The $34,000 new treatment for postpartum depression: breakthrough or barrier?

It’s been all over the headlines: a brand new drug called Zulresso was recently approved by the FDA to treat postpartum depression (PPD) in moms. How could that be anything other than great news, right? With PPD being the most common complication of childbirth, we all want to see it finally receive the attention it deserves.

There’s just a few catches. Some really expensive, complicated ones actually.

First is that this drug is not a pill that a woman can take it home. Instead it is an IV infusion that is given over the course of 60 hours. This means a mom needs to be re-hospitalized to receive this treatment. With this comes the potential separation of moms and their babies (unless they are on a unit that allows their baby to stay with them, which can be really hard to negotiate in reality), as well as from her support network.

In addition, being in a hospital also means potentially being exposed to the germs and complications that come with being there. After having just left one, the idea of having to go back again might be a reason some women who could benefit from this drug opt out from receiving it.

Secondly, the price tag?

Staying in a hospital is also associated with a huge cost—and that is not even included in the $34,000 drug price. It is not yet known what part, if any, of these treatments that insurance companies will cover.

Speaking of insurance, what about women with no or limited insurance? Should they be left out of a treatment for a condition that we know affects women in poverty more frequently? I think most of us know in our gut that that would not be right.

This is not to say that everything about this drug being approved is bad. It is terrific that perinatal mood disorders are getting more visibility and more funding for research. As I’ve written about before, pregnant and breastfeeding women often get ignored in scientific studies, so I am all for including them in drug trials and studying the diseases that affect them.

The important thing is that whenever we make a new discovery about a new treatment for something like PPD, we need to make sure it is accessible to all women, because it affects women of all demographics. We also need to make sure that along the way we don’t forget about complementary therapies: talk therapy, community support, paid maternity leave, adequate childbirth and parenting preparation, sleep hygiene, and high quality breastfeeding support. Without these, no drug will ever be completely successful.

None of these things can be delivered in a pill or IV, but they are just as big as a piece of the puzzle, and are even more priceless than this drug.


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