How Much Does Orilissa Cost Without Insurance?

Orilissa (elagolix) reduces pain caused by endometriosis (excess growth of uterine tissue). It works by lowering estrogen levels in the body. This reduces the growth of uterine tissue, which in turn helps lessen pain.

Orilissa is an oral tablet you’ll take once or twice a day. It isn’t available as a lower-cost generic. So it’s common to wonder how much Orilissa costs and whether your insurance will cover it. Here’s what you should know.

How much does Orilissa cost without insurance?

The list price for 1 dose of Orilissa is $1,047, according to the manufacturer. The average retail price is typically higher because of wholesaler and pharmacy markups.

The table below shows the average retail price for the two most common doses of Orilissa.

What factors affect the cost of Orilissa?

Several factors can affect the cost of Orilissa, including:

• Location: Where you live can affect the cost of your medication. For example, according to GoodRx research, medications are typically more affordable in Denver than in New Orleans.

• Pharmacy: Cash prices can vary from one pharmacy to another, even in the same neighborhood. It’s a good idea to check a few options before filling your prescription.

• Dosage: Prices can vary for different doses of Orilissa. Your prescriber will determine your dosage based on your symptoms, your health history, and how you respond to the medication.

• Insurance coverage: You’ll typically pay less for Orilissa if your prescription insurance covers it. But your copay may vary based on your plan’s formulary (more on that next).

Disclosure

Orilissa

Avg retail price

$1,440.90(Save 17.07%)

GoodRx discount

$1,194.92

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Does insurance cover Orilissa?

Almost all Medicaid and commercial insurance plans cover Orilissa. It’s also covered by more than 90% of plans accessed through the Affordable Care Act (ACA) marketplace. Only about 14% of Medicare plans cover Orilissa, but that’s largely because endometriosis pain isn’t  common among people over age 65.

A prior authorization is required for 70% to 80% of ACA and commercial insurance plans and about 50% of Medicaid plans. This means your prescriber needs to submit information explaining why Orilissa is medically necessary before your plan will cover it.

Step therapy is required for about 50% of commercial, ACA, and Medicaid plans. This means you’re required to try other treatments (or explain why you aren’t able to take them) before they’ll cover Orilissa.

If Orilissa is covered by your insurance, the amount you’ll pay depends on where it falls within your plan’s formulary (list of covered medications). Medications are often classified into different tiers within a formulary — a lower tier typically means a lower copay. You can access your plan’s formulary online or by calling the customer service number on your prescription insurance card.

How different insurance plans cover Orilissa

The table below breaks down the percentage of enrollees who have coverage for Orilissa by insurance type. It also shows the likelihood of having prior authorization and step therapy requirements.

Source: Managed Markets Insight & Technology, LLC™, as of Dec 6, 2025 (See methodology below.)

EXPERT PICKS: WHAT TO READ NEXT

• Endometriosis treatment options: In this guide, experts review the available endometriosis treatments and when one is preferred over others.

• What it feels like: Read firsthand accounts of what endometriosis feels like, and learn about management tips that have helped others.

• When medications aren’t enough: Endometriosis medications don’t work for everyone. Learn about the different types of endometriosis surgery and when they may be considered.

If your insurance doesn’t cover Orilissa, try these options:

• Lower your cost with a manufacturer copay savings card, a patient assistance program, or medication discount cards like GoodRx. (See below for details.)

• Ask your health plan to cover Orilissa by submitting a formulary exception request. Your prescriber may need to provide documentation and a letter of medical necessity explaining why this medication is required for your condition.

• If the formulary exception request is denied, file an appeal.

• Ask your prescriber about switching to an Orilissa alternative, such as Myfembree (relugolix / estradiol / norethindrone acetate), that your insurance may cover.

• Compare insurance plans during the next open enrollment period to find one that offers better coverage for your medications.

Ways to save on Orilissa

Here are five ways to save on Orilissa, with or without insurance coverage.

1. Use a GoodRx coupon

GoodRx could help you save over 20% off the cost of Orilissa without insurance. To use this discount:

• Visit www.goodrx.com or download the app.

• Search for “Orilissa” and then click or tap “Find the lowest prices.”

• Select your prescribed dose and quantity.

• Choose if you want to receive the discount information by text or email. You can also take a screenshot on your phone or save it to your phone’s digital wallet.

• To avoid delays, provide the discount information to the pharmacy before you go in to pick up your prescription.

2. See if you qualify for a copay savings card

If you have commercial insurance, you may be able to pay as little as $5 per month for Orilissa using a savings card from the manufacturer.

To qualify for the Orilissa copay savings card:

• You must have private or commercial insurance.

• You must not be enrolled in a government health insurance program, such as Medicare or Medicaid.

There is an annual maximum benefit of $5,000 per calendar year. And people living or receiving medical treatment in certain states may not be eligible (call 1-800-674-5477 for more information).

3. Check if you’re eligible for a patient assistance program

If you’re uninsured or underinsured and you meet certain income requirements, you may be eligible for the myAbbVie Assist program. It offers Orilissa at no cost to those who qualify, which includes the following criteria:

• U.S. resident

• Have limited or no health insurance coverage

• Demonstrate financial need and meet income restrictions

You can apply for my AbbVie Assist online, or call 1-800-222-6885 for assistance. Keep in mind that your prescriber will also need to complete paperwork to confirm your eligibility for this program.

4. Ask about a 3-month supply

Talk to your prescriber about writing your Orilissa prescription for an 84-day (3-month) supply. With some insurance plans (and cash prices), your price may be lower per month if you purchase 3 months of medication at a time. And you’ll make fewer trips to the pharmacy overall, which will help save you time and money.

5. Tap into your HSA, FSA, or HRA

If you have a health savings account (HSA), a flexible spending account (FSA), or a health reimbursement arrangement (HRA), you can use it to help cover your out-of-pocket costs for Orilissa. These tax-advantaged health accounts let you pay for eligible expenses with tax-free dollars.

Pay directly with your HSA or FSA card at the pharmacy, or cover the cost yourself and submit a request for reimbursement. The funds in an HSA or an HRA typically roll over annually, but you have to use your FSA dollars before the deadline or they’ll expire.

Why trust our experts?

Written by:

Stacia Woodcock, PharmD

Stacia Woodcock, PharmD, is a pharmacy editor for GoodRx. She earned her Doctor of Pharmacy degree from the University of Kentucky and is licensed in New York and Massachusetts.

Reviewed by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

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Methodology

We obtained national prescription coverage data for each medication from Managed Markets Insight & Technology (MMIT). The data reflects health insurance coverage as of Dec 2026. 

We calculated the percentage of enrollees in plans that cover each medication by dividing the number of enrollees covered for the medication within a specific insurance channel (e.g., ACA, Medicare, Medicaid) by the total number of enrollees in all plans within that channel. 

We determined the percentage of enrollees in plans with a prior authorization requirement by calculating the proportion of enrollees in plans that required prior authorization for the medication within each channel.

Finally, we measured the percentage of enrollees in plans with a step therapy requirement by calculating the proportion of enrollees in plans that imposed step therapy requirements for the medication in each channel. 

These estimates, derived from national MMIT coverage data, provide insight into health insurance coverage for each medication. They take into account restrictions such as prior authorization, step therapy, and quantity limits. The percentages are expressed relative to the total number of enrollees covered by various insurance channels, including ACA plans, commercial (excluding ACA) plans, Medicare, and Medicaid (both state-run and managed care plans).