Why Orilissa Costs $552.00 Per Claim
Orilissa (Elagolix) is used to treat womens health. According to CMS Medicare Part D spending data, the program spent $234.0M on this drug, covering 48,000 beneficiaries across 424,000 claims.
A generic version of this drug is available, which means lower-cost alternatives exist. Patients should ask their pharmacist about generic Elagolix or talk to their doctor about therapeutic alternatives that may cost less.
Price Breakdown
Drug Details
Frequently Asked Questions
Orilissa (Elagolix) costs an average of $552.00 per claim based on Medicare Part D data. The estimated annual cost per patient is $4,875.00. Actual out-of-pocket costs depend on your insurance plan and pharmacy.
Orilissa averages $552.00 per Medicare Part D claim — roughly equivalent to a 30-day supply for most patients on standard dosing. Without insurance, expect higher cash-pay prices unless you use a discount program (GoodRx, SingleCare, manufacturer copay assistance). With Medicare or commercial insurance, your out-of-pocket cost depends on your plan's formulary tier and deductible status.
A typical 30-day supply of Orilissa reflects in our Medicare Part D average of $552.00 per claim. Switching to generic Elagolix typically reduces cost by 80-95%. Cash-pay prices vary by pharmacy — comparison shopping (or using GoodRx coupons) often saves 20-50% off the listed price.
Most commercial insurance plans and Medicare Part D plans cover Orilissa, but coverage varies by formulary tier. Insurers typically prefer generic Elagolix (Tier 1, lowest copay) over brand-name Orilissa (Tier 2-3, higher copay). Some plans require prior authorization or step therapy. Check your plan's formulary or call the number on your insurance card to confirm.
Several options for cash-pay patients: (1) Manufacturer patient assistance programs — the manufacturer may offer copay cards or free-drug programs for income-qualified patients; (2) Discount programs like GoodRx, SingleCare, or RxSaver typically save 20-80% off the cash price; (3) Mark Cuban's Cost Plus Drugs offers transparent generic pricing if a generic is available; (4) 340B-eligible community health centers offer drugs at federally negotiated discounts. Switching to generic Elagolix is the single biggest cost reducer if your prescriber is open to it.
Brand-name Orilissa costs more than generic Elagolix primarily for marketing reasons — patients can request the brand from their doctor even when a chemically identical generic exists. The active ingredient and clinical effect are the same.
Yes, a generic version of Orilissa (Elagolix) is available. Generic medications typically cost 80-95% less than brand-name drugs. Ask your pharmacist about generic Elagolix.
Medicare Part D spent $234.0M on Orilissa, covering 48,000 beneficiaries across 424,000 claims. This makes it one of the tracked drugs in the Medicare spending dashboard.
Ask your pharmacist about generic Elagolix, which is typically much cheaper. You can also compare prices at different pharmacies, use prescription discount programs (GoodRx, SingleCare, Cost Plus Drugs), or ask your doctor about therapeutic alternatives in the same drug class.
The this entity record above pulls directly from CMS Medicare Part D Drug Spending data. What follows is the per-entity context — how this entity sits in the broader U.S. Medicare prescription-drug pricing distribution and which underlying factors drive the headline numbers.
The methodology behind every numeric value on this page is publicly documented on the CMS Medicare Part D Drug Spending data portal and described in detail on this site’s methodology page. Refresh cadence varies by underlying series; the page surfaces the as-of date for each number so readers can trace any figure back to the source release.
Practical use of this page is in combination with the comparison and ranking pages elsewhere on the site, which surface the same data for this entity’s peers within U.S. prescription drugs. A single-entity reading without peer context can be misleading when an entity is an outlier on one axis but typical on another.
Related
Cost data reflects Medicare Part D spending and may not represent retail pharmacy prices. Average cost per claim represents the total drug cost (not patient out-of-pocket) divided by total claims.