Orgovyx was approved by Health Canada only last October, so it's not very common up here yet — I was the first to ask for it it at my local pharmacy. My oncologist offered it as a Firmagon alternative when I mentioned the swelling I got every month after the shot.

Its retail price is the same as Firmagon — around CA $300/month (US $220) — but when I checked in April, private Canadian insurance companies were still "researching" it, and it wasn't in the Ontario formulary yet. I would have paid the cost myself to avoid those monthly injections, but fortunately my oncologist signed me up for the Patient Access Programme, so it doesn't cost me anything.

In the U.S., the FDA approved it a bit earlier (I think the drug started out there). Perhaps some oncologists there are reluctant to switch patients from Firmagon because with the monthly injections, they know for sure patients are taking the ADT, while people can accidentally or deliberately skip pills at home.

In my case, I got the Firmagon injections at home anyway because of mobility issues — Homecare trained my spouse to do them, and she continued even after I was out of the wheelchair.