Visanne (dienogest) has become the first endometriosis treatment in 30 years to join Australia’s Pharmaceutical Benefits Scheme (PBS). Endometriosis, a chronic condition affecting one in seven Australian women, involves uterine-like tissue growing outside the uterus, causing significant pain and disruption. Though incurable, Visanne offers new hope as a subsidized option.
What is Visanne?
It is a synthetic progestin that curbs the production of estradiol, the hormone responsible for regulating reproductive cycles and promoting endometrial growth. By limiting estradiol, Visanne mitigates the abnormal tissue growth characteristic of endometriosis, alleviating symptoms like severe pain.
A 2023 study showed that a daily 2 mg dose of this treatment reduced endometrial growth by 26% over a year, significantly easing symptoms, especially period pain. A 2022 study across six countries found over 90% of participants reported reduced pelvic pain.
Potential Side Effects
Common side effects include headaches, breast tenderness, hot flushes, acne, hair loss, abdominal pain, weight gain, and irregular bleeding. Approximately 40% of patients in the 2022 study experienced such effects, with vaginal bleeding being the most reported. Although side effects tend to diminish over time, they can still pose challenges for users.
Encouragingly, Visanne is reported to have minimal impact on bone density, a common concern with other hormonal treatments.
Cost and Accessibility
Previously costing patients A$800 annually, Visanne’s inclusion in the PBS reduces costs to around $380 per year or $90 for concession card holders. While this represents significant savings, the out-of-pocket expense remains a burden for some, especially since supplementary medications like paracetamol might still be needed.
Why Subsidize it?
Visanne’s listing reflects its cost-effectiveness in managing a condition that costs the Australian economy $7.8 billion annually. The condition often disrupts women’s work lives, with studies showing one in six women with endometriosis losing their jobs due to symptoms. By improving accessibility, Visanne supports workforce participation and helps address gender pay disparities.
Who Should Consider it?
While Visanne is a promising option, it is one of several treatments, including oral contraceptives, hormonal implants, and gonadotrophin-releasing hormone therapies. Visanne may halt ovulation, complicating pregnancy for some users, so its suitability depends on individual circumstances. Consultation with a doctor is essential to determine if Visanne is the right choice.
Commentary by YourDailyFit Columnist Alice Winters
Visanne’s addition to the PBS is a milestone for endometriosis care in Australia, breaking a 30-year drought in innovative subsidized treatments. Its mechanism, targeting estradiol production, represents a focused approach to controlling a debilitating condition. The reported efficacy, with notable reductions in endometrial growth and pelvic pain, aligns with its promise as a therapeutic breakthrough.
However, Visanne is not without caveats. The substantial side effect profile, experienced by a significant percentage of users, raises questions about the drug’s long-term tolerability. While side effects may diminish, balancing pain relief with potential new symptoms can be a delicate trade-off. Its minimal impact on bone density is a welcome distinction from other hormonal treatments, potentially broadening its appeal to those concerned about long-term skeletal health.
Cost remains a sticking point. Though PBS inclusion significantly reduces expenses, the ongoing financial burden, compounded by supplementary treatment costs, could exclude lower-income patients from accessing this therapy. This raises the issue of equitable healthcare access—a pressing concern for a condition disproportionately affecting women’s health and economic stability.
Visanne’s introduction highlights the need for a multi-pronged strategy in endometriosis care. Beyond individual treatment, addressing broader societal impacts—workforce productivity and the gender pay gap—adds weight to the drug’s importance. Yet, it should not overshadow the availability of other effective treatments, which may better suit certain individuals.
For those weighing Visanne as a treatment option, the decision must be personalized, considering its side effects, cost, and impact on fertility. This emphasizes the critical role of informed discussions between patients and healthcare providers.
Visanne may not be a perfect solution, but it is a pivotal step forward in tackling a condition that has long been underfunded and overlooked. Its arrival should spur further investment in comprehensive, accessible, and individualized endometriosis care.
