We’ve got been speaking about zuranolone for a very long time, and it’s now obtainable. Zuranolone shall be marketed below the model title ZURZUVAE by Sage Therapeutics in partnership with Biogen. Zuranolone represents a brand new possibility for the remedy of PPD, a quickly appearing oral remedy with security profile and a novel mechanism of motion.
We obtained information a couple of month in the past that the complete 14-day course of zuranolone remedy would price about $15,900. At that time it was not clear how insurers would deal with entry to the brand new remedy. Just a few weeks into the sport, we’ve a bit of bit of knowledge to share.
Will Insurance coverage Cowl the Price of the New Remedy for PPD?
The Coverage Heart for Maternal Psychological Well being has been intently following the rollout of ZURZUVAE, has been monitoring distribution and insurance coverage protection for ZURZUVAE. In a current replace revealed on their web site, they’ve supplied preliminary data on how insurance coverage corporations are dealing with entry to the brand new remedy. They discovered that few insurance coverage corporations have revealed tips relating to the usage of ZURZUVAE:
- Solely 17 of over 1000 insurers (lower than 1%) and one pharmacy profit supervisor (PBM) have revealed protection tips.
- With out revealed protection tips from insurers, prescribers and sufferers usually tend to expertise delays and restricted entry to this new remedy.
- Of the 17 insurers with revealed protection tips, 5 require sufferers to attempt one other antidepressant first, three don’t allow OB/GYNs to prescribe zuranolone, three require a complete psychological analysis, and one requires a prognosis of extreme postpartum melancholy.
The Coverage Heart for Maternal Psychological Well being will proceed to offer related updates relating to any limitations to accessing the drug.
For these with out insurance coverage protection, Sage has introduced that it’s going to present copay help, in order that the affected person could have no out of pocket prices for the remedy. As well as, some states, akin to California, are beginning to restrict or cap the price of drug copays/coinsurance. For instance, California simply handed a legislation capping prescription copays at $250.
Sufferers and prescribers also can contact the Sage entry line Sage Central for help with ZURZUVAE protection at 844-472-4379 (Mon-Fri, 8am-6pm ET). Devoted case managers can be found to help with understanding insurance coverage and protection choices and monetary help packages for eligible sufferers. As well as, they’re able to present academic assets and help with connecting sufferers to help inside their communities.
Though ZURZUVAE has solely been obtainable for a few weeks, a couple of of our colleagues have reported that it has been comparatively straightforward to acquire the brand new remedy for his or her sufferers utilizing the help supplied by Sage Central. That is nice information, as many had been so annoyed by the problem in accessing ZULRESSO, the intravenous model of zuranolone, after it was launched.
We’re very excited to have a brand new possibility for the remedy of postpartum melancholy, particularly one which seems to be comparatively properly tolerated and quickly efficient. Nevertheless, you will need to keep in mind that whereas ZURZUVAE and ZULRESSO are FDA-approved for the remedy of postpartum melancholy, they don’t seem to be the one choices for remedy, even for extreme postpartum melancholy.
For milder PPD signs, psychotherapy, particularly cognitive behavioral remedy, has been proven to be efficient. Extra extreme depressive signs and nervousness repostond to conventional antidepressants, together with selective serotonin and serotonin-norepinephrine reuptake inhibitors (SSRIs and SNRIs). Though these antidepressants sometimes take longer than zuranolone to take impact, they do work, and we’ve knowledge to help the security of those antidepressants in breastfeeding girls.
Ruta Nonacs, MD PhD
