I was one of the original clinical trial patients for what is now, Pluvicto. The pharmaceutical company, Novartis paid for that first round of treatments. I'm 4 of 6 treatments into my "repeat", and Medicare and my supplemental insurer is covering the costs. As you stated and as I learned, Pluvicto is only approved for one set of 6 treatments. So, to answer rayde0's question, I do not know and have not heard of a way to have the repeat round of treatments paid without being a clinical trial patient first.
I hope my experiences and outcome, so far extremely positive, will be a driver for the USFDA's approval of a second round of Pluvicto. But for now, I cannot help you. I know it's easy to say, but stay positive.