Orilissa (elagolix), a treatment that reduces pain in endometriosis, can also have economic benefits, a study reports. The therapy allowed patients to work more and be more productive, which would ultimately be expected to result in cost savings.
The study, “Impact of elagolix on work loss due to endometriosis-associated pain: estimates based on the results of two phase III clinical trials,” was published in the journal Fertility and Sterility.
In addition to the obvious issue of discomfort, pain from endometriosis can have a marked impact on workplace productivity, either in the form of absenteeism or being able to get less done while at work (presenteeism). On average, people with endometriosis lose between half a day and a full day of work per week because of endometriosis-related pain.
Orilissa is an oral gonadotropin-releasing hormone agonist that can reduce pain associated with endometriosis. Results from two placebo-controlled Phase 3 clinical trials, Elaris Endometriosis I (EM-I; NCT01620528) and Elaris Endometriosis II (EM-II; NCT01931670) demonstrated the pain-reducing capabilities of this drug at doses of 150 mg once daily or 200 mg twice daily.
In these clinical trials, participants were asked to complete the Health-Related Productivity Questionnaire, an assessment of workplace productivity related to health.
In this new study, researchers used the results of the questionnaire at baseline (before treatment) and at three months into treatment to see how the reduction of pain via Orilissa translated into workplace productivity in EM-I and EM-II (data from each trial were analyzed separately).
The analysis included participants who were employed full- or part-time in EM-I (672 people) and EM-II (626 people). Most participants were employed full-time (524 in EM-I and 484 in EM-II), the average age was in the early 30s (31.6 for EM-I and 33.5 in EM-II), and the participants were predominantly white (86.3% in EM-I and 88.5% in EM-II).
In both trials, before treatment, participants reported losing an average of 15–16 hours of work the previous week, which accounted for over 40% of their planned employment hours. This was predominantly because of presenteeism, which accounted for 12–13 of the lost hours.
After three months of treatment, compared to baseline, participants treated with Orilissa at 150 mg once daily gained an average of 2.20 and 2.65 hours of work per week in EM-I and EM-II, respectively. Those treated with Orilissa at 200 mg twice daily gained an average of 4.91 and 4.64 hours of work per week, respectively. This was primarily because of a decrease in presenteeism.
The researchers then used this data and the average hourly cost of employment (including benefits) in the United States to calculate expected cost savings. Orilissa is approved for treatment lasting 24 months at a dose of 150 mg once daily or for treatment lasting six months at a dose of 200 mg twice daily.
The average estimated cost savings per patient for 150 mg once daily at 6, 12, and 24 months were over $1,500, $3,100, and $6,200, respectively. For 200 mg twice daily, the estimated cost savings at 6 months were over $3,300 in both trials.
“This study showed that, compared with placebo, treating moderate to severe endometriosis-associated pain with elagolix reduced work loss and improved productivity, which should translate to cost savings,” the researchers concluded. “The results also emphasize the impact of endometriosis-associated pain on women’s ability to work.”