Cost-effectiveness of elagolix versus leuprolide acetate for treating moderate-to-severe endometriosis pain in the USA

J Comp Eff Res. 2019 Apr;8(5):337-355. doi: 10.2217/cer-2018-0124. Epub 2019 Feb 6.


Aim: To assess the cost-effectiveness of elagolix versus leuprolide acetate in women with moderate to severe endometriosis pain.

Methods: A Markov model was developed. The efficacy of leuprolide acetate was derived from statistical prediction models using elagolix trial data. Model inputs were extracted from Phase III clinical trials and published literature.

Results: Compared with leuprolide acetate, elagolix generated positive net monetary benefit (NMB) assuming a payer's willingness-to-pay threshold of US$100,000 per quality-adjusted life year over a 1-year time horizon: US$5660 for elagolix 150 mg and US$6443 for elagolix 200 mg. The 2-year NMBs were also positive.

Conclusion: Elagolix was cost effective versus leuprolide acetate in the management of moderate to severe endometriosis pain over 1- and 2-year time horizons. Results were robust in sensitivity analyses.

Trial registration: NCT01620528 NCT01931670.

Keywords: cost–effectiveness model; dysmenorrhea; elagolix; endometriosis; leuprolide acetate; nonmenstrual pelvic pain.

Publication types

  • Clinical Trial, Phase III
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cost-Benefit Analysis
  • Endometriosis / complications
  • Endometriosis / drug therapy*
  • Female
  • Fertility Agents, Female / economics
  • Fertility Agents, Female / therapeutic use*
  • Humans
  • Hydrocarbons, Fluorinated / economics
  • Hydrocarbons, Fluorinated / therapeutic use*
  • Leuprolide / economics
  • Leuprolide / therapeutic use*
  • Markov Chains
  • Middle Aged
  • Models, Economic
  • Pain / drug therapy
  • Pain / etiology
  • Pyrimidines / economics
  • Pyrimidines / therapeutic use*
  • Severity of Illness Index
  • United States
  • Young Adult


  • Fertility Agents, Female
  • Hydrocarbons, Fluorinated
  • Pyrimidines
  • elagolix
  • Leuprolide

Associated data