Ways to reduce the cost of treatment for endometriosis

Endometriosis is a condition that can affect anyone who menstruates. The main feature is the growth of abnormal tissue that is similar to the endometrium, the tissue that lines the uterus (the womb) and is shed during menstruation. This abnormal tissue is also called endometriosis, and it most often appears on the tissues and organs surrounding the uterus, such as the fallopian tubes, the ovaries, the bowel, bladder, and the connective tissues between these organs. Endometriosis can appear in more distant sites in the body, though this is less common.

Common symptoms include severe pain during menstrual periods, heavy menstrual bleeding, pelvic pain (during or outside of menstrual periods), bladder pain, gastrointestinal pain, bloating, nausea, and infertility.

Symptoms can vary significantly from person to person, and it’s always best to consult a healthcare provider about pain, discomfort, or any symptom or concern. If something does not feel right, make an appointment. Many people with endometriosis spend years without proper treatment due to delays in diagnosis. The normalization of painful menstruation symptoms, stigma, lack of awareness about the condition, and other barriers to care are some of the symptoms that contribute to these delays.

Untreated, endometriosis can progress and lead to complications. These include infertility, increased risk of pregnancy complications, and damage to organs (like the bowel and bladder), and chronic pain. Endometriosis can also contribute to a decline in physical health, mental health, and daily functioning.

Treatment for endometriosis

Treatment for endometriosis will vary from person to person. In most cases, treatment includes medications:

• NSAIDs (nonsteroidal anti-inflammatory drugs) for managing pain.
• Hormonal contraceptives (hormonal birth control). When taken continuously, hormonal birth control can halt hormone production by the ovaries, slowing the growth of endometrial tissue and preventing new endometrial tissue from forming.
• GnRH analogs (gonadotropin-releasing hormone agonists and antagonists) are another treatment option. These drugs temporarily pause estrogen production in the ovaries, which can help shrink endometrial tissue and lessen symptoms, including pain.
• Other types of hormone therapy.
• Medications that combine a GnRH antagonist with hormone therapies.

Medications used to treat endometriosis can cause side effects and several come with safety-related warnings (box warnings). Always talk to your healthcare provider about risks of side effects, how to use a medication properly, and monitoring while on a medication.

It’s also important to discuss preventing pregnancy while taking certain medications—some medications should not be used with hormonal birth control. Some medications can be harmful to a developing fetus if a person becomes pregnant during treatment.

Surgery to remove or destroy misplaced endometrial tissue may also be needed to treat moderate-to-severe endometriosis.

Reducing the cost of treatment

Cost is something that needs to be considered when deciding how to treat any medical condition. If the cost of medication for endometriosis is a concern, the following strategies may be helpful.

Talk to your healthcare provider

This should be your first step whenever you have a concern about a medication, including the cost of a medication. Your healthcare provider may be able to recommend resources or strategies to help reduce out-of-pocket expenses.

Contact your health insurance provider

Contact your insurance provider to find out if specific medications are covered by your insurance plan. Cost and coverage can vary between plans and medications.

Compare pharmacy prices

Medication prices can also vary between different pharmacies. Some health insurance plans also have preferred, in-network pharmacies, which can affect pricing. Compare prices between different pharmacies in your area and prices at online pharmacies.

Ask for a 90-day supply

Sometimes, a prescription can be filled as a 90-day supply (versus a 30-day supply). This may help reduce the cost in some cases. Ask your healthcare provider if this is a possibility. You may also need to contact your insurance provider. At the very least, a 90-day supply can save you a few trips to the pharmacy.

Manufacturer discounts and savings

Sometimes drug manufacturers offer programs to help reduce the cost of medications. Check the website for the medication you’re taking or considering taking. Check if programs are available and what requirements must be met to qualify.

Two types of programs to look for:

Copay cards

Also known as copay savings programs, copay cards have a discount code that will be presented to a pharmacist to apply a discount to a specific drug. These are typically issued to people who have insurance through a provider or insurance they have purchased on their own.

Patient assistance programs (PAPs)

These are usually for people who are uninsured or underinsured and cannot cover the cost of a medication. Eligibility and enrollment processes vary from program to program.

State Pharmaceutical Assistance Programs

Apart from manufacturer's discounts, some states offer financial assistance programs for medications, called State Pharmaceutical Assistance Programs (SPAPs). Eligibility can vary from program to program and medication to medication. You can check for programs in your state by visiting the National Conference of State Legislatures.