Orilissa — Medical Mutual

Endometriosis – initial therapy

Initial criteria

Patient is age ≥ 18 years; AND
Patient has moderate to severe pain; AND
Prescribed by or in consultation with an obstetrician, gynecologist, or reproductive endocrinologist; AND
Patient does not have any of the following contraindications: osteoporosis, severe hepatic impairment, concomitant use of a strong organic anion transporting polypeptide (OATP) 1B1 inhibitor such as cyclosporine or gemfibrozil; AND
Patient is not pregnant; AND
Provider will monitor for decreases in bone density and elevation in lipids; AND
Patient has failed or is intolerant to at least a 3-month trial of nonsteroidal anti-inflammatory drugs (NSAIDs); AND
Patient has tried ONE of the following, unless contraindicated: (i) a contraceptive (e.g., combination oral contraceptives, levonorgestrel-releasing intrauterine systems [e.g., Mirena, Liletta]); OR (ii) an oral progesterone (e.g., norethindrone tablets); OR (iii) a depo-medroxyprogesterone injection; AND
Patient will not use 200 mg twice daily for more than 6 months.

6 months