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The Policy VaultThe Policy Vault

Orilissa (elagolix tablets)Medica

Endometriosis

Preferred products

  • combination oral contraceptives
  • levonorgestrel-releasing intrauterine systems (Mirena, Liletta)
  • depo-medroxyprogesterone injection
  • oral progesterone (norethindrone tablets)
  • Lupron Depot (leuprolide depot injection)
  • Myfembree (relugolix, estradiol, norethindrone tablets)

Initial criteria

  • Patient has tried ONE of the following, unless contraindicated (an exception to the requirement for a trial can be made if the patient had previously used a gonadotropin-releasing hormone agonist (e.g., Lupron Depot [leuprolide depot injection]) or Myfembree (relugolix, estradiol, norethindrone tablets) for endometriosis):
  • i. A contraceptive (e.g., combination oral contraceptives, levonorgestrel-releasing intrauterine systems [e.g., Mirena, Liletta], a depo-medroxyprogesterone injection); OR
  • ii. An oral progesterone (e.g., norethindrone tablets)

Reauthorization criteria

  • Patient is currently receiving Orilissa

Approval duration

6 months