A study in Vietnam found that the hormone pill dienogest is cheaper and gives better quality‑of‑life results than the injectable GnRH‑agonist drugs (like triptorelin, leuprorelin, and goserelin) for treating painful periods caused by endometriosis.

Endometriosis-related dysmenorrhea and pelvic pain impose significant economic and quality-of-life burdens. This study evaluated the cost-effectiveness of dienogest compared to gonadotropin-releasing hormone agonists (GnRH-a) for managing dysmenorrhea and pelvic pain in Vietnam. The cost-effectiveness analysis using a Markov model was conducted from a healthcare payer perspective. Model input parameters were obtained from meta-analyses, published literature, and local data sources. One-way sensitivity, and probabilistic sensitivity analyses (PSA) were performed to assess the robustness of the findings. Vietnamese healthcare system context. Hypothetical cohort of women with endometriosis experiencing dysmenorrhea or pelvic pain. Dienogest compared with GnRH-a therapies (triptorelin, leuprorelin, goserelin). Costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs) were calculated over two years. Dienogest was the dominant treatment for dysmenorrhea, with the lowest cost ($363.3) and highest QALYs (1.74) compared to triptorelin ($739.3; 1.62 QALYs; ICER -$3,292/QALY) and leuprorelin ($744.0; 1.70 QALYs; ICER -$11,454/QALY). For pelvic pain, dienogest ($381.5, 1.64 QALYs) also dominated triptorelin ($720.4; 1.60 QALYs; ICER -$10,919/QALY), leuprorelin ($773.4; 1.54 QALYs; ICER -$4,300/QALY), and goserelin ($753.1; 1.49 QALYs; ICER -$2,609/QALY).One-way sensitivity analysis identified the probability of symptom resolution and utility values as key drivers of cost-effectiveness. PSA confirmed dienogest's high probability (≥ 99%) of being cost-effective at a willingness-to-pay threshold of one GDP per capita. Dienogest is a cost-effective alternative to GnRH-a drugs for treating dysmenorrhea and pelvic pain in Vietnam, offering improved health outcomes at a lower cost. These findings support its broader adoption in clinical practice and healthcare policy.