There has been a lot of news this week about the outrageously high cost of Xtandi, a drug for advanced prostate cancer. Although developed with funding from the U.S. National Institutes of Health (NIH), Xtandi (enzalutamide) is being sold to Americans at about four times the price at which it is sold in other countries. In January, a petition was sent to have the U.S. government step in and require that Xtandi be priced more fairly for Americans. More recently, several congresspeople and senators, including Bernie Sanders, reiterated this request with their own letter to the Secretary of Health and Human Services and the Director of the NIH.
According to the petition, the Japanese company licensed to sell Xtandi, Astellas Pharma Inc., and its U.S. marketing partner, Medivation Inc. charge an average wholesale price of $88.48 per 40 mg capsule in the U.S. However, in Japan the price is just $26.37, in Australia, it is $23.46, and just across the border in Canada the price is only $20.12.
If you only had to take a few capsules of Xtandi for a short time, this might not be such a big deal. But a standard dose of Xtandi is 4 capsules per day for months at a time. That’s 120 pills per month. So the cost of just a one-month supply of 120 pills at the average wholesale price is $10,617. That’s right, over $10,000 per month! If you must get Xtandi and you don’t have insurance which covers it, what are you to do?
First, if you have no insurance or poor insurance and a household income of $100,000 or less, you can apply to get Xtandi for free through Astellas, which may also offer other financial support.
If that doesn’t work for you, another less expensive option (short of travelling to another country) would be to order Xtandi from a verified international online pharmacy, which will send the medication to you from a licensed pharmacy in another country, such as Canada. Currently, several PharmacyChecker.com-verified online pharmacies sell Xtandi for about $41 per 40 mg capsule – about half the cost in the U.S. If you prefer to get your medication from a U.S. pharmacy, many pharmacies offer or accept discount cards which can bring the cost down a little, but only to about $75 per capsule.
It is ridiculous that American taxpayers helped develop this drug but are charged the most to get it. Hopefully, things will change.