Does SGK Cover Trodelvy (Sacituzumab Govitecan)? 2026 Price & Litigation

Trodelvy (sacituzumab govitecan), which has come to the fore in recent years in the treatment of breast and bladder cancer, is licensed in Turkey but is not on the Social Security Institution's (SGK) reimbursement list. As a result, patients who must use the drug end up paying the full cost of treatment themselves and are often forced to pursue legal action. This article covers what Trodelvy is used for, its SGK coverage status, the current price range, and the steps required to reclaim the drug cost through litigation. Compared with Bevax (bevacizumab), which is partially included in the reimbursement list but can still be refused outside certain indications, Trodelvy's process proceeds from the outset as a case involving a drug entirely outside SUT.

What Is Trodelvy (Sacituzumab Govitecan)?

Trodelvy is a drug in the antibody-drug conjugate (ADC) class whose active substance is sacituzumab govitecan. It works by combining an antibody that targets the TROP-2 protein, frequently found on the surface of cancer cells, with a chemotherapeutic agent; this directs the drug straight to the cancer cell and aims to limit damage to healthy tissue. International guidelines list its main uses as:

• Triple-negative breast cancer (metastatic TNBC) that has not responded to prior treatments
• Advanced or metastatic urothelial (bladder and urinary tract) cancer

In aggressive breast cancer cases that are negative for hormone receptors and HER2, where standard chemotherapy options have been exhausted, Trodelvy is among the limited treatment options available.

Trodelvy's SGK Coverage Status

Although Trodelvy is licensed by the Turkish Medicines and Medical Devices Agency (TİTCK), it has not yet been added to SGK's "Reimbursable Drugs List" (Annex 4/A). The cost of drugs not listed in the Health Implementation Communiqué (SUT) is not paid by SGK regardless of the patient's indication. As a result:

• As of today, Trodelvy is not directly covered by SGK for any indication.
• The drug is largely treated as one procured from abroad, and prescribed patients must initially cover the cost themselves.
• It is important for subsequent legal proceedings that the prescribing oncologist issues a health board report documenting that the drug is medically necessary for the patient's treatment.

Trodelvy 2026 Price

As an imported drug, Trodelvy's price fluctuates with the exchange rate and there is no single fixed list price on the market. According to international sources, a 180 mg vial costs approximately 1,100-1,200 USD; since more than one vial may be used per cycle depending on the treatment protocol, the monthly treatment cost can reach hundreds of thousands of TL. It is advisable to confirm the current, exact price directly with the pharmacy or hospital supplying the drug, as prices for such imported products can change frequently with currency movements.

Legal Route When SGK Does Not Cover the Drug

To claim the cost of Trodelvy from SGK, or to reclaim amounts previously paid out of pocket, the following stages are generally followed:

1. Application to TİTCK for Off-Label / Foreign Drug Use

The treating oncologist submits an application to the Turkish Medicines and Medical Devices Agency showing that the drug is necessary for the patient's treatment, that no alternative exists, and that it is supported by scientific literature. This approval is one of the most important grounds in the case to be filed later; its absence does not by itself mean the case will be dismissed, but it can weaken the file.

2. Written Application to SGK

A written application is made to the Provincial Directorate of SGK, together with the TİTCK approval, physician's report, prescription, and any payment documents. SGK largely refuses applications for drugs not on the Annex 4/A list, or fails to respond within the statutory period (implied refusal).

3. Filing a Case

Following SGK's refusal or implied refusal, a case is filed before the labour court or administrative court depending on the patient's social security status:

• Insured persons under SSK/Bağ-Kur: labour court
• Civil servants and retired civil servants (those outside the scope of Article 4/c of Law No. 5510): administrative court

4. Request for an Interim Injunction

The statement of claim requests an [interim injunction](/en/ictihat/odeme-listesi-disi-ilacta-ihtiyati-tedbir) so that SGK temporarily covers the drug while the litigation is pending. The court considers this request if documents are submitted showing that the drug is of vital importance and that no alternative exists. If the injunction is granted, the drug can be obtained free of charge until the case concludes.

5. Expert Examination and Decision

The court typically refers the file to experts from university medical oncology departments to assess whether the drug is necessary for the disease. If the expert report is favourable, SGK may be ordered to pay for the drug.

Required Documents

Duration of Proceedings and Limitation Period

Drug cases filed against SGK generally conclude within an average of 6 to 18 months in practice; this period can vary depending on the court's workload and the expert examination process. For claims to reclaim the drug cost, a 5-year limitation period applies under Article 97 of Law No. 5510, running from the date payment was made or SGK refused payment.