A new oral postpartum treatment is coming, but it’s not cheap

Patients with postpartum depression (PPD) can soon take advantage of a new—and pricey—oral treatment.

Sage Therapeutics executives this week teased the upcoming release of Zurzuvae (zuranolone), which is expected to be made available to adults with PPD in December and more broadly in early 2024. Developed in collaboration with Biogen, the first oral treatment for the condition—which affects an estimated one in seven women, if not more due to underreporting—will have a commercial acquisition price of $15,900 for the full 14-day treatment.

But the price is still lower than Sage’s Zulresso (brexanolone), an intravenous (IV) injection used to treat PPD. The treatment is administered over 60 hours, often in a clinical setting, and costs about $34,000.

Despite the high sticker price for the new oral drug, Sage executives said they’re working with Biogen leaders to ensure anyone prescribed Zurzuvae can access the treatment with few restrictions and a low to no copay, regardless of the patient’s financial situation. That includes working with governmental, nationwide, and regional payers, as well as support programs that offer financial assistance to eligible patients.

“Our goal is to make Zurzuvae available later this year and to enable broad and equitable access for women with PPD who are prescribed this drug,” Sage CEO Barry Greene said in a statement.

Sage spokesperson Matthew Henson noted that “coverage across all payer segments traditionally takes time.”

“Sage and Biogen are committed to addressing any access gaps for patients starting on day one. We are also working with key stakeholders across states to help raise awareness of the importance of treating PPD rapidly and help remove barriers to treatment,” Henson said in an email. “Based on the payer feedback we have to date, we do not anticipate complex prior authorizations associated with the prescription of Zurzuvae, nor do we anticipate step edits through other medications that are not indicated specifically for the treatment of women with PPD.”

Company executives noted in a Tuesday release that more details on the patient support programs will come once the drug is commercially available.

Katrina Furey, a Yale School of Medicine psychiatrist who specializes in women’s mental health, wrote in an email that even though the new oral treatment is cheaper than the IV therapy, “it is significantly more expensive than the cost of traditional treatment with [selective serotonin reuptake inhibitors],” or commonly prescribed antidepressants.

“I’m worried the high price tag could further exacerbate inequities in access to care during the postpartum period,” she wrote, noting that “75% of women who screen positive for depression in the postpartum period do not get connected to treatment, and it is thought that underlying systemic, racial, and economic disparities within American healthcare contribute [to that].”

The FDA in August approved Zurzuvae for the treatment of PPD. But the agency rejected its use to treat adults with major depressive disorder, saying additional studies are needed.

In clinical trials, Zurzuvae was found to ease PPD symptoms, which can range from insomnia to self-harm ideations, in as little as three days. By contrast, more traditional antidepressants can take weeks to ease symptoms.

Sage reported $2.7 million in net revenue from Zulresso sales in the third quarter of 2023—up from $1.7 million in the same quarter of 2022.