Last updated: March 2026
How Much Does Enzalutamide (Xtandi) Cost?
Cost Breakdown by Type
| Type / Procedure | Without Insurance | With Insurance |
|---|---|---|
| 40mg Capsules (30-day, 160mg daily) | $10,000 – $15,000 | $50 – $2,000 |
What Affects the Cost
- Brand-name vs. generic availability
- Insurance formulary tier placement
- Pharmacy choice (retail vs. mail-order vs. Costco)
- Manufacturer savings cards and coupons
- Dosage and quantity prescribed
- Geographic location
Insurance Coverage
Typical coverage: Specialty Tier 5; prior auth required; foundation assistance available
Most insurance plans use a tiered formulary: Tier 1 (generic) $0-$15 copay, Tier 2 (preferred brand) $25-$75, Tier 3 (non-preferred brand) $50-$150, Tier 4 (specialty) $100-$500+. Prior authorization may be required for certain medications. Step therapy may require trying cheaper alternatives first.
How to Save Money
- Always ask for generic when available — saves 50-90%
- Use GoodRx, RxSaver, or similar discount cards
- Costco pharmacy is open to non-members and often has lowest prices
- Mark Cuban's Cost Plus Drugs offers transparent low pricing
- Manufacturer patient assistance programs provide free medication to qualifying patients
- HSA/FSA funds can cover medication costs tax-free
Related Procedures & Costs
Frequently Asked Questions
Xtandi costs $10,000 to $15,000 per month without insurance. Patient assistance programs and copay cards can significantly reduce costs.
Enzalutamide treats metastatic castration-resistant prostate cancer (mCRPC). It blocks androgen receptors more effectively than older anti-androgens.
Most insurance plans cover Xtandi with prior authorization. Specialty copay assistance and manufacturer programs help reduce out-of-pocket costs.