The cost of Enzalutamide (Xtandi) in the United States is being challenged by Knowledge Ecology International (KEI), a public interest advocacy group.  The average US wholesale price of Xtandi in 2015 was $88 per capsule.   That can add up to $129,000 annual cost per man.

There are significant issues related to high costs of treatment. The higher the cost, the more likely that insurance companies will  require pre-authorization to cover the cost of the drug.  That means a man dealing with advanced stage disease is tasked with asking his doctor to spend uncompensated time fighting the insurance company for his treatment.  African American men are particularly at risk, since they experience the highest rate of advanced stage prostate cancer, while experiencing unique and troublesome challenges to access to health care.

Another issue is that Xtandi costs more than twice as much than in most other counties. For example, in Germany, Xtandi cost an average of $36.93 in 2015.

Xtandi was developed with the use of grants from the Department of Defense Prostate Cancer Research Program (DOD PCRP) and the National Institutes of Health (NIH) as well as other federal agencies. “We, the people paid most of the development costs for Xtandi.

KEI along with a group of Democratic congressional members believe that they have a compelling argument for the NIH to override a drug patent on the grounds of “non-use and unreasonable