Call it the little blues pill.
An exciting new drug for treating postpartum depression is making headlines for its game-changing potential — as well as its lofty price.
Zuranolone, marketed as Zurzuvae by makers Sage Therapeutics and Biogen, fetches a price tag of $15,900 for the necessary 14-day course of treatment, Reuters reported.
And while the drug could reshape the lives of the estimated one in seven women who suffer from PPD — an earlier trial of Zuranolone showed improvements in just three days — health professionals like Dr. Sarah Oreck, co-founder of Mavida Health, worry about accessibility.
“Who can use this and in what context will they be able to use it and will insurance companies just dole it out?” she told Vogue.
“My prediction is that it’s going to be an uphill battle for physicians.”
Reports that drug makers are working with insurance companies to make Zuranolone widely available have yet to put a stop to the skepticism.
Sage also faced an uphill battle the last time it brought a postpartum depression drug — the first to receive FDA approval — to market in 2019.
Brexanolone, aka Zulresso, was a 60-hour IV treatment that could only be administered in hospital settings, according to Yale Medicine. Side effects included losing consciousness, according to Reuters. The treatment cost $34,000 per year.
Zuranolone, meanwhile, is a synthetic form of a natural, neurosteroid known as allopregnanolone, which helps regulate mood and behavior, said Dr. Katrina Furey, a Yale School of Medicine psychiatrist. She added that neurotransmitters called GABA-A receptors also play a role.
“[Zuranolone] leads to calming, antidepressant properties,” she said. “When a woman has postpartum depression, she doesn’t have enough allopregnanolone and her GABA-A receptors aren’t firing right, which is what makes her irritable, anxious, and depressed, among other symptoms.”
Dr. Oreck, a reproductive psychiatrist, stressed that while it may be an improvement for those struggling, Zuranolone isn’t necessarily a be-all, end-all for PPD sufferers.
“While it’s exciting to have something targeted for a women’s health issue, we also have to be careful because it’s not a cure,” she said, noting that PPD can resolve itself over the span of months or years.
“Most people don’t have just postpartum depression; actually, postpartum anxiety is even more common,” Oreck stated.
Dr. Furey highlighted another issue with the drug — uncertainty as to whether or not it can be harmful to infants consuming their mother’s breast milk, seeing as the drug does pass into the fluid, she said.
“That, I think, is the biggest hiccup right now with this medication and something I’m sure will be studied further. A woman could pump and dump her milk for the duration of treatment. Or maybe she’s not nursing anyway. Or maybe if her symptoms are so severe, it makes sense to transition to formula so she can focus on her own mental health,” Furey explained.
“But it’s unfortunate since nursing can be an important bonding experience that can help alleviate postpartum depression symptoms. However, for many women, nursing can also add stress.”
It is also advised for women to not drive at least 12 hours, as a main side effect of Zuranolone is being both sleepy and dizzy. Though, Dr. Furey is optimistic about what this treatment means for the future.
“This is exciting because mental health issues are the most common complication of childbirth — beyond anything medical, including diabetes and hypertension,” she said. “Plus, the number one cause of maternal mortality is suicide, which is devastating. So, whatever we can do to get more treatments out there is important.”