Apr. 18, 2019
Claims and Eligibility
Apr. 18, 2019
At the 2018 Clinical and Scientific Meeting of the American College of Obstetricians and Gynecologists results for Zulresso (brexanolone IV) were presented in poster sessions.
Zulresso, produced by Sage Therapeutics, treats moderate to severe Postpartum depression, and requires a 60-hour inpatient infusion. The initial list pricing for Zulresso is approximately $7,500 per vial with an estimated overall cost with hospitalization that can reach $34,000 depending on hospital charges. The infusion also interrupts breast feeding for up to 7 days. Sage Therapeutics has an oral medication in development which will convert the 60-hour inpatient infusion medication to a once-a-day pill.
Blue Cross and Blue Shield of Montana (BCBSMT) is currently reviewing the literature evidence for any medical necessity criteria of this (moderate-severe) postpartum depression drug injection, Zulresso and will develop a medical policy on the coverage of this treatment for BCBSMT members. Currently, there are no facilities in Montana certified to perform the Zulresso infusion. Please stay tuned for future announcements from BCBSMT.
For more information on Zulresso please review the following links from the FDA, Sage Therapeutics, Women’s Mental Health (medical journal) and Stat Health (medical journal).
FDA Press Release
Sage Therapeutics Press Release
Women’s Mental Health
Stat News