Australian men facing life-or-death battle as groundbreaking treatment vanishes from public hospitals

When retirement dreams collide with a cancer diagnosis, every treatment option becomes precious. For thousands of Australian men like 77-year-old Paul Singleton, access to a revolutionary prostate cancer therapy has suddenly disappeared, leaving them to choose between bankruptcy or potentially shortened lives.

The crisis unfolding in Australia's public hospitals affects the most vulnerable cancer patients at their most desperate hour—and it's happening right now.

A retiree's fight for more time

Paul and Hilary Singleton were settling into their golden years when prostate cancer delivered its devastating verdict: Paul had perhaps three years left to live.

That diagnosis came five years ago, and Paul credits his survival to a treatment called Lutetium PSMA—a therapy he describes as transformative compared to the brutal side effects of chemotherapy.

'You can walk around and be happy the next day,' Paul explained.

'With chemo, it's weeks you're knocked out and I could hardly crawl from the bed to the lounge sometimes.'

But when Paul discovered this life-extending treatment was no longer available through public hospitals, he was devastated. 'I just want to live with Hilary and enjoy my life, visit my family,' he said.

The scope of the crisis in Australia

The numbers paint a sobering picture: an estimated 26,368 Australian men will be diagnosed with prostate cancer in 2024, making it the most commonly diagnosed cancer in Australia.

Nearly 72 Australian men are diagnosed every day, with 1 in 6 men facing a prostate cancer diagnosis by age 85.

The good news? Survival rates have improved dramatically to 96 per cent for five-year survival. The troubling reality? Access to the treatments driving these improvements is now under threat.

For men with aggressive, metastatic disease like Paul, newer treatments like Lutetium PSMA represent hope when traditional therapies have failed. The sudden disappearance of this option from public hospitals has created a healthcare crisis affecting some of Australia's most vulnerable patients.

How Lutetium PSMA works—and why it matters

Lutetium PSMA is what's called a 'radioligand' - a sophisticated molecule combining radioactive lutetium with a targeting compound designed to bind specifically to prostate cancer cells.

Think of it as a guided missile that seeks out cancer cells and delivers precise, destructive radiation while sparing healthy tissue.

Anne Savage, CEO of the Prostate Cancer Foundation of Australia, describes the drug as 'groundbreaking' and 'the way forward for aggressive and advanced prostate cancer'.

For patients like Paul, the difference in quality of life compared to traditional chemotherapy is dramatic.

The treatment's appeal extends beyond effectiveness to tolerability. While chemotherapy can leave patients bedridden for weeks, Paul found he could maintain his normal activities between Lutetium PSMA treatments, experiencing only minor side effects like dry eyes and mouth.

The legal battle that changed everything

The crisis began when Swiss pharmaceutical giant Novartis, which markets its version of the drug as Pluvicto, took legal action against Australian providers offering locally compounded versions of Lutetium PSMA.

Court records show that in January 2025, Novartis filed legal proceedings against GenesisCare, a private clinic treating patients with the locally compounded version.

By July 2025, public hospitals had notified patients and specialists they could no longer provide access to Lutetium PSMA, citing fears of intellectual property infringement. The locally compounded version, which had been available for a decade, suddenly vanished from the public health system.

Professor Lee Sze-Ting, former president of the Australasian Association of Nuclear Medicine Specialists, explained the chilling effect: 'Public and private institutions do not dare provide the locally compounded, funded version.'

The devastating cost difference

The financial implications reveal the crisis's true cruelty. Paul had been paying approximately $6,000 per treatment cycle for the locally compounded version—a stretch for a retiree on a full pension, but manageable with family help.

Novartis's Pluvicto, however, could cost patients between $20,000 and $50,000 per round initially. International pricing data shows Pluvicto costs approximately $42,500-$48,500 per dose in the US market, suggesting Australian pricing falls within global norms for this patented medication.

'I don't think I'd be able to finance it,' Paul admits. For many retirees living on fixed incomes, these costs represent an impossible choice between financial ruin and potentially life-saving treatment.

The Medicare funding maze

In April 2024, the Medical Services Advisory Committee approved Lutetium PSMA for Medicare funding, with treatments available from July 2025 at a scheduled fee of $8,000 and Medicare rebates of up to $7,897.60. On paper, this seems like good news.

The reality proves more complex. The Medicare system requires patients to pay the full amount upfront before receiving rebates—a significant barrier for elderly patients on fixed incomes. Novartis acknowledged this creates 'a significant limitation to treatment access for many Australian patients, particularly those treated in a public hospital.'

International perspective reveals the stakes

Market analysts project Novartis could see a threefold expansion in eligible patients as Pluvicto gains approval for earlier-stage treatments. The drug generated $454 million in Q2 2025 sales, growing 32 per cent year-over-year, demonstrating its commercial success.

In Germany, statutory health insurance approved reimbursement after setting a benchmark price above $162,257 annually, enabling market access while other European countries struggle with uneven availability.

The contrast highlights Australia's unique challenge: a treatment that was accessible and affordable through local compounding has been replaced by a commercial product requiring significant upfront investment, effectively pricing out many seniors who need it most.

What this means for Australian families

The implications extend beyond individual patients to entire families. Paul's story reveals how relatives rallied to help fund his treatment when costs were manageable at $6,000 per cycle. At $20,000-$50,000 per treatment, such family support becomes impossible for most households.

By 2040, it's predicted there will be 372,000 men living with or beyond prostate cancer in Australia—a growing population that needs reliable access to effective treatments.

The current crisis particularly affects older Australian men who planned their retirement finances before facing a cancer diagnosis requiring expensive, cutting-edge treatment.

The advocacy response and call for reform

Anne Savage of the Prostate Cancer Foundation describes the situation as a 'stand-off' and advocates for the government to 'create a new approval mechanism specifically for radio pharmaceuticals'.

Medicines Australia, representing pharmaceutical companies, supports a different approach involving Therapeutic Goods Administration evaluation followed by Pharmaceutical Benefits Scheme funding, which wouldn't require large upfront patient costs.

Professor Lee noted that 'many other radiopharmaceuticals were being developed to target a range of cancers' and warned that 'current approval systems are not fit for radionuclide therapies'. The Lutetium PSMA crisis may be just the beginning if systemic reforms aren't implemented.

Looking ahead: what patients can do now

While policy makers debate solutions, patients and families face immediate decisions. Healthcare advocates recommend several steps:

First, patients currently receiving or considering Lutetium PSMA should discuss all options with their oncologist, including clinical trials that might provide access to similar treatments. Second, families should contact the Prostate Cancer Foundation for support navigating the complex landscape of treatment options and financial assistance.

Third, patients should advocate for themselves within the system. The Medicare rebate system, while requiring upfront costs, does provide substantial reimbursement for those who can manage the initial expense.