How Much Does Zurzuvae Cost With and Without Insurance?
Key takeaways:
Zurzuvae (zuranolone) is the first FDA-approved oral treatment for postpartum depression. The pills, which are taken daily for 14 days, became available in December 2023.
Without insurance, the list price for the recommended 14-day treatment is $15,900 — but this is not the amount most people will pay. A manufacturer’s savings program can help reduce the cost to $0 for eligible consumers who have commercial insurance.
Many insurance companies have not added Zurzuvae to their formularies. But the medication still may be covered by your insurance if you request an exception.
Access savings on related medications
About 1 in 8 new mothers report symptoms of postpartum depression (PPD) in the year after delivery. PPD is lingering depression symptoms after having a baby and is typically treated with therapy and/or medications. Without treatment, PPD can have long-term effects for both 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 is an oral capsule that’s typically prescribed as two pills daily 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 manufacturer. What’s more, its effects were maintained for about 4 weeks after the 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 dose is 50 mg (two 25 mg capsules) daily for 2 weeks. But you may need a lower dose 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 will vary depending on your plan. Many insurers have not published coverage guidelines for the medication. You may need to request an exception to have your medication covered. Your prescription plan may want you to try another medication first before covering Zurzuvae. This is known as step therapy.
Here are how some types of insurance are covering Zurzuvae at the time of publication.
Medicaid
Most state and territory Medicaid programs are covering Zurzuvae.
Private health plans
According to a 2023 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 Care Service Corporation (HCSC), Kaiser Permanente, and United Health Group — have Zurzuvae on their formularies, according to a December 2024 analysis by the Policy Center for Maternal Mental Health. Each one also has a coverage policy that explains prior authorization guidelines including restrictions such as requiring a psychiatrist to prescribe the medication or requiring that the enrollee try another medication first.
A health insurance plan does not need to list Zurzuvae on its formulary to cover the medication. A healthcare professional can explain that you need Zurzuvae and request an exception. If you’re denied coverage, your prescriber can help you appeal the decision.
Military insurance and veterans benefits
Tricare, which provides health insurance for military members and their families, has included Zurzuvae as part of its drug formulary. For this specialty medication, you will need prior authorization. Zurzuvae will be 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 can pay as little as $0 for a 14-day supply through the Zurzuvae For You patient support program using a copay assistance card from the manufacturer. Your specialty pharmacy will apply this discount on your behalf if you’re eligible.
People paying cash as well as those covered by Medicare prescription plans, Medicaid, Tricare, and other government insurance plans 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 intravenous (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.
Besides medications, psychotherapy, support groups, and social support, such as help with the baby, can help improve PPD symptoms. These methods can be used alone or in combination with each other or 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.
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 treatment, which is two 25 mg capsules daily for 14 days. And Zurzuvae is only available through specialty pharmacies.
If you have insurance, this medication may be covered. If not, you can ask your prescriber to help you request coverage from your prescription plan. The manufacturer has a patient support program that can help you navigate your insurance. If you have a commercial insurance plan, you can reduce your copay to as little as $0 for a 14-day supply with a manufacturer’s savings card. But you are not eligible for this program if you are covered by government prescription plans or you are paying cash.
Why trust our experts?
References
Biogen. (n.d.). Support designed to help your patients start treatment with ZURZUVAE™ (zuranolone).
Biogen. (2023). ZURZUVAE™ (zuranolone) CIV, a landmark oral treatment for women with postpartum depression (PPD), is now available in the U.S.
Doty, M. (2023). First postpartum depression pill approved by FDA: What to know. University of Texas Southwestern Medical Center.
Gil, B. (2025). The 7 biggest health insurance companies that control almost 75% of the market. Yahoo Finance.
Office on Women’s Health. (2023). Postpartum depression. Office of the Assistant Secretary for Health.
Policy Center for Maternal Mental Health. (2024). One Year Later: How Insurers Are Covering Zurzuvae, the First Postpartum Depression Pill.
Sage Therapeutics, Inc., et al. (n.d.). Zurzuvae savings card programs terms and conditions.
Sage Therapeutics, Inc. (2023). Sage Therapeutics announces third quarter 2023 financial results and highlights pipeline and business progress.
Sage Therapeutics, Inc. (2024). Sage Therapeutics announces third quarter 2024 financial results and highlights pipeline and business updates.
Sage Therapeutics, Inc. (2024). Zurzuvae for you.
U.S. Food and Drug Administration. (2023). FDA approves first oral treatment for postpartum depression.
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