than biologics, but boxed warnings on infection, thrombosis and malignancy. Monthly bloods needed.
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Baricitinib (Olumiant) - JAK1/2
Oral JAK1/2 inhibitor, effective in adults with moderate to severe eczema. Similar monitoring requirements to upadacitinib.
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Abrocitinib (Cibinqo) - JAK1
Oral JAK1 inhibitor with strong itch reduction and rapid onset. Same class-warnings apply and monthly monitoring bloods are required.
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Ciclosporin (short course)
A traditional systemic immunosuppressant, short courses only, requires BP and renal monitoring. Still useful as a bridge or for flare rescue.
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Second-opinion review
A specialist review of your history, EASI/DLQI scores and previous treatments - sometimes the answer is topical optimisation, not a biologic.
Where in London
A small panel of London dermatology biologics units, we picked them.
Consultant dermatologists with real dupilumab caseloads, in clinics that run a proper biologics pathway with pharmacy, nursing and, where needed, paediatric or ophthalmology input.
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Chelsea and Westminster Private Dermatology
NHS-linked private dermatology unit with a well-established biologics service.
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HCA The Wellington Dermatology
St John's Wood - a large private dermatology department with biologics pharmacy support.
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Cadogan Clinic, Chelsea
Private dermatology with consultant-led biologic pathways and specialist nursing.
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Cromwell Hospital (Bupa) Dermatology
Kensington - consultant-led private dermatology with in-house pharmacy and infusion suites.
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London Dermatology Centre
Central London consultant-led private practice with biologic experience.
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The Portland Hospital Paediatric Dermatology
Private paediatric dermatology for children eligible for dupilumab.
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GOSH International Private paediatric
International and Private Care wing of Great Ormond Street for complex paediatric cases.
Consultant dermatologists with real dupilumab and biologic caseloads, not general lists
CQC-registered clinics running a proper biologics pathway with pharmacy and specialist nursing
Ophthalmology and paediatric input available where needed
Home-delivery specialist pharmacy with cool-chain logistics
Safety and side effects
What to expect - honestly.
Dupilumab is one of the better-tolerated systemic treatments in dermatology. It does not broadly suppress the immune system and needs no routine monitoring bloods, but conjunctivitis and injection reactions are real and worth planning for.
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Injection site reactions
Redness, itching or swelling at the injection site - common, usually mild, and settling with rotation of injection sites and cool compresses.
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Conjunctivitis (8–22%)
The commonest new side effect. Usually mild and manageable with lubricant drops or a short course of steroid eye drops. Occasionally severe and needs ophthalmology input.
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Facial and neck redness
A subset of patients develop a persistent pink flush of the face and neck on dupilumab. Managed with topical calcineurin inhibitors or a switch of biologic.
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Herpes simplex reactivation
Occasional cold-sore flares, usually managed with aciclovir. Active herpetic eczema at baseline needs treating before dupilumab starts.
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No general immunosuppression
Unlike ciclosporin or JAK inhibitors, dupilumab does not broadly suppress the immune system. Rates of serious infection are not raised in trials or registries.
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No routine monitoring bloods
Baseline bloods only. There is no ongoing monthly blood test - a real quality-of-life advantage over JAK inhibitors and traditional systemics.
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Vaccinations
Inactivated vaccines are safe. Live vaccines are best given before starting dupilumab or discussed with your dermatologist during treatment.
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Pregnancy and breastfeeding
Human pregnancy data are limited. Registries so far are reassuring, but discussed on a case-by-case basis before starting or continuing in pregnancy.
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Red flags after a dose
Facial swelling, wheeze, severe eye pain or vision change, or a severe injection reaction - contact the clinic the same day or go to A&E.
Baseline workup and plan
Your biologics plan in four parts. Read the last one first.
Whichever London clinic you go to, the plan the dermatologist sends you keeps to the same shape.
A quiet reminder
Biologics language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the plan before your review, just ask.
- 01 Header
Diagnosis, severity scores and prior treatments
Confirmed atopic dermatitis, EASI/BSA/DLQI at baseline, and the full ladder of previous topical and systemic treatments tried.
- 02 Technique
Dosing schedule and self-injection plan
Loading dose 600 mg in clinic, then 300 mg every 2 weeks self-injected at home. Injection technique, storage and sharps handling covered.
- 03 Findings
Baseline workup and eligibility
Screening bloods (FBC, U&E, LFT), ophthalmology if a history of eye disease, and IgE if measured. Contraindications reviewed.
- 04 Impression
Response plan and review interval
Read this first: how response is measured (EASI-75 at 16 weeks), what happens if you respond well, and what happens if you do not.
Recognised by major UK insurers
Cover for dupilumab varies by insurer and by policy - most fund the drug when eligibility criteria are met, often with pre-authorisation and an annual cap. We confirm cover before booking.
Frequently asked
Everything we get asked about dupilumab.
Quick answers on self-injection, conjunctivitis, insurance, paediatric use, treatment duration and NHS wait times.
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Can I self-inject dupilumab at home?
Yes. The loading dose is given in clinic so the nurse can watch for reactions and teach you pen technique. From week two onwards, most patients self-inject at home fortnightly using a pre-filled pen or syringe. Prescriptions are delivered from a specialist pharmacy in a cool-chain box and stored in the fridge.
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How manageable is the conjunctivitis?
Conjunctivitis affects 8 to 22 percent of patients on dupilumab, usually within the first few months. It is typically mild - red, gritty eyes - and responds to lubricant drops, warm compresses and, if needed, a short course of steroid eye drops. A small minority develop severe conjunctivitis that needs ophthalmology input, and rarely a biologic switch.
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Does UK private health insurance cover dupilumab?
Cover varies. Most major insurers will fund dupilumab when eligibility criteria are met and there is a documented failure of optimal topical treatment, but many require pre-authorisation and some cap biologics cover annually. We check your policy before booking and set expectations honestly.
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Can children have dupilumab privately?
Yes. Dupilumab is licensed from 6 months of age for moderate to severe atopic dermatitis. NICE TA681 covers ages 5 to 11 who meet severity criteria, and adolescent dosing is well established. Paediatric dupilumab is delivered in specialist paediatric dermatology clinics with weight-adjusted dosing.
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How long will I need to stay on dupilumab?
There is no fixed stop date. Many patients stay on dupilumab long term because eczema tends to return when it is stopped. Some who achieve durable remission try dose spacing (every 4 weeks) or a break, but relapse is common. This is a shared decision with your consultant after at least 12 months of good control.
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What is the NHS waiting time for dupilumab?
NHS access exists for eligible patients under specialist dermatology, but waiting times for a first biologics-clinic appointment vary widely, commonly several months to a year depending on trust. Going privately is often about accelerating access to the same drug rather than accessing a treatment you could not otherwise get.
Related treatments and tests
Looking for something else?
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Omalizumab for chronic urticaria
Anti-IgE biologic for chronic spontaneous urticaria.
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Eosinophilic oesophagitis (EoE)
Diagnosis and dupilumab-based treatment for EoE.
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Paediatric urticaria clinic
Consultant-led urticaria pathway for children.
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Baby and toddler allergy assessment
Structured allergy work-up for the youngest patients.
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Skin-prick allergy testing (paediatric)
Paediatric skin-prick testing for food and aeroallergens.
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Eczema condition guide
The full patient guide to atopic dermatitis.
Learn more -
Asthma condition guide
Patient guide to asthma and its co-existing Th2 diseases.
Learn more -
Send Enquiry
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Ready to talk?
Send your history and photos. We come back within one working day.
A consultant recommendation, indicative price, and a shortlist of London dermatology biologics clinics that fit your case. Independent, and free.