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The American Cancer Society estimates that in 2026, there will be about 333,830 new cases of prostate cancer in the US. It also projects around 36,320 deaths, which is why effective treatments are important.

One of these treatments is Nubeqa (darolutamide), an androgen receptor inhibitor that has been shown to delay the spread of cancer. In its clinical trial, darolutamide delayed cancer spread for an average of 40.4 months, compared with 18.4 months for placebo, with relatively low rates of side effects.

However, Nubeqa and similar treatments are expensive, and access can be difficult. Here’s what you need to know about Nubeqa’s price and possible ways you can save.

Key Takeaways

  • Nubeqa has a high US list price, costing over $11,500 per month. Annual treatment costs can exceed $140,000 when taken continuously.
  • Retail cash prices may be even higher than the manufacturer’s list price, some reaching up to $14,700, depending on the pharmacy.
  • Despite the high price, most insured patients do not pay the full cost out of pocket. About 95% of commercial insurance plans and all Medicare Part D plans cover Nubeqa.
  • Bayer offers multiple assistance options, including a $0 co-pay program, a free trial, and a patient assistance foundation.
  • Independent nonprofits like PAN Foundation, CancerCare, and HealthWell can also help cover copays, making long-term Nubeqa treatment affordable for many patients.

How much does Nubeqa cost in the US?

According to the Micromedex Red Book, which is the primary source for drug pricing and product information in the US, the list price of 120 tablets of Nubeqa 300 mg is $11,555.

If we look at its FDA-approved dose:

    • Recommended dosage: 600 mg twice daily
    • Total daily dose: 1,200 mg
    • Tablets: 300 mg each
    • Tablets per day: 4
    • Tablets per month (30.4-day average): ~122 tablets

Because dosing slightly exceeds exactly 120 tablets per month, the calculated monthly cost is higher, at $11,718.44. Since Nubeqa is intended for long-term use, often as long as the cancer does not progress and side effects are manageable, costs can add up quickly, reaching roughly $140,621.25 per year.

Retail cash prices may be even higher. Pharmacies set their own cash prices, which can include markups and dispensing fees beyond the manufacturer’s list price. For example, Drugs.com lists a retail cash price of $14,758.36 for a 120-tablet bottle of Nubeqa 300 mg.

Despite its high price, health economics studies suggest that darolutamide may reduce overall costs over time. In a simulation study, adding darolutamide increased total health plan spending by about $158,640 in the first year, but costs declined in subsequent years, largely due to lower spending on serious side effects. By year five, the model showed a net cost savings of roughly $149,000, with similar results observed in high-risk patients.

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How much does Nubeqa cost with insurance?

Nubeqa is usually covered by commercial insurance and Medicare Part D, though often under a specialty tier. According to Bayer, about 95% of commercial insurance plans include Nubeqa on their formulary, and 100% of Medicare Part D plans do.

Commercial insurance

If you have commercial insurance, Bayer reports that the average out-of-pocket cost is about $112 per month, depending on the plan details. Bayer also offers a Nubeqa $0 Co-pay Program, where eligible commercial patients can reduce their copays to $0, with a maximum annual benefit of $25,000.

In practice, many patients effectively pay very little. For instance, in an online patient forum, one user wrote that after insurance and a copay card, his “$14K/month Rx is free the rest of the year.” Another forum member, with Medicare and employer insurance, reported paying nothing for Nubeqa.

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Medicare Part D and Medicaid

If you have Medicare Part D, Nubeqa is also broadly covered, and recent policy changes have greatly limit costs. Medicare Part D plans now have an annual out-of-pocket cap of $2,000, and with Nubeqa’s high price, you would hit that cap after just a few months of treatment. After reaching that cap, the rest of the year’s supply is fully covered by the plan.

Bayer notes that the average Medicare enrollee pays about $175 per month out-of-pocket for Nubeqa. Many end up paying even less, with most Medicare patients reportedly paying under $50 per month because of subsidies and low copays.

You might also be eligible for additional assistance programs, such as:

    • Medicare Extra Help
    • State Pharmaceutical Assistance Programs (SPAPs)
    • Local State Health Insurance Assistance Programs (SHIPs)

Medicaid generally has similar offers, often covering specialty cancer drugs with minimal copays, though specifics vary by state.

Patient assistance programs for Nubeqa (copay cards and foundations)

Drug companies often provide financial assistance to help patients afford costly medications. Nubeqa has several such programs, mainly organized by Bayer.

Nubeqa $0 Co-Pay Program

The most prominent is the Nubeqa $0 Co-Pay Program for commercial patients. Under this program, eligible patients pay as little as $0 for each fill, with up to $25,000 in annual benefits. This covers typical out-of-pocket costs for most insured patients. Note that it’s not valid if you have Medicare/Medicaid and cannot be used with other coupons.

Nubeqa Free Trial

Bayer provides a 1-month free supply (30-day trial) of Nubeqa for patients who are new to the medication. Here are the details: 

    • Must be a new patient who has never tried Nubeqa.
    • Must have a valid prescription for an FDA-approved indication.
    • Patients enrolled in any government insurance (e.g., Medicare, Medicaid) or treated at Veterans Affairs (VA) are generally ineligible for this specific free trial.

To start:

    • Talk to your doctor to see if the program is right for you.
    • Complete and sign an enrollment form with your healthcare provider.
    • Your doctor can submit the request through Access Services by Bayer.

After the first month, Access Services by Bayer will contact you or your doctor to arrange a new prescription for continued treatment. For more information or to verify eligibility, you can contact Access Services by Bayer at 1-800-288-8374, Monday-Friday, 8 AM-8 PM ET.

Bayer US Patient Assistance Foundation

The Bayer US Patient Assistance Foundation is a free program that helps eligible patients in the United States and Puerto Rico get certain Bayer prescription medicines at no cost.

You may be eligible if you:

    • Live in the United States or Puerto Rico
    • Meet an income limit of 300% of the Federal Poverty Level (FPL)
    • Do not have insurance, or your insurance does not cover Nubeqa

Here’s how to apply:

    • Use Bayer’s Find Help Tool to check eligibility
    • Download and complete the application
    • Have your doctor complete their section
    • Submit the form by fax (1-866-575-6568) or mail to Bayer US Patient Assistance Foundation, PO Box 5670, Louisville, KY 40255

You may be asked to provide proof of income (copies only, not originals), such as:

    • Federal tax return from the prior year
    • Wage/tax statements
    • SSA-1099
    • 1099-NT
    • Proof of non-filing letter
    • Provider or patient attestation

Applications are usually reviewed within 2 business days, though missing information can delay approval.

You will receive a mailed notice after a decision is made on your application. If approved, a representative will reach out by phone to set up your medication shipment. The call will appear from 1-866-228-7723.

Also note that if you have Medicare and a household income below 150% of FPL, you must first apply for Medicare’s Low-Income Subsidy (Extra Help). Proof of denial from the LIS program is required before Bayer will consider assistance. Visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to see if you qualify for LIS/Extra Help.

Private foundations

Another aid source is the Patient Access Network (PAN) Foundation, an independent nonprofit. PAN provides grants to cover copays for certain specialty drugs for insured patients, and Nubeqa is one of the covered medications.

To qualify, you typically need to have insurance that covers Nubeqa and income between 400-500% of the federal poverty level. Grants are limited and vary by year, but this program has helped many prostate cancer patients with expensive drugs.

Several other private foundations may assist, including:

    • CancerCare
    • HealthWell
    • The Assistance Fund
    • Patient Advocate Foundation 

Each offer copay support or grants for qualifying cancer treatments, sometimes including Nubeqa.

See also:

Xtandi coupons and discounts, Xtandi price in canada
Xtandi (enzalutamide) - $4,779

Xtandi is an oral medication prescribed for male patients to treat prostate cancer. Xtandi belongs to the drug class, androgen receptor inhibitors.

Erleada coupons and discounts
Erleada (apalutamide) - $5,705

Erleada is a prescription medicine used to treat certain types of prostate cancer, including mCSPC and nmCRPC.

Zytiga coupons and discounts
Zytiga (abiraterone) - $4,089

Zytiga is a prescription treatment used with prednisone to help manage prostate cancer that has spread to other parts of the body.

Orgovyx coupons and discounts
Orgovyx (relugolix) - $419

Orgovyx is used for the treatment of advanced prostate cancer in adult men. It works by lowering the levels of testosterone, a hormone that helps prostate cancer cells grow.

Casodex coupons and discounts
Casodex (bicalutamide) - $334

Casodex is a prescription medication used to treat a specific type of prostate cancer. It is usually given to adult men who have Stage D2 metastatic prostate cancer.

Bottom line

Nubeqa is undeniably expensive, with monthly costs exceeding $11,000 and annual treatment easily climbing past $140,000. However, most patients do not pay that amount out of pocket. Commercial insurance, Medicare Part D coverage, and Bayer’s copay and patient assistance programs substantially reduce real-world costs.

For many patients, monthly out-of-pocket spending is low or even zero once insurance and assistance options are applied. Reviewing coverage early and enrolling in available support programs can make long-term Nubeqa treatment financially manageable despite its high retail price.

Frequently Asked Questions

Nubeqa is a branded cancer medicine, and specialty oncology drugs often have high prices because of research and development costs, complex manufacturing, and the value-based pricing used for life-prolonging therapies. It is also taken long-term, which increases total spending over time. List prices are set by the manufacturer, then supply-chain and pharmacy markups can raise cash prices further.

Yes. Depending on your prostate cancer stage and treatment plan, alternatives can include other androgen receptor pathway inhibitors such as Xtandi (enzalutamide) and Erleada (apalutamide), as well as androgen-signaling options like Zytiga (abiraterone) in some settings. The “best” alternative is cancer-stage specific and should be chosen by an oncology specialist.

No generic darolutamide is widely available in the US as of the most recent FDA label and current product information. If a generic launches, it usually follows patent/exclusivity timelines and FDA approvals for generic versions.

Nubeqa is generally continued until disease progression or unacceptable toxicity, as directed by your prescriber. Many patients stay on it for months to years, depending on cancer response and tolerability.

Yes, Nubeqa is covered under Medicare Part D plans, though it is commonly treated as a specialty medication and may require prior authorization depending on the plan. Bayer’s coverage materials state broad Part D formulary coverage.

No. Nubeqa (darolutamide) is an androgen receptor inhibitor (a hormonal/targeted therapy), not traditional cytotoxic chemotherapy.

Nubeqa can cause elevations in liver enzymes on lab tests, so clinicians monitor liver function during treatment. Most patients do not develop severe liver injury, but any signs of liver problems should be reported promptly.

Long-term effects are usually the continuation of its known side-effect profile over time, such as fatigue and certain lab abnormalities, plus monitoring for cardiovascular events in at-risk patients. Your oncology team typically follows labs and symptoms regularly during ongoing therapy.

The FDA-labeled dose is 600 mg twice daily with food (two 300 mg tablets twice a day) for a total of 1,200 mg per day, usually with ongoing androgen deprivation therapy unless you’ve had an orchiectomy. Dose adjustments may be needed for specific medical situations, so follow your prescriber’s instructions.

Heart failure has been reported in clinical trials, and the FDA label lists it as a clinically relevant adverse reaction (about 2% range in the ARAMIS trial). People with cardiac risk factors should be monitored closely by their care team.

Yes. Pain in extremity, which can include arm or leg pain, is listed among adverse reactions reported in trials. If leg pain is new, severe, one-sided with swelling, or comes with shortness of breath, seek urgent medical evaluation to rule out other causes.

No, Nubeqa should not be crushed. Guidance for darolutamide recommends swallowing the tablets whole and not crushing, cutting, or dissolving them. If swallowing is difficult, ask your pharmacist or oncology team for safer options.

Shortness of breath is not typically one of the most common side effects, but it can happen for many reasons during cancer treatment. Because Nubeqa is associated with cardiac events in a small percentage of patients, new or worsening shortness of breath should be evaluated promptly to rule out heart or lung causes.

Sources

Appukkuttan, S., Farej, R., Miles, L., Purser, M., & Wen, L. (2021). Budget impact analysis of darolutamide for treatment of nonmetastatic castration-resistant prostate cancer. Journal of managed care & specialty pharmacy, 27(2), 166–174. https://doi.org/10.18553/jmcp.2020.20330

Nubeqa Prices, Coupons, Copay Cards & Patient Assistance. (n.d.). Drugs.com. https://www.drugs.com/price-guide/nubeqa

Access Services by Bayer | NUBEQA® (darolutamide) | HCP. (n.d.). Nubeqa HCP US FTP Label. https://www.nubeqahcp.com/access-and-support/access-services-by-bayer?hcp=true

Bayer – Global home. (2026, January 26). https://www.bayer.com/en/

Key statistics for prostate Cancer. (2026, January 13). Prostate Cancer Facts | American Cancer Society. https://www.cancer.org/cancer/types/prostate-cancer/about/key-statistics.html

Fizazi, K., Shore, N., Tammela, T. L., Ulys, A., Vjaters, E., Polyakov, S., Jievaltas, M., Luz, M., Alekseev, B., Kuss, I., Kappeler, C., Snapir, A., Sarapohja, T., & Smith, M. R. (2019). Darolutamide in nonmetastatic, Castration-Resistant prostate cancer. New England Journal of Medicine, 380(13), 1235–1246. https://doi.org/10.1056/nejmoa1815671