New endometriosis pill: How does endometriosis drug Ryeqo work, and is it available on the NHS in Scotland?

A new pill designed to transform the treatment of endometriosis has been approved for use on the NHS in England and Wales. But exactly how does it work, and is it available in Scotland? The Scotsman answers your questions about Ryeqo below.

What is the drug promising a ‘step change’ in the treatment of endometriosis?

The combination drug is called relugolix–estradiol–norethisterone, also known as relugolix combination therapy. But it is best known by its brand name, Ryeqo.

Why is it in the news?

The drug has been approved by the National Institute for Health and Care Excellence (Nice), which provides guidance for health and care across England and Wales. It will only be made available on the NHS for patients whose medical or surgical treatment for endometriosis has failed.

What does the drug do?

As the first long-term daily pill licensed to treat the condition, it works by blocking specific hormones that contribute to endometriosis, while also providing necessary hormone replacement. Unlike injectable treatments which can initially worsen symptoms, the pill can be taken at home, works more quickly, combines hormones in one pill and cuts the need for visits to clinics.

The new drug has been hailed as a breakthrough in treatment for endometriosis. Picture: PA | PA

What did Nice say?

Helen Knight, director of medicines evaluation at Nice, said: “This new treatment marks a potential step-change in how we manage endometriosis, putting control back in patients’ hands while ensuring value for the taxpayer. Instead of travelling to clinics for injections, there is now a daily tablet that can be taken at home.”

What about patients in Scotland who want to use Ryeqo?

The drug has been approved for use in the NHS in Scotland since June 2022 when it was signed off by the Scottish Medicines Consortium, which performs a largely similar role to Nice in England and Wales. The consortium ruled the drug should be allowed in restricted circumstances, primarily for those patients who had unsuccessful treatment via conventional therapies such as tranexamic acid, hormonal contraceptives, and intrauterine delivery systems, or those patients deemed unsuitable for such therapies.

What did that decision mean for patients?

If your GP thinks that Ryeqo is the right medicine for you, you should be able to have the treatment on the NHS in Scotland. The announcement by Nice extends that right for patients in England and Wales.

The charity Endometriosis UK said it noted the drug may be suitable for only a small proportion of the 1.5 million women across the UK with the disease.