Which Country Is Xtandi (Enzalutamide) Cheapest In? — 2026 Guide

Why does the price differ so much between countries?

Xtandi (enzalutamide) is an androgen receptor signalling inhibitor taken as 40 mg capsules or tablets, four of them once daily, across the full spectrum of prostate cancer — non-metastatic castration-resistant disease (nmCRPC), metastatic castration-resistant disease (mCRPC), and metastatic hormone-sensitive disease (mHSPC). Because it is a once-daily oral medicine taken at home, it is dispensed through retail and specialty pharmacies rather than a hospital infusion suite, which places it on national outpatient reimbursement lists and community pharmacy price schedules rather than inside hospital tender procurement — a genuinely different pricing pathway from infused oncology biologics.

The most important within-class dynamic for Xtandi's published price is its competition with abiraterone, another oral androgen-pathway drug used in overlapping prostate-cancer settings. Unlike enzalutamide, abiraterone has widespread generic competition in most markets after its patents and exclusivity periods lapsed, and generic abiraterone is typically available at a markedly lower published price than any patent-protected androgen-pathway drug. That contrast is genuine and important: in markets where clinicians and payers can substitute toward generic abiraterone, it puts downward pressure on how Xtandi is priced or reimbursed, whereas in markets with limited abiraterone genericisation, Xtandi's relative position looks different. This is a real driver of the price differences you will see reported for enzalutamide, and it should not be minimised or dismissed.

In Türkiye, TİTCK applies external reference pricing to Xtandi as it does to other oral oncology products, tracking the lowest ex-factory price across a defined EU reference basket and converting it via the fixed "pharmaceutical euro" (Dönemsel Avro Değeri) rather than the live exchange rate, as shown on the TİTCK price list. Germany's AMNOG framework allows manufacturer-set free pricing for the first months of launch, after which a negotiated price applies retroactively from month seven. NICE evaluates Xtandi against its cost-per-QALY threshold, raised from the historical £20,000–£30,000 band to £25,000–£35,000, announced 1 December 2025 and effective from April 2026 (see NICE).

The United States lacks an equivalent government reference system for a drug like Xtandi: launch pricing is set largely freely by Astellas and Pfizer, the co-marketers, and then negotiated privately with pharmacy benefit managers, so the published list price and what an insured patient or payer actually pays can diverge substantially. Because Xtandi moves through retail rather than hospital procurement, manufacturer co-pay support programmes play a bigger role in shaping real-world cost than the confidential tender discounts seen with infused biologics. For 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.

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 Xtandi I'm being offered genuine?

No falsified batches of Xtandi have been recorded in the WHO's medical product alert series to date. That should not be read as a guarantee against counterfeiting in every market, since any orally dispensed prostate-cancer medicine sourced outside licensed retail or specialty pharmacy channels carries some risk, but there is no documented WHO incident to cite for this product.

Because Xtandi is supplied as capsules or tablets in a carton with blister strips, verification depends on checking the outer carton, the printed batch and expiry codes, and the tablet or capsule appearance before the blister is opened — information that is largely lost once a strip is separated from its original packaging.

• Check that the outer carton is intact and shows no evidence of re-sealing, re-taping or having been opened and closed before dispensing.
• Confirm the capsule or tablet's imprint, colour and size match the Astellas/Pfizer product information leaflet for the strength dispensed.
• Match the batch number and expiry date printed on the outer carton against those printed on the blister foil inside — any mismatch is a hard stop.
• 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, confirm the karekod is registered on the national İlaç Takip Sistemi (İTS) track-and-trace system at its.saglik.gov.tr before it is dispensed.
• Store the medicine at room temperature, below 25–30°C, protected from moisture, in its original blister until each dose is taken.
• Never accept loose capsules or tablets sold without their original carton and blister: separated from that packaging, they cannot be checked 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

• Resmî Gazete — Beşeri Tıbbi Ürünlerin Fiyatlandırılmasına Dair Karar No. 11031 — retrieved: 2026-07-28
• TİTCK — published medicine price list — retrieved: 2026-07-28
• MOHAP (UAE) — import medicine for personal use — retrieved: 2026-07-28
• SFDA (Saudi Arabia) — regulations — retrieved: 2026-07-28
• SFDA Controlled Drugs System — retrieved: 2026-07-28
• Qatar MOPH — drug prices — retrieved: 2026-07-28
• Kuwait Ministry of Health — retrieved: 2026-07-28
• Azerbaijan Tariff Council (Tarif Şurası) — retrieved: 2026-07-28
• NICE (United Kingdom) — retrieved: 2026-07-28
• G-BA (Germany) — AMNOG benefit assessment — retrieved: 2026-07-28
• RAND — International prescription drug price comparisons (published 1 Feb 2024) — retrieved: 2026-07-28
• Frontiers in Pharmacology — European hospital price transparency study (9 Mar 2026) — retrieved: 2026-07-28
• MHRA Guidance Note 14 — supply of unlicensed medicinal products — retrieved: 2026-07-28

Country availability pages for this medicine

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