Title: Pluvicto Cost Per Dose: $52,703 in the US, £20,000 in England
Author: Arthur Harmash
Published: 2026-10-29
Source: https://lymyvoyage.com/articles/pluvicto-cost-per-dose
Citations:
- https://www.cdn.fuse.novartis.com/FA-11673510_PLUVICTO_At_a_Glance_PSM_Addition_Update_Digital_7.26/FA-11673510.PDF
- https://www.cdn.fuse.novartis.com/FA-11546248%20PLUVICTO%20At%20a%20Glance%20-%20Digital%20-%2011.25%20-%20web%20optimized/FA-11546248.PDF
- https://www.biopharmadive.com/news/novartis-fda-approval-pluvicto-prostate-cancer-endocyte/620973/
- https://www.novartis.com/news/media-releases/fda-approves-novartis-radioligand-therapy-pluvicto-earlier-use-chemotherapy-psma-positive-metastatic-castration-resistant-prostate-cancer
- https://www.nice.org.uk/guidance/TA930/chapter/2-information-about-lutetium-177-vipivotide-tetraxetan
- https://www.nice.org.uk/guidance/TA930/chapter/1-Recommendations
- https://www.nice.org.uk/guidance/ta1179
- https://g-ba.de/downloads/39-261-6071/2023-07-06_AM-RL-XII_%28177Lu%29Lutetiumvipivotidtetraxetan_D-894.pdf
- https://www.g-ba.de/downloads/40-268-9844/2023-07-06_AM-RL-XII_%28177Lu%29Lutetiumvipivotidtetraxetan_D-894_TrG.pdf
- https://gkv-spitzenverband.de/media/dokumente/krankenversicherung_1/arzneimittel/amnog_praxisbesonderheiten/23005pb20240601.pdf
- https://canjhealthtechnol.ca/index.php/cjht/article/download/Pc0297/1275?inline=1
- https://www.urologytimes.com/view/agreement-reached-for-public-reimbursement-of-pluvicto-in-canada
- https://pubmed.ncbi.nlm.nih.gov/34161051/
---
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.[^5] 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
| Country | Price per dose | What the figure is | Course | Public access |
|---|---|---|---|---|
| US | $52,703.17[^1] | List price to wholesalers, from July 1, 2026[^1] | $316,219 for six doses (our calculation) | Approved, including before chemotherapy[^4] |
| England | £20,000[^5] | List price excluding VAT; a confidential discount would have applied if recommended[^5] | £120,000 for six doses (our calculation) | Not recommended by NICE, Nov 2023[^6] |
| Germany | €22,000, or €26,180 with VAT[^9] | Manufacturer's price in its December 2022 dossier[^9] | €157,080 a year, the federal committee's figure[^8] | Funded by statutory insurers; price agreement since June 2024[^10] |
| Canada | CAD 27,000[^11] | Price the company submitted to the national drug agency[^11] | About CAD 122,489 per patient, the agency's estimate[^11] | Pan-Canadian agreement, Dec 2024; provinces list it one by one[^12] |
## 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".[^3] Its January 2026 product sheet listed $51,168.13.[^2] 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".[^4] 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.[^5] 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".[^5]
It was not recommended. In November 2023, NICE said Pluvicto "is not recommended" for men whose cancer had progressed after chemotherapy and hormone treatment.[^6] It found that the drug extends life compared with supportive care. But its "most likely cost-effectiveness estimates" were above what NICE normally accepts.[^6]
The earlier-use question never reached a decision. In July 2026, NICE terminated its appraisal of Pluvicto before chemotherapy.[^7]
NICE ended its appraisal of Pluvicto for use before chemotherapy in July 2026 because "the company did not provide an evidence submission".[^7]
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.[^6]
## 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.[^8] 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".[^8] For men whose alternative was the chemotherapy drug cabazitaxel or the targeted drug olaparib, it found the added benefit "not proven".[^8]
The committee's cost figure is €157,080 a year per patient, for the drug alone.[^8] That is six doses at €26,180 each, including 19% VAT.[^9] 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.[^9] The dossier price is €22,000 before VAT.[^9]
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.[^10] Under it, prescriptions for the group with added benefit are treated as a recognised special case in prescribing audits.[^10] 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.[^11] The agency estimated a course would cost about CAD 122,489 per patient.[^11]
It recommended public funding "with conditions".[^11] 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.[^11] It said a "price reduction of 92%" would be needed to reach CAD 50,000 per year.[^11]
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.[^12] The terms were not published. Each province and territory still has to add the drug to its own list.[^12]
## 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.[^9]
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.[^5] Germany's negotiated price is not in the documents reviewed.[^10] Canada's agreed terms were not published.[^12]
- **They cover different patients.** NICE and Germany's committee assessed men who had already had chemotherapy.[^6][^8] The US label now also covers men before chemotherapy and earlier-stage disease.[^1][^4]
- **VAT and currency differ.** Germany's €26,180 includes 19% VAT.[^9] England's £20,000 excludes it.[^5] 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.[^8] 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".[^4]
## 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.
Pluvicto lists at $52,703 a dose in the US. England's appraisal was quoted £20,000. Does the same prostate-cancer drug really cost that much less in England?
Neither figure is what anyone pays. The US price is before rebates. England's has a confidential discount behind it, and NICE never recommended the drug.
The US list price has risen from $42,500 at launch in 2022 to $52,703 in July 2026. That is about 24% in four years.
Germany assessed it in 2023. Its federal committee found "considerable added benefit" for one group of men and none proven for another. It put the drug cost at €157,080 a year.
Canada's drug agency said the drug would need a 92% price cut to meet its value threshold. It still recommended funding with conditions, and a national deal followed in 2024.
In fairness, the drug works. In its main trial, median survival was 15.3 months with Pluvicto against 11.3 months without.
What the numbers cannot show: what any country pays after discounts. Every price here is a list or submitted price, and negotiated prices were not published.
Before treatment, ask for the price per dose in writing, with tax and hospital costs separate. Save this before you compare quotes.
[^1]: https://www.cdn.fuse.novartis.com/FA-11673510_PLUVICTO_At_a_Glance_PSM_Addition_Update_Digital_7.26/FA-11673510.PDF — Novartis Pharmaceuticals Corporation, "Pluvicto At a Glance" (published Jul 2026; price effective Jul 1, 2026). Accessed Oct 29, 2026.
[^2]: https://www.cdn.fuse.novartis.com/FA-11546248%20PLUVICTO%20At%20a%20Glance%20-%20Digital%20-%2011.25%20-%20web%20optimized/FA-11546248.PDF — Novartis Pharmaceuticals Corporation, "Pluvicto At a Glance" (price effective Jan 7, 2026). Accessed Oct 29, 2026.
[^3]: https://www.biopharmadive.com/news/novartis-fda-approval-pluvicto-prostate-cancer-endocyte/620973/ — BioPharma Dive, Kristin Jensen, "Novartis wins FDA approval for prostate cancer radiopharmaceutical", quoting a Novartis statement (published Mar 24, 2022). Accessed Oct 29, 2026.
[^4]: https://www.novartis.com/news/media-releases/fda-approves-novartis-radioligand-therapy-pluvicto-earlier-use-chemotherapy-psma-positive-metastatic-castration-resistant-prostate-cancer — Novartis, "FDA approves Novartis radioligand therapy Pluvicto for earlier use before chemotherapy" (published Mar 28, 2025). Accessed Oct 29, 2026.
[^5]: https://www.nice.org.uk/guidance/TA930/chapter/2-information-about-lutetium-177-vipivotide-tetraxetan — National Institute for Health and Care Excellence, TA930, "Information about lutetium-177 vipivotide tetraxetan" (published Nov 15, 2023). Accessed Oct 29, 2026.
[^6]: https://www.nice.org.uk/guidance/TA930/chapter/1-Recommendations — National Institute for Health and Care Excellence, TA930, "Recommendations" (published Nov 15, 2023). Accessed Oct 29, 2026.
[^7]: https://www.nice.org.uk/guidance/ta1179 — National Institute for Health and Care Excellence, TA1179, "Lutetium-177 vipivotide tetraxetan for treating PSMA-positive hormone-relapsed metastatic prostate cancer after an anti-androgen but not a taxane (terminated evaluation)" (terminated Jul 16, 2026). Accessed Oct 29, 2026.
[^8]: https://g-ba.de/downloads/39-261-6071/2023-07-06_AM-RL-XII_%28177Lu%29Lutetiumvipivotidtetraxetan_D-894.pdf — Gemeinsamer Bundesausschuss (Federal Joint Committee), "Beschluss: (177Lu)Lutetiumvipivotidtetraxetan" (decision Jul 6, 2023). Accessed Oct 29, 2026.
[^9]: https://www.g-ba.de/downloads/40-268-9844/2023-07-06_AM-RL-XII_%28177Lu%29Lutetiumvipivotidtetraxetan_D-894_TrG.pdf — Gemeinsamer Bundesausschuss, "Tragende Gründe zum Beschluss: (177Lu)Lutetiumvipivotidtetraxetan" (Jul 6, 2023), citing the manufacturer's dossier of Dec 20, 2022. Accessed Oct 29, 2026.
[^10]: https://gkv-spitzenverband.de/media/dokumente/krankenversicherung_1/arzneimittel/amnog_praxisbesonderheiten/23005pb20240601.pdf — GKV-Spitzenverband and Novartis Pharma, "Anlage 3 zur Vereinbarung nach § 130b SGB V: Pluvicto, Anerkennung einer Praxisbesonderheit" (in force from Jun 1, 2024). Accessed Oct 29, 2026.
[^11]: https://canjhealthtechnol.ca/index.php/cjht/article/download/Pc0297/1275?inline=1 — CADTH (now Canada's Drug Agency), "CADTH Reimbursement Recommendation: Lutetium (177Lu) Vipivotide Tetraxetan (Pluvicto)", Canadian Journal of Health Technologies (expert committee meeting Jan 11, 2023). Accessed Oct 29, 2026.
[^12]: https://www.urologytimes.com/view/agreement-reached-for-public-reimbursement-of-pluvicto-in-canada — Urology Times, "Agreement reached for public reimbursement of Pluvicto in Canada", citing a Novartis release of Dec 13, 2024 (published Dec 17, 2024). Accessed Oct 29, 2026.
[^13]: https://pubmed.ncbi.nlm.nih.gov/34161051/ — Sartor O. et al., "Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer" (VISION trial), New England Journal of Medicine (published 2021). Accessed Oct 29, 2026.