Postpartum depression is a deadly disease most mothers don’t talk about. Women who have it experience extreme feelings of sadness and anxiety after childbirth, making it difficult for the mother to perform basic care for herself and her child. It affects one in nine women, according to the Centers for Disease Control and Prevention.
“It’s different from ‘baby blues,’” said Dr. Kristina Deligiannidis, a psychiatrist and director of women’s behavioral health at Zucker Hillside Hospital in New York. “That goes away within 14 days of giving birth. Moms with postpartum depression withdraw from everything. It’s this intense sadness.”
Due to the stigma around mental illness, mothers dealing with postpartum depression often don’t seek help. This can be fatal. Deligiannidis said postpartum depression is a leading cause of maternal mortality in the first year of motherhood (just one reason why it's so important to have life insurance while you're pregnant). The only treatment was a combination of general antidepressant medication and counseling until last week, when the Federal Drug Administration approved the drug brexanolone, sold under the name Zulresso. It specifically targets mothers with postpartum depression, and will likely come to market in late June, according to Sandy Walsh, spokeswoman for the Food and Drug Administration.
Unlike other antidepressants, Zulresso is administered by needle and acts much faster — within 72 hours as opposed to weeks.
Deligiannidis helped with the clinical trials of Zulresso over the past couple of years. She said it’s unlike any other medication usually used to treat postpartum depression. Women in the trials report feeling 50% better within 24 hours of receiving the drug, Deligiannidis said.
“This drug is a synthetic version of chemicals our body already makes,” she said. “It works fast. Some mothers can’t wait six to eight weeks to see if an antidepressant works for them. They need something now.”
But this drug costs time — and money.
The price of Zulresso
The drug costs $34,000 per patient without insurance, according to drugmaker Sage Therapeutics. Even if her insurance company covers it or she finds another way to pay for it, the mother would have to be hospitalized for 60 hours under infusion drip.
For now, the drug has to be administered in the hospital, so mothers may have to take time off work or find someone to watch their child while receiving treatment. But Deligiannidis believes that if a mother is suffering enough, she will do whatever she can to make time to get the treatment.
As for the price, Deligiannidis hopes insurance companies will cover the cost.
“We can hope,” she said. “Just so it won’t be another barrier for women looking for help.”
Right now, it’s still up in the air on how insurers will cover Zulresso, if at all.
“As with any new drug or therapy, insurance providers will evaluate the evidence as they normally would to make coverage policy decisions regarding Zulresso,” said Cathryn Donaldson, spokeswoman for America’s Health Insurance Plans, an industry group. “Insurance providers will also continue to work closely with federal and state regulators, providers, employers and other industry leaders.”
How to save on high treatment costs
Deciding if you need a specific treatment is an individual choice, and should involve a conversation with your doctor. If you are considering an expensive treatment, first contact your insurer to learn more about what they cover. Make sure understand how much you will pay.
Once you get your bill, read it carefully. (We have a guide on how to read a hospital bill.) Check for basic errors. If you think there’s a mistake or you are being charged too much, contact the hospital or your insurer.
A little known fact: You can negotiate your medical bill, from before you’ve received the treatment to when you get the bill.
If your insurance claim for the treatment is denied, there are a number of steps you can take, including a formal letter and an external review of your request. Learn more about dealing with an insurance claim denial.
Lastly, if your insurance company does not cover a specific treatment, consider upgrading your health care plan. Though you’ll pay a higher premium for a more robust plan, the additional coverage can be beneficial. Keep in mind, you can’t switch health care plans at any time. You will have to wait for a special enrollment period at your work or on the federal health care exchange (though there are exceptions — like having a child).
You can learn more about federal open enrollment here.