Liquid Hydroxyurea (Xromi) for Children With Sickle Cell Anemia: A New Solution Compounding Existing Problems

Barriers: A New Solution Brings New ProblemsIn 2024, the FDA approved Xromi , a ready-to-use, liquid formulation of hydroxyurea developed by Nova Laboratories Ltd., for children as young as 6 months of age.On the surface, this approval solves a long-standing problem.However, due to obstacles in the US healthcare system, it also creates new limitations to hydroxyurea access.Although Xromi's price is lower than other recently approved SCA treatments, it is far more expensive than generic hydroxyurea, with which it shares its active ingredient, safety profile, and efficacy [ 15 ].At an average retail price of around $900 per 148 mL bottle (100 mg/mL), Xromi costs 30-90 times more than hydroxyurea capsules (GoodRx, September 2025).This price differential directly impacts payers, including any family that pays for their own medications.At this higher price, it is critical Abbreviations: mg/mL, milligrams per milliliter;