The new medication currently costs $34,000 per treatment.
Last week, the FDA approved the first-ever drug for postpartum depression, but critics says that access to the drug will continue to be a challenge.
Writing in a New York Times opinion piece, Elisa Albert, a doula, and Jennifer Block, a journalist who covers women’s health, point out problems with the new treatment.
“Let’s be real about who will have access to Zulresso: women with very good insurance, the ability to advocate for themselves, and the flexibility to leave home for three days for treatment,” they write.
The treatment—which provides fast postpartum depression relief by mimicking a hormone in the brain—costs $34,000 per treatment. Because it is only approved for intravenous delivery right now, women who get the treatment must spend three days in the hospital, likely away from their young infant.
These factors mean that Zulresso will likely not be a treatment for the women who need it most, said Florida midwife and childbirth advocate Jennie Joseph.
“If you’re actually needy, in deep postpartum depression,” she said, you’re “not going to be able to get yourself to the hospital. Where are you a few days after having a baby? You’re in your house being ignored.”
Albert and Block point out that Zulresso reduced depression symptoms by two-thirds, but a placebo treatment reduced symptoms by half. This suggests that women benefit from increased care and attention in the postpartum period, something that can’t simply be substituted with medication.
“If insurers are willing to throw down tens of thousands of dollars for a mother’s mental health, we can think of some alternatives that might have a better cost-benefit ratio: Six months paid leave. A live-in doula and a private sleep-training coach. Weekly massages and pelvic-floor rehab sessions,” Albert and Block write. “In the meantime, we fear that Zulresso is just a stopgap, and yet another instance of pathologizing a very sane reaction to our very insane culture.”
Postpartum depression is the most common complication from childbirth, affecting 1 in 9 women. Women in lower socioeconomic brackets face an even higher risk, but may have trouble accessing Zulresso, especially if Medicaid delays on covering the treatment.
“Those who have the highest rates of postpartum depression and who would benefit the most, I fear it will be limited access to them,” University of Michigan professor of psychiatry and OB/GYN, Dr. Maria Muzik, told NPR.
Options like delivering the treatment in a mother-baby unit could help alleviate some of the barriers to care, she said.
“Over the next six months, I think [there] will be big developments.”