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Earned wage access (EWA) has evolved into an established business practice that can help improve employee financial security as well as talent acquisition and retention. Employers and employees share their thoughts and experiences regarding EWA in a recent ADP research study.
Providing employees with early access to their wages can help them cover unexpected expenses and avoid overdraft fees. This financial benefit, in turn, may lead to improved productivity and engagement in the workplace and can be used to attract new talent.
1. Faster and easier access to funds is based on comparison of traditional banking policies and deposit of paper checks versus deposits made electronically and the additional methods available to access funds via a Card as opposed to a paper check.
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About 1 in 8 people experience symptoms of postpartum depression after giving birth, federal data shows. Suicide and drug overdoses are among the leading causes of pregnancy-related death, defined as death during pregnancy, labor or within the first year of childbirth. Black, Indigenous, Hispanic and low-income people are more likely to be affected.
Most antidepressants take six to eight weeks to take full effect. The new drug zuranolone, which patients take daily for two weeks, acts much faster. But the medication, manufactured jointly by Biogen and Sage Therapeutics under the brand name Zurzuvae, comes with a hefty price tag of nearly $16,000 for the two-week course.
Postpartum depression can be treated with a combination of therapy and other antidepressants. But Zurzuvae is only the second medication, and the first pill, that the FDA has approved specifically for the condition.
In a statement to Stateline, a spokesperson for the federal Centers for Medicare & Medicaid Services said Sage Therapeutics participates in the federal Medicaid drug rebate program, but that individual state Medicaid agencies will determine their own coverage policies.
In New Mexico, more than a third of residents are covered by Medicaid, the highest percentage in the nation, according to 2021 figures analyzed by KFF. New Mexico Medicaid said it automatically adds drugs approved by the FDA to its preferred drug list, meaning Zurzuvae is covered.
The Massachusetts state health department told Stateline it will add Zurzuvae to its preferred drug list in March, but will require prescribers to get prior authorization. The Georgia Department of Community Health said it will consider coverage on a case-by-case basis until May 1, after the issue is discussed at an April drug board meeting.
In a 2022 report, the federal Centers for Disease Control and Prevention detailed causes of pregnancy-related deaths between 2017 and 2019, finding that pregnant and newly postpartum people were more likely to die from mental health-related issues, including suicides and drug overdoses, than any other cause. In total, mental health conditions were responsible for 23 percent of more than 1,000 maternal deaths, the CDC study found.
Sage Therapeutics and Biogen tapped Kay Matthews, founder of Houston-based Shades of Blue, a national Black maternal mental health advocacy and support group, to help craft culturally sensitive advertising campaigns.
Matthews, who struggled with postpartum depression after giving birth to her stillborn daughter, said she was glad to see financial assistance programs offered but hopes they will continue beyond the rollout. Matthews said more pharmaceutical companies should focus on developing postpartum mental health drugs.
Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: [email protected]. Follow Stateline on Facebook and Twitter.
The first pill for postpartum depression approved by the U.S. Food and Drug Administration is now available, but experts worry that\u00a0minority and low-income people, who are disproportionately affected by the condition, won\u2019t have easy access to the new medication.\n\n\n\nAbout 1 in 8 people experience symptoms of postpartum depression after giving birth, federal data shows. Suicide and drug overdoses are among the leading causes of pregnancy-related death, defined as death during pregnancy, labor or within the first year of childbirth. Black, Indigenous, Hispanic and low-income people are more likely to be affected.\n\n\n\nMost antidepressants take six to eight weeks to take full effect. The new drug zuranolone, which patients take daily for two weeks, acts much faster. But the medication, manufactured jointly by Biogen and Sage Therapeutics under the brand name Zurzuvae, comes with a hefty price tag of nearly $16,000 for the two-week course.\n\n\n\nPostpartum depression can be treated with a combination of therapy and other antidepressants. But Zurzuvae is only the second medication, and the first pill, that the FDA has approved specifically for the condition.\n\n\n\nThe first approved drug, brexanolone, also made by Sage Therapeutics, under the brand name Zulresso, costs\u00a0$34,000\u00a0before insurance and requires a 60-hour hospital stay for an IV treatment. Doctors typically must get approval from patients\u2019 health plans before prescribing it, and hospitals must be certified to administer it.\n\n\n\n\n\nExperts and advocates are urging state Medicaid agencies to make sure the low-income patients who are covered under the joint state-federal program have easy access to Zurzuvae. They want Medicaid managed care plans \u2014 and private insurers \u2014 to waive any prior authorization requirements and other restrictions, such as \u201cfail-first\u201d approaches that require patients to try other drugs first.\n\n\n\nZurzuvae became available by prescription last month. Several state Medicaid agencies contacted by Stateline said they haven\u2019t yet adopted a policy and will handle prescriptions on a case-by-case basis. Others said they automatically add FDA-approved drugs to their preferred drug lists, though some require prior authorization.\n\n\n\nMedicaid covers about 41 percent of births nationwide and more than two-thirds of Black and Indigenous births, according to health policy research organization KFF.\n\n\n\nAs of last month, only 17 insurers in at least 14 states \u2014 less than 1 percent of the nation\u2019s 1,000 private insurance companies \u2014 had published coverage guidelines for Zurzuvae, according to an analysis by the Policy Center for Maternal Mental Health. Five of the 17 companies said they will require patients to try a different medication first. Three will mandate that psychiatrists prescribe Zurzuvae, though OB-GYNs can and do treat perinatal and postpartum depression, per the American College of Obstetricians and Gynecologists.\n\n\n\nExperts say restricting prescription privileges to psychiatrists will limit access because many of them don\u2019t accept insurance. While most states now offer Medicaid coverage for a full year postpartum, many psychiatrists don\u2019t accept Medicaid due to low reimbursement rates.\n\n\n\nStates also are grappling with shortages of psychiatrists and OB-GYNs.\n\n\n\n\n\n\u201cA lot of people in the early postpartum period are going to still be served by their obstetric provider, and if their obstetric provider is very, very far away, it\u2019s going to be more difficult for them to get diagnosed with postpartum depression and have the recommended follow-up care, whether that\u2019s through an obstetric provider or referral to a mental health care provider,\u201d said Maria Steenland, a researcher on maternal and reproductive health services and health policy at Brown University.\n\n\n\nIn a statement to Stateline, a spokesperson for the federal Centers for Medicare & Medicaid Services said Sage Therapeutics participates in the federal Medicaid drug rebate program, but that individual state Medicaid agencies will determine their own coverage policies.\n\n\n\nDr. Leena Mittall, a psychiatrist and chief of the Division of Women\u2019s Mental Health at Brigham and Women\u2019s Hospital in Boston, advocates a \u201cno wrong door\u201d approach to the new treatment and mental health coverage overall.\n\n\n\n\u201cI\u2019m really hopeful that there will not be excessive restrictions in terms of especially burdensome authorization processes or availability,\u201d she said. \u201cIf somebody\u2019s seeking treatment or help, that we have multiple points of entry into care.\u201d\n\n\n\nIn New Mexico, more than a third of residents are covered by Medicaid, the highest percentage in the nation, according to 2021 figures analyzed by KFF. New Mexico Medicaid said it automatically adds drugs approved by the FDA to its preferred drug list, meaning Zurzuvae is covered.\n\n\n\nA spokesperson for the Medicaid agency in Louisiana, which has the nation\u2019s second-highest proportion of Medicaid recipients at 32 percent, said it also will cover the drug.\n\n\n\nIn Illinois, where 20 percent of people are covered by Medicaid, officials told Stateline that for now, they will cover the cost of the medication on a case-by-case basis.\n\n\n\n\u201cWe will not have them wait for our system to have it listed on that [preferred drug] roster,\u201d said Dr. Arvind Goyal, chief medical officer of the Illinois Department of Healthcare and Family Services. \u201cWe will maybe talk to the prescriber and make sure that it\u2019s the appropriate medication.\u201d\n\n\n\n\n\nThe Massachusetts state health department told Stateline it will add Zurzuvae to its preferred drug list in March, but will require prescribers to get prior authorization. The Georgia Department of Community Health said it will consider coverage on a case-by-case basis until May 1, after the issue is discussed at an April drug board meeting.\n\n\n\n\u201cWe 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,\u201d Biogen spokesperson Allison Murphy wrote in the statement.\n\n\n\n\u201cWe are also working with key stakeholders across states to help raise awareness of the importance of treating [postpartum depression] rapidly and helping remove potential barriers to treatment.\u201d\n\n\n\nIn a 2022 report, the federal Centers for Disease Control and Prevention detailed causes of pregnancy-related deaths between 2017 and 2019, finding that pregnant and newly postpartum people were more likely to die from mental health-related issues, including suicides and drug overdoses, than any other cause. In total, mental health conditions were responsible for 23 percent of more than 1,000 maternal deaths, the CDC study found.\n\n\n\nThe CDC report also found that about 31 percent of parental-related deaths among Indigenous people were due to mental health conditions. Black people, whose national maternal death rate is three times higher than White people's, are twice as likely as White birthing parents to suffer from a maternal mental health condition but half as likely to get treatment, according to the Maternal Mental Health Leadership Alliance.\n\n\n\nSimilarly, a review published in 2021 in The American Journal of Maternal\/Child Nursing found a higher prevalence of postpartum depression among American Indian and Alaska Native women.\n\n\n\nPrevious analyses also have shown disparities in postpartum depression prevalence and its risk factors among Latinas.\n\n\n\nSage Therapeutics and Biogen tapped Kay Matthews, founder of Houston-based Shades of Blue, a national Black maternal mental health advocacy and support group, to help craft culturally sensitive advertising campaigns.\n\n\n\nMatthews, who struggled with postpartum depression after giving birth to her stillborn daughter, said she was glad to see financial assistance programs offered but hopes they will continue beyond the rollout. Matthews said more pharmaceutical companies should focus on developing postpartum mental health drugs.\n\n\n\n\u201cWe know that all drugs don\u2019t work the same for everybody, right? There\u2019s no one-size-fits-all approach,\u201d she said. \u201cThe more we uplift these things in a way, then we start to really reach towards equitable care within a system that we know wasn\u2019t designed to care for us, but we have the ability to change that.\u201d\n\n\n\n\n\nCatherine Monk, a clinical psychologist and director of the Perinatal Pathways Lab at Columbia University Irving Medical Center, said while the medication \u201cisn\u2019t a panacea,\u201d access to it as a treatment option is an opportunity for insurers to improve mental health coverage parity.\n\n\n\n\u201cWe\u2019re stuck in our unfairness, and I\u2019m deeply concerned about that,\u201d Monk told Stateline. \u201cPlease cover it so we don\u2019t have the situation of greater inequities in terms of access to frontline treatments. \u2026 [There\u2019s] really strong evidence that these untreated mental health conditions contribute to maternal mortality.\u201d\n\n\n\nIn Washington state, Uniform Medical, which covers state government employees, requires a diagnosis of severe postpartum depression, though Zurzuvae is approved for use by the FDA regardless of severity, according to the Policy Center for Maternal Mental Health\u2019s report.\n\n\n\nUniversity of Washington professor Dr. Ian Bennett, a family medicine physician, specializes in perinatal mental health. Bennett said he hopes that state Medicaid agencies won\u2019t use the introduction of Zurzuvae as an excuse to cut back on other types of mental health care for new mothers. UnitedHealthcare Community Plan under Washington\u2019s Apple Health, the state\u2019s Medicaid program, added Zurzuvae to its preferred drug list but requires prior authorization.\n\n\n\n\u201cThe issue is not just that we should be covering these medications, but that there needs to be an attention to the increasing costs of these medications and the need to increase overall coverage and funding of the cost for serving these communities,\u201d he said.\n\n\n\nIn a recent MedPage Today piece, Monk and psychiatrist Dr. Andrew Drysdale criticized the new drug\u2019s high cost, which they fear will limit access to the patients who need it most.\n\n\n\n\u201cWe\u2019ve already seen this play out with infused brexanolone: Barriers to treatment, such as cost, insurance coverage, availability, and logistical difficulties, have hampered uptake,\u201d she and Drysdale wrote.\n\n\n\nStateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org. Follow Stateline on Facebook and Twitter.\n","post_title":"There\u2019s a new pill for postpartum depression, but who can access it?","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"postpartum-depression-pill-zuranolone-access","to_ping":"","pinged":"","post_modified":"2024-01-22 18:20:08","post_modified_gmt":"2024-01-23 00:20:08","post_content_filtered":"","post_parent":0,"guid":"https:\/\/19thnews.org\/?p=66139","menu_order":0,"post_type":"post","post_mime_type":"","comment_count":"0","filter":"raw"},"authors":[{"name":"Nada Hassanein, Stateline","slug":"nada-hassanein-stateline","taxonomy":"author","description":"","parent":0,"count":8,"filter":"raw","link":"https:\/\/19thnews.org\/author\/nada-hassanein-stateline"}]} The 19th
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