Which Country Is Calquence (Acalabrutinib) Cheapest In? — 2026 Guide

    Published Calquence list prices differ across countries because it is an oral capsule or tablet dispensed through retail and specialty pharmacies rather than hospital infusion units, so it is priced under each country's outpatient reference 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?

    Calquence (acalabrutinib) is a second-generation Bruton's tyrosine kinase (BTK) inhibitor approved for chronic lymphocytic leukaemia and mantle cell lymphoma, taken as 100 mg capsules or tablets twice daily on a continuous outpatient schedule. Because it is self-administered at home rather than infused in a hospital day unit, it moves through the retail and specialty-pharmacy channel — the same channel used for ordinary chronic-disease medicines — rather than through hospital procurement tenders. That channel difference matters for published prices: outpatient oral oncology drugs are typically listed on national reimbursement schedules and community pharmacy price lists, which are updated and published on a different cadence and under different negotiation rules than hospital-only infusion products.

    AstraZeneca markets a newer film-coated tablet formulation of acalabrutinib alongside the original capsule, and the tablet removes a proton-pump-inhibitor interaction that reduced capsule absorption in patients on acid-suppressing therapy — a formulation change that affects clinical convenience, not the underlying pricing mechanism. Within the BTK-inhibitor class, Calquence competes with ibrutinib (Imbruvica) and zanubrutinib (Brukinsa), and the degree of that within-class competition varies substantially by market: in some countries all three are reimbursed and compete on negotiated price, while in others only one is listed, which itself shapes how favourably any single product's published price looks.

    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. Germany evaluates Calquence 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 Calquence: 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. Because Calquence moves through retail 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 Calquence I'm being offered genuine?

    No falsified batches of Calquence have been recorded in the WHO's medical product alert series to date. That does not mean the product cannot be counterfeited — any oral oncology medicine dispensed through retail pharmacy channels carries some risk when sourced outside licensed distribution — but it means there is no documented incident to cite, and readers should not be told otherwise.

    Because Calquence is a capsule or 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 capsule or tablet imprint, colour and size match the AstraZeneca product information leaflet for the 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 medicine at room temperature, below 25–30°C, protected from moisture, in its original blister until each dose is taken — never decant capsules into an unlabelled container.
    • Never accept loose capsules sold without their original carton and blister: once separated from that packaging, a capsule 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.