Which Country Is Cabometyx (Cabozantinib) Cheapest In? — 2026 Guide

    Published Cabometyx (cabozantinib) prices differ by country because it is an oral tablet dispensed through outpatient specialty pharmacies rather than a hospital-infused biologic, so it is priced under each country's community reimbursement or negotiation system. Türkiye's fixed-rate external reference pricing keeps its published price structurally lower than in free-pricing markets such as the United States.

    Last reviewed: 2026-07-28Reviewed by: Pharmacy Remedy Pharmacovigilance & Compliance Desk

    Why does the price differ so much between countries?

    Cabometyx (cabozantinib) is a multi-target tyrosine kinase inhibitor developed by Exelixis and marketed by Ipsen outside the United States, acting on VEGFR, MET and AXL receptors. It is approved for advanced renal cell carcinoma, both as monotherapy and in combination with the immune checkpoint inhibitor nivolumab, for previously treated hepatocellular carcinoma, and for progressive differentiated thyroid cancer refractory to radioactive iodine. Cabometyx is supplied as 20 mg, 40 mg and 60 mg film-coated tablets taken once daily by mouth. Because it is self-administered at home rather than infused in hospital, Cabometyx moves through the outpatient specialty-pharmacy channel rather than hospital procurement tenders, and that channel difference shapes how and when its published price is set, updated and disclosed.

    Within the multi-target tyrosine kinase inhibitor class for renal cell carcinoma, Cabometyx competes for guideline positioning against sunitinib, pazopanib, axitinib and lenvatinib, and its frequent use in combination with checkpoint inhibitors such as nivolumab means health technology assessment bodies often evaluate the combination regimen rather than cabozantinib alone. How many alternatives are reimbursed for a given tumour type in a given country materially affects how favourably any single product's published price looks, since payers with more options can negotiate more aggressively. Cabometyx's three separate approved indications — kidney, liver and thyroid cancer — are also frequently assessed independently, which can produce different negotiated outcomes for the same tablet strength depending on which cancer is being treated.

    In Türkiye, TİTCK applies external reference pricing to oral oncology products just as it does to biologics: the published price tracks the lowest ex-factory price found across a defined basket of EU reference countries, converted using the fixed "pharmaceutical euro" (Dönemsel Avro Değeri) rather than the live market rate, as published on the TİTCK price list and periodically updated via the Resmî Gazete. Germany evaluates Cabometyx under its AMNOG early-benefit-assessment framework, with free pricing for the first months followed by a negotiated price backdated to month seven. NICE in England applies its cost-per-QALY threshold, raised from the long-standing £20,000–£30,000 range to £25,000–£35,000, announced 1 December 2025 and effective from April 2026 (see NICE).

    The United States has no equivalent government reference mechanism for an oral oncology drug like Cabometyx: list prices are set largely freely by the manufacturer and then negotiated privately with pharmacy benefit managers and insurers, so the headline list price and what any individual patient pays can diverge sharply, a pattern documented across countries in the RAND 2024 international price comparison. Because Cabometyx moves through retail and specialty pharmacy rather than hospital tenders, the confidential-discount effect seen with infused biologics is less pronounced, but co-pay assistance programmes and formulary tiering still separate published price from what most patients actually pay. For more on the structural reasons behind Türkiye's published prices, see our explainer on why medicines cost less in Türkiye.

    How is the price set in each country?

    The table below compares pricing systems, not prices. Each country publishes — or does not publish — its own official list, and that published list is the only figure worth relying on. Follow the link in the last column and read the current entry yourself.

    CountryPricing systemWho negotiatesPublic price list?Official list
    TürkiyeExternal reference pricing — the lowest ex-factory price in a basket of 5–10 designated EU member states, converted at a fixed pharmaceutical euro (65% of the previous year's average Central Bank rate)Ministry of Health / TİTCK; SGK for reimbursementYesTİTCK price list
    United Arab EmiratesRegulated ceiling pricing with periodic re-pricing against reference marketsMOHAPYesMOHAP registered drug search
    Saudi ArabiaRegulator-set reference pricingSFDAYesSFDA drug list
    QatarRegulated ceiling pricingMOPH Pharmacy and Drug ControlYesMOPH drug prices
    KuwaitMinistry-regulated pricingMinistry of Health, Drug and Food ControlConfirm directly with the ministryKuwait Ministry of Health
    AzerbaijanState price regulationTariff Council with the Analytical Expertise CentreYesTarif Şurası
    GermanyFree pricing for 6 months, then an AMNOG-negotiated price applied retroactively from month 7GKV-Spitzenverband with the manufacturer, after G-BA benefit assessmentYes (Lauer-Taxe, commercial)G-BA
    United KingdomHTA / value-based — NICE cost-per-QALY threshold £25,000–£35,000 from April 2026NICE and the NHS England commercial teamYes (Drug Tariff, BNF)NICE
    United StatesFree pricing with confidential rebates; Medicare negotiation for selected drugs onlyManufacturers with PBMs and insurers; CMS for selected drugsNo single public listCMS
    Label every cross-country comparison "list price". A study published in Frontiers in Pharmacology on 9 March 2026, covering 23 hospitals in 9 European countries, found actual hospital prices 7%–38% below published reference prices, and found that at least half of the hospitals misjudged their own price relative to their peers. Frontiers in Pharmacology

    How can I obtain a medicine legally from a lower-price market?

    There is a lawful route in most countries, and it starts in the same place everywhere: a valid prescription in your own name, issued by the physician treating you. What differs is the import permit. The procedures below are stated only where they could be verified at the national authority.

    United Arab Emirates. MOHAP operates a permit to import medicines for personal use through its Electronic Drug Establishment service. The permit is free and is issued within 3 working days. You log in with a MOHAP account or UAE Pass.

    Saudi Arabia. Applications run through the SFDA Controlled Drugs System at cds.sfda.gov.sa, under a guideline published on 14 August 2025. Read the current SFDA regulations page before you travel — the requirements are revised periodically.

    Qatar. For non-controlled medicines there is no pre-approval: you may carry up to a 60-day supply through the Green Channel, in the original packaging, with a copy of the prescription and a signed, stamped letter from your doctor. For controlled medicines you need advance approval and must use the Red Channel; supporting documents must be no older than 6 months and in Arabic or English.

    Kuwait and Azerbaijan. Confirm the current procedure directly with the national authority before shipping or travelling — Kuwait Ministry of Health and Azerbaijan Tariff Council. We do not publish a step list for these two countries because the procedure could not be verified at source.

    1. United Arab Emirates — obtain a prescription in the applicant's own name, issued within the last 3 months.
    2. Obtain a medical report from the treating facility, authenticated by the health authority and issued within the last year.
    3. Prepare an Emirates ID or passport copy for the applicant.
    4. Log in to the MOHAP service with a MOHAP account or UAE Pass and submit the personal-import application.
    5. Keep the quantity within the limit: no more than a 1-month supply for controlled medicines, and no more than a 3-month supply for non-controlled medicines.
    6. Wait for the decision — the service is free and normally issued within 3 working days.
    7. Contact MOHAP on 800 111 11 or at import.export@mohap.gov.ae if the application stalls.

    What is named patient supply?

    Named patient supply is the international concept behind almost every lawful cross-border medicine route. The clearest codified example is the United Kingdom's MHRA Guidance Note 14, built on Regulation 167 of the Human Medicines Regulations 2012.

    Four conditions define it: the order must be unsolicited; the product must be specified by the prescriber; the prescriber must be directly responsible for the patient; and there must be a genuine special clinical need that no authorised product meets.

    The honesty point matters here: the European Court has held that "financial considerations cannot, in themselves" establish a special clinical need. A lower price in another country is not, by itself, a lawful basis for a named-patient import. The lawful bases are clinical.

    Is the Cabometyx I'm being offered genuine?

    No falsified batches of this product have been recorded in WHO's alert series to date. That absence does not prove that any individual pack is authentic — it only means there is no documented incident to cite, and readers should verify each pack on its own merits rather than relying on the absence of a public alert.

    Because Cabometyx is a tablet dispensed in a carton with a blister strip rather than a single-dose vial, verification depends heavily on checking the outer packaging and the printed batch and expiry information before the blister is ever opened, since a loose strip separated from its carton loses most of its traceable information.

    • Check that the outer carton is sealed and shows no signs of having been re-glued, re-taped or opened and re-closed before dispensing.
    • Confirm the tablet's film coating, imprint, colour and size match the Ipsen/Exelixis product information leaflet for the 20 mg, 40 mg or 60 mg strength dispensed.
    • Match the batch number and expiry date printed on the carton against the numbers printed on the foil of the blister strip inside — they must be identical.
    • Scan the carton's GS1 DataMatrix and confirm it decodes to AI 01 (GTIN), AI 21 (serial number), AI 17 (expiry) and AI 10 (batch).
    • If sourced in Türkiye, verify the karekod is registered on the national İlaç Takip Sistemi (İTS) track-and-trace system at its.saglik.gov.tr before dispensing.
    • Store the tablets at room temperature, protected from heat and moisture, in their original blister until each dose is taken — never decant tablets into an unlabelled container.
    • Never accept loose tablets sold without their original carton and blister: once separated from that packaging, a tablet cannot be verified against any batch or expiry record. Review our guide to checking that a medicine is genuine and our WHO falsified medicine alerts tracker before dispensing.

    Frequently asked questions

    Sources

    Country availability pages for this medicine

    Related pages

    Targeted oral therapies

    Related high-cost medicines

    This page is editorial information about pricing systems, regulation and product authenticity. It is not medical advice and not an offer of sale. All prescription medicines require a valid prescription and, where applicable, an import permit issued by your own national authority.

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    For healthcare professionals

    Prescribers, hospital and specialty pharmacies, oncology centres and procurement departments: named patient supply, documentation and the sourcing workflow.