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No sponsorships, referrals or clinic partnerships
EpiPen, insulin & Ozempic prices refreshed October 2026
Cost comparison only — not medical advice
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Drug Prices

Xtandi Price by Country: $15,353 in the US, about $3,138 in Austria

Enzalutamide for prostate cancer is four 40 mg tablets a day. Here is what 30 days cost in seven places, from official price lists.

Researched with AI assistance; every figure is checked against the primary source cited on this page before publishing. How we work →

Key Takeaways

  • The US list price rose 14% since 2024. Pfizer lists 120 Xtandi 40 mg capsules or tablets at $15,352.94 (March 10, 2026); CMS recorded $13,480 for a 30-day supply in 2024 (our calculation: $15,352.94 ÷ $13,480). Pfizer lists no generic.
  • $7,004 for Medicare from 2027. Medicare’s negotiated price for a 30-day supply takes effect on January 1, 2027 — 48% below the 2024 list price, according to CMS. Per 40 mg capsule it is $61.92, or $7,431 for 120 (our calculation).
  • Europe: about $3,138 to $4,105 for 30 days. Official prices for 120 tablets of 40 mg, scaled from packs of 112 and converted at ECB rates: Austria $3,138, France $3,375, the Netherlands $3,764, the UK $3,922, Switzerland $4,105 (our calculation).
  • Germany: a split benefit verdict. The Joint Federal Committee found a hint of minor added benefit in non-metastatic high-risk prostate cancer (2020) and no proven added benefit in metastatic hormone-sensitive disease (2021). Enzalutamide has no Festbetrag.

Xtandi / Enzalutamide Price by Country (November 2026)

Xtandi (enzalutamide) is taken as 160 mg once a day — four 40 mg capsules or tablets, or two 80 mg tablets (FDA label) — so 30 days = 120 × 40 mg. Pfizer charges the same for 120 × 40 mg and 60 × 80 mg. European packs hold 112 tablets of 40 mg; we scale to 120 (our calculation: pack price ÷ 112 × 120). US dollars at European Central Bank reference rates of November 6, 2026. The price types differ — list price, negotiated price, retail price — and are labelled.

30 days = 120 × 40 mg. US: Pfizer list price (March 10, 2026), CMS data file ($61.924219 per 40 mg capsule from 2027 × 120, our calculation). UK: NHS dm+d. France: public medicines database. Switzerland: BAG public price. Austria: Erstattungskodex, November 2026 (excl. VAT). Netherlands: Zorginstituut average price (to November 1, 2026). Packs of 112 scaled to 120 tablets; converted at ECB rates of November 6, 2026 (our calculation).
CountryOfficial price30 days in US dollarsWhat a patient typically pays
🇺🇸 United States (list)$15,352.94 for 120 × 40 mg or 60 × 80 mg (Pfizer, as of Mar 10, 2026)$15,353—
🇺🇸 United States (Medicare, 2027)$7,004 negotiated price per 30-day supply, from Jan 1, 2027 (CMS); $61.924219 per 40 mg capsule$7,431Depends on the Part D plan and coverage phase
🇬🇧 United KingdomEnzalutamide 40 mg (Astellas) £2,734.67 for 112 tablets (NHS price)$3,922£9.90 per item in England; free in Scotland, Wales and Northern Ireland
🇨🇭 SwitzerlandXtandi CHF 3,137.65 for 112 tablets (public price; limitation)$4,10510% share after the annual deductible
🇫🇷 FranceXtandi €2,821.58 for 112 tablets (official price excluding dispensing fee)$3,375Fully reimbursed (100%)
🇦🇹 AustriaXtandi €2,623.25 for 112 tablets (social-insurance price excl. VAT; effective price may be lower under a price model)$3,138€7.55 prescription fee per pack; insurer approval needed first
🇳🇱 NetherlandsXtandi €3,146.79 for 112 tablets, €28.10 per tablet (average pharmacy price)$3,764Fully reimbursed; counts toward the annual deductible
🇩🇪 GermanyNo statutory price ceiling (Festbetrag) for enzalutamide; no official price found——

We compare prices; we do not recommend where to buy medicine. Cancer treatment decisions belong with your oncology team.

What the Numbers Mean

Medicare’s price takes effect in 2027

The $7,004 is the price Medicare negotiated under the Inflation Reduction Act for a 30-day supply, effective January 1, 2027. CMS’s data file sets $61.924219 per 40 mg capsule, or $7,431 for 120 (our calculation). In 2024 about 35,000 people with Medicare Part D used Xtandi, and Part D spent $3.40 billion on it before rebates (CMS).

Europe: 20% to 27% of the US list price

Austria, France, the Netherlands, the UK and Switzerland publish an official price for enzalutamide 40 mg — about $3,138 to $4,105 for 120 tablets at ECB rates, or 20% to 27% of the US list price (our calculation: $3,138 ÷ $15,353 and $4,105 ÷ $15,353). Medicare’s 2027 price is still about 1.8 times the Swiss price (our calculation: $7,431 ÷ $4,105).

The UK dropped the brand name; Germany assessed the benefit

Since 2026 the NHS lists Astellas’s product as “Enzalutamide 40mg tablets” at £2,734.67 for 112; the Xtandi pack is marked discontinued from May 29, 2026 (dm+d). In Germany the Joint Federal Committee found a hint of minor added benefit for non-metastatic, castration-resistant high-risk prostate cancer (November 5, 2020) and no proven added benefit with hormone therapy in metastatic hormone-sensitive prostate cancer (November 19, 2021).

Frequently Asked Questions

How much does Xtandi cost in the US compared with other countries?

Pfizer lists 120 Xtandi 40 mg capsules or tablets at $15,352.94 (March 10, 2026). Medicare’s negotiated price from January 1, 2027 is $7,004 for a 30-day supply (CMS). In Europe, 112 tablets of 40 mg cost €2,623.25 in Austria (excl. VAT), €2,821.58 in France, €3,146.79 in the Netherlands, £2,734.67 in the UK and CHF 3,137.65 in Switzerland — about $3,138 to $4,105 for 120 tablets at ECB rates.

Does the 80 mg tablet cost less per month?

No: Pfizer lists 60 × 80 mg tablets at the same $15,352.94 as 120 × 40 mg (March 10, 2026).

Is there a generic Xtandi?

Pfizer’s price disclosure lists no generic (“N/A”), CMS negotiates only drugs without generic competition, and the Dutch price list shows only Xtandi and parallel imports.

What do patients pay?

In England each prescription item costs £9.90; in France it is fully reimbursed; in Switzerland insured patients pay a 10% share after the deductible; in Austria a €7.55 prescription fee after the insurer approves it; in the Netherlands it is fully reimbursed but counts toward the annual deductible. In Medicare, it depends on the Part D plan.

Why does the UK list “enzalutamide” instead of Xtandi?

The NHS dictionary (dm+d) lists Astellas’s 40 mg tablets under the generic name at £2,734.67 for 112 since March 27, 2026, and marks the Xtandi-branded pack discontinued from May 29, 2026.

Sources

  1. Pfizer — Colorado prescriber price disclosure, Xtandi: WAC $15,352.94 per package of 120 × 40 mg capsules or tablets and 60 × 80 mg tablets; generics N/A; accurate as of March 10, 2026
  2. CMS — Negotiated prices for initial price applicability year 2027 (fact sheet, November 2025): Xtandi $7,004 negotiated price for a 30-day supply, $13,480 list price (2024), 48% lower; 35,000 Part D enrollees, $3,401,099,000 gross Part D costs in 2024
  3. CMS — Selected drug list and maximum fair price data file (November 2, 2026): Xtandi 40 mg $61.924219 per capsule from January 1, 2027
  4. CMS — Medicare Drug Price Negotiation Program: final guidance and effectuation of the negotiated price
  5. DailyMed — Xtandi prescribing information: 160 mg orally once daily
  6. NHS dm+d — Enzalutamide 40mg tablets (Astellas Pharma), 112: NHS indicative price £2,734.67 (from March 27, 2026); Xtandi 40mg tablets discontinued May 29, 2026
  7. NHS Business Services Authority — prescription charge £9.90 per item (England)
  8. Base de données publique des médicaments — Xtandi 40 mg, 112 tablets: €2,821.58 excluding dispensing fee, 100% reimbursed (bulk files of November 6, 2026)
  9. Federal Office of Public Health (BAG) — Spezialitätenliste: Xtandi 40 mg, 112 tablets, public price CHF 3,137.65; cost share 10%; limitation
  10. Austrian social insurance (Dachverband) — Erstattungskodex monthly data, November 2026: Xtandi 40 mg, 112 tablets, €2,623.25 (social-insurance price excl. VAT; yellow box, RE1; price model)
  11. oesterreich.gv.at — prescription fee (Rezeptgebühr) €7.55 per pack since January 1, 2026
  12. Zorginstituut Nederland — Medicijnkosten.nl: Xtandi 40 mg tablet, Astellas (EU/1/13/846/002), average price €3,146.79 per pack, €28.10 per tablet, fully reimbursed (updated to November 1, 2026)
  13. Gemeinsamer Bundesausschuss — enzalutamide, non-metastatic castration-resistant high-risk prostate cancer: hint of minor added benefit (decision of November 5, 2020)
  14. Gemeinsamer Bundesausschuss — enzalutamide with androgen deprivation, metastatic hormone-sensitive prostate cancer: added benefit not proven (decision of November 19, 2021)
  15. BfArM / GKV-Spitzenverband — Festbetrag list as of November 1, 2026 (no entry for enzalutamide)
  16. European Central Bank — reference rates, November 6, 2026 (1 US dollar = €0.89566 = £0.74711 = CHF 0.8189)

Wellness Vision Editorial Policy

Wellness Vision does not sell medicine, recommend pharmacies or suppliers, or take payments from drug makers. Every price above comes from the official source cited; currency conversions and 30-day figures are our own calculations, shown with their formula. This is a cost comparison, not medical advice.

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