Which Country Is Trodelvy (Sacituzumab Govitecan) Cheapest In? — 2026 Guide

    Published Trodelvy list prices differ across countries because governments price hospital-administered biologics through different systems: Türkiye's fixed-rate external reference pricing, Germany's post-launch AMNOG negotiation, the UK's NICE cost-effectiveness threshold, and largely free US pricing. Türkiye's mechanism structurally produces lower list prices. Lawful import requires a prescription and your own country's personal import permit — never informal courier shipments.

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

    Why does the price differ so much between countries?

    Trodelvy (sacituzumab govitecan) is a Trop-2-directed antibody–drug conjugate that delivers the topoisomerase inhibitor SN-38 into tumour cells, approved for metastatic triple-negative breast cancer, certain HR-positive/HER2-negative breast cancers, and metastatic urothelial carcinoma. It is supplied as a 180 mg single-use lyophilised vial that must be reconstituted by a hospital pharmacist and given by intravenous infusion — there is no oral form, so Trodelvy never reaches a retail pharmacy shelf anywhere. In Türkiye, the Ministry of Health anchors the reference price to the lowest ex-factory price in a designated basket of EU member states, converted using the "pharmaceutical euro" (Dönemsel Avro Değeri), fixed at 65% of the previous year's average Central Bank euro rate rather than the live spot rate. That mechanism, published via the TİTCK price list and gazetted in the Resmî Gazete, is the principal reason Turkish list prices for complex ADCs like Trodelvy sit structurally below list prices in free-pricing markets.

    Germany applies its AMNOG framework: a newly launched oncology ADC can carry a manufacturer-set free price for the first six months on the market, after which a negotiated price agreed between the manufacturer, Gilead, and the GKV-Spitzenverband applies — and that negotiated figure is backdated to month seven rather than to the original launch date. The UK's NICE evaluates cost-effectiveness against a cost-per-QALY threshold that has just been raised from the long-standing £20,000–£30,000 band to £25,000–£35,000, announced 1 December 2025 and taking effect from April 2026 (see NICE); a wider threshold changes whether an ADC like Trodelvy clears the cost-effectiveness bar, but it does not itself set a price.

    The United States has no equivalent statutory reference mechanism for a drug like Trodelvy: launch pricing is essentially free, set by Gilead, and then negotiated privately and confidentially between the manufacturer, payers and pharmacy benefit managers. The RAND Corporation's 2022 international price comparison, published 1 February 2024, found gross US list prices averaged 278% of prices in 33 other high-income countries across all drugs, and 422% for brand-name originator products specifically — a structural, economy-wide gap rather than a figure specific to Trodelvy.

    Because Trodelvy has no biosimilar or generic competitor anywhere and must be reconstituted from a lyophilised vial by a licensed hospital pharmacist immediately before infusion, it stays inside institutional tender procurement in every country rather than moving to retail: hospitals negotiate confidential discounts off the published list price through closed tenders, so the number you see published is rarely what any hospital actually pays. Every country comparison you encounter, including this one, should be read as a comparison of published list prices, not of net acquisition costs. For the underlying mechanics of why Türkiye's published prices sit where they do, 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 Trodelvy I'm being offered genuine?

    No falsified batch of Trodelvy has been recorded in WHO's alert series to date. That absence of a public alert should not be read as a reason to relax verification: Trodelvy is a high-cost cytotoxic biologic administered only in hospital, and the same supply-chain risks that have affected other antibody–drug conjugates and checkpoint inhibitors apply in principle to any product diverted outside licensed distribution.

    Because Trodelvy carries a cytotoxic SN-38 payload, it must be handled, reconstituted and disposed of under hazardous-drug protocols by staff trained in cytotoxic handling inside a licensed hospital pharmacy — this is itself a practical barrier against diversion, since the product cannot realistically be prepared or administered outside that setting. Anyone offered a "ready to inject" Trodelvy vial outside a hospital pharmacy should treat that offer itself as the primary warning sign.

    • Scan the vial carton's GS1 DataMatrix and confirm it decodes to AI 01 (GTIN), AI 21 (serial number), AI 17 (expiry) and AI 10 (batch) — a code that will not scan, or scans to the wrong product, is a hard stop.
    • If the vial is sourced in Türkiye, confirm its karekod is notified to the national İlaç Takip Sistemi (İTS) track-and-trace system at its.saglik.gov.tr before it leaves the pharmacy.
    • Ask for a continuous 2–8°C temperature log covering the actual shipment you are receiving, not a generic cold-chain certificate — Trodelvy must never be frozen or shaken.
    • Confirm reconstitution happens only inside a licensed hospital pharmacy under cytotoxic-handling protocols; a pre-reconstituted or "ready to use" Trodelvy offered outside that setting is not a legitimate supply.
    • Cross-check the batch and lot number against our WHO falsified medicine alerts tracker before administration — no falsified Trodelvy batch has been logged there to date, but the check itself is the safeguard.
    • Be suspicious of any website or broker offering a public "manufacturer batch checker" for Trodelvy: no such consumer-facing tool is operated by Gilead.
    • Review the full verification workflow in our guide to checking that a medicine is genuine.

    Frequently asked questions

    Sources

    Country availability pages for this medicine

    Related pages

    Antibody–drug conjugates

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