Pluvicto Cost Per Dose: $52,703 in the US, £20,000 in England

Pluvicto is a radioactive drug for advanced prostate cancer. It finds a protein on prostate cancer cells, called PSMA (prostate-specific membrane antigen), and delivers radiation to them. It is given as an infusion every six weeks, for up to six doses.¹

In the US, its maker Novartis lists it at $52,703.17 a dose from July 2026.¹ England's medicines regulator was quoted £20,000.² Germany's price comes from a 2022 company dossier, and Canada's from a 2023 submission. None of these is what any health system pays after discounts. This article sets the published numbers side by side and says what each one is.

Four countries, four kinds of price

The US: a list price that keeps rising

When Pluvicto was approved in March 2022, Novartis said its wholesale price "will be $42,500 a dose".¹⁰ Its January 2026 product sheet listed $51,168.13.¹¹ Since July 2026 the figure is $52,703.17.¹

That is about 24% above the launch price in a little over four years. The most recent step, from January to July 2026, was 3%.

At the current list price, six doses come to about $316,000. That is a list price. US insurers and Medicare negotiate or set their own payment rates, and Novartis does not publish what it receives after rebates.

The US is also where the drug can be used earliest. In March 2025 the US Food and Drug Administration (FDA) approved it for men who have not yet had chemotherapy. Novartis said that change "approximately triples the number of patients eligible".³ By July 2026, its product sheet also listed use alongside hormone drugs in cancer that still responds to hormone treatment.¹

England: a list price the NHS does not pay

In England, the price that appears in public is £20,000 per dose, excluding VAT.² It comes from the company's submission to NICE (the National Institute for Health and Care Excellence). NICE notes the company had a commercial arrangement that "would have applied if the technology had been recommended".²

It was not recommended. In November 2023, NICE said Pluvicto "is not recommended" for men whose cancer had progressed after chemotherapy and hormone treatment.⁴ It found that the drug extends life compared with supportive care. But its "most likely cost-effectiveness estimates" were above what NICE normally accepts.⁴

The earlier-use question never reached a decision. In July 2026, NICE terminated its appraisal of Pluvicto before chemotherapy.¹²

So for NHS patients in England, the £20,000 figure is a reference point, not a price anyone routinely pays. Patients already started before the 2023 guidance could continue.⁴

Germany: priced through a benefit assessment

Germany's Federal Joint Committee, the body that decides what statutory health insurers cover, assessed Pluvicto in July 2023.⁶ It split eligible men into two groups.

For men whose alternative was hormone drugs or supportive care, it found an "indication of considerable added benefit".⁶ For men whose alternative was the chemotherapy drug cabazitaxel or the targeted drug olaparib, it found the added benefit "not proven".⁶

The committee's cost figure is €157,080 a year per patient, for the drug alone.⁶ That is six doses at €26,180 each, including 19% VAT.⁵ The committee had to take the price from the company's dossier, because the drug "is not listed" in Germany's standard drug price database.⁵ The dossier price is €22,000 before VAT.⁵

A negotiated price now exists. The document we found is an annex to the price agreement between Novartis and the federal association of statutory insurers, in force from June 2024.⁷ Under it, prescriptions for the group with added benefit are treated as a recognised special case in prescribing audits.⁷ The annex does not state the negotiated price, and we did not find it published elsewhere.

Canada: a submitted price and a value gap

Canada's national drug agency reviewed Pluvicto in early 2023, then under the name CADTH (the Canadian Agency for Drugs and Technologies in Health). The company's submitted price was 27,000 Canadian dollars (CAD) a vial, which is one dose.⁸ The agency estimated a course would cost about CAD 122,489 per patient.⁸

It recommended public funding "with conditions".⁸ But its estimate of value was stark. At the submitted price, it put the cost at CAD 451,407 per quality-adjusted life year gained.⁸ It said a "price reduction of 92%" would be needed to reach CAD 50,000 per year.⁸

In December 2024, Novartis said it had reached an agreement with the pan-Canadian Pharmaceutical Alliance, the body that negotiates prices for public drug plans.⁹ The terms were not published. Each province and territory still has to add the drug to its own list.⁹

What a course actually is

Every course figure above depends on how many doses are given. Novartis's US sheet gives the dose as 7.4 GBq "every 6 weeks for 6 doses", or until the cancer progresses or side effects become intolerable.¹ Germany's committee also counts a maximum of six.⁵

Not every patient gets all six. The main trial, called VISION, gave "four to six cycles".¹³ Canada's per-patient estimate of CAD 122,489 is about four and a half doses at the submitted price. That is our arithmetic on the agency's own figures, not a number it states.

So the six-dose totals in the table are ceilings. A typical course may cost less, but none of the public documents reviewed here says how many doses patients in each country actually receive.

What the headline numbers leave out

• Every price here is a list or submitted price. The US figure is before rebates.¹ England's discount is confidential.² Germany's negotiated price is not in the documents reviewed.⁷ Canada's agreed terms were not published.⁹
• They cover different patients. NICE and Germany's committee assessed men who had already had chemotherapy.⁴⁶ The US label now also covers men before chemotherapy and earlier-stage disease.¹³
• VAT and currency differ. Germany's €26,180 includes 19% VAT.⁵ England's £20,000 excludes it.² Converting between currencies would add an exchange-rate assumption, so the table does not.
• The drug is not the whole bill. Every figure here is the drug alone. The German committee says so explicitly.⁶ Hospital, scanning and administration costs come on top.
• What it buys. In VISION, median survival was 15.3 months with Pluvicto plus standard care, against 11.3 months with standard care alone.¹³ Before chemotherapy, Novartis reports that the final survival analysis "was not statistically significant".³

How to use these numbers

If you are in the US, ask the treating centre what your plan will be billed per dose and what share is yours. The $52,703 list price is the starting point, not the answer.

If you are in England and considering private treatment, ask for the price per dose in writing, with VAT and hospital costs shown separately. NICE's £20,000 is a list price, so a private quote may differ.

In Germany and Canada, ask whether your situation matches the group the public decision covers. Coverage there follows the assessed patient group, not the full label.