Endometriosis New Zealand has submitted applications to Pharmac seeking public funding for two important hormonal treatments for endometriosis – Visanne (dienogest) as a first-line option, and Ryeqo (relugolix with estradiol and norethisterone acetate) as a second-line treatment.
Endometriosis affects an estimated 120,000 people in Aotearoa New Zealand, causing chronic pain, fatigue, fertility challenges and a profound impact on quality of life. For many, the condition disrupts education, career opportunities, relationships and the ability to raise a family.
Endometriosis New Zealand Chief Executive Tanya Cooke says access to affordable and effective treatment options remains one of the biggest challenges in endometriosis care in New Zealand.
“People with endometriosis deserve the same modern, evidence-based treatments that are routinely available overseas. These applications are about giving patients and their clinicians access to more tools to manage this complex and life-changing condition.”
“Endometriosis presents differently for every person. No single treatment works for everyone, and outcomes vary between individuals. That is why having a range of funded hormonal options that sit alongside other treatment options is critical. This allows care to be tailored to the individual, their symptoms and stage of life.”
Hormonal treatments work by suppressing the oestrogen that drives endometriosis, helping to reduce pain and lower the risk of symptoms returning after surgery.
“Endometriosis is an oestrogen-dependent condition, so treatments that reduce or regulate oestrogen can play a crucial role in controlling symptoms and disease progression,” says Dr Sarah Corbett, Specialist Gynaecologist and member of Endometriosis New Zealand’s Clinical Advisory Committee. “Clinically, these therapies are often used as part of a long-term management plan, tailored to a person’s symptoms, response to treatment and stage of life.”
“Visanne is already recommended as a first-line medication option in the Ministry of Health’s 2020 Diagnosis and Management of Endometriosis guidelines,” says Dr Amelia Ryan, Gynaecologist and Clinical Advisory Committee member. “Yet it remains unfunded, expensive, and at times, difficult to access.”
“It makes no sense that a medicine our own clinical guidelines recommend is effectively out of reach for many New Zealanders.”
Visanne is publicly funded in countries including the United Kingdom and Australia, where it is part of routine endometriosis care.
Ryeqo is a newer combination therapy that has been available but unfunded in New Zealand since July 2025. It is designed for people with moderate to severe endometriosis pain who have not had sufficient relief from other medical or surgical treatments.
Large international clinical trials show that most people treated with Ryeqo experience significant reductions in endometriosis-related pain, reduced reliance on painkillers, and meaningful improvements in daily functioning and quality of life. Ryeqo is already widely used overseas, including in Australia and the United Kingdom.
“Without Pharmac funding, both medicines can cost hundreds of dollars every few months, putting them out of reach for many people, particularly those who have lost income due to their condition, are already struggling financially or face high healthcare costs,” Cooke says.
Dr Corbett emphasises that neither Visanne nor Ryeqo are a cure for endometriosis, and they will not work for everyone.
“Endometriosis is complex. Some people respond well to hormonal treatments, for others it doesn’t work so well. That’s why a range of options and personalised care is so important. These medicines give people and clinicians more choices – they represent additional tools in the treatment toolbox.”
Endometriosis New Zealand has worked with both medicine suppliers to ensure the two treatments are provided here. The organisation’s advocacy has been particularly influential in persuading the manufacturer of Visanne to make the treatment available to the New Zealand market.
“These applications are about ensuring all those with endometriosis, regardless of their financial circumstances, have the same access to modern and effective treatment options,” says Cooke. “New Zealanders should not be left behind while those overseas benefit from these treatments.”