Giving Compass' Take:
- Experts and advocates are concerned about the accessibility of the first pill for postpartum depression approved by the U.S. Food and Drug Administration.
- This new drug comes with a high price tag and might be unaffordable for low-income individuals. How can donors advocate for healthcare coverage for this medication, especially when postpartum depression disproportionately impacts minority and low-income people?
- Read about funding maternal and child health.
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The first pill for postpartum depression approved by the U.S. Food and Drug Administration is now available, but experts worry that minority and low-income people, who are disproportionately affected by the condition, won’t have easy access to the new medication.
About 1 in 8 people experience symptoms of postpartum depression after giving birth, federal data shows. Suicide and drug overdoses are among the leading causes of pregnancy-related death, defined as death during pregnancy, labor or within the first year of childbirth. Black, Indigenous, Hispanic and low-income people are more likely to be affected.
Most antidepressants take six to eight weeks to take full effect. The new drug zuranolone, which patients take daily for two weeks, acts much faster. But the medication, manufactured jointly by Biogen and Sage Therapeutics under the brand name Zurzuvae, comes with a hefty price tag of nearly $16,000 for the two-week course.
Postpartum depression can be treated with a combination of therapy and other antidepressants. But Zurzuvae is only the second medication, and the first pill, that the FDA has approved specifically for the condition.
The first approved drug, brexanolone, also made by Sage Therapeutics, under the brand name Zulresso, costs $34,000 before insurance and requires a 60-hour hospital stay for an IV treatment. Doctors typically must get approval from patients’ health plans before prescribing it, and hospitals must be certified to administer it.
Experts and advocates are urging state Medicaid agencies to make sure the low-income patients who are covered under the joint state-federal program have easy access to Zurzuvae. They want Medicaid managed care plans — and private insurers — to waive any prior authorization requirements and other restrictions, such as “fail-first” approaches that require patients to try other drugs first.
Zurzuvae became available by prescription last month. Several state Medicaid agencies contacted by Stateline said they haven’t yet adopted a policy and will handle prescriptions on a case-by-case basis. Others said they automatically add FDA-approved drugs to their preferred drug lists, though some require prior authorization.
Medicaid covers about 41 percent of births nationwide and more than two-thirds of Black and Indigenous births, according to health policy research organization KFF.
As of last month, only 17 insurers in at least 14 states — less than 1 percent of the nation’s 1,000 private insurance companies — had published coverage guidelines for Zurzuvae, according to an analysis by the Policy Center for Maternal Mental Health. Five of the 17 companies said they will require patients to try a different medication first. Three will mandate that psychiatrists prescribe Zurzuvae, though OB-GYNs can and do treat perinatal and postpartum depression, per the American College of Obstetricians and Gynecologists.
Read the full article about postpartum depression by Nada Hassanein at The19th.