Expensive new post-partum depression pill approved

December 6, 2023

Zurzuvae (zuranolone), a new oral treatment for severe postpartum depression is expected to become available in December. Treatment-resistant postpartum depression poses serious risks to new mothers as well as their children - and in trials Zurzuvae offers quicker relief compared to traditional antidepressants like Prozac and Zoloft. Zurzuvae acts on a different neurohormone than other oral antidepressants, and is in the same class as Zulresso, an intravenous antidepressant approved in 2019 that required a multi-day hospitalization and was rarely used .

Zurzuvae was approved for postpartum depression only; the FDA said it would require additional studies to show it was effective for major depressive disorder, a much larger market. The manufacturer announced a price of $15,900 for the 14-day course of treatment. The drug is regulated as a controlled substance as it can cause dependence.

Implications for employers:

-        Mental illness, especially major depression, is a major risk factor for maternal mortality.

-        This underscores the need to screen newly pregnant women for depression, both before and after delivery.

-        Employers can consider pre- and post-partum PG measures, like this HEDIS measure.

-        One recent report suggested that 96% of women of childbearing age lived in geographies with shortages of maternal mental health care.

-        An effective medicine for this terrible disease is good news, although the high price of this medication will necessitate restricting its use to those with severe postpartum depression.

-        Direct-to-consumer advertising could lead to providers feeling pressured to prescribe this medication for patients who have only moderate postpartum depression.

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