January 18, 2024
Experts Call On Medicaid Agencies To Focus On Low-Income Postpartum Patients
Black people, including those who are low-income, are half as likely to get treatment for postpartum depression.
Following the release of a new drug for postpartum depression, experts and advocates are urging Medicaid agencies to focus on ensuring its easy access for low-income patients, 19th News reported.
The Black community, which faces maternal death three times higher than the national rate of white people, are also twice as likely to suffer from a mental health condition, according to the Maternal Mental Health Leadership Alliance.
But Black people, including those who are low-income, are half as likely to get treatment for a variety of reasons.
In December 2023, Sage Therapeutics and Biogen announced Zurzuvae or zuranolone 50 mg (two 25 mg capsules per day) by prescription for treating postpartum depression for adults in the United States, a press release explained.
The product, the first pill the Food and Drug Administration has approved for this condition, had already been found at specialty pharmacies and had been delivered to patients. However, the drug reportedly comes with a “hefty price tag of nearly $16,000 for the two-week course,” according to 19th News.
“We recognize that Black and Brown women are reported to be disproportionally impacted by [postpartum depression]. In addition, those who live in rural areas and those who have Medicaid may be more likely to receive inadequate postpartum care, compared to those who live in urban areas,” Biogen spokesperson Allison Murphy said in the 19th News report.
WHAT ARE EXPERTS AND ADVOCATES SAYING?
- They want the removal of “prior authorization requirements and other restrictions, such as “fail-first” approaches that require patients to try other drugs first.”
- Experts say restricting prescription privileges to psychiatrists will limit access because many of them don’t accept insurance or Medicaid due to low reimbursement rates.
SOME STATES ARE ONBOARD WITH OR WITHOUT CONDITIONS
As of last month, only 17 insurers in at least 14 states—less than 1 percent of the nation’s 1,000 private insurance companies—had published coverage guidelines for Zurzuvae, according to an analysis by the Policy Center for Maternal Mental Health. These include the Medicaid agencies in Louisiana and New Mexico. Other states include:
- Massachusetts: Zurzuvae will be available in March and will require prescribers to get prior authorization.
- Georgia: Pending consideration of coverage on a case-by-case basis until May 1.
- Illinois: The state will cover the cost of the medication on a case-by-case basis.
Kay Matthews, who struggled with postpartum depression after giving birth to her stillborn daughter, told 19th News that more pharmaceutical companies should prioritize the development of postpartum mental health drugs.
“We know that all drugs don’t work the same for everybody, right? There’s no one-size-fits-all approach,” said Matthews, founder of Houston-based Shades of Blue, a national Black maternal mental health advocacy and support group. “The more we uplift these things in a way, then we start to really reach toward equitable care within a system that we know wasn’t designed to care for us, but we have the ability to change that.”