Key takeaways:
Zurzuvae (zuranolone) is the first FDA-approved oral treatment for postpartum depression. The medication, which comes as a capsule that’s typically taken twice daily for 14 days, became available in December 2023.
Without insurance, the list price for the recommended 14-day treatment is $15,900. But most people are able to pay less than this amount. A manufacturer’s savings program can help reduce the cost to $0 for eligible consumers who have commercial insurance.
Some insurance companies have not added Zurzuvae to their formularies. But the medication still may be covered by your prescription medication plan if you request an exception.
Save on related medications
About 1 in 8 new mothers report having symptoms of postpartum depression (PPD) in the year after childbirth. PPD is a mental health condition defined by lingering depression symptoms after having a baby. It is typically treated with therapy and/or medications. Without treatment, PPD can have long-term effects for both a mother and baby.
In 2023, Zurzuvae (zuranolone) became the first oral medication approved by the FDA for PPD. But what is it? And how much does Zurzuvae treatment cost?
What is Zurzuvae used for?
Zurzuvae comes as an oral capsule that’s typically taken twice a day for 2 weeks to treat PPD symptoms. It’s a neuroactive steroid, which means it affects the nerve cells in the brain.
Zurzuvae can lower anxiety and improve depression symptoms as early as the third day of treatment, according to its manufacturers. What’s more, in clinical trials, its effects were maintained for about 4 weeks after participants’ last dose. The capsules can be taken alone or with another oral antidepressant medication.
How much does Zurzuvae cost without insurance?
The manufacturer’s list price for Zurzuvae is $15,900 for a 14-day treatment course. The recommended dosage is 50 mg (two 25 mg capsules) daily for 2 weeks. But you may need a lower dosage in certain cases.
Zurzuvae isn’t a medication you can pick up at your local pharmacy. It’s only available through specialty pharmacies and typically ships to your address after insurance approvals or payment arrangements are complete. Specialty pharmacies have trained staff to help assist you with insurance coverage as well as discount programs to help you access Zurzuvae. Your prescriber will help connect you with a specialty pharmacy to process your prescription.
Does insurance cover Zurzuvae?
Insurance coverage for Zurzuvae varies depending on the plan. You may need to request a formulary exception to get Zurzuvae covered. And your prescription medication plan provider may want you to try another medication before covering Zurzuvae. This is known as step therapy.
Here is how some types of insurance plans are covering Zurzuvae at the time of publication.
Medicaid
Most state and territory Medicaid programs cover Zurzuvae.
Private health plans
According to an analysis by the Policy Center for Maternal Mental Health, only 17 out of the more than 1,000 U.S. insurers had published coverage guidelines for Zurzuvae by mid-December 2023. Only one major health insurance company, Centene, had published coverage criteria.
A year later, 6 top health insurance companies — Centene, CVS Health, Elevance Health, Health Care Service Corporation (HCSC), Kaiser Permanente, and UnitedHealth Group — had Zurzuvae on their formularies, according to a December 2024 analysis by the Policy Center for Maternal Mental Health. Each one also published a coverage policy explaining prior authorization guidelines, including any restrictions around who can prescribe the medication and whether step therapy is required.
A health insurance plan does not need to list Zurzuvae on its formulary to cover the medication. You can request a formulary exception with the help of your prescriber, who will be asked to provide an explanation of why you need Zurzuvae. If you’re denied coverage, your prescriber can also help you appeal the decision.
How to deal with postpartum depression: Learn about postpartum depression and take a quiz to find out if you may have this condition.
Medications for postpartum depression: Take a look at medications that treat postpartum depression and how they compare in resolving symptoms.
How long does postpartum depression last? Find out about the timing of postpartum depression and when to seek professional help.
Military insurance and veterans benefits
Tricare, which provides health insurance for military members and their families, has Zurzuvae listed on its drug formulary. For this specialty medication, you will need prior authorization. Zurzuvae is also available at U.S Department of Veterans Affairs (VA) Veterans Health Administration clinics and medical centers.
What are the best ways to save on Zurzuvae?
If you have commercial insurance, you may qualify for the Zurzuvae For You patient support program. This manufacturer-sponsored program provides a copay assistance card that could reduce your costs to as little as $0 for a 14-day supply. Your specialty pharmacy will apply this discount on your behalf if you’re eligible.
People paying cash, as well as those covered by Medicare, Medicaid, Tricare, or another type of government-sponsored insurance, are not eligible for the Zurzuvae savings card program.
What are the best alternatives to Zurzuvae?
An FDA-approved treatment for PPD called Zulresso (brexanolone), which required a 60-hour IV infusion and a hospital stay, has been discontinued by its manufacturer. Other medications, such as antidepressants, are often used to treat PPD. But they can take several weeks to improve symptoms.
Aside from medication, psychotherapy, support groups, and social support, such as help with childcare, can help improve PPD symptoms. These methods can be used alone or in combination with one another. They can also be used in combination with Zurzuvae.
You can find other PPD resources by contacting your healthcare professional, the National Maternal Mental Health Hotline, and the Postpartum Support International (PSI) HelpLine.
Frequently asked questions
Yes, Zurzuvae is classified as a federal controlled substance because it contains zuranolone. Zuranolone carries a risk of dependence and misuse. State and federal laws limit how often the medication can be dispensed within a certain period of time.
To request a formulary exception for Zurzuvae, you will need to talk to your healthcare professional about completing the required paperwork. They will need to submit a prior authorization form, a letter of medical necessity, and supporting documentation to explain why this is the best treatment for your condition. If you are denied coverage by your health plan, your prescriber can help you appeal the decision.
Check your formulary to see if Zurzuvae is covered and what you can expect to pay out of pocket. According to its manufacturers, Sage Therapeutics and Biogen, Zurzuvae is covered for approximately 95% of people with commercial insurance or Medicaid and by the three largest pharmacy benefit managers.
If you have commercial insurance, you may also be eligible for the manufacturer’s copay savings card, which could reduce your costs to as low as $0 for a 14-day supply.
Yes, Zurzuvae is classified as a federal controlled substance because it contains zuranolone. Zuranolone carries a risk of dependence and misuse. State and federal laws limit how often the medication can be dispensed within a certain period of time.
To request a formulary exception for Zurzuvae, you will need to talk to your healthcare professional about completing the required paperwork. They will need to submit a prior authorization form, a letter of medical necessity, and supporting documentation to explain why this is the best treatment for your condition. If you are denied coverage by your health plan, your prescriber can help you appeal the decision.
Check your formulary to see if Zurzuvae is covered and what you can expect to pay out of pocket. According to its manufacturers, Sage Therapeutics and Biogen, Zurzuvae is covered for approximately 95% of people with commercial insurance or Medicaid and by the three largest pharmacy benefit managers.
If you have commercial insurance, you may also be eligible for the manufacturer’s copay savings card, which could reduce your costs to as low as $0 for a 14-day supply.
The bottom line
Zurzuvae (zuranolone) is the first FDA-approved oral medication to treat postpartum depression. The manufacturer’s list price is nearly $16,000 for the recommended course of treatment, which is two 25 mg capsules daily for 14 days. And Zurzuvae is only available through specialty pharmacies.
If you have insurance, check your formulary to see if Zurzuvae is listed. If not, you can ask your prescriber to help you request a coverage exception from your plan. The manufacturer also has patient support agents who can help you navigate insurance benefits and discount programs.
If you have a commercial insurance plan, you could pay as little as $0 for a 14-day supply with a manufacturer copay savings card. But you are not eligible for this program if you are covered by government-sponsored insurance or you are paying cash.
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References
Biogen. (2023). Zurzuvae (zuranolone) CIV, a landmark oral treatment for women with postpartum depression (PPD), is now available in the U.S.
Burkhard, J., et al. (2024). One year later: How insurers are covering Zurzuvae, the first postpartum depression pill. Policy Center for Maternal Mental Health.
Doty, M. (2023). First postpartum depression pill approved by FDA: What to know. University of Texas Southwestern Medical Center.
Express Scripts. (2025). Tricare formulary search.
Health Resources and Services Administration. (n.d.). National Maternal Mental Health Hotline. U.S. Department of Health and Human Services.
Office of the Federal Register. (2023). 21 CFR Part 1308: Schedules of controlled substances: Placement of zuranolone in Schedule IV.
Office on Women’s Health. (2023). Postpartum depression. U.S. Department of Health and Human Services.
Policy Center for Maternal Mental Health. (2024). Zurzuvae, the new postpartum depression drug now available in the U.S. – This is how insurers have responded.
Postpartum Support International. (n.d.). PSI HelpLine (English and Spanish).
Sage Therapeutics. (2023). Sage Therapeutics announces third quarter 2023 financial results and highlights pipeline and business progress.
Sage Therapeutics. (2024). Sage Therapeutics announces third quarter 2024 financial results and highlights pipeline and business updates.
U.S. Food and Drug Administration. (2023). FDA approves first oral treatment for postpartum depression.
VA Pharmacy Benefits Management Services and National Formulary Committee. (2024). Zuranolone (Zurzuvae) criteria for use: March 2024. U.S. Department of Veterans Affairs.
Zurzuvae. (n.d.). How to get your patients with postpartum depression (PPD) started on Zurzuvae. Sage Therapeutics.
Zurzuvae. (n.d.). Zurzuvae for You. Sage Therapeutics.
Zurzuvae. (2025). Letter of medical necessity and appeal guide. Sage Therapeutics.
Zurzuvae. (2025). Zurzuvae (zuranolone) CIV savings card program terms and conditions. Sage Therapeutics.