High Drug Prices, Limited Access (free issue)
New postpartum depression antidepressant likely out of reach for many
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We hear about them all the time – the incredibly (and ridiculously) high cost of some life-saving drugs. When is enough enough? Who can afford drugs that cost over $1 million per year (lonafarnib) or $2.1 million per year (Zolgensma)? Granted, these are for rare diseases, but still? In whose world are those prices even remotely accessible?
Let’s look at insulin
Those who argue that high costs are needed to promote research and development should then explain why insulin was costing as much as $332 a vial in 2019. (To put it in perspective, someone with diabetes would use two or three vials per month although some may need more. Who can afford that kind of cost?)
“Insulin belongs to the world, not to me.”
Insulin was discovered in 1923 and not by an American pharmaceutical company. It was discovered by researchers in Canada. One of the researchers, Frederick Banting, refused to put his name on a patent, selling it for only a dollar. He is reported as saying, “Insulin belongs to the world, not to me.” So how could a manufacturer justify the sky-high and often unreachable cost for their insulin? Insulin is not optional for people with type 1 diabetes and many with type 2 diabetes or gestational diabetes. They need it to live.
Now, a new antidepressant drug
Now there’s news that a new drug, recently approved for postpartum depression will cost almost $16,000 dollars for two weeks’ worth of medication. The drug, Zurzuvae (zuranolone), is considered a breakthrough because it’s a pill that can be taken at home. Up to now, the only available treatment was by intravenous (IV) and only in certain healthcare facilities.
Postpartum depression is not simply baby blues or feeling down. It is a serious mental health disorder that affects about 1 in 8 women in the U.S. According to a U.S. Food and Drug Administration (FDA) press release:
Postpartum depression is a serious and potentially life-threatening condition in which women experience sadness, guilt, worthlessness—even, in severe cases, thoughts of harming themselves or their child. And, because postpartum depression can disrupt the maternal-infant bond, it can also have consequences for the child’s physical and emotional development,” said Tiffany R. Farchione, M.D., director of the Division of Psychiatry in the FDA’s Center for Drug Evaluation and Research. “Having access to an oral medication will be a beneficial option for many of these women coping with extreme, and sometimes life-threatening, feelings.”
This drug has the potential to save lives and improve the quality of life for many. But at $16K – how many women will be able to afford it?
Let’s look at the cost of other antidepressants. There are many but some of the more common ones are Prozac (fluoxetine), Paxil (paroxetine), Effexor (venlafaxine), Cymbalta (duloxetine). How much do they cost?
According to Drugs.com, costs are about:
$1800 for 100 capsules of Prozac
$900 for 90 tablets of Paxil
$1600 for 90 capsules of Effexor
$1100 for 120 capsules of Cymbalta
Generic versions are even cheaper, sometimes as little as $20 per month
One could argue that there is a big difference in how long it takes for the drugs to work. These antidepressants can take up to six weeks for people to see any changes; study results show that Zurzuvae could start working in as few as three days. That is significant. But, only if the family can afford the drug, right?
Unequal access
In this CNN article, the manufacturer acknowledges that the cost could put certain groups of women at a disadvantage. A spokesperson is quoted as saying that the company recognizes “that black and brown women are disproportionally impacted, and we are prioritizing equitable access as well as advocating for policies that better support underrepresented communities.” This person goes on to say “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 and have private health insurance.”
You can’t tell me that healthcare is equal for all when people have to ration their medications in order to have enough money to eat. You can’t tell me that it’s equal if some women with severe postpartum depression can have access to a drug that could change the course of not just their lives, but of their families, while others can’t.
What do you think?
Leave your comment below. Let’s get a conversation going.
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