“Ridiculous” cost of new postpartum depression pill spurs maternal health providers to push back

In August, news broke that the FDA had approved the first pill specifically for the treatment of postpartum depression.

sold under the brand name Zurzvae (Zuranolone), this announcement raised hopes for effective and targeted treatments for the symptoms that affect it. 1 in 8 women.in clinical researchsome mothers took the pill. Significant improvement in symptoms of depression and anxiety Just 3 days after starting 2 weeks of treatment. The effect lasted for a month and a half.

Postpartum depression is usually treated with selective serotonin reuptake inhibitors (SSRIs) such as Zoloft, Prozac, and Lexapro. But they can take up to 12 weeks to start working, and sometimes they don’t work at all. For many patients with mild postpartum depression, SSRIs combined with support and therapy can be an effective treatment. But for patients with severely debilitating conditions, the news of the first-ever FDA-approved pill is certainly a welcome advance in maternal mental health, an ongoing crisis in the United States.

But last week, the pill’s makers, Sage Therapeutics and Biogen, confirmed many people’s worst fears. The price for the 14-day course is he $15,900. The manufacturer stressed in its announcement that it prioritizes access to treatment with “minimal restrictions” and “little or no out-of-pocket costs,” but it remains unclear how accessible the pill will be. Details such as whether it will be covered by insurance are unknown at this time. As a result, maternal mental health providers fear that all the initial hype surrounding the news may have been for naught as those who need this information most will not have access to it.

“I think the fact that its price tag is almost $16,000 is ridiculous,” Dr. Melissa Simon, an obstetrician-gynecologist at Northwestern Medicine, told Salon. “That’s very prohibitive.”

That’s especially important for patients who are underinsured, uninsured, or whose insurance doesn’t cover the drug’s “prohibitive cost,” Simon said.

She added that it is already difficult for women with postpartum depression to receive treatment in the United States. First, you will need to go to the clinic and make an appointment, which may require you to take time off from work or secure childcare. For others, there may be transportation costs. Simon said many people already “grossly underestimate” the out-of-pocket costs women face to receive treatment.

“All of these out-of-pocket costs impact our country’s lower socio-economic populations and those who face greater social and economic determinants,” she said.

The risk of postpartum depression is Much higher for women of color.Black women are not only more likely to experience postpartum depression, they are also less likely to experience depression. support and treatment.medicaid Funds an estimated 4 in 10 births Only for women 60 days postpartum. A growing number of states are offering insurance to women up to 12 months postpartum subject to certain qualifications, but it’s unclear how much, if any, coverage will be provided for Zurzvae.

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Treatment for postpartum depression depends on its severity. Options range from medication to talk therapy to support groups. In 2019, the FDA approved a drug for the treatment of PPD called brexanolone, sold under the brand name Zuresso, which also belongs to the Zuranolone family of drugs. These drugs target GABA receptors in a person’s brain, which are thought to affect stress.

the study We show that brexanolone is associated with rapid improvement in major depressive symptoms. But there are also many barriers to access for those who need it. It must be administered through an intravenous drip by a doctor or nurse for two and a half days. It is also not safe for breastfeeding. Since its approval, this treatment has only been offered in limited medical settings. It’s also expensive, costing him $34,000 without insurance.

Karen Kleiman, the mother’s mental health therapist, said: Founder of the Postpartum Stress Center, He told Salon that there are very strict criteria for offering brexanolone as a treatment option. Zurzuvae is similar to Brexanolone, but in pill form. Certainly this is part of the charm. Kleiman, referring to what happened with brexanolone, said he wasn’t surprised to hear Zurzvae’s high price tag because “we’ve seen this before.”

“This is kind of a pattern of what happens,” she said. “I’m definitely disappointed, but not shocked.”

Postpartum depression is diagnosed when a woman experiences depressed mood or loss of interest in activities for more than two weeks, usually when the common phenomenon known as “baby blues” has been ruled out. Although the exact cause of PPD remains unknown, experts have long speculated that various factors are involved in her development of PPD. for example, hormonal changes Just as a woman’s significant drop in hormones after childbirth can cause symptoms.other the study They found that women with moderate or low social support were more likely to develop postpartum depression, suggesting that external factors are also involved.

Due to the fact that there are so many potential variables in the causes of postpartum depression, treatment can be far from a one-size-fits-all solution. Some women with more moderate depressive symptoms respond well to standard antidepressant treatment and combination therapy, Kleiman said.

“Our treatments are proving successful,” Klayman said. “For women who are severely disabled by depression, this is obviously a very exciting proposition and we hope that things will change to make it more accessible.”

Klayman said she didn’t want to sound “disappointed,” pointing to the positive news that people are talking about postpartum depression and its solutions following FDA approval. She added that there are certainly systemic issues that factor into what it’s like to be a mother in America today. In particular, she said more young mothers are burning out faster than she’s ever seen in her career.

“Our system is broken and we don’t have a systemic response to make things like child care and health care more affordable and accessible,” she said. “It goes back to women being witches and hysterics and not being taken seriously, having children and living in a society that doesn’t allow her mother to talk about how bad she feels.”

Simon says healthcare providers need to make many strides forward to better support new mothers and reduce the risk of postpartum depression, starting with at least one or two postnatal visits to the doctor. said.

“People who have given birth should have follow-up visits every two to three months postpartum, and regular visits should be increased to cover all medical needs included in those visits,” Simon said. “Mental health, contraception, breastfeeding support, and physical health.”